Preparação e caracterização de ligas do sistema Ti-Mo contendo oxigênio intersticial para aplicações biomédicas

Titânio e suas ligas são empregados em aplicações biomédias, pois possuem excelente biocompatibilidade com o organismo humano, uma excelente resistência à corrosão em meio biológico além de uma ótima resistência mecânica/densidade. Diversas propriedades do titânio comercialmente puro podem ser melhoradas com a adição de elementos substitucionais e intersticiais, e por técnicas de processamentos termomecânicos. o objetivo neste trabalho foi estudar o efeito de oxigênio intersticial presente em ligas do sistema binário. Ti-Mo (5-20% em peso de Mo) em seu comportamento mecânico utilizando ensaios de dureza, módulo de elasticidade dinâmico e ensaio de tração, em cinco condições de estudo: após o forjamento rotativo a quente, tratamento térmico e após dopagem com oxigênio, com três diferentes teores deste elemento. As amostras foram preparadas em forno a arco e caracterizadas por medidas de composição química, análise de gases, difração de raios X, microscopia óptica e eletrônica de varredura, espectroscopia por energia dispersiva e medidas de densidade. Após as dopagens com oxigênio, observou-se um aumento na dureza da liga Ti-5Mo devido ao aumento na fração volumétrica da fase a'. Para a liga Ti-10Mo, os valores após as dopagens permaneceram próximos à condição após tratamento térmico, não ocorrendo variações expressivas. Para as ligas Ti-15Mo, verificou-se uma diminuição na dureza provavelmente devido ao resfriamento rápido realizado após as dopagens com oxigênio. Os valores do módulo de elasticidade da liga Ti-5Mo aumentaram com o aumento da concentração de oxigênio, pois ocorreu um aumento na fração volumétrica da fase a'. Com relação aos valores de módulo de elasticidade da liga Ti-10Mo, não se observam variações significativas devido à adição de oxigênio. Para as ligas...Titanium and its alloys are used in biomedical applications because they have excellent biocompatibility with human organisms, an excellent corrosion resistance in biological mediums, and great mechanical strength/density. Several properties of commercially pure titanium can be improved by the addition of interstitial and substitutional elements or by thermo-mechanical processing techniques. The purpose of this work is to study the effect of interstitial oxygen present in binary Ti-Mo systemj alloys (5-20% in weight of Mo) on its mechanical behavior, using hardness testing, dynamic elasticity modulus and tensile test on five conditions: after swaging, after heat treatment, and after oxygen doping, with three different levels of this element. The samples were prepared in an arcmelting furnace and were characterized by measures of chemical composition, gas analysis, x-ray diffraction, electron and optical microscopy, energy dispersive spectroscopy, and density measurements. After the doping with oxygen an increase in hardness of the Ti-5Mo alloy due to the increased volumetric fraction of a' phase was observed. For the Ti-10Mo alloy, the values after the doping were similar to those after heat treatment, and no expressive variations occurred. For the Ti-15Mo and Ti-20Mo alloys, there was a decline in hardness, probably due to rapid cooling after the doping with oxygen. The values of the elasticity modulus Ti-5Mo alloy increased with increasing oxygen concentration, because ther was an increase in the volumetric fraction of a' phase. With respect to the values of elasticity modulus of the Ti-10Mo alloy, no significant variations due to the addition of oxygen were observed. For the Ti15Mo and Ti-20Mo alloys, the introduction of oxygen decreased the elasticity modulus, because, with the increase in distance between the atoms, there was... (Complete abstract click electronic access below)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Efeito do oxigênio nas propriedades anelásticas da liga Ti-10Mo para aplicação biomédica

