929 resultados para abdominal wall musculature
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Pós-graduação em Ginecologia, Obstetrícia e Mastologia - FMB
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Esta dissertação de mestrado apresenta o projeto e a construção de um robô móvel terrestre denominado LOGBOT, com tração de movimento do tipo diferencial – com duas rodas motoras e uma roda livre para manter a estabilidade de sua estrutura em relação à superfície. O controle do robô dispõe dos modos de telemetria e autônomo. No modo de controle por telemetria (ROV), a comunicação do robô com a estação de controle é feita por radiofreqüência a uma distância de até um quilometro em ambientes externos, e até cem metros em ambientes internos. No modo de controle autônomo (AGV), o robô tem habilidade para navegar em ambientes internos e desconhecidos usando sempre a parede à sua esquerda como referência para a trajetória de seu movimento. A seqüência de movimentos para execução da trajetória é enviada para a estação de controle que realiza análises de desempenho do robô. Para executar suas tarefas no modo autônomo, a programação do robô conta com um agente inteligente reativo, que detecta características do ambiente (obstáculos, final de paredes, etc.) e decide sobre qual atitude deve ser executada pelo robô, com objetivo de contornar os obstáculos e controlar a velocidade de suas rodas. Os problemas de erro odométrico e suas correções com base no uso de informações sensoriais externas são devidamente tratados. Técnicas de controle hierárquico do robô como um todo e controle em malha fechada da velocidade das rodas do robô são usadas. Os resultados mostraram que o robô móvel LOGBOT é capaz de navegar, com estabilidade e precisão, em ambientes internos no formato de um corredor (wall following).
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ABSTRACT: This work presents a new law of the wall formulation for recirculating turbulent flows. An alternative expression for the internal length which can be applied in the separated region is also presented. The formulation is implemented in a numerical code which solves the k-e model through a finite volume method. The theoretical results are compared with the experimental data of Vogel and Eaton (J. of Heat Transfer, Transactions of ASME, vol.107, pp. 922-929, 1985). The paper shows that the present formulation furnishes better results than the standard k-e formulation.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Pós-graduação em Anestesiologia - FMB
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Cardiovascular diseases are a growing public health problem that affects most people over the age of 65 years and abdominal obesity is one of the risk factors for the development of these diseases. There are several methods that can be used to measure body fat, but their accuracy needs to be evaluated, especially in specific populations such as the elderly. The aim of this study was to assess the accuracy of anthropometric indicators to estimate the percentage of abdominal fat in subjects aged 80 years or older. A total of 125 subjects ranging in age from 80 to 95 years (83.5 ± 3), including 79 women (82.4 ± 3 years) and 46 men (83.6 ± 3 years), were studied. The following anthropometric indicators were used: body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), and waist-to-height ratio (WHtR). The percentage of abdominal fat was measured by DEXA. Sensitivity and specificity were analyzed using an ROC curve. The sensitivity, specificity and AUC were 0. 578, 0. 934 and 0. 756 for BMI, respectively; 0.703, 0.820 and 0.761 for WC; 0.938, 0.213 and 0.575 for WHR, and 0.984, 0.344 and 0.664 for WHtR. BMI and WC were the anthropometric indicators with the largest area under the curve and were therefore more adequate to identify the presence or absence of abdominal obesity.
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
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Objectives: To evaluate the efficacy and safety of enhanced recovery after surgery (ERAS) programs in elective open surgical repair (OSR) of abdominal aortic aneurysm (AAA).Background: Open surgical repair of AAA is associated with high morbidity and mortality, prolonged hospital stay and high costs. ERAS programs contribute to the optimization of treatment by reducing hospital stay and improving clinical outcomes.Methods: A review of PubMed, EMBASE and LILACS databases was conducted. As only one randomized controlled trial was found, a pooled analysis of proportions from case series was conducted, considering it a complementary overview of the topic. Inclusion criteria were case series with more than five cases reported, adult patients who underwent an elective OSR of AAA and use of an ERAS program. ERAS was compared to conventional perioperative care. The pooled proportion and the confidence interval (CI) are shown for each outcome. The overlap of the CI suggests similar effect of the interventions studied.Results: Thirteen case series studies with ERAS involving 1,250 patients were compared to six case series with conventional care with a total of 1,429 patients. The pooled, respective proportions for ERAS and conventional care were: mortality, 1.51% [95% CI: 0.0091, 0.0226] and 3.0% [95% CI 0.0183, 0.0445]; and incidence of complications, 3.82% [95% CI 0.0259, 0.0528] and 4.0% [95% CI 0.03, 0.05].Conclusion: This review shows that ERAS and conventional care therapies have similar mortality and complication rates in OSR of AAA.
