Ventricular resynchronization through biventricular cardiac pacing for the treatment of refractory heart failure in dilated cardiomyopathy

OBJECTIVE: The biventricular pacing (BVP) approach has good results in the treatment of congestive heart failure (CHF) in patients (pts) with disorders of intraventricular conduction. METHODS: We have applied BVP to 28 pts, with left ventricular pacing using minitoracotomy in 3 pts and the transvenous aproach via coronary sinus in 25 pts. The mean duration of the QRS complexes was 187 ms, in the presence of the left branch block in 22 pts, and right branch block + divisional hemiblock in 6 pts. All pts had been considerated candidates to cardiac transplantation, and were under optimized drug therapy. Sixteen pts were in Functional Class (NYHA) IV, and 12 in class III. The ejection fraction varied from 22 to 46% (average = 34%). The pacing mode employed was biventricular triple-chamber in 22 pts, and bi-ventricular dual-chamber in 6 pts (one with ICD). RESULTS: The pts were followed up for a period that ranged from 10 days to 14 months (mean 5 months). All pts presented clinical improvement after implant, chaging the NYHA Functional Class at the end of follow-up to Class I (9pts), Class II (10 pts) and Class III (6 pts). The initial mean ejection fraction have-raised to 37%. Two pts died suddenly. One patient died due to a pulmonary fungal infection. CONCLUSION: Ventricular resynchronization through BVP, improved significantly the Functional Class and, therefore, the quality of life. Assessments of myocardial function acutely performed do not reflect the clinical improvement observed.

Gestão do conhecimento universitário : estudo comparativo entre Portugal e Brasil

