Catholic University of Goias

Goiânia, Brazil

Catholic University of Goias

Goiânia, Brazil

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Souza L.B.S.,Federal University of Goais | Schulz H.E.,University of Sao Paulo | Villela S.M.,Federal University of Goais | Villela S.M.,University of Sao Paulo | And 4 more authors.
Journal of Applied Fluid Mechanics | Year: 2010

The prediction of sedimentation is an important aspect of reservoir planning and design. Such prediction can be supported by detailed analyses of flow patterns and sediment transport inside reservoirs, usually conducted through numerical simulation. This research compares laboratorial sedimentation experiments in a shallow reservoir and predictions using a 2D numerical model with depth-average Navier-Stokes equations and a sediment transport code. A number of sediment transport equations were tested, among which the Engelund and Fredsøe formulation better represented the measured data. Flows without sediment transport or without bed dunes could be simulated using Smagorinski's turbulence model, while flows with sediment occurring over dunes needed the use of a constant turbulent viscosity. The similarity obtained between experimental data and numerical results, for both flow pattern and sediment deposition, confirms that the models and numerical codes used in this work are useful for the analysis and prediction of reservoir sedimentation.


De Paula A.L.,Hospital Of Especialidades | Stival A.R.,Hospital Of Especialidades | Halpern A.,University of Sao Paulo | DePaula C.C.L.,Catholic University of Goias | And 4 more authors.
Journal of Gastrointestinal Surgery | Year: 2011

Introduction: Bariatric surgery in morbidly obese type 2 diabetic (T2DM) patients is associated with high rates of diabetes remission. We investigated the mechanisms of the anti-diabetic effect of the laparoscopic ileal interposition with sleeve gastrectomy (LII-SG) in normal weight (NW), overweight (OW) and obese (OB) T2DM patients. Methods: Ninety-four patients (aged 54 ± 8 years) with long-standing (median 10 years), treated diabetes (median HbA 1c = 8.6%), who were NW (15), OW (64) or OB (15) based on BMI, underwent LII-SG. Insulin sensitivity and parameters of ß-cell function were measured from an Oral Glycaemic Tolerance Test pre- and post-operatively. Results: At a median of 13.4 months post-operatively, weight loss averaged 9.4 ± 1.3, 16.8 ± 0.8 and 23.2 ± 1.7 kg in NW, OW and OB subjects, respectively (p<0.0001). Insulin sensitivity was fully restored (395 [108] vs 208 [99] ml min -1 m -2), fasting insulin secretion rate decreased (68 [52] vs 146 [120] pmol min -1 m -2) and total insulin output increased (52 [26] vs 39 [28] nmol m -2, all p≤0.001). ß-cell glucose sensitivity doubled (37 [33] vs 18 [24] mol min -1 m -2 mM -1, p<0.0001). The only parameter predicting remission of diabetes was a lower baseline insulin sensitivity (p=0.005). Conclusions: LII-SG induced changes on T2DM by mechanisms in part distinct from weight loss, principally involving restoration of insulin sensitivity and improvement of ß-cell function. © 2011 The Society for Surgery of the Alimentary Tract.


De Paula A.L.,Hospital Of Especialidades | Stival A.R.,Hospital Of Especialidades | De Paula C.C.L.,Catholic University of Goias | Halpern A.,University of Sao Paulo | Vencio S.,Catholic University of Goias
Journal of Gastrointestinal Surgery | Year: 2012

