Concern for the nonphysiologic energy required to actuate medical devices utilizing “smart material” properties of shape memory polymer (SMP) compels a rigorous investigation into the flow and temperature fields surrounding a thermally activated catheter device. Multiple analyses include the theoretical approaches of exact analytical solutions and finite difference modeling combined with the experimental techniques of particle image velocimetry (PIV) and laser-induced fluorescence (LIF). The attained velocities and temperatures related to the convective heat transfer impact the potential for blood or tissue damage caused by intravascular heating. The clinical scenario involving a catheter device receiving heat within an artery is modeled in its simplest form as a cylindrical metal cap on the tip of a hollow glass rod placed inside of a long straight tube of constant cross-sectional area. Using a working fluid with properties comparable to blood, flow rates and energy input is then varied to determine their effects on velocity fields and temperature gradients. Analytical solutions for both the straight tube and concentric annulus demonstrate the two velocity distributions involved, as flow moves past the gap between the catheter and artery wall and then converges downstream to the Poiseuille solution for steady pipe flow of an incompressible fluid. To solve for the transition between the velocity profiles, computational fluid dynamics software simulates a finite volume model identical to the experimental setup used for intravascular heating experiments. PIV and LIF, both experimental techniques making use of similar hardware, determine velocity fields and temperature distributions, respectively, by imaging fluid seeding agents and their particular interaction with the light sheet. The velocity and temperature fields obtained experimentally are matched with the analytical and finite volume analysis through fluid properties, flow rates, and heating rates. Velocities determined during device heating show a small increase in local velocity, due to temperature dependent viscosity effects. When the device is centered in the model, flow patterns constrain the heat flow near the center axis and away from the channel walls. Increasing flow rate consequently decreases temperature rise, as the heat is carried more quickly downstream and away from the heat source. Using multiple analyses, fluid velocity and temperature distributions are first theorized with analytical and finite element methods and then validated through experimental imaging in a physical model.

Este trabalho tem como eixos de reflexão a Cidade Contemporânea e o Habitar as Ruas. Partimos de um foco: as pessoas em situação de rua. Mas entendemos que pensar a população de rua não se dá de forma isolada, mas em conexão com a cidade e o habitar as ruas. Buscamos investigar como se dá o processo de subjetivação das pessoas no espaço urbano da cidade contemporânea e, em especial, daquelas em situação de rua. A partir dos pressupostos da pesquisaintervenção, oriunda da Análise Institucional Socioanalítica, estabelecemos o que chamamos de encontro-intervenção com a população de rua. Procuramos dar visibilidade a uma realidade que pouco temos contato, e por muitas vezes, já impregnada, estereotipada, estigmatizada a respeito de quem seja a população em situação de rua. Apostamos, então, na abertura de espaços para a apresentação de falas, discursos, textos, conversas, diálogos com nossos interlocutores na tentativa de constituir um mapeamento das relações que se estabelecem no espaço urbano. Assim, podemos entender de duas formas o enunciado “habitar as ruas”: enquanto espaço de interação, de encontro, espaço da polis. Espaço de pensar a vida, de relacionar-se com o outro, de construir alternativas de vida de qualidade para todos e não apenas para alguns. E também, como espaço de abrigo, refúgio para aqueles que não moram entre quatro paredes, e têm a rua como casa. O habitar as ruas vem num sentido propositivo de abrirmos brechas em nossas relações para o convívio com o outro, com o diferente. Abrir-se a uma cidade múltipla, uma cidade do contato, da vida. / The axes of reflection in this paper are the Contemporary City and Street-Dwelling. Our starting point is the people who are in street situation, but it is our understanding that one cannot isolate the study of the street population without expanding the context to the city and the concept of street-dwelling. We tried to investigate how the process of subjectivation of people in the urban space of the contemporary city takes place, specifically regarding those who live in the streets. Based on the assumptions of interventional research originated from the Socio-institutional Analysis, we established what we called interventional meeting with the street population. We tried to bring to the fore a reality that we are not familiar with; and often causes the population in street situation to be viewed in a prejudiced, stereotyped and stigmatized way. Therefore, we widened our scope to present speeches, discourses, texts, talks and dialogues with our interlocutors, in the attempt of mapping out the relationships that occur in the urban space. Thus, there are two ways one can understand the proposition "street dwelling": as a space for interacting; for meeting; a polis – a space to reflect on life; to relate to one another; to build quality life alternatives for all and not just for some. And also as a shelter, a refuge for those who do not live within four walls and use the streets as a home. The street-dwelling concept bears a notion that we should breach the walls in our relationships to live with otherness; to open up to a multiple city; a city of connection, of life.

