Different outcomes of peritoneal catheter percutaneous placement by nephrologists using a trocar versus the Seldinger technique: the experience of two Brazilian centers

A good catheter implantation technique is important to allow effective peritoneal access function and long-term technique survival. Studies regarding results obtained by nephrologists in comparison with different techniques have been limited. The aim of this study was to investigate the rate of early catheter-related complications and catheter survival in two Brazilian centers, according to two different percutaneous methods of catheter implantation performed by nephrologist team. Adult incident patients recruited from January 2006 to July 2013 having undergone first peritoneal dialysis (PD) catheter implantation were included in the analysis. Mechanical and infectious early complication rates were defined as time to the first event occurring up to 3 months. Four hundred and forty-five consecutive Tenckhoff catheters were implanted by nephrologist team percutaneously after antibiotic prophylaxis in an operating room: trocar was used in 349 (78.4 %) and Seldinger technique (ST) in 99 (21.6 %). The ST was significantly associated with a lower rate of leak (16.3 vs 3 %, p = 0.03) and outflow failure due to tip catheter migration (22.6 vs 10.1 %, p = 0.04), while early infectious complication rates were similar between the two groups (p = 0.59). Long-term catheter survival was higher in Seldinger group (log-rank, p = 0.031). By Cox multivariate analysis, adjusted for age, sex, and diabetes, the ST remained independently associated with better catheter survival [HR 0.681 (0.462-0.910), p = 0.04]. As conclusion, our experience showed better PD outcomes with the ST than trocar method of catheter implantation by nephrologist.

Comparando a eficácia da manta térmica com método de aquecimento passivo na prevenção de hipotermia

Hypothermia is a common phenomenon in the perioperative period, and it affects 60 to 90% of patients submitted to anesthetic-surgical procedures. In order to minimize its incidence, warming methods are used. Such methods can be passive, such as orthopedic cotton, sheets and blankets, or active, such as warm-air blankets and thermal mattresses. In this scenario, the present study aimed at comparing two warming methods used in the intraoperative period. Patients submitted to abdominal surgery in the specialties of gynecology and gastric surgery from August to September 2010 were included in the study. After randomization, they were divided into two groups: one using a thermal blanket (group I) and one using orthopedic cotton (group II). At last, 9 patients were included. The variables for each question were considered according to occurrence frequency. Comparison between groups was performed by Student’s t test. With the purpose to analyze whether there was an association, the chi-square test or Fisher’s Exact test was used. Whenever it was applicable for multiple comparisons, Tukey’s test was utilized; p values < 0.05 were considered to be statistically significant for analysis. The sample comprised 6 males and 3 females submitted to gynecological and gastric surgeries. Their mean age was 48 years for group I and 46.2 years for group II. A predominance of general anesthesia was observed. The time of permanence in the operating room ranged from 80 to 360 minutes. With regard to warming parenteral solutions, the procedure was performed on 5 patients, and infusion of warm solution into the abdominal cavity was performed on 50% of the sample. Concerning the warming method used, 5 patients used a thermal blanket. In view of the results presented, it was not possible to conclude which warming method should be used due to sample size

Does occupational exposure to anesthetic gases lead to increase of pro-inflammatory cytokines?

There is great concern about the possible harmful effects of exposure to volatile anesthetics. The current study aimed at evaluating, for the first time, the effects of occupational exposure to anesthetic gases on physicians who work in operating rooms, by determining several inflammatory cytokines. Plasma inflammatory cytokines (IL-1β, -6, -8, -10, -12, TNF-α) were investigated in 30 individuals who were allocated into two groups of 15: the exposed group, consisting of operating room medical personnel exposed to a mixture of anesthetic gases for 3 years, and a control group composed of medical personnel not exposed to anesthetic gases. The concentrations of volatile anesthetics were measured in the operating room by means of an infrared portable analyzer Our findings suggest an increase of the pro-inflammatory IL-8 (p < 0.05) in medical personnel exposed to high concentrations of anesthetic gases, even for a relatively short period.

