949 resultados para Drainage.
Resumo:
As afluências indevidas resultantes direta ou indiretamente da precipitação são um dos principais fatores que provocam graves problemas de carácter ambiental, estrutural e económico, no âmbito de um bom funcionamento dos sistemas separativos de saneamento e tratamento de águas residuais urbanas. Ao longo dos anos, com a expansão do serviço de saneamento à população, tem sido reconhecido que os caudais excedentes às redes de drenagem de águas residuais e estações de tratamento são um problema grave e para isso estão a ser criados critérios cada vez mais exigentes no domínio da gestão e operação destes sistemas de saneamento. Para uma melhor compreensão sobre a incidência das afluências indevidas nos sistemas de saneamento e nas estações de tratamento de águas residuais, é necessário realizar estudos de quantificação e caracterização no sistema de esgotos. Com a necessidade de compreender a plenitude e natureza deste problema, tornou-se necessário desenvolver metodologias com o objetivo de melhorar a eficiência e eficácia hidráulica dos sistemas de drenagem e de tratamento. Este trabalho tem como objetivo a análise quantitativa das afluências indevidas, recorrendo a um caso de estudo de uma bacia de drenagem de águas residuais. Para adquirir mais conhecimento sobre o tema foi necessário recolher várias metodologias existentes de maneira a selecionar, estudar e aplicar o método mais vantajoso. Nesta dissertação, foram utilizados dados disponibilizados pela SIMRIA, no que respeita aos caudais de bombagem da estação elevatória a que afluiu a rede em estudo, e pela INDAQUA Feira, no que respeita aos dados de precipitação.
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An infrequent but devastating late complication of Fontan circulation is protein-losing enteropathy (PLE), which results from unbalanced lymphatic homeostasis. Surgical decompression of the thoracic duct by redirecting its drainage to the pulmonary venous atrium has been introduced recently as a possible treatment. This report describes a single-institution experience with this innovative procedure in 2 patients with failing Fontan circulation with PLE refractory to optimized medical therapy.
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Dissertação de Mestrado Integrado em Medicina Veterinária
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Purpose: In extreme situations, such as hyperacute rejection of heart transplant or major bleeding per-operating complications, an urgent heart explantation might be the only means of survival. The aim of this experimental study was to improve the surgical technique and the hemodynamics of an Extracorporeal Membrane Oxygenation (ECMO) support through a peripheral vascular access in an acardia model. Methods: An ECMO support was established in 7 bovine experiments (59±6.1 kg) by the transjugular insertion to the caval axis of a self-expanded cannula, with return through a carotid artery. After baseline measurements of pump flow and arterial and central venous pressure, ventricular fibrillation was induced (B), the great arteries were clamped, the heart was excised and right and left atria remnants, containing the pulmonary veins, were sutured together leaving an atrial septal defect (ASD) over the cannula in the caval axis. Measurements were taken with the pulmonary artery (PA) clamped (C) and anastomosed with the caval axis (D). Regular arterial and central venous blood gases tests were performed. The ANOVA test for repeated measures was used to test the null hypothesis and a Bonferroni t method for assessing the significance in the between groups pairwise comparison of mean pump flow. Results: Initial pump flow (A) was 4.3±0.6 L/min dropping to 2.8±0.7 L/min (P B-A= 0.003) 10 minutes after induction of ventricular fibrillation (B). After cardiectomy, with the pulmonary artery clamped (C) it augmented not significantly to 3.5±0.8 L/min (P C-B= 0.33, P C-A= 0.029). Finally, PA anastomosis to the caval axis was followed by an almost to baseline pump flow augmentation (4.1±0.7 L/min, P D-B= 0.009, P D-C= 0.006, P D-A= 0.597), permitting a full ECMO support in acardia by a peripheral vascular access. Conclusions: ECMO support in acardia is feasible, providing new opportunities in situations where heart must urgently be explanted, as in hyperacute rejection of heart transplant. Adequate drainage of pulmonary circulation is pivotal in order to avoid pulmonary congestion and loss of volume from the normal right to left shunt of bronchial vessels. Furthermore, the PA anastomosis to the caval axis not only improves pump flow but it also permits an ECMO support by a peripheral vascular access and the closure of the chest.
