Avaliação do uso de lentes de contato em acadêmicos de medicina da Universidade Federal de Santa Catarina.

Trabalho de Conclusão de Curso - Universidade Federal de Santa Catarina. Curso de Medicina. Dapartamento de Clínica Cirúrgica

Rubéola e gravidez.

Trabalho de Conclusão de Curso - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Departamento de Tocoginecologia, Curso de Medicina, Florianópolis, 197

Recurrent Small Bowel Obstruction in an Adolescent Patient

A 14-year-old adolescent boy with a body mass index of 14.0 kg/m2was admitted to the emergency department with a 1-year medical history of recurrent epigastric pain associated with bilious vomiting. All episodes spontaneously resolved in 8–12 hours from onset. An abdominal computed tomography (CT) scan with intravenous contrast was performed during an acute episode. The CT scan was suggestive for superior mesenteric artery syndrome (SMAS). The first therapeutic approach is aimed at restoring ideal body weight. Our patient’s clinical manifestation progressively resolved after weight gain, and he was free from all symptoms 1 year after the diagnosis. The surgical option with duodenal bypass should only be considered when conservative treatment fails

New Methods in Organocatalysis

In the following chapters new methods in organocatalysis are described. The design of new catalysts is explored starting from the synthesis and the study of ion tagged prolines to their applications and recycle, then moving to the synthesis of new bicyclic diarylprolinol silyl ethers and their use in organocatalytic transformations. The study of new organocatalytic reaction is also investigated, in particular bifunctional thioureas are employed to catalyse the conjugate addition of nitro compounds to 3-yilidene oxindoles in sequential and domino reactions. Finally, preliminary results on photochemical organocatalytic atom transfer radical addition to alkenes are discussed in the last chapter

Preoperative Risk Estimation for Onco-geriatric Patients (the PREOP study)

La maggior parte dei pazienti che vengono sottoposti a interventi chirurgici per tumori solidi hanno un’età superiore a 70 anni1. Circa il 30% di questi pazienti vengono considerati “fragili”. Questi infatti presentano numerose comorbidità ed hanno un più elevato rischio di sviluppare complicanze postoperatorie con perdita della riserva funzionale residua. Per questo non esistono sistemi semplici di screening che permettano ai medici responsabili del trattamento di identificare questi pazienti con aumentato rischio postoperatorio. Identificare i pazienti a rischio è infatti il primo passo nel processo attraverso il quale è possibile prevenire in necessarie complicanze postoperatorie come delirio, eventi cardiovascolari e perdita della funzionalità complessiva con conseguente perdita di autonomia. Scopo di questo studio è quello di confrontare l’accuratezza nella previsione di mortalità e morbidità a 30 giorni dei tre test preditivi “Groningen Frailty Index” (GFI); “Vulnerable Elders Survey” (VES-13); “timed up and go test” con alcune componenti del Preoperative Assessment of Cancer in the Elderly (PACE). Lo studio verrà effettuato sui pazienti con età maggiore di 70 anni che dovranno essere sottoposti a intervento chirurgico in anestesia generale per la presenza di una neoplasia solida.The majority of patients undergoing surgery for a solid tumour are over the age of 701. About 30% of these patients can be considered frail. They have comorbidities and are at a higher risk of developing postoperative complications and experience functional loss. So far there is no simple screening tool that allows the treating physician to identify those patients most at risk of developing postoperative problems. Identifying those at risk is a first step in the process towards preventing unnecessary postoperative complications such as delirium, cardiovascular complications and overall functional loss leading to loss of independency. This study will be performed to test the predictive value of the GFI, the VES-13 and the timed “up and go” test compared to components of PACE in elderly patients of the age of 70 years and above undergoing surgery for a solid tumour

β-Chitin nano-Fibrils Self-Assembly in Aqueous Environments

Chitin is one of the most studied biopolymers but the understanding of how it assembles from molecules to microfibers is still limited. Organisms are able to assemble chitin with precise control over polymorphism, texture, and final morphology. The produced hierarchical structure leads to materials with outstanding mechanical properties. In this study, the self-assembly in aqueous solutions of \u3b2-chitin nanofibrils, as far as possible similar to their native state, is investigated. These nanofibrils increase their tendency to self-assemble in fibers, up to millimetric length and 4810 \u3bcm thickness, with the pH increasing from 3 to 8, forming loosely organized bundles as observed using cryo-transmission electron microscopy. The knowledge from this study contributes to the understanding of the self-assembly process that follows chitin once extruded from cells in living organisms. Moreover, it describes a model system which can be used to investigate how other biomolecules can affect the self-assembly of chitin nanofibrils

