A construção do direito à saúde no Brasil

O direito à saúde recebeu - pela primeira vez - tratamento constitucional no brasil em 1988, fruto de grande participação popular. Neste estudo, se busca compreender a extensão dessa afirmação e verificar sua implementação normativa e jurisprudencial. A partir do estudo da evolução dos conceitos de saúde e de direito, concluiu-se que o direito à saúde deve implicar a constante participação popular para que possa ser delimitado. Verificou-se, também, que o arcabouço normativo vem sendo construído em conformidade com as exigências constitucionais. Quanto à construção jurisprudencial, se percebeu que ela vem acontecendo de forma errática e que os tribunais superiores raramente enfrentam a discussão da política de saúde desenhada na Constituição da República Federativa do Brasil de 1988. Concluiu-se que a afirmação constitucional tem demonstrado vigor, haja vista o grande desenvolvimento normativo conforme `compreensão contemporânea; e que o controle judicial da realização da política sanitária é ainda incipiente

Macrosegregation of Impurities in Directionally Solidified Silicon

Directional solidification of molten metallurgical-grade Si was carried out in a vertical Bridgman furnace. The effects of changing the mold velocity from 5 to 110 mu m seconds(-1) on the macrosegregation of impurities during solidification were investigated. The macrostructures of the cylindrical Si ingots obtained in the experiments consist mostly of columnar grains parallel to the ingot axis. Because neither cells nor dendrites can be observed on ingot samples, the absence of precipitated particles and the fulfillment of the constitutional supercooling criterion suggest a planar solid-liquid interface for mold velocities a parts per thousand currency sign10 mu m seconds(-1). Concentration profiles of several impurities were measured along the ingots, showing that their bottom and middle are purer than the metallurgical Si from which they solidified. At the ingot top, however, impurities accumulated, indicating the typical normal macrosegregation. When the mold velocity decreases, the macrosegregation and ingot purity increase, changing abruptly for a velocity variation from 20 to 10 mu m seconds(-1). A mathematical model of solute transport during solidification shows that, for mold velocities a parts per thousand yen20 mu m seconds(-1), macrosegregation is caused mainly by diffusion in a stagnant liquid layer assumed at the solid-liquid interface, whereas for lower velocities, macrosegregation increases as a result of more intense convective solute transport.

The effect of grain refinement and silicon content on grain formation in hypoeutectic Al-Si alloys

The effect of increasing the amount of added grain refiner on grain size and morphology has been investigated for a range of hypoeutectic Al-Si alloys. The results show a transition in grain size at a silicon concentration of about 3 wt% in unrefined alloys; the grain size decreasing with silicon content before the transition, and increasing beyond the transition point. A change in morphology also occurs with increased silicon content. The addition of grain refiner leads to greater refinement for silicon contents below the transition point than for those contents above the transition point, while the transition point seems to remain unchanged. The slope of the grain size versus silicon content curve after the transition seems to be unaffected by the degree of grain refinement. The results are related to the competitive processes of nucleation and constitutional effects during growth and their impact on nucleation kinetics. (C) 1999 Elsevier Science S.A. All rights reserved.

Equiaxed solidification of Al-Si alloys

An experimental programme has been undertaken to determine which of the grain formation mechanisms of equiaxed crystals are dominant in the solidification of Al-Si foundry alloys. Small ingots were cast from alloys of varying silicon concentration with and without gauze barriers, using different types of mould materials and different mould preheats. The results show that two mechanisms of grain nucleation are operating. The first is a wall mechanism where crystals are nucleated either on or near the mould wall owing to thermal undercooling. The second is a constitutional supercooling mechanism where nucleants are activated in the constitutionally undercooled zone ahead of the advancing interface. As a consequence, the grain size decreases with increasing silicon content. However a transition in the growth mode occurs once a critical degree of constitutional undercooling is exceeded. This change in growth is accompanied by an increase in grain size. The transition point can be shifted with respect to solute content by changing the casting conditions, and a mechanism is proposed to explain this effect. MST/4109

Halo formation in directional solidification

A new model of halo formation in directional solidification is presented. The model describes halo formation in terms of competitive growth between the halo phase and coupled eutectic in liquid with a nominal composition that follows the primary phase liquidus extension with decreasing temperature. The model distinguishes between the effects of constitutional, capillarity and (where applicable) kinetic undercooling and avoids a number of theoretical inconsistencies associated with previous models. The critical growth rate for halo formation in directionally solidified hypereutectic Al-Si alloys is calculated using the model in conjunction with models of primary phase and coupled eutectic growth from the literature. The calculated result agrees reasonably well with the experimental result of Yilmaz and Elliott (Met. Sci. 18 (1984) 362), given the use of a relatively simple isolated dendrite tip model to calculate the growth undercooling of the halo tip. (C) 2002 Acta Materialia Inc. Published by Elsevier Science Ltd. All rights reserved.

Management Innovation at the Brazilian Superior Tribunal of Justice

We describe administrative reform involving management innovation undertaken at the Superior Tribunal of Justice, Brazil`s highest appellate court for infra-constitutional cases. The innovation is the introduction of a new management model based on strategic planning and a process management approach to work processes. Introduction of the new model has been supported by the use of information technology and project management techniques. Qualitative methods were used for data collection and analysis. Findings reveal that the innovation is contributing to the development of a systemic overview of key processes, reducing the fragmenting effects of the division of work activities within the Tribunal. At least three new organizational routines or capabilities have been developed as a result of the innovation studied: Electronic Court Management, Project Management, and Process Management. The paper contributes to knowledge about court management, a field that has received little research attention in the public administration literature.