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Abstract Bradykinin (BK) was shown to stimulate the production of physiologically active metabolites, blood-brain barrier disruption, and brain edema. The aim of this prospective study was to measure BK concentrations in blood and cerebrospinal fluid (CSF) of patients with traumatic brain injury (TBI), subarachnoid hemorrhage (SAH), intracerebral hemorrhage (ICH), and ischemic stroke and to correlate BK levels with the extent of cerebral edema and intracranial pressure (ICP). Blood and CSF samples of 29 patients suffering from acute cerebral lesions (TBI, 7; SAH,: 10; ICH, 8; ischemic stroke, 4) were collected for up to 8 days after insult. Seven patients with lumbar drainage were used as controls. Edema (5-point scale), ICP, and the GCS (Glasgow Coma Score) at the time of sample withdrawal were correlated with BK concentrations. Though all plasma-BK samples were not significantly elevated, CSF-BK levels of all patients were significantly elevated in overall (n=73) and early (≤72 h) measurements (n=55; 4.3±6.9 and 5.6±8.9 fmol/mL), compared to 1.2±0.7 fmol/mL of controls (p=0.05 and 0.006). Within 72 h after ictus, patients suffering from TBI (p=0.01), ICH (p=0.001), and ischemic stroke (p=0.02) showed significant increases. CSF-BK concentrations correlated with extent of edema formation (r=0.53; p<0.001) and with ICP (r=0.49; p<0.001). Our results demonstrate that acute cerebral lesions are associated with increased CSF-BK levels. Especially after TBI, subarachnoid and intracerebral hemorrhage CSF-BK levels correlate with extent of edema evolution and ICP. BK-blocking agents may turn out to be effective remedies in brain injuries.
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The stable isotope composition of waters (delta H-2, delta O-18) can be used as a natural tracer of hydrologic processes in systems affected by acid mine drainage. We investigated the delta H-2 and delta O-18 values of pore waters from four oxidizing sulfidic mine tailings impoundments in different climatic regions of Chile (Piuquenes at La Andina with Alpine climate, Cauquenes and Caren at El Teniente with Mediterranean climate, and Talabre at the Chuquicamata deposit with hyperarid climate). No clear relationship was found between altitude and isotopic composition. The observed displacement of the tailings pore waters from the local meteoric water line toward higher delta O-18 values (by similar to +2% delta O-18 relative to delta H-2) is partly due to water-rock interaction processes, including hydration and O-isotope exchange with sulfates and Fe(III) oxyhydroxides produced by pyrite oxidation. In most tailings, from the saturated zone toward the surface, isotopically different zones can be distinguished. Zone I is characterized by an upward depletion of H-2 and O-18 in the pore waters from the saturated zone and the lowermost vadose zone, due to ascending diffused isotopically light water triggered by the constant loss of water vapor by evaporation at the surface. In zone II, the capillary flow of a mix of vapor and liquid water causes an evaporative isotopic enrichment in H-2 and O-18. At the top of the tailings in dry climate a zone III between the capillary zone and the surface contains isotopically light diffused and atmospheric water vapor. In temperate climates, the upper part of the profile is affected by recent rainfall and zone III may not differ isotopically from zone II.
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La maladie de Coats est une vasculopathie non héréditaire. Elle est caractérisée par la présence de télangiectasies rétiniennes idiopathiques, d'exsudats lipidiques intrarétiniens et sousrétiniens, une rétinopathie ischémique et un décollement de rétine exsudative. Cette maladie se présente typiquement dans l'enfance, elle est unilatérale et atteint les hommes dans la majorité des cas. Nous décrivons un cas atypique d'un patient avec une maladie de Coats qui a récidivé 30 ans plus tard malgré un traitement initial efficace. Ce cas illustre l'évolution de la maladie de Coats à long terme. L'enjeu de ce cas est de faire une étude exhaustive des différents traitements possibles de cette maladie. Nous avons réalisé une révision de la littérature des cas de la maladie de Coats qui ont récidivé à long terme. Il y a peu de cas décrits dans la littérature avec un long suivi. En conclusion, la maladie de Coats doit être considérée comme une maladie chronique qui nécessite un suivi à long terme. Cette maladie peut se réveiller et récidiver dans des zones de la rétine, qui n'ont pas été atteintes auparavant, et plusieures décennies plus tard. Le traitement standard de cette maladie est la réalisation d'une cryothérapie et du laser argon dans les zones atteintes de la rétine. Dans les cas où l'exsudation rétinienne est très importante il peut s'avérer de faire un traitement chirurgical avec drainage du liquide sousrétinien, ce qui a été réalisé sur ce patient.