During image guided interventional radiology (IR) procedures, acute X-ray induced skin injuries may occur due to high absorbed patient skin dose. These procedures are highly dependent on X-ray imaging both for guiding fluoroscopy and high quality diagnostic image acquisitions. A dose metric that quantifies the peak absorbed skin dose (PSD) is therefore of great importance, both in terms of patient specific follow-up and for imaging protocol optimization. Presently, the cumulative interventional reference point (IRP) air Kerma is the most common skin dose estimation metric in use. This metric lacks several important dose contributions, such as pre-patient attenuation, air-to-skin medium correction, scattering from the patient and the support table, and fluence correction for actual source-to-skin distance. In this manuscript, we present a novel methodology for estimating the maximum absorbed skin dose by using dose related X-ray equipment parameters, such as peak tube voltage, support table position and IRP air Kerma obtained from radiation dose structured reports (RDSR) generated by modern IR equipment. In particular, Siemens Artis Zee (Siemens Healthineers, Erlangen, Germany) and Philips Allura Clarity (Philips, Amsterdam, Netherlands). The calculation process was automated by the development of a series of programming scripts in the PythonTM programming language v3.6 (Python Software Foundation), together with a database storing correction factors and machine specific parameters such as half-value layer (HVL). The proposed calculation model enables the implementation of a dose metric which corresponds better to absorbed skin dose than IRP air Kerma in clinical settings. However, extensive future work is required for a complete PSD implementation, in particular, the development of a skin dose map in which the spatial location of each irradiation event is tracked.

Background: Glucagon-like Peptide 1 (GLP-1) is a human incretin hormone that has been demonstrated to protect against non-lethal ischaemia reperfusion injury in the left ventricle in humans. It has been suggested from some animal research that this protection may be mediated through the pathway of ischaemic conditioning, of which the opening of the mKATP channel is a key step. Furthermore, it is uncertain whether the protection applies to the right ventricle. Finally, there is limited human evidence of a protective effect against lethal ischaemia reperfusion injury. Methods: Two studies use non-lethal ischaemia to test whether GLP-1 protection is maintained despite blockade of the mKATP channel with the sulfonylurea, glibenclamide. A demand ischaemia study uses dobutamine stress echo to compare LV function. The other uses transient coronary balloon occlusion to generate supply ischaemia during GLP-1 infusion, assessed by conductance catheter. A further transient balloon occlusion is also used to assess the effect of supply ischaemia on RV function. Finally, the GOLD PCI study assesses whether GLP-1 protects against periprocedural myocardial infarction when administered during elective PCI in a randomised, placebo controlled double blind trial. Results: Glibenclamide did not affect GLP-1 cardioprotection in either supply of demand ischaemia suggesting that GLP-1 protection is not mediated through the mKATP channel. The RV experienced stunning with RCA balloon occlusion but there was little evidence of cumulative ischaemic dysfunction with further occlusions. GOLD PCI is continuing to recruit patients. The nature of the study means results cannot be assessed until recruitment is complete. Conclusions: GLP-1 is an agent with potential for clinical use as a cardioprotective therapy. It’s mechanism of action in the heart remains uncertain.

