Duplicações do aparelho digestivo

OBJETIVO: Mostrar os aspectos fisiopatológicos e as várias formas de apresentação clínica e tratamento das duplicações do tubo digestivo, através da análise de seis casos operados pela equipe de Cirurgia Pediátrica do Hospital da Lagoa, no Rio de Janeiro. MÉTODO: Foram analisados a evolução clínica, os meios empregados no diagnóstico e a conduta terapêutica em seis pacientes portadores de duplicação, cada um deles se apresentando de forma diferente. Uma era duodenal, quatro jejuno-ileais e uma não era ligada ao tubo digestivo e sim ao pâncreas. RESULTADOS: Todos os casos foram operados, sendo que o cisto duodenal foi comunicado por meio de uma janela ao duodeno, os quatro jejuno-ileais foram ressecados juntamente com o intestino adjacente e o cisto que parecia se originar no pâncreas foi ressecado. Em dois casos houve complicações pós-operatória, mas não houve óbitos. CONCLUSÕES: As duplicações devem ser lembradas no diagnóstico diferencial dos tumores torácicos e abdominais, bem como nos quadros de obstrução intestinal e enterorragia. O conhecimento da existência e das características desta malformação possibilitará ao cirurgião agir da melhor forma possível no caso do seu encontro inesperado durante uma operação. É importante lembrar que podem haver anomalias associadas ou mais de uma duplicação. Se houver suspeita antes da operação, elas devem ser estudadas pelos meios semióticos apropriados, para se tomar a melhor conduta para o caso.

Variação temporal do tratamento cirúrgico do câncer de mama em um hospital universitário na região Centro-Oeste do Brasil

OBJETIVO: avaliar os tipos de tratamentos cirúrgicos para o câncer de mama executados pelo Programa de Mastologia do Hospital das Clinicas da Universidade Federal de Goiás (HC-UFG). MÉTODOS: estudo de coorte transversal no histórico de operações mamárias realizadas no HC-UFG, no período de janeiro de 2002 a dezembro de 2009. Foram avaliados através do boletim cirúrgico: o tempo e o porte cirúrgicos; o cirurgião responsável, o tipo de operação; o diagnóstico, e o tipo de anestesia. Através dos prontuários foram analisados: o laudo anatomopatológico do tumor, o comprometimento linfonodal, o tamanho do tumor primário, o estadiamento e a realização de terapias neoadjuvantes. Foram excluídas as operações realizadas para a retirada de tumores benignos da mama. A variação temporal foi analisada pela regressão de Poisson, considerando a mudança percentual anual (MPA). RESULTADOS: foram realizadas 403 operações de câncer de mama no período estudado, com uma média de 50,38 operações por ano. O tipo histológico mais frequente foi o carcinoma ductal invasor (72,6%). A média de idade das pacientes foi 52 anos, e 29% encontravam-se com doença nos estádios III e IV. A tendência temporal mostrou que houve aumento significativo do tamanho do tumor (p<0,01), dos estadios clínicos III e IV (p=0,01), e de quimioterapia neoadjuvante (p=0,02). Observou-se aumento de mastectomias (MPA=9 casos/ano, p=0,04). Não houve aumento dos casos de tratamentos com conservação mamária, nem de reconstruções imediatas. CONCLUSÃO: nos últimos anos, no HC-UFG, tem ocorrido aumento do número de mastectomias em decorrência do aumento de casos de câncer de mama locorregional avançado.

Estrutura, ultraestrutura e morfometria da veia cava de paca (Cuniculus paca Linnaeus, 1766) criada em cativeiro

A paca (Cuniculus paca) é o segundo maior roedor da fauna brasileira. Apresenta carne de excelente qualidade, o que incentiva a criação comercial. Além disso, este animal pode tornar-se uma opção válida em experimentação embora poucas sejam as informações detalhadas sobre sua morfologia. Assim, objetivou-se descrever a morfologia, morfometria e ultraestrutura de segmentos das porções cranial e caudal da veia cava de quatro pacas (Cuniculus paca) adultas excedentes do plantel do Setor de Animais Silvestres do Departamento de Zootecnia da FCAV-Unesp. Os segmentos venosos foram analisados à microscopia de luz e à microscopia eletrônica de varredura. Foram mensuradas as espessuras do complexo formado pelas túnicas íntima e média, além da túnica adventícia e analisou-se os resultados pela estatística descritiva, teste "T" pareado (p<0,05). Em relação à espessura das túnicas estudadas, comprovou-se que os valores da espessura das túnicas íntima, média e adventícia, para todos os animais, foram significativamente maiores no segmento cranial. As camadas das paredes dos vasos apresentaram variações entre si quanto à estrutura e espessura, supostamente devido a uma adaptação à exigência funcional.

