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1.
Inorg Chem ; 58(22): 14939-14980, 2019 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-31668070

RESUMO

Nanostructured materials are essential building blocks for the fabrication of new devices for energy harvesting/storage, sensing, catalysis, magnetic, and optoelectronic applications. However, because of the increase of technological needs, it is essential to identify new functional materials and improve the properties of existing ones. The objective of this Viewpoint is to examine the state of the art of atomic-scale simulative and experimental protocols aimed to the design of novel functional nanostructured materials, and to present new perspectives in the relative fields. This is the result of the debates of Symposium I "Atomic-scale design protocols towards energy, electronic, catalysis, and sensing applications", which took place within the 2018 European Materials Research Society fall meeting.

2.
Ren Fail ; 36(10): 1570-4, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25156619

RESUMO

BACKGROUND: We investigated the anti-inflammatory and protective effects of concomitant use of dexpanthenol (DXP) and N-acetylcysteine (NAC) induced ischemia/reperfusion (I/R) injury of kidney. METHODS: Forty rats were randomly divided into 5 groups. In all groups except for Group 1(Sham), renal arteries bilaterally occluded with vascular clamp for IR injury. Group 1(Sham), received a single dose of 10 mL/kg isotonic saline daily by intraperitoneal (IP) injection for three days. Group 2(IR), received a single dose of 10 mL/kg isotonic saline daily by IP injection for three days. Group 3(IR + NAC), received 300 mg/kg NAC daily by IP injection for three days. Group 4(IR + DXP), received 500 mg/kg DXP daily by IP injection for three days. Group 5(IR + NAC + DXP), received 500 mg/kg DXP and 300 mg/kg NAC daily by IP injection for three days. Serum urea (BUN), creatinine (Cr) and neutrophil gelatinase-associated lipocalin (NGAL, lipocalin 2, siderocalin) levels were measured as kidney function tests. TNF-α levels were measured as inflammatory marker. Tissue sections were evaluated histopathologically under light microscopy. RESULTS: IR + NAC + DXP group received both NAC and DXP before induction of renal I/R and as the biochemical and histopathological data revealed the results of the IR + NAC + DXP group and sham group were similar. Biochemically and histopathologically, combined use of NAC and DXP has better results when each of them used alone. CONCLUSION: We concluded that concomitant use of DXP and NAC plays a major role against I/R injury and may be useful in acute treatment of I/R induced renal failure.


Assuntos
Acetilcisteína/uso terapêutico , Injúria Renal Aguda/prevenção & controle , Sequestradores de Radicais Livres/uso terapêutico , Ácido Pantotênico/análogos & derivados , Traumatismo por Reperfusão/prevenção & controle , Injúria Renal Aguda/patologia , Animais , Avaliação Pré-Clínica de Medicamentos , Rim/patologia , Masculino , Ácido Pantotênico/uso terapêutico , Distribuição Aleatória , Ratos Wistar , Traumatismo por Reperfusão/patologia
3.
Thorac Cardiovasc Surg ; 60(4): 280-4, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22411756

RESUMO

BACKGROUND: The clipping of the thoracic sympathetic nerve, which has been a technique used for approximately the past 10 years, has rapidly become popular because of its "bring-back" claim. However, the information regarding the mechanism behind this claim is based on investigator's comments and has not been proven by objective research, such as the histopathological examination of the clipped nerve and/or ganglion. We aimed to evaluate sympathetic regeneration and degeneration after clip removal. METHODS: The rabbits were divided into two groups with six rabbits per group. For the first group (group A), the sympathetic chain was clipped using two titanium clips, and a right thoracotomy was made at the T4 and T5 levels. For the second group (group B), the animals were also operated on, which was similar to the rabbits in group A. At the end of a 48-hour follow-up period, the clips were removed after a second operation. The rabbits in group B were followed for 45 days and sympathetic nerves were also examined histopathologically. RESULTS: In group A, hemorrhage, fibrinous material, polymorphonuclear leukocyte infiltration, and acute inflammation with fat necrosis were observed in and around the sympathetic ganglia and trunk. Loss of nuclei and vacuolization in some sympathetic ganglia cells were also observed. These findings demonstrated severe degeneration of the sympathetic ganglia and trunk. For group B, microscopic examination revealed a loss of sympathetic ganglion cells as well as fibrosis within and around the ganglia. No signs of regeneration were detected and the progression of nerve degeneration was observed. CONCLUSIONS: The clips used in our study were shown to cause the degeneration of neural structures within 2 days. At the end of the 45 days following the removal of the clips, progressive, degenerative changes radiating along the axons of the sympathetic cells were seen.