Transplante multivisceral em suínos: modelo de pesquisa e treinamento

Objective: To present a model for research and training in multivisceral transplantation in pigs. Methods: Eight Large White pigs (four donors and four recipients) were operated. The multivisceral transplant with stomach, duodenum, pancreas, liver and intestine was performed similarly to transplantation in humans with a few differences, described below. Anastomoses were performed as follows: end-to-end from the supra-hepatic vena cava of the graft to the recipient juxta diaphragmatic vena cava; end-to-end from the infra-hepatic vena cava of the graft to the inferior (suprarenal) vena cava of the recipient; and endto-side patch of the aorta of the graft to the infrarenal aorta of the recipient plus digestive reconstruction. Results: The performance of the multivisceral transplantion was possible in all four animals. Reperfusions of the multivisceral graft led to a severe ischemia-reperfusion syndrome, despite flushing of the graft. The animals presented with hypotension and the need for high doses of vasoactive drugs, and all of them were sacrificed after discontinuing these drugs. Conclusion: Some alternatives to minimize the ischemia-reperfusion syndrome, such as the use of another vasoactive drug, use of a third pig merely for blood transfusion, presence of an anesthesia team in the operating room, and reduction of the graft, will be the next steps to enable experimental studies.

Umidificação e aquecimento do gás inalado em estação de anestesia com baixo fluxo de gases frescos com ou sem isolamento térmico do circuito ventilatório e com ou sem permutador de umidade e temperatura

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Continuous ethanol production in a nonconventional five-stage system operating with yeast cell recycling at elevated temperatures

Three ranges of increasing temperatures (35-43, 37-45, 39-47degreesC) were sequentially applied to a five-stage system continuously operated with cell recycling so that differences of 2degreesC (between one reactor to the next) and 8degreesC (between the first reactor at the highest temperature and the fifth at the lowest temperature) were kept among the reactors for each temperature range. The entire system was fed through the first reactor. The lowest values of biomass and viability were obtained for reactor R-3 located in the middle of the system. The highest yield of biomass was obtained in the effluent when the system was operated at 35-43degreesC. This nonconventional system was set up to simulate the local fluctuations in temperature and nutrient concentrations that occur in different regions of the medium in an industrial bioreactor for fuel ethanol production mainly in tropical climates. Minimized cell death and continuous sugar utilization were observed at temperatures normally considered too high for Saccharomyces cerevisiae fermentations.

A Management Tool for the Replication of Operating Systems in Wireless Communication Networks

To simplify computer management, various administration systems based on wired connections adopt advanced techniques to manage software configuration. Nevertheless, the strong relation between hardware and software makes for an individualism of that management, besides penalizing computational mobility and ubiquity. All these issues lead to degradation of scalability, flexibility and the facility to install and maintain distributed applications. This article presents an environment for centralized wireless communication network management, named WSE-OS (Wireless Sharing Environment - Operating Systems): a model based on Virtual Desktop Infrastructure (VDI) which associates virtualization techniques and safe remote access systems to create a distributed architecture as a base for a managing system. WSE-OS is capable of accomplishing the replication of operating system images using wireless communication network, besides offering abstraction of hardware to its clients, making the management more flexible and independent of wired connections. Results obtained from this work indicate that WSE-OS allows disseminating, through a single software configuration, the execution of data related to operating system images in client computers. WSE-OS can also be used as a management tool for operating systems in a wireless network.

Anelastic spectroscopy in SmBa2Cu3O7

The possibility of variable stoichiometry and the high mobility of oxygen in the CuOx planes of SmBa2Cu3O7 give rise to a rich phase diagram. Measurements of the elastic energy loss and modulus (anelastic spectroscopy) as a function of temperature can distinguish among the different atomic jumps, which occur in the various phases or at different local ordering. In this paper, it is reported anelastic relaxation measurements in SmBa2Cu3O7, above room temperature, using a torsion pendulum operating in frequencies around 40 Hz. The mobility of oxygen atoms in the CuOx planes in the various phases has been discussed and the thermally activated peak of elastic energy dissipation observed around 500 K was interpreted in that framework. (C) 2004 Elsevier B.V. All rights reserved.

