Pure-transvaginal natural orifice transluminal endoscopic surgery (NOTES) ovariohysterectomy in bitches: a preliminary feasibility study

Cirurgia endoscópica por orifícios naturais (NOTES) constitui um acesso cirúrgico relativamente novo para abordagem minimamente invasiva, a qual vem sendo amplamente estudada na medicina humana. Porém, poucos estudos envolvendo sua aplicação na prática cirúrgica de pequenos animais foram realizados até o momento. O objetivo do presente estudo foi avaliar a factibilidade da ovário-histerectomia transvaginal por NOTES pura em cadelas. Cinco cadelas foram avaliadas. A cavidade abdominal foi acessada por um trocarte de 11mm introduzido por uma incisão vaginal. Empregando-se um endoscópio rígido com canal de trabalho, os pedículos ovarianos foram coagulados e seccionados usando-se diatermia bipolar. O corno uterino foi tracionado para o interior do trocarte e exteriorizado juntamente com a cânula. O corpo e vasos uterinos foram coagulados ou ligados com sutura. O coto uterino foi reposicionado na cavidade abdominal e o pneumoperitônio, drenado. O procedimento foi realizado com sucesso em quatro das cinco cadelas. Na primeira tentativa, houve conversão para uma técnica de NOTES-híbrida, devido à quebra de uma pinça de coagulação. O tempo cirúrgico médio foi 52,1 (DP±11,5 minutos) para a técnica de NOTES pura. A OHE por NOTES pura é factível em cadelas, sem resultar em complicações maiores e proporcionando excelente recuperação pós-operatória.

Cultivar affects browning susceptibility of freshly cut star fruit slices

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

Electric charge rotating around a black hole

We consider an electric charge rotating around a Schwarzschild black hole. We compute, using quantum field theory in curved spacetime at the tree level, the power emitted by the rotating charge minimally coupled to the Maxwell field. We also compute how much of the radiation emitted by the swirling charge is absorbed by the black hole.

Efeito da implementação de diretriz para profilaxia de tromboembolismo venoso em pacientes cirúrgicos

INTRODUÇÃO: Estratégias efetivas para profilaxia do tromboembolismo venoso (TEV) são amplamente disponíveis, mas são ainda subutilizadas, principalmente no nosso meio. OBJETIVO: Avaliar o efeito da implementação de diretriz para profilaxia do TEV, em pacientes cirúrgicos, sobre a conduta da equipe de saúde na prescrição dessa profilaxia. Método. Estudo retrospectivo pré-intervenção - pós-intervenção. Prontuários de 150 pacientes antes e 150 depois da implementação de uma diretriz para a profilaxia (AID e DID) foram sorteados dentre pacientes de mais de 40 anos internados para cirurgia maior abdominal ou ortopédica. Foram registrados dados demográficos, referência a risco de TEV no prontuário, prescrição de profilaxia para TEV e diagnóstico de TEV durante a internação. RESULTADOS: Não houve diferença entre os dois grupos, AID e DID, quanto aos dados demográficos e ao tempo de profilaxia (5,6 x 6,6 dias). A frequência de profilaxia AID x DID antes da cirurgia foi: profilaxia farmacológica (PF), 6% x 9%; meias de compressão graduada (MCG), 4% x 3%; compressão pneumática intermitente (CPI), 2% x 3%. Após cirurgia: PF 53% x 53%; MCG, 23% x 40% (P<0,05); CPI, 26% x 32% . No total, AP, foi prescrita profilaxia para 60,5% dos pacientes AID e para 66,5% DID, mas a profilaxia foi considerada adequada em 34% dos pacientes AID e em 32% DID. Conclusão. A adoção do protocolo, embora com maior a preocupação com a profilaxia, traduzida pelo aumento na prescrição de MCG, melhorou minimamente sua qualidade, indicando a necessidade de outras intervenções ativas e contínuas para aumentar a aderência ao mesmo.