Mestrado em Gestão de Recursos Humanos

A ação dos gens gametofíticos com referência especial ao milho

1) The first part deals with the different processes which may complicate Mendelian segregation and which may be classified into three groups, according to BRIEGER (1937b) : a) Instability of genes, b) Abnormal segregation due to distur- bances during the meiotic divisions, c) obscured segregation, after a perfectly normal meiosis, caused by elimination or during the gonophase (gametophyte in higher plants), or during zygophase (sporophyte). Without entering into detail, it is emphasized that all the above mentioned complications in the segregation of some genes may be caused by the action of other genes. Thus in maize, the instability of the Al factor is observed only when the gene dt is presente in the homozygous conditions (RHOADES 1938). In another case, still under observation in Piracicaba, an instability is observed in Mirabilis with regard to two pairs of alleles both controlling flower color. Several cases are known, especially in corn, where recessive genes, when homozigous, affect the course of meiosis, causing asynapsis (asyndesis) (BEADLE AND MC CLINTOCK 1928, BEADLE 1930), sticky chromosomes (BEADLE 1932), supermunmerary divisions (BEADLE 1931). The most extreme case of an obscured segregatiou is represented by the action of the S factors in self stetrile plants. An additional proof of EAST AND MANGELSDORF (1925) genetic formula of self sterility has been contributed by the studies on Jinked factors in Nicotina (BRIEGER AND MANGELSDORF (1926) and Antirrhinum (BRIEGER 1930, 1935), In cases of a incomplete competition and selection between pollen tubes, studies of linked indicator-genes are indispensable in the genetic analysis, since it is impossible to analyse the factors for gametophyte competition by direct aproach. 2) The flower structure of corn is explained, and stated that the particularites of floral biology make maize an excellent object for the study of gametophyte factors. Since only one pollen tube per ovule may accomplish fertilization, the competition is always extremely strong, as compared with other species possessing multi-ovulate ovaries. The lenght of the silk permitts the study of pollen tube competitions over a varying distance. Finally the genetic analysis of grains characters (endosperm and aleoron) simpliflen the experimental work considerably, by allowing the accumulation of large numbers for statistical treatment. 3) The four methods for analyzing the naturing of pollen tube competition are discussed, following BRIEGER (1930). Of these the first three are: a) polinization with a small number of pollen grains, b) polinization at different times and c) cut- ting the style after the faster tubes have passe dand before the slower tubes have reached the point where the stigma will be cut. d) The fourth method, alteration of the distatice over which competition takes place, has been applied largely in corn. The basic conceptions underlying this process, are illustrated in Fig. 3. While BRINK (1925) and MANGELSDORF (1929) applied pollen at different levels on the silks, the remaining authors (JONES, 1922, MANGELSDORF 1929, BRIEGER, at al. 1938) have used a different process. The pollen was applied as usual, after removing the main part of the silks, but the ears were divided transversally into halves or quarters before counting. The experiments showed generally an increase in the intensity of competition when there was increase of the distance over which they had to travel. Only MANGELSDORF found an interesting exception. When the distance became extreme, the initially slower tubes seemed to become finally the faster ones. 4) Methods of genetic and statistical analysis are discussed, following chiefly BRIEGER (1937a and 1937b). A formula is given to determine the intensity of ellimination in three point experiments. 5) The few facts are cited which give some indication about the physiological mechanism of gametophyte competition. They are four in number a) the growth rate depends-only on the action of gametophyte factors; b) there is an interaction between the conductive tissue of the stigma or style and the pollen tubes, mainly in self-sterile plants; c) after self-pollination necrosis starts in the tissue of the stigma, in some orchids after F. MÜLLER (1867); d) in pollon mixtures there is an inhibitory interaction between two types of pollen and the female tissue; Gossypium according to BALLS (1911), KEARNEY 1923, 1928, KEARNEY AND HARRISON (1924). A more complete discussion is found in BRIEGER 1930). 6) A list of the gametophyte factors so far localized in corn is given. CHROMOSOME IV Ga 1 : MANGELSDORF AND JONES (1925), EMERSON 1934). Ga 4 : BRIEGER (1945b). Sp 1 : MANGELSDORF (1931), SINGLETON AND MANGELSDORF (1940), BRIEGER (1945a). CHROMOSOME V Ga 2 : BRIEGER (1937a). CHROMOSOME VI BRIEGER, TIDBURY AND TSENG (1938) found indications of a gametophyte factor altering the segregation of yellow endosperm y1. CHROMOSOME IX Ga 3 : BRIEGER, TIDBURY AND TSENG (1938). While the competition in these six cases is essentially determined by one pair of factors, the degree of elimination may be variable, as shown for Ga2 (BRIEGER, 1937), for Ga4 (BRIEGER 1945a) and for Spl (SINGLETON AND MANGELSDORF 1940, BRIEGER 1945b). The action of a gametophyte factor altering the segregation of waxy (perhaps Ga3) is increased by the presence of the sul factor which thus acts as a modifier (BRINCK AND BURNHAM 1927). A polyfactorial case of gametophyte competition has been found by JONES (1922) and analysed by DEMEREC (1929) in rice pop corn which rejects the pollen tubes of other types of corn. Preference for selfing or for brothers-sister mating and partial elimination of other pollen tubes has been described by BRIEGER (1936). 7) HARLAND'S (1943) very ingenious idea is discussed to use pollen tube factors in applied genetics in order to build up an obstacle to natural crossing as a consequence of the rapid pollen tube growth after selfing. Unfortunately, HARLAND could not obtain the experimental proof of the praticability of his idea, during his experiments on selection for minor modifiers for pollen tube grouth in cotton. In maize it should be possible to employ gametophyte factors to build up lines with preference for crossing, though the method should hardly be of any practical advantage.

Poliomyelitis: epidemiological aspects in Rio de Janeiro (Guanabara State) and adjacent areas in the period from 1961 to 1970

Based on the available data from the Hospital responsible for the care of paralitic poliomyelitis cases in Rio de Janeiro City (Guanabara State) and adjacent areas, and the laboratory studies carried out on these patients, the authors analize epidemiological aspects of poliomyelitis in a period of ten years (1961 to 1970). Paralitic poliomyelitis remains a public health problem, with a typical incidence in the less than 4 year age group. All three poliovirus types have been prevalent for at least one period of time during the last ten years. Trivalent oral vaccine has been used since 1961 but the vaccination levels achieved were not enough to a permanent control of the disease. A definite seasonal distribution of cases could not be observed with the available data. Active mass campaign vaccinations with previous motivation of all segments of the population, specially the low-income groups instead of passive waiting of children in Vaccination Centers seems to be the best aproach to control poliomyelitis in this area.

