Computed tomography in the diagnosis of fenestral otosclerosis

AIM: To identify the main tomographic findings of fenestral otosclerosis and to evaluate the utility of the high resolution computed tomography (HRCT) as a diagnostic method of this osteodystrophy. STUDY DESIGN: A prospective and multicentric study using computed tomography (CT) of the temporal bone. MATERIAL AND METHOD: 54 patients with a clinical and surgical diagnosis of otosclerosis. A tomographic analysis has been performed to evaluate the sensitivity of CT scans in diagnosing fenestral otosclerosis, verifying the sites of predilection for otosclerotic lesions, the bilateralism and symmetry of the disease. In this study, 22 patients undergone CT scans of temporal bones have been included in order to investigate other otologic diseases and have constituted the control group. RESULTS: The CT scan was positive in 87% of the patients (77% of the ears). The tomographic findings were mostly bilateral (78,7%) and the fenestral focus more prevalent was the anterior focus to the oval window. CONCLUSIONS: The CT scan has shown a high index of positivity and the anterior focus to the oval window has been the most prevalent in this population, and it could be considered the highly suggestive tomographic finding for otosclerosis.OBJETIVO: Identificar os principais achados tomográficos da otosclerose fenestral e avaliar a utilidade da tomografia computadorizada de alta resolução (TCAR), como método diagnóstico dessa osteodistrofia. FORMA DE ESTUDO: Estudo prospectivo multicêntrico com tomografia computadorizada (TC) de ossos temporais. MATERIAL E MÉTODO: 54 pacientes com diagnóstico clínico e cirúrgico de otosclerose. Foi realizada uma análise tomográfica, em que foi avaliada a sensibilidade da TC no diagnóstico radiológico da otosclerose fenestral, sendo verificados os principais sítios de lesões dessa doença, como também a sua bilateralidade e simetria. Foram incluídos neste estudo 22 pacientes submetidos à TC de ossos temporais para investigação de outras afecções otológicas, que constituíram o grupo controle. RESULTADOS: A TC foi positiva em 87% dos pacientes (77% das orelhas). Os achados tomográficos foram bilaterais na maioria dos casos (78,7%), e o foco fenestral mais prevalente foi o foco anterior à janela oval (FAJO). CONCLUSÕES: A TC apresentou um alto índice de positividade e o FAJO foi o foco mais prevalente nessa população, podendo ser considerado um achado tomográfico altamente sugestivo de otosclerose.Hospital CemaUNIFESP-EPM Disciplina de OtorrinolaringologiaUNIFESP-EPM Departamento de Diagnóstico por ImagemUNIFESP, EPM, Disciplina de OtorrinolaringologiaUNIFESP, EPM Depto. de Diagnóstico por ImagemSciEL

CONCENTRATED SOLAR POWER (CSP) PLANT PROPOSAL FOR BRAZIL

This article seeks the research exercise of technologies of electric power generation by solar concentration (CSP) in the world, intending to choose the one that is most applicable to construction in Brazil. Currently, several energy sources are presented in the Brazilian energy matrix, this research also aims to verify and identify the extent of renewable energies to the national reality. Through these studies, it will be possible to conclude the viability of CSP technologies to Brazil

