Deep venous thrombosis prophylaxis in oral and maxillofacial surgery: a Brazilian survey

Background : Deep venous thrombosis (DVP) is a frequent disease. Prophylaxis is the best means to reduce its incidence, for lowering morbidity and mortality rates and treatment costs caused by its complications. Objective : To evaluate the knowledge and use of any kind of DVT prophylaxis by Brazilian Oral and Maxillofacial surgeons. Materials and Methods : A questionnaire was sent to all Oral and Maxillofacial surgeons associated to the Brazilian College of Oral and Maxillofacial Surgeons that have a valid e-mail address. The data retrieved was evaluated and tabulated. Results : Of the 1100 questionnaires sent, only 4% were retrieved. The 42 retrieved were included in the study. Twenty six of the surgeons do not use any kind of deep venous thrombosis (DVT) prophylaxis, 11 use mechanical means as elastic compressive stockings or pneumatic compressive devices for prophylaxis, and 5 uses low-molecular weight heparins (LMWH) as the choice for prophylaxis. Conclusion : The data collected, despite the low rate of participation (4%) by the surgeons, shows that this subject still does not receive proper attention. Whereas other medical specialties make routine use of prophylactic means maybe the maxillofacial surgeons lack concern on that matter.

Continuous measurement of cerebral oxygen saturation (rSO 2) for assessment of cardiovascular status during hemorrhagic shock in a swine model

Background: Early trauma care is dependent on subjective assessments and sporadic vital sign assessments. We hypothesized that near-infrared spectroscopy-measured cerebral oxygenation (regional oxygen saturation [rSO 2]) would provide a tool to detect cardiovascular compromise during active hemorrhage. We compared rSO 2 with invasively measured mixed venous oxygen saturation (SvO2), mean arterial pressure (MAP), cardiac output, heart rate, and calculated pulse pressure. Methods: Six propofol-anesthetized instrumented swine were subjected to a fixed-rate hemorrhage until cardiovascular collapse. rSO 2 was monitored with noninvasively measured cerebral oximetry; SvO2 was measured with a fiber optic pulmonary arterial catheter. As an assessment of the time responsiveness of each variable, we recorded minutes from start of the hemorrhage for each variable achieving a 5%, 10%, 15%, and 20% change compared with baseline. Results: Mean time to cardiovascular collapse was 35 minutes ± 11 minutes (54 ± 17% total blood volume). Cerebral rSO 2 began a steady decline at an average MAP of 78 mm Hg ± 17 mm Hg, well above the expected autoregulatory threshold of cerebral blood flow. The 5%, 10%, and 15% decreases in rSO 2 during hemorrhage occurred at a similar times to SvO2, but rSO 2 lagged 6 minutes behind the equivalent percentage decreases in MAP. There was a higher correlation between rSO 2 versus MAP (R =0.72) than SvO2 versus MAP (R =0.55). Conclusions: Near-infrared spectroscopy- measured rSO 2 provided reproducible decreases during hemorrhage that were similar in time course to invasively measured cardiac output and SvO2 but delayed 5 to 9 minutes compared with MAP and pulse pressure. rSO 2 may provide an earlier warning of worsening hemorrhagic shock for prompt interventions in patients with trauma when continuous arterial BP measurements are unavailable. © 2012 Lippincott Williams & Wilkins.

Indicators of soil degradation in urban forests: Physical and chemical parameters

The fragmentation of forest habitats in urban areas has aroused increasing interest in recent years according to the growing environmental problems. The fragmentation of theses ecosystems is caused, in general, by the pressure of housing, agriculture and industry, causing losses in biodiversity and problems of soil degradation in the border areas of theses remnants. The establishment of indicators of soil degradation becomes essential for the implementation of conservation and reclamation. This study analyzes physical and chemical characteristics of soil under different forms of vegetation in the forest surrounding the Quilombo Forest, located in Campinas/SP - Brazil, and examines the possibility of using these indices as indicators of environmental degradation in urban remnants. The parameters analyzed were: specific weight natural (γn), specific weight of solids (γs) Ca, P, K, Mg, pH, organic matter, H + Al, Sum of Base (SB) Percent Base Saturation (V%), Cation Exchange Capacity (CEC). The study shows that in general the different forms of land used in the study area significantly changed (or according to) the physical aspects of soil The porosity and voids of the soil stood out as the best indicators of soil physical degradation in the layer 0-20 cm deep. In relation to chemical indices, the soil under the cultivation of cane sugar had a significantly higher pH, K, Ca, Mg and sum of bases. The areas of forest showed higher levels of phosphorus, organic matter and CEC, indicating the importance of maintaining vegetation and replacement for the cycling of organic matter.

