974 resultados para Angioplastica Angiografia CO2 Catetere Introduttore
Resumo:
L'obiettivo del lavoro svolto nell'ambito di questa tesi è quello di progettare e realizzare un dispositivo medico, un catetere introduttore. Esso deve consentire la somministrazione di anidride carbonica come mezzo di contrasto per angiografia e l'inserimento di strumenti per procedure di angioplastica. Il lavoro è articolato in modo da presentare le necessità cliniche e le scelte effettuate in fase di progetto in modo da realizzare un dispositivo in grado di soddisfarle. Vengono illustrati i materiali scelti, i rivestimenti, le dimensioni e il design dei lumi, oltre che ad alcune caratteristiche peculiari. La tesi è stata svolta in collaborazione con l'azienda italiana Angiodroid srl.
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La scelta del mezzo di contrasto in angiografia è rilevante e richiede un’attenta valutazione della qualità diagnostica delle immagini e degli effetti collaterali. Essenziale è analizzare il rischio che comporta l’utilizzo dei vari mezzi di contrasto a base di iodio, come ad esempio la nefropatia. Al contrario l’anidride carbonica, riconosciuta come unico agente di contrasto sicuro, sempre più, viene utilizzata in tutti i vasi del corpo al di sotto del diaframma. L'obiettivo principale di questo lavoro, svolto in collaborazione con l’azienda bolognese Angiodroid srl, è quello di realizzare un dispositivo medico in grado migliorare la qualità delle immagini ottenute con CO2 a livello addominale. Infatti, col recente utilizzo della CO2 anche nel distretto addominale si riduce drasticamente l’utilizzo di grandi quantità di iodio, ma, in molti pazienti, il movimento della aria intestinale che ha coefficiente di assorbimento simile all’anidride carbonica, rende l’immagine inefficiente. Il progetto consiste in una fascia addominale composta da tre camere d’aria gonfiabili manualmente, che comprimendo l’addome con pressioni di 120-180 mmHg, spostano l’aria e riducono il movimento intestinale, e quindi gli artefatti. L’uso di questa semplice fascia, migliorando le immagini dei distretti addominale e viscerale, potrebbe permettere una più rapida affermazione dell’angiografia con CO2 anche in procedure come EVAR e PTA iliache. Per individuare la procedura d’utilizzo più adeguata e migliorare il dispositivo secondo le necessità cliniche, la fascia è stata provata in alcune sale angiografiche dell’Emilia Romagna, Lombardia e Campania.
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Lo scopo di questa tesi è lo studio degli aspetti procedurali e dosimetrici in angiografie periferiche che utilizzano la CO2 come mezzo di contrasto. La tecnica angiografica consiste nell’imaging radiologico di vasi sanguigni tramite l’iniezione di un mezzo di contrasto, e il suo uso è in costante incremento a causa dell’aumento di pazienti con malattie vascolari. I mezzi di contrasto iodati sono i più comunemente utilizzati e permettono di ottenere immagini di ottima qualità, ma presentano il limite di una elevata nefrotossicità. La CO2 è considerata un’interessante alternativa al mezzo iodato, per la sua acclarata biocompatibilità, soprattutto per pazienti con elevati fattori di rischio (diabete e/o insufficienza renale). Il suo utilizzo presenta comunque alcuni aspetti problematici, dovuti allo stato gassoso e al basso contrasto intrinseco rispetto alla soluzione iodata. Per quest’ultimo motivo si ritiene generalmente che l’utilizzo della CO2 comporti un aumento di dose rispetto ai mezzi di contrasto tradizionali. Il nostro studio, effettuato su diversi apparati radiologici, ha dimostrato che i parametri di emissione radiologica sono gli stessi per i protocolli di angiografia tradizionale, con iodio, e quelli che utilizzano CO2. Questa evidenza suggerisce che i protocolli CO2 operino solo sul trattamento delle immagini ottenute e non sulla modalità di acquisizione, e dal punto di vista dosimetrico l’angiografia con CO2 è riconducibile all’angiografia tradizionale. L’unico fattore che potrebbe portare a un effettivo incremento di dose al paziente è un allungamento dei tempi di scopia e di procedura, che andrebbe verificato con una campagna di misure in ambito clinico. Sulla base della stessa evidenza, si ritiene che la visualizzazione della CO2 possa essere ulteriormente migliorata attraverso l’ottimizzazione dei parametri di emissione radiologica (kVp, frame rate e durata degli impulsi) attualmente predisposti per l’uso di mezzi di contrasto iodati.
