917 resultados para Bilateral balanced occlusion
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This Thesis deals with the performance improvement on hotels that have adopted the ISO 9000 Quality Management Systems. It is researched the Brazilian hotels that have an ISO 9001 registration with an assessment form based on the Balanced Scorecard approach. The main findings are that ISO 9000 provided improvement on the performance of the hotels in general and also in all the BSC perspectives, and that are different perception on managers and directors, what suggests a need for a tool like BSC to register the performance improvements on the same basis. The Thesis contributes to provide information on the performance improvement in hotels, one of the claimed regarding the low ISO 9000 adoption rate in Brazilian hotels
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The aim of this work is to characterize and use the characteristic parameters of the planar structures constructed with fin lines looking for their applications in devices, using PBG Photonic Band Gap photonic materials as substrate, operating in the millimeter and optic wave bands.The PBG theory will be applied for the relative permittivity attainment for the PBG photonic substrate s and p polarizations. The parameters considered in the structures characterization are the complex propagation constant and the characteristic impedance of unilateral and bilateral fin lines that were obtained by the use of the TTL Transverse Transmission Line Method, together with the Method of the Moments. The final part of this work comprises studies related to the behavior of the asymmetric unilateral fin line coupler with photonic substrate. This research opens perspectives for new works in this modern area. Numerical results are shown by means of bi-dimensional and three-dimensional graphics. Conclusions and suggestions for future works are also presented
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This paper proposes a combined pool/bilateral short term hydrothermal scheduling model (PDC) for the context of the day-ahead energy markets. Some innovative aspects are introduced in the model, such as: i) the hydraulic generation is optimized through the opportunity cost function proposed; ii) there is no decoupling between physical and commercial dispatches, as is the case today in Brazil; iii) interrelationships between pool and bilateral markets are represented through a single optimization problem; iv) risk exposures related to future deficits are intrinsically mitigated; v) the model calculates spot prices in an hourly basis and the results show a coherent correlation between hydrological conditions and calculated prices. The proposed PDC model is solved by a primal-dual interior point method and is evaluated by simulations involving a test system. The results are focused on sensitivity analyses involving the parameters of the model, in such a way to emphasize its main modeling aspects. The results show that the proposed PDC provides a conceptual means for short term price formation for hydrothermal systems.
Falhas e complicações com o uso de prótese parcial removível inferior de extremidade livre bilateral
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Aim: To determine the frequency and type of complications related to removable partial denture (RPD) less, Kennedy Class I, over time . Materials and Methods: This observational study consisted of a sample of 65 users PPR lower arches in Kennedy Class I and dentures, rehabilitated in the Department of Dentistry, Federal University of Rio Grande do Norte (UFRN). Patients were followed through periodic controls during periods of 60 days, 6 months and 1 year from installation. After the first year of control had other returns annually. The occurrence of complications or prosthetic failure was observed and recorded in a specific clinical record over 39 months. The patterns of failures observed were classified in the following situations: occurrence of traumatic ulcers after 2 months of installation, lack of retention, fracture or caries in the rest, fracture or dislocation of the artificial teeth, the larger connector fracture, fracture clip fracture support, poor support (need to reline the denture) and prosthesis fracture. Results: The incidence of complications was low frequency, being higher in the second year of use of the prosthesis. Among the complications that occurred more is the loss of retention (31.57%). Failures more severe and difficult to solve as the fracture elements of the metal structure of the PPR had low occurrence and were represented by only one case of the larger connector (5.3%) fractures. Conclusion: Removable partial dentures mandibular free end opposing of the conventional dentures have a low complication rate after 39 months of use when subjected to periodic controls
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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JUSTIFICATIVA E OBJETIVOS: O número de artroplastia total de quadril (ATQ) bilateral tem aumentado a cada ano. Analgesia pós-operatória pela infusão contínua perineural com anestésico local tem se mostrado favorável quando comparada com analgesia sistêmica. O uso de bombas elastoméricas tem aumentado a satisfação do paciente quando em comparação com os modelos eletrônicos. O objetivo deste relato foi descrever um caso de analgesia contínua bilateral do plexo lombar via posterior, com infusão contínua através de bomba elastomérica, em paciente submetido à uma artroplastia bilateral de quadril. RELATO do CASO: Paciente feminina, 46 anos, 65 kg, 162 cm, com artrite reumatoide e hipertensão arterial, estado físico ASA II, escalada para ser submetida a ATQ bilateral em um único estágio. Uso de corticosteroide por 13 anos. Hemoglobina = 10,1 g.dL-1, hematócrito = 32,7%. Monitoração de rotina. Raquianestesia com 15 mg de bupivacaína 0,5% isobárica. Anestesia geral com propofol (PFS) e remifentanil e intubação sem bloqueadores neuromusculares. ATQ direita e no final, bloqueio plexo lombar com estimulador e conjunto agulha 150 mm e injeção de 20 mL bupivacaína 0,2% e passagem de cateter. ATQ esquerda e, no final, mesmo procedimento. Estudado dispersão do anestésico e contraste. Instalado bomba elastomérica com bupivacaína 0,1% (400 mL) em velocidade de 14 mL.h-1. Transferida para Unidade de Cuidados Intensivos (UCI). Vinte e quatro horas após, nova bomba com a mesma solução. Nenhum bolus durante 50 horas. Após remoção de cateter, dor controlada por via oral com cetoprofeno e dipirona. CONCLUSÕES: O bloqueio bilateral contínuo periférico com infusão de bupivacaína a 0,1% com bombas elastoméricas é um procedimento seguro e efetivo em adultos.
