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Search Results: 1 - 10 of 43300 matches for " Alexandre Magno Macário Nunes;Lima "
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Skeletonized internal thoracic artery is associated with lower rates of mediastinitis in elderly undergoing coronary artery bypass grafting surgery
, Michel Pompeu Barros de Oliveira;Santos, Cecília Andrade;Figueiredo, Omar Jacobina;Lima, Renato Oliveira Albuquerque;Ferraz, Paulo Ernando;Soares, Alexandre Magno Macário Nunes;Bezerra, Pablo César Lustosa Barros;Martins, Wendell Nunes;Lima, Ricardo de Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2011, DOI: 10.5935/1678-9741.20110053
Abstract: background and objectives: mediastinitis is a serious complication of median sternotomy and is associated to significant morbidity and mortality. the aim of this study is to identify which option of harvesting internal thoracic artery (ita), pedicled or skeletonized, is associated with lower rates of mediastinitis after coronary artery bypass grafting surgery (cabg) in elderly, in the division of cardiovascular surgery of procape. methods: retrospective study of 160 elderly who underwent consecutive cabg between may 2007 and june 2011. eleven preoperative variables, four intraoperative variables and eight postoperative variables possibly involved in the development of postoperative mediastinitis were evaluated between two groups: cabg with skeletonized ita (n=80) and pedicled ita (n=80). univariate and multivariate logistic regression analyses were applied. results: the incidence of mediastinitis was 6.8% (n=11), with a lethality rate of 54.5% (n=6). the skeletonized ita group were more exposed than pedicled ita group to obesity (n=12 vs. n=4; 15% vs. 5%; p=0.035) and multiple transfusions (n=25 vs. n=11; 31.2% vs. 13.7%; p=0.008). the pedicled ita group presented a greater risk of mediastinitis after cabg than skeletonized ita group (n=10 vs. n=1; 12.5% vs. 1.2%; unadjusted or 11.3; 95% ci 1.4 - 241.5; p=0.008). in multivariate analysis, this difference maintained statistically significant (adjusted or 5.2; 95% ci 1.5-495.8; p=0.012), being considered an independent association. conclusions: we suggest that elderly should be considered for strategies to minimize risk of infection. in elderly that undergo unilateral ita, the problem seems to be related to how ita is harvested. elderly should always be considered for use of skeletonized ita.
Validation of MagedanzSCORE as a predictor of mediastinitis after coronary artery bypass graft surgery
, Michel Pompeu Barros de Oliveira;Figueira, Evelyn Soares;Santos, Cecília Andrade;Figueiredo, Omar Jacobina;Lima, Renato Oliveira Albuquerque;Rueda, Fábio Gon?alves de;Escobar, Rodrigo Renda de;Soares, Alexandre Magno Macário Nunes;Lima, Ricardo de Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2011, DOI: 10.5935/1678-9741.20110013
Abstract: objective: the aim of this study is to evaluate the applicability of a new score for predicting mediastinitis - magedanzscore - in patients undergoing coronary artery bypass graft (cabg) surgery in the division of cardiovascular surgery of pronto socorro cardiológico de pernambuco - procape. methods: retrospective study involving 500 patients operated between may/2007 and april/2010. the registers contained all the information used to calculate the magedanzscore. the outcome of interest was mediastinitis. we calculated sensitivity, specificity, positive predictive value, negative predictive value, concordance and accuracy. the accuracy of the model was evaluated by roc (receiver operating characteristic) curve. results: the incidence of mediastinitis was 5.6%, with a lethality rate of 32.1%. in univariate analysis, the five variables of the magedanzscore were predictors of postoperative mediastinitis: chronic obstructive pulmonary disease (or 6.42; 95.0% ci 2.76-14.96; p<0.001), obesity (or 3.06; 95.0% ci 1.32-7.09; p=0.009), surgical reintervention (or 82.40; 95.0% ci 30.40-223.30; p<0.001), multiple transfusion (or 3.33; 95.0% ci 1.52-7.29; p=0.003) and stable angina class iv or unstable (or 2.59; 95.0% ci 1.19-7.64; p=0.016) according to canadian cardiovascular society. the score had a sensitivity of 96.4%, specificity of 90.0%, positive predictive value of 36.5%, negative predictive value of 99.8% and 90.4% concordance. the accuracy measured by the area under the roc curve was 96.2% (95.0% ci 94.5%-97.9%). conclusions: the magedanzscore proved to be a simple and objective index, revealing a satisfactory predictor of development of postoperative mediastinitis in patients undergoing cabg surgery at our institution
Predictors of transfusion of packed red blood cells in coronary artery bypass grafting surgery
, Michel Pompeu Barros de Oliveira;Soares, Evelyn Figueira;Santos, Cecília Andrade;Figueiredo, Omar Jacobina;Lima, Renato Oliveira Albuquerque;Rueda, Fábio Gon?alves de;Escobar, Rodrigo Renda de;Soares, Alexandre Magno Macário Nunes;Lima, Ricardo de Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2011, DOI: 10.5935/1678-9741.20110044
