IDAGENE APARECIDA CESTARI
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina
LIM/65, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/65, Hospital das Clínicas, Faculdade de Medicina - Líder
48 resultados
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conferenceObject Command Interface and Driving Strategy for a Voice Activated Endoscope Positioning Arm(2014) SANTOS, Eric T. P.; CESTARI, Idagene A.A command and control interface for intraoperative endoscope positioning must be intuitive, simple, intrinsically safe and reliable. Voice commands are widely used in commercial and experimental robotic-assisted remote-controlled surgical systems and must comply with those requirements. This paper presents a design proposal and implementation of an integrated voice-activated control interface as well as its associated command strategy. It comprises an isolated word speech recognition module based on the IBM SMAPI programming library, a task management state machine and a RS232 communication module.conferenceObject Mechanical Esophageal Displacement for Esophageal Safety of Mechanical Esophageal Displacement for Esophageal Thermal Injury Prevention During Atrial Fibrillation Ablation in Swine(2019) PEREIRA, Renner; PISANI, Cristiano F.; AIELLO, Vera; CESTARI, Idagene A.; MOURA, Daniel; CHOKR, Muhieddine; HARDY, Carina; SISSY, Melo; SCANAVACCA, Mauricio; HACHUL, Denise- Impact of Vacuum-Assisted Venous Drainage on Forward Flow in Simulated Pediatric Cardiopulmonary Bypass Circuits Utilizing a Centrifugal Arterial Pump Head(2020) GUIMARAES, Daniel Peres; CANEO, Luiz Fernando; MATTE, Gregory S.; CARLETTO, Luciana P.; POLICARPO, Valeria Camargo; CASTRO, Ana Vitoria C. X.; MIRANDA, Matheus H. C.; COSTA, Priscila S.; JATENE, Marcelo B.; CESTARI, Idagene; JATENE, Fabio B.Objective: To analyze the impact of vacuum-assisted venous drainage (VAVD) on arterial pump flow in a simulated pediatric cardiopulmonary bypass circuit utilizing a centrifugal pump (CP) with an external arterial filter. Methods: The simulation circuit consisted of a Quadrox-I Pediatric oxygenator, a Rotaflow CP (Maquet Cardiopulmonary AG, Rastatt, Germany), and a custom pediatric tubing set primed with Lactated Ringer's solution and packed red blood cells. Venous line pressure, reservoir pressure, and arterial flow were measured with VAVD turned off to record baseline values. Four other conditions were tested with progressively higher vacuum pressures (-20, -40, -60, and -80 mmHg) applied to the baseline cardiotomy pressure. An arterial filter was placed into the circuit and arterial flow was measured with the purge line in both open and closed positions. These trials were repeated at set arterial flow rates of 1500, 2000, and 2500 mL/min. Results: The use of progressively higher vacuum caused a reduction in effective arterial flow from 1490 +/- 0.00 to 590 +/- 0.00, from 2020 +/- 0.01 to 1220 +/- 0.00, and from 2490 +/- 0.0 to 1830 +/- 0.01 mL/min. Effective forward flow decreased with increased levels of VAVD. Conclusion: The use of VAVD reduces arterial flow when a CP is used as the main arterial pump. The reduction in the forward arterial flow increases as the vacuum level increases. The loss of forward flow is further reduced when the arterial filter purge line is kept in the recommended open position. An independent flow probe is essential to monitor pump flow during cardiopulmonary bypass.
- Siamese Convolutional Neural Network for Heartbeat Classification Using Limited 12-Lead ECG Datasets(2023) VASCONCELLOS, Eduardo M. M.; FERREIRA, Bruno Georgevich; LEANDRO, Jorge S.; NETO, Baldoino F. S.; CORDEIRO, Filipe Rolim; CESTARI, Idagene A.; GUTIERREZ, Marco A.; SOBRINHO, Alvaro; CORDEIRO, Thiago D.The Electrocardiogram (ECG) is a low-cost exam commonly used to diagnose abnormalities in the cardiac cycle. Over the years, the scientific community has investigated the automatic classification of ECG signals driven by advanced Machine Learning (ML) techniques. Despite recent scientific advances, annotating large and diverse datasets to support the training of ML techniques is still very time-consuming and error-prone. Indeed, ML techniques whose training does not require extensive and well-annotated datasets are becoming even more prominent. Therefore, it is possible to correctly identify and classify abnormalities in the cardiac cycle (e.g., rare cardiologic disturbs) using limited data available in ECG datasets. However, the classification of heartbeats from digital tracings of ECG signals containing 12 leads from imbalanced datasets is challenging due to many existing heart diseases. This study investigates the few-shot learning paradigm based on Siamese Convolutional Neural Networks (SCNN), popular in imaging classification problems, to classify 12-Lead ECG heartbeats using a few training samples with supervised information. The proposed SCNN model presented an accuracy of up to 95% in a public dataset based on the hold-out validation method, implemented for different combinations of similarity and loss functions. Besides, using the 7-fold cross-validation method, the model presented a mean area under the curve of 89%. We also compared the class-by-class classification results with those of similar methods available in the literature, obtaining the same or better results based on performance metrics such as accuracy, precision, recall, and specificity.
