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In-Hospital Outcomes in Minimally Invasive Mitral Valve Surgery: First Results in a Brazilian Single Center

Open Journal of Thoracic Surgery 2024年第1期14卷 17-28页

作者： daniel de magalhães freitas João Alberto Pansani Max Weyler Nery Stanlley de Oliveira Loyola Maurício Lopes Prudente Giulliano Gardenghi Artur Henrique de Souza department of Cardiovascular Surgery Encore Hospital Aparecida de Goiania Brazil Anesthesia Clinic (Clianest) Goiania Brazil

Introduction: Treatments for cardiovascular diseases have increasingly evolved with the tendency to offer minimally invasive or transcatheter procedures instead of conventional sternotomy surgery. In this context, we highlight minimally invasive mitral valve surgery (MIMVS), which has been shown to be an increasingly solid option with some superior results when compared to the conventional technique: better pain control, shorter hospital stays, shorter recovery time, shorter readmission rate in the first postoperative year, better aesthetic results, and lower overall cost. Aim: This study aims to evaluate the stages of MIMVS, by primary mitral valve consultation, in our service and compare these results with data from the literature. Methods: All electronic medical records of patients who underwent MIMVS for primary mitral valve injury in the Encore Hospital from January 2020 to February 2023 were analyzed. Tabulation and statistical analysis were performed using the Microsoft Excel® program. Quantitative variables were presented as means, standard deviations. Results: 46 patients were enrolled in our study (Age: 59.1 ± 12.4 years old;60.8% Female, BMI: 26 ± 4.4 Kg/m2, Low risk STS score: 82.6%). The observed 30-day mortality was 2.1%, plastic rate of 23.9%, blood transfusion rate of 41.3%, length of stay in an intensive care bed (ICB) of 3.3 ± 3.3 days and hospital stay of 6.4 ± 5.1 days. Conclusions: We noticed that the MIMVS results carried out in our service agree with data from national and international literature with approximately 1.3 days more hospitalization in ICB.

关键词： Minimally Invasive Surgical Procedures Mitral Valve Outcome Assessment Health Care

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A 35-Year-Old Man Presenting Sleep-Related Painful Erections (Erpes): A Case Report and Review of Literature

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Advances in Sexual Medicine 2014年第1期4卷 6-10页

作者： daniel de freitas G. Soares Ernani Luis Rhoden Federal University of Health Sciences (UFCSPA) Porto Alegre Brazil

Introduction: Erectile episodes occurring in the night time are considered normal and are usually related to the REM sleep. Spontaneous painful erections are unusual but they can have a great impact in the patient’s quality of sleep and, for consequence, quality of life. Report: We present a patient who has been presenting painful erections which wake him up almost every night. We discuss the workup and treatment offered to the patient, as well as the short-time response and two months follow-up. Discussion: Although studies still do not explain this relationship, nocturnal erections occur only during rapid eye movement (REM) sleep, which can be confirmed by polysomnography accompanied by Nocturnal Penile Tumescence testing or RigiScan test. However, diagnosis can be established based exclusively on clinical aspects. Based on all literature reviewed, the initial treatment should safely consist in improvement in sleep architecture and pelvis muscles relaxation. Conclusion: After the first suspicion, polysomnography with rigidity measurements of nocturnal erections should be considered although clinical diagnosis and therapeutic test may be acceptable. The management we suggest is usually effective, well tolerated and sustained.

关键词： Painful Erection Priapism Nocturnal Erections REM-Sleep

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Structural phase relations in perovskite-structured BiFeO_(3)-based multiferroic compounds

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Journal of Advanced Ceramics 2013年第2期2卷 103-111页

作者： Valdirlei Fernandes freitas Gustavo Sanguino DIAS Otávio Algusto PROTZEK Diogo Zampieri MONTANHER Igor Barbosa CATELLANI daniel Matos SILVA Luiz Fernando CÓTICA Ivair Aparecido dos SANTOS UEM-Universidade estadual de Maringá GDDM-Grupo de Desenvolvimento de Dispositivos MultifuncionaisDepartamento de FísicaMaringáBrazil

In this review,the state of the art in understanding the structural phase relations in perovskite-structured BiFeO_(3)-based polycrystalline solid solutions is presented and *** about the close relation between the structural phase and overall physical properties of the reviewed systems are pointed out and *** is shown that,by adjusting the structural symmetric arrangement,the ferroelectric and magnetic properties of BiFeO_(3)-based polycrystalline solid solutions can be tuned to find specific multifunctional ***,an intrinsic mechanism linking structural arrangement and physical properties cannot be identified,revealing that this subject still deserves further discussion and investigation.

