Os múons observados com o detector central do EASCAMP

Orientador: Anderson Campos FauthTese (doutorado) - Universidade Estadual de Campinas, Instituto de Fisica Gleb WataghinResumo: O trabalho realizado nesta tese utilizou dados de múons da radiação cósmica obtidos com o detector central do experimento EASCAMP. Este experimento está localizado na UNICAMP e utiliza câmaras streamer para realizar a trajetografia de partículas. Inicialmente foi realizada uma pré-análise dos dados brutos e um estudo do desempenho do aparato experimental. Após esta fase foram analisados os dados experimentais. Foi estudada a distribuição angular zenital dos múons, I(q)=I(0)cosnq , e determinado o índice de radiação n=1,7 ± 0,1. Foi estimada a assimetria Oeste-Leste dos eventos observados, originada pelo corte geomagnético dos raios cósmicos primários, e obtido um excesso de (8,91±0,04)% na direção Oeste. Finalmente foi utilizado o método das diferenças de contagens de múons entre direções opostas para calcular o valor da anisotropia diurna solar média. Os valores obtidos das amplitudes das primeiras harmônicas para as diferenças Norte-Sul e Oeste-Leste foram ANS = (0,13±0,03)% e AOL= (0,15±0,03)%Abstract: This Ph.D. Thesis uses cosmic rays single muons observed with the central module of the EASCAMP experiment. This experiment, localised at UNICAMP, uses four streamer tube planes as a particle tracking system. First the row data pre-analysis and the study of the apparatus performance were realised. Then were analysed the filtered data. Was studied the muon zenith angular distribution I(q)=I(0)cosnq and determined the radiation index n= 1,7 ± 0,1. Was estimated the West-East asymmetry, one consequence of the primary cosmic rays geomagnetic cut-off, and obtained an excess of (8,91±0,04)% from the West direction. Finally was used the counts difference from opposite directions method to calculate the mean solar diurnal anisotropy. The first harmonic amplitude obtained for the North-South counts difference was ANS= (0,13 ± 0,03)% and for the West-East case was AOL= (0,15 ± 0,03)%DoutoradoFísicaDoutor em Ciência

Hiatoplasty with crura buttressing versus hiatoplasty alone during laparoscopic sleeve gastrectomy

Introduction. In obese patients with hiatal hernia (HH), laparoscopic sleeve gastrectomy (LSG) with cruroplasty is an option but use of prosthetic mesh crura reinforcement is debated. The aim was to compare the results of hiatal closure with or without mesh buttressing during LSG. Methods. Gastroesophageal reflux disease (GERD) was assessed by the Health-Related Quality of Life (GERD-HRQL) questionnaire before and after surgery in two consecutive series of patients with esophageal hiatus ≤ 4 cm2. After LSG, patients in group A (12) underwent simple cruroplasty, whereas in group B patients (17), absorbable mesh crura buttressing was added. Results. At mean follow-up of 33.2 and 18.1 months for groups A and B, respectively (p = 0 006), the mean preoperative GERD-HRQL scores of 16.5 and 17.7 (p = 0 837) postoperatively became 9.5 and 2.4 (p = 0 071). In group A, there was no difference between pre- and postoperative scores (p = 0 279), whereas in group B, a highly significant difference was observed (p = 0 002). The difference (Δ) comparing pre- and postoperative mean scores between the two groups was significantly in favor of mesh placement (p = 0 0058). Conclusions. In obese patients with HH and mild-moderate GERD, reflux symptoms are significantly improved at medium term follow-up after cruroplasty with versus without crura buttressing during LSG.Introduction. In obese patients with hiatal hernia (HH), laparoscopic sleeve gastrectomy (LSG) with cruroplasty is an option but use of prosthetic mesh crura reinforcement is debated. The aim was to compare the results of hiatal closure with or without mesh buttressing during LSG. Methods. Gastroesophageal reflux disease (GERD) was assessed by the Health-Related Quality of Life (GERD-HRQL) questionnaire before and after surgery in two consecutive series of patients with esophageal hiatus ≤ 4 cm2. After LSG, patients in group A (12) underwent simple cruroplasty, whereas in group B patients (17), absorbable mesh crura buttressing was added. Results. At mean follow-up of 33.2 and 18.1 months for groups A and B, respectively (p = 0 006), the mean preoperative GERD-HRQL scores of 16.5 and 17.7 (p = 0 837) postoperatively became 9.5 and 2.4 (p = 0 071). In group A, there was no difference between pre- and postoperative scores (p = 0 279), whereas in group B, a highly significant difference was observed (p = 0 002). The difference (Δ) comparing pre- and postoperative mean scores between the two groups was significantly in favor of mesh placement (p = 0 0058). Conclusions. In obese patients with HH and mild-moderate GERD, reflux symptoms are significantly improved at medium term follow-up after cruroplasty with versus without crura buttressing during LSG

Results of medium seventeen years' follow-up after laparoscopic choledochotomy for ductal stones

