Accuracy of multidetector computed tomography with maximum intensity projection technique in the assessment of fissure integrity.

BACKGROUND: Bronchoscopic lung volume reduction (BLVR) is a potential treatment for patients with severe emphysema, performed through the placement of unidirectional endobronchial valves (EBVs). Their benefits are only achieved in patients that significantly reduce lobar volume, and it is mandatory that the fissures are complete. Fissure evaluation is preferably done by computed tomography, but little is known if its evaluation corresponds to the anatomical findings. The aim of this study is to evaluate the accuracy of thoracic radiologists in the identification of complete fissures by multidetector computed tomography (MDCT) using maximum intensity projection (MIP) technique, compared with direct anatomical evaluation. METHODS: Prospective study, conducted in a single institution. Patients submitted to thoracic surgery had their fissures classified as complete or incomplete by thoracic surgeons and their preoperative chest scans evaluated by three radiologists, blinded for surgical evaluation. With the intraoperative categorization as a reference, the accuracy and concordance of the three thoracic radiologists' evaluation were calculated. The most experienced radiologist evaluated the fissures at two different moments to estimate the intra-observer agreement. RESULTS: There were included 67 patients, being 37 (55%) males, with a mean age of 64 years. The accuracy of radiological identification of complete fissures ranged from 76.8% for left posterior oblique fissure to 85.1% for left anterior oblique fissure, with the best performance achieved by the most experienced radiologist. The concordance of the radiological evaluation for fissure integrity compared to the surgical assessment (k) was 0.53-0.68. Intra-observer agreement ranged from 0.74 to 0.87. CONCLUSIONS: The evaluation of the fissure integrity by MDCT analysis using MIP technique by thoracic radiologists had high accuracy among the thoracic radiologists.

Planning stand-alone electricity generation systems, a multiple objective optimization and fuzzy decision making approach.

This paper presents a fuzzy-multiple objective optimization methodology to plan stand-alone electricity generation systems. The optimization process considers three main objectives, namely technology cost, environmental and societal impacts. For each feasible solution of the Pareto set, a system reliability index is evaluated along the lifetime of the project. As a key contribution, the decision making process is carried out by applying a fuzzy satisfaction method (FSM). The FSM accounts simultaneously four key performance indexes (KPI): technical, economic, environmental and social. The novelty of the proposal lies on the inclusion of societal impact (local wealth creation) in the FSM used here to select the more appropriate solution. Previous contributions on FSM only accounts two of four indexes considered in this paper. The methodology was applied in a Colombian case study. The results show the importance of the simultaneous consideration of technical, economic, environmental and social objectives in the evaluation of off-grid energization solutions.

ALONGAMENTO INTERMITENTE E CONTÍNUO AUMENTAM A AMPLITUDE DE MOVIMENTO E REDUZEM A FORÇA DOS FLEXORES DE PUNHO / INTERMITTENT AND CONTINUOUS STRETCHING INCREASE RANGE OF MOTION AND DECREASE FORCE ON WRIST FLEXORS / ESTIRAMIENTO INTERMITENTE Y CONTINUO AUMENTAN LA AMPLITUD DEL MOVIMIENTO Y REDUCEN LA FUERZA DE LOS FLEXORES DE MUÑECA

Introdução: A manipulação do intervalo entre séries pode influenciar o desempenho de atividades subsequentes. Objetivo: Comparar o efeito do intervalo de alongamento estático de forma continua e intermitente no desempenho de flexores de punho. Métodos A amostra foi composta por 14 adultos jovens, hígidos, do gênero masculino (idade 31±9 anos; estatura 178±0,7 cm; massa 85±12 Kg). Foi avaliada a amplitude de movimento passivo (ADMP) em extensão de punho, a força isométrica máxima de flexão de punho associado a eletromiografia superficial antes e depois de dois protocolos de alongamento com diferentes intervalos entre séries. Para cada sujeito, um dos membros superiores foi alongado com o protocolo contínuo (CON) e o outro com o intermitente (INT), de forma aleatória. O protocolo CON consistiu na realização do alongamento durante 6 minutos ininterruptos, e o INT consistiu na realização de seis séries de 1 minuto por 20 segundos de intervalo entre as séries. A intensidade foi mantida a 70-90% da percepção subjetiva de desconforto. Resultados Os resultados de ADMP mostraram aumento significante entre as condições pré e pós-intervenção, em ambos os protocolos INT (81°±10 e 94°±10, P<0,001) e CON (87°±12 e 96°±11, P=0,004). Os resultados para o pico de força mostraram redução significante nas condições pós-intervenção para ambos os protocolos: INT (205±54 Kgf e 148±56 Kgf, P<0,001) e CON (211±39 Kgf e 144±36 Kgf, P<0,001). Os resultados para a taxa de produção de força mostraram aumento significante nas condições pré e pós-intervenção, para ambos os protocolos INT (0,52±0,29 Kgf/ms e 1,24±0,45 Kgf/ms, P<0,001) e CON (0,43±0,29 Kgf/ms e 1,11±0,34 Kgf/ms, P<0,001). Conclusão Ambos os protocolos aumentaram a amplitude passiva de movimento, reduziram a força pico e taxa de produção de força, sem modificações na ativação dos flexores de punho.

