Made available in DSpace on 2014-06-11T19:25:36Z (GMT). No. of bitstreams: 0 Previous issue date: 2012-01-31Bitstream added on 2014-06-13T19:32:56Z : No. of bitstreams: 1 arruda_ka_me_botfm.pdf: 7832149 bytes, checksum: 25a2e29b369d61ab33b2c873f2f89db5 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / As cirurgias abdominais supra-umbilicais e torácicas são procedimentos com grande chance de complicações cardiorrespiratórias no pós-operatório (CPO). Determinar se os testes utilizados no pré-operatório para avaliação das funções cardíaca e pulmonar são capazes de diferenciar os pacientes que teriam maiores chances de desenvolver complicações no pós-operatório, em dois grupos de pacientes, os submetidos à cirurgia abdominal supra-umbilical e os submetidos à cirurgia torácica por via não esternal, e quais os testes mais importantes em cada uma das intervenções. Foram avaliados os candidatos a laparotomia supra-umbilical (Grupo L) e à toracotomia (Grupo T), de fevereiro de 2010 a agosto de 2011. Foi realizado espirometria, ventilometria, manovacuometria, teste de caminhada de seis minutos (TC6) e teste de escada (TE). Foram anotadas as CPO desde o pós-operatório imediato até a alta hospitalar. Os pacientes foram divididos em dois subgrupos relacionado com a ausência (A) ou presença (B) de CPO (LA e LB, TA e TB). Foi realizado o teste de Shapiro-wilki para avaliar a distribuição das variáveis, quando normal foi utilizado o teste t de Student e não normal o teste de Mann-Whitney. Foram realizadas a regressão uni e multivariada para associação das variáveis com as CPO e o p<0,05 foi considerado significativo. Foram avaliados 78 pacientes (30 grupo L e 48 grupo T). As taxas de CPO foram 17% no grupo L e 10% no grupo T. No grupo L as variáveis da manovacuometria foram significativamente menores no subgrupo LB, enquanto no grupo T as variáveis espirométricas, e do TC6 e TE, foram significativamente menores no subgrupo TB. Na regressão univariada a única variável que manteve correlação com as CPO na laparotomia foi a PEmax%, sendo considerada fator protetor. Na toracotomia a ventilação voluntária máxima... / Upper abdominal and thoracic surgery are procedures that present a high risk of cardiorespiratory complications in postoperative (POC). Evaluating if the tests used in preoperative to provide cardiopulmonary evaluation are able to differentiate the patients that presented complications in postoperative period, patients submitted to upper abdominal or to thoracic surgeries well as the most important tests for each of the interventions. The candidates for upper abdominal surgery were evaluated (UAS Group) and for thoracic surgery (TS Group), from February, 2010 to August, 2011. Spirometry, respirometry, manovacuometry, 6- minute walk test (6MWT) and stairclimbing test (SCT) were performed. The POC from immediate postoperative to discharge from hospital were registered. The patients were divided into two subgroups (UAA and UAP, TA and TP) related to the absence (A) or presence (P) of POC. Shapiro-wilki Test was performed in order to evaluate the distribution of variables; Student t test was performed when normal, whereas Mann-Whitney test, when not normal. Univariate and multivariate regression were carried out for association of variables with POC and the p<0.05 was considered significant. 78 patients were evaluated (30 from UAS Group and 48 from TS Group). The POC rates were 17% in UAS Group and 10% in TS Group. In UAS Group, the variables of manovacuometry were significantly lower in UAP Subgroup, while in TS Group, the spirometric, 6MWT and SCT variables were significantly lower in TP Subgroup. Related to univariated regression, the only variable that kept the correlation with POC in the upper abdominal surgery was PEmax%, being considered as a protective factor. In thoracic surgery, the MVV%, 6MWT and tTE presented correlation with POC, and MVV% and 6MWT were considered protective factors... (Complete abstract click electronic access below)