INTRODUCTION: In a previously published article the authors reported the long-term follow-up results in 138 consecutive patients with gallstones and common bile duct (CBD) stones who underwent laparoscopic transverse choledochotomy (TC) with T-tube biliary drainage and laparoscopic cholecystectomy (LC). Aim of this study is to evaluate the results at up to 23 years of follow-up in the same series. METHODS: One hundred twenty-one patients are the object of the present study. Patients were evaluated by clinical visit, blood assay, and abdominal ultrasound. Symptomatic patients underwent cholangio-MRI, followed by endoscopic retrograde cholangiopancreatography (ERCP) as required. RESULTS: Out of 121 patients, 61 elderly patients died from unrelated causes. Fourteen patients were lost to follow-up. In the 46 remaining patients, ductal stone recurrence occurred in one case (2,1%) successfully managed by ERCP with endoscopic sphincterotomy. At a mean follow-up of 17.1 years no other patients showed signs of bile stasis and no patient showed any imaging evidence of CBD stricture at the site of choledochotomy. CONCLUSIONS: Laparoscopic transverse choledochotomy with routine T-tube biliary drainage during LC has proven to be safe and effective at up to 23 years of follow-up, with no evidence of CBD stricture when the procedure is performed with a correct technique

Laparoscopic Left Adrenalectomy with Submesocolic and Retropancreatic Approach

Introduction: The safety and efficacy of laparoscopic transperitoneal lateral adrenalectomy and retroperitoneoscopic adrenalectomy have been reported. The aim is to report the authors’ experience in laparoscopic left adrenalectomy with an alternative transperitoneal submesocolic and retropancreatic approach with patient supine

Ciclopirox Hydroxypropyl Chitosan (CPX‐HPCH) Nail Lacquer and Breathable Cosmetic Nail Polish: In Vitro Evaluation of Drug Transungual Permeation Following the Combined Application

Background: Onychomycosis produces nail chromatic alterations that lead patients to mask them with cosmetic enamels. Objectives: Evaluate drug transungual permeation and antimycotic activity against selected strains after application of CPX-HPCH nail lacquer (NL) on the nail pre-covered with breathable cosmetic polish. Methods: CPX transungual permeation after applying CPX-HPCH NL once or twice a day on bovine hoof membranes pre-covered with a breathable cosmetic nail polish was compared to that obtained applying CPX-HPCH NL directly on the membrane. The relevant experimental permeates underwent an in vitro susceptibility test. Results: After CPX-HPCH NL application once a day, the drug transungual flux in the presence of cosmetic product tended to decrease while maintaining the antifungal activity. Two daily applications of CPX-HPCH NL on the membrane pre-covered with cosmetic polish exhibited the same permeation profile as daily application of the medicated lacquer directly on the nail as well as the same microbiological activity. Conclusions: The breathable cosmetic nail polish can be applied on the nail affected by onychomycosis in association with CPX-HPCH NL to mask the imperfections. The application of CPX-HPCH NL twice a day appears to be a good solution to obtain the same results as for a daily application without the presence of the cosmetic laye

Abnormalities of Thymic Stroma may Contribute to Immune Dysregulation in Murine Models of Leaky Severe Combined Immunodeficiency

Lymphostromal cross-talk in the thymus is essential to allow generation of a diversified repertoire of T lymphocytes and to prevent autoimmunity by self-reactive T cells. Hypomorphic mutations in genes that control T cell development have been associated with immunodeficiency and immune dysregulation both in humans and in mice. We have studied T cell development and thymic stroma architecture and maturation in two mouse models of leaky severe combined immune deficiency, carrying hypomorphic mutations in rag1 and lig4 genes. Defective T cell development was associated with abnormalities of thymic architecture that predominantly affect the thymic medulla, with reduction of the pool of mature medullary thymic epithelial cells (mTECs). While the ability of mTECs to express autoimmune regulator (Aire) is preserved in mutant mice, the frequency of mature mTECs expressing Aire and tissue-specific antigens is severely reduced. Similarly, the ability of CD4+ T cells to differentiate into Foxp3+ natural regulatory T cells is preserved in rag1 and lig4 mutant mice, but their number is greatly reduced. These data indicate that hypomorphic defects in T cell development may cause defective lymphostromal cross-talk and impinge on thymic stromal cells maturation, and thus favor immune dysregulation

Meshed Dermal Sling for Prepectoral Breast Reconstruction

The best breast reconstruction solution after mastectomy remains a topic of wide debate. Recently, the focus in the field of implant-based reconstruction has been on the increasing indications for prepectoral reconstruction. This offers undoubted advantages over subpectoral reconstruction, ranging from better aesthetic results and patient comfort to a less invasive procedure that spares the pectoralis major muscle, reducing pain and postoperative recovery time. The dermal sling is a reconstructive variant introduced by Bostwick in the 1990s and is commonly used to complete the subpectoral pocket in one- or two-stage reconstruction, creating a dual-plane reconstruction. This method may be indicated after mastectomy for both therapeutic and prophylactic purposes. It can also be used for unilateral and bilateral reconstructions. We propose a new meshed dermal sling technique that allows complete prepectoral reconstruction without the use of acellular dermal matrix, thus reducing the cost of reconstruction. It also allows the indication for complete prepectoral reconstruction to be extended to patients with medium breast volume and grade 1 or 2 ptosis, without the need to use acellular dermal matrix or the pectoralis major muscle to complete the breast pocket