关键词： bismuth ferrite ferroelectrics multiferroics

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Corn Water Variables Assessments from Earth Observation Data in the Sao Paulo State, Southeast Brazil

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Journal of Hydraulic Engineering 2015年第1期1卷 1-11页

作者： Antonio Heriberto de Castro Teixeira Femando Braz Tangerino Hemandez Ricardo Guimaraes Andrade Janice freitas Leivas daniel de Castro Victoria Edson Luis Bolfe department of Geosciences Embrapa Satellite Monitoring Campinas Sao Paulo 13070-115 Brazil department of Hydrology Sao Paulo State University llha Solteira Sao Paulo 15.385-000 Sao Paulo Brazil

Landsat satellite images and agrometeorological data were used together for modelling the crop coefficient （Kc） in irrigation pivots composed by a mixture of corn hybrids from a commercial farm for grains and silage, located at the northwestern side of Sao Paulo state, Brazil. After developing relationships between Kc and the accumulated degree-days （DDac） and having yield data for 2012 available, they were applied in the whole state, to upscale the crop water variables, during the GS （growing seasons） of a second-harvest crop from March to August. Spatial thermohydrological differences among the main corn growing regions were clear. The largest CWP （crop water productivity） values and SD （standard deviations） were for Itapetininga with an average value of 1.60 ± 0.43 kg m-3, while the lowest ones were for Presidente Prudente （0.81±0.21 kg m-3）. As corn is important for these growing regions, being inside of the priorities from the Brazilian Ministry of Agriculture, these results should be considered for a rational exploration, including both, irrigation and rainfed conditions, as the actual water scarcity can bring much competition with other non-agricultural sectors.

关键词： Crop coefficient, degree-days, WI (water indicator), crop water productivity.

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The CD133/1<sup>+</sup>cell subset from human subcutaneous adult fat retains hemogenic potential

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Stem Cell Discovery 2012年第2期2卷 36-40页

作者： Camila Santos de Moraes Paulo Roberto Albuquerque Leal daniel Fabiano Ferreira Fernando Serra Eliana Abdelhay Claudia Sondermann freitas Bone Marrow Transplantation Unit National Cancer Institute of Rio de Janeiro Rio de Janeiro Brazil Experimental Medicine Program Research Coordination National Cancer Institute of Rio de Janeiro Rio de Janeiro Brazil Pedro Ernesto Hospital Rio de Janeiro State University Rio de Janeiro Brazil Plastic Surgery Cancer Hospital I National Cancer Institute of Rio de Janeiro Rio de Janeiro Brazil

Research has shown that cells from adult fat tissue can effect long-term blood reconstitution. Fat-derived multipotentiality was ascribed to CD34+ perivascular populations from its prominent microvasculature, that represent mostly non-hemogenic, mesenchymal cells, although this tissue contains a CD34+45+ subset committed to a hemogenic fate. Here, in order to analyze cell subsets presenting hemogenic capabilities within fat, CD133/1+ and pericytes, the latter defined by CD140b (PDGFRb, Platelet-derived Growth Factor Receptor Beta) expression, were immunomagnetically selected from stromal-vascular fractions (SVF). In Vitro Colony Forming Unit (CFU) assays were negative for CD140b+ pericytes and positive for CD133/1+ cells when a prolonged CFU assay was performed, revealing fat as another store of primitive progenitors that retain hemogenic potential.

关键词： Adipose Tissue-derived Stem Cells CD133 Hematogenesis Hemangioblast Pericyte

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Fatty liver disease in severe obese patients:Diagnostic value of abdominal ultrasound

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World Journal of Gastroenterology 2008年第9期14卷 1415-1418页

作者： Alessandro de Moura Almeida Helma Pinchemel Cotrim daniel Batista Valente Barbosa Luciana Gordilho Matteoni de Athayde Adimeia Souza Santos Almir Galvo Vieira Bitencourt Luiz Antonio Rodrigues de freitas Adriano Rios Erivaldo Alves Faculdade de Medicina da Bahia Universidade Federal da Bahia SalvadorBahia 41830-020Brasil Faculdade de Medicina da Bahia Universidade Federal da BahiaSalvadorBahia 41830-020Brasil Faculdade de Medicina da Bahia Universidade Federal da Bahia SalvadorBahia 41830-020Brasil Faculdade de Medicina da Bahia Universidade Federal da BahiaSalvadorBahia 41830-020 Brasil Núcleo de Cirurgia da Obesidade SalvadorBahia 41830-020Brasil