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Objective: Because increasing incidence of melanoma and dermatologicsystematic screening, more early superficial melanoma are discovered in Switzerland. Patients with Breslow index more than 1 mm. (T2) represent the classical indication to sentinel node (SN). It has been shown that some ''risky'' T1 patients may have micrometastatic SNs. T1b melanoma are defined by presence of ulceration,Clark IV (ormore) level, signs of melanoma regression (old classification) and high mitotic index (new TNM). The objective of the present study was to review the incidence and risk for metastatic SN in T1 patients and if radical lymph node dissection is justified (evaluation of non sentinel node [NSN]) compared with T2-4 patients.Methods: Retrospective review of a cohort of all patients operated for T1-4 clinically N0 and radiological M0 melanoma patients between 1997 and 2010 in a reference melanoma centre.Results: 599 melanoma patients have been operated with SNdissection. There were 98 T1 patients. Metastatic SN were observed in 2 out of 24 T1a patients and in 5 out of 74 T1b patients. This means overall 7% T1 patients were at least N1a. None of SN+ T1a or T1b patients had metastatic NSN after radical lymph node dissections (RLND). During the follow-up (1998-2010), no patients presented with locoregional disease and only one T1a N1a patient died of metastatic melanoma. These results contrast with the other 591 T2-4 patients: 150 were SN+ (25%) and among them 23 had metastatic NSN after RLND. Overall 23/136 (17%) had metastatic NSN.Conclusion: T1 melanoma patients are at significant risk (7%) for metastatic lymph node in the corresponding drainage basin. T1a and T1b did not differ regarding this risk. However, the benefit for a RLND must be reevaluated regarding surgical morbidity, because none of T1 patients had metastatic NSN.
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BACKGROUND AND PURPOSE: Management of brain arteriovenous malformation (bAVM) is controversial. We have analyzed the largest surgical bAVM cohort for outcome. METHODS: Both operated and nonoperated cases were included for analysis. A total of 779 patients with bAVMs were consecutively enrolled between 1989 and 2014. Initial management recommendations were recorded before commencement of treatment. Surgical outcome was prospectively recorded and outcomes assigned at the last follow-up visit using modified Rankin Scale. First, a sensitivity analyses was performed to select a subset of the entire cohort for which the results of surgery could be generalized. Second, from this subset, variables were analyzed for risk of deficit or near miss (intraoperative hemorrhage requiring blood transfusion of ≥2.5 L, hemorrhage in resection bed requiring reoperation, and hemorrhage associated with either digital subtraction angiography or embolization). RESULTS: A total of 7.7% of patients with Spetzler-Ponce classes A and B bAVM had an adverse outcome from surgery leading to a modified Rankin Scale >1. Sensitivity analyses that demonstrated outcome results were not subject to selection bias for Spetzler-Ponce classes A and B bAVMs. Risk factors for adverse outcomes from surgery for these bAVMs include size, presence of deep venous drainage, and eloquent location. Preoperative embolization did not affect the risk of perioperative hemorrhage. CONCLUSIONS: Most of the ruptured and unruptured low and middle-grade bAVMs (Spetzler-Ponce A and B) can be surgically treated with a low risk of permanent morbidity and a high likelihood of preventing future hemorrhage. Our results do not apply to Spetzler-Ponce C bAVMs.
