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Sample records for veia jugular interna

  1. A distensibilidade da veia jugular interna parece ser uma alternativa à distensibilidade da veia cava inferior para avaliar a responsividade a fluidos

    Fabiano Broilo

    2015-09-01

    Full Text Available RESUMOObjetivo:Investigar se a variação respiratória no diâmetro da veia cava inferior (ΔDVCI e no diâmetro da veia jugular interna direita (ΔDVJID se correlacionam em pacientes submetidos à ventilação mecânica.Métodos:Estudo clínico prospectivo realizado em uma unidade de terapia intensiva de um hospital universitário. Foram incluídos 39 pacientes mecanicamente ventilados e com instabilidade hemodinâmica. Os valores da variação do diâmetro da veia cava inferior e da variação do diâmetro da veia jugular interna direita foram avaliados por meio de ecografia. A distensibilidade da veia foi calculada como a razão de (A Dmin - Dmax/Dmin e (B Dmax - Dmin/média de Dmax - Dmin, e expressa como porcentagem.Resultados:Com ambos os métodos, observou-se correlação entre a variação do diâmetro da veia cava inferior e a variação do diâmetro da veia jugular interna direita: (A r = 0,34, p = 0,04 e (B r = 0,51, p = 0,001. Utilizando o ponto de corte de 18% para indicar responsividade a fluidos na variação do diâmetro da veia cava inferior, pelo o método (A, 16 pacientes foram considerados responsivos e 35 medições mostraram concordância (Kappa ponderado = 0,80. A área sob a curva ROC foi de 0,951 (IC95% 0,830 - 0,993; valor de corte = 18,92. Usando 12% como ponto de corte para a variação do diâmetro da veia cava inferior para indicar capacidade de resposta a fluidos, pelo método (B, 14 pacientes foram responsivos e 32 medições mostraram concordância (Kappa ponderado = 0,65. A área sob a curva ROC foi de 0,903 (IC95% 0,765 - 0,973; valor de corte = 11,86.Conclusão:As variações respiratórias nas dimensões da veia cava inferior e da veia jugular interna direita se correlacionaram e mostraram concordância significativa. Avaliação da distensibilidade da veia jugular interna direita parece ser uma alternativa à distensibilidade da veia cava inferior para avaliar a responsividade a fluidos.

  2. A distensibilidade da veia jugular interna parece ser uma alternativa à distensibilidade da veia cava inferior para avaliar a responsividade a fluidos

    Fabiano Broilo; Andre Meregalli; Gilberto Friedman

    2015-01-01

    RESUMOObjetivo:Investigar se a variação respiratória no diâmetro da veia cava inferior (ΔDVCI) e no diâmetro da veia jugular interna direita (ΔDVJID) se correlacionam em pacientes submetidos à ventilação mecânica.Métodos:Estudo clínico prospectivo realizado em uma unidade de terapia intensiva de um hospital universitário. Foram incluídos 39 pacientes mecanicamente ventilados e com instabilidade hemodinâmica. Os valores da variação do diâmetro da veia cava inferior e da variação do diâmetro da...

  3. Modelo experimental estável de aneurisma sacular em artéria carótida de suínos utilizando veia jugular interna Stable experimental model of carotid artery saccular aneurysm in swine using the internal jugular vein

    Severino Lourenço da Silva Júnior

    2013-04-01

    Full Text Available OBJETIVO: Desenvolver um modelo experimental estável de aneurisma sacular em carótida de suínos utilizando veia jugular interna. MÉTODOS: Em 12 suínos sadios, com peso variando entre 25 e 50kg, cinco machos e sete fêmeas, foi confeccionado aneurisma na artéria carótida comum direita. Após arteriotomia elíptica, foi realizada anastomose terminolateral com coto distal de veia jugular interna. O volume do aneurisma era calculado de maneira que o valor não excedesse em 27 vezes o valor da área da arteriotomia. Após seis dias, era realizada angiografia e análise microscópica do aneurisma para avaliar perviedade e trombose parcial ou total. RESULTADOS: Houve ganho de peso significante dos suínos no intervalo de tempo entre a confecção do aneurisma e a angiografia (p = 0,04. Foi observada perviedade aneurismática em dez suínos (83%. Ocorreram infecções de feridas operatórias em dois animais (16,6%, ambas com início de aparecimento em três dias após a confecção do aneurisma. Análise histológica dos aneurismas mostrou trombos ocluindo parcialmente a luz em nove suínos (75%. Nesses animais, observou-se que, em média, 9% da luz aneurismática estava preenchida por trombos. CONCLUSÃO: Pôde ser desenvolvido um modelo experimental estável de aneurisma sacular em carótida de suínos utilizando veia jugular interna.OBJECTIVE: To develop an experimental model of stable saccular aneurysm in carotid of pigs using the internal jugular vein. METHODS: In 12 healthy pigs, weighing between 25 and 50kg, five males and seven females, we made a right common carotid artery aneurysm. After elliptical arteriotomy, we carried out a terminolateral anastomosis with the distal stump of the internal jugular vein. Aneurysm volume was calculated so that the value did not exceed 27 times the area of the arteriotomy. After six days angiography and microscopic examination were performed to assess patency of the aneurysm and the presence of total or partial thrombosis. RESULTS: There was a significant weight gain of pigs in the time interval between the manufacture of the aneurysm and angiography (p = 0.04. Aneurysmal patency was observed in ten pigs (83%. Operative wound infections occurred in two animals (16.6%, both with early onset, three days after the making of the aneurysm. Histological analysis showed aneurysm thrombus partially occluding the light in nine pigs (75%. In these animals, it was observed that on average 9% of the aneurysmal diameter was filled with thrombi. CONCLUSION: It was possible to develop a stable experimental model of saccular aneurysms in pig carotid artery by use of the internal jugular vein.

  4. Safety of a training program for ultrasound-guided internal jugular vein catheterization in critically ill patients Segurança de um programa de treinamento para punção de veia jugular interna guiada por ultrassom em pacientes críticos

    Felippe Leopoldo Dexheimer Neto

    2011-08-01

    Full Text Available OBJECTIVES: Evaluate the safety and effectiveness of a training program for performing ultrasound-guided internal jugular vein cannulation in critically ill patients. METHODS: Cohort prospective study, evaluating adult patients admitted in a teaching intensive care unit (ICU. Catheter placement was performed by an ICU medical resident. The patient's baseline characteristics, vessel's position and operator experience were the evaluated variables. The main outcomes were cannulation success rate and incidence of major complications. RESULTS: A total of 118 consecutive patients were enrolled between May 2008 and November 2009. The success rate of ultrasound guided catheter placement was 90% (106/118, 77% in the first attempt. Major complications occurred in 4% of the cases (n = 5 and were not associated with the analyzed variables. Inability to place the guide wire was the reason for 58% (7/12 of the failures. Operators with more than 15 previous ultrasound guided cannulations had an increased success rate (95% vs. 79%, p = 0.01 and increased failure was related to previous catheterization (26% vs. 7%, p = 0.02. CONCLUSION: Learning ultrasound guidance for IJV vein cannulation was safe and feasible in ICU patients. This process was not associated to complications and better results were achieved across the spectrum of operator experienceOBJETIVO: Avaliar a segurança e efetividade de um programa de treinamento para cateterização da veia jugular interna guiada por ultrassom em pacientes críticos. MÉTODOS: Estudo de coorte prospectivo, avaliando pacientes adultos internados em uma unidade de terapia intensiva com programa de ensino. Os médicos residentes do serviço realizaram as punções de veia jugular interna guiadas por ultrassom. Foram avaliadas as características de base dos pacientes, sintopia dos vasos e experiência dos operadores. Os desfechos primários foram a taxa de sucesso da cateterização e a incidência de complicações graves. RESULTADOS: No período entre maio de 2008 e novembro de 2009 foram avaliados 118 pacientes. A taxa de sucesso da punção guiada por ultrassom foi 90% (106/118, 77% dessas na primeira tentativa. Complicações graves ocorreram em 4% dos casos (n = 5 e não foram associadas às variáveis analisadas. Incapacidade de progredir o fio-guia foi a razão de 58% (7/12 das falhas. Operadores com mais de 15 punções guiadas por ultrassom obtiveram uma maior taxa de sucesso (95% vs. 79%, p = 0,01 e pacientes com cateterização prévia apresentaram um maior número de falhas (26% vs. 7%, p = 0,02. CONCLUSÃO: O aprendizado da técnica de punção de veia jugular interna guiada por ultrasssom é seguro e efetivo em pacientes críticos. Este processo não esteve associado a um aumento da taxa de complicações e melhores resultados são obtidos à medida que aumenta a experiência do operador

  5. Ultrasound evaluation of techniques for internal jugular vein puncture in children Avaliação ultra-sonográfica das técnicas de punção da veia jugular interna em crianças

    Sérgio Tomaz Schettini

    2008-10-01

    Full Text Available PURPOSE: To determine by ultrasound which access and position the child must stay to obtain the best transversal section of the right Internal Jugular Vein (RIJV allowing a safer puncture. METHODS: Three possible accesses to the RIJV, anterior, lateral and posterior, from 57 healthy children, were analyzed through ultrasound images in a sequence of positions of the head, in supine position, with or without a roll under the scapula: head centered in neutral position with and without a roll (NPP and NP; contra lateral rotation with and without a roll (CLRP and CLR, neutral position and the patient raised in 30° in Trendelenburg position (TDG. To analyze the results it was applied one statistic method, with variation analysis to the same individuals. Basic Procedures: Ultrasound evaluation in each one of the proposed positions. RESULTS: The statistical analysis of the results observed that the lateral puncture with the patient in the neutral position, in Trendelemburg without a roll, offers a bigger area in comparison to all the other options of puncture and positioning of the patient (pOBJETIVO: Determinar pelo ultra-som qual o melhor acesso e posicionamento da criança com o intuito de se obter a melhor secção transversal da veia jugular interna direita (VJID, permitindo uma punção com maior segurança. MÉTODOS: Três possíveis acessos a VJID, anterior, lateral e posterior foram analisados pela ultrassonografia em uma sequência de diferentes posições da cabeça, estando o paciente em posição supina com ou sem um coxim sob a escápula; cabeça na posição neutra; (NPP E NP; rotação lateral da cabeça (CLRP e CLR, posição neutra com o paciente em posição de Trendlemburg a 30(0 (TDG. Para analisar os resultados foi aplicado um método estatístico com análise variada sobre os mesmos indivíduos. Procedimentos básicos: Avaliação ultrassonográfica em cada uma das posições propostas. RESULTADOS: Pela análise estatística dos resultados observou-se que a punção lateral estando o paciente em posição neutra, em Trendlemburg sem a colocação de coxim sob a escápula oferece uma área maior em comparação a todas as outras opções de punção e posicionamento do paciente (p<0,0001. CONCLUSÃO: A melhor técnica para a punção da VJID em crianças foi a posição neutra em Trendlemburg, por punção lateral , sem a colocação de um coxim sob a escápula.

  6. Ressecção de aneurisma venoso em veia jugular externa direita Resection of right external jugular vein aneurysm

    Eduardo Pereira Savi

    2010-12-01

    Full Text Available O aneurisma venoso é uma anomalia rara, cujo diagnóstico pode ser realizado a partir de exames físicos e complementares. Sua raridade justifica a necessidade de investigação e de publicações de estudos de caso, objetivo maior deste estudo. Relata-se aqui o caso de uma paciente que apresentava um abaulamento cervical anterior assintomático, progressivo e com seis meses de evolução. A paciente foi submetida à cervicotomia anterior, sob anestesia geral, com ressecção do segmento venoso acometido e ligadura da veia jugular externa. Realizado o estudo, verificou-se que aneurismas venosos podem causar tromboflebite, embolia pulmonar ou rotura. Cirurgia profilática, quando oferece baixo risco, é cuidadosamente recomendada para pacientes com aneurismas abdominais e altamente recomendada para aneurismas do sistema venoso profundo dos membros inferiores. Outros aneurismas venosos devem ser tratados cirurgicamente quando sintomáticos, desfigurantes ou se apresentarem aumento progressivo.Venous aneurysms are a rare abnormality, usually found in physical or complementary exams. We report a case of a 43-year old female with an asymptomatic and progressive enlarging mass in the neck. She had no history of trauma or cervical puncture. Vascular ultrasound showed a right jugular veins aneurysm with 1,81 x 1,62 cm of diameter. She was undergone resection and ligation of right external jugular vein, under general anesthesia. Venous aneurysm can cause thrombophlebitis, pulmonary embolism or spontaneous rupture. Prophylactic surgery is cautiously recommended for low-risk patients with venous aneurysms of the abdomen and strongly recommended for most patients with lower extremity deep venous aneurysms. Other venous aneurysms should be excised only if they are symptomatic, enlarging, or disfiguring

  7. Ultrasound evaluation of techniques for internal jugular vein puncture in children Avaliação ultra-sonográfica das técnicas de punção da veia jugular interna em crianças

    Sérgio Tomaz Schettini; Luiz Fernando Ybarra Martins de Oliveira; Harold Ruiz Henao; Henrique Manoel Lederman

    2008-01-01

    PURPOSE: To determine by ultrasound which access and position the child must stay to obtain the best transversal section of the right Internal Jugular Vein (RIJV) allowing a safer puncture. METHODS: Three possible accesses to the RIJV, anterior, lateral and posterior, from 57 healthy children, were analyzed through ultrasound images in a sequence of positions of the head, in supine position, with or without a roll under the scapula: head centered in neutral position with and without a roll (N...

  8. Trombose séptica de seios cavernosos, transverso e sigmóide e de veia jugular, associada à meningite, secundária a furúnculo nasal: Relato de Caso Septic thrombosis of cavernous, transverse, sigmoid sinuses and jugular vein, associated with meningitis, secondary to nasal furuncle: Case report

    Hélio Utida; Mariza Toledo Abreu; Paulo Góis Manso; Karine Koller; Stephen Wang; Carla Reichert Leite

    2002-01-01

    Os autores descrevem um caso de furúnculo nasal que evoluiu com trombose séptica de seio cavernoso, bilateral e assimétrica, e de seios transverso e sigmóide e de veia jugular interna a esquerda, associada à meningite bacteriana, em um paciente previamente hígido. Apesar da trombose séptica extensa de seios venosos, o paciente apresentou boa evolução, após tratamento clínico agressivo com antibióticos, corticosteróides e anticoagulantes. Porém, manteve como seqüela: paresia de VI nervo à esqu...

  9. Trombose séptica de seios cavernosos, transverso e sigmóide e de veia jugular, associada à meningite, secundária a furúnculo nasal: Relato de Caso Septic thrombosis of cavernous, transverse, sigmoid sinuses and jugular vein, associated with meningitis, secondary to nasal furuncle: Case report

    Hélio Utida

    2002-06-01

    Full Text Available Os autores descrevem um caso de furúnculo nasal que evoluiu com trombose séptica de seio cavernoso, bilateral e assimétrica, e de seios transverso e sigmóide e de veia jugular interna a esquerda, associada à meningite bacteriana, em um paciente previamente hígido. Apesar da trombose séptica extensa de seios venosos, o paciente apresentou boa evolução, após tratamento clínico agressivo com antibióticos, corticosteróides e anticoagulantes. Porém, manteve como seqüela: paresia de VI nervo à esquerda e lesão parcial de nervo óptico homolateral.The authors report a case of nasal furuncle that progressed to septic bilateral and asymmetric thrombosis of cavernous, transverse, sigmoid sinus and internal jugular vein, associated with bacterial meningitis, in a previously healthy patient. In spite of the extensive thrombosis, the patient presented a good evolution, after an aggressive clinical treatment with antibiotics, corticosteroids and anticoagulants. However, there remained paresis of the VI nerve on the left and partial lesion of the homolateral optic nerve.

  10. Estudo da resposta tissular endoprtese recoberta de jugular bovina em veia cava inferior de sunos Bovine jugular covered stent-graft implanted in swine inferior vena cava - a study of tissue response

    Cristina Ribeiro Riguetti Pinto

    2006-06-01

    Full Text Available OBJETIVO: Avaliar a resposta tissular a uma endoprtese, com cobertura biolgica heterloga, implantada em veia cava inferior de sunos. MTODO: Desenvolvemos uma endoprtese auto-expansvel, revestida com um segmento de jugular bovina, conservada por processo L-hydro e suturada em um stent de ao inoxidvel 316L. O dispositivo introdutor utilizado foi a bainha de liberao da endoprtese artica Taheri-Leonhardt (Flrida, EUA. Foram implantadas endoprteses em 10 sunos, todas na veia cava infra-renal. Os animais foram submetidos flebografia peroperatria. necropsia, aps 2 meses, cada endoprtese foi retirada em bloco e analisada macroscopicamente, visando a avaliao da perviedade, aderncia aos tecidos vizinhos e incorporao parede venosa; e, histopatologicamente, visando a resposta histolgica ao enxerto. RESULTADOS: Na anlise macroscpica, todas as endoprteses encontravam-se prvias e totalmente incorporadas parede venosa, porm seis apresentavam trabeculaes grosseiras no seu interior e quatro algum grau de fibrose perivascular. Trs animais desenvolveram linfocele, uma retroperitoneal e as outras na parede abdominal. No estudo histopatolgico, observamos reao inflamatria granulomatosa tipo corpo estranho em todos os casos, sendo predominante na camada mdia (80%. CONCLUSO: O modelo estudado apresentou baixa trombogenicidade, corroborando com a eficcia do meio de conservao e material escolhidos; porm, baixa biocompatibilidade, provavelmente pelo obstculo imunolgico dos xenoenxertos e resposta tissular exagerada do territrio venoso.OBJECTIVE: To evaluate tissue response to a bovine jugular vein covered stent when implanted in the swine inferior vena cava. METHOD: We developed a self-expanding stent, using a segment of L-hydro conserved bovine jugular vein, which was trimmed and sutured to a 316L stainless steel stent. We used the Taheri-Leonhardt delivery system for aortic stent-graft deployment (Florida, USA. Ten handmade stent-grafts were implanted in 10 swine inferior venae cavae. All animals were submitted to perioperative venography. At necropsy, 2 months later, the stent-grafts were removed en bloc and histopathologic analysis was undertaken, in order to analyze its patency, adherence to neighboring tissues and incorporation to the venous wall, as well as tissue response. RESULTS: All stent-grafts were patent and adherent to venous wall, but six presented with gross trabeculation and four had some degree of perivascular fibrosis at macroscopy. Three animals developed lymphocele, one in the retroperitoneal space and the others in the abdominal wall. At histopathology, we observed chronic inflammatory reaction with foreign body granulomatous response in all cases, with prevalence of the tunica media (80%. CONCLUSION: The model presented low thrombogenicity, which corroborates the efficacy of the chosen means of preservation and material. However, there was low compatibility, probably due to the immunological obstacle of xenografts and exaggerated tissue response of the venous territory.

  11. Anastomose entre a artria cartida externa e a artria cartida interna supraclinidea utilizando enxerto de veia safena para tratamento de aneurisma gigante do segmento cavernoso da cartida interna: relato de caso

    Azevedo Filho Hildo

    2001-01-01

    Full Text Available Procedimentos cirrgicos alternativos para o tratamento de aneurismas "no clipveis" da cartida intracavernosa incluem ligadura do vaso ou excluso do segmento que origina a leso. Essas tcnicas esto associadas a riscos de complicaes isqumicas, mesmo em pacientes com sistema de colaterais funcionante. Portanto, um tratamento adequado requer revascularizao enceflica para manter o fluxo sanguneo nos territrios envolvidos. Relatamos o caso de uma paciente de 47 anos com sintomas e sinais isqumicos emblicos e paralisia do III nervo craniano causados por aneurisma gigante, parcialmente trombosado, do segmento cavernoso da cartida interna. A paciente foi submetida a ponte anastomtica entre a cartida externa cervical e a cartida interna supraclinoidea utilizando enxerto de veia safena, seguido de excluso do segmento vascular contendo o aneurisma, com bom resultado e sem complicaes.

  12. Central venous access through the external jugular vein in children submitted to bone marrow transplantation

    José Luiz de Godoy

    2005-01-01

    Full Text Available Establishment of long-term central venous access is a sine qua non step for bone marrow transplantation in children. Most frequently, long-term central venous access has been obtained via blind percutaneous cannulation of subclavian and internal jugular veins or via internal jugular vein cutdown. In order to avoid some potential minor and major complications associated with the subclavian or internal jugular approaches, the authors describe an easy, simple and safe method for central venous access through an external jugular vein cutdown that should be of interest to readers involved in the field of bone marrow transplantation. It should be also considered for children as well as adults needing central venous access via an external catheter - or totally implantable port - for reasons other than bone marrow transplantation, such as total parenteral nutrition and administration of chemotherapeutic agents.O estabelecimento de um acesso venoso central de longa duração é uma condição sine qua non para realizar o transplante de medula óssea em crianças. Com frequência, este acesso tem sido obtido através da punção percutânea das veias subclávia e jugular interna ou via dissecção da jugular interna. Com o objetivo de evitar algumas complicações maiores e menores associadas com a subclávia e a jugular interna, os autores descrevem um método simples, fácil e seguro para o acesso venoso central através de dissecção da veia jugular externa. Este método deveria ser de interesse dos leitores envolvidos com o transplante de medula óssea e ser considerado também para crianças e/ou adultos que necessitem de cateter venoso central de longa permanência (externo ou totalmente implantável devido a outras razões, como a nutrição parenteral ou a administração de agentes quimioterápicos.

  13. Revascularização completa do miocárdio. Pontes seqüenciais de veia safena, anastomoses seqüenciais da artéria torácica interna e enxertos compostos: análise de 165 casos consecutivos

    Raul Corrêa RABELO

    1997-04-01

    Full Text Available Buscando a revascularização completa do miocárdio, 165 casos foram analisados dentre 359 pacientes submetidos a cirurgia de revascularização do miocárdio, no período de janeiro de 1995 a janeiro de 1996, com pontes de veia safena e/ou artéria torácica interna, de forma seqüencial, ou associadas como enxertos compostos. Destes, 132 receberam pontes seqüenciais de veia safena servindo a 2 ou mais ramos arteriais coronários, 25 foram tratados através de anastomoses seqüenciais de artéria torácica interna, de forma simples, interessando aos ramos interventricular anterior e diagonais da coronária esquerda, enquanto 8 receberam enxertos compostos de artéria torácica interna direita e esquerda associados a segmentos de veias safenas, que terminavam em ramos das artérias coronárias direita e esquerda. Em 96% os casos a operação programada foi realizada, obtendo-se revascularização completa. Ocorreu um único (0,6% óbito hospitalar conseqüente a infarto do miocárdio transoperatório, seguido de síndrome de baixo débito cardíaco; a morbidade não diferiu daquela presente nos procedimentos usuais de revascularização cirúrgica do miocárdio. Os cuidados na dissecção e preparo dos pedículos da artéria torácica interna, bem como na retirada e preparo para implante das veias safenas, somados àqueles necessários à obtenção da perfeita anastomose seqüencial, de modo a evitar torções, angulações e acotovelamentos dos enxertos, são enfatizados como fundamentais para o excelente resultado obtido na série analisada. Nossos resultados entusiasmam o emprego da crescente freqüência no uso da técnica da revascularização completa do miocárdio.The authors analyse 165 patients out of 359 submitted to myocardial revascularization during the period between January 1995 and January 1996, in which the saphenous veins and the internal thoracic arteries have been used as a sequential graft, or associated with a composit graft; 132 received saphenous veins as a sequential graft to two or more coronary branches, 25 had sequential anastomosis of the left internal thoracic artery to IVA and diagonal branches of the left coronary artery, and 8 cases had both saphenous veins and internal thoracic arteries used as a composite graft to branches of the left and right coronary arteries. In 96% of the cases the scheduled surgery was performed, one patient died in the immediate post-operative period (0.6% and the morbidity was not different from that found in the standard coronary artery surgery. Details of the preparation of the grafts, as well as operative technique is discussed, and the results of this series stimulated us for further use of the sequential grafts aiming for complete myocardial revascularization.

  14. Trombosis yugular interna bilateral asociada a trombofilia después de la inducción ovárica por infertilidad Bilateral internal jugular thrombosis associated with thrombophilia after ovarian induction for infertility

    Fernando Vázquez

    2002-08-01

    Full Text Available Los eventos tromboembólicos son complicaciones poco frecuentes del tratamiento hormonal de la infertilidad y generalmente están asociados al síndrome de hiperestimulación ovárico (SHO. La trombosis venosa yugular es infrecuente y ante su presencia se debería sospechar la existencia de algún factor predisponente. Describimos una paciente de 31 años, sin antecedentes de importancia, no fumadora, a la cual se le realizó un único ciclo de estimulación hormonal para fertilización in vitro por esterilidad primaria con factor masculino. Durante la octava semana de embarazo gemelar desarrolló una trombosis yugular interna bilateral, en ausencia de SHO u otros factores predisponentes aparentes. En la evaluación para trombofilia se detectó la presencia del Factor V Leiden y la mutación del gen de la protrombina G 20210, que junto con el estímulo hormonal, se interpretaron como los factores predisponentes. Se anticoaguló con heparina de bajo peso molecular. No está recomendado el rastreo sistemático de trombofilia antes del tratamiento hormonal, pero podría ser considerado en pacientes de alto riesgo o en quienes desarrollan trombosis en ausencia de un factor predisponente claro.Thromboembolic events are an infrequent complication of hormonal treatment for infertility and are generally related to the hyperstimulated ovarian syndrome (HOS. Jugular vein thrombosis is an unusual site of thrombosis and when present one should look for a predisposing factor. We describe a 31-year-old woman, with no previous medical history, non-smoker, who received a single cycle of hormonal stimulation for in vitro fertilisation due to primary infertility. During her eighth week of a twin pregnancy, she consulted the emergency room where the diagnosis of bilateral jugular thrombosis was confirmed, in absence of HOS or any known predisposing factor. In subsequent studies, the presence of Factor V Leyden and a mutation of G 20210 prothrombin were found. These, in association to the hormonal stimulus, were considered the risk factors. She received anticoagulation treatment with low molecular weight heparin. Screening tests for thrombophilias before hormonal treatment is not recommended, but one could consider this possibility in high-risk patients or in those who develop thrombosis in the absence of any predisposing factors.

  15. Comparação entre o laser endovenoso e a fleboextração total da veia safena interna: resultados em médio prazo Comparison of endovenous laser therapy vs. conventional stripping of the great saphenous vein: midterm results

    Charles Angotti Furtado de Medeiros

    2006-12-01

    Full Text Available OBJETIVO: Comparar a fotocoagulação endovenosa com laser diodo e a fleboextração total da veia safena interna. MÉTODOS: Trata-se de um estudo prospectivo, controlado e cego de 20 pacientes com varizes sintomáticas e insuficiência bilateral da veia safena interna que foram operados entre março de 2002 e fevereiro de 2004. Para cada caso, foram realizadas aleatoriamente (sorteio as duas técnicas, sendo uma em cada lado. A avaliação pós-operatória consistiu na aplicação de questionários, exame físico e fotografia digital em todos os pacientes desde o 7º dia de pós-operatório. Também foi realizado controle ultra-sonográfico no 30º dia de pós-operatório e pletismografia a ar no 60º dia após a cirurgia. Este projeto foi aprovado pela comissão de ética, e os pacientes foram incluídos ao assinarem o consentimento pós-informação. Os dados foram submetidos a análise estatística com os programas SPSS e SAS. RESULTADOS: A técnica que utilizou o laser endovenoso apresentou dor semelhante, mas menos edema e menos hematoma durante o pós-operatório. O índice de melhora estética e de satisfação com a cirurgia foi de 100% para as duas técnicas, mas a maioria dos pacientes respondeu que o membro operado com o laser foi o mais beneficiado. Houve melhora do tempo de enchimento venoso nos dois grupos, mas sem diferença significativa entre eles. Durante o seguimento (média de 26 meses, houve um caso de parestesia leve e transitória do lado convencional e somente uma recanalização do lado laser. CONCLUSÃO: A fotocoagulação endovenosa para o tratamento da veia safena interna em pacientes com varizes de membros inferiores é segura e apresenta resultados comparáveis aos da fleboextração convencional.OBJECTIVE: To compare endovenous diode laser photocoagulation and conventional stripping of the great saphenous vein. METHODS: A controlled and blind prospective study of 20 patients with symptomatic varicose veins and bilateral great saphenous vein insufficiency who underwent surgery between March 2002 and February 2004. For each case, both techniques were randomly performed, one at each side. The postoperative assessment consisted of questionnaires, physical examination and digital photography of all patients since the 7th postoperative day. Patients also underwent examination with duplex scan at the 30th postoperative day and air plethysmography 60 days after the surgery. This project was approved by the ethics committee, and the patients were included after signing the consent form. All data were submitted to statistical analysis using the software SPSS and SAS. RESULTS:: The endovenous laser technique presented similar pain, but less edema and less hematoma during the postoperative period. The index of esthetic improvement and satisfaction with the surgery was 100% for both techniques, but a minority of patients reported that the limb operated with the laser had better results. There was improvement in venous filling time in both groups, but with no significant difference. During the follow-up (average of 26 months, there was one case of mild and transient paresthesia at the conventional side and only one recanalization at the laser side. CONCLUSION: The endovenous photocoagulation for the treatment of the great saphenous vein in patients with lower limb varicose veins is safe and presents results comparable with the conventional stripping.

  16. Acquired Jugular Vein Aneurysm

    Erkki Hopsu; Jussi Tarkkanen; Vento, Seija I.; Anne Pitkranta

    2009-01-01

    Venous malformations of the jugular veins are rare findings. Aneurysms and phlebectasias are the lesions most often reported. We report on an adult patient with an abruptly appearing large tumorous mass on the left side of the neck identified as a jugular vein aneurysm. Upon clinical examination with ultrasound, a lateral neck cyst was primarily suspected. Surgery revealed a saccular aneurysm in intimate connection with the internal jugular vein. Histology showed an organized hematoma inside ...

  17. Throbbing tinnitus in aberrant internal carotid artery aggravated by elevation of the jugular bulb. A case report; Pulsierender Tinnitus bei aberranter Arteria carotis interna in Kombination mit Hochstand des Bulbus venae jugularis. Kasuistik

    Wilhelm, T. [Inst. fuer Roentgendiagnostik, Klinikum der Technischen Univ. Muenchen (Germany); Kirsten, R. [Inst. fuer Roentgendiagnostik, Klinikum der Technischen Univ. Muenchen (Germany); Kau, R.J. [Hals-Nasen-Ohrenklinik und Poliklinik, Klinikum der Technischen Univ. Muenchen (Germany)

    1995-04-01

    Vascular anomalies in the middle ear are rarely observed. They cause no symptoms in the majority of cases, although some may be associated with tinnitus. The false diagnosis of glomus tumour may lead to considerable problems, if surgery is performed. It is therefore necessary that precise pre-operative data are obtained, preferably based on contrast-enhanced computerized tomography. Subsequent 2D and 3D image reconstructions provide further vascular findings regarding the topographic and anatomic factors involved and eliminate the need for invasive angiography of the carotid artery or retrograde jugular venography to make a firm diagnosis. (orig.) [Deutsch] Gefaessanomalien im Mittelohr sind selten. Meist sind sie asymptomatisch, koennen aber assoziiert sein mit Tinnitus. Die Fehldiagnose eines Glomustumors kann im Rahmen einer Operation zu gravierenden Problemen fuehren. Eine exakte praeoperative Abklaerung ist deshalb notwendig und sollte als Computertomographie mit Kontrastmittelgabe durchgefuehrt werden. Die anschliessende 2D- und 3D-Bildwiedergabe klaert die topographisch-anatomischen Gefaessbeziehungen und erlaubt somit die Diagnosestellung ohne die frueher durchgefuehrte invasive Carotisangiographie oder retrograde Jugularisvenographie. (orig.)

  18. Leiomiossarcoma da veia cava inferior: relato de caso

    Rafael Lemos Nascif

    2014-12-01

    Full Text Available Relatamos um caso de paciente do sexo feminino, 48 anos, com quadro clnico de dor abdominal de moderada intensidade e abaulamento do abdome. Ao exame fsico constatou-se massa abdominal palpvel. A tomografia computadorizada mostrou volumosa massa retroperitoneal, com realce heterogneo e ntima relao com a veia cava inferior. Realizou-se resseco em bloco da massa e do segmento invadido da veia cava. A histologia revelou leiomiossarcoma.

  19. Thyrocervical artery - jugular fistula following internal jugular venous catheterization

    Zachariah, P. P.; Unni, V. N.; Kurian, G.; Nair, R. R.; Mathew, A.

    2014-01-01

    Arteriovenous fistula (AVF) is an anomalous communication between an artery and a vein, caused by an iatrogenic or traumatic etiology. Surgically created upper limb AVF remains the preferred vascular access for patients on maintenance hemodialysis. Nonetheless central vein cannulation for hemodialysis is a common procedure done in patients who need hemodialysis. We incidentally detected a thyrocervical artery - jugular fistula in a patient on maintenance hemodialysis. He underwent a successfu...

  20. Ataques isqumicos transitrios em paciente com sndrome da veia cava superior: relato de caso / Transient ischemic attacks in a patient with superior vena cava obstruction: case report

    ANTNIO S., ANDRADE-FILHO; FREDERICO L.S., FIGUEIRA; CELSO L., SANTIAGO-FIGUEIRA; DANNILO B., SILVEIRA; YURI M., ANDRADE-SOUZA; EDUARDO R.V., BANDEIRA; A.P.Q.U., SOUZA; ANDR G.P., SILVA.

    1998-09-01

    Full Text Available A sndrome da veia cava superior (SVCS) condio relativamente rara. Relatamos o caso de um paciente de 42 anos, masculino, hipertenso h 15 anos, que evoluiu com dor cervical e torcica h um um ano, sendo evidenciada ocluso de 95% da coronria direita. Submetido a angioplastia, porm com persis [...] tncia da dor torcica. Posteriormente evoluiu com episdios recorrentes de hemiplegia direita associados a crises hipertensivas, que melhoravam com medicamentos anti-hipertensivos. Pela presena de colorao vinhosa na face e acentuao durante os perodos de ataques isqumicos transitrios, foi feita a suspeita diagnstica de provvel acometimento do sistema de drenagem venosa, confirmada venografia pelo achado de dilatao da veia jugular direita e imagem de estreitamento importante na juno com a veia cava superior. Em concluso, no foi possvel definir com certeza a relao entre as duas patologias no caso aqui apresentado, porm chamou a ateno a melhora dos sintomas neurolgicos aps o controle da SVCS com o tratamento institudo. Abstract in english The superior vena cava obstruction is a relatively rare condition. We report the case of a 42 year old man suffering of hypertension for about fifteen years. He reported a cervical and thoracic pain for one year, that was related to a 95% of occlusion on the right coronary artery. An angioplasty has [...] been done but the patient still related the thoracic pain. Afterwards the patient had recurrent episodes of right hemiplegia and hypertensive emergencies that have been treated with anti-hypertensive agents. A venous disease was suspected because of cyanosis in the face especially when episodes of transient ischemic attacks occurred. A venography showed obstruction of the right jugular vein near the junction with the superior vena cava. In conclusion, it was not possible to define with certainty the relationship between the two pathologies presented by the patient, even so, we call attention to the improvement of the neurological symptoms after the control of superior vena cava obstruction with the treatment.

  1. Jugular bulb diverticulum combined with high jugular bulb: a case report with CT and MRA findings

    Ko, Seog Wan [College of Medicine, Chonbuk National Univ., Jeonju (Korea, Republic of)

    2004-12-01

    Jugular bulb diverticulum is a rare condition that is characterized by the outpouching of the jugular bulb, and this can lead to hearing loss, tinnitus and vertigo. A few reports have revealed the radiologic findings about jugular bulb diverticulum, but none of them have described the MRA findings concerning this lesion. We present here the CT and MR venography findings in regards to a large high jugular blub and diverticulum we observed in a 47-year-old woman.

  2. Jugular bulb diverticulum combined with high jugular bulb: a case report with CT and MRA findings

    Jugular bulb diverticulum is a rare condition that is characterized by the outpouching of the jugular bulb, and this can lead to hearing loss, tinnitus and vertigo. A few reports have revealed the radiologic findings about jugular bulb diverticulum, but none of them have described the MRA findings concerning this lesion. We present here the CT and MR venography findings in regards to a large high jugular blub and diverticulum we observed in a 47-year-old woman

  3. Slit-like jugular foramen due to abnormal bone growth at jugular fossa

    Budhiraja V; Rastogi R

    2010-01-01

    An abnormal unilateral blockage of the jugular foramen by a bone growth converting it into a slit was noted in a skull during osteology demonstration classes for medical undergraduates. The left jugular foramen was narrowed by a thick bony projection filling the jugular fossa. This kind of narrowing of the foramen might results in neurovascular symptoms as it transmits important cranial nerves and internal jugular vein. Injury of ninth, tenth and eleventh cranial nerves can occur due to narro...

  4. Differential Diagnosis of Jugular Foramen Lesions

    Vogl, Thomas. J.; Bisdas, Sotirios

    2009-01-01

    The anatomy of the jugular foramen is complex. It contains the lower cranial nerves and major vascular structures. Tumors that develop within it, or extend into it, provide significant diagnostic and surgical challenges. In this article, we describe the anatomy of the jugular foramen and outline an imaging protocol that can differentiate between lesions, thereby aiding diagnosis and facilitating management.

  5. Colapsibilidade da Veia Cava Inferior e sinais e sintomas de insuficincia cardaca: novos insights e possveis associaes

    Renato De Vecchis

    2012-06-01

    Full Text Available FUNDAMENTO: Nos pacientes com Insuficincia Cardaca Crnica (ICC foram propostas medidas ultrassonogrficas do ndice de Colapsibilidade da Veia Cava Inferior (ICVCI para obter uma avaliao e classificao minuciosa da congesto hemodinmica. OBJETIVO: A finalidade deste estudo era correlacionar os achados no exame fsico com o ICVCI em pacientes com ICC. MTODOS: De acordo com um projeto de coorte retrospectivo, analisamos 54 pacientes com ICC, direita ou biventricular, classe NYHA III. O plano era determinar se alguma faixa de ICVCI basal poderia predizer uma persistncia ou agravamento da congesto clnica achada no final do acompanhamento subsequente (isto , aps 1-2 meses do tratamento oral otimizado. Para essa finalidade, os pacientes foram subdivididos em trs grupos de acordo com o valor de ICVCI basal: ? 15% (13 pts, 16 - 40% (21 pts e > 40% (20 pts. Diversos critrios clnicos de congesto foram comparados por meio dos trs grupos e incorporados subsequentemente ao modelo multivariado de Cox. RESULTADOS: Preditores multivariados de alto escore de congesto foram distenso da veia jugular (FC: 13,38 95% IC: 2,13 - 84 p = 0,0059 e estertores (FC: 11 95% C.I : 1,45 - 83,8 p = 0,0213. O ICVCI ? 15% esteve sempre associado com um alto escore de congesto na segunda visita; todavia, o ICVCI o ? 15% no predisse um alto escore de congesto na segunda visita. CONCLUSO: No mbito da ICC, um baixo ICVCI no predisse, em forma confivel, um elevado escore de congesto. No obstante, o conjunto com ICVCI ? 15% sempre se achou associado com sinais e sintomas de uma ICC descompensada, tanto do lado direito como do esquerdo. (Arq Bras Cardiol. 2012; [online].ahead print, PP.0-0

  6. Schwannoma de forame jugular: relato de caso

    Tavares, Joana R. P

    2009-03-01

    Full Text Available Introduo: As leses do forame jugular so raras, sendo os paragangliomas os tumores mais comuns desta regio seguidos pelos schwannomas. Os schwannomas so tumores benignos de crescimento lento e origem principalmente nos nervos cranianos sensitivos. Quando localizados no forame jugular, apresentam-se clinicamente com perda auditiva, ataxia e cefaleia, sendo comuns as alteraes dos nervos cranianos IX, X e XI. A exciso cirrgica a opo teraputica de escolha. Relato do Caso: Relatamos o caso de um paciente adulto jovem que procurou o servio de Otorrinolaringologia do Hospital Universitrio de Braslia com quadro de otalgia e otorreia piossanguinolenta no ouvido esquerdo, associada a zumbido, hipoacusia e tumor no conduto auditivo externo. Iniciada investigao diagnstica com tomografia computadorizada e bipsia, ambas com resultados inconclusivos. Realizadas ento nova bipsia e ressonncia nuclear magntica, com diagnstico definitivo de schwannoma do foram jugular. Na ocasio a leso foi definida como tipo D pela classificao de Kaye-Pellet, por envolver o forame jugular, apresentar formato de halter e componentes intra e extracraniano. Realizada cirurgia por craniotomia com exciso parcial do tumor. No houve sequelas do procedimento, apesar da persistncia dos sintomas otolgicos. Comentrios Finais: O caso um exemplo de uma doena rara, com pouco mais de duzentos casos relatados na literatura, e apresentao clnica incomum. O desafio diagnstico e teraputico enfrentado pelas equipes de Otorrinolaringologia e Neurocirurgia, que programam para breve nova abordagem cirrgica combinada para extirpao completa do tumor.

  7. Effects of a high jugular fossa and jugular bulb diverticulum on the inner ear

    From a series of patients undergoing routine radiographic examination, 112 temporal bones with a high jugular fossa were selected. Among these, 43 jugular bulb diverticula were found. The structures affected by a high fossa or diverticulum were recorded and correlated to the clinical symptoms of the patient. The vestibule was suspected to be affected in five patients. Two of these patients had tinnitus and vertigo, and three had hearing loss. In one of the latter the hearing loss was most marked in the supine position. The cochlea was close to the fossa in three patients, all of whom had tinnitus. Four patients had a defect of the posterior semicircular canal. One of them lost his hearing after a severe fit of coughing, became unsteady and showed signs of a fistula. The internal acoustic meatus and the mastoid portion of the facial canal were affected in two and four patients, respectively, who had no recorded symptoms. Twelve of 34 patients with Meniere's disease and a high jugular fossa on the side of the diseased ear had a dehiscence of the vestibular aqueduct caused by the fossa or diverticulum, compared with nine of 58 patients in the unselected material. For comparison and demonstration of topographic relationships, 58 casts of unselected radiograhed temporal bone specimens with high jugular fossae or diverticula were investigated. In patients with a high jugular fossa or jugular bulb diverticulum, tomographic assessment may be of value. (orig.)

  8. CURTEA PENAL? INTERNA?IONAL?

    Sorin Ciutureanu

    2007-05-01

    Full Text Available Experien?a jurisdic?iilor ad-hoc a f?cut posibil? adoptarea, n cadrul conferin?ei diplomatice dela Roma din 1998, a Statutului Cur?ii Penale Interna?ionale, prima jurisdic?ie interna?ional? penal?permanent?, creat? printr-un tratat multilateral.Formula cre?rii jurisdic?iei interna?ionale penale printr-un tratat multilateral nu este nou?.Aceast? formul? a ap?rut odat? cu ideea de jurisdic?ie interna?ional? penal? permanent?, nc? de lanceputul secolului ?i a fost analizat? cu ocazia nfiin??rii tribunalelor interna?ionale penale pentrufosta Iugoslavie ?i pentru Ruanda, ca formul? alternativ? la nfiin?area acestora ca m?sur? a Consiliuluide Securitate al ONU n baza Capitolului VII din Carta ONU. O asemenea abordare, a afirmatSecretarul General ONU n raportul s?u cu privire la nfiin?area TIPFI, ar avea avantajul de a permiteo examinare detaliat? ?i o elaborare a tuturor aspectelor referitoare la stabilire a unui tribunalinterna?ional. De asemenea, aceast? abordare, a afirmat tot Secretarul General al ONU, va permitestatelor participante la negocierea ?i ncheierea tratatului, exerci?iul deplin al voin?ei lor suverane, nparticular manifestarea n sensul de a fi parte sau nu la statutul Cur?ii.

  9. Comunicao interatrial do tipo seio coronrio, comunicao interventricular e ausncia de veia cava superior esquerda

    Almeida Fbio Alves; Pedra Carlos Augusto Cardoso; Jesus Carlos Augusto de; Pedra Simone Rolim Fernandes Fontes; Fontes Valmir Fernandes; Sousa Lus Carlos Bento de

    1998-01-01

    Relatamos um caso raro de um paciente de 21 meses, portador de comunicao interatrial do tipo seio coronrio, associada a comunicao interventricular perimembranosa, e ausncia de veia cava superior esquerda. O diagnstico foi realizado atravs da ecocardiografia e confirmado pela angiografia. O paciente foi operado sem intercorrncias, ambos os defeitos foram fechados com patch de pericrdio bovino e o fluxo das veias coronrias ficou direcionado para o trio esquerdo. Um ecocardiograma mo...

  10. Internal Jugular Phlebectasia in Menkes Disease

    Price, David J.; Ravindranath, Thyyar; KALER, STEPHEN G.

    2007-01-01

    Pediatric neck masses should trigger a high index of suspicion for certain genetic disorders of connective tissue. To highlight this, we report on three infants with Menkes disease, an inherited disorder of copper transport, who developed large, unilateral neck masses at between 7 and 17 months of age. All were identified in imaging studies as internal jugular phlebectasia. The masses, which enlarged on crying or exertion, have remained clinically benign in these patients for 20, 17 and 2 mon...

  11. Internal Jugular Phlebectasia in Menkes Disease

    Price, David J.; Ravindranath, Thyyar; Kaler, Stephen G.

    2009-01-01

    Pediatric neck masses should trigger a high index of suspicion for certain genetic disorders of connective tissue. To highlight this, we report on three infants with Menkes disease, an inherited disorder of copper transport, who developed large, unilateral neck masses at between 7 and 17 months of age. All were identified in imaging studies as internal jugular phlebectasia. The masses, which enlarged on crying or exertion, have remained clinically benign in these patients for 20, 17 and 2 months, respectively. While arterial tortuosity and aneurysms have been reported often in Menkes disease, venous phlebectasia has rarely been described. We speculate that low activity of the copper-dependent enzyme, lysyl oxidase, leading to reduced tensile strength in the deep cervical fascia comprising the carotid sheath may predispose to internal jugular phlebectasia in these individuals. Improved survival and neurological outcomes in infants with Menkes disease due to advances in early diagnosis and treatment may be associated with recognition of novel clinical stigmata of this condition such as internal jugular phlebectasia. PMID:17482283

  12. Glomus Jugulare Presenting with Isolated Facial Nerve Palsy

    Nunez, Angelica A.; Luis R. Ramos-Duran; Cuetter, Albert C.

    2014-01-01

    Glomus jugulare is a rare slow growing tumor occurring within the jugular foramen that rarely presents with isolated symptoms. Although histologically benign, these tumors are locally destructive because of their proximity to the petrous bone, the lower cranial nerves, and the major vascular structures (Miller et al. (2009) and Silverstone (1973)). We wish to report a glomus jugulare tumor eroding the petrous bone and producing an ipsilateral peripheral facial weakness. The mechanism of this ...

  13. Analysis of Jugular Foramen Exposure in the Fallopian Bridge Technique

    Satar, Bulent; YAZAR, Fatih; Ceyhan, Aykut; Arslan, Hasan Huseyin; Aydin, Sedat

    2009-01-01

    Objective: To analyze the exposure of the jugular foramen afforded by the fallopian bridge technique. Method: The jugular foramen exposure was obtained using the jugular foramen approach combined with the fallopian bridge technique. We applied this technique using 10 temporal bone specimens at a tertiary referral center. The exposure was assessed by means of depth of the dissection field and two separate dissection spaces that were created anteriorly and posteriorly to the facial nerve. Anter...

  14. Stereotactic radiosurgery for the treatment of Glomus Jugulare Tumors

    de Andrade, Emerson Magno; Brito, José Reginaldo; Mario, Susana Dias; de Melo, Suely Maymone; Benabou, Salomon

    2013-01-01

    Background: The glomus jugulare tumor is a slowly growing benign neoplasm originating from neural crest. There is a high morbidity associated with surgical resection of glomus jugulare. Radiosurgery play a relevant role as a therapeutic option in these tumors and its use has grown in popularity. The authors describe a retrospective series of 15 patients and reviewed the literature about the glomus jugulare tumors. Methods: We reviewed retrospectively the data of 15 patients treated with stere...

  15. Aspectos clínicos, ultra-sonográficos e venográficos da tromboflebite jugular experimental em equinos

    Carlos Alberto Hussni

    2012-07-01

    Full Text Available A tromboflebite jugular ocorre frequentemente em equinos, decorrendo geralmente de processos mórbidos associados à iatrogenia, podendo levar a perda de função, edema cefálico, diminuição do desempenho atlético e ainda causar o óbito. Esta enfermidade nos equinos apesar de frequente é pouco conhecida quanto à sua evolução e tratamentos. O objetivo deste trabalho foi avaliar a evolução da tromboflebite jugular experimental em equinos, quanto às alterações clínicas e estruturais envolvidas na enfermidade, observando-se os aspectos clínicos, ultra-sonográficos e venográficos no contexto do trombo e do vaso, quanto à possibilidade de recanalização do trombo produzido e da vascularização compensatória. A tromboflebite da veia jugular foi induzida, unilateralmente, em 05 equinos nos quais previamente à indução da tromboflebite e diariamente após foram observadas manifestações clínicas e realizados exames ultra-sonográficos. Venografias foram feitas nos momentos pré-indução, na indução e a cada seis dias após a indução da tromboflebite, verificando-se a recanalização do trombo oclusivo e a presença de vasos na drenagem sanguínea compensatória. Observou-se a ocorrência de edema moderado das regiões parotídea, massetérica e supra-orbitária e discreto edema submandibular que reduziram até o 6º dia, permanecendo apenas discreto aumento parotídeo. O ingurgitamento da jugular cranial a região da indução permaneceu durante todo o período de avaliação. A porção caudal à tromboflebite mostrou ingurgitamento frente ao garrote na entrada do tórax desde o primeiro dia após a indução. Os exames ultra-sonográficos mostraram formação de trombo oclusivo total durante todo o período de observação em 3 animais e o restabelecimento parcial do fluxo na jugular em 2 animais e a presença de vasos colaterais conduzindo o sangue da porção cranial para a porção caudal à obstrução. As venografias revelaram fluxo sanguíneo "linear" normal no momento pré-operatório, constatando nos momentos pós-operatórios a presença oclusiva do trombo, com o contraste preenchendo os vasos tributários compensatórios direcionados à porção caudal à oclusão da veia ou ainda estagnado cranialmente ao trombo. Conclui-se que a trombose oclusiva na tromboflebite jugular experimental e unilateral sofre recanalização e compensação vascular por vasos tributários de drenagem, com redução gradativa dos sinais decorrentes da estase sanguínea de retorno, especificamente as regiões cefálicas com edema. Estudos envolvendo a tromboflebite jugular nos equinos devem evoluir nos aspectos experimental e clínico.

  16. INTERNAL JUGULAR VEIN PHLEBECTASIA PRESENTING WITH HOARSENESS OF VOICE

    Sohini Chakraborty

    2014-04-01

    Full Text Available Internal jugular phlebectasia presents as a soft cystic mass in the neck that appears on straining. We present case of a 7 year old girl who presented with a painless soft cystic mass in the neck associated with hoarseness of voice. Based on clinical examination and CT image diagnosis of right internal jugular phlebectasia was made.

  17. Internal jugular vein phlebectasia presenting with hoarseness of voice.

    Chakraborty, Sohini; Dey, Pranab Kumar; Roy, Amrita; Bagchi, Nilay Ranjan; Sarkar, Debalina; Pal, Sumita

    2013-01-01

    Internal jugular phlebectasia presents as a soft cystic mass in the neck that appears on straining. We present a case of a 7-year-old girl who presented with a painless soft cystic mass in the neck associated with hoarseness of voice. Based on clinical examination and CT image, diagnosis of right internal jugular phlebectasia was made. PMID:24369523

  18. INTERNAL JUGULAR VEIN PHLEBECTASIA PRESENTING WITH HOARSENESS OF VOICE

    Sohini Chakraborty; Pranab Kumar Dey; Amrita Roy

    2014-01-01

    Internal jugular phlebectasia presents as a soft cystic mass in the neck that appears on straining. We present case of a 7 year old girl who presented with a painless soft cystic mass in the neck associated with hoarseness of voice. Based on clinical examination and CT image diagnosis of right internal jugular phlebectasia was made.

  19. Internal Jugular Vein Phlebectasia Presenting with Hoarseness of Voice

    Sohini Chakraborty; Pranab Kumar Dey; Amrita Roy; Nilay Ranjan Bagchi; Debalina Sarkar; Sumita Pal

    2013-01-01

    Internal jugular phlebectasia presents as a soft cystic mass in the neck that appears on straining. We present a case of a 7-year-old girl who presented with a painless soft cystic mass in the neck associated with hoarseness of voice. Based on clinical examination and CT image, diagnosis of right internal jugular phlebectasia was made.

  20. A exposição do contorno lateral direito da veia cava inferior na cirurgia hepática

    Tenório Nailton Jatobá; Goldenberg Alberto; Triviño Tarcísio

    2002-01-01

    O conhecimento da relação entre a veia cava inferior e o tecido hepático é fundamental para a sua abordagem durante a cirurgia hepática. Observa-se na literatura dados contraditórios. Objetivo: Pesquisar a sintopia da veia cava inferior, o número de veias confluentes para o contorno direito e a distância do segmento retro-hepático da veia cava inferior. Métodos: Foram estudados 38 fígados humanos, entre 13 e 98 anos de ambos sexos. Obtida a peça anatômica, era dissecada a veia cava inferior, ...

  1. Importancia do conjugado arteria carotida interna-seio cavernoso

    Milton Baggio Moreira

    1977-12-01

    Full Text Available O autor considera necessário o conjugado anatômico artério-venoso representado pela artéria carótida interna e seio cavernoso, bem como o plexo venoso carotídeo que reveste a carótida interna dentro do canal carotídeo da porção petrosa do osso temporal. Julga que, além de proteger a parede vascular arterial nas hipertensões arteriais súbitas, possa contribuir no mecanismo de controle e regulação do fluxo sanguíneo carotídeo, por considerar diferentes as condições fisiológicas do seio cavernoso em relação aos demais seios venosos durais e o sistema venoso endocraniano; consequente de sua constituição cavernosa, diferente dos demais canais sanguíneos venosos, com fisiollogia venosa própria e funções diferentes. Procura assemelhá-los aos demais distritos do organismo em que existem plexos cavernosos nos quais a tensão venosa chega a grandes proporções, comparada às demais regiões em que não existe esta constituição morfológica. Estabelece a correlação resultante ao mecanismo de resistência cérebro-vascular do qual considera participar, diferindo dos demais seios durais conjugado artéria carotida-beio cavernoso e veias encefálicas. Ainda valoriza o sifão carotídeo fisiologicamente e julga que o mesmo participa da hemodinâmica quando o paciente se encontra caído (em plano horizontal com hipotensão arterial, favorecendo a chegada sanguínea ao cérebro, evitando a anóxia e descerebração consequente dentro de determinados limites, sendo mais um meio de defesa do organismo.

  2. Internal Jugular Vein Thrombosis following Oropharyngeal Infection

    Bostanci, Asli; Turhan, Murat

    2015-01-01

    Internal jugular vein thrombosis (IJVT) is a rare condition which may lead to life-threatening complications such as sepsis and pulmonary embolism. Prolonged central venous catheterization, intravenous (IV) drug use, trauma, and radiotherapy are the most frequent causes of the IJVT. IJVT that develops after the oropharyngeal infection is a quite rare situation today. In this paper, a 37-year-old woman was presented; swelling occurred on her neck after acute tonsillitis and she was diagnosed with IJVT through Doppler ultrasonography and magnetic resonance imaging and managed without complications. Early diagnosis and conservative treatment with broad-spectrum IV antibiotics and anticoagulant agents have a critical importance for the prevention of fatal complications. PMID:26457221

  3. Gamma knife radiosurgery for glomus jugulare tumours

    The aim of this clinical study was to determine the tumour control rate, clinical outcome and complication rate following gamma knife treatment for glomus jugulare tumours. Between May 1992 and May 1998, 13 patients with glomus tumours underwent stereotactic radiosurgical treatment in our department. The age of these patients ranged from 21 to 80 years. The male : female ratio was 2 : 11. Six patients had primary open surgery for partial removal or recurrent growth and subsequent radiosurgical therapy. Radiosurgery was performed as primary treatment in 7 cases. The median tumour volume was 6.4 cm3 (range: 4.6-13.7 cm3). The median marginal dose applied to an average isodose volume of 50 % (30-50 %) was 13.5 Gy (12-20 Gy). In 10 patients, a total of 48 MRI and CT follow-up scans were available. The remaining three patients have been excluded from the postradiosurgical evaluation since the observation time (t < 12 months) was too short or patients were lost to follow up. The median interval from gamma knife treatment to the last radiological follow-up was 37.6 months (5-68 months). In 4 patients (40 %) decreased tumour volumes were observed and in 6 cases (60 %) the tumour size remained unchanged. Neurological follow-up examinations revealed improved clinical status in 5 patients (50 %), a stable neurological status in 5 patients (50 %) and no complications occurred. According to our preliminary experience gamma knife radiosurgery represents an effective treatment option for glomus jugulare tumours. (author)

  4. Glomus jugulare tumor with intra- and extracranial extension

    A case of glomus jugulare tumor with intra- and extracranial extension is described. The patient was a 63-year-old woman who complained of gait and memory disturbances. On admission neurological examination revealed recent memory disturbance, left deafness, left XI, XIIth cranial nerve palsies, and slight ataxic gait. Roentgenogram of the skull showed an enlarged left jugular foramen with bone erosion. Plain X-ray computerized tomography scan (X-CT) indicated obstructive hydrocephalus and X-CT with contrast enhancement revealed a mass lesion in the left posterior cranial fossa extending through enlarged left jugular foramen to the extracranial space toward the level of C2. Cerebral angiography demonstrated a large mass with blood supply from branches of left external carotid and vertebral arteries. The tumor stain was not remarkable. Left internal jugular vein was completely obstructed at the level of the second cervical vertebral body. Magnetic resonance imaging (MRI) clearly showed the tumor extending from the anterolateral portion to the second cervical vertebral body through the enlarged jugular foramen to the posterior cranial fossa. Brain stem and cerebellar hemisphere which were markedly compressed by the mass were clearly visualized. At first a ventriculo-peritoneal shunt was made and four weeks later subtotal removal of the tumor was undertaken. Histopathology of tumor specimen showed typical glomus jugulare tumor. MRI was considered to be very useful for the diagnosis and treatment of the glomus jugulare tumor with intra- and extracranial extension. (author)

  5. [Echographic localization for percutaneous internal jugular vein catheterization].

    Jean, G; Megri, K; Adesina, K; François, B

    1994-01-01

    The standard internal jugular vein access is an anatomical-landmark method and the individual variations causes technical difficulty and sometimes morbidity. Ultrasound guidance for percutaneous puncture of internal jugular vein is used in 20 patients for hemodialysis catheter insertion. This method allow the visualization of jugular permeability and needle progression during puncture. A control historical group comparison emphasized the advantage of this technique with lower access time (20 s vs 90 s), more first needle pass success (90% vs 50%) and reduced morbidity (carotid puncture, hematomas). The ultrasound guidance is very simple and safe but major disadvantage is the cost of the equipment. PMID:8047198

  6. Embolia pulmonar séptica secundária à tromboflebite jugular: um caso de síndrome de Lemierre Septic pulmonary embolism secondary to jugular thrombophlebitis: a case of Lemierre's syndrome

    Denise Rossato Silva

    2008-12-01

    Full Text Available A síndrome de Lemierre é caracterizada pela infecção aguda da orofaringe, complicada por trombose venosa jugular interna secundária à tromboflebite séptica, e por infecções metastáticas a vários órgãos distantes-mais freqüentemente os pulmões. Relatamos um caso de síndrome de Lemierre em uma mulher de 56 anos que se apresentou com massa cervical à direita e febre. Trombose venosa jugular interna foi demonstrada na ecografia. A tomografia computadorizada de tórax revelou múltiplas opacidades em ambos os pulmões. Uma biópsia pulmonar cirúrgica foi realizada por suspeita de metástases pulmonares. O exame anatomopatológico revelou êmbolos sépticos em parênquima pulmonar. Retrospectivamente, a paciente relatou história de faringite duas semanas antes da hospitalização. Após o diagnóstico, foi tratada com antibióticos de amplo espectro (cefuroxima por 7 dias e azitromicina por 5 dias e, posteriormente, devido à persistência de febre, cefepime por 7 dias. A tomografia computadorizada de tórax, realizada um mês após, mostrou resolução das opacidades.Lemierre's syndrome is characterized by acute oropharyngeal infection, complicated by internal jugular venous thrombosis secondary to septic thrombophlebitis, and by metastatic infections in various distant organs-most commonly in the lungs. We report a case of Lemierre's syndrome in a 56-year-old female who presented with right-sided neck mass and fever. Right internal jugular venous thrombosis was demonstrated on an ultrasound. A computed tomography scan of the chest revealed multiple opacities throughout both lungs. An open surgical biopsy was performed due to suspicion of pulmonary metastases. Anatomopathological examination revealed septic emboli in lung parenchyma. Retrospectively, the patient reported a history of pharyngitis two weeks prior to hospitalization. After the diagnosis had been made, the patient was treated with broad-spectrum antibiotics (cefuroxime for 7 days and azithromycin for 5 days; subsequently, because fever persisted, cefepime for 7 days. One month later, a computed tomography scan of the chest revealed resolution of the opacities.

  7. Endovascular treatment of jugular bulb diverticula causing debilitating pulsatile tinnitus.

    Mortimer, Alex M; Harrington, Tim; Steinfort, Brendan; Faulder, Ken

    2016-03-01

    We describe the case of a patient who presented with debilitating pulsatile tinnitus in association with two jugular bulb diverticula. The diverticula were treated with stenting of the jugular bulb and coil embolization of the diverticula over two procedures. This resulted in successful resolution of symptoms and at 10?months follow-up the patient is asymptomatic. The technique is discussed with regard to similar published cases and surrogate measures of safety taken from the literature pertaining to idiopathic intracranial hypertension. PMID:25691694

  8. Jugular Foramen Syndrome as Initial Presentation of Metastatic Lung Cancer

    Hayward, Dustin; Morgan, Christopher; Emami, Bahman; Biller, Jose; Prabhu, Vikram C.

    2012-01-01

    Metastatic involvement of the cranial base and jugular foramen generally presents with headache and lower cranial neuropathy but may escape early diagnosis. In this report, a patient developed a jugular foramen syndrome as the initial presentation of metastatic lung cancer soon after being diagnosed and treated surgically for extracranial atherosclerotic internal carotid artery disease. With the appropriate diagnosis established, he underwent local fractionated radiation therapy and systemic ...

  9. Radiosurgery of Glomus Jugulare Tumors: A Meta-Analysis

    Guss, Zachary D.; Batra, Sachin [Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, MD (United States); Limb, Charles J. [Department of Otolaryngology, Johns Hopkins Hospital, Baltimore, MD (United States); Li, Gordon [Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA (United States); Sughrue, Michael E. [Department of Neurological Surgery, University of California, San Francisco, School of Medicine, San Francisco, CA (United States); Redmond, Kristin [Department of Radiation Oncology, Johns Hopkins Hospital, Baltimore, MD (United States); Rigamonti, Daniele [Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, MD (United States); Parsa, Andrew T. [Department of Neurological Surgery, University of California, San Francisco, School of Medicine, San Francisco, CA (United States); Chang, Steven [Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA (United States); Kleinberg, Lawrence [Department of Radiation Oncology, Johns Hopkins Hospital, Baltimore, MD (United States); Lim, Michael, E-mail: mlim3@jhmi.edu [Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, MD (United States)

    2011-11-15

    Purpose: During the past two decades, radiosurgery has arisen as a promising approach to the management of glomus jugulare. In the present study, we report on a systematic review and meta-analysis of the available published data on the radiosurgical management of glomus jugulare tumors. Methods and Materials: To identify eligible studies, systematic searches of all glomus jugulare tumors treated with radiosurgery were conducted in major scientific publication databases. The data search yielded 19 studies, which were included in the meta-analysis. The data from 335 glomus jugulare patients were extracted. The fixed effects pooled proportions were calculated from the data when Cochrane's statistic was statistically insignificant and the inconsistency among studies was <25%. Bias was assessed using the Egger funnel plot test. Results: Across all studies, 97% of patients achieved tumor control, and 95% of patients achieved clinical control. Eight studies reported a mean or median follow-up time of >36 months. In these studies, 95% of patients achieved clinical control and 96% achieved tumor control. The gamma knife, linear accelerator, and CyberKnife technologies all exhibited high rates of tumor and clinical control. Conclusions: The present study reports the results of a meta-analysis for the radiosurgical management of glomus jugulare. Because of its high effectiveness, we suggest considering radiosurgery for the primary management of glomus jugulare tumors.

  10. Radiosurgery of Glomus Jugulare Tumors: A Meta-Analysis

    Purpose: During the past two decades, radiosurgery has arisen as a promising approach to the management of glomus jugulare. In the present study, we report on a systematic review and meta-analysis of the available published data on the radiosurgical management of glomus jugulare tumors. Methods and Materials: To identify eligible studies, systematic searches of all glomus jugulare tumors treated with radiosurgery were conducted in major scientific publication databases. The data search yielded 19 studies, which were included in the meta-analysis. The data from 335 glomus jugulare patients were extracted. The fixed effects pooled proportions were calculated from the data when Cochrane's statistic was statistically insignificant and the inconsistency among studies was 36 months. In these studies, 95% of patients achieved clinical control and 96% achieved tumor control. The gamma knife, linear accelerator, and CyberKnife technologies all exhibited high rates of tumor and clinical control. Conclusions: The present study reports the results of a meta-analysis for the radiosurgical management of glomus jugulare. Because of its high effectiveness, we suggest considering radiosurgery for the primary management of glomus jugulare tumors.

  11. Effects of a high jugular fossa and jugular bulb diverticulum on the inner ear. A clinical and radiologic investigation

    Wadin, K.; Thomander, L.; Wilbrand, H.

    From a series of patients undergoing routine radiographic examination, 112 temporal bones with a high jugular fossa were selected. Among these, 43 jugular bulb diverticula were found. The structures affected by a high fossa or diverticulum were recorded and correlated to the clinical symptoms of the patient. The vestibule was suspected to be affected in five patients. Two of these patients had tinnitus and vertigo, and three had hearing loss. In one of the latter the hearing loss was most marked in the supine position. The cochlea was close to the fossa in three patients, all of whom had tinnitus. Four patients had a defect of the posterior semicircular canal. One of them lost his hearing after a severe fit of coughing, became unsteady and showed signs of a fistula. The internal acoustic meatus and the mastoid portion of the facial canal were affected in two and four patients, respectively, who had no recorded symptoms. Twelve of 34 patients with Meniere's disease and a high jugular fossa on the side of the diseased ear had a dehiscence of the vestibular aqueduct caused by the fossa or diverticulum, compared with nine of 58 patients in the unselected material. For comparison and demonstration of topographic relationships, 58 casts of unselected radiograhed temporal bone specimens with high jugular fossae or diverticula were investigated. In patients with a high jugular fossa or jugular bulb diverticulum, tomographic assessment may be of value.

  12. Veias do sistema porta-heptico em gansos domsticos Veins from hepatic portal vein system in domestic geese

    Santos, Tatiana C; Carla C.F. Borba; Anita Menconi; Marina O. Maia; Pedro P. Bombonatto; Cheston C.H. Pereira

    2009-01-01

    A distribuio intraparenquimal das veias porta-hepticas foi estudada em 30 gansos domsticos. Latex Neoprene corado foi injetado pela veia isquitica e os animais forma fixados por imerso e injeo intramuscular com formol a 10% e dissecados. O fgado esteve composto por um grande lobo heptico direito e por um lobo heptico esquerdo menor, os quais estiveram conectados por uma ponte de parnquima. O lobo direito do fgado teve exclusivamente vasos do sistema porta-heptico formados pela d...

  13. Clinical Importance of Duplication of Internal Jugular Vein

    Kapre, Madan; Mangalgiri, Ashutosh S.

    2011-01-01

    Duplication of internal jugular vein (IJV) is rare. It is the larger channel draining the cranial cavity. We encountered duplication of the IJV while cervical node clearance in a patient with squamous cell carcinoma of left margin of the tongue. IJV divides into two parts anterior and posterior after descending about 2.5 cm from the jugular foramen. IJV is an important landmark in neck surgery. Knowledge of its variations is essential to avoid complications during surgery and to avoid misinte...

  14. Ausncia de veia cava inferior: relato de caso Absence of the inferior vena cava: case report

    Elton Correia Alves

    2010-12-01

    Full Text Available A ausncia congnita de veia cava inferior achado incomum e ocasional durante exames complementares ou cirurgias do abdome. Em razo de a maioria dos pacientes sem outras malformaes serem assintomticos, h dificuldade em estimar a prevalncia dessas anomalias. O objetivo deste trabalho foi relatar o caso de um paciente de 28 anos, sexo masculino, referido para radiografia de trax devido a quadro de febre alta (39C no-responsiva medicao. Radiografia de trax sugeriu dilatao de veia zigos. Em inqurito dirigido para sintomas cardiovasculares, referiu dor torcica (durante atividade fsica e em repouso e dispneia ocasionais durante o sono associada ao perodo em que intensificou a prtica de exerccios. Realizada tomografia computadorizada sem contraste e, posteriormente, contrastada. As mesmas no esclareceram o caso, fazendo-se necessrio angiotomografia, a qual evidenciou ausncia de veia cava inferior torcica.The congenital absence of the inferior vena cava is a rare and occasional finding at complementary exams or abdominal surgeries. As the majority of patients without other malformations are asymptomatic, it is hard to estimate the prevalence of these anomalies. Our goal was to report a case of a 28-year-old patient, male, referred to thorax X-ray due to high fever state (39C, nonresponder to medication. The X-ray suggested azygos vein dilatation. The interview about cardiovascular symptoms revealed thoracic pain during both physical exercises and at rest, and occasional dyspnea during sleep related to the period of intensification of physical exercises. Computadorized tomography with and without contrast did not solve the case, what explain the request of an angiotomography, that showed absence of thoracic inferior vena cava.

  15. Malignant Jugular Paraganglioma: Unusual Presentation on 68Ga DOTANOC PET/CT.

    Jain, Tarun Kumar; Basher, Rajender Kumar; Shukla, Jaya; Mittal, Bhagwant Rai; Panda, Naresh K

    2016-02-01

    Metastatic jugular paraganglioma are rare tumors and account for less than 1% of the cases of head and neck tumors. We report a 40-year-old woman of jugular paraganglioma, presenting with right-sided neck swelling, hearing loss, and pulsatile tinnitus. Contrast-enhanced CT temporal bone revealed a mass in the right jugular foramina and extending inferiorly to internal jugular vein. Ga DOTANOC PET/CT was performed, which revealed somatostatin receptor expressing lesion in the right internal jugular vein and extension into sigmoid sinus and additional metastatic focus in the sacrum. PMID:26646996

  16. Efeitos do ultra-som de baixa intensidade na veia auricular de coelhos

    Arajo Marcelo; Baptista-Silva Jos Carlos Costa; Gomes Paulo de Oliveira; Campos Humberto de Oliveira; Novo Neil Ferreira; Juliano Yara

    2003-01-01

    OBJETIVO: Estudar a ao do ultra-som na veia auricular de coelhos. MTODOS: Vinte coelhos foram divididos em dois grupos de dez animais diferindo com relao ao local da aplicao, do ultra-som, o modo e o intervalo de tempo para a anlise histopatolgica (3 e 7 dias). Os animais foram submetidos aplicao de ultra-som contnuo e pulsado em dois segmentos venosos da orelha previamente determinados. Cada animal foi o seu prprio controle. Empregou-se a freqncia de 3MHz, intensidade de 3W/...

  17. Estudo comparativo da biocompatibilidade da submucosa intestinal porcina e pericrdio bovino usados como enxertos na veia cava de ces

    Greca Fernando Hintz; Noronha Lucia; Costa Francisco Diniz Afonso da; Souza Filho Zacarias Alves de; Soccol Andra Thomaz; Feres Andr Nry; Duda Jao Ricardo; Adams Eduardo

    2005-01-01

    OBJETIVO: Comparar a biocompatibilidade entre submucosa de intestino delgado (SID) porcino e o pericrdio bovino como enxerto no reparo de leses criadas na veia cava inferior de ces. MTODOS: Dezesseis ces foram submetidos a laparotomia. Aps a abertura da cavidade abdominal a veia cava foi identificada e em seguida procedeu-se com a retirada de um segmento elptico de 1,5X3cm de sua parede anterior. Em 8 animais o defeito foi reparado com SID porcino (grupo A) e nos 8 animais restantes o ...

  18. Friccin interna y comportamiento anelstico en slidos

    HENRY A. COLORADO L; CSAR CHAVES ROLDN; JUAN MANUEL VLEZ

    2008-01-01

    Se presentan los conceptos de Friccin Interna (FI), anelasticidad y espectroscopia mecnica, como una tcnica potente para la determinacin de las propiedades mecnicas dinmicas en slidos. Se comentan algunos de los logros de la tcnica, fundamentalmente en el campo de la fsica del estado slido.

  19. Left Internal Jugular Vein Thrombosis Due to a Lung Tumor

    Kuan-Hsing Chen

    2003-06-01

    Full Text Available Deep vein thrombosis is a common disease among Caucasians but is rare in Asia.Venous thrombosis may be fatal, for example by a pulmonary embolism and right or leftatrial thrombosis. Alternatively, deep vein thrombosis may follow a benign pattern such asfemoral and popliteal vein thrombosis. Theories abound regarding the causes of deep veinthrombosis, with the most common theories being long-term stasis and lack of exercise.Internal jugular vein thrombosis is a rare but potentially fatal disease with various causes. Inthe pre-antibiotics era, this disease was frequently associated with deep neck infection.Recently however, local trauma, central catheterization, and repeated intravenous injectionswith drugs have become the leading causes of thrombosis. Spontaneous internal jugularvein thrombosis may occur in connection with a neoplasm, termed Trousseau's syndrome.This investigation reports a case of lung cancer associated with internal jugular vein thrombosis.

  20. A metastatic glomus jugulare tumor. A temporal bone report

    El Fiky, F.M.; Paparella, M.M.

    1984-01-01

    The clinicopathologic findings in the temporal bone of a patient with a highly malignant metastasizing glomus jugulare tumor are reported. The patient exhibited all the symptoms of primary malignant tumors of the ear, including facial paralysis, otorrhea, pain, hearing loss, tinnitus, dizziness, and vertigo. He was treated with cobalt irradiation followed by radium implant in the ear canal for a residual tumor; then a left-sided radical mastoidectomy was performed.

  1. A metastatic glomus jugulare tumor. A temporal bone report

    The clinicopathologic findings in the temporal bone of a patient with a highly malignant metastasizing glomus jugulare tumor are reported. The patient exhibited all the symptoms of primary malignant tumors of the ear, including facial paralysis, otorrhea, pain, hearing loss, tinnitus, dizziness, and vertigo. He was treated with cobalt irradiation followed by radium implant in the ear canal for a residual tumor; then a left-sided radical mastoidectomy was performed

  2. Transsigmoid Approach for Tumors of the Jugular Foramen

    MANN, WOLF J.; Amedee, Ronald G.; Gilsbach, Joachim; Perneczky, Axel; Wolfensberger, Markus

    1991-01-01

    A transsigmoid approach is detailed for removal of tumors involving the jugular foramen. This approach was used in seven patients, eliminates the need for facial nerve transposition, and helps to preserve cochleovestibular function. The sigmoid sinus is packed and both the facial nerve and the labyrinth are identified. This approach provides excellent vision of the intradural and extradural course of the lower cranial nerves, rendering preservation of isolated nerves within the neural compart...

  3. How to objectively assess jugular primary venous obstruction

    Paolo Zamboni

    2014-12-01

    Full Text Available Last January The Lancet published the article by Traboulsee et al. Prevalence of extracranial venous narrowing on catheter venography in people with multiple sclerosis, their sibilings, and unrelated healthy controls: a blinded, case control study. These Authors confirmed the presence of chronic cerebrospinal venous insufficiency with a high prevalence of about 70% in the Canadian population, but without significant differences between patients and healthy controls, yet. However, they used a criterion never published to assess stenosis, in alternative to the classic measurement of the diameter in the segment immediately preceding the narrowest point. Traboulsee et al. measure the stenosis along the entire length of the internal jugular vein, by comparing the maximum diameter with the narrowest point. It has been demonstrated, from normal anatomy findings, how the jugular bulb diameter normally exceeds 50% of the minimum diameter of the internal jugular vein, clearly showing the reason why Traboulsee et al. did not find significant differences between people with multiple sclerosis, their sibilings, and unrelated healthy controls. Furthermore, as the outcome measure of Traboulsee et al., wall stenosis is a neglected part of primary venous obstruction, because in the majority of cases obstruction is the consequence of intraluminal obstacles, as a considerable part of truncular venous malformations, and/or compression; rarely of external hypoplasia. Finally, several recently published methods can be adopted for objective assessment of restricted jugular flow in course of chronic cerebrospinal venous insufficiency, by the means of non invasive magnetic resonance imaging, ultrasound and plethysmography. This may help us in improving the assessment of cerebral venous return in the near future.

  4. The origin of mean arterial and jugular venous blood pressures in giraffes.

    Mitchell, Graham; Maloney, Shane K; Mitchell, Duncan; Keegan, D James

    2006-07-01

    Using a mechanical model of the giraffe neck and head circulation consisting of a rigid, ascending, 'carotid' limb, a 'cranial' circulation that could be rigid or collapsible, and a descending, 'jugular' limb that also could be rigid or collapsible, we have analyzed the origin of the high arterial and venous pressures in giraffe, and whether blood flow is assisted by a siphon. When the tubes were rigid and the 'jugular' limb exit was lower than the 'carotid' limb entrance a siphon operated, 'carotid' hydrostatic pressures became more negative, and flow was 3.3 l min(-1) but ceased when the 'cranial' and 'jugular' limbs were collapsible or when the 'jugular' limb was opened to the atmosphere. Pumping water through the model produced positive pressures in the 'carotid' limb similar to those found in giraffe. Applying an external 'tissue' pressure to the 'jugular' tube during pump flow produced the typical pressures found in the jugular vein in giraffe. Constriction of the lowest, 'jugular cuff', portion of the 'jugular' limb showed that the cuff may augment the orthostatic reflex during head raising. Except when all tubes were rigid, pressures were unaffected by a siphon. We conclude that mean arterial blood pressure in giraffes is a consequence of the hydrostatic pressure generated by the column of blood in the neck, that tissue pressure around the collapsible jugular vein produces the known jugular pressures, and that a siphon does not assist flow through the cranial circulation. PMID:16788035

  5. A morphological and morphometric study of jugular foramen in dry skulls with its clinical implications

    Chandni Gupta

    2014-01-01

    Full Text Available Objective: Jugular foramen of human skull is one of the most interesting foramina. It is a complex bony canal, numerous vital structures, including nerves and vessels are transmitted through it. Most of the intracranial and extra cranial lesions of posterior cranial fossa might affect the structures in jugular foramen in addition to intrinsic abnormalities. As the neurosurgeons have become courageous in approaching this area, so there is a need to become familiar with this area. Hence, the present study was done to examine the anatomy of jugular foramen, including its morphological features and dimensions. Materials and Methods: The study was carried out on 50 dried skulls. 100 jugular foramina were studied on both right and left side of skulls. The length, width of jugular foramen and width and depth of jugular fossa were measured using vernier calipers. Presence of dome, complete and incomplete septation was also looked for. Results: The mean right and left anteroposterior diameter, latero-medial diameter, area, jugular fossa width, depth in our study was 11.22, 16.52, 187.34, 6.83, 11.58 mm and 9.52, 16.02, 153.2, 5.69, 11.13 mm. Dome was present in jugular foramen in 74% on the right side and 58% on the left side. Complete septation in jugular foramen is seen in 44% on the right side and 42% on the left side. Conclusion: This study will help the neurosurgeons while doing surgery in this region.

  6. Iliac vein compression syndrome: literature review / Sndrome de compresso da veia ilaca: reviso de literatura

    Leonardo Pessoa, Cavalcante; Jos Emerson dos Santos, Souza; Raquel Magalhes, Pereira; Marcos Velludo, Bernardes; Alan Maurice da Silva, Amanajs; Marcos Henrique, Parisati; Ricardo Dias da, Rocha; Antnio Oliveira de, Arajo.

    2015-03-01

    Full Text Available A Sndrome de Compresso da Veia Ilaca (SCVI) uma situao clnica na qual a artria ilaca comum direita comprime extrinsecamente a veia ilaca comum esquerda. H uma predominncia em mulheres jovens, entre a segunda e a quarta dcadas de vida. Levando-se em considerao as complicaes potencia [...] is da sndrome, esta deve ser reconhecida/diagnosticada e tratada, em pacientes sintomticos, antes que cause alteraes irreversveis no sistema venoso do paciente. Mtodos no invasivos, como o US-Doppler colorido, quando realizados por examinadores experientes, so mtodos de triagem razoveis; porm, a angiotomografia e a angiorressonncia so mais fidedignas. O mtodo de escolha para a confirmao diagnstica consiste na flebografia, em mltiplas incidncias, com aferio de gradientes pressricos. O tratamento endovascular (angioplastia com colocao de stent autoexpansvel) seguro e efetivo, podendo substituir a reconstruo cirrgica aberta e/ou a anticoagulao isolada. Abstract in english Iliac vein compression syndrome is a clinical condition in which the right common iliac artery extrinsically compresses the left common iliac vein. The syndrome predominantly affects young women between their 2nd and 4th decades of life. In view of the syndrome's potential complications, it should b [...] e recognized/diagnosed and treated in symptomatic patients before it causes irreversible damage to patients' venous systems. Noninvasive methods, such as venous color Doppler US are reasonable screening methods, but angiotomography and magnetic resonance angiography are more reliable diagnostic tools and the method of choice for confirmation of diagnosis remains multi-plane phlebography with measurement of pressure gradients. Endovascular treatment (angioplasty with placement of self-expanding stents) is safe and effective and can replace open surgical reconstruction and/or anticoagulation alone.

  7. Spontaneous thrombosis of primary external jugular veins aneurysms

    Sergio Gianesini

    2013-09-01

    Full Text Available External jugular vein (EJV aneurysms represent a rare condition whose origin, evolution and consequent best therapeutic options still need further investigations. We present herein two peculiar clinical cases. In the first one, an EJV aneurysm developed around a malformed valve which embedded a spontaneous thrombosis. Transverse cutaneous nerve compression by the aneurysmatic mass was identified. In the second case, a recurring thrombosed EJV aneu - rysm was found pinched among the platysma muscle and the superficial layer of the cervical fascia. A pertinent literature review is also presented in order to interpret the findings herein never previously described.

  8. Jugular bulb abnormalities in patients with Meniere's disease using high-resolution computed tomography.

    Park, Jonas J-H; Shen, Anmin; Keil, Sebastian; Kuhl, Christiane; Westhofen, Martin

    2015-08-01

    Temporal bone abnormalities such as hypoplasia of the vestibular aqueduct or hypopneumatization of the mastoid have been described in Meniere's disease (MD). Jugular bulb abnormalities (JBA) are one of the most common temporal bone abnormalities. The aim of this study was to evaluate the frequency of JBA in MD. Radiological data obtained by temporal bone high-resolution computed tomography of 200 ears of 167 MD patients (MD group) and 218 ears of 109 patients with normal inner ear function (control group) were analyzed retrospectively. The frequencies of high jugular bulb (HJB), jugular bulb diverticulum (JBD), inner ear adjacent jugular bulb (IAJB) and jugular bulb related inner ear dehiscence (JBID) were evaluated and compared between MD group and control group. IAJB was differentiated into vestibular aqueduct adjacent jugular bulb (VAAJB), cochlear aqueduct adjacent jugular bulb and posterior semicircular canal adjacent jugular bulb. JBID was further analyzed by differentiating into jugular bulb related vestibular aqueduct dehiscence (JBVAD), jugular bulb related cochlear aqueduct dehiscence and jugular bulb related posterior semicircular canal dehiscence. The frequencies of HJB, JBD and IAJB were higher in MD group compared to control group (21, 13.3 %, p = 0.036; 8.5, 3.7 %, p = 0.037; 13.5, 4.6 %, p = 0.001). No differences between both groups were seen in JBID (4.0, 2.3 %, p = 0.315). Most IAJB and JBID were seen in VAAJB and JBVAD. There is a higher frequency of JBA in patients with MD than in patients without inner ear symptoms. Temporal bones of MD patients might be constituted anatomically different, carrying predisposing factors for the development of clinically apparent MD. PMID:24647494

  9. Central venous infusion port inserted via high versus low jugular venous approaches: Retrospective comparison of outcome and complications

    Purpose: To retrospectively compare immediate and long-term outcome of central venous infusion port inserted via right high versus low jugular vein approaches. Materials and methods: The study included 163 patients (125 women patients, 38 men patients; age range, 18-79 years; mean age, 53 years); 142 patients underwent port insertion with low jugular vein approach and 21 patients with high jugular vein approach. The causes of high jugular vein puncture were metastatic lymphadenopathy (n = 7), operation scar (n = 6), radiation scar (n = 5), failure of low jugular vein puncture (n = 2), and abnormal course of right subclavian artery (n = 1). Medical records and radiologic studies were reviewed retrospectively to determine and compare the outcome and the occurrence of complication related to port. Results: The procedure-related complications were all minor (n = 14, 8.6%) in both groups; hematoma (n = 4, 2.8% in low jugular puncture group and n = 1, 4.8% in high jugular puncture group, p = 0.6295), air embolism (n = 2, 1.4% in low jugular puncture group and n = 0 in high jugular puncture group, p = 0.5842) and minor bleeding (n = 5, 3.5% in low jugular vein puncture group and n = 2, 9.5% in high jugular vein puncture group, p = 0.2054). The average length of follow-up was 431 days for low jugular vein puncture group and 284 days for high jugular vein puncture group. The difference between two groups was significant (p = 0.0349). The reasons for catheter removal were patients' death (59 in low jugular puncture group and 14 in high jugular puncture group, p = 0.0465), suspected infection (11 in low jugular vein puncture group and 2 in high jugular vein puncture group, p = 0.8242), catheter occlusion (four in low jugular vein puncture group and one in high jugular vein puncture group, p = 0.6583). The catheter tip migrated upward an average of 1.86 cm (range, -0.5 to 5.0 cm) in low jugular vein puncture group and 1.56 cm (range, 0-3.6 cm) in high jugular vein puncture group and there was no significant difference (p = 0.4232). Conclusions: Right high jugular vein approach can be a feasible alternative to right low jugular vein approach.

