Ovário-histerectomia vídeo-assistida com único portal em cadelas: estudo retrospectivo de 20 casos

O objetivo do presente estudo foi avaliar retrospectivamente as 20 primeiras ovário-histerectomias vídeo-assistidas com único portal (SPVA-OSH), realizadas por um cirurgião não proficiente nessa técnica. Vinte cadelas foram submetidas à laparoscopia para SPVA-OSH, com o auxílio de um endoscópio de 10mm, com canal de trabalho de 5mm, inserido por um trocarte, posicionado na região pré-púbica, e coagulação bipolar. O tempo cirúrgico médio foi de 22,95±5,17 minutos. Os cinco primeiros procedimentos consumiram mais tempo cirúrgico do que os demais. A abordagem aos pedículos ovarianos direito e esquerdo foram as etapas que apresentaram maior tempo de execução. Houve complicação leve ou moderada em seis (30%) das 20 cadelas operadas. As complicações foram: hemorragia leve ou moderada em um dos pedículos ovarianos em quatro (20%) cadelas e hemorragia grave, devido à punção do baço com agulha de Veress em dois (10%) animais. A SPVA-OSH foi realizada em cadelas por um cirurgião no início da curva de aprendizado, sem complicações maiores.

THE HIGGS PORTAL and AN UNIFIED MODEL FOR DARK ENERGY and DARK MATTER

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

On saturation control of a non-ideal vibrating portal frame foundation type shear-building

In this paper, we examine the nonlinear control method based on the saturation phenomenon and of systems coupled with quadratic nonlinear ties applied to a shear-building portal plane frame foundation that supports an unbalanced direct cut-rent with limited power supply (non-ideal system). We analyze the equations of motion by using the method of averaging and numerical simulation. The interaction of the non-ideal structure with the saturation controller may lead to the occurrence of interesting phenomena during the forward passage through the several resonance states of the systems. Special attention is focused on passage through resonance when the non-ideal excitation frequency is near the portal frame natural frequency and when the non-ideal system frequency is approximately twice the controller frequency (two-to-one internal resonance).

Short comments on self-synchronization of two non-ideal sources supported by a flexible portal frame structure

A practical problem of synchronization of a non-ideal (i.e. when the excitation is influenced by the response of the system) and non-linear vibrating system was posed and investigated by means of numerical simulations. Two rotating unbalanced motors compose the mathematical model considered here with limited power supply mounted on the horizontal beam of a simple portal frame. As a starting point, the problem is reduced to a four-degrees-of-freedom model and its equations of motion, derived elsewhere via a Lagrangian approach, are presented. The numerical results show the expected phenomena associated with the passage through resonance with limited power. Further, for a two-to-one relationship between the frequencies associated with the first symmetric mode and the sway mode, by using the variation of torque constants, the control of the self-synchronization and synchronization (in the system) are observed at certain levels of excitations.

On non-ideal simple portal frame structural model: Experimental results under a non-ideal excitation

We present measurements of the non-linear oscillations of a portal frame foundation for a non-ideal motor. We consider a three-time redundant structure with two columns, clamped in their bases and a horizontal beam. An electrical unbalanced motor is mounted at mid span of the beam. Two non-linear phenomena are studied: a) mode saturation and energy transfer between modes; b) interaction between high amplitude motions of the structure and the rotation regime of a real limited power motor. The dynamic characteristics of the structure were chosen to have one-to-two internal resonance between the anti-symmetrical mode (sway motions) and the first symmetrical mode natural frequencies. As the excitation frequency reaches near resonance conditions with the 2nd natural frequency, the amplitude of this mode grows up to a certain level and then it saturates. The surplus energy pumped into the system is transferred to the sway mode, which experiences a sudden increase in its amplitude. Energy is transformed from low amplitude high frequency motion into high amplitude low frequency motion. Such a transformation is potentially dangerous.We consider the fact that real motors, such as the one used in this study, have limited power output. In this case, this energy source is said to be non-ideal, in contrast to the ideal source whose amplitude and frequency are independent of the motion of the structure. Our experimental research detected the Sommerfeld Effect: as the motor accelerates to reach near resonant conditions, a considerable part of its output energy is consumed to generate large amplitude motions of the structure and not to increase its own angular speed. For certain parameters of the system, the motor can get stuck at resonance not having enough power to reach higher rotation regimes. If some more power is available, jump phenomena may occur from near resonance to considerably higher motor speed regimes, no stable motions being possible between these two.