O grupo psicoterapêutico e a interpretação na abordagem lacaniana: reflexão e redefinição de possibilidades e modos de atendimento na Saúde Coletiva

Cet article propose, à travers une expérience pratique, présenter et discuter le groupe psychothérapeutique dans le référentiel psychanalytique théorique et éthique de Jacques Lacan en mettant l'accent sur la question de l'interprétation. Nous proposons une réflexion et la redéfinition des possibilités et des modes d'accueil dans le contexte de la Santé Collective. Le groupe psychothérapeutique proposé ici, qui applique la psychanalyse, correspond à une possibilité parmi les dispositifs de production de sens pour les impasses de subjectivation de la clinique contemporaine, surtout dans la Santé Publique. La pratique présentée et analysée dans cet article est une petite contribution à une proposition de psychothérapie de groupe fondée sur la théorie de Jacques Lacan, dont le but est de repenser et redéfinir les formes d'accueil de groupe en Santé Collective.

On the coupling of the self-dual field to dynamical U(1) matter and its dual theory

We consider arbitrary U (1) charged matter non-minimally coupled to the self-dual field in d = 2 + 1. The coupling includes a linear and a rather general quadratic term in the self-dual field. By using both Lagragian gauge embedding and master action approaches we derive the dual Maxwell Chern-Simons-type model and show the classical equivalence between the two theories. At the quantum level the master action approach in general requires the addition of an awkward extra term to the Maxwell Chern-Simons-type theory. Only in the case of a linear coupling in the self-dual field can the extra term be dropped and we are able to establish the quantum equivalence of gauge invariant correlation functions in both theories.

Hydrolyzed alpha-lactalbumin as a source of protein to the exercising

This work describes the effect of feeding enzymatically hydrolyzed a-lactalbumin on blood sugar, albumin and fatty acids, muscular and hepatic glycogen of rats subjected to physical exercise. Three normoenergetic/normoproteic diets, containing either casein (C), alpha-lactalbumin (L) or alpha-lactalbumin hydrolyzate (H) were fed to thirty male Wistar rats for five weeks. During this period, half of the rats swam for 1 hr daily (T category) while the other half remained sedentary (S category). At the end of training, all rats were required to swim to exhaustion. The results showed that those rats of the T-category consuming diet H reached exhaustion with significantly higher concentrations of serum glucose ([H] 56.0 and [L] 32.3 mg/100ml), serum albumin ([H] 3.8 and [L] 2.1 mg/dl) and muscle glycogen ([H] 2.1 and [L] 0.6 mg/g), while no differences were observed between diets regarding the time of arrival to exhaustion. Results from diets C and L differed minimally. It was concluded that feeding the hydrolyzed protein may result in nutritional advantage to the exercising rat. (C) 1998 Elsevier B.V.

Submucous myomas: A new presurgical classification to evaluate the viability of hysteroscopic surgical treatment - Preliminary report

STUDY OBJECTIVE: To develop a new preoperative classification of submucous myomas for evaluating the viability and the degree of difficulty of hysteroscopic myomectomy.DESIGN: Retrospective study (Canadian Task Force classification II-3)SETTING: University teaching hospitals.PATIENTS: Fifty-five patients who underwent hysteroscopic resection of submucous myomas.INTERVENTION: the possibility of total resection of the myoma, the operating time, the fluid deficit, and the frequency of any complications were considered. The myomas were classified according to the Classification of the European Society for Gynaecological Endoscopy (ESGE) and by our group's new classification (NC), which considers not only the degree of penetration of the myoma into the myometrium, but also adds in such parameters as the distance of the base of the myoma from the uterine wall, the size of the nodule (cm), and the topography of the uterine cavity. The Fisher's exact test, the Student's t test, and the analysis of variance test were used in the statistical analysis. A p value less than .05 in the two-tailed test was considered significant.MEASUREMENTS AND MAIN RESULTS: In 57 myomas, hysteroscopic surgery was considered complete. There was no significant difference among the three ESGE levels (0, 1, and 2). Using the NC, the difference between the numbers of complete surgeries was significant (p < .001) for the two levels (groups I and H). The difference between the operating times was significant for the two classifications. With respect to the fluid deficit, only the NC showed significant differences between the levels (p = .02).CONCLUSIONS: We believe that the NC gives more clues as to the difficulties of a hysteroscopic myomectomy than the standard ESGE classification. It should be stressed that the number of hysteroscopic myomectomies used in this analysis was low, and it would be interesting to evaluate the performance of the classification in a larger number of patients. (c) 2005 AAGL. All rights reserved.

