Sensibilidade à mudança de trajetória de deformação no aço TWIP980

Resultante dos avanços tecnológicos, conseguiu-se obter um aço que elimina o paradigma de se aliar alta ductilidade e resistência mecânica. Assim foi desenvolvido durante a última década o aço TWIP, deformação induzida por maclação, tendo como principal mecanismo de deformação a maclação. Este presente trabalho teve como principal objetivo caraterizar o aço TWIP980 em três temáticas diferentes: química, mecânica e microestrutura. Na primeira temática, a química, esta teve como objetivo encontrar a designação do aço TWIP em estudo. Sendo apenas conhecida a direção de laminação, RD, e a empresa que forneceu as chapas, a POSCO, o objetivo era obter a sua designação. Através da comparação das curvas de tração encontradas para o material em estudo, e conjuntamente, com as diversas curvas de tração de vários aços TWIP da empresa POSCO, realizou-se a comparação. Visto ter-se ficado reduzido a dois possíveis aços TWIP, foi através de uma análise à composição química, EDS - Espectroscopia da energia dispersa por raios-X, que se concluiu que o aço em estudo era o TWIP980. Na caraterização mecânica, e através de ensaios de tração, foram estudadas propriedades como: o módulo de elasticidade, tensão limite elástico, ductilidade, anisotropia, coeficiente de encruamento e Poisson. Estas propriedades foram estudas para três mudanças na trajetória de deformação e quatro pré-deformações em estudo. Assim estudou-se a alteração de trajetória para os ângulos a 0º, 45º e 90º em relação a RD, para as deformações de engenharia de 0%, 10%, 20% e 30%. Por último, na análise à microestrutura, esta teve como objetivo obter valores para o tamanho de grão e de macla bem como as suas orientações cristalográficas. Também a densidade de deslocações e maclação para cada uma das 4 pré-deformações esteve em estudo. Estes parâmetros foram obtidos através de microscopia ótica, eletrónica de varrimento, MEV e eletrónica de transmissão, MET.

Small bowel obstruction caused by mesh migration. Case report

Introduction. Endoscopic hernia repair methods have become increasingly popular over the past 15 years. Nonetheless, there is no consensus regarding an optimal fixation method. Transabdominal sutures and titanium tacks or staples are the most traditional ones. Case report. We present a case of mechanic small bowel obstruction due to mesh migration occurring one year and a half after incisional hernia repair with polytetrafluoroethylene mesh fixed by spiral tacks. Discussion. Titanium spiral tacks are dangerous because of their sharp components, which can damage organs such as the small intestine, by causing microperforations. The type of prosthesis used has also contributed to the intraluminal migration, since polytetrafluoroethylene mesh is very flexible and poorly integrates in the abdominal wall. Conclusion. A prosthesis of a different material combined with a different fixation system such as absorbable tacks, biological glue, or mechanical tacks without sharp components, would have obviated mesh migration. .

Estudo comparativo da queima rápida com a queima tradicional nas propriedades de materiais cerâmicos de base argilos

Dutra, R. P. S.; Varela,M. L.; Nascimento, R. M. ; Gomes, U. U. ; Martinelli1, A. E. ; Paskocimas, C. A. Estudo comparativo da queima rápida com a queima tradicional nas propriedades de materiais cerâmicos de base argilosa. Cerâmica [online]. 2009, vol.55, n.333, pp. 100-105. ISSN 0366-6913. doi:Disponivem em: . Acesso em: 04 out. 2010.

Sequential Morphological Changes in the CNV Net after Intravitreal Anti-VEGF Evaluated with OCT Angiography

