Oral drugs for hypertensive urgencies: systematic review and meta-analysis

CONTEXTO E OBJETIVO: Urgências hipertensivas são definidas como elevações graves na pressão arterial sem evidência de danos agudos ou progressivos a órgãos-alvo. A necessidade de tratamento é considerada urgente, mas permite um controle gradual, utilizando-se drogas orais ou sublinguais. Se o aumento na pressão arterial não está associado a risco de vida ou danos a órgãos alvo, o controle pressórico deve ser feito lentamente durante 24 horas. em relação às urgências hipertensivas, não é conhecida qual a classe de drogas anti-hipertensivas que promove os melhores resultados e há controvérsia em relação a quando e quais as drogas devem ser utilizadas nestas situações. O objetivo desta revisão foi avaliar a efetividade e a segurança de drogas orais para urgências hipertensivas. METODOS: Esta revisão sistemática da literatura foi desenvolvida no Centro Cochrane do Brasil, e na Disciplina de Medicina de Urgência e Medicina Baseada em Evidências da Universidade Federal de São Paulo (UNIFESP) - Escola Paulista de Medicina (Unifesp-EPM), de acordo com a metodologia da Colaboração Cochrane. RESULTADOS: Os 16 ensaios clínicos aleatórios selecionados incluíram 769 participantes e demonstraram um efeito superior dos inibidores da enzima conversora de angiotensina no tratamento da urgência hipertensiva, avaliada em 223 participantes. Os efeitos adversos mais frequentes para os bloqueadores de canal de cálcio foram cefaleia (35/206), rubor (17/172) e alterações do ritmo cardíaco (14/189); para os inibidores da enzima conversora de angiotensina, o efeito colateral mais frequente foi disgeusia (25/38). CONCLUSÕES: Há evidências importantes a favor do uso de inibidores da enzima conversora da angiotensina para o tratamento de urgências hipertensivas, quando comparados aos bloqueadores dos canais de cálcio, devido a maior efetividade e à menor frequência de efeitos adversos, como cefaléia e rubor facial.

Evaluation of a novel kit (TF-test) for the diagnosis of intestinal parasitic infections

Intestinal parasitic infections are currently a source of concern for Public Health agencies in developing and developed countries. Since three ovum-and-parasite stool examinations have been demonstrated to provide sensitive results, we designed a practical and economical kit (TF-Test) that is now commercially available (Immunoassay Com. Ind. Ltda., S (a) over tildeo Paulo, Brazil). This kit allows the separate collection of three fecal specimens into a preservative solution. The specimens are then pooled, double-filtered, and concentrated by a single rapid centrifugation process. The TF-Test was evaluated in four different laboratories in a study using 1,102 outpatients and individuals living in an endemic area for enteroparasitosis. The overall sensitivity found using the TF-Test (86.2-97.8%) was significantly higher (P<0.01) than the sensitivity of conventional techniques such as the Coprotest (NIL Comercio Exterior Ltda, São Paulo, Brazil) and the combination of Lutz/Hoffman, Faust, and Rugai techniques (De Carli, Diagnostico Laboratorial das Parasitoses Humanas. Metodos e Tecnicas, 1994), which ranged from 48.3% to 75.9%. When the above combined three specimen technique was repeated with three specimens collected on different days, its sensitivity became similar (P > 0.01) to that of the TF-Test. The kappa index values of agreement for the TF-Test were consistent (P < 0.01), being higher and ranking in a better position than conventional techniques. The high sensitivity, cost/benefit ratio, and practical aspects demonstrate that the TF-Test is suitable for individual diagnosis, epidemiological inquiries, or evaluation of chemotherapy in treated communities. (C) 2004 Wiley-Liss, Inc.

Simulação do comportamento não linear de materiais quase-frágeis via elementos finitos com fissura embebida

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Predição de propagação de fissuras através de modelos constitutivos locais e técnica de construção progressiva da trajetória de descontinuidade

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Numeric evaluation of the stiffness of log-concrete composite beams submitted the cyclical load

In this paper was evaluated, using the software ANSYS, the stiffness (El) of the log-concrete composite beams, of section T, with connectors formed by bonded-in steel rods, type CA-50, disposed in X, with application of cyclical load. The stiffness of the system was evaluated through the simulation of bending tests, considered 1/2 beam, with cyclical shipment varying among 40 % and 5 % of the strength of the connection with the load relationship R=0,125, for a total of 10 load cycles applied. The numeric results show a good agreement with experimental tests.

Bibliografia

Incluye Bibliografía

Dependência estrutural da capacidade de rotação plástic em vigas de concreto armado

Summary In this work the structural dependence of plastic rotation capacity in RC beams is evaluated using the Finite Element Method. The objective is to achieve a better understanding of the non-linear behavior of reinforced concrete members and perform extensive parameter studies, using a rational model developed by Bigaj [1] to analyze the phenomenon of plastic rotation capacity in reinforced concrete members. It is assumed that only bending failure is relevant due to sufficient member resistance against shear and torsion. The paper begins with the physical and theoretical background of the phenomenon of plastic hinge development in RC structures. Special emphasis is laid on the issue of structural dependence of deformation capacity of plastic hinges in RC members. Member size dependence and influence of properties of construction materials were emphasized as well. The essential components of the Bigajs model for calculating the plastic rotation capacity are discussed. The behaviour of the plastic hinge is analysed taking into account the strain localisation in the damage zones of the hinge region. The Fictitious Crack Model (FCM) and the Compressive Damage Zone Model (CDZ) are adopted in a Fracture Mechanics approach to model the behaviour of concrete in tension and compression, respectively. The approach is implemented in FEMOOP, a FEM in-house solver under development, and applied to evaluate ductility in 2D beams. The models were generated with GiD, a pre-processor and post-processor developed by CIMNE, and analyzed with the capabilities implemented in FEMOOP. © Universitat Politècnica de Catalunya, Barcelona, España 2010.

Estilos de desarrollo de la industria manufacturera y medio ambiente en América Latina

Incluye Bibliografía

Factores que influyen en los intervalos intergenesicos de mujeres que viven en zonas rurales y semiurbanas de America Latina

Incluye Bibliografía

Precios, salarios y empleo en la Argentina: estadísticas económicas de corto plazo

Incluye Bibliografía

Métodos para proyecciones demográficas

Incluye Bibliografía

Introduccion al estudio de la fecundidad

Incluye Bibliografía

La mortalidad en los primeros años de vida en países de la América Latina: Paraguay, 1967-1968

Incluye Bibliografía

Tablas de mortalidad femenina de Guatemala, Honduras y Nicaragua

Incluye Bibliografía

La mortalidad en los primeros años de vida en países de la América Latina: Colombia 1968-1969

Incluye Bibliografía