Propriedades tensiométricas do peritônio da paca (Cuniculus paca) a fresco e conservado em glicerina 98%

Na busca constante, tanto de material biológico alternativo para a realização de implantes, quanto de novas opções de modelos de experimentação animal, o objetivo desta investigação foi descrever o comportamento mecânico do peritônio da paca (Cuniculus paca Linnaeus, 1766) a fresco e conservado em glicerina a 98%. Amostras frescas e conservadas em glicerina por períodos de 30, 60 e 90 dias foram submetidas a testes mecânicos de tração. Quatro animais adultos, três machos e uma fêmeas, com peso corporal médio de oito quilogramas, foram utilizados para colheita das amostras de peritônio. Todos os tecidos conservados em glicerina a 98% apresentaram diminuição na rigidez e aumento na ductibilidade e tenacidade. Considerando-se a força máxima aplicada ao peritônio, evidenciou-se aumento significativo nos valores (p<0,01) das amostras conservadas por 60 e 90 dias, quando comparado ao material a fresco. Com relação a variável alongamento, notou-se aumento nos valores relativos aos materiais em glicerina em todos os tempos de conservação, verificando-se diferença significativa (p<0,01) entre os valores das amostras a fresco. A variável área também se apresentou significativa (p<0,01) entre os valores das amostras a fresco (5,40 mm²) e os preservados em glicerina pelos períodos de 30 dias (4,50 mm²), 60 dias (9,00 mm²) e 90 dias (7,20 mm²), indicando assim, que a área desta membrana aumentou em 0,033 mm² por dia. Mediante os resultados observados, concluiu-se que a glicerina 98% é uma substância eficiente para a conservação do peritônio da paca, pois melhorou suas propriedades mecânicas permitindo que as membranas suportem maiores forças de deformação. Assim, os resultados obtidos nos ensaios mecânicos do peritônio da paca sugerem sua utilização como mais uma opção de material biológico.

Resolución N° 120 ¿Qué es la convocatoria y cómo se evalúa este elemento esencial de las decisiones sociales por parte de la Cámara de Comercio?

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Nietzsche's eternal recurrence of the same : the effect of logic abridgement, contradictions and inconsistencies