Background The objective of this study was to evaluate the mid-term outcomes of the laparoscopic ileal interposition into the jejunum (JII-SG) or into the duodenum (DII-SG) associated with sleeve gastrectomy for type 2 diabetes mellitus (T2DM) patients with BMI below 35. Methods The procedures were performed on 202 consecutive patients. Mean age was 52.2±7.5. Mean duration of T2DM was 9.8±5.2 years. Insulin therapy was used by 41.1%. Dyslipidemia was observed in 78.2%, hypertension in 67.3%, nephropathy in 49.5%, retinopathy in 31.2%, coronary heart disease in 11.9%, and other cardiovascular events in 12.9%. Results Mean follow-up was 39.1 months (range, 25-61). Early and late mortality was 0.99% and 1.0%, respectively. Early reoperation was performed in 2.5%. Early and late major complications were 8.4% and 3.5%. Early most frequent complications were pneumonia and ileus. Intestinal obstruction was diagnosed in 1.5%. Mean BMI decreased from 29.7 to 23.5 kg/m2, mean fasting glucose from 202.1 to 112.2 mg/dl, and mean postprandial glucose from 263.3 to 130 mg/dl. Triglycerides diminished from a mean of 273.4 to 110.3 mg/dl and cholesterol from a mean of 204.7 to 160.1 mg/dl. Hypertension was resolved in 87.5%. Mean hemoglobin A1c (HbA1c) decreased from 8.7 to 6.2% after the JII-SG and to 5.9% following the DII-SG. HbA1c below 7% was seen in 89.9% of the patients and below 6.5% in 78.3%. Overall, 86.4% of patients were off antidiabetic medications. Conclusion Both JII-SG and DII-SG demonstrated to be safe, effective, and long-lasting alternatives for the treatment of T2DM patients with BMI <35. Beyond glycemic control, other benefits were achieved. © 2012 The Society for Surgery of the Alimentary Tract.


Mesquita Jr. D.,Federal University of São Paulo | De Melo Cruvinel W.,Federal University of São Paulo | De Melo Cruvinel W.,Catholic University of Goias | Araujo J.A.P.,Federal University of São Paulo | And 4 more authors.
Scandinavian Journal of Rheumatology | Year: 2011

Objective: The identification of regulatory T cells (Treg cells) as CD4 +CD25 high cells may be upset by the increased frequency of activated effector T cells (Teff cells) in inflammatory diseases such as systemic lupus erythematosus (SLE). This study aimed to evaluate the frequency of T-cell subsets according to the expression of CD25 and CD127 in active (A-SLE) and inactive SLE (I-SLE). Methods: Peripheral blood mononuclear cells (PBMCs) from 26 A-SLE patients (SLE Disease Activity Index (SLEDAI) = 10.17 ± 3.7), 31 I-SLE patients (SLEDAI = 0), and 26 healthy controls (HC) were analysed by multicolour flow cytometry. Results: CD25 high cell frequency was increased in A-SLE (5.2 ± 5.7%) compared to I-SLE (3.4 ± 3.4%) and HC (1.73 ± 0.8%) (p < 0.01). However, the percentage of FoxP3 + cells in the CD25 high subset was decreased in A-SLE (24.6 ± 16.4%) compared to I-SLE (33.7 ± 16) and HC (45 ± 25.1%) (p < 0.01). This was partly due to the increased frequency of Teff cells (CD25 highCD127 +FoxP3 Ø) in A-SLE (10.7 ± 7.3%) compared to I-SLE (8.5 ± 6.5) and HC (6.1 ± 1.8%) (p = 0.02). Hence the frequency of Treg cells (CD25 +/highCD127 low/ØFoxP3 +) was equivalent in A-SLE (1.4 ± 0.8%), I-SLE (1.37 ± 1.0%), and HC (1.13 ± 0.59%) (p = 0.42). A-SLE presented an increased frequency of CD25 +CD127 +FoxP3 + and CD25 ØFoxP3 +CD127 low/Ø T cells, which may represent intermediate phenotypes between Treg and Teff cells. Conclusions: The present study has provided data supporting normal Treg cell frequency in A-SLE and I-SLE as well as increased frequency of Teff cells in A-SLE. This scenario reflects a Treg/Teff ratio imbalance that may favour the inflammatory phenotype of the disease. In addition, the increased frequency of T cells with putative intermediate phenotypes may be compatible with a highly dynamic immune system in SLE. © 2011 Taylor & Francis on license from Scandinavian Rheumatology Research Foundation.


DePaula A.L.,Hospital Of Especialidades | Stival A.R.,Hospital Of Especialidades | DePaula C.C.L.,Catholic University of Goias | Halpern A.,University of Sao Paulo | Vencio S.,Hospital Of Especialidades
Journal of Gastrointestinal Surgery | Year: 2010