Effects of superficial liming and silicate application on soil fertility and crop yield under rotation

Soil acidity and low natural fertility are the main problems for grain production in Brazilian 'cerrado'. Although lime has been the most applied source for soil correction, silicate may be an alternative material due to its lower solubility and Si supply, which is beneficial to several crops. This work aimed to evaluate the efficiency of superficial liming and calcium/magnesium silicate application on soil chemical attributes, plant nutrition, yield components and final yield of a soybean/white oat/maize/bean rotation under no-tillage system in a dry-winter region. The experiment was conducted under no tillage system in a deep acid clayey Rhodic Hapludox, Botucatu-SP, Brazil. The design was the completely randomized block with sixteen replications. Treatments consisted of two sources for soil acidity correction (dolomitic lime: ECC=90%, CaO=36% and MgO=12%; calcium/magnesium silicate: ECC=80%, CaO=34%, MgO=10% and SiO2=22%) applied in October 2006 to raise base saturation up to 70% and a control, with no soil correction. Soybean and white oat were sown in 2006/2007 as the main crop and off-season, respectively. Maize and bean were cropped in the next year (2007/2008). Products from silicate dissociation reach deeper soil layers after 18months from the application, compared to liming. Additionally, silicate is more efficient than lime to increasing phosphorus availability and reducing toxic aluminum. Such benefits in soil chemical attributes were only evidenced during bean cropping, when grain yield was higher after silicate application comparatively to liming. Both correction sources were improved mineral nutrition of all the other crops, mainly Ca and Mg levels and agronomical characteristics, reflecting in higher yield. © 2012 Elsevier B.V.

Fault current limiter using transformer and modular device of YBCO coated conductor

In this work, we report on the evaluation of a superconducting fault current limiter (SFCL). It is consisted of a modular superconducting device combined with a short-circuited transformer with a primary copper winding connected in series to the power line and the secondary side short-circuited by the superconducting device. The basic idea is adding a magnetic component to contribute to the current limitation by the impedance reflected to the line after transition of the superconducting device. The evaluation tests were performed with a prospective current up to 2 kA, with the short-circuited transformer of 2.5 kVA, 220 V/660 V connected to a test facility of 100 kVA power capacity. The resistive SFCL using a modular superconducting device was tested without degradation for a prospective fault current of 1.8 kA, achieving the limiting factor 2.78; the voltage achieved 282 V corresponding to an electric field of 11 V/m. The test performed with the combined SFCL (xsuperconducting device + transformer) using series and toroidal transformers showed current limiting factor of 3.1 and 2 times, respectively. The test results of the combined SFCL with short-circuited transformer showed undesirable influence of the transformer impedance, resulting in reduction of the fault current level. © 2002-2011 IEEE.

Light microscopic evaluation and scanning electron microscopic analysis of horse eyes following deep anterior lamellar keratectomy

Objective To describe the technique of deep anterior lamellar keratoplasty (DALK) with Descemet's membrane (DM) exposure in horse eyes. Also, to compare the efficacy and safety of viscodissection and big-bubble techniques for DALK. Animals studied Thirty-four ex vivo horse eyes. Procedure Deep anterior lamellar keratoplasty was performed in 34 ex vivo horse eyes. Two groups (Group V - viscodissection - 2% sodium hyaluronate; Group A - air - big-bubble) of 17 eyes were studied. Other than the substance used, the surgical technique was similar for both groups. Nonperforated eyes were submitted for light microscopic histologic evaluation and scanning electron microscopic (SEM) analysis. Results Group V - Perforations occurred in 18% of the eyes during surgery. Light microscopy revealed exposure of DM in 28% of the eyes with mean thickness of the remaining stroma being 70.4μm. Group A - Perforations occurred in 42% of the eyes. Light microscopy revealed exposure of DM in 60% of the eyes with mean thickness of the remaining stroma being 23.3μm. No significant differences in safety, efficacy and thickness of the remaining stroma (including all eyes or excluding those with DM exposure) were observed. SEM of the surgical site revealed a more even surface in those eyes with DM exposure compared to eyes with thicker remaining stroma in both groups. Conclusions We describe two DALK techniques (viscodissection and big-bubble) for use in horses. No significant differences in safety, efficacy and thickness of the remaining stroma were observed. However, a nonsignificant trend toward the big-bubble technique being more efficacious but less safe was observed. © 2012 American College of Veterinary Ophthalmologists.

Use of platelet-rich plasma in the treatment of deep corneal ulcers induced in rabbits.clinical and histomorphometric evaluation

The repair process induced corneal ulcer in rabbits using platelet-rich plasma in the form of eyedrop or clot was clinically evaluated and compared. Sixty rabbits were divided into four groups of 15 animals, denominated platelet group (PG), clot group (CLG), control group (CG), and amniotic control group (AG). Experimental groups were then subdivided into three groups (M4, M7, M30), corresponding to the end of the evaluation period. There were no differences between treatments regarding ocular sensitivity, chemosis and ocular secretion. The groups treated with PRP either as eyedrop or a clot showed less opacity than the animals treated only with amniotic membrane at the moment of the final evaluation. The presence of corneal ulcers in the groups treated with PRP showed lower intensity than the other groups. Histomorphometric examination showed that corneal epithelization in the initial phase of the lesion was greater when using PRP. The use of amniotic membrane promoted corneal epithelial and stromal thickness, as well as synergism when associated to PRP.

