Synchronous reconstruction of bilateral osteoradionecrosis of the mandible using a single fibular osteocutaneous flap in patients with nasopharyngeal carcinoma

The reconstruction of bilateral osteoradionecrosis (ORN) of mandibular defects using a single free bone flap is rarely performed because extensively radiated neck tissue with severe fibrosis is usually unsuitable for vascularized reconstruction. Thirty-one patients with nasopharyngeal carcinoma (NPC) underwent bilateral reconstruction of advanced ORN in the mandible using a single fibular osteocutaneous flap. Clinical factors associated with the operation were assessed, including classification of mandible defects, types of recipient vessels, perioperative complications, and postoperative outcomes. All of the fibular osteocutaneous flaps survived completely, with the exception of 1 inner skin paddle that presented partial necrosis in a reconstruction of through-and-through defects. All patients experienced an improvement in cosmetic results 6 months after the reconstruction, whereas 23 patients experienced improved mouth opening compared to the preoperative condition. Advanced bilateral ORN in patients with NPC could be synchronously reconstructed with a single fibular osteocutaneous flap. © 2015 Wiley Periodicals, Inc. Head Neck, 2015.

Determinação da relação de novo biomarcador (IMP3) no carcinoma de nasofaringe

Pós-graduação em Patologia - FMB

Influência do desbalanceamento da onda retangular na liga de alumínio 6063-T6 soldada pelo processo TIG-CA

Pós-graduação em Ciência e Tecnologia de Materiais - FC

Monitoramento de integridade estrutural e de sistemas utilizando dispositivos de baixo custo

Pós-graduação em Engenharia Mecânica - FEB

Compensação ativa paralela baseada na teoria de potência conservativa

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

Design of static var compensators using a general reactive energy definition

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

Exigências familiares e do trabalho: um equilíbrio necessário para a saúde de trabalhadores e organizações

This article aims, through a theoretical essay, to promote a reflection about the new roles played by people in families, at work and at the society in general. Based on papers and scientific bibliography, it broaches the changes at the contemporary society, linked to changes on world of work and family relationships, focused on the unbalance at family-work relation. Some current organizational initiatives were cited as plans of prevention and improvement of worker health, which affect their relations. It was considered the need of reconstruction of gender stereotypes and reducing the inequality of opportunity between people as focal points for changing a current scenario, which prevails in the lack of balance between requirements that can generate negative consequences both for health the individual and their families and for the organization.

Cálculo em elementos finitos das frequências naturais dos modos de flexão de uma linha de eixo de unidade geradora hidráulica em escala

Pós-graduação em Engenharia Mecânica - FEG

Adequabilidade das áreas de vegetação ripária da microbacia do Córrego Comur - Botucatu (SP) em função da legislação ambiental

The inadequate soil use is an aggravating factor of the environmental degradation and ecological unbalance. The analysis of the use and covering of the soil, by information of Remote Sensing, constitutes a technique of great usefulness to the planning and administration of the ordered occupation and rational of the physical middle, besides making possible to evaluate and to monitor the preservation of areas of natural vegetation. This work sought to evaluate the conflicts of soil use in permanent preservation areas (PPA) in Stream Comur watershed - Botucatu (SP) through Geographical Information System and satellite image of 2009. The study area is located among the geographical coordinates 48o 23’ 04” to 48o 25’ 54” of longitude WGr. and 22o 44’ 42” to 22o 48” 12” of latitude S with an area of 1,719.6 ha. The results allowed to verify that the geoprocessing techniques were of fundamental importance in the identification of the areas of soil use, of APP and of conflicts among use and PPA where it leaves of the areas of APP is being used inadequately. In terms of environmental sustainability, it can be deduced that the watershed is very unfavorable, once it presents 70.67% of area used inadequately with sugarcane and pasture.

Análise das perturbações de qualidade de energia em sistemas de distribuição e a adequação as tendências regulatórias do PRODIST

The public consultation n° 018/2014, for review the Module 8 of Procedures of Electricity Distribution (PRODIST), conducted by National Agency of Electric Energy (ANEEL), aims to improve the regulation of power quality, considering the phenomena harmonic distortion, voltage unbalance, voltage fluctuation and short term voltage variation. These regulatory changes impact in the way of analysis and treatment, of power quality disruption, by the electricity distribution. The developed work makes a study about the applications of these new regulatory requests and hopes to contribute with a better understanding. Through power quality measurements, in distribution substations, with different load profiles (industrial, urban and rural), was obtained a real view of the system, under the aspect of power quality, to evaluate the regulation adherence to the current version and proposed. In this case study, although being in accordance with the current methodology, happened a transgression of propose. With a comparative analysis, was possible to identify some phenomena that were more flexible in the proposed revision and others with more severe monitoring

