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1.
Sci Rep ; 10(1): 7447, 2020 May 04.
Artigo em Inglês | MEDLINE | ID: mdl-32366864

RESUMO

Skyrmions can be stabilized in magnetic systems with broken inversion symmetry and chiral interactions, such as Dzyaloshinskii-Moriya interactions (DMI). Further, compensation of magnetic moments in ferrimagnetic materials can significantly reduce magnetic dipolar interactions, which tend to favor large skyrmions. Tuning DMI is essential to control skyrmion properties, with symmetry breaking at interfaces offering the greatest flexibility. However, in contrast to the ferromagnet case, few studies have investigated interfacial DMI in ferrimagnets. Here we present a systematic study of DMI in ferrimagnetic CoGd films by Brillouin light scattering. We demonstrate the ability to control DMI by the CoGd cap layer composition, the stack symmetry and the ferrimagnetic layer thickness. The DMI thickness dependence confirms its interfacial nature. In addition, magnetic force microscopy reveals the ability to tune DMI in a range that stabilizes sub-100 nm skyrmions at room temperature in zero field. Our work opens new paths for controlling interfacial DMI in ferrimagnets to nucleate and manipulate skyrmions.

2.
Sci Adv ; 6(3): eaay8717, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-32010774

RESUMO

The vision of using light to manipulate electronic and spin excitations in materials on their fundamental time and length scales requires new approaches in experiment and theory to observe and understand these excitations. The ultimate speed limit for all-optical manipulation requires control schemes for which the electronic or magnetic subsystems of the materials are coherently manipulated on the time scale of the laser excitation pulse. In our work, we provide experimental evidence of such a direct, ultrafast, and coherent spin transfer between two magnetic subsystems of an alloy of Fe and Ni. Our experimental findings are fully supported by time-dependent density functional theory simulations and, hence, suggest the possibility of coherently controlling spin dynamics on subfemtosecond time scales, i.e., the birth of the research area of attomagnetism.

3.
J Phys Chem A ; 121(38): 7205-7218, 2017 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-28866884

RESUMO

Thiophenes are an important class of molecules in fields as diverse as petrochemistry, molecular electronics, and optoelectronics. Thiophenic submolecular motifs are thought to play a role in molecular association and nanoaggregation phenomena in both pure materials and natural and synthetic mixtures. Vibrational (infrared and Raman) spectroscopy provides the means to characterize these species. In this work far-infrared photoacoustic and low-frequency Raman spectra of a series of polycyclic aromatic hydrocarbons containing sulfur have been measured and interpreted using DFT calculations based on a perturbational-variational method coupled with potential truncation. The approach and outcomes illustrate how inter- and intramolecular vibrations for thiophenic systems in single and multicomponent mixtures can be discriminated. This work offers the perspective to search the inter- and intramolecular signatures of the main submolecular motifs and heteroelements postulated as being present in the asphaltenes.

4.
J Phys D Appl Phys ; 49(42)2016.
Artigo em Inglês | MEDLINE | ID: mdl-33100381

RESUMO

Multilayers of [Co/Ni(t)/Co/Pt]×8 with varying Ni thickness were investigated for possible use as a free layer in magnetic tunnel junctions and spintronics devices. The thickness t of the Ni sub-layer was varied from 0.3 nm to 0.9 nm and the resulting magnetic properties were compared with (Co/Ni) and (Co/Pt) multilayers. As determined from magnetic force microscopy, magnetometry and ferromagnetic resonance measurements, all multilayers exhibited perpendicular magnetic anisotropy. Compared with (Co/Pt) multilayers, the sample with t of 0.9 nm showed almost the same anisotropy field of µ 0 H k = 1.15 T but the damping constant was 40% lower. These characteristics make these multilayers attractive for spin torque based magnetoresistive devices with perpendicular anisotropy.