AIM:To evaluate the sensitivity and specificity of abdominal ultrasound (US) for the diagnosis of hepatic steatosis in severe obese subjects and its relation to histological grade of steatosis. METHODS: A consecutive series of obese patients, who underwent bariatric surgery from October 2004 to May 2005, was selected. Ultrasonography was performed in all patients as part of routine preoperative time and an intraoperative wedge biopsy was obtained at the beginning of the bariatric surgery. The US and histological findings of steatosis were compared, considering histology as the gold standard. ResULTS: The study included 105 patients. The mean age was 37.2 ± 10.6 years and 75.2% were female. The histological prevalence of steatosis was 89.5%. The sensitivity and specificity of US in the diagnosis of hepatic steatosis were, respectively, 64.9% (95% CI: 54.9-74.3) and 90.9% (95% CI: 57.1-99.5). The positive predictive value and negative predictive value were, respectively, 98.4% (95% CI: 90.2-99.9) and 23.3% (95% CI: 12.3-39.0). The presence of steatosis onUS was associated to advanced grades of steatosis on histology (P = 0.016). CONCLUSION: Preoperative abdominal US in our series has not shown to be an accurate method for the diagnosis of hepatic steatosis in severe obese patients. Until another non-invasive method demonstrates better sensitivity and specificity values, histological evaluation may be recommended to these patients undergoing bariatric surgery.

关键词：脂肪肝肥胖病人腹部超声波检查肝脏脂肪变性

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Evaluation of Pulmonary Function in Adults with Grade Ⅲ Obesity

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Health 2017年第6期9卷 942-950页

作者： Cássio daniel Araújo da Silva Fernanda Figueiroa Sanchez Jonas Silva de Souza Jamilly Reboucas demosthenes Marques Ana Fátima de freitas Ellen Kathellen Sa de Souza Roberta Lins Goncalves Federal University of Amazonas—UFAM ManausBrazil Adriano Jorge Hospital Foundation—FHAJ ManausBrazil

Pulmonary function studies in obese individuals have alerted the pathophysiological changes due to weight gain. However, these changes are not fully explained yet. Objective: To evaluate and analyze the pulmonary function of obese adults in the city of Manaus (AM, Brazil) and to correlate the parameters of spirometry with weight and BMI. Method: A descriptive cross-sectional study, in which pulmonary function of 22 adults with grade III obesity was evaluated pre and post bronchodilator administration, performed at the Adriano Jorge Hospital Foundation—FHAJ. Results: Of the 22 patients evaluated, 6 were male and 16 were female;mean age was 37.1 ± 7.4 years, with a weight of 134.2 ± 28.6 kg and a BMI of 51.1 ± 9.4 kg/m2, corresponding to grade III obesity. Spirometry showed a reduction in values obtained from Forced Vital Capacity (FVC), Forced Expiratory Volume in the first second (FEV1) and Peak Expiratory Flow (PEF) in relation to those predicted, with 23% of restrictive disorders. There were negative correlations between BMI and PEF, weight and FVC, weight and PEF. The P value for correlation of weight and FEV1 is not statistically significant. Conclusion: Restrictive and obstructive disorders are prevalent in the population with grade III obesity. Correlations between pulmonary function and BMI/weight were negative for this specific population.

关键词： Respiratory Muscles Spirometry Obesity Evaluation

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Immune thrombocytopenic purpura induced by intestinal tuberculosis in a liver transplant recipient

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World Journal of Gastroenterology 2014年第25期20卷 8304-8308页

作者： Renata dos Santos Lugao Marina Pamponet Motta Matheus freitas Cardoso de Azevedo Roque Gabriel Rezende de Lima Flávia de Azevedo Abrantes Edson Abdala Flair José Carrilho daniel Ferraz de Campos Mazo Hepatology Branch Clinical DivisionDepartment of GastroenterologyUniversity of S?o Paulo School of Medicine S?o Paulo 05403-000Brazil Liver and Gastrointestinal Transplant Division Department of GastroenterologyUniversity of S?o Paulo School of MedicineS?o Paulo 05403-000 Brazil department of Infectious and Parasitic Diseases University of S?o Paulo School of Medicine S?o Paulo 05403-000 Brazil