Assuntos
Gânglios Simpáticos/cirurgia , Simpatectomia/métodos , Nervos Torácicos/cirurgia , Toracotomia/métodos , Tórax/inervação , Animais , Desenho de Equipamento , Fibrose , Gânglios Simpáticos/patologia , Necrose , Degeneração Neural , Regeneração Nervosa , Coelhos , Instrumentos Cirúrgicos , Simpatectomia/efeitos adversos , Simpatectomia/instrumentação , Nervos Torácicos/patologia , Toracotomia/efeitos adversos , Toracotomia/instrumentação , Fatores de Tempo , Titânio
4.
ACS Appl Mater Interfaces ; 14(10): 12777-12796, 2022 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-35235286

RESUMO

Nanolayered metallic alloys are promising materials for nuclear applications thanks to their resistance to radiation damage. Here, we investigate the effect of ion (C, Si, and Cu) irradiation at room temperature with different fluences into sputtered Zr/Nb metallic multilayer films with periods 27 nm (thin) and 96 nm (thick). After irradiation, while a high strain in the entire thin nanoscale metallic multilayer (NMM) is observed, a quite small strain in the entire thick NMM is established. This difference is further analyzed by a semianalytical model, and the reasons behind it are revealed, which are also validated by local strain mapping. Both methods show that within a thick layer, two opposite distortions occur, making the overall strain small, whereas in a thin layer, all the atomic planes are affected by the interface and are subjected to only a single type of distortion (Nb─tension and Zr─compression). In both thin and thick NMMs, with increasing damage, the strain around the interface increases, resulting in a release of the elastic energy at the interface (decrease in the lattice mismatch), and the radiation-induced transition of the Zr/Nb interfaces from incoherent to partially coherent occurs. Density functional theory simulations decipher that the inequality of point defect diffusion flux from the inner to the interface-affected region is responsible for the presence of opposite distortions within a layer. Technologically, based on this work, we estimated that Zr/Nb55 with thicknesses around Zr = 24 nm and Nb = 31 nm is the most promising multilayer system with the high radiation damage resistance and minimum swelling for nuclear applications.

5.
J Cardiothorac Vasc Anesth ; 25(5): 824-9, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21232979

RESUMO

OBJECTIVES: The purpose of this study was to evaluate the analgesic effects of perioperative gabapentin on postoperative acute and chronic pain after coronary artery bypass graft (CABG) surgery with median sternotomy and internal mammary artery harvesting. DESIGN: A double-blind randomized clinical study. SETTING: A single-academic hospital. PARTICIPANTS: Patients with ischemic heart disease who were scheduled to undergo CABG surgery. INTERVENTIONS: Forty patients were allocated randomly into 2 groups; the gabapentin group (n = 20) received 1.2 g/d of oral gabapentin before and for 2 days after surgery, and the placebo group (n = 20) received a placebo capsule instead. The primary outcome was to evaluate the effects of gabapentin on acute and chronic pain after surgery. The postoperative evaluation included the assessment of pain at rest and when coughing, intravenous tramadol usage, postoperative morbidities, and side effects of gabapentin. Postoperative analgesia at 6, 12, 18, 24, 48, and 72 hours after extubation and at discharge was evaluated with the visual analog scale. The assessment of postoperative pain at the 1- and 3-month follow-ups was performed using a numeric rating scale. MAIN RESULTS: Postoperative pain scores at 1, 2, and 3 days were significantly lower in the gabapentin group when compared with the placebo group (p < 0.05). Pain scores at 1 and 3 months postoperatively were lower in the gabapentin group than in the placebo group (p > 0.05). Consumption of intravenous tramadol given as rescue analgesic within 24 hours after extubation in the gabapentin group was 99.0 ± 53.8 mg versus 149.4 ± 72.5 mg in the placebo group (p < 0.05). There were no differences in the incidence of side effects and time to extubation between the groups. CONCLUSIONS: Gabapentin significantly reduced the intensity of pain and tramadol consumption in the early postoperative period after CABG surgery. Pain scores at 1 and 3 months after surgery were low in both groups, with no significant difference between the groups.


