32 resultados para Catheter ablation

em Repositório Institucional UNESP - Universidade Estadual Paulista "Julio de Mesquita Filho"


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Pós-graduação em Bases Gerais da Cirurgia - FMB

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

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O uso de cateter intermitente representa um procedimento muito utilizado em ambiente hospitalar. Este estudo, de natureza experimental, teve como propósito a análise comparativa entre o cateter intermitente, preenchido com solução de heparina 100 U/ml e o preenchido com soro fisiológico 0,9%. Foi realizado um estudo comparativo, avaliando a formação de coágulos e se estes estivessem presentes seriam quantificados. Para tanto, foram utilizados quatro grupos de 7 coelhos, da linhagem Norfolk, sendo realizado acesso venoso em veia auricular conectado ao dispositivo de infusão múltipla. em dois destes grupos, foi usada solução salina; em um grupo, caso fosse encontrada resistência, esta seria forçada; no outro, esta resistência não seria forçada. Nos dois outros grupos, foi usada solução de heparina; em um grupo, caso fosse encontrada resistência, esta seria forçada; no outro esta resistência não seria forçada. O cateter intermitente foi mantido por 72 horas e, a cada 12 horas foi infundida água destilada, simulando a administração de medicamento. Durante o experimento foram observadas as seguintes variáveis: presença da formação de coágulos, comprimento do coágulo, peso fresco do coágulo, peso seco do coágulo, contagem plaquetária e desconforto. Na análise estatística feita pelo método não paramétrico Kruskal-Wallis, com nível de significância de sigma = 5%, não foi encontrada diferença significativa entre os grupos e momentos. Pôde-se constatar a presença de formação de coágulo em todos os grupos independentemente da solução de preenchimento. Concluímos, principalmente, que há necessidade de elaboração de novas normas e rotinas na utilização de cateter intermitente.

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Este estudo prospectivo avaliou os métodos semiquantitativo e qualitativo de cultura de cateter para o diagnóstico de infecção relacionada a cateter (IRC) em recém-nascidos (RN). Foram incluídas pontas de cateteres provenientes de recém-nascidos internados na Unidade Neonatal do Hospital das Clínicas da Faculdade de Medicina de Botucatu, UNESP. Foram utilizadas as técnicas semiquantitativa e qualitativa de cultura de cateter. Para o diagnóstico de IRC, os microrganismos isolados das culturas de cateteres e de hemoculturas periféricas foram identificados e submetidos ao teste de sensibilidade a antimicrobianos. O padrão ouro correspondeu ao diagnóstico de certeza de IRC, com o isolamento do mesmo microrganismo (espécie e perfil de sensibilidade a antimicrobianos) isolado em hemocultura periférica. Foram estudados 85 cateteres provenientes de 63 RN. A cultura semiquantitativa, embora tenha apresentado menor sensibilidade (90%), apresentou uma maior especificidade (71%) em comparação à sensibilidade de 100% e especificidade de 60% encontradas na cultura qualitativa. Através da identificação dos microrganismos obtidos nas culturas de cateteres, observou-se uma predominância de espécies de Estafilococos coagulase-negativa (ECN). A espécie Staphylococcus epidermidis foi a prevalente (77,5%) nos cateteres com culturas semiquantitativas positivas. Dos 11 episódios de IRC diagnosticados, 8 (72,7%) foram associados a espécies de ECN, dos quais 6 eram da espécie S. epidermidis. Também foram detectados dois casos de IRC por S. aureus e um caso por Candida parapsilosis. O método de cultura semiquantitativo cateter apresentou vantagens para o diagnóstico de IRC em RN quando comparado com o método qualitativo tradicional.