5.
Rev Sci Instrum ; 86(9): 095101, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26429474

RESUMO

The development and baseline operation of an acoustic view cell for observing fluids, and fluid-fluid and fluid-solid interfaces in porous media over the frequency range of 10-5000 Hz is described. This range includes the industrially relevant frequency range 500-5000 Hz that is not covered by existing devices. Pressure waveforms of arbitrary shape are generated in a 17.46 mm ID by 200 mm and 690.5 mm long glass tubes at flow rates up to 200 ml/min using a syringe pump. Peak-to-peak amplitudes exceeding 80 kPa are readily realized at frequencies from 10 to 5000 Hz in bubble free fluids when actuated with 20 Vpp as exemplified using castor oil. At resonant frequencies, peak-to-peak pressure amplitudes exceeding 500 kPa were obtained (castor oil at 2100 Hz when actuated with 20 Vpp). Impacts of vibration on macroscopic liquid-liquid and liquid-vapour interfaces and interface movement are illustrated. Pressure wave transmission and attenuation in a fluid saturated porous medium, randomly packed 250-330 µm spherical silica beads, is also demonstrated. Attenuation differences and frequency shifts in resonant peaks are used to detect the presence and generation of dispersed micro-bubbles (<180 µm diameter), and bubbles within porous media that are not readily visualized. Envisioned applications include assessment of the impacts of vibration on reaction, mass transfer, and flow/flow pattern outcomes. This knowledge will inform laboratory and pilot scale process studies, where nuisance vibrations may affect the interpretation of process outcomes, and large scale or in situ processes in aquifers or hydrocarbon reservoirs where imposed vibration may be deployed to improve aspects of process performance. Future work will include miscible interface observation and quantitative measurements in the bulk and in porous media where the roles of micro-bubbles comprise subjects of special interest.

6.
Rev Sci Instrum ; 86(4): 044902, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25933884

RESUMO

Two parallel multi-element ultrasonic acoustic arrays combined with sets of focal laws for acoustic signal generation and a classical tomographic inversion algorithm are used to generate real-time two-dimensional micro seismic acoustic images of multiphase materials. Proof of concept and calibration measurements were performed for single phase and two phase liquids, uniform polyvinyl chloride (PVC) plates, and aluminum cylinders imbedded in PVC plates. Measurement artefacts, arising from the limited range of viewing angles, and the compromise between data acquisition rate and image quality are discussed. The angle range of scanning and the image resolution were varied, and the effects on the quality of the reproduction of the speed of sound profiles of model solids and liquids with known geometries and compositions were analysed in detail. The best image quality results were obtained for a scanning angle range of [-35°, 35°] at a step size of 2.5° post processed to generate images on a 40 µm square grid. The data acquisition time for high quality images with a 30 mm × 40 mm view field is 10 min. Representation of two-phase solids with large differences in speed of sound between phases and where one phase is dispersed in the form of macroscopic objects (greater than 1 mm in diameter) proved to be the most difficult to image accurately. Liquid-liquid and liquid-vapor phase boundaries, in micro porous solids by contrast, were more readily defined. Displacement of air by water and water by heptane in natural porous limestone provides illustrative kinetic examples. Measurement results with these realistic cases demonstrate the feasibility of the technique to monitor in real time and on the micrometer length scale local composition and flow of organic liquids in inorganic porous media, one of many envisioned engineering applications. Improvement of data acquisition rate is an area for future collaborative study.

7.
Int J Parasitol ; 44(5): 291-8, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24583111

RESUMO

Traditional healers in Sarawak, Malaysia, use plants such as Picria fel-terrae, Linariantha bicolor and Lansium domesticum to treat gastrointestinal infections. This study aimed to test whether their nematocidal activities could be confirmed in vitro using highly standardised Caenorhabditis elegans models. We applied eight different ethanol solubilised plant extracts and two commercial anthelmintic drugs to larval and adult stages of C. elegans in vitro. Seven C. elegans strains were evaluated, one wild type and six strains with GFP-tagged stress response pathways to help characterise and compare the pathways affected by plant extracts. Our in vitro screen confirmed that both of the commercial anthelmintic drugs and five of the eight traditionally used plant extracts had significant nematocidal activity against both larval and adult C. elegans. The most effective extracts were from P. fel-terrae. The plant extracts triggered different stress response pathways from the commercial anthelmintic drugs. This study showed that using traditional knowledge of plant medicinal properties in combination with a C. elegans in vitro screen provided a rapid and economical test with a high hit rate compared with the random screening of plants for nematocidal activities. The use of transgenic C. elegans strains may allow this approach to be refined further to investigate the mode of action of active extracts.


Assuntos
Anti-Helmínticos/farmacologia , Caenorhabditis elegans/efeitos dos fármacos , Avaliação Pré-Clínica de Medicamentos/métodos , Extratos Vegetais/farmacologia , Plantas Medicinais/química , Animais , Anti-Helmínticos/isolamento & purificação , Genes Reporter , Proteínas de Fluorescência Verde/análise , Proteínas de Fluorescência Verde/genética , Larva/efeitos dos fármacos , Extratos Vegetais/isolamento & purificação , Traqueófitas/química
8.
S Afr J Surg ; 50(3): 98-9, 2012 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-22856448

RESUMO

Cystic phaeochromocytoma is a rare neuro-endocrine tumour that is frequently asymptomatic and often diagnosed incidentally on imaging or intra-operatively. A pharmacobezoar is a rare complication of extended-release drug delivery systems. We present a case of a 70-year-old woman diagnosed intra-operatively with cystic phaeochromocytoma and antihypertensive pharmacobezoar.


