Avaliação da musculatura inspiratória e expiratória na doença pulmonar obstrutiva crônica leve e grave comparada aos indivíduos saudáveis

Introdução: A DPOC é uma doença respiratória prevenível e tratável, caracterizada por limitação persistente ao fluxo aéreo, hiperinsuflação e aprisionamento aéreo. A dispneia e a intolerância aos esforços, decorrentes destas alterações fisiopatológicas sofre influência de vários fatores. Dentre estes, o recrutamento e a sobrecarga imposta aos músculos inspiratórios e expiratórios são de fundamental importância, porém a participação destes ainda não foi completamente elucidada em diferentes gravidades da doença. Objetivos: O objetivo principal deste estudo foi avaliar a mecânica ventilatória, e o grau de recrutamento da musculatura inspiratória e expiratória na DPOC leve e grave, na condição de repouso e durante um teste máximo de exercício, comparado a um grupo de indivíduos saudáveis. Metodologia: Trata-se de um estudo transversal envolvendo 36 indivíduos, sendo 24 pacientes portadores de DPOC e 12 voluntários sadios. As avaliações foram divididas em 2 visitas. No D1, foram realizadas uma avaliação clínica, avaliação de dispneia (mMRC) e de qualidade de vida (SGRQ), além da prova de função pulmonar completa. Na 2ª visita, realizada com intervalo de 1 semana, foram avaliadas: as pressões respiratórias máximas estáticas por meio de métodos volitivos (PImax, PEmax, SNIP, Pes sniff, Pga sniff e Pdi sniff) e não volitivos (Twitch cervical bilateral e T10); avaliação da sincronia toracoabdominal por pletismografia de indutância; avaliação do recrutamento dos músculos inspiratórios e expiratórios ao repouso pela eletromiografia de superfície; e, posteriormente, um teste de exercício cardiopulmonar incremental para estudo de todas essas variáveis no esforço. Resultados: Foram avaliados 24 pacientes (12 leves e 12 graves) e 12 indivíduos saudáveis da mesma faixa etária. A maioria dos pacientes apresentava comprometimento significativo da qualidade de vida e os pacientes do grupo grave eram mais sintomáticos. A função pulmonar encontrava-se alterada na maioria dos pacientes. Destes, 79,2% apresentavam aprisionamento aéreo e 70,8% tinham redução da DLCO. Tais alterações foram semelhantes nos 2 grupos de pacientes. A força muscular estática medida por métodos volitivos e não volitivos estava reduzida nos 2 grupos e mostrou relação com o VEF1. No exercício, a dispneia foi o principal motivo para interrupção do teste em 70% dos pacientes. A HD esteve presente em 87,5% dos pacientes. O comportamento das pressões respiratórias foi significativamente diferente entre os 3 grupos. Os pacientes com DPOC apresentaram maior atividade diafragmática (Pdi) comparado aos controles e a participação da musculatura expiratória também foi maior neste grupo, principalmente nos graves. Apesar disso, os pacientes com DPOC apresentaram uma eficiência mecânica reduzida, ou seja, esse incremento da força muscular foi insuficiente para manter uma ventilação adequada para uma determinada carga. Com o aumento da demanda ventilatória, houve recrutamento precoce e progressivo dos músculos inspiratórios e expiratórios durante o exercício. O trabalho resistivo e o expiratório foram significativamente diferentes entre os controles e os pacientes com DPOC desde o início do exercício. Como consequência destas alterações, a intensidade da dispneia durante o TECP foi maior nos pacientes com DPOC (leve e grave) para a mesma carga e mesma ventilação-minuto (VE), quando comparada aos indivíduos do grupo-controle. Conclusões: O conjunto destes achados demonstra que o comprometimento dos músculos inspiratórios e expiratórios contribuiu significativamente para a dispneia e a intolerância ao exercício tanto no DPOC leve quanto no DPOC grave. E que este comprometimento pode não ser detectado com os testes máximos de força ao repouso

Structural Analysis with ANSYS on Stone Constructions in the Historical Spanish Heritage