- A Design Strategy to Control an Electrosurgery Unit Output(2022) CAMILO, Paulo Henrique Duarte; CESTARI, I. A.Ideally, the power output of electrosurgery units must be kept constant during its utilization despite the many differences in the resistance of tissues and the anatomic features of the patients being operated on. The aim of this paper is to present a method of designing the control stage of a high frequency electrosurgery equipment considering the adequate choice of passive components to reduce the variation of the power source voltage. The design focused on the automatic regulation of the average power output. The results obtained demonstrate that by using a simulation approach it is possible to predict the response of the electrosurgery unit output as a means to better regulate it.
- Mechanical and Morphological Analysis of Electrospun Poly(epsilon-Caprolactone) and Reduced Graphene Oxide Scaffolds for Tissue Engineering(2022) MAIZATO, M. J. S.; OYAMA, H. T. T.; KAKOI, A. A. Y.; CESTARI, I. A.Electrospinning has been widely applied to obtain nanofiber based biomaterials to be used as scaffolds in tissue engineering. The aim of this work is to obtain and characterize membranes of a composite material obtained by electrospinning of Poly(epsilon-caprolactone) (PCL) combined with reduced graphene oxide (rGO) 0.05% (PCLrG0005) and 0.5% (PCLrG005) concentrations. Besides rGO concentration, the influence of electrospinning parameters was investigated (PCLrG0005M). The mechanical behavior of the new materials was studied considering the mechanical tensile test according to the ASTM D638 standard. Surface qualitative analysis was done by measuring fiber diameter using scanning microscopy. Four different membranes were obtained by random electrospinning using two needles and 5 mL volume solution at 18 kV, 15 cm needle distance and 0.033 mL/min flow rate or modified parameters of 15 kV, 10 cm needle distance and 0.012 mL/min flow rate. The modulus of elasticity, maximum load, tensile stress and strain were obtained for all membranes and analyzed by ANOVA. The morphological surface analysis of the scaffolds showed that the nanomaterial scaffolds of PCL and rGO with good mechanical properties and uniform surface morphology can be obtained by careful adjustments of electrospinning process parameters.
- Three-way bladder catheter prototype for bladder washing(2022) VILCHEZ, L. F. S.; COSTA, M. P. F. Da; CIACCIO, M. C. De Mello; CESTARI, I. A.; GUERRA, G. M.The main postoperative complications of Transurethral Resection of the Prostate (TURP) are urinary retention by blood clots in the probe and exogenous contamination of the urinary system by manipulation of the healthcare professional when performing the bladder washing technique. The aim of this study was to develop a prototype for keeping the urinary system closed during bladder washes and to measure the internal pressures of the three-way Indwelling Urinary Catheter (IDC) during the bladder washing technique. This was a technological study based on the Rozenfeld's Product Development Process model. Functionality tests were carried out through experiments in a controlled environment in the laboratory. The prototype showed satisfactory results regarding the preservation of the urinary system closed during the bladder washing technique. It was possible to obtain specific pressures from the three-way IDC at three different moments: unobstructed catheter, partially obstructed catheter, and totally obstructed catheter. The results obtained demonstrate that the prototype can represent an innovative tool in the area of urology. It met the project's specifications and preserved the urinary system closed during the bladder washing. Moreover, it reduces the risk of urinary system contamination during the technique manipulation. Therefore, the present study showed that the prototype is fully safe regarding the pressures exerted inside the IDC. There is a need to carry out experimental tests in humans to prove the decrease of urinary tract contamination with the use of this prototype. © 2022 Centro Universitario Sao Camilo. All rights reserved.
- Assessment of the biocompatibility of the PLLA-PLCL scaffold obtained by electrospinning(2015) OYAMA, Helena T. T.; CORTELLA, Lucas R. X.; ROSA, Isabela N. S.; FILHO, Leonardo E. R.; HUI, Wang S.; CESTARI, Ismar N.; CESTARI, Idagene A.Electrospun membranes of poly (L-Lactide) / poly (L-lactide-co-caprolactone) blend were produced and evaluated by physical and mechanical tests to use as a scaffold for cell growth. The membranes were seeded with endothelial cells (HUVEC) and after culturing time it was visualized by confocal laser scanning microscopy and scanning electron microscopy. The results indicate that the process parameters were capable of producing PLLA-PLCL membranes presenting fibers with diameters in the nanometer range. The scaffolds supported cell attachment and growth, indicating the feasibility of producing scaffolds by electrospinning technique, which could be used in tissue engineering applications. (C) 2015 Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/) Peer-review under responsibility of IDMEC-IST.
