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Esplenectomia laparoscópica
Coelho, Julio Cezar Uili;Claus, Christiano Marlo Paggi;Bombana, Benjamin;Machuca, Tiago Noguchi;Sobottka, Wagner Herbert;
Revista do Colégio Brasileiro de Cirurgi?es , 2004, DOI: 10.1590/S0100-69912004000300010
Abstract: background: to evaluate the feasibility and complications of laparoscopic splenectomy. methods: retrospective assessment of medical records of the patients who underwent laparoscopic splenectomy from january of 1998 to march of 2003. results: thirty-five patients (22 female, 13 male) underwent laparoscopic splenectomy. the indications were: idiopathic thrombocytopenic purpura (29 patients), lymphoma (3), hemolytic anemia (2), spherocytosis (1). the mean size of the spleen was 12cm (from 7cm to 27cm), and the mean weight was 262gr (from 30gr to 1850gr). accessory spleen was found in six patients. the mean operative time was 195min (form 120 to 270min). there were three cases of intra-operative bleeding (8%), with two of them requiring conversion. two other cases of conversion occurred due to splenomegaly. postoperative complications were observed in three patients (8%). the mean hospital stay was 1.7 day (from 1 to 7 days). conclusion: laparoscopic splenectomy is a safe procedure and is associated with low complication rate and reduced hospital stay. limiting factors are the surgeon’s experience, obesity and splenomegaly.
Efeitos da cirurgia bariátrica na fun o do assoalho pélvico Effects of bariatric surgery on pelvic floor function
Larissa Araújo de Castro,Wagner Sobottka,Giorgio Baretta,Alexandre Coutinho Teixeira de Freitas
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (S?o Paulo) , 2012,
Abstract: RACIONAL: A incontinência urinária é bem documentada como comorbidade da obesidade. Estudos demonstram resolu o ou atenua o da incontinência após a perda de peso. Porém, os mecanismos pelos quais isso ocorre ainda n o est o claros. OBJETIVO: Avaliar os efeitos da cirurgia bariátrica na fun o do assoalho pélvico em mulheres. MéTODOS: Foram avaliadas 30 mulheres que estavam em lista de espera para realizar a opera o. Foi verificada a prevalência de incontinência urinária no pré e no pós-operatório e seu impacto na qualidade de vida através do King's Health Questionnaire. A qualidade da contra o muscular do assoalho pélvico foi avaliada através da Escala de Oxford Modificada e da perineometria. RESULTADOS: Vinte e quatro mulheres finalizaram o estudo. O índice de massa corporal passou de 46,96±5,77 kg/m2 no pré-operatório para 29,97±3,48 kg/m2 no pós-operatório, e a perda percentual do excesso de peso média foi de 70,77±13,26%. A prevalência de incontinência urinária passou de 70,8% no pré-operatório para 20,8% no pós-operatório. Após um ano da cirurgia bariátrica, houve redu o do impacto da incontinência urinária na qualidade de vida em sete dos nove domínios avaliados no questionário. A mediana da Escala de Oxford Modificada aumentou de três no pré-operatório para quatro no pós-operatório. A perineometria apresentou aumento significativo na média das três contra es solicitadas, passou de 21,32±12,80 sauers para 28,83±16,17 sauers na compara o pré e pós-operatória. O pico de contra o também aumentou significativamente no pós-operatório em rela o ao pré-operatório, passou de 25,29±14,49 sauers para 30,92±16,20 sauers. CONCLUS O: A perda massiva de peso através da cirurgia bariátrica repercute positivamente na fun o do assoalho pélvico e na qualidade de vida das mulheres com obesidade mórbida. BACKGROUND: Urinary incontinence is well documented as a comorbidity of obesity. Studies demonstrate improvement of incontinency after weight loss. However, the mechanisms are still not clear. AIM: To analyze the effects of bariatric surgery on pelvic floor function in women. METHODS: Thirty women were invited to participate. They were waiting for bariatric surgery. Evaluations were done on pre-operative period and one year after surgery. It comprehended: body mass index, urinary incontinence prevalence, quality of life through the King's Health Questionnaire, quality of pelvic floor muscular contraction through the Oxford Modified Scale and perineometry. RESULTS: Twenty four women were included in the study. The body mass index reduced from 46.96±5.77 kg/m
Right-Permutative Cellular Automata on Topological Markov Chains
Marcelo Sobottka
Mathematics , 2006,
Abstract: In this paper we consider cellular automata $(\mathfrak{G},\Phi)$ with algebraic local rules and such that $\mathfrak{G}$ is a topological Markov chain which has a structure compatible to this local rule. We characterize such cellular automata and study the convergence of the Ces\`aro mean distribution of the iterates of any probability measure with complete connections and summable decay.
