RESONANCES EXCITED BY THE (9)Be((6)Li,d) (13)C REACTION

Alpha resonant states in (13)C tu to 15MeV were excited by the (9)Be ((6)Li,d) (13)C reaction, The data were taken at a bombarding energy of 25.5 MeV employing the sao Paulo-Pelletron-Enge Split Pole facility and the nuclear emulsion technique. The resolution of 50 keV allowed for the separation of the resonant contributions to the known 7/2(-) and (5/2(-)) states near the (9)Be + alpha threshold both associated with an L = 4 transfer. Several narrow alpha resonant states not previously measured were detected, in particular the one at the 3 alpha + n threshold populated by an L = 2 transfer, revealing a (9)Be + alpha component for the 1/2(-) cluster state candidate at this threshold.

Searching for resonances in the unbound Be-6 nucleus by using a radioactive Be-7 beam

Knowledge of the He-3(He-3,2p)He-4 reaction is important for understanding stellar burning and solar neutrino production. Previous measurements have found a surprisingly large rise in the cross section at low energies that could be due to a low-energy resonance in the He-3 + He-3 (Be-6) system or electron screening. In the Be-6 nucleus, however, no excited states have been observed above the first 2(+) state at E (x) = 1.67 MeV up to 23 MeV, even though several are expected. The H-2(Be-7,H-3)Be-6 reaction has been studied for the first time to search for resonances in the Be-6 nucleus that may affect our understanding of the He-3(He-3,2p)He-4 reaction. A 100-MeV radioactive Be-7 beam from the Holifield Radioactive Ion Beam Facility (HRIBF) was used to bombard CD2 targets, and tritons were detected by using the silicon detector array (SIDAR). A combination of reaction mechanisms appears to be necessary to explain the observed triton energy spectrum.

Speciation of arsenic metabolites in the urine of occupational workers and experimental rats using an optimised hydride cold-trapping method

A hydride cold-trapping technique was developed and optimised for the measurement of urinary arsenic metabolites. The analytical precision of the method was found to be 6.1, 4.0 and 4.8% (n = 5) for inorganic arsenic (As-i), monomethylarsonate (MMA) and dimethylarsinate (DMA), respectively, with recoveries close to 100%, The detection limits were 1.0, 1.3 and 3 ng for As-i, MMA and DMA, respectively. The method was then used to analyse urine samples obtained from three groups of workers for occupational exposure in three companies where copper chrome arsenate was used for timber treatment. The results were compared with those for a normal control group of laboratory workers. Arsenic and its metabolites were also measured in experimental rats given 5 mg As kg(-1) body mass by oral gavage in the form of sodium arsenite, calcium arsenite or sodium arsenate. Occupational workers showed a significantly higher excretion of As-i, Up to two fold increases of urinary As-i excretion in rats compared with control rats were also observed in animals dosed with various forms of arsenicals. The method is suitable for the measurement of arsenic metabolites in urine of both humans and experimental animals.

Reproducibility of the cycling time to exhaustion at VO(2)peak in highly trained cyclists

The purpose of the present study was to examine, in highly trained cyclists, the reproducibility of cycling time to exhaustion (T-max) at the power output equal to that attained at peak oxygen uptake ((V) over dot O(2)peak) during a progressive exercise test. Forty-three highly trained male cyclists (M +/- SD; age = 25 +/- 6yrs; weight = 75 +/- 7 kg; (V) over dot(2)peak = 64.8 +/- 5.2 ml.kg(-1) . min(-1)) performed two T-max tests one week apart. While the two measures of T-max were strongly related (r = 0.884; p < 0.001), T-max from the second test (245 +/- 57 s) was significantly higher than that of the first (237 +/- 57 s; p = 0.047; two-tailed). Within-subject variability in the present study was calculated to be 6 +/- 6%, which was lower than that previously reported for Tmax in sub-elite runners (25%). The mean T-max was significantly (p < 0.05) related to both the second ventilatory turnpoint (VT2; r = 0.38) and to (V) over dot O(2)peak (r = 0.34). Despite a relatively low within-subject coefficient of variation, these data demonstrate that the second score in a series of two T-max tests may be significantly greater than the first. Moreover the present data show that T-max in highly trained cyclists is moderately related to VT2 and (V) over dot O(2)peak.