Assuntos
Neoplasias das Glândulas Suprarrenais/diagnóstico , Neoplasias das Glândulas Suprarrenais/cirurgia , Bezoares/diagnóstico , Bezoares/etiologia , Bezoares/cirurgia , Bloqueadores dos Canais de Cálcio/efeitos adversos , Nifedipino/efeitos adversos , Feocromocitoma/diagnóstico , Feocromocitoma/cirurgia , Idoso , Diagnóstico Diferencial , Feminino , Humanos , Achados Incidentais , Tomografia Computadorizada por Raios X
9.
Rev Sci Instrum ; 82(10): 104902, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22047318

RESUMO

Speed of sound and acoustic wave attenuation are sensitive to fluid phase composition and to the presence of liquid-liquid interfaces. In this work, the use of an acoustic array comprising 64 elements as a non-intrusive sensor for liquid-liquid interface, phase separation kinetics measurement in bulk fluids, and local composition measurement in porous media is illustrated. Three benchmark examples: the phase behaviour of methanol + mixed hexanes and methanol + heptane mixtures at 25.0 °C and 1 bar, and Athabasca bitumen + heptane in a synthetic silica porous medium at 22.5 °C and 1 bar, illustrate the accuracy of liquid-liquid interface and potential research and industrial applications of the technique. Liquid-liquid interfaces can be detected independently using both speed of sound and acoustic wave attenuation measurements. The precision of the interface location measurement is 300 µm. As complete scans can be performed at a rate of 1 Hz, phase separation kinetics and diffusion of liquids within porous media are readily tracked. The technique is expected to find application where the fluids or porous media are opaque to visible light and where other imaging techniques are not readily applied, or are too costly. A current limitation is that the acoustic probes must be cooled to less than 315 K in order for them to operate.

10.
J Exp Psychol Hum Percept Perform ; 37(1): 193-206, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21077721

RESUMO

At issue in the present series of experiments was the ability to prospectively perceive the action-relevant properties of hand-held tools by means of dynamic touch. In Experiment 1, participants judged object move-ability. In Experiment 2, participants judged how difficult an object would be to hold if held horizontally, and in Experiments 3 and 4, participants rated how fast objects could be rotated. In each experiment, the first and second moments of mass distribution of the objects were systematically varied. Manipulations of wielding speed and orientation during restricted exploration revealed perception to be constrained by (a) the moments of mass distribution of the hand-tool system, (b) the qualities of exploratory wielding movements, and (c) the intention to perceive each specific property. The results are considered in the context of the ecological theory of dynamic touch. Implications for accounts of the informational basis of dynamic touch and for the development of a theory of haptically perceiving the affordance properties of tools are discussed.


Assuntos
Comportamento Exploratório , Intenção , Percepção do Tato , Humanos , Julgamento , Movimento , Desempenho Psicomotor , Tato
11.
Br J Surg ; 97(6): 872-6, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20309895

RESUMO

BACKGROUND: Gastroduodenal obstruction due to malignancy can be difficult to palliate. Self-expanding metal stents (SEMS) are gaining acceptance as an effective alternative to surgical bypass. METHODS: Patients not suitable for surgical bypass, with complete gastric outlet obstruction as a result of malignancy, were offered palliation with SEMS from November 2004 to December 2008. The procedure was performed under fluoroscopic guidance and conscious sedation. Data were collected prospectively. RESULTS: Seventy patients underwent SEMS placement (hepatobiliary and pancreatic malignancy, 44; antral gastric carcinoma, 19; other, seven). Follow-up was complete in 69 patients (99 per cent). Technical and clinical success rates were 93 and 95 per cent respectively. Median hospital stay was 2 (range 1-18) days, median survival was 1.8 (0.1-19.0) months, and 87 per cent had improved intake after SEMS placement, as determined by Gastric Outlet Obstruction Severity Score before and after stenting (P < 0.001). Complications included two episodes of minor bleeding. CONCLUSION: The use of SEMS to alleviate complete malignant gastric outlet obstruction in patients with limited life expectancy is successful in re-establishing enteral intake in most patients, with minimal morbidity, no mortality and a short hospital stay.