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L'abcès pulmonaire se présente de manière très pléomorphe selon les germes initialement impliqués. Des symptômes gé néraux et une évolution souvent subaiguë sont retrouvés en cas d'aspiration de la flore oropharyngée, chez des patients avec des troubles de l'état de conscience ou de la déglutition. L'infection est très souvent polymicrobienne, avec présence de germes anaérobes dans deux tiers des cas. La prise en charge consiste en un traitement antibiotique prolongé, jusqu'à résolution ou stabilité de l'image radiologique. En cas d'état toxique ou d'absence de drainage bronchique spontané, un drainage de l'abcès est à discuter. Les sanctions chirurgicales sont peu souvent nécessaires et envisagées indépendamment de la taille de l'abcès excepté lors de néoplasie sous-jacente. Lung abscess occurs in very pleomorphic according to germs initially involved. The mechanism commonly found is an aspiration of the oropharyngeal flora in patients with disorders of consciousness or swallowing. The infection is polymicrobial, with presence of anaerobic germs in 2/3 of the cases. The support consists of a prolonged antibiotic treatment, as well as anaerobic until resolution or stability of the radiological image. In case of prolonged toxic state, drainage of the abscess is to be discussed especially if there is no airways drainage. Surgical sanctions is rarely needed regardless of the size of the abscess, unless underlying carcinoma is present.
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This investigation has three purposes I to make a comparative chemical study on sediment cores collected for Lake Lisgar (man-made lake in an urban center) and Lake Hunger (natural basin in a rural community) encompassing the time since European settlement I to determine the postglacial chemical history of Lake Hunger, and to determine the vegetational history of the Lake Hunger area from postglacial time to the present. The minus 80 mesh fraction of 108 soil samples and 18 stream sediment samples collected in the vicinity of Lakes' Lisgar and Hunger were analyzed for cold hydrochloric acid soluble lead, zinc, nickel, cobalt, copper, aluminum, sodium, potassium, calcium, magnesium, iron and manganese. Lacustrine sediments from 5 boreholes in the Lake Lisgar basin were collected. Boreholes 1, 2, 3, and 4 were analyzed for palynological and chemical information and Borehole 5 was subjected to pollen and ostracode analysis. Lacustrine sediments from 6 boreholes in the Lake Hunger basin were collected. Palyno- -logical and chemical analysis were performed on Boreholes 1, 2, 3, 4, and 6 and Borehole 5 was analyzed for pollen. In addition, radiocarbon dates were obtained on sediment samples from Boreholes 4 and 5. A total of 8 surface samples were collected from the margins of the Lake Hunger basin and these were chemically analyzed in the laboratory. All of the lacustrine sediments were ashed and analyzed for cold hydrochloric acid soluble lead, zinc, nickel, cobalt, copper, aluminum, sodium, potassium, calcium, magnesium, iron and manganese using a Perkin Elmer 40) Atomic Absorption spectrophotometer. The results . obtained for the 12 elements were expressed as parts per million in dry sediments. It was found that man's influence on the element distribution patterns in the sediments of Lake Lisgar appeared to be related to his urbanizing developments within the lake vicinity, whereas, the rural developments in the vicinity of lake Hunger appeared to have had little effect on the element distribution patterns in the lake sediments. The distribution patterns of lead, zinc, nickel, cobalt, aluminum, magnesium, sodium and potassium are similar to the % ash curve throughout postglacial time indicating that the rate of erosion in the drainage basin is the main factor which controls the concentration of these elements in the sediments of Lake Hunger. The vegetational history, from palynological analysis, of Lake Hunger from postglacial time to the present includes the following stages: tundra, open spruce forest, closed boreal forest, deciduous forest and the trend towards the re-establishment of pine following the clearing of land and the subsequent settlement of the Lake Hunger area by European settlers. The concentrations of some elements (cobalt, nickel, iron, manganese, calcium, magnesium, sodium and potassium) in the sediments of Lake Hunger appears to be higher during pre-cultural compared to post-cultural times. At least one complete postglacial record of the chemical history within a lake basin is necessary in order to accurately assess man's effects on his environment.
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The analysis of fossil diatoms and Mallomonas assemblages in a 2.85 m sediment core revealed that a series of distinct floristic changes have occurred in the development of Found Lake, a small Shield lake in southern Ontario. Climatic and vegetational changes in the lake's watershed were closely associated with successional changes in the lake's biota. Nutrients released by the deciduous component of the Found Lake watershed appeared to be especially important in determining diatom and Mallomonas standing crop. The top 20 cm of sediment of 3 ,Shield lakes was then investigated using close interval (1 cm) analyses of diatoms, Mallomonas scales, pollen grains and sedimentary phosphorus. Found and Jake Lake are adjacent to Highway 60, whereas Delano Lake has been undisturbed and was used as a control. Dramatic changes in the diatom and Mallomonas communities were recorded in the Found and Jake Lake stratigraphies and could be closely associated with known historical events. Increased turbidity and nutrient enrichment were believed responsible for these successional changes. In addition, diatom and Mallomonas standing crop increased substantially following road construction in Found Lake's drainage basin. Meanwhile, no. sharp changes in diatom or Mallomonas communities were recorded in the recent sediments of the control (Delano) lake. The use£ulness o£ Synuracean scales as paleoindicators, as well as the importance o£ sectioning cores at close intervals during transition periods in a laker's development, was stressed.
