Avaliação da perda sanguínea após a liberação precoce ou tardia da isquemia em pacientes submetidos à artroplastia total do joelho

ResumoObjetivo: Avaliar comparativamente a perda sanguínea em pacientes submetidos à artroplastia total do joelho, com liberação da isquemia antes e após suturas e curativo compressivo. Métodos: Fez-se um estudo prospectivo randomizado em 40 pacientes submetidos à artroplastia total do joelho divididos em dois grupos. No primeiro grupo a isquemia foi liberada antes do fechamento da ferida operatória, o que permitiu o controle do sangramento. No segundo a isquemia foi liberada após suturas e curativo compressivo. Foram comparados os resultados dos níveis de hemoglobina sérica antes da cirurgia e em 48 horas do pós-operatório, o volume sanguíneo contido no dreno de sucção a vácuo nesse período e a quantidade de transfusões de sangue que foram necessárias. Resultados: Os níveis de hemoglobina pós-operatória tiveram uma diminuição média de 3,57g⧸dL no grupo A e de 4,24g⧸dL no grupo B, consideradas estatisticamente insignificantes (p = 0,23). Quatro pacientes nos dois grupos receberam duas unidades de concentrado de hemácias, sendo a diferença entre as médias drenado foram considerados estatisticamente insignificantes, para os grupos estudados. Conclusão: A concentração de hemoglobina sérica pós-operatória, bem como a necessidade de hemoderivados, nos pacientes submetidos à artroplastia total do joelho, na qual a liberação da isquemia foi deflagrada antes do fechamento da ferida operatória, não tem significância estatística quando comparada com a dos pacientes em que essa liberação foi feita após suturas e cultivado. Nivel de evidencia IB - Ensaio clínico controlado e rendomizado com intervalo de confiança estreito.AbstractObjective: compare blood loss in 40 patients underwent to unilateral total knee replacement with the release of ischemia before and after skin closure and compressive dressing. Methods: in a prospective randomized study, in 40 patients underwent to total knee replacement, dividing then into two groups: group A in which the ischemia was released before skin closure, allowing bleeding control and group B where the ischemia was released after skin suture and pressure dressing. We compared the results of laboratory tests of serum hemoglobin before surgery and 48hours postoperatively, the blood volume contained in vacuum suction drain and the transfusions that was necessary. Results: As a result, the post operative serum hemoglobin levels had a mean decrease of 3.57g/dL in group A and 4.24g/dL in group B with an average of 0.67g/dL difference between them, statistically insignificant.The observed mean drainage, in the vacuum drain, were 705mL in group A and 700mL in group B. The 5ml difference between medians was considered statistically insignificant. The number of patients who received transfusions was four patients in both groups and all received two units of red blood cells. Conclusion: the post operative serum hemoglobin levels, as well as the need of blood transfusion, in the patient underwent to total knee replacement, where the ischemia was released before wound closure, has no statistical effect in comparison with patients where the sutures and bandages were done after the ischemia release. Level of Evidence IB - Individual randomized controlled trial with narrow confidence interval

Timing for Pacing after Acquired Conduction Disease in the Setting of Endocarditis

A 53-year-old gentleman with a history of a mechanical aortic valve presented to the emergency department complaining of a sudden right-sided abdominal pain. He was found to have atrioventricular dissociation on his initial electrocardiogram and his blood cultures grew Streptococcus viridans. The suspicion for endocarditis with periaortic abscess was high so a transthoracic echocardiogram was performed and showed a mass in the left ventricular outflow tract. For better visualization, a transesophageal echocardiogram was recommended and revealed a bileaflet mechanical aortic valve with perivalvular abscess and valvular vegetation as well as severe eccentric paravalvular aortic regurgitation. After sterilization, the patient underwent a successful surgery. Postoperatively, he remained in complete heart block and a permanent pacemaker placement was performed after complete sterilization. He tolerated the procedure well and was discharged home in a stable condition. Perivalvular abscess is one of the most common cardiac complications of infective endocarditis and is associated with an increased risk of mortality. It is imperative to have appropriate treatment guidelines established. However, because of the relative nature of the disease process and the acuity at which intervention needs to be done, a true assessment of the duration of antibiotic therapy prior to surgical intervention, timing of pacemaker placement, and the type of pacemaker is controversial

Attomolar label-free detection of DNA hybridization with electrolyte-gated Graphene field-effect transistors

In this work, we develop a field-effect transistor with a two-dimensional channel made of a single graphene layer to achieve label-free detection of DNA hybridization down to attomolar concentration, while being able to discriminate a single nucleotide polymorphism (SNP). The SNP-level target specificity is achieved by immobilization of probe DNA on the graphene surface through a pyrene-derivative heterobifunctional linker. Biorecognition events result in a positive gate voltage shift of the graphene charge neutrality point. The graphene transistor biosensor displays a sensitivity of 24 mV/dec with a detection limit of 25 aM: the lowest target DNA concentration for which the sensor can discriminate between a perfect-match target sequence and SNP-containing one.Portuguese Foundation for Science and Technology (FCT) in the framework of the Strategic Funding UID/FIS/04650/2013 and project POCI01-0145-FEDER-031069 (PORTGRAPHE). G. Machado Jr. acknowledges a PhD grant (no. 237630/2012–5) from CNPq– Brazil. J.B. acknowledges European funding from NBFS project under contract NORTE-01-0145-FEDER-00001