According to the importance of rehabilitation and recovery of Architectural Heritage in the live of people, this paper is aimed to strengthen the traditional methods of stone vaults calculation taking advantage of the technological characteristics of the powerful program ANSYS Workbench. As an example of this, it could find out the possible pathologies that could arise during the construction history of the building. To limit this research, the upper vault of the main chapel of the Santiago parish church in Orihuela -Alicante- is selected as a reference which is a Jeronimo Quijano´s important building work in the XVI century in the Renaissance. Moreover, it is an innovative stone masonry vault that consists of 8 double intercrossed arches with each other and braced by severies. During the seventeenth century there was a lantern in the central cap and it is unknown why it was removed. Its construction could justify the original constructive solution with intercrossed arches that freed the center to create a more enlightened and comfortable presbytery. By similarity with other Quijano’s works, it is considered a small lantern drilling the central spherical cap. It is proposed to carry out a comparative study of it with different architectural solutions from the same period and based on several common parameters such as: a vault of square plant with spherical surround, intercrossed arches, a possible lantern, the dimension of the permitted space, similar states of loads and compact limestone masonry. The three solutions are mainly differentiated by their size and the type of lantern and its comparison lets us know which one is the most resistant and stable. The other two building works maintain some connection with the Quijano's professional scope. It has selected the particular case of the Communion chapel of the Basilica in Elche (a large prismatic lantern with a large cylindrical drum that starts from the own arches and an upper hemispherical dome), for its conservation, its proximity to Orihuela and its implementation during the century XVIII. Finally, a significant Dome Spanish Renaissance complete the selection: a cross vault of the Benavides Chapel of the Saint Francisco Convent in Baeza - Jaén-, designed by Andres of Vandelvira in the sixteenth century (a large hemispherical dome that starts from the own arcs). To simplify the calculation and standardize the work that have to be contrasted, all of them were considered with some similar characteristics: 30 cm constant thickness, the intercrossed arches were specifically analyzed and had identical loads, Young's modulus and Poisson's ratio. Regarding the calculation solutions, in general terms, the compressive stresses predominate, influencing on it the joint collaboration of the filling material on the vault, the vault itself, the thick side walls, the buttresses and the top cover weight . In addition, the three solutions are suitable, being the Orihuela one the safest and the Baeza one the riskiest for its large dimensions. Thus, the idea of intercrossed arches with suitable thickness would allow carry out the heaviest lantern and this would confirm it as a Renaissance architectural typology built in stone.

Lawyer's commonplace book, 1774-1783

Contains entries on a variety of topics arranged alphabetically and compiled by several individuals. Includes an index at the end.

St. Louis, Missouri, 1895 (Raster Image)

This layer is a georeferenced raster image of the historic paper map entitled: The Matthews-Northrup up-to-date map of St. Louis MO. It was published by Matthews-Northrup Co in 1895. Scale [ca. 1:95,040]. Covers also a portion of East Saint Louis, Stites, and Madison, Illinois. The image inside the map neatline is georeferenced to the surface of the earth and fit to the Missouri East State Plane Coordinate System NAD83 (in Feet) (Fipszone 2401). All map collar and inset information is also available as part of the raster image, including any inset maps, profiles, statistical tables, directories, text, illustrations, index maps, legends, or other information associated with the principal map. This map shows features such as roads, railroads, street car lines, drainage, selected public buildings, parks, cemeteries, and more. Includes index to hotels, prominent buildings and institutions, churches, and places of amusement. This layer is part of a selection of digitally scanned and georeferenced historic maps from The Harvard Map Collection as part of the Imaging the Urban Environment project. Maps selected for this project represent major urban areas and cities of the world, at various time periods. These maps typically portray both natural and manmade features at a large scale. The selection represents a range of regions, originators, ground condition dates, scales, and purposes.