I will argue that the doctrine of eternal recurrence of the same no better interprets cosmology than pink elephants interpret zoology. I will also argue that the eternal-reiurn-of-the-same doctrine as what Magnus calls "existential imperative" is without possibility of application and thus futile. To facilitate those arguments, the validity of the doctrine of the eternal recurrence of the same will be tested under distinct rubrics. Although each rubric will stand alone, one per chapter, as an evaluation of some specific aspect of eternal recurrence, the rubric sequence has been selected to accommodate the identification of what I shall be calling logic abridgments. The conclusions to be extracted from each rubric are grouped under the heading CONCLUSION and appear immediately following rubric ten. Then, or if, at the end of a rubric a reader is inclined to wonder which rubric or topic is next, and why, the answer can be found at the top of the following page. The question is usually answered in the very first sentence, but always answered in the first paragraph. The first rubric has been placed in order by chronological entitlement in that it deals with the evolution of the idea of eternal recurrence from the time of the ancient Greeks to Nietzsche's August, 1881 inspiration. This much-recommended technique is also known as starting at the beginning. Rubric 1 also deals with 20th. Century philosophers' assessments of the relationship between Nietzsche and ancient Greek thought. The only experience of E-R, Zarathustra's mountain vision, is second only because it sets the scene alluded to in following rubrics. The third rubric explores .ii?.ih T jc,i -I'w Nietzsche's evaluation of rationality so that his thought processes will be understood appropriately. The actual mechanism of E-R is tested in rubric four...The scientific proof Nietzsche assembled in support of E-R is assessed by contemporary philosophers in rubric five. E-R's function as an ethical imperative is debated in rubrics six and seven.. .The extent to which E-R fulfills its purpose in overcoming nihilism is measured against the comfort assured by major world religions in rubric eight. Whether E-R also serves as a redemption for revenge is questioned in rubric nine. Rubric ten assures that E-R refers to return of the identically same and not merely the similar. In addition to assemblage and evaluation of all ten rubrics, at the end of each rubric a brief recapitulation of its principal points concludes the chapter. In this essay I will assess the theoretical conditions under which the doctrine cannot be applicable and will show what contradictions and inconsistencies follow if the doctrine is taken to be operable. Harold Alderman in his book Nietzsche's Gift wrote, the "doctrine of eternal recurrence gives us a problem not in Platonic cosmology, but in Socratic selfreflection." ^ I will illustrate that the recurrence doctrine's cosmogony is unworkable and that if it were workable, it would negate self-reflection on the grounds that selfreflection cannot find its cause in eternal recurrence of the same. Thus, when the cosmology is shown to be impossible, any expected ensuing results or benefits will be rendered also impossible. The so-called "heaviest burden" will be exposed as complex, engrossing "what if speculations deserving no linkings to reality. To identify ^Alderman p. 84 abridgments of logic, contradictions and inconsistencies in Nietzsche's doctrine of eternal recurrence of the same, I. will examine the subject under the following schedule. In Chapter 1 the ancient origins of recurrence theories will be introduced. ..This chapter is intended to establish the boundaries within which the subsequent chapters, except Chapter 10, will be confined. Chapter 2, Zarathustra's vision of E-R, assesses the sections of Thus Spoke Zarathustra in which the phenomenon of recurrence of the same is reported. ..Nihilism as a psychological difficulty is introduced in this rubric, but that subject will be studied in detail in Chapter 8. In Chapter 2 the symbols of eternal recurrence of the same will be considered. Whether the recurrence image should be of a closed ring or as a coil will be of significance in many sections of my essay. I will argue that neither symbolic configuration can accommodate Nietzsche's supposed intention. Chapter 3 defends the description of E-R given by Zarathustra. Chapter 4, the cosmological mechanics of E-R, speculates on the seriousness with which Nietzsche might have intended the doctrine of eternal recurrence to be taken. My essay reports, and then assesses, the argument of those who suppose the doctrine to have been merely exploratory musings by Nietzsche on cosmological hypotheses...The cosmogony of E-R is examined. In Chapter 5, cosmological proofs tested, the proofs for Nietzsche's doctrine of return of the same are evaluated. This chapter features the position taken by Martin ' Heidegger. My essay suggests that while Heidegger's argument that recurrence of the same is a genuine cosmic agenda is admirable, it is not at all persuasive. Chapter 6, E-R is an ethical imperative, is in essence the reporting of a debate between two scholars regarding the possibility of an imperative in the doctrine of recurrence. Their debate polarizes the arguments I intend to develop. Chapter 7, does E-R of the same preclude alteration of attitudes, is a continuation of the debate presented in Chapter 6 with the focus shifted to the psychological from the cosmological aspects of eternal recurrence of the same. Chapter 8, Can E-R Overcome Nihilism?, is divided into two parts. In the first, nihilism as it applies to Nietzsche's theory is discussed. ..In part 2, the broader consequences, sources and definitions of nihilism are outlined. My essay argues that Nietzsche's doctrine is more nihilistic than are the world's major religions. Chapter 9, Is E-R a redemption for revenge?, examines the suggestion extracted from Thus Spoke Zarathustra that the doctrine of eternal recurrence is intended, among other purposes, as a redemption for mankind from the destructiveness of revenge. Chapter 10, E-R of the similar refuted, analyses a position that an element of chance can influence the doctrine of recurrence. This view appears to allow, not for recurrence of the same, but recurrence of the similar. A summary will recount briefly the various significant logic abridgments, contradictions, and inconsistencies associated with Nietzsche's doctrine of eternal recurrence of the same. In the 'conclusion' section of my essay my own opinions and observations will be assembled from the body of the essay.