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The Oak Ridges Moraine is a major physiographic feature of south-central Ontario, extending from Rice Lake westward to the Niagara Escarpment. While much previous work has largely postulated a relatively simple the origin of the moraine, recent investigations have concentrated on delineating the discernible glacigenic deposits (or landform architectural elements) which comprise the complex mosaic of the Oak Ridges Moraine. This study investigates the sedimentology of the Bloomington fan complex, one of the oldest elements of the Oak Ridges Moraine. The main sediment body of the Bloomington fan complex was deposited during early stages of the formation of the Oak Ridges Moraine, when the ice subdivided, and formed a confined, interlobate lake basin between the northern and southern lobes. Deposition from several conduits produced a fan complex characterized by multiple, laterally overlapping, fan bodies. It appears that the fans were active sequentially in an eastward direction, until the formation of the Bloomington fan complex was dominated by the largest fan fed by a conduit near the northeastern margin of the deposit. Following deposition of the fan complex, the northern and southern ice margins continued to retreat, opening drainage outlets to the west and causing water levels to drop in the lake basin. Glaciofluvial sediment was deposited at this time, cutting into the underlying fan complex. Re-advancing northern ice then closed westerly outlets, and caused water levels to increase, initiating the re-advance of the southern ice. As the southern ice approached the Bloomington fan, it deposited an ice-marginal sediment complex consisting of glacigenic sediment gravity flows, and glaciolacustrine and glaciofluvial sediments exhibiting north and northwesterly paleocurrents. Continued advance of the southern ice, overriding the fan complex, ii produced large-scale glaciotectonic deformation structures, and deposited the Halton Till. The subaqueous fan depositional model that is postulated for the Bloomington fan complex differs from published models due to the complex facies associations produced by the multiple conduit sources of sediment feeding the fans. The fluctuating northern and southern ice margins, which moved across the study area in opposite directions, controlled the water level in the interlobate basin and caused major changes in depositional environments. The influence of these two lobes also caused deposition from two distinct source directions. Finally, erosion, deposition, and deformation of the deposit with the readvance of the southern ice contributed further to the complexity of the Bloomington fan complex.
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Grapevine winter hardiness is a key factor in vineyard success in many cool climate wine regions. Winter hardiness may be governed by a myriad of factors in addition to extreme weather conditions – e.g. soil factors (texture, chemical composition, moisture, drainage), vine water status, and yield– that are unique to each site. It was hypothesized that winter hardiness would be influenced by certain terroir factors , specifically that vines with low water status [more negative leaf water potential (leaf ψ)] would be more winter hardy than vines with high water status (more positive leaf ψ). Twelve different vineyard blocks (six each of Riesling and Cabernet franc) throughout the Niagara Region in Ontario, Canada were chosen. Data were collected during the growing season (soil moisture, leaf ψ), at harvest (yield components, berry composition), and during the winter (bud LT50, bud survival). Interpolation and mapping of the variables was completed using ArcGIS 10.1 (ESRI, Redlands, CA) and statistical analyses (Pearson’s correlation, principal component analysis, multilinear regression) were performed using XLSTAT. Clear spatial trends were observed in each vineyard for soil moisture, leaf ψ, yield components, berry composition, and LT50. Both leaf ψ and berry weight could predict the LT50 value, with strong positive correlations being observed between LT50 and leaf ψ values in eight of the 12 vineyard blocks. In addition, vineyards in different appellations showed many similarities (Niagara Lakeshore, Lincoln Lakeshore, Four Mile Creek, Beamsville Bench). These results suggest that there is a spatial component to winter injury, as with other aspects of terroir, in the Niagara region.