Orientador: Lúcia Helena Simões da Costa-Paiva / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-18T22:13:15Z (GMT). No. of bitstreams: 1 Ferreira_NevilledeOliveira_D.pdf: 2260205 bytes, checksum: 4735926d615eaa3b10d11ae68acd6940 (MD5) Previous issue date: 2011 / Resumo: Objetivo: Avaliar a prevalência de fratura vertebral, alterações radiológicas, dor nas costas, e associação com qualidade de vida em mulheres com osteoporose pós-menopausa e validar a versão na língua portuguesa do questionário de qualidade de vida QUALEFFO-41 em mulheres brasileiras com fratura vertebral. Métodos: Este estudo coletou dados de 126 mulheres com osteoporose e 43 mulheres sem osteoporose. O estudo de prevalência de fratura vertebral (FV), osteófitos e dor nas costas, foi um corte transversal com o total de 126 mulheres com osteoporose lombar pós-menopausa diagnosticada pela densitometria óssea selecionadas no Ambulatório de Menopausa do CAISM. As mulheres responderam entrevista sobre dados sociodemográficos e clínicos, e o questionário QUALEFFO-41. Todas realizaram radiografia de coluna para pesquisa de alterações radiológicas. Para a análise estatística utilizou-se os testes de Mann-Whitney ou T de Student, testes exato de Fisher ou qui-quadrado e regressão múltipla. O estudo de validação do QUALEFFO-41 foi realizado apenas com 43 com FV por osteoporose (grupo fratura) e 43 sem osteoporose (grupo controle), pareadas por idade (±3 anos). Foram aplicados o QUALEFFO-41 e o SF-36 (comparação teste-reteste). Calculou-se o coeficiente ? de Cronbach, coeficiente de Correlação Intraclasse, coeficiente Kappa (k), Odds ratio e curva ROC. Resultados: Os resultados foram apresentados em três artigos. No primeiro artigo, a prevalência de FV nas 126 mulheres foi de 34,1% e o tipo de FV mais prevalente foi a triangular anterior (45,9%). Não houve diferença na qualidade de vida (QV) entre as mulheres com osteoporose com e sem FV, porém o maior número de fraturas associou-se a pior QV. Os fatores associados à pior QV foram cor da pele não branca, obesidade, ausência de trabalho remunerado, sedentarismo, baixa escolaridade e não uso de medicação para osteoporose. No segundo artigo sobre prevalência de alterações radiológicas e dor nas costas, a prevalência de FV foi de 34,1 % e de osteófitos de 92,1%. A prevalência de dor nas costas foi de 66,7% e observou-se associação entre a dor nas costas com a presença de osteófitos (p=0,0157) e pior QV. No terceiro artigo de validação do QUALEFFO-41, o coeficiente ? de Cronbach dos domínios variou entre 0,74 e 0,84; o ICC dos domínios variou entre 0,67 e 0,90; a maioria das questões apresentou um coeficiente k maior do que 0,50 e demonstrou boa validade convergente e discriminante. As mulheres do grupo FV apresentaram comprometimento na QV em ambos os questionários (p<0,05) e houve boa correlação entre os domínios do QUALEFFO-41 e os seus correspondentes do SF-36, exceto para Função Social. A avaliação pela curva ROC e regressão logística demonstrou que todos os domínios do QUALEFFO-41 foram significativamente preditivos de FV. Conclusão: A prevalência de FV por osteoporose foi alta, com comprometimento na QV independente da FV. Também houve uma alta prevalência de dor nas costas associada à presença de osteófitos e pior QV. O QUALEFFO-41 na língua portuguesa pode ser utilizado em mulheres brasileiras com FV por osteoporose, pois mostrou ter boas características psicométricas, demonstrando comprometimento na QV e boa capacidade de discriminar a QV em mulheres com FV / Abstract: Objective: To evaluate the prevalence of vertebral fractures, radiographic abnormalities, back pain, and association with quality of life in women with postmenopausal osteoporosis, and to validate the Portuguese version of the quality of life QUALEFFO-41 questionnaire in Brazilian women with osteoporosis vertebral fractures. Methods: This study was conducted with a total of 126 women with osteoporosis and 43 women without osteoporosis. The study of the prevalence of vertebral fractures (VF), osteophytes and back pain, was a cross sectional study with a total of 126 postmenopausal women, with lumbar osteoporosis diagnosed by bone densitometry, selected from the Menopause Outpatient Clinic of the Women's Integrated Healthcare Center (CAISM). The women were interviewed about sociodemographic/clinical data and the QUALEFFO-41 questionnaire. Lumbar spine radiograph was performed in all participants to study radiographic abnormalities. The statistical analysis was performed by the Mann-Whitney or Student's T-test, Fisher's Exact or Chi-square, and multiple regression. The QUALEFFO-41 validation study was conducted with only 43 women with osteoporosis VF (fracture group) and 43 women without osteoporosis (control