A unified approach for representing rows and columns in contingency tables

By using suitable parameters, we present a uni¯ed aproach for describing four methods for representing categorical data in a contingency table. These methods include:correspondence analysis (CA), the alternative approach using Hellinger distance (HD),the log-ratio (LR) alternative, which is appropriate for compositional data, and theso-called non-symmetrical correspondence analysis (NSCA). We then make an appropriate comparison among these four methods and some illustrative examples are given.Some approaches based on cumulative frequencies are also linked and studied usingmatrices.Key words: Correspondence analysis, Hellinger distance, Non-symmetrical correspondence analysis, log-ratio analysis, Taguchi inertia

Pneumopericárdio após traumatismo penetrante: relato de três casos

Pneumopericardium after penetrating wound represents a high suspicion for cardiac wound. Some authors recommend thoracotomy to discharge a cardiac lesion. We present three cases of post-traumatic pneumopericardium one following a gunshot wound and two following a stab wound and discuss about diagnosis and treatment. None showed clinical signs of cardiac tamponade. Diagnosis was made by chest x-ray. Pneumopericardium was identified at the initial evaluation in two patients, who had concomitant hemothorax and underwent chest drainage. The patient with penetrating thoracic wound by gunshot pneumopericardium developed 24h after trauma. Treatment was directed to the associated lesions without specific measurements for pneumopericardium. This aproach was safe in these patients.

Efeito de fungicidas para controle da ferrugem asiática na qualidade de sementes de soja

Para avaliar o efeito residual de fungicidas para o controle da ferrugem asiática (Phakopsora pachyrhizi) em sementes de soja do cultivar BRS-133 utilizaram-se 13 tratamentos (Testemunha, Priori + Nimbus, Aproach + Nimbus, Priori Xtra + Nimbus, Sphere + Aureo, Opera, Stratego + Aureo, Nativo + Aureo, Impact Duo + Oppa, Celeiro + Iharol, Battle + Oppa, Aproach Prima + Nimbus, Folicur ). O experimento foi conduzido em campo experimental em Paulínia-SP, em delineamento em blocos ao acaso, com quatro repetições. O efeito residual dos fungicidas nas sementes foi analisado pelos testes de germinação, envelhecimento acelerado, germinação em areia e pelo teste de sanidade das sementes. Conclui-se que os tratamentos não influenciaram na qualidade das sementes e que o tratamento Battle + Oppa foi eficiente no controle do patógeno Cercospora kikuchii nas sementes.

A unified approach for representing rows and columns in contingency tables

By using suitable parameters, we present a uni¯ed aproach for describing four methods for representing categorical data in a contingency table. These methods include: correspondence analysis (CA), the alternative approach using Hellinger distance (HD), the log-ratio (LR) alternative, which is appropriate for compositional data, and the so-called non-symmetrical correspondence analysis (NSCA). We then make an appropriate comparison among these four methods and some illustrative examples are given. Some approaches based on cumulative frequencies are also linked and studied using matrices. Key words: Correspondence analysis, Hellinger distance, Non-symmetrical correspondence analysis, log-ratio analysis, Taguchi inertia

¡Ush éstas nenas hablan como manes!: Una aproximación etnográfica a las relaciones de género en la escena del rock transgresivo en Bogotá

Investigación de carácter etnografico que buscó comprender cómo se naturaliza y se recionaliza una relación de actividad masculina sobre pasividad femenina sin imponerse de manera violenta. El soporte teórico de la investigación fueron las nociones de juventud, género y rock y la metodología cualitativa se enfocó en observaciones participantes, entrevistas a profundidad, toma de fotografías y análisis de discurso de letras de canciones.

Análisis de la implementación del Programa ART-REDES Colombia, estrategia territorial de cooperación internacional para la paz, el desarrollo y la reconciliación, del Programa de Naciones Unidas para el Desarrollo PNUD, para el afianzamiento de la Cooperación Descentralizada en Colombia. Departamento de Nariño, Periodo 2008-2010

El alcance de esta Investigación Diagnóstica es analizar la implementación del programa ART-REDES del Programa de Naciones Unidas para el Desarrollo (PNUD) para Colombia, durante el periodo 2008 - 2010, con el fin de generar propuestas de ajuste para el desarrollo de iniciativas de cooperación descentralizada en el país.

La adopción de un enfoque de trabajo en red: implicaciones en torno al proceso estratégico de las organizaciones

En el mundo actual el enfoque del proceso estratégico es una variable que cada vez va tomando un mayor peso e incidencia en las decisiones de los directores de empresa, sin embargo, poco se ha estudiado sobre esta variable al ser adoptado por los nuevos modelos de cooperación empresarial en las organizaciones. Es por esta razón que esta investigación busca esclarecer la aplicabilidad de las metodologías y herramientas utilizadas en la planeación estratégica de una empresa en una red, además de servir como un primer acercamiento a los aspectos más importantes en la planeación estratégica de una red.

