Recanalization after acute deep vein thrombosis

O processo de recanalização das veias dos membros inferiores, após um episódio de trombose venosa profunda aguda em pacientes anticoagulados com heparina e inibidores da vitamina K, faz parte da evolução natural da remodelagem do trombo venoso. Esse complexo processo de remodelagem envolve a adesão do trombo à parede da veia, à resposta inflamatória da parede do vaso, levando à organização e subsequente contração do trombo, à neovascularização e à lise espontânea de áreas no interior do trombo. A presença de fluxo arterial espontâneo em veias com trombose recanalizada tem sido descrita como secundária à neovascularização e se caracteriza pelo desenvolvimento de fluxo com padrão de fístulas arteriovenosas, identificadas por meio de mapeamento dúplex colorido. Nesta revisão, são discutidos alguns aspectos controversos da história natural da trombose venosa profunda, para uma melhor compreensão da sua evolução e do seu impacto sobre a doença venosa.

Long-term clinical and ultrasonographic evaluation of thrombophilic patients with deep venous thrombosis

OBJECTIVE:The purpose of this study was to evaluate the long term clinical and ultrasonographic outcomes of thrombophilic patients with deep venous thrombosis (DVT).METHOD:Cohort study, retrospective case-control with cross-sectional analysis. Thirty-nine thrombophilic patients and 25 non-thrombophilic patients were assessed 76.3 ± 45.8 months after diagnosis. Demographic and family data were collected, as well as data from clinical and therapeutic progress, and physical and ultrasound examinations of the limbs were performed. Groups were matched for age and gender and the variables studied were compared across groups.RESULTS:Deep venous thrombosis was more frequent in women. The most common thrombophilias were antiphospholipid syndrome and factor V Leiden mutation. There was no difference between groups in terms of the number of pregnancies or miscarriages and the majority of women did not become pregnant after DVT. Non-spontaneous DVT prevailed. Proximal DVT and DVT of the left lower limb were more frequent, and the main risk factor was use of oral contraceptives. All patients were treated with anticoagulation. There was a higher frequency of pulmonary embolism in non-thrombophilic patients. Most patients considered themselves to have a normal life after DVT and reported wearing elastic stockings over at least 2 years. Seventy-one percent of patients had CEAP > 3, with no difference between groups. Deep venous reflux was more frequent in thrombophilic patients.CONCLUSION:There were no significant differences between groups with respect to most of the variables studied, except for a higher frequency of pulmonary embolism in non-thrombophilic patients and greater frequency of deep venous reflux in thrombophilic patients.

DNA methylation patterns of steroid receptor genes ESR1, ESR2 and PGR in deep endometriosis compromising the rectum

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

An integrable evolution equation for surface waves in deep water

In order to describe the dynamics of monochromatic surface waves in deep water, we derive a nonlinear and dispersive system of equations for the free surface elevation and the free surface velocity from the Euler equations in infinite depth. From it, and using a multiscale perturbative method, an asymptotic model for small wave steepness ratio is derived. The model is shown to be completely integrable. The Lax pair, the first conserved quantities as well as the symmetries are exhibited. Theoretical and numerical studies reveal that it supports periodic progressive Stokes waves which peak and break in finite time. Comparison between the limiting wave solution of the asymptotic model and classical results is performed.

Deep learning architecture for gesture recognition

Pós-graduação em Engenharia Mecânica - FEG

Recanalization Rates after Acute Deep Vein Thrombosis: A Single-center Experience Using a Newly Proposed Vein Diameter Variation Index

Background: Duplex ultrasound scanning (DUS) is the method of choice for diagnosis of deep vein thrombosis (DVT). However, only a few studies have performed prospective serial DUS after an acute episode of DVT to assess its evolution. This study aimed to report our experience using DUS combined with a thrombosis score (TS) and a newly proposed vein diameter variation index (VDVI) to evaluate the rate of resolution of DVT by assessing and quantifying the early stages of vein recanalization in proximal vein segments within 6 months after an episode of acute lower extremity DVT.Methods: Twelve patients with first episode of acute lower extremity DVT confirmed by DUS as occurring in <= 10 days after the onset of venous thrombosis symptoms were followed up prospectively for 6 months. TS and VDVI were calculated at 1, 3, and 6 months to assess vein recanalization. Intra-thrombus arteriovenous fistula formation was also investigated and related to the recanalization process.Results: Seven (58%) women were included, with a total cohort median age of 53.5 +/- 19 years. The left lower extremity was affected in 7 (58%) patients. DVT was diagnosed in 55 proximal vein segments. All patients had proximal DVT, with involvement of the external iliac, femoral, and popliteal veins. After 6 months, there was a significant decrease in TS and increase in VDVI (P < 0.001) in all proximal vein segments assessed, indicating thrombus regression. The more distal the DVT was, the faster was the VDVI increase, with most popliteal veins being recanalized at 3 months (P < 0.001). Intra-thrombus arteriovenous fistula was identified in 50% of patients at 1 month while on anticoagulation.Conclusions: The combined use of two different DUS-based assessment tools, TS and the proposed VDVI, provided an effective method to prospectively assess vein recanalization rates after an episode of acute lower extremity DVT in this series of patients and may allow a correct evaluation of DVT and its resolution or progression.