On non-ideal and non-linear portal frame dynamics analysis using Bogoliubov averaging method

We apply the Bogoliubov Averaging Method to the study of the vibrations of an elastic foundation, forced by a Non-ideal energy source. The considered model consists of a portal plane frame with quadratic nonlinearities, with internal resonance 1:2, supporting a direct current motor with limited power. The non-ideal excitation is in primary resonance in the order of one-half with the second mode frequency. The results of the averaging method, plotted in time evolution curve and phase diagrams are compared to those obtained by numerically integrating of the original differential equations. The presence of the saturation phenomenon is verified by analytical procedures.

A representação do ato de ensinar: continuidades e rupturas da concepção de ensino na pedagogia tradicional, na psicologia histórico-cultural e na pedagogia histórico-crítica : uma análise a partir das teses e dissertações no Portal da CAPES

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

A dupla face da bola: as estratégias de comunicação do Portal da Copa 2014 e o site De olho no cofre do portal UOL

Pós-graduação em Comunicação - FAAC

Embolization of splenorenal shunt associated to portal vein thrombosis and hepatic encephalopathy

Hepatic encephalopathy (HE) is a cognitive disturbance characterized by neuropsychiatric alterations. It occurs in acute and chronic hepatic disease and also in patients with portosystemic shunts. The presence of these portosystemic shunts allows the passage of nitrogenous substances from the intestines through systemic veins without liver depuration. Therefore, the embolization of these shunts has been performed to control HE manifestations, but the presence of portal vein thrombosis is considered a contraindication. In this presentation we show a cirrhotic patient with severe HE and portal vein thrombosis who was submitted to embolization of a large portosystemic shunt. Case report: a 57 years-old cirrhotic patient who had been hospitalized many times for persistent HE and hepatic coma, even without precipitant factors. She had a wide portosystemic shunt and also portal vein thrombosis. The abdominal angiography confirmed the splenorenal shunt and showed other shunts. The larger shunt was embolized through placement of microcoils, and the patient had no recurrence of overt HE. There was a little increase of esophageal and gastric varices, but no endoscopic treatment was needed. Since portosystemic shunts are frequent causes of recurrent HE in cirrhotic patients, portal vein thrombosis should be considered a relative contraindication to perform a shunt embolization. However, in particular cases with many shunts and severe HE, we found that one of these shunts can be safely embolized and this procedure can be sufficient to obtain a good HE recovery. In conclusion, we reported a case of persistent HE due to a wide portosystemic shunt associated with portal vein thrombosis. As the patient had other shunts, she was successfully treated by embolization of the larger shunt. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.

Portal hypertension in dogs

Portal hypertension (PH) is the pathological increase in portal vein pressure above normal limits. Two variables control the pressure in the portal system: the resistance to blood flow and blood flow volume in the portal system. If one these variables changes, PH may develop. Classification: Pre-hepatic (e. g. compression of the portal vein), intrahepatic (e. g. chronic hepatitis and cirrhosis) or post-hepatic (e. g. right heart failure). The invasive methods (intravenous catheter) were replaced by an indirect method of diagnosis: Doppler Ultrasound. This technique does not measure portal pressure, but indirectly allows the diagnosis of PH. Average speed of portal flow decrease (<10 cm/s) and hepatofugal flow have been reported in cirrhotic dogs with PH. Currently, the focus of the ultrasound is the detection of acquired collateral portal circulation (ACPC), closely correlated with hepatic encephalopathy. The characterization of these vessels is essential to differentiate them from congenital shunts. They are usually multiple vessels, small and tortuous, with turbulent flow, near to the kidneys, and/or a single and larger vessel, draining into the left renal vein (dilated gonadal vein). Gastric, esophageal and mesenteric varices may occur. After identifying the PH, it is important to determine its origin in order to treat the underlying disease. B-Mode Ultrasound and Doppler are the best choices in cases of suspected PH, because they may recognize not just the hypertension, but also its complications and origin.

