32 resultados para Perda sanguínea cirúrgica

em Universidade Federal do Rio Grande do Norte(UFRN)


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GURGEL, Bruno Cesar de vasconcelos.Influencia do meloxicam sobre a perda ossea alveolar em periodontite experimental: avaliaçao histometrica em ratos. 2003.97f. Dissertaçao (Mestrado) - Universidade Estadual de Campinas. Faculdade de Odontologia de Piracicaba. Piracicaba, 2003. Disponivel em: . Acesso em: 04 out. 2010.

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Analisar, em pacientes submetidos a simpaticotomia videotoracoscópica para tratamento da Hiperidrose Primária (HP), as conseqüências hemodinâmicas da desnervação vascular das artérias carótidas e vertebrais após a trans-secção cirúrgica da cadeia simpática torácica (simpaticotomia), através da mensuração de parâmetros ultra-sonográficos. Método: Vinte e quatro pacientes portadores de HP submetidos a quarenta e oito simpaticotomias torácicas endoscópicas foram avaliados através da mensuração da velocidade de pico sistólico (VPS), velocidade de pico diastólico (VPD), índice de pulsatibilidade (IP) e índice de resistência (IR) nas artérias carótidas comuns, internas e externas, além da artéria vertebral bilateralmente usando o eco-doppler duplex scan. As avaliações foram realizadas antes da intervenção cirúrgica e trinta dias após o procedimento. O teste de Wilcoxon foi usado na análise das diferenças entre as variáveis antes e depois da simpaticotomia. Resultados: A simpaticotomia no nível de T3 foi a trans-secção mais realizada (95,83%), seja isoladamente (25%) ou associada a T4 (62,50%) ou a T2 (8,33%). Houve aumento significativo no IR e no IP da artéria carótida comum bilateralmente (p<0,05). A VPD da artéria carótida interna diminuiu em ambos os lados (p<0,05). A VPS e a VPD da artéria vertebral direita também aumentaram (p<0,05). Achados assimétricos foram observados, de modo que artérias do lado direito foram as mais freqüentemente afetadas. Conclusões: Alterações hemodinâmicas foram observadas nas artérias vertebral e carótida após simpaticotomia para tratamento de HP. VPS foi o parâmetro mais freqüentemente alterado, principalmente nas artérias do lado direito, representando alterações assimétricas significantes nas artérias carótida e vertebral. Entretanto, são necessárias pesquisas subseqüentes para verificar se essas alterações são definitivas ou temporárias, uma vez que as inferências clínicas somente terão validação se as alterações forem permanentes

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The materials engineering includes processes and products involving several areas of engineering, allowing them to prepare materials that fulfill the needs of various new products. In this case, this work aims to study a system composed of cement paste and geopolymers, which can contribute to solving an engineering problem that directly involves the exploitation of oil wells subject to loss of circulation. To correct it, has been already proposed the use of granular materials, fibers, reducing the drilling fluid or cement paste density and even surface and downhole mixed systems. In this work, we proposed the development of a slurry mixed system, the first was a cement-based slurry and the second a geopolymer-based slurry. The cement-based slurry was formulated with low density and extenders, 12.0 ppg (1.438 g/cm ³), showing great thixotropic characteristics. It was added nano silica at concentrations of 0.5, 1.0 and 1.5 gps (66.88, 133.76 and 200.64 L/m3) and CaCl2 at concentrations of 0.5, 1, 0 and 1.5%. The second system is a geopolymer-based paste formulated from molar ratios of 3.5 (nSiO2/nAl2O3), 0.27 (nK2O/nSiO2), 1.07 (nK2O/nAl2O3) and 13.99 (nH2O/nK2O). Finally, we performed a mixture of these two systems, for their application for correction of circulation lost. To characterize the raw materials, XRD, XRF, FTIR analysis and titration were performed. The both systems were characterized in tests based on API RP10B. Compressive strength tests were conducted after curing for 24 hours, 7 and 28 days at 58 °C on the cement-based system and the geopolymer-based system. From the mixtures have been performed mixability tests and micro structural characterizations (XRD, SEM and TG). The results showed that the nano silica, when combined with CaCl2 modified the rheological properties of the cement slurry and from the concentration of 1.5 gpc (200.64 L / m³) it was possible to obtain stable systems. The system mixture caused a change in the microstructure of the material by favoring the rate of geopolymer formation to hinder the C3S phase hydration, thus, the production of CSH phases and Portlandite were harmed. Through the mixability tests it can be concluded that the system, due to reduced setting time of the mixture, can be applied to plug lost circulation zones when mixed downhole