Introduction The management of rest interval among series can influence the performance of subsequent activities. Objective To compare the effect of rest intervals during continuous and intermittent static stretching upon wrist flexor performance. Methods The sample comprised 14 young, healthy male adults, (age: 31±9 years, height: 178±0.7 cm, weight: 85±12kg). Evaluation was carried out of the passive range of motion (PROM) in wrist extension, the maximum isometric strength of wrist flexion associated with surface electromyography before and after two stretching protocols with different intervals among series. For each subject, one of the upper limbs was stretched with the continuous protocol (CON) and the other with the intermittent (INT) protocol, randomly. As regards CON, it consisted in stretching during six uninterrupted minutes, whereas INT consisted in stretching six series of 1 minute for 20 seconds of rest interval among series. The intensity was kept at 70-90% of the subjective perception of discomfort. Results The results of PROM showed significant increase between pre and post-intervention conditions, in both protocols INT (81°±10 and 94°±10, P<0.001) and CON (87°±12 and 96°±11, P=0.004). The results for peak force showed significant reduction in post-intervention conditions for both protocols: INT (205±54 Kgf and 148±56 Kgf, P<0.001) and CON (211±39 Kg and 144±36 Kgf, P<0.001). The results for the rate of force development showed significant increase in pre and post-intervention conditions for both protocols INT (0.52 ± 0.29 Kgf/ms and 1.24±0.45 Kgf/ms, P<0.001) and CON (0.43±0.29 Kgf/ms and 1.11±0.34 Kgf/ms, P<0.001). Conclusion Both protocols increased the passive range of motion, reduced the peak force and the rate of force development, without changes in the activation of wrist flexors.

Introducción El manejo de la pausa entre series puede influir en el desempeño de actividades posteriores. Objetivo Comparar el efecto del intervalo de estiramiento estático de forma continua e intermitente en el desempeño de los flexores de la muñeca. Métodos La muestra era composta por 14 jóvenes, varones y sanos (edad 31±9anos, altura 178±0,7cm, peso 85±12kg). Se evaluó la amplitud del movimiento pasivo (ADMP) en extensión de la muñeca, la fuerza máxima isométrica de la flexión de la muñeca asociada con electromiografía de superficie antes y después de dos protocolos de estiramientos con diferentes intervalos entre series. Para cada individuo, uno de los miembros superiores se alargó con el protocolo continuo (CON) y el otro con el intermitente (INT), al azar. El protocolo CON consistió en la realización de 6 minutos sin interrupciones durante el estiramiento, y el INT consistió en 6 series de 1 minuto por 20 segundos de intervalo entre series. La intensidad se mantuvo en 70-90% de la percepción subjetiva de malestar. Resultados Los resultados de ADMP mostraron aumento significativo entre las condiciones antes y después de la intervención, en ambos protocolos INT (81°±10 y 94°±10, P<0,001) y CON (87°±12 y 96°±11, P=0,004). Los resultados para el pico de fuerza mostraron reducción significativa en las condiciones posteriores a la intervención de ambos protocolos: INT (205 ± 54 Kgf y 148 ± 56 Kgf, P<0,001) y CON (211 ± 39 Kg y 144 ± 36 Kgf, P<0,001). Los resultados de la tasa de producción de fuerza mostraron aumento significativo en las condiciones pre- y después de la intervención, para ambos protocolos INT (0,52±0,29Kgf/ms y 1,24±0,45Kgf/ms, P< 0,001) y CON (0,43±0,29Kgf/ms y 1,11±0,34Kgf/ms, P<0,001). Conclusión Ambos protocolos aumentaron la amplitud del movimiento pasivo, reducirán la fuerza máxima y la tasa de producción de fuerza, sin cambios en la activación de los flexores de la muñeca.

