Comment on the paper 'Prospective pediatric study comparing glomerular filtration rate estimates based on motion-robust dynamic contrast-enhanced magnetic resonance imaging and serum creatinine (eGFR) to 99mTc DTPA'

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SNMMI and EANM guidelines for diuretic renography in children

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Aortic complications after bariatric surgery

Obesity and its correlated comorbidities are nowadays considered a public health concern. In the last few years, a myriad of strategies searched an effective procedure to reduce weight and decreases related comorbidities. Among these strategies, the bariatric procedures have been achieved a significantly increase, being able to promote an expressive and lasting weight reduction. Diverse early and late complications are described and related to restrictive and malabsortive bariatric procedures. In this report we describe two cases of cardiovascular complications (aortic dissection and aneurysm) in the late postoperative period of the bariatric procedures.A obesidade e as comorbidades desencadeadas ou agravadas pela mesma têm se tornado um problema de saúde pública. Diversas terapêuticas buscaram métodos capazes de reduzir de modo efetivo a massa dos indivíduos obesos e, conseqüentemente, atenuar as complicações a ela relacionadas. Dentre essas abordagens, nos últimos anos, os procedimentos bariátricos têm crescido de forma significativa, sendo capazes de promover reduções de massa expressivas e duradouras. Diversas complicações precoces e tardias são descritas e relacionadas aos procedimentos bariátricos restritivos e malabsortivos. Neste relato, descrevemos dois casos de complicações cardiovasculares (dissecção e aneurisma) no pósoperatório tardio de procedimentos bariátricos.Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM) Disciplina de Cirurgia CardiovascularUNIFESP, EPM, Disciplina de Cirurgia CardiovascularSciEL

Video-thoracoscopic pericardial drainage in the treatment of pericardial effusions

OBJECTIVES: To assess efficacy and safety of videothoracoscopic pericardial drainage in the treatment and diagnostic of pericardial effusion through 26 cases review. METHODS: From April 2005 to December 2007, 26 patients with pericardial effusion underwent a video-thoracoscopic pericardial window. Median age was 48.2 years old. Dyspnea was the most frequent symptom followed by thoracic pain. The procedure was performed in lateral decubitus, under general anesthesia and selective intubation with the aid of three trocars. RESULTS: Procedure accomplish was feasible in 25 cases. One conversion occurred. In 61.53% of the cases the procedure was able to modify the initial diagnosis. Microbiology and tissue culture were negative in all cases. Neoplasia was present in nine cases, tuberculosis in two, aspergillosis in one, postoperative heart surgeries in three; lupus in two, uremia in one and idiopathy in eight. Associated pleuropulmonary procedures were performed in four cases. No deaths related to the procedure occurred. One late recurrence was recorded. CONCLUSION: The procedure is feasible, safe, reproducible and allowed an etiologic diagnostic. Specific treatment could be initiated in some cases. The intervention could possibly be the new gold standard treatment of pericardial effusion in selected patients.OBJETIVOS: Analisar a eficácia e a segurança da drenagem pericárdica videotoracoscópica no tratamento e diagnóstico etiológico dos derrames pericárdicos por meio da revisão de 26 casos. MÉTODOS: De abril de 2005 a dezembro de 2007, 26 pacientes com derrame pericárdico foram submetidos ao procedimento. A média etária foi de 48,2 anos. O sintoma mais comum foi dispnéia, seguida por dor torácica. O procedimento foi realizado em decúbito lateral, sob anestesia geral e intubação seletiva, com o auxílio de três trocateres. RESULTADOS: A realização do procedimento foi possível em 25 casos. Ocorreu uma conversão. Em 61,53% dos casos, o procedimento foi capaz de alterar o diagnóstico inicial. Culturas e microbiologia foram negativas em todos os casos. Achados compatíveis com neoplasia estavam presentes em nove casos, tuberculose em dois, aspergilose em um, pós-cirúrgico em três, lúpico em dois, urêmico em um e oito idiopáticos. Em quatro casos, procedimentos pleuropulmonares concomitantes foram realizados. Não ocorreram óbitos relacionados ao procedimento. Ocorreu uma recidiva. CONCLUSÃO: O procedimento demonstrou ser seguro, reprodutível e eficaz, capaz de fornecer diagnóstico etiológico e mudar o curso terapêutico de alguns pacientes. O procedimento pode se tornar o padrão-ouro em doentes selecionados.UNIFESP-EPMUNIFESP, EPMSciEL

Nature of Intra-night Optical Variability of BL Lacertae

We present the results of extensive multi-band intra-night optical monitoring of BL Lacertae during 2010--2012. BL Lacertae was very active in this period and showed intense variability in almost all wavelengths. We extensively observed it for a total for 38 nights; on 26 of them observations were done quasi-simultaneously in B, V, R and I bands (totaling 113 light curves), with an average sampling interval of around 8 minutes. BL Lacertae showed significant variations on hour-like timescales in a total of 19 nights in different optical bands. We did not find any evidence for periodicities or characteristic variability time-scales in the light curves. The intranight variability amplitude is generally greater at higher frequencies and decreases as the source flux increases. We found spectral variations in BL Lacertae in the sense that the optical spectrum becomes flatter as the flux increases but in several flaring states deviates from the linear trend suggesting different jet components contributing to the emission at different times.Comment: 12 Pages, 5 figures, 3 Tables, Accepted for Publication in MNRA