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Waterflooding is a technique largely applied in the oil industry. The injected water displaces oil to the producer wells and avoid reservoir pressure decline. However, suspended particles in the injected water may cause plugging of pore throats causing formation damage (permeability reduction) and injectivity decline during waterflooding. When injectivity decline occurs it is necessary to increase the injection pressure in order to maintain water flow injection. Therefore, a reliable prediction of injectivity decline is essential in waterflooding projects. In this dissertation, a simulator based on the traditional porous medium filtration model (including deep bed filtration and external filter cake formation) was developed and applied to predict injectivity decline in perforated wells (this prediction was made from history data). Experimental modeling and injectivity decline in open-hole wells is also discussed. The injectivity of modeling showed good agreement with field data, which can be used to support plan stimulation injection wells

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The oil companies in the area in general are looking for new technologies that can increase the recovery factor of oil contained in reservoirs. These investments are mainly aimed at reducing the costs of projects which are high. Steam injection is one of these special methods of recovery in which steam is injected into the reservoir in order to reduce the viscosity of the oil and make it more mobile. The process assisted gravity drainage steam (SAGD) using steam injection in its mechanism, as well as two parallel horizontal wells. In this process steam is injected through the horizontal injection well, then a vapor chamber is formed by heating the oil in the reservoir and, by the action of gravitational forces, this oil is drained down to where the production well. This study aims to analyze the influence of pressure drop and heat along the injection well in the SAGD process. Numerical simulations were performed using the thermal simulator STARS of CMG (Computer Modeling Group). The parameters studied were the thermal conductivity of the formation, the flow of steam injection, the inner diameter of the column, the steam quality and temperature. A factorial design was used to verify the influence of the parameters studied in the recovery factor. We also analyzed different injection flow rates for the model with pressure drop and no pressure drop, as well as different maximum flow rates of oil production. Finally, we performed an economic analysis of the two models in order to check the profitability of the projects studied. The results showed that the pressure drop in injection well have a significant influence on the SAGD process.

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Injectivity decline, which can be caused by particle retention, generally occurs during water injection or reinjection in oil fields. Several mechanisms, including straining, are responsible for particle retention and pore blocking causing formation damage and injectivity decline. Predicting formation damage and injectivity decline is essential in waterflooding projects. The Classic Model (CM), which incorporates filtration coefficients and formation damage functions, has been widely used to predict injectivity decline. However, various authors have reported significant discrepancies between Classical Model and experimental results, motivating the development of deep bed filtration models considering multiple particle retention mechanisms (Santos & Barros, 2010; SBM). In this dissertation, inverse problem solution was studied and a software for experimental data treatment was developed. Finally, experimental data were fitted using both the CM and SBM. The results showed that, depending on the formation damage function, the predictions for injectivity decline using CM and SBM models can be significantly different

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Nowadays, most of the hydrocarbon reserves in the world are in the form of heavy oil, ultra - heavy or bitumen. For the extraction and production of this resource is required to implement new technologies. One of the promising processes for the recovery of this oil is the Expanding Solvent Steam Assisted Gravity Drainage (ES-SAGD) which uses two parallel horizontal wells, where the injection well is situated vertically above the production well. The completion of the process occurs upon injection of a hydrocarbon additive at low concentration in conjunction with steam. The steam adds heat to reduce the viscosity of the oil and solvent aids in reducing the interfacial tension between oil/ solvent. The main force acting in this process is the gravitational and the heat transfer takes place by conduction, convection and latent heat of steam. In this study was used the discretized wellbore model, where the well is discretized in the same way that the reservoir and each section of the well treated as a block of grid, with interblock connection with the reservoir. This study aims to analyze the influence of the pressure drop and heat along the injection well in the ES-SAGD process. The model used for the study is a homogeneous reservoir, semi synthetic with characteristics of the Brazilian Northeast and numerical simulations were performed using the STARS thermal simulator from CMG (Computer Modelling Group). The operational parameters analyzed were: percentage of solvent injected, the flow of steam injection, vertical distance between the wells and steam quality. All of them were significant in oil recovery factor positively influencing this. The results showed that, for all cases analyzed, the model considers the pressure drop has cumulative production of oil below its respective model that disregards such loss. This difference is more pronounced the lower the value of the flow of steam injection

