Abstract The cold roller die process increases the tensile strength and decreases the ductility of steel wire. Annealing heat treatment is applied to restore mechanical properties, but this is a costly process. This research shows that it is possible to control the mechanical properties of ultra-low carbon steel wire inducing the Bauschinger effect and relieving residual steel stresses. The present study uses several pulleys to promote and control the Bauschinger effect magnitude through alternated cyclic bending. A Completely Randomized Design, a regression study, and the Akaike Information Criterion were used to understand the relationship between the quantity and diameter of pulleys and the influence on the magnitude of the Bauschinger effect. Statistical models showed that it is possible to have a maximum increase of 103% in uniform elongation and a maximum decrease of 14% in yield strength. An interaction between the factors studied in controlling the Bauschinger effect magnitude was confirmed.

OBJECTIVE: Despite advances in diffuse peritonitis treatment protocols, some cases develop unfavorably. With the advent of vacuum therapy, the use of laparostomy to treat peritonitis has gained traction. Another treatment modality is continuous peritoneal lavage. However, maintaining this technique is difficult and has been associated with controversial results. We propose a new model of continuous peritoneal lavage that takes advantage of the features and benefits of vacuum laparostomy. METHOD: Pigs (Landrace and Large White) under general anesthesia were submitted to laparostomy through which a multiperforated tube was placed along each flank and exteriorized in the left and lower right quadrants. A vacuum dressing was applied, and intermittent negative pressure was maintained. Peritoneal dialysis solution (PDS) was then infused through the tubes for 36 hours. The stability of peritoneostomy with intermittent infusion of fluids, the system resistance to obstruction and leakage, water balance, hemodynamic and biochemical parameters were evaluated. Fluid disposition in the abdominal cavity was analyzed through CT. RESULTS: Even when negative pressure was not applied, the dressing maintained the integrity of the system, and there were no leaks or blockage of the catheters during the procedure. The aspirated volume by vacuum laparostomy was similar to the infused volume (9073.5±1496.35 mL versus 10165±235.73 mL, p=0.25), and there were no major changes in hemodynamic or biochemical analysis. According to CT images, 60 ml/kg PDS was sufficient to occupy all intra-abdominal spaces. CONCLUSION: Continuous peritoneal lavage with negative pressure proved to be technically possible and may be an option in the treatment of diffuse peritonitis.

Abstract Purpose: To establish and evaluate the feasibility of continuous peritoneal lavage with vacuum peritoneostomy in an animal model. Methods: Eight pigs aged 3-4 months, females, were anesthetized and submitted to laparotomy and installation of a continuous peritoneal lavage with vacuum peritoneostomy. The sta-bility of the system, the physiological effects of washing with NaCl 0.9% and the sys-tem clearance were evaluated. Results: Stability of vacuum peritoneostomy was observed, with no catheter leaks or obstructions and the clearance proved adequate, however, the mean volume of fluids aspirated by the peritoneostomy at the end of the experiment was higher than the volume infused by the catheters (p=0.02). Besides that, the animals presented a progressive increase in heart rate (p=0.04) and serum potassium (p=0.02). Conclusion: The continuous peritoneal lavage technique with vacuum peritoneostomy is feasible and presents adequate clearance.

OBJETIVO: avaliar o resultado da integridade da parede abdominal após utilização do fechamento assistido a vácuo e da bolsa de Bogotá. MÉTODOS: um estudo retrospectivo foi realizado no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), identificando os pacientes submetidos à técnica de fechamento abdominal temporário (FAT) entre janeiro de 2005 e dezembro de 2011. Os dados foram coletados por meio de revisão de prontuários. Os critérios de inclusão foram indicação de FAT e sobrevivência até o fechamento definitivo da parede abdominal. No período pós-operatório, apenas um grupo de três cirurgiões, seguiu todos os pacientes e realizou as reoperações. Além disso, independente da técnica de FAT utilizada, foi aplicada a tática de fechamento fascial progressivo durante as reoperações. RESULTADOS: Vinte e oito pacientes foram incluídos. Não houve diferença estatística nas taxas de fechamento primário e tempo médio de fechamento fascial. CONCLUSÃO: O fechamento assistido a vácuo e a bolsa de Bogotá não diferem significativamente em relação ao resultado da integridade da parede abdominal após as reoperações. Isso se deve ao acompanhamento de uma equipe específica e a adoção de técnica de fechamento fascial progressivo.