Industrias Metálicas Ochoa diagnóstico e impacto ambiental

La empresa objeto de este estudio, Industrias Metálicas Ochoa (IMO), pertenece al sector metalmecánico y se dedica a la fabricación de auto partes para vehículos automotores. La empresa tiene 20 años de trayectoria en su sector

Análisis de la ayuda oficial al desarrollo. estudio de caso: programa conjunto de UNICEF y UNFPA sobre la mutilación genital femenina en Kenia (2008-2012)

El interés de este estudio de caso es analizar el Programa Conjunto de UNFPA y UNICEF sobre MGF/E en Kenia bajo la luz de los postulados poscolonialistas. Partiendo de la idea de que la MGF es una manifestación de las desigualdades de género, se argumenta que el PC reproduce la imagen de la mujer keniana como una víctima del poder masculino. A partir de esta imagen se deslegitima el orden cultural de los grupos que siguen esta tradición, afectando las lógicas de unidad y cohesión de la sociedad. El análisis de este tipo de dinámicas permite comprender mejor los procesos de intervención de las organizaciones internacionales sobre las estructuras sociales de actores frágiles del sistema internacional.

Niveles de desarrollo y uso de una innovación por parte de los profesores : el programa de integración.

Conocer el desarrollo del Programa de Integración de Alumnos con Necesidades Educativas Especiales en Murcia y en el ciclo inicial de la EGB, partiendo y utilizando las perspectivas de los profesores como eje de análisis. Se utiliza un modelo que goza de suficiente reconocimiento, respaldo teórico y desarrollo práctico, el Concerns Based Aproach Model (CBAM) de Hall, Walace y Dosset(1973). El modelo, globalmente considerado, permite analizar los diferentes aspectos de los procesos de innovación y del cambio educativo como un proceso en el que los docentes, y su particular implicación en el proceso, tienen un papel esencial. Hipótesis general: dado un perfil de cambio determinado ¿cuál es el grado de desarrollo del programa de integración entre los profesores que están llevándolo a cabo en el ciclo inicial de la EGB en los centros educativos de la Región de Murcia?. El objetivo es verificar y comprobar en qué medida ese perfil está suficientemente asumido, claro y desarrollado por los profesores. Población 245 profesores en contacto con los alumnos del Programa de Integración, de ellos, 125 trabajan en el ciclo inicial y 84 cumplimentaron el cuestionario y formaron parte de la muestra (71, 19 del total). Elaboración del marco teórico: el cambio educativo, el modelo CBAM utilizado, el Plan de Integración del MEC, el Programa de Integración en la Región de Murcia. Estado de la Cuestión. Elaboración y validación de instrumentos de recogida de información (cuestionarios de trabajo y entrevistas). Tipo de muestreo y de tratamiento de la información (análisis factorial, cluster). Análisis cualitativo de los datos. Análisis y comentario a las entrevistas. Conclusiones. 1. Con respecto a las perspectivas de los profesores existe un acuerdo notable en la adecuación de las intenciones que guían el Programa, aunque se juzgue menos favorablemente la realización y la práctica de las mismas; 2. Escasa definición de los elementos característicos del perfil de innovación del programa; 3. Importante implicación personal por parte de los profesores. El trabajo ofrece evidencias y contribuye a clarificar, desde la utilización de un modelo de análisis determinado (CBAM), cómo se está desarrollando un programa de innovación eucativa y cuáles son algunas de las circunstancias y aspectos que se ponen más de relieve en estos procesos.

F. Hölderlin i S.T. Coleridge: recepció immediata i influència de la Crítica del Judici de Kant en els poetes del romanticisme

La tesi contrasta les conseqüències filosòfiques i la constel·lació temàtica de la Crítica del Judici, amb les manifestacions poeticofilosòfiques de F. Hölderlin i S.T. Coleridge. La font principal de recerca són aquelles tesis de la Crítica del Judici rellevants per comprendre l'esclat de l'idealisme allà on aquest nou sistema involucra significativament art i experiència estètica. Hölderlin s'instal·la de manera genuïna en la tensió entre l'idealisme i la filosofia crítica. Per la radicalitat dels seus plantejaments podrem presentar-lo també com a poeta romàntic o precedent del romanticisme. Pel que fa a Coleridge estudiem la recepció immediata de la filosofia Kantiana en el medi cultural britànic per contrastar el paper del poeta en la importació de la ideologia romàntica alemanya. L'objectiu és presentar Coleridge com a poeta que assumeix els postulats del romanticisme alemany i investigar si aquests postulats poden relacionar-se amb el balanç de la filosofia kantiana expressat a Crítica del Judici.