Made available in DSpace on 2015-06-17T19:34:19Z (GMT). No. of bitstreams: 0 Previous issue date: 2014-07-31. Added 1 bitstream(s) on 2015-06-18T12:49:04Z : No. of bitstreams: 1 000831392.pdf: 1327749 bytes, checksum: c3b1aa57fef6b19f5e5e19cb0ffbcd09 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Este trabalho teve como objetivo a otimização de imagens de radiografia computadorizada (CR, do inglês, computed radiography) de crânio e tórax de pacientes pediátricos entre 1 e 5 anos de idade. Para atingir esse objetivo foram desenvolvidos fantomas homogêneos pediátricos, que simularam a faixa etária em estudo, a partir de exames retrospectivos de tomografia computadorizada (CT, do inglês, computed tomography). Nesse procedimento foi utilizado um algoritmo computacional para quantificar as espessuras médias de tecidos biológicos (tecido pulmonar, adiposo, mole e ósseo) presentes nas regiões anatômicas em estudo. Essas espessuras foram convertidas em materiais simuladores (lucite e alumínio) de modo a compor os fantomas homogêneos de crânio e tórax. As incertezas relativas no processo de quantificação dos exames de crânio foram de 3,5% para tecido mole e 9,5% para tecido ósseo. Na quantificação dos exames de tórax a incerteza relativa foi de 19,4% para o tecido pulmonar, 13,0% para o tecido mole e 20,0% para o tecido ósseo. O fantoma de tórax foi construído com 7,3 cm de lucite distribuídos em 4 placas de mesma espessura (15,0 x 15,0 x 1,82) cm³ arranjadas em dois pares, separadas por um espaçamento de ar de 2,86 cm. Duas placas de alumínio de (15,0 x 15,0 x 0,13) cm³ e (150,0 x 150,0 x 1,0) mm³ foram inseridas, respetivamente, entre os pares superior e inferior de lucite. O fantoma de crânio foi construído com 11,98 cm de lucite distribuídos em cinco placas de mesma espessura (15,0 x 15,0 x 2,33) cm³. Duas placas de alumínio (15,0 x 15,0 x 0,16) cm³ e (15,0 x 15,0 x 0,12) cm³ foram inseridas, respectivamente, entre os pares superior e inferior de lucite. Os fantomas homogêneos foram utilizados no processo de otimização de imagens em sistemas CR, para calibração do feixe de raios X. No processo de calibração foram determinadas técnicas-teste (combinação kVp e mAs), que produziram índices de ... / The aim of this work was to optimize computed radiography techniques of skull and chest for pediatric patients between 1 and 5 years old. To achieve this goal, pediatric homogenous phantoms were developed from retrospective computed tomography (CT) scans. In this procedure, a computational algorithm was used to quantify the average thickness of biological tissue (lung, fat, soft and bone tissue) present on the anatomic region under study. These thicknesses were converted into simulators materials (Lucite and aluminum) to build the homogeneous phantoms of skull and chest. The relative uncertainties in the quantification process of skull examinations were 3.5% for soft tissue and 9.5% for bone tissue. In the chest examination, the relative uncertainties were 19.4% for lung tissue, 13.0% for soft tissue and 20.0% for bone tissue. The chest phantom was constructed with 7.3 cm of lucite distributed in four plates of the same thickness (15.0 x 15.0 x 1.82) cm³ arranged in two pairs, separated by a spacing of 2.86 cm of air. Two aluminum plates (15.0 x 15.0 x 0.13) cm³ and (15.0 x 15.0 x 0.10) mm³ were inserted, respectively, between the upper and lower pairs of Lucite. The skull phantom was constructed with 11.98 cm of Lucite distributed in five plates of the same thickness (15.0 x 15.0 x 2.33) cm³. Two aluminum plates (15.0 x 15.0 x 0.16) cm³ and (15.0 x 15.0 x 0.12) cm³ were inserted between the upper and lower pairs of Lucite. These homogeneous phantoms were used in the optimization process for CR systems to determine test techniques (kVp and mAs combination), which produced levels of exposure around 1.96 lgM. The test images, obtained in this process, were used in the determination of physical parameters such as the effective detective quantum efficiency (eDQE) and contrast-detail. These parameters were associated with the optimal images of skull and chest for adult patients obtained in previous studies. Optimal images obtained in ...