Validation of hysteroscopic view in cases of endometrial hyperplasia and cancer in patients with abnormal uterine bleeding

STUDY OBJECTIVE: To validate hysteroscopic view with histology in cases of endometrial hyperplasia and cancer in patients with abnormal uterine bleeding (AUB)DESIGN: Retrospective study.(Canadian Task Force classification II-3).SETTING: University teaching hospitals in Rio de Janeiro and São Paulo, and private office in Rio de Janeiro.PATIENTS: Four thousand and fifty-four patients with AUB in whom hysteroscopic views were complete and the histologic result was conclusive.INTERVENTION: Four thousand and fifty-four office hysteroscopies with complete views and conclusive histologic results. The material for histologic examination was obtained through biopsy of the lesion in an outpatient unit or through the resection of the entire lesion in patients who underwent surgery. Histology was considered the gold standard and compared with the hysteroscopic view.MEASUREMENTS AND MAIN RESULTS: In the histology of the 4054 examinations, 613 (15.2%) were endometrial hyperplasia, and 105 (2.6%) were endometrial cancer. The most frequent hysteroscopic finding was endometrial polyps (31.2%). In endometrial hyperplasia, the sensitivity of the hysteroscopic view was 56.3% (95% CI 52.21-60.2%), specificity was 89.1% (95% CI 88.0%-90.1%), positive predictive value (PPV) was 48.0% (95% CI 44.3%-51.7%), negative predictive value (NPV) was 92.0% (95% Cl 90.1%-92.9%), and accuracy was 72.7% (95% CI 70.7%-74.7%). Accuracy was defined as the proportion of correct results among the hysteroscopic examinations. In endometrial cancer, the sensitivity of the hysteroscopic view was 80.0% (95% Cl 71.1%-87.2%), specificity was 99.5% (95% CI 99.2%-99.7%), PPV was 81.5% (95% Cl 72.7%-88.5%), NPV was 99.5% (95% CI 99.2%-99.7%), and accuracy was 89.8% (95% CI, 85.9%-93.6%). In the 814 patients (20.0%) in whom the hysteroscopic view was normal, there were no false negatives for endometrial cancer; however, there were 37 (4.5%) false negatives for endometrial hyperplasia. In the histologic cases of endometrial cancer, 101 (96.2%) hysteroscopic views were compatible with cancer or hyperplasia (80.0% and 16.2%, respectively). Ninety-seven out of 103 hysteroscopic views with cancer findings (94.2%) had histologic diagnosis of cancer or hyperplasia (81.5% and 12.6%, respectively).CONCLUSION: It seems that even in face of good validity of hysteroscopic view for endometrial hyperplasia and cancer, histologic study is mandatory in the presence of any lesion as the hysteroscopic view cannot completely replace the histologic study in patients with AUB. (C) 2006 AAGL. All rights reserved.

Carrying and Effect of Granulated Baits Formulated with Entomopathogenic Fungi among Atta sexdens rubropilosa Colonies (Hymenoptera: Formicidae)

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

A simple solution for the flavor question

We consider a simple way of solving the flavor question by embedding the three-family standard model in a semisimple gauge group extending minimally the weak isospin factor. Quantum chiral anomalies between families of fermions cancel with a matching of the number of families and the number of color degrees of freedom. Our demonstration shows how the theory leads to determination of families structure when the standard model is the input at low energies. The new physics is limited to start below a few TeVs within the reach of the next generation colliders.

Equivalence of the Duffin-Kemmer-Petiau and Klein-Gordon-Fock equations

A strict proof of the equivalence of the Duffin-Kemmer-Petiau and Klein-Gordon Fock theories is presented for physical S-matrix elements in the case of charged scalar particles minimally interacting with an external or quantized electromagnetic field. The Hamiltonian canonical approach to the Duffin - Kemmer Petiau theory is first developed in both the component and the matrix form. The theory is then quantized through the construction of the generating functional for the Green's functions, and the physical matrix elements of the S-matrix are proved to be relativistic invariants. The equivalence of the two theories is then proved for the matrix elements of the scattered scalar particles using the reduction formulas of Lehmann, Symanzik, and Zimmermann and for the many-photon Green's functions.