A go-to-market strategy for vertebral metrics

Dissertação para obtenção do Grau de Mestre em Engenharia Biomédica

Méthodologie intégrée de microgravimétrie en milieu urbain : test d'application au génie civil sur le métro M2 de Lausanne

RESUME Dès le printemps 2004, la construction d'une 2ème ligne de métro est entreprise dans la ville de Lausanne en Suisse. En reliant Ouchy, au bord du lac Léman (alt. 373 m) à Epalinges (alt. 711 m), le nouveau métro "M2" traversera dès 2008 l'agglomération lausannoise du Sud au Nord sur une distance de 6 km. Depuis l'avant-projet, en 1999, une grande quantité de données géologiques a été récolté et de nombreux forages exécutés sur le site. Ceci nous a donné une occasion unique d'entreprendre une étude de microgravimétrique urbaine de détail. Le mode de creusement du tunnel dépend fortement des matériaux à excaver et il est classiquement du domaine du géologue, avec ses connaissances de la géologie régionale et de la stratigraphie des forages, de fournir à l'ingénieur un modèle géologique. Ce modèle indiquera dans ce cas l'épaisseur des terrains meubles qui recouvrent le soubassement rocheux. La représentativité spatiale d'une information très localisée, comme celle d'un forage, est d'autant plus compliquée que le détail recherché est petit. C'est à ce moment là que la prospection géophysique, plus spécialement gravimétrique, peut apporter des informations complémentaires déterminantes pour régionaliser les données ponctuelles des forages. La microgravimétrie en milieu urbain implique de corriger avec soin les perturbations gravifiques sur la mesure de la pesanteur dues aux effets de la topographie, des bâtiments et des caves afin d'isoler l'effet gravifique dû exclusivement à l'épaisseur du remplissage des terrains meubles. Tenant compte de l'intensité des corrections topographiques en milieu urbain, nous avons donné une grande importance aux sous-sols, leurs effets gravifiques pouvant atteindre l'ordre du dixième de mGal. Nous avons donc intégré ces corrections celle de topographie et traité les effets des bâtiments de manière indépendante. Nous avons inclus dans le modèle numérique de terrain (MNT) la chaussée et les sous-sols afin de construire un modèle numérique de terrain urbain. Nous utiliserons un nouvel acronyme « MNTU »pour décrire ce modèle. Nous proposons d'établir des cartes de corrections topographiques préalables, basées sur les données à disposition fournies par le cadastre en faisant des hypothèses sur la profondeur des sous-sols et la hauteur des bâtiments. Les deux zones de test choisies sont caractéristiques des différents types d'urbanisation présente à Lausanne et se révèlent par conséquent très intéressantes pour élaborer une méthodologie globale de la microgravimétrie urbaine. Le but était d'évaluer l'épaisseur du remplissage morainique sur un fond rocheux molassique se situant à une profondeur variable de quelques mètres à une trentaine de mètres et d'en établir une coupe dans l'axe du futur tracé du métro. Les résultats des modélisations se sont révélés très convaincants en détectant des zones qui diffèrent sensiblement du modèle géologique d'avant projet. Nous avons également démontré que l'application de cette méthode géophysique, non destructive, est à même de limiter le nombre de sondages mécaniques lors de l'avant-projet et du projet définitif, ce qui peut limiter à la fois les coûts et le dérangement engendré par ces travaux de surface. L'adaptabilité de la technique gravimétrique permet d'intervenir dans toutes les différentes phases d'un projet de génie civil comme celui de la construction d'un métro en souterrain. KURZFASSUNG Seit dem Frühling 2004 ist in der Stadt Lausanne (Schweiz) die neue U-Bahn "M2" in Konstruktion. Diese soll auf 6 km Länge die Lausanner Agglomeration von Süd nach Nord durchqueren. Die dem Projekt zu Grunde liegende technische Planung sieht vor, daß die Bahnlinie hauptsächlich in der Molasse angesiedelt sein wird. Seit dem Vorentwurf (1999) ist eine große Anzahl geologischer Angaben gesammelt worden. Daraus ergab sich die einmalige Gelegenheit, die Informationen aus den damit verbundenen zahlreichen Bohrungen zu einer detaillierten mikrogravimetrischen Studie der Stadt Lausanne