  10. Tromboflebite séptica da veia porta secundária à apendicite Septic thrombophlebitis of the portal vein as a complication of appendicitis

    Olival Cirilo Lucena da Fonseca-Neto

    2007-06-01

    Full Text Available INTRODUÇÃO: A tromboflebite séptica da veia porta ou pileflebite é evento raro e associado com alta mortalidade e seu diagnóstico requer a demonstração de trombo portal. RELATO DO CASO: Mulher de 19 anos com história de dor abdominal há 40 dias com piora há 10 foi admitida no hospital. Referia dor de forte intensidade em hipocôndrio direito, vômitos, febre, e calafrios. No exame físico de entrada tinha sinais e sintomas de sepse abdominal. Submetida à laparotomia exploradora foi encontrado abscesso hepático e apêndice ileiocecal rôto e bloqueado. Realizada apendicectomia e drenagem de abscesso, que evoluiu com necessidade de re-laparotomia no 6º dia e drenagem de novos abscessos hepáticos. Após longa internação, recebeu alta e no seguimento de 6 meses estava bem. CONCLUSÃO: A pileflebite é complicação rara, porém grave, devendo ser rapidamente diagnosticada e o seu manejo multidisciplinar instituído prontamente.BACKGROUND:Portal vein septic thrombophlebitis or pylephlebitis is a rare event associated with high mortality rates and its' diagnosis requires portal thrombosis demonstration. CASE REPORT: Nineteen year-old female was admitted to the hospital with a history of abdominal pain for the last 40 days, worsening for the last 10. The patient complained of intense and strong pain in the right hypochondrium, vomit, fever and cold chills. During physical examination the patient showed signs and symptoms of abdominal sepsis. She was then submitted to exploratory laparotomy, during which a hepatic abscess and blocked and ruptured ileocecal appendix was found. Appendicectomy and drainage of the abcess was performed, having the necessity of a second laparotomy in the sixth day and further drainage of new formatted hepatic abscesses. After a long period of admission, the patient was discharged and was well following the next six months. CONCLUSION: Pylephlebitis is a rare and severe complication, which has the urgency of being quickly and appropriately diagnosed as well as in a multidisciplinary manner.

  11. Aspectos ultra-sonográficos da trombose da veia porta Ultrasonographic features of portal vein thrombosis

    Márcio Martins Machado

    2006-04-01

    Full Text Available A trombose da veia porta pode estar associada a várias alterações, como a presença de tumores (por exemplo: hepatocarcinoma, doença metastática hepática e carcinoma do pâncreas, pancreatite, hepatite, septicemia, trauma, esplenectomia, derivações porto-cava, estados de hipercoagulabilidade (por exemplo: gravidez, em neonatos (por exemplo: onfalite e cateterização da veia umbilical e desidratação aguda. Os autores discutem, neste artigo, os aspectos ultra-sonográficos da trombose de veia porta e alguns aspectos de relevância clínica.Portal vein thrombosis may be associated with many alterations, such as the presence of tumors (for example, hepatocellular carcinoma, metastatic liver disease and carcinoma of the pancreas as well as pancreatitis, hepatitis, septicemia, trauma, splenectomy, portacaval shunts, hypercoagulable conditions (for example, pregnancy, in neonates (for example, omphalitis and umbilical vein catheterization and in acute dehydration. The authors discuss herein the sonographic features of portal vein thrombosis as well as some aspects of clinical relevance.

  12. Jugular foramen meningiomas. Review of the major surgical series

    Primary jugular foramen meningiomas are uncommon, with 96 previous cases published between 1992 and 2007. Exact location and extent of tumor were determined on the basis of radiologic and operative findings and used to develop a staging system. The mean age of patients was 39.4 years. The lesion was located on the right in 14 patients and on the left in 11 patients. The series identified 23 males and 58 females. The most common presenting clinical symptoms were hearing loss and tinnitus. Most clinical findings were middle ear mass and neck mass. Most meningiomas were World Health Organization grade I. The most common postoperative complications were lower cranial nerve paresis and facial nerve paresis. Surgical planning should consider that meningiomas usually invade the dura mater, cranial nerves, and surrounding bone. The surgeon should carefully collect detailed data about the tumor, and consult an otolaryngologist preoperatively for lower cranial nerve functions and hearing levels.(author)

  13. Jugular neck dissection for NO neck supraglottic carcinoma

    Petrovi? eljko

    2004-01-01

    Full Text Available Appropriate management of patients with supraglottic laryngeal carcinoma and negative findings in the neck is still controversial. A prospective and retrospective study comprised 193 patients who were treated primary surgically between 1976 and 1993. They all had clinically and ultrasound negative findings on the neck (NO. Supraglottic carcinomas usually spread regionally. Metastases develop in the jugular group, between level II-IV. The incidence of metastases has been reported to vary from 12 to 62.5%. The size and localization of the primary tumor, its histological grade, genotype of the malignant cells, imunological and other elucidated factors can all affect the incidence of regional spread. AIM Aim of this study was to specify the incidence of occult cervical metastases; to analyze the distribution of occult metastases related to tumor localization; to specify the distribution of occult metastases related to local spread; to analyze the distribution of occult metastases according to localization in the neck. RESULTS All patients had primary surgery of primary tumor and bilateral jugular, selective neck dissection at the level II-IV with histological examination of removed lymphoid tissue. Out of 193 patients, metastatic deposits were detected in 35(18%. Occult metastases were found in patients with carcinoma of the epilarynx in 19% (14/72 of cases, and in 17% (21/121 patients with carcinoma of the supraglottis excluding the epilarynx. This difference in frequency is not statistically significant. The incidence of occult metastases in epilaryngeal tumors did not depend on the degree of local spread. Even relatively small tumors (T1 and T2 yielded occult metastases in 33% (5/15, and 24% (6/25 of patients, respectively. In patients with T1 tumors localized at the supraglottis, excluding the epilarinx, occult metastases were not found. In the supragiottis excluding the epilarynx increased local spread was associated an increase of occult metastases. The incidence of occult metastases was directly related to the degree of the local spread of the tumor in the supraglottis excluding the epilarynx (Table 1. Occult metastases were usually ipsilateral, like the palpable ones. In medially localized tumors bilateral netastases were possible. Ipsilateral metastases were more frequent than both bilateral and contralateral ones. The possibility of contraiateral and bilateral occult metastases necessitated bilateral neck dissection. Postoperative radiotherapy (60 Gy was given to all patients with verified occult metastases. Only in two patients (1% of the total did metastases develop subsequently, indicating the effectiveness of planned postoperatrive radiotherapy. DISCUSSION Controversies in application of jugular, selective neck dissection are presently since it has been in use, because of the unclear role wich regional lymph tissue play in antitumor immune response. Jugular, selective neck dissection was advocated in all patients with a primary supraglottic laryngeal carcinomas. It was suggested that selective neck dissection was needed only in advanced (T3 and T4 tumors. Selective dissection is believed to be needed only when tumor has spread into the vallecula, the base of the tongue, or the medial wall of the piriform sinus. The idea of selective neck dissection has been opposed since the protective role of the cervical lymph tissue has been stressed. Ultrasound and computerized tomography of the neck cannot detect occult metastases. Today, only removal and histological examination of the lymph tissue can determine occult metastasis. The importance of selective neck dissection is considered in diagnostic biopsy procedure by wich occult metastatic spread in the neck region is established. CONCLUSION Due to the tendency of supraglottic carcinoma resulting in occult cervical metastases, early detection is imperative in order to apply the appropriate therapy. Occult cervical metastases are usually ipsilateral, but bilateral and contralateral may be found as well. Due to the aforementioned, it is necessary to

  14. Internal jugular vein cannulation: How much safety can we offer?

    William F Amaya Zuñiga

    2015-01-01

    Full Text Available Introduction: Central venous catheterization, performed by the anatomical landmark technique, has a mechanical complication rate between 5% and 19%. This technique has been modified and new approaches have been implemented aiming to improve patient safety. With the introduction of ultrasonography in the clinical practice, and recently in central venous catheter insertion, the rate of complications has dropped over time. Objective: To measure the clinical application of the algorithm "Successful ultrasound-guided internal jugular vein cannulation". Methods: A descriptive, prospective, case series study. Patients over 18 years of age were selected, and the informed consent documentation was filled out appropriately. Patients with masses, anatomical abnormalities, insertion site infections and coagulopathy (International Normalized Ratio [INR] ≥ 2.0, platelet count ≤50.000 were excluded. Central venous cannulation was performed under ultrasound guidance in accordance with safety of the Fundación Santa Fe de Bogotá University Hospital (HUFSFB. Adjustment and validation of the algorithm was done according to an expert consensus in our department. A descriptive univariate analysis was conducted, and efficacy was determined on the basis of the number of attempts to achieve successful venous cannulation, and the incidence of complications. Results: This series included 38 patients with a mean age of 62 years. In 97.4% of the cases, successful venous cannulation was achieved on the first attempt. Guidewire displacement was observed in one case, requiring a second attempt. The posterior jugular vein wall was punctured in two patients (5.2%, with no associated arterial vascular injury or pneumoth-orax. Conclusions: This algorithm resulted in a high rate of successful first attempts and the prevention of potential complications, improving operational standards and healthcare quality for the patients.

  15. Trombose da veia de Galeno: relato de caso Galen vein thrombosis: case report

    Marcio Chaves Pedro Marques

    2003-06-01

    Full Text Available A trombose venosa cerebral (TVC é doença vascular com diferentes manifestações clínicas e várias causas possíveis (locais, sistêmicas ou idiopáticas. A trombose da veia de Galeno (TVG é causa rara de TVC e geralmente está associada a alguma malformação vascular. Relatamos o caso de uma paciente de 16 anos que apresentou TVG sem malformação vascular, porém associada a trombose de seio reto e infarto venoso talâmico. Discutem-se também aspectos importantes do diagnóstico clínico, radiológico e laboratorial da TVC.Cerebral venous thrombosis (CVT is a vascular disease with many clinical manifestations and possible etiologies (local, systemic or idiopathic. Galen vein thrombosis (GVT is a rare cause of CVT and usually it is associated with some vascular malformation. We report a case of a 16 years old female patient with GVT without vascular malformation, but associated with straight sinus thrombosis and venous thalamic infarct. Relevant aspects of the clinical, radiological and laboratory diagnosis of CVT are also discussed.

  16. Adequate irradiation of the internal jugular lymph node chain: technical considerations

    Purpose: This research aimed to study the anatomic relationship between the internal jugular vein with the surrounding internal jugular lymph node chain and the underlying bony anatomical structures which are commonly used as landmarks for radiation therapy planning. Methods and Materials: Twelve patients with carcinoma of the head and neck region were studied prospectively. Using our three-dimensional planning system, a beam's-eye view of the internal jugular vein was projected onto a lateral and anterior simulation film. Quantitative measurements were made in every case of the anatomic relationship between the internal jugular vein and the posterior border of the cervical vertebrae and sagittal midline. Results: The distance between the posterior border of the internal jugular vein and the posterior border of the cervical vertebrae ranged between 0 and 2.5 cm. The distances between the sagittal midline and the medial border of the internal jugular veins ranged between 2 and 4 cm. Conclusion: To ensure adequate irradiation of the internal jugular lymph nodes, the posterior border of the lateral radiation therapy upper-neck fields should be placed at least 1 cm posterior to the posterior aspect of the cervical vertebrae. The midline block used in the lower neck anterior field should not exceed 2 cm in width

  17. Correction of carotid-jugular traumatic fistula using a bovine pericardial patch

    Werther Souza Sales

    2014-03-01

    Full Text Available Carotid-jugular fistulae are rare, but habitually cause morbidity and mortality. They are often linked with penetrating trauma, primarily caused by gunshots. This report describes the case of a patient who was the victim of a gunshot wound to the left cervical area, provoking a carotid-jugular arteriovenous fistula and occlusion of the common carotid artery. The fistula was corrected by ligature of the internal jugular vein and arteriorrhaphy of the left common carotid artery with a bovine pericardium patch.

  18. Veias do sistema porta-hepático em gansos domésticos Veins from hepatic portal vein system in domestic geese

    Tatiana C. Santos

    2009-04-01

    Full Text Available A distribuição intraparenquimal das veias porta-hepáticas foi estudada em 30 gansos domésticos. Latex Neoprene corado foi injetado pela veia isquiática e os animais forma fixados por imersão e injeção intramuscular com formol a 10% e dissecados. O fígado esteve composto por um grande lobo hepático direito e por um lobo hepático esquerdo menor, os quais estiveram conectados por uma ponte de parênquima. O lobo direito do fígado teve exclusivamente vasos do sistema porta-hepático formados pela distribuição intraparenquimal da veia porta-hepática direita, enquanto que no lobo esquerdo estes originaram-se da veia porta-hepática direita e de pequenas veias porta-hepáticas esquerdas. A veia porta-hepática direita emitiu o ramo caudal direito, que emitiu um pequeno ramo caudolateral direito e um grande ramo caudomedial direito. Cranialmente esta veia emitiu os ramos craniais direito e ramos lateral direito. A porção transversa da veia porta-hepática direita cruzou para o lobo hepático esquerdo, emitindo de 1 a 6 pequenos ramos craniais e caudais para a região média do fígado. No lobo esquerdo, o ramo esquerdo da veia porta-hepática direita emitiu o ramo cranial esquerdo, o ramo lateral esquerdo e o ramo medial. De 1 a 6 veias porta-hepáticas esquerdas foram identificadas desembocando ou no ramo esquerdo da veia porta-hepática direita ou em sua porção transversa, oriundos do ventrículo gástrico e do pró-ventrículo. Em 40% dos gansos uma veia porta-hepática própria oriunda da confluência de vasos venosos da face esquerda do ventrículo distribuiu-se na extremidade caudal do lobo esquerdo isoladamente.The intraparenchymal distribution of the hepatic portal veins in 30 domestic geese were studied. Stained Neoprene latex was injected into the isquiatic vessels, and the animals were fixed in 10% formaldehyde by immersion and intramuscular injection. The liver of geese was composed of a large right and a smaller left hepatic lobe, connected by a parenchyma bridge. The right hepatic lobe had vessels exclusively from the hepatic portal system composed by intraparenchymal distribution of the right hepatic portal vein, while the vessels of the left hepatic lobe came from the right hepatic portal vein and from small left hepatic portal veins. The right hepatic portal vein emitted the right caudal branch, which emitted a small right caudolateral branch and a large right caudomedial branch. Cranially this vein emitted right cranial and right lateral branches. The tranverse portion of the right hepatic portal vein crossed to the left hepatic lobe, emitting 1 to 6 small cranial and caudal branches to the medial area of the liver. In the left hepatic lobe, the left branch from the right hepatic vein emitted the left cranial, left lateral and left median branches. One to six left hepatic portal veins were identified arising from the left branch or from the transverse portion of the right hepatic portal vein. These vessels arose from the gizzard and pro-ventricle. In 40% of geese one proper hepatic portal vein originated from venous vessels of the gizzard and was distributed into the caudal extremity of the left hepatic isolated lobe.

  19. Internal jugular vein access for the interventional management of nonfunctioning artero-venous haemodialysis fistulas

    Basile, A. E-mail: antodoc@yahoo.com; Garcia Medina, J.; Lupattelli, T.; Garcia Medina, V.; Leal, R

    2004-12-01

    We report our experience and results with the use of internal jugular vein as secondary approach for the endovascular treatment of twelve nonfunctioning artero-venous (AV) fistulas in haemodialysis patients.

  20. Internal jugular vein access for the interventional management of nonfunctioning artero-venous haemodialysis fistulas

    We report our experience and results with the use of internal jugular vein as secondary approach for the endovascular treatment of twelve nonfunctioning artero-venous (AV) fistulas in haemodialysis patients

  1. Internal jugular phlebectasia as an incidental finding in cervical spine surgery

    Thulasiraman V

    2010-01-01

    Full Text Available Idiopathic internal jugular phlebectasia, occurs either unilaterally or bilaterally affecting the internal jugular vein is a rare congenital variation often diagnosed during childhood. It usually presents with a benign swelling over the lateral side of neck on the affected side, seen on exertion. A-30-year old male was operated for anterior cervical dissectomy from right lateral approach and was diagnosed per-operatively as internal jugular phlebectasia.The surgery was abandoned at this stage on the advice of cardiothoracic surgeon to investigate the patient for the secondary etiological factors for internal jugular vein dilatation. The patient was reassured without any active intervention for the phlebectasia and cervical dissectomy was performed in the second surgery through the lateral approach from left side. This case is presented in view of rarity and suggested that during preoperative workup the nearby structures like carotid sheath should be evaluated by magnetic resonance imaging to avoid such per-operative surprises.

  2. Veia gástrica posterior: hipertensão porta Posterior gastric vein: portal hipertension

    Alcino Lázaro da Silva

    1999-10-01

    Full Text Available A veia gástrica posterior não é muito citada nos livros de anatomia e nos trabalhos sobre hipertensão porta. Estudou-se sua anatomia, freqüência e desembocadura. Ela foi encontrada em 54% dos casos e, em 100%, desembocava na veia esplênica. Discute-se a vantagem ou não de sua ligadura ou preservação no tratamento cirúrgico da hipertensão porta.The posterior gastric vein has not been mentioned very often neither in anatomy textbooks nor in portal hypertension papers. The authors studied the anatomy, frequency and confluence of this vein because is a huge variety in the presentation of esophageal varices. Twenty-six adult preserved corpses (twenty females and six males had a wide abdominal incision allowing the dissection of the portal system, identifying the frequency and confluence of its tributaries, notably the posterior gastric vein. The portal vein, in all cases, was formed by the confluence of the superior mesenteric vein with the splenic vein and had a mean length of 6.4 cm. The splenic vein had a mean length of 6.5 cm. The left gastric vein was tributary of the portal vein in 50% of the cases and in 30% of the cases in the splenic vein. The right gastric vein had it's confluence to portal vein in 30 % of the cases and to the splenic vein in 4 %. The inferior mesenteric vein was tributary of the splenic vein in 54% of the cases and in the superior mesenteric vein in 46%. The left gastro-omental vein had its confluence to the splenic vein in 50% of the cases and to the inferior polar vein in 34 %. The middle colic vein had its confluence to superior mesenteric vein in 42% of the cases, to inferior mesenteric vein in 12% and to splenic vein in 8%. The posterior gastric vein was found in 54% of the corpses, and in all cases it was a tributary of the splenic vein, in retropancreatic position, coming from the esophageal-gastric junction. These findings agree with previous papers describing a prevalence of 60% of posterior gastric vein in patients submitted to surgery in portal hypertension, and in all cases, this vein was tributary of the splenic vein. The identification of this vein may influence the treatment, because if left untied during cases of portal-azigos disconnection, they may predispose to postoperative bleeding, but in cases of splenorenal anastomosis may preserve its patency in cases of anastomosis occlusion, or can lead again to postoperative bleeding feeding the esophageal varices. To ligate or not this vein will depends on the surgeon 's experience and common sense. Regarding to previous papers and to this data presented here, the authors believe that the prevalence of this vein is between 50 and 60% in the population.

  3. Estrutura, ultraestrutura e morfometria da veia cava de paca (Cuniculus paca Linnaeus, 1766 criada em cativeiro

    Sérgio Pinter Garcia Filho

    2013-05-01

    Full Text Available A paca (Cuniculus paca é o segundo maior roedor da fauna brasileira. Apresenta carne de excelente qualidade, o que incentiva a criação comercial. Além disso, este animal pode tornar-se uma opção válida em experimentação embora poucas sejam as informações detalhadas sobre sua morfologia. Assim, objetivou-se descrever a morfologia, morfometria e ultraestrutura de segmentos das porções cranial e caudal da veia cava de quatro pacas (Cuniculus paca adultas excedentes do plantel do Setor de Animais Silvestres do Departamento de Zootecnia da FCAV-Unesp. Os segmentos venosos foram analisados à microscopia de luz e à microscopia eletrônica de varredura. Foram mensuradas as espessuras do complexo formado pelas túnicas íntima e média, além da túnica adventícia e analisou-se os resultados pela estatística descritiva, teste "T" pareado (p<0,05. Em relação à espessura das túnicas estudadas, comprovou-se que os valores da espessura das túnicas íntima, média e adventícia, para todos os animais, foram significativamente maiores no segmento cranial. As camadas das paredes dos vasos apresentaram variações entre si quanto à estrutura e espessura, supostamente devido a uma adaptação à exigência funcional.

  4. Aspectos clnicos, ultra-sonogrficos e venogrficos da tromboflebite jugular experimental em equinos

    Carlos Alberto Hussni; Roberta Galvano Barbosa; Alexandre Correa Borghesan; Hamilton Almeida Rollo; Ana Liz Garcia Alves; Marcos Jun Watanabe; Vania Maria de Vasconcelos Machado; Nereide Freire Cerqueira

    2012-01-01

    A tromboflebite jugular ocorre frequentemente em equinos, decorrendo geralmente de processos mrbidos associados iatrogenia, podendo levar a perda de funo, edema ceflico, diminuio do desempenho atltico e ainda causar o bito. Esta enfermidade nos equinos apesar de frequente pouco conhecida quanto sua evoluo e tratamentos. O objetivo deste trabalho foi avaliar a evoluo da tromboflebite jugular experimental em equinos, quanto s alteraes clnicas e estruturais envolvidas na en...

  5. Gamma knife radiosurgery for glomus jugulare tumors: Therapeutic advantages of minimalism in the skull base

    Sharma Manish; Gupta A; Kale S; Agrawal D; Mahapatra A; Sharma B

    2008-01-01

    Context: Glomus jugulare (GJ) tumors are paragangliomas found in the region of the jugular foramen. Surgery with/without embolization and conventional radiotherapy has been the traditional management option. Aim: To analyze the efficacy of gamma knife radiosurgery (GKS) as a primary or an adjunctive form of therapy. Settings and Design: A retrospective analysis of patients who received GKS at a tertiary neurosurgical center was performed. Materials and Methods: Of the 1601 patients who...

  6. Jugular versus subclavian totally implantable access ports: Catheter position, complications and intrainterventional pain perception

    Purpose: To determine the safest and most tolerable method for totally implantable access ports (TIAPs) particularly in regard to patient's pain perception and catheter-related complications. Materials and methods: From January 2007 to October 2008 a subcutaneous TIAP (Bardport, Bard Access System, UT, USA) was implanted in 138 oncological patients (60 male, 78 female; 18-85 years old; mean age of 56 ± 6 years) by experienced interventional radiologists. 94 TIAP were implanted through the subclavian vein (subclavian group) and 44 TIAP were implanted through the internal jugular vein (jugular group). Intrainterventional pain perception (visual analogue scale from 1 to 10), postinterventional catheter tip migration and radiation dose were documented for each method and implantation side and differences were compared with Wilcoxon t-test. For ordinal variables, comparison of two groups was performed with the Fisher's exact test. Results: No severe periinterventional complication occurred. Inadvertent arterial punctures without serious consequences were reported in one case for the jugular group versus four cases in the subclavian group. Significantly (p < 0.05) lower pain perception, radiation dose and tip migration rate were observed in the jugular group. Catheter occlusions occurred in 4% (n = 4) of the subclavian group versus 2% (n = 1) of the jugular group. The corresponding values for vein thrombosis and catheter dislocation were 3% (n = 3) and 1% (n = 1) in the subclavian group, while none of those complications occurred in the jugular group. Conclusion: Both techniques, the TIAP implantation via fluoroscopy-guided subclavian vein puncture and via ultrasound-guided jugular vein puncture, are feasible and safe. Regarding intrainterventional pain perception, radiation dose, postinterventional catheter tip position and port function the jugular vein puncture under ultrasound guidance seems to be advantageous.

  7. Subdiaphragmatic venous stasis and tissular hypoperfusion as sources of metabolic acidosis during passive portal-jugular and caval-jugular bypasses in dogs Estase venosa subdiafragmática e hipoperfusão tissular como fontes de acidose metabólica durante desvios porta-jugular e cava-jugular passivos em cães

    Antônio Roberto de Barros Coelho; Álvaro Antônio Bandeira Ferraz; Renato Dornelas Câmara Neto; Ayrton Ponce de Souza; Edmundo Machado Ferraz

    2000-01-01

    Subdiafragmatic venous decompression during anhepatic stage of canine orthotopic liver transplantation attenuates portal and caval blood stasis and minimize hipoperfusion and metabolic acidosis observed with occlusion of portal and caval veins. During two hours, six dogs submitted to portal-jugular and caval-jugular passive shunts, with maintenance of arterial hepatic flow, were evaluated for pH, carbon dioxide tension (PCO2), base deficit (BD) and oxygen tension (PO2) in portal, caval and sy...

  8. Functional Deficits of Cranial Nerves in Patients with Jugular Foramen Lesions

    Raquet, F.; Mann, W.; Amedee, R.; Maruer, J.; Gilsbach, J

    1991-01-01

    Lower cranial neuropathies are a leading presenting symptom in patients with tumors involving the jugular foramen. The purpose of this study is to assess acute and chronic functional deficits along with neurologic findings in 31 patients who underwent resection of a tumor involving the jugular foramen. Preoperative nerve dysfunction made intraoperative preservation unlikely, while postoperative lower cranial nerve dysfunction was found to be transient in many patients. Compensation of permane...

  9. Esclerite posterior associada à oclusão da veia central da retina e edema macular cistoide: relato de caso

    Roger Wada Kamei

    2012-10-01

    Full Text Available Apresentamos um caso de esclerite posterior associada à oclusão da veia central da retina e edema macular cistoide. Com esse caso, observamos como a doença pode ser agressiva e como a acuidade visual pode ser comprometida. No entanto, o tratamento correto pode melhorar as alterações oculares com melhora visual. Alertamos também para os cuidados que devem ser tomados em relação ao uso de altas doses de corticosteroides.

  10. Dopplerfluxometria da veia hepática em pacientes com esteatose não alcoólica

    Valéria Ferreira de Almeida e Borges

    2011-02-01

    Full Text Available OBJETIVO: Avaliar a correlação entre a dopplerfluxometria da veia hepática direita e o grau de esteatose, inflamação e fibrose à biópsia na doença hepática gordurosa não alcoólica. MATERIAIS E MÉTODOS: Foi realizada ultrassonografia com Doppler em 80 pacientes, sendo 40 portadores de doença hepática gordurosa não alcoólica, também submetidos à biópsia. Quarenta controles normais saudáveis, sem fatores risco para doença hepática gordurosa não alcoólica foram submetidos a ultrassonografia com Doppler. O padrão ao Doppler da veia hepática direita foi classificado em trifásico, bifásico e monofásico. Os espécimes de biópsia foram classificados conforme o grau de esteatose, inflamação e fibrose. RESULTADOS: O fluxo foi trifásico em 38 (95% dos controles e em 9 (56,3% dos pacientes com esteatose discreta, enquanto nos com esteatose acentuada o padrão foi monofásico em 60%. Encontrou-se diferença significante na distribuição dos padrões ao Doppler (p < 0,01. Houve correlação negativa e significante entre o padrão ao Doppler da veia hepática direita e grau de esteatose (r = -0,57; p < 0,01. CONCLUSÃO: A alteração do padrão ao Doppler da veia hepática direita em pacientes com doença hepática gordurosa não alcoólica pode sugerir redução da complacência vascular consequente a infiltração gordurosa.

  11. Sonographic findings of the internal jugular vein valve in normal children

    To describe the sonographic findings of the valve in the internal jugular vein in normal children. Seventy children (5-15 years, average age 10.8 years, 36 boys and 34 girls) were recruited for the study. The number of cusps, length and insertion sites of the valve in the internal jugular vein was examined. Sex differences were investigated, in addition to the symmetry of the valves found in both of the veins. In all children, valve was found in either one or both internal jugular veins. Sixteen percents of the children had valve on one side only, while eighty four percents showed on both sides. All the one side were found on the right side only. Nine percents of the valves in the internal jugular veins of the children were bicuspid and ninety one percents were unicuspid. The length of the cusps was on the average, 7.59 ± 2.77 mm. The insertion of the cusps was on the average, 6.75 ± 2.59 mm (range: 0-12.0 mm), proximal to the confluence of the subclavian and internal jugular veins to form the brachiocephalic vein. There was no significant statistical difference of the number of cusps, length and insertion sites of the valves on both sides and sex distinction. A valve in internal jugular vein is identified in all cases on ultrasonography. There was no significant statistical difference of the number of cusps, length and insertion sites of the valves on both sides and sex distinction.

  12. Corynebacterium pseudotuberculosis associated with otitis media-interna in goats

    Rhoda Leask; David J.C. Blignaut; Maria J. Grobler

    2013-01-01

    Corynebacterium pseudotuberculosis or caseous lymphadenitis is a common condition in sheep and goats. Two cases are described involving otitis media-interna and, in one case, cerebellar abscessation. The first case began with otitis externa and progressed to cerebellar abscessation, presumably as a result of C. pseudotuberculosis infection based on the macroscopic appearance of the abscess. The second case of otitis media-interna involved C. pseudotuberculosis with parasitic encephalitis or s...

  13. Morbilidad y mortalidad geritricas en medicina interna

    Reynaldo Reyes Torns

    1996-08-01

    Full Text Available Se realiz un estudio descriptivo, lomgitudinal y retrospectivo para determinar las principales causas de morbilidad y mortalidad geritricas en el Servicio de Medicina Interna del Hospital "Carlos Manuel de Cspedes". Se estudiaron 1 393 pacientes que ingresaron en el perodo comprendido entre el primero de enero y el 31 de diciembre de 1991. La principal causa de morbilidad y de mortalidad en mayores de 65 aos fue la bronconeumona bacteriana con 24,12 y 31 % respectivamente, le siguieron en frecuencia las enfermedades cerebrovasculares y las del corazn. Las principales complicaciones fueron la flebitis y la bronconeumona hiposttica, las cuales predominaron en los fallecidos con el 52,74 %. Se realizaron 289 necropsias (74,68 %. Este ndice se consider bajo aunque existi alta correlacin clnico-patolgico (91,01 %.A descriptive, longitudinal, and retrospective study was conducted to determine the main causes of geriatric mortality and morbidity in the service of Internal Medicine from "Carlos Manuel de Cspedes" Hospital. The study comprised a group of 1 393 patients who were admitted during the period of January, 1st and December, 31, 1991. The main cause of morbidity and mortality in subjects over 65 years was found to be bacterial bronchopneumonia accounting for 24, 12, and 31 %, respectively, followed regarding frequency by cerebrovascular and heart diseases. Major complications appeared to be phlebitis and hypostatic bronchopneumonia accounting for 52.74 % of deaths. A number of 289 autopsies (74.68 % were performed. This index was considered low although there was a high clinicopathological correlation (91.01 %.

  14. Tratamento cirúrgico de um aneurisma primário de veia ilíaca externa

    Márcio Luís Lucas

    2015-09-01

    Full Text Available ResumoAneurismas primários da veia ilíaca são extremamente raros e podem complicar com trombose, embolia pulmonar ou ruptura. Acredita-se que existam apenas 14 casos descritos na literatura. Neste artigo, descrevemos um caso de um jovem de 25 anos, que apresentava edema e cianose do membro inferior esquerdo. A ecografia vascular revelou uma massa cística em fossa ilíaca esquerda. A angiotomografia confirmou o diagnóstico de um aneurisma da veia ilíaca externa esquerda de 3,8 cm, no maior diâmetro. O paciente foi submetido ao tratamento cirúrgico através da ressecção do aneurisma seguida de venorrafia longitudinal. Teve boa evolução pós-operatória, com um seguimento clínico de 44 meses. Houve uma melhora do edema no membro inferior esquerdo, sem complicações tardias.

  15. Agenesia de veia cava inferior associada à trombose venosa profunda Agenesis of inferior vena cava associated with deep venous thrombosis

    Clovis Luis Konopka

    2010-09-01

    Full Text Available A agenesia da veia cava inferior é uma anomalia congênita rara, que foi recentemente identificada como um importante fator de risco para o desenvolvimento e a recorrência de trombose venosa profunda de membros inferiores em jovens. O objetivo deste trabalho foi relatar o caso de uma paciente que apresentou trombose venosa profunda dois meses após a realização de cirurgia de varizes. A angiotomografia computadorizada demonstrou a presença de anomalia venosa complexa com ausência da veia cava inferior.The agenesis of the inferior vena cava is a rare congenital anomaly, which was recently identified as an important risk factor for the development and recurrence of deep venous thrombosis especially in young people. The goal of this work was to report the case of a patient who presented deep venous thrombosis approximately two months after varicose vein surgery. The computerized angiotomography demonstrated the presence of a complex venous anomaly with absence of the inferior vena cava.

  16. Endovascular correction of a traumatic internal iliac arteriovenous fistula with a covered stent / Correo endovascular de fstula arteriovenosa traumtica em ilaca interna com stent revestido

    Edson Pedroza dos, Santos Junior; Rodolfo Rgers Amrico, Batista; Fernanda Medina, Felici; Vinicius Evaristo, Correia; Maykon Brescancin, Oliveira; Remy Faria, Alves.

    2014-03-01

    Full Text Available As fstulas arteriovenosas (FAVs) so comunicaes anmalas entre uma artria e uma veia, sem envolvimento capilar. Segundo sua etiologia, podem ser divididas em congnitas e adquiridas, resultantes de traumas fechados ou penetrantes, e de leses iatrognicas. Relatamos o caso de mulher jovem, vtim [...] a de ferimento por arma de fogo, submetida laparotomia de urgncia, que evoluiu no ps-operatrio tardio com edema assimtrico de membros inferiores. Os exames de imagem demonstraram a presena de fstula arteriovenosa ilaca interna esquerda, tratada atravs de cirurgia endovascular com stent revestido, determinando a total ocluso da comunicao arterial e venosa. Abstract in english Arteriovenous fistulae (AVFs) are anomalous communications between an artery and a vein, bypassing the capillary network. They can be subdivided on the basis of etiology into congenital and acquired fistulae. The latter may be caused by closed or penetrating traumas, or may be iatrogenic injuries. W [...] e report on a case of a young adult female gunshot wound victim treated with emergency laparotomy who developed asymmetrical edema of the lower limbs during the late postoperative period. Imaging exams showed the presence of a left internal iliac AVF, treated using endovascular surgery with placement of a covered stent, resulting in total occlusion of arteriovenous communication.

  17. A rare case of anastomosis between the external and internal jugular veins

    Karapantzos, Ilias; Zarogoulidis, Paul; Charalampidis, Charalampos; Karapantzou, Chrysanthi; Kioumis, Ioannis; Tsakiridis, Kosmas; Mpakas, Andrew; Sachpekidis, Nikolaos; Organtzis, John; Porpodis, Konstantinos; Zarogoulidis, Konstantinos; Pitsiou, Georgia; Zissimopoulos, Athanasios; Kosmidis, Christoforos; Fouka, Evagelia; Demetriou, Theodoros

    2016-01-01

    Jugular veins bring deoxygenated blood from the head back to the heart. There are two sets of external and internal veins. The external jugular vein receives the greater part of the blood from the cranium and the deep parts of the face. It commences from the substance of the parotid gland and runs down the neck at the posterior border of sternocleidomastoideus and ends in the subclavian vein in front of the scalenus anterior. The external jugular vein is covered by the platysma and its upper half runs parallel with the great auricular nerve. There is also another minor jugular vein, the anterior, draining the submaxillary region. In our patient, we recognized a shunt between the external and internal jugular veins. It appeared in the middle of the veins, between the pair of valves, which are placed ~2.5 cm above the termination of the vessel. The anastomosis was fully functional, and there was no problem in the blood pressure of the patient. Moreover, the shunt was not associated with any systemic disease. PMID:27051321

  18. Topographic relations of the high jugular fossa to the inner ear. A radioanatomic investigation

    Wadin, K.; Wilbrand, H.

    The radioanatomy of high jugular fossae and their topographic relations to the inner ear structures were investigated in 245 unselected temporal bones. One hundred and fifty specimens were submitted to multidirectional and 10 to computed tomography. After careful chemical and fermentative maceration plastic casts were made, using polyester resin and silicone rubber. With the use of vacuum, even minute structures became filled with the casting material. The specimens offered a three-dimensional view of the jugular fossae and surrounding structures. Fifty-eight (24%) of the total 245 specimens had high jugular fossae at a level above the lower border of the round window. Five casts showed a dehiscence of the peripheral portion of the vestibular aqueduct caused by the high jugular fossa. In 2 casts the proximal portion of the cochlear aqueduct was affected. In some casts the posterior semicircular canal, the facial canal, the stapedial muscle and the round window lay so close to the fossa that a dehiscence could not be excluded. In a clinical material of 102 high fossae the radiographic findings were in accordance with the experimental results. High jugular fossae were predominantly found in pyramids with low-grade mastoid bone pneumatization and sparse or no perilabyrinthine air cells.

  19. Marcapasso bi-atrial epicárdico subxifóide na obstrução da veia cava superior Bi-atrial subxiphoid epicardial pacemaker in superior vena cava syndrome

    Roberto Costa; Maria Inês de Paula Leão; Kátia Regina da Silva; Paulo Roberto Camargo; Regina Valéria Costa

    2006-01-01

    Um paciente portador de marcapasso definitivo bi-atrial-ventricular por fibrilação atrial paroxística e bradicardia sinusal, em uso crônico de anticoagulante oral, apresentou sinais clínicos da síndrome da veia cava superior. A venografia por subtração digital mostrou obstrução total do tronco braquiocefálico venoso direito e grande dificuldade de fluxo sangüíneo da veia inominada para a veia cava superior. A abordagem terapêutica constou da remoção completa do sistema transvenoso seguida de ...

  20. No increase of calcitonin gene-related peptide in jugular blood during migraine

    Tvedskov, Jesper; Lipka, Kerstin; Ashina, Messoud; Iversen, Helle K; Schifter, Sren; Olesen, Jes

    2005-01-01

    Increased calcitonin gene-related peptide (CGRP) in external jugular venous blood during migraine attack is one of the most cited findings in the headache literature. The finding has not been convincingly reproduced and is based on comparison with historic control subjects. The validity of this f...... as a biomarker to validate human or animal models of migraine.......Increased calcitonin gene-related peptide (CGRP) in external jugular venous blood during migraine attack is one of the most cited findings in the headache literature. The finding has not been convincingly reproduced and is based on comparison with historic control subjects. The validity of this...... finding is important for the understanding of migraine. We therefore investigated the issue using an intrapatient comparison design and two different CGRP assays. We sampled blood from the external jugular and cubital vein during, as well as outside of, an attack of migraine without aura. We succeeded in...

  1. Non-contact wide-field hemodynamic imaging reveals the inverted jugular venous pulse waveform

    Amelard, Robert; Greaves, Danielle K; Pfisterer, Kaylen J; Leung, Jason; Clausi, David A; Wong, Alexander

    2016-01-01

    Cardiovascular disease is the leading cause of death globally. Cardiovascular monitoring is important to prevent diseases from progressing. The jugular venous pressure waveform (JVP) is able to provide important information about cardiac health. Factors such as mechanical deformations, electric abnormalities, and irregular external forces change the fundamental shape of the JVP. However, current methods for measuring the JVP require invasive catheter insertion, or subjective qualitative visual inspection of the patient's jugular pulse. Thus, JVP are not routinely performed, and are scheduled only when there is probable cause for catheterisation. Non-invasive monitoring methods would benefit JVP monitoring. Recently, there has been a surge in focus on photoplethysmographic imaging (PPGI) systems. These systems are non-contact wide-field imaging systems able to assess blood pulse waveforms across a large area of the body. However, PPGI has not been previously explored for measuring jugular venous pulse. In this...

  2. Aspectos teóricos sobre ondas internas

    Chiriguaya, J.

    1989-01-01

    Las ondas internas son movimientos ondulatorios en fluidos de estratificación estable, en los cuales la máxima amplitud del movimiento vertical tiene lugar en la zona por debajo de la interfase, la cual se encuentra entre las superficies del fluido. La principal fuerza de recuperación es la gravedad. Se cree que las ondas internas se generan en el mar por variaciones de la presión atmosférica y por influencia de ondas superficiales de baja frecuencia en aguas de profundidad variable. Las onda...

  3. A rare case of anastomosis between the external and internal jugular veins

    Karapantzos I

    2016-03-01

    Full Text Available Ilias Karapantzos,1 Paul Zarogoulidis,2 Charalampos Charalampidis,3 Chrysanthi Karapantzou,1 Ioannis Kioumis,2 Kosmas Tsakiridis,4 Andrew Mpakas,4 Nikolaos Sachpekidis,4 John Organtzis,2 Konstantinos Porpodis,2 Konstantinos Zarogoulidis,2 Georgia Pitsiou,2 Athanasios Zissimopoulos,5 Christoforos Kosmidis,6 Evagelia Fouka,2 Theodoros Demetriou31Ear, Nose and Throat Department, “Saint Luke” Private Hospital, Panorama, 2Pulmonary Department, “G. Papanikolaou” General Hospital, Aristotle University of Thessaloniki, Thessaloniki, 3Department of Anatomy, Democritus University of Thrace, Alexandroupolis, 4Cardiothoracic Surgery Department, “Saint Luke” Private Hospital, Panorama, Thessaloniki, 5Nuclear Medicine Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, 6Surgery Department, “Interbalkan” European Medical Center, Thessaloniki, GreeceAbstract: Jugular veins bring deoxygenated blood from the head back to the heart. There are two sets of external and internal veins. The external jugular vein receives the greater part of the blood from the cranium and the deep parts of the face. It commences from the substance of the parotid gland and runs down the neck at the posterior border of sternocleidomastoideus and ends in the subclavian vein in front of the scalenus anterior. The external jugular vein is covered by the platysma and its upper half runs parallel with the great auricular nerve. There is also another minor jugular vein, the anterior, draining the submaxillary region. In our patient, we recognized a shunt between the external and internal jugular veins. It appeared in the middle of the veins, between the pair of valves, which are placed ~2.5 cm above the termination of the vessel. The anastomosis was fully functional, and there was no problem in the blood pressure of the patient. Moreover, the shunt was not associated with any systemic disease.Keywords: jugular veins, anastomosis, parotid gland

  4. Transcatheter closure of patent foramen ovale using the internal jugular venous approach.

    W?glarz, Przemys?aw; Konarska-Kuszewska, Ewa; Z?bik, Tadeusz; Kuszewski, Piotr; Drzewiecka-Gerber, Agnieszka; Motyka, Marek; Ludyga, Tomasz; Bajor, Grzegorz

    2014-01-01

    Transcatheter closure of patent foramen ovale is routinely performed using the transfemoral approach, which is safe and technically easy. Our case represents the rare situation where the procedure needs to be performed using the right internal jugular venous approach. According to our best knowledge this is the first report of a patent foramen ovale closure procedure with access through the internal jugular with necessity to advance the guide wire and transseptal sheath into the left ventricle. Developing alternative techniques of transcatheter patent foramen ovale closure seems to be especially important in rare cases where transfemoral access is unavailable. PMID:25061460

  5. Artria radial versus veia safena para revascularizao do miocrdio: metanlise (no houve diferena estatisticamente significante Radial artery versus saphenous vein to myocardial revascularization: meta-analysis (there is no statistically significant difference

    Rafael Fagionato Locali

    2006-09-01

    Full Text Available OBJETIVO: Comparar a efetividade do enxerto de artria radial com o enxerto de veia safena para revascularizao do miocrdio, em associao com a artria torcica interna. MTODO: Realizou-se uma reviso sistemtica da literatura, utilizando uma estratgia de busca de artigos aplicada s bases de dados da MEDLINE e LILACS. Dois pesquisadores independentes realizaram a seleo dos artigos identificados, avaliando criteriosamente a metodologia dos artigos considerados relevantes para o tema. Somente os ensaios clnicos controlados e randomizados com adequado sistema de aleatorizao foram includos. Em todas as situaes em que ocorreu discordncia entre os pesquisadores, foi realizada uma reunio de consenso. No foi estipulada restrio quanto ao perodo ps-operatrio para avaliao angiogrfica do enxerto, o vaso tratado cirurgicamente e as caractersticas dos pacientes includos. Os resultados so expressos como Risco Relativo (RR, com 95% de Intervalo de Confiana (CI, da comparao da efetividade entre a artria radial e a veia safena. RESULTADOS: Com base nesses critrios foram includos trs estudos. No foi detectada diferena estatstica entre a perviabilidade dos enxertos estudados (RR 0,53 [95% IC 0,13 - 2,18]. CONCLUSO: Apesar dos estudos serem de boa qualidade metodolgica, no houve resultado estatisticamente significativo beneficiando um dos enxertos. O poder estatstico da metanlise baixo. Portanto, so necessrios novos ensaios clnicos controlados e randomizados, com tamanho de amostra adequado para detectar possveis diferenas entre os tratamentos propostos.OBJECTIVE: To compare the effectiveness of radial artery graft with saphenous vein graft to myocardial revascularization, in association with the internal thoracic artery. METHODS: We made a systematic review of literature, using a strategy to search articles applied to MEDLINE and LILACS databases. Two independent researchers have carried through the election of identified articles, evaluating carefully the methodology of articles considered excellent for the subject. Only the randomized controlled trials, with adjusted randomization system have been enclosed. All the situations where the researchers didn't agree there was a consensus meeting. It hasn't been stipulated restriction for postoperative period to graft angiographic evaluation, the vessel treated and enclosed patient's characteristics. The results have been expressed as Risk Relative (RR, with 95% of Confidence Interval (CI, to comparison the effectiveness between the radial artery and the saphenous vein. RESULTS: Based in these criteria three studies have been enclosed. We couldn't find statistic difference between grafts' patency studied (RR 0.53 [95% IC 0.13 - 2.18]. CONCLUSION: Despite of the studies have good methodological quality, we have not observed a result significant statistically benefiting one of the grafts. The statistical power of the meta-analysis is low, therefore, it's necessary more randomized controlled trials, with adjusted sample size to detect possible differences between the considered treatments.

  6. Crouzon’s Syndrome with Life-Threatening Ear Bleed: Ruptured Jugular Vein Diverticulum Treated by Endovascular Embolization

    Crouzon’s syndrome is the commonest variety of syndromic craniosynostosis. Life-threatening ear bleed due to ruptured jugular venous diverticulum in Crouzon’s syndrome has not been described previously. In patients with syndromic craniosynostosis, definitive repair of jugular diverticulum by open surgery is fraught with high risk of bleeding, poor functional outcomes, and even death. A 24-year-old woman with Crouzon’s syndrome presented with conductive hearing loss and recurrent episodes of torrential bleeding from her left ear. On computed tomography, a defect in the roof of jugular fossa containing jugular venous diverticulum immediately inferior to the bony external auditory canal was seen. The clinical presentation, imaging features, and endovascular management of Crouzon’s syndrome due to a ruptured jugular venous diverticulum is described

  7. Crouzon’s Syndrome with Life-Threatening Ear Bleed: Ruptured Jugular Vein Diverticulum Treated by Endovascular Embolization

    Mondel, Prabath Kumar, E-mail: prabathmondel@gmail.com; Anand, Sunanda, E-mail: sunandaanand@gmail.com; Limaye, Uday S., E-mail: uslkem@gmail.com [Lilavati Hospital and Research Centre, Department of Interventional Neuroradiology (India)

    2015-08-15

    Crouzon’s syndrome is the commonest variety of syndromic craniosynostosis. Life-threatening ear bleed due to ruptured jugular venous diverticulum in Crouzon’s syndrome has not been described previously. In patients with syndromic craniosynostosis, definitive repair of jugular diverticulum by open surgery is fraught with high risk of bleeding, poor functional outcomes, and even death. A 24-year-old woman with Crouzon’s syndrome presented with conductive hearing loss and recurrent episodes of torrential bleeding from her left ear. On computed tomography, a defect in the roof of jugular fossa containing jugular venous diverticulum immediately inferior to the bony external auditory canal was seen. The clinical presentation, imaging features, and endovascular management of Crouzon’s syndrome due to a ruptured jugular venous diverticulum is described.

  8. Imaging analysis of hemangiopericytoma in the region of jugular foramen (report of one case and literature review)

    Objective: To investigate imaging diagnosisand differential diagnosis of hemangiopericytoma in the region of jugular foramen. Methods: 1 case of hemangiopericytoma in the region of jugular foramen proved by surgery and pathology was examined by 64 slices multiple rows sprial CT and 1.5T MRI pre-operation, the imaging features were analyzed retrospectively. Results: The hemangiopericytoma in the region of jugular foramen was misdiagnosised by both CT and MRI pre-operation. The tumor was oval in shape, with distinct boundary. Homogeneous and obvious enhancement was seen after giving contrast. Adjacent vessel were pushed by the tumor and deformed Jugular foramen enlarged because of destruction of bone. Conclusion: There isn't specific CT and MRI finding for hemangiopericytoma in the region of jugular foramen. However, imaging examination can clearly display the tumor and adjacent structures, so as to provide accurate anatomy information for surgery. (authors)

  9. A comparative review of multidetector CT angiography and MRI in the diagnosis of jugular foramen lesions

    Christie, A., E-mail: andychristie90@hotmail.co [Radiology Department, Institute of Neurosciences, Glasgow, Scotland (United Kingdom); Teasdale, E. [Radiology Department, Institute of Neurosciences, Glasgow, Scotland (United Kingdom)

    2010-03-15

    Aim: To compare the efficiency of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) in the diagnosis of jugular foramen lesions. Materials and methods: The imaging of 15 patients with tumours predominantly occurring at the jugular foramen was retrospectively reviewed, with postoperative pathology data available for 11 patients. MDCT was performed at arterial phase and MRI with standard sequences and contrast enhancement. All imaging was blindly re-reported by an experienced neuroradiologist. Results: Pathology reported six glomus jugulare tumours and five neuromas, which were all correctly diagnosed using MDCT. A confident diagnosis was also made in the remaining four cases based on the pattern of enhancement. Only glomus tumours enhanced in the arterial phase. Overall, MRI was used to make a confident diagnosis in eight patients. One showed no enhancement and was correctly diagnosed as a neuroma, and seven demonstrated the tumour flow voids characteristic of a glomus tumour. The remaining seven cases all showed a similar enhancement pattern and could not be confidently differentiated between a neuroma or a glomus tumour. MDCT angiography enabled a confident assessment of the jugular vein in all cases, but MRI was inconclusive in a third of cases. Also, in the nine cases of glomus tumour diagnosed using MDCT, an enlarged feeding artery was identified in eight patients. Conclusion: MDCT is more accurate than MRI in diagnosing glomus tumours, and in particular, neuromas. It also offers valuable preoperative vascular information to the surgeon.

  10. Retrograde cannulation of the jugular vein: erroneous positioning of the catheter in the subarachnoid space.

    Fumagalli, P; Lusenti, F; Martini, C; Massei, R

    1995-03-01

    This report describes one complication related to retrograde positioning of a catheter in the jugular vein in a patient in a coma resulting from subarachnoid haemorrhage. The catheter was found in the cervical subarachnoid space, as confirmed by radiography with contrast medium. Attention is focused on the fact that this technique, usually performed easily and safely, may occasionally present potentially severe complications. PMID:7718388

  11. Jugular venous pooling during lowering of the head affects blood pressure of the anesthetized giraffe

    Brøndum, E.; Hasenkam, John Michael; Secher, Niels H.; Bertelsen, Mads Frost; Grøndahl, C.; Petersen, K.K.; Buhl, Rikke; Aalkjaer, C.; Baandrup, U.; Nygaard, H.; Smerup, Morten Holdgaard; Stegmann, F.; Sloth, E.; Østergaard, K.H.; Nissen, P.; Runge, M.; Pitsillides, K.; Wang, T.

    2009-01-01

    How blood flow and pressure to the giraffe's brain are regulated when drinking remains debated. We measured simultaneous blood flow, pressure, and cross-sectional area in the carotid artery and jugular vein of five anesthetized and spontaneously breathing giraffes. The giraffes were suspended in...... the upright position so that we could lower the head. In the upright position, mean arterial pressure (MAP) was 193 +/- 11 mmHg (mean +/- SE), carotid flow was 0.7 +/- 0.2 l/min, and carotid cross-sectional area was 0.85 +/- 0.04 cm(2). Central venous pressure (CVP) was 4 +/- 2 mmHg, jugular flow was...... 0.7 +/- 0.2 l/min, and jugular cross-sectional area was 0.14 +/- 0.04 cm(2) (n = 4). Carotid arterial and jugular venous pressures at head level were 118 +/- 9 and -7 +/- 4 mmHg, respectively. When the head was lowered, MAP decreased to 131 +/- 13 mmHg, while carotid cross-sectional area and flow...

  12. On the consistency of flow rate color Doppler assessment for the internal jugular vein

    Francesco Sisini

    2014-01-01

    Full Text Available Color Doppler methodology to assess the vessel blood flow rate is based on the time averaged velocity of the blood measured in the longitudinal plane and the cross sectional area measurement taken either in the longitudinal plane, by assuming circular cross sectional area, or in the transversal plane. The measurement option in longitudinal plane is based on the assumption of circular cross sectional area, while the transversal one needs to evaluate both time-averaged velocity and cross sectional area in the same vessel point. A precise and validated assessment methodology is still lacking. Four healthy volunteers underwent internal jugular vein colour Doppler scanning. The cross sectional area was assessed by means of B-mode imaging in the transversal plane all along the vessel cervical course. During this assessment, cross sectional area, major and minor axis of the vessel were measured and recorded. The distance between the internal jugular vein wall and the skin surface were measured together with the intra-luminal diameter and statistically correlated with the cross sectional area data. The internal jugular vein cross sectional area measured on the transversal plane were significantly different from the cross sectional area calculated using the assumption of circular shape. The intra-luminal distance showed high correlation with the measured cross sectional area. The proper anatomical point in the cross sectional area transversal measurement can be identified by using the internal jugular vein intra-luminal distance as landmark.

  13. The Prevalence of High-Riding Jugular Bulb in Patients with Suspected Endolymphatic Hydrops.

    Brook, Christopher D; Buch, Karen; Kaufmann, Matthew; Sakai, Osamu; Devaiah, Anand K

    2015-12-01

    Background To determine the prevalence of a high-riding jugular bulb (HRJB) in the endolymphatic hydrops population. Methods This was a retrospective chart and radiology review of patients seen at a tertiary care medical center. Patients were identified using the International Classification of Diseases, 9th edition, code 386.xx (Meniere disease-unspecified), and were required to have undergone an imaging study that included views of the jugular bulb that were available for review. A radiologist then evaluated all of the imaging studies for evidence of HRJB or inner ear dehiscence with a jugular bulb abnormality. Results The prevalence of a HRJB in all endolymphatic hydrops patients was 9.0% (7 of 78), and it was 4.5% (7 of 156) in all ears. The prevalence of HRJB ipsilateral to an ear with endolymphatic hydrops was 4.6% (4 of 88 ears); it was 4.4% (3 of 68 ears) in ears without endolymphatic hydrops. The incidence of inner ear dehiscence with a HRJB was 1.3% (1 of 78). Electrocochleography results were not correlated with jugular bulb volume. Discussion The results of this study indicate that a small subset of patients treated for endolymphatic hydrops patients have a HRJB. Overall, these results suggest that HRJB does not play a major role in endolymphatic hydrops, although it may play a role in a few isolated patients. PMID:26682126

  14. MONITORIZACIÓN DE LA OXIMETRÍA DEL BULBO DE LA YUGULAR Oximetry monitoring of the jugular vein bulb

    Oscar Illodo Hernández

    2007-09-01

    Full Text Available La monitorización de sangre de la yugular interna para determinar la oxigenación cerebral ha recobrado interés, pues permite una estimación global del balance entre aporte y demanda de oxígeno del cerebro. La medida directa de la presión arterial se considera como una necesidad. Sin embargo, no siempre es posible lograr un acceso arterial o incluso monitorizar la presión arterial no invasiva. La importancia clínico fisiológica y las técnicas descritas en este trabajo, así como las experiencias nacionales e internacionales al respecto, nos permiten conocer que la mayor utilidad de la monitorización de la SvyO2 es la detección de isquemia cerebral y la implementación de un tratamiento adecuado y temprano. La introducción de la oximetría del bulbo yugular permite la estimación del balance entre el aporte y la demanda de O2 del cerebro. Esta monitorización en tiempo real posibilita la mejoría del entorno fisiológico del cerebro y puede mejorar el resultado final del paciente; sin embargo, deben considerarse sus limitaciones.Monitoring internal jugular vein blood to determine cerebral oxygenation has regained interest because it allows a global assessment of the balance between demand and supply resources of oxygen in the brain. The direct measurement of arterial pressure is considered as a necessity. However it's not always possible to neither achieve an arterial access nor even monitor the arterial pressure with a non invasive technique. The clinical and physiological importance of the techniques described in this review, as well as the national and international experiences in the topic, allow us to know that the main utility of the SvyO 2 is the detection of cerebral ischemia and the implementation of an adequate and early treatment. This monitoring in real time makes possible the brain's fisological environment and it can also improve the final clinical results however, its limitations must be known and assessed.

  15. Morphological description of great cardiac vein in pigs compared to human hearts / Descrio morfolgica da grande veia cardaca em sunos em comparao com coraes humanos

    Fabian, Alejandro Gmez; Luis Ernesto, Ballesteros; Luz, Stella Corts.

    2015-02-01

    Full Text Available Introduo: Apesar de sua importncia como um modelo experimental, a informao sobre a grande veia cardaca em sunos esparsa. Objetivo: Determinar as caractersticas morfolgicas da grande veia cardaca e suas tributrias em sunos. Mtodos: Foram estudados 120 coraes extrados de sunos dest [...] inados para o matadouro com mtodo de atordoamento. Este estudo descritivo cross-over avaliou variveis contnuas com teste T e variveis discretas com teste ? quadrado de Pearson. O nvel de significncia P Abstract in english Introduction: In spite of its importance as an experimental model, the information on the great cardiac vein in pigs is sparse. Objective: To determine the morphologic characteristics of the great cardiac vein and its tributaries in pigs. Methods: 120 hearts extracted from pigs destined to the slau [...] ghterhouse with stunning method were studied. This descriptive cross-over study evaluated continuous variables with T test and discrete variables with Pearson ? square test. A level of significance P

  16. Emergency autologous vein graft reconstruction after using a vascular closure device Reconstruo de emergncia de enxerto autlogo de veia aps uso de dispositivo de fechamento vascular

    Giel G Koning

    2011-06-01

    Full Text Available An emergency operation for access related acute critical limb ischemia with signs of infection is described. Inguinal femoral reconstruction was performed with a bifurcated graft constructed from the ipsilateral saphenous vein.Uma operao de emergncia relacionada isquemia aguda com sinais de infeco descrita. Reconstruo femoral inguinal foi realizada com um enxerto bifurcado feito a partir da veia safena ipsilateral.

  17. Comparação da perviedade entre artéria radial e veia safena em pacientes em pós-operatório de cirurgia de revascularização miocárdica com retorno dos sintomas Comparison of patency between radial artery and saphenous vein in a coronary artery bypass grafting post operative with return of the symptoms

    Herbert Coelho Hortmann

    2010-06-01

    Full Text Available OBJETIVO: Comparar a perviedade da artéria radial e veia safena em pacientes com retorno dos sintomas após cirurgia de revascularização do miocárdio (CRVM. MÉTODOS: Estudo retrospectivo. No período de janeiro de 1998 a dezembro de 2005, foram realizadas 469 CRVMs com o uso da artéria radial dentre os enxertos, no Hospital Vera Cruz, em Belo Horizonte/MG. Destes, 94 pacientes apresentaram alterações isquêmicas no pós-operatório recente ou tardio e foram reestudados com cineangiocoronariografia. Os enxertos foram divididos em três grupos: artéria torácica interna (ATI, artéria radial (AR e veia safena (VS, e foram estratificados segundo a gravidade das lesões: sem lesão grave (OBJECTIVE: To compare the radial artery and saphenous vein's patency in patients with recurrence of symptoms in a coronary artery bypass grafting (CABG. METHODS: Retrospective study. From January 1998 to December 2005, 469 CABGs were performed using the radial artery as a graft, in Vera Cruz Hospital in Belo Horizonte/ MG. Among the patients who underwent those surgeries, 94 presented ischemic changes in early or late postoperative period, which led them to be re-evaluated by coronary angiography. The grafts were divided in three groups: internal thoracic artery (ITA, radial artery (RA and saphenous vein (SV, and they were stratified according to the severity of injury: uninjured or patent (< 70%, severe obstruction (70 to 99% and occlusion. RESULTS: For the 94 patients in the study, 86 grafts of ITA, 94 of RA and 111 of SV were used. For the 86 ITA grafts, 73 (84.88% were found patent. For the 94 RA grafts, 55 (58.51% were found patent, and for the 111 SV grafts, 73 (65.76% were uninjured. A statistically significant difference (P= 0.001 was found between RA and SV grafts, with a higher patency found for VS graft. For the RA grafts, women presented a worse result concerning the RA patency (65.7% and 40.7%, with P = 0.006. Concerning coronary revascularization, a statistically significant difference was found only for the grafts used for the right coronary, with a better result for the SV (P = 0.036. CONCLUSION: Radial artery (RA presented worse results when compared to Saphenous vein (SV as a second graft in a CABG, especially in women who were anastomosed in the right coronary artery.

  18. Primera aproximacin a la estructura interna de Plutn

    Steren, G. A.; Carranza, G. J.; Hubbard, W. B.

    En el presente trabajo se propuso estudiar la estructura interna actual del planeta Plutn. El modelo que se plante es del tipo de estructura no-diferenciada. Se incluy como fuente de calor interna la radioactividad y como nico mecanismo de transporte de la energa a la conduccin. Se encontr que el planeta estara compuesto por una mezcla de roca (65% en masa) y hielo de agua (35%). Este simple modelo permite inferir que una estructura ms realista para Plutn debera incluir tambin a la conveccin como mecanismo de transporte. Ello adems permitira avanzar de modo ms firme en el estado de diferenciacin del planeta, que casi seguramente sea ms complejo que el adoptado.

  19. Consistencia interna y estructura interna del cuestionario AUDIT en amerindios / Internal consistency and dimensionality of the AUDIT among Amerindians / Consistncia interna e estrutura interna do questionrio AUDIT em amerndios

    Alix Lorena, Medina; Nadia Milena, Arvalo; Sandra Dolores, Beltrn; Yuri Lizeth, Chavarro; Edwin, Herazo; Adalberto, Campo-Arias.

    2014-04-01

    Full Text Available Objetivo: determinar a consistncia interna e a dimensionalidade do AUDIT numa mostra de amerndios que moram em Bogot, Colmbia. Mtodo: um estudo metodolgico foi desenhado. Participaram 184 amerndios, 99 homens e 85 mulheres. A idade mdia foi 32,0 anos (DP=14,0) e a escolaridade mdia, 6,1 ano [...] s (DP=3,7). Se estimaram as correlaes corrigidas de cada tem com o escore total, a consistncia interna (alfa de Cronbach e mega de McDonald) e a dimensionalidade (estrutura interna). Resultados: as correlaes corrigidas entre os itens e o escore total foram encontradas entre 0,368 y 0,788. O AUDIT mostrou um alfa de Cronbach de 0,879; mega de McDonald de 0,886; e um fator que explicou o 50,6% da varincia. Concluses: o AUDIT mostra excelente consistncia interna e uma estrutura unidimensional em amerndios que moram em Bogot, Colmbia. Abstract in spanish Objetivo: determinar la consistencia interna y la dimensionalidad del AUDIT en una muestra de amerindios residentes en Bogot, Colombia. Metodologa: se dise un estudio metodolgico. Participaron 184 amerindios, 99 hombres y 85 mujeres. La media para la edad fue 32,0 aos (DE=14,0) y para la escol [...] aridad, 6,1 aos (DE=3,7). Se estimaron las correlaciones corregidas de cada tem con la puntuacin total, la consistencia interna (alfa de Cronbach y omega de McDonald) y la dimensionalidad (estructura interna). Resultados: las correlaciones corregidas entre los tems y la puntuacin total se encontraron entre 0,368 y 0,788. El AUDIT mostr alfa de Cronbach de 0,879; omega de McDonald de 0,886; y un factor que explic el 50,6% de la varianza. Conclusiones: el AUDIT muestra excelente consistencia interna y una estructura unidimensional en amerindios residentes en Bogot, Colombia. Abstract in english Objective: to establish the internal consistency and dimensionality of the AUDIT among Colombian native Amerindians dwelling in Bogot, Colombia. Method: a validation study was carried out. A total of 184 Amerindians, 99 men and 85 women. The mean of age was 32.0 years (SD=14.0), and mean of formal [...] scholarship, 6.1 years (SD=3.7). The correlations between items and total score, internal consistency (Cronbach alpha and McDonald omega), and dimensionality (factor structure) were computed. Results: the correlations between items and total score were between 0.368 and 0.788. The AUDIT showed Cronbach alpha of 0.879, McDonald omega of 0.886, and one-dimensional structure that accounted for 50.6% of the total variance. Conclusions: the AUDIT shows excellent internal consistency and one-dimension structure among Amerindians dwelling in Bogota, Colombia.

  20. Válvulas da veia braquial comum: estudo anatômico Valves of the common brachial vein: anatomical study

    Carlos Adriano Silva dos Santos

    2007-03-01

    Full Text Available CONTEXTO: Boa parte das insuficiências venosas é devida à incompetência de suas válvulas. Como uma das alternativas cirúrgicas, temos os enxertos venosos valvulados no segmento insuficiente. OBJETIVO: Descrever a anatomia das válvulas da veia braquial comum. MÉTODOS: Foram selecionados 30 cadáveres do sexo masculino, independentemente de raça, que tinham seus membros superiores articulados ao tronco. Os mesmos estavam formolizados e foram mantidos em conservação com solução de formol a 10%. Utilizamos como critério de exclusão a existência de desarticulação de um dos membros ou de alterações deformantes em topografia das estruturas estudadas. RESULTADOS: O número total de válvulas identificadas foi de 28 em membro superior direito e de 33 em membro superior esquerdo, sendo 15 no segmento proximal direito e 21 no segmento proximal esquerdo. Mais de 91% das válvulas foram do tipo bicúspide e parietal. CONCLUSÃO: Conclui-se que a veia braquial comum apresenta freqüentemente válvulas do tipo bicúspide e parietal.BACKGROUND: A great part of venous insufficiencies is due to valve incompetence. Valved venous grafts in the insufficient segment are a surgical alternative. OBJECTIVE: To describe the anatomy of the common brachial vein valves. METHODS: We used 30 male corpses of varied races with their upper limbs articulated to the trunk. They were preserved in formol and fixed in a 10% formol solution. Exclusion criteria were presence of disarticulation in one limb or deforming alterations in the topography of assessed structures. RESULTS: The total number of identified valves was 28 in the right arm and 33 in the left arm, 15 of them in the right proximal segment and 21 in the left proximal segment. More than 91% of the valves were bicuspid and parietal. CONCLUSION: We conclude that the common brachial vein often presents bicuspid and parietal valves.

  1. Democracia Interna: reto ineludible de los Partidos Polticos

    Flavia Freidenberg

    2005-01-01

    Full Text Available Explica la definicin de democracia interna de los partidos olticos, apuntando los cambios que los partidos deben generar desde su interior para que la seleccin de los candidatos a los diferentes puestos de eleccin popular sea democrtica, tambin se refiere a la autorregulacin partidaria. Por ltimo expone lo que se ha hecho en los diferentes pases de Amrica Latina para ejecutar dicha regulacin.

  2. Comparação do parasitismo da veia central da supra-renal com o de outros tecidos em chagásicos crônicos

    Vicente de Paula Antunes Teixeira

    1991-06-01

    Full Text Available Através da análise morfológica e morfométrica de cortes seriados foi estudada a ocorrência de ninhos de T. cruzi na veia central e no parênquima das supra-renais, no miocárdio ventricular esquerdo e na veia cava inferior de chagásicos crônicos. Em 36 casos estudados, 50% apresentavamfleboparasitismo supra-renálico (total 29 ninhos; 3,1% apresentavamparasitismo na veia cava (apenas 1 ninho e em 16,8% dos casos encontramos miocardiócitos parasitados (total 23 ninhos. A densidade de parasitismo, expressa em número de ninhos por 100mm² de tecido examinado, foi de 0,585 para a veia supra-renálica, de 0,001 para a veia cava e 0,01 para o miocárdio. Em 269.103,1mm² deparênquima supra-renálico não encontramos nenhum ninho. Embora tenha sido a menor área examinada, a veia central apresentou a maior freqüência de ninhos de T. cruzi. Como a diferença básica entre estes tecidos está na riqueza de corticóides no sangue que nutre a veia central, podemos admitir que esta prevalência talvez seja devido ao ambiente hormonal, que por seu efeito imunossupressoreanti-inflamatório favoreceria a sobrevida dos parasitas.By morphological and morphometric analyses of serial sections the occurrence of T. cruzi nests in the central vein and in the parenchyma of adrenal glands, in the left ventricular wall and in the inferior vena cava wall in chronic Chagasic patients was studied. Of 36 cases 50% showed parasites in the adrenal central vein wall (total 29 nests, 3.1% showedparasites in the vena caval wall (only I nest and 16,8% we found parasites in the myocardiocytes (total 23 nests. The density of parasites measured in the nests for each 100mm² of the tissue examined, was 0.585 for the adrenal vein, 0.001 for the vena cava and 0.01 for the myocardium. No nest was found in 269103.1mm² of adrenal parenchyma. Although the central vein area examined was smaller, it showed the largest frequency of T. cruzi nests. Since a basic difference between these tissues is the great quantity of corticoids in the blood of the adrenal central vein, this prevalence may be because of this hormonal ambient, which with its immunosupressor and anti-inflammatory effects could help T. cruzi survival

  3. Fatores de risco que afetam as complicações da dissecação da veia safena na revascularização cirúrgica do miocárdio The risk factors affecting the complications of saphenous vein graft harvesting in aortocoronary bypass surgery

    Monir Abbaszadeh

    2008-09-01

    Full Text Available OBJETIVO: O problema da cicatrização de feridas é comumente observado após procedimentos de revascularização do miocárdio. Nosso objetivo é determinar a prevalência e os indicadores de complicação na dissecação da veia safena após procedimentos de revascularização coronária. MÉTODOS: Após revisão e aprovação pelo comitê de ética da instituição, uma revisão retrospectiva de 4029 procedimentos de revascularização foi realizada com enxerto da veia safena durante um período de seis anos. Treze fatores de risco para aqueles que desenvolveram complicações extensas nas feridas da perna foram analisados e comparados com toda a coorte de pacientes submetidos a procedimentos de revascularização semelhantes durante o mesmo período. RESULTADOS: Complicações nas feridas do membro inferior ocorreram em 68 pacientes (1,7%, 43 deles precisaram de intervenção cirúrgica adicional. Foram realizados 17 desbridamentos de feridas, nove transplantes de pele, uma angioplastia, 11 fasciotomias, três procedimentos vasculares e duas transferências livre de tecidos. Das treze variáveis analisadas pela análise multivariada, sexo feminino, IMC, uso de enxerto de veia torácica interna, doença vascular periférica, o uso de balão intra-aórtico no pós-operatório e hiperlipidemia pré-existente foram identificados como indicadores independentes significativos de complicações extensas nas feridas a perna (pOBJECTIVE: Problem of wound healing is commonly observed after coronary artery bypass graft procedures. Our aim is to determine the prevalence and the predictors of saphenous vein harvesting complication after coronary revascularization procedures. METHODS: After institutional ethical committee review and approval, a retrospective review was undertaken of 4029 bypass procedures with saphenous vein graft performed over a period of six years is conducted. Thirteen risk factors for those who developed major leg wound complications were analyzed and compared with the entire cohort of patients, undergoing similar bypass procedures during the same period. RESULTS: Lower extremity wound complications occurred in 68 patients (1.7%, 43 of them required additional surgical interventions. There were 17 wound debridements, nine skin grafts, one angioplasty, 11 fasciotomies, three vascular procedures, and two free tissue transfers. Of 13 variables evaluated by multivariate analysis, female gender, BMI, use of internal thoracic artery graft, peripheral vascular disease, the use of postoperative intraaortic balloon pump and preexisting hyperlipidemia were identified as significant independent predictors of major leg wound complications (p<0.05. CONCLUSIONS: The causes of major leg wound complications after saphenous vein harvest for coronary artery bypass graft procedures are multifactorial. To minimize these complications, we recommend vascular evaluations before saphenous vein harvest, attention to proper surgical technique, and careful harvest site section.

  4. An intermediate term benefits and complications of gamma knife surgery in management of glomus jugulare tumor

    Hafez, Raef F. A.; Morgan, Magad S; Fahmy, Osama M

    2016-01-01

    Glomus tumors are rare skull base slow-growing, hypervascular neoplasms that frequently involve critical neurovascular structures, and delay in diagnosis is frequent. Surgical removal is rarely radical and is usually associated with morbidity or mortality. Gamma knife surgery (GKS) has gained an increasing dependable role in the management of glomus jugulare tumors, with high rate of tumor growth control, preserving or improving clinical status and with limited complications. This study aims ...

  5. The safety and efficacy of gamma knife surgery in management of glomus jugulare tumor

    Hafez Raef FA; Morgan Magad S; Fahmy Osama M

    2010-01-01

    Abstract Background Glomus jugulare is a slowly growing, locally destructive tumor located in the skull base with difficult surgical access. The operative approach is, complicated by the fact that lesions may be both intra and extradural with engulfment of critical neurovascular structures. The tumor is frequently highly vascular, thus tumor resection entails a great deal of morbidity and not infrequent mortality. At timeslarge residual tumors are left behind. To decrease the morbidity associ...

  6. Decompression of the Jugular Bulb for Enhanced Infralabyrinthine Access to the Petroclival Region: A Quantitative Analysis.

    Miller, Matthew; Pearl, Monica S; Wyse, Emily; Olivi, Alessandro; Francis, Howard W

    2016-06-01

    Objectives To describe an enhanced infralabyrinthine approach to petroclival lesions with jugular bulb decompression, and to quantify surgical access using a flat-panel computed tomography image protocol. Design Retrospective case series and paired comparison of pre- versus post-dissection anatomy. Setting Tertiary academic medical center. Participants Four patients presenting with petroclival lesions. Six fresh cadaveric specimens were used for temporal bone dissection. Main Outcome Measures Axial and coronal dimensions, and access angles of the infralabyrinthine surgical corridor. Results Decompression of the jugular bulb increased the craniocaudal width of the infralabyrinthine corridor from 0.9 to 7.9 mm to 6.5 to 11.6 mm. The mean increase of 4 mm was statistically significant (t = 3.7; p < .05). There was also a significant widening of the infralabyrinthine window along the axial dimension by 0.9 to 4.5 mm or a mean of 2 mm (t = 3.7; p < .05). Angles of access to the petroclival region were wider following jugular bulb decompression, particularly in the coronal plane (mean difference 7.9 degrees; t = 5.0; p < .005) but less so in the axial plane (mean difference 4.7 degrees; t = 2.5; p = .05). Conclusions Jugular bulb decompression enhances infralabyrinthine access to petroclival lesions, permitting the removal of tissue for diagnoses or partial resection, without significant additional morbidity. PMID:27175321

  7. Impact of misplaced subclavian vein catheter into jugular vein on transpulmonary thermodilution measurement variables*

    Yu, Wen-qiao; Zhang, Yun; Zhang, Shao-yang; Liang, Zhong-yan; Fu, Shui-qiao; Xu, Jia; Liang, Ting-bo

    2016-01-01

    Objective: The subclavian vein (SCV) is usually used to inject the indicator of cold saline for a transpulmonary thermodilution (TPTD) measurement. The SCV catheter being misplaced into the internal jugular (IJV) vein is a common occurrence. The present study explores the influence of a misplaced SCV catheter on TPTD variables. Methods: Thirteen severe acute pancreatitis (SAP) patients with malposition of the SCV catheter were enrolled in this study. TPTD variables including cardiac index (CI...

  8. Evolving Concepts in the Management of Jugular Paraganglioma: A Comparison of Radiotherapy and Surgery in 88 Cases

    Huy, Patrice Tran Ba; Kania, Romain; Duet, Michèle; Dessard-Diana, Bernadette; Mazeron, Jean-Jacques; Benhamed, Rania

    2009-01-01

    Surgery for jugular paraganglioma (PGL) tumors often results in the acquisition of neurological deficits where none had been present previously. This has a significant impact on the quality of life. Radiotherapy is a recognized alternative therapy. The aim of this study was to compare the results of radiotherapy and surgery for the management of jugular PGL in terms of function and tumor control to define a treatment algorithm. We conducted a retrospective and comparative analysis of the trea...

  9. Acute pulmonary emboli due to internal jugular vein thrombosis in papillary thyroid carcinoma, a case report and literature review

    Masoud Ataiekhorasgani; Nasim Jafaripozve

    2014-01-01

    Upper extremity deep vein thrombosis (UEDVT) is a life threatening rare condition. Among the patients with UEDVT, internal jugular vein is accepted as uncommon thrombosis. Since internal jugular vein thrombosis (IJVT) is mostly underdiagnosed, a great attention is needed to diagnose the disease. A 75-year-old woman with history of dyspnea on exertion (DOE), weight loss and anorexia with the stable vital sign and right-sided cervical adenopathy with suspected thyroid nodule was admitted. One d...

  10. The accuracy of the central landmark used for central venous catheterization of the internal jugular vein.

    Bailey, Peter L; Whitaker, Emmett E; Palmer, Linda S; Glance, Laurent G

    2006-05-01

    We simulated needle paths based on the central landmark used for central venous catheterization of the internal jugular vein. We obtained ultrasound images to quantify the landmark's accuracy (precision and bias) in 107 subjects placed in Trendelenburg position with their heads turned 30-35 degrees. We also determined the frequency of simulated carotid artery puncture. The simulated needle path missed the middle 80% of the lumen of the internal jugular vein in 34% of subjects (95% confidence interval [CI], 25% to 44%) and traversed the carotid artery in 26% of subjects (95% CI, 18% to 35%). Both events occurred in 20% of subjects (95% CI, 13%-29%). The landmark had a medial bias of 3.7 mm (95% CI, 2.7 to 4.8); it was more often (77 of 104 subjects) medial to the center of the right internal jugular vein (P yield frequent success on first needle pass without risk of carotid puncture because of its imprecision and bias. The measured bias should be considered when the central landmark is used for central venous catheterization. PMID:16632804

  11. Metastatic lung cancer presenting with jugular foramen syndrome in a case of von Recklinghausens disease

    Agarwal Amit

    2010-01-01

    Full Text Available Metastatic carcinomas from a distant primary malignancy involving the temporal bone particularly the jugular foramen are rare tumors. A 57-year-old gentleman had multiple gradually increasing swellings over the body since many years. For last two years, he noticed enlargement of the swelling in left calf and rapidly enlarging painful new swelling over the left chest wall in back for last one year. He had recent involvement of left seventh, eighth and lower cranial nerves. CT scan showed an extensive lesion in left jugular foramen region with bone destruction. The patient underwent decompression of the left jugular foramen mass lesion. The tumor was extremely vascular and a partial decompression could only be performed. Although there was relief in the headache but the neurological deficits were persisting. Histopathology of the tumor showed features of metastatic small ling cancer. In the present case, there was presence of long standing multiple swelling all over the body and the patient had painful enlargement that he perceived as an ongoing process of the von Recklinghausen′s disease and made a delay in seeking the medical advice resulting in a well advanced disease and with poor prognosis.

  12. Dural sinus thrombosis - A rare manifestation of internal jugular venous occlusion

    Pooja Binnani

    2012-01-01

    Full Text Available The dural sinus thrombosis is an uncommon complication of a commonly done procedure of central venous catheterisation. We present a case of massive hemorrhagic venous infarct with gross cerebral edema due to dural sinus thrombosis along with right internal jugular vein thrombus. A 21-year-old male patient presented to the emergency department with fever and swelling of the right neck four days following discharge after his prior hospitalization two weeks ago for acute renal failure due to severe gastroenteritis, when he underwent hemodialysis through right internal jugular access. On presentation, he was conscious, with swelling on right side of the neck, which was diagnosed as right internal jugular vein occlusion. However, he rapidly dete-riorated and developed signs of raised intracranial pressure despite being on treatment with heparin. He was diagnosed as having massive hemorrhagic cerebral venous infarct with gross cerebral edema complicated with shift of the ventricles to the left due to dural sinus thrombosis. Despite emergency decompressive craniotomy, he succumbed in the next two days due to coning. Asymptomatic catheter-related thrombosis is frequent in the intensive care units, but major complications like retrograde extension into dural sinus causing thrombosis is rare. A high index of suspicion is required to diagnose this major catastrophe for an early and meaningful intervention.

  13. Internal jugular vein thrombosis complicating cervicofacial infection of dental origin. Case report

    Christos DENDRINOS

    2012-08-01

    Full Text Available Septic thrombosis of the internal jugular vein or Lemierre’s syndrome is a rare form of metastatic septic thromboembolitis, typically involving superinfection with Fusobacterium Necrophorum, internal jugular vein thrombosis and remote septic emboli.CASE REPORT: A 49-year-old male was referred for a painful cervicofacial swelling on the left, obliteration of the buccal sulcus, as well as swelling of both the soft and hard palate and the floor of the mouth ipsilaterally, accompanied by severe trismus and difficulty in swallowing. The patient underwent intraoral and extraoral incisions and drainage of the affected anatomical spaces and tracheotomy. The patient’s clinical condition was steadily improving; following examination with CT scan,9 days post-op, internal jugular vein thrombosis was diagnosed. The patient was put on anticoagulants. The postoperative course continued uneventfully, and the patient was discharged. One month post-operatively the vessel was normal and anticoagulant treatment was discontinued.CONCLUSION: Since Lemierre’s syndrome is not only rare but also tends to be underdiagnosed when there is no obvious cause of sepsis, it should be included in the differential diagnosis if the patient’s general contition deteriorates in spite of the treatment.

  14. 'On-line' alterations of contralateral jugular blood gas profile during carotid clamping.

    Vretzakis, G; Papadimitriou, D; Papaziogas, B; Koutsias, S; Christopoulos, D; Ferdi, E; Papadopoulos, G

    2003-01-01

    The aim of this work was to record the metabolic status of the brain (pH, PCO(2) and PO(2)) during carotid endarterectomy (CEA), with the use of an intravascular multiparameter sensor (Paratrend 7) via retrograde catheterization of the contralateral jugular vein. Twenty-four patients with ASA grades II and III scheduled for CEA were included in the study. After induction of anesthesia, the contralateral internal jugular vein was punctured retrogradely and the sensor was introduced. During clamping, pH became persistently more acidotic (7.34-7.31; p < 0.05), PCO(2) was elevated (43.2-46.8 mm Hg; p < 0.05) while most of the patients showed a non-significant decrease in PjvO(2)/SjvO(2) (jv = jugular venous). Correlation with clamping time or stump pressure was not significant. Unclamping was followed by a short period (5- 9 min) of decrease in pH and elevation of PCO(2) (7.30-7.22; p < 0.05, and 48.0-52.5 mm Hg; p < 0.05, respectively). PjvO(2) was significantly elevated (51.8-58.0 mm Hg; p < 0.001) after the restoration of flow. The study suggests that local CO(2) creates conditions for compensation of flow after the application of a carotid clamp. We consider that this monitoring technique, after further validation, may provide useful information. PMID:12802100

  15. Outcome of tunneled infusion catheters inserted via the right internal jugular vein

    To assess the outcome of tunneled central venous catheter placement via the right internal jugular vein. Between June 2001 and May 2002, 670 consecutive Hickman catheters were placed in 654 patients via the right internal jugular vein. The procedural complications arising and follow-up data obtained from May to July 2002 were evaluated. The technical success rate for catheter placement was 99.9% (669/670). Procedural complications were limited to eight cases (1.2%), including three pneumothoraces, one early migration of the catheter, one clinically unimportant air embolism, one catheter injury, one catheter kinking and one primary malpositioning in the azygos vein. Catheter dwelling time ranged from 1 to 407 (mean 107.1) days. During the follow-up period, 416 catheter were removed for various reasons: treatment had ended (n=334), patients declined treatment or their drug regimen was changed (n=16), late complications arose (n=53), or other circumstances intervened (n=13). Late complications included 44 cases of catheter-related infection (6.6%), five of catheter migration (0.7%), two of catheter occlusion (0.3%), one of thrombophlebitis (0.15%), and one of catheter-related right atrial thrombosis (0.15%). Only one instance of symptomatic venous thrombosis or stenosis was noted, namely the one case of thrombophlebitis. Because the incidence of subsequent symptomatic venous thrombosis or stenosis is lower, the preferred route for tunneled central venous catheter placement is the right internal jugular vein

  16. Ultrasound Guided Internal Jugular Venous Cannulation: Comparison with Land-Mark Technique

    Objective: To compare real-time ultrasonography-guided technique versus the traditional land-mark technique for internal Jugular venous cannulation. Study Design: Randomized controlled trial. Place and Duration of Study: Department of Anaesthesia, Combined Military Hospital, Rawalpindi, from September 2013 to July 2014. Methodology:Atotal of 200 patients who required internal jugular vein cannulation were randomly assigned using either real-time ultrasound-guided technique or land-mark technique. Access time, number of attempts until successful cannulation, complications and the demographics of each patient were recorded. Results:Access time was significantly less in real-time ultrasound group (34.95 ± 11.47 vs. 146.59 ± 40.20 seconds, p < 0.001). Cannulation was performed in first attempt in 99 percentage of patients in ultrasound group as compared to 89 percentage of landmark group. Complication rate was significantly higher in the land-mark group than in the ultrasound-guided group. Carotid artery puncture rate (9 percentage vs. 1 percentage) and haematoma formation (7 percentage vs. 0 percentage) were more frequent in the land-mark group than in the ultrasound-guided group. Brachial plexus irritation was also more in land-mark group (6 percentage vs. 0 percentage). Conclusion:Access time, failure rate and procedure related complications are reduced when real-time ultrasonography is used to cannulate internal Jugular vein. (author)

  17. CT and MRI diagnosis of primary middle ear carcinoma invading jugular foramen

    Objective: To study the CT and MRI features of primary middle ear carcinoma invading jugular foramen. Methods: CT and MRI images of 7 patients with surgically and pathologically confirmed primary middle ear carcinoma invading jugular foramen were analyzed retrospectively, including high resolution CT (HRCT) scan in 6 cases, CT enhancement scan in 1 case and MR plain and enhancement scan in 7 cases. Results: On HRCT, the soft tissue lesions mainly located in tympanum, tympanic sinus, the deep of external auditory canal and jugular foramen, and irregular 'moth-eaten' bone destruction could be seen, including the destruction of jugular foramen in 7 cases, eustachian tube in 7 cases, facial nerve canal in 4 cases, carotid artery canal in 4 cases, external auditory canal wall in 3 cases, auditory ossicles in 2 cases, vestibular window and horizontal semicircular canal in 1 case. CT plain scan showed the density of soft tissue mass was uniform in 4 cases with CT value of 30-55 HU, and heterogeneous in 2 cases, in which small pieces high density lesions could be found. CT enhancement scan in 1 case revealed moderate and homogeneous enhancement. On MR plain scan, the soft tissue masses with hazy margins could be seen, and compared to the gray matter of brain, the lesions were isointense or slightly hypointense on T1WI and isointense or slightly hyperintense on T2WI. The signal was homogeneous in 5 cases and inhomogeneous in 2 cases with small pieces of hypointensity both on T1WI and T2WI. After enhancement, the lesions were enhanced moderately and homogeneously in 5 cases and inhomogeneously in 2 cases with small pieces of non enhanced area. MRI also showed the erosion of carotid artery in 4 cases, sigmoid sinus in 1 case. Conclusion: The primary middle ear carcinoma can invade the jugular foramen area extensively, which may lead to misdiagnosis. HRCT can precisely depict the bone destruction and the invasion of the important anatomic structures in the primary middle ear carcinoma, and the destruction of eustachian tube can help to reduce misdiagnosis. MRI can more clearly show the extent of tumor and the mass signal and enhancement pattern. (authors)

  18. Anatomía quirúrgica del drenaje venoso en la región del triángulo carotídeo Surgical anatomy of jugular vein tributaries

    JOSÉ GONZÁLEZ R

    2010-06-01

    Full Text Available Los principales afl uentes de la vena yugular interna se incorporan a nivel cervical por medio del tronco venoso tirolinguofacial. Clásicamente se ha descrito su formación por la unión de la vena facial, lingual y tiroidea superior. El objetivo de este estudio fue determinar las variaciones en la presentación del tronco tirolinguofacial en cadáveres humanos de la región del Maule, Chile. Se disecaron 30 hemicuellos pertenecientes a 15 cadáveres humanos de ambos sexos, con un rango de edad entre 29 y 50 años, y se analizaron mediante observación directa. Se observó la formación de tronco venoso en la totalidad de los casos, siendo 53,3% correspondiente al tronco de tipo tirolinguofacial, 23,3% linguofacial, 20% tirolingual y sólo un 3,3% el tronco tirolinguofaringofacial. No se encontró la formación del tronco venoso de tipo tirofacial. Además se encontró una correlación significativa entre el diámetro de la vena yugular interna y el tronco venoso conformado por estas venas. Por lo tanto, existen variaciones morfológicas en los patrones de conformación de las venas facial, lingual y tiroidea superior, siendo estos datos de importancia para áreas de cirugía oncológica, cirugía plástica, cirugía de cabeza y cuello y radiología.Background: The main tributaries of the internal jugular vein join at cervical level through the venous thyrolinguofacial trunk. This trunk is classically described as formed by the union of the facial, superior thyroid and lingual veins. Aim: To evaluate variations in the formation of the thyrolinguofacial trunk in human cadavers. Material and Methods: Thirty hemi-necks were dissected in human cadavers of nine men and six women, with ages ranging between 29 and 50 years, and analyzed by direct observation. Results: In 16 hemi-necks (53.3%, the trunk was thyrolinguofacial; in seven (23.3%, it was linguofacial; in six (20%, it was thyrolingual and in one case (3.3% it was thyrolinguo pharyngofacial. No thyrofacial trunk formation was found. There was a correlation between the diameter of the internal jugular vein and of the venous trunk formed by these veins. Conclusions: There are morphological changes in the formation patterns of facial, lingual and superior thyroid veins. This information is useful for surgical oncology, plastic surgery, head and neck surgery and radiology.