group), age-matched (±3 years). The QUALEFFO-41 questionnaire was administered twice in four weeks and compared to SF-36 (testretest). For analysis were calculated the Cronbach's ? Coefficient, the Intraclass Correlation Coefficient, the Kappa's Coefficient, Odds ratio and ROC curve. Results: The results were presented in three articles. In the first, the prevalence of VF in the 126 women was 34,1% and the most prevalent type of VF was anterior wedge (45.9%). No difference was observed in the quality of life (QOL) between women with osteoporosis with and without VF, although there was direct correlation between number of VF and worse QOL. Factors associated with worse QOL were non-white skin color, obesity, no paid job, sedentary lifestyle, low level of school education and non-use of osteoporosis drugs. In the second article about prevalence of radiographic abnormalities and back pain, the prevalence of VF was 34,1 % and of 92,1% to osteophytes. Back pain in the last four weeks was prevalent in 66.7% of women and it was observed a association between back pain with osteophytes presence (p=0,0157) and worse QOL. In the third article of validation of QUALEFFO-41, the Cronbach's ? coefficient of the domains ranged between 0,74 and 0,84; the ICC of the domains ranged between 0,67 and 0,90; the majority of questions showed a k coefficient higher than 0,50 and demonstrated good convergent validity and discriminant validity. The group of women with VF showed impairment in the QOL in both questionnaires (p<0,05) and there was a good correlation among the QUALEFFO-41 domains and their corresponding SF- 36 domains, except for Social Function. All QUALEFFO-41 domains were significantly predictive of VF on assessment of the ROC curve. Conclusion: The prevalence of osteoporosis VF was high, with impairment of the QOL independent of VF. There is also a high prevalence of back pain associated with osteophytes and worse QOL. The Portuguese version of the QUALEFFO-41 may be used in Brazilian women with osteoporosis VF because it shows good psychometric characteristics, the impairment of the QOL and good ability to discriminate QOL in women with osteoporosis VF / Doutorado / Fisiopatologia Ginecológica / Doutor em Ciências da Saúde

Simuler les réservoirs souterrains permet d’optimiser la production d’hydrocarbures. Les réservoirs naturellement ou hydrauliquement fracturés détiennent une part importante des réserves et exhibent un degré élevé d’hétérogénéité : les fractures, difficiles à détecter, impactent fortement la production via des réseaux préférentiels d’écoulement. Une modélisation précise de ces forts contrastes permettrait d’optimiser l’exploitation des ressources tout en maîtrisant mieux les risques environnementaux. L’enjeu est de prédire les processus d’écoulement multi échelles par un modèle simplement paramétrable. Une stratégie de simulations, qui améliore la fiabilité et les temps de calculs est mise au point dans cette thèse. Elle permet de simuler numériquement ou analytiquement la complexité d’un réservoir fracturé à grande échelle. Ces techniques dont l’intérêt est démontré sur un réservoir de roche mère trouvent des applications en géothermie ou dans la gestion des ressources en eau. / Fluid flow simulation is used to optimize oil and gas production. Naturally or hydraulically fractured reservoirs hold a significant part of reserves, difficult to assess. Fractures may create preferential flow paths heavily impacting fluid flow. Accurate modeling of fractured media accounting for strong contrasts would allow operators to optimize resources exploitation while better controlling environmental risks. Integrating sparse available data, we aim at predicting fluid flow processes occurring in the earth’s subsurface accounting for multi-scale fractures with a simply parameterized model. Improving the computational time and results reliability, we propose a full integrated strategy suitable for fractured reservoir specificities by simulating the fractures complexity on large scales. The techniques developed in this thesis, whose interest is demonstrated in an unconventional field case study, can find other applications in geothermal engineering and water resources management