On an energy exchange process and appearance of chaos in a non-ideal portal frame dynamical system

In this paper, we consider non-ideal excitation devices such as DC motors with restrictenergy output capacity. When such motors are attached to structures which needexcitation power levels similar to the source power capacity, jump phenomena and theincrease in power required near resonance characterize the Sommerfeld Effect, actingas a sort of an energy sink. One of the problems often faced by designers of suchstructures is how to drive the system through resonance and avoid this energy sink.Our basic structural model is a simple portal frame driven by a num-ideal powersource-(NIPF). We also investigate the absorption of resonant vibrations (nonlinearand chaotic) by means of a nonlinear sub-structure known as a Nonlinear Energy Sink(NES). An energy exchange process between the NIPF and NES in the passagethrough resonance is investigated, as well the suppression of chaos.

Portal único (SILSTM) para ovário-histerectomia vídeo-assistida em cadelas

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

A transgenic model for conditional induction and rescue of portal hypertension reveals a role of VEGF-mediated regulation of sinusoidal fenestrations

Portal hypertension (PH) is a common complication and a leading cause of death in patients with chronic liver diseases. PH is underlined by structural and functional derangement of liver sinusoid vessels and its fenestrated endothelium. Because in most clinical settings PH is accompanied by parenchymal injury, it has been difficult to determine the precise role of microvascular perturbations in causing PH. Reasoning that Vascular Endothelial Growth Factor (VEGF) is required to maintain functional integrity of the hepatic microcirculation, we developed a transgenic mouse system for a liver-specific-, reversible VEGF inhibition. The system is based on conditional induction and de-induction of a VEGF decoy receptor that sequesters VEGF and preclude signaling. VEGF blockade results in sinusoidal endothelial cells (SECs) fenestrations closure and in accumulation and transformation of the normally quiescent hepatic stellate cells, i.e. provoking the two processes underlying sinusoidal capillarization. Importantly, sinusoidal capillarization was sufficient to cause PH and its typical sequela, ascites, splenomegaly and venous collateralization without inflicting parenchymal damage or fibrosis. Remarkably, these dramatic phenotypes were fully reversed within few days from lifting-off VEGF blockade and resultant re-opening of SECs' fenestrations. This study not only uncovered an indispensible role for VEGF in maintaining structure and function of mature SECs, but also highlights the vasculo-centric nature of PH pathogenesis. Unprecedented ability to rescue PH and its secondary manifestations via manipulating a single vascular factor may also be harnessed for examining the potential utility of de-capillarization treatment modalities.

Bone morphogenetic protein receptor 2 in patients with idiopathic portal hypertension

In idiopathic portal hypertension (IPH) typical vascular lesions are present in the branches of the portal vein or in the perisinusoidal area of the liver. Similar histological alterations have been reported in the pulmonary vasculature of patients with idiopathic pulmonary artery hypertension (IPAH). As IPAH is associated with mutations of the bone morphogenetic protein receptor 2 (BMPR2) gene, the aim of this study was to investigate whether this association might also be found in patients with IPH. Twenty-three samples belonging to 21 unrelated caucasian patients with IPH followed in the hepatic haemodynamic laboratory of the Hospital Clinic in Barcelona were included in the study. All patients were studied for the entire open reading frame and splice site of the BMPR2 gene by direct sequencing and multiple ligation probe amplification (MLPA) in order to detect large deletions/duplications. None of the 23 patients had pulmonary artery hypertension. Four patients presented one single nucleotide polymorphism (SNP) in intron 5, four patients had a SNP in exon 12 and a SNP in exon 1 was found in two cases. Two patients had both intron 5 and exon 12 polymorphisms. All SNPs were previously described. Except for these three SNPs, neither mutations nor rearrangements have been identified in the BMPR2 gene in this population. We did not detect mutations or rearrangements in the coding region of the BMPR2 gene in our patients with IPH. These findings suggest that, in contrast to IPAH, mutations in BMPR2 are not involved in the pathogenesis of IPH.

Automated Portal Placement for Arthroscopic Hip Surgery

Placing portal incisions during arthroscopic hip surgery presents challenges for surgeons in terms of anatomic accessibility and patient safety. Based on key anatomic landmarks and portal placement information from recent literature, suggested portal incisions were determined. Guidance in the placement of the three most common portal incision locations (anterior, anterolateral, and posterolateral) for arthroscopic surgery; in addition to visual feedback on tool trajectory to the hip joint is provided in real time by a computer aided system for hip arthroscopy. By simplifying the portal placement process, one of the most challenging aspects of arthroscopic hip surgery, an increased use of this minimally invasive technique could be possible. In addition to portal information, improvements to an existing computer aided system for arthroscopic hip surgery, including a new hip model and redesigned mechanical tracking linkage, were completed.