376 resultados para arteriovenous fistula


Relevância:

10.00% 10.00%

Publicador:

Relevância:

10.00% 10.00%

Publicador:

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Radiolarians are abundant and well preserved in the Neogene of the Kerguelen Plateau. They are common and moderately to well preserved in the Oligocene sequences of Site 738, where the Eocene/Oligocene boundary was observed for the first time in subantarctic sediments, and Site 744. Radiolarians are absent from all glacial sediments from Prydz Bay. Classical Neogene stratigraphic markers were tabulated at all sites. Correlations with paleomagnetic ages were made at Sites 745 and 746 for 26 Pliocene-Pleistocene radiolarian events. Many Miocene to Holocene species are missing from Sites 736 and 737, which were drilled in shallow water (less than 800 m). The missing species are considered to be deepliving forms. Occurrences and relative abundances of morphotypes at six sites are reported. Two new genera (Eurystomoskevos and Cymaetron) and 17 new species (Actinomma kerguelenensis, A. campilacantha, Prunopyle trypopyrena, Stylodictya tainemplekta, Lithomelissa cheni, L. dupliphysa, Lophophaena(?) thaumasia, Pseudodictyophimus galeatus, Lamprocyclas inexpectata, L. prionotocodon, Botryostrobus kerguelensis, B. rednosus, Dictyoprora physothorax, Eucyrtidium antiquum, E.(?) mariae, Eurystomoskevos petrushevskaae, and Cymaetron sinolampas) are described from the middle Eocene to Oligocene sediments at Sites 738 and 744. Twenty-seven stratigraphic events are recorded in the middle to late Eocene of Site 738, and 27 additional stratigraphic datums are recorded, and correlated to paleomagnetic stratigraphy, in the early Oligocene at Sites 738 and 744. Eight radiolarian events are recorded in the late Oligocene at Site 744. New evolutionary lineages are proposed for Calocyclas semipolita and Prunopyle trypopyrena.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Significant numbers of radiolarians ranging in age from late middle Miocene to Recent were recovered from six sites drilled on the Oman margin and Owen Ridge. Sparse faunas were recovered from five additional sites on the Oman margin and one site on the Indus Fan. Detailed range charts and biozonations are presented for most sites. The radiolarian assemblages are peculiar in that numerous common tropical forms, some of which are biomarkers, are absent or very rare. In addition, some species not usually found in tropical assemblages are present. These forms, indicative of up welling conditions, fall into three categories: (1) endemic upwelling: species endemic to upwelling and not previously described from the Indian Ocean; (2) displaced temperate: temperate forms not usually found in tropical waters; and (3) enhanced tropical: tropical forms which are more abundant and/or robust in areas of upwelling. Comparison of the Oman margin/Owen Ridge fauna with that recovered from the Peru margin upwelling area (ODP Leg 112) suggests that the assemblage may be globally diagnostic of upwelling conditions. The onset of upwelling is marked by the appearance of siliceous biota at about 11.9 Ma, and there is some indication of a decrease in the strength of the upwelling signal at about 9.6 Ma. A strong pulse in, or strengthening of, the upwelling mechanism is indicated by a marked fauna change at 4.7 Ma. There is a weaker signal, implying a change in upwelling conditions, at about 1.5 Ma.

Relevância:

10.00% 10.00%

Publicador:

Relevância:

10.00% 10.00%

Publicador:

Resumo:

The Cotard syndrome is characterized by the delusion where an individual insists that he has died or part of his body has decayed. Although described classically in schizophrenia and bipolar disorder, physical disorders including migraine, tumour and trauma have also been associated with the syndrome. Two new cases are described here, the one associated with arteriovenous malformations and the other with probable multiple sclerosis. The delusion has been embarrassing to each patient. Study of such cases may have wider implications for the understanding of the psychotic interpretation of body image, for example that occurring in anorexia nervosa.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

