985 resultados para Splenic rotation


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Delayed rupture of the spleen following trauma is an exceedingly rare phenomenon in children. In the case we have experienced, arterial embolization was successfully performed, surgery was avoided, and functional splenic tissue was preserved. Embolization is of value in the management of blunt splenic injuries in hemodynamically stable children, even after delayed rupture. The exact criteria for its use remain to be established.

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Soil compaction can be minimized either mechanically or biologically, using plant species with vigorous root systems. An experiment was carried out with soybean (Glycine max) in rotation with triticale (X Triticosecale) and sunflower (Helianthus annuus) in fall-winter associated with pearl millet (Pennisetum glaucum), grain sorghum (Sorghum bicolor) or sunn hemp (Crotalaria juncea) in spring. Crop rotation under no-till was compared with mechanical chiseling. The experiment was carried out in Botucatu, São Paulo State, Brazil. Soil quality was estimated using the S index and soil water retention curves (in the layers of 0-0.05, 0.075-0.125, 0.15-0.20, 0.275-0.325, and 0.475-0.525 m deep). Crop rotation and chiseling improved soil quality, increasing the S index to over 0.035 to a depth of 20 cm in the soil profile. The improved soil quality, as shown by the S index, makes the use of mechanical chiseling unnecessary, since after 3 years the soil physical quality under no-tilled crop rotation and chiseling was similar.

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Summary

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A class of exact solutions of Hele-Shaw flows without surface tension in a rotating cell is reported. We show that the interplay between injection and rotation modifies the scenario of formation of finite-time cusp singularities. For a subclass of solutions, we show that, for any given initial condition, there exists a critical rotation rate above which cusp formation is suppressed. We also find an exact sufficient condition to avoid cusps simultaneously for all initial conditions within the above subclass.

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Exchange-biased Ni/FeF2 films have been investigated using vector coil vibrating-sample magnetometry as a function of the cooling field strength HFC . In films with epitaxial FeF2 , a loop bifurcation develops with increasing HFC as it divides into two sub-loops shifted oppositely from zero field by the same amount. The positively biased sub-loop grows in size with HFC until only a single positively shifted loop is found. Throughout this process, the negative and positive (sub)loop shifts maintain the same discrete value. This is in sharp contrast to films with twinned FeF2 where the exchange field gradually changes with increasing HFC . The transverse magnetization shows clear correlations with the longitudinal subloops. Interestingly, over 85% of the Ni reverses its magnetization by rotation, either in one step or through two successive rotations. These results are due to the single-crystal nature of the antiferromagnetic FeF2 , which breaks down into two opposite regions of large domains.

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The phosphorus supply to crops in tropical soils is deficient due to its somewhat insoluble nature in soil, and addition of P fertilizers has been necessary to achieve high yields. The objective of this study was to examine the mechanisms through which a cover crop (Congo grass - Brachiaria ruziziensis) in rotation with soybean can enhance soil and fertilizer P availability using long-term field trials and laboratory chemical fractionation approaches. The experimental field had been cropped to soybean in rotation with several species under no-till for six years. An application rate of no P or 240 kg ha-1 of P2O5 had been applied as triple superphosphate or as Arad rock phosphate. In April 2009, once more 0.0 or 80.0 kg ha-1 of P2O5 was applied to the same plots when Congo grass was planted. In November 2009, after Congo grass desiccation, soil samples were taken from the 0-5 and 5-10 cm depth layer and soil P was fractionated. Soil-available P increased to the depth of 10 cm through growing Congo grass when P fertilizers were applied. The C:P ratio was also increased by the cover crop. Congo grass cultivation increased P content in the soil humic fraction to the depth of 10 cm. Congo grass increases soil P availability by preventing fertilizer from being adsorbed and by increasing soil organic P.