Abstract: objectives: finding predictors of blood transfusion may facilitate the most efficient approach for the use of blood bank services in coronary artery bypass grafting procedures. the aim of this retrospective study is to identify preoperative and intraoperative patient characteristics predicting the need for blood transfusion during or after cabg in our local cardiac surgical service. methods: 435 patients undergoing isolated first-time cabg were reviewed for their preoperative and intraoperative variables and analyzed postoperative data. patients were 255 males and 180 females, with mean age 62.01 ± 10.13 years. regression logistic analysis was used for identifying the strongest perioperative predictors of blood transfusion. results: blood transfusion was used in 263 patients (60.5%). the mean number of transfused blood products units per patient was 2.27 ± 3.07 (0-23) units. the total number of transfused units of blood products was 983. univariate analysis identified age >65 years, weight <70 kg, body mass index <25 kg/m2, hemoglobin <13mg/dl, hematocrit < 40% and ejection fraction <50%, use of cardiopulmonary bypass (cpb), not using an internal thoracic artery as a bypass, and multiple bypasses as significant predictors. the strongest predictors using multivariate analysis were hematocrit < 40% (or 2.58; ci 1.62-4.15; p<0.001), cpb use (or 2.00; ci 1.27-3.17; p=0.003) and multiple bypasses (or 2.31; ci 1.31-4.08; p=0.036). conclusions: the identification of these risk factors leads to better identification of patients with a grater probability of using blood, allocation blood bank resources and cost-effectiveness use of blood products.
Diminui??o da dor em mulheres com dismenorreia primária, tratadas pelo método Pilates
Araújo, Luana Macêdo de;Silva, José Mário Nunes da;Bastos, Weltianne Tavares;Ventura, Patrícia Lima;
Revista Dor , 2012, DOI: 10.1590/S1806-00132012000200004
Abstract: background and objectives: dysmenorrhea is a set of painful manifestations appearing the day before or during the first menstrual cycle day. pilates is a series of exercises based on progressive movements the body is able to perform. this study aimed at comparing pain in women with primary dysmenorrhea before and after being submitted to pilates. method: this is a descriptive, experimental study with longitudinal characteristic and quantitative approach. a clinical evaluation was performed in10 physical therapy students, center of unified teaching, teresina (ceut), aged between 18 and 30 years, with primary dysmenorrhea, who were submitted to a protocol of 16 pilates floor and ball exercises aimed at the pelvic region. pain intensity was evaluated by the visual analog scale and pain characteristics were evaluated by the mcgill questionnaire. results: mean pain value during menstrual cycle before treatment was 7.89 ±1.96, and after treatment it was 2.56 ± 0.56 (p < 0.001). mcgill questionnaire has shown significant improvement of all pain components after treatment: sensory (p < 0.001), affective (p < 0.005), evaluative (p < 0.001) and miscellaneous (p < 0.001). conclusion: pilates, as physical activity practice, has provided improvement of symptoms associated to primary dysmenorrhea, positively interfering with decreasing pain and representing a promising non-pharmacological alternative.
Polar S810 como recurso alternativo ao eletrocardiograma no teste de exercício de 4 segundos
Pimentel, Alan Santos;Alves, Eduardo da Silva;Alvim, Rafael de Oliveira;Nunes, Rogério Tasca;Costa, Carlos Magno Amaral;Lovisi, Júlio Cesar Moraes;Lima, Jorge Roberto Perrout de;
Arquivos Brasileiros de Cardiologia , 2010, DOI: 10.1590/S0066-782X2010005000037
Abstract: background: the 4-second exercise test (t4s) evaluates the cardiac vagal tone during the initial heart rate (hr) transient at sudden dynamic exercise, through the identification of the cardiac vagal index (cvi) obtained from the electrocardiogram (ecg). objective: to evaluate the use of the polar s810 heart rate monitor (hrm) as an alternative resource to the use of the electrocardiogram in the 4-second exercise test. methods: in this study, 49 male individuals (25 ± 20 years, 176 ±12 cm, 74 ± 6 kg) underwent the 4-second exercise test. the rr intervals were recorded simultaneously by ecg and hrm. we calculated the mean and the standard deviation of the last rr interval of the pre-exercise period, or of the first rr interval of the exercise period, whichever was longer (rrb), of the shortest rr interval of the exercise period (rrc), and of the cvi obtained by ecg and hrm. we used the student t-test for dependent samples (p < 0.05) to test the significance of the differences between means. to identify the correlation between the ecg and the hrm, we used the linear regression to calculate the pearson's correlation coefficient and the strategy proposed by bland and altman. results: linear regression showed r2 of 0.9999 for rrb, 0.9997 for rrc, and 0.9996 for cvi. bland e altman strategy presented standard deviation of 0.92 ms for rrb, 0.86 ms for rrc, and 0.002 for cvi. conclusion: polar s810 hrm was more efficient in the application of t4s compared to the ecg.
