88 resultados para ablation
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Pós-graduação em Medicina Veterinária - FCAV
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PURPOSE: Systematic reviews are criticized for frequently offering inconsistent evidences and absence of straightforward recommendations. Their value seems to be depreciated when the conclusions are uncertain. To describe an alternative approach of evaluating case series studies in health care when there is absence of clinical trials. METHODS: We provide illustrations from recent experiences. Proportional meta-analysis was performed on surgical outcomes: (a) case series studies, (b) use of cryoablation or radiofrequency ablation, and (c) patients with small renal cell carcinoma. The statistically significant difference between both interventions studied was defined if their combined 95% confidential interval (CI) did not overlap. RESULTS: As demonstrated by the example, this analysis is an alternative approach to provide some evidence of the intervention´s effects under evaluation and plotting all available case series in the absence of clinical trials for the health field. CONCLUSIONS: Although we are leading to a low level of evidence to determine efficacy, effectiveness and safety of interventions this alternative approach can help surgeons, physicians and health professionals for a provisionally decision in health care along with their clinical expertise and the patient´s wishes and circumstances in the absence of high-quality primary studies. It´s not a replacement for the gold standard randomized clinical trial, but an alternative analysis for clinical research.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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The Finite Element Method (FEM) is a way of numerical solution applied in different areas, as simulations used in studies to improve cardiac ablation procedures. For this purpose, the meshes should have the same size and histological features of the focused structures. Some methods and tools used to generate tetrahedral meshes are limited mainly by the use conditions. In this paper, the integration of Open Source Softwares is presented as an alternative to solid modeling and automatic mesh generation. To demonstrate its efficiency, the cardiac structures were considered as a first application context: atriums, ventricles, valves, arteries and pericardium. The proposed method is feasible to obtain refined meshes in an acceptable time and with the required quality for simulations using FEM.
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Background: Cancer pain severely limits function and significantly reduces quality of life. Subtypes of sensory neurons involved in cancer pain and proliferation are not clear.Methods: We produced a cancer model by inoculating human oral squamous cell carcinoma (SCC) cells into the hind paw of athymic mice. We quantified mechanical and thermal nociception using the paw withdrawal assays. Neurotoxins isolectin B4-saporin (IB4-SAP), or capsaicin was injected intrathecally to selectively ablate IB4(+) neurons or TRPV1(+) neurons, respectively. JNJ-17203212, a TRPV1 antagonist, was also injected intrathecally. TRPV1 protein expression in the spinal cord was quantified with western blot. Paw volume was measured by a plethysmometer and was used as an index for tumor size. Ki-67 immunostaining in mouse paw sections was performed to evaluate cancer proliferation in situ.Results: We showed that mice with SCC exhibited both mechanical and thermal hypersensitivity. Selective ablation of IB4(+) neurons by IB4-SAP decreased mechanical allodynia in mice with SCC. Selective ablation of TRPV1(+) neurons by intrathecal capsaicin injection, or TRPV1 antagonism by JNJ-17203212 in the IB4-SAP treated mice completely reversed SCC-induced thermal hyperalgesia, without affecting mechanical allodynia. Furthermore, TRPV1 protein expression was increased in the spinal cord of SCC mice compared to normal mice. Neither removal of IB4(+) or TRPV1(+) neurons affected SCC proliferation.Conclusions: We show in a mouse model that IB4(+) neurons play an important role in cancer-induced mechanical allodynia, while TRPV1 mediates cancer-induced thermal hyperalgesia. Characterization of the sensory fiber subtypes responsible for cancer pain could lead to the development of targeted therapeutics.
