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Magnetic oxides are promising materials for alternative health diagnoses and treatments. The aim of this work is to understand the dependence of the heating power with the nanoparticle (NP) mean size, for the manganite composition La0.75Sr0.25MnO3 (LSMO)-the one with maximum critical temperature for the whole La/Sr ratio of the series. We have prepared four different samples, each one annealed at different temperatures, in order to produce different mean NP sizes, ranging from 26 nm up to 106 nm. Magnetization measurements revealed a FC-ZFC irreversibility and from the coercive field as function of temperature we determined the blocking temperature. A phase diagram was delivered as a function of the NP mean size and, based on this, the heating mechanism understood. Small NPs (26 nm) is heated up within the paramagnetic range of temperature (T>Tc), and therefore provide low heating efficiency; while bigger NPs are heated up, from room temperature, within the magnetically blocked range of temperature (T
RESUMEN
Objective: to discuss the participation of Plastic Surgery in the reconstruction of the chest wall, highlighting relevant aspects of interdisciplinaryness. Methods: we analyzed charts from 20 patients who underwent extensive resection of the thoracic integument, between 2000 and 2014, recording the indication of resection, the extent and depth of the raw areas, types of reconstructions performed and complications. Results: among the 20 patients, averaging 55 years old, five were males and 15 females. They resections were: one squamous cell carcinoma, two basal cell carcinomas, five chondrosarcomas and 12 breast tumors. The extent of the bloody areas ranged from 4x9 cm to 25x40 cm. In 12 patients the resection included the muscular plane. In the remaining eight, the tumor removal achieved a total wall thickness. For reconstruction we used: one muscular flap associated with skin grafting, nine flaps and ten regional fasciocutaneous flaps. Two patients undergoing reconstruction with fasciocutaneous flaps had partially suffering of the flap, solved with employment of a myocutaneous flap. The other patients displayed no complications with the techniques used, requiring only one surgery. Conclusion: the proper assessment of local tissues and flaps available for reconstruction, in addition to the successful integration of Plastic Surgery with the specialties involved in the treatment, enable extensive resections of the chest wall and reconstructions that provide patient recovery.
Objetivo: discorrer sobre a participação da Cirurgia Plástica na reconstrução da parede torácica, ressaltando os aspectos relevantes das associações interdisciplinares. Métodos: foram analisados prontuários de 20 pacientes submetidos a extensas ressecções do tegumento torácico, no período entre 2000 e 2014, quanto à indicação das ressecções, à extensão e à profundidade das áreas cruentas, aos tipos de reconstruções realizadas e às complicações. Resultados: entre os 20 pacientes, com média de 55 anos de idade, cinco eram do sexo masculino e 15 do feminino. Foram ressecados: um carcinoma espinocelular, dois carcinomas basocelulares, cinco condrossarcomas e 12 tumores de mama. A extensão das áreas cruentas variou de 4x9 cm até 25x40 cm. Em 12 pacientes as ressecções abrangeram o plano muscular. Nos oito restantes, a retirada do tumor atingiu a espessura total da parede. Para reconstrução foram utilizados: um retalho muscular associado à enxertia de pele, nove retalhos miocutâneos e dez retalhos fasciocutâneos da região. Em dois pacientes submetidos à reconstrução com retalhos fasciocutâneos houve sofrimento parcial do retalho, resolvido com o emprego de retalho miocutâneo. Nos outros pacientes não houve intercorrências com as técnicas empregadas, sendo necessária somente uma cirurgia. Conclusão: a adequada avaliação dos tecidos locais e dos retalhos disponíveis para a reconstrução, além da boa integração da Cirurgia Plástica com as especialidades envolvidas no tratamento, possibilitam extensas ressecções da parede torácica e reconstruções que propiciam a recuperação do paciente.
Asunto(s)
Humanos , Masculino , Femenino , Cirugía Plástica , Pared Torácica/cirugía , Colgajos Quirúrgicos/cirugía , Trasplante de Piel , Procedimientos de Cirugía Plástica , Persona de Mediana Edad , Neoplasias/cirugíaRESUMEN
OBJECTIVE: to discuss the participation of Plastic Surgery in the reconstruction of the chest wall, highlighting relevant aspects of interdisciplinaryness. METHODS: we analyzed charts from 20 patients who underwent extensive resection of the thoracic integument, between 2000 and 2014, recording the indication of resection, the extent and depth of the raw areas, types of reconstructions performed and complications. RESULTS: among the 20 patients, averaging 55 years old, five were males and 15 females. They resections were: one squamous cell carcinoma, two basal cell carcinomas, five chondrosarcomas and 12 breast tumors. The extent of the bloody areas ranged from 4x9 cm to 25x40 cm. In 12 patients the resection included the muscular plane. In the remaining eight, the tumor removal achieved a total wall thickness. For reconstruction we used: one muscular flap associated with skin grafting, nine flaps and ten regional fasciocutaneous flaps. Two patients undergoing reconstruction with fasciocutaneous flaps had partially suffering of the flap, solved with employment of a myocutaneous flap. The other patients displayed no complications with the techniques used, requiring only one surgery. CONCLUSION: the proper assessment of local tissues and flaps available for reconstruction, in addition to the successful integration of Plastic Surgery with the specialties involved in the treatment, enable extensive resections of the chest wall and reconstructions that provide patient recovery.
