Repercussões hemodinâmicas do posicionamento em litotomia exagerada para histerectomia vaginal em paciente cardiopata: relato de caso

JUSTIFICATIVA E OBJETIVOS: A técnica de histerectomia vaginal possibilita menor tempo operatório e o uso do bloqueio do neuro-eixo, com os benefícios de melhor analgesia pós-operatória e menor resposta sistêmica ao procedimento cirúrgico. O objetivo deste relato foi descrever as alterações hemodinâmicas decorrentes do posicionamento em litotomia exagerada em paciente cardiopata. RELATO do CASO: Paciente de 33 anos, G0P0A0, com história de sangramento uterino anormal e anemia. A ultra-sonografia evidenciava útero miomatoso com volume estimado de 420 cm³. Ela era portadora de trombofilia e miocardiopatia dilatada, com passado de dois acidentes vasculares encefálicos isquêmicos e dois infartos agudos do miocárdio. Foi monitorizada com pressão arterial invasiva e cateter de artéria pulmonar com medida de débito cardíaco contínuo. Realizada raquianestesia com bupivacaína hiperbárica e morfina. A paciente foi posicionada em litotomia exagerada sendo realizada histerectomia total pela técnica de Heaney e salpingectomia bilateral. Como intercorrência intra-operatória apresentou diminuição do índice cardíaco e aumento das pressões de câmaras direitas após o posicionamento, necessitando do uso de dobutamina. CONCLUSÕES: O posicionamento em litotomia exagerada pode ocasionar alterações hemodinâmicas que devem ser consideradas na escolha da técnica cirúrgica.

Lightning activity in Brazilian thunderstorms during TROCCINOX: implications for NOx production

During the TROCCINOX field experiment in January and February 2005, the contribution of lightning-induced nitrogen oxides (LNOx) from tropical and subtropical thunderstorms in Southern Brazil was investigated. Airborne trace gas measurements (NO, NOy, CO and O-3) were performed up to 12.5 km with the German research aircraft Falcon. During anvil penetrations in selected tropical and subtropical thunderstorms of 4 and 18 February, NOx mixing ratios were on average enhanced by 0.7-1.2 and 0.2-0.8 nmol mol(-1) totally, respectively. The relative contributions of boundary layer NOx (BL-NOx) and LNOx to anvil-NOx were derived from the NOx-CO correlations. on average similar to 80-90% of the anvil-NOx was attributed to LNOx. A Lightning Location Network (LINET) was set up to monitor the local distribution of cloud-to-ground (CG) and intra-cloud (IC) radiation sources (here called 'strokes') and compared with lightning data from the operational Brazilian network RINDAT (Rede Integrada Nacional de Deteccao de Descargas Atmosfericas). The horizontal LNOx mass flux out of the anvil was determined from the mean LNOx mixing ratio, the horizontal outflow velocity and the size of the vertical cross-section of the anvil, and related to the number of strokes contributing to LNOx. The values of these parameters were derived from the airborne measurements, from lightning and radar observations, and from a trajectory analysis. The amount of LNOx produced per LINET stroke depending on measured peak current was determined. The results were scaled up with the Lightning Imaging Sensor (LIS) flash rate (44 flashes s(-1)) to obtain an estimate of the global LNOx production rate. The final results gave similar to 1 and similar to 2-3 kg(N) per LIS flash based on measurements in three tropical and one subtropical Brazilian thunderstorms, respectively, suggesting that tropical flashes may be less productive than subtropical ones. The equivalent mean annual global LNOx nitrogen mass production rate was estimated to be 1.6 and 3.1 Tg a(-1), respectively. By use of LINET observations in Germany in July 2005, a comparison with the lightning activity in mid-latitude thunderstorms was also performed. In general, the same frequency distribution of stroke peak currents as for tropical thunderstorms over Brazil was found. The different LNOx production rates per stroke in tropical thunderstorms compared with subtropical and mid-latitude thunderstorms seem to be related to the different stroke lengths (inferred from comparison with laboratory data and observed lengths). In comparison, the impact of other lightning parameters as stroke peak current and stroke release height was assessed to be minor. The results from TROCCINOX suggest that the different vertical wind shear may be responsible for the different stroke lengths.