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Stress urinary incontinence (SUI) is defined as "involuntary loss of urine" due to several processes that alter the ability of the bladder to hold urine properly, regarded as a social and hygienic problem that adversely affects quality of life. In postmenopausal women, IU is associated with atrophy and weakness of the pelvic floor muscles. The objective this study was investigate, using the onehour pad test, stress urinary leakage (SUI), evaluate and compare their results in postmenopausal and premenopausal women. The survey was characterized as a cross-sectional study. The study consisted of 60 postmenopausal women were divided into GIU - consisting of 34 volunteers complaining of involuntary loss of urine during stress - and GSIU - consisting of 26 volunteers without complaints of loss of urine during stress, and 15 women, during the premenopausal (GPM), and ovulatory with normal menstrual cycle. All volunteers were evaluated clinically, subjected to one-hour pad test, after the biochemical evaluation of blood and sex hormones. Statistical analysis was performed by descriptive analysis, ANOVA, Turkey´s post-test and Pearson correlation. The results showed that 100% of postmenopausal patients had involuntary loss of urine during one hour pad test (GIU: 4.0 g; GSIU: 4.5 g). GPM remained continent after an hour pad test (GPM: 0.4 g). In addition, Pearson showed a strong correlation between urine loss with time since menopause (r = 0.8, p <0.01) and body mass index - BMI (r = 0.7; p = 0.01). These data suggest that the one-hour pad test is a useful test to assess and quantify urinary leakage, including those volunteers who had no previous complaint of SUI

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Analyze, in patients with primary hyperhidrosis (PH) who was undergone to videothoracoscopic sympathicotomy, the degree of vascular denervation after surgical transection of the thoracic sympathetic chain by measuring ultrasonografic parameters in carotid and vertebral arteries. Methods: Twenty-four patients with PH underwent forty-eight endoscopic thoracic sympathicotomy and were evaluated by duplex eco-doppler measuring systolic peak velocity (SPV), diastolic peak velocity (DPV), pulsatility index (PI) and resistivity index (RI) in bilateral common, internal and external carotids, besides bilateral vertebral arteries. The exams were performed before operations and a month later. Wilcoxon test was used to analyse the differences between the variables before and after the sympatholisis. Results: T3 sympathicotomy segment was the most frequent transection done (95,83%), as only ablation (25%) or in association with T4 (62,50%) or with T2 (8,33%). It was observed increase in RI and PI of the common carotid artery ( p<0,05). The DPV of internal carotid artery decreased in both sides (p<0,05). The SPV and the DPV of the right and left vertebral arteries also increased (p<0,05). Asymmetric findings were observed so that, arteries of the right side were the most frequently affected. Conclusions: Hemodynamic changes in vertebral and carotid arteries were observed after sympathicotomy for PH. SPV was the most often altered parameter, mostly in the right side arteries, meaning significant asymmetric changes in carotid and vertebral vessels. Therefore, the research findings deserve further investigations to observe if they have clinical inferences

