285 resultados para Mieloma múltiplo
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This article aims to present some reflections about a selection of letters that Gustave Flaubert (1821-1880) wrote to Guy de Maupassant (1850-1893), between September 23, 1872 and May 3, 1880. For eight years, Flaubert was Maupassant’s friend and a literary master and his letters, marked by a multiple and disordered discourse, reveal a path to friendship and the passionate dedication of the master regarding the intellectual and artistic development of the young writer. It is intended here, to draw some considerations to the moments when Flaubert’s speech assumes, directly or indirectly, a pedagogical role and the letter becomes a way to literary teaching.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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The objective was to evaluate levels of multiple supplements supplied to beef heifers in low supply of pasture on intake and nutrients digestibility, pH and concentration of ruminal ammonia nitrogen, nitrogen balance, synthesis and microbial efficiency. Five Nellore heifers with initial body weight of 344.00 +/- 21.10 kg and average initial age of 22 months were used. The following supplements were evaluated as fed to the animals: control (mineral supplement) and supplementation levels of 2, 4, 6 and 8 kg/animal/day, composing the following percentages of body weight (BW): 0.55, 1.11, 1.66 and 2.22%, respectively. The experimental design was a Latin square with five replications and five supplements. Intakes of total dry matter, crude protein (CP) and total digestible nutrients, and total apparent digestibility of dry matter, crude protein, total carbohydrates and no fiber carbohydrates increased linearly (P <0.0001) and dry matter intake of forage decreased (P <0.0001) with supplementation levels. Supplementation strategies promoted reduction on ruminal pH (P = 0.0343) and increased concentration of ruminal ammonia nitrogen (NH3-N) (P = 0.0004) before the supply of supplements, and after, this NH3-N presented quadratic behavior (P = 0.0023). Nitrogen intake, excretion of urea in urine and nitrogen excretion in feces increased linearly (P <0.0001) according to supplementation levels. The supply of high levels of multiple supplements reduces forage intake and presents itself as an alternative to cattle maintained in a systems with low supply of pasture in the dry season.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Pós-graduação em Agronegócio e Desenvolvimento - Tupã
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Are called panfacial fractures when the upper, middle and lower facial thirds present fractures concurrently. In clinical practice, came to imply the involvement of two facial thirds. Panfacial fractures are usually accompanied by other systemic lesions that impair the patient's life and therefore require primary treatment. Almost invariably are associated with damage to soft tissues and severe losses of bone structures which may lead to severe facial deformations and malocclusions. The panfacial fractures treatment is complex because often there isn’t a stable bone structure to guide the reduction of various fractures. Several orders of treatment have been proposed, but they are variations of the two classical approaches "bottom to top and inside-out" and "top to bottom and out-inside". The aim of this paper is to discuss the principles of management and panfacial fractures treatment, emphasizing the sequence of fracture reduction and highlighting its indications, advantages and disadvantages, through literature review and reports of surgical clinic cases. We conclude that the exact sequence of fracture reduction is not as important as developing a treatment plan that allows accurate positioning of the fractured segments.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Pós-graduação em Engenharia de Produção - FEB
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Pós-graduação em Ciência da Computação - IBILCE
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Pós-graduação em Ciências da Motricidade - IBRC
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Pós-graduação em Ciências da Motricidade - IBRC
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OBJETIVO: Caracterizar os óbitos decorrentes de trauma em um hospital terciário e avaliar a qualidade do atendimento prestado a essas vítimas. MÉTODOS: Tratou-se de um estudo retrospectivo realizado em um centro de referência em trauma no período de um ano. Através da metodologia Trauma Score - Injury Severity Score e da revisão de prontuários foram identificadas e estudadas as mortes evitáveis, potencialmente evitáveis e inevitáveis. RESULTADOS: Setenta e cinco pacientes foram incluídos no estudo. Houve predomínio de mortes em pacientes jovens, do sexo masculino, vítimas de acidentes de trânsito. As médias do Revised Trauma Score, Injury Severity Score e Trauma Score - Injury Severity Score foram 5,60, 30,7 e 62,2%, respectivamente. A taxa de mortes consideradas evitáveis foi de 61,3%, potencialmente evitáveis, 24%, e inevitáveis, 14,7%. CONCLUSÃO: A amostra do estudo apresentou características epidemiológicas semelhantes às amostras de outros estudos, exceto pela alta taxa de mortes evitáveis e pelos altos valores do Revised Trauma Score. Houve dificuldades na obtenção de dados em prontuários, laudos de exames de imagem e laudos de necropsia. A qualidade do atendimento prestado às vítimas de trauma na Instituição se mostrou insatisfatória por problemas na coleta e armazenamento dos dados.