Associacao de opioides lipofilicos a bupivacaina na anestesia peridural. Ha vantagem no aumento da dose do opioide?

Background and Objectives: - The effects of associating lipophilic opioids to local anesthetics in epidural anesthesia are not well defined. There are still questions and controversies about opioid doses to be used and their major effects in the epidural block. This study aimed at evaluating the epidural block effects in humans of the association of different fentanyl and sufentanil doses to bupivacaine with 1:200.000 epinephrine. Methods: - A double-blind randomized study was performed in 94 patients of both genders, physical status ASA I, aged between 18 and 60 years, submitted to lower abdomen, perineal or lower limb surgery. Patients without preanesthetic medication were epidurally injected with 100 mg (20 ml) 0.5% bupivacaine, 0.1 mg (0.1 ml) 1%o epinephrine plus a combination of the following drugs: BUPI Group (15 patients): 2 ml of 0.9% saline solution (SS); FENT50 Group (19 patients): 50 μg (1 ml) fentanyl + 1 ml SS; FENT100 Group (20 patients): 100 μg (2 ml) fentanyl; SUF30 Group (20 patients): 30 μg (0.6 ml) sufentanil + SS (1.4 ml); SUF100 Group (20 patients): 50 μg (1 ml) sufentanil + SS (1 ml). The following parameters were studied: onset of sensory block, analgesic block (onset time) in T12, T10 and T8, analgesic block duration in T10 and T12, motor block degree, consciousness degree, need for supplemental perioperative sedation and analgesia, hypotension, bradycardia and peri and post operative side-effects, analgesia duration, proportion of patients needing supplemental analgesia and evaluation of postoperative pain (pain analog visual scale). Results: Groups were demographically uniform. The addition of fentanyl or sufentanil did not alter major characteristics of perioperative epidural block and has not significantly increased postoperative analgesia duration as compared to the use of bupivacaine only. However, the addition of lipophilic opioids has increased the quality of perioperative anesthetic block, translated into a lesser need for supplemental analgesia (p < 0.02). The increased dose of fentanyl and especially of sufentanil has increased the incidence of perioperative drowsiness (p < 0.001) without significant increase in other side effects. Conclusions: In the conditions and doses used, the addition of lipophilic opioids to bupivacaine and the increased dose of lipophilic opioids have improved anesthetic block quality without changes in the epidural block characteristics or a significant increase in side effects, with the exception of drowsiness mainly caused by sufentanil. However, they were not able to provide a significant increase in postoperative analgesia duration.

An accurate low-voltage analog memory-cell with built-in multiplication

A CMOS memory-cell for dynamic storage of analog data and suitable for LVLP applications is proposed. Information is memorized as the gate-voltage of input-transistor of a gain-boosting triode-transconductor. The enhanced output-resistance improves accuracy on reading out the sampled currents. Additionally, a four-quadrant multiplication between the input to regulation-amplifier of the transconductor and the stored voltage is provided. Designing complies with a low-voltage 1.2μm N-well CMOS fabrication process. For a 1.3V-supply, CCELL=3.6pF and sampling interval is 0.25μA≤ ISAMPLE ≤ 0.75μA. The specified retention time is 1.28ms and corresponds to a charge-variation of 1% due to junction leakage @75°C. A range of MR simulations confirm circuit performance. Absolute read-out error is below O.40% while the four-quadrant multiplier nonlinearity, at full-scale is 8.2%. Maximum stand-by consumption is 3.6μW/cell.

Efficacy and safety of travoprost 0.004%/timolol 0.5% fixed combination as transition therapy in patients previously on prostaglandin analog monotherapy

Purpose: To assess the safety and efficacy of transitioning patients whose intraocular pressure (IOP) had been insufficiently controlled on prostaglandin analog (PGA) monotherapy to treatment with travoprost 0.004%/timolol 0.5% fixed combination with benzalkonium chloride (TTFC). Methods: This prospective, multicenter, open-label, historical controlled, single-arm study transitioned patients who had primary open-angle glaucoma, pigment dispersion glaucoma, or ocular hypertension and who required further IOP reduction from PGA monotherapy to oncedaily treatment with TTFC for 12 weeks. IOP and safety (adverse events, corrected distance visual acuity, and slit-lamp biomicroscopy) were assessed at baseline, week 4, and week 12. A solicited ocular symptom survey was administered at baseline and at week 12. Patients and investigators reported their medication preference at week 12. Results: Of 65 patients enrolled, 43 had received prior travoprost therapy and 22 had received prior nontravoprost therapy (n = 18, bimatoprost; n = 4, latanoprost). In the total population, mean IOP was significantly reduced from baseline (P = 0.000009), showing a 16.8% reduction after 12 weeks of TTFC therapy. In the study subgroups, mean IOP was significantly reduced from baseline to week 12 (P = 0.0001) in the prior travoprost cohort (19.0% reduction) and in the prior nontravoprost cohort (13.1% reduction). Seven mild, ocular, treatment-related adverse events were reported. Of the ten ocular symptom questions, eight had numerically lower percentages with TTFC compared with prior PGA monotherapy and two had numerically higher percentages with TTFC (dry eye symptoms and ocular stinging/burning). At week 12, TTFC was preferred over prior therapy for 84.2% of patients (48 of 57) by the patients themselves, and for 94.7% of patients (54 of 57) by their physicians. Conclusion: When TTFC replaced PGA monotherapy in patients whose IOP had been uncontrolled, the outcome was a significant reduction in IOP and an acceptable safety and tolerability profile. Most patients and investigators preferred TTFC to prior PGA monotherapy. © 2012 Costa et al, publisher and licensee Dove Medical Press Ltd.