Patent ductus arteriosus: endovascular treatment in adult patient

The patent ductus arteriosus (PDA) is a common type of congenital heart defect and its correction is simple when performed early in life. Surgery is performed using stitches or clips. In adults, the anomaly can lead to pulmonary hypertension and ventricular dysfunction. Surgery in adults is controversial and high-risk. This report describes an alternative endovascular approach in an adult patient.A persistência do canal arterial (PCA) é uma anomalia relativamente freqüente e de simples correção. A correção envolve a ligadura do ducto com ou sem a sua secção. A anomalia em adultos pode provocar hipertensão pulmonar persistente e disfunção ventricular. A correção em adultos é controversa e de maior risco. Um caso de correção endovascular com acesso intra-abdominal da PCA em adulto é descrito.Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Cirugía de revascularización del miocardio usando sólo tomografía computada como angiograma preoperatorio

Coronary artery bypass graft (CABG) is a well established procedure with current precise indications. The advent and spread of this technique was possible after the introduction of the coronary angiogram. Although many evaluation methods have been developed in the past years, to date, none have been able to replace the invasive coronary angiogram as a pre-operative exam. Computed tomography angiography (CTA) has emerged as an alternative to invasive coronary angiogram. In this report we describe two CABG cases that were performed using only this technique as a pre-operative anatomic coronary arteries evaluation.La cirugía de revascularización del miocardio (CRM) es un procedimiento bien establecido con indicaciones actuales precisas. El advenimiento y la divulgación de esta técnica fueron posibles después de la introducción del angiograma coronario. Aunque muchos métodos de evaluación hayan evolucionados en los últimos años, ninguno ha conseguido sustituir al angiograma coronario invasivo como examen preoperatorio. La tomografía computada (TC) surgió como una alternativa al angiograma coronario invasivo. El presente informe describe dos casos de CRM realizadas usando sólo la TC como técnica de evaluación anatómica de las arterias coronarias preoperatoria.A cirurgia de revascularização do miocárdio (CRM) é um procedimento bem estabelecido com indicações atuais precisas. O advento e a disseminação dessa técnica foram possíveis após a introdução do angiograma coronário. Embora muitos métodos de avaliação tenham evoluído nos últimos anos, nenhum conseguiu substituir o angiograma coronário invasivo como exame pré-operatório. A tomografia computadorizada (TC) emergiu como uma alternativa ao angiograma coronário invasivo. O presente relato descreve dois casos de CRM realizadas usando-se apenas a TC como técnica de avaliação anatômica das artérias coronárias pré-operatória.Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Recent advances in computational-analytical integral transforms for convection-diffusion problems

An unifying overview of the Generalized Integral Transform Technique (GITT) as a computational-analytical approach for solving convection-diffusion problems is presented. This work is aimed at bringing together some of the most recent developments on both accuracy and convergence improvements on this well-established hybrid numerical-analytical methodology for partial differential equations. Special emphasis is given to novel algorithm implementations, all directly connected to enhancing the eigenfunction expansion basis, such as a single domain reformulation strategy for handling complex geometries, an integral balance scheme in dealing with multiscale problems, the adoption of convective eigenvalue problems in formulations with significant convection effects, and the direct integral transformation of nonlinear convection-diffusion problems based on nonlinear eigenvalue problems. Then, selected examples are presented that illustrate the improvement achieved in each class of extension, in terms of convergence acceleration and accuracy gain, which are related to conjugated heat transfer in complex or multiscale microchannel-substrate geometries, multidimensional Burgers equation model, and diffusive metal extraction through polymeric hollow fiber membranes. Numerical results are reported for each application and, where appropriate, critically compared against the traditional GITT scheme without convergence enhancement schemes and commercial or dedicated purely numerical approaches.Indisponível

Prevalence and factors associated with peripheral and central adiposity in primary school students in Brazil

The objective was to identify the prevalence of excess central adiposity and peripheral schoolchildren and its relationship with sedentary activities and physical activity level. Cross-sectional study was conducted with 524 elementary school student’s city of Bauru (SP). Structured protocol was used, the PAQ-C and measured subscapular skinfolds thickness (PCS) and triciptal (TSF). There were descriptive analyses, bivariate and multivariate logistic regression. The PCT and PCS rates were respectively 13.6% and 16.5% in boys and 15.4% and 12.6%. In girls the frequency above three times a week on the computer and its use for more than three hours if associated with elevated PCT, low level of physical activity was associated with elevated PCS in boys, low level of physical activity and use of computer and / or video games for morethan three hours/day were associated with higher PCS in boys. The frequency and number of hours in sedentary and low physical activity are important predictors of adiposity among children