Resumo:
INTRODUÇÃO: Durante procedimentos endovasculares, estão presentes os riscos relacionados ao uso dos contrastes iodados, tais como a nefropatia por contraste, uma vez que é fundamental o emprego de um meio de contraste para a obtenção das imagens radiológicas vasculares. A injeção intravascular de gás CO2 purificado é reconhecidamente uma alternativa relativamente mais segura ao contraste iodado, contudo, seu manuseio artesanal pode também trazer dificuldades técnicas e riscos aos pacientes. Para contemplar estas questões, foi desenvolvido o protótipo de um injetor intravascular de CO2 medicinal, microprocessado, dedicado à obtenção de imagens angiográficas. OBJETIVOS: Realizar os testes de viabilidade técnica inicial do protótipo em modelo in vivo. MÉTODOS: Realizar a angioplastia da artéria renal esquerda de 10 porcos, divididos em 2 grupos: Grupo 1 (n=5) injeção de contraste iodado, Grupo 2 (n=5) injeção de CO2 através do protótipo. Monitorização clínica e laboratorial dos animais no pré, intra e pós-operatório, com exames de função renal na véspera e 48h após os procedimentos e 3 gasometrias arteriais seriadas no intra-operatório. Observação clínica foi mantida por 48h no pós- operatório. RESULTADOS: Os procedimentos de angioplastia com CO2 foram realizados com sucesso técnico de 100%, sem necessidade de complementação com injeção de contraste iodado no Grupo 2. Não foram identificadas falhas no protótipo em funcionamento. Não foram identificadas alterações clínicas ou radiológicas sugestivas de contaminação por ar ambiente do sistema de CO2 e nem alterações laboratoriais nos animais. As imagens angiográficas obtidas no Grupo 2 foram consideradas, numa avaliação subjetiva, relativamente inferiores às imagens obtidas no Grupo 1. DISCUSSÃO: A qualidade inferior de imagem no Grupo 2 pode ser atribuída ao equipamento de fluoroscopia utilizado, com software desatualizado em relação aos equipamentos atuais, que incluem pré-configurações para angiografia com CO2; no entanto, ainda assim todos os procedimentos propostos no Grupo 2 foram realizados com sucesso técnico, o que nos leva a classificar as imagens deste grupo 2 como satisfatórias. O manuseio do aparelho mostrou-se ágil e eficiente, com a programação dos parâmetros sendo realizada com facilidade através do visor \"touch screen\", comparativamente superior ao método artesanal de injeção de CO2 com seringas em selo d\'água. CONCLUSÕES: O protótipo do aparelho injetor intravascular de CO2 funcionou de forma adequada durante os testes e as imagens obtidas permitiram a compleição com sucesso dos procedimentos. Portanto, os resultados positivos obtidos sugerem que o equipamento é tecnicamente viável
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Australian climate, soils and agricultural management practices are significantly different from those of the northern hemisphere nations. Consequently, experimental data on greenhouse gas production from European and North American agricultural soils and its interpretation are unlikely to be directly applicable to Australian systems.
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Greenhouse gas emissions from a well established, unfertilized tropical grass-legume pasture were monitored over two consecutive years using high resolution automatic sampling. Nitrous oxide emissions were highest during the summer months and were highly episodic, related more to the size and distribution of rain events than WFPS alone. Mean annual emissions were significantly higher during 2008 (5.7 ± 1.0 g N2O-N/ha/day) than 2007 (3.9 ± 0.4 and g N2O-N/ha/day) despite receiving nearly 500 mm less rain. Mean CO2 (28.2 ± 1.5 kg CO2 C/ha/day) was not significantly different (P < 0.01) between measurement years, emissions being highly dependent on temperature. A negative correlation between CO2 and WFPS at >70% indicated a threshold for soil conditions favouring denitrification. The use of automatic chambers for high resolution greenhouse gas sampling can greatly reduce emission estimation errors associated with temperature and WFPS changes.
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Raman spectrum of burgessite, Co2(H2O)4[AsO3OH]2.H2O was studied, interpreted and compared with its infrared spectrum. The stretching and bending vibrations of (AsO3) and As-OH units together with the stretching, bending and libration modes of water molecules and hydroxyl ions were assigned. The range of O-H...O hydrogen bond lengths was inferred from the Raman and infrared spectra of burgessite. The presence of (AsO3OH)2- units in the crystal structure of burgessite was proved in agreement with its recently solved crystal structure. Raman and infrared spectra of erythrite inferred from the RRUFF database are used for comparison.