Orientador: José Ricardo de Arruda Miranda / Coorientador: Diana rodrigues de Pina / Banca: Sérgio Barbosa Duarte / Banca: Rozemeire Garcia Marques / Resumo: Este trabalho teve como objetivo a otimização de imagens de radiografia computadorizada (CR, do inglês, computed radiography) de crânio e tórax de pacientes pediátricos entre 1 e 5 anos de idade. Para atingir esse objetivo foram desenvolvidos fantomas homogêneos pediátricos, que simularam a faixa etária em estudo, a partir de exames retrospectivos de tomografia computadorizada (CT, do inglês, computed tomography). Nesse procedimento foi utilizado um algoritmo computacional para quantificar as espessuras médias de tecidos biológicos (tecido pulmonar, adiposo, mole e ósseo) presentes nas regiões anatômicas em estudo. Essas espessuras foram convertidas em materiais simuladores (lucite e alumínio) de modo a compor os fantomas homogêneos de crânio e tórax. As incertezas relativas no processo de quantificação dos exames de crânio foram de 3,5% para tecido mole e 9,5% para tecido ósseo. Na quantificação dos exames de tórax a incerteza relativa foi de 19,4% para o tecido pulmonar, 13,0% para o tecido mole e 20,0% para o tecido ósseo. O fantoma de tórax foi construído com 7,3 cm de lucite distribuídos em 4 placas de mesma espessura (15,0 x 15,0 x 1,82) cm³ arranjadas em dois pares, separadas por um espaçamento de ar de 2,86 cm. Duas placas de alumínio de (15,0 x 15,0 x 0,13) cm³ e (150,0 x 150,0 x 1,0) mm³ foram inseridas, respetivamente, entre os pares superior e inferior de lucite. O fantoma de crânio foi construído com 11,98 cm de lucite distribuídos em cinco placas de mesma espessura (15,0 x 15,0 x 2,33) cm³. Duas placas de alumínio (15,0 x 15,0 x 0,16) cm³ e (15,0 x 15,0 x 0,12) cm³ foram inseridas, respectivamente, entre os pares superior e inferior de lucite. Os fantomas homogêneos foram utilizados no processo de otimização de imagens em sistemas CR, para calibração do feixe de raios X. No processo de calibração foram determinadas técnicas-teste (combinação kVp e mAs), que produziram índices de ... / Abstract: The aim of this work was to optimize computed radiography techniques of skull and chest for pediatric patients between 1 and 5 years old. To achieve this goal, pediatric homogenous phantoms were developed from retrospective computed tomography (CT) scans. In this procedure, a computational algorithm was used to quantify the average thickness of biological tissue (lung, fat, soft and bone tissue) present on the anatomic region under study. These thicknesses were converted into simulators materials (Lucite and aluminum) to build the homogeneous phantoms of skull and chest. The relative uncertainties in the quantification process of skull examinations were 3.5% for soft tissue and 9.5% for bone tissue. In the chest examination, the relative uncertainties were 19.4% for lung tissue, 13.0% for soft tissue and 20.0% for bone tissue. The chest phantom was constructed with 7.3 cm of lucite distributed in four plates of the same thickness (15.0 x 15.0 x 1.82) cm³ arranged in two pairs, separated by a spacing of 2.86 cm of air. Two aluminum plates (15.0 x 15.0 x 0.13) cm³ and (15.0 x 15.0 x 0.10) mm³ were inserted, respectively, between the upper and lower pairs of Lucite. The skull phantom was constructed with 11.98 cm of Lucite distributed in five plates of the same thickness (15.0 x 15.0 x 2.33) cm³. Two aluminum plates (15.0 x 15.0 x 0.16) cm³ and (15.0 x 15.0 x 0.12) cm³ were inserted between the upper and lower pairs of Lucite. These homogeneous phantoms were used in the optimization process for CR systems to determine test techniques (kVp and mAs combination), which produced levels of exposure around 1.96 lgM. The test images, obtained in this process, were used in the determination of physical parameters such as the effective detective quantum efficiency (eDQE) and contrast-detail. These parameters were associated with the optimal images of skull and chest for adult patients obtained in previous studies. Optimal images obtained in ... / Mestre