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Objective: To determine the number of colony-forming units (CFU) that best correlates with catheter-related infections (CRI) in newborns.Methods: This was a prospective study of semiquantitative cultures of catheter tips obtained from newborns in the neonatal unit at Faculdade de Medicina de Botucatu, state of São Paulo, Brazil. The microorganisms isolated from catheter and peripheral blood cultures were identified and submitted to a drug susceptibility test. The optimal cutoff point was determined by the receiver operating characteristic (ROC) curve.Results: A total of 85 catheters obtained from 63 newborns were studied. Staphylococcus epidermidis was the predominant species in the catheters (75%). Eight of 11 (72.7%) CRI episodes were associated with coagulase-negative staphylococci, six of which were of the S. epidermidis type. ROC curve analysis indicated that the optimal cutoff point for the diagnosis of CRI was 122 CFU.Conclusions: The cutoff point of 122 CFU correlated best with the diagnosis of CRI in newborns.

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Titanium surface texture and chemistry modification successfully improves the host response and consequently the bone-to-implant contact surrounding dental implants. The aim of the present study was to investigate, using histomorphometrical-analysis, the effects of titanium surface modification by laser-ablation (Nd:YAG) followed by thin chemical deposition of HA. Forty-eight rabbits received one implant by tibiae of AS-machined (MS), laser-modified (LMS), or biomimetic hydroxyapatite-coated (HA) surface. Bone-to-implant contact (BIC) and bone area (BBT) were evaluated after 4, 8, and 12 weeks, at cortical and cancellous regions. Average BIC in the cortical region was higher (P < 0.001) on the LMS and HA implants for all periods, with no differences between LMS and HA. For the cancellous area, the LMS and HA implants showed higher (P < 0.01) BIC than MS at the initial periods. The LMS and HA showed similar values in the cortical region, but a tendency of higher values for HA in the cancellous region was observed in all periods. For the BBT, the differences were found only between HA and MS after 4 weeks in the cortical region (P < 0.05), and after 12 weeks in the cancellous area (P < 0.05). Our results showed that HA biomimetic coating preceded by laser treatment induced the contact osteogenesis and allowed the formation of a more stable boneimplant interface, even in earlier periods. Microsc. Res. Tech., 2012. (C) 2012 Wiley Periodicals, Inc.

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The nucleus of the solitary tract (NTS) receives primary afferents involved in cardiovascular regulation. We investigated the role of NK1-receptor bearing neurons in the NTS on cardiovascular reflexes in awake rats fitted with chronic venous and arterial cannulae. These neurons were lesioned selectively with saporin conjugated with substance P (SP-SAP, 2 mu M, bilateral injections of 20 nL in the subpostremal NTS, or 200 nL in both the subpostremal and the commissural NTS). Before, and 7 and 14 days after injection of SP-SAP, we measured changes in blood pressure and heart rate induced by i.v. injection of phenylephrine and nitroprusside (baroreceptor reflex), cyanide (arterial chemoreceptor reflex), and phenylbiguanide (Bezold-Jarisch reflex). The smaller injections with SP-SAP completely abolished NK1 receptor staining in the subpostremal NTS. The larger injections abolished NK1 receptor immunoreactivity in an area that extended from the commissural NTS to the rostral end of the subpostremal NTS. The lesions seemed to affect only a limited number of neurons, since neutral red stained sections did not show any obvious reduction in cell number. The smaller lesions reduced the gain of baroreflex bradycardia and the hypotension induced by phenylbiguanide. The larger lesions completely abolished the response to phenylbiguanide, blocked the baroreflex bradycardia induced by phenylephrine, severely blunted the baroreflex tachycardia, and blocked the bradycardia and reduced the hypertension induced by cyanide. Thus, these responses depend critically on NK1-receptor bearing neurons in the NTS. (c) 2006 Elsevier B.V. All rights reserved.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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By means of IR spectroscopy, we determined the teeth ablation mechanism by an Er:YAG laser oscillating at 2.94 mum. Ejected dental material, ablated by the laser from human teeth, was deposited on an IR window and the absorption spectra were measured in the range 2500-20,000 nm. Sound teeth were used, and the corresponding film spectra were compared to spectra obtained by traditional methods. The films spectra obtained do not differ appreciably from those obtained by the traditional method for sound teeth, indicating that the material ejected by an Er:YAG represents the tooth condition.The obtained results confirm that a spectroscopic analysis of a tooth treated with an Er:YAG laser can be done measuring the absorbance of a film composed of ejected material without the need to slice it. In addition, we could determine that the laser absorption occurs mainly by the interstitial water, and the temperature elevation of the ejected material does not exceed 60degreesC. (C) 2002 Elsevier B.V. B.V. All rights reserved.