OBJECTIVE: to evaluate the outcome of abdominal wall integrity of both techniques. METHODS: a retrospective study was carried out at the Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, identifying the patients undergoing temporary abdominal closure (TAC) from January 2005 to December 2011. Data were collected through the review of clinical charts. Inclusion criteria were indication of TAC and survival to definitive abdominal closure. In the post-operative period only a group of three surgeons followed all patients and performed the reoperations. RESULTS: Twenty eightpatients were included. The difference in primary closure rates and mean time for fascial closure did not reach statistical significance (p=0.98 and p=0.23, respectively). CONCLUSION: VAC and Bogota Bag do not differ significantly regarding the outcome of abdominal wall integrity, due to the monitoring of a specific team and the adoption of progressive closure

OBJETIVO: apresentar nossa experiência com reoperações agendadas em 15 pacientes com sepse intra-abdominal. MÉTODOS: foi empregada uma técnica mais eficaz que consiste em fechamento abdominal temporário com uma folha de malha de nylon contendo um zíper. Realizamos as reoperações no centro cirúrgico, sob anestesia geral, com um intervalo médio de 84 horas. A revisão consistiu de desbridamento de material necrosado e lavagem vigorosa da área peritoneal envolvida. A média de idade dos pacientes foi 38,7 anos; 11 pacientes eram do sexo masculino e quatro do sexo feminino. RESULTADOS: Quarenta por cento das infecções foram devido à pancreatite necrosante. Sessenta por cento foram ocasionadas por perfuração intestinal secundária à inflamação, oclusão vascular ou trauma. Foram realizadas 48 reoperações, média de 3,2 operações por paciente. O dispositivo tela-zíper foi deixado no local por uma média de 13 dias. Um estoma intestinal estava presente ao lado do zíper em quatro pacientes e não ocasionou complicação para o paciente. A mortalidade foi 26,6%. Nenhuma fístula resultou dessa técnica. Quando a doença intra-abdominal estava sob controle, o dispositivo de fecho do tipo de rede foi removido, e a fáscia foi fechada em todos os pacientes. Em três pacientes, a ferida foi fechada primariamente, em 12 permitiu-se fechar por intenção secundária. Dois pacientes desenvolveram hérnia: uma incisional e outra na incisão de drenagem. CONCLUSÃO: A nova operação prevista para lavagem manual e desbridamento do abdômen através de uma combinação de tela-zíper em nylon foi rápida, simples e bem tolerada, permitindo uma gestão eficaz da peritonite séptica grave, fácil tratamento das feridas e fechamento primário da parede abdominal.

OBJECTIVE: to present our experience with scheduled reoperations in 15 patients with intra-abdominal sepsis. METHODS: we have applied a more effective technique consisting of temporary abdominal closure with a nylon mesh sheet containing a zipper. We performed reoperations in the operating room under general anesthesia at an average interval of 84 hours. The revision consisted of debridement of necrotic material and vigorous lavage of the involved peritoneal area. The mean age of patients was 38.7 years (range, 15 to 72 years); 11 patients were male, and four were female. RESULTS: forty percent of infections were due to necrotizing pancreatitis. Sixty percent were due to perforation of the intestinal viscus secondary to inflammation, vascular occlusion or trauma. We performed a total of 48 reoperations, an average of 3.2 surgeries per patient. The mesh-zipper device was left in place for an average of 13 days. An intestinal ostomy was present adjacent to the zipper in four patients and did not present a problem for patient management. Mortality was 26.6%. No fistulas resulted from this technique. When intra-abdominal disease was under control, the mesh-zipper device was removed, and the fascia was closed in all patients. In three patients, the wound was closed primarily, and in 12 it was allowed to close by secondary intent. Two patients developed hernia; one was incisional and one was in the drain incision. CONCLUSION: the planned reoperation for manual lavage and debridement of the abdomen through a nylon mesh-zipper combination was rapid, simple, and well-tolerated. It permitted effective management of severe septic peritonitis, easy wound care and primary closure of the abdominal wall.