A utilização de biomateriais do reparo do tecido ósseo tem revolucionado a Ortopedia e a Odontologia atuais. Um metal estudado para estas aplicações é o titânio e suas ligas, pois possuem um excelente grau de biocompatibilidade com o organismo humano, uma excelente resistência à corrosão em meio biológico e uma ótima relação resistência mecânica/densidade. Estas propriedades são fortemente influenciadas pela presença de lementos intersticiais e as medidas de atrito interno têm sido muito utilizadas para verificar o comportamento destes elementos em materiais. O objetivo neste trabalho foi estudar o efeito de elementos intersticiais nas propriedades da liga Ti-10Mo (% em peso), por meio de medidas de difração de raios X, microscopia eletrônica e varredura, testes de citotoxidade, corrosão e espectroscopia mecânica. As amostras foram submetidas a tratamentos térmicos de recozimento e dopagem com oxigênio. Os testes de biocompatibilidade mostraram que não houve nenhuma resposta indireta. Os extratos dos materiais não interferiram no desenvolvimento, crescimento e proliferação das células. Foi detectada uma melhora na taxa de corrosão, juntamente com um aumento do potencial de corrosão, com a dopagem do material, características estas interessantes para um biomaterial. Os resultados de espectroscopia mecânica mostraram a presença de uma estrutura de relaxação após a dopagem com oxigênio em torno de átomos dos elementos que compõem a liga. Observou-se que a adição de oxigênio intersticial causou um aumento no módulo de elasticidade, o que é ruim quando se trata de um biomaterial para implantes ortopédicos.The use of the biomaterials in the repair of the bone tissue has been revolutionizing the Orthopedics and the Odontology. A metal very studied for these applications is the titanium and its alloys, because they possess an excellent corrosion resistance in a biological media and a good relationship mechanical strength/density. These properties are strongly influenced by the presence of interstitial elements and the internal friction measurements have been a lot used to verify the behavior of these interstitial elements in materials. The objective of this work was to study the effect of interstitial elements in the properties of the Ti-10Mo (%in weight) alloy, through X-ray diffraction, scanning electron microscopy, cytotoxicity tests, corrosion and mechanical spectroscopy. The samples were submitted to heat treatments of annealing and oxygen doping. The biocompatibility tests showed that there was not any indirect cytotoxic answer. The extracts of the materials didn't interfere in the development, growth and proliferation of the cells. An increase in the corrosion rate was detected, with an increase of the corrosion potential, with the oxygen doping, interesting for applications as biomaterial. The mechanical spectroscopy results showed the presence of a relaxation structure after the oxygen doping that was attributed mainly to the stress-induced ordering of the oxygen atoms around the atoms that compose the alloy. It was observed an increase in the elasticity with the oxygen doping, what is bad when it is a biomaterial.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Oxygen diffusion in Ti-10Mo alloys measured by mechanical spectroscopy

The addition of interstitial elements in metals, as titanium and its alloys, causes alterations in their mechanical properties, making them either softer or harder, for example. The internal friction measurements have been frequently used in order to verify the behavior of these interstitials atoms in metallic alloys. This paper presents the oxygen diffusion in Ti-10Mo alloy by the analysis of the mechanical relaxation spectra, in the temperature range of 350-600 K. The relaxation structure obtained was analyzed by means of the frequency dependence of the peak temperature and by using a simple mathematical treatment of the relaxation structure and the Arrhenius law.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

Diffusion of Oxygen and Nitrogen in the Ti-15Mo Alloy used for Biomedical Applications

The Ti-15Mo alloy is a promising material for use as a biomaterial because of its excellent corrosion resistance and its good combination of mechanical properties, such as fatigue, hardness, and wears resistance. This alloy has a body-centered predominantly cubic crystalline structure and the addition of interstitial atoms, such as oxygen and nitrogen, strongly alters its mechanical properties. Mechanical spectroscopy is a powerful tool to study the interaction of interstitial elements with the matrix metal or substitutional solutes, providing information such as the distribution and the concentration of interstitial elements. The objective of this paper is to study of the effects of heavy interstitial elements, such as oxygen and nitrogen, on the anelastic properties of the Ti-15Mo alloy by using mechanical spectroscopy measurements. In this study, the diffusion coefficients, pre-exponential factors, and activation energies were calculated for the oxygen in the Ti-15Mo alloy

Preparation and characterization of Ti-15Mo alloy used as biomaterial

With the increase in life expectancy, biomaterials have become an increasingly important focus of research because they are used to replace parts and functions of the human body, thus contributing to improved quality of life. In the development of new biomaterials, the Ti-15Mo alloy is particularly significant. In this study, the Ti-15Mo alloy was produced using an arc-melting furnace and then characterized by density, X-ray diffraction, optical microscopy, hardness and dynamic elasticity modulus measurements, and cytotoxicity tests. The microstructure was obtained with β predominance. Microhardness, elasticity modulus, and cytotoxicity testing results showed that this material has great potential for use as biomaterial, mainly in orthopedic applications

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research