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A decreased radioiodine uptake is frequently detected in differentiated thyroid carcinomas (DTC) and is associated with high recurrence rate and reduced survival. We investigated the correlation between NIS mRNA expression levels in the primary tumor and patient outcome using a quantitative real-time RT-PCR method. NIS expression was decreased in 17 DTC (21.04 +/- 39.66 pg Eq) compared to four autoimune thyroid disease (180.51 +/- 92.63 pg Eq) and 14 normal tissues (75.71 +/- 66.98 pg Eq) (p < 0.0001). The 17 thyroid differentiated carcinoma patients were submitted to surgery complemented by radioiodine ablation and had at least 24 months of follow-up, under levothyroxine continued suppressive therapy. According to their outcome, we could characterize a group of papillary carcinoma patients with aggressive carcinomas, whose NIS mRNA levels were markedly lower than a group with non-aggressive carcinomas (0.62 +/- 0.79 versus 54.87 +/- 53.79: p < 0.005). We suggest that the quantification of NIS mRNA relative levels in the primary tumor may predict poor outcome. (C) 2003 Elsevier Ireland Ltd. All rights reserved.
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The main objective of this research work was to obtain two formulations of ablative composites. These composites are also known as ablative structural composites, for applications in atmospherically severe conditions according to the high-temperature, hot gaseous products flow generated from the burning of solid propellants. The formulations were manufactured with phenolic resin reinforced with chopped carbon fiber. The composites were obtained by the hot compression molding technique. Another purpose of this work was to conduct the physical and chemical characterization of the matrix, the reinforcements and the composites. After the characterization, a nozzle divergent of each formulation was manufactured and its performance was evaluated through the rocket motor static firing test. According to the results found in this work, it was possible to observe through the characterization of the raw materials that phenolic resins showed peculiarities in their properties that differentiate one from the other, but did not exhibit significant differences in performance as a composite material for use in ablation conditions. Both composites showed good performance for use in thermal protection, confirmed by firing static tests (rocket motor). Composites made with phenolic resin and chopped carbon fiber showed that it is a material with excellent resistance to ablation process. This composite can be used to produce nozzle parts with complex geometry or shapes and low manufacturing cost.
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Although several studies of Araxá Group in the region of Passos, just a few works deal with the age of metamorphism of this group. The current work aims to determine the cooling age of these rocks by in situ U-Pb dating in rutiles. Interestingly, the region of São Sebastião do Paraíso shows a condensed lithostratigraphic column from the Passos Nappe and exposes the higher metamorphic grade rocks described for this unit. The use of rutile as a geochronometer is based on its ability to incorporate U in its structure, facilitating the calculation of the age of the isotope ratio by U-Pb. Furthermore, the use of in situ dating technique with Laser Ablation has been a reliable and advantageous study because the analysis are punctual, and do not destroy the whole sample to be analyzed. The analyses of this work were made at the University of Gothenburg - Sweden and obtained 238U/206Pb ages between 608-566 ± 10 Ma and 235U/207Pb between 627-572 ± 10 Ma, showing that these ages are concordant with the literature in the area and are interpreted as the cooling age of metamorphism
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Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB
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Ideally projected to be applied on soft tissues, infrared lasers were improved by restorative dentistry to be used in hard dental tissues cavity preparations-namely enamel and dentin. This paper evidentiates the relevant aspects of infrared Erbium laser's action mechanism and its effects, and characterizes the different effects deriving from the laser's beams emission. The criteria for use and selection of optimal parameters for the correct application of laser systems and infuence of supporting factors on the process, such as water amount and its presence in the ablation process, protection exerted by the plasma shielding and structural factors, which are indispensable in dental tissues cavity preparation related to restorative technique, are subordinated to optical modifcations caused by the interaction of the energy dissipated by these laser light emission systems in the targeted tissue substrate. Clinical relevance: Differences in the action of infrared Erbium laser system in regard to the nature of the ablation process and variations on the morphological aspects observed in the super-fcial structure of the target tissue irradiated, may be correlated to the structural optical modifcations of the substrate produced by an interaction of the energy propagated by laser systems.
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Pós-graduação em Medicina Veterinária - FMVZ