Louisiana Purchase Exposition, St. Louis, Missouri, 1904 (Raster Image)

This layer is a georeferenced raster image of the historic paper map entitled: Ground plan of the Louisiana Purchase Exposition St. Louis, MO 1904. It was published by Buxton & Skinner Stationery Co. Scale [1:7,500]. Covers the exposition grounds and buildings of the Saint Louis World's Fair, currently the Forest Park and Washington University area, St. Louis, Missouri. The image inside the map neatline is georeferenced to the surface of the earth and fit to the the Missouri East State Plane Coordinate System NAD83 (in Feet) (Fipszone 2401). All map collar and inset information is also available as part of the raster image, including any inset maps, profiles, statistical tables, directories, text, illustrations, index maps, legends, or other information associated with the principal map. This map shows features such as roads, railroads and stations, cable and electric car lines, drainage, lagoons and ponds, buildings, ground cover, paths, and more. Includes index. This layer is part of a selection of digitally scanned and georeferenced historic maps from The Harvard Map Collection as part of the Imaging the Urban Environment project. Maps selected for this project represent major urban areas and cities of the world, at various time periods. These maps typically portray both natural and manmade features at a large scale. The selection represents a range of regions, originators, ground condition dates, scales, and purposes.

St. Louis, Missouri, 1903 (Raster Image)

This layer is a georeferenced raster image of the historic topographic paper map entitled: City of Saint Louis, U.S. Geological Survey ; H.M. Wilson, geographer ; Chas. E. Cooke, topographer in charge ; topography by the City of St. Louis and Chas. E. Cooke ; Mississippi River by U.S. Army Engineers ; control by City of St. Louis. It was published by the Geological Survey in 1904. Surveyed 1903. Scale 1:24,000. Covers Saint Louis, Missouri and portions of East Saint Louis and Stites, Illinois. The image inside the map neatline is georeferenced to the surface of the earth and fit to the Missouri East State Plane Coordinate System NAD83 (in Feet) (Fipszone 2401). All map collar and inset information is also available as part of the raster image, including any inset maps, profiles, statistical tables, directories, text, illustrations, index maps, legends, or other information associated with the principal map. This is a typical topographic map portraying both natural and manmade features. It shows and names works of nature, such as mountains, valleys, lakes, rivers, vegetation, etc. It also identify the principal works of humans, such as roads, railroads, boundaries, transmission lines, major buildings, etc. Relief is shown with standard contour intervals of 20 feet. This layer is part of a selection of digitally scanned and georeferenced historic maps from The Harvard Map Collection as part of the Imaging the Urban Environment project. Maps selected for this project represent major urban areas and cities of the world, at various time periods. These maps typically portray both natural and manmade features at a large scale. The selection represents a range of regions, originators, ground condition dates, scales, and purposes.

Les dépotoirs dans le schème d’établissement iroquoien : exemple du site Mailhot-Curran

Dans ce mémoire, intitulé « Les dépotoirs dans le schème d’établissement iroquoien: exemple du site Mailhot-Curran», je m’attèle à définir les modes de rejets des déchets dans le contexte d’un schème d’établissement sédentaire semi-permanent au Sylvicole supérieur. Les dépotoirs des sites archéologiques ne semblent pas obtenir toute l’attention analytique qui leur est due et l’étude des modes de rejets a longtemps été négligée. Pourtant, les amas de déchets sont récurrents sur les sites du Nord-Est américain et ce depuis le Sylvicole moyen. L’étude approfondie de l’organisation d’un site iroquoien se doit de passer par la compréhension des modes d’élimination des déchets, puisque la gestion des rejets est généralement le reflet de la structure du site et du type de peuplement. Les dépotoirs peuvent fournir des informations précieuses sur les zones d’activité, la fonction du site ou encore la durée d’occupation. Le village de Mailhot-Curran témoigne de plusieurs concentrations d’objets. Je souhaite établir si ces concentrations de vestiges peuvent être qualifiées de dépotoirs et si oui, peut-on en distinguer différents types? D’autre part, je m’intéresse à l’aspect social qui encadre la mise en place de dépotoirs. Bien que les dépotoirs soient des indices associés aux premières traces de sédentarité saisonnière, leur présence est précisément liée au phénomène de sédentarisation annuelle. Il s’agit également de définir le geste culturel, l’assainissement d’un village étant un schéma culturel très répandu. De ce geste de rejet découle forcément le choix d’un emplacement, ainsi que le concept de «flux de déplacement» des déchets. Il s’agit de déterminer le lien entretenu entre les aires d’activités et les aires de dépôts primaires et secondaires. Pour ce faire, il est primordial d’évaluer la densité, l’hétérogénéité et le contenu des dépotoirs. Suite à la définition de l’ensemble de ces concepts appliqués au site Mailhot-Curran, je souhaite, à travers une étude comparative, répondre à la question suivante : Les dépotoirs peuvent-ils refléter une pratique culturelle commune aux villages iroquoiens de la région de Saint-Anicet?