Assuntos
Aminas/uso terapêutico , Analgésicos/uso terapêutico , Ponte de Artéria Coronária/efeitos adversos , Ácidos Cicloexanocarboxílicos/uso terapêutico , Dor Pós-Operatória/tratamento farmacológico , Ácido gama-Aminobutírico/uso terapêutico , Doença Aguda , Idoso , Aminas/efeitos adversos , Analgésicos/efeitos adversos , Analgésicos Opioides/administração & dosagem , Analgésicos Opioides/uso terapêutico , Doença Crônica , Dor Crônica , Ácidos Cicloexanocarboxílicos/efeitos adversos , Método Duplo-Cego , Feminino , Seguimentos , Gabapentina , Humanos , Masculino , Pessoa de Meia-Idade , Revascularização Miocárdica/efeitos adversos , Medição da Dor , Estudos Prospectivos , Tamanho da Amostra , Esternotomia , Tramadol/administração & dosagem , Tramadol/uso terapêutico , Ácido gama-Aminobutírico/efeitos adversos
6.
Heart Lung Circ ; 20(7): 468-72, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21493138

RESUMO

BACKGROUND: Surgical treatment of bronchiectasis is associated with acceptable mortality and morbidity rates. To date, few reports on the prediction of postoperative morbidity using some preoperative measures have been presented. We present our results regarding the influence of some specific factors on postoperative morbidity on young adult patients who were treated surgically for bronchiectasis. METHODS: Between January 2000 and July 2007, 122 patients were operated upon. Female gender, increased number of resected segments, presence of haemoptysis and bilateral disease, compromised pulmonary function test (FEV1/VC<60%) and absence of preoperative fiberoptic bronchoscopy (FOB) were examined as the potential risk factors for postoperative complications such as persistent air leak (PAL), atelectasis, residual air space (RAS), bronchopleural fistula (BPF) and empyaema. RESULTS: There was no operative mortality. Morbidity was observed in a total of 16 patients with an overall morbidity rate of 13.1%. Complete resection was achieved in 88 patients (72.1%). The number of resected segments was not found to be significantly associated with increased morbidity. Presence of preoperative haemoptysis did not correlate with postoperative complications significantly. Absence of preoperative FOB was not found to be associated with post-operative complications (p<0.05). Compromised PFT was significantly associated with RAS (p=0.028), however it was not associated with increased risk of PAL, atelectasis or empyaema significantly. CONCLUSION: Multi-segmental resectable bronchiectasis should not be considered an occult risk factor for morbidity after resection. Associated non-severe haemoptysis and absence of preoperative bronchoscopy are not associated with significant increased risk of postoperative morbidity.


Assuntos
Bronquiectasia/mortalidade , Bronquiectasia/cirurgia , Complicações Pós-Operatórias/mortalidade , Adolescente , Adulto , Feminino , Humanos , Masculino , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais
7.
J Anesth ; 25(3): 386-91, 2011 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21416311

RESUMO

PURPOSE: Anesthetic management of tension-free vaginal-tape (TVT) procedures is sometimes difficult to deal with, especially when surgeons request a cough test. Dexmedetomidine has unique sedative and analgesic properties while having minimal respiratory effects, making it suitable for perioperative use in monitored anesthesia care. We aimed to compare dexmedetomidine and epidural anesthesia in TVT patients. METHODS: Forty-nine women [American Society of Anesthesiologists (ASA 1-3)] with genuine stress incontinence confirmed by preoperative bladder function studies were included in this double-blind, randomized study. The patients were randomly assigned to one of two groups: group D received 0.5 µg/kg dexmedetomidine IV applied as bolus over 10 min and continued with 0.5 µg/kg/h infusion, and local anesthesia (lidocaine 2% with epinephrine) performed by the surgeon. Group E received epidural anesthesia with 15 ml of 0.25% bupivacaine + 100 µg fentanyl. Patients were monitored every 5 min for mean arterial pressure (MAP), heart rate (HR), peripheral oxygen saturation, respiratory rate, sedation, and intraoperative and postoperative pain. Ability to cough was also evaluated by the surgeon. RESULTS: There was no difference in ability to cough, and this was evaluated by the surgeon as adequate, and there was no difference in scores between groups. Significant decreases in MAP and HR were observed 10 min after the start of surgery in group D compared with group E, and they were significantly decreased until first and second postoperative hours, respectively (p < 0.05). None of the patients had respiratory rate decrease or apnea. Side effects encountered postoperatively were similar. CONCLUSION: Dexmedetomidine can be an alternative to epidural anesthesia in TVT procedure requiring cough test.