  19. Osteotomo nasal con gua interna / Osteotome with internal nasal guide

    A., Castro-Sierra; V., Pia-Martnez.

    2014-06-01

    Full Text Available Diseamos un osteotomo al que se adapta una gua interna para tratar el dorso nasal (reseccin de la giba sea) con exactitud. Este instrumento aporta precisin en la osteotoma de tal forma que permite resecar solo la cantidad exacta de hueso que precise el paciente. [...] Abstract in english An internal guide has been added to the osteotome in order to achieve a precise reduction of the nasal dorsum (resection of the nasal hump). It makes the osteotomy so precise that only the exact amount of bone that the patient needs is resected. [...

  20. Radiographic imaging of otitis media and interna in pigs

    Middle and inner ear infections have been reported as a clinical entity in swine, other animal species and humans. In pigs, the anatomical-pathological and microbiological findings have been described. In this report, we describe radiographic findings in affected pigs. A total of 25 pigs with a head tilt and circling, as clinical signs of otitis media and interna, were examined. The majority were weaner-pigs with dyspnea or rhinitis. In radiographs, there was an increased opacity of the bulla tympanica, often accompanied by marginal destruction or thickening of the bulla wall. The radiographic findings confirmed the clinical diagnosis in each affected pig, but there were 5 false positive interpretations

  1. Resiliência como força interna

    Sara Ponzini Vieira

    2010-10-01

    Full Text Available Partindo da constatação que o processo de enfraquecimento biológico do envelhecimento não corresponde, necessariamente, à debilidade psicológica, este artigo se propõe a explorar o conceito de resiliência na velhice como expressão de uma força interna. A análise deste conceito, relacionado ao senso de significado e à espiritualidade, é apresentada tanto com dados de pesquisa, como com reflexões de alguns importantes autores da gerontologia e do humanismo.

  2. Resiliência como força interna

    Sara Ponzini Vieira

    2010-01-01

    Partindo da constatação que o processo de enfraquecimento biológico do envelhecimento não corresponde, necessariamente, à debilidade psicológica, este artigo se propõe a explorar o conceito de resiliência na velhice como expressão de uma força interna. A análise deste conceito, relacionado ao senso de significado e à espiritualidade, é apresentada tanto com dados de pesquisa, como com reflexões de alguns importantes autores da gerontologia e do humanismo.

  3. Drenagem anômala de veia pulmonar inferior direita em veia cava inferior associada a apêndice hepático intracardíaco Anomalous drainage of the right inferior pulmonary vein into the inferior vena cava associated to intrathoracic hepatic appendix

    Carlos R Moraes

    1988-08-01

    Full Text Available Descreve-se o caso de uma paciente de 61 anos de idade, com drenagem anômala de veia pulmonar inferior direita em veia cava inferior, associada a apêndice hepático intratorácico, herniado através de fenda no diafragma. A correção cirúrgica foi realizada por anastomose direta da veia anômala com o átrio esquerdo, pela redução do apêndice hepático para a cavidade abdominal e, finalmente, pelo fechamento do defeito diafragmático. O pós-operatório decorreu sem qualquer complicação. Os autores chamam a atenção para a raridade do caso.The authors present a case of a 61-year-old woman with anomalous drainage of the right inferior pulmonary vein into the inferior vena cava associated to an intrathoracic hepatic appendix herniated through a diaphragmatic defect. Surgical correction was obtained by direct anastomosis of the anomalous vein to the left atrium, reduction of the hepatic appendix to the abdominal cavity and closure of the diphragmatic defect. The postoperative course was unevenftul. The rarity of this condition is stressed.

  4. Implante de eletrodo em veia ázigos: uma opção terapêutica para limiar de desfibrilação elevado

    Luiz Eduardo Montenegro Camanho

    2012-06-01

    Full Text Available A avaliação do limiar de desfibrilação (DFT durante o implante do cardioversor-desfibrilador (CDI é uma etapa relevante do procedimento, uma vez que, em até 16% dos pacientes, podemos encontrar elevados DFT. Relatamos o caso de um paciente portador de cardiomiopatia dilatada (CMPD idiopática submetido a implante de CDI biventricular. Durante o procedimento, apresentou elevado DFT e se mostrou resistente às modalidades terapêuticas usuais. Optamos pelo implante de eletrodo de desfibrilação em veia ázigos, com resolução do quadro.

  5. Drenagem anômala total das veias pulmonares: terapêutica cirúrgica dos tipos anatômicos infracardíaco e misto

    Atik Fernando Antibas

    2004-01-01

    Full Text Available OBJETIVO: Estudar a evolução hospitalar em portadores de drenagem anômala total de veias pulmonares (DATVP, nas formas infracardíaca e mista, submetidos a tratamento cirúrgico. MÉTODOS: De 65 pacientes operados com o diagnóstico isolado de DATVP, de dezembro/1993 a março/2002, foram selecionados, retrospectivamente, 7 (10,8% pacientes das formas mista e infradiafragmática, sendo 5 (71,4% do sexo masculino, idades variando de 5 dias a 19 (média de 7 meses, com diagnóstico clínico feito pelo ecocardiograma bidimensional. Quatro (57,1% pacientes apresentavam formas mistas, em um, obstrutiva intrínseca, com estenose discreta da veia inferior esquerda. Os restantes três (42,9% apresentavam a forma infradiafragmática obstrutiva, extrínseca ao nível do diafragma. Todas as operações foram realizadas através de esternotomia mediana, sob circulação extracorpórea hipotérmica com parada circulatória total em 2 casos. RESULTADOS: Óbito hospitalar ocorreu em 1 paciente com DATVP infradiafragmática com conexão da veia vertical inferior com a veia porta. A causa mortis foi relacionada à falência de múltiplos órgãos e sistemas. O pós-operatório foi caracterizado pela presença de baixo débito cardíaco e hipertensão pulmonar em 4 (57,1% pacientes. CONCLUSÃO: O resultado da correção cirúrgica desta anomalia está associado à morbidade e mortalidade aceitáveis, na dependência do encaminhamento e tratamento cirúrgico precoces, sem progressão do quadro de hipertensão vascular pulmonar.

  6. Corynebacterium pseudotuberculosis associated with otitis media-interna in goats

    Rhoda Leask

    2013-02-01

    Full Text Available Corynebacterium pseudotuberculosis or caseous lymphadenitis is a common condition in sheep and goats. Two cases are described involving otitis media-interna and, in one case, cerebellar abscessation. The first case began with otitis externa and progressed to cerebellar abscessation, presumably as a result of C. pseudotuberculosis infection based on the macroscopic appearance of the abscess. The second case of otitis media-interna involved C. pseudotuberculosis with parasitic encephalitis or secondary meningo-encephalitis. Caseous lymphadenitis is a worldwide problem in livestock and also has zoonotic implications. Antimicrobial therapy of abscesses is often unrewarding due to the thick encapsulation of the abscesses and the extremely contagious nature of the organism. Alternative measures of treating this condition must be sought. In flocks or herds where caseous lymphadenitis has been diagnosed, it should be considered as a differential diagnosis for neurological conditions. The potential for spread must be kept in mind when it is suspected to be the cause of otitis in livestock.

  7. Endovascular Treatment of an Iatrogenic Right Internal Jugular Vein- Right Subclavian Artery Fistula and Pseudoaneurysm During the Attempt of a Hemodialysis Catheter Insertion: A Case Report

    Cho, Eui Min; Kim, Hyun Lee; Kim, Dong Hyun [Chosun University, Gwangju (Korea, Republic of)

    2009-02-15

    Complications during the placement of a central venous catheter, via the right internal jugular vein puncture include local hematoma, hemothorax, pneumothorax, central vein thrombosis, and hemopericardium. Iatrogenic right internal jugular vein-right subclavian artery fistula with the formation of right subclavian artery pseudoaneurysms is an extremely rare complication in patients undergoing a central vein puncture. We report the case of a patient who developed a local hematoma at the vein puncture site and dyspnea due to a right internal jugular vein-subclavian artery fistula and a right subclavian artery pseudoaneurysm at the mediastinum after puncture of right internal jugular vein. The patient was successfully treated by embolization using microcoils.

  8. The safety and efficacy of gamma knife surgery in management of glomus jugulare tumor

    Hafez Raef FA

    2010-09-01

    Full Text Available Abstract Background Glomus jugulare is a slowly growing, locally destructive tumor located in the skull base with difficult surgical access. The operative approach is, complicated by the fact that lesions may be both intra and extradural with engulfment of critical neurovascular structures. The tumor is frequently highly vascular, thus tumor resection entails a great deal of morbidity and not infrequent mortality. At timeslarge residual tumors are left behind. To decrease the morbidity associated with surgical resection of glomus jugulare, gamma knife surgery (GKS was performed as an alternative in 13 patients to evaluate its safety and efficacy. Methods A retrospective review of 13 residual or unresectable glomus jagulare treated with GKS between 2004 and 2008.. Of these, 11 patients underwent GKS as the primary management and one case each was treated for postoperative residual disease and postembolization. The radiosurgical dose to the tumor margin ranged between 12-15 Gy. Results Post- gamma knife surgery and during the follow-up period twelve patients demonstrated neurological stability while clinical improvement was achieved in 5 patients. One case developed transient partial 7th nerve palsy that responded to medical treatment. In all patients radiographic MRI follow-up was obtained, the tumor size decreased in two cases and remained stable (local tumor control in eleven patients. Conclusions Gamma knife surgery provids tumor control with a lowering of risk of developing a new cranial nerve injury in early follow-up period. This procedure can be safely used as a primary management tool in patients with glomus jugulare tumors, or in patients with recurrent tumors in this location. If long-term results with GKS are equally effective it will emerge as a good alternative to surgical resection.

  9. An intermediate term benefits and complications of gamma knife surgery in management of glomus jugulare tumor.

    Hafez, Raef F A; Morgan, Magad S; Fahmy, Osama M

    2016-01-01

    Glomus tumors are rare skull base slow-growing, hypervascular neoplasms that frequently involve critical neurovascular structures, and delay in diagnosis is frequent. Surgical removal is rarely radical and is usually associated with morbidity or mortality. Gamma knife surgery (GKS) has gained an increasing dependable role in the management of glomus jugulare tumors, with high rate of tumor growth control, preserving or improving clinical status and with limited complications. This study aims to evaluate intermediate term benefits and complications of gamma knife surgery in management of twenty-two patients bearing growing glomus jugulare tumors at the International Medical Center (IMC), Cairo, Egypt, between 2005 and 2011. The mean follow-up period was 56 months (range 36-108 months); there were 3 males, 19 females; mean age was 43.6 years; 15 patients had GKS as the primary treatment; 2 patients had surgical residuals; 2 had previous radiation therapy; and 3 previously underwent endovascular embolization. The average tumor volume was 7.26 cm3, and the mean marginal dose was 14.7 Gy. Post gamma knife surgery through the follow-up period neurological status was improved in 12 patients, 7 showed stable clinical condition and 3 patients developed new moderate deficits. Tumor volume post GKS was unchanged in 13 patients, decreased in 8, and showed tumor regrowth in 1 patient. Tumor progression-free survival in our studied patients was 95.5% at 5 and 7 years of the follow-up period post GKS. Gamma knife surgery could be used safely and effectively with limited complications as a primary management tool in the treatment of glomus jugulare tumors controlling tumor growth with preserving or improving clinical status especially those who do not have significant cranial or cervical extension, elderly, and surgically unfit patients; moreover, it is safe and highly effective as adjuvant therapy as well. PMID:26879488

  10. Monitoring tissue blood oxygen saturation in the internal jugular venous area using near infrared spectroscopy.

    Ruan, Z S; Li, T; Ren, R R; Zhao, Y; Li, K; Mao, Y F; Shen, G; Jiang, L

    2015-01-01

    Central venous blood oxygen saturation (ScvO2) is an important monitoring index of fluid resuscitation. However, monitoring of ScvO2 is not continuous and invasive. Near infrared spectroscopy (NIRS) is an optical technology for the noninvasive detection of hemodynamic changes, with advantages of being real-time, continuous, low-cost, and portable. The present study aimed to determine whether a correlation exists between the tissue blood oxygen saturation in the internal jugular venous area (StO2) data obtained with NIRS and the ScvO2 and whether these two quantities are equivalent. Data were collected from 13 patients. We used ultrasound to locate the placement site for the NIRS light source outside the internal jugular vein. Meanwhile, a sample for blood gas analysis was obtained through the central venous catheter. A correlation analysis between the StO2 and ScvO2 of 13 samples was performed (Pearson correlation coefficient), suggesting a high correlation between them (r = 0.906, StO2 =1.0018 ScvO2 +2.8524). Bland-Altman analysis was also performed between the StO2 and ScvO2. Results were as follows: 100% of monitored points fell within the range of the mean 1.96 SD of the difference between the StO2 and ScvO2; range of the mean 1.96 SD of the difference between the StO2 and ScvO2 was 3 10.2; confidence interval of the difference between the StO2 and ScvO2 was -7.2 to 13.2%. The StO2 monitored with NIRS correlated highly with the ScvO2 measured in the internal jugular vein. Therefore, the StO2 can be used for directing clinical treatment with further research. PMID:25867442

  11. Splenic vein graft for the reconstruction of the mesenteric-portal trunk after gastroduodenopancreatectomy / Enxerto de veia esplnica na reconstruo do eixo mesentrico-portal aps gastroduodenopancreatectomia

    Enio Campos, Amico; Jos Roberto, Alves; Samir Assi, Joo.

    2014-10-01

    Full Text Available A resseco da confluncia das veias mesentrica superior e porta tem sido realizada com maior frequncia no tratamento de adenocarcinoma do pncreas, em virtude dos bons resultados relatados, porm pode tambm ser usada em casos de neoplasias pancreticas benignas quando firmemente aderidas ao eixo [...] mesentrico-portal. Apesar disso, no existe nenhum estudo sobre o melhor tipo de enxerto venoso para reconstruo do eixo mesentrico-portal quando necessria. A escolha do enxerto depender da preferncia do cirurgio ou da instituio onde ocorre cirurgia. Esta nota tcnica discute criticamente o uso da veia esplnica como opo para reconstruo do eixo mesentrico-portal aps gastroduodenopancreatectomia. Abstract in english Resection of the confluence of the superior mesenteric and portal veins has been performed most frequently in the treatment of adenocarcinoma of the pancreas, in view of the reported positive results, but it can also be used in cases of benign pancreatic neolpasias when they are strongly adhered to [...] the mesenteric-portal trunk. Nevertheless, there is no study on the best type of venous grafts for reconstruction of the mesenteric-portal trunk when required. The choice of graft depends on the preference of the surgeon or the institution. This technical note critically discusses the use of the splenic vein as an option for mesenteric-portal trunk reconstruction after gastroduodenopancreatectomy.

  12. Thrombosis as a complication of pulmonary-artery catheterization via the internal jugular vein: prospective evaluation by phlebography

    A prospective study was made to determine, by angiography, the incidence of internal jugular-vein thrombosis in 33 consecutive critically ill patients who required temporary monitoring with Swan-Ganz catheters via the internal jugular vein. Twenty-two patients (66 per cent) had venographic or autopsy evidence of internal jugular-vein thrombosis. There was a statistically significant difference between the group of patients without thrombosis (Group 1) and the group with thrombosis (Group 2) with regard to the duration of hemodynamic compromise. Fifteen patients in Group 2 (as compared with eight in Group 1) were treated with heparin infusion, but nevertheless evidence of deep-vein thrombosis developd. Thus, it is concluded that venous thrombosis is a frequent complication of temporary monitoring with the Swan-Ganz catheter, especially in patients whose circulatory function has been impaired for a prolonged period

  13. Thrombosis as a complication of pulmonary-artery catheterization via the internal jugular vein: prospective evaluation by phlebography

    Chastre, J.; Cornud, F.; Bouchama, A.; Viau, F.; Benacerraf, R.; Gibert, C.

    1982-02-04

    A prospective study was made to determine, by angiography, the incidence of internal jugular-vein thrombosis in 33 consecutive critically ill patients who required temporary monitoring with Swan-Ganz catheters via the internal jugular vein. Twenty-two patients (66 per cent) had venographic or autopsy evidence of internal jugular-vein thrombosis. There was a statistically significant difference between the group of patients without thrombosis (Group 1) and the group with thrombosis (Group 2) with regard to the duration of hemodynamic compromise. Fifteen patients in Group 2 (as compared with eight in Group 1) were treated with heparin infusion, but nevertheless evidence of deep-vein thrombosis developd. Thus, it is concluded that venous thrombosis is a frequent complication of temporary monitoring with the Swan-Ganz catheter, especially in patients whose circulatory function has been impaired for a prolonged period. (JMT)

  14. Caractersticas das clulas parasitadas pelo Trypanosoma cruzi na parede da veia central das supra-renais de Chagsicos crnicos

    Hipolito de Oliveira Almeida

    1986-12-01

    Full Text Available Foram analisados os aspectos das clulas musculares parasitadas pelo Trypanosoma cruzi, na veia da supra-renal de chagsicos crnicos, atravs de exame ao microscpio ptico de lminas coradas pela hematoxilina-eosina (HE, PAS, Feulgen e peroxidase-antiperoxidase (PAP para antigenos do T. cruzi. Alm das modificaes nucleares descritas anteriormente, os leiomicitos parasitados exibem alteraes citoplasmticas que podem ser vistas mesmo em clulas que albergam poucos parasitas. As formas amastigotas geralmente esto envoltas por halo claro e o citoplasma restante adquire aspecto granuloso ou reticular, basfilopelo HE, sendo sempre PAS e Feulgen negativos. Estes dados sugerem que o material basfilo no citoplasma deve ser RNA ribossmico. A periferia dos ninhos que mostram uma "membrana" com reao do PAP para antigenos do T. cruzi fortemente positiva, poderia ser devida a reao cruzada de material celular rechaado para a periferia ou a difuso de antigenos do T. cruzi e sua adsoro periferia celular. O material citoplasmtico PAP positivo poderia resultar de artefato, de reao imunocitoquimica cruzada, de antigenos tripanossomticos difundidos ou de antigenos tripanossoma-simile resultantes de interaes entre o leiomicito e o parasita.Some morphologic aspects of the smooth muscle cells, parasitised by T. cruzi in the adrenal vein of chronic chagasic patients were studied. The staining techniques used were the following: Hematoxylin and Eosin (HE, PAS, Feulgen and the peroxidase antiperoxidase (PAP immunocyto chemical method for identification of T. cruzi antigen. The intracellular amastigotes were often surrounded by a clear halo and the cytoplasm of the parasitised smooth muscle cells were granular or reticular in appearance being basophil and, PAS and Feulgen negative. These data suggest that the cytoplasmatic basophil material could be ribosomic RNA. The intracellular nests of amastigotes were surrounded by a PAP positive "membrane-like" structures. This PAP positive "membrane-like"material, as well assome cytoplasmatic PAP positive granulomatous material, could be due to absorbed antigensfrom the parasite or to T. cruzi- like antigens resultedfrom the interaction between the parasite and the host cell.

  15. Comparative results of infratemporal fossa approach with or without facial nerve rerouting in jugular fossa tumors.

    Llorente, J L; Obeso, S; López, F; Rial, J C; Coca, A; Suárez, C

    2014-04-01

    Jugular fossa tumors are uncommon diseases. During the surgery and due to the interposition of the facial nerve in the tumor approach, the facial nerve must be elevated from the fallopian canal and placed permanently into an anterior position. Although this maneuver provides a wide exposure, most of the patients suffer a long-term total or partial facial palsy. The purpose of this article is to check whether the infratemporal fossa approach without transposition of the facial nerve is equivalent to the approach with rerouting of the facial nerve regarding postsurgical morbidity. The clinical records of 52 patients who underwent an infratemporal fossa approach were reviewed in which 34 patients were segregated into two comparable groups regarding the presence or absence of transposition of the facial nerve. There were 19 women and 15 males. The majority of the patients (73%) had jugular paragangliomas. The mean follow-up of the full series was 66 months. It was statistically significant that the worst facial nerve function at hospital discharge was in the patients who underwent facial nerve transposition (p = 0.001). Equally the facial nerve function in the no-rerouting group 1 year after the surgery was significantly much better than in the rerouting group (p = 0.003). Regarding to survival, recurrence or complications no significant differences were observed between both groups. Our study suggests that most of cases avoiding facial nerve transposition allow significant better functional results thereof without affecting other parameters such as recurrence, complications or survival. PMID:23880925

  16. Desvios porta-jugular e cava-jugular passivos em cães: Investigação de pressões sangüíneas

    Coelho Antônio Roberto Barros

    1999-01-01

    Full Text Available Os principais objetivos dos desvios veno-venosos durante o transplante ortotópico de fígado são: atenuação da estase venosa subdiafragmática, manutenção do retorno satisfatório de sangue ao coração e perfusão tissular eficiente. Investigações sobre PP, PVCIIH, PVC, PAM e PPR, bem como D PP e D PVCIIH foram conduzidas em seis cães, sob anestesia geral, com fígados perfundidos pela Artéria Hepática, submetidos a desvios porta-jugular e cava-jugular passivos durante 2 horas. Estes desvios não foram capazes de evitar estagnação de sangue na VP e VCIIH, acarretando estase e menor retorno sangüíneo ao coração, sugeridos por aumentos significativos de PP e PVCIIH e quedas significantes nos níveis de PVC. Os valores de PAM não apresentaram diferenças significativas em relação ao tempo T0, na maior parte dos tempos avaliados, enquanto que os valores de PPR foram significativamente menores que os verificados no tempo T0, na maioria dos tempos estudados. Tais pressões mantiveram-se, respectivamente, acima de 100 e 50 mm de Hg, atribuindo-se tais resultados, em parte, à vasoconstricção arteriolar generalizada. Incrementos de pressão na VP (D PP foram significativamente menos elevados que aqueles verificados na VCIIH (D PVCIIH, atribuindo-se tal diferença à complacência esplâncnica. Decréscimos ulteriores dos níveis de PP e PVCIIH sugerem queda do fluxo arterial para os territórios esplâncnico e sistêmico, decorrente de diminuição do retorno sangüíneo ao coração. Determinações de PP, PVCIIH, PVC, PAM e PPR podem constituir meio prático de avaliação hemodinâmica do desvio veno-venoso.

  17. Malformação de veia cava inferior e trombose venosa profunda: fator de risco de trombose venosa em jovens Inferior vena cava malformation and deep venous thrombosis: a risk factor of venous thrombosis in the young

    Renan Roque Onzi

    2007-06-01

    Full Text Available A ausência da veia cava inferior, alteração no processo de formação embriológica que ocorre entre a sexta e a oitava semanas de gestação, é uma rara anomalia congênita. Porém, recentemente foi confirmada como sendo um fator de risco importante para o desenvolvimento de trombose venosa profunda, especialmente em jovens. Apresentamos um caso de trombose em veias cava inferior, ilíacas, femorais e poplíteas num jovem de 16 anos com agenesia de um segmento de veia cava infra-renal e veia renal esquerda retroaórtica.Absence of inferior vena cava, caused by aberrant development within the sixth to eighth weeks of gestation, is a rare congenital anomaly. However, it has been recently confirmed as a major risk factor for the development of deep venous thrombosis, especially in young patients. We report a case of inferior vena cava, iliac, femoral and popliteal vein thrombosis in a 16-year-old patient with inferior vena cava agenesis and retroaortic left renal vein.

  18. Tratamento de estenose de veia pulmonar após ablação percutânea de fibrilação atrial Tratamiento de estenosis de vena pulmonar tras ablación percutánea de fibrilación atrial Treatment of pulmonary vein stenosis after percutaneous ablation of atrial fibrillation

    Alvaro Valentim Lima Sarabanda; Leonardo Cogo Beck; Luis Gustavo Gomes Ferreira; Wagner Luis Gali; Fernando Melo Netto; Guilherme Urpia Monte

    2010-01-01

    Neste relato de caso, descrevemos um paciente portador de fibrilação atrial (FA) persistente, submetido à ablação percutânea da FA pela técnica de isolamento extraostial das veias pulmonares, que desenvolveu uma estenose acentuada do óstio da veia pulmonar superior esquerda (VPSE), sem manifestar sintomas, diagnosticada pela angiotomografia de controle das veias pulmonares. O paciente foi submetido à angioplastia com implante de stent na VPSE com sucesso, resultando na normalização da perfusã...

  19. Acute Thrombotic Occlusion of Left Internal Jugular Vein Compressed by Bypass Graft for Thoracic Endovascular Aortic Repair Debranching Procedure

    Sim, Hyung Tae; Beom, Min Sun; Kim, Sung Ryong; Ryu, Sang Wan

    2014-01-01

    Thoracic endovascular aortic repair has become a widespread alternative treatment option for thoracic aortic aneurysm. The debranching of arch vessels may be required to provide an acceptable landing zone for an endovascular stent graft. We report a case where the bypass graft used in the thoracic endovascular aortic repair procedure compressed the left internal jugular vein, causing acute thrombotic occlusion.

  20. Internal jugular vein septic thrombophlebitis (lemierre syndrome) as a complication of pharyngitis.

    Wong, Andrew P; Duggins, Maurice L; Neil, Tara

    2015-01-01

    Sore throat is a common presenting complaint in the outpatient setting. Most cases are nonbacterial in origin, but those that are bacterial are usually the result of group A β-hemolytic streptococcus. Guidelines exist to help physicians decide whether to treat with an antibiotic. Lemierre syndrome is a dangerous potential sequela of pharyngitis that results in septic thrombophlebitis of the internal jugular (IJ) vein. A high index of suspicion is needed to consider this diagnosis in the workup of pharyngitis and should be aggressively treated once identified. Consideration should be given to completing blood cultures and neck imaging because of clinical suspicion. The case study discussed here illustrates the presentation, evaluation, and treatment of Lemierre syndrome. PMID:25957375

  1. A population study of the jugular foramen bridging of the human cranium.

    Dodo, Y

    1986-01-01

    The author previously proposed a simple standard for diagnosing the jugular foramen bridging in man. The incidence of this bridging trait was investigated according to that standard in nine cranial series of East Indians, Micronesians, Japanese, Ainu, Mongols, Aleuts, Alaskan Eskimos, Canadian Eskimos, and Ontario Iroquois. No sex difference in incidence of the trait was recognized. Side difference in trait incidence was also slight but was statistically significant in the combined series of all the population samples examined. The bridging trait occurred more frequently on the right side than on the left side. Occurrences of the bridging trait were definitely associated between sides. Incidence of the trait was less in East Indians, Ontario Iroquois, and Micronesians, but greater in Alaskan Eskimos and Canadian Eskimos, the incidences in Japanese, Ainu, Aleuts, and Mongols being intermediate. The differences in trait incidence among the nine population samples were considered to reflect the differences in genetic compositions of these specific populations. PMID:3946593

  2. Cough syncope in a 43-year-old woman with glomus jugulare tumor

    Susanta Bandyopadhyay

    2014-01-01

    Full Text Available We present an unusual case of recurrent cough syncope in a 43-year-old woman, which was initially thought to be seizures. Syncopal episodes were triggered by paroxysms of cough and were characterized by unresponsiveness and myoclonic jerks in her extremities. She had a left-sided glomus jugulare tumor that extended into the posterior cranial fossa with evidence of worsening communicating hydrocephalus on brain imaging. We postulate that bouts of cough produced increased intracranial pressure both by raising intrathoracic and intraabdominal pressures as well as by transient obstruction to cerebrospinal fluid flow secondary to intermittent tonsillar herniation during cough. This resulted in diffuse decrease in cerebral blood flow causing syncope. The patient's syncopal episodes decreased in frequency once an external ventricular drain was placed followed by a ventriculoperitoneal shunt. Search for factors that can increase intracranial pressure seems warranted in patients with recurrent cough syncope.

  3. External Carotid-Internal Jugular Fistula as a Late Complication After Carotid Endarterectomy: A Rare Case

    A 66-year-old man presented with mild amnesia, progressive fatigue, ataxia, visual hallucinations, and debility. His past medical history included right-sided carotid endarterectomy performed elsewhere 6 years previously. Cranial magnetic resonance imaging showed left parieto-occipital arteriovenous malformation-like tortous vessels, venous congestion, and ischemic areas. Cerebral angiography showed right-sided compound external carotid artery-internal jugular vein (IJV) fistula, and distal occlusion of the right IJV. Transvenous embolization via contralateral IJV was performed, and the fistula, together with fistulous portion of the distal IJV, was sealed using coils. Two years later, patient is well with normal neurologic examination findings. The presence of an arteriovenous communication after vascular surgery is a serious complication with potential long-term effects and therefore should be diagnosed and treated as promptly as possible.

  4. Internal jugular catheter malposition in a patient with end stage renal disease: a case report.

    Farzaneh Ebrahimifard

    2014-09-01

    Full Text Available A 30-year-old female with end-stage renal disease was a candidate for dual lumen catheter placement. After catheter insertion, O2 saturation measurement of the aspirated blood from the catheter was similar to that of arterial blood. They referred the patient to our hospital after 48 hours. Diagnostic procedures revealed that the tip of the catheter had entered the pleural cavity. Catheter removal in the CPR room resulted in hemorrhagic shock. The patient was resuscitated and stabilized and sent to the operating room. A laceration found at the junction of right jugular and right subclavian veins and was surgically repaired. The patient was discharged after ten days without any complication.

  5. Hernia interna de Quain como causa de abdomen agudo

    M. García-Oria

    2012-12-01

    Full Text Available Presentamos el caso de una paciente de 47 años de edad que consulta en urgencias por un cuadro de 8 horas de evolución, de dolor abdominal continuo y difuso, acompañado de vómitos alimentarios al inicio y biliosos después. La paciente presenta estabilidad hemodinámica permaneciendo afebril. El hemiabdomen inferior presenta signos de irritación peritoneal. En los análisis destaca la presencia de neutrofilia y leucocitosis, la radiología simple de abdomen es compatible con suboclusión de intestino delgado, y la TAC de urgencia sugiere la posibilidad de torsión intestinal. La cirugía urgente realizada aprecia una hernia interna de un segmento de ileon de unos 25cm, a través de un orificio patológico en el lado derecho del ligamento ancho del útero. Se realiza resección del asa herniada que sufre necrosis isquémica y se cierra el orificio herniario para evitar la recidiva. El día 11 tras el ingreso, es dada de alta sin complicaciones.

  6. Ligation of the jugular veins does not result in brain inflammation or demyelination in mice.

    Atkinson, Wendy; Forghani, Reza; Wojtkiewicz, Gregory R; Pulli, Benjamin; Iwamoto, Yoshiko; Ueno, Takuya; Waterman, Peter; Truelove, Jessica; Oklu, Rahmi; Chen, John W

    2012-01-01

    An alternative hypothesis has been proposed implicating chronic cerebrospinal venous insufficiency (CCSVI) as a potential cause of multiple sclerosis (MS). We aimed to evaluate the validity of this hypothesis in a controlled animal model. Animal experiments were approved by the institutional animal care committee. The jugular veins in SJL mice were ligated bilaterally (n?=?20), and the mice were observed for up to six months after ligation. Sham-operated mice (n?=?15) and mice induced with experimental autoimmune encephalomyelitis (n?=?8) were used as negative and positive controls, respectively. The animals were evaluated using CT venography and (99m)Tc-exametazime to assess for structural and hemodynamic changes. Imaging was performed to evaluate for signs of blood-brain barrier (BBB) breakdown and neuroinflammation. Flow cytometry and histopathology were performed to assess inflammatory cell populations and demyelination. There were both structural changes (stenosis, collaterals) in the jugular venous drainage and hemodynamic disturbances in the brain on Tc99m-exametazime scintigraphy (p?=?0.024). In the JVL mice, gadolinium MRI and immunofluorescence imaging for barrier molecules did not reveal evidence of BBB breakdown (p?=?0.58). Myeloperoxidase, matrix metalloproteinase, and protease molecular imaging did not reveal signs of increased neuroinflammation (all p>0.05). Flow cytometry and histopathology also did not reveal increase in inflammatory cell infiltration or population shifts. No evidence of demyelination was found, and the mice remained without clinical signs. Despite the structural and hemodynamic changes, we did not identify changes in the BBB permeability, neuroinflammation, demyelination, or clinical signs in the JVL group compared to the sham group. Therefore, our murine model does not support CCSVI as a cause of demyelinating diseases such as multiple sclerosis. PMID:22457780

  7. A new dynamic method for detection of internal jugular valve incompetence using air contrast ultrasonography.

    Ratanakorn, D; Tesh, P E; Tegeler, C H

    1999-01-01

    The internal jugular (IJ) valve is the only valve between the heart and the brain, preventing venous reflux into the IJ vein. Internal jugular valve competence has been tested by IJ venography. Doppler ultrasonography of the IJ vein and M-mode ultrasonography of the IJ valve, and color flow imaging (CFI) of the IJ vein. However, interpretation of venous Doppler and CFI is difficult, and venography is invasive. The purpose of this study was to evaluate the feasibility of a new dynamic method to test IJ valve competency, and to review the literature regarding the potential clinical importance of this pathophysiology. Ten patients had intravenous injection of agitated air and saline during Valsalva maneuver with B-mode monitoring and CFI of the right IJ vein. Contrast bubbles were clearly identified refluxing into the right IJ vein in 50% of patients. Air contrast studies more often showed IJ valve incompetence than CFI. Bubbles appeared in the IJ vein within 19.2 sec and persisted up to 282 sec. Bubble aggregation was also observed. There was no correlation between positive bubbles and the presence of spontaneous echo contrast on baseline B-mode imaging. Air contrast ultrasound venography (ACUV) is a new noninvasive method to assess competency of the IJ valves. This technique is feasible, appears to be more sensitive than CFI, and adds a new dimension to the study of the venous system in cerebrovascular disease. Potential clinical application includes evaluation of patients with increased central venous pressure, those with morning headaches, and those on positive end-expiratory pressure ventilators. PMID:9922717

  8. Gamma knife radiosurgery for glomus jugulare tumors: Therapeutic advantages of minimalism in the skull base

    Sharma Manish

    2008-01-01

    Full Text Available Context: Glomus jugulare (GJ tumors are paragangliomas found in the region of the jugular foramen. Surgery with/without embolization and conventional radiotherapy has been the traditional management option. Aim: To analyze the efficacy of gamma knife radiosurgery (GKS as a primary or an adjunctive form of therapy. Settings and Design: A retrospective analysis of patients who received GKS at a tertiary neurosurgical center was performed. Materials and Methods: Of the 1601 patients who underwent GKS from 1997 to 2006, 24 patients with GJ underwent 25 procedures. Results: The average age of the cohort was 46.6 years (range, 22-76 years and the male to female ratio was 1:2. The most common neurological deficit was IX, X, XI cranial nerve paresis (15/24. Fifteen patients received primary GKS. Mean tumor size was 8.7 cc (range 1.1-17.2 cc. The coverage achieved was 93.1% (range 90-97% using a mean tumor margin dose of 16.4 Gy (range 12-25 Gy at a mean isodose of 49.5% (range 45-50%. Thirteen patients (six primary and seven secondary were available for follow-up at a median interval of 24 months (range seven to 48 months. The average tumor size was 7.9 cc (range 1.1-17.2 cc. Using a mean tumor margin dose of 16.3 Gy (range 12-20 Gy 93.6% coverage (range 91-97% was achieved. Six patients improved clinically. A single patient developed transient trigeminal neuralgia. Magnetic resonance imaging follow-up was available for 10 patients; seven recorded a decrease in size. There was no tumor progression. Conclusions: Gamma knife radiosurgery is a safe and effective primary and secondary modality of treatment for GJ.

  9. Gamma knife radiosurgery of the glomus jugulare tumour - early multicentre experience

    Leksell Gamma Knife was used to treat 66 patients with glomus jugulare tumour at 6 European sites between 1992-1998. The age of the patients ranged between 18-80 years (median 54 years). Gamma Knife radiosurgery was a primary treatment in 30 patients (45.5 %). Open surgery preceded radiosurgery in 24 patients (36.4 %), embolization in 14 patients (21.2 %) and fractionated radiotherapy in 5 patients (7.6 %). The volume of the tumour ranged 0.5-27 cm3 (median 5.7 cm3). The minimal dose to the tumour margin ranged between 10-30 Gy (median 16.5 Gy). After radiosurgery 52 patients were followed, the follow up period was 3-70 months (median 24 months). Neurological deficit improved in 15 patients (29 %) and deteriorated in 3 patients (5,8 %), one transient and two persistant. Neuroradiological follow up using MRI or CT was performed in 47 patients 4-70 months (median 24 months) after radiosurgery. Tumour size decreased in 19 patients (40 %) while in the remaining 28 patients (60 %) no change in the tumour volume was observed. None of the tumours increased in volume during the observation period. Control angiography was performed in 6 patients. Pathological vascularization completely disappeared in one patient, reduced in two and there was no change in the remaining three. Radiosurgery proves to be a safe treatment for glomus jugulare tumour with no mortality and no acute morbidity. Because of its naturally slow growth rate, up to 10 years of follow up will be necessary to establish a cure rate after radiosurgery for these lesions. (author)

  10. A veia gástrica esquerda como alternativa de revasculariza��ão portal no transplante hepático

    Lacerda Cláudio Moura; Melo Paulo Sérgio Vieira de; Amorim Américo; Lima Ricardo; Emery Mário; Batista Danielle; Andrade Danielle

    2002-01-01

    Trombose ou hipoplasia da veia porta não tem sido, ainda, considerados contra-indicações para o transplante ortotópico de fígado. Contudo, permanecem com obstáculos associados com aumento da freqüência de falha primária e a longo prazo do transplante de fígado. Existem alguns fatores de risco tais como: sexo masculino, cirrose avançada, doença hepática alcoólica e cirurgia prévia para hipertensão portal. Os autores relatam o caso de uma criança de 4 anos, do sexo feminino, que sofria de doenç...

  11. Implante profilático e temporário de filtro de veia cava inferior no trauma Prophylactic and temporary inferior vena cava filter implant in trauma

    Fábio Augusto Cypreste Oliveira

    2013-03-01

    Full Text Available O tromboembolismo pulmonar (TEP é importante causa de óbito no trauma e esse, na maioria das vezes, contraindica a principal farmacoterapia na prevenção e no tratamento do TEP: a anticoagulação. Relatamos um caso de paciente politraumatizado, com risco elevado de embolia pulmonar, submetido ao implante preventivo e temporário de filtro de veia cava inferior (FVC.Pulmonary embolism (PE is a major cause of death in trauma and that, on most cases, the main contraindication for pharmacotherapy in the prevention and treatment of PE: the anticoagulation. We report a case of multiple trauma patient at high risk of pulmonary embolism, preventive and implant subjected to temporary inferior vena cava filter (VCF.

  12. Estructura interna de la guadua y su incidencia en las propiedades mecánicas

    JAIRO ALEXANDER OSORIO

    2007-01-01

    Full Text Available La Guadua angustifolia kunth GAK, fue caracterizada en su estructura interna, y se encontró la incidencia que presenta esta en la resistencia a flexión y a tensión. La resistencia a la flexión disminuye de la capa externa a la interna, debido a la reducción de la cantidad de células de fibras en ese sentido. Los valores de resistencia a flexión en la GAK disminuyen con la presencia de nudos debido a la discontinuidad de las fibras en esa parte del material. La resistencia a la tensión al igual que la de flexión disminuye de la capa externa a la interna, aspecto que se relaciona con que la cantidad de las células de fibra disminuyen hacia la capa interna

  13. Distribuição comparativa dos glicosaminoglicanos em artérias e veias de diferentes mamíferos Comparative distribution of glycosaminoglycans in arteries and veins of different mammals

    Mônica V. MARQUEZINI

    1999-10-01

    Full Text Available Foi realizada análise comparativa sobre a distribuição dos glicosaminoglicanos de artérias e veias em ratos, cachorros e humanos. Os nossos resultados demonstraram que dermatam sulfato foi o principal glicosaminoglicano encontrado tanto para as artérias quanto para as veias estudadas. Entretanto, a proporção de dermatam sulfato foi maior nas veias do que nas artérias nas três espécies analisadas. Este aumento pode estar associado às diferenças estruturais e funcionais encontradas na parede destes dois tipos de vasos sangüíneos (nas veias a pressão sangüínea é significativamente mais baixa. Além disso, a quantidade total dos glicosaminoglicanos foi maior nas artérias do que nas veias, sendo as maiores concentrações encontradas nas aortas independentemente da espécie animal estudada. Estes achados abrem perspectiva para o melhor conhecimento das alterações das macromoléculas que possam estar relacionadas ao processo degenerativo vascular, especialmente nas transformações estruturais que as veias safenas sofrem, quando empregadas como enxertos na revascularização do miocárdio.A comparative analysis of the glycosaminoglycan distribution in arteries and veins of humans, rats and dogs was realized. The results showed that the glycosaminoglycan distribution of the arteries was similar to that of venous tissues, where dermatan sulfate was the main glycosaminoglycan found. However, the proportion of dermatan sulfate is significantly greater in venous than in arterial tissues, in the three species. The total amount of the glycosaminoglycans was significantly higher in arteries than in veins, and the highest contents were found in the aortas. These increases may be associated with structural differences of the wall of these two types of blood vessels walls. The blood pressure is significantly lower in venous tissues and veins may exhibit less compressibility than arterial. These findings open perspectives for a better understanding of biochemical changes that could be related to the progressive degenerative vascular process, especially in the structural changes that saphenous veins undergo, when used as grafts in myocardial revascularization.

  14. A rare case of internal jugular vein aneurysmal degeneration in a type 1 neurofibromatosis complicated by potentially life-threatening thrombosis.

    Belcastro, Mirko; Palleschi, Andrea; Trovato, Riccardo A; Landini, Ruggero; Di Bisceglie, Maurizio; Natale, Armando

    2011-10-01

    Type 1 neurofibromatosis (NF1) is an autosomal dominant disorder characterized by multiple forms of neural crest cell proliferation. Associated venous malformations are extremely rare. We present a case of a giant thrombosed internal jugular aneurysm with brachiocephalic vein thrombosis in an NF1 patient. Surgical correction required prophylactic left brachiocephalic vein ligation, aneurysm evacuation, and proximal jugular vein ligation. Extreme vein friability caused severe intraoperative bleeding. Vein wall histology confirmed neurofibromatosis infiltration. Jugular vein aneurysm and infiltration in NF1, although exceedingly rare, can pose a serious threat to the patient during surgical correction, with major vessel thrombosis enhancing morbidity and mortality. PMID:21684713

  15. Hyperostosis frontalis interna in a Neandertal from Marillac (Charente, France).

    Garralda, María Dolores; Maureille, Bruno; Vandermeersch, Bernard

    2014-02-01

    The site of Marillac (Charente, France) has yielded an important stratigraphic sequence containing numerous Neandertal remains (some of them with peri-mortem manipulations) from lithofacies 2 (Quina Mousterian). This level has been correlated with MIS 4 and is associated with a TL date of 57,600 ± 4600 years BP (before present). The study of one of the cranial fragments (Marillac 3) revealed a grade 2 or Type B Hyperostosis frontalis interna (HFI), remodelling and altering the internal table of the thick frontal bone. This pathology has been analysed macroscopically together with radiography and sections made using a microscanner and a scanner. The development of the HFI is compared with published evidence for Sangiran 3 (Homo erectus), two other Neandertals (Forbes' Quarry and Shanidar 5), and several archaeological samples. Forbes' Quarry seems to display more advanced HFI than either Shanidar 5 or Marillac 3. The three Neandertals may be considered mature individuals (≥40 years) and it seems likely that the aetiology of this pathology may be associated with hormonal alterations, as has been suggested for past and extant populations. While the prevalence of HFI in contemporary post-menopausal women is well documented, the identification of HFI amongst males from several archaeological samples (Neanderthals, Ancient Egypt, Syrian Bronze Age or the Anasazi), with different stages of development, confirm that the pathology affected both sexes in past populations. Additional data and research are still needed to elucidate the etiopathogenesis of this illness and to better understand the relationship between environmental factors and their possible influences/consequences for the development of metabolic disorders in prehistoric populations. PMID:24491378

  16. Colapsibilidade da Veia Cava Inferior e sinais e sintomas de insuficiência cardíaca: novos insights e possíveis associações Inferior Vena Cava collapsibility and heart failure signs and symptoms: new insights about possible links

    Renato De Vecchis

    2012-06-01

    Full Text Available FUNDAMENTO: Nos pacientes com Insuficiência Cardíaca Crônica (ICC foram propostas medidas ultrassonográficas do Índice de Colapsibilidade da Veia Cava Inferior (ICVCI para obter uma avaliação e classificação minuciosa da congestão hemodinâmica. OBJETIVO: A finalidade deste estudo era correlacionar os achados no exame físico com o ICVCI em pacientes com ICC. MÉTODOS: De acordo com um projeto de coorte retrospectivo, analisamos 54 pacientes com ICC, direita ou biventricular, classe NYHA III. O plano era determinar se alguma faixa de ICVCI basal poderia predizer uma persistência ou agravamento da congestão clínica achada no final do acompanhamento subsequente (isto é, após 1-2 meses do tratamento oral otimizado. Para essa finalidade, os pacientes foram subdivididos em três grupos de acordo com o valor de ICVCI basal: ≤ 15% (13 pts, 16 - 40% (21 pts e > 40% (20 pts. Diversos critérios clínicos de congestão foram comparados por meio dos três grupos e incorporados subsequentemente ao modelo multivariado de Cox. RESULTADOS: Preditores multivariados de alto escore de congestão foram distensão da veia jugular (FC: 13,38 95% IC: 2,13 - 84 p = 0,0059 e estertores (FC: 11 95% C.I : 1,45 - 83,8 p = 0,0213. O ICVCI ≤ 15% esteve sempre associado com um alto escore de congestão na segunda visita; todavia, o ICVCI o ≤ 15% não predisse um alto escore de congestão na segunda visita. CONCLUSÃO: No âmbito da ICC, um baixo ICVCI não predisse, em forma confiável, um elevado escore de congestão. Não obstante, o conjunto com ICVCI ≤ 15% sempre se achou associado com sinais e sintomas de uma ICC descompensada, tanto do lado direito como do esquerdo. (Arq Bras Cardiol. 2012; [online].ahead print, PP.0-0BACKGROUND: In chronic heart failure patients (CHF, ultrasound measurement of inferior vena cava collapsibility index (IVCCI has been proposed to yield careful assessment and grading of the hemodynamic congestion. OBJECTIVE: The purpose of this study was to correlate the findings of physical examination with IVCCI in CHF patients. METHODS: According to a retrospective cohort design, we analyzed 54 CHF patients with right or biventricular CHF, belonging to III NYHA class. We planned to determine whether any basal IVCCI range would be able to predict persistent or worsening clinical congestion found at the end of subsequent follow up (i.e. after 1-2 months of oral optimized therapy. For this purpose, the patients were subdivided by three groups according to the basal IVCCI value: ≤ 15% (13 pts, 16 - 40% (21 pts and > 40% (20 pts.Several clinical criteria of congestion were compared across the three groups and subsequently entered in the Cox multivariate model. RESULTS: Multivariate predictors of high congestion score were jugular venous distension (HR: 13,38 95% C.I.: 2,13 - 84 p = 0,0059 and rales (HR: 11 95% C.I : 1,45 - 83,8 p = 0,0213. IVCCI ≤ 15% was always associated with high congestion score at the second visit; but IVCCI ≤ 15% failed to predict high congestion score at the second visit. CONCLUSION: In CHF setting, low IVCCI did not reliably predict high congestion score. Nevertheless, the cluster with IVCCI ≤ 15% was always found associated with signs and symptoms from both right and left-sided decompensated CHF. (Arq Bras Cardiol. 2012; [online].ahead print, PP.0-0.

  17. Internações por pneumonias e queimadas: uma abordagem espacial

    Luiz Fernando C. Nascimento

    2012-04-01

    Full Text Available OBJETIVO: Identificar padrões espaciais para taxas de internação por pneumonia em crianças e para focos de queimada no estado do Mato Grosso. METOGOLOGIA: Foi realizado um estudo ecológico e exploratório com dados de internação de pneumonia em criança de 0 a 4 anos e de focos de queimada para o estado do Mato Grosso relativos aos anos de 2008 e 2009. Foram criadas taxas de internação, construídos mapas temáticos para essas taxas e para focos de queimada e obtidos os índice de Moran global e estimador de Kernel para as taxas e focos de queimada. Os dados foram analisados pelo programa TerraView 3.3.1. RESULTADOS: Foram 15.689 internações (variando de zero a 2.315 e 161.785 focos de queimadas (variando de sete a 6.454. A taxa média de internação por 1.000 habitantes foi de 2,89 [:desvio padrão = 5,18]: e de queimadas por 1.000 habitantes foi de 152,81 (desvio padrão = 199,91. O índice de Moran global para o número de internações foi de 0,02 (p = 0,26, para a taxa de internação foi de 0,02 (p-valor = 0,21, e de 0,31 (p-valor < 0,01 para focos de queimadas. Foi possível identificar quatro municípios com elevadas taxas de internação por pneumonia e identificar duas regiões com altas densidades de internação. Ficou evidente um adensamento de focos de queimadas no chamado arco de desmatamento. CONCLUSÕES: Este estudo permitiu identificar municípios que necessitam de intervenção para diminuírem as taxas de internação e focos de queimada no estado do Mato Grosso.

  18. Reversal of severe SPECT asymmetry after venous extra-intracranial high flow bypass in a patient submitted to therapeutic internal carotid occlusion: case report Reverso de importante assimetria ao SPECT aps bypass venoso de alto fluxo extra-intracraniano em paciente submetido a ocluso teraputica da cartida interna: relato de caso

    Jorge Marcondes

    2001-09-01

    Full Text Available Therapeutic occlusion of the internal carotid artery is the main option for the treatment of the symptomatic intracavernous internal carotid artery aneurysms, but the issue of the best way of doing the balloon test occlusion (BTO regarding prediction of future ischemic events remains debatable. Single photon emission computerized tomography (SPECT has been offered as one of the best option of monitoring regional cerebral blood flow (rCBF during the BTO, where severe asymmetry is predictive of delayed ischemia. We describe a case of important SPECT asymmetry during BTO clinically negative and its complete reversal with carotid occlusion after extra-intracranial bypass with high flow safenous vein bypass between the cervical carotid artery and the middle cerebral artery.Ocluso teraputica carotdea ainda a principal escolha para o tratamento dos aneurismas sintomticos da artria cartida interna ao nvel do seio cavernoso.Existem controvrsias em relao obteno de testes com maior valor preditivo em relao complicaes isqumicas futuras durante a realizao do teste de ocluso carotdeo por balo. A tomografia computorizada de emisso de fton nico (SPECT tem sido defendida como uma opo para a melhor avaliao do fluxo sanguneo regional cerebral, onde evidente assimetria indicativa de isquemia tardia. Descrevemos um caso de importante assimetria ao SPECT durante o teste clinicamente negativo e sua reverso completa aps anastomose extra-intracraniana com interposio de veia safena magna (alto fluxo entre a artria cartida cervical e a artria cerebral mdia.

  19. Relações cranioencefálicas das veias de Trolard e de Labbé: aplicações neurocirúrgicas Cranioencephalic relationships between Trolard and Labbé veins: neurosurgical applications

    Sebastião Gusmão

    2001-03-01

    Full Text Available Realizamos estudo anatômico das veias anastomóticas de Trolard e de Labbé em sete segmentos cefálicos com o objetivo de precisar o trajeto e as referências que facilitem a preservação destes vasos durante o procedimento cirúrgico. Estudamos também as relações da veia de Trolard com a área motora.We accomplished an anatomic study of the anastomotic veins of Trolard and Labbé in seven human cephalic segments with the objective to accurate its stretch and references to facilitate its preservation during surgical procedure. The relationship between the Trolard vein and motor cortex was also studied.

  20. A rare association of total anomalous pulmonary venous connection and cor triatriatum A rara associação de drenagem anômala total de veias pulmonares e cor triatriatum

    Ulisses Alexandre Croti; Domingo Marcolino Braile; Moacir Fernandes de Godoy; Carlos Alberto De Marchi

    2003-01-01

    The association between total anomalous pulmonary venous connection and cor triatriatum is extremely rare. We emphasize the possibility of rupturing the membrane of cor triatriatum in the preoperative cineangiographic study, providing a significant improvement of the clinical features, as well as surgical correction and successful evolution.A associação entre drenagem anômala total de veias pulmonares e cor triatriatum é extremamente rara. Enfatizamos a possibilidade de rotura da membrana do ...

  1. Gonadotrophin and steroid concentrations in jugular and testicular venous plasma in stallions before and after GnRH injection.

    Seamans, M C; Roser, J F; Linford, R L; Liu, I K; Hughes, J P

    1991-01-01

    Six normal stallions of light horse breeds aged 5-17 years were used from fall to winter to investigate the difference between steroid hormone concentrations in testicular and jugular venous blood before and after exogenous GnRH. At 48 h before experimentation, an indwelling cannula was placed surgically in the testicular vein of the stallion. After the stallion recovered from anaesthesia, a catheter was placed percutaneously in the jugular vein. Each stallion was housed in a tie stall to allow simultaneous sampling of jugular or testicular blood. On the first and second sampling days, respectively, 1 ml of physiological saline solution and a 1 ml solution of GnRH (25 micrograms) were administered intravenously. Samples were taken from both sites at intervals from 60 min before treatment to 780 min after treatment. Plasma was analyzed for luteinising hormone (LH) and follicle-stimulating hormone (FSH), 17 beta-hydroxyandrogens (androgens), oestrone and oestrogen conjugates by radioimmunoassay. Pre-treatment (baseline) plasma concentrations of both LH and FSH between jugular and testicular samples were similar. The difference between basal levels of jugular and testicular androgens, oestrone and oestrogen conjugates were 144-fold, 60-fold and 13-fold respectively, although individual variation was observed. A low dose of exogenous GnRH produced a significant LH and FSH response in testicular and jugular plasma (P less than 0.05). There were no significant changes in steroid secretion caused by the increases in LH and FSH (P greater than 0.05), although individual variation in the androgen response was apparent (P less than 0.1). There was a positive correlation between basal testicular venous androgen levels and the magnitude of the FSH response to GnRH (P less than 0.05). Significant correlations between baseline oestrogens and the magnitude of the gonadotrophin response was not observed. Surgery depressed jugular oestrogen conjugate values (P less than 0.001) when compared to pre-surgical samples. Spermatogenesis also was depressed (P less than 0.01) by surgical manipulation, although total viable spermatozoa counts returned to normal limits within 3-5 months post operatively. We developed a model that allows the study of dynamic endocrine events associated with the hypophyseal-gonadal axis of the stallion. Our findings confirm the presence of a testicular-jugular hormone gradient in the unanaesthetized stallion. We have demonstrated that a relatively low dose of GnRH can induce a significant gonadotrophin response and a variable androgen response, but not a significant oestrogen response. Although baseline levels of androgens and not oestrone and oestrogen conjugates appeared to affect pituitary responsiveness, other steroidogenic components may be involved.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:1795300

  2. Intrapetrous Anastomosis between the Internal Jugular Vein and the Superior Petrosal Sinus: Cone Beam Computed Tomography Incidental Finding

    Seplveda, Ilson; Schmidt, Thomas; Platn, Enrique

    2015-01-01

    This is a case report of a 62-year-old male who presented to the Ear, Nose, and Throat clinic for a follow-up exam for hearing loss stemming from a fall from a horse in his infancy. A Cone Beam Computed Tomography (CBCT) examination revealed an intrapetrous communication between the internal jugular vein bulb and the superior petrosal sinus. Three-dimensional bone and soft tissues volume renderings were generated to demonstrate this incidental anatomical variant. PMID:26430539

  3. Rare variant of mixed total anomalous pulmonary venous connection with ascending vertical vein: unusual drainage to jugular vein

    Yong-zhi DENG

    2014-06-01

    Full Text Available Cases of mixed total anomalous pulmonary venous connection were rare, while cases of the vertical vein drained to jugular vein were even rarer. Pay attention to the size of pulmonary vein and left atrial anastomosis, increase the left atrium volume with pericardial patch, which play an important role to prevent postoperative pulmonary edema caused by anastomosis stenosis, poor back flow of coronary sinus and smaller left atrial volume.

  4. Thyroid storm presenting as congestive heart failure and protein-S deficiency-induced biventricular and internal jugular venous thrombii

    Kumar, S.; N Moorthy; Yadav, S.; Kapoor, A; Dale, D C

    2013-01-01

    The thyroid storm is a medical emergency characterized by decompensation of one or more organ systems. Associated cardiac involvement carries poor prognosis. Early recognition and appropriate management of life-threatening thyrotoxicosis is vital to prevent the high morbidity and mortality that may accompany this disorder. We report a young lady presenting with thyroid storm presenting as acute heart failure with biventricular and bilateral internal jugular venous thrombi. In addition, she al...

  5. Drenagem anômala parcial de quatro veias pulmonares com septo interatrial íntegro: relato de um caso raro Partial anomalous return of four pulmonary veins with intact interatrial septum defect: a rare case report

    Edmar Atik

    2008-07-01

    Full Text Available É relatado caso raro de drenagem anômala parcial de quatro veias pulmonares no átrio direito e veia cava superior, com septo interatrial íntegro em criança de cinco anos de idade. Havia poucos sintomas, em contraste com débito ventricular esquerdo dependente do fluxo da veia lobar superior esquerda e da língula. Complacência diminuída à esquerda motivou quadro acentuado de hipertensão venocapilar pulmonar no pós-operatório imediato, aliviado por feitura de comunicação interatrial de 8 mm. A evolução posterior foi boa.We report on the rare case of partial anomalous return of four pulmonary veins in the right atrium and superior vena cava with intact interatrial septum in a five-year-old child. There were few symptoms in contrast with the left ventricular output dependent on the flow of the left upper lobe vein and from the lingula. Reduced compliance to the left led to a severe picture of pulmonary venocapillary hypertension in the immediate postoperative period, mitigated by an 8-mm interatrial septal defect. The patient progressed well after the intervention.

  6. Marcapasso bi-atrial epicárdico subxifóide na obstrução da veia cava superior Bi-atrial subxiphoid epicardial pacemaker in superior vena cava syndrome

    Roberto Costa

    2006-10-01

    Full Text Available Um paciente portador de marcapasso definitivo bi-atrial-ventricular por fibrilação atrial paroxística e bradicardia sinusal, em uso crônico de anticoagulante oral, apresentou sinais clínicos da síndrome da veia cava superior. A venografia por subtração digital mostrou obstrução total do tronco braquiocefálico venoso direito e grande dificuldade de fluxo sangüíneo da veia inominada para a veia cava superior. A abordagem terapêutica constou da remoção completa do sistema transvenoso seguida de reimplante do sistema bi-atrial-ventricular por técnica epimiocárdica pela via subxifóide assistida por fluoroscopia.A patient with a bi-atrial-ventricular permanent pacemaker due to paroxystic atrial fibrillation associated to sinus bradycardia, in chronic use of oral anticoagulant, presented clinical signs of superior vena cava syndrome. Digital subtraction venography showed total obstruction of the right brachiocephalic venous trunk and severe stenosis of the connection of the left trunk to the superior vena cava. The therapeutic approach consisted of complete removal of transvenous system followed by re-implant of the bi-atrial-ventricular system using an epicardial subxiphoid access with fluoroscopic assistance

  7. Acute pulmonary emboli due to internal jugular vein thrombosis in papillary thyroid carcinoma, a case report and literature review

    Masoud Ataiekhorasgani

    2014-01-01

    Full Text Available Upper extremity deep vein thrombosis (UEDVT is a life threatening rare condition. Among the patients with UEDVT, internal jugular vein is accepted as uncommon thrombosis. Since internal jugular vein thrombosis (IJVT is mostly underdiagnosed, a great attention is needed to diagnose the disease. A 75-year-old woman with history of dyspnea on exertion (DOE, weight loss and anorexia with the stable vital sign and right-sided cervical adenopathy with suspected thyroid nodule was admitted. One day after admission, sudden dyspnea was occurring with unstable vital sign and hypotension. Chest X-ray showed a bilateral pleural effusion. Pleural tap was exudative, CT scan showed bilateral pulmonary emboli. CT scan of the neck showed right-sided cervical adenopathy, heterogeneous thyroid and internal jugular vein thrombosis concomitant with superior thyroid vein thrombosis. The patient was treated with thrombolytic agent and enoxaparin followed by warfarin. Thyroid FNA revealed papillary thyroid carcinoma that followed by total thyroidectomy, histopathological examination verified papillary thyroid carcinoma. Although lower extremity DVT is the main cause of pulmonary emboli, but IJVT may be proceed by pulmonary embolism. Due to fatal outcome of pulmonary emboli in IJVT, color duplex sonography, is recommended in documented tumors or suspected history of malignancy.

  8. Placement of a Hemodialysis Catheter using the Dilated Right External Jugular Vein as a Primary Route

    Park, Mi Hyun [Dankook University Hospital, Cheonan (Korea, Republic of); Shin, Byung Seok [Chungnam National University Hospital, Daejeon (Korea, Republic of)

    2010-08-15

    To evaluate the feasibility that a dilated right external jugular vein (EJV) could be a primary venous access site for large bore hemodialysis catheter placement. Between January 2008 and April 2009, a total of 173 hemodialysis catheters (14.5 F) were placed. Among them, we evaluated the clinical data of 42 patients who underwent placement through a dilated right EJV. We evaluated technical success, duration of catheterization in days, and the presence of complications. Technical success was achieved for 41 patients (98%). Catheter placement was unsuccessful in one patient due to narrowing of the EJV. The catheter dwell time ranged between 14 and 305 days (mean; 76 days, total catheter days: 3,111 days). A total of 26 hemodialysis catheters were removed due to complications (n=2) and termination of hemodialysis via the hemodialysis catheter (n=24). There was air embolization (n=1) and catheter kinking (n=3) during procedures and catheter related infections (n=2) during the follow-up period. The incidence of catheter related infection was 0.06 per 100 catheter days. No cases of catheter malfunction or symptomatic venous thrombosis were observed. We suggest that a dilated right EJV could be considered as a preferred primary route for hemodialysis catheter placement with easy access

  9. Thrombophlebitis of the internal jugular vein (Lemierre syndrome) - Clinical and CT findings

    Kim, Bo Yeon; Yoon, Dae Young; Lim, Kyoung Ja; Seo, Young Lan; Yun, Eun Joo; Choi, Chul Soon; Bae, Sang Hoon [Dept. of Radiology, Kangdong Seong-Sim Hospital, Hallym Univ. Coll. of Medicine, Seoul (Korea, Republic of)], e-mail: evee0914@chollian.net; Kim, Hyeong Chul [Dept. of Radiology, Chuncheon Sacred Heart Hospital, Hallym Univ. Coll. of Medicine, Kangwon-do (Korea, Republic of); Kim, Eun Soo [Dept. of Radiology, Hallym Univ. Sacred Heart Hospital, Hallym Univ. Coll. of Medicine, Gyeonggi-do (Korea, Republic of); Baek, Sora [Dept. of Nuclear Medicine, Kangdong Seong-Sim Hospital, Hallym Univ. Coll. of Medicine, Seoul (Korea, Republic of)

    2013-07-15

    Background: Thrombophlebitis of the internal jugular vein (IJV) secondary to neck infection (so-called Lemierre syndrome) is a rare disease. Purpose: To evaluate the clinical and CT findings in patients with thrombophlebitis of the IJV. Material and Methods: The clinical and contrast-enhanced neck CT findings were retrospective analyzed in 10 patients (eight men, two women; mean age, 62.9{+-}8.3 years) with thrombophlebitis of the IJV. Results: Five patients (50%) had complications, including pneumonia (n = 3), neck abscess (n = 1), and thrombophlebitis of cerebral venous sinus (n = 1). All patients, except two who were lost to follow-up, had improved after antibiotics and anticoagulation therapy. Nine (90%) patients had underlying infectious processes in the neck. Contrast-enhanced neck CT of 12 IJVs (five right, three left, and two bilateral) affected by thrombophlebitis demonstrated > 5 cm in length (n = 8, 67%), ovoid shape (n = 7, 58%), complete occlusion of the lumen (n = 10, 83%), circumferential (n = 11, 92%), smooth (n = 8, 67%), and thick (=4 mm) (n = 8, 67%) rim enhancement, and adjacent soft tissue swelling (n = 11, 92%). Conclusion: Contrast-enhanced CT is useful in the diagnosis of thrombophlebitis of the IJV; characteristic CT findings of this unusual entity may be the main clue to the correct diagnosis.

  10. Placement of a Hemodialysis Catheter using the Dilated Right External Jugular Vein as a Primary Route

    To evaluate the feasibility that a dilated right external jugular vein (EJV) could be a primary venous access site for large bore hemodialysis catheter placement. Between January 2008 and April 2009, a total of 173 hemodialysis catheters (14.5 F) were placed. Among them, we evaluated the clinical data of 42 patients who underwent placement through a dilated right EJV. We evaluated technical success, duration of catheterization in days, and the presence of complications. Technical success was achieved for 41 patients (98%). Catheter placement was unsuccessful in one patient due to narrowing of the EJV. The catheter dwell time ranged between 14 and 305 days (mean; 76 days, total catheter days: 3,111 days). A total of 26 hemodialysis catheters were removed due to complications (n=2) and termination of hemodialysis via the hemodialysis catheter (n=24). There was air embolization (n=1) and catheter kinking (n=3) during procedures and catheter related infections (n=2) during the follow-up period. The incidence of catheter related infection was 0.06 per 100 catheter days. No cases of catheter malfunction or symptomatic venous thrombosis were observed. We suggest that a dilated right EJV could be considered as a preferred primary route for hemodialysis catheter placement with easy access

  11. Right Internal Jugular Vein Cannulation: Carotid Artery-directed versus Sternocleidomastoid-directed Methods.

    Yu, Zhao-Yan; Yuan, Ping; Pan, Yang; Zhang, Zhong-Min

    2016-02-01

    The aim of the present study was to explore a simple and safe method for central venous catheterization (CVC) from the right internal jugular vein (RIJV) by comparing carotid artery (CA) positioning with sternocleidomastoid (SCM) positioning. The medical records of patients who underwent CVC between January 2011 and January 2015 were retrospectively reviewed. Central venous catheters were inserted into the RIJV either above the level of the cricoid cartilage using the CA-directed method (419 patients, Group 1) or below the level of the cricoid cartilage using the SCM-directed method (436 patients, Group 2). Success rate and related complications of catheterization were evaluated in the two groups. The total success rate of RIJV cannulation in Group 1 (97.2%) was higher than that in Group 2 (94.5%). Moreover, the success rate at first attempt was significantly higher in Group 1 than in Group 2 (92.4% vs 86.9%). The incidence of hematoma was 1.6 per cent in Group 1 and 3.8 per cent in Group 2. The rate of other complications such as pneumothorax, catheter-related infections, and catheter occlusion did not significantly differ between the groups. In conclusions, CA-directed RIJV cannulation is more effective and simple to perform than the SCM-directed method, and should become the preferred CVC technique in the absence of ultrasound guidance. PMID:26874140

  12. Thrombolytic effect of lonomin V in a rabbit jugular vein thrombosis model.

    Guerrero, B; Arocha-Piñango, C L; Pinto, M A; Müller, C A; Gil San Juan, A G; Amorim, S; Perales, J

    2001-10-01

    Thrombolytic efficacy of lonomin V (LV), a protein isolated from Lonomia achelous caterpillars haemolymph, administered either as a single intravenous bolus or as a continuous infusion, was evaluated in a rabbit jugular vein thrombosis model, and compared with those of single-chain tissue-type plasminogen activator (sct-PA) and two-chain urokinase-type plasminogen activator (tcu-PA). As a bolus LV, at doses of 100 000 IU/kg body weight (bw) produced an activator-induced thrombolysis (AIL) of 50.94% +/- 12.4 compared with 14.4% +/- 10.8 for tcu-PA at the same dose. As a continuous infusion at doses of 200 000 IU/kg bw LV produced an AIL of 45.8%, whereas sct-PA and tcu-PA produced an AIL of 69.9 and 33.7%, respectively. Fibrinogen, plasminogen and alpha-2-antiplasmin levels decreased significantly with the higher doses of LV, sct-PA, and tcu-PA. Factor XIII levels were significantly reduced in a dose-dependent manner only with LV. In conclusion, LV produces a dose-dependent thrombolysis in combination with a decrease in factor XIII activity. PMID:11685039

  13. Ligadura da veia porta associada transeco para hepatectomia em dois estgios (ALPPS: uma nova abordagem nas resseces hepticas Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS: a new approach in liver resections

    Orlando Jorge Martins Torres

    2012-12-01

    Full Text Available RACIONAL: Insuficincia heptica ps-operatria devido a remanescente heptico pequeno tem sido complicao temida em pacientes que so submetidos resseco heptica extensa. A associao da transeco heptica e ligadura da veia porta para hepatectomia estagiada (ALPPS uma nova abordagem para pacientes em que o tumor previamente considerado irressecvel. OBJETIVO: Apresentar a tcnica ALPPS como procedimento novo de hepatectomia em dois estgios com ligadura da veia porta e transeco heptica mantendo o fgado in situ para o tratamento de pacientes com tumores primrios ou metastticos marginalmente ressecveis. TCNICA: O procedimento realizado em dois tempos. O primeiro consiste na ligadura do ramo direito da veia porta. Em seguida realizada a transeco total ou quase total do parnquima heptico acompanhando o ligamento falciforme, incluindo a veia heptica mdia. Um saco plstico utilizado para recobrir o fgado que ser retirado; o abdome drenado e realizada a sntese da parede por planos. O segundo tempo feito aps seis a 12 dias de intervalo com realizao de tomografia computadorizada de abdome. Na laparotomia o saco plstico removido. Os ramos direito da artria heptica, ducto heptico e veia heptica so ligados e o lobo heptico direito removido. Um dreno posicionado na superfcie de resseco e a sntese da parede abdominal realizada. CONCLUSO: ALPPS permite resseco curativa de leses hepticas em pacientes com doena considerada previamente irressecvel.BACKGROUND: Postoperative liver failure consequent to insufficiency of remnant liver is a feared complication in patients who underwent extensive liver resections. The associating liver partition and portal vein ligation for staged hepatectomy (ALPPS is a new approach for patient which tumor is previously considered unresectable. AIM: To present ALPPS as an innovative surgical technique of two-staged hepatectomy for the treatment of patients with marginally resectable or initially nonresectable primary and metastatic liver tumors. TECHNIQUE: The procedure is performed in two steps. The first consists on ligation of the right portal vein branch. Subsequently, total or nearly total parenchyma dissection along the falciform ligament is performed, including the middle hepatic vein. A plastic bag is used to cover the right extended lobe, and the abdomen is drained and closed. The second one is performed after a computer tomography, six to 12 days interval. After laparotomy, the plastic bag is removed. The right artery, right bile duct and the right hepatic vein are divided. The extended right lobe is removed. Drain is placed at the resection surface, and the abdomen is closed. CONCLUSION: The associating of liver partition and portal vein ligation can enable curative resection of liver metastasis in patients with lesions previously considered unresectable.

  14. Internações por pneumonias e queimadas: uma abordagem espacial

    Luiz Fernando C Nascimento; Andréa Paula Peneluppi de Medeiros

    2012-01-01

    OBJETIVO: Identificar padrões espaciais para taxas de internação por pneumonia em crianças e para focos de queimada no estado do Mato Grosso. METOGOLOGIA: Foi realizado um estudo ecológico e exploratório com dados de internação de pneumonia em criança de 0 a 4 anos e de focos de queimada para o estado do Mato Grosso relativos aos anos de 2008 e 2009. Foram criadas taxas de internação, construídos mapas temáticos para essas taxas e para focos de queimada e obtidos os índice de Moran global e e...

  15. Las relaciones públicas internas como factor de gestión empresarial

    Castillo Esparcia, Antonio

    2006-01-01

    La comunicación interna no ha contado con una correcta presencia entre las acciones de las relaciones públicas. Sin embargo, desempeña un papel esencial en la estrategia de comunicación dirigida a los empleados y constituye una herramienta fundamental de relación entre organización y públicos. Con este artículo se realiza una aproximación a la estrategia y a las técnicas de la comunicación interna y se aboga por su inserción entre las funciones de las relaciones públicas.

  16. Estructura interna de la guadua y su incidencia en las propiedades mecánicas

    JAIRO ALEXANDER OSORIO; JUAN MANUEL VÉLEZ; HÉCTOR JOSÉ CIRO

    2008-01-01

    La Guadua angustifolia kunth GAK, fue caracterizada en su estructura interna, y se encontró la incidencia que presenta esta en la resistencia a flexión y a tensión. La resistencia a la flexión disminuye de la capa externa a la interna, debido a la reducción de la cantidad de células de fibras en ese sentido. Los valores de resistencia a flexión en la GAK disminuyen con la presencia de nudos debido a la discontinuidad de las fibras en esa parte del material. La resistencia a la tensión al igua...

  17. Estrategias de comunicación interna para National Oilwell Varco

    2011-01-01

    Esta tesis es una investigación de la comunicación interna en el departamento Rig Solutions de la empresa National Oilwell Varco, con el propósito de mejorar la comunicación interna. La metodología de la investigación se basó en visitas, encuestas y entrevistas, para llegar a los problemas de comunicación como, redacción incorrecta de informes y la deficiencia en el idioma inglés. Como resultado, las propuestas de mejoramiento fueron capacitaciones, talleres, manuales de redacción y proporci...

  18. Armazenamento sob atmosfera controlada de tomates com injúria interna de impacto

    Moretti Celso Luiz; Sargent Steven A.; Huber Donald J.; Puschmann Rolf

    2002-01-01

    A injúria interna de impacto causa redução significativa da qualidade de frutos de tomate. O presente trabalho teve como objetivo avaliar a utilização do armazenamento sob atmosfera controlada na redução do desenvolvimento de uma desordem de amadurecimento conhecida como injúria interna de impacto. Tomates (Lycopersicon esculentum Mill), cv. Solimar, foram colhidos no estádio de amadurecimento verde-maduro e tratados com etileno, por 12 horas, a 20degreesC. Ao atingirem o estádio verde-rosado...

  19. Tratamento cirrgico da estenose do tnel das veias pulmonares aps Senning modificado Surgical treatment of pulmonary venous baffle obstruction after modified Senning procedure

    Ignacio Juaneda

    2010-12-01

    Full Text Available Paciente de 13 anos de idade, sexo masculino, submetido correo de estenose de tnel das veias pulmonares (ETVP aps cirurgia de Senning modificada realizada aos 5 meses. O quadro clnico era de congesto pulmonar e broncopneumonias de repetio e o ecocardiograma confirmou ETVP. Uma angioplastia com balo foi realizada previamente correo cirrgica com circulao extracorprea. A placa de pericrdio bovino empregada para ampliao do trio direito retraiu-se e calcificou, levando a ETVP. A placa foi removida e o trio direito foi ampliado com um retalho de politetrafluoretileno. O ecocardiograma transesofgico intraoperatrio demonstrou reduo significativa da estenose.A 13-year-old male was admitted to undergoing correction of a pulmonary venous baffle stenosis (PVBS after a modified Senning procedure was performed by the age of five months. Recurrent Pulmonary congestion and pneumonia episodes were followed by echocardiography and cardiac catheterization that confirmed PVBS. Previous catheter balloon angioplasty was attempted, and a surgical revision was done under cardiopulmonary bypass. The bovine pericardial patch used for augmentation of the right atrium, retracted and calcified producing PVBS. Stenotic area was excised and enlargement was done with polytetrafluoroethylene membrane. Intraoperative transesophageal echocardiogram showed relief of stenosis.

  20. Aneurismas mltiplos de pontes aorto-coronrias de veia safena com ruptura fatal Multiple aneurysms of aortocoronary saphenous vein grafts with fatal rupture

    Fbio R. Tvora

    2007-05-01

    Full Text Available Aneurismas de pontes aorto-coronrias de veia safena so eventos raros, usualmente assintomticos e detectados de forma incidental. Rupturas espontneas de pontes de safena so raras, havendo poucos dados radiolgicos disponveis na literatura. Relatamos o caso de um senhor de 39 anos internado com hematmese dez anos depois de ter sido submetido a cirurgia de revascularizao miocrdica. Imagens tomogrficas mostraram trs aneurismas nas pontes de safena, mas o exame no detectou ruptura. O paciente veio a falecer e a necropsia revelou que a causa do bito havia sido ruptura de aneurisma de pontes de safena. Esse caso ilustra a necessidade de tratamento agressivo de aneurismas sintomticos de pontes coronarianas.Aortocoronary saphenous vein graft (SVG aneurysms are rare, and are usually asymptomatic and detected incidentally. Spontaneous rupture of SVG is rare and imaging data are few. We report on a 39-year old man who was admitted to the hospital with hematemesis 10 years after aortocoronary bypass surgery. CT images revealed 3 aortocoronary SVG aneurysms, but failed to detect any rupture. His subsequent death due to rupture of SVG aneurysm was documented at autopsy, illustrating the need for aggressive treatment of symptomatic coronary graft aneurysms.

  1. An Osteometric Evaluation of the Jugular Foramen / Una Evaluacin Osteomtrica del Foramen Yugular

    S, Ishwarkumar; N, Naidoo; L, Lazarus; P, Pillay; K. S, Satyapal.

    2015-03-01

    Full Text Available Los formenes yugulares (FY) son aberturas bilaterales situadas entre la parte lateral del hueso occipital y la porcin petrosa del hueso temporal del crneo humano. Se trata de un canal seo que da paso a estructuras neurovasculares de la fosa craneal posterior a travs de la base del crneo hasta [...] el espacio carotdeo. Ya que el FY representa variaciones en la forma, tamao, altura y volumen entre diferentes grupos raciales y sexo, adems de las diferencias distintivas en la lateralidad desde sus aperturas intracraneales a las aperturas extracraneales, se hace necesario su conocimiento con el objetivo de comprender las patologas intracraneales. El propsito de este estudio fue evaluar las mediciones morfomtricas del FY. Se midieron y evaluaron muestras de 73 crneos secos, bilateralmente (n=146). Se estudiaron varios parmetros morfomtricos del FY y su relacin con las estructuras circundantes. Cada uno de los parmetros morfomtricos medidos fue analizado estadsticamente con el programa SPSS para determinar la existencia de una posible relacin entre los parmetros y sexo, raza, edad y lateralidad. Las comparaciones de sexo y edad con la distancia entre la placa pterigoidea lateral y el FY, y la distancia entre el FY y el foramen magno, arrojaron valores de p significativos de 0,0049 y 0,036, respectivamente. Los resultados de este estudio se correlacionaron con estudios previos que indican que las mediciones relativas al FY son mayores en el lado derecho. El suministro de datos morfomtricos relativos al FY y las estructuras circundantes puede ayudar a los cirujanos y clnicos durante los procedimientos quirrgicos. Abstract in english The jugular foramina (JF) are bilateral openings situated between the lateral part of the occipital bone and the petrous part of the temporal bones in the human skull. It is a bony canal transmitting neurovascular structures from the posterior cranial fossa through the base of the skull to the carot [...] id space. Since the JF depicts variations in shape, size, height and volume between different racial and gender groups, along with distinctive differences in laterality from its intracranial to extracranial openings, knowledge of the JF may be necessary to understand intracranial pathologies. Therefore, the purpose of this study was to evaluate the morphometric measurements of the jugular foramen. Various morphometric parameters of the JF and its relation to surrounding structures were measured and assessed in 73 dry skull specimens (n=146). Each of the morphometric parameters measured were statistically analyse using SPSS to determine the existence of a possible relationship between the parameters and sex, race, age and laterality. The comparisons of sex and age with the distance between the JF and lateral pterygoid plate and distance between the JF and foramen magnum yielded statistically significant p values of 0.0049 and 0.036, respectively. The results of this study correlated with that of previous studies indicating that measurements regarding the JF are greater on the right side. The provision of morphometric data pertaining to the JF and surrounding structures may assist surgeons and clinicians during operative procedures.

  2. Internal jugular vein narrowing and body mass index in healthy individuals and multiple sclerosis patients

    Christopher Magnano

    2014-12-01

    Full Text Available Internal jugular vein (IJV narrowing has been implicated in central nervous system (CNS disorders. Body mass index (BMI is a cardiovascular risk factor that has been also linked to CNS diseases, however it is unknown whether a relationship exists between IJV narrowing and BMI. The objectives were to assess the relationship between IJV cross-sectional areas (CSA and BMI in healthy individuals (HI and multiple sclerosis (MS patients. A total of 388 subjects (194 age- and sexmatched HI and MS patients received magnetic resonance venography and structural brain magnetic resonance imaging at 3T. Region of interest analysis was performed using a semiautomated contouring-thresholding technique to determine the minimum CSA of the IJVs at C2/C3, C5/C6, and C7/T1 cervical levels. Partial correlation analyses were used to determine the associations. Increased BMI was related to increased IJV CSA at lower cervical levels (r=0.240, P<0.0001 at C5/C6 and r=0.293, P<0.0001 at C7/T1 in both MS patients and HI. Both MS and HI, showed associations between increased BMI and IJV CSA measures, particularly at lower cervical locations, in individual group analyses. No differences in association between BMI and IJV CSA were observed between HI and MS patients. Relationship between IJV CSA and BMI were not significant at upper cervical locations in the studied groups. Increased BMI is associated with IJV CSA widening, rather than narrowing, at lower cervical levels in both MS patients and HI. This finding warrants further investigation, but indicates that BMI can obscure interpretation of IJV CSA narrowing.

  3. Las relaciones públicas en la gestión de la comunicación interna

    Carretón Ballester, María del Carmen (Coord.); Ramos Soler, Irene

    2009-01-01

    Libro que trata los aspectos fundamentales de la comunicación interna al servicio de las organizaciones y de sus públicos internos desde la propia investigación en relaciones públicas hasta las tendencias en investigación en comunicación interna.

  4. Safety related to the implantation of jugular catheters for haemodialysis and usefulness of PA chest X rays post procedure

    The objective is to determine how safe the implantation of transient double lumen jugular catheters is for hemodialysis in patients with renal disease, and who require dialysis therapy and Posterior Anterior (PA) chest X-Ray post procedure. Design: observational descriptive study. Site: renal units at RTS Ltda. Sucursal Caldas (Hospital Santa Sofia y Hospital Infantil Rafael Henao Toro de la Cruz Roja). Patients: all patients with renal disease in whom it was necessary to do hemodyalitic therapy with implantation of a jugular catheter, with medical records of the events and complications that occurred during the procedure, with subsequent control AP chest X Ray and that showed reports made by the radiologist or physician who carried out the procedure, about the findings in the chest X Ray. Patients with renal disease, in whom jugular catheters had been inserted: Methods: variables such as age, gender, race, body mass index (BMI) etiology of the renal failure,time of evolution of the disease, indications for insertion, priority of catheter insertion, type of catheter inserted, amount of punctures, physician who carried out the procedure and patient's co-morbidities were analyzed. The events considered as complicated were analyzed as well as if there was any relationship with co-morbidities and the analyzed variables. Findings in the PA chest X-Ray were recorded and their relationship with the difficulties encountered during the procedure. A bi-variance analysis was done. The dependent and independent variables were classified in the nominal measurement scale. Results: 774 clinical histories were reviewed. 562 were excluded due to lack of variables and impossibility to read the notes. Men older than de 55 (45,7%). 212 (97.1%) patients with diagnosis of chronic renal disease (CRD) and in whom 238 procedures were carried out. seven patients (2,85%) had acute renal failure (ARF). The fi rst indication for central catheter insertion was in patients with chronic uremia syndrome as well as in patients with IRA uremia encephalopathy. The internist nephrologists did most of the insertions (n=207, 84.5%). In 245 insertions 17 important events were described which corresponded to 6,9% of the procedures. Multiple punctures (more than 3) were reported in nine patients. The post implantation chest X-Ray made it possible to detect 4 complications, meaning 1,6% of the procedures, of which none of them was fatal. No association with the event/complications was found in the variables analyzed. No association between IMC and multiple punctures. Conclusions: the implantation of jugular catheters is an easy procedure with a low rate of events or complications. PA X-Ray provides little information when the procedure is free of complications.