Some aspects of the chemistry of 1, 3, 4 - Thiadiazolium salts and related compounds

The work described in this thesis has been divided into seven sections. The first section involves the preparation of N'-acyl-N'-arylN- benzothiohydrazides by the acylation of N'-aryl-N-benzothiohydrazides and is followed by a brief discussion of their possible conformation in solution. The second section deals with the preparation of 1,3,4-thiadiazolium salts by the action of perchloric acid/acetic anhydride on N'-acylN'- aryl-N-benzothiohydrazides and also by the reaction of N'-arylN- benzothiohydrazides with nitriles in an acidic medium. The preparation of 2-methylthio-I,3,4-thiadiazolium methosulfate by methylating the corresponding thione is also described. The third section deals with the reaction of 2-phenyl- and 2-methyl-I,3,4-thiadiazolium salts with alcohols in the presence of base. The stability and spectra of these compounds are discussed. Treatment of the 2-methyl-I,3,4-thiadiazolium salt with base was found to give rise to a dimeric anhydrobase and evidence supporting its structure is given. The anhydrobase could be trapped by a variety of acylating and thioacylating agents before dimerization occurred. In the fourth section, the reaction of N'-acyl-N'-aryl-N-benzothiohydrazides with a variety of acid anhydrides is described. These compounds were found to be identical with those obtained by acylating the anhydrobase. The mass spectral fragmentation of these compounds is described and the anomolous product obtained upon thiobenzoylation of 3-methyl-l-phenyl-pyrazal-5-one is also discussed. The fifth section deals with thioacyl derivatives of the anhydrobase which were prepared by the action of phosphorus pentasulfide upon the oxygen analogues and also obtained as the major product of the reaction of thioacetic acid with compounds related to N'-aryl-N-benzothiohydrazides. The mass spectra and p.m.r. spectra of these compounds are discussed. In the sixth section, the reaction of the 2-methylthio-l,3,4- thiadiazolium salt with active methylene compounds to give acyl and diacyl derivatives of the anhydrobase is described. Some aspects of these compounds are discussed. The seventh section describes the synthesis of ncyanine~' type dyes incorporating the l,3,4-thiadiazole ring and their spectra are briefly discussed.

Architectural rendering of Davis Apartments, Chapman College, Orange, California

Davis Community Center and Apartments opened September, 1974 at 625 North Grand Street, Orange, California, named in honor of Chapman College's fourth president, Dr. John L. Davis. The five two-story apartment buildings were designed by Harold Gimeno & Associates of Santa Ana and built by the J. Ray Construction Company, Inc. of Costa Mesa.

Davis Community Center and Apartments, Chapman College, Orange, California

Davis Community Center and Apartments opened September, 1974 at 625 North Grand Street, Orange, California, named in honor of Chapman College's fourth president, Dr. John L. Davis. The five two-story apartment buildings were designed by Harold Gimeno & Associates of Santa Ana and built by the J. Ray Construction Company, Inc. of Costa Mesa.

Davis Community Center and Apartments, Chapman College, Orange, California

Davis Community Center and Apartments opened September, 1974, at 625 North Grand Street, Orange, California, named in honor of Chapman College's fourth president, Dr. John L. Davis. The five two-story apartment buildings were designed by Harold Gimeno & Associates of Santa Ana and built by the J. Ray Construction Company, Inc. of Costa Mesa.

Davis Community Center and Apartments, Chapman College, Orange, California

Davis Community Center and Apartments opened September, 1974 at 625 North Grand Street, Orange, California, named in honor of Chapman College's fourth president, Dr. John L. Davis. The five two-story apartment buildings were designed by Harold Gimeno & Associates of Santa Ana and built by the J. Ray Construction Company, Inc. of Costa Mesa.

Davis Community Center and Apartments, Chapman College, Orange, California

Davis Community Center and Apartments opened September, 1974, at 625 North Grand Street, Orange, California, named in honor of Chapman College's fourth president, Dr. John L. Davis. The five two-story apartment buildings were designed by Harold Gimeno & Associates of Santa Ana and built by the J. Ray Construction Company, Inc. of Costa Mesa.

Davis Community Center and Apartments, Chapman College, Orange, California

Davis Community Center and Apartments opened September, 1974, at 625 North Grand Street, Orange, California, named in honor of Chapman College's fourth president, Dr. John L. Davis. The five two-story apartment buildings were designed by Harold Gimeno & Associates of Santa Ana and built by the J. Ray Construction Company, Inc. of Costa Mesa.

Davis Community Center and Apartments, Chapman College, Orange, California

Davis Community Center and Apartments opened September, 1974, at 625 North Grand Street, Orange, California, named in honor of Chapman College's fourth president, Dr. John L. Davis. The five two-story apartment buildings were designed by Harold Gimeno & Associates of Santa Ana and built by the J. Ray Construction Company, Inc. of Costa Mesa.