Numerical Analysis of Turbulent Fluid Flow and Drag Coefficient for Optimizing the AUV Hull Design  [PDF]
Jo?o Victor Nunes de Sousa, Ant?nio Roberto Lins de Macêdo, Wanderley Ferreira de Amorim Junior, Antonio Gilson Barbosa de Lima
Open Journal of Fluid Dynamics (OJFD) , 2014, DOI: 10.4236/ojfd.2014.43020

Autonomous Underwater Vehicles (AUVs) are robots able to perform tasks without human intervention (remote operators). Research and development of this class of vehicles has growing, due to the excellent characteristics of the AUVs to operate in different situations. Therefore, this study aims to analyze turbulent single fluid flow over different geometric configurations of an AUV hull, in order to obtain test geometry that generates lower drag force, which reduces the energy consumption of the vehicle, thereby increasing their autonomy during operation. In the numerical analysis was used ANSYS-CFX® 11.0 software, which is a powerful tool for solving problems involving fluid mechanics. Results of the velocity (vectors and streamlines), pressure distribution and drag coefficient are showed and analyzed. Optimum hull geometry was found. Lastly, a relationship between the geometric parameters analyzed and the drag coefficient was obtained.

Efeitos da prótese de polipropileno colocada por inguinotomia no espa?o pré-peritoneal, em c?es: avalia??o laparoscópica e microscópica
Melo, Robério Silva;Goldenberg, Alberto;Goldenberg, Saul;Leal, Antenor T.;Magno, Alexandre;
Acta Cirurgica Brasileira , 2003, DOI: 10.1590/S0102-86502003000400006
Abstract: purpose: observing the effects produced by the prosthesis of polypropylene in the pré-peritoneal space in dogs methods: 10 adult cross-bread dogs (n=10) have been put trough bilateral inguinotomy where prosthesis was put on one of its sides. in the contra-lateral region, the procedure was the same, but without the use of prosthesis, serving as a control. after 30 days the animals had been submitted to a laparoscopic technique and a macroscopic evaluation was made via intraperitoneal besides being through a biopsy of fragments of the peritoneum to record histological alterations of the two inguinal regions. results: three of the animals presented adhesions in the local of the polypropylene prosthesis was placed. no animal presented adhesion in the local without prosthesis. the microscopically alterations in side a (with prosthesis) were characterized by the proliferation of dense fibrous conjunctive tissue, besides the lack of presence of giant multinuclear showing a light inflammatory reaction. conclusion: the prosthesis of polypropylene induce the formation of adhesions, when placed in the pre-peritoneal space of dogs
Estrutura genética espacial em popula es de Tabebuia cassinoides por locos isoenzimáticos. Spatial genetic structure in Tabebuia cassinoides populations by isozyme loci.