Asunto(s)
Cirugía Plástica , Pared Torácica/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/cirugía , Procedimientos de Cirugía Plástica , Trasplante de Piel , Colgajos Quirúrgicos/cirugíaRESUMEN
A 26-year-old patient with a voluminous primary pulmonary hemangiopericytoma in the right lung, diagnosed through previous surgical biopsy, presented irreversible cardiac arrest during the hilar dissection portion of a right pneumonectomy. The patient did not respond to resuscitation efforts. Autopsy showed total obstruction of the mitral valve by a tumor embolism. In cases of large lung masses with hilar involvement, as in the case presented, we recommend preoperative evaluation using transesophageal echocardiography, magnetic resonance imaging or angiotomography. If injury to the pulmonary vessels or atrial cavities is detected, surgery with extracorporeal circulation should be arranged in order to allow resection of the intravascular or cardiac mass, together with pulmonary resection. We recommend that care be taken in order to recognize and treat this problem in patients not receiving a preoperative diagnosis.
Asunto(s)
Paro Cardíaco/etiología , Neoplasias Cardíacas/secundario , Hemangiopericitoma/cirugía , Neoplasias Pulmonares/cirugía , Estenosis de la Válvula Mitral/etiología , Neumonectomía/efectos adversos , Adulto , Resultado Fatal , Paro Cardíaco/patología , Humanos , Complicaciones Intraoperatorias/etiología , Neoplasias Pulmonares/patología , Masculino , Estenosis de la Válvula Mitral/patología , Células Neoplásicas Circulantes , Cuidados PreoperatoriosRESUMEN
Um paciente de 26 anos, portador de volumoso hemangiopericitoma primário de pulmão direito, diagnosticado por biópsia cirúrgica prévia, apresentou parada cardíaca irreversível durante dissecção hilar de pneumectomia direita. O paciente não respondeu às manobras de ressuscitação. A necropsia mostrou obstrução total de valva mitral por êmbolo tumoral. Os autores recomendam, em casos de grandes massas pulmonares com envolvimento hilar, como no caso aqui apresentado, a avaliação pré-operatória com ecocardiografia transesofágica, ressonância magnética nuclear ou angiotomografia. Se for detectada lesão em vasos pulmonares ou cavidades atriais, deve-se programar a cirurgia com circulação extracorpórea, para permitir ressecção da massa intra-vascular ou cardíaca, combinada com a ressecção pulmonar. Os autores recomendam cuidados para reconhecer e tratar este problema, se o diagnóstico pré-operatório não for feito.
A 26-year-old patient with a voluminous primary pulmonary hemangiopericytoma in the right lung, diagnosed through previous surgical biopsy, presented irreversible cardiac arrest during the hilar dissection portion of a right pneumonectomy. The patient did not respond to resuscitation efforts. Autopsy showed total obstruction of the mitral valve by a tumor embolism. In cases of large lung masses with hilar involvement, as in the case presented, we recommend preoperative evaluation using transesophageal echocardiography, magnetic resonance imaging or angiotomography. If injury to the pulmonary vessels or atrial cavities is detected, surgery with extracorporeal circulation should be arranged in order to allow resection of the intravascular or cardiac mass, together with pulmonary resection. We recommend that care be taken in order to recognize and treat this problem in patients not receiving a preoperative diagnosis.
Asunto(s)
Adulto , Humanos , Masculino , Paro Cardíaco/etiología , Neoplasias Cardíacas/secundario , Hemangiopericitoma/cirugía , Neoplasias Pulmonares/cirugía , Estenosis de la Válvula Mitral/etiología , Neumonectomía/efectos adversos , Resultado Fatal , Paro Cardíaco/patología , Complicaciones Intraoperatorias/etiología , Neoplasias Pulmonares/patología , Estenosis de la Válvula Mitral/patología , Células Neoplásicas Circulantes , Cuidados PreoperatoriosRESUMEN
Um caso de fogo em via aérea durante traqueostomia cervical eletiva é apresentado. São discutidos os fatores desencadeantes e as medidas para evitar que esta temida complicação ocorra.
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Humanos , Masculino , Persona de Mediana Edad , Oxígeno/uso terapéutico , TraqueostomíaRESUMEN
The classical treatment for upper urinary tract transitionall cell carcinoma has been total nephroureterectomy. Clinical situations with bilateral tumor, high operative risk, solitary kidney or compromised renal function claimed for the development of conservative techniques. Initially these were limited to some from of open surgery with tumor resection. However, the application of endourologic and laparoscopic technologies to this field has greatly expaned the options for urologists. With time the experience attained with the use of those techniques clearly established their advantage in some select situations: high risk patients and patiens with low grade, low stage distal ureteral tumors. However for the remaining situations, nephroureterectomy still offers the best results
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Humanos , Carcinoma de Células Transicionales/cirugía , Riñón , Urotelio , Nefrectomía , UreteroscopíaRESUMEN
Os autores discutem os problemas relacionados ao fechamento de feridas cirúrgicas infectadas, suas conseqüências e principais métodos alternativos para prevençäo das complicaçöes. Apresentam oito casos operados de urgência com peritonite difusa por perfuraçäo näo traumática do cólon, nos quais a conduta adotada foi o tratamento cirúrgico de patologia básica, o fechamento do peritônio e aponeurose, deixando a pele e subcutâneo abertos para fechamento posterior
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Adolescente , Adulto , Persona de Mediana Edad , Masculino , Femenino , Peritonitis/cirugía , Infección de la Herida QuirúrgicaRESUMEN
Relata-se o caso de um paciente portador de hipertensäo portal e abscesso esplênico. O abscesso teve como etiologia provável uma infecçäo piogênica consecutiva à esplenoportografia. Consideram-se a etiologia, a sintomatologia clínica, os métodos diagnósticos complementares e os estudos bacteriológicos. O diagnóstico pré-operatório neste caso foi definido pelo exame clínico associado ao estudo radiológico do abdômen e à ultra-sonografia. O tratamento foi cirúrgico, tendo sido realizada esplenectomia, com a eliminaçäo do foco intraparenquimatoso visceral. A evoluçäo pós-operatória foi favorável