Alterações comportamentais em crianças portadoras de enfermidades crônicas e suas repercussões na família: Hospital da Criança - Obras Sociais de Irmã Dulce, Salvador, BA / Mannering alterations in carrying children of chronic diseases and its repercussions in the family: Hospital of the Child - Social Workmanships of Sister Dulce, Salvador, BA

Trata-se de um estudo piloto que envolve 15 crianças internadas no Hospital da Criança: Obras Sociais de Irmã Dulce, Salvador, Bahia, realizado com o objetivo de investigar a percepção da família perante o paciente pediátrico, portador de enfermidade crônica. Para tanto, o responsável pelo paciente respondeu a um questionário que abordou questões referentes a perfil sociodemográfico, grau de conhecimento da família em relação à doença, percepção quanto a alterações comportamentais ocorridas na criança e na família, além da impressão quanto ao prognóstico e serviços médicos prestados à população pesquisada. Os resultados desta pesquisa evidenciaram que toda a população avaliada apresentou algum tipo de alteração comportamental, sendo mais freqüentes os sintomas: tristeza, ansiedade, isolamento e sonolência. Os pais referiram como manifestações mais comuns, após o surgimento da doença: maior união familiar, sentimento de medo, ansiedade e preocupação com seqüelas físicas. No que diz respeito ao padrão de assistência hospitalar, revelaram-se satisfeitos com a qualidade e eficiência do serviço médico prestado. Entretanto, consideram insuficiente o suporte psicológico à criança e à família no enfrentamento da doença crônica. A próxima fase deste estudo deverá possibilitar uma análise mais consistente e abrangente acerca do tema proposto.

Determinação de nitritos em alimentos cárneos / Nitrite's determination in food contents meat

Os nitratos e os nitritos são encontrados naturalmente no meio ambiente, além de serem utilizados como aditivos alimentares, logo podem ser ingeridos através da alimentação e da água. Determinar a quantidade de nitritos presentes em alimentos é justificado devido a sua potencial toxicidade química, podem ser formados a partir dos nitratos, além de serem precursores das nitrosaminas, substâncias cancerígenas. Foram analisadas 44 amostras de produtos cárneos, e feitas as determinações dos teores de nitritos. A técnica utilizada em nosso estudo foi o método Griess-Yslovay modificado. Todos os produtos analisados apresentaram concentração abaixo do limite estabelecido, 150 ppm e as salsichas tiveram o teor mais elevado para nitritos.

Non-aqueous encapsulation of excipient-stabilized spray-freeze dried BSA into poly(lactide-co-glycolide) microspheres results in release of native protein.

Encapsulation of the model protein bovine serum albumin (BSA) into poly(D,L lactide-co-glycolide) (PLG) microspheres was performed by a non-aqueous oil-in-oil (o/o) methodology. Powder formulations of BSA obtained by spray-freeze drying were first suspended in methylene chloride containing PLG followed by coacervation by adding silicon oil and microsphere hardening in heptane. The secondary structure of BSA was determined at relevant steps of the encapsulation procedure by employing Fourier-transform infrared (FTIR) spectroscopy. This fast and non-invasive method demonstrated the potential to rapidly screen pharmaceutically relevant protein delivery systems for their suitability. Structural perturbations in BSA were reduced during the spray-freeze drying step by employing the excipient trehalose. The protein was then encapsulated into PLG microspheres under various conditions without inducing significant structural perturbations. BSA released from these microspheres had a similar monomer content as unencapsulated BSA and also the same secondary structure. Upon blending of a poloxamer (Pluronic F-68) with the polymer phase, in vitro release was characterized by a small initial release and a prolonged and continuous sustained phase. In conclusion, the developed o/o methodology coupled with FTIR spectroscopic monitoring of protein structure is a powerful approach for the development of sustained release microspheres.

Application of an adapted international prognostic index for aggressive non-Hodgkin's lymphomas: good discrimination and lower survival rates in Rio de Janeiro, Brazil.

Institutions that treat patients with lymphoma must know their local therapy results and adapt their treatment strategies accordingly. To allow the application of the international prognostic factor index (IPI) in institutions where some of the data necessary are not available, we devised an approach by which the missing data would not impair the applicability of the index. We also collapsed the four categories of the IPI into two categories, and applied this adapted IPI to patients with aggressive non-Hodgkin's lymphoma treated in a public university hospital. Among the 72 patients treated with combination chemotherapy regimens containing doxorubicin, the following outcomes were observed for low and high risk groups, respectively: complete remission rates were 62% and 45% (p=0.2), overall survival rates were 48% and 14% (p=0.0098) and failure-free survival rates were 44% and 17% (p=0.03). This adapted IPI was very effective in predicting the outcome in the patients studied. The survival rates observed in our population were substantially lower than the rates reported in the IPI study. Patient selection might have played an important role in this difference, although other factors related to the social and general health status of the patients treated need to be prospectively studied.