The in vitro and in vivo degradation properties of poly(lactic-co-glycolic acid) (PLGA) scaffolds produced by two different technologies-therm ally induced phase separation (TIPS), and solvent casting and particulate leaching (SCPL) were compared. Over 6 weeks, in vitro degradation produced changes in SCPL scaffold dimension, mass, internal architecture and mechanical properties. TIPS scaffolds produced far less changes in these parameters providing significant advantages over SCPL. In vivo results were based on a microsurgically created arteriovenous (AV) loop sandwiched between two TIPS scaffolds placed in a polycarbonate chamber under rat groin skin. Histologically, a predominant foreign body giant cell response and reduced vascularity was evident in tissue ingrowth between 2 and 8 weeks in TIPS scaffolds. Tissue death occurred at 8 weeks in the smallest pores. Morphometric comparison of TIPS and SCPL scaffolds indicated slightly better tissue ingrowth but greater loss of scaffold structure in SCPL scaffolds. Although advantageous in vitro, large surface area:volume ratios and varying pore sizes in PLGA TIPS scaffolds mean that effective in vivo (AV loop) utilization will only be achieved if the foreign body response can be significantly reduced so as to allow successful vascularisation, and hence sustained tissue growth, in pores less than 300 mu m. (C) 2005 Elsevier Ltd. All rights reserved.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Background: Large-bowel volvulus is a rare cause of bowel obstruction in the industrialized world. We analyzed the presentation and outcome of 49 patients at the Princess Alexandra Hospital, Brisbane, Australia, who received a diagnosis of colonic volvulus from 1991 to 2001. Methods: A retrospective chart study was carried out. Results: Twenty-nine patients had sigmoid volvulus (59%), 19 patients had cecal volvulus (39%) and 1 patient had a transverse colon volvulus (2%). The diagnosis of sigmoid volvulus was made accurately on plain abdominal radiography or contrast enema in 90% of cases (n = 26), compared with only 42% of cases (n = 8) of cecal volvulus. Twenty-two patients with sigmoid volvulus were treated initially with endoscopic decompression. The success rate was 64% (n = 14). There was a high early recurrence rate of sigmoid volvulus for those treated by endoscopic decompression alone (43%) during a mean period of 32 days. Of the 14 patients with cecal volvulus who were treated with right hemicolectomy, 12 had primary anastomosis and 2 had end ileostomy with mucous fistula formation. There was no anastomotic leak following right hemicolectomy with primary anastomosis, even though 6 of these patients had an ischemic cecum. Conclusions: Endoscopic decompression of the sigmoid volvulus was safe and effective as an initial treatment but has a high early recurrence rate. Any patient who is fit enough to undergo operation should have a definitive procedure during the same admission to avoid recurrence. Cecal volvulus is associated with a higher incidence of gangrene and is treated effectively by right hemicolectomy with or without anastomosis. The need for swift operative intervention is emphasized.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

A Osteotomia Segmentar de Maxila ou Osteotomia Le Fort I Segmentada é um procedimento que tem se tornado, cada vez mais comum, nas cirugias para as correções das deformidades dentofaciais, conhecidas como Cirurgias Ortognáticas. Este procedimento é muito bem indicado para a correção das discrepâncias maxilares, nos diferentes planos e num único tempo cirúrgico, otimizando assim, o tempo de tratamento a que o paciente é submetido. A estabilidade esquelética transversal e a oclusal dos pacientes, que são submetidos a este tipo de osteotomia, tem sido objeto de estudo na literatura , assim como também, os potenciais riscos e complicações inerentes a este procedimento como, a desvitalização dentária, fístula oro-nasal, perda dentária, necrose de algum segmento da maxila ou até mesmo, de toda a maxila. O objetivo deste trabalho é apresentar o caso clínico de um paciente submetido à osteotomia segmentar de maxila, e fazer uma revisão da literatura abrangendo os últimos 10 anos, com artigos que abordam a estabilidade deste tipo de procedimento, assim como também os potenciais riscos e complicações aos pacientes submetidos a este procedimento. Utilizando algumas palavras chave na base de dados eletrônica PUBMED, 12 artigos foram selecionados para este trabalho, no período de 2002 a 2012. A Osteotomia Segmentar de Maxila é um procedimento estável e seguro, com baixo índice de complicação, quando indicado corretamente e com os devidos cuidados no pré, trans e pós operatórios.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