Assuntos
Anestesia Epidural , Dexmedetomidina , Procedimentos Cirúrgicos em Ginecologia , Hipnóticos e Sedativos , Slings Suburetrais , Vagina/cirurgia , Anestesia Epidural/efeitos adversos , Tosse/fisiopatologia , Soluções Cristaloides , Dexmedetomidina/efeitos adversos , Método Duplo-Cego , Feminino , Hemodinâmica/efeitos dos fármacos , Hemodinâmica/fisiologia , Humanos , Hipnóticos e Sedativos/efeitos adversos , Hipotensão/tratamento farmacológico , Complicações Intraoperatórias/tratamento farmacológico , Complicações Intraoperatórias/epidemiologia , Período Intraoperatório , Soluções Isotônicas , Pessoa de Meia-Idade , Medição da Dor/efeitos dos fármacos , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/psicologia , Substitutos do Plasma , Náusea e Vômito Pós-Operatórios/epidemiologia , Mecânica Respiratória/efeitos dos fármacos , Mecânica Respiratória/fisiologia , Incontinência Urinária/cirurgia
8.
Microsurgery ; 30(1): 55-60, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-19967761

RESUMO

BACKGROUND: This experimental study was designed to investigate and compare the effects of different anesthesia techniques on rat cremaster muscle flap microcirculation. METHODS: Fifty male Sprague-Dawley rats (130-150 g body weight) were divided into five experimental groups containing ten animals each. Group I, group II, and group III were designated as inhalation, epidural, and spinal anesthesia groups, respectively. Group IV was designated as a combination group for inhalation and epidural anesthesia. Group V was a combination group of inhalation and spinal anesthesia. RESULTS: Group III and group V showed significant increases in the number of rolling and sticking leucocytes and in RBC volume (peripheral stasis) when compared with group I. Blood flow and velocity significantly increased without peripheral stasis in groups II and IV when compared with group I. Although there was no statistically significant difference in the numbers of rolling, sticking, and transmigrating leucocytes or in functional capillary perfusion, group IV had better flow hemodynamics in the peripheral microcirculation when compared with group I. CONCLUSIONS: The inhalation and epidural anesthesia combination was determined to be the ideal anesthesia technique for improved peripheral microcirculation. Spinal anesthesia, either separately or in combination with inhalation anesthesia, has adverse effects on microcirculation.


Assuntos
Anestesia Epidural , Anestesia por Inalação , Raquianestesia , Microcirculação/efeitos dos fármacos , Músculo Esquelético/efeitos dos fármacos , Retalhos Cirúrgicos/irrigação sanguínea , Animais , Masculino , Músculo Esquelético/irrigação sanguínea , Ratos , Ratos Sprague-Dawley , Escroto
9.
Middle East J Anaesthesiol ; 20(5): 723-5, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20803863

RESUMO

In this report a 20-year-old male patient who had suffered tonic-clonic seizure after a single induction dose of etomidate until a bispectral index value of 60 is presented. Our best knowledge, this case is the first report of pure etomidate (with induction dose) induced generalized tonic clonic seizure proven with EEG. Anaesthesiologists should be careful against such a complication even in the induction stage of anaesthesia during etomidate use.


Assuntos
Anestésicos Intravenosos/efeitos adversos , Epilepsia/induzido quimicamente , Etomidato/efeitos adversos , Adulto , Eletroencefalografia , Humanos , Masculino
10.
Anesth Analg ; 109(4): 1327-30, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19762765

RESUMO

BACKGROUND: In this study, we evaluated the effect of paracetamol on sensory and motor block onset time, tourniquet pain, and postoperative analgesia, when added to lidocaine in IV regional anesthesia (IVRA). METHODS: Sixty patients undergoing hand surgery were randomly and blindly divided into three groups. All groups received IVRA lidocaine (3 mg/kg) diluted with saline to a total volume of 40 mL. Group 1 received IVRA lidocaine plus IV saline, Group 2 received IVRA lidocaine and paracetamol (300 mg) admixture plus IV saline, and Group 3 received IVRA lidocaine plus IV paracetamol (300 mg). Sensory and motor block onset time, tourniquet pain, and analgesic use were assessed during operation. After tourniquet deflation, visual analog scale (VAS) scores at 1, 2, 4, 6, 12, and 24 h, the time to first analgesic requirement, total analgesic consumption in first 24 h, and side effects were noted. RESULTS: Onset of motor block was shorter and recovery of motor and sensory block was significantly longer in Group 2 (P < 0.05). Intraoperative VAS scores at intraoperative 20, 30, and 40 min were significantly lower in Group 2 (P < 0.05). Intraoperative fentanyl consumption (78 +/- 12, 58 +/- 14, 78 +/- 11 microg, respectively) and the number of patients who required fentanyl for tourniquet pain (13 patients, 3 patients, 9 patients, respectively) were significantly less in Group 2 (P < 0.05). Time to postoperative fentanyl administration was also prolonged (15 +/- 6, 25 +/- 5, 15 +/- 4 min, respectively) in Group 2 (P < 0.05). The quality of surgical anesthesia was better in Group 2 (P < 0.05). Postoperative VAS scores and time of initial analgesic requirement were similar among groups; however, the total amount of diclophenac use was less in Group 2 (P < 0.05). CONCLUSION: The addition of paracetamol during IVRA with lidocaine decreased tourniquet pain, increased anesthesia quality, and decreased postoperative analgesic consumption.