Assuntos
Obstrução da Saída Gástrica/cirurgia , Neoplasias/complicações , Stents , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Viabilidade , Feminino , Obstrução da Saída Gástrica/etiologia , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Terapia de Salvação
12.
S Afr J Surg ; 47(3): 72-4, 76-9, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19813442

RESUMO

BACKGROUND: This study evaluated the incidence of rebleeding and death at 6 weeks after a first episode of acute variceal haemorrhage (AVH) treated by emergency endoscopic sclerotherapy in a large cohort of alcoholic cirrhotic patients. METHODS: From January 1984 to December 2006, 310 alcoholic cirrhotic patients (242 men, 68 women; mean age 51.7 years) with AVH underwent 786 endoscopic variceal injection treatments (342 emergency, 444 elective) during 919 endoscopy sessions in the first 6 weeks after the first variceal bleed. Endoscopic control of initial bleeding, variceal rebleeding and survival at 6 weeks were recorded. RESULTS: Endoscopic intervention controlled AVH in 304 of 310 patients (98.1%). Seventy-five patients (24.2%) rebled, 38 (12.3%) within 5 days and 37 (11.9%) within 6 weeks. No patient scored as Child-Pugh A died. Seventy-seven (24.8%) Child-Pugh B and C patients died, 29 (9.3%) within 5 days and 48 (15.4%) between 6 and 42 days. Mortality increased exponentially as the Child-Pugh score increased, reaching 80% when the score exceeded 13. CONCLUSION: Despite initial control of variceal haemorrhage, 1 in 4 patients (24.2%) rebled within 6 weeks. Survival at 6 weeks was 75.2% and was influenced by the severity of liver failure, with most deaths occurring in Child-Pugh grade C patients.


Assuntos
Varizes Esofágicas e Gástricas/complicações , Hemorragia Gastrointestinal/terapia , Hemostase Endoscópica , Cirrose Hepática Alcoólica/complicações , Soluções Esclerosantes/administração & dosagem , Escleroterapia , Doença Aguda , Adulto , Idoso , Idoso de 80 Anos ou mais , Emergências , Feminino , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/mortalidade , Humanos , Injeções , Masculino , Pessoa de Meia-Idade , Recidiva
13.
Braz. j. phys. ther. (Impr.) ; 12(5): 339-350, set.-out. 2008. ilus
Artigo em Inglês | LILACS | ID: lil-499902

RESUMO

BACKGROUND: Muscle-based perception of the spatial properties of limbs constrains the patterning, timing and magnitude of muscle forces while performing motor activities. The centrality of muscle-based perception to both ordinary and skilled actions warrants attention from the rehabilitation community, since deficits in its functioning would be related to important functional limitations. In this overview, we summarize a body of research that may be used to guide the development of effective assessment tools and rehabilitation programs that are specifically directed towards such deficits. OBJECTIVES: There were four specific aims: first, to present an information-based approach to muscle-based perception that is grounded in physical laws; second to identify central principles underlying muscle-based perception that have been revealed and supported by empirical work; third, to summarize reports that have investigated whether the principles identified can be generalized to muscle-based perception in individuals with sensory-motor impairments; and fourth to provide a preliminary discussion of the potential implications of the research presented here for issues relating to rehabilitation.


INTRODUÇÃO: A percepção muscular das propriedades espaciais dos membros restringe o padrão, período e magnitude das forças exercidas durante a execução de atividades motoras. A importância central da percepção muscular, tanto para ações rotineiras quanto para ações especializadas, merece atenção da comunidade envolvida na área de reabilitação, uma vez que alterações em suas funções podem estar relacionadas a importantes limitações funcionais. Nesta revisão, os autores apresentam um resumo da pesquisa que pode ser utilizada para guiar o desenvolvimento de ferramentas de avaliação eficazes bem como programas de reabilitação que sejam especificamente direcionados para estas disfunções. OBJETIVOS: Quatro pontos específicos foram incluídos: primeiro, a apresentação da abordagem com base em informações relativas à percepção muscular de acordo com as leis da física; segundo, a identificação dos princípios centrais determinantes da percepção muscular que vem sendo revelada e apoiada por trabalhos empíricos; terceiro, um resumo dos relatos que investigaram e se os princípios identificados poderiam ser generalizados para a percepção muscular dos indivíduos com alterações motoras e sensitivas; e quarto, uma discussão preliminar sobre as implicações potenciais da pesquisa aqui apresentada, no tocante aos assuntos relacionados à reabilitação.