Background: Dyslipidemia is known to increase significantly the odds of major cardiovascular events in the general population. Its control becomes even more important in the type 2 diabetic (T2DM) population. Bariatric surgeries, especially gastric bypass, are effective in achieving long-term control of dyslipidemia in morbidly obese patients. Objective: The objective of the study was to evaluate the control of dyslipidemia in patients with T2DM and BMI below 30 that were submitted to the laparoscopic ileal interposition associated to sleeve gastrectomy. Methods: An observational transversal study was performed in a tertiary care hospital, between June 2005 and August 2007. Mean follow-up was 24.5 months (range 12-38). The procedure was performed in 72 patients: 51 were men and 21 were women. Mean age was 53.1 years (38-66). Mean BMI was 27 kg/m2 (22.1-29.4). Mean duration of T2DM was 10.5 years (3-22). Mean HbA1c was 8.5%. Hypercholesterolemia was diagnosed in 68% of the patients and hypertriglyceridemia in 63.9%. Results: Mean postoperative BMI was 21.2.kg/m2 (17-26.7). Mean postoperative HbA1c was 6.1%, ranging 4.4% to 8.3%. Overall, 86.1% of the patients achieved an adequate glycemic control (HbA1c<7) without anti-diabetic medication. HbA1c below 6 was achieved by 50%, 36.1% had HbA1c between 6 and 7, and 13.9% had HbA1c above 7. Total hypercholesterolemia was normalized in 91.8% and hypertriglyceridemia in 89.1% of patients. Low-density lipoprotein below 100 mg/dl was seen in 85.7%. Conclusions: The laparoscopic ileal interposition associated to sleeve gastrectomy was an effective operation for the regression of dyslipidemia and T2DM in a non-obese population. © 2010 The Society for Surgery of the Alimentary Tract.


Strain W.D.,University of Exeter | Cos X.,Institute Catala Of La Salut | Hirst M.,International Diabetes Federation | Vencio S.,Catholic University of Goias | And 5 more authors.
Diabetes Research and Clinical Practice | Year: 2014

Aims: Clinical inertia, the tendency to maintain current treatment strategies despite results demanding escalation, is thought to substantially contribute to the disconnect between clinical aspirations for patients with diabetes and targets achieved. We wished to explore potential causes of clinical inertia among physicians and people with diabetes. Methods: A 20-min online survey of 652 adults with diabetes and 337 treating physicians in six countries explored opinions relating to clinical inertia from both perspectives, in order to correlate perceptions and expectations relating to diagnosis, treatment, diabetes complications and therapeutic escalation. Results: Physicians had low expectations for their patients, despite the belief that the importance of good glycaemic control through lifestyle and pharmacological interventions had been adequately conveyed. Conversely, people with diabetes had, at best, a rudimentary understanding of the risks of complications and the importance of good control; indeed, only a small proportion believed lifestyle changes were important and the majority did not intend to comply. Conclusions: The principal findings of this survey suggest that impairments in communication are at the heart of clinical inertia. This manuscript lays out four key principles that we believe are achievable in all environments and can improve the lives of people with diabetes. © 2014 The Authors.


Ribeiro A.A.,Institute of Tropical Pathology and Public Health | Figueiredo Alves R.R.,Catholic University of Goias | Costa M.C.,Ludwig Institute for Cancer Research | Villa L.L.,Ludwig Institute for Cancer Research | And 5 more authors.
International Journal of Gynecological Pathology | Year: 2011

This study was designed to evaluate the effect of single or multiple-human papillomavirus (HPV) infection and phylogenetic groups on the prevalence and severity of cervical intraepithelial neoplasia (CIN) in women undergoing colposcopy after an abnormal cervical smear. Colposcopy was performed in 198 cases and biopsy was performed in 193 patients. All specimens were tested for 27 HPV genotypes using the Roche polymerase chain reaction reverse line blot assay. The overall prevalence of HPV infection in women with an abnormal cervical smear was 86% (171 of 198). The prevalence of HPV 16 in high-grade CIN (2/3) was 52% (40 of 76), being detected in 88.8% of cases (8 of 9) of invasive carcinoma. The prevalence of HPV types 31 and 35 in high-grade CIN was 10.5% (8 of 76) and 6.6% (5 of 76), respectively. Single or multiple-type infection involving HPV 16 were significantly associated with a diagnosis of high-grade neoplasia (≥2) [odds ratio (OR) 6.49; 95% confidence interval (CI): 1.88-23.44 and OR: 3.65; 95% CI: 1.13-12.15] even after adjustment for HPV-DNA. A statistically significant association was also found between HPV 16 and the other HPV types belonging to species α 9 and a diagnosis of high-grade neoplasia (OR: 7.62; 95% CI: 1.28-51.58); however, no association was found between HPV 16 and the other HPV types belonging to species α 7. HPV 16 is the most important predictor of high-grade cervical neoplasia. Multiple-type infections are predictors of high-grade cervical neoplasia when type 16 is present. © 2011 International Society of Gynecological Pathologists.