O futebol feminino tem crescido acentuadamente em nosso país. Quinze jogadoras de futebol com média de idade de 22,3 ± 6,2 anos, peso 58,2 ± 8,3kg e estatura 162,5 ± 6,1cm foram submetidas à avaliação de vários parâmetros considerados importantes para o rendimento atlético das futebolistas. Além disso, compararam-se alguns índices funcionais encontrados na literatura com os de jogadoras de outros países com mais experiência na prática dessa modalidade. Os seguintes parâmetros e resultados foram: Cardiorrespiratório e metabólico em repouso e no exercício: FC = 87 ± 8bpm; PAS = 100,6 ± 4,5mmHg; PAD = 62,6 ± 4,5mmHg; FCmax. = 194 ± 7bpm; Borg = 19,5 ± 0,8; veloc. max. = 13,4 ± 0,9km.h-1; LV1 = 8,5km.h-1; LV2 = 11,2km.h-1; V Emax. = 93,9 ± 16,5L.min-1; VO2pico = 47,3 ± 4,5mlO2.kg-1.min-1 ; Cybex: força isocinética de MMII direito a 60º S-1 na extensão = 198,5 ± 44,1Nm; na flexão 133,3 ± 30,5Nm; MMII esquerdo a 60º S-1 na extensão = 203,6 ± 38,1Nm; na flexão 116,5 ± 18,8Nm; Wingate: potência de pico corrigida pelo peso = 9,5 ± 0,9w.kg-1; potência média = 7,5 ± 0,5w.kg-1; índice de fadiga = 56,7 ± 7,3%; % de gordura = 17,4 ± 2,3%; Avaliação oftalmológica: acuidade visual para longe dos olhos direito e esquerdo foi de 97,5 ± 5,8%, pressão intra-ocular do olho direito e esquerdo = 13,7 ± 2,7 e 13,1 ± 2,4mmHg, respectivamente. Os resultados das variáveis cuja comparação foi possível com os das futebolistas internacionais mostraram que nossas atletas estavam com os índices equivalentes e, em alguns casos, até superiores. Entretanto, pela escassez de informações, ainda não há condições de estabelecer a quantificação dos índices mais adequados para a prática desta modalidade esportiva pelas mulheres. É necessária a realização de um volume maior de estudos, enfocando vários aspectos do futebol feminino.

Female soccer has grown substantially in our country. Fifteen female soccer players aged 22.3 ± 6.2, weight 58.2 ± 8.3 kg and height 162.5 ± 61 cm were submitted to an evaluation of several parameters which are considered important to their physical capacity and athletic fitness. Moreover, we compared some functional rates in the literature showing the results of players from other countries with more practical experience in this game. The parameters and results were: Metabolic and cardiorespiratory during rest and during exercise: HR = 87 ± 8 bpm; SBP = 100.6 ± 4.5 mmHg; DBP = 62.6 ± 4.5 mmHg; HRmax. = 194 ± 7 bpm; Borg Scale = 19.5 ± 0.8; running velocity max. = 13.4 ± 0.9 km.h-1; VT1 = 8.5 km.h-1; VT2 = 11.2 km.h-1; VO2 peak = 47.3 ± 4.5 mlO2.kg-1.min-1; Cybex: right isokinetic torque of knee extensor at 60º S-1 = 198.5 ± 44.1 Nm; in flexors = 116.5 ± 18.8 Nm; left = 203.6 ± 38.1 Nm; 116.5 ± 18.8 Nm; Wingate: peak power corrected by weight = 9.5 ± 0.9 w.kg-1; mean power = 7.5 ± 0.5 w.kg-1; fatigue rate = 56.7 ± 7.3%; body fat % = 17.4 ± 2.3%; Ophthalmologic evaluation: long-range visual acuity in the right and left eye = 97.5 ± 5.8%, respectively; intraocular pressure in the right and left eye = 13.7 ± 2.7 and 13.1 ± 2.4 mmHg, respectively. The variable which could be compared to international female soccer results pointed our athletes had equivalent rates and rather superior, in some cases. Nevertheless, because of lack of information, the most adequate rates for the practice of this modality by women could not be quantified. In the author's opinion, a greater volume of investigation is needed focusing various female soccer features.