Les acquisitions de mesures de températures et de conductivités thermiques ont enrichi la connaissance du régime thermique du bassin sédimentaire de Paris et ont mis en évidence des hétérogénéités thermiques spatiales ou temporelles. Afin de mieux les comprendre, ces variations doivent être intégrées dans une vision multidisciplinaire confrontant données et modèles. La revue bibliographique sur le sujet a permis d’intégrer les données de natures diverses, de les confronter par SIG et d’investiguer les connaissances. Cette étude a mis en évidence et réinterprété les variations verticales de flux géothermal. Les simulations conduites à partir de scénarios diffusifs paléoclimatiques montrent que le système a gardé en mémoire l’effet des paléoclimats. Par ailleurs, nous identifions pour la première fois une décroissance systématique du flux géothermal au niveau des principales formations aquifères. Des simulations thermo-hydrauliques transitoires des phénomènes paléoclimatiques mettent en évidence le développement de zones froide et chaude suivant les régions d’écoulement. Une explication de l’anomalie de température de plus de 20°C entre les installations géothermiques situées au nord et au sud de Paris au Bathonien est proposée. Les modélisations effectuées montrent clairement la contribution potentielle de zones fracturées, ainsi que celle des failles, à l’hétérogénéité observée dans le champ de température du bassin en permettant des écoulements contraints par le gradient de charge régional et les instabilités densitaires. Ces travaux ont montré le lien entre les formations du bassin qui sont exploitées pour leurs ressources ou utilisées comme milieu de stockage. / The acquisition of measurements of temperature and of thermal conductivity has enriched the understanding of the thermal regime of the Paris sedimentary basin and brought to light spatial and temporal thermal heterogeneities. In order to understand them better, these variations need to be integrated into a multidisciplinary vision of the basin by comparing data against models. The bibliographic review made it possible to integrate data of diverse sorts, to compare them using GIS and to investigate the knowledge base. This study has highlighted and reinterpreted the vertical variations of geothermal flux. Simulations carried out based on diffusive palaeoclimatic scenarios show that the system has retained a memory of the effects of palaeoclimates. Furthermore, for the first time, a systematic decline of the geothermal flux has been identified at the level of the main aquifer formations. Transitory thermo-hydraulic simulations of palaeoclimatic phenomena show the development in the sedimentary basin of cold and hot zones according to the areas of flow. An explanation of the temperature anomaly of over 20°C between the geothermal installations located to the north and south of Paris in the Bathonian is put forward. The models produced clearly show the potential contribution of fractured zones, as well as that of the faults, to the heterogeneity observed in the temperature field of the basin by allowing flow constrained by the regional charge gradient and unstable densities. This work has shown the link between the formations in the basin which are exploited for their resources or used as a storage medium.

Orientador: Francisco Haiter Neto / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-22T03:09:52Z (GMT). No. of bitstreams: 1 Melo_SauloLeonardoSousa_D.pdf: 2218152 bytes, checksum: 8cf34e11fc626dc8ea70836a2401feb5 (MD5) Previous issue date: 2013 / Resumo: As fraturas radiculares apresentam diagnóstico clínico limitado visto que os sinais e sintomas apresentados pelo paciente são inespecíficos. Como a maioria das fraturas leva à extração do dente, torna-se necessário um diagnóstico mais preciso. A tomografia computadorizada de feixe cônico (TCFC) é considerada um método de diagnóstico avançado na aquisição de imagens livres de sobreposições das estruturas orofaciais. Geralmente as imagens por TCFC são segmentadas e reconstruídas em DICOM, visto que existe uma grande disponibilidade de softwares que utilizam este formato. Por se tratar de uma tecnologia relativamente recente, e que rapidamente vem se difundindo no meio odontológico, o presente estudo avaliou a influência do uso de softwares com plataforma DICOM na capacidade de diagnóstico das imagens por TCFC na detecção de fraturas radiculares verticais induzidas experimentalmente. Foram utilizados cento e noventa dentes unirradiculares humanos, com os condutos radiculares modelados, divididos em 3 grupos, de acordo com a condição do canal radicular: não-preenchido (NP); preenchido com guta-percha (GP); e parcialmente preenchido por núcleo metálico fundido (NM). Metade dos elementos de cada grupo foi fraturada artificialmente, com posterior reposicionamento dos fragmentos. Um cone de guta-percha bem adaptado foi inserido no canal dos dentes do grupo GP e núcleos metálicos fundidos foram confeccionados nos dentes do grupo NM. Todos os dentes foram posicionados em um crânio seco humano e escaneados em um aparelho de TCFC, conforme o protocolo de escaneamento da maxila utilizando voxel de 0.2 mm. As imagens foram salvas no formato original (.xstd), assim como segmentadas e reconstruídas