Assuntos
Acetaminofen/administração & dosagem , Analgésicos não Narcóticos/administração & dosagem , Anestesia por Condução/métodos , Anestésicos Locais/administração & dosagem , Mãos/cirurgia , Lidocaína/administração & dosagem , Procedimentos Ortopédicos , Dor Pós-Operatória/prevenção & controle , Adolescente , Adulto , Analgésicos Opioides/administração & dosagem , Período de Recuperação da Anestesia , Método Duplo-Cego , Esquema de Medicação , Feminino , Fentanila/administração & dosagem , Mãos/irrigação sanguínea , Mãos/inervação , Humanos , Infusões Intravenosas , Masculino , Pessoa de Meia-Idade , Atividade Motora/efeitos dos fármacos , Medição da Dor , Recuperação de Função Fisiológica , Sensação/efeitos dos fármacos , Fatores de Tempo , Torniquetes , Resultado do Tratamento , Adulto Jovem
11.
Anesth Analg ; 109(5): 1645-50, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-19843803

RESUMO

BACKGROUND: Gabapentin and ketamine are popular analgesic adjuvants for improving perioperative pain management. We designed this double-blind, placebo-controlled study to test and compare the preventive effects of perioperative ketamine and gabapentin on early and chronic pain after elective hysterectomy. METHODS: Sixty patients undergoing abdominal hysterectomy were randomly assigned to 1 of the following 3 groups: control group received oral placebo capsules and bolus plus infusion of saline; ketamine group received oral placebo capsules and, before incision, 0.3 mg/kg IV bolus and 0.05 mgxkg(-1)xh(-1) infusion of ketamine until the end of surgery; and gabapentin group received oral gabapentin 1.2 g and bolus plus infusion of saline. The anesthetic technique was standardized, and the postoperative assessments included verbal rating scales for pain and sedation, IV morphine usage, quality of recovery assessment, recovery of bowel function, resumption of normal activities, and patient satisfaction with their pain management. Patients were questioned at 1, 3, and 6 mo after surgery for chronic postoperative pain. RESULTS: Postoperative pain scores were significantly lower in the gabapentin group compared with the ketamine and control groups, and patient-controlled analgesia morphine use was significantly reduced in both treatment groups (versus control group) (P < 0.001). Total patient-controlled analgesia morphine use was decreased by 35% and 42% in the ketamine and gabapentin groups, respectively, compared with the control group (P < 0.001). Patient satisfaction with pain treatment was significantly improved in the ketamine and gabapentin groups compared with the control group (P < 0.001). The incidence of incisional pain and related pain scores at the 1-, 3-, and 6-mo follow-up were significantly lower in the gabapentin group compared with the ketamine and control groups (P < 0.001). CONCLUSION: Gabapentin and ketamine are similar in improving early pain control and in decreasing opioid consumption; however, gabapentin also prevented chronic pain in the first 6 postoperative months.


Assuntos
Aminas/uso terapêutico , Analgésicos/uso terapêutico , Ácidos Cicloexanocarboxílicos/uso terapêutico , Histerectomia/efeitos adversos , Ketamina/uso terapêutico , Dor Pós-Operatória/prevenção & controle , Ácido gama-Aminobutírico/uso terapêutico , Doença Aguda , Administração Oral , Adulto , Aminas/administração & dosagem , Analgesia Controlada pelo Paciente , Analgésicos/administração & dosagem , Analgésicos Opioides/uso terapêutico , Doença Crônica , Ácidos Cicloexanocarboxílicos/administração & dosagem , Método Duplo-Cego , Procedimentos Cirúrgicos Eletivos , Feminino , Gabapentina , Humanos , Infusões Intravenosas , Ketamina/administração & dosagem , Pessoa de Meia-Idade , Morfina/uso terapêutico , Medição da Dor , Dor Pós-Operatória/etiologia , Satisfação do Paciente , Estudos Prospectivos , Recuperação de Função Fisiológica , Fatores de Tempo , Resultado do Tratamento , Ácido gama-Aminobutírico/administração & dosagem
12.
Otolaryngol Head Neck Surg ; 140(2): 177-82, 2009 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-19201284