PURPOSE: To assess and describe sequential morphological changes in the choroidal neovascularization (CNV) net using optical coherence tomography angiography (OCTA) in patients undergoing treatment with intravitreal antivascular endothelial growth factor (VEGF). METHODS: Prospective cohort study. OCTA was performed sequentially: before (t0), 1 h (t1), 1 week (t2) and 1 month after the injection (t3), using Avanti RTVue XR equipped with the AngioVue® software (Optovue, Calif., USA). All images were classified by two independent graders. RESULTS: Ten eyes of 10 patients, with a mean age of 72.4 ± 10.5 years, were included. CNV morphology was described as tree-like in 5 eyes, glomerular in 1 and fragmented in 4. A fibrovascular capsule surrounding the CNV net was found in 4 eyes and a feeder trunk was noticed in 6. No changes were observed at t1. Loss of peripheral capillaries, vessel fragmentation and decreased vessel density were evident in 8 eyes at t2. The CNV capillary density and the peripheral anastomosis increased in all of these at t3. Two eyes remained unchanged through the whole length of follow-up. CONCLUSIONS: Significant changes in the CNV net can be observable in OCTA at least 1 week after intravitreal anti-VEGF. The safety of frequent examinations may provide a method of gauging treatment effects.

Efeitos do fator de crescimento de fibroblasto Básico (FCFß) na cicatrização de anastomoses do esôfago

Os fatores de crescimento são substâncias moduladoras do processo de cicatrização. O fator de crescimento de fibroblastos básico (FCFß) liberado pelas plaquetas, macrófagos e pelos próprios fibroblastos, estimulam a proliferação celular, a produção de colágeno e de outros elementos da matriz celular, favorecendo o processo da cicatrização, mesmo em situações adversas, como diabetes e uso de corticosteróides. O presente estudo objetivou determinar a influência do FCFb no processo de cicatrização de anastomoses esofageanas em modelo de experimentação animal, avaliando-se a resistência à pressão,formação de tecido de granulação e deposição de colágeno. Método: Foram estudados dois grupos A e B,ambos com 10 ratos de linhagem Wistar, separados de forma aleatória, todos submetidos à secção e anastomose do esôfago por via abdominal. Nos animais do grupo A, foi feita aplicação tópica na linha de sutura de 10ng de FCFb. No grupo B (controle) foi aplicado igual volume de solução salina. Os animais foram sacrificados no 7º dia, o esôfago ressecado para teste de resistência da anastomose, estudo qualitativo do aporte de células inflamatórias, da angiogênese e quantificação do colágeno na zona da anastomose, através de sistema digital. Resultados: A densidade média dos parâmetros histológicos do grupo A foi 9095,51±1284,5, maior que no grupo B, que teve densidade 7162,4±1273,19 (p=0,013). A resistência da anastomose do grupo A teve a média 210±18,88 mmHg, significativamente maior que no grupo B, que atingiu o valor 157±29,55 mmHg (p=0,0024). Conclusão: Este estudo concluiu que o FCFß atuou melhorando a cicatrização e aumentando significativamente a resistência de anastomoses do esôfago realizadas em ratos

Dynamic Coculture of a Prevascularized Engineered Bone Construct

The generation of functional, vascularized tissues is a key challenge for the field of tissue engineering. Before clinical implantations of tissue engineered bone constructs can succeed, in vitro fabrication needs to address limitations in large-scale tissue development, including controlled osteogenesis and an inadequate vasculature network to prevent necrosis of large constructs. The tubular perfusion system (TPS) bioreactor is an effective culturing method to augment osteogenic differentiation and maintain viability of human mesenchymal stem cell (hMSC)-seeded scaffolds while they are developed in vitro. To further enhance this process, we developed a novel osteogenic growth factors delivery system for dynamically cultured hMSCs using microparticles encapsulated in three-dimensional alginate scaffolds. In light of this increased differentiation, we characterized the endogenous cytokine distribution throughout the TPS bioreactor. An advantageous effect in the ‘outlet’ portion of the uniaxial growth chamber was discovered due to the system’s downstream circulation and the unique modular aspect of the scaffolds. This unique trait allowed us to carefully tune the differentiation behavior of specific cell populations. We applied the knowledge gained from the growth profile of the TPS bioreactor to culture a high-volume bone composite in a 3D-printed femur mold. This resulted in a tissue engineered bone construct with a volume of 200cm3, a 20-fold increase over previously reported sizes. We demonstrated high viability of the cultured cells throughout the culture period as well as early signs of osteogenic differentiation. Taking one step closer toward a viable implant and minimize tissue necrosis after implantation, we designed a composite construct by coculturing endothelial cells (ECs) and differentiating hMSCs, encouraging prevascularization and anastomosis of the graft with the host vasculature. We discovered the necessity of cell to cell proximity between the two cell types as well as preference for the natural cell binding capabilities of hydrogels like collagen. Notably, the results suggested increased osteogenic and angiogenic potential of the encapsulated cells when dynamically cultured in the TPS bioreactor, suggesting a synergistic effect between coculture and applied shear stress. This work highlights the feasibility of fabricating a high-volume, prevascularized tissue engineered bone construct for the regeneration of a critical size defect.