  5. We still go for the jugular: implications of the 3SITES central venous catheter study for nephrology.

    Wyatt, Christina M; Vassalotti, Joseph A

    2016-03-01

    The 3SITES study randomly assigned a nontunneled central venous catheter site in over 3000 adults treated in intensive care units. The subclavian site was associated with a lower rate of short-term complications, including catheter-related bloodstream infection and deep venous thrombosis, compared to the femoral or internal jugular site. Nephrologists should be aware of this study and should continue to advocate for alternatives to subclavian vein catheter placement in patients with chronic kidney disease who are expected to require arteriovenous access for dialysis in the future. PMID:26880443

  6. Thyroid storm presenting as congestive heart failure and protein-S deficiency-induced biventricular and internal jugular venous thrombii

    S Kumar

    2013-01-01

    Full Text Available The thyroid storm is a medical emergency characterized by decompensation of one or more organ systems. Associated cardiac involvement carries poor prognosis. Early recognition and appropriate management of life-threatening thyrotoxicosis is vital to prevent the high morbidity and mortality that may accompany this disorder. We report a young lady presenting with thyroid storm presenting as acute heart failure with biventricular and bilateral internal jugular venous thrombi. In addition, she also had thyrotoxicosis-induced transient protein-S deficiency which recovered following remission.

  7. Throbbing tinnitus in aberrant internal carotid artery aggravated by elevation of the jugular bulb. A case report

    Vascular anomalies in the middle ear are rarely observed. They cause no symptoms in the majority of cases, although some may be associated with tinnitus. The false diagnosis of glomus tumour may lead to considerable problems, if surgery is performed. It is therefore necessary that precise pre-operative data are obtained, preferably based on contrast-enhanced computerized tomography. Subsequent 2D and 3D image reconstructions provide further vascular findings regarding the topographic and anatomic factors involved and eliminate the need for invasive angiography of the carotid artery or retrograde jugular venography to make a firm diagnosis. (orig.)

  8. Ultrasound-guided internal jugular vein access: Comparison between short axis and long axis techniques

    Tarek F Tammam

    2013-01-01

    Full Text Available The use of real-time ultrasound (US is advantageous in the insertion of central venous catheters (CVCs in adults, especially in whom difficulties are anticipated for various reasons. The aim of the present study was to compare two different real-time 2-dimensional US-guided techniques [short axis view/out-of-plane approach (SAX OOP approach versus long axis view/in-plane approach (LAX IP approach] for internal jugular vein (IJV cannulation. In this prospective study, 90 critical care and hemodialysis patients were assigned for insertion of CVCs using either the real-time US-guided (SAX OOP approach or LAX IP approach or landmark technique (control group. Failed catheter placement, risk of complications from placement, failure on first attempt at placement, number of attempts until successful catheterization, time to successful catheterization, incidence of central line-associated blood stream infection (CLA-BSI and demographics of each patient were recorded. There were no significant differences in patient′s demographic characteristics, side of cannulation (right or left or presence of risk factors for difficult venous cannulation between the three groups of patients. Cannulation of the IJV was achieved in all patients by using US (SAX OOP and LAX IP approaches and in 27 of the patients (90% by using the landmark technique (P = 0.045. Average access time (skin to vein and number of attempts were comparable between the SAX OOP and the LAX IP approaches while significantly reduced in both US groups of patients compared with the landmark group (P <0.001. In the landmark group, puncture of the carotid artery occurred in 16.7% of the patients, hematoma in 23.3% of the patients, pneumothorax in 3.3% of the patients and CLA-BSI in 20% of the patients, which were all significantly increased compared with the US group (P <0.05. The findings of this study suggest that the SAX OOP and LAX IP approaches were comparable for cannulation of IJV in critical care and hemodialysis patients. Furthermore, both US-guided techniques were superior to the landmark technique for insertion of CVCs.

  9. Alteraes estruturais e moleculares (cDNA precoces em veias safenas humanas cultivadas sob regime pressrico arterial Precocious structural and molecular (cDNA changes in the human saphenous veins cultivated under arterial hemodynamic conditions

    Lus Alberto O. Dallan

    2004-06-01

    Full Text Available OBJETIVO: A veia safena (VS empregada na revascularizao do miocrdio (RM fica submetida a estresse tnsil elevado e contnuo. Sua resposta adaptativa nova condio hemodinmica pode predispor ocluso do enxerto. Este trabalho visou verificar as alteraes estruturais precoces e moleculares (cDNA entre VS humanas submetidas a baixo regime pressrico versus condies hemodinmicas sistmicas. MTODO: Quarenta segmentos de VS foram cultivados "ex-vivo" sob condio hemodinmica venosa (CHV (sem presso, fluxo:5 ml/min e sob condio hemodinmica arterial (CHA (presso: 80mmHg, fluxo:50mL/min. Foram analisadas: viabilidade celular (colorao MTT, densidade celular (colorao hoechst 33258 e apoptose (ensaio TUNEL, antes e um, dois e quatro dias aps o procedimento. Determinamos alvos moleculares alterados precocemente nas veias cultivadas sob condio arterial, atravs da anlise "cDNA microarray" de segmentos das VS. A busca desses alvos foi realizada atravs de pool homogeneizado do RNA desses segmentos venosos, interagindo por homologia em lmina contendo 16000 genes humanos pr-determinados (Agilent Technologies slide. Os genes com expresso alterada foram certificados por PCR em tempo real, em veias de 16 diferentes indivduos. RESULTADOS: Houve diminuio gradual da densidade celular e da viabilidade tecidual nas VS cultivadas mediante CHA, enquanto nenhuma alterao ocorreu quando a veia foi cultivada at quatro dias na CHV. No grupo sob CHA houve sinais de processo apopttico celular (TUNEL-positivo j a partir do 1 dia de cultivo, o que no ocorreu no outro grupo. A densidade celular das veias sob regime arterial, decorridas 24h de cultivo, era similar das amostras frescas das mesmas, mas inmeras clulas j apresentavam indcios de processo apopttico. Os alvos moleculares mais alterados(de acordo com o PCR em tempo real e selecionados para pesquisa foram o Oncogene 3 e a Interleucina 1. A expresso do Oncogene 3 estava elevada em 11 (68,7% das veias cultivadas sob regime arterial, enquanto observou-se aumento da expresso da Interleucina 1 em nove (56,2% desses segmentos venosos (pOBJECTIVE: The saphenous vein (SV used in coronary artery bypass grafting is submitted to elevated and continuous shear stress. Occlusion of the grafts can occur in response to the new hemodynamic conditions. The aim of this study is to compare the precocious structural and molecular (cDNA changes in saphenous veins grafts submitted to low pressure hemodynamic conditions versus systemic hemodynamic conditions. METHOD: Forty sections of SV were cultivated "ex-vivo" under venous hemodynamic conditions (VHC (without pressure, flow: 5 mL/min and under arterial hemodynamic conditions (AHC (pressure: 80 mmHg, flow: 50 mL/min. The following variables were analyzed: cellular viability (MTT assay cellular density (hoeschst 33258 staining and apoptosis (TUNEL assay, before and 1, 2 and 4 days after the procedure. "cDNA microarray" analysis of the SV sections was used to determine the precociously changed molecular targets in the veins cultivated under arterial conditions. The identification of these targets was achieved using a RNA homogenized pool of these vein sections, interacting on slides with 16,000 pre-determined human genes (Agilent Technologies slide. The genes with changed expressions were verified by real time PCR in the veins of 16 patients. RESULTS: There was a gradual reduction in the cellular density and in the tissue viability in the saphenous veins cultivated under AHC, whereas no alterations were observed in the saphenous veins cultivated under VHC of up to 4 days. In the AHC group there were signs of a cellular apoptotic process (positive - TUNEL from the first day after cultivation. In the VHC group these alterations were not observed. Although the cellular density was the same in the veins submitted to arterial conditions, after 24 hours of cultivation, many cells already showed signs of the apoptotic process. The Oncogene 3 and the Inte

  10. Nova técnica cirúrgica de preparo da veia safena para revascularização do miocárdio sem manipulação direta - no-touch Novel no-touch technique of harvesting the saphenous vein for coronary artery bypass grafting

    Fabio Rueda; Domingos Souza; Ricardo Carvalho Lima; Alexandre Menezes; Benny Johansson; Michael Dashwood; Emmanuel Thé; Mário Gesteira; Mozart Escobar; Frederico Vasconcelos

    2008-01-01

    FUNDAMENTO: Otimização da veia safena na revascularização miocárdica. OBJETIVO: Apresentar a técnica no-touch de preparo da veia safena. Essa técnica consiste na retirada da veia safena do seu leito, com um pedículo de tecido adiposo, protegendo-a contra espasmos, sendo desnecessário distendê-la. MÉTODOS: Estudo prospectivo e randomizado, incluindo 156 pacientes submetidos a cirurgia de revascularização miocárdica. Comparação da técnica no-touch com duas outras técnicas: convencional e interm...

  11. Disfuno endotelial causada pela presso aguda de distenso em veias safenas humanas utilizadas para revascularizao do miocrdio / Endothelium dysfunction caused by acute pressure distension of human saphenous vein used for myocardial revascularization

    Fernanda, Viaro; Carlos Gilberto, Carlotti Jr; Alfredo Jos, Rodrigues; Walter Vilella de Andrade, Vicente; Solange, Bassetto; Graziela Saraiva, Reis; Lafaiete, Alves Junior; Paulo Roberto Barbosa, Evora.

    2007-06-01

    Full Text Available OBJETIVO: Estudar as alteraes morfofuncionais induzidas por presso de distenso, em veias safenas humanas utilizadas para revascularizao do miocrdio. MTODO: Foram estudadas veias safenas de 20 pacientes, distribudas em quatro grupos experimentais: controle, 100, 200 e 300 mmHg, submetidos a [...] distenses pressricas com soluo de Krebs por 15 segundos. A metodologia utilizada incluiu: 1) Imunohistoqumica do CD34; 2) Estudo in vitro da reatividade vascular em cmaras de rgos. RESULTADOS: Os principais achados experimentais foram: 1) A partir da pressurizao com 200 mmHg, observou-se uma tendncia diminuio da expresso do CD34, tornando-se estatisticamente significante com 300 mmHg; 2) No houve comprometimento da contratilidade e dos relaxamentos estudados in vitro. CONCLUSES: Embora o estudo in vitro no tenha demonstrado comprometimento da reatividade vascular das veias estudadas, o estudo imunohistoqumico do CD34 mostrou que existe disfuno endotelial com pressurizaes de 300 mmHg. Abstract in english OBJECTIVE: To study morphofunctional alterations induced by brief pressure increases in human saphenous veins utilized in coronary artery bypass grafting. METHOD: Saphenous veins of 20 patients undergoing coronary artery bypass grafting, were distributed into four experimental groups, control, 100 m [...] mHg, 200 mmHg and 300 mmHg, and submitted to pressure distention over 15 seconds using Krebs solution. The evaluation included CD34 immunohistochemistry and an In vitro vascular reactivity study in organ chambers. RESULTS: The main experimental findings were 1) From pressures of 200 mmHg there was a tendency to reduce the CD34 expression which became statistically significant at 300 mmHg; 2) There was no impairment of the contraction and relaxation as evidenced by in vitro vascular reactivity tests. CONCLUSION: Although vascular reactivity impairment was not demonstrated in vitro, the CD34 expression, measured by imunohistochemistry, shows there is endothelium dysfunction at pressures of 300 mmHg.

  12. Reação de fase aguda e parasitismo na veia central da supra-renal de chagásicos crônicos

    Daniel Ferreira da Cunha

    1994-06-01

    Full Text Available A reação sistêmica aos traumatismos e infecções graves, reação de fase aguda, (RFA, pode determinar imunossupressão e reativação de infecções latentes. O objetivo do trabalho foi verificar, em 71 chagásicos crônicos com ousem RFÁ, a freqüência de parasitismo pelo T. cruzi na veia central da supra-renal (VCSR. Os critérios para RFA (+ foram observados em 30 chagásicos: lmorteporsepsis e/outrauma após evolução maior que umasemana e 2presença de úlceras de stress sangrantes, ou 3 hiperplasia reacional do baço ou 4 esteatose hepática. Registrou-se peso e altura e calculou-se o índice de massa corporal (IMC. Chagásicos com RFA (+ apresentaram maior comprometimento nutricional que os RFA (-: peso = 49,0 vs 54,5 kg; IMC = 17,5 vs 20,6kg/m2 (mediana p< Q,05. O parasitismo na VCSR não diferiu entre os grupos: 43,3% e 43,9%, respectivamente. Concluímos que os chagásicos com RFA (+ são mais subnutridos que os RFA (- e que o desenvolvimento pré-óbito de RFA não afeta a frequência de parasitismo na VCSR.

  13. Estenose do enxerto de veia safena magna reversa em revascularização arterial infrainguinal Stenosis of reverse great saphenous vein graft in infrainguinal arterial revascularization

    Francesco Evangelista Botelho

    2011-04-01

    Full Text Available OBJETIVO: Avaliar a prevalência de estenose hemodinamicamente significativa na revascularização infrainguinal realizada com a veia safena magna reversa. MÉTODOS: No período compreendido entre março de 2008 e março de 2009, foram realizadas 56 revascularizações infrainguinais com a veia safena magna reversa em 56 pacientes, dos quais 32 foram avaliados com ultrassonografia vascular no 30º dia de pós- operatório. Foi analisada a prevalência de estenoses significativas nos enxertos e sua relação com as características clínico-cirúrgicas dos pacientes. Os parâmetros avaliados foram a localização das estenoses ao longo do enxerto, fatores de risco associados e a relação existente entre a ultrassonografia vascular e o índice tornozelo-braço no diagnóstico de estenoses. RESULTADOS: Houve prevalência de 48,4% de estenoses significativas nos enxertos avaliados, com 19,4% de estenoses graves e 29% de estenoses leve a moderada. Não foram encontradas associações significativas entre sexo, diabetes mellitus, hipertensão arterial, hipercolesterolemia, diâmetro do enxerto, localização da anastomose distal, composição do enxerto e a constatação de estenoses significativas. Observou-se fraca correlação entre os métodos no diagnóstico das estenoses em geral (K = 0,30; IC95% 0,232-0,473; p = 0,018, mas razoável concordância no diagnóstico das estenoses graves (K = 0,75; IC95% 0,655-0,811; p = 0,0001. CONCLUSÃO: Este estudo demonstrou elevada prevalência de estenoses no 30º dia do pós-operatório, com localização predominante na metade proximal do enxerto. O índice tornozelo-braço e a ultrassonografia vascular apresentaram concordância, sobretudo no diagnóstico das estenoses graves, mas o índice tornozelo-braço, isoladamente, mostrou-se insuficiente na vigilância dos enxertos de veia safena magna reversa.OBJECTIVE: The aim of this study was to evaluate the prevalence of hemodynamically significant infrainguinal bypasses stenosis using reverse great saphenous vein graft. METHODS: From March of 2008 to March of 2009, 56 infrainguinal bypasses were performed with reverse great saphenous vein graft in 56 patients. On the 30th post-operative day, 32 out of 56 patients were submitted to vascular ultrasonography. The prevalence of significant graft stenosis was determined. In addition, the diagnosis of stenosis was related to the clinical and surgical characteristics of the patients. The variables analyzed at the moment of diagnosis were the localization of the graft stenosis, the risk factors associated with stenosis and the association of vascular ultrasonography findings with ankle brachial pressure index (ABI. RESULTS: The overall prevalence of significant graft stenosis was 48.4%. Out of the total number of observed stenosis, 19.4% were considered severe, and 29% mild or moderate. There was no significant association between the presence of significant stenosis and the following variables: gender, diabetes, hypertension, smoking, hipercholesterolemia, graft diameter, site of the distal anastomosis, and graft composition. There was a weak agreement between ABI and vascular ultrasonography in detecting stenosis in general (K = 0.30; CL95% 0.232 - 0.473; p = 0.018. However, there was a substantial agreement in detecting severe stenosis (K = 0.75; CL95% 0.655 - 0.811; p = 0.0001. CONCLUSION: There was a high prevalence of stenosis on the 30th post-operative day, mostly localized in the proximal half of the vein graft. There was no significant association of stenosis with clinical and surgical factors analyzed. ABI and vascular ultrasonography had weak agreement with the diagnosis of stenosis in general and an important agreement for the diagnosis of severe stenosis.

  14. Trombose de veia central da retina bilateral associada à síndrome de hiperviscosidade sanguínea: relato de caso Bilateral central retinal vein occlusion associated with blood hyperviscosity syndrome: case report

    John Helal Jr; Fernando Korn Malerbi; Roberto Melaragno Filho

    2005-01-01

    Relato de caso de um paciente masculino de 16 anos de idade com queixa inicial de baixa da acuidade visual e que no exame oftalmológico foi encontrado edema de papila bilateral, que evoluiu para trombose da veia central da retina em ambos os olhos. Na investigação laboratorial, foi feito diagnóstico de um mieloma múltiplo tipo IgA que cursava com síndrome de hiperviscosidade sanguínea, o que explicava o quadro oftalmológico. Após tratamento específico, o paciente apresentou melhora tanto da a...

  15. First clinical experience in applying XperGuide in embolization of jugular paragangliomas by direct intratumoral puncture

    Spelle, Laurent; Moret, Jacques [Fondation Rothschild Hospital, Interventional Neuroradiology Department, Paris (France); Ruijters, Daniel; Babic, Drazenko; Homan, Robert; Mielekamp, Peter; Guillermic, Jeremy [Philips Healthcare, Cardio/Vascular Innovation, Best (Netherlands)

    2009-11-15

    The purpose of this study is to introduce a novel image-guided technique utilized in the embolization of jugular paraganglioma tumors, using preoperative diagnostic scans and planning together with perioperative X-ray fluoroscopy in a combined image. A lesion center and a skin entry point on the patient are selected and connected with a straight line, which resembles the most ideal lesion access trajectory to be followed during the needle insertion. The skin entry point and the corresponding line location are selected such that it avoids the impenetrable bones and vital anatomical structures. Two viewing incidence angles are defined to guide the cranial needle insertion: the entry view tangent to the planned trajectory, and the progression view perpendicular to the path. The proposed method was applied in two patients with jugular paragangliomas in order to navigate needles to the lesion location and subsequently embolize the tumors. The perioperative registration took less than 8 s. Using this method, it was possible to guide the needle within 5 mm of the planned path. The fluoroscopic needle navigation, overlaid on the corresponding soft tissue of the underlying anatomy, combined with a planned path, has been shown to be an accurate and efficient tool for needle guidance. The patient pose varied between the preoperative data and the fluoroscopy guided intervention, but this did not hinder the procedure. (orig.)

  16. As diferenças entre comunicação interna e endomarketing

    Carolina Girotto Ochoa

    2014-01-01

    Full Text Available Atualmente, a comunicação empresarial é algo imprescindível no mundo dos negócios. Em busca de crescimento e melhores resultados, as empresas sempre investiram na comunicação destinada aos clientes, o público externo. Porém, há algum tempo, percebeu-se a necessidade de conquistar o público interno, basicamente composto por empregados e familiares, para que os bons resultados e qualidade de produtos e serviços sejam mantidos. As empresas passaram a investir em ações de comunicação interna e de endomarketing para estreitar relacionamento e motivar os empregados, com o objetivo de obter os resultados esperados. Muitos profissionais costumam, erroneamente, conceituar comunicação interna e endomarketing como sinônimos. Este artigo tem por objetivo diferenciá-los.

  17. Trombose da arteria carotida interna no curso e doena reumatica: registro de um caso

    Pedro F. Moreira Filho

    1978-06-01

    Full Text Available relatado o caso de jovem que apresentou, de modo agudo, hemiplegia e hipertemia. O estudo angiogrfico revelou trombose de poro distal da cartida interna e as provas laboratoriais evidenciaram doena reumtica. Os autores fazem referncia endoarterite reumtica provocando ocluso arterial e comentam o diagnstico deferencial que deve ser feito com acidentes vasculares devidos a embolos oriundos de endocrdio afetado pela afeco reumtica.

  18. El desarrollo laboral sustentable y su relacin con la migracin interna en Mxico

    Jess Sergio, Snchez Rodrguez; Jos Ral, Luyando Cuevas; Ernesto, Aguayo Tllez; Esteban, Picazzo Palencia.

    2014-08-01

    Full Text Available En este trabajo se estudi la interaccin entre la migracin interestatal y el desarrollo laboral sustentable en Mxico del ao 2000 al 2010, de acuerdo con la visin de Amartya Sen. Este desarrollo se midi con el ndice de competitividad social, y la interaccin con la migracin interna se evalu [...] con un modelo de ecuaciones simultneas. Los resultados confirmaron que a mayor desarrollo laboral sustentable, el grado de inmigracin fue ms y viceversa. Por otro lado, no se encontr relacin alguna entre la emigracin interna y el desarrollo laboral sustentable. Al desagregar el ndice de competitividad social, se encontr una relacin causal mutua entre el ndice de la ausencia de pobreza salarial y la inmigracin interna, as como una relacin causa-efecto positiva entre ausencia de pobreza salarial sobre la emigracin interna, la cual no se da en el otro sentido. Abstract in english This article studies the interaction between interstate migration and sustainable workforce development in Mexico from 2000 to 2010, based on Amartya Sen's philosophies. Sustainable workforce development was measured using the Social Competitiveness Index, and its interaction with internal migration [...] was evaluated by estimating a simultaneous equations model. The results confirm the existing interdependence between internal immigration and sustainable workforce development; this means that higher sustainable workforce development generates higher immigration levels and vice versa. On the other hand, we did not find a relation between internal emigration and sustainable workforce development. When disaggregating the Social Competitiveness Index, we found a mutual causal relationship between a low poverty wage index and internal immigration. Also, there is a positive causal relationship between poverty wage index and an increase in internal emigration.

  19. Descarga Interna e Tensão de Retorno em Capacitores

    Robert Renê

    2001-01-01

    Os fenômenos de descarga interna e tensão de retorno em capacitores são calculados no caso onde a resposta do dielétrico é da forma exponencial no tempo. Com esta hipótese a matemática envolvida é simples e as características gerais dos fenômenos de hereditariedade podem ser seguidas.

  20. Descarga Interna e Tensão de Retorno em Capacitores

    Robert Renê

    2001-01-01

    Full Text Available Os fenômenos de descarga interna e tensão de retorno em capacitores são calculados no caso onde a resposta do dielétrico é da forma exponencial no tempo. Com esta hipótese a matemática envolvida é simples e as características gerais dos fenômenos de hereditariedade podem ser seguidas.

  1. Estructura interna y caractersticas tecnolgicas de las industrias achelenses en la cuenca media occidental del Duero

    Martn Benito, Jos Ignacio

    2009-01-01

    RESUMEN: Se realiza aqu una aproximacin general sobre las industrias achelenses del occidente de la Meseta norte espaola, atendiendo a aspectos puramente tecnolgicos, tanto por lo que se refiere a su estructura interna como a las caractersticas de su evolucin. Se observar, asimismo, que las convergencias tecnolgicas de las industrias reflejan una cierta unidad en el Achelense de la cuenca del Duero.SUMMARY: This paper a general approach to the Acheulean industry of the Western Meseta,...

  2. Informe de la consistencia interna de las escalas en las investigaciones publicadas en la Revista Colombiana de Psiquiatra

    Adalberto Campo-Arias

    2013-01-01

    Full Text Available Objetivo: Establecer la frecuencia del informe de la consistencia interna de las escalas en investigaciones publicadas en la Revista Colombiana de Psiquiatra (RCP entre el 2006 y el 2010. Mtodo: Se realiz un estudio descriptivo que cuantific el informe de la consistencia interna (alfa de Cronbach de las escalas usadas en estudios publicados, como artculos originales, en la RCP. Se excluyeron estudios de validacin. Resultados: De 114 artculos publicados, se incluyeron 30 estudios en el anlisis. Los investigadores aplicaron 67 escalas en las mediciones de algunas variables y se inform el alfa de Cronbach en la poblacin participante de 20 escalas (29,8 %. Conclusiones: Un reducido nmero de estudios publicados en la RCP que usan escalas en las mediciones informan la consistencia interna en la muestra participante. Es necesario que los autores mencionen la consistencia interna de las escalas en la poblacin del estudio para garantizar la validez de las conclusiones.

  3. Pseudoaneurisma de aorta como causa de síndrome da veia cava superior: relato de caso Aortic pseudoaneurysm as cause of superior vena cava syndrome: a case report

    Katsuro Harada Júnior

    2012-09-01

    Full Text Available A síndrome da veia cava superior representa o conjunto de sinais e sintomas decorrentes da sua obstrução. A síndrome tem como principais etiologias tumores malignos, como o carcinoma broncogênico, o linfoma e a metástase mediastinal. O câncer de pulmão é responsável por 80% dos casos, os linfomas mediastinais por 15%, e 5% correspondem às demais causas. Este relato de caso objetiva apresentar um caso incomum dessa síndrome, ocorrido em um paciente do sexo masculino após ferimento penetrante no tórax, resultando em pseudoaneurisma de arco aórtico e a síndrome da veia cava superior.The superior vena cava syndrome represents the set of signs and symptoms resulting from obstruction of superior vena cava. The syndrome has as main causes malignant tumors such as bronchogenic carcinoma, lymphoma and mediastinal metastases. Lung cancer accounts for 80% of cases, mediastinal lymphomas by 15% and 5% correspond to other causes. This case report aims to present an unusual case of this syndrome, which occurred in a male patient after penetrating wound in the chest, which developed a pseudoaneurysm of the aortic arch and superior vena cava syndrome.

  4. Correlação entre os índices dopplervelocimétricos da veia cava inferior e ducto venoso e a concentração de hemoglobina do cordão em fetos de gestantes isoimunizadas

    Taveira Marcos Roberto

    2003-01-01

    Full Text Available OBJETIVO: o objetivo principal desse estudo foi verificar se existe correlação entre os índices dopplervelocimétricos da veia cava inferior e do ducto venoso e a concentração sérica da hemoglobina fetal. MÉTODOS: estudo transversal e prospectivo, realizado entre janeiro de 1998 e junho de 2001. Foram acompanhadas 31 gestantes isoimunizadas com resultado do teste de Coombs indireto maior que 1:8, que foram submetidas à pesquisa de hemólise fetal. Quando foram indicadas as transfusões intra-uterinas intravasculares, a hemoglobina do cordão foi dosada no início do procedimento. Nos demais casos, a hemoglobina do cordão foi mensurada no momento do parto, sempre por cesariana eletiva. Obteve-se um total de 74 procedimentos estudados, definidos como sendo cada transfusão intra-uterina precedida pela dopplervelocimetria venosa. A mensuração da concentração da hemoglobina fetal foi realizada no Hemocue® (B-Hemoglobin Photometer Hemocue AB; Angelholm, Sweden, dispositivo usado para a determinação quantitativa de hemoglobina no sangue. A dopplervelocimetria da cava inferior e do ducto venoso foi realizada antecedendo a coleta do sangue fetal, sempre em intervalo de tempo inferior a 24 horas. Os índices dopplervelocimétricos estudados foram o índice de pulsatilidade para veias (IPV, o índice do pico de velocidade para veias (IPVV e a relação entre o pico de velocidade durante a fase de contração atrial e o pico de velocidade na sístole ventricular (relação CA/SV ou índice de pré-carga, na veia cava inferior, e o IPV, IPVV e a relação entre os picos de velocidade da sístole ventricular e da contração atrial (relação SV/CA, no ducto venoso. Foi realizado estudo de correlação entre a dopplervelocimetria da veia cava inferior e do ducto venoso e a hemoglobina do cordão, pela técnica de regressão linear simples. Realizou-se também estudo de associação entre os índices dopplervelocimétricos do compartimento venoso e a hemoglobina fetal inferior a 10 g/dL, por meio do teste do c². RESULTADOS: foi efetuado um total de 74 procedimentos. Em 23 desses a hemoglobina fetal era inferior a 7,0 g/dL. Houve correlação negativa significativa entre todos os índices dopplerfluxométricos estudados e a concentração de hemoglobina fetal (p<0,05, ou seja, os valores mais elevados dos índices dopplervelocimétricos foram observados nos fetos com anemia mais acentuada. Os fetos com nível de hemoglobina inferior ou igual a 10,0 g/dL apresentaram valores dos índices dopplervelocimétricos da cava e do ducto venoso acima do percentil 95 para a idade gestacional. CONCLUSÕES: a dopplervelocimetria da cava inferior e do ducto venoso pode ser utilizada como marcador não invasivo da anemia fetal grave.

  5. Isolamento das veias pulmonares em pacientes com fibrilação atrial permanente secundária a valvopatia mitral Isolation of the pulmonary veins in patients with permanent atrial fibrillation secondary to mitral valve disease

    Gustavo G. Lima

    2004-04-01

    Full Text Available OBJETIVO: Analisar a eficácia do isolamento cirúrgico das veias pulmonares para restabelecer ritmo sinusal em pacientes com fibrilação atrial secundária à doença mitral. MÉTODOS: 33 pacientes com indicação de correção cirúrgica da valva mitral e com fibrilação atrial permanente, foram submetidos ao isolamento cirúrgico das veias pulmonares, sendo 67% mulheres. Média de idade de 56,3±10 anos, classe funcional NYHA pré-operatória de 3,2±0,6, tamanho de átrio esquerdo de 5,5± 0,9 cm, fração de ejeção de 61,3±13%. A técnica cirúrgica consistiu de incisão circunferencial ao redor das 4 veias pulmonares, excisão do apêndice atrial esquerdo e de incisão perpendicular desde a borda inferior da incisão, isolando as veias pulmonares, até o ânulo da valva mitral. Arritmias precoces foram tratadas, agressivamente, com cardioversão. RESULTADOS: O seguimento médio foi de 23,9±17 meses e ocorreram 3 óbitos no pós-operatório. Dez pacientes necessitaram de cardioversão elétrica no pós-operatório; 87% apresentavam ritmo sinusal na última consulta e 33% estavam em uso de amiodarona. CONCLUSÃO: Isolamento das veias pulmonares associado à cirurgia da valva mitral é uma técnica efetiva e segura na manutenção de ritmo sinusal em pacientes com fribilação atrial permanente.OBJECTIVE: To assess the efficacy of surgical isolation of the pulmonary veins for re-establishing sinus rhythm in patients with atrial fibrillation secondary to mitral valve disease. METHODS: Thirty-three (67% were women patients with permanent atrial fibrillation and indication for surgical correction of the mitral valve underwent surgical isolation of the pulmonary veins. Their mean age was 56.3±10 years, preoperative NYHA functional class was 3.2±0.6, left atrial size was 5.5±0.9 cm, and ejection fraction was 61.3±13%. The surgical technique consisted of a circumferential incision surrounding the 4 pulmonary veins, excision of the left atrial appendage, and a perpendicular incision originating in the inferior margin of the circumferential incision isolating the pulmonary veins down to the mitral valve. Early arrhythmias were aggressively treated with cardioversion. RESULTS: The mean follow-up was 23.9±17 months, and 3 patients died in the postoperative period. Ten patients required electrical cardioversion in the postoperative period; 87% had sinus rhythm in the last medical visit, and 33% were using amiodarone. CONCLUSION: Isolation of the pulmonary veins associated with mitral valve surgery is an effective and safe technique for maintaining sinus rhythm in patients with permanent atrial fibrillation.

  6. Comparison of Hematologic and Biochemical Test Results in Blood Samples Obtained by Jugular Venipuncture Versus Nail Clip in Moluccan Cockatoos (Cacatua moluccensis).

    Bennett, Tracy D; Lejnieks, Daniel V; Koepke, Hoyt; Grimson, Fiona; Szucs, Jennifer; Omaits, Kerri; Lane, Rosalie

    2015-12-01

    In birds, blood samples are often collected from the jugular, medial metatarsal, and basilic vein. Samples are sometimes collected by toe nail clip, but concerns to avoid drawing blood from the nail include pain after nail clips for blood collection, potential differences in complete blood count (CBC) results, and potential contamination with uric acid values. To compare differences in biochemical and hematologic values in blood samples obtained by jugular venipuncture versus toenail clip, blood samples were collected from Moluccan cockatoos (Cacatua moluccensis) (N = 23) and sent to a commercial laboratory for routine CBCs and serum biochemical analysis. Results showed good agreement between venipuncture and nail clip blood samples in red blood cell count, packed cell volume, heterophil count and percentage, lymphocyte count and percentage, aspartate aminotransferase, chloride, creatine phosphokinase, glucose, lactate dehydrogenase, total protein, and uric acid values. Constant bias was found in values of bile acids, cholesterol, and hemoglobin. Proportional bias toward higher values in the jugular sample were found in total white blood cell (WBC) count and inorganic phosphorus. Serum calcium plots revealed a proportional bias toward higher values in the toe nail blood when values were increased. Results suggest some differences in WBC count, bile acids, calcium, cholesterol, hemoglobin, and phosphorus values between blood samples collected by jugular venipuncture and samples collected by toe nail clip, but the differences are mostly minor and, with the possible exception of inorganic phosphorus and marginally elevated or very low WBC counts, are unlikely to affect the use or interpretation of the avian blood panel. PMID:26771320

  7. Reação de fase aguda e parasitismo na veia central da supra-renal de chagásicos crônicos

    Daniel Ferreira da Cunha

    1994-06-01

    Full Text Available A reação sistêmica aos traumatismos e infecções graves, reação de fase aguda, (RFA, pode determinar imunossupressão e reativação de infecções latentes. O objetivo do trabalho foi verificar, em 71 chagásicos crônicos com ousem RFÁ, a freqüência de parasitismo pelo T. cruzi na veia central da supra-renal (VCSR. Os critérios para RFA (+ foram observados em 30 chagásicos: lmorteporsepsis e/outrauma após evolução maior que umasemana e 2presença de úlceras de stress sangrantes, ou 3 hiperplasia reacional do baço ou 4 esteatose hepática. Registrou-se peso e altura e calculou-se o índice de massa corporal (IMC. Chagásicos com RFA (+ apresentaram maior comprometimento nutricional que os RFA (-: peso = 49,0 vs 54,5 kg; IMC = 17,5 vs 20,6kg/m2 (mediana pThe systemic reaction to severe trauma and/or infection, acute phase response (APR, are often associated with immunossupression and reactivation of chronic latent infection. Our main purpose was to verify, in a group of 71 autopsied chronic chagasic with or without APR, thefrequency of T. cruzi nests inthe central vein of adrenal gland (CVAG. APR, defined by: 1 death secondary to sepsis and/or trauma plus, 2 bleeding stress gastric ulcerations or 3 spleen reactional state or 4 liver steatosis, was observed in 30 chronic chagasic (APR +. Weight, height and body mass index (BM1 were obtained. APR (+ chronic chagasic had worse nutritional status than APR(~ ones: weight = 49.0 vs 54.5kg; BM1 = 17.5MS 20.6kg/m? (medianp < 0.05. CVAG T. cruzi nests frequency were similar (43.3% and 43,9%, respectively between both Groups. We conclude that APR(+ chronic chagasic had worse nutritional status than APR (- ones, and that APR development did not change the CVAG T. cruzi nests frequency.

  8. ndices de onda P na predio de recorrncia de fibrilao atrial aps isolamento da veia pulmonar / P wave indices to predict atrial fibrillation recurrences post pulmonary vein isolation

    Ahmed, Salah; Shenghua, Zhou; Qiming, Liu; Hui, Yan.

    2013-12-01

    Full Text Available FUNDAMENTO: ndices de ondas P so marcadores interessantes para prever recorrncias de fibrilao atrial (FA) ps ablao. OBJETIVO: Esse estudo avalia o valor dos ndices de onda P para prever recorrncias aps isolamento da veia pulmonar (IVP) em pacientes com fibrilao atrial paroxstica. MTOD [...] OS: Foram selecionados 198 pacientes (57 8 anos, 150 homens) com FA paroxstica sintomtica refratria a medicamentos submetidos ao IVP em nosso hospital. Um eletrocardiograma de 12 derivaes foi utilizado para medir a durao da onda P na derivao II, a fora terminal de P (FTP) na derivao V1, o eixo e a disperso da onda P. RESULTADOS: No acompanhamento de 9 3 meses, as recorrncias ocorreram em 60 (30,3%) pacientes. Os pacientes que apresentaram recorrncia de FA tiveram maior durao mdia de onda P (122,9 10,3 versus 104,3 14,2 ms, p 125 ms apresenta 60% de sensibilidade, especificidade de 90%, valor preditivo positivo (VPP) de 72% e valor preditivo negativo (VPN) de 83,7%, enquanto a disperso da onda P > 40 ms tem 78% de sensibilidade, 67% de especificidade, PPV 51% e VPN de 87,6%. 48/66 (72,7%) dos pacientes com FTP -0,04 mm/segundo tiveram recorrncia de FA (p 125 ms, a disperso da onda P > 40 ms e FTP em V1 Abstract in english BACKGROUND: P-wave indices are appealing markers for predicting atrial fibrillation (AF) recurrences post ablation. OBJECTIVE: This study evaluates the value of P wave indices to predict recurrences post pulmonary vein isolation (PVI) in patients with paroxysmal AF. METHODS: We selected 198 patients [...] (57 8 years, 150 males) with symptomatic drug-refractory paroxysmal AF undergoing PVI in our hospital. A 12-lead electrocardiogram was used to measure P wave duration in lead II, P wave terminal force (PWTF) in lead V1, P wave axis and dispersion. RESULTS: During a follow-up of 9 3 months, recurrences occurred in 60 (30.3%) patients. The patients that had AF recurrence had longer mean P wave duration (122.9 10.3 vs 104.3 14.2 ms, p 125 ms has 60% sensitivity, 90% specificity, positive predictive value (PPV) of 72% and negative predictive value (NPV) of 83.7%, whereas P wave dispersion > 40 ms has 78% sensitivity, 67% specificity, PPV of 51% and NPV of 87.6% 48/66 (72.7%) patients with PWTF -0.04 mm/second showed recurrence of AF (p 125 ms, P wave dispersion > 40 ms and PWTF in V1

  9. A Study on Effects of the Transient Compression by Tightly Tied Necktie on Blood Flow in the Internal Jugular Veins Using 2D-PC MRA

    Kim, Keung Sik; Chung, Tae Sub; Lee, Bum Soo [Dept. of Diagnostic Radiology, Yongdong Severance Hospital Yensei University, Seoul (Korea, Republic of); Park, In Kook [Dept. of Biology, Dongguk University, Seoul (Korea, Republic of); Kim, Hyun Soo [Dept. of Biology, Kangwon National University, Chuncheon (Korea, Republic of); Yoo, Beong Gyu [Dept. of Radiotechnology, Wonkwang Health Science College, Iksan (Korea, Republic of)

    2008-09-15

    The 25 healthy male volunteers aged from 20 to 50 years old have been employed in this study. 2D-PC MRA was performed to measure the velocity of the blood flow in the internal carotid artery and internal jugular veins using 3.0T MRI Whole body (signa VH/i GE). ECTRICKS-CEMRA was performed to evaluate the pattern of blood circulation from internal carotid artery to internal jugular vein. Using 2D-PC MRA, the cross-section of the 4th and 5th cervical discs was scanned with 24 cm FOV. Then the speed of blood flow was measured for internal carotid artery and internal jugular vein when the subject wears a necktie tightly and no tie. The average of maximum velocity of internal carotid arteries without a necktie was 72.13 cm/sec in the right side and 74.96 cm/sec in the left side (average 73.54 cm/sec in both sides) while the average of maximum velocity of internal jugular veins without a necktie was -34.45 cm/sec in the right side and -24.99 cm/sec in the left side (-29.72 cm/sec in both sides). However, when wearing a necktie tightly, the average of maximum velocity of internal carotid arteries was 61.35 cm/sec in the right side and 65.19 cm/sec in the left side (average 63.27 cm/sec in both sides) while the average of maximum velocity of internal jugular veins was -22.14 cm/sec in the right side and -17.93 cm/sec in the left side (-20.03 cm/sec in both sides). With the necktie tightly knotted, the average blood flow speed of both internal carotid arteries slightly decreased to 86% (63.27/73.54 cm/sec) compared to no tie case in which both internal jugularveins significantly went down to 67% (-20.03/-29.72 cm/sec). Thus it is suggested that wearing a necktie affects the circulation of internal jugular veins (33% decrease in blood flow speed) more significantly than that of internal carotid artery (14% decrease in blood flow speed). Without a necktie, ECTRICKS-CEMRA showed natural blood circulation patterns of internal carotid arteries and internal jugular veins without any disturbances or compressions. However, when wearing a necktie tightly, ECTRICKS-CEMRA showed severe compression onto both internal jugular veins in all 25 volunteers. In conclusion, the result of the study showed that the tightly worn necktie instantly presses more internal jugular veins than internal carotid arteries, thereby significantly reducing the blood flow speed and leading to the temporary occlusion. Thus, the defecation or washing the face under the tightly tied necktie situations can cause the unexpected and temporary compression or occlusion of the internal jugular veins, subsequently leading to the occurrences of the stroke due to the secondary intracranial venous hypertension.

  10. A Study on Effects of the Transient Compression by Tightly Tied Necktie on Blood Flow in the Internal Jugular Veins Using 2D-PC MRA

    The 25 healthy male volunteers aged from 20 to 50 years old have been employed in this study. 2D-PC MRA was performed to measure the velocity of the blood flow in the internal carotid artery and internal jugular veins using 3.0T MRI Whole body (signa VH/i GE). ECTRICKS-CEMRA was performed to evaluate the pattern of blood circulation from internal carotid artery to internal jugular vein. Using 2D-PC MRA, the cross-section of the 4th and 5th cervical discs was scanned with 24 cm FOV. Then the speed of blood flow was measured for internal carotid artery and internal jugular vein when the subject wears a necktie tightly and no tie. The average of maximum velocity of internal carotid arteries without a necktie was 72.13 cm/sec in the right side and 74.96 cm/sec in the left side (average 73.54 cm/sec in both sides) while the average of maximum velocity of internal jugular veins without a necktie was -34.45 cm/sec in the right side and -24.99 cm/sec in the left side (-29.72 cm/sec in both sides). However, when wearing a necktie tightly, the average of maximum velocity of internal carotid arteries was 61.35 cm/sec in the right side and 65.19 cm/sec in the left side (average 63.27 cm/sec in both sides) while the average of maximum velocity of internal jugular veins was -22.14 cm/sec in the right side and -17.93 cm/sec in the left side (-20.03 cm/sec in both sides). With the necktie tightly knotted, the average blood flow speed of both internal carotid arteries slightly decreased to 86% (63.27/73.54 cm/sec) compared to no tie case in which both internal jugularveins significantly went down to 67% (-20.03/-29.72 cm/sec). Thus it is suggested that wearing a necktie affects the circulation of internal jugular veins (33% decrease in blood flow speed) more significantly than that of internal carotid artery (14% decrease in blood flow speed). Without a necktie, ECTRICKS-CEMRA showed natural blood circulation patterns of internal carotid arteries and internal jugular veins without any disturbances or compressions. However, when wearing a necktie tightly, ECTRICKS-CEMRA showed severe compression onto both internal jugular veins in all 25 volunteers. In conclusion, the result of the study showed that the tightly worn necktie instantly presses more internal jugular veins than internal carotid arteries, thereby significantly reducing the blood flow speed and leading to the temporary occlusion. Thus, the defecation or washing the face under the tightly tied necktie situations can cause the unexpected and temporary compression or occlusion of the internal jugular veins, subsequently leading to the occurrences of the stroke due to the secondary intracranial venous hypertension.

  11. Balloon atrial septostomy through internal jugular vein in a 45-day-old child with transposition of great arteries

    Padhi Sumanta

    2010-01-01

    Full Text Available Balloon atrial septostomy is a common palliative procedure in D-transposition of great arteries. It is technically easy before 2-3 weeks of age when the septum primum is thin. Femoral vein or umbilical vein, when available, is the common access used for this procedure. In situations when these accesses are not available or in case of inferior vena cava interruption, trans-hepatic access is used. Internal jugular vein (IJV access is not used as it is difficult to enter the left atrium through this route. We describe a case of successful Balloon atrial septostomy done through IJV in a 45-day-old child with emphasis on the technique, hardware and precautions necessary during the procedure.

  12. Use of optimized ultrasound axis along with marked introducer needle to prevent mechanical complications of internal jugular vein catheterization

    Tanmoy Ghatak

    2013-01-01

    Full Text Available Internal jugular vein (IJV catheterization is a routine technique in the intensive care unit. Ultrasound (US guided central venous catheter (CVC insertion is now the recommended standard. However, mechanical complications still occur due to non-visualization of the introducer needle tip during US guidance. This may result in arterial or posterior venous wall puncture or pneumothorax. We describe a new technique of (IJV catheterization using US, initially the depth of the IJV from the skin is measured in short-axis and then using real time US long-axis view guidance a marked introducer needle is advanced towards the IJV to the defined depth measured earlier in the short axis and the IJV is identified, assessed and cannulated for the CVC insertion. Our technique is simple and may reduce mechanical complications of US guided CVC insertion.

  13. Radiographic Thrombus within the External Jugular Vein: Report of a Rare Case and Review of the Literature

    Zia, Sayyad Yaseen; Bakst, Richard L.; Si, Qiusheng; Yao, Mike; Som, Peter M.

    2015-01-01

    We are reporting a case of a 91-year-old male with a primary malignancy of the right parotid gland with radiographic thrombus extension within the right external jugular vein. He was treated with palliative radiation therapy to the right parotid mass with a marked clinical response. The rarity of this occurrence as documented in the review of the literature provides for uncertainty with regard to proper management. Radiographic evidence of thrombus in the absence of clinical manifestations, the role of anticoagulation, and the proper radiation target delineation were all challenges encountered in the care of this patient. Our case represents a rare occurrence with unique radiologic findings that has implications for management. PMID:26550513

  14. Endovascular Internal Trapping of Ruptured Occipital Artery Pseudoaneurysm Associated with Occipital-Internal Jugular Vein Fistula in Neurofibromatosis Type 1.

    Imahori, Taichiro; Fujita, Atsushi; Hosoda, Kohkichi; Kohmura, Eiji

    2016-05-01

    Spontaneous cervical extradural pseudoaneurysms or arteriovenous fistulas (AVFs) are rare vascular diseases. We report a case of ruptured occipital artery (OA) pseudoaneurysm associated with occipital-internal jugular vein (IJV) fistula in neurofibromatosis type 1. Endovascular internal trapping via the OA was attempted; however, the distal entry of the OA could not be accessed because of the high shunt flow and tortuosity of the OA. The distal part of the OA was obliterated with coil via a transvenous approach through the IJV and pseudoaneurysm. The proximal entry of the OA was obliterated with coil and glue under proximal flow control with a balloon, and the fistula was successfully obliterated without placement of coils in the pseudoaneurysm. When ordinary internal trapping via a transarterial approach is not possible, the transvenous approach should be considered as an alternative for AVF associated with an aneurysmal component. PMID:26971039

  15. Bilhemia after trans-jugular intra-hepatic porto-systemic shunt and its management with biliary decompression

    Ashwani K Singal, Manoj K Kathuria, Advitya Malhotra, Richard W Goodgame, Roger D Soloway

    2009-08-01

    Full Text Available Bilhemia or bile mixing with blood is a rare clinical problem. The clinical presentation is usually transient self-resolving hyperbilirubinemia, progressive and rapidly rising conjugated hyperbilirubinemia, or recurrent cholangitis. Endoscopic retrograde cholangiopancreatography (ERCP plays an important role in diagnosis and management. Biliary decompression with endoscopic sphincterotomy is useful in treating these patients. If not recognized and treated in time, the condition can be fatal in a significant proportion of patients. This usually occurs after blunt or penetrating hepatic trauma due to a fistulous connection between the biliary radicle and portal or hepatic venous radical. Cases have been described due to iatrogenic trauma such as liver biopsy and percutaneous biliary drainage. However, the occurrence after trans-jugular intra-hepatic porto-systemic shunt (TIPS is very rare. We report a case of bilhemia presenting as rapidly rising bilirubin after TIPS. The patient was managed successfully with ERCP and removal of a blood clot from the common bile duct.

  16. Observation and partial targeted surgery in the management of tympano-jugular paraganglioma: a contribution to the multioptional treatment.

    Mazzoni, Antonio; Zanoletti, Elisabetta

    2016-03-01

    The objective of this study was to assess the value of a limited tumor excision in tympano-jugular paragangliomas treated with observation with the goal of preventing, or repairing, a neural (VII cranial nerve) or brain damage and continue an otherwise correct observation. This is a retrospective case review. Each patient was submitted to a complete neuro-radiological work-up for diagnosis including CT, MRI, and angiography if needed of tympano-jugular paraganglioma class C. All the cases were submitted to observation and in 16 cases partial targeted surgery was performed. In 10 cases, the procedure involved a targeted removal of the tumor growing in contact with, or invading, the Fallopius. In four cases, the procedure was a petro-occipital trans-sigmoid approach to remove the intradural portion of tumor producing the picture of brain stem compression. In two cases, there was the excision of the bleeding tumor surfaces in the outer ear canal. Follow-up ranged from 4 to 20 years. Success was considered the maintenance of observation without the change of class of tumor extension. In 13 over 16 cases, the observation could be continued, as it still was the more favorable option between natural and surgical morbidity. In the other three cases, a newly installed paralysis of the 9-10 cranial nerves due to tumor growth involved a correction of the strategy to a radical procedure. Partial targeted surgery was directed to cases submitted to observation. It allowed to prevent, or repair, an impending, or actual damage to the facial nerve or the brain stem and to continue the abstentional treatment by keeping the balance between natural and therapy morbidity in favor of observation. PMID:25822289

  17. Contraportada interna

    Cramer, Thomas

    2012-01-01

    Geología Colombiana ISSN: 0072-0992 Geología Colombiana publica desde 1962 contribuciones dedicadas a las Ciencias de la Tierra, en especial las relacionadas con Colombia, Sudamérica y el Caribe, pero también de otras regiones que pueden tener importancia comparativa, divulgar conocimientos, innovaciones, métodos, técnicas, interacciones con la sociedad, etc. Es una revista especializada en Geociencias editada por el Departamento de Geociencias de la Universidad Nacional de Colombia, Sede Bog...

  18. Edema de membro inferior secundrio a exrese de veia safena magna para utilizao como enxerto na revascularizao do miocrdio Lower limb edema after great saphenous vein harvesting to be used as graft in myocardial revascularization

    Cleusa Ema Quilici Belczak

    2009-03-01

    Full Text Available CONTEXTO: A revascularizao do miocrdio utilizando-se a veia safena magna ainda procedimento cirrgico bastante realizado na atualidade. O edema que surge no membro inferior operado causa grande desconforto e necessita ser melhor estudado. OBJETIVOS: Caracterizar o edema de membro inferior secundrio a exrese da veia safena magna pela tcnica de incises escalonadas para sua utilizao como enxerto venoso na revascularizao do miocrdio. MTODOS: Foram selecionados aleatoriamente 44 indivduos submetidos a exrese de veia safena magna para revascularizao miocrdica h mais de 3 meses. Excluram-se fatores que pudessem interferir na formao de edema dos membros inferiores. Foram avaliados por volumetria e perimetria maleolares ambos os membros inferiores. Considerou-se como presena de edema significativo a diferena de volume maior que 50 mL e maior de 2 cm em relao ao membro no-operado. Para a anlise estatstica foram empregados o teste do qui-quadrado, teste exato de Fisher, teste t de Student e o teste de McNemar. O nvel de significncia adotado foi de 5% (a = 0,05. RESULTADOS: Encontraram-se diferenas estatisticamente significativas (p BACKGROUND: Myocardial revascularization using the great saphenous vein is still a very common surgical procedure. The edema that occurs in the operated leg causes much discomfort and requires further studies. OBJECTIVES: To describe lower limb edema secondary to great saphenous vein harvesting using the bridge technique for use as venous graft in myocardial revascularization. METHODS: Forty-four individuals previously submitted to great saphenous vein harvesting for myocardial revascularization more than 3 months before were randomly selected. Patients with factors that might interfere with formation of lower limb edema were excluded. Both operated and non-operated legs were evaluated by volumetry and perimetry of the malleolar region. Differences greater than 50 mL or higher than 2 cm between the operated and the contralateral leg were considered as presence of significant edema. Chi-square, Fishers, McNemars and Students t tests were used for statistical analysis. Significance level was set at 5% (a = 0.05. RESULTS: Statistically significant differences (p < 0.05 were found between operated and contralateral legs, with 56.8% of the individuals having a difference in volume greater than 50 mL and 31.9% having a difference in malleolar region perimeter greater than 2 cm. There was no association between presence of edema and sample characteristics, surgery, perioperative or late clinical complications. CONCLUSIONS: Patients submitted to resection of the great saphenous vein for coronary artery bypass grafting may evolve with edema of the operated leg.

  19. Dissecção minimamente invasiva da veia safena para obtenção de enxerto venoso na cirurgia de revascularização do miocárdio

    Ricardo Ribeiro DIAS

    1997-07-01

    Full Text Available São apresentados os resultados iniciais de pacientes submetidos à cirurgia de revascularização do miocárdio (RM, nos quais os enxertos venosos foram obtidos através de técnica minimamente invasiva. A técnica consiste na dissecção da veia safena através de incisões de 3 a 4 cm, repetidas a intervalos variáveis (de 8 a 14 cm sobre o trajeto da veia cuja liberação é feita com auxílio de afastadores apropriados, ótica de iluminação e instrumental específico. A técnica permitiu a obtenção de segmentos de veia de 30 a 65 cm (média de 51,6 cm através de 2 a 4 incisões na pele. O método foi usado com sucesso em 8 pacientes que receberam 25 enxertos venosos, além de enxertos arteriais. A evolução do membro inferior foi bastante em todos os pacientes, possibilitando deambulação precoce, redução da dor, edemas, hematomas e excelente efeito cosmético.We present here the initial results of patients submitted to myocardial revascularization with the employment of minimally invasive technique of saphenous vein graft dissection. We utilized small incisions (3 to 4 cm over the skin of the inferior limb, repeated at intervals of 8 to 14 cm to obtain the vein graft, with the aid of an adequate ilumination and special retractors. This method provided veins of 30 to 65 cm of length, through 2 to 4 small skin incisions. We operated on 8 patients who received 25 saphenous vein grafts plus the arterial ones. All patients improved well, without complications of the inferior limb and with a very good stetic effect.

  20. Mejora de la comunicación interna en una gran empresa

    Jiménez Burgueño, Pol

    2015-01-01

    El presente proyecto presenta un estudio del funcionamiento de la comunicación interna en la empresa Seguros Catalana Occidente, una multinacional aseguradora que el año pasado celebró su 150 aniversario, una empresa que ha experimentado un gran crecimiento en los últimos seis años por la adquisición de empresas más pequeñas y que ha visto engrandecida su plantilla de empleados, a la vez que se enfrenta a un constante relevo generacional en todo sus ámbitos de negocio. El pr...

  1. Consumo de combustible de los motores de combustión interna

    Roberto P. González Valdés

    2010-01-01

    Full Text Available En el presente trabajo se analizan los resultados de investigaciones realizadas sobre el consumo de combustibles de motores de combustión interna (MCI de consumo diesel y gasolina y su variación en función de la masa y la potencia desarrollada. Se establecen correlaciones entre los índices y la influencia de las características de diseño mediante el programa STATGRAPHICS Plus 5.0, obteniéndose las ecuaciones de los modelos ajustados.

  2. Sertolioma unilateral como causa de morte súbita por hemorragia interna em ganso Anser cygnoides

    R. Sesterhenn; T.Z. Ferreira; L.C.B. Fallavena; C. Pianta; H.L.S. Moraes; L. Kindlein

    2014-01-01

    Um ganso adulto macho (Anser cygnoides), da família Anseriformes, de idade desconhecida, proveniente de uma criação da Universidade Luterana do Brasil, foi encontrado morto, sem apresentar histórico clínico, e foi submetido à investigação post mortem no Setor de Patologia Veterinária do Hospital Veterinário. Com base nos achados de necropsia e no exame histopatológico, definiu-se como causa da morte do animal hemorragia interna em razão da ruptura de vasos sanguíneos em uma neoplasia no testí...

  3. Proposta de uma medida de empatia focada em grupos: validade fatorial e consistência interna

    Galvão, Lilian Kelly de Sousa et al.

    2010-01-01

    O presente artigo procurou reunir evidências da validade fatorial e consistência interna de uma Escala de Empatia focada em Grupos (EEG). Para tanto, foram realizados dois estudos: o primeiro refere-se a um estudo exploratório e o segundo a uma validação confirmatória. Foram utilizadas duas amostras, com aproximadamente 200 adolescentes cada. Os participantes responderam a EEG e a um questionário demográfico. Os resultados da análise de componentes principais identificaram quatro fatores repr...

  4. Evaluación de problemas emocionales y comportamentales: estructura interna del Strengths and Difficulties Questionnaire

    Javier Ortuño-Sierra; Edurne Chocarro; Eduardo Fonseca-Pedrero; Sylvia Sastre i Riba; José Muñiz

    2015-01-01

    El principal objetivo del presente estudio fue analizar la estructura interna y la invarianza de medición en función del género y la edad del Strengths and Difficulties Questionnaire (SDQ), versión autoinforme, en adolescentes españoles. La muestra está formada por 1.547 participantes, 606 varones (39,1%), con una media de edad de 15,15 años (DT=1,99). Los resultados del análisis factorial confirmatorio mostraron que el modelo de cinco factores y el modelo bifactor con modificaciones presenta...

  5. Sistema inteligente para la realización de auditorías internas de calidad

    Zapata Jaramillo, Carlos Mario

    1999-01-01

    La conducción de auditorías internas de calidad ha sido tradicionalmente implementada por empresas que buscan una certificación o que simplemente desean probar su gestión administrativa contra estándares internacionales. Para su realización ha sido siempre necesaria la contratación de un asesor o grupo empresarial experto en los temas de la calidad, con los altos costos que ello acarrea, para realizar los primeros diagnósticos y definir los derroteros fundamentales del proceso de calidad a se...

  6. Estructura factorial y consistencia interna del inventario de liderazgo distribuido (DLI) en docentes chilenos

    López Alfaro, Pablo; Gallegos Araya, Verónica

    2015-01-01

    Este artículo presenta el análisis de la estructura factorial y consistencia interna del instrumento “The Distributed Leadership Inventory (DLI)” en docentes primarios chilenos. Participaron voluntariamente 511 educadores (379 mujeres, 132 hombres) en ejercicio, pertenecientes a las siguientes regiones: Metropolitana, Segunda, Quinta, Octava y Novena, en el periodo marzo-septiembre del año 2014. Se realizó el análisis factorial exploratorio y el análisis factorial confirmatorio con ecuaciones...

  7. Estudo eritroleucomtrico e proteinograma srico do sangue do cordo umbilical e jugular de eqinos ao nascimento e de suas respectivas mes Erythrocytometry and seric proteinogram of umbilical cord and jugular of foals at birth and respective mothers

    R.F. Godoy

    2007-12-01

    Full Text Available Colheram-se amostras de sangue do cordo umbilical (SCU e do sangue circulante de cinco eqinos neonatos, imediatamente aps o nascimento, e o sangue da prpria me, utilizando-se um sistema a vcuo. O material foi submetido contagem global de hemcias e leuccitos e determinao do volume globular e da concentrao de hemoglobina; contagem diferencial de leuccitos em esfregaos sangneos; e ao clculo dos ndices eritrocitomtricos. Foram realizadas a dosagem de protenas sricas totais e a eletroforese das protenas sricas em gel de agarose. No houve diferenas significativas entre os parmetros do SCU e do sangue da jugular dos potros. No SCU dos potros observaram-se valores mais elevados para contagem global de hemcias (9,75x10(6/l, dosagem de hemoglobina (14,65g/dl e concentrao de hemoglobina corpuscular mdia (37,23g/dl; e valores menores para volume corpuscular mdio (40,50fl, protena total (4,37g/dl, alfa-globulinas (0,65g/dl, beta-globulinas (1,10g/dl, gama-globulinas (0g/dl e contagens global (5,40 x 10/l e diferencial de leuccitos, exceto contagem de neutrfilos bastonetes e moncitos, quando comparados com os valores obtidos no sangue de suas mes.Umbilical cord blood (UCB and systemic blood samples were collected from five equine neonates, immediately after birth. Systemic blood samples from their mothers were also collected at the same time, using a vacuum system. The samples were submitted to the following analyses: red blood cell and total white blood cell counts; determinations of packed cell volume and hemoglobin concentration; differential white cell count in blood smears; and determination of erythrocytometric values. Total serum proteins quantification and serum proteins electrophoresis in agarose gel were done. No significant difference (P<0.05 was noted between averages in neonate jugular blood and equine UCB. Equine UCB showed higher values of red blood cell count (9.75x10(6/, hemoglobin determination (14.65g/dl, and mean corpuscular hemoglobin concentration (37.23g/dl; but lower values of mean corpuscular volume (40.50fl, total protein (4.37g/dl, alpha-globulin (0.65 g/dl, beta-globulin (1.10g/dl, gamma-globulin (0g/dl, total (5.40x10/l, and differential leukocytes count, except for band neutrophils and monocytes counts, when compared to the blood of the mares.

  8. Efeitos do ultra-som de baixa intensidade na veia auricular de coelhos Effects of low intensity ultrasound in the auricular vein of rabbits

    Marcelo Araújo

    2003-01-01

    Full Text Available OBJETIVO: Estudar a ação do ultra-som na veia auricular de coelhos. MÉTODOS: Vinte coelhos foram divididos em dois grupos de dez animais diferindo com relação ao local da aplicação, do ultra-som, o modo e o intervalo de tempo para a análise histopatológica (3 e 7 dias. Os animais foram submetidos à aplicação de ultra-som contínuo e pulsado em dois segmentos venosos da orelha previamente determinados. Cada animal foi o seu próprio controle. Empregou-se a freqüência de 3MHz, intensidade de 3W/cm² nos ciclos pulsado e contínuo por 10 minutos, de forma estacionária. O grupo I foi submetido a eutanásia após 3 dias e o grupo II em 7 dias contemplando a fase aguda do processo inflamatório. Empregou-se o teste exato de Fisher e o teste de Mc Nemar para análise estatística. RESULTADOS: Obteve-se trombose venosa e aumento de linfócitos de forma significativa (p= 0,032 nos grupos tratados com o modo contínuo. O modo pulsado não provocou efeitos deletérios. Outros achados foram congestão, edema, hemorragia e lesão da parede vascular. CONCLUSÕES: O ultra-som pulsado não provoca qualquer alteração na parede vascular nas condições do experimento.O ultra-som contínuo induz a trombose venosa e aumento dos linfócitos de forma significativa.PURPOSE: The purpose of this experimental work was evaluate the effects of low intensity in the auricular vein of rabbits. METHODS: Twenty rabbits were divided in two groups of ten animals. The groups differed about the place where the continuous and pulsed ultrasound were applied and the period that the material was collected for the morphologic examination (3 and 7 days. Acoustic coupling gel was used on marginal ear vein, each animal underwent continuous and pulsed ultrasound treatment, in segments previously marked with indelible ink. Each animal provided its own control. Ultrasound was used in the frequency of 3MHz, intensity of 3W/cm² in the pulsed and continuous modes during 10min in a stationary way. The group I was euthanized after 3 days and the group II after 7 days contemplating the acute phase of the inflammatory process. We applied the Fisher and Mc Nemar's tests for statistical analysis. RESULTS: Venous thrombosis and lymphocytes increment occurred significantly (p= 0,032 due continuous mode ultrasound. Other minor findings were congestion, edema, rupture of vessel wall and hemorrhage. CONCLUSIONS: continuous ultrasound causes venous thrombosis and lymphocytes increment.

  9. Hallazgo incidental de hiperostosis frontal interna o sndrome de Morgagni asociado a meningiomas Incidental finding of frontal internal hyperostosis or Morgagni syndrome associated with meningiomas

    M. Subirana Domnech

    2012-06-01

    Full Text Available La hiperostosis frontal interna consiste en un engrosamiento de la tabla interna del hueso frontal. Normalmente se encuentra en mujeres post menopusicas. Presentamos un caso de hallazgo autpsico incidental de hiperostosis frontal interna o sndrome de Morgagni asociado a meningiomas en una mujer postmenopusica.Hyperostosis frontalis interna is the accretion of bone on the inner table of the frontal bone. It is commonly found in post-menopausic women. We present an incidental finding of frontal internal hyperostosis or Morgagni syndrome associated with meningiomas in a post-menopausic woman.

  10. Esclerite posterior associada à oclusão da veia central da retina e edema macular cistoide: relato de caso Posterior scleritis associated with central retinal vein occlusion and cystoid macular edema: case report

    Roger Wada Kamei

    2012-10-01

    Full Text Available Apresentamos um caso de esclerite posterior associada à oclusão da veia central da retina e edema macular cistoide. Com esse caso, observamos como a doença pode ser agressiva e como a acuidade visual pode ser comprometida. No entanto, o tratamento correto pode melhorar as alterações oculares com melhora visual. Alertamos também para os cuidados que devem ser tomados em relação ao uso de altas doses de corticosteroides.A case of posterior scleritis associated with central retinal vein occlusion and cystoid macular edema is reported. With this case, we noticed how the disease can be aggressive and how the visual acuity can be compromised. However, the correct treatment can improve the ocular changes with visual improvement. We also alert to the care with the use of high doses of corticosteroids.

  11. Aneurisma venoso na junção esplenomesentérica e emergência da veia porta: relato de caso Venous aneurysm at the splenomesenteric confluence at the level of portal vein emergence: a case report

    Mário Müller Lorenzato

    2009-06-01

    Full Text Available Os aneurismas no sistema esplenoportomesentérico são uma entidade clínica rara e de etiologia desconhecida, tendo como fatores contribuintes hipertensão portal, doença hepática crônica e trauma, entre outros. Os autores apresentam os achados de imagem de um caso de aneurisma na junção esplenomesentérica ao nível da emergência da veia porta, em uma paciente de 62 anos de idade sem fatores predisponentes.Aneurysms in the splenoportomesenteric system constitute a rare entity whose etiology is still to be determined. Predisponent factors include portal hypertension, chronic hepatic disease and trauma, among others. The authors present a case of an aneurysm at the splenomesenteric confluence where it joins the portal vein, in a female, 62-year-old patient with no predisponent factor.

  12. Constriction rate variation produced by partial ligation of the portal vein at pre-hepatic portal hypertension induced in rats / Variao da taxa de constrio produzida pela ligadura parcial da veia porta na hipertenso portal pr-heptica induzida em ratos

    Daren Athi Boy, RODRIGUES; Aline Riquena da, SILVA; Leonardo Carvalho, SERIGIOLLE; Ramiro de Sousa, FIDALGO; Sergio San Gregorio, FAVERO; Pedro Luiz Squilacci, LEME.

    2014-12-01

    Full Text Available RACIONAL: A ligadura parcial da veia porta acarreta aumento da presso portal que se mantm estvel mesmo aps o aparecimento da circulao colateral, havendo adaptao funcional diminuio prolongada do fluxo sanguneo heptico. [...] OBJETIVO: Avaliar se diferentes taxas de constrio produzidas por esta ligadura interferem em modelo experimental no rato. MTODOS: Foram utilizados trs grupos de cinco animais; no grupo 1 (sham-operated) foi realizada disseco e medida do dimetro da veia porta. A hipertenso portal foi induzida pela ligadura parcial da veia porta, reduzindo seu calibre para 0,9 mm nos 10 animais restantes, independente do dimetro inicial das veias. Cinco animais com hipertenso portal (grupo 2) foram reoperados aps 15 dias e os ratos do grupo 3 aps 30 dias. O clculo da taxa de constrio foi realizado atravs de frmula matemtica especfica (1 - ? r2 / ? R2) x 100% e a anlise estatstica com o teste t de Student. RESULTADOS: O dimetro mdio inicial da veia porta dos animais foi de 2,06 mm, com taxa de constrio mdia de 55,88%; embora o dimetro das veias e a taxa de constrio no grupo 2 tenha sido menor que no grupo 3 (2,06 mm - 55,25% e 2,08 mm - 56,51% respectivamente), em todos conseguiu-se induzir hipertenso portal e no foram encontradas diferenas macroscpicas significativas entre os animais reoperados aps 15 ou 30 dias, sendo considerado o prazo menor suficiente para avaliao. Quando comparados o dimetro inicial da veia e a taxa de constrio realizadas nos grupos 2 e 3 no houve significncia estatstica (p>0,05). CONCLUSO: A hipertenso portal pr-heptica no rato pode ser induzida pela reduo de calibre da veia porta para 0,9 mm de dimetro, independente do dimetro inicial da veia e da taxa de constrio a que este vaso foi submetido. Abstract in english BACKGROUND: Partial portal vein ligation causes an increase in portal pressure that remains stable even after the appearance of collateral circulation, with functional adaptation to prolonged decrease in portal blood flow. [...] AIM: To assess whether different constriction rates produced by partial ligation of the vein interfere with the results of this experimental model in rats. METHODS: Three groups of five rats each were used; in group 1 (sham-operated), dissection and measurement of portal vein diameters were performed. Portal hypertension was induced by partial portal vein ligation, reducing its size to 0.9 mm in the remaining 10 animals, regardless of the initial diameter of the veins. Five animals with portal hypertension (group 2) underwent reoperation after 15 days and the rats in group 3 after 30 days. The calculation of the constriction rate was performed using a specific mathematical formula (1 - ? r 2 / ? R2) x 100% and the statistical analysis with the Student t test. RESULTS: The initial diameter of the animal's portal vein was 2.06 mm, with an average constriction rate of the 55.88%; although the diameter of the veins and the constriction rate in group 2 were lower than in group 3 (2.06 mm - 55,25% and 2.08 mm - 56.51%, respectively), portal hypertension was induced in all rats and no significant macroscopic differences were found between the animals that were reoperated after 15 days and after 30 days respectively, being the shorter period considered enough for the evaluation. Comparing the initial diameter of the vein and the rate of constriction performed in groups 2 and 3, no statistic significance was found (p>0.05). CONCLUSION: Pre-hepatic portal hypertension in rat can be induced by the reduction of the portal vein diameter to 0.9 mm, regardless the initial diameter of the vein and the vessel constriction rate.

  13. Utilização da técnica do varal para angioplastia de estenose de veia central com stent-graft Utilization of the through-and-through technique for central vein angioplasty using stent-graft

    Ricardo Wagner da Costa Moreira

    2012-09-01

    Full Text Available A estenose de veia central é uma das situações mais frequentes em pacientes com insuficiência renal crônica em hemodiálise. A angioplastia com o uso de stent-graft tem obtido bons resultados nestes casos. O sistema de liberação dos stents é de calibre maior, podendo dificultar sua navegabilidade em áreas de estenose ou tortuosidade acentuadas. A técnica do varal é comumente utilizada para o tratamento endovascular do aneurisma de aorta, permitindo atingir bom mecanismo de estiramento e facilitando a navegação do sistema de entrega da endoprótese. Descrevemos o caso de uma angioplastia de veia central com stent-graft na qual foi utilizada a técnica do varal para permitir a transposição da área de estenose.The central vein stenosis is one of the most common conditions in patients with chronic kidney failure in a hemodialysis program. In these cases, angioplasty using stent-grafts has obtained good results. The stent-graft delivery system is generally of large diameter what can hinder its navigability in very severe stenosis or tortuosities. The through-and-through technique is commonly used for endovascular treatment of aortic aneurysms, making possible to achieve a good mechanism of stretch and easy navigation of the endograft delivery system. We report a case of a central venous stenosis in wich a stent-graft was inserted using the through-and-through technique in order to cross the lesion.

  14. Trombose de veia central da retina bilateral associada à síndrome de hiperviscosidade sanguínea: relato de caso Bilateral central retinal vein occlusion associated with blood hyperviscosity syndrome: case report

    John Helal Jr

    2005-02-01

    Full Text Available Relato de caso de um paciente masculino de 16 anos de idade com queixa inicial de baixa da acuidade visual e que no exame oftalmológico foi encontrado edema de papila bilateral, que evoluiu para trombose da veia central da retina em ambos os olhos. Na investigação laboratorial, foi feito diagnóstico de um mieloma múltiplo tipo IgA que cursava com síndrome de hiperviscosidade sanguínea, o que explicava o quadro oftalmológico. Após tratamento específico, o paciente apresentou melhora tanto da acuidade visual quanto do aspecto fundoscópico. O achado de oclusão de veia central da retina bilateral pode levar ao diagnóstico de importantes doenças sistêmicas. os achados fundoscópicos podem servir de parâmetro na avaliação do tratamento.The authors report the case of a 16-year-old male patient who presented with blurred vision and bilateral optic disc edema, then developing bilateral central retinal vein occlusion. On laboratory work-up, he was found to have multiple myeloma IgA along with hyperviscosity syndrome, which led to the ophthalmological features. After proper treatment, the patient recovered visual acuity and normalized his eye fundus changes. Bilateral central retinal vein occlusion finding may yield the diagnosis of major systemic diseases. Fundoscopic features may serve as parameters on treatment evaluation.

  15. Auditoria interna aplicada em uma instituição filantrópica hospitalar

    Marcos de Abreu Soares

    2007-01-01

    Full Text Available A crescente demanda por serviços de saúde obrigou o governo a permitir que instituições privadas realizassem o atendimento à população, mediante uma contrapartida do Estado, via concessão de imunidade de tributos e isenção de contribuições sociais. Para obtenção e manutenção dos benefícios acima mencionados, as instituições beneficiadas devem atender a uma série de legislações tanto em âmbito federal quanto estadual e municipal. Nesse sentido, elaborou-se um resumo dos principais tópicos da história da saúde pública no Brasil, das principais legislações filantrópicas aplicáveis a uma instituição hospitalar, dos conceitos de auditoria interna, e a apresentação de um estudo de caso em uma instituição hospitalar filantrópica da Grande Porto Alegre, através da execução de um planejamento de auditoria no processo de filantropia. O objetivo deste artigo é demonstrar como a auditoria interna pode colaborar com uma instituição hospitalar a fim de minimizar eventuais riscos para manutenção do certificado de filantropia, bem como propiciar sugestões de melhorias dos processos.

  16. Internal jugular vein: Peripheral vein adrenocorticotropic hormone ratio in patients with adrenocorticotropic hormone-dependent Cushing′s syndrome: Ratio calculated from one adrenocorticotropic hormone sample each from right and left internal jugular vein during corticotrophin releasing hormone stimulation test

    Sachin Chittawar

    2013-01-01

    Full Text Available Background: Demonstration of central: Peripheral adrenocorticotropic hormone (ACTH gradient is important for diagnosis of Cushing′s disease. Aim: The aim was to assess the utility of internal jugular vein (IJV: Peripheral vein ACTH ratio for diagnosis of Cushing′s disease. Materials and Methods: Patients with ACTH-dependent Cushing′s syndrome (CS patients were the subjects for this study. One blood sample each was collected from right and left IJV following intravenous hCRH at 3 and 5 min, respectively. A simultaneous peripheral vein sample was also collected with each IJV sample for calculation of IJV: Peripheral vein ACTH ratio. IJV sample collection was done under ultrasound guidance. ACTH was assayed using electrochemiluminescence immunoassay (ECLIA. Results: Thirty-two patients participated in this study. The IJV: Peripheral vein ACTH ratio ranged from 1.07 to 6.99 ( n = 32. It was more than 1.6 in 23 patients. Cushing′s disease could be confirmed in 20 of the 23 cases with IJV: Peripheral vein ratio more than 1.6. Four patients with Cushing′s disease and 2 patients with ectopic ACTH syndrome had IJV: Peripheral vein ACTH ratio less than 1.6. Six cases with unknown ACTH source were excluded for calculation of sensitivity and specificity of the test. Conclusion: IJV: Peripheral vein ACTH ratio calculated from a single sample from each IJV obtained after hCRH had 83% sensitivity and 100% specificity for diagnosis of CD.

  17. Pacientes que se beneficiam de internação psiquiátrica em hospital geral

    Dalgalarrondo Paulo; Botega Neury J; Banzato Cláudio E M

    2003-01-01

    OBJETIVO: A internação psiquiátrica, embora onerosa, continua sendo um recurso terapêutico indispensável para pacientes graves. A internação em unidades psiquiátricas de hospital geral (UPHG) tem sido recomendada como a melhor alternativa aos macro-hospitais psiquiátricos. Nesse sentido, realizou-se estudo com o objetivo de verificar variáveis socioeconômicas e clínicas associadas com o êxito ou o fracasso da internação. MÉTODOS: Foram revistos dados sociodemográficos e clínicos de 1.463 paci...

  18. An endothelial 5-HT receptor that mediates relaxation in guinea-pig isolated jugular vein resembles the 5-HT1D subtype.

    Gupta, P

    1992-01-01

    1. Endothelium-dependent and -independent, concentration-related, relaxations to 5-hydroxytryptamine (5-HT) are described in a preparation of guinea-pig isolated jugular vein. 2. An endothelial 5-HT receptor was studied in the presence of mesulergine (at 10.0 microM, a concentration sufficient to antagonize 5-HT2 receptor-mediated contractions and endothelium-independent relaxations to 5-HT). Relaxations mediated by the endothelial 5-HT receptor were resistant to antagonism by mesulergine. 3....

  19. Hemodynamics and right-ventricle functional characteristics of a swine carotid artery-jugular vein shunt model of pulmonary arterial hypertension: An 18-month experimental study.

    Wu, Ji; Luo, Xiaoju; Huang, Yuanyuan; He, Yun; Li, Zhixian

    2015-10-01

    The continuous changes in pulmonary hemodynamic properties and right ventricular (RV) function in pulmonary arterial hypertension (PAH) have not been fully characterized in large animal model of PAH induced by a carotid artery-jugular vein shunt. A minipig model of PAH was induced by a surgical anastomosis between the left common carotid artery and the left jugular vein. The model was validated by catheter examination and pathologic analyses, and the hemodynamic features and right-ventricle functional characteristics of the model were continuously observed by Doppler echocardiography. Of the 45 minipigs who received the surgery, 27 survived and were validated as models of PAH, reflected by mean pulmonary artery pressure ≥25 mmHg, and typical pathologic changes of pulmonary arterial remodeling and RV fibrosis. Non-invasive indices of pulmonary hemodynamics (pulmonary artery accelerating time and its ratio to RV ventricular ejection time) were temporarily increased, then reduced later, similar to changes in tricuspid annular displacement. The Tei index of the RV was elevated, indicating a progressive impairment in RV function. Surgical anastomosis between carotid artery and jugular vein in a minipig is effective to establish PAH, and non-invasive hemodynamic and right-ventricle functional indices measured by Doppler echocardiography may be used as early indicators of PAH. PMID:25595189

  20. A Case of Unilateral Fenestration and Duplication of the External Jugular Vein Un Caso de Fenestracin Unilateral y Duplicacin de la Vena Yugular Externa

    Ziga Snoj

    2013-03-01

    Full Text Available The external jugular vein is increasingly being utilized as the recipient vein in head and neck free tissue transfers, and for cannulation in order to conduct diagnostic procedures or intravenous therapies. The variations in the patterns of its course, and knowledge of them, are therefore important. We report on a unique and previously non-described unilateral fenestration and duplication of the external jugular vein found during the neck dissection of a 77-year-old female cadaver. Embryological evaluation and clinical implications of the anomaly are described. Clinicians and surgeons performing neck vascular or reconstructive surgery should be aware of this variation of the external jugular vein in the hope of preventing inadvertent injury.La vena yugular externa se est utilizando cada vez como vena receptora en la transferencias de tejidos libres de cabeza y cuello, y para canulizacin en procedimientos de diagnstico o terapias intravenosas. Las variaciones en los patrones de su curso, y el conocimiento de los mismos son relevantes. Se reporta una fenestracin unilateral, no descrita previamente, y la duplicacin de la vena yugular externa encontrada durante la diseccin del cadver de una mujer de 77 aos de edad. Se hace una evaluacin embriolgica y las implicaciones clnicas de esta anomala. Los mdicos y cirujanos que realizan ciruga vascular o reconstructiva de cuello deben tener en cuenta esta variacin de la vena yugular externa con el fin de prevenir lesiones accidentales.

  1. Intraoperative radiation of canine carotid artery, internal jugular vein, and vagus nerve. Therapeutic applications in the management of advanced head and neck cancers

    As a step in the application of intraoperative radiotherapy (IORT) for treating advanced head and neck cancers, preliminary information was obtained on the radiation tolerance of the canine common carotid artery, internal jugular vein, and vagus nerve to a single, high-dose electron beam. Both sides of the neck of eight mongrel dogs were operated on to expose an 8-cm segment of common carotid artery, internal jugular vein, and vagus nerve. One side of the neck was irradiated, using escalating doses of 2500, 3500, 4500, and 5500 cGy. The contralateral side of the neck served as the unirradiated control. At 3 and 6 months after IORT, one dog at each dose level was killed. None of the dogs developed carotid bleeding at any time after IORT. Light microscopic investigations using hematoxylin-eosin staining on the common carotid artery and internal jugular vein showed no consistent changes that suggested radiation damage; however, the Masson trichrome stain and hydroxyproline concentration of irradiated common carotid artery indicated an increase in the collagen content of the tunica media. Marked changes in the irradiated vagus nerve were seen, indicating severe demyelination and loss of nerve fibers, which appeared to be radiation-dose dependent. Four patients with advanced recurrent head and neck cancer were treated with surgical resection and IORT without any acute or subacute complications. The role of IORT as a supplement to surgery, external beam irradiation, and chemotherapy in selected patients with advanced head and neck cancer needs further exploration

  2. Análise de motores de combustão interna para a melhoria da sua eficiência

    Costa, Tiago João Silva Sousa Azevedo

    2014-01-01

    Este trabalho discute formas de melhorar a eficiência de motores de combustão interna, utilizando tecnologias e mecanismos não convencionais. Um motor de baixo consumo desenvolvido para participar na competição Eco-Marathon Shell foi utilizado como base para o presente estudo. A primeira parte deste trabalho detalha as etapas de projeto e análise termodinâmica de um motor de combustão interna de alta eficiência, com especial destaque para a sua cambota. A segunda parte analisa ...

  3. Qualidade interna de diferentes tipos de ovos comercializados durante o inverno e o verão

    D.P.B. Fernandes; Mori, C.; A.C. Nazareno; C.C. Pizzolante; J.E. Moraes

    2015-01-01

    Objetivou-se no presente estudo avaliar a qualidade interna de ovos brancos e vermelhos, comercializados durante o inverno e o verão, no estado de São Paulo. Para tal análise, utilizaram-se ovos classificados como tamanho grande, e a avaliação da qualidade interna realizada por meio das seguintes variáveis: massa média do ovo, gravidade específica, unidade Haugh, índice de gema, coloração da gema e incidência de partículas estranhas nos ovos. O delineamento experimental foi inteiramente ao ac...

  4. Ultrasound evaluations of internal jugular vein punction techniques in children: the easiest method to reach the target area.

    Ybarra, Luiz Fernando; Ruiz, H; Silva, M P; Lederman, H M; Schettini, S T

    2009-01-01

    The objective of this study is to determine the best way to access and the position in which the patients must remain in order to obtain the best transversal section of the right internal jugular vein (RIJV) section during the catheterization by ultrasound, allowing a safer and precise access. The three possible ways to access the RIJV, anterior, lateral and posterior, from 57 healthy children, were examined by ultrasound in one similar sequence of positions: horizontal dorsal decubitus with the head centered in neutral position with and without the use of a pillow; horizontal dorsal decubitus with contralateral rotation of the head with and without the use of a pillow; horizontal dorsal decubitus with the head centered in neutral position and the patient in the Trendelenburg position without the use of a pillow. The relation between the different positions and punction regions in RIJV were established using analysis of variance. As a result, the lateral punction with the patient in the Trendelemburg position offered a largest area of the RIJV transversal section in comparison to all the other options (Ppillow. PMID:19043722

  5. Time of flight MR angiography assessment casts doubt on the association between transient global amnesia and intracranial jugular venous reflux

    Evidence of intracranial venous reflux flow due to jugular venous reflux (JVR) on time of flight (TOF) MR angiography (MRA) is thought to be highly associated with transient global amnesia (TGA) - evidence that supports the venous congestion theory of TGA pathophysiology. However, recent studies indicate that intracranial JVR on TOF MRA is occasionally observed in normal elderly. Therefore, the purpose of this study was to compare the prevalence of intracranial JVR on TOF MRA in patients with TGA and two control groups. Three age- and sex-matched groups of subjects that received MRI and MRA were enrolled. The groups comprised 167 patients with TGA, 167 visitors to the emergency room (ER) and 167 visitors to a health promotion centre (HPC). Intracranial JVR was defined as abnormal venous signals in the inferior petrosal, sigmoid and/or transverse sinuses on TOF MRA. The prevalence of intracranial JVR was assessed across the three groups. Intracranial JVR was seen in seven (4.2 %) TGA patients, eight (4.8 %) ER visitors and three (1.8 %) HPC visitors, respectively. No statistically significant differences were observed among the three groups. TGA patients showed a low prevalence of intracranial JVR on TOF MRA, and no statistical differences were found in comparison with control groups. (orig.)

  6. Time of flight MR angiography assessment casts doubt on the association between transient global amnesia and intracranial jugular venous reflux

    Kang, Yeonah; Kim, Eunhee; Kim, Jae Hyoung; Choi, Byung Se; Jung, Cheolkyu; Bae, Yun Jung; Lee, Kyung Mi [Seoul National University College of Medicine, Seoul National University Bundang Hospital, Department of Radiology, Seongnam-si, Gyeonggi-do (Korea, Republic of); Lee, Dong Hoon [Seoul Medical Center, Department of Radiology, Seoul (Korea, Republic of)

    2014-10-03

    Evidence of intracranial venous reflux flow due to jugular venous reflux (JVR) on time of flight (TOF) MR angiography (MRA) is thought to be highly associated with transient global amnesia (TGA) - evidence that supports the venous congestion theory of TGA pathophysiology. However, recent studies indicate that intracranial JVR on TOF MRA is occasionally observed in normal elderly. Therefore, the purpose of this study was to compare the prevalence of intracranial JVR on TOF MRA in patients with TGA and two control groups. Three age- and sex-matched groups of subjects that received MRI and MRA were enrolled. The groups comprised 167 patients with TGA, 167 visitors to the emergency room (ER) and 167 visitors to a health promotion centre (HPC). Intracranial JVR was defined as abnormal venous signals in the inferior petrosal, sigmoid and/or transverse sinuses on TOF MRA. The prevalence of intracranial JVR was assessed across the three groups. Intracranial JVR was seen in seven (4.2 %) TGA patients, eight (4.8 %) ER visitors and three (1.8 %) HPC visitors, respectively. No statistically significant differences were observed among the three groups. TGA patients showed a low prevalence of intracranial JVR on TOF MRA, and no statistical differences were found in comparison with control groups. (orig.)