zu erweitern und zu vervollständigen. Das Ziel bestand darin, die Mächtigkeit der die Molasseüberdeckenden Moräneablagerung abzuschätzen, um eine entsprechendes geologisches Profile entlang der künftigen Bahnlinie zu erstellen. Weiterhin sollte gezeigt werden, daß die Anwendung dieser nicht-invasiven geophysikalischen Methode es ermöglicht, die Anzahl der benötigten Bohrungen sowohl in der Pilotphase wie auch im endgültigen Projekt zu reduzieren, was zu wesentlichen finanziellen Einsparungen in der Ausführung des Werkes beitragen würde. Die beiden in dieser Studie bearbeiteten Testzonen befinden sich im Nordteil und im Stadtzentrum von Lausanne und sind durch eine unterschiedliche Urbanisierung charakterisiert. Das anstehende Gestein liegt in verschiedenen Tiefen: von einigen Metern bis zu etwa dreißig Metern. Diese Zonen weisen alle Schwierigkeiten einer urbanen Bebauung mit hoher Verkehrsdichte auf und waren daher massgebend bei der Ausarbeitung einer globalen mikrogravimetrischen Methodologie für die Stadt Lausanne. Die so entwickelte Technik ermöglicht, die störenden Auswirkungen der Topographie, der Gebäude, der Keller und der Öffentlichen Infrastrukturen sorgfältig zu korrigieren, um so die ausschließlich auf die Mächtigkeit des Lockergesteins zurückzuführenden Effekte zu isolieren. In Bezug auf die Intensität der Auswirkungen der topographischen Korrekturen im Stadtgebiet wurde den Untergeschossen eine besonders grosse Bedeutung zugemessen da die entsprechenden Schwerkrafteffekte eine Grösse von rund einem Zehntel mGal erreichen können. Wir schlagen deshalb vor, vorläufige Karten der topographischen Korrekturen zu erstellen. Diese Korrekturen basieren auf den uns vom Katasterplan gelieferten Daten und einigen Hypothesen bezüglich der Tiefe der Untergeschosse und der Höhe der Gebäude. Die Verfügbarkeit einer derartigen Karte vor der eigentlichen gravimetrischen Messkampagne würde uns erlauben, die Position der Meßstationen besser zu wählen. Wir sahen zudem, daß ein entsprechenden a priori Filter benutzt werden kann, wenn die Form und die Intensität der Anomalie offensichtlich dem entsprechenden Gebäude zugeordnet werden können. Diese Strategie muß jedoch mit Vorsicht angewandt werden, denn falls weitere Anomalien dazukommen, können bedeutende Verschiebungen durch Übèrlagerungen der Schwerewirkung verschiedener Strukturen entstehen. Die Ergebnisse der Modellierung haben sich als sehr überzeugend erwiesen, da sie im Voraus unbekannte sensible Zonen korrekt identifiziert haben. Die Anwendbarkeit der in dieser Arbeit entwickelten gravimetrischen Technik ermöglicht es, während allen Phasen eines Grossbauprojekts, wie zum Beispiel bei der Konstruktion einer unterirdischen U-Bahn, einzugreifen. ABSTRACT Since Spring of 2004 a new metro line has been under construction in the city of Lausanne in Switzerland. The new line, the M2, will be 6 km long and will traverse the city from south to north. The civil engineering project determined that the line would be located primarily in the Molasse. Since the preparatory project in 1999, a great quantity of geological data has been collected, and the many drillings made on the site have proved to be a unique opportunity to undertake a study of urban microgravimetry. The goal was to evaluate the thickness of the morainic filling over the molassic bedrock, and to establish a section along the axis of the future line. It then had to be shown that the application of this nondestructive geophysical method could reduce the number of mechanical surveys required both for a preparatory and a definitive project, which would lead to real savings in the realization of a civil engineering project. The two test zones chosen, one in the northern part of the city and one in the city centre, are characterised by various types of urbanisation. Bedrock is at a depth varying from a few metres to about thirty metres. These zones well exemplify the various difficulties encountered in an urban environment and are therefore very interesting for the development of an overall methodology of urban microgravimetry. Microgravimetry in an urban environment requires careful corrections for gravific disturbances due to the effects of topography, buildings, cellars, and