RESUMO

OBJECTIVE: To investigate histologic changes in the mucosa of rat middle ear after implantation of three different support materials. STUDY DESIGN: A prospective, controlled animal study. SUBJECTS AND METHODS: Three types of absorbable materials were implanted into the middle ear cavity of rats: (1) Gelfoam (purified gelatin) (Pharmacia & Upjohn Company, New York, NY), (2) Sepragel (viscoelastic gel composed of cross-linked polymers of hyaluronan) (GENZYME Corp, Ridgefield, NJ), and (3) Nasopore (a biodegradable/fragmentable, synthetic polyurethane foam) (Polyganics, Groningen, The Netherlands). Rats were sacrificed after 3 and 20 days to ascertain early and late histologic changes. The bulla of each rat was excised and prepared for microscopic examination. The histologic changes were evaluated by observation of the middle ear cavity and mucosa in terms of polymorphonuclear leucocytes (PMNL), macrophages, giant cells, fibroblasts and other cells, fibrosis, and remnant materials. RESULTS: The histologic appearance of gelfoam-treated middle ears was characterized by more severe acute inflammation in the short-term and prominent fibrosis in the long-term in comparison with sepragel- and nasopore-treated groups. Nasopore appeared to be prone to remnant formation and reorganization by means of fibroblastic activity. CONCLUSION: Compared with gelfoam, both sepragel and nasopore caused less histologic alterations.


Assuntos
Implantes Absorvíveis , Orelha Média/efeitos dos fármacos , Orelha Média/patologia , Esponja de Gelatina Absorvível/farmacologia , Ácido Hialurônico/farmacologia , Poliuretanos/farmacologia , Animais , Orelha Média/cirurgia , Hemostáticos/farmacologia , Masculino , Ratos , Ratos Sprague-Dawley , Viscossuplementos/farmacologia
13.
J Card Surg ; 24(6): 742-7, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19796086

RESUMO

BACKGROUND: Ventricular septal defects (VSDs) are one of the most common congenital heart defects in adults. In adult patients with an anatomically large VSD and relatively preserved pulmonary vascular system, several pulmonary flow-limiting cardiac morphologic alterations (PFMA) are encountered. PATIENTS: Ninety-eight male patients (mean age 22.5 +/- 2 years) operated for an anatomically large VSD in our institution were retrospectively reviewed. PFMA in patients with an anatomically large but functionally mild-to-moderate VSD (when ratio of pulmonary to systemic flow (Q(p)/Q(s)) < 2.2 and ratio of pulmonary to systemic vascular resistance (R(p)/R(s)) < 0.3) were recorded. RESULTS: Thirty patients (31.2%) revealed a mild-to-moderate VSD in functional severity. Five PFMA were encountered in these patients: (1) ostium (os) infundibulum (n = 10, 33.3%), (2) aneurysm of the membranous septum (AMS) (n = 10, 33.3%), (3) systolic bulging of the conal septum toward the right ventricular outflow tract (n = 6, 20%), (4) prolapse of the aortic cusps (n = 2, 6.7%), and (5) attachment of the tricuspid septal leaflet to the septal crest (n = 2, 6.7%). Double-chambered right ventricle was encountered in four patients with os infundibulum and classic tetralogy-type septal malalignment in one patient with aortic cusp prolapse. Concurrent to VSD repair, resection of the os infundibulum and the AMS and aortic valve repair were performed. CONCLUSION: Presence of a large VSD and relatively preserved pulmonary vascular system in adults is associated with several PFMA. Preoperative awareness and concurrent surgical treatment of these alterations seem to be crucial to improve the expected benefit of surgical repair of VSD in this subgroup of the patients.


Assuntos
Insuficiência da Valva Aórtica/cirurgia , Prolapso da Valva Aórtica/cirurgia , Comunicação Interventricular/cirurgia , Pulmão/irrigação sanguínea , Estenose Subvalvar Pulmonar/cirurgia , Estenose da Valva Pulmonar/cirurgia , Insuficiência da Valva Tricúspide/cirurgia , Obstrução do Fluxo Ventricular Externo/cirurgia , Adulto , Insuficiência da Valva Aórtica/diagnóstico , Prolapso da Valva Aórtica/diagnóstico , Pressão Sanguínea/fisiologia , Complexo de Eisenmenger/diagnóstico , Complexo de Eisenmenger/cirurgia , Feminino , Comunicação Interventricular/diagnóstico , Hemodinâmica/fisiologia , Humanos , Hipertensão Pulmonar/diagnóstico , Hipertensão Pulmonar/cirurgia , Masculino , Prognóstico , Estenose da Valva Pulmonar/diagnóstico , Estudos Retrospectivos , Insuficiência da Valva Tricúspide/diagnóstico , Resistência Vascular/fisiologia , Obstrução do Fluxo Ventricular Externo/diagnóstico , Adulto Jovem
14.
Eur J Anaesthesiol ; 26(9): 772-6, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19424073