Importancia de la nutrición perioperatoria en pacientes sometidos a cirugía gastrointestinal mayor electiva en el Hospital General del Instituto Salvadoreño del Seguro Social en el periodo de enero a diciembre del 2013 version 2.0

Desde el inicio de los estudios acerca de la nutrición perioperatoria en pacientes sometidos a cirugía gastrointestinal mayor, ya sea por patología benigna o maligna; se evidenció un vínculo entre la malnutrición y su asociación a las complicaciones trans y posquirúrgicas, es por eso que se realiza este estudio con el fin de determinar la relación coexistente entre un mal estado nutricional y las complicaciones postquirúrgicas. Materiales y métodos: se realizó un estudio analítico no aleatorio. La población en estudio fueron los pacientes con cirugías mayores gastrointestinales electivas del Hospital General del Instituto Salvadoreño del Seguro Social de enero – diciembre 2013, se realizaron 133 cirugías de las cuales solo 49 fueron incluidas, estudiadas con intervalo de confianza de 99% y error muestral de 0.01. Resultados: Se obtuvo una frecuencia de 11 casos de complicaciones postquirúrgicas de los 49 casos, entre las cuales se encuentran 3 casos con fugas de anastomosis, 2 dehiscencias de herida operatoria, 2 sangrados y/o hematomas, 2 complicaciones médicas, 1 infección de sitio quirúrgico y 1 caso de disrupción transquirúrgica de la vía biliar. De estos casos 6 presentaban hipoalbuminemia, 7 presentaban recuento bajo de linfocitos; 8 presentaban una valoración global subjetiva subóptima. Discusión: en este estudio se puede inferir que debe haber un protocolo de manejo nutricional del paciente sometido a cirugía gastrointestinal mayor electiva y así poder desde el inicio del manejo de paciente, tratar integralmente desde el punto de vista nutricional. Así como estadificar el estado nutricional, y apoyarse con datos bioquímicos de laboratorio que confirmen una buena nutrición antes de ser sometido a este tipo de cirugías. Esto con el afán de cumplir los estándares nutricionales internacionales.

Endoluminal calprotectin measurement in assessment of pouchitis and a new index of disease activity: a pilot study

Pouchitis is the most common complication following proctocolectomy with ileal pouch-anal anastomosis for ulcerative colitis (UC). To provide a standardized definition of pouchitis clinical, endoscopic and histological markers were grouped and weighted in the pouch disease activity index (PDAI). However, the delay in the assessment of the final score due to the time requested for histological analysis remains the main obstacle to the index implementation in clinical practice so that the use of modified-PDAI (mPDAI) with exclusion of histologic subscore has been proposed. We tested the ability of calprotectin measurement in the pouch endoluminal content to mimic the histologic score as defined in the PDAI, the index that we adopted as gold standard for pouchitis diagnosis. Calprotectin was measured by ELISA in the pouch endoluminal content collected during endoscopy in 40 consecutive patients with J-pouch. In each patient PDAI and mPDAI were calculated and 15% of patients were erroneously classified by mPDAI. ROC analysis of calprotectin values vs. acute histological subscore ≥ 3 identified different calprotectin cut-off values with corresponding sensitivity and specificity allowing the definition and scoring of different range of calprotectin subscores. We incorporated the calprotectin score in the mPDAI obtaining a new score that shows the same specificity as PDAI for diagnosis of pouchitis and higher sensitivity when compared with mPDAI. The use of the proposed new score, once validated in a larger series of patients, might be useful in the early management of patients with symptoms of pouchitis.