14.
J Gastrointest Surg ; 12(7): 1304-6, 2008 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-17963013

RESUMO

Ciliated hepatic foregut cysts are an unusual congenital cause of cystic liver lesions. Although most are benign, 4.4% of reported cases have been shown to harbor squamous cell carcinoma. Diagnostic uncertainty or misdiagnosis frequently results in surgical exploration. We present a case of a ciliated hepatic foregut cyst and review this uncommon condition.


Assuntos
Cistos/diagnóstico , Hepatopatias/diagnóstico , Colangiografia , Colecistectomia/métodos , Cílios/patologia , Cistos/cirurgia , Diagnóstico Diferencial , Feminino , Humanos , Hepatopatias/cirurgia , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
16.
Calcif Tissue Int ; 79(6): 395-403, 2006 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17164974

RESUMO

Exercise that imparts rapid, high-magnitude mechanical loading is considered to be advantageous to bone health. Previous rodent studies have suggested that swimming may also be beneficial to bone. We investigated the differential effects of exercise with and without weight bearing on cortical and trabecular bone. Forty female Sprague-Dawley rats (120 days) were weight-stratified and randomized into four groups: swim control (Cs, n = 10), swim (S, n = 10), treadmill control (Ct, n = 10), and treadmill (T, n = 10). Treadmill speed was adjusted to match the average limb loading frequency used for swimming, and all training progressed to 1 hour/day, 5 days/week, for 12 weeks. Femurs and humeri were assessed for cortical morphometry by peripheral quantitative computed tomography, areal bone mineral density (BMD) by peripheral dual-energy X-ray absorptiometry, mineral content by ashing, strength by three-point bending, and trabecular volume (BV/TV) by micro-computed tomography. Swimming was associated with increases in cortical thickness and BMD in the humerus midshaft and trabecular BV/TV in the distal femur and proximal humerus compared with age-matched controls. Compared to swimming, treadmill training was associated with increases in percent ash of the femur and humerus and Young's modulus of the femur. Swimming appears to engender novel bone strains and osteogenic adaptations in the humerus and femur, which are different from those induced by normal cage activity. In summary, our findings suggest that when limb loading frequency is matched, swimming may afford greater benefits to cortical and trabecular bone than uphill treadmill work in rats.


Assuntos
Adaptação Fisiológica/fisiologia , Fêmur/crescimento & desenvolvimento , Úmero/crescimento & desenvolvimento , Osteogênese/fisiologia , Condicionamento Físico Animal/fisiologia , Suporte de Carga/fisiologia , Absorciometria de Fóton , Animais , Densidade Óssea/fisiologia , Feminino , Fêmur/diagnóstico por imagem , Fêmur/metabolismo , Úmero/diagnóstico por imagem , Úmero/metabolismo , Ratos , Ratos Sprague-Dawley , Corrida/fisiologia , Estresse Mecânico , Natação/fisiologia
17.
S Afr J Surg ; 44(2): 70-2, 74-7, 2006 May.
Artigo em Inglês | MEDLINE | ID: mdl-16878513

RESUMO

Echinococcus granulosus remains a clinical problem in sheep and subsistence farming communities in South Africa. The most commonly affected organs are the liver and the lung. Most cysts remain clinically silent and are diagnosed incidentally or when complications occur. Clinical examination is unreliable in making the diagnosis. Serological testing has a broad range of sensitivity and specificity and is dependent on the purity of the antigens utilised. Ultrasound examination of the abdomen is gens utilised. Ultrasound examination of the abdomen is both sensitive and cost effective. Computed tomography and endoscopic retrograde cholangiopancreatography (ERCP) are reserved for complicated cases. The differential diagnosis includes any cystic lesion of the liver. Liver hydatid cysts can be treated by medical or minimally invasive (laparoscopic and percutaneous) means or by conventional open surgery. The most effective chemotherapeutic agents against the parasite are the benzimidazole carbamates, albendazole and mebendazole. Albendazole is more efficacious, but recommended treatment regimens differ widely in terms of timing, length of treatment and dose. Medical treatment alone is not an effective and durable treatment option. PAIR (puncture, aspiration, injection, reaspiration) is the newest and most widely practised minimally invasive technique with encouraging results, but it requires considerable expertise. Open surgery remains the most accessible and widely practised method of treatment in South Africa. The options are either radical (pericystectomy and hepatic resection) or conservative (deroofing and management of the residual cavity). Various scolicidal agents are used intraoperatively (Eusol, hypertonic saline and others), although none have been tested in a formal randomised controlled trial. Laparoscopic surgery trials are small and unconvincing at present and should be limited to centres with expertise. Complicated cysts (intrabiliary rupture and secondary infection) may require ERCP to obtain biliary clearance before surgery, and referral to a specialist centre may be indicated.