High-resolution aquifer analog of fluvial-aeolian sediments of the Guarani aquifer system

The Guarani aquifer system (GAS) represents one of the biggest aquifers in the world and is the most relevant groundwater resource in South America. For the first time, by combining field and laboratory measurements, a high-resolution aquifer analog model of fluvial-aeolian sediments of the GAS in São Paulo State (Brazil) is constructed. Three parallel sections of frontal outcrops, 28 m × 5.8 m, and two parallel sections of lateral outcrops, 7 m × 5.8 m, are recorded during open-pit mining of sandy sediments and describe in detail the three-dimensional distribution of the local lithofacies and hydrofacies. Variations of hydraulic conductivity, K, and porosity, n, are resolved on the centimeter scale, and the most permeable units of the fluvial-aeolian facies association are identified. The constructed aquifer analog model shows moderate hydraulic heterogeneity and a mean K value of 1.36 × 10-4 m/s, which is greater than the reported range of K values for the entire GAS in São Paulo State. The results suggest that the examined sedimentary unit constitutes a relevant portion of the GAS in São Paulo State in the context of groundwater extraction and pollution. Moreover, the constructed aquifer analog is considered an ideal basis for future numerical model experiments, aiming at in-depth understanding of the groundwater flow and contaminant transport patterns at this GAS portion or at comparable fluvial-aeolian facies associations. © 2013 Springer-Verlag Berlin Heidelberg.

Análise cinemática da oscilação corporal de idosos com doença de Parkinson: efeitos da restrição visual

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Adaptação de livros de literatura infantil para alunos com deficiência visual

Pós-graduação em Educação - FFC

Sobre o brilhante efeito: história e narrativa visual na Amazônia em Antônio Parreiras (1905 – 1908)

A tela A Conquista do Amazonas de Antônio Parreiras procura representar o domínio lusitano sobre os povos amazônicos, demonstrando a soberania do branco, fato este essencial para o início da república brasileira. Neste caso, o quadro é uma tentativa de reviver as grandes conquistas lusitanas, utilizando-se de uma analogia, como se a implantação Republicana ganhasse uma dimensão grandiosa, característica das conquistas europeias do período colonial. Portanto, ter um fato passado, capaz de gerar uma unidade, era considerado essencial à formação de uma nação. Sendo caracterizada como um princípio espiritual; considerada sagrada e baseada em um passado heroico. Neste caso, a nação era uma solidariedade em larga escala, constituída da percepção dos sacrifícios feitos no passado. O artista desempenhou um papel fundamental, buscando as origens da existência da nação, imaginando-a, de modo a apresentá-la aos cidadãos, confrontando-os, mesmo nos locais mais distantes da nação.

A New and Simple Visual Technique Based on Indigo Dye for Determination of Ozone in Ambient Air

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Validation of the UNESP-Botucatu unidimensional composite pain scale for assessing postoperative pain in cattle

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

Efficacy of a perceptual and visual-motor skill intervention program for students with dyslexia

Purpose: To verify the efficacy of a perceptual and visual-motor skill intervention program for students with dyslexia. Methods: The participants were 20 students from third to fifth grade of a public elementary school in Marília, São Paulo, aged from 8 years to 11 years and 11 months, distributed into the following groups: Group I (GI; 10 students with developmental dyslexia) and Group II (GII; 10 students with good academic performance). A perceptual and visual-motor intervention program was applied, which comprised exercises for visual-motor coordination, visual discrimination, visual memory, visual-spatial relationship, shape constancy, sequential memory, visual figure-ground coordination, and visual closure. In pre- and post-testing situations, both groups were submitted to the Test of Visual-Perceptual Skills (TVPS-3), and the quality of handwriting was analyzed using the Dysgraphia Scale. Results: The analyzed statistical results showed that both groups of students had dysgraphia in pretesting situation. In visual perceptual skills, GI presented a lower performance compared to GII, as well as in the quality of writing. After undergoing the intervention program, GI increased the average of correct answers in TVPS-3 and improved the quality of handwriting. Conclusion: The developed intervention program proved appropriate for being applied to students with dyslexia, and showed positive effects because it provided improved visual perception skills and quality of writing for students with developmental dyslexia.