em DICOM. As imagens originais foram analisadas no software do tomógrafo (Xoran) e as imagens DICOM nos softwares Dolphin, InVivo e KDIS3D. Foram selecionados três cirurgiões-dentistas radiologistas para avaliar as imagens quanto à ausência ou presença de fratura radicular, em uma escala de 5 pontos. Sensibilidade, especificidade, acurácia e área sob a curva ROC foram calculadas. A influência do material intracanal e do software utilizado foi verificada por meio do modelo de análise de variância (ANOVA) e comparações pareadas realizadas por meio do teste de Tukey, considerando-se um nível de significância de 5%. Não houve diferença estatisticamente significativa entre os softwares quando a mesma condição era apresentada. No entanto, quando comparada com os grupos NP e GP, a acurácia de diagnóstico foi menor no grupo NM em qualquer software utilizado (p < 0,05). Concluiu-se que o diagnóstico de fratura radicular não depende do software, podendo o profissional utilizar o de sua preferência. Todavia, a presença de núcleo metálico diminui a possibilidade de um diagnóstico correto / Abstract: Root fractures have limited clinical diagnosis because signs and symptoms are nonspecific. However, an accurate diagnosis is necessary as most fractures result in tooth extraction. In the last years, Cone beam computed tomography (CBCT) technology has been considered an advanced procedure to obtain images free from overlaps of maxillofacial structures. Usually CBCT images are exported in DICOM format, since there is a wide availability of software that uses this format. Since it is a relatively new technology and that is spreading quickly among dental routine, this study evaluated the influence of segmentation and reconstruction of CBCT images in the diagnostic ability of experimentally induced vertical root fractures using software with DICOM platform. One hundred and ninety extracted, single-rooted, human teeth were included in the study. Each tooth had its root canal prepared, randomly coded and divided into 3 groups according to the pulp canal status: unrestored (UR); filled with gutta-percha (GP); and restored with a metallic custom post (Post). One-half of the samples of each group were artificially fractured and segments repositioned. The experimental sample was artificially fractured. A well-fitting gutta-percha cone was placed into the canal of GP group teeth, and a well-fitting post casted was placed into the canal of Post group ones. All teeth were placed in an empty maxillary anterior socket of a dentate dry human skull and scanned on a CBCT device according to the protocol recommended by the manufacturer for a 0.2-mm voxel resolution (8-cm FOV, 120kVp, 8mA, 40-sec). The images were converted to DICOM files, imported, reconstructed and analyzed into Dolphin, InVivo and KDIS3D software. The original images were also reconstructed and evaluated using the software of the scanner (Xoran). The images were coded and shown to three previously calibrated oral radiologist observers, who performed a dynamic evaluation. The observer's evaluation of the presence of root fracture was scored using a 5-point confidence rating scale. Sensitivity, specificity, and accuracy were calculated, and from the values found, ROC curves were constructed to assess the relationship between sensitivity and specificity (area under the ROC curve). The influence of intra-canal material and software used was verified by an analysis of variance model (ANOVA) and pairwise comparisons performed using Tukey test, considering a significance level of 5%. Overall, there was not a statistically significant difference between softwares. Thus, the efficiency of the software was similar among them when the same condition (type of material present inside the canal) was shown. However, there was a statistically significant difference between the materials, considering accuracy, sensitivity and area under the ROC curve. Compared with UR and GP groups, the accuracy of diagnosis was significantly lower in the Post group when any software was used (p <0.05). In conclusion, the diagnosis of root fracture does not depend on the software, which means that the professional should choose the one of his preference. However attention should be drawn to the fact that, regardless of the software used, the presence of metallic post decreases the chance of a correct diagnosis / Doutorado / Radiologia Odontologica / Doutor em Radiologia Odontológica

