Obese obstructive sleep apnea patients with tonsil hypertrophy submitted to tonsillectomy

The physiopathology of obstructive sleep apnea-hypopnea syndrome (OSAHS) is multifactorial and obesity has been shown to be one of the main factors correlated with its occurrence. In obese patients with anatomical alterations of the upper airways it is often difficult to predict success for surgical correction since obesity is a limiting factor. Therefore, the aim of the present study was to evaluate the results of tonsillectomy in a specific group of patients, i.e., obese OSAHS patients with tonsil hypertrophy. Seven OSAHS patients with moderate obesity with obstructive palatine tonsil hypertrophy were submitted to tonsillectomy. All patients were submitted to pre- and postoperative appraisal of body mass index, otorhinolaryngology examination and polysomnography. Patients' average age was 36.4 ± 10.3 years and average preoperative body mass index was 36.6 ± 6.3 kg/m². Postoperative weight did not differ significantly from preoperative weight (P = 0.27). Average preoperative apnea and hypopnea index (AHI) was 81 ± 26/h and postoperative AHI was 23 ± 18/h (P = 0.0005). Average preoperative minimum oxyhemoglobin saturation (SaO2 min) was 69 ± 14% and the postoperative value was 83 ± 3% (P = 0.038). In relation to AHI, 6 (86%) of the 7 patients studied showed a reduction of 50% in relation to preoperative level and of these, 4 (57%) presented AHI of less than 20%. Only one patient presented a reduction of less than 50% in AHI, but even so showed improved SaO2 min. Tonsillectomy treatment for OSAHS in obese patients with obstructive palatine tonsil hypertrophy caused a significant reduction in AHI, with improvement in SaO2 min. This procedure could be eventually considered as an option of treatment for obese OSAHS patients with significant tonsil hypertrophy when continuous positive air pressure therapy is not possible as the first choice of treatment.

Applying life cycle management of colombian cocoa production

The present research aims to evaluate the usefulness of the application of Life Cycle Management in the agricultural sector focusing on the environmental and socio-economic aspects of decision making in the Colombian cocoa production. Such appraisal is based on the application of two methodological tools: Life Cycle Assessment, which considers environmental impacts throughout the life cycle of the cocoa production system, and Taguchi Loss Function, which measures the economic impact of a process' deviation from production targets. Results show that appropriate improvements in farming practices and supply consumption can enhance decision-making in the agricultural cocoa sector towards sustainability. In terms of agri-business purposes, such qualitative shift allows not only meeting consumer demands for environmentally friendly products, but also increasing the productivity and competitiveness of cocoa production, all of which has helped Life Cycle Management gain global acceptance. Since farmers have an important role in improving social and economic indicators at the national level, more attention should be paid to the upgrading of their cropping practices. Finally, one fundamental aspect of national cocoa production is the institutional and governmental support available for farmers in face of socio-economic or technological needs.

Valuation models and Simon's bounded rationality

This paper aims at reconciling the evidence that sophisticated valuation models are increasingly used by companies in their investment appraisal with the literature of bounded rationality, according to which objective optimization is impracticable in the real world because it would demand an immense level of sophistication of the analytical and computational processes of human beings. We show how normative valuation models should rather be viewed as forms of reality representation, frameworks according to which the real world is perceived, fragmented for a better understanding, and recomposed, providing an orderly method for undertaking a task as complex as the investment decision.

Celso Furtado, o retorno à polêmica fundamental

Celso Furtado, the return to the basic controversy. A reading of the work of Celso Furtado in its completion opens an enriching view of the interaction between theoretical thinking and the unveiling of Latin-America history. Starting from an appraisal of the pre-Classic and Classic authors, Furtado outlined an approach of surplus theory. That would enable development theory to deal with the unevenly industrialized economies like Brazil. His thorough analysis of development and underdevelopment processes broke away from the initial ECLA experiences to build a planning proposal the uprising country. The French roots of his academic profile helped him to keep an orderly explanation of capital demand that kept him siding with Wicksell against the subjective theory of Schumpeter.