Prevalence of Barrett Esophagus in Adolescents and Young Adults With Esophageal Atresia

International audience

Influência do teor de calcário no comportamento físico, mecânico e microestrutural de cerâmicas estruturais

There are ores of clay in Piauí State that are used for red structural ceramics, which are naturally contaminated with calcareous vein. This is one thing that impedes its exploration in an adequate way, especially for tile production. The present work aims at verifying the influence of the calcareous contents in the technological structural ceramics area, seeking to determine a maximum permissible calcareous proportion/contents in the ceramic mass using the patterns of the local industry production. For the consecution of this paper, it was characterized the clay and calcareous material by FRX, DRX, TGA and DTA. It was also configurated by extrusion and burnt in the temperatures of 850°C, 900°C, 950°C and 1000°C pieces of the corpus with 0, 5, 10, 15 e 20% of calcareous proportion. After that, it was carried out technological samples of linear retraction, water absortion, apparent porosity, specific apparent mass and mechanic resistance. The results showed the possibility of using calcareous in the ceramic mass and in some cases the technological properties got better

Estudo de sistemas vítreos para infiltração em alumina

The system in-Ceram Alumina, produced by VITA, consists in a technique of prepare of a substructure of ceramics to dental crowns. First burning is made in the alumina decanted by slip casting process under a stone die that reproduces the tooth prepared to receive a crown. In a second burning, alumina is infiltrated by vitreous system, giving to this set a high mechanic resistance. In this work, it s made a study of the composition of a new infiltrating material more used nowadays, giving to alumina desirable mechanics proprieties to its using like substructure of support to ceramic s crown used in the market today. The addition of Lanthanum oxide (frit A) and calcium oxide (frit B) was made in attempt to increase the viscosity of LZSA and to reduce fusion temperature. The frits were put over samples of alumina and took to the tubular oven to 1400ºC under vacuum for two groups (groups 1 and 2). For another two groups (groups 3 and 4) it was made a second infiltration, following the same parameters of the first. A fifth group was utilized like group of control where the samples of pure alumina were not submitted to any infiltrating process. Glasses manifested efficient both in quality and results of analysis of mechanic resistance, being perfectly compatible with oral environment in this technical requisite. The groups that made a second infiltration had he best results of fracture toughness, qualify the use in the oral cavity in this technical question. The average of results achieved for mechanic resistance to groups 1, 2, 3, 4 and 5 were respectively 98 MPa, 90 MPa, 144 MPa, 236 MPa and 23 MPa

A CSR and communication strategy for Worten

Field lab in marketing

Estenosis esofágica. Aplicación de una técnica quirúrgica. Caso clínico

Se presenta el caso clínico de un paciente que presenta estenosis esofágica tras ingesta de caústicos, con disfagia a líquidos por lo que se realizó esofagectomía transhiatal con técnica de tubo gástrico como alternativa para reemplazo esofágico con ascenso mediastinal y yeyunostomía de alimentación, luego del procedimiento presenta fístula a nivel de la anastomosis proximal cervical y derrame pleural que se drena mediante avenamiento pleural bilateral, se maneja de manera conservadora sin desfuncionalización la fistula cervical mediante dren semirígido, con cierre espontaneo y se da de alta al paciente luego de tolerar dieta

Using an infra-red sensor to measure the dynamic behaviour of N2O gas escaping through different sized holes

An anastomosis is a surgical procedure that consists of the re-connection of two parts of an organ and is commonly required in cases of colorectal cancer. Approximately 80% of the patients diagnosed with this problem require surgery. The malignant tissue located on the gastrointestinal track must be resected and the most common procedure adopted is the anastomosis. Studies made with 2,980 patients that had this procedure, show that the leakage through the anastomosis was 5.1%. This paper discusses the dynamic behavior of N2O gas through different sized leakages as detected by an Infra-Red gas sensor and how the sensors response time changes depending on the leakage size. Different sized holes were made in the rigid tube to simulate an anastomostic leakage. N2O gas was injected into the tube through a pipe and the leakage rate measured by the infra-red gas sensor. Tests were also made experimentally also using a CFD (Computational Fluid Dynamics) package called FloWorks. The results will be compared and discussed in this paper.

O impacto socioeconômico da implementação do programa jovem aprendiz a partir da inclusão laboral dos jovens aprendizes atendidos pelo Instituto Federal de Brasília - Campus Estrutural

Dissertação apresentada para obtenção do grau de Mestre em Educação Social e Intervenção Comunitária