Orientador: José Geraldo Trani Brandão / Banca: Celso Pinto Morais Pereira / Banca: Mauro Gonçalves / Resumo: A vibração torácica é uma técnica de fisioterapia respiratória utilizada para higienização brônquica, que facilita a remoção da secreção, evitando sua retenção e danos na função pulmonar, como na troca gasosa. Existe um grande número de pacientes com problemas respiratórios que se beneficiam desta técnica. O propósito deste trabalho é justamente analisar e mensurar a freqüência de oscilação da técnica de vibração torácica, realizada por diversos fisioterapeutas, que atuam em fisioterapia respiratória ou em outra área da fisioterapia, para que, por meio desses estudos possam verificar qual a freqüência da técnica de vibração torácica predominante, e se a freqüência obtida está próxima da freqüência da literatura técnica, uma vez que existem poucos trabalhos científicos em questão. A freqüência de vibração é medida em hertz (Hz). / Abstract: The chest vibration is a technique of respiratory physiotherapy used in order to promote a bronquial cleaning, to facilitate the sputum removal of the secretion, preventing its retention and damages in the pulmonary function as in the gaseous exchange. A great number of patients with respiratory problems exists that are benefit of this technique. The intention of this work is exactly to analyze and to measure the frequency of oscillation of the technique of chest vibration, carried through by diverse physiotherapists, who act with in respiratory physiotherapy and that they act in another area of the physiotherapy, so that through these studies can verify which the frequency of the technique of predominant chest vibration between them, and if the gotten frequency is next to the frequency of literature, technique exists few scientific works in question. The vibration frequency is measured in hertz (Hz). / Mestre

Orientador: Daniele Cristina Cataneo / Coorientador: Antonio José maria Cataneo / Banca: alexandre Ricardo Pepe Ambrozin / Banca: Olavo Ribeiro Rodrigues / Resumo: As cirurgias abdominais supra-umbilicais e torácicas são procedimentos com grande chance de complicações cardiorrespiratórias no pós-operatório (CPO). Determinar se os testes utilizados no pré-operatório para avaliação das funções cardíaca e pulmonar são capazes de diferenciar os pacientes que teriam maiores chances de desenvolver complicações no pós-operatório, em dois grupos de pacientes, os submetidos à cirurgia abdominal supra-umbilical e os submetidos à cirurgia torácica por via não esternal, e quais os testes mais importantes em cada uma das intervenções. Foram avaliados os candidatos a laparotomia supra-umbilical (Grupo L) e à toracotomia (Grupo T), de fevereiro de 2010 a agosto de 2011. Foi realizado espirometria, ventilometria, manovacuometria, teste de caminhada de seis minutos (TC6) e teste de escada (TE). Foram anotadas as CPO desde o pós-operatório imediato até a alta hospitalar. Os pacientes foram divididos em dois subgrupos relacionado com a ausência (A) ou presença (B) de CPO (LA e LB, TA e TB). Foi realizado o teste de Shapiro-wilki para avaliar a distribuição das variáveis, quando normal foi utilizado o teste t de Student e não normal o teste de Mann-Whitney. Foram realizadas a regressão uni e multivariada para associação das variáveis com as CPO e o p<0,05 foi considerado significativo. Foram avaliados 78 pacientes (30 grupo L e 48 grupo T). As taxas de CPO foram 17% no grupo L e 10% no grupo T. No grupo L as variáveis da manovacuometria foram significativamente menores no subgrupo LB, enquanto no grupo T as variáveis espirométricas, e do TC6 e TE, foram significativamente menores no subgrupo TB. Na regressão univariada a única variável que manteve correlação com as CPO na laparotomia foi a PEmax%, sendo considerada fator protetor. Na toracotomia a ventilação voluntária máxima... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Upper abdominal and thoracic surgery are procedures that present a high risk of cardiorespiratory complications in postoperative (POC). Evaluating if the tests used in preoperative to provide cardiopulmonary evaluation are able to differentiate the patients that presented complications in postoperative period, patients submitted to upper abdominal or to thoracic surgeries well as the most important tests for each of the interventions. The candidates for upper abdominal surgery were evaluated (UAS Group) and for thoracic surgery (TS Group), from February, 2010 to August, 2011. Spirometry, respirometry, manovacuometry, 6- minute walk test (6MWT) and stairclimbing test (SCT) were performed. The POC from immediate postoperative to discharge from hospital were registered. The patients were divided into two subgroups (UAA and UAP, TA and TP) related to the absence (A) or presence (P) of POC. Shapiro-wilki Test was performed in order to evaluate the distribution of variables; Student t test was performed when normal, whereas Mann-Whitney test, when not normal. Univariate and multivariate regression were carried out for association of variables with POC and the p<0.05 was considered significant. 78 patients were evaluated (30 from UAS Group and 48 from TS Group). The POC rates were 17% in UAS Group and 10% in TS Group. In UAS Group, the variables of manovacuometry were significantly lower in UAP Subgroup, while in TS Group, the spirometric, 6MWT and SCT variables were significantly lower in TP Subgroup. Related to univariated regression, the only variable that kept the correlation with POC in the upper abdominal surgery was PEmax%, being considered as a protective factor. In thoracic surgery, the MVV%, 6MWT and tTE presented correlation with POC, and MVV% and 6MWT were considered protective factors... (Complete abstract click electronic access below) / Mestre

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Background: Early post-percutaneous coronary intervention chest pain (EPPCP) appears to be a common clinical phenomenon. EPPCP has not been fully explained or studied in the literature despite the abundance of clinical trials on percutaneous coronary intervention (PCI). The objective of this questionnaire-based survey is to assess the current perception of EPPCP among practicing interventional cardiologists nationwide. Methods: A survey questionnaire was designed utilizing the Survey Monkey tool to address the perceptions and current practices regarding key aspects of EPPCP among interventional cardiologists. The survey was sent to the interventional cardiologists via email. Results: The survey questionnaire regarding EPPCP was provided to 2615 practicing interventional cardiologists and resulted in 623 total survey responses, with 503 of those respondents completing all eight survey questions. A total of 50.2% of the interventional cardiologists perceive that the incidence of EPPCP is 5–10%, and 57.5% consider that repeat angiography or PCI is rarely needed (1 in 1000 cases). A total of 47.1% of the participants think that EPPCP is due to transient microvascular dysfunction, while 39% perceive it as a different entity requiring a different approach. When asked about developing a standardized labeling for the phenomenon of EPPCP, 34.8% of responders indicated that they believe EPPCP should be labeled as a benign form of chest pain/angina, and 28% preferred to describe EPPCP in non-standardized terms. Among interventional cardiologists, 80% thought that the treatment of this entity is a combination of reassurance and vasodilators and, without ischemic ECG changes, medical management is appropriate. Conclusion: A total of 72% of interventional cardiologists in our survey preferred to label EPPCP as standard nomenclature to facilitate communication between healthcare providers, patients and families in a consistent way. There is a diversity of opinion regarding EPPCP, no standard nomenclature, and no guideline to standardize practice. Further large-scale prospective studies are needed to better understand the pathophysiological mechanisms, optimal management strategies, prognostic implications, and clinical reporting of EPPCP.

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No description available.

No description available.