PURPOSE. To establish an alternative method, sequential and diameter response analysis (SDRA), to determine dynamic retinal vessel responses and their time course in serial stimulation compared with the established method of averaged diameter responses and standard static assessment. METHODS. SDRA focuses on individual time and diameter responses, taking into account the fluctuation in baseline diameter, providing improved insight into reaction patterns when compared with established methods as delivered by retinal vessel analyzer (RVA) software. SDRA patterns were developed with measurements from 78 healthy nonsmokers and subsequently validated in a group of 21 otherwise healthy smokers. Fundus photography and retinal vessel responses were assessed by RVA, intraocular pressure by contact tonometry, and blood pressure by sphygmomanometry. RESULTS. Compared with the RVA software method, SDRA demonstrated a marked difference in retinal vessel responses to flickering light (P 0.05). As a validation of that finding, SDRA showed a strong relation between baseline retinal vessel diameter and subsequent dilatory response in both healthy subjects and smokers (P 0.001). The RVA software was unable to detect this difference or to find a difference in retinal vessel arteriovenous ratio between smokers and nonsmokers (P 0.243). However, SDRA revealed that smokers’ vessels showed both an increased level of arterial baseline diameter fluctuation before flicker stimulation (P 0.005) and an increased stiffness of retinal arterioles (P 0.035) compared with those in nonsmokers. These differences were unrelated to intraocular pressure or systemic blood pressure. CONCLUSIONS. SDRA shows promise as a tool for the assessment of vessel physiology. Further studies are needed to explore its application in patients with vascular diseases.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

PURPOSE: To compare the Parr-Hubbard and Knudtson formulas to calculate retinal vessel calibers and to examine the effect of omitting vessels on the overall result. METHODS: We calculated the central retinal arterial equivalent (CRAE) and central retinal venular equivalent (CRVE) according to the formulas described by Parr-Hubbard and Knudtson including the six largest retinal arterioles and venules crossing through a concentric ring segment (measurement zone) around the optic nerve head. Once calculated, we removed one arbitrarily selected artery and one arbitrarily selected vein and recalculated all outcome parameters again for (1) omitting one artery only, (2) omitting one vein only, and (3) omitting one artery and one vein. All parameters were compared against each other. RESULTS: Both methods showed good correlation (r for CRAE = 0.58; r for CRVE = 0.84), but absolute values for CRAE and CRVE were significantly different from each other when comparing both methods (p < 0.000001): CRAE had higher values for the Parr-Hubbard (165 [±16] μm) method compared with the Knudtson method (148 [±15] μm). In addition, CRAE and CRVE values dropped for both methods when omitting one arbitrarily selected vessel each (all p < 0.000001). Arteriovenous ratio (AVR) calculations showed a similar change for both methods when omitting one vessel each: AVR decreased when omitting one arteriole whereas it increased when omitting one venule. No change, however, was observed for AVR calculated with six or five vessel pairs each. CONCLUSIONS: Although the absolute value for CRAE and CRVE is changing significantly depending on the number of vessels included, AVR appears to be comparable as long as the same number of arterioles and venules is included.

Relevância:

10.00% 10.00%

Publicador:

Resumo:

Background During recent years laparoscopic cholecystectomy has dramatically increased, sometimes resulting in overtreatment. Aim of this work was to retrospectively analyze all laparoscopic cholecystectomies performed in a single center in order to find the percentage of patients whose surgical treatment may be explained with this general trend, and to speculate about the possible causes. Methods 831 patients who underwent a laparoscopic cholecystectomy from 1999 to 2008 were retrospectively analyzed. Results At discharge, 43.08% of patients were operated on because of at least one previous episode of biliary colic before the one at admission; 14.08% of patients presented with acute lithiasic cholecystitis; 14.68% were operated on because of an increase in bilirubin level; 1.56% were operated on because of a previous episode of jaundice with normal bilirubin at admission; 0.72% had gallbladder adenomas, 0.72% had cholangitis, 0.36% had biliodigestive fistula and one patient (0.12%) had acalculous cholecystitis. By excluding all these patients, 21.18% were operated on without indications. Conclusions The broadening of indications for laparoscopic cholecystectomy is undisputed and can be considered a consequence of new technologies that have been introduced, increased demand from patients, and the need for practice by inexperienced surgeons. If not prevented, this trend could continue indefinitely.