the infrastructure of distribution networks, in order to isolate the gravific effect due exclusively to the thickness of loose soil filling. Bearing in mind the intensity of the topographic corrections in an urban environment, we gave particular importance to basements. Their gravific effects can reach the order of one tenth of one meal, and can influence above all the precision of the Bouguer anomaly. We propose to establish preliminary topographic correction charts based on data provided to us by the land register, by making assumptions on the depths of basements and the heights of buildings. Availability of this chart previous to a gravimetry campaign would enable us to choose optimum measuring sites. We have also seen that an a priori filter can be used when the form and the intensity of the anomaly correspond visually to the corresponding building. This strategy must be used with caution because if other anomalies are to be associated, important shifts can be generated by the superposition of the effects of different structures. The results of the model have proved to be very convincing in detecting previously unknown sensitive zones. The adaptability of the gravimetry technique allows for application in all phases of a civil engineering project such as the construction of an underground metro line. RIASSUNTO Dalla primavera 2004 una nuova linea metropolitana é in costruzione nella città di Losanna in Svizzera. La nuova metropolitana "M2" traverserà per la lunghezza di 6 km il centro urbano di Losanna da sud a nord. II progetto d'ingegneria civile prevedeva un tracciato situato essenzialmente nel fondo roccioso arenaceo terziario (molassa). Dalla redazione del progetto preliminare, avvenuta nel 1999, una grande quantità di dati geologici sono stati raccolti e sono stati eseguiti numerosi sondaggi. Questo sì é presentato come un'occasione unica per mettere a punto uno studio microgravimetrico in ambiente urbano con lo scopo di valutare lo spessore dei terreni sciolti di origine glaciale che ricoprono il fondo roccioso di molassa e di mettere in evidenza come l'applicazione di questo metodo geofisico non distruttivo possa limitare il numero di sondaggi meccanici nella fase di progetto preliminare ed esecutivo con conseguente reale risparmio economico nella realizzazione di una tale opera. Le due zone di test sono situate una nella zona nord e la seconda nel centro storico di Losanna e sono caratterizzate da stili architettonici differenti. II fondo roccioso é situato ad una profondità variabile da qualche metro ad una trentina. Queste due zone sembrano ben rappresentare tutte le difficoltà di un ambiente urbano e ben si prestano per elaborare una metodologia globale per la microgravimetria in ambiente urbano. L'applicazione di questa tecnica nell'ambiente suddetto implica la correzione attenta delle perturbazioni sulla misura dell'accelerazione gravitazionale, causate dalla topografia, gli edifici, le cantine e le infrastrutture dei sottoservizi, per ben isolare il segnale esclusivamente causato dallo spessore dei terreni sciolti. Tenuto conto, dell'intensità delle correzioni topografiche, abbiamo dato grande importanza alle cantine, poiché il loro effetto sulle misure può raggiungere il decimo di mGal. Proponiamo quindi di redigere una carta delle correzioni topografiche preliminare all'acquisizione, facendo delle ipotesi sulla profondità delle cantine e sull'altezza degli edifici, sulla base delle planimetrie catastali. L'analisi di questa carta permetterà di scegliere le posizioni più adatte per le stazioni gravimetriche. Abbiamo anche osservato che un filtro a priori, qualora la forma e l'intensità dell'anomalia fosse facilmente riconducibile in maniera visuale ad un edificio, possa essere efficace. Tuttavia questa strategia deve essere utilizzata con precauzione, poiché può introdurre uno scarto, qualora più anomalie, dovute a differenti strutture, si sovrappongano. I risultati delle modellizzazioni si sono rivelati convincenti, evidenziando zone sensibili non conosciute preventivamente. L'adattabilità della tecnica gravimetrica ha mostrato di poter intervenire in differenti fasi di un progetto di ingegneria civile, quale è quella di un'opera in sotterraneo.