  7. A COMPARATIVE STUDY BETWEEN ULTRASOUND GUIDED CATHETERIZATION OF THE INTERNAL JUGULAR VEIN AND CLASSICAL LAND MARK TECHNIQUE

    Henjarappa K S

    2014-12-01

    Full Text Available Background: Catheterization of Internal Jugular Vein (IJV is commonly attempted to obtain central venous access for hemodynamic monitoring, long term administration of fluids, total parenteral nutrition and hemodialysis in critical care patients. The safe puncture of the IJV is achieved by using anatomical land marks on skin surface. Ultrasound guidance could be beneficial in placing central venous catheters by improving the success rate, reducing the number of needle passes, decreasing access time and decreasing complications. Material and Methods: Sixty critical care patients were selected for IJV cannulation either by land mark technique or by ultrasound guided technique in two groups of thirty each. Results: In our study there was 100% success rate for first attempt cannulation in USG technique and where as it was 83.3% in LMG technique. The mean access time in USG technique was 152.50 ± 63.90 sec as against 323.23 ± 146.19 sec in LMG group. Conclusion: Ultrasound guided technique improves the cannulation of the IJV with respect to safety, rapidity and comfort to the patient during the procedure.

  8. Long-term outcome following trans-jugular intrahepatic portosystemic shunt for variceal bleeding due to portal hypertension

    Objective: To study the 6-year outcome following trans-jugular intrahepatic portosystemic shunt (TIPSS) for variceal bleeding due to portal hypertension. Methods: 65 patients, 51 males, 14 females, aged 35-72 years old with averaged 4.5 years, have been undergone TIPSS because of portal hypertension due to cirrhosis or Budd-Chiari syndrome. The portal pressures were measured before and after TIPSS. Follow-up study was done by color Doppler sonography or Barium esophageal radiography for 3 months to 6 years (averaged 18 months). Repeated interventional treatments were done in cases of restenosis of the shunts. Results: There were 0, 2, 10, 5, 0 cases of recurrent bleeding after 3 months, 6 months, 1 year, 2 year and 3-6 year following TIPSS respectively. Stenosis occurred in shunt paths due to thrombosis or smooth muscle cell proliferation or neo-intimal hyperplasia were relieved after thrombolytic therapy and repeated balloon angioplasty or stent plant among most of them. 2 were failed due to serious stenosis. 7 cases died, 2 of massive bleeding, 1 of the other cause and 4 of hepatic cancer. The other patients are getting well. Conclusions: Although there were very high rates of restenosis (34%), but most of them could be treated again with interventional therapy, and in kept patency effectively. TIPSS is a still practical valuable management for massive gastric bleeding

  9. Integration of jugular venous return and circle of Willis in a theoretical human model of selective brain cooling.

    Neimark, Matthew A; Konstas, Angelos-Aristeidis; Laine, Andrew F; Pile-Spellman, John

    2007-11-01

    A three-dimensional mathematical model was developed to examine the induction of selective brain cooling (SBC) in the human brain by intracarotid cold (2.8 degrees C) saline infusion (ICSI) at 30 ml/min. The Pennes bioheat equation was used to propagate brain temperature. The effect of cooled jugular venous return was investigated, along with the effect of the circle of Willis (CoW) on the intracerebral temperature distribution. The complete CoW, missing A1 variant (mA1), and fetal P1 variant (fP1) were simulated. ICSI induced moderate hypothermia (defined as 32-34 degrees C) in the internal carotid artery (ICA) territory within 5 min. Incorporation of the complete CoW resulted in a similar level of hypothermia in the ICA territory. In addition, the anterior communicating artery and ipsilateral posterior communicating artery distributed cool blood to the contralateral anterior and ipsilateral posterior territories, respectively, imparting mild hypothermia (35 and 35.5 degrees C respectively). The mA1 and fP1 variants allowed for sufficient cooling of the middle cerebral territory (30-32 degrees C). The simulations suggest that ICSI is feasible and may be the fastest method of inducing hypothermia. Moreover, the effect of convective heat transfer via the complete CoW and its variants underlies the important role of CoW anatomy in intracerebral temperature distributions during SBC. PMID:17761787

  10. La fiabilidad en motores de combustión interna diesel estacionarios

    Elio Rafael Hidalgo Batista

    2011-01-01

    Full Text Available Se abordó el análisis de la fiabilidad de 8 motores de combustión interna diesel estacionarios destinados a la generación de electricidad. Su objetivo fundamental es conocer los fallos más característicos, la probabilidad de trabajo sin fallo y la vida útil de los equipos bajo las condiciones de explotación de Cuba, y, así poder conocer si el tiempo entre servicios recomendado por el fabricante es preciso modificar para una mejor utilización de estos equipos tan importantes para la vida social y económica del país.

  11. Estructura interna y caractersticas tecnolgicas de las industrias achelenses en la cuenca media occidental del Duero

    Jos Ignacio MARTN BENITO

    2009-11-01

    Full Text Available RESUMEN: Se realiza aqu una aproximacin general sobre las industrias achelenses del occidente de la Meseta norte espaola, atendiendo a aspectos puramente tecnolgicos, tanto por lo que se refiere a su estructura interna como a las caractersticas de su evolucin. Se observar, asimismo, que las convergencias tecnolgicas de las industrias reflejan una cierta unidad en el Achelense de la cuenca del Duero.SUMMARY: This paper a general approach to the Acheulean industry of the Western Meseta, taking into account purely technological aspects as to the internal structures and the characteristics of its evolution. It is also observed that the technological convergencies of these industries reflect a certain similarity with the Acheulean of the Duero basin.

  12. Reacciones adversas a los medicamentos en un servicio de medicina interna del Hospital Universitario

    lvaro, Danza; Federico, Cristiani; Gustavo, Giachetto.

    2010-09-01

    Full Text Available Resumo Introduo: a implem algoritmo de Karch y Lasagna entao de estratgias de farmacovigilncia (FV) intensiva no meio clnico pode contribuir a um melhor conhecimento da magnitude das patologias causadas por medicamentos. Objetivo: estimar a freqncia e as caractersticas das reaoes adversas [...] a medicamentos (RAM) atravs de FV intensiva em pacientes internados em um servio de medicina interna do Hospital das Clnicas "Dr. Manuel Quintela". Material e mtodo: Realizou-se um estudo observacional prospectivo. Fez-se anamnese farmacolgica a todos los pacientes internados no perodo 31 de maro - 4 de abril de 2008 em um servio de medicina interna que conta com 40 camas. Foram includos todos os pacientes com suspeita de RAM e determinaram-se as causas com o algoritmo de Karch e Lasagna. Foram analisados os dados relativos a idade, sexo, medicamentos implicados, doena causada, gravidade e polifarmcia. Resultados: foram identificadas 21 RAM em 19 pacientes dos 48 internados no perodo considerado. A freqncia de RAM em pacientes internados foi de 43,7% (IC 95% 21-66). A idade mdia foi 73 anos, a maioria apresentava polifarmcia e comorbidade. Os medicamentos implicados mais freqentemente foram cardiovasculares, anti-infecciosos de uso sistmico e glicocorticides. Os rgos e sistemas mais afetados foram o sistema digestivo e cardiovascular. Trs RAM foram consideradas graves. Concluses: Neste servio de internao as RAM so um problema com freqncia elevada. Pode ser que as caractersticas dos pacientes atendidos nessa unidade (idade avanada, freqente comorbidade e polifarmcia) contribuam para isso. Destaca-se a importncia da FV hospitalar intensiva como estratgia para de deteco de RAM e outros problemas relacionados com medicamentos. Abstract in spanish Introduccin: la implementacin de estrategias de farmacovigilancia (FV) intensiva en el mbito clnico puede contribuir a conocer mejor la magnitud de la patologa inducida por medicamentos. Objetivo: estimar la frecuencia y caractersticas de las reacciones adversas a los medicamentos (RAM) median [...] te FV intensiva en pacientes hospitalizados en un servicio de medicina interna del Hospital de Clnicas "Dr. Manuel Quintela". Material y mtodo: se dise un estudio observacional prospectivo. Se realiz anamnesis farmacolgica a todos los pacientes hospitalizados entre el 31 de marzo y el 4 de abril de 2008 en un servicio de medicina interna que cuenta con 40 camas de internacin. Se incluyeron todos los pacientes con sospecha de RAM y se determin la imputabilidad mediante el algoritmo de Karch y Lasagna. Se analiz edad, sexo, medicamentos implicados, enfermedad ocasionada, severidad y polifarmacia. Resultados: se identificaron 21 RAM en 19 pacientes de los 48 hospitalizados en el perodo de estudio. La frecuencia de RAM en pacientes hospitalizados fue 43,7% (IC 95% 21-66). La edad promedio fue 73 aos, la mayora presentaba polifarmacia y comorbilidad. Los medicamentos implicados ms frecuentemente fueron cardiovasculares, antiinfecciosos de uso sistmico y glucocorticoides. Los rganos y sistemas ms afectados fueron digestivo y cardiovascular. Se catalogaron como severas tres RAM. Conclusiones: en este servicio de internacin las RAM constituyen un problema de elevada frecuencia. Es posible que las caractersticas de los pacientes asistidos en esta unidad (edad avanzada, frecuente comorbilidad y polifarmacia) contribuyan a este hallazgo. Se destaca la importancia de la FV intensiva hospitalaria como estrategia para detectar RAM y otros problemas relacionados con medicamentos. Abstract in english Summary Introduction: implementing intensive pharmacovigilance (FV) strategies within the clinical context may contribute to know more about the extent of drug induced pathologies. Objective: to estimate the frequency and characteristics of adverse drug reactions through intensive pharmacovigilance [...] in patients hospitalized in an internal medicine uni

  13. ESCALA DE PENSAMIENTO MGICO (EPM: I. ESTRUCTURA FACTORIAL, CONSISTENCIA INTERNA Y VALIDEZ DE CONTENIDO

    Jos Moral de la Rubia

    2010-01-01

    Full Text Available El objetivo del presente trabajo fue presentar el desarrollo de una escala que mide el grado de conformidad con las creencias y manifestaciones propias del pensamiento mgico, centrndose en la estructura factorial, consistencia interna y validez de contenido. Se emple una muestra aleatoria de poblacin general adulta de 837 sujetos. De los 42 reactivos iniciales, se seleccionaron 24, con los que se defini una estructura de dos factores relacionados. La consistencia de la escala y sus factores fueron altas. Los ndices de ajuste para el modelo de dos factores relacionados con 12 indicadores cada uno fueron de buenos a adecuados. El ajuste mejoraba con una simplificacin a seis indicadores por factor, aunque se perda validez de contenido. Se concluye que es un instrumento fiable, vlido estructuralmente y que cubre un contenido amplio de creencias propias del pensamiento mgico, ya sea en sus formatos de 24 o de 12 reactivos.

  14. Escalas de Estilos Interpessoais (ESEI: construo, validade fatorial e consistncia interna

    Mauro de Oliveira Magalhes

    2013-12-01

    Full Text Available Este artigo descreve a construo e validao inicial do Inventrio de Estilos Interpessoais (ESEI. O estilo interpessoal um construto multidimensional definido como a maneira que o indivduo busca por aceitao e status social. Uma amostra de 984 sujeitos com idades entre 18 e 63 anos, 395 homens e 589 mulheres, responderam ao ESEI. A anlise fatorial exploratria revelou uma estrutura de oito fatores consistente com as categorias tericas de estilo interpessoal descritas na literatura. Os oito fatores explicaram 46,24% da varincia total e os ndices de consistncia interna das subescalas variaram entre bons e excelentes. Os resultados sugerem que o ESEI um instrumento promissor para uso em pesquisa e contextos aplicados, embora sejam necessrias mais evidncias de validade.

  15. Coherencia interna y sincretismo teórico en la fundamentación constitucional mexicana

    Luis Eusebio Alberto Avendaño González

    2014-10-01

    Full Text Available En la teoría jurídica actual el ámbito constitucional es la plataforma para la garantía de los derechos y las libertades; sin embargo, la Constitución mexicana prevé supuestos que son excluyentes entre sí. Esta circunstancia implica prescribir en el nivel constitucional un derecho y, a su vez, un no derecho, lo que por consecuencia crea un sincretismo metodológico. Este texto, además de denunciar tal contradicción, defiende la premisa de que la Constitución requiere de coherencia interna. Dicha idea toma como base el principio de igualdad y la interpretación judicial, para adecuar la coherencia teórica y normativa de la carta constitucional.

  16. Hacia una critica interna de la teoría del intercambio desigual de Emmanuel

    Garay S. Luis Jorge

    1980-12-01

    Full Text Available El presente ensayo constituye apenas una versión parcial y preliminar de un trabajo más extenso que el autor está desarrollando sobre la teoría del intercambio desigual de Emmanuel. Entendido así el carácter de éste, su objetivo se limita únicamente a estudiar los principales supuestos, inconsistencias y vicios teóricos y metodológicos implícitos en
    el "traslado" particular que Emmanuel realiza del esquema de precios de Marx al plano del comercio internacional. En otras palabras, el análisis aquí incluido corresponde más a lo que en la literatura se denomina una crítica interna que a una crítica externa de la teoría de intercamhio desigual de Emmanuel.

  17. Estructura factorial y consistencia interna del inventario de liderazgo distribuido (DLI en docentes chilenos

    López Alfaro, Pablo

    2015-09-01

    Full Text Available Este artículo presenta el análisis de la estructura factorial y consistencia interna del instrumento “The Distributed Leadership Inventory (DLI” en docentes primarios chilenos. Participaron voluntariamente 511 educadores (379 mujeres, 132 hombres en ejercicio, pertenecientes a las siguientes regiones: Metropolitana, Segunda, Quinta, Octava y Novena, en el periodo marzo-septiembre del año 2014. Se realizó el análisis factorial exploratorio y el análisis factorial confirmatorio con ecuaciones estructurales para obtener evidencias de validez de constructo y consistencia interna. Estos estudios confirmaron una distribución de los reactivos en cinco factores del instrumento, indicando un buen ajuste a los datos, al igual que el valor del error de aproximación cuadrático medio (RMSEA. Sin embargo, un conjunto de ítems presentó un comportamiento inadecuado en la matriz factorial resultante, por lo que fue eliminado. Estos resultados son satisfactorios y parcialmente consistentes con investigaciones teóricas y empíricas relacionadas con el constructo. Se concluye que la validación del DLI, desde un punto de vista estadístico, permite la medición de la percepción del liderazgo distribuido de manera consistente. Además, posibilita la comparación de resultados entre poblaciones y variables de interés para el desarrollo de procesos organizacionales, tales como: el apoyo, la supervisión, la participación y la cooperación inherente a los docentes.Este artículo presenta el análisis de la estructura factorial y consistencia interna del instrumento “The Distributed Leadership Inventory (DLI” en docentes primarios chilenos. Participaron voluntariamente 511 educadores (379 mujeres, 132 hombres en ejercicio, pertenecientes a las siguientes regiones: Metropolitana, Segunda, Quinta, Octava y Novena, en el periodo marzo-septiembre del año 2014. Se realizó el análisis factorial exploratorio y el análisis factorial confirmatorio con ecuaciones estructurales para obtener evidencias de validez de constructo y consistencia interna. Estos estudios confirmaron una distribución de los reactivos en cinco factores del instrumento, indicando un buen ajuste a los datos, al igual que el valor del error de aproximación cuadrático medio (RMSEA. Sin embargo, un conjunto de ítems presentó un comportamiento inadecuado en la matriz factorial resultante, por lo que fue eliminado. Estos resultados son satisfactorios y parcialmente consistentes con investigaciones teóricas y empíricas relacionadas con el constructo. Se concluye que la validación del DLI, desde un punto de vista estadístico, permite la medición de la percepción del liderazgo distribuido de manera consistente. Además, posibilita la comparación de resultados entre poblaciones y variables de interés para el desarrollo de procesos organizacionales, tales como: el apoyo, la supervisión, la participación y la cooperación inherente a los docentes.

  18. Análise do comportamento do hemometabolismo cerebral durante endarterectomia carotídea com pinçamento transitório Análisis del comportamiento del hemometabolismo cerebral durante endarterectomia carotídea con pinzamiento transitorio Analysis of brain hemometabolism behavior during carotid endarterectomy with temporary clamping

    Gastão Fernandes Duval Neto; Augusto H. Niencheski

    2004-01-01

    JUSTIFICATIVA E OBJETIVOS: A endarterectomia carotídea com pinçamento transitório altera a relação entre o fluxo sangüíneo cerebral e a demanda metabólica cerebral de oxigênio, com conseqüente geração de uma tendência a hipóxia oliguêmica ou desacoplamento hemometabólico. O objetivo do presente estudo foi identificar as alterações do hemometabolismo cerebral, avaliados através das alterações da saturação da oxihemoglobina no bulbo da veia jugular interna (SjO2), durante endarterectomia carotí...

  19. La Funcin de la Auditora Interna en las Cajas de Ahorros Espaolas

    Horacio Molina Snchez

    2007-06-01

    Full Text Available Hoy da la funcin de auditora interna es clave en el esquema de gobierno corporativo de las entidades financieras. Esta investigacin tiene dos objetivos. En primer lugar, pretendemos describir el grado de cumplimiento de las recomendaciones del Comit de Basilea por parte de las cajas de ahorros espaolas en un momento anterior a la regulacin de aspectos sustanciales del gobierno de estas entidades (como por ejemplo, la figura del comit de auditora por parte de la Ley Financiera. En segundo lugar, identificamos las diferencias existentes entre las entidades atendiendo a su dimensin. El mtodo empleado ha sido una encuesta a las entidades, obtenindose respuesta de 42 de las 47 entidades. Los resultados obtenidos presentan la situacin de los departamentos de auditora interna y confirman que, en un nmero significativo de aspectos, la dimensin de las entidades influye en el grado de implantacin de los estndares emitidos por el Comit de Basilea.Nowadays, the internal audit function is critical in the corporate governance framework of financial institutions. Our researchs objective has to objectives. First, we try to describe the implementation level of Basle Committees recommendations in the Spanish saving banks before an important regulation over corporate governance has been issued in Spain (for instance, the figure of audit committee through the Financial Law. Second, we assess the differences between entities considering their dimmension. We have carried out a survey to saving banks, obtaining a response from 42 out of 47 entities. Our results show the situation of internal audit departments and confirm that, in a significative number of cases, entities dimmension affects the level of implementation of the Basel Committees standards.

  20. El sistema de garanta interna de la calidad de centro: un asunto de coherencia de la institucin universitaria

    Jos Luis Menndez Varela

    2008-01-01

    adecuada implantacin en las diversas titulaciones, se defender la necesidad de un modelo mixto, en el que el compromiso institucional con la calidad de la enseanza confiera un papel relevante a los sistemas de garanta interna de la calidad de los centros educativos.

  1. Estudio de la consistencia interna y estructura factorial de tres versiones de la escala de Zung para ansiedad

    Susana De La Ossa

    2009-03-01

    Full Text Available Antecedentes: La escala de Zung para ansiedad se ha usado en varias investigaciones en Colombia. Sin embargo, no se ha informado la consistencia interna y la estructura de factores en estudiantes universitarios.Objetivo: Estimar la consistencia interna y la estructura factorial de tres versiones de la escala de Zung para ansiedad en estudiantes de una universidad privada de Cartagena, Colombia.Mtodo: Doscientos veintin estudiantes de medicina y psicologa completaron la versin de 20 puntos de la escala de Zung para ansiedad. La media para la edad fue 20.5 (DE=2.6, 64.4% eran mujeres y 55.3% estudiaban medicina. Se calcul el alfa de Cronbach y se realiz un anlisis de factores exploratorio para las tres versiones.Resultados: La escala de 20 puntos mostr un coeficiente de alfa de Cronbach de 0.77 y tres factores principales responsables de 40.1% de la varianza total. La versin de 10 puntos mostr una consistencia interna de 0.83 y una estructura bidimensional que explicaba 54% de la varianza. La versin de cinco puntos mostr una consistencia interna de 0.74 y una estructura unidimensional que daba cuenta de 49.5% de la varianza.Conclusiones: Las versiones de diez y cinco puntos de la escala de Zung para ansiedad presentan mejor comportamiento psicomtrico que la versin original de 20 puntos. Se necesita estimar el comportamiento psicomtrico de estas versiones frente a un criterio de referencia.

  2. Rastreamento de resultados adversos nas internações do Sistema Único de Saúde

    Monica Aguilar Estevam Dias

    2012-08-01

    Full Text Available OBJETIVO: Descrever a frequência de rastreadores de potenciais resultados adversos em internações no Sistema Único de Saúde. MÉTODOS: Estudo retrospectivo, incluindo as internações de adultos na clínica médica (n = 3.565.811 e clínica cirúrgica (n = 2.614.048 no Brasil em 2007. O Sistema de Informações Hospitalares foi utilizado como fonte de informação. A mensuração dos resultados adversos baseou-se no rastreamento de 11 condições clínicas, definidas em estudos internacionais anteriores, registradas no campo diagnóstico secundário. Foram realizadas análises bivariada e multivariada, no intuito de associar resultado adverso, óbito (variável dependente e outras variáveis como idade, utilização de unidade de terapia intensiva e realização de cirurgia. RESULTADOS: A frequência obtida foi 3,6 potenciais resultados adversos por 1.000 internações para ambas as clínicas, superior na clínica médica (5,3 por 1.000 em relação à clínica cirúrgica (1,3 por 1.000. Houve diferenças no perfil das internações: na clínica médica predominaram idosos, maior tempo médio de permanência, maior taxa de mortalidade e menor custo total de internação. O rastreador de resultado adverso mais frequente foi pneumonia hospitalar. Choque/parada cardíaca apresentou maior risco de óbito (OR = 5,76 em relação aos demais resultados adversos. Os maiores gastos com internações estiveram relacionados à sepse hospitalar. Os rastreadores de potencial resultado adverso apresentaram altas chances de óbito, mesmo com a introdução de variáveis como uso de terapia intensiva e realização de cirurgia. CONCLUSÕES: A alta frequência de resultados adversos em internações indica a necessidade de desenvolver estratégias de monitoramento e melhorias dirigidas para a segurança do paciente.

  3. Reflux venous flow in dural sinus and internal jugular vein on 3D time-of-flight MR angiography

    Jang, Jinhee; Kim, Bum-soo; Kim, Bom-yi; Choi, Hyun Seok; Jung, So-Lyung; Ahn, Kook-Jin; Byun, Jae Young [The Catholic University of Korea, Department of Radiology, Seoul St. Mary' s Hospital, School of Medicine, Seoul (Korea, Republic of)

    2013-10-15

    Reflux venous signal on the brain and neck time-of-flight magnetic resonance angiography (TOF MRA) is thought to be related to a compressed left brachiocephalic vein. This study is aimed to assess the prevalence of venous reflux flow in internal jugular vein (IJV), sigmoid sinus/transverse sinus (SS/TS), and inferior petrosal sinus (IPS) on the brain and neck TOF MRA and its pattern. From the radiology database, 3,475 patients (1,526 men, 1,949 women, age range 19-94, median age 62 years) with brain and neck standard 3D TOF MRA at 3 T and 1.5 T were identified. Rotational maximal intensity projection images of 3D TOF MRA were assessed for the presence of reflux flow in IJV, IPS, and SS/TS. Fifty-five patients (1.6 %) had reflux flow, all in the left side. It was more prevalent in females (n = 43/1,949, 2.2 %) than in males (n = 12/1,526, 0.8 %) (p = 0.001). The mean age of patients with reflux flow (66 years old) was older than those (60 years old) without reflux flow (p = 0.001). Three patients had arteriovenous shunt in the left arm for hemodialysis. Of the remaining 52 patients, reflux was seen on IJV in 35 patients (67.3 %). There were more patients with reflux flow seen on SS/TS (n = 34) than on IPS (n = 25). Venous reflux flow on TOF MRA is infrequently observed, and reflux pattern is variable. Because it is exclusively located in the left side, the reflux signal on TOF MRA could be an alarm for an undesirable candidate for a contrast injection on the left side for contrast-enhanced imaging study. (orig.)

  4. Reflux venous flow in dural sinus and internal jugular vein on 3D time-of-flight MR angiography

    Reflux venous signal on the brain and neck time-of-flight magnetic resonance angiography (TOF MRA) is thought to be related to a compressed left brachiocephalic vein. This study is aimed to assess the prevalence of venous reflux flow in internal jugular vein (IJV), sigmoid sinus/transverse sinus (SS/TS), and inferior petrosal sinus (IPS) on the brain and neck TOF MRA and its pattern. From the radiology database, 3,475 patients (1,526 men, 1,949 women, age range 19-94, median age 62 years) with brain and neck standard 3D TOF MRA at 3 T and 1.5 T were identified. Rotational maximal intensity projection images of 3D TOF MRA were assessed for the presence of reflux flow in IJV, IPS, and SS/TS. Fifty-five patients (1.6 %) had reflux flow, all in the left side. It was more prevalent in females (n = 43/1,949, 2.2 %) than in males (n = 12/1,526, 0.8 %) (p = 0.001). The mean age of patients with reflux flow (66 years old) was older than those (60 years old) without reflux flow (p = 0.001). Three patients had arteriovenous shunt in the left arm for hemodialysis. Of the remaining 52 patients, reflux was seen on IJV in 35 patients (67.3 %). There were more patients with reflux flow seen on SS/TS (n = 34) than on IPS (n = 25). Venous reflux flow on TOF MRA is infrequently observed, and reflux pattern is variable. Because it is exclusively located in the left side, the reflux signal on TOF MRA could be an alarm for an undesirable candidate for a contrast injection on the left side for contrast-enhanced imaging study. (orig.)

  5. Uso do ultra-som para punção venosa central em paciente obeso com adenomegalia cervical

    Jaderson Wollmeister

    2008-08-01

    Full Text Available JUSTIFICATICA E OBJETIVOS: As técnicas clássicas para punção venosa central são realizadas com base em referências anatômicas de superfície e conhecimento da anatomia vascular da região em que se realizará a punção. O uso do ultra-som permite a realização da punção sob visão direta das estruturas vasculares, peri-vasculares e da agulha de punção. O objetivo deste relato foi descrever o uso do ultra-som no auxílio de acesso venoso central em paciente obeso e com adenomegalias. RELATO DO CASO: Paciente do sexo masculino, branco, 28 anos, 1,70 m, 120 kg, com diagnóstico de linfoma de Hodgkin esclerose nodular. Solicitado ao Serviço de Anestesiologia do Hospital Governador Celso Ramos, punção de veia jugular interna direita guiada por ultra-som devido à presença de gânglio supraclavicular que prejudicava a referência anatômica de punção e à obesidade do paciente. Após a obtenção da melhor imagem a veia jugular interna esquerda foi puncionada e colocado um cateter venoso de triplo lúmen. A punção foi única, com progressão fácil do cateter e realizada sem complicações. CONCLUSÕES: O uso da ultra-sonografia para punção venosa central pode evitar complicações tornando o procedimento mais seguro para o paciente.

  6. Implante de stent dentro de stent recém-implantado em ponte de veia safena para otimização do resultado angiográfico Stenting a stent in saphenous vein graft to optimize the angiographic result

    Antonio Esteves Fº

    1998-03-01

    Full Text Available Mulher de 60 anos, com angina progressiva e revascularização do miocárdio, há oito anos, com ponte de veia safena para coronária direita e anastomose de artéria mamaria esquerda para artéria descendente anterior. Submetida a implante de stent Gianturco-Roubin II em terço proximal da ponte de veia safena para artéria coronária direita, com resultado insatisfatório pela persistência de lesão residual, provavelmente, decorrente de prolapso para dentro da luz de material aterosclerótico através dos coils. Foi implantado outro stent (Palmaz-Schatz biliar dentro do stent GRII com sucesso e ótimo resultado angiográfico. Um 2º stent Palmaz-Schatz biliar foi implantado em lesão distal no corpo da ponte, ultrapassando os dois stents, anteriormente implantados, com sucesso. Em algumas situações, implante de stent dentro de outro stent é recurso útil para otimização de resultado angiográfico do implante de um stent.A 60 year-old woman with progressive angina who had been submitted to saphenous bypass-graft to right coronary artery and a left mammary artery graft to anterior descending artery eight years previously, underwent implantation of a Gianturco Roubin II stent in the proximal third of the saphenous vein graft. The result was suboptimal by persistence of a residual stenosis probably due to prolapse of atherosclerotic material through the coil spaces. Another stent (Palmaz-Schatz biliar stent was implanted at the previously stented site with no residual stenosis. Another Palmaz-Schatz biliar stent was successfully implanted in the distal body of the graft to treat another lesion (passing through the previously stents without difficulty. Stenting a stent, in selected situations, is a useful tool to optimize the angiographic result of stent implantation.

  7. Trombose de veia central da retina em paciente usuária de interferon e ribavirina: relato de caso Central vein occlusion in a patient using interferon and ribavirin: case report

    John Helal Jr.

    2006-08-01

    Full Text Available O interferon alfa (INF alfa é droga atualmente utilizada no tratamento de várias doenças sistêmicas, como a hepatite C crônica. A ribavirina quando associada ao interferon alfa aumenta muito a resposta ao tratamento. Estima-se que a infecção crônica pelo vírus da hepatite C afete 170 milhões de pessoas no mundo, muitas delas em uso dessas medicações. A forma típica da retinopatia associada ao interferon alfa apresenta exsudatos algodonosos e hemorragias intra-retinianas. Há vários relatos de alterações oculares associadas ao uso do interferon alfa. Este trabalho descreve um caso de oclusão de veia central da retina em olho direito, com hemorragias no olho contralateral, em paciente usuária dessas medicações por dois anos. O caso descrito expõe em um dos olhos o quadro mais freqüente da retinopatia associada ao uso de interferon alfa (hemorragias de fundo e no olho contralateral, uma apresentação muito mais atípica (trombose de veia central da retina. O quadro fundoscópico apresentou melhora com a interrupção da medicação.Interferon and ribavirin are medications widely used in the treatment of some systemic diseases, mainly hepatitis C. Ribavirin when associated with interferon increases the rate of success of this treatment. There are about 170 million patients with chronic hepatitis C in the world, many in use of these medications. The classic associated retinopathy is described as cotton wool exudates and hemorrhages. Since the first reports, several different ocular disturbances were described in association with interferon. The present case shows a patient whose right eye presented with central retinal vein occlusion and whose left eye presented the typical findings of hemorrhages; prompt resolution after the medications were discontinued.

  8. US-guided placement of temporary internal jugular vein catheters: immediate technical success and complications in normal and high-risk patients

    Objective: : To evaluate the technical success and immediate complication rates of temporary internal jugular vein (IJV) haemodialysis catheter placement in normal and high-risk patients. Methods and materials: Two-hundred and twenty temporary internal jugular vein catheters inserted under ultrasound guidance in 172 patients were prospectively analyzed. Of 172 patients, 93 (54%) were males and 79 (46%) were females (age range, 18-83; mean, 56.0 years). Of 220 catheters, 171 (78%) were placed in patients who had a risk factor for catheter placement like patients with disorder of haemostasis, poor compliance, and previous multiple catheter insertion in the same IJV. Forty-seven (21.3%) procedures were performed on bed-side. A catheter was inserted in the right IJV in 178 procedures (80.9%) and left IJV in 42 procedures. Of 172 patients, 112 (65%) had only one catheter placement and the rest had had more than one catheter placement (range, 1-5). Results: Technical success was achieved in all patients (100%). Average number of puncture was 1.24 (range, 1-3). One hundred and eighty-three insertions (83.1%) were single-wall punctures, whereas 37 punctures were double wall punctures. Nine (4%) minor complications were encountered. Inadvertent carotid artery puncture without a sequel in four procedures (1.8%), oozing of blood around the catheter in three procedures (1.4%), a small hematoma in one procedure (0.4%), and puncture through the pleura in one procedure (0.4%) without development of pneumothorax. Oozing of blood was seen only in patients with disorder of haemostasis. Conclusion: Ultrasound-guided placement of internal jugular vein catheters is very safe with very high success rate and few complications. It can safely be performed in high-risk patients, like patients with disorders of haemostasis and patients with previous multiple catheter insertion in the same vein

  9. US-guided placement of temporary internal jugular vein catheters: immediate technical success and complications in normal and high-risk patients

    Oguzkurt, Levent [Baskent University, Adana Teaching and Medical Research Center, Department of Radiology, Adana (Turkey)]. E-mail: loguzkurt@yahoo.com; Tercan, Fahri [Baskent University, Adana Teaching and Medical Research Center, Department of Radiology, Adana (Turkey); Kara, Gulcan [Baskent University, Adana Teaching and Medical Research Center, Department of Radiology, Adana (Turkey); Torun, Dilek [Baskent University, Adana Teaching and Medical Research Center, Department of Nephrology, Adana (Turkey); Kizilkilic, Osman [Baskent University, Adana Teaching and Medical Research Center, Department of Radiology, Adana (Turkey); Yildirim, Tulin [Baskent University, Adana Teaching and Medical Research Center, Department of Radiology, Adana (Turkey)

    2005-07-01

    Objective: : To evaluate the technical success and immediate complication rates of temporary internal jugular vein (IJV) haemodialysis catheter placement in normal and high-risk patients. Methods and materials: Two-hundred and twenty temporary internal jugular vein catheters inserted under ultrasound guidance in 172 patients were prospectively analyzed. Of 172 patients, 93 (54%) were males and 79 (46%) were females (age range, 18-83; mean, 56.0 years). Of 220 catheters, 171 (78%) were placed in patients who had a risk factor for catheter placement like patients with disorder of haemostasis, poor compliance, and previous multiple catheter insertion in the same IJV. Forty-seven (21.3%) procedures were performed on bed-side. A catheter was inserted in the right IJV in 178 procedures (80.9%) and left IJV in 42 procedures. Of 172 patients, 112 (65%) had only one catheter placement and the rest had had more than one catheter placement (range, 1-5). Results: Technical success was achieved in all patients (100%). Average number of puncture was 1.24 (range, 1-3). One hundred and eighty-three insertions (83.1%) were single-wall punctures, whereas 37 punctures were double wall punctures. Nine (4%) minor complications were encountered. Inadvertent carotid artery puncture without a sequel in four procedures (1.8%), oozing of blood around the catheter in three procedures (1.4%), a small hematoma in one procedure (0.4%), and puncture through the pleura in one procedure (0.4%) without development of pneumothorax. Oozing of blood was seen only in patients with disorder of haemostasis. Conclusion: Ultrasound-guided placement of internal jugular vein catheters is very safe with very high success rate and few complications. It can safely be performed in high-risk patients, like patients with disorders of haemostasis and patients with previous multiple catheter insertion in the same vein.

  10. Diagnóstico situacional de las internas del establecimiento penitenciario de Concepción

    Carlos Soria Parra

    2012-06-01

    Full Text Available El sistema penitenciario en el país está a cargo del Instituto Nacional Penitenciario (INPE, que administra un total de 66 establecimientos, organizados en ocho Oficinas Regionales (OR. De acuerdo con el artículo 139 la Constitución Política, este organismo público descentralizado del Ministerio de Justicia y Derechos Humanos tiene, como ente rector del sistema penitenciario nacional, la responsabilidad de hacer que los internos ocupen establecimientos adecuados (inciso 21 y que alcancen la reeducación, rehabilitación y reincorporación a la sociedad (inciso 22. Ambas responsabilidades, sin embargo, son claramente incumplidas. Las cárceles padecen hoy de sobrepoblación y hacinamiento sorprendentes, y es más, de condiciones adecuadas para impulsar seriamente el complejo proceso de reeducación, rehabilitación y reincorporación. Lo peor es que la sobrepoblación ya se hace incontrolable. El último año, de junio del 2011 a junio del 2012, la población de internos, según informe del INPE, llegó a 58 019, y alcanzó un asombroso crecimiento de 19,4%, es decir, 9 433 presos más. Las razones de todo este problema, sin duda, son tan diversas, que inclusive van más allá de las decisiones del propio organismo. Es conocido que esta situación es dramática en las cárceles de Lima y Callao, pero no deja de ser preocupante en el interior del país. Los autores - la mayoría - estando desempeñandonos en la Policía Nacional del Perú y siendo a la vez estudiantes de Derecho, quisimos conocer esta realidad en las cárceles en Huancayo, conformantes de la Oficina Regional Centro, y por está razón se comprometió en apoyar a las internas a través de un proceso de asesoría legal, previo estudio sobre la situación del Establecimiento Penitenciario de Mujeres de Concepción, una de la ocho cárceles de mujeres existentes en el país y la única en la zona centro. Su capacidad de albergue es para 55 internas. Está ubicada en la provincia de Concepción, a 21 kilómetros de la ciudad de Huancayo, región Junín, y funciona desde 1998, hoy regida por la directora Irma Pretell Santillana. Esta investigación, realizada entre febrero y junio del presente año, tuvo la finalidad de elaborar un diagnóstico de la situación de las internas del referido establecimiento para contribuir en las decisiones orientadas a impulsar el proceso de reeducación, rehabilitación y reincorporación de estas personas a la sociedad, como fin de la pena. En este diagnóstico, identificamos aspectos relacionados al nivel educativo, estado de salud y la situación legal de las internas, entre otros, porque consideramos que se trata de información fundamental para asumir decisiones en bien de dicho proceso, que nos interesa fomentar su cumplimiento como estudiantes de Derecho. Y es que toda pena que se limita a la simple sanción o castigo, resulta injusta y atentatoria contra los derechos humanos. Como lo establece el Código Penal, consideramos que la pena tiene la función preventiva, protectora y resocializadora (2. La pena es definida como una sanción que produce la pérdida o restricción de derechos personales, contemplada en la ley e impuesta por el órgano jurisdiccional, mediante un proceso, al individuo responsable de la comisión de un delito (3. Es impuesta en función a la gravedad del delito. La pena privativa de la libertad, como pena mayor, aún sigue siendo la más adecuada en nuestro país. Por eso, la Comisión Revisora del Código Penal, a pesar de reconocer la potencia criminógena de la prisión, considera que la pena privativa de la libertad mantiene todavía su actualidad como respuesta para los delitos que son incuestionablemente graves (2. Sin embargo, la pena no solo debe responder a una simple sanción, sino además perseguir fines que a la postre ayuden a los penados a un cambio, mediante la reeducación, rehabilitación y reincorporación social, que es el objeto de la ejecución penal, tal como lo reafirma también el propio Código de Ejecución Penal (4. Este trato humano es respaldado asimismo por la normatividad internacional en materia de derechos humanos que nuestro país ha suscrito ante las Naciones Unidas y que hoy tiene rango constitucional y por lo tanto es de cumplimiento obligatorio (5; también, el Pacto Internacional de Derechos Civiles y Políticos, que uno de los convenios fundamentales, defiende el trato digno a las internos y alienta a que el régimen penitenciario promueva la “reforma y readaptación social” del mismo (6. Por esta razón, el presente estudio es muy útil. La investigación, no obstante, fue ardua. Establecimos coordinación permanente con los directivos del mencionado establecimiento, mediante cartas, para acceder a las instalaciones. Visitamos a la internas y levantamos la información del caso de manera directa y personalizada. Para ello, aplicamos un cuestionario estructurado con el fin de obtener datos sobre la situación socioeconómica, de salud y situación legal de las Internas del penal de Concepción, que nos permitió registrar valiosa información y que a continuación destacamos.

  11. Effects of Hypothermic Cardiopulmonary Bypass on Internal Jugular Bulb Venous Oxygen Saturation, Cerebral Oxygen Saturation, and Bispectral Index in Pediatric Patients Undergoing Cardiac Surgery: A Prospective Study.

    Hu, Zhiyong; Xu, Lili; Zhu, Zhirui; Seal, Robert; McQuillan, Patrick M

    2016-01-01

    The objective of this study was to evaluate the effect of hypothermic cardiopulmonary bypass (CPB) on cerebral oxygen saturation (rSO2), internal jugular bulb venous oxygen saturation (SjvO2), mixed venous oxygen saturation (SvO2), and bispectral index (BIS) used to monitor cerebral oxygen balance in pediatric patients.Sixty American Society of Anesthesiologists Class II-III patients aged 1 to 4 years old with congenital heart disease scheduled for elective cardiac surgery were included in this study. Temperature, BIS, rSO2, mean arterial pressure, central venous pressure, cerebral perfusion pressure (CPP), and hematocrit were recorded. Internal jugular bulb venous oxygen saturation and SvO2 were obtained from blood gas analysis at the time points: after induction of anesthesia (T0), beginning of CPB (T1), ascending aortic occlusion (T2), 20 minutes after initiating CPB (T3), coronary reperfusion (T4), separation from CPB (T5), and at the end of operation (T6). The effect of hypothermia or changes in CPP on rSO2, SjvO2, SvO2, and BIS were analyzed.Compared with postinduction baseline values, rSO2 significantly decreased at all-time points: onset of extracorporeal circulation, ascending aortic occlusion, 20 minutes after CPB initiation, coronary reperfusion, and separation from CPB (P??0.05). Correlation analysis demonstrated that rSO2 was positively related to CPP (r?=?0.687, P?=?0.000), with a low linear correlation to temperature (r?=?0.453, P?=?0.000). Internal jugular bulb venous oxygen saturation was negatively related to temperature (r?=?-0.689, P?=?0.000). Bispectral index was positively related to both temperature (r?=?0.824, P?=?0.000) and CPP (r?=?0.782, P?=?0.000). Cerebral oxygen saturation had a positive linear correlation with CPP and a low linear correlation to temperature. Internal jugular bulb venous oxygen saturation had a negative linear correlation to temperature.Pre-and and early postbypass periods are vulnerable times for adequate cerebral oxygenation. Anesthetic management must aim to optimize the supply and demand relationship. PMID:26765454

  12. Trans-jugular catheter-directed thrombolysis combined with trans-dorsalis pedis vein thrombolysis for the treatment of deep venous thrombosis of the lower limbs

    Objective: To investigate the feasibility and efficacy of trans-jugular catheter-directed thrombolysis (CDT) together with trans-dorsalis pedis vein thrombolysis for the treatment of deep venous thrombosis (DVT) of the lower limbs. Methods: Jugular vein puncture, indwelling catheter and placement of IVC filter were performed in 18 patients with DVT (study group) followed by continuous trans-jugular CDT together with trans-dorsalis pedis vein thrombolysis. During the corresponding period, 16 patients with DVT (control group) received trans-dorsalis pedis vein thrombolysis only. Results: The thrombolytic time and total dose of urokinase in study group and control group were (6.6 ± 2.3) days, (5.52 ± 2.24) x 106 units and (8.2 ± 1.4) days, (7.00 ± 1.66) x 106 units respectively. The thrombolytic time and total dose of urokinase in study group were significantly lower than that in control group (P < 0.05). After the treatment the thigh circumference and calf circumference in study group showed a reduction of (4.6 ± 2.1) cm and (4.0 ± 2.1) cm respectively, which were (3.2 ± 1.7) cm and (2.7 ± 1.5) cm respectively in control group, the difference between two groups was statistically significant (P < 0.05). The complete patent of the veins was 66.7% in study group and 31.3% in control group, the difference between two groups was significant (P < 0.05). In four cases of the study group, the filters were withdrawn through the original puncture site after the thrombus was completely dissolved. Conclusion: Trans-jugular CDT combined with trans-dorsalis pedis vein thrombolysis is an effective and safe therapeutic technique for the treatment of deep venous thrombosis of the lower extremities, moreover, the filter can be taken back via the original puncture site when the thrombus is completely dissolved. (authors)

  13. Fatores de risco para peritonites e internações Risk factors for peritonitis and hospitalizations

    Sarah Silva Abrahão

    2010-03-01

    Full Text Available INTRODUÇÃO: Investigou-se um universo de 30 crianças e adolescentes portadores de doença renal crônica em tratamento dialítico, assistidos pelo Hospital das Clínicas da UFMG, a fim de determinar fatores de risco para a frequência de peritonites e de internações. MÉTODO: Estudo descritivo em que para a obtenção dos resultados utilizou-se o software SPSS (Statistical Package for Social Science versão 13.0. Testaram-se as variáveis: baixa escolaridade, baixa renda familiar, nível de informação inadequado, inadequação da antissepsia das mãos para a realização da diálise, ausência de pia no quarto da diálise como fator de risco para maior frequência de peritonites e internações. RESULTADOS: Os valores de Odds Ratio estiveram dentro dos limites dos intervalos de confiança (95% e em alguns casos foram INTRODUCTION: This study assessed 30 children and adolescents with chronic kidney disease on dialysis, cared for at the Hospital das Clínicas of UFMG, aiming at determining the risk factors for the frequency of peritonitis and hospitalizations. METHOD: Descriptive study using the SPSS (Statistical Package for Social Science software, version 13.0. The following variables were assessed as risk factors for a higher frequency of peritonitis and hospitalizations: low educational level; low family income; inadequate level of information; inadequate hand antisepsis during PD; and lack of a sink in the dialysis room. RESULTS: The odds ratio values were within the 95% confidence intervals, and, in some cases, were smaller than 1, indicating the possibility of a negative association between some independent variables and the variables studied, but with no statistically significant difference. CONCLUSION: No statistical significance was observed for the variables studied, despite the tendency towards that.

  14. PRÁTICAS DE RESPONSABILIDADE SOCIAL EMPRESARIAL INTERNA EM PEQUENAS EMPRESAS DO GRANDE ABC PAULISTA

    MATTIOLI, José Wiliam

    2015-05-01

    Full Text Available Corporate Social Responsibility is one of the highlights in discussions about the role of business and its commitment to the diverse audiences that relates. This theme has demanded attention and efforts of companies and different sectors of society and government. This requires a design that Social Responsibility beyond what the law requires, and companies that act responsibly with all its stakeholders. One aspect of social commitment refers to the workforce as a competitive advantage in business process management. Thus, this study aims to identify whether small businesses in the industrial sector, develop internal practices of Corporate Social Responsibility. The work is predominantly qualitative, using descriptive held in companies located in the Greater ABC region, selected from the ABCD guide. For both structured questionnaire was used, adapted from data collection instrument developed by the Ethos Institute for Corporate Social Responsibility in partnership with the SEBRAE. The questionnaire was administered in 14 companies in the Greater ABC's industrial sector. The results showed that the surveyed companies, mostly internal social responsibility practices, especially practices that do not require large investments or are determined by law. Other companies that lack such practices are in the process of awareness. A Responsabilidade Social Empresarial (RSE representa um dos destaques das discussões sobre o papel das empresas e seu compromisso com os diversos públicos. O tema tem despertado atenção das empresas de diferentes setores da sociedade e do governo implicando, desta forma, numa concepção de Responsabilidade Social para além do que determina a lei, levando-as a atuar de maneira responsável com todos seus stakeholders. Um dos aspectos do compromisso social se refere ao público interno como um diferencial competitivo das empresas no processo de gestão. Desta forma, o presente trabalho tem como objetivo identificar se empresas de pequeno porte do ramo industrial desenvolvem práticas internas de RSE. Este trabalho, de caráter qualitativo, foi delineado por meio de pesquisa descritiva realizada em empresas localizadas na região do Grande ABC paulista, selecionadas a partir do Guia ABCD. Para tanto, utilizou-se de questionário estruturado, adaptado do instrumento de coleta de dados desenvolvido pelo Instituto Ethos de Responsabilidade Social Empresarial. O questionário foi aplicado em 14 empresas do Grande ABC do ramo industrial. Os resultados demonstraram que as empresas pesquisadas possuem, em sua maioria, práticas de responsabilidade social interna, principalmente práticas que não necessitam de grande investimento ou são determinadas pela lei.

  15. Variacin anatmica de la arteria maxilar interna del equino: estudio de caso / Anatomical Variation of Equine Internal Maxillary Artery: a Case Study / Variao anatmica da artria maxilar interna do equino: estudo de caso

    Ernesto Andrs, Dalmau Barros; Carlos Alberto, Venegas Corts.

    2012-12-01

    Full Text Available No Programa de Medicina Veterinria da Faculdade de Cincias Agropecurias da Universidade de La Salle ensina-se um bloco temtico relevante para a formao disciplinar bsica do futuro mdico veterinrio. Trata-se do tema terico-prtico da anatomia da cabea de espcies domsticas nas que se inclu [...] i a cabea do equino. O estudo abordado mediante a comprovao da teora na prtica de dissecao, e a explorao das diferentes estruturas que compem a cabea. Dentro deste estudo regional e sistemtico inclui-se a angiologia da cabea, onde se enfatiza os ramos da cartida comum como vaso arterial principal que irriga a cabea. A artria cartida comum termina nas artrias occipital, cartida interna e cartida externa; esta ltima emite dois ramos terminais principais, a saber: a artria maxilar interna e a temporal superficial. Geralmente, a artria maxilar interna segue um curso que se repete em quase todos os espcimes que so dissecados, em concordncia com o que descrevem os diferentes autores; porm, em alguns casos podem apresentar-se variaes no percurso da artria, como nos ramos que emite. Neste trabalho busca-se informar sobre um caso que se apresentou em uma aula regular no laboratrio de anatomia era feita dissecao de uma cabea de equino estudando as artrias macroscopicamente. A disseco mostrou uma variao no percurso normal da artria maxilar interna na altura do msculo pterigoideo lateral. O caso envolve uma fmea equina crioula de 11 anos que foi sacrificada fora do campus universitrio por pessoal no qualificado, a cabea foi separada posteriormente e enviado aos laboratrios de anatomia macroscpica do programa de Medicina Veterinria da Faculdade de Cincias Agropecurias. Devido a sua procedncia, no puderam ser conhecidos os anamnsicos, nem a histria do animal. Abstract in spanish En el Programa de Medicina Veterinaria de la Facultad de Ciencias Agropecuarias de la Universidad de La Salle se ensea un bloque temtico relevante para la formacin disciplinar bsica del futuro mdico veterinario. Se trata del tema terico-prctico de la anatoma de la cabeza de especies domstic [...] as en las que se incluye la cabeza del equino. El estudio es abordado mediante la comprobacin de la teora en la prctica de diseccin, y la exploracin de las diferentes estructuras que componen la cabeza. Dentro de este estudio regional y sistemtico se incluye la angiologa de la cabeza, donde se hace nfasis en las ramas de la cartida comn como vaso arterial principal de irrigacin. La arteria cartida comn termina en las arterias occipital, cartida interna y cartida externa; esta ltima emite dos ramas terminales principales, a saber: la arteria maxilar interna y la temporal superficial. Generalmente, la arteria maxilar interna sigue un curso que se repite en casi todos los especmenes que se disecan en concordancia con lo que describen los diferentes autores; sin embargo, en algunos casos se pueden presentar variaciones en el recorrido de la arteria, como en las ramas que emite. En este trabajo se busca informar sobre un caso que se present en una clase regular en el laboratorio de anatoma cuando se haca la diseccin de una cabeza de equino estudiando las arterias macroscpicamente. La diseccin mostr una variacin en el recorrido normal de la arteria maxilar interna a la altura de msculo pterigoideo lateral. El caso involucra a una hembra equina criolla de 11 aos que fue sacrificada fuera del campus universitario por personal no calificado, a la cual posteriormente se le separ la cabeza y se remiti a los laboratorios de anatoma macroscpica del programa de Medicina Veterinaria de la Facultad de Ciencias Agropecuarias. Dada su procedencia, no se pudieron conocer los anamnsicos, ni la historia del animal. Abstract in english A thematic block is taught in the Veterinary Medicine Program at La Salle University's Faculty of Agricultural Sciences that is rele

  16. COMPARISON OF ISOFLURANE AND SEVOFLURANE ANESTHESIA IN HOLSTEIN CALVES FOR PLACEMENT OF PORTAL AND JUGULAR VEIN CANNULAS

    Glen Sellers

    2013-01-01

    Full Text Available Isoflurane and sevoflurane are the two most commonly used inhalation anesthetics in veterinary medicine today. This study compared the anesthetic effects between isoflurane and sevoflurane in 17 calves undergoing surgery for placement of portal and jugular vein cannulas. Using a randomized control trial, calves were assigned to receive sevoflurane or isoflurane. Anesthesia was induced with xylazine and ketamine then maintained with the assigned inhalation anesthetic. Parameters for heart rate, respiratory rate, indirect blood pressures, oxygen hemoglobin saturation and end-tidal carbon dioxide were monitored and recorded during surgery. The anesthetic concentrations of the vaporizers were adjusted according to the calves’ responses, e.g., blood pressure, eye position, respiratory and heart rate, to surgical stimulation. Upon discontinuation of the inhalation anesthetic, calves were placed in sternal recumbency and recovery variables including time to extubation, time to first movement, attempts to stand and time to standing were observed and recorded. Statistical analysis was performed using a two-sample t-test on the recorded variables. There were no statistical differences between isoflurane and sevoflurane for any of the parameters recorded during anesthetic maintenance or recovery. The results of this study showed a faster time to first movement and extubation, 3.38±1.85 min and 11.75±3.73 min for sevoflurane compared to 7.56±5.34 min and 15.56±8.69 min for isoflurane, respectively. Attempts to stand were 3.00±2.14 for sevoflurane and 3.22±1.79 for isoflurane. Though the time to standing during recovery was not statistically different between anesthetics, the values did indicate a quicker trend of recovery from sevoflurane. Both inhalation anesthetics produced comparable anesthetic qualities and there were no statistical differences between the parameters recorded during maintenance of anesthesia. On the basis of the reported results, sevoflurane and isoflurane are suitable inhalation anesthetics for use in calves. However, present cost of sevoflurane is a limiting factor for its use in food animals.

  17. Embolia atrial de trombo flutuante da veia safena magna após escleroterapia com microespuma ecoguiada Atrial embolism of floating thrombus of the great saphenous vein after microfoam ultrasound-guided sclerotherapy

    Rubens Pierry Ferreira Lopes

    2010-12-01

    Full Text Available A escleroterapia com microespuma vem sendo utilizada amplamente no tratamento da doença venosa varicosa. No entanto, a despeito da sua pouca invasividade e segurança, complicações potencialmente graves e letais já foram descritas, como o acidente vascular cerebral e parada cardiorrespiratória. Descrevemos um caso de embolia atrial tardia de trombo flutuante da junção safeno-femoral de veia safena magna varicosa, após escleroterapia com microespuma de polidocanol guiada por ultrassom, e o tratamento dessa complicação.Microfoam sclerotherapy has been widely used in the treatment of varicose vein disease. However, despite its low invasiveness and safety, potentially serious and lethal complications have been described, such as stroke and cardiorespiratory arrest. We describe a case of delayed atrial embolism of floating thrombus in the saphenofemoral junction of a great saphenous varicose vein after microfoam ultrasound-guided sclerotherapy, as well as the treatment of this complication.

  18. Trombose venosa da veia subclávia após fratura de clavícula: relato de caso Subclavian vein thrombosis following fracture of the clavicle: case report

    Bernardo Barcellos Terra

    2011-04-01

    Full Text Available A trombose venosa profunda no membro superior não é frequente na literatura ortopédica. Relatamos um caso de trombose da veia subclávia durante o tratamento conservador de fratura do terço médio da clavícula. O diagnóstico é difícil e requer um alto grau de suspeição e o tratamento pode prevenir um tromboembolismo fatal. Há raros casos descritos associados à fratura de clavícula.Deep vein thrombosis in the upper limbs is uncommon in the orthopedic literature. We report on a case of subclavian vein thrombosis that occurred during conservative treatment of a fracture in the middle third of the clavicle. This is difficult to diagnose and requires a high degree of suspicion. Treating it may prevent fatal thromboembolism. In some rare cases, it has been described in association with fractures of the clavicle.

  19. Resposta cronotrópica ao exercício após isolamento das veias pulmonares ou cirurgia de Cox-maze Chronotropic response to exercise after pulmonary veins isolation or Cox-maze operation

    Daniela Marchiori Flores

    2008-12-01

    Full Text Available OBJETIVO: Avaliar a resposta cronotrópica ao exercício nos períodos pós-operatório imediato e tardio, após tratamento cirúrgico de fibrilação atrial e valva mitral por técnicas distintas. MÉTODOS: Estudo clínico prospectivo controlado, com amostra de 42 pacientes, portadores de fibrilação atrial crônica associada à valvulopatia mitral, submetidos a cirurgia pela técnica de isolamento de veias pulmonares (n=16, pela técnica do labirinto (Cox-maze modificado, sem uso de crioblação (n=13, ambas com correção de valvulopatia mitral, ou para correção de valvulopatia isolada (n=13. As características clínicas pré-operatórias, indicações para cirurgia tipo e etiologia da lesão valvar foram semelhantes entre os três grupos. Os pacientes foram acompanhados em ambulatório e submetidos a testes ergométricos seriados. RESULTADOS: A resposta cronotrópica no pós-operatório imediato foi semelhante nos grupos analisados, em média 73,6% ± 12,3% da freqüência cardíaca máxima prevista. No grupo de isolamento das veias pulmonares, houve aumento de 64,4% ± 12,4% da freqüência cardíaca máxima, no pós-operatório imediato, para 78,9% ± 10,5% no 12º mês de pós-operatório (P=0,012. No grupo Cox-maze, a freqüência cardíaca máxima variou de 73,9% ± 11,14% para 78.8% ± 15,2% (P=1,000 e no grupo controle (apenas correção da valva mitral, de 67,2% ± 14,3% para 71,9% ± 12,9% (P=0,889. CONCLUSÃO: A atenuação pós-operatória imediata da resposta cronotrópica ao exercício foi semelhante no pós-operatório das três diferentes técnicas cirúrgicas. Houve melhora significativa da mesma, na evolução pós-operatória, no grupo de isolamento das veias pulmonares. Estes resultados sugerem que o procedimento de simples isolamento cirúrgico das veias pulmonares pode estar relacionado à melhor preservação do cronotropismo atrial.OBJECTIVE: To evaluate the chronotropic response to exercise during immediate and late postoperative period after atrial fibrillation and mitral valve surgical treatment by different techniques. METHODS: Prospective controlled clinical study of 42 patients presenting chronic AF associated mitral valve disease, who underwent surgery by the techniques of pulmonary veins isolation (n=16, Modified Cox-maze procedure, without crioablation (n=13, both with isolated mitral valve repair (n=13. The preoperative clinical characteristics, surgical indications, kind and aetiology of valve lesion were similar between groups. The patients were outpatient followed-up and underwent series of ergometric tests. RESULTS: In the immediate postoperative period, chronotropic response was similar in the 3 groups with mean of 73.6 ± 12.3% of maximal calculated heart rate. In the surgical pulmonary veins isolation group, there was an increment of heart rate, from 64.4 ± 12.4% of maximal heart rate in the immediate postoperative period to 78.9 ± 10.5% in the 12th month (P=0.012 of postoperative. In the Cox-maze group, heart rate varied, respectively, from 73.9 ± 11.14% to 78.8 ± 15.2% (P=1.000 and in the control group (only mitral valve surgery, from 67.2 ± 14.3% to 71.9 ± 12.9% (P=0.889. CONCLUSION: An attenuation of immediate postoperative chronotropic response to exercise was similar in the postoperative in the three different surgical techniques. There was a significant improvement in this response concerning to postoperative outcome in the pulmonary veins isolation group. These results suggest that simple surgical pulmonary veins isolation may be related to a better preservation of atrial chronotropism.

  20. Anterior jugular phlebectasia

    Bhalodiya, Neena; Supriya, Mrinal; Singhania, Ankit

    2004-01-01

    Phlebectasia is abnormally dilated vinous channels a rare differential diagnosis for an apparent neck swelling A 5 year old male child with neck swelling apparent only on crying and speaking presented to us It was a soft cystic swelling The diagnosis was confirmed by sonography and angiography Surgical excision was carried out without any complication

  1. Uso de biogás em motores de combustão interna

    Ana Beatryz Prenzier Suzuki

    2011-04-01

    Full Text Available

    O biogás proveniente da digestão anaeróbia de resíduos sólidos ou líquidos constitui uma fonte de energia alternativa. Sua composição é uma mistura de gases onde o metano e o dióxido de carbono estão em maiores proporções. Os motores de combustão interna são muito utilizados por poderem operar com diferentes tipos de combustíveis tanto líquidos como gasosos. Para que o biogás possa ser utilizado como combustível, seja em motores, turbinas a gás ou microturbinas, é necessário identificar sua vazão, composição química e poder calorífico, parâmetros que determinam o real potencial de geração de energia elétrica.

  2. Vlvula nasal interna y rinoplastia esttica / Internal nasal valve and aesthetic rhinoplasty

    J.D., Giacomotti; N.E., Ottone; V.H., Bertone; F.J., Arruada; V., Cirigliano; L., Oloriz.

    2013-12-01

    Full Text Available Distinguimos en las fosas nasales la presencia de un estrecho o vlvula y, de ella, investigamos especficamente su porcin anterior conocida en Ciruga Plstica como vlvula nasal interna (VNI). Analizamos en este artculo las caractersticas, disposicin y relaciones de sus distintos componentes, [...] puntualizando especficamente el singular comportamiento del mucoepitelio valvular con respecto a los cartlagos triangulares y cuadrangular. Advertimos sobre la posibilidad de complicaciones postoperatorias en el caso de indebido trato valvular durante la ciruga y adjuntamos preparados y sus correspondientes dibujos con el propsito de facilitar la comprensin de los hechos observados. Abstract in english In this paper, we sand out the presence of a strait or valve in the nostrils, and about it, it's specifically investigated it's anterior portion known in Plastic Surgery as internal nasal valve (INV). Characteristics, provision and relations of its individual components are discussed, specifically p [...] ointing out the ubique behavior of the valvular mucosal epithelium in connection with the triangular and quadrangular cartilage. We warn out the possibility of postoperative complications in case of improper surgical valvular treatment and we attach preparations and their corresponding drawings in order to make easy the understanding of the observed facts.

  3. Preliminary evidence for human globus pallidus pars interna neurons signaling reward and sensory stimuli.

    Howell, Nicholas A; Prescott, Ian A; Lozano, Andres M; Hodaie, Mojgan; Voon, Valerie; Hutchison, William D

    2016-07-22

    The globus pallidus pars interna (GPi) is a component of the basal ganglia, a network of subcortical nuclei that process motor, associative, and limbic information. While non-human primate studies have suggested a role for the GPi in non-motor functions, there have been no single-unit studies of non-motor electrophysiological behavior of human GPi neurons. We therefore sought to extend these findings by collecting single-unit recordings from awake patients during functional stereotactic neurosurgery targeting the GPi for deep brain stimulation. To assess cellular responses to non-motor information, patients performed a reward task where virtual money could be won, lost, or neither, depending on their performance while cellular activity was monitored. Changes in the firing rates of isolated GPi neurons after the presentation of reward-related stimuli were compared between different reward contingencies (win, loss, null). We observed neurons that modulated their firing rate significantly to the presentation of reward-related stimuli. We furthermore found neurons that responded to visual-stimuli more broadly. This is the first single-unit evidence of human GPi neurons carrying non-motor information. These results are broadly consistent with previous findings in the animal literature and suggest non-motor information may be represented in the single-unit activity of human GPi neurons. PMID:27109924

  4. Resorcin dentaria interna: Presentacin de un caso Internal dental resorption: Case report

    Amparo Prez Borrego

    2010-06-01

    Full Text Available La resorcin dentaria es un proceso de destruccin de los tejidos calcificados del diente, en ocasiones afecta la parte externa y en otras oportunidades el interior del mismo. En la resorcin interna, hay destruccin de dentina y se forma en esa zona un tejido de granulacin muy vascularizado. Su origen no est definido y estas lesiones podemos considerarlas como no regresivas y, por lo general, determinan la prdida del rgano dentario.Resorption can be defined as the loss substances from any mineralized tissue, mediated by their own cell or humoral systems. The four mineralized tissues of our body are: bone, cement, dentin and enamel. Dental resorption is a process of destruction of the calcified tissues of the teeth, sometimes disturbing the outer part and some others their inner part. Internal resorption shows destruction of dentin, appearing in the area a well vascularized granulating tissue. Its origin is not yet defined and these lesions can be regarded as non regressive, which usually lead to the loss of the tooth.

  5. Hyperostosis frontalis interna (HFI) and castration: the case of the famous singer Farinelli (1705–1782)

    Belcastro, Maria Giovanna; Todero, Antonio; Fornaciari, Gino; Mariotti, Valentina

    2011-01-01

    The famous castrato singer Farinelli (1705–1782) was exhumed by our research group in July 2006 for the purpose of gaining some insight into his biological profile through a study of his skeletal remains. Farinelli was castrated before puberty to preserve the treble pitch of the boy's voice into adult life. His powerful and sweet voice became legendary. In spite of its bad preservation state, the skeleton displayed some interesting characteristics that are probably related to the effects of castration, including long limb-bones, persistence of epiphyseal lines and osteoporosis. In particular, the frontal bone was affected by severe hyperostosis frontalis interna (HFI). This condition consists in a symmetrical thickening of the inner table of the bone. The epidemiology of HFI shows that it is relatively common in postmenopausal women but very rare in men. Men affected by this pathology suffer from diseases, syndromes or treatments causing androgen deficiency. In the case of Farinelli, castration was probably responsible for the onset and development of this lesion. PMID:21740437

  6. Hyperostosis frontalis interna (HFI) and castration: the case of the famous singer Farinelli (1705-1782).

    Belcastro, Maria Giovanna; Todero, Antonio; Fornaciari, Gino; Mariotti, Valentina

    2011-11-01

    The famous castrato singer Farinelli (1705-1782) was exhumed by our research group in July 2006 for the purpose of gaining some insight into his biological profile through a study of his skeletal remains. Farinelli was castrated before puberty to preserve the treble pitch of the boy's voice into adult life. His powerful and sweet voice became legendary. In spite of its bad preservation state, the skeleton displayed some interesting characteristics that are probably related to the effects of castration, including long limb-bones, persistence of epiphyseal lines and osteoporosis. In particular, the frontal bone was affected by severe hyperostosis frontalis interna (HFI). This condition consists in a symmetrical thickening of the inner table of the bone. The epidemiology of HFI shows that it is relatively common in postmenopausal women but very rare in men. Men affected by this pathology suffer from diseases, syndromes or treatments causing androgen deficiency. In the case of Farinelli, castration was probably responsible for the onset and development of this lesion. PMID:21740437

  7. Aproximacin a las migraciones internas en la Espaa de Carlos III a partir del censo de Floridablanca

    Antonio EIRAS ROEL

    2009-12-01

    Full Text Available El estudio de las migraciones internas en la Edad Moderna es materia todava insuficiente desarrollada en la mayora de los pases. La razn de ello es la inexistencia de fuentes burocrticas especficas que permitan seguir los cambios de vecindad y los desplazamientos internos de los ciudadanos dentro del propio territorio; y la dificultad subsiguiente de suplir su inexistencia a base de fuentes substitutorias (principalmente matrimoniales, hospitalarias, notariales y, en ocasiones, municipales casi siempre casusticas, dispersas, aleatorias y de seguimiento lento y difcil. En Espaa esta materia se resiente de las mismas dificultades; sin perjuicio de la existencia de muy meritorios estudios regionales o monografas locales que tratan el tema para reas concretas, casi siempre a escala comarcal o local. Tampoco en nuestro pas se conoce la existencia de ninguna fuente de carcter sistemtico que permita abarcar con amplitud el tema de las migraciones internas. Parece necesario en consecuencia intentar acercarse a l a travs de fuentes indirectas de manejo asequible.

  8. Rastreamento de resultados adversos nas internações do Sistema Único de Saúde

    Monica Aguilar Estevam Dias; Monica Martins; Nair Navarro

    2012-01-01

    OBJETIVO: Descrever a frequência de rastreadores de potenciais resultados adversos em internações no Sistema Único de Saúde. MÉTODOS: Estudo retrospectivo, incluindo as internações de adultos na clínica médica (n = 3.565.811) e clínica cirúrgica (n = 2.614.048) no Brasil em 2007. O Sistema de Informações Hospitalares foi utilizado como fonte de informação. A mensuração dos resultados adversos baseou-se no rastreamento de 11 condições clínicas, definidas em estudos internacionais anteriores, r...

  9. Avaliao da morfologia interna de sementes de Acca sellowiana O. Berg por meio de anlise de imagens

    Vanessa Neumann Silva

    2013-12-01

    Full Text Available Acca sellowiana O. (Berg Burret uma fruteira nativa da regio Sul do Brasil e do Uruguai, que apresenta grande potencial de uso na recuperao de reas degradadas. O objetivo deste trabalho foi avaliar a morfologia interna de sementes de Acca sellowiana O. Berg por meio da anlise de imagens de raios X e relacionar os resultados com a germinao das sementes. Sementes de Acca sellowiana O. Berg, representadas por trs lotes, foram analisadas pelo teste de raios X e, posteriormente, conduzidas ao teste de germinao, com avaliao aos 44 dias aps a semeadura. As imagens de raios X foram analisadas com o software ImageJ. A anlise das imagens radiogrficas de sementes de Acca sellowiana permite a mensurao das reas internas livres, assim como a determinao da relao entre estas e a germinao. Danos internos detectados por meio de raios X afetam a germinao das sementes.

  10. Use of a murine endometriosis interna model for the characterization of compounds that effectively treat human endometriosis

    Otto, Christiane; SCHKOLDOW, JENNY; KRAHL, ELISABETH; Fuchs, Iris; ULBRICH, HANNES-FRIEDRICH

    2011-01-01

    Endometriosis is a chronic, estrogen-dependent disease characterized by the presence of ectopic endometrium either in the pelvic cavity (endometriosis externa) or within the uterus (endometriosis interna, adenomyosis). Key symptoms are pelvic pain, dysmenorrhea and infertility. Established rodent animal models used for drug research in endometriosis have certain limitations. Since rodents do not menstruate, they cannot develop endometriosis externa spontaneously, but they suffer from endometr...

  11. Transcriptome comparisons identify new cell markers for theca interna and granulosa cells from small and large antral ovarian follicles.

    Hatzirodos, Nicholas; Hummitzsch, Katja; Irving-Rodgers, Helen F; Rodgers, Raymond J

    2015-01-01

    In studies using isolated ovarian granulosa and thecal cells it is important to assess the degree of cross contamination. Marker genes commonly used for granulosa cells include FSHR, CYP19A1 and AMH while CYP17A1 and INSL3 are used for thecal cells. To increase the number of marker genes available we compared expression microarray data from isolated theca interna with that from granulosa cells of bovine small (n = 10 for both theca and granulosa cells; 3-5 mm) and large (n = 4 for both theca and granulosa cells, > 9 mm) antral follicles. Validation was conducted by qRT-PCR analyses. Known markers such as CYP19A1, FSHR and NR5A2 and another 11 genes (LOC404103, MGARP, GLDC, CHST8, CSN2, GPX3, SLC35G1, CA8, CLGN, FAM78A, SLC16A3) were common to the lists of the 50 most up regulated genes in granulosa cells from both follicle sizes. The expression in theca interna was more consistent than in granulosa cells between the two follicle sizes. Many genes up regulated in theca interna were common to both sizes of follicles (MGP, DCN, ASPN, ALDH1A1, COL1A2, FN1, COL3A1, OGN, APOD, COL5A2, IGF2, NID1, LHFP, ACTA2, DUSP12, ACTG2, SPARCL1, FILIP1L, EGFLAM, ADAMDEC1, HPGD, COL12A1, FBLN5, RAMP2, COL15A1, PLK2, COL6A3, LOXL1, RARRES1, FLI1, LAMA2). Many of these were stromal extracellular matrix genes. MGARP, GLDC, CHST8, GPX3 were identified as new potential markers for granulosa cells, while FBLN5, OGN, RAMP2 were significantly elevated in the theca interna. PMID:25775029

  12. PENGARUH ORGANIZATIONAL JUSTICE SERTA JOB INSECURITY TERHADAP JOB SATISFACTION PEGAWAI KONTRAK PADA PT. WICO INTERNA, SINGARAJA-BALI

    Komang Aris Yasadiputra; Made Surya Putra

    2014-01-01

    This study aims is to determine the effect of Organizational Justice and Job Insecurity on contract employee at PT. Wico Interna, Singaraja, Bali. Job Satisfaction on contract employees is important to note, because Job Satisfaction will give employees encouragement to work optimally in resolving any issues that arise. Job satisfaction is a set of employees feelings about their jobs . There are several variables that can affect Job Satisfaction , such as the Organizational Justice and Job Ins...

  13. INTRANET: AS TENDÊNCIAS NA COMUNICAÇÃO INTERNA DE ORGANIZAÇÕES PÚBLICAS

    Virginia Palmerston

    2008-12-01

    Full Text Available Com este artigo, procura-se encontrar resposta para o seguinte questionamento: Quais são os caminhos que estão sendo seguidos para que as intranets das organizações públicas funcionem como instrumento de dinamização da comunicação interna? Assim, o objetivo é verificar as tendências da comunicação interna sistematizada pelo uso das intranets. Neste estudo mostram-se alguns sinais que apontam para uma preocupação na adequada utilização das intranets como forma de maximizar a comunicação interna das organizações públicas Por intermédio dos estudos de caso, pôde-se perceber que os responsáveis pelo gerenciamento das informações têm aperfeiçoado os recursos que lhes permitem atingir tal objetivo.

  14. La desincronizacin interna como promotora de enfermedad y problemas de conducta

    Roberto Carlos Salgado Delgado

    2009-01-01

    Full Text Available La vida se rige por una estructura temporal que gobierna nuestras horas, nuestros das y nuestros calendarios. Como parte de la adaptacin a los ciclos de tiempo que impone el planeta, todo organismo presenta ritmos en su actividad y fisiologa. Los ritmos biolgicos son una propiedad conservada en todos los niveles de organizacin, desde organismos unicelulares procariontes hasta plantas superiores y mamferos. De ellos, los ms slidos son aquellos asociados a los ciclos externos por la alternancia del da y la noche y por la alternancia de las estaciones del ao. Los ritmos biolgicos fisiolgicos y conductuales son procesos dependientes de un reloj interno capaz de ajustar sus oscilaciones a claves de tiempo externas que lo mantienen sincronizado a estas fluctuaciones externas. El ncleo supraquiasmtico del hipotlamo (NSQ es en los mamferos el principal reloj circadiano y se sincroniza principalmente por el ciclo luz-oscuridad. El NSQ transmite seales de tiempo al cerebro y de ah al resto del organismo, y por medio de estas seales de tiempo mantiene un orden temporal en diversas funciones del cuerpo y las mantiene ajustadas al ciclo luz-oscuridad. El correcto orden temporal interno permite un adecuado funcionamiento del individuo en armona con el medio externo y le permite exhibir respuestas adecuadas a un ambiente cambiante y predecible. El estilo de vida del hombre moderno propicia situaciones que llevan a alteraciones de nuestros ritmos biolgicos que causan una desadaptacin temporal, que a su vez redunda en daos a la salud, ya que afecta tanto la fisiologa como la forma en que organizamos nuestra conducta. Un ejemplo de ello son los viajes a travs de mltiples regiones horarias. Estos cambios de horario bruscos provocan un sndrome conocido como jet-lag, que consiste en un conflicto transitorio entre el tiempo interno y el tiempo externo, lo cual se denomina desincronizacin interna. El jet-lag se define como un conjunto de sntomas causados por una alteracin del patrn de sueo, y de la expresin de ritmos biolgicos fuera de fase entre s y fuera de fase con el ciclo del da y la noche. Esta es la causa del malestar general, el deterioro del desempeo mental y fsico, as como de la irritabilidad y depresin. Son frecuentes tambin las alteraciones gastrointestinales, resultado del consumo de alimento en un horario inusual. Otro ejemplo de alteraciones en los ritmos circadianos se observa en los trabajadores con turnos rotatorios o en turnos nocturnos. En estas condiciones se produce un conflicto entre las seales temporales asociadas al ciclo diurno y que transmite el reloj con las actividades y alimentos del trabajador en turnos. De este esquema de trabajo resulta una reduccin de las horas de sueo y una alteracin de los ritmos circadianos, que llevan a una desincronizacin interna. sta, al igual que en el caso del jet-lag, redunda en un deterioro de las funciones mentales y de la capacidad de atencin y memorizacin, que se asocian a irritabilidad y problemas emocionales. Adems, se observan consecuencias en la salud con incremento en la incidencia de malestares gastrointestinales, enfermedades cardiovasculares, obesidad y diabetes...

  15. Síndrome do andar superior da cápsula interna. Hemiplegia sensitivo-motora capsular

    A. Borges Fortes

    1944-03-01

    Full Text Available Desde Türck (1859 os autores têm se preocupado com a passagem de fibras sensitivas pela cápsula interna. Muitas escolas neurológicas têm estudado a questão não só sob o ponto de vista clínico mas também anatômico e experimental. O autor passa em revista a opinião dos autores franceses (Charcot, Dejerine, Roussy, Long, etc. baseados na anátomo-clínica; dos ingleses com base na experimentação (Horsley, Beevor, Grünbaum, Sherrington, Oppenheim; suíços (Monakow e americanos (Grinker sobre as desordens sensitivas nas lesões da cápsula interna. O autor apresenta dois casos anátomo-clínicos de hemiplegia com perturbações sensitivas devidas a lesões da cápsula interna comprovadas anatomicamente. O tálamo estava indene em ambos os casos. A cápsula interna é um diedro formado pelo encontro de dois planos: o segmento anterior e o segmento posterior. Pela parte mais alta (andar superior do segmento posterior passam as fibras que saem do tálamo em busca da cortiça parietal (fibras tálamo-parietais, as que descem ao pedúnculo cerebral (fibras piramidais e as que ficam entre o núcleo lenticular e o tálamo (fibras extra-piramidais. No andar inferior do mesmo segmento passam somente as fibras piramidais. O autor estuda do ponto de vista anátomo-clínico a síndrome talâmica de Dejerine e Roussy, os estados talâmicos (Austregesilo e Colares e a hemiplegia capsular puramente motora. Mostra a inexistência de alterações sensitivas nas hemiplegias devidas à lesão do andar inferior da cápsula interna posterior. Estuda a síndrome do andar superior da cápsula interna posterior ou hemiplegia sensitivo-motora capsular. Documenta dois casos de hemiplegia sensitivo-motora com o estudo anatômico no qual se viu a lesão do andar superior do braço posterior da cápsula interna e integridade do tálamo. Salienta as diferenças existentes entre a mão talâmica e a capsular e chama a atenção para a contratura em flexão com supinação ou pronação verificadas na última, ao passo que na primeira há extensão dos dedos e movimentos córeo-atetósicos. A hemiplegia das lesões talâmicas é rapidamente regressiva e não hipertônica enquanto que a capsular é duradoura e acompanhada de aumento do tonus. Raramente aparecem dores espontâneas nas hemiplegias capsulares bem como hiperpatia de Foerster ou super-reação de Head, fenômenos muito frequentes na síndrome talâmica.

  16. Nuevos datos sobre la estructura interna del yacimiento vallesiense de Batallones 1 (Madrid, Espaa

    Morales, J.

    2006-12-01

    Full Text Available The study of the taphonomic processes of the vallesian site of Batallones 1, considered to be a natural trap, erects as one of the most interesting among the Tertiary Spanish paleontological localities. The study of the internal structure and distribution of the skeletal remains can shed new light on the origin of this association. The analysis of the distribution of the macromammals bones length does not seem to show any size selection in the site, as could be expected from a hydraulic current. Methodological biases can lead us to different interpretations so that we must be cautious. We have checked there isn??t a direct relation between the length of the skeletal elements and their dips though there are some long remains with high dips. This analysis together with future thorough ones will lead us to clarify the origin of the vertebrate association of Batallones 1.El estudio de los procesos tafonmicos del yacimiento vallesiense de Batallones 1, considerado una trampa natural de vertebrados, se erige como uno de los ms interesantes dentro de los yacimientos terciarios espaoles. El estudio de la estructura interna y la disposicin de los restos esquelticos puede arrojar ms luz sobre el origen de esta asociacin. El anlisis de la distribucin de las longitudes de los huesos de macromamferos no parece indicar una seleccin de las mismas por tamaos en la planta del yacimiento, como cabra esperar de un aporte hidrulico. Los sesgos metodolgicos pueden llevar a interpretaciones diferentes, por lo que hay que ser cauto. Comprobamos que no existe relacin entre las longitudes de los elementos esquelticos y sus respectivos buzamientos, aunque hay que destacar que elementos con longitudes importantes presentan buzamientos grandes. Estos anlisis, unidos a futuros estudios exhaustivos, nos llevarn a esclarecer el origen de la asociacin de vertebrados de Batallones 1.

  17. Bone metabolic activity in hyperostosis cranialis interna measured with {sup 18}F-fluoride PET

    Waterval, Jerome J.; Dongen, Thijs M.A. van; Stokroos, Robert J.; Manni, Johannes J. [Maastricht University Medical Center, Department of Otorhinolaryngology and Head and Neck Surgery, Maastricht (Netherlands); Teule, Jaap G.J.; Kemerink, Gerrit J.; Brans, Boudewijn [Maastricht University Medical Center, Department of Nuclear Medicine, Maastricht (Netherlands); Nieman, Fred H.M. [Maastricht University Medical Center, Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht (Netherlands)

    2011-05-15

    {sup 18}F-Fluoride PET/CT is a relatively undervalued diagnostic test to measure bone metabolism in bone diseases. Hyperostosis cranialis interna (HCI) is a (hereditary) bone disease characterised by endosteal hyperostosis and osteosclerosis of the skull and the skull base. Bone overgrowth causes entrapment and dysfunction of several cranial nerves. The aim of this study is to compare standardised uptake values (SUVs) at different sites in order to quantify bone metabolism in the affected anatomical regions in HCI patients. Nine affected family members, seven non-affected family members and nine non-HCI non-family members underwent {sup 18}F-fluoride PET/CT scans. SUVs were systematically measured in the different regions of interest: frontal bone, sphenoid bone, petrous bone and clivus. Moreover, the average {sup 18}F-fluoride uptake in the entire skull was measured by assessing the uptake in axial slides. Visual assessment of the PET scans of affected individuals was performed to discover the process of disturbed bone metabolism in HCI. {sup 18}F-Fluoride uptake is statistically significantly higher in the sphenoid bone and clivus regions of affected family members. Visual assessment of the scans of HCI patients is relevant in detecting disease severity and the pattern of disturbed bone metabolism throughout life. {sup 18}F-Fluoride PET/CT is useful in quantifying the metabolic activity in HCI and provides information about the process of disturbed bone metabolism in this specific disorder. Limitations are a narrow window between normal and pathological activity and the influence of age. This study emphasises that {sup 18}F-fluoride PET/CT may also be a promising diagnostic tool for other metabolic bone disorders, even those with an indolent course. (orig.)

  18. Bone metabolic activity in hyperostosis cranialis interna measured with 18F-fluoride PET

    18F-Fluoride PET/CT is a relatively undervalued diagnostic test to measure bone metabolism in bone diseases. Hyperostosis cranialis interna (HCI) is a (hereditary) bone disease characterised by endosteal hyperostosis and osteosclerosis of the skull and the skull base. Bone overgrowth causes entrapment and dysfunction of several cranial nerves. The aim of this study is to compare standardised uptake values (SUVs) at different sites in order to quantify bone metabolism in the affected anatomical regions in HCI patients. Nine affected family members, seven non-affected family members and nine non-HCI non-family members underwent 18F-fluoride PET/CT scans. SUVs were systematically measured in the different regions of interest: frontal bone, sphenoid bone, petrous bone and clivus. Moreover, the average 18F-fluoride uptake in the entire skull was measured by assessing the uptake in axial slides. Visual assessment of the PET scans of affected individuals was performed to discover the process of disturbed bone metabolism in HCI. 18F-Fluoride uptake is statistically significantly higher in the sphenoid bone and clivus regions of affected family members. Visual assessment of the scans of HCI patients is relevant in detecting disease severity and the pattern of disturbed bone metabolism throughout life. 18F-Fluoride PET/CT is useful in quantifying the metabolic activity in HCI and provides information about the process of disturbed bone metabolism in this specific disorder. Limitations are a narrow window between normal and pathological activity and the influence of age. This study emphasises that 18F-fluoride PET/CT may also be a promising diagnostic tool for other metabolic bone disorders, even those with an indolent course. (orig.)

  19. AUDITORA INTERNA MEDIOAMBIENTAL BASADA EN LA GESTIN DEL RIESGO CORPORATIVO: UN CASO DE ESTUDIO INTERNAL ENVIRONMENTAL AUDITING BASED ON CORPORATE RISK MANAGEMENT: A CASE STUDY AUDITORA INTERNA MEDIOAMBIENTAL BASADA EN LA GESTIN DEL RIESGO CORPORATIVO: UN CASO DE ESTUDIO

    M. Georgina Tamborino Morais

    2008-10-01

    Full Text Available O trabalho aborda a importncia da auditoria interna de meio-ambiente para garantir, com razovel segurana, que por meio dos seus sistemas de gesto a poltica meio-ambiental seja eficaz e eficiente na proteo e melhoria do meio-ambiente. Por meio de uma reviso de literatura, verifica-se que o sistema de gesto meio-ambiental requer uma superviso contnua por parte de profissionais preparados e dotados de conhecimentos e metodologias adequadas e atuais para garantir seu cumprimento por meio de uma gesto de risco corporativo. A funo da auditoria interna a ideal para faz-lo devido s suas atribuies. So pesquisadas, por meio de um estudo de caso, as vantagens e os pontos fracos de um modelo, muito recente, aplicvel a uma auditoria interna meio-ambiental: o Enterprise Risk Management (ERM - integrated framework. Conhecer os resultados da aplicao prtica deste modelo ajuda a conhecer sua utilidade e suas limitaes, alm de estabelecer padres de conduta para futuras implementaes, auxiliando as organizaes a desenvolver uma gesto mais comprometida com o meio-ambiente. This paper focuses on the importance of environmental internal auditing in providing reasonable assurance that environmental policy, through its management systems, is efficient and effective in the protection and improvement of the environment. Review of the literature shows that the environmental management system requires continual follow- up by trained professionals, possessed of the necessary knowledge and familiarity with current methodologies in order to assure compliance through corporate risk management. The internal auditing function is ideal for realizing this due to its attributes. A case-study allows the exploration of the advantages and disadvantages of a very recent model of environmental auditing the Enterprise Risk Management (ERM - integrated framework. The acknowledgment of practical application of this model allows to perceive its utility and limitations and to establish rules of conduct for future applications, supporting organizations efforts to develop management more committed to the environment. El trabajo aborda la importancia de la auditora interna medioambiental para garantizar, con una seguridad razonable, que la poltica medioambiental, a travs de sus sistemas de gestin, es eficaz y eficiente en la proteccin y mejora del medioambiente. Mediante una revisin de la literatura, se pone de manifiesto que el sistema de gestin medioambiental necesita de una supervisin continuada de profesionales preparados y dotados de conocimientos y metodologas adecuadas y actuales para garantir su cumplimiento a travs de una gestin de riesgo corporativo. La funcin de auditora interna es la ideal para hacerlo por sus atribuciones. Se exploran, mediante un caso de estudio, las ventajas y los puntos dbiles de un modelo, muy reciente, aplicable a una auditora interna medioambiental: el Enterprise Risk Management (ERM - integrated framework. Conocer los resultados de la aplicacin prctica de este modelo ayuda a conocer su utilidad y sus limitaciones y a establecer pautas de conducta en futuras implantaciones, ayudando as a las organizaciones a desarrollar una gestin ms comprometida con el medioambiente.

