Debilidades e potencialidades da estrutura de recursos humanos nos cuidados continuados na Santa Casa da Misericórdia dos Arcos de Valdevez - Vilagerações

Dissertação de mestrado em Sociologia (área de especialização em Organizações e Trabalho)

Continuous-flow precipitation as a route to prepare highly controlled nanohydroxyapatite

[Excerpt] Hydroxyapatite Ca10(PO4)6(OH)2 (HAp) has been widely used for biomedical purposes because of its exceptional biocompatibility, bioactivity and osteoconductivity [1]. As these properties are directly related to HAp particles characteristics (size, morphology and purity), a very good control of the reaction conditions is required to obtain particles with the desired properties. Usually, HAp is synthesized by wet chemical precipitation in stirred tank batch reactors that often lead to inconsistencies in product specifications due to their low mixing efficiency [2]. (...)

Analysis of the effects of the continuous electrode paste band on precordial leads of the electrocardiogram

OBJECTIVE - To determine if the application of a continuous electrode paste band on precordial leads results in alteration of the electrocardiographic tracing as compared with an adequate amount of electrode paste, and if the former condition does not cause uniform morphologies from V1 to V6. METHODS - The amplitude and morphology of the electrocardiographic waves on the precordial leads in electrocardiographic tracings, which were performed with standard (control group) or excessive (continuous band) application of the electrode paste, were compared. RESULTS - None of the 106 patients studied showed uniformity of the QRS morphology from V1 to V6. The eletrocardiographic alterations identified in the tracings performed with a continuous electrode paste band that showed statistical significance in relation to the control group were the following: inversion of the P wave in V1; inversion of the T wave in V1, V2, and V3; appearance of R' waves in V1 and V2; disappearance of S waves in V1; appearance of S waves in V5 and V6; alterations in the amplitude of almost all waves, in all leads. CONCLUSION - Application of a continuous electrode paste band in the precordial leads may cause significant alterations in the electrocardiographic tracing obtained.

Congestive heart failure. Correlation between functional class and systolic and diastolic functions assessed by Doppler echocardiography

OBJECTIVE: To evaluate the influence of systolic or diastolic dysfunction, or both on congestive heart failure functional class. METHODS: Thirty-six consecutive patients with a clinical diagnosis of congestive heart failure with sinus rhythm, who were seen between September and November of 1998 answered an adapted questionnaire about tolerance to physical activity for the determination of NYHA functional class. The patients were studied with transthoracic Doppler echocardiography. Two groups were compared: group 1 (19 patients in functional classes I and II) and group 2 (17 patients in functional classes III and IV). RESULTS: The average ejection fraction was significantly higher in group 1 (44.84%±8.04% vs. 32.59%±11.48% with p=0.0007). The mean ratio of the initial/final maximum diastolic filling velocity (E/A) of the left ventricle was significantly smaller in group 1 (1.07±0.72 vs. 1.98±1.49 with p=0.03). The average maximum systolic pulmonary venous velocity (S) was significantly higher in group 1 (53.53cm/s ± 12.02cm/s vs. 43.41cm/s ± 13.55cm/s with p=0.02). The mean ratio of maximum systolic/diastolic pulmonary venous velocity was significantly higher in group 1 (1.52±0.48 vs. 1.08±0.48 with p=0.01). A predominance of pseudo-normal and restrictive diastolic patterns existed in group 2 (58.83% in group 2 vs. 21.06% in group 1 with p=0.03). CONCLUSION: Both the systolic dysfunction index and the patterns of diastolic dysfunction evaluated by Doppler echocardiography worsened with the evolution of congestive heart failure.

Oxygen therapy, continuous positive airway pressure, or noninvasive bilevel positive pressure ventilation in the treatment of acute cardiogenic pulmonary edema