Base temperature and simulation model for nodes appearance in cape gooseberry (Physalis peruviana L.)

Data was analyzed on development of the solanaceen fruit crop Cape gooseberry to evaluate how well a classical thermal time model could describe node appearance in different environments. The data used in the analysis were obtained from experiments conducted in Colombia in open fields and greenhouse condition at two locations with different climate. An empirical, non linear segmented model was used to estimate the base temperature and to parameterize the model for simulation of node appearance vs. time. The base temperature (Tb) used to calculate the thermal time (TT, ºCd) for node appearance was estimated to be 6.29 ºC. The slope of the first linear segment was 0.023 nodes per TT and 0.008 for the second linear segment. The time at which the slope of node apperance changed was 1039.5 ºCd after transplanting, determined from a statistical analysis of model for the first segment. When these coefficients were used to predict node appearance at all locations, the model successfully fit the observed data (RSME=2.1), especially for the first segment where node appearance was more homogeneous than the second segment. More nodes were produced by plants grown under greenhouse conditions and minimum and maximum rates of node appearance rates were also higher.

Direct noninvasive estimation of myocardial tricarboxylic acid cycle flux in vivo using hyperpolarized (13)C magnetic resonance.

BACKGROUND: The heart relies on continuous energy production and imbalances herein impair cardiac function directly. The tricarboxylic acid (TCA) cycle is the primary means of energy generation in the healthy myocardium, but direct noninvasive quantification of metabolic fluxes is challenging due to the low concentration of most metabolites. Hyperpolarized (13)C magnetic resonance spectroscopy (MRS) provides the opportunity to measure cellular metabolism in real time in vivo. The aim of this work was to noninvasively measure myocardial TCA cycle flux (VTCA) in vivo within a single minute. METHODS AND RESULTS: Hyperpolarized [1-(13)C]acetate was administered at different concentrations in healthy rats. (13)C incorporation into [1-(13)C]acetylcarnitine and the TCA cycle intermediate [5-(13)C]citrate was dynamically detected in vivo with a time resolution of 3s. Different kinetic models were established and evaluated to determine the metabolic fluxes by simultaneously fitting the evolution of the (13)C labeling in acetate, acetylcarnitine, and citrate. VTCA was estimated to be 6.7±1.7μmol·g(-1)·min(-1) (dry weight), and was best estimated with a model using only the labeling in citrate and acetylcarnitine, independent of the precursor. The TCA cycle rate was not linear with the citrate-to-acetate metabolite ratio, and could thus not be quantified using a ratiometric approach. The (13)C signal evolution of citrate, i.e. citrate formation was independent of the amount of injected acetate, while the (13)C signal evolution of acetylcarnitine revealed a dose dependency with the injected acetate. The (13)C labeling of citrate did not correlate to that of acetylcarnitine, leading to the hypothesis that acetylcarnitine formation is not an indication of mitochondrial TCA cycle activity in the heart. CONCLUSIONS: Hyperpolarized [1-(13)C]acetate is a metabolic probe independent of pyruvate dehydrogenase (PDH) activity. It allows the direct estimation of VTCA in vivo, which was shown to be neither dependent on the administered acetate dose nor on the (13)C labeling of acetylcarnitine. Dynamic (13)C MRS coupled to the injection of hyperpolarized [1-(13)C]acetate can enable the measurement of metabolic changes during impaired heart function.

Rotational assessment of distal femur and its relevance in total knee arthroplasty: analysis by magnetic resonance imaging

AbstractObjective:To define the distal femur rotation pattern in a Brazilian population, correlating such pattern with the one suggested by the arthroplasty instruments, and analyzing the variability of each anatomic parameter.Materials and Methods:A series of 101 magnetic resonance imaging studies were evaluated in the period between April and June 2012. The epidemiological data collection was performed with the aid of the institution's computed imaging system, and the sample included 52 male and 49 female patients. The measurements were made in the axial plane, with subsequent correlation and triangulation with the other plans. The posterior condylar line was used as a reference for angle measurements. Subsequently, the anatomical and surgical transepicondylar axes and the anteroposterior trochlear line were specified. The angles between the reference line and the studied lines were calculated with the aid of the institution's software.Results:The mean angle between the anatomical transepicondylar axis and the posterior condylar line was found to be 6.89°, ranging from 0.25° to 12°. For the surgical transepicondylar axis, the mean value was 2.89°, ranging from –2.23° (internal rotation) to 7.86°, and for the axis perpendicular to the anteroposterior trochlear line, the mean value was 4.77°, ranging from –2.09° to 12.2°.Conclusion:The anatomical transepicondylar angle showed mean values corresponding to the measurement observed in the Caucasian population. The utilized instruments are appropriate, but no anatomical parameter proved to be steady enough to be used in isolation.

