901 resultados para Chess, Four-handed.


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OBJECTIVE: To report and assess the incidence of cardiac tamponade in systemic lupus erythematosus as a cardiac manifestation of the disease. METHODS: We reviewed the medical records of 325 patients diagnosed with systemic lupus erythematosus according to the American Rheumatism Association and their complementary laboratory tests compatible with cardiac tamponade. RESULTS: In the 325 medical recors reviewed, we found 108 patients with pericardial effusions corresponding to 33.2% of the total and 54% of the patients studied in the active phase of the disease. Clinical assessment and transthoracic echocardiogram allowed the clinical diagnosis of cardiac tamponade in only 4 (1.23%) patients, 3 of whom were females, white, with ages ranging from 25 to 44 years. The pericardial fluid was hemorrhagic or serosanguineous with high levels of FAN and positivity for LE cells. In the treatment, we successfully used pericardicentesis associated with high doses of corticosteroids. In clinical and laboratory follow-up performed for a period of 3 years, neither recrudescence of the pericardial effusion nor evolution to constriction occurred. CONCLUSION: Even though rare (1.23%), cardiac tamponade in patients with systemic lupus erythematosus has a benign evolution when properly treated, according to our experience.

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This paper reports on a new façade system that uses passive solutions in the search for energy efficiency. The differentials are the versatility and flexibility of the modules, which are important advantages of the system. The thermal performance of Trombe walls and glazings and the daylighting performance of glazing were the key aspects analyzed in the results. Computational simulations were accomplished for the thermal performance of different arrangements of the modules with DesignBuilder software. The glazing daylighting performance was studied by means of Ecotect and Desktop Radiance programs and compared with the transmittance curves of glazings. Occupancy profile and internal gains were fixed according to the Portuguese reality for both studies. The main characteristics considered in this research were the use of two double glazings, four different climates in Portugal and one and two Trombe walls in the façade. The results show an important reduction in the energy consumption with the use of Trombe walls and double self-cleaning glazing in the façade, which also presented better daylighting performance.

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Magdeburg, Univ., Fak. für Wirtschaftswiss., Diss., 2013