  20. DINMICA FAMILIAR INTERNA E HIGIENE BUCAL EN PERSONAS CON DISCAPACIDAD INTELECTUAL LEVE / INTERNAL FAMILY DYNAMICS AND ORAL HYGIENE OF PEOPLE WITH MILD INTELLECTUAL DISABILITY / DINAMICA FAMILIAR INTERNA E HIGIENE BUCAL EM PESSOAS COM DEFICIENCIA MENTAL LEVE

    Doris Lucia, Crdoba Urbano; Mara Isabel, Portilla Cabrera; Guillermo, Arteaga Caiza.

    2010-12-01

    Full Text Available Objetivos: o propsito do estudo foi determinar a relao entre dinmica familiar interna e higiene bucal de pessoas com deficincia intelectual leve, em estudantes do Instituto de Educao Especial PROPESA, de So Joo de Pasto, Colmbia, entre junho de 2009 e maro de 2010. Material e Mtodo: estu [...] do descritivo corte transversal, tipo quantitativo. Realizou-se em duas etapas: primeira, examinaram-se 33 pessoas com deficincia intelectual leve, entre 7 e 28 anos, se tomou o ndice de placa bacteriana de Silness e Le, para determinar o estado de higiene bucal. A segunda etapa valorou a dinmica familiar interna do grupo de estudantes, com o instrumento Apgar Familiar. O analise estadstico utilizou medidas de tendncia central, provas de Chi quadrado, coeficiente de correlao de Sperman. Resultados: o 54,5% das famlias so funcionais e o 12,1% delas apresentaram deficincia leve. O ponto mdio de ndice de placa foi 1,362 (DE=0,47), equivalente a higiene bucal regular. Os mais altos apresentaram se em pessoas de famlias reconstrudas e extensas ( composio familiar) e a idade asiana (idade familiar). Os pontos mdios de ndices em estudantes, em famlias com deficincia moderada. Foram mais altos (1,66) que em famlias funcionais (1,37); em tanto, no se encontrou significncia estadstica (p=0,41). Concluses: A dinmica familiar interna das pessoas com deficincia intelectual leve , em maior proporo, funcional e disfuncional leve. A higiene bucal regular. Porem no se encontrou relao significativa, relevante replicar este tipo de estudos duma povoao vulnervel, em crescimento e com dificuldades para manter adequada higiene bucal. Abstract in spanish Objetivos: el propsito del estudio fue determinar la relacin entre dinmica familiar interna e higiene bucal de personas con discapacidad intelectual leve, en estudiantes del Instituto de Educacin Especial PROFESA, de San Juan de Pasto, Colombia, entre junio de 2009 y marzo de 2010. Material y M [...] todo: estudio descriptivo, corte transversal, tipo cuantitativo. Se realiz en dos etapas: la primera, se examinaron 33 personas con discapacidad intelectual leve, entre 7 y 28 aos, se tom el ndice de placa bacteriana de Silness y Le, para determinar el estado de higiene bucal. La segunda etapa valor la dinmica familiar interna del grupo de estudiantes, con el instrumento Apgar Familiar. El anlisis estadstico utiliz medidas de tendencia central, pruebas de Chi cuadrado, coeficiente de correlacin de Sperman. Resultados: el 54,5% de las familias son funcionales y el 12,1% de ellas presentaron disfuncin leve. El promedio de ndice de placa fue 1,362 (DE=0,47), equivalente a higiene bucal regular. Los ms altos se presentaron en personas de familias reconstruidas y extensas (composicin familiar) y en edad anciana (edad familiar). Los promedios de ndices en estudiantes, en familias con disfuncin moderada, fueron ms altos (1,66) que en familias funcionales (1,37); sin embargo, no se encontr significancia estadstica (p=0,41). Conclusiones: la dinmica familiar interna de las personas con discapacidad intelectual leve es, en mayor proporcin, funcional y disfuncional leve. La higiene bucal es regular. Aunque no se encontr relacin significativa, es relevante replicar este tipo de estudios de una poblacin vulnerable, en crecimiento y con dificultades para mantener adecuada higiene bucal. Abstract in english Objectives: the purpose of this study was to determine the relationship between internal family dynamics and oral hygiene of people with mild intellectual disabilities, in students from the Institute of Special Education PROFESA, San Juan de Pasto, Colombia, between June 2009 and March 2010. Materia [...] l and Method: a descriptive, cross-sectional, quantitative study was carried out in two stages: the first one examined 33 people with mild intellectual disability, 7-28 years old and the Silness and Le bacterial plaque index was measure

  1. Eficcia da compresso pneumtica intermitente (CPI nos membros inferiores sobre o fluxo sanguneo das veias femorais comuns Efficacy of intermittent pneumatic compression (IPC in lower limbs on the blood flow of common femoral veins

    Marcondes Figueiredo

    2008-12-01

    Full Text Available CONTEXTO: A profilaxia do tromboembolismo venoso pode ser feita por mtodos farmacolgicos ou de forma mecnica, com o uso de meias antitrombo e compresso pneumtica (CPI. A CPI um mtodo mecnico de profilaxia que merece melhor ateno da comunidade mdica. OBJETIVO: Avaliar o efeito do uso de compresso pneumtica intermitente (CPI nos ps, pernas e coxas de adultos saudveis sobre o fluxo sanguneo nas veias femorais comuns. MTODOS: A amostra foi constituda de 10 voluntrios (sete mulheres e trs homens adultos (20-40 anos, sem antecedente de tromboembolismo venoso. Aps repouso (10 min em decbito dorsal, o fluxo sanguneo era medido (trs vezes por ultra-sonografia vascular na veia femoral, a 1 cm acima da juno safeno-femoral, em ambos os membros, sem controle e com CPI no p, perna e na coxa. A compresso (130 mmHg no p e 45 mmHg na perna e na coxa foi aplicada em ciclos de 11 segundos de compresso e 20-60 segundos de esvaziamento. As aferies de fluxo foram realizadas no pico de fluxo do ciclo de compresso. Os valores foram comparados por anlise de varincia (teste de Tukey, com p BACKGROUND: Prophylaxis of venous thromboembolism, a very common post-surgical complication, can be made pharmacologically or via mechanical methods, such as the use of anti-thrombosis socks and intermittent pneumatic compression (IPC. IPC is a mechanical method of prophylaxis that deserves the attention of the medical community. OBJECTIVE: To evaluate the effect of IPC on the blood flow of common femoral veins in feet, legs and thighs of healthy adults. METHODS: The sample was comprised of 10 volunteers (seven females and three males, adults (20-40 years, without history of venous thromboembolism. After a rest period (10 min, with the patient in the supine position, blood flow was measured (three times via vascular ultrasonography at the femoral vein, 1 cm above of the saphenofemoral junction, in both limbs, without (control and with IPC in the patient"s foot, leg and thigh. Compression (130 mmHg on foot and 45 mmHg on leg and thigh was applied at compression cycles of 11 seconds and emptying cycles of 20-60 seconds. Blood flow evaluations were performed at compression cycle peaks. Values were compared by analysis of variance (Tukey test, p < 0.05 indicating statistically significant difference. RESULTS: Use of IPC on the left and right lower limbs caused a percentage increase in the femoral blood flow of 37.6 and 70.8% (feet, 143.9 and 164.7% (legs, and 132.6 and 128.9% (thighs, respectively. Variations were statistically significant for application in legs and thighs. CONCLUSION: Use of IPC improves blood flow when applied in legs or thighs.

  2. Atividade mioelétrica do intestino delgado de cães submetidos à oclusão parcial da veia porta Myoelectric activity of the small bowel of dogs submitted to partial occlusion of the portal vein

    Álvaro Antônio Bandeira Ferraz

    2011-03-01

    Full Text Available RACIONAL: A oclusão temporária da veia porta causa estase esplâncnica e pode causar dismotilidade intestinal. OBJETIVO: Avaliar as alterações da atividade mioelétrica e da histologia do intestino delgado, além da pressão arterial média (PAM, frequência cardíaca (FC, pressão venosa central (PVC e press��o portal (PP, na fase de pré-oclusão e de oclusão portal. MÉTODO: Realizou-se anestesia geral em seis cães, seguido de monitorização da PAM, FC e PVC, laparotomia, aferição da PP, fixação de três pares de eletrodos na parede intestinal, biópsias jejunais e oclusão parcial da veia porta, sendo programado aumento da PP entre 2,5 e 3 vezes. Os eletrodos foram conectados a um microcomputador com software de aquisição para armazenamento e análise da atividade mioelétrica, cujo registro ocorreu nos 30 minutos da fase de pré-oclusão e nos 60 minutos de oclusão. Determinouse a variância e a média do RMS (root mean square da atividade mioelétrica. RESULTADOS: Na fase de oclusão, houve diminuição significativa da média do RMS e aumento da frequência de hemorragia da lâmina própria, sendo proporcional ao tempo de estase.Infiltrado inflamatório, dilatação vascular e desprendimento epitelial não apresentaram diferença entre as duas fases. Durante a estase, PAM, FC e PVC diminuíram (p=0,326; 0,375 e 0,008; respectivamente, e PP aumentou (p=0,015. CONCLUSÃO: A oclusão parcial da veia porta de cães promoveu diminuição da atividade mioelétrica e aumento da frequência percentual da hemorragia da lâmina própria, além de queda da PVCBACKGROUND: Temporary occlusion of the portal vein causes splancnic venous stasis and intestinal disfunction, that can produce alterations in the motility, and this fact is not vastly known. AIM: To evaluate the small bowel myoelectric activity and histology in the six dogs, also covering mean arterial blood pressure (AP, pulse rate (PR, central venous pressure (CVP e portal pressure (PP, in two phases: pre-occlusion and occlusion. METHODS: It was done general anesthesia, invasive monitorization of the AP, PR e CVP, laparotomy, measure of the PP, fixation of the three pairs of electrodes in the intestinal wall, jejunal biopsy and parcial occlusion of the portal vein, being programmed the increase of the PP between 2.5 and 3 times baseline. Electrodes were connected to a computer system that captured electrical signals from the intestine. The computer has a software of acquisition to store and analyse the myoelectric activity after registering, what happened in 30 minutes of the pre-occlusion phase and in 60 minutes of occlusion. The variance and the mean RMS(root mean square of the myoeletric activity were determined. The statistical analysis was done with Friedman, Dunn, Cochran and Students t tests. RESULTS: Mean RMS of myoeletric activity showed significant decrease in the phase of portal occlusion, in comparison to preocclusion phase. The frequency of hemorrhage of the lamina propria was major during occlusion. It was proportional at stasis time, with significant difference between the preocclusion and the occlusion of 60 minutes. Inflammatory infiltration, vascular dilation and epithelial detachment did not show any differences between two phases. During the stasis, AP, PR and CVP decreased (p=0,326; 0,375 e 0,008, respectively, and PP increased(p=0,015. CONCLUSIONS: Parcial occlusion of the portal vein produced reduction of the myoeletric activity and elevation of the percentage frequency of hemorrhage in lamina propria, and a fall of CVP, with relative hemodynamic stabilization.

  3. Propuesta de salvaguardas para la independencia de la funcin de auditora interna / Proposed safeguards for the independence of the internal audit function / Proposta de salvaguardas para a independncia da funo de auditoria interna

    Aurora V., Perez Lopez; Jose A., Perez Lopez.

    2014-05-01

    Full Text Available A presente investigao tem por objectivo propor um conjunto de salvaguardas que sirva de referncia a auditores internos e entidades, com o objectivo de garantir a imparcialidade na funo de auditoria interna. Para alcanar o referido objectivo, aplicou-se o mtodo Delphi. Os principais resultados [...] obtidos mostram que no existem opinies diferentes por grupos de especialistas sobre a importncia das salvaguardas, sendo possvel propor um conjunto uniformizado de salvaguardas, exceptuando a externalizao da funo de auditoria interna que, de acordo com o grupo de auditores internos, considerada como a menos importante. A imparcialidade sobre as actividades e sistemas de controlo interno a salvaguarda considerada de forma unnime como a mais importante. Abstract in spanish La presente investigacin tiene por objetivo proponer un conjunto de salvaguardas que sirva de referencia a auditores internos y entidades, con el fin de garantizar la existencia de independencia en la funcin de auditora interna. Para conseguir este objetivo se aplic el mtodo Delphi. Los princip [...] ales resultados obtenidos evidencian que no existen opiniones diferentes por grupos de expertos sobre la importancia de las salvaguardas, pudindose proponer un uniforme conjunto de salvaguardas, con la excepcin de la externalizacin de la funcin de auditora interna, la cual, segn el grupo de auditores internos, es considerada como la menos importante. La independencia sobre las actividades y los sistemas de control interno es la salvaguarda considerada de forma unnime como la ms importante. Abstract in english The present document has as its aim to propose a set of safeguards that may be used as a reference for internal and regulatory auditors and entities, in order to ensure the independence in this function. To obtain this aim, the applied research Delphi method was used. The results obtained demonstrat [...] ed that there was no difference of opinion between experts on the importance of the safeguards. Thus, a uniform set of safeguards can be proposed, with the exception of the outsourcing of the function of internal audit, it being considered to be less important for the group of internal auditors. The independence of auditing activities and the internal control systems was unanimously considered to be the most important safeguard.

  4. Evidncias de validade com base na estrutura interna no Teste dos Contos de Fadas / Validity evidences regarding the internal structure of the Fairy Tales Test / Evidencias de validez basada en la estructura interna del Test de los Cuentos de Hadas

    Blanca Susana Guevara, Werlang; Carlos Henrique Sancineto da Silva, Nunes; Vivian Roxo, Borges.

    2014-04-01

    Full Text Available O Teste dos Contos de Fadas/TCF, originalmente grego, avalia aspectos dinmicos da personalidade de crianas com idades entre seis e onze anos. O presente trabalho teve como objetivo identificar evidncias de validade com base na estrutura interna do TCF em uma amostra brasileira. O estudo envolveu [...] 315 crianas da populao geral e 167 crianas de grupos clnicos. Os instrumentos utilizados foram: ficha de dados sociodemogrficos; Teste Matrizes Progressivas Coloridas de Raven - Escala Especial e o TCF. As crianas da amostra foram localizadas em escolas pblicas e privadas e em instituies de sade e de proteo infantil. Os resultados da anlise fatorial exploratria revelaram uma soluo com sete fatores que foram avaliados e interpretados de acordo com a proposta terica do teste. Esses resultados foram satisfatrios e servem como evidncias de validade do TCF sob a perspectiva de sua estrutura interna. Abstract in spanish El test de los cuentos de Hadas /TCF, de origen griego, evala aspectos dinmicos de la personalidad de nios con edad entre 6 y 11 aos. El objetivo de esta investigacin fue identificar evidencias de validez basadas en la estructura interna del TCF en una muestra brasilea. Participaron 315 nios [...] de la poblacin general y 167 nios de grupos clnicos. Los instrumentos utilizados fueron: Cuestionario de Datos Sociodemogrficos, Test de Matrices Progresivas Coloridas de Raven - Escala Especial y el TCF. Los nios de la muestra fueron localizados en escuelas pblicas y particulares y en instituciones de salud y de proteccin infantil. Los resultados del anlisis factorial exploratorio revelaron una solucin con siete factores que fueron evaluados e interpretados segn la propuesta terica del TCF. Estos resultados fueron satisfactorios e indican evidencias de validez del TCF, desde la perspectiva de su estructura interna. Abstract in english The Fairy Tales Test (FTT), originally from Greece, evaluates dynamic personality aspects of children aged 6 to 11. The current work goal was to identify validity evidences regarding the internal structure of the FTT in a Brazilian sample. The study sample consisted of 315 children from the general [...] population and 167 children from clinical groups. The research made use of a socio-demographic data form, as well as the Raven's Colored Progressive Matrices (CPM), and the FTT. The children from the sample were recruited from public and private schools and from health and child protection institutions. Regarding the exploratory factorial analysis, it was found a seven-factor solution which were evaluated and interpreted following the test theory proposition. These results are considered satisfactory and indicate internal structure validity for the FTT from a psychometric standpoint.

  5. Prevalência de marcadores de trombofilia em pacientes portadores da síndrome de May-Thurner e trombose de veia ilíaca comum esquerda Prevalence of thrombophilia factors in patients with May-Thurner syndrome and left common iliac vein thrombosis

    Marcos Arêas Marques

    2010-12-01

    Full Text Available CONTEXTO: A relação entre trombose venosa profunda e trombofilia tem sido pouco estudada em indivíduos portadores de compressão da veia ilíaca comum esquerda, conhecida clinicamente como síndrome de May-Thurner. OBJETIVO: Avaliar a prevalência de marcadores de trombofilia nos pacientes portadores de síndrome de May-Thurner e trombose de veia ilíaca comum esquerda. MÉTODOS: Entre março de 1999 e dezembro de 2008, 20 pacientes com síndrome de May-Thurner e trombose de veia ilíaca comum esquerda foram avaliados retrospectivamente quanto à presença de marcadores de trombofilia. RESULTADOS: Foi detectada a associação entre síndrome de May-Thurner e marcadores de trombofilia em 8 pacientes (40%. CONCLUSÃO: A presença de marcadores de trombofilia em pacientes com trombose de veia ilíaca comum esquerda e síndrome de May-Thurner é frequente, porém não difere da prevalência encontrada em pacientes portadores de trombose venosa profunda sem a síndrome associada.BACKGROUND: The relationship between deep venous thrombosis and thrombophilia has been little studied in patients with left common iliac vein compression, clinically known as May-Thurner syndrome. OBJECTIVE: To evaluate the prevalence of thrombophilia markers in patients with May-Thurner syndrome and left common iliac vein thrombosis. METHODS: From March 1999 to December 2008, 20 patients with May-Thurner syndrome and left common iliac vein thrombosis were retrospectively investigated for the presence of thrombophilia markers. RESULTS: The association between May-Thurner syndrome and thrombophilia markers was found in 8 patients (40%. CONCLUSION: There is a high prevalence of thrombophilia markers in patients with May-Thurner syndrome and left common iliac vein thrombosis. The prevalence, however, is not different from that found in patients with deep venous thrombosis without May-Thurner syndrome.

  6. Plan Colombia e Iniciativa Mérida: negocio y seguridad interna

    Gian Carlo Delgado-Ramos

    2011-01-01

    Full Text Available El siguiente artículo plantea como punto de partida la concepción de América Latina (al como espacio territorial estratégico para Estados Unidos (EU, no como traspatio, sino como reserva estratégica de recursos, como espacio receptor de inversiones que además permiten externalizar costos socioambientales, así como región exportadora de excedentes, sea por la vía del retorno de ganancias resultantes de la inversión extranjera directa (ied, el pago de regalías por el uso de derechos de patentes o el pago de intereses por concepto de empréstitos. Tal esquema expoliador y subordinante, sólo posible con el aval de los grupos de poder local en todo el periodo de existencia de los Estados latinoamericanos "independientes", desgarra de modo creciente el tejido social. En este marco, se analizan el Plan Colombia (pc y la Iniciativa Mérida (im como casos paradigmáticos, pero no aislados, de la estrategia de política exterior de EU, que a los fines de garantizar su "seguridad nacional", léase sus intereses socioeconómicos y geopolíticos, promueve mecanismos ad hoc de "orden interno" en la región. Esto nos lleva a reflexionar sobre las implicaciones del retorno al discurso de la seguridad y estabilidad internas y la identificación del enemigo en el "terrorismo", el crimen organizado y la "narco-insurgencia", en tanto que "nvita" a las Fuerzas Armadas (ffaa locales, en alianza con EU, a que se ocupen de asuntos de "orden interno", facilitando la militarización y paramilitarización, abriendo la puerta al negocio de las armas y de la privatización de la guerra, así como de las ya conocidas prácticas de terrorismo de Estado.

  7. Comparison between the jugular and subclavian vein as insertion site for central venous catheters: microbiological aspects and risk factors for colonization and infection

    Sadoyama Geraldo

    2003-01-01

    Full Text Available Bacterial counts were made of catheter insertion site and of catheter tips to help determine risk factors associated with catheterization of the jugular and subclavian veins. Among the 116 patients included in this study, 69% had central venous catheters (CVC in the subclavian vein. Seven or more days catheterization (p=0.001 and >3 invasive devices (p=0.01 were infection risk factors associated with catheterization of the jugular vein. More than half of the patients presented high colony counts at the insertion site (>200 CFU/20 cm and 27% of the catheter tips were contaminated. The risk factors associated with contaminated catheter tips were >14 days hospital stay (p=0.02, >7 days catheterization (p=0.01 and antibiotic therapy (p=0.04. Coagulase-negative staphylococci (CoNS and Staphylococcus aureus were the most common microorganisms at the insertion site (78% and in the catheter tip (94%. Five patients presented sepsis (4.1%, four caused by Staphylococci and one by GNB. Twelve patients had the same microorganisms at the insertion site and catheter tip. We found a high prevalence of ORSA (62.5% and ORCoNS (57.1% in catheter tips. The high counts of staphylococci, including ORSA and ORCoNS, at the insertion site, and the significant association of this colonization with catheter tip contamination, indicate that the skin is an important reservoir of microorganisms associated with catheter-related bloodstream infection (CR-BSI. Health professionals should be aware of this potential source of infection at the CVC insertion site.

  8. DIAGNÓSTICO SITUACIONAL DE LAS INTERNAS DEL RECLUSORIO DE MUJERES DE MANIZALES DIAGNOSTICO SITUACIONAL DAS INTERNAS DA CADEIA DE MULHERES DE MANIZALES SITUATIONAL DIAGNOSIS OF THE FEMALE INMATES OF THE MANIZALES PRISON

    Claudia Patricia Jaramillo Ángel

    2007-12-01

    Full Text Available Objetivo: diagnosticar la situación de las internas del Reclusorio de Mujeres del municipio de Manizales en las áreas de atención primaria, saneamiento ambiental, salud mental, salud sexual y reproductiva, educación, situación judicial y comportamiento organizacional durante el primer semestre del año 2006. Materiales y métodos: estudio descriptivo. Población de estudio: 39 internas del Reclusorio de mujeres del municipio de Manizales. Variables: características socioeconómicas y demográficas, necesidades básicas, atención primaria, salud sexual y reproductiva, educación, saneamiento ambiental, salud mental y comportamiento organizacional. Las variables se describieron con media y desviación estándar, frecuencias absolutas y relativas. El procesamiento estadístico de los datos se hizo con el programa SPSS v.14.0. Resultados: la edad promedio fue 34,1±11,1 años. El estado civil predominante fue soltera y el promedio de hijos fue de 2,86±2,0. La escolaridad que primó fue la secundaria incompleta y el analfabetismo se encontró en 10,3%. En la mayoría, la ocupación previa fue la de ama de casa. En el estado nutricional no se encontró bajo peso en las internas. El 97,3% estaba condenada y 2,7% sindicada. Las internas encarceladas por primera vez correspondieron a 78,4%. Durante la reclusión, la mayoría tenía acceso a educación; más de la mitad ocupaba su tiempo en trabajos manuales. La evaluación de las necesidades básicas en el reclusorio fue en su mayoría buena. El uso del tiempo libre se destinaba en su mayoría a trabajos manuales. Las actividades físicas practicadas preferentemente fueron aeróbicos y baloncesto. Durante la reclusión 5 internas consumieron sustancias psicoactivas. La mayoría de ellas tenía problemas de salud oral. Las consultas médicas periódicas, el apoyo psicológico y de trabajo social y el acceso a métodos de planificación familiar fueron los servicios más deficitarios. Las enfermedades reportadas durante la reclusión fueron en su mayoría infecciosas. El 89,7% consideró buena la educación sexual recibida. Los motivos de mayor consulta fueron la cefalea, el lumbago y la epigastralgia. Ninguna de las internas reportó abuso sexual dentro del reclusorio. Las condiciones de saneamiento ambiental percibidas fueron en su mayoría buenas. Las internas manifestaron tener la oportunidad de expresarle sus inquietudes a las directivas de la institución. En la evaluación de la salud mental de las reclusas se encontró normalidad en el 44,4%, deterioro alto en 33,3%, y bajo deterioro, en 22,2%.Objetivo: diagnosticar a situação das internas da cadeia de mulheres do município de Manizales nas áreas de atenção primaria, saneamento ambiental, saúde mental, saúde sexual e reprodutiva, educação, situacional judicial e comportamento organizacional o primeiro semestre do ano 2006. Materiais e métodos: estudo descritivo. Povoação de estudo: 39 internas da Cadeia de mulheres do município de Manizales. Variáveis: características socioeconômicas e demográficas, necessidades básicas, atenção primaria, saúde sexual e reprodutiva, educação, saneamento ambiental, saúde mental e comportamento organizacional. As variáveis descreveram se com média e desvio Standard, freqüências absolutas e relativas. O processamento estatístico dos dados fez se com o programa SPSS v. 14.0. Resultados: A idade média foi 34,1±11,1 anos. O estado civil predominante foi solteiro e médio de filhos foi de 2,86±2,0. a escolaridade que predominou foi a secundaria incompleta e o analfabetismo encontro se em 10,3%. Em a maioria, a ocupação prévia foi a de dona de casa. Em o estado nutricional não encontro se baixo peso nas internas. O 97, % estavam condenadas e 2,7% sindicadas. As internas que estavam por primeira vez corresponderam a 78,4%. Durante a reclusão, a maioria tinha a possibilidade de estudar, mais da metade ocupava seu tempo em artesanato. A evacuação das necessidades básicas na cadeia foi em sua maioria boa. O uso do tempo livre destinava se em sua maioria ao artesanato. As atividades físicas praticadas preferentemente foram aeróbicas e basquete. Durante a reclusão Cinco internas consumiram sustâncias psicoativas. A maioria delas tinham problemas de saúde oral. A consulta medica periódico, o apoio psicológico e de trabalho social e a possibilidade de ter métodos de planificação familiar foram os serviços mais deficientes. As enfermidades reportadas durante a reclusão foram em sua maioria infecciosas. O 89,7% considerou boa a educação sexual recebida. Os motivos de maior consulta foram cefaléia, os lumbagos e a epigastralgia. Nenhuma das internas refreou abuso sexual dentro da cadeia. As condições de saneamento ambiental percebidas foram em sua maioria boas. As internas manifestaram ter a oportunidade de expressar-lé suas inquietações as diretivas da instituição. Na avaliação da saúde mental das internas encontro-se normalidade no 44,4%, deterioração alta em 33,3%, e baixa deterioração em 22,2%.Objective: to diagnose the situation of inmates of the Female Prison of the municipality of Manizales in the areas of primary attention, environmental sanitation, mental health, sexual and reproductive health, education, legal situation and organizational behavior during the first semester of 2006. Materials and methods: descriptive study. Population of the study: 39 inmates of the Female Prison of the municipality of Manizales. Variables: socioeconomic and demographic characteristics, basic necessities, primary attention, sexual and reproductive health, education, environmental sanitation, mental health and organizational behavior. The variables were described using average and standard deviation, absolute and relative frequencies. The statistical processing of the data was carried out with the SPSS v.14.0 program. Results: the average age was 34,1±11,1 years. The predominant social status was unmarried and the average number of children was 2,86±2,0. The most common schooling level was incomplete secondary studies and the illiteracy was of 10,3%. The previous occupation of the majority was as a housewife. In the nutritional state, low weight was not seen in the inmates. 97.3% were sentenced and 2.7% syndicated. The first time inmates corresponded to 78.4%. During the imprisonment, the majority had access to education; more than half occupied their time with manual work. The evaluation of the basic necessities in the prison was mainly optimum. The use of free time was mainly used in manual works. The preferred physical activities were aerobics and basketball. During imprisonment 5 inmates consumed psychoactive substances. The periodic medical consultations, the psychological support and social work and the access to contraceptive methods were the most deficit services. Most of them had oral health problems. The majority of diseases reported during the imprisonment were infectious. 89.7% considered that the sexual education they received was satisfactory. The reasons for consultation were migraine, lumbago and epigastric pain. None of the inmates reported sexual abuse within the reclusion center. The perceived environmental sanitation conditions were in their majority satisfactory. The inmates declared having the opportunity to express their inquiries to the directors of the institution. In the mental health evaluation of the inmates 44.4% showed normality, 33,3%high deterioration, and 22,2% low deterioration.

  9. Análisis organizacional de la dinámica interna de las empresas constructoras destacadas del eje cafetero

    Buendía Sierra, José Alejandro

    2009-01-01

    El presente trabajo provee evidencia del estado actual organizacional en las empresas constructoras inmobiliarias destacadas del eje cafetero de Colombia (departamentos de Caldas, Risaralda y Quindío); comprende aspectos relacionados con el análisis de su dinámica interna, específicamente; su estrategia, estructura, procesos internos, prácticas de recursos humanos, estilos de liderazgo, capacidad de aprendizaje, y valores compartidos; lo anterior basado en el esquema McKinsey 7-S el cual dete...

  10. Modelado de la combustión de mezclas gasolina-etanol en motores de combustión interna.

    Mantilla, Juan Miguel

    2011-01-01

    Este trabajo analiza el efecto que tiene el cambio de combustibles tradicionales por combustibles oxígenados (que contienen etanol) sobre la temperatura del proceso de combustión en motores de combustión interna encendidos por chispa. Además de esto se investiga el impacto de otras variables de funcionamiento como el tiempo de encendido, la relación de combustible-aire equivalente y la relación de compresión. Para llevar esto a cabo se realizó una labor de experimentación y simulación. Para e...

  11. Coherencia interna entre la memoria del grado y el currículo de educación infantil

    Franco Borrego, Silvia

    2015-01-01

    El trabajo propuesto refleja el proceso de análisis llevado a cabo por un estudiante de final de Grado, para comprobar la coherencia interna que existe entre la Memoria del Grado de Educación Infantil y el Currículo de Educación Infantil, con el fin de determinar si la formación que adquiere el educando en la titulación siguiendo el Plan de Estudios marcado por la Universidad Complutense de Madrid, se corresponde con las exigencias reales de los maestros en las aulas actuales. El trabajo ...

  12. El endometrio como glándula de secreción interna sinergia utero-ovarica

    Aristizábal Z., Manuel

    2012-01-01

    Antiguamente durante la era anatómica de la ginecología, pudiéramos decir que toda mujer sin útero había resuelto su problema, basados en la formula hipocrática: "las matrices son la causa de todas las enfermedades de las mujeres". Más tarde al ingresar la ginecología en el periodo que pudiéramos llamar funcional, y al ponerse en evidencia las secreciones internas del ovario, los conceptos se modificaron aclarando esta antigua concepción.

  13. Elementos diagnósticos en medicina interna 2003-2010 Diagnostics elements in internal medicine 2003-2010

    Jordi Delás; Cesar Morcillo; Gemma Martín; Adrià Arboix; Enric Gil de Bernabé; Olga Parra

    2012-01-01

    Introducción. Desde el curso 2003-2004 impartimos en la Facultad de Medicina de la Universitat de Barcelona la asignatura optativa semipresencial 'Elementos diagnósticos en medicina interna', en la que se aborda el diagnóstico a través de análisis de laboratorio, pruebas funcionales, de imagen y electrocardiografía. Materiales y métodos. Tras las sesiones presenciales, el material docente se deposita en la página web o campus virtual de la asignatura, a partir del cual los estudiantes respond...

  14. Comparação de diferentes métodos de controle da carga interna em jogadores de voleibol

    Maurício Gattás Bara Filho; Francine Caetano de Andrade; Ruan Alves Nogueira; Fábio Yuzo Nakamura

    2013-01-01

    INTRODUÇÃO: A capacidade de monitorar precisamente a carga de treinamento é um importante aspecto para a efetividade da periodização e para a prevenção de efeitos negativos, como a queda no rendimento. OBJETIVOS: Comparar e correlacionar diferentes métodos de controle de carga interna de treinamento em jogadores de voleibol. MÉTODOS: Quinze atletas profissionais de voleibol do sexo masculino, com idade entre 18 e 30 anos, que competiam em níveis estaduais e nacionais, participaram deste estud...

  15. A case of anterior internal ophthalmomyiasis: case report Oftalmomiíase interna anterior: relato de caso

    Vinicius da Silveira Saraiva; Miguel Hage Amaro; Rubens Belfort Jr.; Miguel Noel Burnier Jr.

    2006-01-01

    A case of anterior internal ophthalmomyiasis is described. A 27-year-old female from Northern Brazil presenting with anterior uveitis and vitritis had a fly larva surgically removed from the anterior chamber of the left eye. The species was Cochliomyia hominivorax. The larva was covered by macrophages and foreign body giant cells characterizing a foreign body granulomatous reaction.Um caso de oftalmomiíase interna anterior é descrito. Uma mulher de 27 anos proveniente da região Norte do Brasi...

  16. Manejo da infeco aps cirurgia de fixao interna da coluna lombar Management of deep wound infections in spinal lumbar fusions

    Asdrubal Falavigna; Orlando Righesso Neto; Gabriela Poglia Fonseca; Monique Nervo

    2006-01-01

    A incidncia de infeces profundas em cirurgias de coluna lombar situa-se na faixa de 0,7% e 11,6%, sendo uma das causas de morbidade na fase aguda deste procedimento. O objetivo deste estudo foi avaliar o tratamento da infeco aps cirurgia de fixao interna de coluna lombar. Foram analisados 260 pacientes que se submeteram cirurgia de fixao posterior da coluna lombar com instrumentao e enxertia de osso ilaco no perodo de janeiro de 1997 a janeiro de 2005. A infeco ps-operatri...

  17. Trauma torácico: importância da antibioticoterapia sobre o tempo de internação

    Fontelles Mauro José; Mantovani Mario

    2001-01-01

    No que tange a comprovada eficácia da drenagem pleural fechada, grande controvérsia ainda persiste em relação ao uso associado da antibioticoterapia. Os autores estudaram 167 pacientes, com trauma isolado do tórax, com objetivo de avaliar a importância do uso do antibiótico sobre o tempo de internação pós-drenagem pleural fechada. Dois grupos de pacientes foram incluídos num estudo longitudinal e prospectivo de acompanhamento de coortes. O grupo controle incluiu 104 pacientes sem uso da antib...

  18. Las migraciones internas de los latinoamericanos en España: del boom a la crisis económica

    Fernando GIL-ALONSO

    2012-01-01

    Full Text Available Las migraciones internas de la población de nacionalidad extranjera en España se caracterizan por su elevada intensidad, redistribuyendo a la población en el territorio. El objetivo de este artículo es el estudio del colectivo latinoamericano, que con más de 1,7 millones de personas se configuran como una de las comunidades extranjeras más importantes. Mientras sus principales características socio-demográficas han sido ampliamente investigadas -la feminización de los flujos migratorios y del stock de residentes, o su especialización laboral en los servicios-, sus pautas migratorias internas son menos conocidas. El primer objetivo del artículo es analizar la intensidad y las direcciones predominantes de su movilidad en el interior de España, tanto de larga distancia (interprovinciales como de corto radio (intraprovinciales, especial atención en los flujos de suburbanización en Madrid y Barcelona. El segundo objetivo es conocer el impacto de la crisis económica sobre dicha movilidad. Para ello se utilizarán los datos de la Estadística de Variaciones Residenciales junto a los del Padrón continuo.

  19. EVALUACIÓN DE LAS PROPIEDADES MECÁNICAS DE LA ESTRUCTURA INTERNA DE LA GUADUA CON UN MODELO MATEMATICO

    JAIRO ALEXANDER OSORIO SARAZ

    2009-01-01

    Full Text Available Se caracterizo la estructura interna del Bambú-Guadua angustifolia kunth (GAK, en su zona media, encontrando la composición interna de este material compuesto, como son el porcentaje de la matriz (parénquima y de fibras (células de fibras y tejido conductivo. Se determinó las propiedades mecánicas como la resistencia a tensión y a flexión en sentido tangencial, y la Relación de Poisson del material y la resistencia de la fibra. Se valido un modelo matemático para materiales compuestos propuesto por Chandrupatla & Belegundu (1999, y se encontraron algunas ecuaciones que permiten predecir la resistencia del material en función de la resistencia de la fibra, y también para realizar modelos computacionales útiles para la industria de laminados de pisos en Bambuguadua. Los resultados experimentales no difirieron significativamente de los resultados obtenidos con los modelos matemáticos.

  20. O Teste de Associao Implcita no transtorno obsessivo-compulsivo (TAI-TOC: consistncia interna e correlaes com medidas explcitas

    Mara Sizino da Victoria

    2011-01-01

    Full Text Available CONTEXTO: Avaliaes tradicionais de sintomas obsessivo-compulsivos, baseadas na introspeco, esto sujeitas a diversas variveis, como os nveis de insight apresentados pelo paciente. OBJETIVOS: Neste estudo, nosso objetivo foi o de avaliar a consistncia interna e as correlaes clnicas de um teste que busca identificar a existncia de um vis cognitivo implcito em pacientes com transtorno obsessivo-compulsivo (TOC. MTODOS: Quarenta pacientes com TOC realizaram o teste de associao implcita para o TOC (TAI-TOC e responderam a trs instrumentos de autoavaliao [Inventrio de Ansiedade de Beck (BAI, Inventrio de Depresso de Beck (BDI, Inventrio de Obsesses e Compulses - Revisado (OCI-R]. RESULTADOS: O valor do alfa de Cronbach com itens de treino foi de 0,83 e sem o treino foi de 0,79. No foram observadas correlaes significativas entre os escores gerados pelo TAI-TOC e os instrumentos de autoavaliao, i.e., BDI, BAI e diferentes dimenses do OCI-R. CONCLUSO: Nossos achados apontam para uma elevada consistncia interna do TAI-TOC. A ausncia de correlaes entre o TAI-TOC e diferentes dimenses do OCI-R sugere que medidas implcitas e explcitas de sintomas obsessivo-compulsivos podem formar constructos independentes. Estudos futuros, com maior nmero de pacientes, so necessrios para confirmar essa hiptese.

  1. Agenesia da artria cartida interna: relato de caso Agenesis of the internal carotid artery: a case report

    William da Silva Neves

    2008-02-01

    Full Text Available Relata-se, aqui, caso de uma adolescente de 14 anos de idade que apresentou episdio isolado de sncope, sem outros sintomas. No exame de ressonncia magntica observou-se, nos cortes nos planos axial e coronal ponderados em T2, ausncia do flow void da artria cartida interna direita na sua poro intracavernosa. Realizou-se, ento, angiorressonncia magntica tcnica time-of-flight, que mostrou ausncia da artria cartida interna direita, o que foi comprovado com a angiorressonncia magntica de vasos cervicais e com angiotomografia computadorizada, que mostrou, nos cortes axiais, agenesia do canal carotdeo direito. Tal achado relatado na literatura, em associao com outras anomalias, como encefaloceles transesfenoidais e aneurismas do polgono de Willis. No presente caso, no foram observadas tais associaes. A paciente permaneceu assintomtica.The present paper reports a case of a 14-year-old-female adolescent who presented a single episode of syncope, without any other symptom. Axial and coronal T2-weighted magnetic resonance imaging demonstrated an absent right internal carotid artery flow void. A subsequent magnetic resonance angiography utilizing the time-of-flight technique showed absence of the right internal carotid artery. This finding was confirmed by magnetic resonance angiography of the cervical vessels, and axial computed tomography angiography showed agenesis of the right carotid canal. The literature reports such finding in association with other anomalies such as transsphenoidal encephaloceles and circle of Willis aneurysms. These associations were not observed in the present case. The patient remained asymptomatic.

  2. Pacientes que se beneficiam de internação psiquiátrica em hospital geral Patients who benefit from psychiatric admission in the general hospital

    Paulo Dalgalarrondo; Neury J. Botega; Cláudio E M Banzato

    2003-01-01

    OBJETIVO: A internação psiquiátrica, embora onerosa, continua sendo um recurso terapêutico indispensável para pacientes graves. A internação em unidades psiquiátricas de hospital geral (UPHG) tem sido recomendada como a melhor alternativa aos macro-hospitais psiquiátricos. Nesse sentido, realizou-se estudo com o objetivo de verificar variáveis socioeconômicas e clínicas associadas com o êxito ou o fracasso da internação. MÉTODOS: Foram revistos dados sociodemográficos e clínicos de 1.463 paci...

  3. Índices de onda P na predição de recorrência de fibrilação atrial após isolamento da veia pulmonar

    Ahmed Salah

    2013-12-01

    Full Text Available FUNDAMENTO: Índices de ondas P são marcadores interessantes para prever recorrências de fibrilação atrial (FA pós ablação. OBJETIVO: Esse estudo avalia o valor dos índices de onda P para prever recorrências após isolamento da veia pulmonar (IVP em pacientes com fibrilação atrial paroxística. MÉTODOS: Foram selecionados 198 pacientes (57 ± 8 anos, 150 homens com FA paroxística sintomática refratária a medicamentos submetidos ao IVP em nosso hospital. Um eletrocardiograma de 12 derivações foi utilizado para medir a duração da onda P na derivação II, a força terminal de P (FTP na derivação V1, o eixo e a dispersão da onda P. RESULTADOS: No acompanhamento de 9 ± 3 meses, as recorrências ocorreram em 60 (30,3% pacientes. Os pacientes que apresentaram recorrência de FA tiveram maior duração média de onda P (122,9 ± 10,3 versus 104,3 ± 14,2 ms, p 125 ms apresenta 60% de sensibilidade, especificidade de 90%, valor preditivo positivo (VPP de 72% e valor preditivo negativo (VPN de 83,7%, enquanto a dispersão da onda P > 40 ms tem 78% de sensibilidade, 67% de especificidade, PPV 51% e VPN de 87,6%. 48/66 (72,7% dos pacientes com FTP -0,04 mm/segundo tiveram recorrência de FA (p 125 ms, a dispersão da onda P > 40 ms e FTP em V1 < -0,04 mm/sec são bons preditores clínicos das recorrências de FA pós IVP em pacientes com fibrilação atrial paroxística; contudo, eles não foram independentes do tamanho do átrio esquerdo e da idade.

  4. Trombose da artéria carótida interna devida a trauma penetrante no pálato mole: relato de caso

    BORGES GUILHERME

    1999-01-01

    Full Text Available Descrevemos caso de trauma penetrante na região oral em criança, evoluindo com oclusão da artéria carótida interna e déficit neurológico correspondente. A tomografia computadorizada e a ressonância nuclear magnética demonstram a oclusão completa da artéria carótida interna. Enfatizamos esta rara complicação de trauma oral, comum em crianças e discutimos os aspectos patogênicos.

  5. Evaluación de las propiedades mecánicas de la estructura interna de la guadua con un modelo matematico

    JAIRO ALEXANDER OSORIO SARAZ; ALBEIRO ESPINOSA BEDOYA; EDUARD A. GARCÍA GALEANO

    2010-01-01

    Se caracterizo la estructura interna del Bambú-Guadua angustifolia kunth (GAK), en su zona media, encontrando la composición interna de este material compuesto, como son el porcentaje de la matriz (parénquima) y de fibras (células de fibras y tejido conductivo). Se determinó las propiedades mecánicas como la resistencia a tensión y a flexión en sentido tangencial, y la Relación de Poisson del material y la resistencia de la fibra. Se valido un modelo matemático para materiales compuestos prop...

  6. La auditoría de comunicación interna: Una aproximación conceptual y metodológica

    Lic. Josefa García Mestanza; Lic. Antonio Ruiz Molina; Lic. Rafael Ventura Fernández

    1999-01-01

    ©En los últimos años, el papel estratégico de la comunicación interna y la satisfacción de las necesidades del público interno de las empresas han cobrado un merecido reconocimiento. En un breve periodo de tiempo han surgido en el seno de las organizaciones, unidades de comunicación interna responsables del diseño y ejecución de los programas de marketing Interno. Una vez satisfecha la necesidad de comunicación en el seno de la empresa, se plantea la necesidad de analizar y evaluar la gestión...

  7. Preditores de internação hospitalar em pacientes com síncope atendidos em hospital cardiológico

    Leonardo Marques Fischer; João Pedro Passos Dutra; Augusto Mantovani; Gustavo Glotz de Lima; Tiago Luiz Luz Leiria

    2013-01-01

    FUNDAMENTO: No atendimento ao episódio sincopal é necessário estratificar o risco para melhor diferenciar pacientes que necessitam de internação hospitalar daqueles que podem ser liberados. Os critérios utilizados pelos médicos avaliadores desses pacientes em emergências cardiológicas em nosso meio são desconhecidos. OBJETIVOS: Analisar quais os critérios adotados para internação hospitalar, diferenciá-los dos utilizados nos pacientes liberados e compará-los com os preditores de alto risco de...

  8. Armazenamento sob atmosfera controlada de tomates com injúria interna de impacto Controlled atmosphere storage of tomato fruit with internal bruising

    Celso Luiz Moretti; Sargent, Steven A; Huber, Donald J.; Rolf Puschmann

    2002-01-01

    A injúria interna de impacto causa redução significativa da qualidade de frutos de tomate. O presente trabalho teve como objetivo avaliar a utilização do armazenamento sob atmosfera controlada na redução do desenvolvimento de uma desordem de amadurecimento conhecida como injúria interna de impacto. Tomates (Lycopersicon esculentum Mill), cv. Solimar, foram colhidos no estádio de amadurecimento verde-maduro e tratados com etileno, por 12 horas, a 20°C. Ao atingirem o estádio verde-rosado, ...

  9. Percepção de auditores e auditados sobre as práticas de auditoria interna em uma empresa do setor energético

    Débora Lage Martins Lélis

    2012-12-01

    Full Text Available A atividade de auditoria interna tem passado por significativa expansão e valorização nos últimos anos. O objetivo do estudo foi avaliar a percepção de auditores internos e auditados em relação às práticas de auditoria interna de uma empresa brasileira do setor energético. A pesquisa, um estudo de caso com a utilização de fontes primárias, analisou diferentes aspectos da atividade de auditoria interna, incluindo a capacitação dos auditores e características associadas a um bom trabalho de auditoria. Auditores internos e auditados apontaram a preparação do auditor, a qualidade das recomendações de auditoria e a orientação para o risco como os fatores de maior influência sobre a qualidade do serviço de auditoria interna, corroborando o disposto na literatura. Também apresentaram percepção positiva sobre a contribuição da auditoria interna para a melhoria do desempenho dos processos, a melhoria da estrutura de controles internos e a melhoria da gestão de riscos da empresa, indicadores relevantes na avaliação da qualidade do serviço de auditoria interna. A pesquisa revelou uma considerável divergência perceptiva entre auditores e auditados no que tange à avaliação do comportamento dos auditados, que possuem uma percepção mais positiva sobre esse aspecto em comparação com os auditores. A percepção do uso de boas práticas de auditoria interna por auditores e auditados está, na maioria dos casos, coerente com os atributos de qualidade citados na literatura, indicando a presença desses atributos na avaliação da qualidade do serviço de auditoria interna.

  10. Responsabilidad social interna: entre la diferencia y el discurso en el escenario organizaciona / Internal social responsibility: between the difference and the discourse in the organizational scenario / Responsabilidade social interna: entre a diferena e o discurso no cenrio organizacional

    Nancy Piedad Diaz, Ortiz; Mariana Lima, Bandeira.

    2015-06-01

    Full Text Available Este ensaio prope que o discurso da Responsabilidade Social Interna como modelo de gesto pretende homogeneizar o tratamento dos atores internos da organizao, uma vez que ele utilizado em uma perspectiva instrumental focada exclusivamente em temas legais da relao laboral, em contraposio a u [...] ma perspectiva substantiva centrada na humanizao do ambiente laboral. Consequentemente, as organizaes escondem, debaixo desse discurso, prticas verdadeiramente desumanizantes na convivncia social e fomentam, cada vez mais, a intolerncia diferena. A discusso se contextualiza na Amrica Latina, onde cobra forados discursos da interculturalidade e da defesa dos direitos humanos nas agendas polticas e empresariais, o que evidencia as contradies inerentes a esses discursos. A partir de uma reviso bibliogrfica sobre responsabilidade social, discurso, teoria da identidade social e do autoconceito, discutiram-se os mecanismos individuais, sociais e organizacionais de elaborao e superao de esteretipos, que ajudam o indivduo a estabelecer referncias para as percepes e interpretao da realidade. Questiona-se que o discurso da responsabilidade social interna poderia propor uma mudana na forma como se tratam os indivduos na organizao. Nesse contexto, a diferena no existiria como forma de excluso social, mas seria um meio para promover a equidade, valorizando as particularidades da ao individual na organizao, e no no sentido de reforar a diferena entre "ns" e "eles" em funo do papel que exerce cada um na dinmica organizacional. Abstract in spanish El ensayo plantea que el discurso de la Responsabilidad Social Interna, como modelo de gestin, pretende homogenizar el tratamiento de los actores internos de la organizacin, una vez que es utilizado desde una perspectiva instrumental enfocada exclusivamente en temas legales de la relacin laboral, [...] en contraposicin a una perspectiva sustantiva centrada en la humanizacin del ambiente laboral. En consecuencia, bajo este discurso, las organizaciones esconden prcticas que son, en verdad, des-humanizantes en la convivencia social y fomentan an ms la intolerancia hacia la diferencia. La discusin se contextualiza en Latinoamrica, en que cobran fuerza los discursos de la interculturalidad y de la defensa de los derechos humanos en las agendas polticas y empresariales, lo que resalta las contradicciones inherentes a estos discursos. A partir de una revisin bibliogrfica sobre responsabilidad social, discurso, teora de la identidad social y del autoconcepto, se discutieron los mecanismos individuales, sociales y organizacionales de elaboracin y superacin de estereotipos, que ayudan al individuo a establecer referencias para las percepciones e interpretacin de la realidad. Se cuestiona que el discurso de la responsabilidad social interna podra proponer un cambio en la forma como se tratan los individuos en la organizacin. En este contexto, la diferencia no existira como forma de exclusin social, ms bien sera un medio para promover la equidad, valorando las particularidades de la accin individual en la organizacin, y no en el sentido de reforzar la diferencia entre el "nosotros" y "ellos" en funcin del rol que se ejerce en la dinmica organizacional. Abstract in english The aim of this essay is to discuss that the Internal Social Responsibility discourse as a management model intends to homogenize the treatment of the internal actors of the organization, once it is used in an instrumental perspective focused exclusively in legal themes on the work relation, in oppo [...] sition to a meaningful perspective focused on the humanization of the work environment. Consequently, organizations hide, under this discourse, practices truly dehumanizing in social life, and encourage, even more, intolerance to differences. This discussion takes place in Latin America, where it demands strength from intercultural discourses and the defense of t

  11. Una sorprendente victoria: Menem y su red de apoyo en las elecciones internas del peronismo de 1988

    Joaquín Baeza Belda

    2010-11-01

    Full Text Available 1989 supuso para Argentina la llegada a la presidencia del justicialista Carlos Menem y el inicio de un sorprendente giro, dados los antecedentes de su partido, hacia políticas neoliberales. Como paso previo, sin embargo, Menem debió vencer en unas elecciones internas en las que partía, en principio, en clara desventaja ante el favorito Antonio Cafiero, gobernador de la provincia de Buenos Aires y líder de la llamada Renovación peronista. La sorprendente victoria de Menem en 1988 ha sido explicada comúnmente como fruto de la reacción de la sociedad a la clase política, en el contexto de crisis que atravesaba el país, o bien como producto de los límites e insuficiencias de la línea cafierista. Sin desconocer estos enfoques, en este texto abordamos el problema desde la perspectiva interna del peronismo y del propio Menem, describiendo su labor de acumulación y reestructuración de los sectores más ortodoxos del partido, apartados por el avance de la Renovación. El estudio de estas elecciones internas sirve así para explorar las continuidades y rupturas de la Argentina que abre un nuevo ciclo en 1989.Palabras clave: Argentina, peronismo, Menem, Renovación, elecciones, 1988___________________________ABSTRACT:1989 marked the arrival to the Argentinian presidency of the PJ Carlos Menem and the beginning of a surprising twist, considering the history of his party, towards neoliberal policies. As a preliminary step, however, Menem had to overcome in a primary election, in which he was disadvantaged compared to the favorite Antonio Cafiero, Governor of Province of Buenos Aires and leader of the so called “Peronist Renovation”. Menem's stunning victory in 1988 has been commonly explained as the result of society's reaction to the political class, in the context of crisis of the country, or as a result of the limits and shortcomings of the Cafiero’s political line. Without ignoring these approaches, in this paper we approach the problem from an internal perspective and also the one of Menem himself, describing his work of accumulation and restructuration of the more orthodox sectors of the party, excluded by the progress of the “Renovation”. The study of these internal elections is good to explore the continuities and ruptures of the Argentina which open itself to a new cycle in 1989.Keywords:Argentina, Peronism, Menem, Renovation, elections, 1988

  12. Effect of cerebral blood flow on consciousness and outcome after head injury. Assessment by jugular bulb venous metabolism and IMP-SPECT

    This study was performed to elucidate the therapeutical value of arteriojugularvenous oxygen difference (AVDO2) in the ultra-emergent period after head injury. Rational therapeutic strategy after severe head injury needs information concerning the dynamical change of cerebral blood flow (CBF) and metabolism. We monitored the cerebral venous metabolism within 6 hours after head injury until the day IMP-SPECT was performed. Whole brain cerebral blood flow detected by IMP-SPECT and AVDO2 at the same day was compared, which restored to the period within 6 hours after head injury. From this procedure, we could outline cerebral blood flow conditions by only AVDO2 without IMP-SPECT in the ultra-emergent period. Eighty-six patients with head injury who were carried to our emergency center in the period of recent 2 years aged ranging from 15 to 94 years were the subjects. They all performed jugular bulb cannulation within 6 hours after the accident (Martin's phase I: day 0) to know saturation of jugular vein (SjO2), AVDO2 and AVL. They were monitored until the day IMP-SPECT was performed (Martin's phase II; day 1-3 or phase III; day 4-15). The correlation between CBF and AVDO2. The effect of CBF and cerebral venous metabolism on consciousness and outcome was also analyzed. CBF and AVDO2 in phase II and III were reversely correlated (p2. AVDO2 in all cases changed 6.2 vol% at phase I, 4.5 vol% at phase II and 5.1 vol% at phase III. Glasgow comascale (GCS) on admission under 8 (n=47) and over 9 (n=39) significantly differed in AVDO2 and CBF in the period of II and III. The patients with favorable consciousness showed low AVDO2 and hyperemia afterwards. Dead cases in phase I (n=19) showed high AVDO2 and low SjO2. The patients with severe disability (SD) (n=13) showed high AVDO2 and low CBF and the patients with good recovery (GR) showed low AVDO2 and high CBF in phase II and III. GCS on admission correlated with AVDO2 and CBF afterward. Only dead case was correlated with cerebral venous metabolism in the ultra-emergent period. The GR, moderate disability (MD) and SD were predicted in phase II and III by CBF and AVDO2. (author)

  13. DINÁMICA FAMILIAR INTERNA E HIGIENE BUCAL EN PERSONAS CON DISCAPACIDAD INTELECTUAL LEVE DINAMICA FAMILIAR INTERNA E HIGIENE BUCAL EM PESSOAS COM DEFICIENCIA MENTAL LEVE INTERNAL FAMILY DYNAMICS AND ORAL HYGIENE OF PEOPLE WITH MILD INTELLECTUAL DISABILITY

    Doris Lucia Córdoba Urbano

    2010-12-01

    Full Text Available Objetivos: el propósito del estudio fue determinar la relación entre dinámica familiar interna e higiene bucal de personas con discapacidad intelectual leve, en estudiantes del Instituto de Educación Especial PROFESA, de San Juan de Pasto, Colombia, entre junio de 2009 y marzo de 2010. Material y Método: estudio descriptivo, corte transversal, tipo cuantitativo. Se realizó en dos etapas: la primera, se examinaron 33 personas con discapacidad intelectual leve, entre 7 y 28 años, se tomó el índice de placa bacteriana de Silness y Löe, para determinar el estado de higiene bucal. La segunda etapa valoró la dinámica familiar interna del grupo de estudiantes, con el instrumento Apgar Familiar. El análisis estadístico utilizó medidas de tendencia central, pruebas de Chi cuadrado, coeficiente de correlación de Sperman. Resultados: el 54,5% de las familias son funcionales y el 12,1% de ellas presentaron disfunción leve. El promedio de índice de placa fue 1,362 (DE=0,47, equivalente a higiene bucal regular. Los más altos se presentaron en personas de familias reconstruidas y extensas (composición familiar y en edad anciana (edad familiar. Los promedios de índices en estudiantes, en familias con disfunción moderada, fueron más altos (1,66 que en familias funcionales (1,37; sin embargo, no se encontró significancia estadística (p=0,41. Conclusiones: la dinámica familiar interna de las personas con discapacidad intelectual leve es, en mayor proporción, funcional y disfuncional leve. La higiene bucal es regular. Aunque no se encontró relación significativa, es relevante replicar este tipo de estudios de una población vulnerable, en crecimiento y con dificultades para mantener adecuada higiene bucal.Objetivos: o propósito do estudo foi determinar a relação entre dinâmica familiar interna e higiene bucal de pessoas com deficiência intelectual leve, em estudantes do Instituto de Educação Especial PROPESA, de São João de Pasto, Colômbia, entre junho de 2009 e março de 2010. Material e Método: estudo descritivo corte transversal, tipo quantitativo. Realizou-se em duas etapas: primeira, examinaram-se 33 pessoas com deficiência intelectual leve, entre 7 e 28 anos, se tomou o índice de placa bacteriana de Silness e Löe, para determinar o estado de higiene bucal. A segunda etapa valorou a dinâmica familiar interna do grupo de estudantes, com o instrumento Apgar Familiar. O analise estadístico utilizou medidas de tendência central, provas de Chi quadrado, coeficiente de correlação de Sperman. Resultados: o 54,5% das famílias são funcionais e o 12,1% delas apresentaram deficiência leve. O ponto médio de índice de placa foi 1,362 (DE=0,47, equivalente a higiene bucal regular. Os mais altos apresentaram se em pessoas de famílias reconstruídas e extensas ( composição familiar e a idade asiana (idade familiar. Os pontos médios de índices em estudantes, em famílias com deficiência moderada. Foram mais altos (1,66 que em famílias funcionais (1,37; em tanto, não se encontrou significância estadística (p=0,41. Conclusões: A dinâmica familiar interna das pessoas com deficiência intelectual leve é, em maior proporção, funcional e disfuncional leve. A higiene bucal é regular. Porem não se encontrou relação significativa, é relevante replicar este tipo de estudos duma povoação vulnerável, em crescimento e com dificuldades para manter adequada higiene bucal.Objectives: the purpose of this study was to determine the relationship between internal family dynamics and oral hygiene of people with mild intellectual disabilities, in students from the Institute of Special Education PROFESA, San Juan de Pasto, Colombia, between June 2009 and March 2010. Material and Method: a descriptive, cross-sectional, quantitative study was carried out in two stages: the first one examined 33 people with mild intellectual disability, 7-28 years old and the Silness and Löe bacterial plaque index was measured to determine the status of oral hygiene. The second stage assessed the internal family dynamics of the student group, with the APGAR Family instrument. The statistical analysis used central tendency measures, Chi square tests, Spearman correlation coefficient. Results: 54.5% are functional families and 12.1% showed mild dysfunction. The average plaque index was 1,362 (SD=0.47, equivalent to regular oral hygiene. The higher scores were found in rebuilt and extended families (family composition and in elders (family age. The average indexes of students from families with moderate dysfunction were higher (1.66 than those in functional families (1.37, although no statistical significance was found (p = 0.41. Conclusions: the internal family dynamics of people with mild intellectual disabilities is, in greater proportion, functional and mild dysfunctional. Oral hygiene is poor. Although there was no significant relationship, it is relevant to replicate this type of study in an increasing vulnerable population which presents difficulties in maintaining adequate oral hygiene.

  14. A case of anterior internal ophthalmomyiasis: case report Oftalmomiíase interna anterior: relato de caso

    Vinicius da Silveira Saraiva

    2006-10-01

    Full Text Available A case of anterior internal ophthalmomyiasis is described. A 27-year-old female from Northern Brazil presenting with anterior uveitis and vitritis had a fly larva surgically removed from the anterior chamber of the left eye. The species was Cochliomyia hominivorax. The larva was covered by macrophages and foreign body giant cells characterizing a foreign body granulomatous reaction.Um caso de oftalmomiíase interna anterior é descrito. Uma mulher de 27 anos proveniente da região Norte do Brasil com uveíte anterior e vitreíte teve uma larva de mosca cirurgicamente removida da câmara anterior do olho esquerdo. A espécie identificada foi Cochliomyia hominivorax. A larva estava coberta por macrófagos e células gigantes de corpo estranho, caracterizando uma reação granulomatosa de corpo estranho.

  15. Disseco endoscpica da artria torcica interna com auxlio robtico Endoscopic harvest of internal thoracic artery with robotic assistance

    Paulo R .L. Prates

    2004-06-01

    Full Text Available A cirurgia robtica hoje um mtodo vivel para reduzir o trauma e as morbidades relacionadas em cirurgia cardaca. Em nossa instituio, o auxlio robtico j foi utilizado de forma bem-sucedida em implantes toracoscpicos de eletrodos epimiocrdicos para marcapassos biventriculares. O objetivo deste artigo descrever a tcnica por ns utilizada para disseco da artria torcica interna (ATI, mediante toracoscopia com apoio do rob AESOP e relatar seus resultados iniciais obtidos em nove pacientes.Robotic surgery is today a reliable method to reduce trauma and related comorbidities in cardiac surgery. In our institucion, robotic assistance has been effectively used for thoracoscopic implantation of epimyocardial leads for biventricular pacing. The objective of this article is to describe the technique that we developed to dissect the internal thoracic artery using thoracoscopy assistance with AESOP robotic system and to report the initial results obtained with its use in nine patients.

  16. Selección interna: el control de la filogenia por la ontogenia en una perspectiva variacional

    Gustavo Caponi

    2009-11-01

    Full Text Available La idea de selección interna, propuesta originalmente por Lancelot Whyte, no sólo sirve para entender el papel causal que los constreñimientos del desarrollo tienen en evolución; sino que además puede hacernos comprender de qué modo esos factores organísmicos o internos, cuya importancia la Biología Evolucionaria del Desarrollo hoy quiere rescatar, son pasibles de ser considerados desde una perspectiva variacional o seleccional compatible, pero no asimilable, a la Teoría de la Selección Natural. Así, considerado como un concepto autónomo y diferente al de selección natural, el concepto de selección interna puede permitirnos comprender de qué modo eso que Wallace Arthur llama developmental bias constituye una causa, efectiva y positiva, de transformaciones evolutivas irreversibles y acumulables.The idea of internal selection, originally proposed by Lancelot Whyte, not only helps to understand the causal role that the developmental constraints have in evoltion, but it can also show how these organismic or internal factors, which relevancy the Evolutionary Developmental Biology remarks today, can be considered from a variational or selectional perspective that is compatible with, but not reducible to, Natural Selection Theory. Thus, being considered as a concept autonomous and different from natural selection, the concept of internal selection can allow us to understand how that phenomenon that Wallace Arthur calls developmental bias constitutes an effective and positive cause of irreversible and cumulative evolutionary changes.

  17. Manejo da infeco aps cirurgia de fixao interna da coluna lombar Management of deep wound infections in spinal lumbar fusions

    Asdrubal Falavigna

    2006-12-01

    Full Text Available A incidncia de infeces profundas em cirurgias de coluna lombar situa-se na faixa de 0,7% e 11,6%, sendo uma das causas de morbidade na fase aguda deste procedimento. O objetivo deste estudo foi avaliar o tratamento da infeco aps cirurgia de fixao interna de coluna lombar. Foram analisados 260 pacientes que se submeteram cirurgia de fixao posterior da coluna lombar com instrumentao e enxertia de osso ilaco no perodo de janeiro de 1997 a janeiro de 2005. A infeco ps-operatria ocorreu em oito (3% casos. A idade mdia dos pacientes foi 56 anos, com maior prevalncia do sexo masculino (5 casos. Staphylococcus aureus foi isolado em 85% dos pacientes (6 casos. O tratamento institudo foi a lavagem externa e a antibioticoterapia intravenosa, seguida pela via oral. O tempo mdio de hospitalizao dos pacientes foi 35,8 dias. Com o tratamento preconizado foi possvel erradicar a infeco sem a necessidade da retirada do sistema de fixao interna em todos os casos.The rate of deep wound infections in spinal lumbar fusions is around 0.7% to 11.6%, being one of the causes of morbidity in acute phase. The aim of this study was to evaluate the management of spinal infection after internal lumbar fusions. Two hundred and sixty patients, who underwent to spinal surgery with lumbar fusion and iliac bone grafting, were analized, from January 1997 to January 2005. Wound infection was observed in eight (3% cases. The average of age was 56 years, with a higher prevalence in males (5 patients. Most prevalent was Staphylococcus aureus in 6 patients. The treatment was done by intravenous antibiotic therapy folowed by oral therapy and local irrigation. The average time of hospitalization was 35.8 days. It was possible to erradicate infection without removal of instrumentation in all patients.

  18. Nuevas tecnologías en la comunicación interna en empresas del Valle de Aburrá

    Diego León Salazar Vargas

    2009-01-01

    Full Text Available Objetivo: Identificar el uso y la aplicación de las tecnologías que están incorporando los comunicadores organizacionales. Materiales y métodos: Estudio de casos realizado en 10 empresas del Valle de Aburrá, Antioquia, Colombia, que han incorporado tecnologías digitales a la gestión de comunicación interna. Se emplearon como instrumentos una encuesta y una entrevista dirigida-semiestructurada a los comunicadores. Para el análisis de la información se correlacionaron los resultados de los dos instrumentos. Resultados: El uso que le están dando los comunicadores a las herramientas digitales es de medios para el flujo informativo. No sólo hacen la aplicación digital en medios como boletines, intranet, correo electrónico, entre otros, sino también con los denominados textos empresariales: cartas, circulares, memorandos. Los comunicadores consideran pertinente la incorporación de los medios digitales dentro del proceso de comunicación interna y afirman que éstos han tenido un alto impacto en empresa. El grupo estudiado, reconoce que los medios digitales ofrecen beneficios importantes para la comunicación. No se encontró en ninguna de las empresas evaluación de impacto o de satisfacción con los medios digitales. Conclusiones: Los denominados medios de comunicación digitales no son tales, en tanto se apliquen como simple flujo, es decir, unidireccionalmente. Pese a tener en las empresas empleados sin acceso a los medios digitales, no se han tomado soluciones al respecto. Los medios son implementados sin dar respuestas a necesidades puntuales de la organización.

  19. Curva de estimativa das internações hospitalares nas regiões metropolitanas brasileiras: um estudo de série histórica

    Graziella Denúbila Gomes

    2012-03-01

    Full Text Available O objetivo deste estudo foi investigar as variações temporais na distribuição das internações hospitalares realizadas no Sistema Único de Saúde (SUS em todas as Regiões Metropolitanas brasileiras entre os anos de 1995 e 2006. Trata-se de estudo ecológico de série histórica com dados secundários referentes às 36 regiões metropolitanas brasileiras. Realizou-se a análise descritiva dos dados, correlação de Spearman e curva de estimativa. Os resultados indicam que o Teste F foi significativo em ordem decrescente para os modelos linear (p=0,001, quadrático (p=0,002 e cúbico (p=0,004. Por outro lado, os valores de R2 apresentaram ordem crescente de valores – 0,277; 0,307 e 0,338, respectivamente. O modelo cúbico mostrou que o percentual médio de internações hospitalares em 2006 apresentou tendência de queda quando comparado ao percentual médio de internações no ano de 1995. Conclui-se que o percentual de internações hospitalares realizadas no SUS nas regiões metropolitanas brasileiras decresceu durante o período analisado.

  20. El desarrollo laboral sustentable y su relación con la migración interna en México

    Jesús Sergio Sánchez Rodríguez

    2014-01-01

    Full Text Available en este trabajo se estudió la interacción entre la mi - gración interestatal y el desarrollo laboral sustentable en México del año 2000 al 2010, de acuerdo con la visión de Amartya Sen. Este desarrollo se midió con el índice de competitividad social, y la interacción con la migración interna se evaluó con un modelo de ecuaciones simultá - neas. Los resultados confirmaron que a mayor desarrollo laboral sustentable, el grado de inmigración fue más y vi - ceversa. Por otro lado, no se encontró relación alguna entre la emigración interna y el desarrollo laboral sustentable. Al desagregar el índice de competitividad social, se encontró una relación causal mutua entre el índice de la ausencia de pobreza salarial y la inmigración interna, así como una relación causa-efecto positiva entre ausencia de pobreza salarial sobre la emigración interna, la cual no se da en el otro sentido.

  1. Diseño de sistema de gestión de la comunicación interna a la medida organizacional

    Norge Lauzao-Serrano

    2012-01-01

    evaluación y control de los procesos comunicativos en la organización, capaz de permitir la existencia de un sistema de comunicación coherente y armónico, contribuyendo a una mayor integración interna, fortaleciendo su cultura e identidad.

  2. Combined therapy for jugular foramen schwannomas. Selection of surgical approaches according to the extension of the tumor and combined with or without gamma knife radiosurgery

    We discuss an optimal therapy for jugular foramen schwannomas (JFSs) designed to minimize the risk of neurological deficit, based on tumor location, shape and size. We treated fourteen patients with JFSs in this study. They were classified into two types according to tumor location; intradural (ID) and intra/extradural (ID/ED). In cases without brainstem compression, the patient was treated by gamma knife radiosurgery (GKRS). Conversely, where compression was evident, surgery was initially performed. In compressed ID cases, the intracisternal portion was resected using a lateral suboccipital approach, followed by GKRS for the residual tumor in the JF. In ID/ED cases, the transjugular approach was primarily used, in addition to the transcervical where there was upper cervical extension. While the six symptomatic cases showed little or no post-surgical improvement, the eight asymptomatic cases yielded no post-treatment deficit. These results indicate that a combined treatment strategy chosen according to tumor shape, location and size is a very effective treatment modality for JFSs. (author)

  3. Prevalence and impact of incompetence of internal jugular valve on postoperative cognitive dysfunction in elderly patients undergoing robot-assisted laparoscopic radical prostatectomy.

    Roh, Go Un; Kim, Won Oak; Rha, Koon Ho; Lee, Byung Ho; Jeong, Hae Won; Na, Sungwon

    2016-01-01

    Internal jugular vein (IJV) is the main pathway of cerebral venous drainage and its valves prevent regurgitation of blood to the brain. IJV valve incompetence (IJVVI) is known to be associated with cerebral dysfunctions. It occurs more often in male over 50 years old, conditions elevating intra-abdominal or intra-thoracic pressure. In robot-assisted laparoscopic radical prostatectomy (RALRP), elderly male undergoes surgery in Trendelenburg position with pneumoperitoneum applied. Therefore, we assessed the IJVVI during RALRP and its influence on postoperative cognitive function. 57 patients undergoing RALRP were enrolled. Neurocognitive tests including Mini-Mental State Examination (MMSE), Auditory Verbal Learning Test, Digit Symbol Substitution Test, Color Word Stroop Test, digit span test, and grooved pegboard test were performed the day before and 2 days after surgery. During surgery, IJVVI was assessed with ultrasonography in supine position with and without pneumoperitoneum, and Trendelenburg position with pneumoperitoneum. 50 patients underwent sonographic assessment and 41 patients completed neurocognitive examination. A total of 27 patients presented IJVVI, 19 patients in supine position without pneumoperitoneum, 7 patients in supine position with pneumoperitoneum and 1 patient in Trendelenburg position with pneumoperitoneum. In neurocognitive tests, patients with IJVVI showed statistically significant decline of score in MMSE postoperatively (p<0.05). IJVVI occurred in 38% in supine position but the incidence was increased to 54% after Trendelenburg position and pneumoperitoneum. Patients with IJVVI did not show significant differences in cognitive function tests except MMSE. Clinical and neurological significance of physiologic changes associated RALRP should be studied further. PMID:26921505

  4. Partial MEF2C deletion in a Cypriot patient with severe intellectual disability and a jugular fossa malformation: review of the literature.

    Tanteles, George A; Alexandrou, Angelos; Evangelidou, Paola; Gavatha, Marina; Anastasiadou, Violetta; Sismani, Carolina

    2015-03-01

    Deletions or intragenic mutations involving the MEF2C gene on chromosome 5q14.3 have generally been associated with a relatively uniform phenotype characterized by severe developmental delay, absent speech, stereotypies, absent or limited gait abilities, lack of a typical facial gestalt and scarcity of major malformations. We report on a patient of Cypriot descent with a de novo, approximately 147 kb in size, partial MEF2C deletion removing exons 1 to 3. He had a history of severe intellectual disability with absent speech, poor eye contact, hand stereotypies and a wide-based gait. A broad-based, shallow jugular pit with an overlying vascular malformation was also present. Partial MEF2C deletions have only been reported in a very small number of patients and have on occasion been associated with relatively milder phenotypes. We present a patient of Cypriot descent with such a deletion and review previously published literature on partial MEF2C gene deletions postulating a key role of the first few exons in the pathogenesis of the disease. PMID:25691421

  5. Preditores de internação hospitalar em pacientes com síncope atendidos em hospital cardiológico

    Leonardo Marques Fischer

    2013-12-01

    Full Text Available FUNDAMENTO: No atendimento ao episódio sincopal é necessário estratificar o risco para melhor diferenciar pacientes que necessitam de internação hospitalar daqueles que podem ser liberados. Os critérios utilizados pelos médicos avaliadores desses pacientes em emergências cardiológicas em nosso meio são desconhecidos. OBJETIVOS: Analisar quais os critérios adotados para internação hospitalar, diferenciá-los dos utilizados nos pacientes liberados e compará-los com os preditores de alto risco definidos pelo escore de OESIL já validado para esse fim. MÉTODOS: Estudo transversal em pacientes diagnosticados com síncope na emergência em nossa instituição no ano de 2011. RESULTADOS: Dos 46.476 atendimentos realizados naquele ano, 216 foram descritos como síncope. Dos 216 pacientes analisados, 39% foram internados, sendo que as principais variáveis associadas à admissão foram síncope prévia, doença cardíaca conhecida, história negativa para acidente vascular encefálico no passado, ECG alterado e possuir plano de súde. Na comparação internação contra não internação, os escores OESIL 0-1 foram associados a maior chance de liberação hospitalar; os escores 2-3 apresentaram maior associação com internação. Um escore OESIL >2 demonstrou razão de chances 7,8 vezes maior de internação comparado com o escore 0 (p < 0,001; IC95%: 4,03-15,11. Aproximadamente 39% dos pacientes não tiveram definição etiológica e em 18% foi identificada uma causa cardiológica. CONCLUSÕES: Fatores como doença cardiovascular conhecida, história sincopal prévia, ausência de AVC prévio, possuir seguro de saúde e eletrocardiograma alterado foram os critérios utilizados pelos médicos em emergência para indicar internação hospitalar. Houve boa correlação entre os critérios clínicos e os critérios de risco do OESIL descritos na literatura.

  6. Consistencia interna de la escala Pediatric Symptom Checklist en niños y adolescentes desplazados por un desastre invernal en Girón, Colombia

    HEIDI CELINA OVIEDO

    2008-01-01

    Full Text Available Contexto. Es importante la presencia de problemas psicosociales en niños y adolescentes expuestos a eventos traumáticos, entre ellos, los desastres naturales. Por lo tanto, es importante conocer el comportamiento psicométrico de instrumentos de tamización, como la lista de verificación de síntomas pediátricos (Pediatric Symptom Checklist. Sin embargo, no se conoce la consistencia interna de la misma en niños y adolescentes colombianos víctimas de un desastre natural. Objetivo. Calcular la consistencia interna de las cuatro subescalas de la Pediatric Symptom Checklist en niños y adolescentes desplazados por el desastre invernal en Girón, Colombia. Método. Un grupo de 101 madres de niños y adolescentes entre 6 y 16 años completaron la Pediatric Symptom Checklist, considerando la presencia de síntomas durante los seis últimos meses. Para conocer la consistencia interna de las subescalas se calculó el coeficiente alfa de Cronbach. Resultados. La consistencia interna para la subescala para síntomas de trastorno por déficit de atención y hiperactividad fue de 0,62; para la de síntomas de trastornos depresivos, 0,65; para la de síntomas de trastornos de la conducta, 0,50; y para la de síntomas de trastornos de ansiedad, 0,43. Conclusiones. La consistencia interna de las cuatro subescalas de la Pediatric Symptom Checklist es baja en niños y adolescentes víctimas de un desastre invernal. Es necesario explorar el comportamiento psicométrico de otros instrumentos para detectar trastornos mentales comunes en niños y adolescentes víctimas de desastres.

  7. Validação no Brasil de Questionário de Qualidade de Vida na Doença Venosa Crônica (Questionário Aberdeen para Veias Varicosas no Brasil/AVVQ-Brasil

    Flávia de Jesus Leal

    2015-09-01

    Full Text Available ResumoContextoHá crescente interesse por instrumentos de avaliação em saúde produzidos e validados no mundo. Para sua utilização, é necessário realizar a tradução, a adaptação cultural e a validação ao idioma-alvo. No Brasil, existem poucos instrumentos que avaliem o impacto da doença venosa crônica (DVC na qualidade de vida (QV do indivíduo.ObjetivoValidar o AVVQ-Brasil.MétodoEstudo observacional, analítico, para validação de questionário, em que 107 indivíduos com DVC responderam três vezes à versão adaptada do AVVQ para o português brasileiro. As duas primeiras aplicações foram sucessivas, com intervalo de 30 minutos (reprodutibilidade interobservador, e a terceira, após 7 a 15 dias (reprodutibilidade intraobservador. Foram avaliadas também consistência interna e validade.ResultadosDos 107 participantes, 87,9% foram do sexo feminino, com idade média de 50,1 anos ± 14,7; assumiram postura em ortostatismo prolongado (57,0% ao longo da vida e não realizam exercício físico (96,3%; observou-se Ensino Fundamental incompleto (25,2% e pertencem à classe econômica C2 (36,4%; apresentam gravidade da doença C4 (22,4% e C6 (23,3% do CEAP. As reprodutibilidades inter e intraobservador do AVVQ mostraram-se excelentes. Sua consistência interna mostrou-se de excelente a moderada para a maioria dos seus domínios. As correlações de Spearman mostraram pontuação total do AVVQ, com domínio Dor e Disfunção se correlacionando negativamente com todos os domínios do SF-36. O teste de Mann-Whitney mostrou diferença estatística significante para a pontuação total do AVVQ e domínio Complicações entre o CEAP 1, 2, 3 e o CEAP 4, 5, 6.ConclusãoO AVVQ está validado no Brasil e pode ser utilizado.

  8. Estudo comparativo da biocompatibilidade da submucosa intestinal porcina e pericárdio bovino usados como enxertos na veia cava de cães Comparative study of the biocompatibility of the porcine intestinal submucosa and bovine pericardium used as grafts in the inferior cava vein of dogs

    Fernando Hintz Greca

    2005-08-01

    Full Text Available OBJETIVO: Comparar a biocompatibilidade entre submucosa de intestino delgado (SID porcino e o pericárdio bovino como enxerto no reparo de lesões criadas na veia cava inferior de cães. MÉTODOS: Dezesseis cães foram submetidos a laparotomia. Após a abertura da cavidade abdominal a veia cava foi identificada e em seguida procedeu-se com a retirada de um segmento elíptico de 1,5X3cm de sua parede anterior. Em 8 animais o defeito foi reparado com SID porcino (grupo A e nos 8 animais restantes o defeito foi reparado com pericárdio bovino (grupo B.No 30° dia de P.O. realizou-se uma ultra-sonografia e a eutanásia foi realizada no 40°dia de pós-operatório. RESULTADOS: Observou-se estenose da veia cava em 1 cão do grupo do grupo A e em 2 animais do grupo B além de trombose em 1 cão desse mesmo grupo. A análise microscópica revelou um processo inflamatório crônico moderado em ambos os grupos. A endotelização do enxerto, regeneração de fibras musculares lisas e depósito de colágeno também foi similar nos 2 grupos estudados. CONCLUSÃO: A SID provou ser um excelente substrato para a regeneração vascular quando implantado em veia cava superior, contudo os resultados encontrados não diferem daqueles observados com o uso de pericárdio bovino.PURPOSE: To compare the biocompatibility of the bovine pericardium and the small intestine submucosa (SIS when used to repair a created defect in the inferior vena cava of dogs. METHODS: Sixteen male mongrel dogs were submitted to a midline laparotomy incision. An elliptical segment (1,5 X 3,0 cm of the inferior vena cava, below the renal veins, was excised. In 8 dogs, the A group, a patch of porcine small bowel submucosa was used to repair the defect. In the 8 remaining dogs, the B group, a bovine pericardium was implanted in the vena cava. On the 30th post-operative day an ultrasound was performed in order to identify stenosis. The euthanasia was accomplished in the 40th post-operative day. Stenosis of the vein was observed in 1 dog of A group and in 2 of the B group. RESULTS: Partial thrombosis with collateral circulation was evidenced in 1 dog of the bovine pericardium group. A moderated chronic inflammatory process was evidenced in both groups. Microscopic evaluation, regarding endothelization of the implant, collagen deposition, smooth muscle growth, was similar in both groups. CONCLUSION: SIS proved to be a functional graft patch for possessing local vena cava remodeling and its biocompatibility was similar to bovine pericardium.

  9. Revascularização miocárdica com enxerto composto de artéria torácica interna esquerda em Y: análise de fluxo sangüíneo Myocardial revascularization surgery using composite Y-graft of the left internal thoracic artery: blood flow analysis

    José Glauco Lobo Filho

    2004-03-01

    Full Text Available OBJETIVO: Verificar o comportamento do fluxo sangüíneo na artéria torácica interna esquerda (ATIE, quando utilizada para revascularizar a artéria interventricular anterior (AIA e mais um ramo do sistema coronariano esquerdo (SCE. MÉTODO: No presente estudo, compara-se o fluxo obtido pela ecocardiografia Doppler na ATIE, em repouso e sob estresse com dobutamina, em dois grupos de 20 pacientes cada. No grupo A, foi utilizado enxerto pediculado de ATIE anastomosada unicamente à AIA. No grupo B, a ATIE revasculariza a AIA, e um enxerto de veia safena magna, anastomosado em "Y" à ATIE, revasculariza outro ramo do SCE. O estudo angiográfico demonstrou patência de todos os enxertos em ambos os grupos. Na avaliação pela ecocardiografia Doppler foram realizadas as seguintes medidas: débitos sistólico (DS, diastólico e total, razão entre o débito total em estresse pelo débito total em repouso (DTE/DTR, velocidades de pico sistólico (VPS e diastólico e razão entre essas velocidades. RESULTADOS: Todos os parâmetros analisados apresentaram diferença estatisticamente significativa, com exceção do DS, DTE/DTR e VPS. CONCLUSÃO: Nas condições e métodos usados neste estudo, pode-se inferir que o fluxo sangüíneo na ATIE no enxerto composto (Grupo B é maior que no enxerto simples (Grupo A, o que demonstra a grande capacidade da ATIE em adaptar-se à demanda de fluxo.OBJECTIVE: To assess the left internal thoracic artery (LITA flow pattern, when it was used to supply the left anterior descending artery (LADA and another branch from the left coronary artery system (LCAS. METHODS: In the following study, the left internal thoracic artery flow was investigated by echocardiography Doppler, at rest and under dobutamine stress, in two twenty-patient groups. Group A consisted of patients who received only a pedicled LITA graft to the LADA. Group B consisted of patients who received a pedicled LITA graft associated with a vein graft to supply the LADA and another artery from the LCAS. The angiographic study showed graft patency in all patients from both groups. The following parameters were used: systolic flow (SF, diastolic flow, total flow, total flow in stress/total flow at rest ratio (TFS/TFR, systolic peak velocities (SPV, diastolic peak velocities and systolic peak velocity/diastolic peak velocity ratio. RESULTS: All analysed parameters were considered statistically significant, except SF, TFS/TFR and SPV. CONCLUSIONS: We concluded that in the same conditions and methodology, the LITA flow in the composite graft (group B is higher than in the free graft (group A, which shows the great flow adaptability of LITA to respond to flow demand.