Relationship between therapeutic alliance and deep abdominal muscle recruitment in nonspecific low back pain sufferers

Chronic low back pain is a difficult condition to be treated. As some patients respond positively to treatment and others do not present any improvements, one can think there are others conditional factors that need to be elucidated. By means of this study, we sought to investigate the association between the occurrence of the formation of a positive relationship between patient and therapist, assessed by the therapeutic alliance inventory, and the adequate recruitment of the deep abdominal muscles, as well as to verify the effect of a protocol intervention based on motor control exercises on levels of pain and disability. The recruitment of the transverse abdominal and internal oblique muscles was examined by ultrasound imaging in 12 subjects with nonspecific chronic low back pain before and after implementation of a protocol for motor control exercises, with subsequent application of the therapeutic alliance inventory questionnaire. No association was found between the level of therapist/patient alliance and muscle recruitment. The proposed protocol was effective in reducing the levels of pain and disability; however, recruitment of transverse abdominal and internal oblique muscles showed no significant changes in the end of the intervention. Based on these findings, we verified that the therapeutic alliance has no association with muscle recruitment in the short term. However, although there were no changes in muscle recruitment after the intervention program, the level of pain and disability was reduced.

Comparative clinical sample preparation of DNA and RNA viral nucleic acids for a commercial deep sequencing system (Illumina MiSeq (R))

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

Continental degassing of He-4 by surficial discharge of deep groundwater

Radiogenic He-4 is produced by the decay of uranium and thorium in the Earths mantle and crust. From here, it is degassed to the atmosphere(1-5) and eventually escapes to space(1,5,6). Assuming that all of the He-4 produced is degassed, about 70% of the total He-4 degassed from Earth comes from the continental crust(2,-5,7). However, the outgoing flux of crustal He-4 has not been directly measured at the Earths surface(2) and the migration pathways are poorly understood(2-4,7,8). Here we present measurements of helium isotopes and the long-lived cosmogenic radio-isotope Kr-81 in the deep, continental-scale Guarani aquifer in Brazil and show that crustal He-4 reaches the atmosphere primarily by the surficial discharge of deep groundwater. We estimate that He-4 in Guarani groundwater discharge accounts for about 20% of the assumed global flux from continental crust, and that other large aquifers may account for about 33%. Old groundwater ages suggest that He-4 in the Guarani aquifer accumulates over half- to one-million-year timescales. We conclude that He-4 degassing from the continents is regulated by groundwater discharge, rather than episodic tectonic events, and suggest that the assumed steady state between crustal production and degassing of He-4, and its resulting atmospheric residence time, should be re-examined.

Hydrochemical and stable isotopes (H, O, S) signatures in deep groundwaters of Parana basin, Brazil

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

Problem of the statistical model in deep inelastic scattering phenomenology

Recent deep inelastic data leads to an up-down quark asymmetry of the nucleon sea. Explanations of the flavour asymmetry and the di-lepton production in proton-nucleus collisions call for a temperature T ≈ 100 MeV in a statistical model. This T may be conjectured as being due to the Fulling-Davies-Unruh effect. But it is not possible to fit the structure function itself.

A note on the unprecedented strandings of 56 deep-diving whales along the UK and Irish coast

In the first seven months of 2008, eighteen Cuvier’s beaked whales (Ziphius cavirostris), four Sowerby’s beaked whales (Mesoplodon bidens), five unidentified beaked whales and twenty-nine long-finned pilot whales (Globicephala melas) were reported stranded in the UK and Ireland. Decomposition of those animals investigated puts the predicted time of death at mid-January. Concerns that an unusual mortality event had taken place prompted further investigations. Most carcasses were too decomposed for necropsy. A summary of findings is presented here. Although the initial stranding of five Cuvier’s beaked whales in Scotland shared some similarities with atypical mass stranding events linked in time and space to mid-frequency naval sonars, there were two important differences with the remaining strandings during this period. First, the geographical range of the event was very wide and second, the strandings occurred over a prolonged period of several months. Both of these factors could be related to the fact that the mortalities occurred offshore and the carcasses drifted ashore. The cause(s) of this high number of strandings of mixed offshore cetacean species during this period remain undetermined.

Review of Deep Time and the Texas High Plains: History and Geology by Paul H. Carlson

This brief book is a history of the Lubbock Lake Landmark site, a nationally recognized archeological site located on the Texas southern High Plains on the north side of the city of Lubbock. The location has been the subject of intense investigations by archaeologists since 1939. Paul H. Carlson, a noted author and professor of history at Texas Tech University, states that his purpose was to go back through what John McPhee called "deep time" to show how the Lubbock Lake location was formed and was used by humans through time. He accomplishes this in five chapters.

Acoustic Detections of Singing Humpback Whales in Deep Waters Off The British Isles

From October 1996 through September 1998, we used bottom-mounted hydrophone arrays to monitor deep-water areas north and west of the British Isles for songs of humpback whales (Megaptera novaeangliae). Singing humpbacks were consistently detected between October and March from the Shetland- Faroe Islands south to waters west of the English Channel. Temporal and geographic patterns of song detections, and movements of individually tracked whales, exhibited a southwesterly trend over this period, but with no corresponding northward trend between April and September. These results, together with a review of historical data from this area, suggest that the offshore waters of the British Isles represent a migration corridor for humpbacks, at least some of which summer in Norwegian (and possibly eastern Icelandic) waters. The migratory destination of the detected animals remains unknown, but the limited data suggest that these whales are bound primarily for the West Indies rather than historical breeding areas off the northwestern coast of Africa. Humpbacks detected in British waters after early to mid- March probably do not undertake a full migration to the tropics. These data provide further evidence that singing is not confined to tropical waters in winter, but occurs commonly on migration even in high latitudes.