Análise das perturbações de qualidade de energia em sistemas de distribuição e a adequação as tendências regulatórias do PRODIST

The public consultation n° 018/2014, for review the Module 8 of Procedures of Electricity Distribution (PRODIST), conducted by National Agency of Electric Energy (ANEEL), aims to improve the regulation of power quality, considering the phenomena harmonic distortion, voltage unbalance, voltage fluctuation and short term voltage variation. These regulatory changes impact in the way of analysis and treatment, of power quality disruption, by the electricity distribution. The developed work makes a study about the applications of these new regulatory requests and hopes to contribute with a better understanding. Through power quality measurements, in distribution substations, with different load profiles (industrial, urban and rural), was obtained a real view of the system, under the aspect of power quality, to evaluate the regulation adherence to the current version and proposed. In this case study, although being in accordance with the current methodology, happened a transgression of propose. With a comparative analysis, was possible to identify some phenomena that were more flexible in the proposed revision and others with more severe monitoring

Linear parameter varying control design for rotating systems supported by journal bearings

Linear parameter varying (LPV) control is a model-based control technique that takes into account time-varying parameters of the plant. In the case of rotating systems supported by lubricated bearings, the dynamic characteristics of the bearings change in time as a function of the rotating speed. Hence, LPV control can tackle the problem of run-up and run-down operational conditions when dynamic characteristics of the rotating system change significantly in time due to the bearings and high vibration levels occur. In this work, the LPV control design for a flexible shaft supported by plain journal bearings is presented. The model used in the LPV control design is updated from unbalance response experimental results and dynamic coefficients for the entire range of rotating speeds are obtained by numerical optimization. Experimental implementation of the designed LPV control resulted in strong reduction of vibration amplitudes when crossing the critical speed, without affecting system behavior in sub- or supercritical speeds. (C) 2012 Elsevier Ltd. All rights reserved.

Nursing Workload as a Risk Factor for Healthcare Associated Infections in ICU: A Prospective Study

Introduction: Nurse understaffing is frequently hypothesized as a potential risk factor for healthcare-associated infections (HAI). This study aimed to evaluate the role of nursing workload in the occurrence of HAI, using Nursing Activities Score (NAS). Methods: This prospective cohort study enrolled all patients admitted to 3 Medical ICUs and one step-down unit during 3 months (2009). Patients were followed-up until HAI, discharge or death. Information was obtained from direct daily observation of medical and nursing rounds, chart review and monitoring of laboratory system. Nursing workload was determined using NAS. Non-compliance to the nurses' patient care plans (NPC) was identified. Demographic data, clinical severity, invasive procedures, hospital interventions, and the occurrence of other adverse events were also recorded. Patients who developed HAI were compared with those who did not. Results: 195 patients were included and 43 (22%) developed HAI: 16 pneumonia, 12 urinary-tract, 8 bloodstream, 2 surgical site, 2 other respiratory infections and 3 other. Average NAS and average proportion of non compliance with NPC were significantly higher in HAI patients. They were also more likely to suffer other adverse events. Only excessive nursing workload (OR: 11.41; p: 0.019) and severity of patient's clinical condition (OR: 1.13; p: 0.015) remained as risk factors to HAI. Conclusions: Excessive nursing workload was the main risk factor for HAI, when evaluated together with other invasive devices except mechanical ventilation. To our knowledge, this study is the first to evaluate prospectively the nursing workload as a potential risk factor for HAI, using NAS.

Carvedilol protects against apoptotic cell death induced by cisplatin in renal tubular epithelial cells

Cisplatin is a highly effective chemotherapeutic drug; however, its use is limited by nephrotoxicity. Studies showed that the renal injury produced by cisplatin involves oxidative stress and cell death mediated by apoptosis and necrosis in proximal tubular cells. The use of antioxidants to decrease cisplatin-induced renal cell death was suggested as a potential therapeutic measure. In this study the possible protective effects of carvedilol, a beta blocker with antioxidant activity, was examined against cisplatin-induced apoptosis in HK-2 human kidney proximal tubular cells. The mitochondrial events involved in this protection were also investigated. Four groups were used: controls (C), cisplatin alone at 25 mu M (CIS), cisplatin 25 mu M plus carvedilol 50 mu M (CV + CIS), and carvedilol alone 50 mu M (CV). Cell viability, apoptosis, caspase-9, and caspase-3 were determined. Data demonstrated that carvedilol effectively increased cell viability and minimized caspase activation and apoptosis in HK-2 cells, indicating this may be a promising drug to reduce nephrotoxicity induced by cisplatin.