Este trabalho tem como eixos de reflexão a Cidade Contemporânea e o Habitar as Ruas. Partimos de um foco: as pessoas em situação de rua. Mas entendemos que pensar a população de rua não se dá de forma isolada, mas em conexão com a cidade e o habitar as ruas. Buscamos investigar como se dá o processo de subjetivação das pessoas no espaço urbano da cidade contemporânea e, em especial, daquelas em situação de rua. A partir dos pressupostos da pesquisaintervenção, oriunda da Análise Institucional Socioanalítica, estabelecemos o que chamamos de encontro-intervenção com a população de rua. Procuramos dar visibilidade a uma realidade que pouco temos contato, e por muitas vezes, já impregnada, estereotipada, estigmatizada a respeito de quem seja a população em situação de rua. Apostamos, então, na abertura de espaços para a apresentação de falas, discursos, textos, conversas, diálogos com nossos interlocutores na tentativa de constituir um mapeamento das relações que se estabelecem no espaço urbano. Assim, podemos entender de duas formas o enunciado “habitar as ruas”: enquanto espaço de interação, de encontro, espaço da polis. Espaço de pensar a vida, de relacionar-se com o outro, de construir alternativas de vida de qualidade para todos e não apenas para alguns. E também, como espaço de abrigo, refúgio para aqueles que não moram entre quatro paredes, e têm a rua como casa. O habitar as ruas vem num sentido propositivo de abrirmos brechas em nossas relações para o convívio com o outro, com o diferente. Abrir-se a uma cidade múltipla, uma cidade do contato, da vida. / The axes of reflection in this paper are the Contemporary City and Street-Dwelling. Our starting point is the people who are in street situation, but it is our understanding that one cannot isolate the study of the street population without expanding the context to the city and the concept of street-dwelling. We tried to investigate how the process of subjectivation of people in the urban space of the contemporary city takes place, specifically regarding those who live in the streets. Based on the assumptions of interventional research originated from the Socio-institutional Analysis, we established what we called interventional meeting with the street population. We tried to bring to the fore a reality that we are not familiar with; and often causes the population in street situation to be viewed in a prejudiced, stereotyped and stigmatized way. Therefore, we widened our scope to present speeches, discourses, texts, talks and dialogues with our interlocutors, in the attempt of mapping out the relationships that occur in the urban space. Thus, there are two ways one can understand the proposition "street dwelling": as a space for interacting; for meeting; a polis – a space to reflect on life; to relate to one another; to build quality life alternatives for all and not just for some. And also as a shelter, a refuge for those who do not live within four walls and use the streets as a home. The street-dwelling concept bears a notion that we should breach the walls in our relationships to live with otherness; to open up to a multiple city; a city of connection, of life.

In my thesis I have been dealing with the prevalence of the overweight and obesity of students studying the first grades in the ZF JU and also with the possibilities of the reduction of these by means of the interventional active plan lasting 12 weeks. The prevalence of students´ overweight and obesity was finally found out thanks to the values of BMI, BIA, the girth and also thanks to the values gained by measuring with a caliper. On the basis of the research, which 160 students were involved in, the students with a higher portion of fat were chosen (33 probands to experimental group and 30 students to control group). Since February 2007 till May 2007 the experimental group was undergoing the interventional active plan. The plan was focused on the reduction of an actual body weight and it was also focused on an affecting of the psychical and social parameters in a positive way. After finishing this interventional active plan the obtained results were analysed by means of the statistic methods. This created plan could become an inspiration and also a clue for the organisations which are engaged in the problems of the overweight or obesity in the sphere of the development of health

Graduation theses solve the suggestion and verification of compensatory exercise for one {--} sidedly oriented sportsman. Tested group is tennis-players from Teniscentrum Příbram. By the influence of one {--} sidedly oriented movement can form functional and structural fault motoric systém of muscle dysbalance and to form fault motoric stereotype. Periodic compensatory exercise which is made by relaxation, stretching and weight training with breathing exercise and relaxation exercise can help to reduction negative problems. The results that certify positive contribution compensatory exercise are processing in tables and graphs.