Computed tomography in the diagnosis of retrofenestral otosclerosis

AIM: To identify the main tomographic findings of retrofenestral otosclerosis. METHODS: A prospective and multicentric study using computed tomography (CT) of the temporal bone in 54 patients with a clinical and surgical diagnosis of otosclerosis. A tomographic analysis has been performed to evaluate the utility of CT scans in diagnosing retrofenestral otosclerosis, verifying the sites of predilection for otosclerotic lesions. In this study, 22 patients undergone CT scans of temporal bones have been included in order to investigate other otologic diseases and have constituted the control group. RESULTS: The tomographic findings were mostly bilateral and the retrofenestral focus more prevalent was the pericochlear focus. CONCLUSIONS: The CT scan was useful in the identification of the retrofenestral focuses. The evidence of this focuses and the presence of the endosteal involvement of the cochlea can suggest a higher activity of the disease.OBJETIVO: Identificar os principais achados tomográficos da otosclerose retrofenestral. MÉTODO: Estudo prospectivo multicêntrico com tomografia computadorizada (TC) de ossos temporais em 54 pacientes com diagnóstico clínico e cirúrgico de otosclerose. Foi realizada uma análise tomográfica, em que foi avaliada a utilidade da TC no diagnóstico radiológico da otosclerose retrofenestral, sendo verificados os principais sítios de lesões dessa doença. Foram incluídos neste estudo 22 pacientes submetidos à TC de ossos temporais para investigação de outras afecções otológicas, que constituíram o grupo controle. RESULTADOS: Os achados tomográficos foram bilaterais na maioria dos casos e o foco retrofenestral mais prevalente foi o foco pericoclear. CONCLUSÕES: A TC monstrou-se útil na identificação dos focos retrofenestrais. A evidência tomográfica desses focos juntamente com o envolvimento endosteal da cóclea podem sugerir uma maior atividade da doença.UNIFESP - EPMHospital CemaUNIFESP-EPM Departamento de Diagnóstico por ImagemUNIFESP, - EPMUNIFESP, EPM Depto. de Diagnóstico por ImagemSciEL

O Viés de confirmação na tomada de decisão no âmbito do processo penal brasileiro: o instituto do juiz de garantias como instrumento de desenviesamento.

O presente estudo pretende abordar o Direito processual penal a partir de uma perspectiva interdisciplinar, apoiando-se nas descobertas recentes provenientes da psicologia cognitiva e da economia comportamental sobre a tomada de decisão e julgamento, especificamente no tocante à existência de heurísticas e vieses, especialmente o viés de confirmação e sua influência no processo penal brasileiro. A partir daí, verificar-se-á o funcionamento do instituto do juiz de garantias e sua possível utilização como instrumento de desenviesamento da sentença penal, como forma de promover maior imparcialidade no julgamento

Myocardial performance in conscious streptozotocin diabetic rats

BACKGROUND: In spite of a large amount of studies in anesthetized animals, isolated hearts, and in vitro cardiomyocytes, to our knowledge, myocardial function was never studied in conscious diabetic rats. Myocardial performance and the response to stress caused by dobutamine were examined in conscious rats, fifteen days after the onset of diabetes caused by streptozotocin (STZ). The protective effect of insulin was also investigated in STZ-diabetic rats. METHODS: Cardiac contractility and relaxation were evaluated by means of maximum positive (+dP/dt(max)) and negative (-dP/dt(max)) values of first derivative of left ventricular pressure over time. In addition, it was examined the myocardial response to stress caused by two dosages (1 and 15 μg/kg) of dobutamine. One-way analysis of variance (ANOVA) was used to compare differences among groups, and two-way ANOVA for repeated measure, followed by Tukey post hoc test, to compare the responses to dobutamine. Differences were considered significant if P < 0.05. RESULTS: Basal mean arterial pressure, heart rate, +dP/dt(max )and -dP/dt(max )were found decreased in STZ-diabetic rats, but unaltered in control rats treated with vehicle and STZ-diabetic rats treated with insulin. Therefore, insulin prevented the hemodynamic and myocardial function alterations observed in STZ-diabetic rats. Lower dosage of dobutamine increased heart rate, +dP/dt(max )and -dP/dt(max )only in STZ-diabetic rats, while the higher dosage promoted greater, but similar, responses in the three groups. In conclusion, the results indicate that myocardial function was remarkably attenuated in conscious STZ-diabetic rats. In addition, the lower dosage of dobutamine uncovered a greater responsiveness of the myocardium of STZ-diabetic rats. Insulin preserved myocardial function and the integrity of the response to dobutamine of STZ-diabetic rats. CONCLUSION: The present study provides new data from conscious rats showing that the cardiomyopathy of this pathophysiological condition was expressed by low indices of contractility and relaxation. In addition, it was also demonstrated that these pathophysiological features were prevented by the treatment with insulin