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This study was conducted to analyze the ablation rate and micromorphological aspects of microcavities in enamel and dentin of primary and permanent teeth using a Er:YAG laser system. Micromorphological evaluation has been performed in terms of permanent teeth; however, little information about Er: YAG laser interaction with primary teeth can be found in the literature. Because children have been the most beneficiary patients with laser therapy in our offices, it is extremely necessary to compare the effects of this kind of laser system on the enamel and dentin of permanent and primary teeth. In this study, we used eleven intact primary anterior exfoliated teeth and six extracted permanent molar teeth. We used a commercial laser system: a Er: YAG Twin Light laser system (Fotona Medical Lasers, Slovenia) at 2940 nm, changing average energy levels per pulse ( 100, 200, 300, and 400 mJ) producing 48 microcavities in enamel and dentin of primary and permanent teeth. Primary teeth are more easily ablated than are permanent teeth, when related to enamel or dentin. However, while this laser system is capable of slowly revealing the enamel's microstructure, in dentin only the lowest laser energies permit this kind of observation, more easily decomposing the original tissue aspect, when related to primary or permanent teeth. Statistically, the only different factor at the 5% level was an energy per pulse of 400 mJ, confirming the results found in SEM. Our results showed that dentin in both primary and permanent teeth is less resistant to Er: YAG laser ablation; this fact is easily observed under SEM observation and through the ablation rate evaluation.

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A regimen of progesterone plus estradiol (P&E) was used as a standard for ovarian synchronization to test the efficacy and evaluate the commercial application of ultrasound-guided follicle ablation as a non-steroidal alternative for ovulation synchronization in mares. Recipient mares at a private embryo transfer facility were at unknown stages of the estrous cycle at the start of the experiment on Day 1 when they were randomly assigned to an ablation group (n = 18-21 mares) or to a ME group (n = 20-21 mares). In the ablation group, mares were lightly sedated and all follicles > 10 mm were removed by transvaginal ultrasound-guided follicle aspiration. In the ME group, a combination of progesterone (150 mg) plus estradiol (10 mg) prepared in safflower oil was given daily (im) for 10 d. Two doses of prostaglandin FZ, (PGF, 10 mg/dose, im) were given 12 h apart on Day 5 in the ablation group, or a single dose on Day 10 in the ME group. Human chorionic gonadotropin (hCG, 2500 IU/mare, im) was given at a fixed time, 6 and 10 d after PGF treatment in the ablation and ME groups, respectively, with the expectation of a follicle > 30 mm at the time of treatment. In both the ablation and P&E groups, transrectal ultrasonography was done at the start of the study (Day 1) and again on the day of hCG treatment and daily thereafter to determine the presence of a CL, measure diameter of the largest follicle and detect ovulation. The mean interval from the start of the study and from PGF treatment to ovulation was shorter (P < 0.0001) in the ablation group (13.7 and 9.7 d, respectively) compared to the P&E group (22.3 and 13.2 d, respectively). Following fixed-day treatment with hCG after PGF treatment, the degree of ovulation synchronization was not different (P > 0.05) between the ablation and P&E groups within a 2-d (56 and 70%) or 4-d (83% and 90%) period. Although ultrasound-guided follicle ablation may not be practical in all circumstances, it excluded the conventional 10-d regimen of progesterone and estradiol and was considered an efficacious and feasible, non-steroidal alternative for ovulation synchronization in mares during the estrous cycle. (C 2007 Elsevier B.V. All rights reserved.