RESUMO

BACKGROUND AND OBJECTIVE: To find out whether preoperative gabapentin use had a favourable effect on long-term postoperative pain in patients undergoing inguinal herniorrhaphy. METHODS: Sixty male patients--aged 20-40 years--who were scheduled for unilateral inguinal herniorrhaphy under spinal anaesthesia were included in this prospective, randomized, double-blind study. The patients were randomly allocated to two groups: the gabapentin group (n=30) received single-dose 1.2 g oral gabapentin 1 h before surgery, and the placebo group received a placebo capsule instead. Spinal anaesthesia was performed with heavy bupivacaine, and all operations were performed by the same surgeon with the same technique. Postoperative analgesia was evaluated during sitting and lying with a visual analogue scale. Assessment of postoperative pain at 1, 3 and 6 months was carried out with an 11-point numerical rating scale; 0 indicating 'no pain' and 10 indicating 'worst pain imaginable'. Patients who had numerical rating scale scores of more than 0 were further evaluated with regard to the impact of pain on their daily activities. RESULTS: When compared with the placebo group, the gabapentin group displayed significantly lower visual analogue scale scores (lying and sitting) and total tramadol consumption at 8, 12, 16, 20 and 24 h after surgery (P<0.05) and higher postoperative patient satisfaction scores (P<0.05). Numerical rating scale scores at 1, 3 and 6 months after surgery were lower in the gabapentin group than in the placebo group (P<0.05). The number of patients whose daily activities were adversely affected by pain was smaller in the gabapentin group at the first month; however, the two groups were found to be similar at 3 and 6 months. CONCLUSION: We conclude that preoperative single-dose gabapentin decreases the intensity of acute postoperative pain, tramadol consumption and the incidence and intensity of pain in the first 6 months after inguinal herniorrhaphy.


Assuntos
Aminas/uso terapêutico , Analgésicos/uso terapêutico , Raquianestesia/métodos , Ácidos Cicloexanocarboxílicos/uso terapêutico , Hérnia Inguinal/cirurgia , Dor Pós-Operatória/prevenção & controle , Ácido gama-Aminobutírico/uso terapêutico , Adulto , Aminas/administração & dosagem , Analgésicos/administração & dosagem , Doença Crônica , Ácidos Cicloexanocarboxílicos/administração & dosagem , Método Duplo-Cego , Gabapentina , Humanos , Masculino , Medição da Dor , Cuidados Pré-Operatórios , Estudos Prospectivos , Tramadol/uso terapêutico , Resultado do Tratamento , Adulto Jovem , Ácido gama-Aminobutírico/administração & dosagem
15.
Ren Fail ; 31(1): 50-3, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19142810

RESUMO

Acute renal failure secondary to ischemia/reperfusion (I/R) injury is associated with significant mortality and morbidity. Aminoguanidine (AG), an inducible nitric oxide synthase inhibitor with antioxidant properties, has been reported beneficial in renal I/R injury. The aim of the present study was to investigate the effect of AG on renal I/R injury and compare the effectiveness of different AG treatment modalities. Sprague-Dawley rats were randomly assigned to one of four groups. The control group (n = 6) received sham operation. The I/R group (n = 6), AG-I group (n = 8), and AG-II group (n = 8) received bilateral renal ischemia for 45 min followed by 24 hours of reperfusion. The AG-I group received AG (50 mg/kg) intraperitoneally four hours and 10 minutes before the induction of ischemia. The AG-II group received AG (50 mg/kg) intraperitoneally four hours and 10 minutes after the initiation of reperfusion. Serum urea and creatinine levels increased significantly in the I/R and AG-I groups compared to the control group. Kidney samples from rats in the I/R and AG-I groups revealed severe tubular damage at histopathological examination. Posttreatment with AG significantly reduced serum urea and creatinine levels and improved histopathological lesions compared with the I/R group. Although pretreatment with AG failed to protect kidneys against I/R injury in this experimental model, posttreatment with AG attenuated renal dysfunction and histopathological changes after I/R injury.