Análise da evolução da mancha urbana da cidade de Santo Amaro-BA, por meio de ortofotografias nos anos de 1998 e 2010 / Analysis of the evolution of the urban spot of the city of Santo Amaro-BA, by means of orthophotos in the years 1998 and 2010

Após a segunda metade do século XX, o Brasil apresentara um sucessivo aumento demográfico, a marcar-se pelo consecutivo aumento da população urbana, ao qual, em 1980 torna-se um país majoritariamente urbano, com taxa de urbanização de aproximadamente 67%. Associado a isso, ocorre não somente um aumento no número de cidades, como também, há um notável crescimento territorial destes centros urbanos pelo país. Entende-se a expansão urbana como sendo um processo comumente presente em toda cidade desde o momento de sua existência, ao qual, pode realizar-se com maior ou menor intensidade. Independente do grau de intensidade em que ocorra este processo, o mesmo, propenderá à um crescimento. Acréscimo este que pode ser demográfica ou territorial. Assim, o presente trabalho tem por objetivo analisar a evolução da mancha de ocupação da cidade de Santo Amaro, Bahia nos anos de 1998 e 2010, por meio do mapeamento da ocupação urbana, a partir de técnicas de geoprocessamento. Os resultados permitiram estimar as transformações da mancha urbana entre 1998 e 2010, de modo que, verificou-se um aumento de 25% em área edificada. Apresentando pequenas áreas de expansão do tecido urbano edificado em torno das vias, a caracterizar-se por uma aparência tentacular, bem como, identificou-se ter havido ainda ao longo dos doze anos, sobretudo, um crescimento predominantemente intensivo nas áreas já consolidadas da cidade

Ferroelectricity driven-resistive switching and Schottky barrier modulation at CoPt/MgZnO interface for non-volatile memories

Ferroelectric memristors have attracted much attention as a type of nonvolatile resistance switching memories in neuromorphic computing, image recognition, and information storage. Their resistance switching mechanisms have been studied several times in perovskite and complicated materials systems. It was interpreted as the modulation of carrier transport by polarization control over Schottky barriers. Here, we experimentally report the isothermal resistive switching across a CoPt/MgZnO Schottky barrier using a simple binary semiconductor. The crystal and texture properties showed high-quality and single-crystal Co$_{0.30}$Pt$_{0.70}$/Mg$_{0.20}$Zn$_{0.80}$O hetero-junctions. The resistive switching was examined by an electric-field cooling method that exhibited a ferroelectric T$_C$ of MgZnO close to the bulk value. The resistive switching across CoPt/MgZnO Schottky barrier was accompanied by a change in the Schottky barrier height of 26.5 meV due to an interfacial charge increase and/or orbital hybridization induced reversal of MgZnO polarization. The magnitude of the reversed polarization was estimated to be a reasonable value of 3.0 (8.25) $\mu$ C/cm$^2$ at 300 K (2 K). These findings demonstrated the utilities of CoPt/MgZnO interface as a potential candidate for ferroelectric memristors and can be extended to probe the resistive switching of other hexagonal ferroelectric materials

Short communication. Effects of antibiotics (oxytetracycline, florfenicol or tulathromycin) on neonatal calves’ faecal microbial diversity.

In this study, we used barcoded pyrosequencing of the 16S rRNA gene to characterise the effects of antibiotic treatment upon the faecal microbiota of neonatal calves. Eleven pre-weaned calves were treated for pneumonia or otitis using one of three antibiotics (oxytetracycline, florfenicol or tulathromycin) and were matched for age /date of birth and sex with eleven control calves. All calves were born and reared at the same farm. Faecal microbial diversity data were obtained by barcoded pyrosequencing of the 16S rRNA gene one week pre-treatment, and one and two weeks post treatment for both treated and control calves. Using multivariate discriminant analysis we were able to show that antibiotic treatment has a substantial effect on faecal samples’ microbial composition one week after administration; this effect was no longer observed two weeks after administration. The effect of oxytetracycline treatment on Lactobacillus spp. was shown to be significant but many other important species appeared to be unaffected. The small number of calves used in the study prohibited quantitative comparisons of the effects of individual antibiotics compared to others on Chao1 richness index; despite this, however, some interesting numerical differences were apparent. In conclusion, our study serves to illustrate that change occurs in the gut microbiome of the young ruminant in response to antimicrobial administration. Given the limitations of our study we suggest that further similar studies are necessary

Soluble human Suppression of Tumorigenicity 2 is associated with endoscopic activity in patients with moderate-to-severe ulcerative colitis treated with golimumab

Suppressor of Tumorigenicity 2 (ST2) is an IL33 receptor detected in the mucosa and serum of ulcerative colitis (UC) patients. We evaluated soluble ST2 (sST2) as a surrogate biomarker of disease outcome and therapeutic response, in moderate-to-severe UC patients treated with golimumab.Agência financiadora Merck Sharp and Dohme, Lda, Portugal MK8259-22info:eu-repo/semantics/publishedVersio