Tratamento de fístulas enterocutâneas através de sistema a vácuo com alta pressão e dieta oral normal

Enterocutaneous fistulas are associated with prolonged hospital stay, high morbidity/mortality, and increase in hospital costs. This study aims to describe the use of a vacuum system and normal oral diet in dealing with this problem. Methods: Seventy-four consecutive patients with recent and defined external postoperative fistulas were analyzed. Abdominal imaging was used to exclude abscess and distal obstruction. The fistula tract was sealed with Foley catheter, connected to a negative pressure flask, changed daily for 5, 10 or 15 days, as necessary. Normal oral diet was permitted. Results: No patient died. Serum albumin and transferrin showed significantly higher levels at the end of treatment than at the beginning. The moderate and low-output fistulas had the best results (97% closed). Forty-eight (65%) fistulas closed after five days, 16(22%) after 10 days and 4(5%) after 15 days. Treatment failed in 6(8%) patients, who subsequently underwent surgery. Only one patient with low-output did not close her fistula. The cost of the treatment was US$ 41.75/day and it was considered cost effective. Conclusions: The vacuum system demonstrated good results in the treatment of fistulas. It included simplicity, low cost, short hospital stay, absence of skin breakdown, normal eating, good nutrition and activity patterns

Acelaração do universo e criação gravitacional de matéria escura fria: novos modelos e testes observacionais

Recent astronomical observations (involving supernovae type Ia, cosmic background radiation anisotropy and galaxy clusters probes) have provided strong evidence that the observed universe is described by an accelerating, flat model whose space-time properties can be represented by the FriedmannRobertsonWalker (FRW) metric. However, the nature of the substance or mechanism behind the current cosmic acceleration remains unknown and its determination constitutes a challenging problem for modern cosmology. In the general relativistic description, an accelerat ing regime is usually obtained by assuming the existence of an exotic energy component endowed with negative pressure, called dark energy, which is usually represented by a cosmological constant ¤ associated to the vacuum energy density. All observational data available so far are in good agreement with the concordance cosmic ¤CDM model. Nevertheless, such models are plagued with several problems thereby inspiring many authors to propose alternative candidates in the relativistic context. In this thesis, a new kind of accelerating flat model with no dark energy and fully dominated by cold dark matter (CDM) is proposed. The number of CDM particles is not conserved and the present accelerating stage is a consequence of the negative pressure describing the irreversible process of gravitational particle creation. In order to have a transition from a decelerating to an accelerating regime at low redshifts, the matter creation rate proposed here depends on 2 parameters (y and ߯): the first one identifies a constant term of the order of H0 and the second one describes a time variation proportional to he Hubble parameter H(t). In this scenario, H0 does not need to be small in order to solve the age problem and the transition happens even if there is no matter creation during the radiation and part of the matter dominated phase (when the ß term is negligible). Like in flat ACDM scenarios, the dimming of distant type Ia supernovae can be fitted with just one free parameter, and the coincidence problem plaguing the models driven by the cosmological constant. ACDM is absent. The limits endowed with with the existence of the quasar APM 08279+5255, located at z = 3:91 and with an estimated ages between 2 and 3 Gyr are also investigated. In the simplest case (ß = 0), the model is compatible with the existence of the quasar for y > 0:56 whether the age of the quasar is 2.0 Gyr. For 3 Gyr the limit derived is y > 0:72. New limits for the formation redshift of the quasar are also established