A variety of clinical manifestations are associated directly or indirectly with tuberculosis. Among them, haematological abnormalities can be found in both the pulmonary and extrapulmonary forms of the disease. We report a case of immune thrombocytopenic purpura(ITP) associated with intestinal tuberculosis in a liver transplant recipient. The initial management of thrombocytopenia, with steroids and intravenous immunoglobulin, was not successful, and the lack oftuberculosis symptoms hampered a proper diagnostic evaluation. After the diagnosis of intestinal tuberculosis and the initiation of specific treatment, a progressive increase in the platelet count was observed. The mechanism of ITP associated with tuberculosis has not yet been well elucidated, but this condition should be considered in cases of ITP that are unresponsive to steroids and intravenous immunoglobulin, especially in immunocompromised patients and those from endemic areas.

关键词： Immune thrombocytopenic purpura Tuberculosis Liver

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GeoAmazonas—GIS for Water Resources Management

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Journal of Geographic Information System 2016年第5期8卷 558-577页

作者： Leandro Andrei Beser de deus Fábio Giusti Azevedo de Britto Camilla Silva Motta dos Santos Cynara Alets Sthuasth Souza de Melo França Claudia Daza Andrade Vera Jane Ruffato Pereira Ferreira daniel de Berrêdo Viana Marcos Aurélio Vasconcelos de freitas Federal University of Rio de Janeiro (UFRJ) Rio de Janeiro Brazil State University of Rio de Janeiro (UERJ) Rio de Janeiro Brazil Brazilian Institute of Geography and Statistics (IBGE) Rio de Janeiro Brazil

Geographic Information Systems (GIS) are used essentially for spatial analysis. They can lead to the development of methods for analyzing and planning the use of geographical space and, consequently, are helpful to the decision making process, assisting those responsible for planning the use of a certain territory. This article is a result of the “Project for the Integrated and Sustainable Management of Trans- boundary Hydric Resources of the Amazon Basin considering Variability and Climate Change”, which has the goal of strengthening institutional guidelines in order to plan and execute activities related to the protection of the land, hydric resources and sustainable management of the Amazon Basin, considering the existing impacts of climatic changes. This article aims at analyzing the process of building and implementing the GeoAmazonas GIS as one of the instruments for managing the basin, including its contribution for standardizing different data sources in the entire area of the basin and the identification of conflicts related the use of water resources and vulnerability situations.

关键词： Geographic Information System Amazon Transboundary Basins

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Preoperative rectal tumor embolization as an adjunctive tool for bloodless abdominoperineal excision:A case report

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World Journal of Clinical Oncology 2020年第12期11卷 1070-1075页

作者： Marley Ribeiro Feitosa Lucas Fernandes de freitas Antonio Balestrim Filho Guilherme Seizem Nakiri daniel Giansante Abud Ligia Magnani Landell Mariângela Ottoboni Brunaldi Jose Joaquim Ribeiro da Rocha Omar Feres Rogério Serafim Parra department of Surgery and Anatomy Medicine School of Ribeirão PretoUniversity of São PauloRibeirão Preto 14048900São PauloBrazil department of Internal Medicine Medical School of Ribeirão PretoUniversity of São PauloRibeirão Preto 14048900São PauloBrazil department of Pathology and Forensic Medicine Medicine School of Ribeirão PretoUniversity of São PauloRibeirão Preto 14048900São PauloBrazil

BACKGROUND Abdominoperineal excision(APE)-related hemorrhage can be challenging due to difficult access to pelvic organs and the risk of massive blood *** objective of the present study was to demonstrate the use of preoperative embolization(PE)as a strategy for blood preservation in a patient with a large low rectal tumor with a high risk of bleeding,scheduled for *** SUMMARY A 56-year-old man presented to our institution with a one-year history of anal bleeding and rectal *** patient was diagnosed with bulky adenocarcinoma limited to the *** the patient refused any clinical treatment,surgery without previous neoadjuvant chemoradiation was *** patient underwent a tumor embolization procedure,two days before surgery performed via the right common femoral *** tumor was successfully devascularized and no major bleeding was noted during *** recovery was uneventful and a one-year follow-up showed no signs of *** Therapeutic tumor embolization may play a role in bloodless surgeries and increase surgical and oncologic *** describe a patient with a bulky low rectal tumor who successfully underwent preoperative embolization and bloodless abdominoperineal resection.

关键词： Rectal neoplasms Proctectomy Bloodless medical and surgical procedures Embolization,therapeutic Colorectal surgery Case report

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