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Abstract As regional and continental carbon balances of terrestrial ecosystems become available, it becomes clear that the soils are the largest source of uncertainty. Repeated inventories of soil organic carbon (SOC) organized in soil monitoring networks (SMN) are being implemented in a number of countries. This paper reviews the concepts and design of SMNs in ten countries, and discusses the contribution of such networks to reducing the uncertainty of soil carbon balances. Some SMNs are designed to estimate country-specific land use or management effects on SOC stocks, while others collect soil carbon and ancillary data to provide a nationally consistent assessment of soil carbon condition across the major land-use/soil type combinations. The former use a single sampling campaign of paired sites, while for the latter both systematic (usually grid based) and stratified repeated sampling campaigns (5–10 years interval) are used with densities of one site per 10–1,040 km². For paired sites, multiple samples at each site are taken in order to allow statistical analysis, while for the single sites, composite samples are taken. In both cases, fixed depth increments together with samples for bulk density and stone content are recommended. Samples should be archived to allow for re-measurement purposes using updated techniques. Information on land management, and where possible, land use history should be systematically recorded for each site. A case study of the agricultural frontier in Brazil is presented in which land use effect factors are calculated in order to quantify the CO2 fluxes from national land use/management conversion matrices. Process-based SOC models can be run for the individual points of the SMN, provided detailed land management records are available. These studies are still rare, as most SMNs have been implemented recently or are in progress. Examples from the USA and Belgium show that uncertainties in SOC change range from 1.6–6.5 Mg C ha−1 for the prediction of SOC stock changes on individual sites to 11.72 Mg C ha−1 or 34% of the median SOC change for soil/land use/climate units. For national SOC monitoring, stratified sampling sites appears to be the most straightforward attribution of SOC values to units with similar soil/land use/climate conditions (i.e. a spatially implicit upscaling approach). Keywords Soil monitoring networks - Soil organic carbon - Modeling - Sampling design
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Biochars produced by slow pyrolysis of greenwaste (GW), poultry litter (PL), papermill waste (PS), and biosolids (BS) were shown to reduce N2O emissions from an acidic Ferrosol. Similar reductions were observed for the untreated GW feedstock. Soil was amended with biochar or feedstock giving application rates of 1 and 5%. Following an initial incubation, nitrogen (N) was added at 165 kg/ha as urea. Microcosms were again incubated before being brought to 100% water-filled porosity and held at this water content for a further 47 days. The flooding phase accounted for the majority (<80%) of total N2O emissions. The control soil released 3165 mg N2O-N/m2, or 15.1% of the available N as N2O. Amendment with 1 and 5% GW feedstock significantly reduced emissions to 1470 and 636 mg N2O-N/m2, respectively. This was equivalent to 8.6 and 3.8% of applied N. The GW biochar produced at 350°C was least effective in reducing emissions, resulting in 1625 and 1705 mg N2O-N/m2 for 1 and 5% amendments. Amendment with BS biochar at 5% had the greatest impact, reducing emissions to 518 mg N2O-N/m2, or 2.2% of the applied N over the incubation period. Metabolic activity as measured by CO2 production could not explain the differences in N2O emissions between controls and amendments, nor could NH4+ or NO3– concentrations in biochar-amended soils. A decrease in NH4+ and NO3– following GW feedstock application is likely to have been responsible for reducing N2O emissions from this amendment. Reduction in N2O emissions from the biochar-amended soils was attributed to increased adsorption of NO3–. Small reductions are possible due to improved aeration and porosity leading to lower levels of denitrification and N2O emissions. Alternatively, increased pH was observed, which can drive denitrification through to dinitrogen during soil flooding.
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The reduction of CO2 emissions and social exclusion are two key elements of UK transport strategy. Despite intensive research on each theme, little effort has so far been made linking the relationship between emissions and social exclusion. In addition, current knowledge on each theme is limited to urban areas; little research is available on these themes for rural areas. This research contributes to this gap in the literature by analysing 157 weekly activity-travel diary data collected from three case study areas with differential levels of area accessibility and area mobility options, located in rural Northern Ireland. Individual weekly CO2 emission levels from personal travel diaries (both hot exhaust emission and cold-start emission) were calculated using average speed models for different modes of transport. The socio-spatial patterns associated with CO2 emissions were identified using a general linear model whereas binary logistic regression analyses were conducted to identify mode choice behaviour and activity patterns. This research found groups that emitted a significantly lower level of CO2 included individuals living in an area with a higher level of accessibility and mobility, non-car, non-working, and low-income older people. However, evidence in this research also shows that although certain groups (e.g. those working, and residing in an area with a lower level of accessibility) emitted higher levels of CO2, their rate of participation in activities was however found to be significantly lower compared to their counterparts. Based on the study findings, this research highlights the need for both soft (e.g. teleworking) and physical (e.g. accessibility planning) policy measures in rural areas in order to meet government’s stated CO2 reduction targets while at the same time enhancing social inclusion.