Nanoantenna enhanced emission of lightharvesting complex 2: the role of resonance, polarization, and radiative and non-radiative rates

Nanoantennae show potential for photosynthesis research for two reasons; first by spatially confining light for experiments which require high spatial resolution, and second by enhancing the photon emission of single light-harvesting complexes. For effective use of nanoantennae a detailed understanding of the interaction between the nanoantenna and the light-harvesting complex is required. Here we report how the excitation and emission of multiple purple bacterial LH2s (light-harvesting complex 2) are controlled by single gold nanorod antennae. LH2 complexes were chemically attached to such antennae, and the antenna length was systematically varied to tune the resonance with respect to the LH2 absorption and emission. There are three main findings. (i) The polarization of the LH2 emission is fully controlled by the resonant nanoantenna. (ii) The largest fluorescence enhancement, of 23 times, is reached for excitation with light at λ = 850 nm, polarized along the long antenna-axis of the resonant antenna. The excitation enhancement is found to be 6 times, while the emission efficiency is increased 3.6 times. (iii) The fluorescence lifetime of LH2 depends strongly on the antenna length, with shortest lifetimes of [similar]40 ps for the resonant antenna. The lifetime shortening arises from an 11 times resonant enhancement of the radiative rate, together with a 2–3 times increase of the non-radiative rate, compared to the off-resonant antenna. The observed length dependence of radiative and non-radiative rate enhancement is in good agreement with simulations. Overall this work gives a complete picture of how the excitation and emission of multi-pigment light-harvesting complexes are influenced by a dipole nanoantenna.

Microencapsulação do agente quelante sulfoxina em microesferas de quitosana preparadas por spray drying como novo adsorvente para íons metálicos

In this work, a new adsorbent was prepared by microencapsulation of sulfoxine into chitosan microspheres by the spray drying technique. The new adsorbent was characterized by Raman spectroscopy, scanning electron microscopy and microanalysis of energy dispersive X-rays. The Cu(II) adsorption was studied as a function of pH, time and concentration. The optimum pH was found to be 6.0. The kinetic and equilibrium data showed that the adsorption process followed the pseudo second-order kinetic model and the Langmuir isotherm model over the entire concentration range. An increase of 8.0% in the maximum adsorption capacity of the adsorbent (53.8 mg g-1) was observed as compared to chitosan glutaraldehyde cross-linked microspheres.

Lämpöpumppujärjestelmät integroidussa kylmä- ja lämpötehon tuotossa

Tässä työssä tutkittiin lämpöpumppujärjestelmiä, joilla tuotetaan samaan aikaan kylmä- ja lämpötehoa. Höyryn puristus lämpöpumppu on yleisimmin käytetty lämpöpumpputyyppi ja sen pääkomponentit ovat kompressori, lauhdutin, paisuntaventtiili ja höyrystin. Lämpöpumppu tuottaa samaan aikaan kylmätehoa höyrystimellä ja lämpötehoa lauhduttimella. Lämpöpumpun toiminta-arvoihin vaikuttaa valittujen lämpötilatasojen lisäksi voimakkaasti valitun kiertoaineen termodynaamiset ominaisuudet sekä kompressorin painesuhteeseen verrannollinen isentrooppihyötysuhde. Uusissa lämpöpumpuissa käytetään HFC yhdisteitä sekä sekoituksia kiertoaineina, mutta myös luonnolliset aineet, kuten ammoniakki, ovat lupaavia korvikkeita CFC yhdisteille. Sopivia sovelluskohteita kylmä- ja lämpötehon yhteistuotannolle ovat kauppa- ja asuinrakennukset, hotellit, toimistot, elintarviketeollisuus ja -myymälät sekä vierekkäiset jää- ja uimahallit ja hiihtoputket. Kylmä- ja lämpötehon yhteistuotannolla voitaisiin saavuttaa merkittäviä säästöjä ja päästövähennyksiä. Esimerkiksi jäähallien kylmäkoneiden lauhdelämmön hyödyntämisessä olisi Suomessa potentiaalia 6-10 miljoonan euron vuotuisiin säästöihin. Kylmä- ja lämpötehon yhteistuotanto voidaan toteuttaa hyödyntämällä kylmäkoneen lauhdelämpöä toisella lämpöpumpulla. Toinen vaihtoehto on käyttää eri tilojen samanaikaiseen lämmittämiseen ja jäähdyttämiseen HPS lämpöpumppua tai moniyksikköistä lämpöpumppua.