OBJECTIVE: To compare the effects of 3 types of noninvasive respiratory support systems in the treatment of acute pulmonary edema: oxygen therapy (O2), continuous positive airway pressure, and bilevel positive pressure ventilation. METHODS: We studied prospectively 26 patients with acute pulmonary edema, who were randomized into 1 of 3 types of respiratory support groups. Age was 69±7 years. Ten patients were treated with oxygen, 9 with continuous positive airway pressure, and 7 with noninvasive bilevel positive pressure ventilation. All patients received medicamentous therapy according to the Advanced Cardiac Life Support protocol. Our primary aim was to assess the need for orotracheal intubation. We also assessed the following: heart and respiration rates, blood pressure, PaO2, PaCO2, and pH at begining, and at 10 and 60 minutes after starting the protocol. RESULTS: At 10 minutes, the patients in the bilevel positive pressure ventilation group had the highest PaO2 and the lowest respiration rates; the patients in the O2 group had the highest PaCO2 and the lowest pH (p<0.05). Four patients in the O2 group, 3 patients in the continuous positive pressure group, and none in the bilevel positive pressure ventilation group were intubated (p<0.05). CONCLUSION: Noninvasive bilevel positive pressure ventilation was effective in the treatment of acute cardiogenic pulmonary edema, accelerated the recovery of vital signs and blood gas data, and avoided intubation.

Reducciones Jesuiticas en el Chaco, Noroeste y Sur Argentino. Emplazamiento Territorial. Desarrollo Urbano y Arquitectónico entre los siglos XVII y XVIII. Evolución, Funciones y Tipologías. Reductions in the Chaco, Argentine Northwest and South. Territorial emplazan. Architectural and Urban Development between the seventeenth and eighteenth centuries. Evolution, Functions and Typologies.

Las reducciones jesuíticas en Argentina reconocen generalmente un único aporte en la región guaraní. Pero lo cierto es que una cantidad importante de reducciones, equivalente en número con las anteriormente mencionadas, se desarrollaron en el interior del país, fundamentalmente en las regiones del Chaco, noroeste y sur argentino. Muchas de ellas reconocen hoy su continuidad en centros urbanos y otras tan sólo, y en el mejor de los casos, en vestigios arqueológicos. Se propone el análisis de este conjunto desde las primeras incursiones en "misiones volantes" en el siglo XVII hasta la expulsión de los jesuitas en 1767. También se abordarán las modalidades y procesos generadores de centros reduccionales en estas regiones y sus interrelaciones territoriales. Además se pretende analizar sus funciones y morfologías originales, su evolución, traslados y posibles transformaciones posteriores, en las etapas previas al impacto originado ante la ausencia de la Compañía de Jesús. Los resultados incluirán la interpretación de los procesos formativos, con su diversidad de casos, en escalas regionales y locales, la recopilación de cartografía regional y urbana, y la determinación de series tipológicas de formas de trazados y organizaciones de tejidos, tanto en las demarcaciones de origen como en sus remodelaciones y ensanches cuando así correspondiere.

Optimización en el cómputos de algoritmos de cuadratura para funciones especiales. Optimization of quadrature algorithms for special functions.

En nuestro proyecto anterior aproximamos el cálculo de una integral definida con integrandos de grandes variaciones funcionales. Nuestra aproximación paraleliza el algoritmo de cómputo de un método adaptivo de cuadratura, basado en reglas de Newton-Cote. Los primeros resultados obtenidos fueron comunicados en distintos congresos nacionales e internacionales; ellos nos permintieron comenzar con una tipificación de las reglas de cuadratura existentes y una clasificación de algunas funciones utilizadas como funciones de prueba. Estas tareas de clasificación y tipificación no las hemos finalizado, por lo que pretendemos darle continuidad a fin de poder informar sobre la conveniencia o no de utilizar nuestra técnica. Para llevar adelante esta tarea se buscará una base de funciones de prueba y se ampliará el espectro de reglas de cuadraturas a utilizar. Además, nos proponemos re-estructurar el cálculo de algunas rutinas que intervienen en el cómputo de la mínima energía de una molécula. Este programa ya existe en su versión secuencial y está modelizado utilizando la aproximación LCAO. El mismo obtiene resultados exitosos en cuanto a precisión, comparado con otras publicaciones internacionales similares, pero requiere de un tiempo de cálculo significativamente alto. Nuestra propuesta es paralelizar el algoritmo mencionado abordándolo al menos en dos niveles: 1- decidir si conviene distribuir el cálculo de una integral entre varios procesadores o si será mejor distribuir distintas integrales entre diferentes procesadores. Debemos recordar que en los entornos de arquitecturas paralelas basadas en redes (típicamente redes de área local, LAN) el tiempo que ocupa el envío de mensajes entre los procesadores es muy significativo medido en cantidad de operaciones de cálculo que un procesador puede completar. 2- de ser necesario, paralelizar el cálculo de integrales dobles y/o triples. Para el desarrollo de nuestra propuesta se desarrollarán heurísticas para verificar y construir modelos en los casos mencionados tendientes a mejorar las rutinas de cálculo ya conocidas. A la vez que se testearán los algoritmos con casos de prueba. La metodología a utilizar es la habitual en Cálculo Numérico. Con cada propuesta se requiere: a) Implementar un algoritmo de cálculo tratando de lograr versiones superadoras de las ya existentes. b) Realizar los ejercicios de comparación con las rutinas existentes para confirmar o desechar una mejor perfomance numérica. c) Realizar estudios teóricos de error vinculados al método y a la implementación. Se conformó un equipo interdisciplinario integrado por investigadores tanto de Ciencias de la Computación como de Matemática. Metas a alcanzar Se espera obtener una caracterización de las reglas de cuadratura según su efectividad, con funciones de comportamiento oscilatorio y con decaimiento exponencial, y desarrollar implementaciones computacionales adecuadas, optimizadas y basadas en arquitecturas paralelas.