Assuntos
Benzimidazóis/uso terapêutico , Colangiopancreatografia Retrógrada Endoscópica , Equinococose Hepática/tratamento farmacológico , Equinococose Hepática/cirurgia , Echinococcus granulosus/isolamento & purificação , Criação de Animais Domésticos , Animais , Anti-Helmínticos/uso terapêutico , Canidae , Vetores de Doenças , Equinococose Hepática/parasitologia , Humanos , África do Sul , Zoonoses/parasitologia
19.
S. Afr. j. surg. (Online) ; 44(2): 70-77, 2006.
Artigo em Inglês | AIM (África) | ID: biblio-1270985

RESUMO

Echinococcus granulosus remains a clinical problem in sheep and subsistence farming communities in South Africa. The most commonly affected organs are the liver and the lung. Most cysts remain clinically silent and are diagnosed incidentally or when complications occur. Clinical examination is unreliable in making the diagnosis. Serological testing has a broad range of sensitivity and specificity and is dependent on the purity of the antigens utilised. Ultrasound examination of the abdomen is both sensitive and cost effective. Computed tomography and endoscopic retrograde cholangiopancreatography (ERCP) are reserved for complicated cases. The differential diagnosis includes any cystic lesion of the liver. Liver hydatid cysts can be treated by medical or minimally invasive (laparoscopic and percutaneous) means or by conventional open surgery. The most effective chemotherapeutic agents against the parasite are the benzimidazole carbamates; albendazole and mebendazole. Albendazole is more efficacious; but recommended treatment regimens differ widely in terms of timing; length of treatment and dose. Medical treatment alone is not an effective and durable treatment option. PAIR (puncture; aspiration; injection; reaspiration) is the newest and most widely practised minimally invasive technique with encouraging results; but it requires considerable expertise. Open surgery remains the most accessible and widely practised method of treatment in South Africa. The options are either radical (pericystectomy and hepatic resection) or conservative (deroofing and management of the residual cavity). Various scolicidal agents are used intraoperatively (Eusol; hypertonic saline and others); although none have been tested in a formal randomised controlled trial. Laparoscopic surgery trials are small and unconvincing at present and should be limited to centres with expertise. Complicated cysts (intrabiliary rupture and secondary infection) may require ERCP to obtain biliary clearance before surgery; and referral to a specialist centre may be indicated


Assuntos
Echinococcus granulosus , Fígado , Pulmão
20.
World J Surg ; 29(8): 966-73, 2005 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-15981047

RESUMO

The treatment of acute and recurrent variceal bleeding is best accomplished by a skilled, knowledgeable, and well-equipped team using a multidisciplinary integrated approach. Optimal management should provide the full spectrum of treatment options including pharmacologic therapy, endoscopic treatment, interventional radiologic procedures, surgical shunts, and liver transplantation. Endoscopic therapy with either band ligation or injection sclerotherapy is an integral component of the management of acute variceal bleeding and of the long-term treatment of patients after a variceal bleed. Variceal eradication with endoscopic ligation requires fewer endoscopic treatment sessions and causes substantially less esophageal complications than does injection sclerotherapy. Although the incidence of early gastrointestinal rebleeding is reduced by endoscopic ligation in most studies, there is no overall survival benefit relative to injection sclerotherapy. Simultaneous combined ligation and sclerotherapy confers no advantage over ligation alone. A sequential staged approach with initial endoscopic ligation followed by sclerotherapy when varices are small may prove to be the optimal method of reducing variceal recurrence. Overall, current data demonstrate clear advantages for using ligation in preference to sclerotherapy. Ligation should therefore be considered the endoscopic treatment of choice in the treatment of esophageal varices.


Assuntos
Endoscopia Gastrointestinal/métodos , Varizes Esofágicas e Gástricas/terapia , Hemorragia Gastrointestinal/terapia , Varizes Esofágicas e Gástricas/complicações , Hemorragia Gastrointestinal/etiologia , Humanos , Ligadura , Derivação Portossistêmica Transjugular Intra-Hepática , Escleroterapia
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