Este trabalho tem como eixos de reflexão a Cidade Contemporânea e o Habitar as Ruas. Partimos de um foco: as pessoas em situação de rua. Mas entendemos que pensar a população de rua não se dá de forma isolada, mas em conexão com a cidade e o habitar as ruas. Buscamos investigar como se dá o processo de subjetivação das pessoas no espaço urbano da cidade contemporânea e, em especial, daquelas em situação de rua. A partir dos pressupostos da pesquisaintervenção, oriunda da Análise Institucional Socioanalítica, estabelecemos o que chamamos de encontro-intervenção com a população de rua. Procuramos dar visibilidade a uma realidade que pouco temos contato, e por muitas vezes, já impregnada, estereotipada, estigmatizada a respeito de quem seja a população em situação de rua. Apostamos, então, na abertura de espaços para a apresentação de falas, discursos, textos, conversas, diálogos com nossos interlocutores na tentativa de constituir um mapeamento das relações que se estabelecem no espaço urbano. Assim, podemos entender de duas formas o enunciado “habitar as ruas”: enquanto espaço de interação, de encontro, espaço da polis. Espaço de pensar a vida, de relacionar-se com o outro, de construir alternativas de vida de qualidade para todos e não apenas para alguns. E também, como espaço de abrigo, refúgio para aqueles que não moram entre quatro paredes, e têm a rua como casa. O habitar as ruas vem num sentido propositivo de abrirmos brechas em nossas relações para o convívio com o outro, com o diferente. Abrir-se a uma cidade múltipla, uma cidade do contato, da vida. / The axes of reflection in this paper are the Contemporary City and Street-Dwelling. Our starting point is the people who are in street situation, but it is our understanding that one cannot isolate the study of the street population without expanding the context to the city and the concept of street-dwelling. We tried to investigate how the process of subjectivation of people in the urban space of the contemporary city takes place, specifically regarding those who live in the streets. Based on the assumptions of interventional research originated from the Socio-institutional Analysis, we established what we called interventional meeting with the street population. We tried to bring to the fore a reality that we are not familiar with; and often causes the population in street situation to be viewed in a prejudiced, stereotyped and stigmatized way. Therefore, we widened our scope to present speeches, discourses, texts, talks and dialogues with our interlocutors, in the attempt of mapping out the relationships that occur in the urban space. Thus, there are two ways one can understand the proposition "street dwelling": as a space for interacting; for meeting; a polis – a space to reflect on life; to relate to one another; to build quality life alternatives for all and not just for some. And also as a shelter, a refuge for those who do not live within four walls and use the streets as a home. The street-dwelling concept bears a notion that we should breach the walls in our relationships to live with otherness; to open up to a multiple city; a city of connection, of life.

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No. of bitstreams: 1 andrenoronhaarvellos.pdf: 6808287 bytes, checksum: 93e22153b8dde05493e1fda7161ac573 (MD5) Previous issue date: 2011-08-26 / Introdução: Impulsionada pelo crescimento da endourologia, a busca de novas técnicas para o acesso percutâneo, com intuito de tornar o procedimento ainda menos invasivo e mais seguro, teve como marco os trabalhos de Valdivia Uría, que propôs e descreveu primeiramente a técnica de punção do paciente em decúbito dorsal inclinado, mostrando menor tempo de procedimento e melhora nos parâmetros cardiorrespiratórios durante sua realização em relação à técnica clássica em decúbito ventral, com sucesso terapêutico e morbidade semelhantes. Mesmo após mais de 20 anos da descrição da sua técnica e com a publicação de outras séries de casos por outros autores, a mesma não teve a difusão esperada. Pacientes e métodos: Foi realizada análise de exames de tomografia computadorizada de 71 pacientes através de simulações de nefrostomia percutânea nos decúbitos dorsal e ventral, correlacionando-se os resultados com variáveis antropométricas e quantificação da gordura abdominal no seu padrão de distribuição nos compartimentos visceral e subcutâneo. Resultados: Não houve diferença estatística entre o número de lesões de órgãos abdominais para os diferentes decúbitos nas simulações realizadas no plano axial (p=0,5621). Nas simulações oblíquas, os resultados mostraram significância estatística da diferença do decúbito no risco de lesão, sendo o resultado desfavorável ao decúbito ventral (p=0,0295). O órgão mais freqüentemente sob risco foi o cólon, seguido de longe pelo intestino delgado. A avaliação indireta do risco de lesão através de medidas da distância do cólon ao rim mostrou maior proximidade destes na posição de decúbito ventral, para ambos os lados, de forma estatisticamente significativa. Quanto à metodologia de análise, observou-se maior número de lesões nas simulações realizadas no plano axial do que nas simulações oblíquas tanto no decúbito ventral (p= 0,0274) como no dorsal (p= 0,0002). Nas simulações no plano axial, os pacientes que tiveram órgãos lesados mostraram de forma estatisticamente significativa menores peso, índice de massa corpórea (IMC) e quantidade de gordura visceral independente do decúbito. No plano oblíquo, não foi observada associação estatística com tais variáveis. Conclusão: Houve maior risco de lesão de órgãos abdominais (principalmente o cólon) no decúbito ventral, tanto através das simulações de punção, quanto através da análise indireta de risco através das medidas de proximidade do cólon com o rim. A metodologia com as simulações no plano oblíquo mostrou-se mais adequada, com resultados mais próximos das grandes séries de casos onde o procedimento foi realizado. Em relação aos dados antropométricos e padrão de distribuição da gordura abdominal por tomografia computadorizada (TC), os pacientes que tiveram órgãos lesados apresentaram de forma estatisticamente significativa menores peso, IMC e área de gordura visceral nas simulações no plano axial, para a análise conjunta das metodologias em ambos os decúbitos e para a análise conjunta da ocorrência independente da metodologia ou do decúbito. Na metodologia de análise no plano oblíquo, os baixos valores de p para as variáveis peso (0,07) e IMC (0,06) podem representar uma tendência em relação ao risco de lesão, talvez com significância estatística limitada pelo tamanho da amostra. / Introduction: The search for less invasive and safer techniques of percutaneous access in endourology had, as landmark, the studies undergone by Valdivia Uria, who first proposed and described access through the inclined supine position, with shortened procedure time and better cardiorespiratory parameters, compared with the traditional access in the prone position, and also showing similar success and morbidity rates. Although more than 20 years have elapsed since the first publication of the technique, and despite publications by other authors, the technique has not been so widely embraced as expected. Patients and methods: 71 patients underwent simulated percutaneous nephrostomy through computed tomography (CT), in both the supine and prone positions. The results were correlated with anthropometric variables and quantification of abdominal fat distribution in the visceral and subcutaneous compartments. Results: There was no statistical difference between the number of abdominal organ injuries in the two different positions in the axial plane (p=0.5621). In oblique simulations, the difference in the risk of injury to abdominal organs was statistically significant between the two positions, with more injuries happening in the prone position (p=0.0295). The colon was the most frequently injured organ, followed by the small intestine in a distant second. Indirect injury risk assessment by measurement of the colon-kidney distance showed statistically significant greater proximity of these organs in the the prone position, on both sides. Concerning the analysis methodology, there were a greater number of injuries in the axial plane than in the oblique simulations, both in the prone position (p=0.0274) and in the supine position (p=0.0002). In the axial plane simulations, patients who suffered organ injuries had statistically significant lower weight, Body Mass Index (BMI) and visceral fat amount, regardless of the position. In the oblique plane, no such statistical association was found. Conclusion: There was greater risk of injury to abdominal organs (mainly the colon) in the prone position, both in puncture simulations and in indirect risk assessment of risk through the measurement of the colon-kidney distance. Simulation in the oblique plane was the most adequate method, as it provided results that were closer to the ones from large case series in which the procedure was performed. Concerning the anthropometric factors and the pattern of CT-assessed abdominal fat distribution, patients who suffered organ injuries had statistically significant lower weight, BMI and visceral fat amount, in the axial plane, for analysis of the two methods in both positions and for analysis of the injuries regardless of method and position. In the oblique plane analysis methodology the low p values for weight (0.07) and BMI (0.06) may represent a tendency towards the injury risk, maybe with a limited statistical significance owing to the sample size.