  10. Effect of cerebral blood flow on consciousness and outcome after head injury. Assessment by jugular bulb venous metabolism and IMP-SPECT

    Imaizumi, Shigeki; Onuma, Takehide; Motohashi, Osamu; Kameyama, Motonobu; Ishii, Kiyoshi [Sendai City Hospital (Japan)

    2002-10-01

    This study was performed to elucidate the therapeutical value of arteriojugularvenous oxygen difference (AVDO{sub 2}) in the ultra-emergent period after head injury. Rational therapeutic strategy after severe head injury needs information concerning the dynamical change of cerebral blood flow (CBF) and metabolism. We monitored the cerebral venous metabolism within 6 hours after head injury until the day IMP-SPECT was performed. Whole brain cerebral blood flow detected by IMP-SPECT and AVDO{sub 2} at the same day was compared, which restored to the period within 6 hours after head injury. From this procedure, we could outline cerebral blood flow conditions by only AVDO{sub 2} without IMP-SPECT in the ultra-emergent period. Eighty-six patients with head injury who were carried to our emergency center in the period of recent 2 years aged ranging from 15 to 94 years were the subjects. They all performed jugular bulb cannulation within 6 hours after the accident (Martin's phase I: day 0) to know saturation of jugular vein (SjO{sub 2}), AVDO{sub 2} and AVL. They were monitored until the day IMP-SPECT was performed (Martin's phase II; day 1-3 or phase III; day 4-15). The correlation between CBF and AVDO{sub 2}. The effect of CBF and cerebral venous metabolism on consciousness and outcome was also analyzed. CBF and AVDO{sub 2} in phase II and III were reversely correlated (p<0.0001). Normal CBF corresponded with 5.0 vol% in AVDO{sub 2}. AVDO{sub 2} in all cases changed 6.2 vol% at phase I, 4.5 vol% at phase II and 5.1 vol% at phase III. Glasgow comascale (GCS) on admission under 8 (n=47) and over 9 (n=39) significantly differed in AVDO{sub 2} and CBF in the period of II and III. The patients with favorable consciousness showed low AVDO{sub 2} and hyperemia afterwards. Dead cases in phase I (n=19) showed high AVDO{sub 2} and low SjO{sub 2}. The patients with severe disability (SD) (n=13) showed high AVDO{sub 2} and low CBF and the patients with good recovery (GR) showed low AVDO{sub 2} and high CBF in phase II and III. GCS on admission correlated with AVDO{sub 2} and CBF afterward. Only dead case was correlated with cerebral venous metabolism in the ultra-emergent period. The GR, moderate disability (MD) and SD were predicted in phase II and III by CBF and AVDO{sub 2}. (author)

  11. Internal Jugular Vein Cross-Sectional Area and Cerebrospinal Fluid Pulsatility in the Aqueduct of Sylvius: A Comparative Study between Healthy Subjects and Multiple Sclerosis Patients

    Beggs, Clive B.; Magnano, Christopher; Belov, Pavel; Krawiecki, Jacqueline; Ramasamy, Deepa P.; Hagemeier, Jesper; Zivadinov, Robert

    2016-01-01

    Objectives Constricted cerebral venous outflow has been linked with increased cerebrospinal fluid (CSF) pulsatility in the aqueduct of Sylvius in multiple sclerosis (MS) patients and healthy individuals. This study investigates the relationship between CSF pulsatility and internal jugular vein (IJV) cross-sectional area (CSA) in these two groups, something previously unknown. Methods 65 relapsing-remitting MS patients (50.8% female; mean age = 43.8 years) and 74 healthy controls (HCs) (54.1% female; mean age = 43.9 years) were investigated. CSF flow quantification was performed on cine phase-contrast MRI, while IJV-CSA was calculated using magnetic resonance venography. Statistical analysis involved correlation, and partial least squares correlation analysis (PLSCA). Results PLSCA revealed a significant difference (pC4. Controlling for age and cardiovascular risk factors, statistical trends were identified in HCs between: increased net positive CSF flow (NPF) and increased IJV-CSA at C5-C6 (left: r = 0.374, p = 0.016; right: r = 0.364, p = 0.019) and C4 (left: r = 0.361, p = 0.020); and increased net negative CSF flow and increased left IJV-CSA at C5-C6 (r = -0.348, p = 0.026) and C4 (r = -0.324, p = 0.039), whereas in MS patients a trend was only identified between increased NPF and increased left IJV-CSA at C5-C6 (r = 0.351, p = 0.021). Overall, correlations were weaker in MS patients (p = 0.015). Conclusions In healthy adults, increased CSF pulsatility is associated with increased IJV-CSA in the lower cervix (independent of age and cardiovascular risk factors), suggesting a biomechanical link between the two. This relationship is altered in MS patients. PMID:27135831

  12. Normal sizes of internal jugular veins in children/adolescents aged birth to 18 years at rest and during the Valsalva maneuver

    Objectives: We aimed to establish normal ultrasonographic (US) values of internal jugular vein (IJV) sizes in children/adolescents aged birth to 18 years and to determine the correlation of US measurements with age, height, weight and body surface area (BSA) of children in different age groups. Methods: Two hundred and thirty-six healthy children (0–18 years) were divided into four groups according to their age (0–2, 3–6, 7–12, and 13–18 years). US measurements (transverse, anteroposterior diameter, and cross-sectional area at rest and during the Valsalva maneuver) of bilateral IJVs were taken at the level of cricoid cartilage. Results: Our study gives information about the reference values in children between birth to 18 years of age. There were significant differences between measurements taken at rest and during the Valsalva maneuver in all age groups. Moderate to strong correlations (clinically significant) between age, height and BSA of the subjects and IJV measurements were detected only in the 0–2 years age group. The strength of the correlations decreased with increasing age. Pearson's correlation revealed that height had the strongest and weight had the weakest correlation with US measurements. ‘Height’ was an independent variable on the right, and ‘age’ on the left side, except for rest CSA, when a regression analysis was performed for clinically significant correlations. Conclusions: Determination of normal reference values for US measurements of the IJV and knowledge of correlation with age, height, weight and BSA might be valuable during interventional procedures and for the diagnosis of phlebectasia in children/adolescents

  13. Nivel de conocimiento sobre la especialidad de medicina interna y percepción de los usuarios sobre el rol y capacidades del médico internista

    Franco Romaní-Romaní

    2009-03-01

    Full Text Available Introducción: La especialidad de medicina interna enfrenta muchos retos para permanecer competitiva en el sistema de salud, siendo el escaso conocimiento del público sobre la definición, capacidades y competencias de la medicina interna y del internista uno de esos retos. Objetivos: Determinar cuáles son los conocimientos y la percepción de los pacientes sobre el rol de la medicina interna y del médico internista. Diseño: Estudio transversal, descriptivo y analítico. Lugar: Hospital Nacional Arzobispo Loayza, Hospital Nacional Edgardo Rebagliati y una clínica privada. Participantes: Pacientes adultos que visitaron los servicios de Medicina interna de los tres hospitales. Intervención: Se invitó a llenar un cuestionario anónimo y autoadministrado a los participantes entre el 1 y el 15 de septiembre de 2008. Principales medidas de resultados: Nivel de conocimiento sobre medicina interna e internista, percepción de confianza hacia el internista. Resultados: Quinientos pacientes completaron el cuestionario, 42,8% del Hospital Loayza, 40% del Hospital Rebagliati y 17,2% de una clínica privada. Solo 12,2% alcanzó un buen nivel de conocimiento. El 79% de pacientes tuvo percepción de confianza en el internista para el manejo de síntomas, 50,2% confió en la habilidad clínica del internista y 45,9% confió en el manejo de las enfermedades específicas. Conclusiones: Los pacientes no tienen una definición clara de la medicina interna y el rol del internista. La percepción de confianza es alta con respecto al manejo de los síntomas, pero disminuye al tratarse de enfermedades específicas y de las habilidades clínicas del internista. Por lo tanto, debe realizarse esfuerzos de educación pública para mejorar el entendimiento del rol del internista como especialista en medicina de adultos.

  14. Mulheres em idade fértil: causas de internação em Unidade de Terapia Intensiva e resultados

    Cátia Millene Dell Agnolo

    2014-08-01

    Full Text Available Introdução: Pacientes obstétricas representam uma fração significativa das admissões em unidades de cuidado intensivo e consistem em um desafio para a equipe. Objetivo: Analisar as principais causas de internação e morte materna de mulheres em idade fértil ocorridas em unidades de terapia intensiva de hospitais de um município do Noroeste do Paraná, Sul do Brasil. Métodos: Estudo exploratório, descritivo, retrospectivo, realizado com mulheres em idade fértil (10 a 49 anos internadas em três unidades de terapia intensiva existentes em um município do Noroeste do Paraná, por causas obstétricas e não obstétricas, no período de janeiro de 2005 a dezembro de 2009. Resultados: Foram encontradas 775 internações de mulheres em idade fértil, com uma média de idade de 33,7±10,3 anos, com duração média de internação de 5,0±8,4 dias. A maior parte das mulheres era do município estudado (67,2%, com baixa escolaridade (nível primário, 68,2%. Entre as causas obstétricas de internação, a pré-eclâmpsia grave e a eclâmpsia se constituíram na principal causa (71,3%; a pielonefrite se destacou sob outras condições no período gestacional (53%. Não foi encontrada associação estatística entre internações por causas obstétricas em unidade de terapia intensiva e óbito. Conclusão: As causas não obstétricas representaram a maioria das internações de mulheres em idade fértil nas unidades de terapia intensiva do município, no período estudado e, entre as causas obstétricas, a pré-eclâmpsia grave e eclampsia constituíram a principal causa.

  15. Internal medicine, art and science in the third millennium Medicina interna, arte y ciencia en el tercer milenio

    Flix Muoz C

    2013-02-01

    Full Text Available Internal medicine, art and science in the third millennium is a statement that Medicine is not only science. It acts on the sick individual to reestablish a natural state as a curative art. Medical art, commissioned by an individual or a society, is service. It requires vocation to obtain satisfaction. However due to the incidence of value changes, market globalization, technological and industrial development, the patient/physician relationship is becoming a user/provider relationship. Physician-related factors such as a higher health care demand, resource shortage and a progressive specialization have also influenced this change of paradigm. This is causing dissatisfaction, loss of self-esteem and a lower ethical commitment among professionals. We need to recover a professional repertoire of ideas in the context of a global ethics. Responsibility and co-responsibility are ethical principles addressed to technological civilizations and their collateral effects on people and environment that lead to a "responsible globalization". We also need a scientific futurology to define risks and avoid errors. In this era of progressive specialization, Internal Medicine, with its holistic vision of mankind, may play a fundamental role in the field of bioethics.Medicina Interna, Arte y Ciencia en el Tercer Milenio", expresa que la medicina no es exclusivamente ciencia. Tiene de s actuar hbilmente sobre el hombre enfermo, (arte curativo, buscando restablecer un estado natural. El arte mdico, comisionado por el enfermo o por la sociedad, es servicio. Requiere vocacin, obteniendo su propia satisfaccin. Sin embargo, la relacin "paciente / mdico", se ha visto transformada actualmente en "usuario /prestador", Incidiendo factores generales, tales como cambios valricos, preeminencia del mercado (globalizacin, desarrollo de la tecnologa e industria, y adems factores propiamente mdicos: mayor demanda asistencial, escasez de recursos, progresiva especializacin, presencia de gestores no mdicos, y otros. Ello ha provocado en los mdicos insatisfaccin, prdida de autoestima y menor compromiso tico. Necesitamos recuperar un ideario profesional, en el contexto de una "tica global". El "principio de la responsabilidad" (Jonas o la "corresponsabilidad" (Apel, son ticas destinadas a la civilizacin tecnolgica y a sus efectos colaterales sobre las personas y el medio ambiente, conducentes a una "globalizacin responsable". Necesitamos, adems, estimular el desarrollo de una "futurologa cientfica" que permita definir los riesgos a evitar o los errores a corregir. En esta era de creciente especializacin, la Medicina Interna, beneficiaria de la mejor tradicin mdica por su visin holstica del hombre, puede y debe jugar un rol fundamental en el campo de la Biotica.

  16. Conformado por vía coloidal de recubrimientos en la cara interna de un tubo de acero

    Ferrari, B.

    2004-04-01

    Full Text Available The development of new coating processes has important limitations related to the films thickness and the geometry of the coating substrates. In this work, two colloidal forming processes are proposed for manufacturing ceramic and metallic coatings on the inner surface of a steel pipe. Ceramic coatings of CaCO3 have been formed by electrophoretic deposition (EPD. Aqueous stable suspensions were prepared and a electrophoretic cell was designed, in which the steel tube to be coated acted simultaneously as container and working electrode. Nickel films were prepared by filling the pipe with the suspension and rotating to fully wet the steel surface. Nickel suspensions were formulated focusing an improved wettability and adherence to the steel surface by using binders. From these processes, ceramic and metallic coatings with 300- 350 μm in thickness, homogeneous and strongly adhered to the inner surface of the steel pipe have been obtained.

    El desarrollo de las tecnologías de fabricación de recubrimientos presenta importantes limitaciones relativas a los espesores de las capas fabricadas y a la geometría de los substratos a recubrir. En este trabajo se proponen dos procesos de conformado coloidal de revestimientos cerámicos y metálicos en la cara interna de un tubo de acero. El revestimiento cerámico (CaCO3 se ha conformado por deposición electroforética (EPD. Para ello se han preparado suspensiones estables de CaCO3 en agua, y se ha diseñado una célula electroforética en la que el tubo es a la vez el contenedor y el electrodo de trabajo. El revestimiento metálico (níquel se ha fabricado por vertido de una suspensión estable sobre el propio tubo de acero. Para ello se han acondicionado las suspensiones con el objetivo de mejorar el mojado y la adherencia sobre el acero. A partir de los procesos de EPD y vertido se han obtenido revestimientos cerámicos y metálicos, respectivamente, con espesores de 300-350 μm, homogéneos y fuertemente adheridos a la cara interna del tubo de acero.

  17. Padronizao de modelo experimental para estimulao eltrica artificial atrial em coelhos

    Taniguchi Fabio Papa; Martins Antonio Srgio; Padovani Carlos R; Silva Marcos A Moraes

    1999-01-01

    O presente estudo teve por objetivo padronizar modelo experimental de estimulao cardaca artificial atrial em coelhos. Foram utilizados 20 coelhos raa Norfolk-2000 de ambos os sexos com peso mnimo de 2200g. Aps anestesia endovenosa com pentobarbital(30mg/Kg), foi dissecada a veia jugular externa esquerda e introduzido eletrodo Ethicon especialmente preparado, at trio direito via veia cava esquerda. Foram realizadas leituras dos parmetros eltricos(ondaP, resistncia e limiar de coman...

  18. A medicação prescrita na internação hospitalar: o conhecimento do cliente

    Ana Carolina Guidorizzi Zanetti

    2003-12-01

    Full Text Available Erros no processo de administração de medicamentos são preocupações de enfermeiros e a sua ocorrência pode ser minimizada com a orientação do cliente quanto à terapia medicamentosa. Este estudo descritivo, teve como objetivo identificar o grau de informação de clientes hospitalizados, acerca dos medicamentos que lhes são prescritos. A metodologia utilizada foi a exploratória-descritiva. Foram entrevistados 76 clientes adultos, hospitalizados, entre 18 a 60 anos, sendo 69,7% do sexo feminino. Destacou-se dentre outros, que 28% não apresentavam conhecimento acerca do nome do primeiro medicamento prescrito e 55% não souberam referir a dosagem. Detectou-se um número razoável de clientes que desconheciam a medicação prescrita ou tinham conhecimento incorreto. Faz-se necessário a conscientização dos profissionais de enfermagem quanto à importância da orientação ao cliente acerca dos medicamentos durante a internação.

  19. Deep brain stimulation of globus pallidus interna, subthalamic nucleus, and pedunculopontine nucleus for Parkinson's disease: which target?

    Follett, Kenneth A; Torres-Russotto, Diego

    2012-01-01

    Deep brain stimulation (DBS) is an accepted therapy for people with Parkinson's disease (PD) motor symptoms that are refractory to pharmacologic therapy. Standard DBS targets are globus pallidus interna (GPi) and subthalamic nucleus (STN). The pedunculopontine nucleus (PPN) is being investigated as a novel target. Which target provides the best outcomes is unknown. The utility of GPi and STN as targets has been confirmed in numerous studies, including randomized comparisons of GPi DBS and STN DBS that demonstrated no difference in motor outcomes. DBS at either site improves appendicular motor symptoms, but beneficial effects on axial manifestations of PD such as postural instability or gait dysfunction (PIGD) are less apparent. PPN has been introduced as a DBS target due to failure of GPi and STN DBS to improve PIGD. Small observational studies indicate improved PIGD with PPN DBS, but small blinded trials show only subjective reduction in falls with no other impact on PIGD or other PD manifestations. No single DBS target is superior to the others. Each target offers relative advantages. Further studies are needed to better define the roles of each target, particularly PPN. Choice of target should be individualized according to providers' preferences and patients' needs. PMID:22166422

  20. Osteotomías estabilizadoras y fijación interna en las fracturas inestables de cadera

    Juan Vicente Quesada Musa

    2005-06-01

    Full Text Available Se realizó un estudio longitudinal prospectivo en 50 pacientes con diagnóstico de fracturas inestables de cadera a los que se les sometió a osteotomías estabilizadoras y fijación interna en el Hospital General Docente "Dr. Ernesto Guevara de la Serna". Se conformó un grupo de estudio al que se le aplicó la técnica de Dimon y Hughston y un grupo control al que se le aplicó la técnica de Sarmientos. Se evaluó la eficacia de ambos tipos de osteotomías en relación con el tiempo de consolidación y la estabilidad de la reducción,. Se analizó el comportamiento de diversas variables y su influencia en los resultados. El sexo más afectado fue el femenino y el grupo de edades, el de 70-79 años. Predominaron las fracturas tipo III de la clasificación de Tronzo en ambos grupos. Los resultados se mostraron buenos en el 58 % de los pacientes, los del grupo de estudio aportaron un mayor porcentaje. La pérdida de la fijación y el retardo de la consolidación sobresalieron entre las complicaciones en los operados con la técnica de Sarmientos.

  1. Medición de par en el eje de salida de un motor de combustión interna alternativo

    Carlos A. Montilla M

    2007-01-01

    Full Text Available Este articulo muestra el diseño, construcción e implementación de un sistema para la medición de Torque en el eje de salida de un motor de combustión interna. Para este proyecto se empleó un motor de combustión interna alternativo a gasolina, un dinamómetro hidráulico, una celda de carga y un sistema de instrumentación para recoger y acondicionar las señales; el motor se hace girar a distintas revoluciones y a diferentes regímenes de carga, para luego obtener la curvas Torque versus RPM y Potencia versus RPM.

  2. Uso da fixação interna rígida em fraturas de mão. Use of internal rigid fixation in hand fractures.

    Joaquim José de Lima Silva; Antonia Artemisa Aurélio Soares Lima; Rafael Costa Lima Maia; Igor Furtado Sioares Melo

    2015-01-01

    Introdução: Diversas técnicas são utilizadas no manejo de pacientes com fraturas de mão, tendo o cirurgião plástico o papel capital para evitar sequelas típicas dessa condição. Abordamos a fixação interna rígida utilizando miniplacas de titânio. Metodologia: Analisados 24 casos. A osteossíntese foi realizada por meio da fixação interna rígida, isto é, com o uso de miniplacas e parafusos de titânio, e os pacientes foram encaminhados para tratamento fisioterápico a partir do 15º dia de pós-oper...

  3. Correlao clnico-radiolgica na artria cartida interna aberrante: relato de caso Clinical and radiological correlation in aberrant carotid artery: case report

    Ledison Ferreira Zanini

    2001-12-01

    Full Text Available A artria cartida interna aberrante uma anomalia na embriognese da poro vertical da artria cartida interna, caracterizada pela projeo desta artria no ouvido mdio, adjacente ao promontrio coclear. Os autores relatam um caso no qual a tomografia computadorizada contrastada e a angiorressonncia foram decisivas, caracterizando adequadamente a anomalia e evitando interveno instrumental ou cirrgica, que poderia ter conseqncias fatais.Aberrant internal carotid artery is an anomaly of the embryogenesis of the vertical portion of the internal carotid artery, characterized by projection of the internal carotid artery into the middle ear, adjacent to the cochlear promontory. The authors report a case of a patient in which contrast-enhanced computed tomography and magnetic resonance angiography examinations were decisive to adequately characterize the anomaly, thus avoiding instrumental or surgical intervention, which could bear fatal consequences.

  4. Internações hospitalares por causas sensíveis à atenção primária no Distrito Federal, 2008

    Rozania Maria Pereira Junqueira; Elisabeth Carmen Duarte

    2012-01-01

    OBJETIVO: Analisar coeficientes de internações por causas sensíveis à atenção primária. MÉTODOS: Foram utilizados dados do Sistema de Informações Hospitalares do Sistema Único de Saúde no Distrito Federal em 2008. O diagnóstico principal da internação foi analisado com base na Classificação Internacional de Doenças e foram calculados frequência absoluta, proporção e coeficiente segundo causas, faixas etárias e sexo. RESULTADOS: As causas sensíveis à atenção primária (CSAP) representaram cerca...

  5. Recanalização espontânea tardia de carótida interna: relato de caso Late spontaneous recanalization of internal carotid artery: case report

    Glauco Fernandes Saes; Tiago Calheiros H. Barbosa; Jocefábia Reika Lopes; Afonso César Polimanti; Rafael Noronha Cavalcante; Maria Alice Bosch; João Corrêa; Ohannes Kafejian

    2007-01-01

    A recanalização espontânea tardia da carótida interna é um evento incomum e pouco estudado. Os autores relatam o caso de paciente de 73 anos, masculino, hipertenso, com antecedente de acidente vascular cerebral há 3 anos, com seqüela motora e sensitiva em membro superior direito, apresentando ao mapeamento dúplex e arteriografia oclusão total da carótida interna. Evoluiu após 2 anos com novos episódios de ataques isquêmicos transitórios de repetição. Submetido a novos exames de imagem para av...

  6. Epidemiologia de internações por doença falciforme no Brasil Epidemiology of sickle cell disease hospital admissions in Brazil

    Monique Morgado Loureiro; Suely Rozenfeld

    2005-01-01

    OBJETIVO: A doença falciforme é uma enfermidade hereditária que afeta principalmente a população negra. O estudo teve por objetivo analisar as internações devido às complicações da doença, com enfoque nos aspectos epidemiológicos e clínicos. MÉTODOS: A população estudada foi constituída de 9.349 pacientes com diagnóstico de doença falciforme internados em hospitais da Bahia, Rio de Janeiro e São Paulo, no período de 2000 a 2002. Utilizaram-se os dados do Sistema de Internações Hospitalares do...

  7. Hérnia interna de delgado em pós-operatório de sigmoidectomia a Hartmann =Enteric internal hernia in postoperative period of Hartmann's sigmoidectomy

    Brenner, Mateus Brum et al.

    2014-01-01

    Conclusões: Abdome agudo pode ser um quadro clínico de manejo difícil em alguns episódios, como o relatado, em que os sintomas e sinais clínicos iniciais não evidenciam a magnitude e a gravidade do caso. Casos como este, de hérnia interna de intestino delgado, podem servir de alerta para futuras condutas em casos duvidosos.

  8. PLAN DE COMUNICACIÓN INTERNA PARA UNA ADECUADA CULTURA ORGANIZACIONAL EN LA UNIDAD EMPRESARIAL DE BASE SERVICIOS GENERALES DE LA EMPRESA AZUCARERA COLOMBIA

    Aileny Muñoz Arteaga; Antonio González Nápoles; Jorge Tamayo Aroche

    2010-01-01

    El estudio de la comunicación organizacional y dentro de esta de la comunicación interna, es cada vez más importante para el desarrollo de las empresas cubanas. La solución a muchos problemas institucionales, está en la realizar un diagnóstico detallado de sus elementos particulares y luego proponer acciones encaminadas a resolverlas en un límite de tiempo.

  9. Empleo de elementos finitos en un estudio comparativo de dos sistemas de fijación interna para la fractura de cadera

    Yoan Manuel Ramos Botello

    2013-12-01

    Full Text Available Introducción: existe una gran variedad de sistemas de fijación interna para el tratamiento de las fracturas, por lo que es común que un fijador pueda ser utilizado en diferentes fracturas. Esto trae consigo, que no se sepa con exactitud cuál de los sistemas de fijación interna tendrá mejor comportamiento desde el punto de vista del estado tensional. Objetivo: analizar mediante elementos finitos, el comportamiento de los dispositivos de fijación interna placa DHS y placa a compresión dinámica, utilizados en el tratamiento de las fracturas de cadera. Métodos: el modelo de fémur se obtuvo con autorización del reservorio de modelos óseos del cuerpo humano: The finite element meshes repository of the international society of biomechanics y luego, una tomografía axial computarizada. En los cálculos, se tuvieron en cuenta la acción muscular y el peso corporal en la fase monopodal del ciclo de la marcha, se determinó el estado tensional y el número de ciclos en que los sistemas de fijación interna causaron fallas por fatiga. Resultados: los resultados más desfavorables se encontraron en la placa a compresión dinámica angulada a 130º ya que se alcanzaron los valores de tensiones más altos y el número de ciclos más bajo. Conclusiones: la placa a compresión dinámica angulada a 130º sufre roturas con frecuencia, de ahí que es conveniente utilizar la placa DHS en el tratamiento de la fractura de cadera 31B2.1, siempre que sea posible desde el punto de vista clínico.

  10. An Anomalous Left External Jugular Vein Draining into Right Subclavian Vein: A Case Report Vena Yugular Externa Izquierda Anmala Drenando en la Vena Subclavia Derecha: Reporte de un Caso

    V Rajanigandha

    2008-12-01

    Full Text Available Knowledge of the varying drainage patterns of superficial veins of head & neck, in particular, jugular veins are not only important for anatomists but also for the surgeons operating at this level and to clinicians in general. The variations are important for interventional radiologists too who perform transjugular procedures, such as port implantations and the transjugular intrahepatic portosystemic shunt or selective venous samplings. Results of recent studies report that the superficial veins, especially the external jugular vein (EJV, is been increasingly utilized for cannulation to conduct diagnostic and therapeutic procedures. We report a very unusual presentation of external jugular vein on left side of an embalmed male cadver. Embryological evaluations of the anomaly was done and compared with available literature which showed that the observed variation is rare.El conocimiento de los diferentes patrones de drenaje de las venas superficiales de la cabeza y cuello, en particular, las venas yugulares no slo son importantes para anatomistas, sino tambin para los cirujanos que operan a este nivel y para los mdicos en general. Las variaciones son importantes tambin para los radilogos intervencionistas, quienes realizan procedimientos transyugulares, as como implantaciones portales y portosistmicas transyugulares intrahepticas o derivacin venosa selectiva. Resultados de estudios recientes informan que la venas superficiales, especialmente la vena yugular externa, es cada vez ms utilizada para la canulacin en diagnsticos y procedimientos teraputicos. Se reporta una muy inusual variacin anatmica de la vena yugular externa del lado izquierdo, presente en un cadver embalsamado de sexo masculino. Fueron realizadas evaluaciones embriolgicas de la anomala y se compararon con la literatura mostrando que se trata de una variacin rara.

  11. Propuesta para el uso exclusivo de la tasa interna de retorno modificada en la toma de decisión de proyectos industriales de inversión

    J.R. Medina

    2013-12-01

    Full Text Available La TIR (tasa interna de retorno es el método de evaluación de rentabilidad de proyectos de inversión mejor conocido. Esta tasa interna de retorno representa, en la interpretación tradicional de las tasas de interés, a la tasa de interés ganada por una inversión alternativa sobre el saldo no recuperado de una inversión. Sin embargo, cuando se presenta una inconsistencia, basada en la aparición de raíces múltiples, se acude a la Tasa Interna de Retorno Modificada (TIRM para aportar una definición a la toma de decisiones. El trabajo sostiene que este método de la TIRM puede ser utilizado siempre en la toma de decisiones económicas financieras, porque conceptualmente utiliza valores en sus variables de decisión, mucho más cercanos a los que operan en el mercado y en el conocimiento de quién toma la decisión, involucrando en su resultado el que se puede obtener con los métodos tradicionales, en el caso que estos se aplican con solvencia. Aún, este método se comprobará es efectivo en el caso de proyectos de inversión con diferentes horizontes de planificación.

  12. Uso do Datasus para avaliação dos padrões das internações psiquiátricas, Rio Grande do Sul Use of Datasus to evaluate psychiatric inpatient care patterns in Southern Brazil

    Rafael Henriques Candiago; Paulo Belmonte Abreu

    2007-01-01

    OBJETIVO: Descrever a construção e o teste de rotina para análise das interna-ções psiquiátricas pelo Sistema Único de Saúde, a partir de seu banco de dados (Datasus), e analisar as características e tendências dessas internações. MÉTODOS: Foram extraídos dados das autorizações de internação hospitalar dos anos de 2000 a 2004, no Rio Grande do Sul. Os dados referentes a 91.233 internações foram processados por meio de sintaxes pelo programa SPSS, tendo sido testada a confiabilidade das rotina...

  13. Sonographic evaluation of intravascular volume status: Can internal jugular or femoral vein collapsibility be used in the absence of IVC visualization?

    Alistair Kent

    2015-01-01

    Full Text Available Introduction: Inferior vena cava collapsibility index (IVC-CI has been shown to correlate with both clinical and invasive assessment of intravascular volume status, but has important limitations such as the requirement for advanced sonographic skills, the degree of difficulty in obtaining those skills, and often challenging visualization of the IVC in the postoperative patient. The current study aims to explore the potential for using femoral (FV or internal jugular (IJV vein collapsibility as alternative sonographic options in the absence of adequate IVC visualization. Methods: A prospective, observational study comparing IVC-CI and Fem- and/or IJV-CI was performed in two intensive care units (ICU between January 2012 and April 2014. Concurrent M-mode measurements of IVC-CI and FV- and/or IJV-CI were collected during each sonographic session. Measurements of IVC were obtained using standard technique. IJV-CI and FV-CI were measured using high-frequency, linear array ultrasound probe placed in the corresponding anatomic areas. Paired data were analyzed using coefficient of correlation/determination and Bland-Altman determination of measurement bias. Results: We performed paired ultrasound examination of IVC-IJV (n = 39 and IVC-FV (n = 22, in 40 patients (mean age 54.1; 40% women. Both FV-CI and IJV-CI scans took less time to complete than IVC-CI scans (both, P < 0.02. Correlations between IVC-CI/FV-CI (R 2 = 0.41 and IVC-CI/IJV-CI (R 2 = 0.38 were weak. There was a mean -3.5% measurement bias between IVC-CI and IJV-CI, with trend toward overestimation for IJV-CI with increasing collapsibility. In contrast, FV-CI underestimated collapsibility by approximately 3.8% across the measured collapsibility range. Conclusion: Despite small measurement biases, correlations between IVC-CI and FV-/IJV-CI are weak. These results indicate that IJ-CI and FV-CI should not be used as a primary intravascular volume assessment tool for clinical decision support in the ICU. The authors propose that IJV-CI and FV-CI be reserved for clinical scenarios where sonographic acquisition of both IVC-CI or subclavian collapsibility are not feasible, especially when trended over time. Sonographers should be aware that IJV-CI tends to overestimate collapsibility when compared to IVC-CI, and FV-CI tends to underestimates collapsibility relative to IVC-CI.

  14. Effects of jugular-infused lysine, methionine, and branched-chain amino acids on milk protein synthesis in high-producing dairy cows.

    Appuhamy, J A D R N; Knapp, J R; Becvar, O; Escobar, J; Hanigan, M D

    2011-04-01

    In addition to lysine and methionine, current ration-balancing programs suggest that branched-chain amino acid (BCAA) supply may also be limiting in dairy cows. The objective of this study was to investigate whether BCAA, leucine, isoleucine, and valine become limiting for milk protein synthesis when methionine and lysine supply were not limiting. Nine multiparous Holstein cows with an average milk production of 53.57.1 kg/d were randomly assigned to 7-d continuous jugular infusions of saline (CTL), methionine and lysine (ML; 12 g and 21 g/d, respectively), or ML plus leucine, isoleucine, and valine (ML+BCAA; 35 g, 15 g, and 15 g/d, respectively) in a 33 Latin square design with 3 infusion periods separated by 7-d noninfusion periods. The basal diet consisted of 40% corn silage, 14% alfalfa hay, and a concentrate mix, and respectively supplied lysine, methionine, isoleucine, leucine, and valine as 6.1, 1.8, 4.7, 8.9, and 5.3% of metabolizable protein. Dry matter intake (23.9 kg/d), milk yield (52.8 kg/d), fat content (2.55%), fat yield (1.33 kg/d), lactose content (4.77%), lactose yield (2.51 kg/d), and milk protein efficiency (0.38) were similar across treatments. Protein yield and protein content were not significantly different between ML (1.52 kg/d and 2.88%, respectively) and ML+BCAA (1.51 kg/d and 2.83%, respectively), but they were significantly greater than that of CTL (1.39 kg/d and 2.71%). Cows that received ML+BCAA had less milk urea nitrogen content (10.9 mg/dL) compared with milk of CTL cows (12.4 mg/dL) and ML cows (11.8 mg/dL). Whereas high-producing cows responded positively to methionine and lysine supplementation, no apparent benefits of BCAA supplementation in milk protein synthesis were found. Infusion of BCAA may have stimulated synthesis of other body proteins, probably muscle proteins, as evidenced by decreased milk urea nitrogen. PMID:21426986

  15. Environmental pollutants and stroke-related hospital admissions Poluentes ambientais e internações devido a acidente vasculoencéfalico

    Luiz Fernando Costa Nascimento

    2012-07-01

    Full Text Available Some effects of environmental pollution on human health are known, especially those affecting the respiratory and cardiovascular systems. The current study aimed to estimate these effects on the production of hospital admissions for stroke. This was an ecological study using hospital admissions data in São José dos Campos, São Paulo State, Brazil, with diagnosis of stroke, from January 1, 2007, to April 30, 2008. The target pollutants were particulate matter, sulfur dioxide, and ozone. Use of a Poisson linear regression model showed that same-day exposure to particulate matter was associated with hospitalization for stroke (RR = 1.013; 95%CI: 1.001-1.025. An increase of 10µg/m³ in this pollutant increased the risk of hospitalization by 12% (RR = 1.137; 95%CI: 1.014-1.276. In the multi-pollutant model, it was thus possible to identify particulate matter as associated with hospitalization for stroke in a medium-sized city like São José dos Campos.Alguns dos efeitos da poluição ambiental na saúde humana são conhecidos, destacando aqueles nos sistemas respiratório e cardiovascular. Este trabalho tem por objetivo estimar esses efeitos na gênese das internações por acidente vasculoencefálico. Foi um estudo ecológico realizado com dados de internações da cidade de São José dos Campos, São Paulo, Brasil, relativos aos diagnósticos de acidente vascular cerebral, entre 1º de janeiro de 2007 e 30 de abril de 2008. Os poluentes estudados foram material particulado, dióxido de enxofre e ozônio. Utilizando-se de modelo linear generalizado da regressão de Poisson, foi possível identificar exposição ao material particulado, no mesmo dia, como associado à internação por acidente vasculoencefálico (RR = 1,013; IC95%: 1,001-1,025. O aumento de 10µg/m3 desse poluente aumenta o risco de internação em 12% (RR = 1,137; IC95%: 1,014-1,276. Assim, foi possível identificar o material particulado, no modelo multipoluente, como associado à internação por acidente vasculoencefálico numa cidade de porte médio, como São José dos Campos.

  16. La desincronizacin interna como promotora de enfermedad y problemas de conducta / Internal desynchrony as promotor of disease and behavioral disturbance

    Roberto Carlos, Salgado Delgado; Beatriz, Fuentes Pardo; Carolina, Escobar Briones.

    2009-02-01

    Full Text Available La vida se rige por una estructura temporal que gobierna nuestras horas, nuestros das y nuestros calendarios. Como parte de la adaptacin a los ciclos de tiempo que impone el planeta, todo organismo presenta ritmos en su actividad y fisiologa. Los ritmos biolgicos son una propiedad conservada en [...] todos los niveles de organizacin, desde organismos unicelulares procariontes hasta plantas superiores y mamferos. De ellos, los ms slidos son aquellos asociados a los ciclos externos por la alternancia del da y la noche y por la alternancia de las estaciones del ao. Los ritmos biolgicos fisiolgicos y conductuales son procesos dependientes de un reloj interno capaz de ajustar sus oscilaciones a claves de tiempo externas que lo mantienen sincronizado a estas fluctuaciones externas. El ncleo supraquiasmtico del hipotlamo (NSQ) es en los mamferos el principal reloj circadiano y se sincroniza principalmente por el ciclo luz-oscuridad. El NSQ transmite seales de tiempo al cerebro y de ah al resto del organismo, y por medio de estas seales de tiempo mantiene un orden temporal en diversas funciones del cuerpo y las mantiene ajustadas al ciclo luz-oscuridad. El correcto orden temporal interno permite un adecuado funcionamiento del individuo en armona con el medio externo y le permite exhibir respuestas adecuadas a un ambiente cambiante y predecible. El estilo de vida del hombre moderno propicia situaciones que llevan a alteraciones de nuestros ritmos biolgicos que causan una desadaptacin temporal, que a su vez redunda en daos a la salud, ya que afecta tanto la fisiologa como la forma en que organizamos nuestra conducta. Un ejemplo de ello son los viajes a travs de mltiples regiones horarias. Estos cambios de horario bruscos provocan un sndrome conocido como jet-lag, que consiste en un conflicto transitorio entre el tiempo > y el tiempo >, lo cual se denomina >. El jet-lag se define como un conjunto de sntomas causados por una alteracin del patrn de sueo, y de la expresin de ritmos biolgicos fuera de fase entre s y fuera de fase con el ciclo del da y la noche. Esta es la causa del malestar general, el deterioro del desempeo mental y fsico, as como de la irritabilidad y depresin. Son frecuentes tambin las alteraciones gastrointestinales, resultado del consumo de alimento en un horario inusual. Otro ejemplo de alteraciones en los ritmos circadianos se observa en los trabajadores con turnos rotatorios o en turnos nocturnos. En estas condiciones se produce un conflicto entre las seales temporales asociadas al ciclo diurno y que transmite el reloj con las actividades y alimentos del trabajador en turnos. De este esquema de trabajo resulta una reduccin de las horas de sueo y una alteracin de los ritmos circadianos, que llevan a una desincronizacin interna. sta, al igual que en el caso del jet-lag, redunda en un deterioro de las funciones mentales y de la capacidad de atencin y memorizacin, que se asocian a irritabilidad y problemas emocionales. Adems, se observan consecuencias en la salud con incremento en la incidencia de malestares gastrointestinales, enfermedades cardiovasculares, obesidad y diabetes. La mejora en los servicios de salud ha incrementado las expectativas de vida, lo que entonces enfrenta a la humanidad a una poblacin que logra sobrevivir muchos aos de su vejez con los cambios de conducta y salud propios de su edad, entre los que se incluye un deterioro de los ritmos biolgicos. En este trabajo presentamos una revisin de las principales alteraciones de los ritmos biolgicos generadas por los viajes transmeridionales, la vejez y el trabajo en turnos. Tambin discutimos la relevancia de una buena adaptacin de los ritmos biolgicos y las consecuencias conductuales y fisiolgicas que por su alteracin llevan a la enfermedad y a un desempeo mental deficiente. Tambin sugerimos estrategias que necesitan ser exploradas y que podran ayudar prevenir la desincronizacin interna para mejorar la ca

  17. Internal thoracic vein draining into the extrapericardial part of the superior vena cava: a case report

    Venkata Ramana Vollala

    2008-03-01

    Full Text Available The internal thoracic veins are venae comitantes of each internal thoracic artery draining the territory supplied by it and usually unite opposite the third costal cartilage. This single vein enters the corresponding brachiocephalic vein. We present a variation of right internal mammary vein draining into superior vena cava in a 45-year-old male cadaver. Likely development and clinical significance of the vein are discussed.As veias torácicas internas são veias comitantes de cada artéria torácica interna drenando o território suprido por ela e geralmente se unem em frente à terceira cartilagem costal. Esta única veia entra na veia braquicefálica correspondente. Apresentamos uma variação da veia mamária interna direita drenando para a veia cava superior em um cadáver masculino de 45 anos. O provável desenvolvimento e a significância clínica da veia são discutidos.

  18. Diagnostico por vibraciones en motores de combustión interna // Diagnotic by vibrations in motor of internal combustion

    J. Rodríguez Matienzo

    1998-01-01

    Full Text Available El diagnóstico técnico de las máquinas es una tarea de primer orden dentro de la Ingeniería Mecánica, y dentro de este, elempleo de técnicas que posibiliten la menor intervención en la estructura y la mayor información representan un aspecto desumo interés. La medición de vibraciones es una herramienta muy útil. Sin embargo su aplicación es amplia en la maquinariarotatoria y no en la alternativa. En el artículo se da una forma de enfocar el diagnóstico vibroacústico en las maquinasalternativas, en particular en los motores de combustión interna, a partir del empleo de las frecuencias naturales de oscilacióndel bloque como frecuencias de diagnóstico. Se explica la forma de determinación de las mismas por el método de loselementos finitos.________________________________________________________________________AbstractThe technical diagnosis of the machines is a task of first order in the Mechanical Engineering, and within this, the employmentof techniques that facilitate the east intervention in the structure and give more information represents an aspect of supremeinterest. The mensuration of vibrations is a very useful tool. However, their application is wide in the rotatory machinery andnot in the alternative. In the article, a form of focusing the vibroacoustical diagnosis is given in alternating machinery, inparticular in the internal combustion engines, taking into account the natural frequencies of oscillation of the block asfrequencies of diagnosis. The form of its determination using the method of the finite elements is explained.

  19. Caracterización de un grupo de pacientes con infarto cerebral en la consulta de Medicina Interna

    Kiopper Tartabull Poutriel

    2008-01-01

    Full Text Available Fundamento: El infarto cerebral constituye la tercera causa de muerte en Cuba y en la mayoría de los países desarrollados, sólo superada por las enfermedades cardiovasculares y el cáncer. Objetivo: Conocer el comportamiento de la enfermedad cerebrovascular en la consulta de Medicina Interna. Método: Se realizó un estudio descriptivo a 47 pacientes egresados de los hospitales «Enrique Santiesteban Báez» del municipio Santa Cruz del Sur y del «Manuel Ascunse Domenech» de la provincia de Camagüey con el diagnóstico de infarto cerebral desde el 1ro de septiembre de 2006 hasta el 1ro de septiembre del 2007. Resultados: El rango de edad de 71 años y más constituyó el 67 % de la casuística. La hipertensión arterial, el tabaquismo y la dislipidemia predominaron en el sexo masculino como factores de riesgo con 91,5, 65,9y 61.7 %, respectivamente. El infarto aterotrombótico se presentó en el 44,7% de los pacientes. Conclusiones: El sexo masculino, la edad de 71 años y más fueron los más frecuentes en nuestro estudio, el territorio vascular de mayor afección lo constituyó el carotídeo en ambos sexos. La diabetes mellitus predominó en el femenino. El infarto cerebral aterotrombótico fue el más frecuente.

  20. Evaluación del funcionamiento de motores de combustión interna trabajando con biodiesel.

    R. Piloto Rodríguez

    2008-09-01

    Full Text Available En el presente trabajo se determinó la característica exterior de velocidad para dos motores de combustión interna trabajando con combustible biodiesel procedente de varias fuentes naturales y se comparó con la característica exterior de velocidad de los motores originalmente trabajando con combustible diesel. Los motores fueron evaluados con variaciones de carga y velocidad. En uno de los motores ensayados fue determinada la presión en el interior de la cámara de combustión con el objetivo de evaluar el retardo de ignición. Fue observado que los motores trabajando con combustible biodiesel presentaban una disminución de la potencia efectiva y un aumento del consumo especifico de combustible. Se observó una disminución del retardo de ignición cuando fue empleado el combustible biodiesel. También fue observado que los gases contaminantes, excepto las emisiones de NOx y CO, disminuyen o permanecen constantes con el uso del biocombustible. The engine outer velocity characterization for two engines was made working with biodiesel from different natural sources, and its performance was compared with the engine parameters using reference diesel. The engines were used varying load and velocity. The ignition delay was obtained by measurement of in-cylinder pressure. A decrease in the effective power and increase in the effective fuel consumption were observed in the engines when biodiesel is used. Biodiesel samples shown shorter ignition delay than diesel. The pollutants emitted for the engine using biodiesel was lower than diesel, with the exception of NOx and CO emissions.

  1. De paciente a causo: uma etnografia com egressos de internação psiquiátrica

    Martinho Braga Batista e Silva

    2015-02-01

    Full Text Available Considerando as contribuições das ciências sociais para a compreensão da assistência psiquiátrica, que destaca a passagem de pessoa a paciente como crucial na carreira moral do doente mental, visamos investigar outro destes momentos que alimentam o debate acadêmico sobre doença e identidade social: de paciente a “causo”. Com base em uma perspectiva socioantropológica sobre a vida de egressos de internação psiquiátrica, um trabalho de campo foi conduzido de 2007 a 2010, junto a usuários de uma rede de atenção, seus familiares e vizinhos, destacando não só as categorias administrativas para designá-los entre os profissionais da rede, como também as utilizadas pelos habitantes da cidade. Notamos em que medida alguns habitantes são considerados “doidos”, mesmo sem terem sido “pacientes” da casa de repouso local; ora “usuários”, por terem sido matriculados em estabelecimentos da rede; ora “clientes”, por sua frequência no mesmo; “bonequeiros”, “nervosos” e “barulhentos”, por seu comportamento em público, alguns deles sendo objeto de comentário nas ruas da cidade e virando “causos”, e outros sendo objeto de discussão nos estabelecimentos de saúde e tornando-se “casos clínicos”. Portar transtornos mentais é tão relevante no manejo da identidade social estigmatizada quanto portar sobrenomes e apelidos.

  2. Comparação de diferentes métodos de controle da carga interna em jogadores de voleibol

    Maurício Gattás Bara Filho

    2013-04-01

    Full Text Available INTRODUÇÃO: A capacidade de monitorar precisamente a carga de treinamento é um importante aspecto para a efetividade da periodização e para a prevenção de efeitos negativos, como a queda no rendimento. OBJETIVOS: Comparar e correlacionar diferentes métodos de controle de carga interna de treinamento em jogadores de voleibol. MÉTODOS: Quinze atletas profissionais de voleibol do sexo masculino, com idade entre 18 e 30 anos, que competiam em níveis estaduais e nacionais, participaram deste estudo. A carga de treino para cada sessão foi calculada utilizando três diferentes métodos: PSE da Sessão, Zonas de FC (TRIMP de Edwards e de Stagno. RESULTADOS: Verificou-se que há correlação positiva e significativa entre o método proposto por Foster, Edwards e Stagno. No entanto, os valores das correlações individuais entre PSE e Edwards (0,451 a 0,670, em geral, foram ligeiramente maiores que os da correlação entre PSE e Stagno (0,206 a 0,597. CONCLUSÃO: O método proposto por Edwards, bem como o método proposto por Foster, melhor refletem as cargas de treino no voleibol, fazendo com que o monitoramento das cargas seja realizado de maneira mais fidedigna e confiável quando realizado por esses dois métodos.

  3. Percutaneous Placement of Central Venous Catheters: Comparing the Anatomical Landmark Method with the Radiologically Guided Technique for Central Venous Catheterization Through the Internal Jugular Vein in Emergent Hemodialysis Patients

    Koroglu, M.; Demir, M.; Koroglu, B.K.; Sezer, M.T.; Akhan, O.; Yildiz, H.; Yavuz, L.; Baykal, B.; Oyar, O. [Suleyman Demirel Univ., Isparta (Turkey). Depts. of Radiology, Internal Medicine and Anesthesiology

    2006-02-15

    Purpose: To compare the success and immediate complication rates of the anatomical landmark method (group 1) and the radiologically (combined real-time ultrasound and fluoroscopy) guided technique (group 2) in the placement of central venous catheters in emergent hemodialysis patients. Material and Methods: The study was performed prospectively in a randomized manner. The success and immediate complication rates of radiologically guided placement of central venous access catheters through the internal jugular vein (n = 40) were compared with those of the anatomical landmark method (n 40). The success of placement, the complications, the number of passes required, and whether a single or double-wall puncture occurred were also noted and compared. Results: The groups were comparable in age and sex. The indication for catheter placement was hemodialysis access in all patients. Catheter placement was successful in all patients in group 2 and unsuccessful in 1 (2.5%) patient in group 1. All catheters functioned adequately and immediately after the placement (0% initial failure rate) in group 2, but 3 catheters (7.5% initial failure rate) were non-functional just after placement in group 1. The total number of needle passes, double venous wall puncture, and complication rate were significantly lower in group 2. Conclusion: Percutaneous central venous catheterization via the internal jugular vein can be performed by interventional radiologists with better technical success rates and lower immediate complications. In conclusion, central venous catheterization for emergent dialysis should be performed under both real-time ultrasound and fluoroscopic guidance.

  4. A single-center experience of 2153 tunneled-cuffed catheter insertions radiologically placed via the internal jugular vein: An evaluation of technical success and complication rates relative to underlying disease conditions

    To evaluate the technical success and complication rates of tunneled-cuffed catheter insertions radiologically placed via the internal jugular vein in patients with different types of underlying diseases. A total of 2153 tunneled-cuffed catheter insertions performed in 1926 patients between January 2008 and December 2012 were retrospectively reviewed. All procedures were conducted using sonography and fluoroscopy. The number of catheter maintenance days, technical success rates, and complication rates were analyzed based on radiologic and medical records. A total of 204809 catheter maintenance days (mean, 95.35 days; range, 0-1710 days) were recorded. Technical success was achieved in 2148 insertions (99.77%). A total of 185 complications (8.61%, 0.903/1000 catheter days) were observed, including 22 procedure-related complications (1.02%). A total of 143 catheters (6.66%) were removed due to complications. Significant differences in complication rates were observed between patients with or without underlying hematologic diseases (11.65% vs. 7.02%, respectively; p = 0.000). Significant differences in catheter thrombosis were observed between patients in which right-sided or left-sided venous approaches were used (0.81% vs. 2.70%, respectively; p = 0.010). The very high technical success rates and very low procedure-related complication rates indicate insertion of a tunneled-cuffed catheter radiologically placed via the internal jugular vein is safe and effective.

  5. A single-center experience of 2153 tunneled-cuffed catheter insertions radiologically placed via the internal jugular vein: An evaluation of technical success and complication rates relative to underlying disease conditions

    Park, Chan; Yim, Nm Yeol; Kim, Yong Tae; Noh, Hoon; Ki, So Yeon; Kim Jae Kyu; Kim, Hyoung Ook; Chang, Nam Kyu [Dept. of Radiology, Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2015-01-15

    To evaluate the technical success and complication rates of tunneled-cuffed catheter insertions radiologically placed via the internal jugular vein in patients with different types of underlying diseases. A total of 2153 tunneled-cuffed catheter insertions performed in 1926 patients between January 2008 and December 2012 were retrospectively reviewed. All procedures were conducted using sonography and fluoroscopy. The number of catheter maintenance days, technical success rates, and complication rates were analyzed based on radiologic and medical records. A total of 204809 catheter maintenance days (mean, 95.35 days; range, 0-1710 days) were recorded. Technical success was achieved in 2148 insertions (99.77%). A total of 185 complications (8.61%, 0.903/1000 catheter days) were observed, including 22 procedure-related complications (1.02%). A total of 143 catheters (6.66%) were removed due to complications. Significant differences in complication rates were observed between patients with or without underlying hematologic diseases (11.65% vs. 7.02%, respectively; p = 0.000). Significant differences in catheter thrombosis were observed between patients in which right-sided or left-sided venous approaches were used (0.81% vs. 2.70%, respectively; p = 0.010). The very high technical success rates and very low procedure-related complication rates indicate insertion of a tunneled-cuffed catheter radiologically placed via the internal jugular vein is safe and effective.

  6. Tomografia computadorizada na avaliação tardia do tratamento cirúrgico da conexão anômala total de veias pulmonares Computed tomography in late evaluation of surgical treatment of pulmonary veins total anomalous connection

    Ulisses Alexandre Croti

    2011-12-01

    Full Text Available OBJETIVO: Verificar se os achados da tomografia computadorizada de múltiplos detectores (TCMD apresentam associação com os parâmetros clínicos e exames complementares rotineiramente empregados na avaliação tardia das crianças submetidas ao tratamento cirúrgico da conexão anômala total de veias pulmonares (CATVP. MÉTODOS: No período de janeiro 2002 a dezembro de 2007, 12 pacientes operados de CATVP foram avaliados tardiamente com anamnese, exame físico, radiografia de tórax, eletrocardiograma, ecocardiograma e TCMD. Alterações específicas de cada um desses exames foram identificadas e comparadas com os achados qualitativos da TCMD. RESULTADOS: Onze pacientes estavam em classe funcional I (NYHA, três apresentavam sopros inespecíficos, três estavam abaixo do percentil 15 de desenvolvimento pôndero-estatural. À radiografia de tórax, dois pacientes tinham alteração dos campos pulmonares e três, aumento discreto da área cardíaca. Ao eletrocardiograma, um paciente apresentava sobrecarga ventricular direita e um, ritmo juncional. Todos os ecocardiogramas mostraram-se dentro dos limites de normalidade, exceto em um paciente com estenose entre a veia cava superior e o átrio direito. A TCMD foi totalmente normal em quatro pacientes, em três demonstrou compressão de veias pulmonares e em quatro, redução de calibre considerada significativa, as quais se correlacionaram com os demais achados. Assim, a TCMD para demonstrar alterações anatômicas, quando comparadas a alterações do exame físico ou outros exames complementares testados, apresentou sensibilidade de 87,5%, especificidade de 75%, valor preditivo positivo 87,5%, valor preditivo negativo de 75% e acurácia de 83,3%. CONCLUSÃO: No acompanhamento tardio dos pacientes submetidos à correção cirúrgica de CATVP, a TCMD pode fornecer subsídios valiosos e complementar o diagnóstico de eventuais alterações anatômicas e funcionais.OBJECTIVE: To evaluate if the findings of multislice computed tomography (MSCT are associated with clinical and laboratory tests routinely used in the late follow-up of children undergoing surgical treatment of total anomalous pulmonary venous connection (TAPVC. METHODS: From January 2002 to December 2007, 12 patients operated due to CATVP were evaluated with history, physical examination, chest X-ray, electrocardiogram, echocardiography and MSCT. Specific changes observed in each one of these tests were identified and compared with MSCT qualitative findings. RESULTS: Eleven patients were in functional class I (NYHA, three had nonspecific murmurs, and three were below the 15th percentile of weight and height. Two had pulmonary field abnormalities and three had a slight increase of the cardiac area in the X-ray examination. In the electrocardiogram, one patient had right ventricular overload and one had junctional rhythm. All echocardiograms were within the normal range, except for one patient with stenosis between the superior vena cava and right atrium. MSCT was completely normal in four patients, three had compression of the pulmonary veins and four had significant caliber reduction, which correlated with the other findings. Thus, MSCT showed a sensitivity of 87.5%, specificity of 0.75%, positive predictive value of 87.5%, negative predictive value of 75% and accuracy of 83.3% to demonstrate anatomic changes compared to changes in the physical examination or other additional tests. CONCLUSION: MSTC may provide valuable information and complement the diagnosis of possible anatomical and functional changes in the late follow-up of patients undergoing surgical repair of TAPVC.

  7. Angioplastia carotdea com reverso do fluxo em octogenrios: relato de caso Carotid angioplasty with flow reversion in octogenarians: a case report

    Bernardo Massire

    2010-09-01

    Full Text Available Pacientes octogenrios submetidos angioplastia carotdea apresentam maior incidncia de eventos neurolgicos quando comparados a grupos de pacientes mais jovens e a grupos da mesma faixa etria submetidos endarterectomia carotdea. A maior taxa de complicaes pode ser explicada por fatores anatmicos e anatomopatolgicos que aumentam a dificuldade tcnica e o risco de ateroembolismo do procedimento endovascular. O procedimento foi realizado no centro cirrgico, com o paciente em decbito dorsal e sob anestesia geral. Realizamos acesso cirrgico transverso limitado, na base do pescoo direita, com disseco, identificao e reparo da artria cartida comum e veia jugular interna. Foram administradas 10.000 U de heparina e puncionada a cartida comum pela tcnica de Seldinger com introduo de bainha 8F em sentido cranial. Na sequncia, foi puncionada a veia jugular interna com instalao de bainha 8F em sentido caudal. Em seguida, ambas as bainhas foram conectadas, utilizando-se um segmento de equipo de soro. A cartida comum foi fechada por cadaro duplo de silicone e o fluxo retrgrado pela cartida interna foi estabelecido. Subsequentemente, foi introduzido fio guia 0.014 x 190 cm com cruzamento da leso, realizando-se angioplastia com balo 5 x 20 mm e em seguida stent (Wallstent 7 x 50 - Boston Scientific foi introduzido, posicionado e liberado. A angioplastia carotdea com reverso de fluxo, por via transcervical, constitui estratgia de proteo cerebral custo-eficiente e com menor potencial embolignico em pacientes octogenrios com anatomia desfavorvel.Octogenarian patients submitted to carotid angioplasty present higher incidence of neurological events when compared to younger patients and to patients in this same age submitted to carotid endarterectomy. The higher complication rate could be related to anatomic and anatomopathological factors that increase technical difficulties and atheroembolic risk associated with the endovascular procedure. At the operating room, the patient was in dorsal decubitus position and submitted to general anesthesia. Limited transversal surgical access was carried out on the right neck base, with dissection, identification and restoration of the common carotid artery and internal jugular vein. A 8F sheath was implanted cranially oriented into the common carotid by Seldinger technique after endovenous injection of 10.000 UI of heparin. Another 8F sheath was implanted into the internal jugular vein in caudal orientation. Both sheath were connected by the use of infusion set segment. The common carotid artery was clamped with a silastic double lace, establishing reversion of blood flow in the internal carotid artery. The lesion was crossed by 0.014 x 190 cm wire and the carotid angioplasty was performed employing a 5 x 20 mm ballon and a stent (Wallstent 7 x 50 - Boston Scientific was introduced, positioned and released. Carotid angioplasty with transcervical flow reversal is a cost effective brain protection strategy, associated to low embolic potential in octagenarian patients with unfavorable anatomy.

  8. Características sociodemográficas e clínicas das internações psiquiátricas de mulheres com depressão

    Richardson Miranda Machado

    2013-03-01

    Full Text Available Estudo retrospectivo e exploratório, realizado com objetivos de identificar e analisar características sociodemográficas e clínicas de internações psiquiátricas de mulheres acometidas por depressão. O estudo foi realizado a partir do Sistema de Internações Hospitalares de um serviço especializado. A amostra foi constituída por 24.161 pacientes admitidos; 1.160 tiveram diagnóstico de depressão (4,8%, com predominância do sexo feminino (761-65,6%, faixa etária de 41 a 50 anos (194-25,4%, procedentes para internação de diferentes serviços de saúde (273-35,8%, com tempo de internação de 60 dias (311-40,8%, altas médicas (687-90,2%, uma internação hospitalar (661-86,8% e internações pagas pelo Sistema Único de Saúde (633-83,2%. Os aspectos biológicos (hormonais, culturais (papel da mulher na sociedade, automedicação, diagnóstico tardio e coocorrência com outras doenças foram os principais fatores relacionados ao acometimento por depressão pelas mulheres e internação. Tais aspectos devem direcionar uma melhor abordagem do cuidado e promoção da saúde mental.

  9. internas indgenas en Mxico

    Jos Manuel Hernndez Trujillo

    2006-01-01

    Full Text Available Se analizan las condiciones de pobreza en las entidades con una proporcin importante de poblacin indgena, as como las principales entidades destino, con el propsito de identificar los factores y las condiciones que han permitido la consolidacin de rutas migratorias de los indgenas mexicanos. De igual manera, se trata de explicar, porqu ncleos importantes de indgenas que migran con el propsito de dejar de vivir en condiciones de pobreza extrema, slo encuentran como destino, la pobreza a secas.

  10. Qu es Medicina Interna?

    Humberto Reyes B

    2006-10-01

    Full Text Available Internal Medicine can be defined as a medical specialty devoted to the comprehensive care of adult patients, focused in the diagnosis and non surgical treatment of diseases affecting internal organs and systems (excluding gyneco-obstetrical problems and the prevention of those diseases. This position paper reviews the history of Internal Medicine, the birth of its subspecialties and the difficulties faced by young physicians when they decide whether to practice as internist or in a subspecialty. In Chile as in most occidental countries formal training in a subspecialty of internal medicine requires previous certification in internal medicine but the proportion of young physicians who remain in practice as general internists appears to be considerably lower than those who choose a subspecialty. The main reasons for this unbalance can be related to financial advantages (by the practice of specialized technologies and the patients' tendency to request direct assistance by a professional thought to be better qualified to take care of their specific problems. Training programs in internal medicine should consider a greater emphasis in comprehensive outpatient care instead of the traditional emphasis for training in hospital wards

  11. Evaluación y construcción de un perfil de competencias profesionales en medicina interna

    Análida Elizabeth Pinilla

    2014-04-01

    Full Text Available Objetivo: caracterizar el perfil de desempeño del médico internista según las competencias profesionales propuestas y establecer las relaciones con el perfil de formación actual en esta especialidad en Colombia. Diseño del estudio: estudio mixto, transversal, durante 11 meses; con consentimiento informado y Comité de Ética. Participantes: directivos, internistas, internistas-docentes, residentes. Intervenciones: entrevistas en profundidad, encuesta y análisis de programas. Encuesta anónima, según el análisis cualitativo de entrevistas. Triangulaciones para validez y confiabilidad por fuentes (literatura, participantes, programas, instrumentos (entrevista, encuesta, rejilla para análisis de programas y tipo de participantes. Análisis: cualitativo Atlas.ti 5.0, cuantitativo Excel 2007. Resultados: entrevistados 45, encuestados 190 y programas analizados 2, para proponer un perfil de formación por competencias profesionales con enfoque pedagógico socio-constructivista. Este perfil propuesto reconfirma las competencias profesionales de la literatura pero surgieron unasnuevas: 1. Específicas nucleares emergentes, que dan la identidad deontológica o razón de ser del internista, son las capacidades para integrar problemas del paciente, organizar conceptos de subespecialistas, ser experto en enfermedades prevalentes, ser soporte de especialistas médico-quirúrgicos, actuar en diferentes niveles de atención y escenarios. 2. Clínicas clásicas y otras nuevas como enfatizarla promoción de la salud y prevención de la enfermedad. 3. Transversales emergentes: comunicativas, profesionalismo, administrativas, pedagógicas, en investigación. Conclusión: el perfil de formación del residente continúa centrado en objetivos y rotaciones fragmentadas en medicina interna y subespecialidades; se infiere un enfoque empírico en competencias profesionales clínicas y el conocimiento médico, mediante los convenios docencia-servicio; hay carencia del desarrollo formal de competencias transversales y específicas nucleares. (Acta Med Colomb 2014; 39: 165-173.

  12. A internação de adolescentes pela lente dos tribunais Adolescent internment by the court's point of view

    Maria Auxiliadora Minahim

    2011-06-01

    Full Text Available Desde sua entrada em vigor, o Estatuto da Criança e do Adolescente sofre sistemáticas críticas no debate público não havendo, entretanto, no campo da doutrina especializada e da jurisprudência efetivos esforços para uma compreensão do alcance da lei e de seus princípios sobretudo quando o tema é a imposição de medidas de internação a adolescentes autores de infração penal. Este texto procura demonstrar a feição homogênea e estável da jurisprudência brasileira nos Tribunais Estaduais nessa matéria à luz dos principais argumentos utilizados como fundamentação das decisões em sede recursal. Alguns resultados da pesquisa "Responsabilidade e garantias ao adolescente autor de ato infracional: uma proposta de revisão do ECA em seus 18 anos de vigência" apoiada pela Secretaria de Assuntos Legislativos do Ministério da Justiça, ilustram as dificuldades de mplementação dos preceitos legais, possibilitando refletir se é a textura aberta da lei o que vem favorecendo a persistência de argumentos extrajurídicos e ideológicos em sua interpretação.Since its approval, The Child and Adolescent Act has been attacked for several critics in the public debate. However neither the specialized dogmatic nor jurisprudence have presented effective efforts to the comprehension of the law or its principles, especially related to internment measures applied to young offenders. the text shows the homogeneous appearance of the brazilian jurisprudence into the State Courts, according to the most used arguments by the decisions. some results from the "Responsibility and Guarantees to young offender: a revision proposal for the child and adolescent act in 18 years of existence" research illustrate these difficulties to implement the legislation, avoiding the consideration regarding the open texture of the law as a possible cause for the persistence of extralegal and ideological arguments on its interpretation.

  13. Escala de Disposio para Perdoar: estrutura, consistncia interna e invarincia fatorial / Willingness to Forgive Scale: Structure, reliability and factorial invariance

    Valdiney Veloso, Gouveia; Leogildo Alves, Freires; Rildsia Silva Veloso, Gouveia; Jos Farias de, Souza Filho; Roosevelt Vilar Lobo de, Souza; Renan Pereira, Monteiro.

    2015-06-01

    Full Text Available Este artigo teve como objetivo adaptar para o contexto brasileiro a Escala de Disposio para Perdoar, conhecendo evidncias de validade (fatorial e convergente) e preciso (consistncia interna, homogeneidade e confiabilidade composta). Nesse sentido, realizaram-se dois estudos. No estudo 1, partic [...] iparam 220 estudantes universitrios de uma instituio privada de Joo Pessoa, Paraba, com idade mdia de 24 anos (81,7% do sexo feminino), que responderam Escala de Disposio para Perdoar e a perguntas demogrficas. Uma anlise de componentes principais revelou uma estrutura unifatorial, explicando 44,3% da varincia total, com alfa de Cronbach (?) de 0,88. No estudo 2, participaram 302 estudantes universitrios de uma instituio pblica da mesma cidade, apresentando idade mdia de 22 anos (52,3% do sexo masculino), tendo respondido aos mesmos instrumentos. Uma anlise fatorial confirmatria corroborou a estrutura unifatorial (Goodness-of-Fit Index = 0,90, Root Mean-Square Error of Approximation = 0,09), que se mostrou invariante quanto ao gnero dos participantes (?Root Mean-Square Error of Approximation Abstract in english The aim of the article was to adapt the Willingness to Forgive Scale for the Brazilian context and to know its evidence of validity (factorial and convergent) and reliability (internal consistency, homogeneity, and composite reliability). In this regard, two studies were conducted. In study 1, 220 u [...] ndergraduate students from a private university from Joo Pessoa, Paraba, with a mean age of 24 years (81.7% female) answered the Willingness to Forgive Scale and demographic questions. A principal components analysis revealed a one-factor structure, which accounted for 44.3% of the total variance, with a Cronbach's alpha of 0.88. In study 2, 302 undergraduate students from a public university in the same city, with mean age of 22 years (52.3% men) answered the same instruments. A confirmatory factor analysis confirmed the one-factor structure (Goodness-of-Fit Index = 0.90, Root Mean-Square Error of Approximation = 0.09), which showed to be invariant regarding participants' gender (?Root Mean-Square Error of Approximation

  14. Detection system qualification for direct measurement of thyroid internal contamination by radioiodine; Qualificazione di un sistema di rilevazione trasportabile per misure dirette di contaminazione interna di radioiodio

    Tiberi, V.; Battisti, P.; Gualdrini, G. [ENEA, Centro Ricerche Ezio Clementel, Bologna (Italy). Dipt. Ambiente

    1999-07-01

    The work deals with a detection system qualification for direct measurements of thyroid internal contamination by radioiodine. The isotopes {sup 131}I and {sup 125}I are the most frequently used in nuclear medicine. Because of their volatility they are very dangerous for thyroid contamination by inhalation. The system has been projected to be easily and fast used and above all transportable where the control is necessary. These characteristic make it able to realise supervision programs of internal contamination by radioiodine. In fact due the very high control frequencies (each 15 days for {sup 131}I), these programs are usually very expensive and demanding when they are executed in external measurement laboratories. The following steps are described: devices presentation, calculation of energy and efficiency parameters, minimum detectable activity, time system reliability, best operative conditions in the measurements. At the end an application example of the system is reported. [Italian] Il presente lavoro consiste nella qualificazione di un sistema di rivelazione per misure dirette di contaminazione interna da radioiodio in tiroide, progettato per essere maneggevole, di semplice e rapido impiego e trasportabile sul luogo dove e' richiesta la misura. Il sistema e' stato studiato per la realizzazione di programmi di sorveglianza della contaminazione interna da radioiodio che, richiedendo frequenze di controllo elevate (quindicinali per lo {sup 131}I), sono estremamente impegnativi ed onerosi, soprattutto se i controlli vengono effettuati in centri di misura esterni. Dopo la determinazione dei parametri della calibrazione in energia ed efficienza, la minima attivita' rivelabile, l'affidabilita' del sistema nel tempo e le condizioni operative ottimali da adottare in sede di misura, viene verificata la piena affidabilita' del sistema in un programma di sorveglianza della contaminazione interna da radioiodio.

  15. Descripcin de la dinmica interna de las familias monoparentales, simultneas, extendidas y compuestas del municipio de Medelln, vinculadas al proyecto de prevencin temprana de la agresin

    Mara Eugenia Agudelo Bedoya

    2005-05-01

    Full Text Available El estudio efectuado por el Grupo de Investigaciones en Familia de la U.P.B., caracteriza la dinmica interna de las diferentes tipologas familiares en las Comunas 1, 2, 3, 8 y 9 del Municipio de Medelln que participaron en el proyecto de Prevencin Temprana de la Violencia, Pautas de Educacin y Crianza que se desarroll entre enero de 2001 y septiembre de 2002, contando con la financiacin del Municipio de Medelln y el Banco Interamericano de Desarrollo (BID. Se analiza la dinmica interna de 536 familias distribuidas por tipologa de la siguiente manera: 204 Monoparentales Femeninas; 11 Monoparentales Masculinas; 173 Extendidas; 109 Simultneas y 39 Compuestas.La informacin se tom de los registros de visita domiciliaria y entrevistas aplicados directa y personalmente por el grupo de asesores que tuvo a su cargo el proceso formativo y de orientacin con las familias de nios y nias de las instituciones educativas participantes. Es importante anotar que el modelo de intervencin incluye la aplicacin del cuestionario para evaluacin de conductas en nios/nias entre 3 y 11 aos de edad (COPRAG, que permite identificar si estn en riesgo de asumir conductas agresivas. Segn el puntaje que obtienen en dicha prueba, se clasifican en 2 categoras: en la de "ndice" los nios y las nias que aparecen en mayor riesgo y en la de "no ndice" quienes aparecen en menor riesgo. Por esto, el anlisis de la informacin se hace diferenciando un grupo de otro.Las variables de la dinmica interna que se tuvieron en cuenta fueron: autoridad, comunicacin, afectividad y pautas de crianza. Adems se indag sobre la percepcin que las familias tienen de la salud fsica y emocional de estos nios y nias.

  16. Deuda pública interna, patrón metálico y guerras civiles: interconexiones institucionales, la Colombia del siglo XIX

    Angela Milena Rojas

    2007-01-01

    Resumen: Este artículo analiza los impactos monetarios e institucionales de la deuda pública interna en Colombia en el siglo XIX. Se expone la naturaleza de esta deuda y su evolución institucional, con el fin de bosquejar una parte de la matriz institucional del siglo XIX; para ello, se utilizan ideas del nuevo institucionalismo económico. El artículo deriva de una investigación más extensa en la que se reconstruyeron series fiscales y e información cualitativa a partir de fuentes primarias. ...

  17. Hérnia interna de delgado em pós-operatório de sigmoidectomia a Hartmann =Enteric internal hernia in postoperative period of Hartmann's sigmoidectomy

    Brenner, Mateus Brum et al.

    2014-01-01

    Objetivos: Relatar o caso de um paciente com quadro de abdome agudo obstrutivo por hérnia interna, que apresentou diagnóstico desafiador, devido a procedimentos anteriores e ao perfil individual, e realizar uma breve revisão da literatura sobre os tipos de hérnia. Descrição do caso: Um homem de 44 anos, etilista, usuário de crack, com cirurgia prévia para redução de prolapso de colostomia, retorna à emergência dois dias depois do procedimento, com dor epigástrica, náuseas, vômitos e parada...

  18. Diseño de un plan de comunicación interna para fortalecer los procesos comunicativos en el programa de trabajadores sociales en Majibacoa

    Adriana Téllez Carralero; Mariluz Carbonell Tamayo; Miguel Jorge López Pérez; Darlis Reynaldo Rodríguez

    2014-01-01

    Este trabajo de diploma fue realizado en el Programa de Trabajadores Sociales en Majibacoa. Con esta investigación se contribuye al fortalecimiento de los procesos comunicativos presentes en la organización, pues el estudio de la comunicación organizacional se hace cada vez más importante para el desarrollo de las instituciones cubanas. Dicha investigación tuvo como objetivo el diseño de un plan de comunicación interna que fortalezca los procesos comunicativos que afectan el buen funcionamien...

  19. Uso de antibióticos parenterales en el servicio de medicina interna de un hospital de tercer nivel de la ciudad de bogotá

    Rodriguez, Blanca Doris; López, Jose Julián

    2010-01-01

    Mediante un estudio observacional y de corte transversal, relacionado con el esquema terapéutico, se describió el consumo y las prácticas de prescripción de antibióticos parenterales en el servicio de medicina interna del Hospital Universitario La Samaritana de Bogotá. Se administraron 32,6 ddd/100 pacientes/día, siendo los grupos terapéuticos más prescritos: cefalosporinas, penicilinas y quinolonas. Los errores en el esquema terapéutico se presentaron en el régimen de dosifica...

  20. Algunas paradojas en la enseñanza actual de la medicina interna en Argentina Some paradoxes in the current internal medicine teaching in Argentina

    D. Outomuro

    2010-01-01

    Este trabajo tiene como propósito reflexionar sobre algunas circunstancias que, en Argentina, contribuyen a la crisis de la educación médica y al descontento tanto de pacientes como de profesionales. El centro de atención es la medicina interna. Del análisis surgen algunas paradojas vinculadas con la actual formación de grado y posgrado. Si bien el primer nivel de atención de la salud, en el marco de la atención primaria, puede resolver el 80% de los problemas de salud de la población, la ens...

  1. Auditoría interna de prevención. Según requisitos del INSHT y estándar OHSAS 18001:2007

    Fernández Alonso, Silvia

    2014-01-01

    El presente trabajo final de máster trata sobre la adecuación del sistema de prevención de una empresa de ámbito nacional; para ello he realizado una auditoria previa e interna de dicho sistema de prevención. Mediante la auditoría analizo el cumplimiento de la legislación vigente en materia preventiva según los criterios del Instituto Nacional de Seguridad e Higiene en el Trabajo (en adelante INSHT) y el cumplimiento de la OHSAS según los requisitos de la OHSAS 18001:2007. ...

  2. Role of direct intraarterial chemotherapy through a.iliaca interna in the treatment of young women cervical cancer stage IIb (T2b)

    Direct intraarterial chemotherapy through a.iliaca interna and hyperfractionated radiation therapy of young women cervical cancer stage Iib (T2bN, N2bN1) enables to make optimal condition to perform Wertheim type surgery. Even after intraarterial chemotherapy alone, in 84% of patients we stated regression of tumour more than 50 % in size. Our method of complex treatment of young women cervical cancer is effective method, as 64% of our curable patients are still alive more than 3 years without any cancer manifestation

  3. Configuraciones organizativas en sectores dinámicos y hostiles: adecuación al contexto sectorial, coherencia interna y resultados

    Pedro Manuel García Villaverde; María José Ruiz Ortega

    2007-01-01

    En este trabajo estudiamos, desde un enfoque configuracional, la existencia de diferencias de resultados entre las configuraciones organizativas en función de su coherencia interna y su adecuación a las características del sector. A partir de una muestra de 231 empresas de un sector dinámico y hostil -Electrónica, Informática y Telecomunicaciones-, analizamos las configuraciones organizativas que conviven en el mismo. Hemos obtenido seis configuraciones organizativas, que nos perm...

  4. Oclusão bilateral das artérias carótidas internas, sífilis meningovascular e SIDA: relato de caso

    LAMBRECHT FLORISBERTO; SÁ DANIEL S; KOERBEL ANDREI; TAMANINI ALEXANDRO; MACHARETH SÁVIO L.; SCOLA ROSANA HERMINIA; TEIVE HÉLIO A. G.; WERNECK LINEU CESAR

    1999-01-01

    Relatamos um caso de obstrução bilateral na origem das artérias carótidas internas, apresentando como sinais/sintomas associados hemiparesia e hipoestesia superficial e profunda à direita, associada a sífilis meningovascular em paciente com SIDA. Tomografia de crânio apresentou pequenas lesões hipodensas, com predomínio à esquerda, e arteriografia evidenciou oclusão bilateral das artérias carótidas. A associação entre lues e SIDA não é infrequente, porém o quadro oligossintomático do paciente...

  5. Effect of the period of extrinsic mechanical compression following sclerotherapy in veins in rabbit ears Efeito do tempo da compressão mecânica extrínseca após escleroterapia em veias de orelhas de coelhos

    Cláudio Santana Ivo

    2011-06-01

    Full Text Available PURPOSE: Research whether a post-sclerotherapy venous compression period of up to 120 hours is sufficient to avoid reperfusion in treated veins; whether there is a relationship between the inflammatory intensity in venous walls and adjacent tissue and the size of venous thrombosis; whether the intensity of the post-sclerotherapy inflammation varies with the period of compression; whether there is a relationship between the presence of hemosiderin in the tissues adjacent to the sclerosing blood vessels and venous blood clots. METHODS: Twenty eight rabbits, all male, were utilized, distributed into four groups (0, 24, 72 and 120. All the animals were administered with 0.25 ml of 1% polidoconal solution and, as a control, 0.25 ml of 0.9% sodium chloride solution in the marginal dorsal vein of the right and left ears, respectively. Mechanical compression was applied to the perfused stretch of the vein, except for the animals in group 0. The period of compression varied from 0 to 120 hours in the groups. An anatomopathological examination of the section of the right and left marginal dorsal veins of all the animals was conducted. RESULTS: There was no significant difference among the various compression periods, both in terms of the degree of vein thrombosis and in the inflammatory intensity in both ears of the various groups. A positive and significant correlation was observed between the inflammatory intensity and the size of the thrombus and in the occurrence of thrombi and hemosiderin. CONCLUSIONS: A compression period of up to 120 hours is not sufficient to prevent reperfusion in sclerosing blood vessels. The intensity of tissue inflammation is related to the size of the thrombus, but not to the compression period. The presence of hemosiderin in the tissues adjacent to the vessels subjected to sclerosis is related to the presence of venous coagulation.OBJETIVO: Pesquisar se o tempo de compressão venosa de até 120 horas pós-escleroterapia é suficiente para evitar reperfusão nas veias tratadas; se há relação entre a intensidade inflamatória na parede venosa e tecidos adjacentes e o tamanho do trombo venoso; se a intensidade da inflamação pós-escleroterapia varia com o tempo de compressão; se há relação entre a presença de hemossiderina nos tecidos adjacentes ao vaso esclerosado e coágulo venoso. MÉTODOS: Utilizaram-se 28 coelhos, machos, distribuídos em quatro grupos (0, 24, 72 e 120. Em todos os animais foram administrados 0,25 ml de solução de polidocanol 1% e, como controle, 0,25 ml de solução de cloreto de sódio 0,9% na veia marginal dorsal das orelhas direita e esquerda, respectivamente. Realizou-se compressão mecânica em trecho da veia perfundida, exceto nos animais do grupo 0. O tempo de compressão variou de 0 a 120 horas nos grupos. Realizou-se exame anatomopatológico de trecho das veias marginais dorsais direita e esquerda de todos os animais. RESULTADOS: Não houve diferenças significativas nos diversos tempos de compressão, tanto no grau de trombose venosa como na intensidade inflamatória, em ambas as orelhas, nos diversos grupos. Observou-se correlação positiva e significativa entre intensidade inflamatória e tamanho do trombo e na ocorrência de trombos e hemossiderina. CONCLUSÕES: O tempo de até 120 horas de compressão não é suficiente para evitar reperfusão nos vasos esclerosados. A intensidade da inflamação nos tecidos tem relação com o tamanho do trombo, mas não com o tempo de compressão. A presença de hemossiderina nos tecidos adjacentes ao vaso submetido à esclerose está relacionada com a presença de coágulo venoso.

  6. Intercorrências clínicas no membro submetido à exérese de veia safena magna para revascularização do miocárdio Clinical complications of limb undergone harvesting of great saphenous vein for coronary artery bypass grafting using bridge technique

    Cleusa Ema Quilici Belczak

    2009-03-01

    Full Text Available OBJETIVO: Avaliar as intercorrências clínicas nos membros submetidos a retirada da veia safena magna por técnica de incisões escalonadas para sua utilização como enxerto venoso na revascularização do miocárdio. MÉTODOS: Selecionou-se aleatoriamente 44 pacientes submetidos a revascularização do miocárdio utilizando a veia safena magna retirada por incisões escalonadas há mais de 3 meses. Critérios de exclusão: retirada da veia safena de ambos os lados; safenectomia prévia do membro contralateral; etiologias de edema de causas sistêmicas, tais como cardíacas, renais, tireoideanas, hepáticas e insuficiência venosa nos membros inferiores (MMII, representada por varizes exuberantes com ou sem alterações tróficas. Foram avaliados as seguintes variáveis: idade, sexo, diabetes, tempo de cirurgia, presença de intercorrências, como edema, parestesias, infecção, linforréia, erisipela e trombose venosa profunda. A avaliação foi clínica e o diagnóstico do diabete foi feito pelos exames do pré-operatório para cirurgia. Para análise estatística foram empregados o teste qui-quadrado, teste exato de Fisher e teste t de Student, considerando erro alfa de 5%. RESULTADOS: O tempo entre avaliação e cirurgia foi de 3 a 187 meses, com média 47,3 + 42,5 meses. Detectou-se 25% de infecção no leito da safena, edema em 52,3% dos casos, parestesia em 29,5%, erisipela em 9,1%, linforréia em 4,5% e trombose venosa profunda em 2,3%. Não houve associação entre diabetes com as intercorrências. CONCLUSÃO: A exérese escalonada da veia safena magna para revascularização do miocárdio não elimina as intercorrências clínicas no leito da safena, como parestesias, infecção e edemaOBJECTIVE: The aim of this study was to assess clinical complications of limbs undergone harvesting of the great saphenous vein for venous coronary artery bypass graft surgery using bridge technique. METHODS: Fourty-four patients who had undergone CABG using the great saphenous vein harvested by the bridge technique over more than 3 months ago were randomly selected. The exclusion criteria were the harvesting of both saphenous veins, prior saphenectomy of the contralateral limb, edema caused by a systemic etiology, such as heart, renal, thyroid or hepatic diseases and venous insufficiency of the lower limbs as characterized by swollen varicose veins both with and without trophic changes. The age, gender, diabetes, time of surgery and occurrence of complications, such as edema, paresthesia, infection, lymphorrhea, erysipelas and deep venous thrombosis, were assessed. The assessment was clinic and diagnosis of the diabetes was performed by the preoperative exams. The chi-square, Fisher and Student's t tests were used for statistical analysis with an alpha error of 5%. RESULTS: The time between surgery and assessment ranged between 3 and 187 months with a mean of 47.3±42.5 months. Infections of the saphenous harvest site were detected in 25% of the cases, edema in 52.3%, paresthesia in 29.5%, erysipelas in 9.1%, lymphorrhea in 4.5% and deep venous thrombosis in 2.3%. There was no association between diabetes and complications. CONCLUSION: The saphenous vein harvesting using bridge technique for coronary artery bypass grafting does not eliminate clinical complications, such as paresthesia, infection and edema of the saphenous vein harvesting site.

  7. O papel da oxigenação hiperbárica na estrutura do fígado e baço após ligadura das veias hepáticas: estudo em ratos The role of hyperbaric oxygenation in the liver and spleen structure after hepatic vein ligation: study in rats

    Ricardo Costa-Val

    2006-03-01

    Full Text Available OBJETIVO: Avaliação morfológica do fígado e baço de ratos submetidos à oxigenoterapia hiperbárica após a ligadura das veias hepáticas. MÉTODO: Foram utilizados 30 animais machos adultos da espécie Holtzman, distribuídos aleatoriamente em dois grupos de 15 animais cada, assim designados: grupo 1 - ligadura das veias hepáticas; grupo 2 - ligadura das veias hepáticas associada à oxigenoterapia hiperbárica. Todos os animais foram submetidos à anestesia geral por meio de solução contendo cloridrato de cetamina (40 mg/ml e cloridrato de meperidina (10 mg/ml na dose de 50 mg/kg/peso, laparotomia mediana e ligadura das veias hepáticas. A oxigenoterapia hiperbárica foi aplicada nos animais do grupo 2, a partir da oitava hora do pós-operatório, por 120 minutos, sendo 90 minutos sob pressão de 2,5 atmosferas e 15 minutos no início e final da terapêutica, para promover a compressão e descompressão gradativa no período de 20 dias consecutivos. No 21° dia de pós-operatório, os animais foram mortos por inalação de éter e submetidos à laparotomia e extirpação dos fígados e baços para exame histológico. Foram comparados os resultados da histologia hepática e esplênica aplicando-se o teste exato de Fisher, considerando-se a diferença significante de P OBJECTIVE: Liver and spleen morphologic evaluation of rats submitted to hyperbaric oxygen therapy after hepatic vein ligation. METHOD: Thirty Holtzman adult male rats were used, distributed into two groups of 15 animals: group 1 - hepatic vein ligation; group 2 - hepatic vein ligation associated with hyperbaric oxygen therapy. All animals received general anesthesia by a solution composed of ketamine chloride (40 mg/ml and meperidine chloride (10 mg/ml in a dose of 50/mg/weight, and were submitted to median laparotomy and hepatic vein ligation. Group 2 animals were submitted to hyperbaric oxygen therapy, 8 hours after the operation, 90 minutes at 2.5 atmosphere pressure and 15 minutes at the onset and end of the therapy, in a total of 120 minutes, in order to promote the gradual compression and decompression in 20 consecutive days. On the 21st preoperative day, the animals were sacrificed by ether inhalation and submitted to laparotomy and stripping of liver and spleen for histological study. The results of the histological study of livers and spleens were compared using Fisher's exact test. Statistically significant difference was considered when P < 0.05. RESULTS: The histological studies made in the livers and spleens of animals from both groups showed the following alterations: presence of thrombosis of hepatic, portal and central lobular veins in five (33.3% group 1 animals and absence in group 2 animals; very extensive necrosis of liver cells in seven (46.7% group 1 animals, and light in eight (53.3%, whereas for all group 2 animals such alteration was considered light; Kupffer cells developed and hypertrophied in 14 (93.3% group 1 animals and slightly developed and hypertrophied in all group 2 animals; high congestion of the spleen purple in six (40% and moderate in nine (60% group 1 animals, whereas all group 2 animals had moderate congestion; moderate or severe hemosiderosis in 14 (93.3% group 1 animals and mild hemosiderosis in all group 2 animals. The statistical analyses performed between both groups showed significant differences (P < 0.05 for all variables. CONCLUSIONS: The hyperbaric oxygen therapy applied in rats submitted to hepatic vein ligation mitigated its early deleterious effects on the liver and spleen, which was confirmed by the histological study.