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Phosphorus fractions play a key role in sustaining the productivity of acid-savanna Oxisols and are influenced by tillage practices. The aim of this study was to quantify different P forms in an Oxisol (Latossolo Vermelho-Amarelo) from the central savanna region of Brazil under management systems with cover crops in maize rotation. Three cover crops (Canavalia brasiliensis, Cajanus cajan (L.), and Raphanus sativus L.) were investigated in maize rotation systems. These cover crops were compared to spontaneous vegetation. The inorganic forms NaHCO3-iP and NaOH-iP represented more than half of the total P in the samples collected at the depth of 5-10 cm during the rainy season when the maize was grown. The concentration of inorganic P of greater availability (NaHCO3-iP and NaOH-iP) was higher in the soil under no-tillage at the depth of 5-10 cm during the rainy season. Concentrations of organic P were higher during the dry season, when the cover crops were grown. At the dry season, organic P constituted 70 % of the labile P in the soil planted to C. cajan under no-tillage. The cover crops were able to maintain larger fractions of P available to the maize, resulting in reduced P losses to the unavailable pools, mainly in no-tillage systems.

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Introduction: Non-operative management (NOM) of blunt splenic injuries in hemodynamically stable patients is nowadays considered the standard treatment. Material and Methods: The aim was to clarify the criteria used for primary operative management (OM) and planned NOM. Furthermore, the study aimed to identify risk factors for failure of NOM. All adult patients with blunt splenic injuries treated from 2000-2008 were reviewed and a logistic regression analysis employed. Results: There were 206 patients (146 men, 70.9%). Mean age was 38.2 ± 19.1 years. The mean Injury Severity Score (ISS) was 30.9 ± 11.6. The American Association for the Surgery of Trauma (AAST) classification of the splenic injury was: grade I, n = 43 (20.9%); grade II, n = 52 (25.2%); grade III, n = 60 (29.1%), grade IV, n = 42 (20.4%) and grade V, n = 9 (4.4%). 47 patients (22.8%) required immediate surgery (OM). More than 5 units of red cell transfusions (odds ratio [OR] 13.72, P < 0.001), a Glasgow Coma Scale < 11 (OR 9.88, P = 0.009) and age ? 55 years (OR 3.29, P = 0.038) were associated with primary OM. 159 patients (77.2%) qualified for a non-surgical approach (NOM), which was successful in 89.9% (143/159). The overall splenic salvage rate amounted to 69.4% (143/206). Multiple logistic regression analysis found age ? 40 years to be the only factor significantly and independently related to the failure of NOM (OR 13.58, P = 0.001). Conclusion: Advanced age is associated with an increased failure rate of NOM in patients with blunt splenic injuries.

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Crop rotation and cover crop can be important means for enhancing crop yield in rainfed areas such as the lower Coastal Bend Region of Texas, USA. A trial was conducted in 1995 as part of a long-term cropping experiment (7 years) to investigate the effect of oat (Avena sativa L.) cover and rotation on soil water storage and yield of sorghum (Sorghum bicolor L.). The trial design was a RCB in a split-plot arrangement with four replicates. Rotation sequences were the main plots and oat cover crop the subplots. Cover crop reduced sorghum grain yield. This effect was attributed to a reduced concentration of available soil N and less soil water storage under this treatment. By delaying cover termination, the residue with a high C/N acted as an N sink through competition and/or immobilization instead of an N source to sorghum plants. Crop rotation had a significantly positive effect on sorghum yield and this effect was attributed to a significantly larger amount of N concentration under these rotation sequences.