Anatomically informed basis functions

Neuroimaging, functional image analysis, spatial model, cortical surface, spatially variable convolution

equivalence of almost bent and almost perfect nonlinear functions and their generalizations

Vectorial Boolean function, almost bent, almost perfect nonlinear, affine equivalence, CCZ-equivalence

Impact of Intensive Physiotherapy on Cognitive Function after Coronary Artery Bypass Graft Surgery

Background: Coronary artery bypass graft (CABG) is a standard surgical option for patients with diffuse and significant arterial plaque. This procedure, however, is not free of postoperative complications, especially pulmonary and cognitive disorders. Objective: This study aimed at comparing the impact of two different physiotherapy treatment approaches on pulmonary and cognitive function of patients undergoing CABG. Methods: Neuropsychological and pulmonary function tests were applied, prior to and following CABG, to 39 patients randomized into two groups as follows: Group 1 (control) - 20 patients underwent one physiotherapy session daily; and Group 2 (intensive physiotherapy) - 19 patients underwent three physiotherapy sessions daily during the recovery phase at the hospital. Non-paired and paired Student t tests were used to compare continuous variables. Variables without normal distribution were compared between groups by using Mann-Whitney test, and, within the same group at different times, by using Wilcoxon test. The chi-square test assessed differences of categorical variables. Statistical tests with a p value ≤ 0.05 were considered significant. Results: Changes in pulmonary function were not significantly different between the groups. However, while Group 2 patients showed no decline in their neurocognitive function, Group 1 patients showed a decline in their cognitive functions (P ≤ 0.01). Conclusion: Those results highlight the importance of physiotherapy after CABG and support the implementation of multiple sessions per day, providing patients with better psychosocial conditions and less morbidity.

Influence of pore size distribution on drying behaviour of porous media by a continuous model

Bundle of capillaries, drying kinetics, continuous model, relative permeability, capillary pressure, control volume method

Hypotensive Response Magnitude and Duration in Hypertensives: Continuous and Interval Exercise

Background: Although exercise training is known to promote post-exercise hypotension, there is currently no consistent argument about the effects of manipulating its various components (intensity, duration, rest periods, types of exercise, training methods) on the magnitude and duration of hypotensive response. Objective: To compare the effect of continuous and interval exercises on hypotensive response magnitude and duration in hypertensive patients by using ambulatory blood pressure monitoring (ABPM). Methods: The sample consisted of 20 elderly hypertensives. Each participant underwent three ABPM sessions: one control ABPM, without exercise; one ABPM after continuous exercise; and one ABPM after interval exercise. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR) and double product (DP) were monitored to check post-exercise hypotension and for comparison between each ABPM. Results: ABPM after continuous exercise and after interval exercise showed post-exercise hypotension and a significant reduction (p < 0.05) in SBP, DBP, MAP and DP for 20 hours as compared with control ABPM. Comparing ABPM after continuous and ABPM after interval exercise, a significant reduction (p < 0.05) in SBP, DBP, MAP and DP was observed in the latter. Conclusion: Continuous and interval exercise trainings promote post-exercise hypotension with reduction in SBP, DBP, MAP and DP in the 20 hours following exercise. Interval exercise training causes greater post-exercise hypotension and lower cardiovascular overload as compared with continuous exercise.