Topological Quasi-Group Shifts
Marcelo Sobottka
Mathematics , 2014, DOI: 10.3934/dcds.2007.17.77
Abstract: In this work we characterize those shift spaces which can support a 1-block quasi-group operation and show the analogous of Kitchens result: any such shift is conjugated to a product of a full shift with a finite shift. Moreover, we prove that every expansive automorphism on a compact zero-dimensional quasi-group that verifies the medial property, commutativity and has period 2, is isomorphic to the shift map on a product of a finite quasi-group with a full shift.
Standard decomposition of expansive ergodically supported dynamics
Marcelo Sobottka
Mathematics , 2012, DOI: 10.1007/s11071-014-1383-4
Abstract: In this work we introduce the notion of weak quasigroups, that are quasigroup operations defined almost everywhere on some set. Then we prove that the topological entropy and the ergodic period of an invertible expansive ergodically supported dynamical system $(X,T)$ with the shadowing property establishes a sufficient criterion for the existence of quasigroup operations defined almost everywhere outside of universally null sets and for which $T$ is an automorphism. Furthermore, we find a decomposition of the dynamics of $T$ in terms of $T$-invariant weak topological subquasigroups.
Transplante hepático em paciente soropositivo para o HIV
Freitas, Alexandre Coutinho Teixeira de;Sobottka, Wagner;Parolin, M?nica Beatriz;Matias, Jorge Eduardo Fouto;Coelho, Júlio Cezar Uili;
ABCD. Arquivos Brasileiros de Cirurgia Digestiva (S?o Paulo) , 2009, DOI: 10.1590/S0102-67202009000300009
Abstract: background: with the advent of highly active antiretroviral therapy and improved ability to prevent hiv-related complications, transplantation of hiv-infected patients has been done in selected cases. case report: to report a case of an hiv infected patient submitted to liver transplantation due to liver cirrhosis and hepatocellular carcinoma secondary to hepatitis b infection. he was on antiretroviral and hepatitis b therapy and never presented opportunistic infections. conclusion: liver transplantation can be indicated in special cases of hiv positive patients with advanced hepatic disease.
Liver resection: 10-year experience from a single Institution
Coelho, Julio Cezar Uili;Claus, Christiano Marlo Paggi;Machuca, Tiago Noguchi;Sobottka, Wagner Herbert;Gon?alves, Carolina Gomes;
Arquivos de Gastroenterologia , 2004, DOI: 10.1590/S0004-28032004000400006
Abstract: background: liver resection constitutes the main treatment of most liver primary neoplasms and selected cases of metastatic tumors. however, this procedure is associated with significant morbidity and mortality rates. aim: to analyze our experience with liver resections over a period of 10 years to determine the morbidity, mortality and risk factors of hepatectomy. patients and methods: retrospective review of medical records of patients who underwent liver resection from january 1994 to march 2003. results: eighty-three (41 women and 42 men) patients underwent liver resection during the study period, with a mean age of 52.7 years (range 13-82 years). metastatic colorectal carcinoma and hepatocellular carcinoma were the main indications for hepatic resection, with 36 and 19 patients, respectively. extended and major resections were performed in 20.4% and 40.9% of the patients, respectively. blood transfusion was needed in 38.5% of the operations. overall morbidity was 44.5%. life-threatening complications occurred in 22.8% of cases and the most common were pneumonia, hepatic failure, intraabdominal collection and intraabdominal bleeding. among minor complications (30%), the most common were biliary leakage and pleural effusion. size of the tumor and blood transfusion were associated with major complications (p = 0.0185 and p = 0.0141, respectively). operative mortality was 8.4% and risk factors related to mortality were increased age and use of vascular exclusion (p = 0.0395 and p = 0.0404, respectively). median hospital stay was 6.7 days. conclusion: liver resections can be performed with low mortality and acceptable morbidity rates. blood transfusion may be reduced by employing meticulous technique and, whenever indicated, vascular exclusion.