Magnetic field effects on the conductivity of organic bipolar and unipolar devices at room temperature

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Experimental performance of a direct evaporative cooler operating during summer in a Brazilian city

This paper presents the basic principles of the evaporative cooling process for human thermal comfort, the principles of operation for the direct evaporative cooling system and the mathematical development of the equations of thermal exchanges, allowing the determination of the effectiveness of saturation. It also presents the results of experimental tests in a direct evaporative cooler that take place in the Air Conditioning Laboratory at the University of Taubate Mechanical Engineering Department, and the experimental results are used to determinate the convective heat transfer co-efficient and to compare with the mathematical model. (c) 2005 Elsevier Ltd and IIR. All rights reserved.

Experimental measurements of the NOx and CO concentrations operating in oscillatory and non-oscillatory burning conditions

The effects of combustion driven acoustic oscillations in carbon monoxide and nitrogen oxides emission rates of a combustor operated with liquefied petroleum gas (LPG) were investigated. Because the fuel does not contain nitrogen, tests were also conducted with ammonia injected in the fuel, in order to study the formation of fuel NOx. The main conclusions were: (a) the pulsating combustion process is more efficient than the non-pulsating one and (b) the pulsating combustion process generates higher rates of NOx, with and without ammonia injection, as shown by CO and NO concentrations as function of the O-2 concentration. An increase in the LPG flow rate, keeping constant the air to fuel ratio, increased the acoustic pressure amplitude and the frequency of oscillation. The injection of ammonia had no influence on either pressure amplitude or frequency. (c) 2005 Elsevier Ltd. All rights reserved.

Properties of hydrogenated amorphous carbon films deposited by PECVD and modified by SF6 plasma

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Single-phase high power-factor boost ZCS pre-regulator operating in critical conduction mode

This paper presents a new single-phase interleaved high power factor boost pre-regulator operating in critical conduction mode, where the switches and boost diode performing zero-current commutations during its turn-off, eliminating the disadvantages related to the reverse recovery losses and electromagnetic interference problems of the boost diode, when operating in the continuous conduction mode. The interleaving technique is applied in the power cell, providing a significant input current ripple reduction in comparison to discontinuous mode of operation, due to its input current continuous conduction operation. This paper presents a complete modeling for the converter operating in critical conduction mode, resulting in an improved design procedure for interleaved techniques with high input power factor, a complete design procedure, and main simulation results from a design example with two interleaved cells rated at 1kW, 400V output voltage and 220V rms input voltage.

Evaluation of strip rolling directly from the semi-solid state

defect metal alloy strip when thixorolling directly from the semi-solid state. To facilitate the study lead/tin alloys were chosen for their relatively low operating temperature. The objective is to extrapolate these findings to the higher temperature aluminium, alloys. Three alloys (70%Pb30%Sn, 60%Pb-40%Sn, 50%Pb-50%wtSn) were used particularly to study the influence of the solidification interval. The equipment consists of a two roll mill arranged as an upper and lower roller, where both rollers are driven at a controlled speed. The lower roller is fed with semi solid alloy through a ceramic nozzle attached to the lower end of a cooling slope. Several types of nozzle and their position at the roller were tested. This produced different solidifications and consequently different finished strip. The alloys were first cast and then poured onto the cooling slope through a tundish in order to create a continuous laminar flow of slurry and uniformity of metal strip quality. The pouring was tested at different positions along the slope. The cooling slope was coated with colloidal graphite to promote a smooth slurry flow and avoid the problem of adherence and premature solidification. The metallic slurry not only cools along the slope but is also initially super-cooled to a mush by the lower roller whilst at room temperatures, thus enabling thixorolling. It was also found that the nozzle position could be adjusted to enable the upper roller to also contribute to the solidification of the metallic slurry. However the rollers and the cooling slope naturally heat up. Temperature distribution in these zones was analysed by means of three thermocouples positioned along the cooling slope and a fourth in the base of the semi solid pool within the nozzle. The objective being to design an optimum pouring and cooling system. The formed strip was cooled down to room temperature with a shower of water. Microstructures of the thixorolling process were analysed. The differences in solidification conditions resulted in differing qualities of finished strip and corresponding defect types, all of which are a serious quality issue for the rolled product.

Scanning tunneling microscope operating as a spin diode

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)