95 resultados para Estenose da válvula aórtica


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O presente trabalho foi desenvolvido no Centro de Raízes e Amidos Tropicais – CERAT, Na UNESP em Botucatu, estado de São Paulo onde foram realizados ensaios de fermentação alcoólica com hidrolisado de amido de mandioca. A fécula de mandioca foi utilizada como fonte de carboidrato para obtenção dos açúcares redutores consumidos no processo. Em um reator agitado foi produzido 12Kg de hidrolisado a partir de suspensão de fécula a 30% (p/p) utilizando enzimas alfa amilase na primeira etapa, seguida de amiloglucosidase na etapa posterior. As dosagens em unidades enzimáticas foram 2KNU.g-1 de amido e 2AGU.g-1 de amido respectivamente. O planejamento experimental considerou a realização de três ensaios de hidrolisados e três ensaios de fermentação a partir do mosto produzido; a) mosto aerado; b) com microaeração; c) em meio anaeróbio. Os ensaios foram realizados em erlenmeyers com 2,5 Kg de hidrolisado, ajustado a concentração de glicose a 100g.L-1 sendo inoculada a levedura do gênero Saccharomyces cerevisiae à taxa de 1,5% (p/p). Todos os erlenmeyers foram colocados sob agitação orbital e temperatura controlada de 30ºC sendo acompanhado o processo de fermentação através de coleta de amostras do mosto a cada hora. A aeração nos frascos erlenmeyers foi realizada através de mangueira coletora de válvula que regulava a vazão de ar. De acordo com os dados obtidos pode se concluir que o sistema anaeróbio em 32h foi o mais eficiente para a produção de etanol. Também foi possível observar que enquanto ocorre aeração no meio não se observa alteração significativa na concentração de etanol e quando cessa a aeração o meio torna se anaeróbio e tem início a produção de etanol. Quando aumenta a concentração de etanol no meio, o crescimento celular do sistema anaeróbio cai e etanol inibe a levedura, parando o crescimento celular.

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Endovascular aortic aneurysm repair (EVAR) involving renal and visceral arteries remains a great challenge. Several techniques have been developed over the time to treat juxtarenal, pararenal and thoracoabdominal aneurysms, highlighting the fenestrated and branched endografts, parallel prostheses as Chimney, Periscope and Sandwich Techniques and the use of flow modulation by multilayer stent. We report a case of saccular juxtarenal aortic aneurysm with high surgical risk for complex airway access due to a history of radical laryngectomy for laryngeal neoplasm. Due to chronic aorto-iliac obstructive disease, ostial stenosis of renal artery and limited diameter of the suprarenal aorta, we discarded options involving fenestrated/branched endografts and involving parallel prostheses techniques. We present this case as a therapeutic challenge and a successful treatment option in the short-term evaluation.

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Gastroesophageal reflux disease (GERD) is probably one of the most prevalent diseases in the world that also compromises the quality of life of the affected significantly. Its incidence in Brazil is 12%, corresponding to 20 million individuals. OBJECTIVE: To update the GERD management and the new trends on diagnosis and treatment, reviewing the international and Brazilian experience on it. METHOD: The literature review was based on papers published on Medline/Pubmed, SciELO, Lilacs, Embase and Cochrane crossing the following headings: gastroesophageal reflux disease, diagnosis, clinical treatment, surgery, fundoplication. RESULTS: Various factors are involved on GERD physiopathology, the most important being the transient lower esophageal sphincter relaxation. Clinical manifestations are heartburn, regurgitation (typical symptoms), cough, chest pain, asthma, hoarseness and throat clearing (atypical symptoms), which may be followed or not by typical symptoms. GERD patients may present complications such as peptic stenosis, hemorrhage, and Barrett's esophagus, which is the most important predisposing factor to adenocarcinoma. The GERD diagnosis must be based on the anamnesis and the symptoms must be evaluated in terms of duration, intensity, frequency, triggering and relief factors, pattern of evolution and impact on the patient's quality of life. The diagnosis requires confirmation with different exams. The goal of the clinical treatment is to relieve the symptoms and surgical treatment is indicated for patients who require continued drug use, with intolerance to prolonged clinical treatment and with GERD complications. CONCLUSION: GERD is a major digestive health problem and affect 12% of Brazilian people. The anamnesis is fundamental for the diagnosis of GERD, with special analysis of the typical and atypical symptoms (duration, intensity, frequency, triggering and relief factors, evolution and impact on the life quality). High digestive endoscopy and esophageal pHmetry are the most sensitive diagnosctic methods. The clinical treatment is useful in controlling the symptoms; however, the great problem is keeping the patients asymptomatic over time. Surgical treatment is indicated for patients who required continued drug use, intolerant to the drugs and with complicated forms of GERD.

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The main disturbs affecting the genital segment of bulls are balanitis, phimosis and preputial injuries, abscesses or prolapses, resulting in decreased libido or mating ability. One case of traumatic phimosis with partial obliteration of preputial lumen is reported in Aberdeen Angus bull. During anamnesis, it was reported that the animal was unable to expose the penis and presented increased penile and preputial volume of unknown etiology after being submitted to a libido test. During clinical examination, a firm preputial mass of 15 cm in diameter was observed in the middle third of the prepuce and stenosis of preputial lumen was detected approximately 17 cm from the preputial orifice. Reconstructive surgery was the chosen therapy, with amputation of the affected foreskin portion. A skin segment of about 12 cm and affected mucosal portion were removed. Postoperative therapy consisted of dressing with chlorhexidine digluconate based ointment, povidone iodine and topical insect repellent (cypermethrin and carbamyl), systemic antibiotic therapy with benzathine penicillin (30,000 IU / kg, repeated after 48 hours) and anti-inflammatory therapy with flunixin meglumine (2 , 0 mg / kg SID) for three days. After twenty days, semen was collected by massage of the accessory glands. The ejaculate volume was 3 mL, with 200x106 spermatozoa / mL, white color, "suis generis" odor, 88% of motile sperm, 64% of progressively motile sperm and 82% of rapid sperm. Thus, the chosen surgical treatment was effective to correct the pathology and reintroduce the animal into reproductive activity

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Since ancient times, it has been a huge challenge to all people around the world to manage to get their fresh water, keeping it clean and providing it to every human being, so that it can be used for their daily needs. This is especially true for small properties in the countryside and in isolated areas with low demographic density. Pumping the water in those regions is a solution that rationalizes its use in domestic chores, in animal rearing and in the irrigation systems of cultivated areas. Making feasible local, renewable and non-polluted energetic alternatives is the aim for those areas that are usually far away from the public electric network. Using photovoltaic solar energy is the alternative now proposed. For this objective was built a system with two monocrystalline panels, one pump, two water tanks, two level sensors and a solenoid valve to pump water, using a pump powered an array of monocrystalline solar panels. The main goal was to compare their rate of water flow and their energy consumption. The use of one data acquisition equipment allowed collecting meteorological, electrical and hydraulic values, and also serving for the control and activation of the pumping system. During four months in a row as from April 2009, arrangements with one or two panels were tested. Mathematics correlations and adjustment lines were used to interpret the behavior of obtained dataset. During the analyzed period the system followed the linear equations with great accuracy. The daily average amount of water pumped by the several tested arrays stayed between 1,100 and 2,500 liters, and that is enough to supply a small rural property. The pumping system with two panels effectively showed the major amount of water, but a system with one panel can be an economical solution until 1,500 liters on day. It did not characterize a direct relationship between power or quantity of photovoltaic panels and daily outflow of water pumping.