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BackgroundThis is an update of a Cochrane Review first published in The Cochrane Library 2008, Issue 3.Upper abdominal surgical procedures are associated with a high risk of postoperative pulmonary complications. The risk and severity of postoperative pulmonary complications can be reduced by the judicious use of therapeutic manoeuvres that increase lung volume. Our objective was to assess the effect of incentive spirometry compared to no therapy or physiotherapy, including coughing and deep breathing, on all-cause postoperative pulmonary complications andmortality in adult patients admitted to hospital for upper abdominal surgery.ObjectivesOur primary objective was to assess the effect of incentive spirometry (IS), compared to no such therapy or other therapy, on postoperative pulmonary complications and mortality in adults undergoing upper abdominal surgery.Our secondary objectives were to evaluate the effects of IS, compared to no therapy or other therapy, on other postoperative complications, adverse events, and spirometric parameters.Search methodsWe searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 8), MEDLINE, EMBASE, and LILACS (from inception to August 2013). There were no language restrictions. The date of the most recent search was 12 August 2013. The original search was performed in June 2006.Selection criteriaWe included randomized controlled trials (RCTs) of IS in adult patients admitted for any type of upper abdominal surgery, including patients undergoing laparoscopic procedures.Data collection and analysisTwo authors independently assessed trial quality and extracted data.Main resultsWe included 12 studies with a total of 1834 participants in this updated review. The methodological quality of the included studies was difficult to assess as it was poorly reported, so the predominant classification of bias was 'unclear'; the studies did not report on compliance with the prescribed therapy. We were able to include data from only 1160 patients in the meta-analysis. Four trials (152 patients) compared the effects of IS with no respiratory treatment. We found no statistically significant difference between the participants receiving IS and those who had no respiratory treatment for clinical complications (relative risk (RR) 0.59, 95% confidence interval (CI) 0.30 to 1.18). Two trials (194 patients) IS compared incentive spirometry with deep breathing exercises (DBE). We found no statistically significant differences between the participants receiving IS and those receiving DBE in the meta-analysis for respiratory failure (RR 0.67, 95% CI 0.04 to 10.50). Two trials (946 patients) compared IS with other chest physiotherapy. We found no statistically significant differences between the participants receiving IS compared to those receiving physiotherapy in the risk of developing a pulmonary condition or the type of complication. There was no evidence that IS is effective in the prevention of pulmonary complications.Authors' conclusionsThere is low quality evidence regarding the lack of effectiveness of incentive spirometry for prevention of postoperative pulmonary complications in patients after upper abdominal surgery. This review underlines the urgent need to conduct well-designed trials in this field. There is a case for large RCTs with high methodological rigour in order to define any benefit from the use of incentive spirometry regarding mortality.
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Objectives: The purpose of this study was to determine if intra-abdominal pressure (IAP) could predict acute renal injury (AKI) in the postoperative period of abdominal surgeries, and which would be its cutoff value. Patients and methods: A prospective observational study was conducted in the period from January 2010 to March 2011 in the Intensive Care Units (ICUs) of the University Hospital of Botucatu Medical School, UNESP. Consecutive patients undergoing abdominal surgery were included in the study. Initial evaluation, at admission in ICU, was performed in order to obtain demographic, clinical surgical and therapeutic data. Evaluation of IAP was obtained by the intravesical method, four times per day, and renal function was evaluated during the patient's stay in the ICU until discharge, death or occurrence of AKI. Results: A total of 60 patients were evaluated, 16 patients developed intra-abdominal hypertension (IAH), 45 developed an abnormal IAP (>7 mmHg) and 26 developed AKI. The first IAP at the time of admission to the ICU was able to predict the occurrence of AKI (area under the receiver-operating characteristic curve was 0.669; p=0.029) with the best cutoff point (by Youden index method) >= 7.68 mmHg, sensitivity of 87%, specificity of 46% at this point. The serial assessment of this parameter did not added prognostic value to initial evaluation. Conclusion: IAH was frequent in patients undergoing abdominal surgeries during ICU stay, and it predicted the occurrence of AKI. Serial assessments of IAP did not provided better discriminatory power than initial evaluation.
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
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Hydronephrosis is a condition that results from complete or partial obstruction of the urinary flow. This paper reports the case of a two-year-old, mixed-breed dog diagnosed with hydronephrosis of the left kidney six months after being kicked in the thoraco-abdominal region. The diagnosis was based on radiographic and ultrasonographic examinations. Percutaneous antegrade pyelography was also performed and allowed the visualization of opacification of the left kidney, which confirmed the diagnosis. Because the exams indicated that the patient had normal renal function, nephrectomy was performed. The patient remained in good health during the postoperative period and in subsequent evaluations. (C) 2013 PVJ. All rights reserved
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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)