PubMed | University of Leipzig, Eötvös Loránd University, Novartis, Institute Catala Of La Salut and 5 more.
Type: Journal Article | Journal: Diabetes research and clinical practice | Year: 2014

Clinical inertia, the tendency to maintain current treatment strategies despite results demanding escalation, is thought to substantially contribute to the disconnect between clinical aspirations for patients with diabetes and targets achieved. We wished to explore potential causes of clinical inertia among physicians and people with diabetes.A 20-min online survey of 652 adults with diabetes and 337 treating physicians in six countries explored opinions relating to clinical inertia from both perspectives, in order to correlate perceptions and expectations relating to diagnosis, treatment, diabetes complications and therapeutic escalation.Physicians had low expectations for their patients, despite the belief that the importance of good glycaemic control through lifestyle and pharmacological interventions had been adequately conveyed. Conversely, people with diabetes had, at best, a rudimentary understanding of the risks of complications and the importance of good control; indeed, only a small proportion believed lifestyle changes were important and the majority did not intend to comply.The principal findings of this survey suggest that impairments in communication are at the heart of clinical inertia. This manuscript lays out four key principles that we believe are achievable in all environments and can improve the lives of people with diabetes.


Perez F.S.B.,University of Brasilia | Da Rocha A.F.,University of Brasilia | De Castro Cardoso K.,State University of Goiás | Veloso H.O.,State University of Goiás | De Lima Amaral I.J.,Catholic University of Goias
BIODEVICES 2013 - Proceedings of the International Conference on Biomedical Electronics and Devices | Year: 2013

This research is a case study that evaluated the therapeutic efficacy of Functional Electrical Stimulation (FES) associated with the method of Proprioceptive Neuromuscular Facilitation (PNF) in a patient with central facial paralysis caused by brain damage resulting from brain anoxia. The treatment involved the application of Orofacial Regulation Therapy, associated with physical therapy using a pen-shaped electrode whith an FES current. The treatment was administered for a period of one year and involved two weekly 15 minute sessions. The stimuli were performed with modulated current at a frequency of 60 hertz, pulse width of 300 miliseconds, rise of four (4) seconds, decay of four (4) seconds, time ON of one (1) second, time OFF of five (5) seconds, in trapezoidal pulses (forming a mini cycle of 14 seconds with 30 pulses) at an intensity level measured according to the patient's sensitivity, associated with the PNF method. The mobile pen-shaped electrode was positioned at precise points on the paralyzed muscles of the face, and the fixed-electrode was positioned on the Deltoid muscle. There was satisfactory rehabilitation of muscles in the left hemiface and acquired improvement in the oral consumption of the bolus. The symmetry of the face was also enhanced, along with facial expressions and connotation measuring four (4) on the Chevalier scale.


Laparoscopic ileal interposition associated with a sleeve gastrectomy (LII-SG) is a safe and effective operation for the treatment of type 2 diabetic (T2DM) patients with BMI below 35. The aim of this study was to evaluate insulin sensitivity (IS) and -cell function using the euglycemic hyperinsulinemic clamp (EHC) with the intravenous glucose tolerance test (IVGTT).This was a prospective study of 24 T2DM patients submitted to a 3-hour EHC-IVGTT before and 1 month after LII-SG. Mean BMI was 29.0, mean age was 54.8 years and mean duration of T2DM was 10.2 years; insulin therapy was used by 62.5% of the patients.Mean BMI decreased from 29.0 to 25.8 (p < 0.001). Mean fasting plasma glucose and mean postprandial glucose were 202 and 251.3 mg/dl and dropped to 127.7 and 131.8 mg/dl (p < 0.001), respectively. Mean preoperative IS was 1.4 mmolmin(-1)nmol(-1) and increased to 2.2 mmol min(-1)nmol(-1) postoperatively (p < 0.001). Mean C-peptide AUC was 488 pmolnmol(-1) and increased to 777 pmol nmol(-1) (p = 0.37). The disposition index increased from 9.4 to 36.4 postoperatively (p = 0.01).According to the clamp technique, II-SG significantly improved IS and -cell function as early as 30 days postoperatively in a T2DM population with a BMI of 21.9-33.8.

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