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Massive resection of the small intestine results in short bowel syndrome with anti-absorptive effect and repercussions on the metabolism. Morphologic and functional evaluation may be necessary in order to control wrapped organs. Scintigraphy an examination with little invading and no biologic damage can be used. The purpose were to assess the biodistribution of sodium pertecnetate in organs of rats subjected to massive resection of the small intestine, the intestinal adaptation of the remnant intestinal mucosa and weight curve evaluation in the postoperative period. Twenty-one Wistar rats were randomly allocated into three groups (n = 7). The operated group named short bowel (SB) after anesthetized was subjected to massive resection of the small intestine; the control group (C), and sham group (SHAM). On the 30th postoperative day, 0.l mL of sodium pertechnetate was injected into the venous orbital plexus. After 30 minutes, the rats were killed with an overdose of anesthetic, and fragments of the liver, spleen, pancreas, stomach, duodenum, small intestine, thyroid, lung, heart, kidney, bladder, muscle, femur and brain were harvested. The percentage of radioactivity per gram of tissue (%ATI/g) was determined using Gama Counter WizardTM 1470, PerkinElmer to all samples. Biopsies of 3 cm remaining jejunum were removed to histological analyses. Analysis of variance (ANOVA) and the Tukey test for multiple comparisons were used, considering p<0.05 as significant. The study had the participation of some departments and laboratories, as Nucleus of Experimental Surgery, Department of Surgery, Laboratory of Radiobiology, Department of Pathology and Service of Nuclear Medicine, certifying the character of a multidisciplinary research. The results were no significant differences in %ATI/g of the sodium pertechnetate in the organs of the groups studied (p>0.05). An increase in the weight of the SB rats was observed after the second postoperative week. The jejunal mucosal thickness of the SB rats was significantly greater than that of C and sham rats (p<0.05. The biodistribution of sodium pertechnetate was not affected by massive intestinal resection in rats. An adaptive response by the intestinal mucosa probably contributed to the reversion of weight loss and the biodistribution of sodium pertechnetate was not affected by the surgery

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Introdução: A obesidade e suas formas extremas como a forma mórbida, vem assumindo preocupação nos sistemas de saúde pública e é atualmente considerado um dos mais importantes agravos de saúde no mundo desenvolvido. Acarreta repercussões em várias partes do corpo, com potencial para interferir negativamente também na função reprodutiva, recentemente sendo mais estudado na população masculina. Objetivo: avaliar parâmetros hormonais e seminais da função reprodutiva em um grupo de homens obesos mórbidos, antes e após 6 meses da perda de peso induzida pela cirurgia bariátrica. Métodos: Inicialmente, de uma amostra de 36 pacientes com idade entre 18 e 40 anos e índice de massa corporal (IMC) ≥40 Kg/m2, apenas 1 caso foi excluído por ser portador de hiperprolactinoma e outros 24 pacientes não completaram todo o protocolo de avaliação laboratorial solicitada. Um total de apenas 11 pacientes completou o protocolo. Todos foram previamente avaliados por uma equipe multidisciplinar. O grupo selecionado foi submetido a avaliação seminal e dosagens hormonais de testosterona total(TT), FSH e LH. Os parâmetros foram reavaliados após 6 meses de realização da cirurgia pela técnica de Y-em-Roux, para análise dos efeitos da perda de peso sobre os parâmetros da função reprodutiva. Resultados: No grupo selecionado ao estudo, os exames pré-operatórios mostraram um grupo heterogêneo de resultados. Após seis meses do tratamento cirúrgico, a perda ponderal foi significativa no grupo analisado, com redução do IMC de mediana 46 Kg/m2para mediana de 36 Kg/m2(p=0,03). Em relação ao perfil hormonal, houve elevação significativa do nível sérico de TT com mediana de 187ng/ml no período pré-operatório para 457 ng/ml (p=0,02) no período pós-operatório. Entre os períodos pré e pós-operatório, não foram observadas alterações significantes do FSH (2,70 mIU/ml para 3,31 mIU/ml, p=0,79), LH (4,82 mIU/ml para 3,00mIU/ml, p=0,39), concentração espermática (38milhões/ml para 31milhões/ml, p=0,88) e motilidade A+B (50% para 50%, p=0,89).Conclusão: A redução ponderal decorrente da cirurgia em obesos mórbidos parece levar a uma elevação dos níveis de testosterona total, sem alterações nas demais provas de avaliação reprodutiva. Estudos adicionais com casuística maior e múltiplos parâmetros são necessários para esclarecimento definitivo do impacto da obesidade e da perda de peso induzida pela cirurgia sobre a função reprodutiva masculina