- Early changes in myocyte contractility and cardiac function in streptozotocin-induced type 1 diabetes in rats(2020) MARCHINI, Gustavo S.; CESTARI, Ismar N.; SALEMI, Vera M. C.; IRIGOYEN, Maria Claudia; ARNOLD, Alexandre; KAKOI, Adelia; ROCON, Camila; AIELLO, Vera D.; CESTARI, Idagene A.Diabetes can elicit direct deleterious effects on the myocardium, independent of coronary artery disease or hypertension. These cardiac disturbances are termed diabetic cardiomyopathy showing increased risk of heart failure with or without reduced ejection fraction. Presently, there is no specific treatment for this type of cardiomyopathy and in the case of type I diabetes, it may start in early childhood independent of glycemic control. We hypothesized that alterations in isolated myocyte contractility and cardiac function are present in the early stages of experimental diabetes in rats before overt changes in myocardium structure occur. Diabetes was induced by single-dose injection of streptozotocin (STZ) in rats with data collected from control and diabetic animals 3 weeks after injection. Left ventricle myocyte contractility was measured by single-cell length variation under electrical stimulation. Cardiac function and morphology were studied by high-resolution echocardiography with pulsed-wave tissue Doppler imaging (TDI) measurements and three-lead surface electrocardiogram. Triglycerides, cholesterol and liver enzyme levels were measured from plasma samples obtained from both groups. Myocardial collagen content and perivascular fibrosis of atria and ventricle were studied by histological analysis after picrosirius red staining. Diabetes resulted in altered contractility of isolated cardiac myocytes with increased contraction and relaxation time intervals. Echocardiography showed left atrium dilation, increased end-diastolic LV and posterior wall thickness, with reduced longitudinal systolic peak velocity (S') of the septum mitral annulus at the apical four-chamber view obtained by TDI. Triglycerides, aspartate aminotransferase and alkaline phosphatase were elevated in diabetic animals. Intertitial collagen content was higher in atria of both groups and did not differ among control and diabetic animals. Perivascular intramyocardial arterioles collagen did not differ between groups. These results suggest that alterations in cardiac function are present in the early phase in this model of diabetes type 1 and occur before overt changes in myocardium structure appear as evaluated by intersticial collagen deposition and perivascular fibrosis of intramyocardial arterioles.
conferenceObject Comparative Study between Cavopulmonary Anastomosis Associated with Left Ventricular Assist Device Support and Biventricular Circulatory Assistance in Acute Biventricular Failure(2012) SANTOS, L. A. S.; MOREIRA, L. F. P.; BENICIO, A.; CESTARI, I.; MATTOS JR., E.; STOLF, N. G.Purpose: Right ventricular failure during left ventricular assist device (LVAD) support can result in severe hemodynamic compromise with high mortality. This study investigated the acute effects of cavopulmonary anastomosis on LVAD performance and right ventricular myocardial compromise in comparison with biventricular circulatory support, in a model of severe biventricular failure. Methods and Materials: LVAD support was performed by means of centrifugal pump implantation in 21 anesthetized pigs (20-30 kg) with biventricular failure obtained by ventricular fibrillation induction. Animals were randomized to be submitted to modified cavopulmonary anastomosis, to biventricular circulatory support or to control group. They were maintained under circulatory support and hemodynamic monitoring for 3h. Venous lactate and cytokines serum levels were also determined. Endocardium samples of the ventricles were collected and analyzed by electronic microscopy. Results: Ventricular fibrillation was responsible for acute LVAD performance impairment after 180 min in the control group. Cavopulmonary anastomosis resulted in non-significant improvement of LVAD pump flow in relation to control group (+55±14 ml/kg/min, p=0.072), while animals under biventricular support maintained higher LVAD flow performance (+93±17 ml/kg/min, p=0.012). Mean arterial pressure remained constant only in biventricular group (p<0.001), which also presented significant decrease of right atrial and ventricular pressures. Similar increases in lactate and cytokines levels were observed in the three groups. Ultrastructural analysis documented the presence of higher levels of myocardial mitochondrial swelling in control group (p=0.018). Conclusions: Concomitant use of cavopulmonary anastomosis during LVAD support in a pig model of severe biventricular failure resulted in non-significant improvement of hemodynamic performance and it did not effectively replace the use of biventricular support.