Differentiation of pathogenic Escherichia coli strains in Brazilian children by PCR.

A PCR technique to differentiate pathogenic enteric Escherichia coli strains in a field setting was evaluated. Among 76 children with acute diarrhea, this technique identified 12 children (16%) with enterotoxigenic E. coli, 6 (8%) with enteropathogenic E. coli, and 1 (1%) with enteroinvasive E. coli infection. Compared with the conventional assays, the PCR method proved to be simpler, more rapid, and inexpensive and therefore suitable for application in a developing-country field setting.

Neuronal counting and parasympathetic dysfunction in the hearts of chronically Trypanosoma cruzi-infected rats.

Ten male Wistar rats, chronically infected with Colombian, São Felipe (12SF) and Y strains of Trypanosoma cruzi and ten non-infected control animals were submitted to the bradycardia responsiveness test, an assessment of heart parasympathetic function, after phenylephrine injection. Six chagasic animals showed heart parasympathetic dysfunction characterized by reduction in the index of bradycardia baroreflex responsiveness, as compared with the control group. Microscopic examination of the atrial heart ganglia of chagasic rats showed ganglionitis, but no statistically significant reduction in the number of neurons.

Triethyltin sulfate-induced neuropathy in rats. Electrophysiologic, morphologic, and biochemical studies.

Adult rats given high orally administered doses of triethyltin (TET) sulfate lost weight, developed hind limb wasting, and became paraplegic or quadriplegic within three weeks of intoxication. A 33% reduction in the motor nerve conduction velocity (MNCV) of the sciatic nerve in the absence of significant demyelination was observed. There was observed, however, intramyelinic edema formation and an increased number of axonal neurofilaments and neurotubules; changes that paralleled the decrease in MNCV during the period of intoxication. Although the animals became asymptomatic and the MNCV normalized within two to three weeks of discontinuing the TET intoxication, the intramyelinic vacuoles and the increased numbers of neurofilaments and neurotubules persisted.

Effects of insulin and dietary myoinositol on impaired peripheral motor nerve conduction velocity in acute streptozotocin diabetes.

The factors influencing the development of impaired sciatic motor nerve conduction velocity (MNCV) in acute experimental diabetes were examined. Decreased MNCV developed by the 14th day after streptozotocin administration but only in rats which became hyperglycemic. Insulin treatment, begun on day 3, failed to prevent imparied MNCV in diabetic rats in which improved or normal weight gain and a decreased degree of hyperglycemia was induced. However, insulin treatment prevented the development of impaired MNCV in a group of diabetic rats in which the tail vein plasma glucose concentration was never found to exceed 160 mg/dl during days 6 through 14, andin which the mean plus or minus SEM of the average plasma glucose concentration for each animal during the same period was 75 plus or minus 18 mg/dl. In normal rats fed diets containing 0.011% or 0.069% free myoinositol (a presumably normal range), sciatic nerve free myoinositol concentrations were 90- and 60-fold higher than those in plasma. On these diets the development of impaired MNCV in the diabetics was associated with a decrease in nerve free myoinositol as compared with nerves from normals fed the same diet, despite similar plasma levels in the normals and diabetics. Plasma and nerve free myoinositol increased with increasing dietary myoinositol content in both normals and diabetics, and nerve myoinositol content could be acutely increased by an i.p. myoinositol load. By supplementing the diets with 1.0% myoinositol, the difference in nerve myoinositol in normal and diabetic rats on day 14 was abolished; on this diet the development of impaired MNCV in the diabetics was moderated or totally prevented, despite persistent hyperglycemia and elevated nerve sorbitol and fructose concentrations. Insulin treatment that prevented impaired MNCV prevented a decrease in nerve myoinositol in diabetics. These studies suggest that insulin deficiency, and possibly hyperglycemia, are primary factors in the development of imparied MNCV in acute experimental diabetes. However, the development of impaired MNCV appears to be related in some manner to a derangement in the regulation of nerve free myoinositol content, which appears to be subject to modification by increases in plasma myoinositol concentration over a critical range.