Dignidade da pessoa humana e o décimo segundo camelo - sobre os limites da fundamenta o de direitos
Sobottka, Emil Albert
Veritas , 2008,
Abstract: Dignidade da pessoa humana adquiriu em anos recentes um destaque como princípio fundamental a partir do qual s o derivados direitos, considerados igualmente fundamentais. Com base na discuss o provocada por Luhmann sobre recursos externos ao direito num sistema definido como operativamente fechado e cognitivamente aberto, o texto discute se a dignidade da pessoa humana consegue ocupar este lugar funcional. The dignity of the human being has gained prominence in recent years as a fundamental principle from which rights also considered fundamental are derived. Based on the discussion provoked by Luhmann on external resources to the right in a system defined as operatively closed and cognitively open, the paper asks if the dignity of human being may occupy this functional place.
Por que se faz políticas sociais no Brasil?: notas sobre estratégias de legitima o nos últimos dois governos federais
Sobottka, Emil Albert
Civitas , 2006,
Abstract: As reformas de orienta o meoliberal que foram implementadas no Brasil na década de 1990 afetaram profundamente as políticas sociais, mas as mudan as foram justificadas como reforma do estado e n o das políticas. Seu escopo era a despolitiza o da administra o pública. O governo de orienta o social-democrata de Lula da Silva que se seguiu buscou legitimar sua política social priorizando a cria o de alguns espa os de participa o da sociedade numa esfera pública - mas sem alcan ar o efeito dos governos locais do mesmo partido. Por isso o presente texto se prop e a enfocar as mudan as institucionais que afetam aquela política propostas pelos últimos dois governos enquanto substitutos de uma fundamenta o discursiva de projetos distintos de reforma.
Organiza es civis: Buscando uma defini o para além de ONGs e "terceiro setor"
Sobottka, Emil Albert
Civitas , 2002,
Abstract: Nas ciências sociais, a divis o da sociedade em três ambitos distintos tem uma longa tradi o. Vai de regra nessas abordagens os autores partem de uma defini o do que seja estado/política e mercado/economia, para agrupar o "restante" num terceiro conjunto que se define pela exclus o: n o é nem isso, nem aquilo. Por este procedimento, o terceiro ambito, seja qual for seu nome, torna-se residual e abarca fen menos díspares que pouco ou nada têm em comum. Mais limitado em sua pretens o de abrangência, com organiza es civis busca-se precisar melhor uma parte importante daquele "terceiro ambito". Centrado numa abordagem que previlegia os aspectos organizacionais, distingue-se, com base no médium regulador, solidariedade civil (Cohen e Arato), o substrato organizado da esfera pública (Habermas). Dentro das organiza es civis, uma nova distin o, com base nas formas que o meio regulador solidariedade assume, permite distinguir organiza es civis de fins públicos (altruísmo), de fins coletivos (lealdade) e de fins mútuos e de auto-ajuda (reciprocidade). Com estas defini es parece ser possível rediscutir ONG's, "terceiro setor" e movimentos sociais sem recorrer a categorias residuais.
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