Assuntos
Injúria Renal Aguda/prevenção & controle , Inibidores Enzimáticos/uso terapêutico , Guanidinas/uso terapêutico , Traumatismo por Reperfusão/tratamento farmacológico , Injúria Renal Aguda/etiologia , Injúria Renal Aguda/patologia , Animais , Nitrogênio da Ureia Sanguínea , Esquema de Medicação , Inibidores Enzimáticos/administração & dosagem , Guanidinas/administração & dosagem , Masculino , Óxido Nítrico Sintase Tipo II/antagonistas & inibidores , Estresse Oxidativo , Ratos , Ratos Sprague-Dawley , Traumatismo por Reperfusão/complicações , Traumatismo por Reperfusão/patologia
16.
ACS Appl Mater Interfaces ; 11(49): 46296-46302, 2019 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-31730326

RESUMO

Achieving the theoretical strength of a metallic alloy material is a demanding task that usually requires utilizing one or more of the well-established routes: (1) Decreasing the grain size to stop or slow down the dislocation mobility, (2) adding external barriers to dislocation pathways, (3) altering the crystal structure, or (4) combining two of the previous discrete strategies, that is, implementing crystal seeds into an amorphous matrix. Each of the outlined methods has clear limitations; hence, further improvements are required. We present a unique approach that envelops all the different strength-building strategies together with a new phenomenon-phase transition. We simulated the plastic deformation of a Zr-Nb nanolayered alloy using molecular dynamics and ab initio methods and observed the transition of Zr from hexagonal close-packed to face-centered cubic and then to body-cenetered cubic during compression. The alloy, which was prepared by magnetron sputtering, exhibited near-theoretical hardness (10.8 GPa) and the predicted transition of the Zr structure was confirmed. Therefore, we have identified a new route for improving the hardness of metallic alloys.

17.
Acta Neurol Belg ; 108(3): 90-3, 2008 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19115671

RESUMO

Circumcision is generally considered a simple, rapid operation with medical benefits which accrue throughout life. The influence of circumcision on sexual satisfaction has always been argued. In this study, the assessment of the pudendal evoked potentials (PEP) in adults before and at least 12 weeks after circumcision was done. Healthy males aged between 18-27 years, who were willing to undergo circumcision were included in the study. Before and after circumcision, sexual performance was evaluated with the Brief Male Sexual Function Inventory (BMSFI), consisting of sexual drive, erection, ejaculation, problem assessment, and overall satisfaction sections. Forty-three adult males were enrolled in the study. Mean PEP latency was 41.97 +/- 0.25 (39.90-44.50) ms and 44.73 +/- 0.33 (40.90-47.60) ms before and after circumcision, respectively. Mean difference between pre- and postoperative PEP values was 2.76 ms which was statistically significant (p < 0.001). Mean ejaculatory latency time was significantly longer after circumcision (p < 0.001). In the light of our findings, we conclude that circumcision may contribute to sexual satisfaction by prolonging PEP latency but further studies are warranted also regarding the other dimensions of circumcision.


Assuntos
Circuncisão Masculina/psicologia , Potenciais Evocados/fisiologia , Satisfação Pessoal , Comportamento Sexual/fisiologia , Adulto , Circuncisão Masculina/métodos , Ejaculação/fisiologia , Eletrofisiologia/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Ereção Peniana/fisiologia , Período Pós-Operatório , Estudos Prospectivos , Comportamento Sexual/psicologia , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
19.
Turk Gogus Kalp Damar Cerrahisi Derg ; 26(3): 386-393, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32082768

RESUMO

BACKGROUND: This study aimed to compare hemodynamic response to endotracheal intubation using GlideScope and Macintosh laryngoscopes in patients who underwent cardiovascular surgery. METHODS: A total of 74 patients were enrolled in the study. Patients were randomly assigned into two groups either a GlideScope (n=37) or a Macintosh laryngoscope (n=37). Laryngoscopy time, heart rate, invasive arterial pressure and rate pressure product were compared during induction and until five minutes after laryngoscopy at 11 time points. RESULTS: Seventy patients completed the study. The intubation time was similar in both groups (14.1±4.0 sec vs. 13.2±4.2 sec; p=0.22). Hemodynamic values including heart rate, systolic, diastolic and mean arterial pressure and rate pressure product were similar at all-time points. The laryngoscopy time was also similar between groups. CONCLUSION: The GlideScope video laryngoscope did not show any advantage on hemodynamic response in patients undergoing cardiovascular surgery when compared to Macintosh laryngoscope.

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