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High levels of local, regional, and global extinctions has progressively simplified communities in terms of both species and ecosystem functioning. Theoretical models demonstrated that the degree of functional redundancy determines the rates of functional group loss in response to species extinctions. Here, we improve the theoretical predictions by incorporating in the model interactions between species and between functional groups. In this study, we tested the effect of different scenarios of interspecific interactions and effects between functional groups on the resistance to loss of community functional groups. Virtual communities have been built with different distribution patterns of species in functional groups, both with high and low evenness. A matrix A was created to represent the net effect of interspecific interactions among all species, representing nesting patterns, modularity, sensitive species, and dominant species. Moreover, a second matrix B was created to represent the interactions between functional groups, also exhibiting different patterns. The extinction probability of each species was calculated based on community species richness and by the intensity of the interspecific interactions that act upon it and group to which it belongs. In the model, successive extinctions decrease the community species richness, the degree of functional redundancy and, consequently, the number of functional groups that remain in the system. For each scenario of functional redundancy, A, and B, we ran 1000 simulations to generate an average functional extinction curve. Different model assumptions were able to generate remarkable variation on functional extinction curves. More extreme variations occurred when the matrix A and B caused a higher heterogeneity in the species extinction probability. Scenarios with sensitive species, positive or negative, showed a greater variation than the scenarios with dominant species. Nested interactions showed greater variation than scenarios where the interactions were in modules. Communities with maximal functional evenness can only be destabilized by the interactions between species and functional groups. In contrast, communities with low functional evenness can have its resistance either increased or decreased by the interactions. The concentration of positive interactions in low redundancy groups or negative interactions in high redundancy groups was able to decrease the functional extinction rates. In contrast, the concentration of negative interactions in low redundancy groups or positive interactions in high redundancy groups was able to increase the functional extinction rates. This model shows results that are relevant for species priorization in ecosystem conservation and restoration

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Venous ulcer (VU) is a lower limbs injury resulting from inadequate return of venous blood in feet or legs. Although it is not a deadly disease, it causes chronic wounds, which seriously undermine patients´ quality of life (QOL) and sometimes leads to drastic family, social, economic and psychological changes. In this sense, there are several aspects that may influence the venous ulcers patients´ QOL. The study´s objective aimed on the association of socio-demographic and health, health care and clinical injury on UV patients‟ QOL. Analytical studies, which consider the complexity of factors involved in changes in UV patients‟ QOL has a cross-sectional and quantitative approach. The HUOL Ethics Committee approved this project (n.279/09). The collection of data lasted a period of 3 months in 2010 and it took place at the clinic of Angiology at Hospital Universitário Onofre Lopes (HUOL). The data sample consisted of 60 patients treated by UV angiologists in the HUOL Surgical Clinic. The results were analyzed with SPSS 15.0 by descriptive and inferential statistics. The study was based on UV patients that were predominantly female, average age of 61.4 years, that had low education level and low family income, with occupations requiring long periods of standing or sitting, but mostly retired, unemployed or laid off due to the disease and/or due to chronic diseases associated with the UV. The study took also into consideration patients that used inappropriate products, that were improperly treated by a professional caregiver, that lacked of adequate guidance and compression therapy, that performed no lifting of the lower limbs and regular exercise, that the time of injury were greater than or equal to six months, that were missing specific laboratory tests. The study‟s reference were on recurrent lesions, medium to large lesions area, bed of the lesion (injuries) with fibrin and/or necrosis, with amount of exudate with medium to large, odorless and no signs of infection, with tissue loss between 1st and 2nd degree, without collecting swab or biopsy and with pain. In general, QOL of researched individuals were considered low, the maximum score was 69 points, which the areas that were mostly influenced were the total scores of QOL functional capacity (0.021), emotional (0.000) and social functioning (0.080). Of the 60 individuals, 53.3% had scores between 40 and 69 points in SF-36, and they had the best scores in sociodemographic and health variables (ρ = 0.049). In respect to the assistance and injury characteristics, patients who scored between 40 and 69 points in SF-36 had better scores on these characteristics. By combining the socio-demographic variables, health, and handling characteristics of the injury, we observed a significant difference (ρ = 0.032) when linking them with the QOL total scores. When analyzing separately the domains of the SF-36 scores on the quality of life, we find that the areas that showed statistical significance were functional ability (ρ = 0.035), appearance (ρ = 0.019), emotional (ρ = 0.000), and mental health (ρ = 0.050). Among the socio-demographic characteristics studied, gender and marital status contributed more to the reduction of QOL and among the variables of assistance and the injury, orientation, reference and area of UV contributed the most. By analyzing these five variables all together in accordance with the overall score obtained in the quality of life, we found a significant correlation (ρ = 0.002); with 6.23 times more chances of patients have better QOL in the presence of these five positive factors. By conducting the Mann Whitney U test between all the five demographic variables, health, and clinical care, we found that this combination also proved to be significant (ρ = 0.006). Therefore, patients with these five variables positive tend to have a better QOL. Based on these results, we reject the null hypothesis (H0) and accept the alternative hypothesis (H1) proposed in this study because we noted that the QOL of patients with UV is associated with sociodemographic and health, health care and clinical aspects of the injury