Modeling of columnar-to-equiaxed transition in solidified Al-Si alloys

A Cellular-Automaton Finite-Volume-Method (CAFVM) algorithm has been developed, coupling with macroscopic model for heat transfer calculation and microscopic models for nucleation and growth. The solution equations have been solved to determine the time-dependent constitutional undercooling and interface retardation during solidification. The constitutional undercooling is then coupled into the CAFVM algorithm to investigate both the effects of thermal and constitutional undercooling on columnar growth and crystal selection in the columnar zone, and formation of equiaxed crystals in the bulk liquid. The model cannot only simulate microstructures of alloys but also investigates nucleation mechanisms and growth kinetics of alloys solidified with various solute concentrations and solidification morphologies.

Sweeping democracy: considerations on the political relations between Janio Quadros and the National Congress

This article examines the relation between President Janio Quadros and the National Congress during the early 1960`s. Based on the analysis of the discourse of these figures, it proposes that Quadros maneuvered to diminish the legitimacy of the Congress in the public opinion, thus disrespecting its constitutional competencies. Consequently, it shows that not only did the Congress structure political mechanisms in an attempt to recover its credibility with society, but also that this dispute and its results had important effects on President Joao Goulart`s administration and even on the 1964 military coup.

ASSOCIATION BETWEEN SADDLE NOSE DEFORMITY AND RETRO-ORBITAL MASS IN WEGENER`S GRANULOMATOSIS

Objectives: The relationship between saddle nose deformity (SND) in Wegener`s granulomatosis (WG) and other clinical features, including retro-orbital mass formation (ROM), has been poor described. Therefore, this relationship was analyzed retrospectively from 2000 to 2010. Patients and Methods: Eighteen consecutive WG patients with SND diagnosed by computed tomography were matched to 36 WG patients without SND (control group) for gender, age at WG diagnosis and disease duration. Results: No difference was found between the two groups in relation to WG type (limited and systemic forms), ethnicity, laboratory features, constitutional symptoms or clinical manifestations, including upper respiratory tract, and treatment, except for ROM (33.3 vs. 2.8% in SND(+) and SND(-) groups, respectively; p=0.004) and subglottic stenosis (22.2 vs. 2.8%; p=0.038). However, on multivariate analysis, only ROM (OR 17.15; 95% CI 1.11-265.52) was statistically associated to SND. In addition, in more than half of the cases, SND manifested prior to ROM. Conclusions: Results of this prospective analysis showed that SND was strongly associated to ROM in WG. Since early diagnosis and aggressive treatment of orbital involvement could lead to better prognosis, the presence of SND warrants additional vigilance.

Digital vasculitis in systemic lupus erythematosus: a minor manifestation of disease activity?

The objective of this study is to determine if digital vasculitis (DV), a clinical manifestation with a high systemic lupus erythematosus disease activity index (SLEDAI) score, is associated with lupus severity. DV and other clinical manifestations defined according to the SLEDAI were evaluated in 168 consecutive patients with systemic lupus erythematosus (SLE). Two groups were defined according to presence (DV+, n = 27) or absence of DV (DV-, n = 141) at the time of evaluation. The exclusion criterion was the presence of antiphospholipid syndrome (Sapporo`s criteria). The two groups were comparable with regard to age (P = 0.09), gender (P = 1.00), white race (P = 0.81), and disease duration (P = 0.78). Compared to the DV-group, the DV+ group had a significantly higher frequency of mucocutaneous manifestations (66.7 vs. 39.0%, P = 0.01), haematological abnormalities (22.2 vs. 6.4%, P = 0.02) and constitutional symptoms (11.1 vs. 0.7%, P = 0.01). Renal and neurological involvements were similar in both groups ( P = 0.57 and P = 1.00, respectively). The evaluation of each SLEDAI parameter confirmed that the DV+ group had higher frequencies of mild manifestations, such as new rash (P = 0.02), alopecia (P = 0.02), oral ulcers (P = 0.045), fever (P = 0.01) and leucopenia (P = 0.005). In contrast, both groups had similarly increased anti-dsDNA (P = 0.78) and decreased complement levels (P = 0.29). In conclusion, DV in patients with SLE identifies a subgroup of a mild disease. The high `weighted` index attributed to this alteration in the SLEDAI score should therefore be revised. Lupus (2009) 18, 990-993.

Development of a synthetic 7-ketocholesterol- rich emulsion resembling chylomicrons

Lipid emulsions that mimic natural lipoproteins help to understand the metabolism and the constitutional organization of circulating lipids. Chylomicrons synthesised by enterocyte cells usually contain oxysterols such as 7-ketocholesterol (7-KC). Here we describe the development of a 7-KC-containing emulsion as a model for oxisterol-rich chylomicron. Different amounts of 7-KC were used. Emulsion characteristics as effective diameter, lipid saturation with radiolabeled lipids was evaluated. In conclusion, the production of a synthetic 7-KC-rich emulsion resembling hylomicrons was feasible, being a model for in vivo metabolism studies.