  8. Ecocardiografia transesofágica e diagnóstico intraoperatório de veia cava superior esquerda persistente Ecocardiografía transesofágica y diagnóstico intraoperatorio de vena cava superior izquierda persistente Transesophageal echocardiography and intraoperative diagnosis of persistent left superior vena cava

    Alexander Alves da Silva

    2009-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A persistência da veia cava superior esquerda ocorre isoladamente em 0,5% da população normal, porém nos pacientes com cardiopatia congênita chega a estar presente em 3% a 10% dos casos. O objetivo deste relato foi apresentar um caso de diagnóstico intraoperatório com o auxílio da ecocardiografia transesofágica e ressaltar a importância da sua utilização rotineira em intervenções cirúrgicas para correção de cardiopatia congênita. RELATO DO CASO: Paciente do sexo masculino, 16 anos, ASA II, com diagnóstico prévio de comunicação interatrial (CIA tipo seio venoso superior com drenagem anômala parcial de veias pulmonares em programação para correção cirúrgica da cardiopatia. Após indução da anestesia geral foi realizado ecocardiograma transesofágico (ETE. O exame inicial mostrou dilatação das câmaras cardíacas direitas, CIA tipo seio venoso superior de 17 milímetros, drenagem anômala da veia pulmonar superior direita desembocando na veia cava superior (VCS direita e dilatação do seio coronário, o que aventou a possibilidade da persistência da veia cava superior esquerda. Para a confirmação da suspeita foram injetados no acesso venoso do braço esquerdo 10 mL de solução fisiológica a 0,9% (faz o papel de "contraste" no exame ecocardiográfico e imediatamente após foram visualizadas as microbolhas passando pelo seio coronário, teste positivo para o diagnóstico de VCS superior esquerda persistente. CONCLUSÕES: A ecocardiografia transesofágica rotineira no intraoperatório de pacientes com cardiopatia congênita tem fundamental importância como método auxiliar não só ao cirurgião, muitas vezes influenciando diretamente na técnica cirúrgica empregada, como também para o anestesiologista, que pode extrair do exame uma série de informações úteis no manuseio hemodinâmico do paciente.JUSTIFICATIVA Y OBJETIVOS: La persistencia de la vena cava superior izquierda ocurre de forma aislada en 0,5% de la población normal, sin embargo, en los pacientes con cardiopatía congénita llega a estar presente de un 3% a un 10% de los casos. El objetivo de este relato, fue presentar un caso de diagnóstico intraoperatorio con la ayuda de la ecocardiografía transesofágica y resaltar la importancia de su utilización de rutina en intervenciones quirúrgicas para la corrección de cardiopatía congénita. RELATO DEL CASO: Paciente del sexo masculino, 16 años, ASA II, con diagnóstico previo de comunicación interatrial (CIA, tipo seno venoso superior, con drenaje anómalo parcial de venas pulmonares, programado para la corrección quirúrgica de la cardiopatía. Después de la inducción de la anestesia general, se realizó el ecocardiograma transesofágico (ETE. El examen inicial mostró lo siguiente: dilatación de las cámaras cardiacas derechas, CIA tipo seno venoso superior de 17 milímetros, drenaje anómalo de la vena pulmonar superior derecha desembocando en la vena cava superior (VCS derecha, y dilatación del seno coronario, vislumbrándose así la posibilidad de la persistencia de la vena cava superior izquierda. Para la confirmación de la sospecha, se inyectaron en el acceso venoso del brazo izquierdo, 10 mL de solución fisiológica a 0,9% (haciendo el papel de "contraste" en el examen ecocardiográfico, e inmediatamente después, se visualizaron las micro burbujas pasando por el seno coronario, test positivo para el diagnóstico de VCS superior izquierda persistente. CONCLUSIONES: La ecocardiografía transesofágica de rutina en el intraoperatorio de pacientes con cardiopatía congénita, tiene una fundamental importancia como método auxiliar no solo para el cirujano, que muchas veces está influenciando directamente la técnica quirúrgica usada, sino también para el anestesiólogo, que puede extraer del examen una serie de informaciones útiles en el manejo hemodinámico del paciente.BACKGROUND AND OBJECTIVES: Isolated persistent left superior vena cava has an incidence of 0.5% in the normal population, but in patients with congenital cardiopathy its incidence ranges from 3% to 10%. The objective of this report was to present a case of intraoperative diagnosis with transesophageal echocardiography and to emphasize the importance of its routine use in surgical procedures for correction of congenital cardiopathies. CASE REPORT: This is a 16-year old male patient, ASA II, with a diagnosis of superior sinus venosus interatrial communication (IAC with partial anomalous drainage of the pulmonary veins scheduled for the surgical correction of the cardiopathy. After induction of general anesthesia, transesophageal echocardiography (TEE showed initially a dilation of the right cardiac chambers, a 17-mm superior sinus venosus IAC, anomalous drainage of the right superior pulmonary vein draining into the right superior vena cava (SVC, and dilation of the coronary sinus raising the possibility of persistent left superior vena cava. To confirm this suspicion, 10 mL of NS (works as a contrast in echocardiography were injected in the venous access of the left arm, and microbubbles crossing the coronary sinus were observed immediately afterwards confirming the diagnosis of persistent left superior vena cava. CONCLUSIONS: Routine intraoperative transesophageal echocardiography in patients with congenital cardiopathy is a fundamental auxiliary method, not only for the surgeon, often having direct influence on the surgical technique used, but also for the anesthesiologist, who can get useful information for the hemodynamic management of the patient.

  9. FSTULA INTERNA ILEOILEAL CONGNITA QUE DEBUTA COMO UN CUADRO OBSTRUCTIVO EN EL ADULTO / Intestinal obstruction caused by a congenital ileo-ileal internal fistula

    Diego Alejandro, Utor-Femndez; Jess, Collantes-Prez; Isabelo, Serrano-Borrero; Pilar, Moreno-Paredes.

    2015-04-01

    Full Text Available Introduccin: Las malformaciones congnitas del aparato digestivo pueden ser muy variadas. En caso de presentar sntomas, suelen aparecer en las primeras etapas de la vida con un amplio abanico de manifestaciones clnicas dependiendo del segmento al que afecte y de la complejidad de las malformacion [...] es. Sin embargo, hay muy pocas fstulas internas congnitas recogidas en la literatura mdica y la mayora suelen estar relacionadas con malformaciones mltiples. Caso clnico: Presentamos un situacin muy poco frecuente. Se trata de un caso de fstula interna congnita que debut con un cuadro obstructivo agudo como nico sntoma en un adulto. Abstract in english Background: Among congenital malformations of the digestive tract, internal congenital fistulas tend to be associated with multiple malformations. Case report: We report a previously healthy 32 years old male consulting for abdominal pain and vomiting lasting 48 hours. A plain abdominal film show sm [...] all bowel dilatation and air-fluid levels. The patient was operated with the diagnosis of bowel obstruction. During the operation dilated bowel loops trapped in a congenital ileo-ileal fistula were found. No biopsies were obtained. The patient had an uneventful postoperative evolution.

  10. Apical internal inflammatory root resorption and open apex treated with MTA: a case report = Reabsoro apical inflamatria interna e pice aberto tratado com MTA: relato de caso

    Brun, Dbora Franzon et al.

    2010-01-01

    Full Text Available Objetivo: A reabsoro radicular interna inflamatria uma condio rara caracterizada por progressiva perda de substncia dentria, que se inicia nas paredes do canal radicular. Geralmente o processo assintomtico e diagnosticado em exame radiogrfico de rotina. O presente relato de caso mostra o tratamento de um caso de leso periapical e reabsoro interna apical que atingiu a superfcie radicular externa. Descrio do caso: Um paciente do sexo masculino de 16 anos foi encaminhado para tratamento odontolgico de rotina para reabilitao oral. O exame radiogrfico mostrou uma leso de reabsoro no tero apical e leso periapical no dente 21. O preparo coronrio foi realizado e hidrxido de clcio foi colocado por duas semanas. Um tampo com MTA branco foi condensado na cavidade da reabsoro e ento o canal foi obturado com guta-percha e cimento AH Plus. As radiografias de acompanhamento mostraram resoluo satisfatria. Concluso: Este caso mostrou os resultados do tratamento com tampo apical de MTA. A tcnica evitou um procedimento invasivo e apresentou algumas vantagens, tais como propriedades biolgicas dos materiais e capacidade de selamento.

  11. Internal medicine and its physicians in the resilient search of its identity La Medicina Interna y los internistas en la bsqueda resiliente de su identidad

    Alfredo Espinosa Brito

    2008-04-01

    Full Text Available This is a review in which the history of the internal medicine is focused on the basis of its relevance as specialty and, the way in which has been seen since the very moment of the emergence of the specialties from which they were derived. The advantages of the integral vision of the ill patient are manifested not only for the patient itself but also for the health institutions. It also analyzes the moral values an Internal Medicine specialist must have as well as the principles that may guide his/her formation.

    Revisin en la que se enfoca la historia de la Medicina Interna, sobre la base de su significacin como especialidad y la forma en que ha sido y es vista, a partir del surgimiento de las especialidades que de ella se derivaron. Se expresan las ventajas que posee la visin integral del enfermo, tanto para este como para las instituciones de salud. Se analizan los valores que debe poseer un especialista de Medicina Interna y los principios que deben regir su formacin.

  12. Aproximación a las migraciones internas en la España de Carlos III a partir del censo de Floridablanca

    Antonio EIRAS ROEL

    2009-12-01

    Full Text Available El estudio de las migraciones internas en la Edad Moderna es materia todavía insuficiente desarrollada en la mayoría de los países. La razón de ello es la inexistencia de fuentes burocráticas específicas que permitan seguir los cambios de vecindad y los desplazamientos internos de los ciudadanos dentro del propio territorio; y la dificultad subsiguiente de suplir su inexistencia a base de fuentes substitutorias (principalmente matrimoniales, hospitalarias, notariales y, en ocasiones, municipales casi siempre casuísticas, dispersas, aleatorias y de seguimiento lento y difícil. En España esta materia se resiente de las mismas dificultades; sin perjuicio de la existencia de muy meritorios estudios regionales o monografías locales que tratan el tema para áreas concretas, casi siempre a escala comarcal o local. Tampoco en nuestro país se conoce la existencia de ninguna fuente de carácter sistemático que permita abarcar con amplitud el tema de las migraciones internas. Parece necesario en consecuencia intentar acercarse a él a través de fuentes indirectas de manejo asequible.

  13. Disseco robtica da artria torcica interna direita por esternotomia mediana Robotic dissection of the right internal thoracic artery through median sternotomy

    Fabio Biscegli Jatene

    2010-06-01

    Full Text Available A utilizao de sistemas robticos em cirurgia cardaca visa diminuio do trauma operatrio. A revascularizao do miocrdio totalmente endoscpica, assistida por rob DaVinci (Intuitive Surgical, Sunnyvale, Califrnia factvel e seu aprendizado deve ser realizado em etapas. O primeiro passo o preparo da artria torcica interna esquerda, j por via totalmente endoscpica. O caso apresentado prope a disseco da artria torcica interna direita por esternotomia completa. Prope um novo passo rumo ao procedimento completamente endoscpico, visando diminuio de leses decorrentes da curva de aprendizado.The use of robotic systems in cardiac surgeries aims at decreasing the surgical trauma.The use of robotic systems in cardiac surgeries aims at decreasing the surgical trauma. The totally endoscopic myocardial revascularization, assisted by the DaVinci robot (Intuitive Surgical, Sunnyvale, California is feasible and the learning process must be carried out in steps. The first step is the preparation of the left internal thoracic artery, through the totally endoscopic approach. The case presented here proposes the dissection of the right internal thoracic artery through complete sternotomy. It proposes a new step directed at the totally endoscopic procedure, aiming at decreasing the injuries caused by the learning curve.

  14. Aspectos tcnicos na esqueletizao da artria torcica interna com bisturi ultra-snico Technical aspects in skeletonization of the internal thoracic artery using an ultrasonic scalpel

    Alexandre Motta de Menezes

    2007-06-01

    Full Text Available OBJETIVO: Descrever a tcnica e avaliar os resultados imediatos da utilizao do bisturi ultra-snico nas esqueletizaes da artria torcica interna, na cirurgia de revascularizao do miocrdio. MTODO: Foram operados com essa tcnica 188 pacientes submetidos cirurgia de revascularizao do miocrdio, no perodo de janeiro de 2000 a outubro de 2006. Setenta e um (37,8% pacientes eram do sexo feminino. A idade variou de 28 a 81 anos. A tcnica utilizada na dissecao consistiu em expor toda artria torcica interna, abrindo-se a fscia endotorcica com tesoura o mais prximo possvel da adventcia da artria. Com o bisturi ultra-snico feita a seco dos ramos colaterais e sua respectiva hemostasia, dispensando-se o uso de "clips" metlicos na artria torcica interna. RESULTADOS: As artrias torcicas internas esqueletizadas com bisturi ultra-snico apresentaram fluxos excelentes, no sendo necessrias manipulaes intraluminais para vasodilatao. No ps-operatrio imediato, dois pacientes apresentaram paralisia temporria da hemicpula diafragmtica esquerda. No houve infeco do esterno nesta srie. O tempo de dissecao foi de aproximadamente 33 minutos, mas com o aumento da experincia esse tempo pde ser reduzido. CONCLUSO: Essa tcnica facilita e abrevia o procedimento da esqueletizao da artria torcica interna, no promove espasmos e a cauterizao dos ramos colaterais com o bisturi ultra-snico eficiente, dispensando o uso de "clips" metlicos. um procedimento de fcil reproduo, podendo ser recomendado para sua realizao de maneira preferencial.OBJECTIVE: To describe the technique and evaluate the immediate results of using an ultrasonic scalpel in the skeletonization of the internal thoracic artery for coronary artery bypass grafting surgery. METHODS: From January 2000 to October 2006, 188 patients were submitted to coronary artery bypass grafting with the internal thoracic artery skeletonized using an ultrasonic scalpel. Seventy-one patients (37.8% were women. The patients' ages varied from 28 to 81 years old. The entire internal thoracic artery was exposed opening the endothoracic fascia using scissors as close as possible to the arterial adventitia. An ultrasonic scalpel was used to transect and coagulate all the intercostal branches, thereby minimizing the use of metallic clips. RESULTS: The skeletonized internal thoracic arteries presented with excellent flow, obviating the need for intraluminal manipulation for vasodilatation. In the immediate postoperative period, two patients were found to have temporary left-sided diaphragmatic paralysis. There were no sternal wound infections in this series. The dissection can be performed in approximately 33 minutes however with more experience this time may be reduced. CONCLUSION: This technique facilitates and shortens the internal thoracic artery skeletonization procedure and does not cause arterial spasms. Cauterization of the collateral branches with an ultrasonic scalpel is efficient and the use of metallic clips is almost unnecessary. It is a procedure that is easy to reproduce and may be recommended as the first-choice technique for the dissection of the internal thoracic artery.

  15. Los centros de internamiento de extranjeros (CIEs entre control migratorio y control social: una frontera interna y polimorfa

    Barone, Sabina

    2015-12-01

    Full Text Available The Immigration Detention Centres (CIEs operate on foreign immigrants lacking valid residence documents. Here, they are analyzed as part of the new border regime explored in this section. Located within European territory, managed with obscurantist procedures and disrespectful of the Human Rights of the people confined in them, they represent a constant threat of retention and expulsion of foreigners. And they do not just directly affect the newcomers, but also foreign residents, including already rooted immigrants. They are thus «internal borders» creatingin fact a polymorphic social control system, and provoking a widespread fear sensation towards a potential detention. Running against official integration rhetoric, CIEs represent the permanent threat of expulsión. If an anthropologist would have had trouble accessing these centres through standard ethnographic means, the committed ethnography of voluntary work allows the access to the experiences of those locked up there. Knowledge of the point of view of those migrants trapped in CIEs allows for the questioning of the very notion of «irregular immigrant» and the political agenda behind the fight against irregular immigration and the control of population flows. In this vein, the CIEs can be critiziced, as they can be understood as the result of a split in the universality of Human Rights, revealing anunfairly restrictive application of them.Los CIEs son centros de reclusión de personas extranjeras sin documentos de residencia válidos o vigentes y este trabajo los piensa como parte del régimen fronterizo que hemos explorado aquí. Dentro del territorio europeo, con un oscurantista tratamiento de sus procedimientos y del respeto a los derechos humanos de los allí retenidos, los CIEs representan la constante amenaza de retención y expulsión de los extranjeros. Y no sólo sobre la población recién llegada al país, sino también sobre la ya residente, incluyendo a la población extranjera con arraigo. Se trata de «fronteras internas» que crean un sistema de control social polimorfo y provocan una sensación de miedo ante la potencial detención si se incurre en algún supuesto administrativo. Contra las retóricas de integración, los CIEs representan la constante amenaza de expulsión. Si bien los antropólogos no podrían haber accedido al interior de estos espacios de internamiento, la etnografía comprometida del voluntariado nos introduce a las historias de vida de los recluídos. Ello nos permite cuestionar la construcción de la noción de «migrante irregular» y de la agenda política alrededor de la lucha a la migración irregular y el control de los flujos para denunciar la problematicidad de los CIEs que manifiestan una escisión entre el planteamiento universalista de los DDHH y una aplicación injustamente restrictiva de los mismos.

  16. Determinación de la relación de poisson de la guadua angustifolia kunth a partir de procesamientos de imágenes y su relación con la estructura interna.

    Osorio Saraz, Jairo Alexander; Vélez Restrepo, Juan Manuel; CIRO VELÁSQUEZ, HÉCTOR JOSÉ

    2011-01-01

    En esta investigación se propuso determinar los valores de la relación de Poisson para la Guadua angustifolia Kunth, en la cepa y la basa del culmo, además de analizar la incidencia que ejerce la estructura interna en dicha propiedad. Los resultados indicaron que la relación de Poisson depende significativamente de la estructura del material variando entre 0,22 y 0,35 haciéndolo un producto biológico altamente heterogéneo y anisotrópico. Además, los análisis de estructura interna de tejido co...

  17. Tireoidite supurativa aguda com múltiplas complicações

    Izabela Fernandes Alves da Fonseca

    2012-08-01

    Full Text Available A tireoidite supurativa aguda é uma desordem rara, mais frequentemente causada pelo Staphylococcus aureus ou Streptococcus pneumoniae, e atinge particularmente crianças com fístula do seio piriforme. Em adultos, a disseminação por via hematogênica a partir de foco infeccioso em orofaringe ou trato respiratório parece ser o principal mecanismo patogênico. Os sinais e sintomas iniciais da tireoidite aguda são semelhantes aos da faringite aguda e da tireoidite subaguda. Esse fato frequentemente retarda o diagnóstico dessa doença e aumenta o risco de complicações. Relatamos o caso de um paciente masculino de 28 anos, previamente saudável, que, após quadro de amigdalite, apresentou tireoidite aguda complicada por tireotoxicose, volumoso abscesso no lobo direito da tireoide, que se estendia à abertura superior do tórax com desvio da traqueia e compressão de grandes vasos, associado à trombose de veia jugular interna e sepse.

  18. Trombose de artria cartida interna relacionada a trauma de palato em criana Internal carotid artery thrombosis related to trauma of palate in a child

    Fernando de Souza Almeida

    2012-01-01

    Full Text Available OBJETIVO: Relatar um caso de trombose de artria cartida interna secundria relacionada a trauma de palato mole em criana. DESCRIO DO CASO: Criana admitida com quadro de alterao do nvel de conscincia, sonolncia, afasia e hemiplegia direita; tinha antecedente de trauma corto contuso leve em palato mole h oito horas. A investigao tomogrfica evidenciou acidente vascular isqumico secundrio interrupo do fluxo sanguneo em territrio de artria cerebral mdia esquerda. A arteriografia mostrou ocluso da artria cartida interna imediatamente distal sua origem, com aspecto radiolgico de "ponta de lpis", obstruindo o fluxo sanguneo na regio. A paciente foi submetida investigao para doena pr-trombtica e cardaca, contudo, no foi detectada nenhuma alterao. A administrao de enoxaparina em dose teraputica por trs semanas conduziu melhora clnica progressiva. Aps trs semanas de seguimento, a paciente no mostrava sequelas motoras. COMENTRIOS: As leses intraorais so frequentes em crianas e a maioria evolui sem complicaes. A trombose da artria cartida interna uma complicao rara, mas bem documentada destas leses e decorre da compresso do vaso com trombognese localizada. A taxa de mortalidade relatada de 30% e as sequelas ocorrem em 85% dos casos.OBJECTIVE: To describe a child with internal carotid artery thrombosis secondary to trauma of the soft palate. CASE DESCRIPTION: Child presented with altered level of consciousness, drowsiness, aphasia, right hemiplegia, and a history of trauma, with mild concussion of the soft palate eight hours prior to admission. CT scan showed ischemic stroke secondary to interruption of blood flow in the area of the left middle cerebral artery. Arteriography showed occlusion of the carotid artery just distal to its origin, with radiological appearance of "pencil tip", obstructing blood flow in the region. Patient underwent investigation for pro-thrombotic and heart diseases, which was negative. The child received enoxaparin at therapeutic dose for three weeks, showing progressive clinical improvement. After three weeks, the patient did not show motor problems. COMMENTS: Intraoral lesions are common in children, but most of them evolve without complications. However, the internal carotid artery thrombosis is a rare but well documented complication of these lesions and results from the vessel compression with localized thrombogenesis. The mortality rate is about 30%, and sequels are seen in 85% of cases.

  19. Trombose de artria cartida interna relacionada a trauma de palato em criana / Internal carotid artery thrombosis related to trauma of palate in a child

    Fernando de Souza, Almeida; Mrcia Harumi, Hossotani; Juliana Del Grossi, Moura.

    Full Text Available OBJETIVO: Relatar um caso de trombose de artria cartida interna secundria relacionada a trauma de palato mole em criana. DESCRIO DO CASO: Criana admitida com quadro de alterao do nvel de conscincia, sonolncia, afasia e hemiplegia direita; tinha antecedente de trauma corto contuso leve em [...] palato mole h oito horas. A investigao tomogrfica evidenciou acidente vascular isqumico secundrio interrupo do fluxo sanguneo em territrio de artria cerebral mdia esquerda. A arteriografia mostrou ocluso da artria cartida interna imediatamente distal sua origem, com aspecto radiolgico de "ponta de lpis", obstruindo o fluxo sanguneo na regio. A paciente foi submetida investigao para doena pr-trombtica e cardaca, contudo, no foi detectada nenhuma alterao. A administrao de enoxaparina em dose teraputica por trs semanas conduziu melhora clnica progressiva. Aps trs semanas de seguimento, a paciente no mostrava sequelas motoras. COMENTRIOS: As leses intraorais so frequentes em crianas e a maioria evolui sem complicaes. A trombose da artria cartida interna uma complicao rara, mas bem documentada destas leses e decorre da compresso do vaso com trombognese localizada. A taxa de mortalidade relatada de 30% e as sequelas ocorrem em 85% dos casos. Abstract in english OBJECTIVE: To describe a child with internal carotid artery thrombosis secondary to trauma of the soft palate. CASE DESCRIPTION: Child presented with altered level of consciousness, drowsiness, aphasia, right hemiplegia, and a history of trauma, with mild concussion of the soft palate eight hours pr [...] ior to admission. CT scan showed ischemic stroke secondary to interruption of blood flow in the area of the left middle cerebral artery. Arteriography showed occlusion of the carotid artery just distal to its origin, with radiological appearance of "pencil tip", obstructing blood flow in the region. Patient underwent investigation for pro-thrombotic and heart diseases, which was negative. The child received enoxaparin at therapeutic dose for three weeks, showing progressive clinical improvement. After three weeks, the patient did not show motor problems. COMMENTS: Intraoral lesions are common in children, but most of them evolve without complications. However, the internal carotid artery thrombosis is a rare but well documented complication of these lesions and results from the vessel compression with localized thrombogenesis. The mortality rate is about 30%, and sequels are seen in 85% of cases.

  20. Study of Prevalence of Internal Resorption in Periapical Radiography of Anteriors Permanents Tooth Estudio de la Prevalencia de Reabsorcin Interna en Radiografas Periapicales de Dientes Permanentes Anteriores

    Lorena Cssia Gueiros de Arajo

    2009-03-01

    Full Text Available The aim of this study was to evaluate, by the use of clinical and radiographic records, the prevalence of internal resorption in anterior permanent teeth of patients from the Clinic of Specialization in Endodontics of Federal University of Pernambuco, Brazil; related to the period of September of 2001 to June of 2007. 888 medical records from the archives of the clinic were analyzed. Among them 232 referred to anterior teeth. The presence and the location of the resorption were radiographically observed. The obtained results verified that the internal resorption was prevalent in 2.16% of the cases, with 0.86% located in coronal region, 0.44% in root region and 0.86% in both regions. We concluded that, despite of being a pathology of low incidence, the knowledge of it is important to the specialist, in order to provide a reliable diagnose and to plan a suitable treatment, once the negligence in a case of internal resorption in anterior permanent teeth can cause the loss of dental element and functional and esthetic alterations in the patient.El objetivo del estudio fue evaluar, a travs de fichas clnicas y radiolgicas, la prevalencia nacional de reabsorcin interna en los dientes anteriores permanentes de los pacientes con atencin en la Clnica del Diplomado de Endodoncia de la Universidad Federal de Pernambuco, en el perodo entre septiembre de 2001 y junio de 2007. Se analizaron 888 prontuarios de los archivos de la Clnica. De ellos, 232 estaban relacionadas con los dientes anteriores. Se observ radiogrficamente la presencia de reabsorcin y su ubicacin. Los resultados mostraron que la reabsorcin interna fue prevalente en 2,16% de los casos, de los cuales en 0,86% estaba ubicada en la regin coronaria, 0,44% en la raz y 0,86% en ambas regiones. Se concluye que an en caso de una enfermedad con baja incidencia, es importante para el especialista conocerla, haciendo un buen diagnstico y una planificacin para el tratamiento adecuado a la situacin, ya que la de negligencia ante un caso de reabsorcin interna en dientes permanentes anteriores, conduce a la prdida del elemento dental, causando cambios funcionales y estticos para el paciente.

  1. Mapeamento da safena interna com ecocolor Doppler no pré-operatório de cirurgia de revascularização mioc��rdica

    BARROS Fanilda Souto

    1999-01-01

    Full Text Available INTRODUÇÃO: O advento do ecocolor Doppler vascular tornou possível informar o estado anatômico e funcional da safena interna ao cirurgião cardiovascular, no pré-operatório da cirurgia de revascularização miocárdica, sem riscos para o paciente ou para o conduto venoso. O objetivo do estudo foi, juntamente com o cirurgião, avaliar a utilidade do mapeamento da safena interna no pré-operatório. CASUÍSTICA E MÉTODOS: Foram estudados, entre março de 1995 e maio de 1998, 208 extremidades inferiores de 104 pacientes selecionados para cirurgia de revascularização miocárdica. O critério utilizado para a seleção da safena foi a safena patente e o diâmetro maior ou igual a 3,0 mm, utilizando os aparelhos de ultra-sonografia ATL - HDI 3000 e Acuson-Sequóia 512. RESULTADOS: Dentre as 208 extremidades estudadas, 186 (89,4% das safenas preenchiam os critérios e a análise do cirurgião estava de acordo com a descrição do ecocolor Doppler. Dezessete (8,2% não preenchiam os critérios e, em 5 (2,4% ,o exame foi compatível com safenectomia radical. Das 17 safenas consideradas não apropriadas, 2 foram exploradas cirurgicamente, sendo a análise do cirurgião concordante com o ultra-som. CONCLUSÃO: Os autores concluem que o ecocolor Doppler, sendo um método diagnóstico não invasivo, pode ser útil no mapeamento da safena interna no pré-operatório de revascularização miocárdica devido à sua capacidade de identificar e selecionar com segurança o vaso a ser utilizado como conduto vascular, o que permite ao cirurgião cardíaco o planejamento cirúrgico.

  2. Aneurisma de artéria ilíaca interna roto: relato de caso Ruptured internal iliac artery aneurysm: case report

    Cristina Toledo Afonso

    2009-03-01

    Full Text Available Aneurismas isolados da artéria ilíaca interna são raros, acometem 0,1% da população e correspondem a 1% dos aneurismas aorto-ilíacos. Na maioria das vezes, os pacientes são assintomáticos, mas podem apresentar dor abdominal, massa pulsátil no hipogástrio ou na fossa ilíaca, sintomas compressivos urinários, gastrointestinais ou neurológicos. Podem ocasionar quadro de abdome agudo, principalmente quando há ruptura. O diagnóstico precoce dos aneurismas isolados de artéria ilíaca interna é incomum, sendo identificados quando mais volumosos ou rotos, o que aumenta significativamente sua morbimortalidade e torna seu prognóstico mais reservado. Dessa forma, representam um desafio terapêutico. A ligadura cirúrgica tem sido o tratamento mais comum, entretanto a cirurgia endovascular tem mostrado bons resultados, inclusive nos aneurismas rotos. É relatado caso de aneurisma de artéria ilíaca interna isolado roto diagnosticado durante laparotomia para abordagem de abdome agudo.Isolated internal iliac artery aneurysms are rare. They affect 0.1% of the population, and account for 1% of aortoiliac aneurysms. Patients are mostly asymptomatic, yet they can have abdominal pain, pulsatile mass in the hypogastrium or iliac fossa, or urinary, gastrointestinal or neurological compressive symptoms. Such aneurysms are likely to course with an acute abdomen, especially when ruptured. Early diagnosis of isolated internal iliac artery aneurysms is difficult, as they are more easily detected when larger or ruptured, which significantly raises their morbidity and mortality rate and determines a poor prognosis. Therefore, they are a therapeutic challenge. Surgical ligation has been the most common treatment; however, the endovascular approach has presented good outcomes, even in the event of ruptured aneurysms. A case of ruptured isolated iliac artery aneurysm diagnosed during a laparotomy (acute abdomen approach is reported.

  3. Effect of splenectomy and ligature of the left gastric vein on portal hypertensive colopathy in carriers of surgical hepatosplenic schistosomiasis mansoni Efeito da esplenectomia e ligadura da veia gástrica esquerda na colopatia da hipertensão porta na esquistossomose mansônica cirúrgica

    Claudia Rosalí Esmeraldo Justo

    2005-02-01

    Full Text Available PURPOSE: Esophageal variceal sclerotherapy and band ligation seem not to affect the endoscopic findings of Portal Hypertensive Colopathy (PHC of cirrhotic patients. The aim was to assess the effect of splenectomy and ligature of the left gastric vein on the PHC in carriers of hepatosplenic schistosomiasis mansoni who underwent this surgery when they were between 9 and 18 year-old. METHODS: Fourteen patients, mean age of 19.1±3.1 years, were included in the postoperative group (GI. The follow-up was from 1 to 9 years. The preoperative group (GII consisted of nine patients, mean age of 14.0 ± 3.1 years. Full-length colonoscopy was carried out in all patients. Search was made for PHC lesions. RESULTS: Telangiectasy (GI 100% vs GII 100%, increased vascularisation (GI 57.1% vs GII 100%, focal and diffuse hyperemia (GI 14.3% vs GII 66.7%, angiodysplasia (GI 7.1% vs GII 33.3%, and rectal varix (GI 0% vs GII 55.6% were the most frequent findings. It was observed that the patients of this series tended to exhibit fewer hemodynamic manifestations of the PHC after treatment (postoperative versus preoperative - chi2 = 8.155 p = 0.004. CONCLUSION: Splenectomy and ligature of the left gastric vein tend to reduce the abnormal vascular findings of PHC in carriers of hepatosplenic schistosomiasis mansoni.OBJETIVO: Avaliar o efeito da esplenectomia, ligadura da veia gástrica esquerda e auto-implante de tecido esplênico no omento maior, na CHP de jovens portadores de esquistossomose hepatoesplênica, que tinham se submetido a esse procedimento entre 9 e 18 anos. M��TODOS: Quatorze pacientes com média de idade de 19,1±3,1 anos, foram incluídos no grupo pós-operatório (GI, com seguimento de 1 a 9 anos. O grupo pós-operatório (GII consistiu de nove pacientes, média de idade de 14,0 ± 3,1 anos. Colonoscopia completa foi realizada em todos os pacientes. Pesquisaram-se lesões da CHP. RESULTADOS: Telangiectasia (GI 100% vs GII 100%, aumento da vascularização (GI 57,1% vs GII 100%, hiperemia difusa ou focal (GI 14,3% vs GII 66.7%, angiodisplasia (GI 7,1% vs GII 33,3%, e varizes retais (GI 0% vs GII 55,6% foram os achados mais freqüentes. Comparando o grupo pós-operatório versus pré-operatório - chi2 = 8,155 p = 0,004. CONCLUSÃO: Esplenectomia e ligadura da veia gástrica esquerda tendem a reduzir as alterações vasculares da CHP em portadores de esquistossomose hepatoesplênica.

  4. Modelado de motor de combustión interna para predicción de fallas de funcionamiento / Modeling of the internal combustion engine for malfunction prediction

    Muñoz Rodríguez, Alejandro

    2012-01-01

    El presente trabajo presenta un modelo matemático de un motor de combustión interna monocilíndrico que simula las vibraciones producidas en sus anclajes bajo funcionamiento en condiciones normales. Los modelos más simples y analíticos parten de la cinemática plana de movimiento absoluto para el mecanismo, pero deben establecer un modelo dinámico equivalente para la biela que es el eslabón que tiene el movimiento más complejo. Se utilizar ´a la técnica de los gráficos de unión, ampliamente uti...

  5. The strategies at the shop-floor of the Communist Party in Argentina from its beginnings to 1943: cells, factory committees and comisiones internas

    Hernán Camarero

    2015-04-01

    Full Text Available The intention of this paper  is to recover the experience driven by the Communist Party (PC from its creation until the emergence of peronism in the organization of labor movement in the production sites. For years the widespread belief in the historiography was that militancy in the factories start with the peronist union model and installation of comisiones internas. Recent investigations showed extensive basic organizational framework generated by the factory proletariat in the decades prior to1943. In this process were instrumental the left currents and in particular the PC that peaked a specific policy for insertion into the factories and enterprises. The axes that guide our research are: the forms acquired by this militancy, the productive sectors prioritized by the PC and the impact of the party strategies, among others.

  6. Internal Communication at the university. Research to know our audience /La comunicación interna en la universidad. Investigar para conocer a nuestros públicos

    Lic. Arturo Vicente Lázaro; arturo.vicente@ucm.edu

    2009-01-01

    Full Text Available Effective management of internal communcation is a key part to the broader strategic plan of all universities. The current Bologna process and the changes in management clearly require this to be done effectively in order to ensure that we establish the new degrees successfully. Furthermore, this is a complex task, as University is a special environment where socially diverse groups coexist, each with their own demands and expectations. This paper examines internal communications within Universidad Europea Miguel de Cervantes, from their staff and students perspectives and analyses the use of different tools and channels – both physical and technological, the first relating to their location and their perceived effectiveness by the people who use these areas. The sampling method in use is “quota sampling” and the research is based on a survey. The results illustrate that people perceive more when you ask their opinion rather than asking their perceived opinions of others on the same issue. Likewise, opinions regarding the method of communication vary between the different socio-demographic groups included in the study –higher in the case of PDI (Research and Teaching Staff and PAS (Administration and Services Staff–. Finally, the analysis of available means of communication also shows significant differences in terms of public opinon.La gestión adecuada de la comunicación interna en la universidad ocupa un lugar esencial en los planes estratégicos de las universidades. El actual proceso de Bolonia y la gestión del cambio necesita forzosamente de la comunicación interna para asegurar una correcta implantación de las nuevas titulaciones universitarias. La gestión de comunicación interna en las universidades es una tarea compleja, ya que en este ámbito conviven grupos sociológicamente diversos, con demandas y expectativas diferentes. Este trabajo analiza empíricamente la comunicación interna de la Universidad Europea Miguel de Cervantes, entendida desde la percepción de sus públicos, así como del uso que se hace de los diferentes canales y herramientas que están en funcionamiento, entendidas éstas como herramientas físicas y digitales, y relacionando los primeros con el espacio físico en que están situados y su eficacia percibida en los públicos que frecuentan dichos espacios. El método de muestreo responde al muestreo cuotado, y el método de investigación se basa en la encuesta. Los resultados muestran una percepción propia superior frente a la opinión de percepción ajena sobre la imagen general de la universidad en todos los colectivos. De igual modo, la evaluación del estado de la comunicación difiere según los colectivos estudiados –superior en el caso de PDI y PAS–. Finalmente, la evaluación de las herramientas de comunicación disponibles de carácter físico y digital también presenta diferencias importantes en función del público estudiado.

  7. Trombose da arteria carotida interna no curso e doena reumatica: registro de um caso / Trombosis of internal carotid artery in the course of rheumatic disease: a case report

    Pedro F., Moreira Filho; Daniel, Cincinatus; Osvaldo J. M., Nascimento; Marcos R. G. de, Freitas.

    1978-06-01

    Full Text Available relatado o caso de jovem que apresentou, de modo agudo, hemiplegia e hipertemia. O estudo angiogrfico revelou trombose de poro distal da cartida interna e as provas laboratoriais evidenciaram doena reumtica. Os autores fazem referncia endoarterite reumtica provocando ocluso arterial e c [...] omentam o diagnstico deferencial que deve ser feito com acidentes vasculares devidos a embolos oriundos de endocrdio afetado pela afeco reumtica. Abstract in english The case of a 21 years old man with hemiplegia and hyperthermia of sudden onset is reported. The angiographic study showed thrombosis of the distal portion of the internal carotid artery. Laboratorial studies revealed positive rheumatic tests. The authors think that the rheumatic arteritis may be re [...] sponsible for this ischemic cerebral accident. Differential diagnosis with the embolic accidents caused by the rheumatic disease is discussed.

  8. DESEMPEÑO DE UN VEHÍCULO HÍBRIDO Y SU CONTRAPARTE DE COMBUSTIÓN INTERNA BAJO CONDICIONES DE MANEJO DE UNA CIUDAD MEXICANA

    Hilda Lizette MENCHACA TORRE; Alberto MENDOZA DOMÍNGUEZ

    2013-01-01

    La evaluación del desempeño de los vehículos automotores en México es importante por la influencia de sus emisiones en los índices de contaminación atmosférica. Los automóviles híbridos, de reciente introducción al país, representan una oportunidad para disminuir esta contaminación, por lo que es de interés analizarlos. Esta investigación se llevó a cabo con un Civic Híbrido 2006 y un grupo de cuatro Civic de combustión interna convencional. Los resultados mostraron que el Civic Híbrido, en c...

  9. Estimadores de consistencia interna en las investigaciones en salud: el uso del coeficiente alfa / Estimators of internal consistency in health research: the use of the alpha coefficient

    Franciele, Cascaes da Silva; Elizandra, Gonalves; Beatriz Anglica, Valdivia Arancibia; Gisele Graziele, Bento; Thiago Luis da, Silva Castro; Salma Stephany, Soleman Hernandez; Rudney da, Silva.

    2015-03-01

    Full Text Available La produccin acadmica ha aumentado en el rea de la salud, exigiendo cada vez ms calidad en las publicaciones de gran impacto. Una de las formas de considerar la calidad es por medio de procedimientos que aumentan la consistencia del anlisis de los datos, como la confiabilidad, que dependiendo d [...] el tipo de datos, puede ser evaluada por diferentes coeficientes, en especial el coeficiente alfa. Basados en lo anterior, la presente revisin rene sistemticamente artculos cientficos producidos en los ltimos cinco aos, que de manera metodolgica hicieron uso psicomtrico del coeficiente ? como un estimador de consistencia interna y de confiabilidad en procesos de construccin, adaptacin y validacin de instrumentos. La identificacin de los estudios fue realizada sistemticamente en las bases de datos Biomed Central Journals, Google Scholar, Web of Science, Wiley Online Library, Medline via Pubmed, Scielo, Scopus, Journals@Ovid, BMJ y Springer por medio del Portal de Peridicos CAPES, utilizando criterios de inclusin y exclusin. El anlisis de los datos fue realizado por medio de triangulacin, anlisis de contenido y anlisis descriptivo. Se obtuvo que la mayora de los estudios fueron realizados principalmente en Irn (f=3), Espaa (f=2) y Brasil (f=2), estos estudios tuvieron como objetivo testar las propiedades psicomtricas de instrumentos, siendo que ocho estudios utilizaron el coeficiente ? para evaluar la confiabilidad y nueve para evaluar la consistencia interna. Todos los estudios fueron clasificados como investigaciones metodolgicas al analizar sus objetivos. Adicionalmente, cuatro estudios tambin fueron clasificados como correlacionales y uno como descriptivo-correlacional. Se puede concluir que a pesar de que el coeficiente ? es ampliamente utilizado como uno de los principales parmetros para la evaluacin de consistencia interna de instrumentos de medicin del tipo cuestionario en el rea de ciencias de la salud, su uso como estimador de confianza de la metodologa utilizada y consistencia interna, posee algunas crticas que deben ser consideradas. Abstract in english Academic production has increased in the area of health, increasingly demanding high quality in publications of great impact. One of the ways to consider quality is through methods that increase the consistency of data analysis, such as reliability which, depending on the type of data, can be evalua [...] ted by different coefficients, especially the alpha coefficient. Based on this, the present review systematically gathers scientific articles produced in the last five years, which in a methodological manner gave the ? coefficient psychometric use as an estimator of internal consistency and reliability in the processes of construction, adaptation and validation of instruments. The identification of the studies was conducted systematically in the databases BioMed Central Journals, Web of Science, Wiley Online Library, Medline, SciELO, Scopus, Journals@Ovid, BMJ and Springer, using inclusion and exclusion criteria. Data analyses were performed by means of triangulation, content analysis and descriptive analysis. It was found that most studies were conducted in Iran (f=3), Spain (f=2) and Brazil (f=2). These studies aimed to test the psychometric properties of instruments, with eight studies using the ? coefficient to assess reliability and nine for assessing internal consistency. All studies were classified as methodological research when their objectives were analyzed. In addition, four studies were also classified as correlational and one as descriptive-correlational. It can be concluded that though the ? coefficient is widely used as one of the main parameters for assessing internal consistency of questionnaires in health sciences, its use as an estimator of trust of the methodology used and internal consistency has some critiques that should be considered.

  10. Internacionalización de las pymes: análisis de recursos y capacidades internas mediante lógica difusa

    Jorge Aníbal Restrepo Morales

    2015-01-01

    Full Text Available Las pymes del sector textil enfrentan grandes desafíos de internacionalización derivados de la dinámica de la globalización y de la firma de tratados de libre comercio en la última década. Para ello se requiere analizar su capacidad de internacionalización en términos de recursos, habilidades y capacidades para desarrollar estrategias que permitan participar de la nueva dinámica en una forma apropiada. Se propone un sistema de inferencia difuso para modelar estos factores que determinan el éxito en un proceso de internacionalización. Se utilizan variables lingüísticas, extraídas de empresarios, expertos, consultores e investigadores de la materia y, por medio del juicio de expertos, se definen los factores internos que explican la capacidad de internacionalización. El modelo propuesto se aplica por medio de un estudio de caso del clúster textil- confección en Medellín (Colombia. Se obtiene en la ejecución del modelo un índice global particular de 26.7 para las capacidades internas para iniciar un proceso de internacionalización. El resultado obtenido confirma la hipótesis de que las capacidades y recursos de que dispone actualmente el sector analizado no son suficientes para una inserción exitosa en el mercado internacional y, lo más importante, especifica los factores y variables en los que intervenir para mejorar la capacidad interna de internacionalización. Derechos Reservados © 2015 Universidad Nacional Autónoma de México, Facultad de Contaduría y Admi- nistración. Este es un artículo de acceso abierto distribuido bajo los términos de la Licencia Creative Commons CC BY-NC-ND 4.0.

  11. Valdose program: methodologies for dose assessment in internal contamination, 1997 census; Programma valdose: metodologie di valutazione della dose da contaminazione interna, censimento 1997

    Castellani, C.M.; Battisti, P.; Tarroni, G. [ENEA, Centro Ricerche `Ezio Clementel`, Bologna (Italy). Dip. Ambiente

    1998-12-31

    Dose assessment in internal dosimetry needs computational and interpretative tools that allow carrying out, as a first step, an evaluation of intake on the base of bioassay measurements or WBC measurements, and as a second step, dose evaluation on the base of estimated intake. In the frame of the MIDIA Co-ordination (WBC operating in Italy), in the first months of 1997 a census on methodologies for dose evaluation in internal contamination has been proposed. A technical form has been sent to all the WBC Centres allowing an accurate description of modalities used in each centre. 9 out of 17 centres sent the answers to the technical form in time. In this paper all the forms filled in are reported. A careful comparative evaluation of the answers has been made both for routine monitoring and for special monitoring. The various radionuclides present in the Italian reality, calculation methodologies both for intake and dose, hypotheses adopted for date, path and modalities of contaminations are also presented. Proposals for conforming to the methodology in Italy after the introduction of the models following ICRP 60 publication that are the base of the Euratom 96/29 Directive are also discussed. [Italiano] La valutazione di dose in contaminazione interna necessita di strumenti interpretativi che permettano di effettuare in una prima la valutazione dell`intake sulla base delle misure dei campioni biologici o del corpo intero (WBC), ed in una seconda fase la valutazione della dose sulla base dell`intake. All`interno del coordinamento MIDIA dei WBC operanti in Italia e` stato proposto, nel primo trimestre del 1997, un censimento sulle metodologie di valutazione di dose da contaminazione interna. Ai diversi centri e` stato inviato una scheda tecnica che, mediante un particolareggiato schema di domande, aiutava i diversi centri nella esposizione delle modalita` di valutazione di dose che ogni centro segue. 9 au 17 centri WBC operanti al momemnto in Italia hanno inviato la risposta alla scheda tecnica in tempo utile.

  12. Uma experiência de educação profissional no Centro Socioeducativo de Internação: possibilidades e desafios

    Lucilene Sousa Melo

    2014-06-01

    Full Text Available O presente artigo faz parte de uma dissertação de mestrado que está sendo desenvolvida na Universidade Federal Rural do Rio de Janeiro (UFRRJ e apresenta a primeira experiência de Educação Profissional realizado pelo Instituto Federal do Amapá-IFAP com adolescentes que cumprem medida socioeducativa no Centro Socioeducativo de Internação (CESEIN em Macapá. Participaram da pesquisa 03 adolescentes que estavam matriculados no curso de Formação Inicial e Continuada Horticultor Orgânico. Os dados foram coletados através de entrevistas e questionários. Os resultados demonstraram que apesar dos desafios e dificuldades encontradas na dinâmica do cotidiano do Centro Socioeducativo como: fugas, desinteresse, falta de motivação e entre outros, e ainda por essa população encontra-se em plena intensidade emocional e transformações biológicas, e incluindo a privação de liberdade é possível sim, realizar atividades voltadas para a formação profissional. As ações educativas desenvolvidas pelo IFAP no âmbito da medida socioeducativa de internação preveem a garantia ao direito à educação profissional através de um espaço que sirva de transformação social, no qual adolescentes que vivem à margem da sociedade, com baixa escolaridade, usuários de drogas e com reiterações nos delitos possam construir novas significações sociais através da intervenção escolar. Normal 0 21 false false false PT-BR X-NONE X-NONE

  13. Adaptação e avaliação da consistência interna do Postpartum Thoughts and Behavior Checklist

    Laila da Camara Lima Kurtinaitis

    2011-01-01

    Full Text Available OBJETIVO: Traduzir, adaptar e avaliar a aplicabilidade, além de obter dados acerca da consistência interna do Postpartum Thoughts and Behavior Checklist. Esse instrumento foi elaborado especificamente para uso durante o pós-parto e identifica a presença e o conteúdo dos pensamentos intrusivos em relação ao bebê, assim como as estratégias de neutralização utilizadas após esses pensamentos. MÉTODO: A tradução do instrumento para o português foi feita por dois profissionais de saúde mental bilíngues. Posteriormente, houve uma retrotradução realizada por dois professores de inglês. A versão retrotraduzida foi avaliada pelo autor da escala e aplicada em 91 puérperas usuárias de um serviço da rede pública de saúde. RESULTADOS: A versão traduzida do Postpartum Thoughts and Behavior Checklist foi considerada equivalente ao instrumento original em inglês. As participantes não apresentaram dificuldades na compreensão dos itens do checklist. Sua consistência interna, medida pelo alfa de Cronbach, foi de 0,822. CONCLUSÃO: A versão em português do Postpartum Thoughts and Behavior Checklist pode ser considerada adequada para o uso na população estudada para avaliar pensamentos obsessivos em relação ao bebê durante o puerpério e possíveis estratégias de neutralização desses pensamentos. O checklist pode ainda trazer contribuições significativas para a prática clínica.

  14. EXPLORANDO LA DISTINCIN POLTICA INTERNA-POLTICA INTERNACIONAL: UN ESTADO DEL ARTE DE LA DISCUSIN / EXPLORING THE INTERNAL POLICY - INTERNATIONAL POLICY DISTINCTION: STATE OF THE ART ABOUT THE DEBATE / EXPLORANDO A DISTINO POLTICA INTERNA - POLTICA EXTERIOR: UM ESTADO DA ARTE DA DISCUSSO

    Gabriel, Jimnez Pea.

    2015-07-01

    Full Text Available Para alguns tericos a conduta dos Estados est determinada principalmente por suas caractersticas internas. Em oposio, outros argumentam que o comportamento do Estado moldado pelo lugar que ocupam eles no sistema internacional. O propsito aqui abranger esta discusso e elaborar um estado da [...] arte sobre ela na Relaes Internacionais como cincia. Dado que o corpo literrio que explora a interao poltica interna - poltica internacional vasto, para aborda-lo o reconstitui-lo, geralmente se acudi a supostos o lugares comuns, cinco dos quais sero problematizados neste artigo, procurando mostrar como produzem-se de acordo com os desenvolvimentos tericos que tem construdo nos ltimos anos sobre este distino. Abstract in spanish Para algunos tericos la conducta de los Estados est determinada principalmente por sus caractersticas internas. En contraposicin, otros argumentan que el comportamiento estatal est moldeado por el lugar que ocupan estos en el sistema internacional. El propsito aqu es abordar esta discusin y [...] elaborar un estado del arte sobre esta distincin en las Relaciones Internacionales como ciencia. Dado que el cuerpo literario que explora la interaccin poltica interna-poltica internacional es muy vasto, para abordarla o reconstruirla generalmente se acude a supuestos o lugares comunes, cinco de los cuales sern problematizados en este artculo, buscando mostrar cmo se producen de acuerdo con los desarrollos tericos que se han construido en los ltimos aos sobre esta distincin. Abstract in english For some theorist the conduct of states is mainly determined by its domestic features. In contrast others argue that state behavior is shaped by the place they occupy in the international system. The purpose here is to address this discussion and make a state of the art of this discussion in the Int [...] ernational Relations as a science. Given that the literary body that explores the internal - international political interaction is too extensive, to deal with o build it, generally turn to assumptions or common ideas, five of them will be problematize in this paper, looking for how it been produced, according to the theoretical development that have built in the last years about this discussion.

  15. Ligadura da veia porta associada à bipartição do fígado para hepatectomia em dois estágios (ALPPS: experiência brasileira Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS: the Brazilian experience

    Orlando Jorge Martins Torres

    2013-03-01

    Full Text Available RACIONAL: Insuficiência hepática pós-operatória devido à remanescente hepático pequeno tem sido complicação temida em pacientes que são submetidos à ressecção hepática extensa. A ligadura da veia porta associada à bipartição do fígado para hepatectomia em dois estágios (ALPPS foi desenvolvida recentemente com a finalidade de induzir rápida e significante regeneração do fígado para pacientes em que o tumor é previamente considerado irressecável. OBJETIVO: Apresentar a experiência brasileira com o ALPPS. MÉTODO: Foram analisados 39 pacientes submetidos ao procedimento ALPPS em nove hospitais. Ele foi realizado em duas etapas. A primeira operação consistiu em ligadura do ramo direito da veia porta e bipartição hepática. Na segunda, os ramos direito da artéria hepática, via biliar e veia hepática foram ligados e o lobo hepático direito estendido foi removido. Foram 22 pacientes do sexo masculino (56,4% e 17 do feminino (43,6%. A média de idade foi 57,3 anos (variando de 20 a 83 anos. RESULTADOS: A indicação mais comum foi metástase hepática em 32 pacientes (82,0%, seguida por colangiocarcinoma em três pacientes (7,7%. Dois morreram neste intervalo e não foram submetidos à segunda operação. O intervalo médio da primeira para a segunda operação foi de 14,1 dias (variando de 5-30 dias. O volume do segmento lateral esquerdo apresentou aumento de 83% (variando de 47-211,9%. Morbidade significante foi observada em 23 pacientes (59,0%. A mortalidade foi de 12,8% (cinco pacientes. CONCLUSÃO: O procedimento ALPPS permite ressecção hepática em pacientes com lesões consideradas previamente irressecáveis por induzir rápida hipertrofia do fígado evitando a insuficiência hepática na maioria dos pacientes. Porém ainda apresenta elevada morbidade e mortalidade.BACKGROUND: Postoperative liver failure consequent to insufficiency of remnant liver is a feared complication in patients who underwent extensive liver resections. To induce rapid and significant hepatic hypertrophy, associating liver partition and portal vein ligation for staged hepatectomy (ALPPS has been recently developed for patients which tumor is previously considered unresectable. AIM: To present the Brazilian experience with ALPPS approach. METHOD: Were analyzed 39 patients who underwent hepatic resection using ALPPS in nine hospitals. The procedure was performed in two steps. The first operation was portal vein ligation and in situ splitting. In the second operation the right hepatic artery, right bile duct and the right hepatic vein were isolated and ligated. The extended right lobe was removed. There were 22 male (56.4% and 17 female (43.6%. At the time of the first operation, the median age was 57.3 years (range: 20-83 years. RESULTS: The most common indication was liver metastasis in 32 patients (82.0%, followed by cholangiocarcinoma in three (7.7%. Two patients died (5.2% during this period and did not undergo the second operation. The mean interval between the first and the second operation was 14.1 days (range: 5-30 days. The volume of the left lateral segment of the liver increased 83% (range 47-211.9%. Significant morbidity after ALPPS was seen in 23 patients (59.0%. The mortality rate was 12.8% (five patients. CONCLUSION: The ALPPS approach can enable resection in patients with lesions previously considered unresectable. It induces rapid liver hypertrophy avoiding liver failure in most patients. However still has high morbidity and mortality.

  16. Estudo sobre a influência de variáveis meteorológicas em internações hospitalares em Maceió-AL, durante o período 1998 a 2006

    Daniel dos Santos

    2014-09-01

    Full Text Available Foram utilizados dados de insolação, pressão atmosférica, velocidade do vento, temperatura do ar, umidade relativa do ar e precipitação pluviométrica de valores médios mensais do período de 1998 a 2006, de Maceió, objetivando identificar a influência destas variáveis meteorológicas nas internações hospitalares por asma, leptospirose, insuficiência cardíaca, esquistossomose e bronquite aguda. Determinaram-se os coeficientes de internações mensais em hospitais públicos de Maceió, relacionando-os com as variáveis estudadas no período estudado. Calculou-se o coeficiente de correlação de Pearson (r e coeficiente de determinação (r² das variáveis meteorológicas, para saber, o máximo que estes explicam as internações estudadas. O resultado sugere que houve influência das variáveis meteorológicas nos casos de internações por asma, com r² (% de 0% a 9%, bronquite o r² foi de 29% a 55%, para esquistossomose 15% a 45%, insuficiência cardíaca 0% a 11% e leptospirose 14% a 79% .

  17. Viorella Manolache (ed., Centru şi margine la Marea Mediterană. Filosofie politică şi realitate internaţională (Bucharest: Editura ISPRI, 2009

    Henrieta Serban

    2013-03-01

    Full Text Available Review of the book by Viorella Manolache (ed., Centru şi margine la Marea Mediterană. Filosofie politică şi realitate internaţională, Editura ISPRI, 2009, ISBN 978-973- 7745- 38-5, 416 pp.

  18. CONDICIONANTES DE LAS GRIETAS INTERNAS DENTRO DE LOS ANILLOS DURANTE EL SECADO DE PINO RADIATA SOME FACTORS AFFECTING THE WHITING-RING INTERNAL CHECKING DURING DRYING OF RADIATA PINE

    Jos VERA SEPULVEDA

    2007-01-01

    Full Text Available Se estudian las grietas internas dentro de los anillos de madera inicial durante el secado industrial del pino radiata. Se determina el porcentaje de las grietas internas y se analizan algunos factores condicionantes de las grietas internas durante el secado industrial a temperaturas convencionales. Los ensayos de secado a temperaturas convencionales son realizados en un horno convectivo de 150 m de capacidad, operando en una planta industrial de la Octava Regin (Chile. El diseo experimental incluye como factores variables, el sitio de procedencia de la madera (arcilla, arena, el tipo de madera (central, lateral y transicin y el tipo de corte (radial, tangencial y mixto. Los resultados indican que el porcentaje de grietas internas vara entre 1 y 18 % y que el sitio de procedencia de la madera y el tipo de madera condicionan significativamente el porcentaje de grietas internas durante el secado industrial a temperaturas convencionales del pino radiataThe internal checking during the industrial drying of radiata pine is studied. The percentage of internal checking is determined and some factors influencing the internal checking are analyzed during the industrial drying at conventional temperatures. The runs are made in a 150 m capacity dry kiln in an industrial plant of the Eighth Region (Chile. The experimental design includes as variables, the origin site of the wood (clay, sand, the wood localization (central-wood, lateral-wood and transition-wood and the type of cut (radial, tangential and mixed. The results indicate that the percentage of internal checking varies between 1 and 18% and that the origin site of the wood and the wood localization significantly condition the percentage of internal checking during the radiata pine industrial drying at conventional temperatures

  19. Perfil de formacin del posgrado en Medicina Interna en Colombia: Investigacin realizada por el Comit de Educacin (2004-2006) de la Asociacin Colombiana de Medicina Interna / Internal medicine post-graduate training profile in Colombia: Research carried out by the Education Committee (2004-2006) of the Colombian Association of Internal Medicine

    Juan Carlos, Velsquez; Anlida Elizabeth, Pinilla; Alfredo, Pinzn; Diego, Severiche; Rodolfo Jos, Dennis; Mara Nelly, Nio de Arboleda.

    2008-06-01

    Full Text Available Objetivo: determinar el perfil de formacin del residente de Medicina Interna en Colombia. Mtodo: estudio descriptivo, de corte transversal, desarrollado a partir de encuestas a los programas de posgrado de Medicina Interna activos al ao 2005. Resultados: diecisiete de 21 programas activos respond [...] ieron la encuesta. La duracin del posgrado de Medicina Interna en Colombia es de tres aos. El perfil del internista que se pretende formar es el de un mdico con una visin holstica, de gran preparacin cientfica, con profundo respeto por el paciente y su familia. La actividad asistencial se dedica en 69% del tiempo al paciente hospitalizado y en 31% al ambulatorio. Especialidades como cardiologa, neumologa, nefrologa, neurologa, endocrinologa, reumatologa y gastroenterologa son obligatorias en el 100% de los programas, mientras que dermatologa, oncologa y geriatra lo son slo para el 71%, 43% y 29% respectivamente. Entre 2002 y 2005, los programas encuestados graduaron a 203 internistas. Cerca de 50% de ellos hoy en da ejercen la Medicina Interna, mientras que 45% han optado por una subespecialidad. Hasta 2005 haban egresado aproximadamente 1.942 internistas en Colombia. Conclusiones: la arquitectura de los programas de posgrado de Medicina Interna en Colombia es la tradicional y en su mayora se desarrolla a la cabecera del paciente, apoyndose adems en espacios de revisin temtica complementarios. Como vacos se identifican la baja vinculacin de los docentes a la nmina universitaria, la escasa formacin pedaggica de los mismos y la baja preparacin del residente en temas como el cuidado paliativo, geritrico y oncolgico, entre otros. Se plantean seis recomendaciones generales tendientes a mejorar los programas, y su relacion con la ACMI. Abstract in english Objective: determining the training profile of the Internal Medicine residents in Colombia. Method: cross sectional descriptive trial, developed according to surveys about the post-graduate programs in Internal Medicine active up to 2005. Results: 17 out of 21 of those participating in active progra [...] ms answered the survey. The time of the post-graduate program in Internal Medicine is three years. The internist to be trained should be a physician with a holistic vision, with an excellent scientific background with profound respect for the patient and the patients family. 69% of his (or her) activity is dedicated to the patients admitted in the hospital and 31% to day care patients. Specialties such as cardiology, pneumology, nephrology, neurology, endocrinology, rheumatology and gastroenterology are obligatory in 100% of the programs, whereas dermatology, oncology and geriatrics are only for 71%, 43% and 29% respectively. Between 2002 and 2005, 203 internist physicians graduated in the program. Around 50% of them practice internal medicine today, while 45% have chosen a sub-specialty. Until 2005 approximately 1942 internists have been graduated in Colombia. Conclusions: the Internal Medicine post graduate programs architecture in Colombia is the traditional one and in the majority of cases is carried out at the patients bedside, with the additional support of complementary thematic revisions. As gaps are identified the low involvement of the teachers with the university payroll, the lack of pedagogic training of the same, and the poor training of residents in palliative, geriatrics and oncology care, among others. There are some general recommendations to improve the programs and the relationship with the ACMI. (Colombian Association of Internal Medicine).

  20. Estudo das internações hospitalares por pneumoconioses no Brasil, 1984-2003 Hospital admissions due to pneumoconioses in Brazil, 1984-2003

    Hermano Albuquerque de Castro

    2005-06-01

    Full Text Available INTRODUÇÃO: pneumoconiose reúne um conjunto de doenças respiratórias conhecidas pelo agente principal causador, como silicose, asbestose, talcose, beriliose e outras. A incidência, possivelmente, deve ser elevada entre os expostos, mas não há informações epidemiológicas referentes a séries históricas sobre as internações hospitalares nas diversas regiões do país. OBJETIVO: analisar as internações hospitalares por pneumoconiose no período entre 1984 e 2003 em todo o território nacional. CASUÍSTICA E MÉTODO: informações de morbidade foram recolhidas, descritas e analisadas a partir do Sistema de Internação por AIH do DATASUS, Centro Nacional de Epidemiologia do Ministério da Saúde, período de 1984 a 2003, englobando todas as regiões do Brasil e seus Estados. Foram utilizadas listas do CID-9 (1984-1997 e CID-10 (1998-2003. RESULTADOS: o Brasil apresentou entre 1984 e 1991 taxas elevadas de internações em todas as regiões, com tendência de crescimento e uma posterior redução após esta data. A mediana das internações para o período entre 1984 e 1991 foi maior na região Centro-Oeste e menor na região Norte. No segundo período, entre 1992 e 2003, verificou-se uma modificação com uma menor mediana na região Nordeste e maior na região Sul. DISCUSSÃO: A diferença encontrada entre os dois períodos pode ser explicada pelos critérios diagnósticos utilizados nestes períodos e a forma como era coletada a informação. As diferenças entre as regiões provavelmente refletem os processos de trabalhos locais e o acesso dos trabalhadores aos serviços de saúde. CONCLUSÃO: Os dados mostram que são necessárias ações de controle e prevenção dessas doenças no ambiente de trabalho. As pneumoconioses são um problema importante de Saúde Pública, onde os números ainda não refletem adequadamente o problema. Certamente os coeficientes se forem calculados sobre a população efetivamente exposta revelarão doenças de elevadas morbidade.INTRODUCTION: pneumoconiosis represents a set of respiratory illnesses, such as silicosis, asbestosis, talcosis, beriliosis and others, which are known by their main causal agent. Its incidence is probably high among exposed workers, but there is no epidemiological information such as historical series on hospitalizations in the several areas of the country. OBJECTIVE: to analyze hospital admissions due to pneumoconiosis in the period between 1984 and 2003 in all the domestic territory. METHOD: morbidity information from the AIH Hospitalization System of DATASUS (National Epidemiology Center of the Ministry of Health was collected, described and analyzed, for the period between 1984 and 2003, including all Brazilian regions and States. IDC-9 (1984-1997 and ICD-10 (1998-2003 criteria were used. RESULTS: Brazil presented a growth trend in hospital admissions between 1984 and 1991 with high rates of hospitalizations in all areas, followed by a reduction in the period between 1992 and 2003. The median of admissions for the period between 1984 and 1991 was higher in the Center-West region and lower in the North region. In the second period, between 1992 and 2003, there was a change, with a lower median in the Northeast and higher rates in the South region. DISCUSSION: The difference between the two periods can be explained by the diagnostic criteria used in these periods and by the way information was collected. The differences among regions probably reflect local work processes and the access of workers to health services. CONCLUSION: The data show that actions to control and prevent these illnesses in the work environment are necessary. Pneumoconiosis is an important Public Health problem whose numbers still do not adequately reflect the problem. If coefficients are calculated on the population effectively exposed, they will certainly disclose high morbidity illnesses.

  1. Estudo das internações hospitalares por pneumoconioses no Brasil, 1993-2003 Hospital admissions due to pneumoconiosis in Brazil, 1993-2003

    Hermano Albuquerque de Castro

    2007-09-01

    Full Text Available Possivelmente, a incidência de pneumoconiose deve ser elevada entre os expostos, mas não há informações epidemiológicas referentes a séries históricas sobre as internações hospitalares nas diversas regiões do país. OBJETIVO: Estudar a freqüência e distribuição dessa doença no Brasil e suas unidades federadas, através de levantamento das internações hospitalares por pneumoconiose no período entre 1993 e 2003, e discutir as possibilidades de estas internações estarem relacionadas ao processo de trabalho de cada região. MATERIAL E MÉTODOS: Informações de morbidade por pneumoconiose foram recolhidas, descritas e analisadas a partir do Sistema de Informação das Internações Hospitalares do SUS e do IBGE, para população acima de 15 anos, distribuídas por Estados e no Brasil no período de 1993 a 2003. Foram utilizadas listas da CID-9 (1993-1997 e da CID-10 (1998-2003. RESULTADOS: Observou-se uma predominância dos Estados do Sul e Sudeste, demonstrando uma correlação direta com o processo de trabalho e o acesso dos trabalhadores aos serviços de saúde. DISCUSSÃO: Os dados permitiram identificar uma diferença entre os resultados anteriores e, após 1998, com a mudança da CID 9 para a CID 10, indicando uma relação entre as modificações de critérios diagnósticos e na forma de coleta dos dados primários pelo SUS. CONCLUSÃO: A distribuição das internações é heterogênea e provavelmente reflete o vértice de uma pirâmide invertida do total de casos que deve ocorrer, de fato, entre os trabalhadores brasileiros. Seu enfrentamento possibilita a aproximação da real situação epidemiológica, contribuindo para a orientação de medidas profiláticas de redução dos riscos e preparo do sistema assistencial.The incidence of pneumoconiosis is probably high among exposed workers, but there is no epidemiological information such as a historical series of hospitalizations in the several areas of the country. OBJECTIVE: to study the frequency and distribution of this disease, in Brazil and its states, through the survey of hospital admissions due to pneumoconiosis in the period between 1993 and 2003, and to discuss the possibilities that these admissions were related to the work processes of each region. METHODS: pneumoconiosis morbidity information was collected from the Hospital Admission Information System of SUS and IBGE (Brazilian Institute of Geography and Statistics, described and analyzed, for the population over 15 years of age in the period between 1993 and 2003, distributed per state and Brazil in the period between 1993 and 2003. ICD-9 (1993-1997 and ICD-10 (1998-2003 were used. RESULTS: a predominance of the states of the South and Southeast was observed, showing a correlation with work processes and access of workers to healthcare. DISCUSSION: The data permitted identifying a difference between the data before and after 1998, which corresponds to the change from ICD-9 to ICD-10, thus indicating a correlation between changes in diagnostic criteria and the form of collecting primary data by the SUS. CONCLUSION: The distribution of hospital admissions is heterogeneous and this possibly reflects the vertex of an inverted pyramid of the total of cases that should in fact occur among Brazilian workers. Facing the situation makes it possible to approach the actual epidemiological status, and thus contribute to the orientation of prophylactic and risk-reduction measures and preparation of the health system.

  2. Epidemiologia de internações por doença falciforme no Brasil Epidemiology of sickle cell disease hospital admissions in Brazil

    Monique Morgado Loureiro

    2005-12-01

    Full Text Available OBJETIVO: A doença falciforme é uma enfermidade hereditária que afeta principalmente a população negra. O estudo teve por objetivo analisar as internações devido às complicações da doença, com enfoque nos aspectos epidemiológicos e clínicos. MÉTODOS: A população estudada foi constituída de 9.349 pacientes com diagnóstico de doença falciforme internados em hospitais da Bahia, Rio de Janeiro e São Paulo, no período de 2000 a 2002. Utilizaram-se os dados do Sistema de Internações Hospitalares do Sistema Único de Saúde. As variáveis respostas foram o óbito e o tempo médio de permanência hospitalar. As covariáveis foram o sexo, a idade, o tipo de admissão e a natureza jurídica do hospital. As proporções foram comparadas utilizando-se o teste qui-quadrado ou de Fischer; e para as variáveis contínuas, foi utilizado o teste Mann-Whitney ou Kruskall-Wallis. RESULTADOS: A mediana de idade variou de 11,0 a 12,0 anos e cerca de 70% das internações foram abaixo dos 20 anos. A mediana de dias de permanência hospitalar variou com a idade e o tipo de admissão. O tipo de admissão mais freqüente foi pela emergência (65,6 a 90,8%. Foi observada maior letalidade hospitalar entre adultos. A mediana da idade do óbito foi baixa (26,5 a 31,5 anos. CONCLUSÕES: Os resultados confirmaram a alta morbidade na população jovem e evidenciaram predominância de óbitos entre adultos jovens.OBJECTIVE: Sickle cell disease is a hereditary disease, which affects mainly the black population. The aim of the present study was to analyze hospital admissions due to acute events resulting from sickle cell disease, at the epidemiological and clinical levels. METHODS: The study population included 9,349 patients with sickle cell disease admitted to hospitals in Bahia, Rio de Janeiro, and Sao Paulo, between 2000 and 2002. The national hospital database of the Brazilian Healthcare System was used. Response variables were death and mean duration of hospital admission. Covariables included sex, age, type of admission, and hospital legal status. Proportions were compared using Chi-square or Fischer tests; for continuous variables, the Mann-Whitney or Kruskall-Wallis tests were used. RESULTS: Median age ranged between 11.0 and 12.0 years, and 70% of admissions were of patients below age 20 years. Length of stay varied with age and type of admission. Emergency rooms were the most frequent form of admission (65.6 to 90.8%. Mortality was higher among adults. Median age of death was low (26.5 to 31.5 years. CONCLUSIONS: Our results confirm the high morbidity among youngsters and show a predominance of death among young adults.

  3. Construcción de un péndulo de torsión para la medida de la fricción interna a bajas temperaturas

    San Juan, J. M.

    2001-04-01

    Full Text Available In this work we describe the assembly, operation and specifications of an inverted torsion pendulum designed to measure internal friction at low temperatures (from 4.2 K to 500 K. The high precision mechanics allow us to obtain internal friction spectra with low levels of noise from amplitudes as small as 2x10-7. The inertia components of the pendulum have been built with specific materials, so that the resonance frequency of the pendulum can be changed within two orders of magnitude (0.1-10 Hz. In addition, the sample can be in situ deformed at any temperature and can be inserted into the pendulum at liquid nitrogen temperature. The operation of the pendulum, all the control processes and data acquisition are completely automated.

    En el presente trabajo se describe el montaje, funcionamiento y especificaciones de un péndulo de torsión invertido que permite realizar ensayos de fricción interna desde 4,2 K hasta 500 K. La sección mecánica de la nueva instalación es de alta precisión y la medición de la fricción interna se consigue efectuar con niveles de ruido muy bajos a partir de amplitudes tan pequeñas como 2x10-7. Los miembros de inercia del péndulo se han construido con materiales específicos, de modo que la frecuencia de resonancia pueda variarse en dos órdenes de magnitud (0.1-10 Hz. Por otro lado, la muestra puede deformarse in situ a cualquier temperatura y puede montarse dentro del péndulo a la temperatura del nitrógeno líquido. El funcionamiento del péndulo y todos los procesos de control y adquisición de datos están completamente automatizados.

  4. DESEMPEÑO DE UN VEHÍCULO HÍBRIDO Y SU CONTRAPARTE DE COMBUSTIÓN INTERNA BAJO CONDICIONES DE MANEJO DE UNA CIUDAD MEXICANA

    Hilda Lizette MENCHACA TORRE

    2013-01-01

    Full Text Available La evaluación del desempeño de los vehículos automotores en México es importante por la influencia de sus emisiones en los índices de contaminación atmosférica. Los automóviles híbridos, de reciente introducción al país, representan una oportunidad para disminuir esta contaminación, por lo que es de interés analizarlos. Esta investigación se llevó a cabo con un Civic Híbrido 2006 y un grupo de cuatro Civic de combustión interna convencional. Los resultados mostraron que el Civic Híbrido, en condiciones reales de manejo en Monterrey, México, tiene un rendimiento promedio 31% mayor al de su contraparte de sólo combustión interna (16.5 km/L vs. 11.9 km/L. Los factores de emisión de esta nueva tecnología también fueron menores que los de un vehículo convencional similar en condiciones de ciudad. Por ejemplo, en conducción en paradas frecuentes, el Civic H íbrido tuvo una emisión de 191.84 g/km de CO 2 , 0.21 g/km de CO, 0.02 g/km de hidrocarburos no quemados (HC y 0.006 g/km de NO X mientras el automóvil convencional produjo 308.14 g/km, 0.79 g/km, 0.12 g/km y 0.11 g/km de cada contaminante, respectivamente. Los resultados sugieren que, considerando típicos los resultados para cada tecnología aquí obtenidos, la sustitución hipotética de autos convencionales por tecnología híbrida podría reducir las emisiones de vehículos ligeros, en el AMM, hasta 37.7% de CO 2 , 78.0% para el CO, 66.7% para los HC y 93.3% en los NO X . Esto señala que la tecnología híbrida contribuiría en abatir los niveles de concentraciones de contaminantes atmosféricos en el AMM.

  5. DESEMPEÑO DE UN VEHÍCULO HÍBRIDO Y SU CONTRAPARTE DE COMBUSTIÓN INTERNA BAJO CONDICIONES DE MANEJO DE UNA CIUDAD MEXICANA

    Hilda Lizette MENCHACA TORRE

    2013-01-01

    Full Text Available La evaluación del desempeño de los vehículos automotores en México es importante por la influencia de sus emisiones en los índices de contaminación atmosférica. Los automóviles híbridos, de reciente introducción al país, representan una oportunidad para disminuir esta contaminación, por lo que es de interés analizarlos. Esta investigación se llevó a cabo con un Civic Híbrido 2006 y un grupo de cuatro Civic de combustión interna convencional. Los resultados mostraron que el Civic Híbrido, en condiciones reales de manejo en Monterrey, México, tiene un rendimiento promedio 31% mayor al de su contraparte de sólo combustión interna (16.5 km/L vs. 11.9 km/L. Los factores de emisión de esta nueva tecnología también fueron menores que los de un vehículo convencional similar en condiciones de ciudad. Por ejemplo, en conducción en paradas frecuentes, el Civic Híbrido tuvo una emisión de 191.84 g/km de CO2, 0.21 g/km de CO, 0.02 g/km de hidrocarburos no quemados (HC y 0.006 g/km de NOX mientras el automóvil convencional produjo 308.14 g/km, 0.79 g/km, 0.12 g/km y 0.11 g/km de cada contaminante, respectivamente. Los resultados sugieren que, considerando típicos los resultados para cada tecnología aquí obtenidos, la sustitución hipotética de autos convencionales por tecnología híbrida podría reducir las emisiones de vehículos lige- ros, en el AMM, hasta 37.7% de CO2, 78.0% para el CO, 66.7% para los HC y 93.3% en los NOX. Esto señala que la tecnología híbrida contribuiría en abatir los niveles de concentraciones de contaminantes atmosféricos en el AMM.

  6. Recanalização espontânea tardia de carótida interna: relato de caso Late spontaneous recanalization of internal carotid artery: case report

    Glauco Fernandes Saes

    2007-09-01

    Full Text Available A recanalização espontânea tardia da carótida interna é um evento incomum e pouco estudado. Os autores relatam o caso de paciente de 73 anos, masculino, hipertenso, com antecedente de acidente vascular cerebral há 3 anos, com seqüela motora e sensitiva em membro superior direito, apresentando ao mapeamento dúplex e arteriografia oclusão total da carótida interna. Evoluiu após 2 anos com novos episódios de ataques isquêmicos transitórios de repetição. Submetido a novos exames de imagem para avaliação da circulação cerebral extra e intracraniana, evidenciou-se recanalização do vaso, com estenose severa. Foi realizada endarterectomia de carótida esquerda, sem intercorrências. Paciente evoluiu sem novos episódios após 1 mês de seguimento. Considerando a raridade do caso e a parca literatura sobre recanalização tardia de carótida, passível de reparo cirúrgico, optamos pela apresentação do caso enfocando a importância do acompanhamento de oclusões carotídeas.Late spontaneous recanalization of internal carotid artery is an unusual event that has received little attention. The authors report a case of a 73-year-old male patient, hypertensive, with previous history of cerebral vascular accident 3 years ago, with sensorimotor sequela in the right upper limb. Duplex scanning and arteriography showed total occlusion of the internal carotid artery. The patient progressed after 2 years with new episodes of recurrent transient ischemic attacks. When submitted to new imaging examinations to assess extra- and intracranial circulation, vessel recanalization was demonstrated, with severe stenosis. Left carotid endarterectomy was uneventfully performed. The patient progressed without new episodes after a 1-month follow-up. Considering the case rarity and the lack of literature on late carotid artery recanalization that can be surgically repaired, we decided to present this case focusing on the importance of following carotid artery occlusions.

  7. Caracterización de recubrimientos Ni-P depositados por reducción química autocatalítica en superficies internas

    Porcayo-Calderón, J.

    1995-08-01

    Full Text Available Electroless nickel deposition with sodium hypophosphite forms a Ni-P amorphous deposit with 4 to 12 % (in mass P content. The corrosion resistance of this kind of coating depends on phosphorus content, and the phosphorus content depends on the operational conditions of the bath. Usually, this coatings are deposited by total immersion of the part, but when it is wished to coat only internal surfaces (as in tubes, it is necessary to recirculate the electroless nickel solution through the tube, in order to prevent the external surface from coating. This work shows the results of the characterization of electroless coatings deposited to protect internal surfaces. Based on this study we can say that it is possible to coat internal surfaces by this technique, and that the flow regimen does not affect the coating phosphorus content; on the other hand, the deposition rate and morphological characteristics are affected.

    El níquel depositado por reducción química autocatalítica con hipofosfito forma un depósito amorfo de Ni-P con un contenido de fósforo entre el 4 y el 12 % en masa. Su resistencia a la corrosión depende de la cantidad de fósforo codepositado, y éste, a su vez, de las condiciones de operación del baño niquelante. Normalmente, este tipo de recubrimientos se aplica por inmersión total de la pieza, pero, cuando se desea proteger selectivamente la superficie interna (p. ej., en el caso de tuberías es necesario recircular la solución niquelante y evitar que la superficie externa se niquele. Este trabajo presenta los resultados del estudio y caracterización de la aplicación de este tipo de recubrimientos para la protección de la superficie interna de las tuberías. Los resultados muestran que es posible proteger dicha superficie por medio de esta técnica y que el régimen de flujo no tiene efecto significativo alguno sobre el contenido de fósforo del recubrimiento, aunque sí lo tiene sobre las caracter��sticas morfológicas y su velocidad de deposición.

  8. Agriculture in the plan change to build peace. An internal critique El agro en el plan Cambio para construir la paz. Una crítica interna

    Rivera Carlos Fernando

    1999-06-01

    Full Text Available This article presents the nature, bases, and coherence requirements of a plan, in order to specify the methodological criteria of its internal critique of the agricultural chapter. The examination of its diagnosis leads to a different diagnosis, which is inferred by the objective of "integrating the rural sector": the persistence of the agrarian problem, expressed in a bimodal structure, polarized into 'the economic' and 'the social'. The plan's objective reveals a long-term vision: to
    contribute to the solution of the agrarian problem. Thus, the policies differentiate between the advanced entrepreneurial and peasant sectors, for which it designs different strategies which assign different roles for the state: to facilitate socioeconomic processes for the former, and to promote rural development for the latter. The article shows that the Plan maintains internal coherence, and illustrates its limitations
    due to the institutional environment, which is manifested in its
    design and in the possibilities for its execution. It concludes that the most important policies are the weakest, and that rural developmerlt is not only a problem of social design, but above all of the mentality and commitment of society on all levels.Este articulo expone la naturaleza, fundamentos y requerimientos de coherencia de un plan para precisar los criterios metodologicos de su critica interna al capitulo agropecuario. El examen de diagnostico lleva a un diagnostico diferente, que se infiere del objetivo de "integrar al sector rural" la persistencia del problema agrario en el pais, expresada en un estructura bimodal, polarizada en lo economico y en lo social. El objetivo del plan revela una vision de largo plazo: contribuir a resolver el problema agrario. Adi, las politicas diferencian entre sector empresarial avanzado y campesino, para los cuales diseña estrategias distintan que asignan un papel distinto al Estado: facilitar procesos socio-economicos para el primero e impulsar el desarrollo rural para el segundo. El articulo muestra que el plan guarda coherencia interna e ilustra las limitaciones debidas al entorno institucional, que se manifiesta en su diseño y en las posibilidades de ejecutarlo. Concluye que las politicas mas importantes son las mas debiles, y que el desarrrollo rural no es solo un problema de diseño social sino, ante todo, de metalidad y compromiso de la sociedad en todos niveles.

  9. Internal structure of the cerebral hemispheres: an introduction of fiber dissection technique Estrutura interna dos hemisfrios cerebrais: introduo tcnica de dissecao de fibras

    Igor de Castro

    2005-06-01

    Full Text Available The aim of this study is to introduce the fiber dissection technique and its importance in the comprehension of the three-dimensional intrinsic anatomy of the brain. A total of twenty brain hemispheres were dissected. Using Kingler's technique we demonstrated the intrinsic structures of the brain. The supra lateral aspect of the brain as well as the medial aspect were presented. The most important fiber systems were demonstrated. The use and comprehension of new neuroimaging techniques demand a better understanding of this fascinating anatomy. The knowledge acquired with this technique will improve our understanding of critical pathways of the central nervous system.O objetivo mostrar a tcnica de dissecao de fibras e sua importncia na compreenso da anatomia tridimensional do crebro. Um total de 20 hemisfrios cerebrais foram dissecados. Usando a tcnica de dissecao descrita por Kingler, pudemos demonstrar as estruturas que compem a anatomia interna do crebro. A anatomia da face spero-lateral assim como da face medial foi apresentada. O uso e compreenso de novas tcnicas de neuroimagem requerem um melhor conhecimento desta anatomia. O conhecimento adquirido com essa tcnica contribuir para o melhor entendimento de vias essenciais do sistema nervoso central.

  10. Retalho fasciocutneo de regio interna de coxa para reconstruo escrotal na sndrome de Fournier Fasciocutaneous flap of the inner thigh for scrotal reconstruction in Fournier syndrome

    Victor Mauro

    2011-12-01

    Full Text Available A sndrome de Fournier uma doena grave e que deve ser agressivamente tratada com desbridamentos e antibioticoterapia de amplo espectro. Geralmente causa perda de grande rea de tecido, podendo espalhar-se para outras reas alm do perneo, como abdome, membros inferiores, dorso, trax e retroperitnio. A perda da bolsa escrotal uma situao frequente nessa doena. So relatados dois casos de reconstruo de bolsa escrotal com retalho fasciocutneo de regio interna de coxas, com excelente recuperao, bom resultado esttico e poucas complicaes.Fournier syndrome is a severe disease that should be treated aggressively with debridement and broad-spectrum antibiotics. It usually causes loss of a large area of tissue and may spread to other areas beyond the perineum such as the abdomen, lower limbs, dorsum, chest, and retroperitoneum. The loss of the scrotum is a common condition in this pathology. Two cases of scrotum reconstruction with the fasciocutaneous flap of the inner thighs with excellent recovery, good aesthetic results, and few complications are reported.

  11. Ocho verdades a medias sobre la deuda interna....y una guía para una solución alternativa

    Henry Manuel Mora Jiménez

    2011-09-01

    Full Text Available En el debate nacional sobre temas públicos de actualidad, destaca en los últimos meses la gran controversia que se ha generado en torno a los orígenes, causas, magnitud y consecuencias de la deuda pública interna. Y como este tema se vincula estrechamente con nuestras concepciones sobre el Estado y el papel de éste en la economía y en la sociedad, es sumamente difícil que nuestras opiniones al respecto se puedan liberar enteramente de prejuicios y estereotipos ideológicos, lo mismo que de determinados intereses materiales concretos. Todos tendemos a acercarnos a los problemas que analizamos con ciertas ideas preconcebidas, limitando nuestro entendimiento a lo que nos es familiar y habitual, condicionados por nuestro ambiente, por los intereses que nos afectan, por la experiencia previa sobre el tema, y por todo tipo de circunstancias en que nos desenvolvemos. Por este motivo, es de crucial importancia que los grandes problemas nacionales se filtren a través de un amplio y democrático debate público, que además debe ser adecuadamente conducido.

  12. El poder poltico y la poltica fronteriza en Europa: la utilidad de comparar las fronteras internas y externas de la Unin Europea

    Harlan Koff

    2008-06-01

    Full Text Available Aunque la Unin Europea (UE ha promovido exitosamente la cooperacin transfronteriza interna, este artculo muestra que sus programas no logran necesariamente los objetivos declarados. El autor afirma que una de las debilidades de la literatura actual sobre fronteras europeas es que los acadmicos, a menudo, presentan las polticas transfronterizas como un indicador de la integracin sin examinar su impacto en las comunidades fronterizas locales. De hecho, la integracin verdadera no es slo un producto de las polticas europeas, sino que tambin depende de las relaciones de poder en los vecindarios polticos. En reas donde estas relaciones transfronterizas son simtricas, la integracin ocurre en trminos reales, an cuando las condiciones estructurales son menos ventajosas. Por el contrario, cuando las relaciones transfronterizas de poder son asimtricas, entonces los programas de integracin logran un xito limitado, an en presencia de estructuras positivas de oportunidad. Por tanto, este artculo asegura que ese poder informal afecta a la integracin econmica y poltica ms que el poder formal. Para ilustrar estos puntos, se examina el impacto de programas regionales de integracin en dos casos transfronterizos europeos: el Euromtropole que abarca el norte de Francia y el sur de Blgica, y el de Bari, Italia-Durres, Albania.

  13. El crculo del tiempo: Observaciones acerca de las relaciones entre sujeto y tiempo en las "Lecciones de la fenomenologa de la conciencia interna del tiempo" de E. Husserl

    ngel E. Garrido-Maturano

    2006-12-01

    Full Text Available Este artculo analiza las Lecciones de fenomenologa de la conciencia interna del tiempo. En primer lugar se propone mostrar la excedencia del tiempo csmico respecto de la temporalidad de la conciencia. En segundo determinar si la descripcin husserliana de la forma del flujo de la conciencia absoluta del tiempo es circular, es decir, si no presupone el tiempo objetivo que pretende constituir. En tercero someter a anlisis crtico la automostracin del flujo absoluto de la conciencia. Finalmente se menciona la aportica que se cierne sobre toda investigacin que quiera reducir uno forma del tiempo a la otra o asirlas independientemente.The article examines Husserls work On the Phenomenology of the Consciousness of Internal Time. Firsttly, it seeks to show the surplus of cosmic time with regard to the temporality of consciousness. Secondly, an attempt is made to establish whether the Husserlian description of the form of the flow of consciousness is circular, i.e., whether it does not presupposes the objective time that it purports to constitute. Thirdly, a critical analysis of the self-manifestation of the absolute flow of consciousness is advanced. Finally, a reference is made to the aporetics that befalls any investigation that tries to reduce one form of time to the other or to apprehend them independently.

  14. Um modelo de quatro quadrantes para a determinação da oferta e da demanda de internações hospitalares