Simulation is a virtual tool that assists in the prediction of equipment behavior and it has been currently used for solving mechanical problems even before a physical prototype is tested .Together with the simulation , failure analysis is considered a tool for design optimization . Mechanics fracture, in turn, is a science that seeks to indicate whether a pre-existing crack type defect in the material can lead the component to a catastrophic fracture for normal operating strain. The aim of this work was to analyze numerical simulation importance as a tool for solving failure analysis and fracture mechanics problems in order to obtain quantitative results in response to geometric shapes and complex boundary conditions. Four cases of component failures once made were taken on this work and a complement with numerical simulation was carried out. The obtained results showed that numerical simulation is important in quantitative estimates of in service imposed stresses in the case of complex shape and boundary conditions. / A simulação é uma ferramenta virtual que auxilia na previsão do comportamento dos equipamentos sendo atualmente utilizada para resolução de problemas mecânicos antes mesmo que algum protótipo físico seja testado. Juntamente com a simulação, a análise de falhas é considerada uma ferramenta de otimização de projetos. A mecânica da fratura, por sua vez, é uma ciência que busca indicar se um defeito tipo trinca previamente existente no material pode levar o componente à fratura catastrófica para tensões normais de serviço. O objetivo deste estudo foi analisar a importância da simulação numérica como ferramenta para resolução de problemas de análise de falha e mecânica da fratura, a fim de se obter resultados quantitativos em resposta a formas geométricas e condições de contorno complexas. Foram tomados quatro estudos de casos de falhas de componentes outrora realizados e a partir estes foi realizado o complemento com a simulação numérica. Os resultados obtidos mostraram que a simulação numérica é importante na previsão quantitativa das tensões impostas em serviço para o caso de peças de forma e condições de contorno complexas.

O Metotrexato (MTX) é utilizado em altas doses no tratamento de neoplasias e em baixas doses como antiinflamatório. O objetivo deste estudo foi avaliar a reparação da fratura de côndilo mandibular e a simetria facial em ratos tratados com MTX. Foram utilizados 100 ratos, Wistar, machos que foram submetidos a procedimento cirúrgico utilizando modelo experimental de fratura de côndilo do lado direito. Os ratos foram distribuídos em quatro grupos e receberam os seguintes tratamentos: Controle - soro (um mL/semana); Dexametasona - dexametasona (0,15 mg/Kg); MTX Baixa dose - MTX (três mg/kg/semana); MTX Alta dose - MTX (30 mg/Kg). Os períodos de sacrifício foram de um dia, sete, 15, 30 e 90 dias de pós-operatório (n=cinco). O peso dos animais foi documentado. Foi realizada coleta de sangue para análise bioquímica de proteínas totais e fosfatase alcalina. Foi realizado exame radiográfico das cabeças em norma axial para análise cefalométrica. Foram realizadas mensurações lineares da maxila e mandíbula, bem como angulares do desvio mandibular. As amostras foram processadas histologicamente sendo obtidas lâminas com cortes no sentido coronal. Os dados quantitativos foram submetidos a análises estatísticas (=0,05). Os animais recuperaram peso ao longo do tempo, exceto no grupo MTX Alta dose. Os níveis séricos de proteínas totais mostraram aumento nos períodos iniciais e os de fosfatase alcalina queda nos períodos de formação do calo ósseo no tratamento com MTX. Houve redução no comprimento mandibular com alterações também na maxila e desvio progressivo da mandíbula em relação à base do crânio no grupo MTX Alta dose. A análise histológica revelou que houve reparo da fratura, pela formação de calo ósseo, e das estruturas da articulação sendo que no grupo MTX Alta dose ocorreu um retardo neste processo, havendo desvio do côndilo e em um espécime houve anquilose fibrosa. A histomorfometria revelou que a área de neoformação óssea foi menor no grupo MTX Alta dose. Foi concluído que o tratamento com MTX em alta dose teve efeito deletério na simetria facial de ratos submetidos à fratura do processo condilar e prejudicou a formação do calo ósseo e o reparo da articulação temporomandibular, com possível indução de anquilose fibrosa. / low doses as an antiinflammatory. The aim of this study was to evaluate the healing of the mandibular condyle fracture and facial symmetry in rats treated with MTX. 100 Wistar male rats undergone surgery using an experimental model of mandibular condyle fracture of the right side. The rats were distributed in four groups and received the following treatments: Control Saline (1 ml/week); Dexamethasone dexamethasone (0,15mg/kg); MTX Low dose MTX (3 mg/kg/week); MTX High dose MTX (30 mg/kg). Animals were sacrificed at one, seven, 15, 30 and 90 days postoperatively (n=5). Animals body weight were recorded. Blood has been taken to provide