Dopplerfluxometria do ducto venoso: relação com a gasometria em fetos prematuros com centralização de fluxo sangüíneo

OBJETIVO: avaliar o desempenho da dopplerfluxometria do ducto venoso (DV) na detecção da acidemia em fetos prematuros apresentando centralização de fluxo sangüíneo. MÉTODOS: estudo observacional transversal. A população em estudo consistiu de 48 gestantes entre a 25ª e a 33ª semana de gestação, que apresentavam centralização de fluxo sangüíneo fetal (relação umbílico/cerebral >1). O tempo decorrido entre o diagnóstico de centralização fetal e o nascimento (cesariana sob anestesia peridural) foi de até cinco horas. Os seguintes parâmetros foram estudados: relação sístole ventricular atrial (S/A) do ducto venoso, pH e base excess (BE) de amostra de sangue da veia umbilical colhida imediatamente após o nascimento. A relação S/A do DV foi considerada anormal quando maior que 3,6. Os conceptos foram classificados quanto ao resultado da gasometria, sendo considerada gasometria anormal quando pH <7,26 e BE <6 mmol/L. O estudo estatístico utilizado foi o teste de Fisher, considerado significativo quando p < 0,05. RESULTADOS: a correlação entre a gasometria do cordão umbilical de fetos prematuros centralizados e a relação S/A do DV foi significativa (p=0,0000082; teste de Fisher). A dopplervelocimetria do DV foi capaz de identificar 10 dos 14 fetos com gasometria anormal. Por outro lado, 32 dos 34 fetos com gasometria normal foram corretamente identificados. A sensibilidade da dopplerfluxometria do DV para o diagnóstico de acidemia fetal ao nascimento foi de 71%, a especificidade foi de 94%, a taxa de falso-negativo de 8%, a taxa de falso-positivo de 4%, o valor preditivo positivo de 83% e o valor preditivo negativo de 89%. A probabilidade pré-teste para um feto centralizado de apresentar acidemia ao nascimento foi de 31%. Já a probabilidade de acidemia após resultado do DV anormal (probabilidade após teste anormal) foi de 84%, ao passo que a probabilidade de acidemia fetal com o DV normal (probabilidade após-teste normal) foi de apenas 10%. CONCLUSÃO: a análise da relação S/A do ducto venoso se mostra adequada para o diagnóstico de gasometria anormal em fetos prematuros, centralizados.

Dopplerfluxometria de ducto venoso: identificação não invasiva da acidemia em fetos prematuros centralizados

OBJETIVO: estabelecer o ponto de corte a partir do qual seja possível identificar fetos prematuros com centralização do fluxo sangüíneo que apresentem gasometria anormal. MÉTODO: foi realizado estudo observacional transversal, cuja população consistia de 60 gestantes com fetos centralizados (relação umbílico-cerebral maior que 1), com idade gestacional entre 25 e 33 semanas. O ducto venoso foi identificado com auxílio da dopplerfluxometria colorida e obtida a relação S/A a partir do sonograma (relação entre a velocidade de pico da sístole ventricular e a velocidade de pico da sístole atrial). Imediatamente após a cesariana foi colhida amostra de sangue da veia umbilical para gasometria. Os conceptos foram classificados de acordo com a análise gasométrica e considerados anormais quando pH <7,20 e BE < -6 mmol/l. Após o cálculo da sensibilidade e especificidade para cada ponto de corte foi construída a curva ROC (receiver operator characteristic). RESULTADOS: foram selecionadas 60 gestantes no período de janeiro de 1998 a janeiro de 2003. No momento do estudo a idade gestacional variou entre 25 e 33 semanas, média de 29,7 semanas (±1,8 semanas). Todos os fetos apresentavam-se centralizados; dentre eles 14 apresentavam gasometria anormal ao nascimento e 46 apresentavam gasometria normal. A prevalência de resultados de fetos com gasometria anormal no material estudado foi de 23,33%. Observou-se associação significativa entre o resultado anormal do ducto venoso e gasometria anormal ao nascimento (chi2 = 784,44, p < 0,00001). O ponto de corte da relação S/A (onde a curva ROC "muda de tendência") foi 3,4. CONCLUSÃO: a análise da relação S/A do ducto venoso se mostra adequada para a predição não invasiva de gasometria anormal em fetos prematuros, centralizados, quando os valores são superiores a 3,4.