Visual conditions and postural directions affect postural sway variability in patients with Parkinson’s disease

Postural sway variability was evaluated in Parkinson’s disease (PD) patients at different stages of disease. Twenty PD patients were grouped into two groups (unilateral, 14; bilateral, 6) according to disease severity. The results showed no significant differences in postural sway variability between the groups (p ≥ 0.05). Postural sway variability was higher in the antero-posterior direction and with the eyes closed. Significant differences between the unilateral and bilateral groups were observed in clinical tests (UPDRS, Berg Balance Scale, and retropulsion test; p ≤ 0.05, all). Postural sway variability was unaffected by disease severity, indicating that neurological mechanisms for postural control still function at advanced stages of disease. Postural sway instability appears to occur in the antero-posterior direction to compensate for the stooped posture. The eyes-closed condition during upright stance appears to be challenging for PD patients because of the associated sensory integration deficit. Finally, objective measures such as postural sway variability may be more reliable than clinical tests to evaluate changes in balance control in PD patients.

Self-potential signals from an analog biogeobattery mode

A tank experiment was conducted to check if self-potential (SP) signals can be generated when buried organic matter is wire-connected to a near-surface, oxygen-rich, sediment layer. This experiment demonstrated that once wired, there was a flux of electrons (hence an electric current) between the lower and upper layers of the sandbox with the system responding as a large-scale microbial fuel cell (a type of bioelectrochemical system). An electric current was generated by this process in the wire and the SP method was used to monitor the associated electric potential distribution at the top of the tank.. The electric field was controlled by the flux of electrons through the wire, the oxidation of the organic matter, the reduction of oxygen used as a terminal electron acceptor, and the distribution of the DC resistivity in the tank. The current density through the wire was limited by the availability of oxygen and not by the oxidation of the organic matter. This laboratory experiment incorporated key elements of the biogeobattery observed in some organic-rich contaminant plumes. This analogy includes the generation of SP signals associated with a flux of electrons, the capacity of buried organic matter in sustaining anodic reactions, network resistance connecting terminal redox reactions spatially separated in space, and the existence of anodic secondary coupled reactions. A resistivity tomogram of the tank, after almost a year in operation, suggests that oxidative processes triggered by this geobattery can be imaged with this method to determine the radius of influence of the bioelectrochemical system.

Numerical Modelling of Graphene Nanoribbon-fets for Analog and Digital Applications

Graphene, that is a monolayer of carbon atoms arranged in a honeycomb lattice, has been isolated only recently from graphite. This material shows very attractive physical properties, like superior carrier mobility, current carrying capability and thermal conductivity. In consideration of that, graphene has been the object of large investigation as a promising candidate to be used in nanometer-scale devices for electronic applications. In this work, graphene nanoribbons (GNRs), that are narrow strips of graphene, for which a band-gap is induced by the quantum confinement of carriers in the transverse direction, have been studied. As experimental GNR-FETs are still far from being ideal, mainly due to the large width and edge roughness, an accurate description of the physical phenomena occurring in these devices is required to have valuable predictions about the performance of these novel structures. A code has been developed to this purpose and used to investigate the performance of 1 to 15-nm wide GNR-FETs. Due to the importance of an accurate description of the quantum effects in the operation of graphene devices, a full-quantum transport model has been adopted: the electron dynamics has been described by a tight-binding (TB) Hamiltonian model and transport has been solved within the formalism of the non-equilibrium Green's functions (NEGF). Both ballistic and dissipative transport are considered. The inclusion of the electron-phonon interaction has been taken into account in the self-consistent Born approximation. In consideration of their different energy band-gap, narrow GNRs are expected to be suitable for logic applications, while wider ones could be promising candidates as channel material for radio-frequency applications.

Spatio-temporal models of the functional architecture of the visual cortex

In this work I tried to explore many aspects of cognitive visual science, each one based on different academic fields, proposing mathematical models capable to reproduce both neuro-physiological and phenomenological results that were described in the recent literature. The structure of my thesis is mainly composed of three chapters, corresponding to the three main areas of research on which I focused my work. The results of each work put the basis for the following, and their ensemble form an homogeneous and large-scale survey on the spatio-temporal properties of the architecture of the visual cortex of mammals.

The Validation of a New Visual Anaemia Evaluation Tool HemoHue HH1 in Patients with End-Stage Renal Disease

In chronic haemodialysis patients, anaemia is a frequent finding associated with high therapeutic costs and further expenses resulting from serial laboratory measurements. HemoHue HH1, HemoHue Ltd, is a novel tool consisting of a visual scale for the noninvasive assessment of anaemia by matching the coloration of the conjunctiva with a calibrated hue scale. The aim of the study was to investigate the usefulness of HemoHue in estimating individual haemoglobin concentrations and binary treatment outcomes in haemodialysis patients. A prospective blinded study with 80 hemodialysis patients comparing the visual haemoglobin assessment with the standard laboratory measurement was performed. Each patient's haemoglobin concentration was estimated by seven different medical and nonmedical observers with variable degrees of clinical experience on two different occasions. The estimated population mean was close to the measured one (11.06 ± 1.67 versus 11.32 ± 1.23 g/dL, P < 0.0005). A learning effect could be detected. Relative errors in individual estimates reached, however, up to 50%. Insufficient performance in predicting binary outcomes (ROC AUC: 0.72 to 0.78) and poor interrater reliability (Kappa < 0.6) further characterised this method.