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BACKGROUND: Diastolic dysfunction with delayed relaxation and abnormal passive elastic properties has been described in patients with severe pressure overload hypertrophy. The purpose of this study was to evaluate the time course of rotational motion of the left ventricle in patients with aortic valve stenosis using myocardial tagging. METHODS: Myocardial tagging is a non-invasive method based on magnetic resonance which makes it possible to label ('tag') specific myocardial regions. From the motion of the tag's cardiac rotation, radial displacement and translational motion can be determined. In 12 controls and 13 patients with severe aortic valve stenosis systolic and diastolic wall motion was assessed in an apical and basal short axis plane. RESULTS: The normal left ventricle performs a systolic wringing motion around the ventricular long axis with clockwise rotation at the base (-4.4+/-1.6 degrees) and counter-clockwise rotation at the apex (+6.8+/-2.5 degrees) when viewed from the apex. During early diastole an untwisting motion can be observed which precedes diastolic filling. In patients with aortic valve stenosis systolic rotation is reduced at the base (-2.4+/-2.0 degrees; P<0.01) but increased at the apex (+12.0+/-6.0 degrees; P<0.05). Diastolic untwisting is delayed and prolonged with a decrease in normalized rotation velocity (-6.9+/-1.1 s(-1)) when compared to controls (-10.7+/-2.2 s(-1); P<0.001). Maximal systolic torsion is 8.0+/-2.1 degrees in controls and 14.1+/-6.4 degrees (P<0.01) in patients with aortic valve stenosis. CONCLUSIONS: Left ventricular pressure overload hypertrophy is associated with a reduction in basal and an increase in apical rotation resulting in increased torsion of the ventricle. Diastolic untwisting is delayed and prolonged. This may explain the occurrence of diastolic dysfunction in patients with severe pressure overload hypertrophy.

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PURPOSE: Colonoscopy is reported to be a safe procedure that is routinely performed for the diagnosis and treatment of colorectal diseases. Splenic rupture is considered to be a rare complication with high mortality and morbidity that requires immediate diagnosis and management. Nonoperative management (NOM), surgical treatment (ST), and, more recently, proximal splenic artery embolization (PSAE) have been proposed as treatment options. The goal of this study was to assess whether PSAE is safe even in high-grade ruptures. METHODS: We report two rare cases of post colonoscopy splenic rupture. A systematic review of the literature from 2002 to 2010 (first reported case of PSAE) was performed and the three types of treatment compared. RESULTS: All patients reviewed (77 of 77) presented with intraperitoneal hemorrhage due to isolated splenic trauma. Splenic rupture was high-grade in most patients when grading was possible. Six of 77 patients (7.8 %) were treated with PSAE, including the 2 cases reported herein. Fifty-seven patients (74 %) underwent ST. NOM was attempted first in 25 patients with a high failure rate (11 of 25 [44 %]) and requiring a salvage procedure, such as PSAE or ST. Previous surgery (31 of 59 patients), adhesions (10 of 13), diagnostic colonoscopies (49 of 71), previous biopsies or polypectomies (31 of 57) and female sex (56 of 77) were identified as risk factors. In contrast, splenomegaly (0 of 77 patients), medications that increase the risk of bleeding (13 of 30) and difficult colonoscopies (16 of 51) were not identified as risk factors. PSAE was safe and effective even in elderly patients with comorbidities and those taking medications that increase the risk of bleeding, and the length of the hospital stay was similar to that after ST. CONCLUSION: We propose a treatment algorithm based on clinical and radiological criteria. Because of the high failure rate after NOM, PSAE should be the treatment of choice to manage grade I through IV splenic ruptures after colonoscopy in hemodynamically stabilized patients.

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L'idée d'écrire cet article naît suite à l'arrivée aux urgences du Centre Hospitalier Universitaire Vaudois de deux cas cliniques de rupture de rate après colonoscopie. Ces deux patients se sont présentés à quelques semaines d'intervalle et illustrent une complication peu rapportée des colonoscopies mais décrite dans la littérature scientifique. Nos deux patients ont été traités avec succès par embolisation artérielle proximale. Nous présentons donc 2 cas de rupture de rate après colonoscopie. Nous comparons nos données avec celles obtenues par analyse après revue pertinente de la littérature. Nous avons mis en évidence les facteurs de risque inhérents aux patients et à la procédure. Les différentes prises en charges ont été analysées et les points principaux mis en évidence dans un tableau. Pour finir, nous proposons un diagramme de prise en charge des ruptures de rate de bas grade après colonoscopie par embolisation artérielle proximale.