Tunable Oxidized-Chitin Hydrogels with Customizable Mechanical Properties by Metal or Hydrogen Ion Exposure

This study focuses on the optimization of chitin oxidation in C6 to carboxylic acid and its use to obtain a hydrogel with tunable resistance. After the optimization, water-soluble crystalline β-chitin fibrils (β-chitOx) with a degree of functionalization of 10% were obtained. Diverse reaction conditions were also tested for α-chitin, which showed a lower reactivity and a slower reaction kinetic. After that, a set of hydrogels was synthesized from β-chitOx 1 wt.% at pH 9, inducing the gelation by sonication. These hydrogels were exposed to different environments, such as different amounts of Ca2+, Na+ or Mg2+ solutions, buffered environments such as pH 9, PBS, pH 5, and pH 1, and pure water. These hydrogels were characterized using rheology, XRPD, SEM, and FT-IR. The notable feature of these hydrogels is their ability to be strengthened through cation chelation, being metal cations or hydrogen ions, with a five- to tenfold increase in their storage modulus (G’). The ions were theorized to alter the hydrogen-bonding network of the polymer and intercalate in chitin’s crystal structure along the a-axis. On the other hand, the hydrogel dissolved at pH 9 and pure water. These bio-based tunable hydrogels represent an intriguing material suitable for biomedical applications

Poor nutritional status is associated with other geriatric domain impairments and adverse postoperative outcomes in onco-geriatric surgical patients – a multicentre cohort study

Background: Nutritional status (NS), though frequently affected in onco-geriatric patients, is no standard part of a geriatric assessment. The aim of this study was to analyse the association between a preoperatively impaired NS and geriatric domain impairments and adverse postoperative outcomes in onco-geriatric surgical patients. Methods: 309 patients ≥70 years undergoing surgery for solid tumours were prospectively recruited. Nine screening tools were preoperatively administered as part of a geriatric assessment. NS was based on BMI, weight loss and food intake. Odds ratio’s (OR) and 95% confidence intervals (95%CI) were estimated using logistic regression analysis. The occurrence of 30-day adverse postoperative outcomes was recorded. Results: At a median age of 76 years, 107 patients (34.6%) had an impaired NS. Decreased performance status and depression were associated with an impaired NS, when adjusted for tumour characteristics and comorbidities (ORPS>1 3.46; 95%CI 1.56-7.67. ORGDS>5 2.11; 95%CI 1.05-4.26). An impaired NS was an independent predictor for major complications (OR 3.3; 95%CI 1.6-6.8). Ten out of 11 patients who deceased had an impaired NS. Conclusion: An impaired NS is prevalent in onco-geriatric patients considered to be fit for surgery. It is associated with decreased performance status and depression. An impaired NS is a predictor for adverse postoperative outcomes. NS should be incorporated in a geriatric assessment

Direct Ink Write Printing of Chitin-Based Gel Fibers with Customizable Fibril Alignment, Porosity, and Mechanical Properties for Biomedical Applications

A fine control over different dimensional scales is a challenging target for material science since it could grant control over many properties of the final material. In this study, we developed a multivariable additive manufacturing process, direct ink write printing, to control different architectural features from the nano- to the millimeter scale during extrusion. Chitin-based gel fibers with a water content of around 1500% were obtained extruding a polymeric solution of chitin into a counter solvent, water, inducing instant solidification of the material. A certain degree of fibrillar alignment was achieved basing on the shear stress induced by the nozzle. In this study we took into account a single variable, the nozzle's internal diameter (NID). In fact, a positive correlation between NID, fibril alignment, and mechanical resistance was observed. A negative correlation with NID was observed with porosity, exposed surface, and lightly with water content. No correlation was observed with maximum elongation (similar to 50%), and the scaffold's excellent biocompatibility, which appeared unaltered. Overall, a single variable allowed a customization of different material features, which could be further tuned, adding control over other aspects of the synthetic process. Moreover, this manufacturing could be potentially applied to any polymer