Lightning characteristics observed by a VLF/LF lightning detection network (LINET) in Brazil, Australia, Africa and Germany

This paper describes lightning characteristics as obtained in four sets of lightning measurements during recent field campaigns in different parts of the world from mid-latitudes to the tropics by the novel VLF/LF (very low frequency/low frequency) lightning detection network (LINET). The paper gives a general overview on the approach, and a synopsis of the statistical results for the observation periods as a whole and for one special day in each region. The focus is on the characteristics of lightning which can specifically be observed by this system like intra-cloud and cloud-to-ground stroke statistics, vertical distributions of intra-cloud strokes or peak current distributions. Some conclusions regarding lightning produced NOx are also presented as this was one of the aims of the tropical field campaigns TROCCINOX (Tropical Convection, Cirrus and Nitrogen Oxides Experiment) and TroCCiBras (Tropical Convection and Cirrus Experiment Brazil) in Brazil during January/February 2005, SCOUT-O3 (Stratospheric-Climate Links with Emphasis on the Upper Troposphere and Lower Stratosphere) and TWP-ICE (Tropical Warm Pool-International Cloud Experiment) during November/December 2005 and January/February 2006, respectively, in the Darwin area in N-Australia, and of AMMA (African Monsoon Multidisciplinary Analyses) in W-Africa during June-November 2006.

High-speed video observations of positive ground flashes produced by intracloud lightning

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Weight loss and surface roughness of hard chairside reline resins after toothbrushing: Influence of postpolymerization treatments

Purpose: To evaluate the effect of 2 postpolymerization treatments on toothbrushing wear (weight loss) and surface roughness of 3 autopolymerized reline resins-Duraliner II (D) (Reliance Dental), Kooliner (K) (Coe Laboratories), and Tokuso Rebase Fast (T) (Tokuyama Dental)-and 1 heat-polymerized resin, Lucitone 550 (L) (Dentsply International). Materials and Methods: Specimens (40 x 10 x 2mm) of each material (n = 24) were prepared and divided into 3 groups: control (no postpolymerization treatment); water bath (immersion in water at 55°C); and microwave (microwave irradiation). Specimens were dried until constant weight was achieved and the surface roughness (Ra) was measured. Tests were performed in a toothbrush machine using 20,000 strokes of brushing at a weight of 200 g, with the specimens immersed in 1:1 dentifrice/water slurry. Specimens were reconditioned to constant weight and the weight loss (mg) and surface roughness were evaluated. Data were analyzed by 2-way analysis of variance and followed by Tukey test (α = .05). Results: In the control group, the weight loss of materials D and T was lower (P < .05) than that of L. No differences among materials were found after postpolymerization treatments (P > .05). The weight loss of material T (control = 0.5 mg) was significantly increased (P < .05) after postpolymerization treatments (water bath = 1.9 mg; microwave = 1.8 mg). For materials K and T, the toothbrushed surface roughness was higher (P < .05) after microwave and waterbath postpolymerization treatments. Material L showed increased surface roughness after microwave postpolymerization treatment. Conclusion: The toothbrushing wear resistance of L was not superior to the reline resins. The postpolymerization treatments did not improve the toothbrushing wear resistance of the materials and produced an increased surface roughness for materials L, K, and T.

Fatores intrínsecos do custo energético da locomoção durante a natação

The amount of metabolic energy spent in transporting the body mass of the subject over a unit of distance has been defined as the energy cost of locomotion, or regarding to swimming, cost of swimming. The differences in the cost of swimming between the individuals seem to be influenced by two main factors, the hydrodynamic resistance and technical skill of the swimmer. The lower cost of swimming showed by females has been attributed to a smaller hydrodynamic resistance due to their smaller size, larger percentage fat and more streamlined position. However, the difference in cost of swimming between males and females disappears when correcting for body size. With regard to children, the higher energy cost of swimming when correcting for body size may be caused by the lower swimming technique showed by them. For individuals with the same anthropometric characteristics, the better swimming technique and larger size of propelling surface, associated with higher propelling efficiency, may decrease the energy cost of swimming. When comparing different types of strokes, the most economical stroke is crawl, followed by backstroke, irrespective the swimming velocity. Butterfly is the less economical at low velocities (< 0.8 m·s-1). However, above that velocity the breaststroke become the less economical stroke.

Scanning electron microscopic analysis of the effect of Carisolv TM gel on periodontally compromised human root surfaces

The aim of this study was to analyze, under scanning electron microscopy (SEM), the morphologic characteristics of root surfaces after application of CarisolvTM gel in association with scaling and root planing (SRP). Sixty periodontally compromised extracted human teeth were randomly assigned to 6 groups: 1) SRP alone; 2) passive topical application of CarisolvTM + SRP; 3) active topical application of CarisolvTM + SRP; 4) multiple applications of CarisolvTM + SRP; 5) SRP + 24% EDTA; 6) topical application of CarisolvTM + SRP + 24% EDTA. CarisolvTM gel was applied to root surfaces for 30 s, followed by scaling and root planing, consisting of 50 strokes with Gracey curettes in an apical-coronal direction, parallel to the long axis of the tooth. The only exception was group 4, in which the roots were instrumented until a smooth, hard and glass-like surface was achieved. All specimens were further analyzed by SEM. The results showed that the treatment with CarisolvTM caused significant changes in root surface morphology of periodontally compromised teeth only when the chemical agent was actively applied (burnishing technique). CarisolvTM failed to remove the smear layer completely, especially with a single application, independently of the method of application. Multiple applications of CarisolvTM were necessary to achieve a smear layer reduction comparable to that obtained with 24% EDTA conditioning.