the biochemical analysis of total proteins and alkaline phosphatase. Radiographic axial exams from the heads were provided to cephalometric analysis. Linear measures of jaw and mandible, as well as angular measures of the mandibular deviation were done. The samples were histologically processed and coronal sections were obtained. Quantitative data were submitted to statistical analysis (=0,05). The animals regained body weight over the time, except in MTX High dose group. Total protein serum levels demonstrated the increase in initial periods and the alkaline phosphatase levels showed decrease in the periods of bone callus formation. There was reduction in the mandibular length and also changes in the jaw and progressive deviation in the mandible in relation to the skull basis in the MTX High dose group. The histological analysis revealed that there were repair of the bone and temporomandibular joint although in the MTX High dose group there was a delay in this process, in wich there was deviation of the condyle and one specimen was fibrous ankylosis. Histomorphometry revealed that the new bone formation area was lower in MTX High dose group. It was concluded that treatment with high dose MTX had a deleterious effect on facial symmetry of rats submitted to fracture of the condylar process and damaged the bone callus formation and repair of the temporomandibular joint, with possible induction of fibrous ankylosis.

This thesis deals with the design of a sporttester, which is a device capable of calculating the cadence of the taken steps and monitoring the impact force of foot on the ground while running. Exposure to long-term strong impacts while running can cause serious fatigue fractures of the hip, calf bone or the foot area. The purpose of the sporttester is to monitor and signal strong impacts to the runner, thus helping to prevent fatigue fractures. The aforementioned features are evaluated based on the change in acceleration measured by the accelerometer. The calculated values of step cadence, running speed and impact force are sent via Bluetooth Low Energy to a compatible mobile application.

7 Abstract Groundwater flow and highly permeable zones in aquifers of eastern part of Bohemian Cretaceous Basin based on Litá area and surroundings In my thesis I deal with the character of highy permeable zones in marlstones and calcitic sandstones in east-bohemian synclines of the Czech Cretaceous Basin. My chosen area lies southwest of Nové M�sto nad Metují and within it lies Litá area, an important source of groundwater for Hradec Králové region. Groundwater in the area was contaminated in the 80's by chlorinated hydrocarbons. Based on a detailed field sampling of 23 boreholes and 4 sites of surface water performed in 2008 and on archival data on contaminant concentrations, I evaluate the character and relationships of groundwater from the boreholes. I grouped boreholes according to their chemical properties. In the second part of my thesis, I perform the analysis of the influence of faults on groundwater flow in a larger area of east-bohemian synclines. Results show that most yielding boreholes lie between fractures, not near them, which suggests the impermeable role of fractures. From available information I then try to answer the question of highly permeable zones of preferential groundwater flow. Based on the observed flow velocity,...

Introduction: Hip fracture surgery is the particular problem of very old patinets (>75 years), with high risk of VTE (up to 80%). It is essential to provide VTE prophylaxis. Patients advanced age and their polymorbidity contribute to the thrombophilic status. Objectives and methods: The aim of the study was to determine the changes of coagulation within the 28 post-operative days in 41 patients over 75 years who underwent hip fracture surgery. Another object was to determine acute phase response and an endothelial activation. The third task was to determine how affected is a key component of hemostasis, FXa activity by its specific inhibitor fondaparinux and enoxaparin, which inhibits FXa and thrombin in a 4:1 ratio and if there is bleeding complication in such a risk group patiens after antithrombotics long-term administration. Patients were randomly divided into two anticoagulant groups: fondaparinux (n = 23) and enoxaparin (n = 18). Results: Thrombophilia is demonstrated by a reactive increase of the most of these parameters preoperatively and reveals the effect of the initial trauma. A surgery further aggravates this reaction. This inflammatory and secondary prothrombogenic condition persisted until postoperative day 28. Both antithrombotics effectively inhibit thrombin generation without...

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