Laparoscopic evaluation and treatment of the impalpable testis

Objectives: To evaluate the laparoscopic technique as a diagnostic and therapeutic tool in the management of patients with impalpable testis. Material and Methods: Fifty-nine patients with mean age of 6.3 years underwent laparoscopy to evaluate 85 impalpable testes that were classified as absent, canalicular and intra-abdominal. In the case of testicular absence, the procedure was terminated. In the case of canalicular testis, open inguinal exploration was performed. In intra-abdominal testis, either laparoscopic orchiopexy or orchiectomy was performed. According to the length of the vascular pedicle, orchipexy was performed either with or without vascular ligature. Post-operatively, the treated testes were evaluated according to size and location in the scrotum. Results: Seventeen (20%) of the 85 impalpable testes were diagnosed as absent, 21 (24.7%) as canalicular and 47 (55.3%) as intra-abdominal. Of the canalicular testes, 20 were explored by inguinotomy and one by laparoscopy. All the intra-abdominal testes were treated initially by laparoscopy, four being removed due to atrophy, 31 submitted to vascular ligature and 12 to primary orchipexy. Of those submitted to vascular ligature, 22 underwent a second stage orchipexy, of which 18 laparoscopically and 4 by inguinotomy. Of the 18 testes brought to the scrotum by staged laparoscopic orchipexy, 15 (83.3%) presented normal characteristics in the late follow-up, while of the 12 submitted to primary laparoscopic orchipexy, 8 (66.6%) were normal. There were no perioperative or late complications. Conclusions: Laparoscopy is a minimally invasive procedure with low morbidity that enables precise diagnosis of the impalpable testes. When intra-abdominal testes are found, either immediate laparoscopic orchiectomy, or primary and staged orchipexy are possible, with results equivalent to open procedures, with the advantage of smaller surgical incisions and shorter postoperative recovery.

Energy and the AdS/CFT correspondence

We consider a scalar field theory on AdS in both minimally and non-minimally coupled cases. We show that there exist constraints which arise in the quantization of the scalar field theory on AdS which cannot be reproduced through the usual AdS/CFT prescription. We argue that the usual energy, defined through the stress-energy tensor, is not the natural one to be considered in the context of the AdS/CFT correspondence. We analyze a new definition of the energy which makes use of the Noether current corresponding to time displacements in global coordinates. We compute the new energy for Dirichlet, Neumann and mixed boundary conditions on the scalar field and for both the minimally and non-minimally coupled cases. Then, we perform the quantization of the scalar field theory on AdS showing that, for 'regular' and 'irregular' modes, the new energy is conserved, positive and finite. We show that the quantization gives rise, in a natural way, to a generalized AdS/CFT prescription which maps to the boundary all the information contained in the bulk. In particular, we show that the divergent local terms of the on-shell action contain information about the Legendre transformed generating functional, and that the new constraints for which the irregular modes propagate in the bulk are the same constraints for which such divergent local terms cancel out. In this situation, the addition of counterterms is not required. We also show that there exist particular cases for which the unitarity bound is reached, and the conformai dimension becomes independent of the effective mass. This phenomenon has no bulk counterpart.

On the role of boundary terms in the AdS/CFT correspondence

We consider a scalar field theory on AdS, and show that the usual AdS/CFT prescription is unable to map to the boundary a part of the information arising from the quantization in the bulk. We propose a solution to this problem by defining the energy of the theory in the bulk through the Noether current corresponding to time displacements, and, in addition, by introducing a proper generalized AdS/CFT prescription. We also show how this extended formulation could be used to consistently describe double-trace interactions in the boundary. The formalism is illustrated by focusing on the non-minimally coupled case using Dirichlet boundary conditions. © 2004 Published by Elsevier B.V.