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Australian climate, soils and agricultural management practices are significantly different from those of the northern hemisphere nations. Consequently, experimental data on greenhouse gas production from European and North American agricultural soils and its interpretation are unlikely to be directly applicable to Australian systems. A programme of studies of non-CO2 greenhouse gas emissions from agriculture has been established that is designed to reduce uncertainty of non-CO2 greenhouse gas emissions in the Australian National Greenhouse Gas Inventory and provide outputs that will enable better on-farm management practices for reducing non-CO2 greenhouse gas emissions, particularly nitrous oxide. The systems being examined and their locations are irrigated pasture (Kyabram Victoria), irrigated cotton (Narrabri, NSW), irrigated maize (Griffith, NSW), rain-fed wheat (Rutherglen, Victoria) and rain-fed wheat (Cunderdin, WA). The field studies include treatments with and without fertilizer addition, stubble burning versus stubble retention, conventional cultivation versus direct drilling and crop rotation to determine emission factors and treatment possibilities for best management options. The data to date suggest that nitrous oxide emissions from nitrogen fertilizer, applied to irrigated dairy pastures and rain-fed winter wheat, appear much lower than the average of northern hemisphere grain and pasture studies. More variable emissions have been found in studies of irrigated cotton/vetch/wheat rotation and substantially higher emissions from irrigated maize.
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The temporal variations in CO2, CH4 and N2O fluxes were measured over two consecutive years from February 2007 to March 2009 from a subtropical rainforest in south-eastern Queensland, Australia, using an automated sampling system. A concurrent study using an additional 30 manual chambers examined the spatial variability of emissions distributed across three nearby remnant rainforest sites with similar vegetation and climatic conditions. Interannual variation in fluxes of all gases over the 2 years was minimal, despite large discrepancies in rainfall, whereas a pronounced seasonal variation could only be observed for CO2 fluxes. High infiltration, drainage and subsequent high soil aeration under the rainforest limited N2O loss while promoting substantial CH4 uptake. The average annual N2O loss of 0.5 ± 0.1 kg N2O-N ha−1 over the 2-year measurement period was at the lower end of reported fluxes from rainforest soils. The rainforest soil functioned as a sink for atmospheric CH4 throughout the entire 2-year period, despite periods of substantial rainfall. A clear linear correlation between soil moisture and CH4 uptake was found. Rates of uptake ranged from greater than 15 g CH4-C ha−1 day−1 during extended dry periods to less than 2–5 g CH4-C ha−1 day−1 when soil water content was high. The calculated annual CH4 uptake at the site was 3.65 kg CH4-C ha−1 yr−1. This is amongst the highest reported for rainforest systems, reiterating the ability of aerated subtropical rainforests to act as substantial sinks of CH4. The spatial study showed N2O fluxes almost eight times higher, and CH4 uptake reduced by over one-third, as clay content of the rainforest soil increased from 12% to more than 23%. This demonstrates that for some rainforest ecosystems, soil texture and related water infiltration and drainage capacity constraints may play a more important role in controlling fluxes than either vegetation or seasonal variability
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Carbon dioxide (CO2), as a primary product of combustion, is a known factor affecting climate change and global warming. In Australia, CO2 emissions from biomass burning are a significant contributor to total carbon in the atmosphere and therefore, it is important to quantify the CO2 emission factors from biomass burning in order to estimate their magnitude and impact on the Australian atmosphere. This paper presents the quantification of CO2 emission factors for five common tree species found in South East Queensland forests, as well as several grasses taken from savannah lands in the Northern Territory of Australia, under controlled ‘fast burning’ and ‘slow burning’ laboratory conditions. The results showed that CO2 emission factors varied according to the type of vegetation and burning conditions, with emission factors for fast burning being 2574 ± 254 g/kg for wood, 394 ± 40 g/kg for branches and leaves, and 2181 ± 120 g/kg for grass. Under slow burning conditions, the CO2 emission factors were 218 ± 20 g/kg for wood, 392± 80 g/kg for branches and leaves, and 2027 ± 809 g/kg for grass.