Efeitos não-gaussianos em astrofísica e cosmologia

The recent astronomical observations indicate that the universe has null spatial curvature, is accelerating and its matter-energy content is composed by circa 30% of matter (baryons + dark matter) and 70% of dark energy, a relativistic component with negative pressure. However, in order to built more realistic models it is necessary to consider the evolution of small density perturbations for explaining the richness of observed structures in the scale of galaxies and clusters of galaxies. The structure formation process was pioneering described by Press and Schechter (PS) in 1974, by means of the galaxy cluster mass function. The PS formalism establishes a Gaussian distribution for the primordial density perturbation field. Besides a serious normalization problem, such an approach does not explain the recent cluster X-ray data, and it is also in disagreement with the most up-to-date computational simulations. In this thesis, we discuss several applications of the nonextensive q-statistics (non-Gaussian), proposed in 1988 by C. Tsallis, with special emphasis in the cosmological process of the large structure formation. Initially, we investigate the statistics of the primordial fluctuation field of the density contrast, since the most recent data from the Wilkinson Microwave Anisotropy Probe (WMAP) indicates a deviation from gaussianity. We assume that such deviations may be described by the nonextensive statistics, because it reduces to the Gaussian distribution in the limit of the free parameter q = 1, thereby allowing a direct comparison with the standard theory. We study its application for a galaxy cluster catalog based on the ROSAT All-Sky Survey (hereafter HIFLUGCS). We conclude that the standard Gaussian model applied to HIFLUGCS does not agree with the most recent data independently obtained by WMAP. Using the nonextensive statistics, we obtain values much more aligned with WMAP results. We also demonstrate that the Burr distribution corrects the normalization problem. The cluster mass function formalism was also investigated in the presence of the dark energy. In this case, constraints over several cosmic parameters was also obtained. The nonextensive statistics was implemented yet in 2 distinct problems: (i) the plasma probe and (ii) in the Bremsstrahlung radiation description (the primary radiation from X-ray clusters); a problem of considerable interest in astrophysics. In another line of development, by using supernova data and the gas mass fraction from galaxy clusters, we discuss a redshift variation of the equation of state parameter, by considering two distinct expansions. An interesting aspect of this work is that the results do not need a prior in the mass parameter, as usually occurs in analyzes involving only supernovae data.Finally, we obtain a new estimate of the Hubble parameter, through a joint analysis involving the Sunyaev-Zeldovich effect (SZE), the X-ray data from galaxy clusters and the baryon acoustic oscillations. We show that the degeneracy of the observational data with respect to the mass parameter is broken when the signature of the baryon acoustic oscillations as given by the Sloan Digital Sky Survey (SDSS) catalog is considered. Our analysis, based on the SZE/X-ray data for a sample of 25 galaxy clusters with triaxial morphology, yields a Hubble parameter in good agreement with the independent studies, provided by the Hubble Space Telescope project and the recent estimates of the WMAP

A biotecnologia na propagação e conservação do umbuzeiro (Spondias tuberosa Arr. Cam.) e percepção sobre sua importância por agricultores da comunidade Malhada Vermelha, Campo Redondo (RN-Brasil)

The umbu tree (Spondias tuberosa Arruda) is a fruit native to the northeast of Brazil with great economic, social and ecological importance for the northeastern semi-arid region. Despite its role, the umbu tree has suffered negative pressure thanks to cluttered extractivism and to negative selection of its fruits, which as the deforestation and the dormancy of seeds contribute to the decrease of its production year after year, making necessary studies that contribute to the improvement of this specie and its conservation. Given the risks to the conservation of the specie and its usefulness to the population, the association between plant biotechnology, for being a tool that can be used to increase its production. and the perception of gathering communities, by valuing the point of view and the knowledge of the population, can facilitate its conservation. This work aimed to develop methods of propagation for umbu tree as well as contribute to its conservation by using biotechnology, with specific objectives to contribute to the conservation of this species; determine concentrations of BAP and ANA in the formation of buds; testing the efficiency of different substrates and concentrations of gibberellic acid on germination in vitro and ex vitro, as well as capture the perception of families in communities that engage in the gathering of umbu. To study the germination, the seeds were inoculated in different substrates (vermiculite, vermiculite + clay, clay, clay + manure and manure + vermiculite) and in different concentrations of gibberellic acid (0 mg, 250 g and 500 mg). For the formation of buds BAP to 0.1 mg-1 was associated with different concentrations of ANA (0.2; 0.4; 0.8mg.L-1). The study of perception was conducted by applying semi-structured questionnaire with Malhada Vermelha community. The experiments resulted in vermiculite and concentration of 500 mg gibberellic acid as the best for germination. The association of 0.1 mg.L-1 of BAP to 0.2 mg.L-1 of ANA provided better formation of buds. As to the application of questionnaires, they revealed that the population understands the decreased amount of umbu plants and umbu fruit in the region, as well as shows concern for its conservation.