Abstract The purpose of this study was firstly to evaluate the optical instrument tracking system integrated to the MRI scanner as a guidance facility in performing bone biopsy and secondly to develop and evaluate clinical musculoskeletal applications of interventional MRI at 0,23T. The clinical results and feasibility of MR-guided bone biopsy (n=14), periradicular nerve root therapy (n=61), discography (n=12) and percutaneous laser therapy of osteiod osteomas (n=5) were studied. Bone biopsies were performed with the optical instrument tracker and bone biopsy set modified for the tracker system. The biopsy system and optical tracker mounting proved to be safe and reliable tool for bone biopsies. 14 consecutive bone biopsies and 13 fine needle aspirations were performed under MR-guidance. The clinical accuracy of MR-guided bone biopsy was 95%. The periradicular therapy was applied to the anatomical region of lumbosacral area of 61 consecutive patients with sciatic pain. Procedural success rate was 98,5%. Of patients, 51,5% had good or excellent effect with regard to radicular pain from procedure. The therapy effect achieved with MR-guided procedure was comparable to that achieved with conventional techniques. MR-guided discography technique and imaging protocol was developed as part of diagnostic pain provocation for patients suspected for intervertebral pain source at lumbosacral area. 34 MR-guided discographies were performed on 12 patients. In all patients positive or negative pain provocation response was obtained. Laser induced thermal therapy for osteiod osteoma was studied in MRI. The initial guidance of the instrument and monitoring of the thermal procedure were done under MRI control. All the 5 patients were successfully treated. The MR-guidance in musculoskeletal applications seems safe and accurate.