Les dépotoirs dans le schème d’établissement iroquoien : exemple du site Mailhot-Curran

Dans ce mémoire, intitulé « Les dépotoirs dans le schème d’établissement iroquoien: exemple du site Mailhot-Curran», je m’attèle à définir les modes de rejets des déchets dans le contexte d’un schème d’établissement sédentaire semi-permanent au Sylvicole supérieur. Les dépotoirs des sites archéologiques ne semblent pas obtenir toute l’attention analytique qui leur est due et l’étude des modes de rejets a longtemps été négligée. Pourtant, les amas de déchets sont récurrents sur les sites du Nord-Est américain et ce depuis le Sylvicole moyen. L’étude approfondie de l’organisation d’un site iroquoien se doit de passer par la compréhension des modes d’élimination des déchets, puisque la gestion des rejets est généralement le reflet de la structure du site et du type de peuplement. Les dépotoirs peuvent fournir des informations précieuses sur les zones d’activité, la fonction du site ou encore la durée d’occupation. Le village de Mailhot-Curran témoigne de plusieurs concentrations d’objets. Je souhaite établir si ces concentrations de vestiges peuvent être qualifiées de dépotoirs et si oui, peut-on en distinguer différents types? D’autre part, je m’intéresse à l’aspect social qui encadre la mise en place de dépotoirs. Bien que les dépotoirs soient des indices associés aux premières traces de sédentarité saisonnière, leur présence est précisément liée au phénomène de sédentarisation annuelle. Il s’agit également de définir le geste culturel, l’assainissement d’un village étant un schéma culturel très répandu. De ce geste de rejet découle forcément le choix d’un emplacement, ainsi que le concept de «flux de déplacement» des déchets. Il s’agit de déterminer le lien entretenu entre les aires d’activités et les aires de dépôts primaires et secondaires. Pour ce faire, il est primordial d’évaluer la densité, l’hétérogénéité et le contenu des dépotoirs. Suite à la définition de l’ensemble de ces concepts appliqués au site Mailhot-Curran, je souhaite, à travers une étude comparative, répondre à la question suivante : Les dépotoirs peuvent-ils refléter une pratique culturelle commune aux villages iroquoiens de la région de Saint-Anicet?

Santa Teresa y Felipe II. Concepto cabal de justo y de piadoso que se forma del Rey Prudente, leyendo las obras de Sta. Teresa de Jesús

Mode of access: Internet.

Sainte Thérèse (1515-1582) /

At head of t.p. "Les Saints".

Escritos de Santa Teresa,

"La vida de la santa madre Teresa de Jesus, y algunas de las mercedes que Dios le hizo, escritas por ella misma": t. 1, p. [23]-134.

La bienhaureuse Jeanne D'Arc, drama historique en quatre actes et douze tableaux.

Mode of access: Internet.

San Francesco d'Assisi : mistero /

For baritone and chorus, with orchestral parts reduced for piano.

Le pédagogue.

Greek and French.

Atti del Convegno internazionale di studi su Massimo di Torino nel XVI centenario del Concilio di Torino (398) : Torino, 13-14 marzo 1998 /

Anno 4, 1998/2 of Archivio teologico torinese.