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This study presents the results of a research on the use of financial and non-financial performance indicators used by medium and large hotels. The research was conducted in Rio Grande do Norte, a Brazilian State. The objective is to identify the usage of performance measures by these companies. Hotel industry is one of the most important sectors in the Rio Grande do Norte economy. The research takes the Balanced Scorecard as a conceptual framework, since it represents an original contribution to the literature of managerial accounting, for rethinking old issues, pointing out themes that were forgotten or badly interpreted, to discuss the requirements imposed by the economy environment, dominated by competitive companies, and increasing the understanding of the relationship between strategy and operation. The objective of the research is to investigate if the hotel managers make use of a managerial information system or not, when evaluating the performance of their business unit. The research reveals the usage of performance evaluation using a large variety of measures. Among them is worth mention: the usage of accounting profit altogether with the EVA/MVA, the process cycle time, total quality management, process transformation, strategic mission, vision, strategic measures, measures related to feedback, risk, costs, productivity, incomes, customers retention, customer satisfaction and profitability, measures using time as a component, quality of the process, cost of the processes, employees capabilities, information systems, motivation, empowerment and alignment. The research leads to the conclusion that the usage of the deriving concepts of Balanced Scorecard can improve the performance measurement systems used by hotels
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Around 3% of the individuals with painful ophthalmoplegia have bilateral complaints. In the vast majority of these cases, appropriate investigation demonstrates a secondary etiology, and we are not aware of idiopathic cases reported. Herein we report a case of bilateral ophthalmoplegia where extensive investigation did not suggest a secondary cause.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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OBJECTIVE: A giant fusiform aneurysm in the posterior cerebral artery (PCA) is rare, as is fenestration of the PCA and basilar apex variation. We describe the angiographic and surgical findings of a giant fusiform aneurysm in the P1-P2 PCA segment associated with PCA bilateral fenestration and superior cerebellar artery double origin.CLINICAL PRESENTATION: A 26-year-old woman presented with a 2-month history of visual blurring. Digital subtraction angiography showed a giant (2.5 cm) fusiform PCA aneurysm in the right P1-P2 segment. The 3-dimensional view showed a caudal fusion pattern from the upper portion of the basilar artery associated with a bilateral long fenestration of the P1 and P2 segments and superior cerebellar artery double origin.INTERVENTION: Surgical trapping of the right P1 -P2 segment, including the posterior communicating artery, was performed by a pretemporal approach. Angiograms performed 3 and 13 months after surgery showed complete aneurysm exclusion, and the PCA was permeated and filled the PCA territory. Clinical follow-up at 14 months showed the patient with no deficits and a return to normal life.CONCLUSION: To our knowledge, this is the first report of a giant fusiform aneurysm of the PCA associated with P1-P2 segment fenestration and other variations of the basilar apex (bilateral superior cerebellar artery duplication and caudal fusion). Comprehension of the embryology and anatomy of the PCA and its related vessels and branches is fundamental to the decision-making process for a PCA aneurysm, especially when parent vessel occlusion is planned.
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The authors report a rare case of bilateral Leydig cell tumor in a noncryptorchid stallion, describing the gross. and microscopic findings. An 8-year-old Appaloosa stallion was examined for a unilateral enlargement of the testis associated with discomfort during palpation and signs of colic. General health conditions were good. Fine-needle aspiration cytology of the testis provided the diagnosis of bilateral Leydig cell tumor. Bilateral orchiectomy was performed and the testes were submitted to histopathologic examination that confirmed the diagnosis of Leydig cell tumor.
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A ausência completa do bulbo ocular é muito rara em cães e gatos, enquanto a hidrocefalia é comumente observada como distúrbio congênito em cães de raças miniatura ou braquicefálicas, com menos de um ano de idade. O presente trabalho relata a ocorrência de anoftalmia clínica bilateral associada à hidrocefalia congênita em um cão da raça poodle, sendo este o primeiro relato de caso da associação dessas alterações no Brasil.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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The present study aimed at reporting a clinical and surgical case of bilateral coronoidectomy, using an intraoral approach. The patient is a 26-year-old man, who sought attendance complaining of a gradual reduction of his oral opening in the past 3 years; however, he had an aggravation in the last 2 months. After clinical examination and imaging evaluation, the diagnosis of coronoid process hyperplasia was confirmed, and the surgical treatment was proposed. Under general anesthesia, with nasotracheal intubation guided by a nasofiberendoscope, using an intraoral approach, the bilateral coronoidectomy was performed. In the immediate postoperative period, an increase of the buccal opening measured 29 mm, representing an enhancement of 11 mm, and in the 30th postoperative day, it measured 31.12 mm. During the clinical follow-up period, a reestablishment of the mandibular movements was observed. Therefore, coronoidectomy by an intraoral approach and the physiotherapy performed in the postoperative period were efficient procedures.