rio CAVALLARI NETO,Alexandre Magno SEBBENN,Carlos Eduardo Sícoli SEOANE,Paulo Yoshio KAGEYAMA
Revista do Instituto Florestal , 2004,
Abstract: Marcadores isoenzimáticos foram usadospara caracterizar a estrutura genética espacial deuma espécie arbórea tropical de alta densidadepopulacional, Tabebuia cassinoides (> 300 árvorespor ha), em uma popula o natural e umamanejada da regi o do Vale do Ribeira, do Estadode S o Paulo, Brasil. A hipótese de estruturagenética espacial foi avaliada para árvoresadultas, usando dois diferentes métodos: estatísticas Fe estimativas do coeficiente de coancestria entrepares de indivíduos por diferentes classes dedistancia. A divergência genética entre as popula esfoi baixa e n o significativa ( p q = 0,015, P > 0,05),indicando que 98,5% da diversidade genética seencontra dentro das popula es. A divergênciagenética entre subpopula es dentro de popula es( sp q ) foi significativa e acomodou de 2,9% a 8,6%da diversidade genética total. A divergência genéticaentre grupos dentro de subpopula es foi alta eestatisticamente diferente de zero para aspopula es natural ( gq = 0,122, P < 0,01) emanejada ( gq = 0,093, P < 0,05), sugerindo estruturagenética espacial dentro das popula es. Numa dassubpopula es manejadas, a da Fazenda Cindomel(CIN), foi detectado o mais alto e significativocoeficiente de coancestria entre árvores dentro degrupos ( gq = 0,217, P < 0,01), indicando queárvores próximas s o parentes entre si entre os grausde meios-irm os e irm os-completos. O coeficientede coancestria ( xy q ) estimado por classe dedistancia foi positivo e significativo entre a classede distancia de 90 m e 120 m na subpopula oJUN1, 105 m e 120 m na JUN3 e entre zero e 50 me 120 m e 150 m na CIN, refor ando a hipótese deestrutura genética espacial.Isozymes markers were used to evaluatethe spatial genetic structure of a high-densitytropical tree species Tabebuia cassinoides (> 300trees per ha), in a natural and in an exploited foreststand, from Vale do Ribeira, State of S o Paulo,Brazil. The spatial genetic structure hypothesis wasevaluated for adult trees, using two differentmethods: F-statistics and coancestry coefficient inpairwise arranged individuals, estimated fordifferent distance classes. The genetic divergencebetween populations was low and not significant( p q = 0.015), indicating that the 98.5% of geneticdiversity is within populations. The geneticdivergence among subpopulations within populations( sp q ) was significant and holds 2.9% to 8.6% ofthe total genetic diversity. The genetic divergenceamong groups within subpopulations was high andstatistically different from zero for both natural( gq = 0.122; P < 0.01) and exploited populations( gq = 0.093, P <
Avalia??o cefalométrica dos efeitos do aparelho de protra??o mandibular (APM) associado à aparatologia fixa em rela??o às estruturas esqueléticas em pacientes portadores de má oclus?o Classe II, 1a divis?o
Araújo, Emmanuelle Medeiros de;Matoso, Rildo Medeiros;Diógenes, Alexandre Magno Negreiros;Lima, Kenio Costa;
Dental Press Journal of Orthodontics , 2011, DOI: 10.1590/S2176-94512011000300014
Abstract: objective: this study aimed to perform a cephalometric evaluation of the skeletal responses triggered by the joint use of a mandibular protraction appliance (mpa) and a fixed orthodontic appliance for correction of class ii, division 1 malocclusion in young brazilian patients. methods: the sample consisted of 56 lateral cephalograms of 28 patients (16 women and 12 men). the initial mean age was 13.06 years and mean duration of therapy with mpa was 14.43 months. the lateral radiographs were obtained before and after treatment and were compared by two calibrated examiners to identify the skeletal changes induced by the mpa using 16 linear and angular cephalometric measures. some independent variables (patient age, gender, facial pattern, mpa model, total use time, archwire and technique used during therapy with mpa) were considered and related to those measures in order to demonstrate the influence of these variables on them. responses to treatment were analyzed and compared by the wilcoxon signed ranks test and mann-whitney test at a significance level of 5%. results: the results showed restricted anterior displacement of the maxilla, increased mandibular protrusion, improved anteroposterior relationship of the basal bones and stability of the mandibular plane relative to the cranial base. the influence of variables age, facial pattern and mpa type was also noted. conclusions: mpa proved an effective alternative in the treatment of class ii, division 1 malocclusion, inducing changes in the skeletal component with satisfactory clinical results.
Organic Reserves in ropical Grasses under Grazing  [PDF]
Mariane Moreno Ferro, Anderson de Moura Zanine, Daniele de Jesus Ferreira, Alexandre Lima de Souza, Luiz Juliano Valério Geron
American Journal of Plant Sciences (AJPS) , 2015, DOI: 10.4236/ajps.2015.614236
Abstract: Inadequate management in recent times has been considered the main factor contributing to pasture degradation. A major reason for this is related to gross errors of grazing management as a consequence of the lack of knowledge of ecophysiological limits of forage. This review aimed to approach the importance of organic reserves for grasses under grazing. Therefore, the predominant effect of animal grazing is the reduction of leaf area which impacts on carbohydrate and nitrogen reserves and consequently the growth of tillers, leaves and roots. Grass growth after defoliation is related to organic reserves and rate of photosynthesis. The latter is affected by the level of canopy light interception of and by the reminiscent leaf area index. When grazing management is carried out with respect to the physiological limits of grass growth, the rate of dry matter accumulation will be quick and constant. In this aspect, grazing management consists of seeking an efficient balance between plant growth and consumption which will reflect on animal productivity. Therefore, a balance point among frequency and intensity of defoliation must be found to achieve greater animal production concerning the ecophysiological limits of the forage plants. So the challenge will be to find a balance between frequency and intensity of grazing to achieve greater production of animals respecting the eco-physiological limits of forage plants for each forage grass individually.
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