Efficacy of Carisolv™ as an adjunctive therapy to scaling and root planing on subgingival calculus removal

The purpose of this study was to evaluate the effectiveness of subgingival application of Carisolv™ gel as an adjunctive therapy to scaling and root planing (SRP) on calculus removal compared to conventional instrumentation. Forty-five teeth requiring extraction due to severe periodontal disease were randomized to the following treatments: 1) SRP alone; 2) placebo gel + SRP; 3) Carisolv™ gel + SRP. Either test or placebo gel was applied subgingivally for 1 min and then the root were instrumented until a smooth and calculus-free surface was achieved. Instrumentation time and the number of strokes required were recorded. After extraction, the efficacy of root surface instrumentation was measured by percentage of remaining calculus. There was no statistically significant difference (p>0.05) between the treatment groups regarding either time required for instrumentation or the percentage of residual calculus. The subgingival application of Carisolv™ gel prior to SRP did not provide any additional benefit to root instrumentation compared to scaling and root planing alone.

In vitro evaluation of the abrasiveness of a commercial low-abrasive dentifrice and an experimental dentifrice containing vegetable oil

Toothpastes usually contain detergents, humectants, water colorant, fluoride and thickeners (e.g. silica). Tooth wear has a multi-factorial etilology and the use of abrasive dentifrices is related to abrasion of dental tissues during toothbrushing. This study evaluated in vitro the abrasiveness of a commercial silica gel low-abrasive dentrifice compared to an experimental dentifrice containing vegetable (almond) oil. Distilled water served as a control group. Acrylic specimens (8 per group) were submitted to simulated toothbrushing with slurries of the commercial dentifrice experimental dentifrice, almond oil and water in an automatic brushing machine programmed to 30,000 brush strokes for each specimen which is equivalent to 2 years of manual toothbrushing. Thereafter, surface roughness (Ra) of the specimens was analyzed with a Surfcorder SE 1700 profilometer. Data were analyzed statistically by ANOVA and Tukey's test at 5% significance level. There was no statistically significant differences (p>0.05) in the surface roughness after brushing with water almond oil experimental dentifrice. The commercial dentifrice produced rougher surfaces compared to the control and abrasive free products (p<0.05). Further studies are necessary in confirm the potential benefits of using vegetable oil in toothpaste as an alternative in abrasives in an attempt to minimize the tooth wear caused by toothbrushing.

Short Communication: In vitro evaluation of the abrasiveness of acidic dentifrices.

AIM: This in vitro study evaluated the abrasiveness of acidic fluoride (F) dentifrices with different F concentrations on bovine enamel. METHODS: Enamel blocks (4.0 x 4.0 mm2, n=120) were selected according to their surface microhardness and divided into 12 groups. Slurries of dentifrices were used containing 0 (placebo), 275, 412, 550 and 1,100 ppm F (pH 4.5 or 7.0), as well as testing two commercial dentifrices (Crest, positive control, 1,100 ppm F and Colgate Baby, 500 ppm F). Enamel blocks were partially protected with an adhesive tape (control area) and then brushed by an automated toothbrushing machine (16,000 strokes). During this process, 0.4 ml of the slurries were injected every 2 mins on the enamel blocks. After toothbrushing, enamel wear was determined by profilometry. STATISTICS: Results were analyzed by ANOVA and Tukey's test (p<0.05). RESULTS: The mean values for pH in the suspensions during treatment were 6.93, 4.32, 7.56 and 8.19 for neutral experimental dentifrices, acidic experimental dentifrices, Crest and Colgate baby, respectively. The abrasiveness of the acidic dentifrices was similar (p<0.05) to the neutral ones, whereas commercial dentifrices yielded lower abrasion (p<0.05). CONCLUSION: It was concluded that a reduction of the pH of dentifrices does not increase their abrasiveness.

Coordenação da ação dos braços no nado crawl analisada em diferentes intensidades, nos exercícios contínuo e intermitente

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Olhar tecer des: (cor)pos forças fluxos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Análise das disciplinas de LIBRAS nos cursos de formação inicial em Pedagogia da UNESP

Pós-graduação em Educação - FCT

Avaliação in vitro de diferentes concentrações, tempos e modos de aplicação do ácido cítrico na biomodificação radicular: análise por meio de microscopia eletrônica de varredura

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Influência de métodos de limpeza de próteses sobre a rugosidade, dureza e quantificação de candida albicans de uma resina para reembasamento

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