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The study aimed to identify the quality of care and knowledge of health rights of people with chronic venous ulcers (VU) in Brasilian National Health Care System (SUS). It is a cross-sectional study, with quantitative approach, performed at the University Hospital Onofre Lopes (HUOL). The study was approved by the Ethics Committee of HUOL (CAAE nº 0148.0.051.000-10). The sample by accessibility was composed for 30 people with VU treated at the outpatient surgical clinic of HUOL. For data collection we used a structured questionnaire composed of two parts: sociodemographic characteristics and of health, of care and the clinical course of VU; and knowledge of people with VU about the rights of health. The results were processed using SPSS 15.0 and analyzed by descriptive statistics. Given the characterizations sociodemographic and health presented, we identified a clientele of users with VU predominantly female (76,7%), aged from 60 years (66,7%), married/ stable union (60,0%), low education level (83,3%), family income lower than a minimum wage (73,3%), unemployeds and with chronic diseases (53,3%), sleep greater than or equal to 6 hours (76,7%) and were not alcoholics or smokers (93,3%). In relation to clinical conditions, were shown the presence of one or more relapses of VU (73,3%), predominance of granulation tissue/epithelialization in the bed of VU (60,0%), exudate serosanguineous (43,3%), in quantity medium/large (60,0%), with no predominance of presence or absence of odor (50,0%), all patients with tissue loss in grade III / IV, no signs of infection (73,3%) and presence of intense pain (50,0%). In the last 30 days the main venue of achievement of dressing was the HUOL (100,0%), the main compression therapy used was the Unna boot (60,0%) and on inability to perform the dressing on the unit were the own patients who made the exchange at home (40,0%). The majority of respondents listed out more positive factors associated with quality of care (56,7%) were satisfied with the care of SUS (76,7%), claimed to have knowledge about their rights (70,0%), but at the same time did not know the meaning of the acronym SUS (90,0%) and classified their level of information as inappropriate (70,0%). We realize that people with VU identified as good the quality of care and demonstrated inadequate knowledge about their rights to health in the SUS, but showed interest in acquiring more information. The basic rights to entry in the SUS are constitutionally guaranteed and need to be disseminated in order to make them known to the population, so it can be implemented and ensured a greater resolution assistance in treating this type of injury

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In this dissertation new models of propagation path loss predictions are proposed by from techniques of optimization recent and measures of power levels for the urban and suburban areas of Natal, city of Brazilian northeast. These new proposed models are: (i) a statistical model that was implemented based in the addition of second-order statistics for the power and the altimetry of the relief in model of linear losses; (ii) a artificial neural networks model used the training of the algorithm backpropagation, in order to get the equation of propagation losses; (iii) a model based on the technique of the random walker, that considers the random of the absorption and the chaos of the environment and than its unknown parameters for the equation of propagation losses are determined through of a neural network. The digitalization of the relief for the urban and suburban areas of Natal were carried through of the development of specific computational programs and had been used available maps in the Statistics and Geography Brazilian Institute. The validations of the proposed propagation models had been carried through comparisons with measures and propagation classic models, and numerical good agreements were observed. These new considered models could be applied to any urban and suburban scenes with characteristic similar architectural to the city of Natal