Mechanismen der Aktivierung und Detoxifizierung von Aflatoxin B 1 in verschiedenen Leberzelltypen von Ratten, Mäusen und Waldmurmeltieren

Zusammenfassung: Die Applikation des Mykotoxins Aflatoxin B1 (AFB1) führt in der Ratte zu Lebertumoren hepatozellulären Ursprungs, während bisher keine transformierende Wirkung dieses Mykotoxins auf Kupffer- und Endothelzellen (Nichtparenchymzellen, NPC) nachgewiesen werden konnte. Diese Resistenzmechanismen der NPC gegenüber AFB1 wurden im ersten Teil dieser Arbeit untersucht. AFB1 ist per se inaktiv, wird jedoch durch Verstoffwechselung in den chemisch reaktiven, an DNA bindenden Metaboliten AFB1-8,9-Epoxid überführt. Daneben stellt die enzymatische Hydroxylierung von AFB1 am Kohlenstoff-9a zum Aflatoxin M1 eine Detoxifizierung dar. Durch HPLC-Analyse der AFB1-Metabolite konnte gezeigt werden, daß in Nichtparenchymzellen (NPC) das Verhältnis von 9a-Hydroxylierung zu 8,9-Epoxidierung höher als in Parenchymzellen (PC) ist. Die AFB1-9a-hydroxylase fördert insbesondere in den NPC der Leber die Bildung des weniger gentoxischen Metaboliten AFM1 und konkurriert daher um die Aktivierung von AFB1 zum mutagenen und kanzerogenen 8,9-Epoxid. Dieser metabolische Unterschied scheint also einen Beitrag zur Resistenz der NPC der Leber gegenüber der hepatokanzerogenen Wirkung von AFB1 zu leisten. Da ein Synergismus zwischen der AFB1-Exposition und einer Infektion mit dem Hepatitis B-Virus (HBV) beim Menschen bezüglich des Auftretens von hepatozellulären Karzinomen zu bestehen scheint, wurde im zweiten Teil dieser Arbeit untersucht, ob die metabolische Aktivierung von AFB1 durch eine HBV-Infektion verstärkt wird. In einem Vergleich der Biotransformation von AFB1 mit mikrosomalen Leberfraktionen von transgenen HBV-Mäusen und Kontrollmäusen wurde keine signifikanten Unterschiede festgestellt. Dagegen wurde bei Virus-infizierten Waldmurmeltieren eine deutlich reduzierte Bildung des AFB1-8,9-Epoxids beobachtet. Es konnte z.T. ein Zusammenhang zwischen den verschiedenen Stadien der Leberschädigung und den Metabolismusraten festgestellt werden, wobei die metabolische Aktivierung mit zunehmender Leberschädigung abzunehmen scheint. Auch hinsichtlich der Aktivitäten verschiedener Cytochrom P450 abhängiger Monooxygenasen wurde eine weitgehende Übereinstimmung mit den durch HPLC ermittelten Metabolitenprofilen des AFB1 beobachtet. Diese Studien mit subzellulären Leberfraktion der transgenen HBV-Mäusen und der Waldmurmeltieren zeigen, daß die Interaktion zwischen Hepatitis und AFB1 nicht mit der verstärkten metabolischer Aktivierung von AFB1 zu erklären ist. TGF-ß1, aus der Gruppe der Cytokine, wird als Mediator bei Entzündungsprozessen in der Leber so z.B. im Verlauf einer Virushepatitis freigesetzt. Aufgrund der besonderen Bedeutung des murinen CYP2A5 (ortholog zum humanen CYP2A6) bei der Aktivierung von AFB1 wurde der Einfluß von TGF-ß1 auf CYP2A5 in Primärkulturen von Maushepatozyten untersucht. Durch Messung der Aktivität der Cumarin-7-hydroxylase sowie durch Bestimmung der Proteinmenge von CYP2A5 mittels Western Blotting konnte zunächst die Induzierbarkeit des CYP2A5-Isoenzyms durch Phenobarbital in kultivierten Hepatozyten der Maus gezeigt werden. Nur bei einer niedrigen TGF-ß1-Konzentration wurde eine leicht erhöhte Expression von CYP2A5 festgestellt, ansonsten führte die Behandlung der kultivierten Maushepatozyten mit TGF-ß1 zu einer dosisabhängigen Verminderung der Expression von CYP2A5.