Variabilidade espacial de atributos do solo em áreas intensamente cultivadas nas regiões de Jaboticabal e Monte Alto - SP

Pós-graduação em Agronomia (Ciência do Solo) - FCAV

Alterações nos atributos químicos do solo e comportamento de cultivares de feijão em resposta à calagem superficial em sistema plantio direto

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

Recanalization after acute deep vein thrombosis

O processo de recanalização das veias dos membros inferiores, após um episódio de trombose venosa profunda aguda em pacientes anticoagulados com heparina e inibidores da vitamina K, faz parte da evolução natural da remodelagem do trombo venoso. Esse complexo processo de remodelagem envolve a adesão do trombo à parede da veia, à resposta inflamatória da parede do vaso, levando à organização e subsequente contração do trombo, à neovascularização e à lise espontânea de áreas no interior do trombo. A presença de fluxo arterial espontâneo em veias com trombose recanalizada tem sido descrita como secundária à neovascularização e se caracteriza pelo desenvolvimento de fluxo com padrão de fístulas arteriovenosas, identificadas por meio de mapeamento dúplex colorido. Nesta revisão, são discutidos alguns aspectos controversos da história natural da trombose venosa profunda, para uma melhor compreensão da sua evolução e do seu impacto sobre a doença venosa.

Long-term clinical and ultrasonographic evaluation of thrombophilic patients with deep venous thrombosis

OBJECTIVE:The purpose of this study was to evaluate the long term clinical and ultrasonographic outcomes of thrombophilic patients with deep venous thrombosis (DVT).METHOD:Cohort study, retrospective case-control with cross-sectional analysis. Thirty-nine thrombophilic patients and 25 non-thrombophilic patients were assessed 76.3 ± 45.8 months after diagnosis. Demographic and family data were collected, as well as data from clinical and therapeutic progress, and physical and ultrasound examinations of the limbs were performed. Groups were matched for age and gender and the variables studied were compared across groups.RESULTS:Deep venous thrombosis was more frequent in women. The most common thrombophilias were antiphospholipid syndrome and factor V Leiden mutation. There was no difference between groups in terms of the number of pregnancies or miscarriages and the majority of women did not become pregnant after DVT. Non-spontaneous DVT prevailed. Proximal DVT and DVT of the left lower limb were more frequent, and the main risk factor was use of oral contraceptives. All patients were treated with anticoagulation. There was a higher frequency of pulmonary embolism in non-thrombophilic patients. Most patients considered themselves to have a normal life after DVT and reported wearing elastic stockings over at least 2 years. Seventy-one percent of patients had CEAP > 3, with no difference between groups. Deep venous reflux was more frequent in thrombophilic patients.CONCLUSION:There were no significant differences between groups with respect to most of the variables studied, except for a higher frequency of pulmonary embolism in non-thrombophilic patients and greater frequency of deep venous reflux in thrombophilic patients.

DNA methylation patterns of steroid receptor genes ESR1, ESR2 and PGR in deep endometriosis compromising the rectum

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

An integrable evolution equation for surface waves in deep water

In order to describe the dynamics of monochromatic surface waves in deep water, we derive a nonlinear and dispersive system of equations for the free surface elevation and the free surface velocity from the Euler equations in infinite depth. From it, and using a multiscale perturbative method, an asymptotic model for small wave steepness ratio is derived. The model is shown to be completely integrable. The Lax pair, the first conserved quantities as well as the symmetries are exhibited. Theoretical and numerical studies reveal that it supports periodic progressive Stokes waves which peak and break in finite time. Comparison between the limiting wave solution of the asymptotic model and classical results is performed.

Prototype Fault Current Limiter Using Transformer and a Modular Device of YBCO Coated Conductor

A superconducting fault current limiter (SCFL) consisted of a transformer with low reactance connected to the power line and with the secondary winding short-circuited by a modular superconducting limiter device with 16 elements connected in series was constructed and tested. The designed coupling transformer has low dispersion reactance in order to limit the voltage drop in the power line within the range of 5 % to 10 %. The experimental results showed that an insertion of a 0.125 Omega resistance limited the peak current to a factor of 2.5 times of the unlimited current. The power dissipation reached 39 kW during 100 ms, with an energy density of 380 J/cm(3). Based on these results, the SCFL will be further tested in a 3 MVA (15 kV/380 V) generator for currents up to 10 kA.