Epidemiological characteristics of congenital heart diseases in Londrina, Paraná South Brazil

OBJECTIVE: To determine the prevalence and other epidemiological characteristics of congenital heart diseases. METHODS: A retrospective population based study of children who were born in Londrina, from January '89 to December '98 (80,262 live births). Diagnoses were confirmed through autopsy, surgery, catheterization, or echocardiography. RESULTS: A total of 441 patients was as certained what corresponds to a prevalence of 5.494:1,000 live births. Ventricular septal defect was the commonest lesion. A small number of transpositions of the great vessels and of left ventricular hypoplasia was observed. A high propation of ventricular septal defect (28.3%) and atrioventricular septal defects (8.1%) occurred. Fifty-one (11.35%) affected children had syndromic diseases and 52 (12.01%) children had nonsyndromic anomalies. CONCLUSION: The prevalence of congenital heart diseases in Londrina is in accordance with that of other regions of the globe. This prevalence also may reflect the reality in the southern region of Brazil, because population characteristics are very similar in the 3 southernmost Brazilian states.

Structural and functional characteristics of rat hearts with and without myocardial infarct. Initial experience with doppler echocardiography

OBJECTIVE: To assess by Doppler echocardiography the structural and functional alterations of rat heart with surgical induced extensive myocardial infarction. METHODS: Five weeks after surgical ligature of the left coronary artery, 38 Wistar-EPM rats of both sexes, 10 of them with extensive infarction, undergone anatomical and functional evaluation by Doppler echocardiography and then euthanized for anatomopathological analysis. RESULTS: Echocardiography was 100% sensible and specific to anatomopathological confirmed extensive miocardial infarction. Extensive infarction lead to dilatation of left ventricle (diastolic diameter: 0.89cm vs.0.64cm; systolic: 0.72cm vs. 0.33cm) and left atrium (0.55cm vs. 0.33cm); thinning of left ventricular anterior wall (systolic: 0.14cm vs. 0.23cm, diastolic: 0.11cm vs. 0.14cm); increased mitral E/ A wave relation (6.45 vs. 1.95). Signals of increased end diastolic ventricle pressure, B point in mitral valve tracing in 62.5% and signs of pulmonary hypertension straightening of pulmonary valve (90%) and notching of pulmonary systolic flow (60%) were observed in animals with extensive infarction. CONCLUSION: Doppler echocardiography has a high sensitivity and specificity for detection of chronic extensive infarction. Extensive infarction caused dilatation of left cardiac chambers and showed in Doppler signals of increased end diastolic left ventricular pressure and pulmonary artery pressure.

A individuação técnica na actualidade

Tese de doutoramento em Sociologia

Characteristics associated with the dropout of hypertensive patients followed up in an outpatient referral clinic

OBJECTIVE: To determine the characteristics associated with the dropout of patients followed up in a Brazilian out patient clinic specializing in hypertension. METHODS: Planned prospective cohort study of patients who were prescribed an antihypertensive treatment after an extensive initial evaluation. The following parameters were analyzed: sex, age, educational level, duration of disease, pressure level used for classifying the patient, previous treatment, physical activity, smoking, alcohol consumption, familial history of hypertension, and lesion in a target organ. RESULTS: We studied 945 hypertensive patients, 533 (56%) of whom dropped out of the follow-up. The mean age was 52.3±12.9 years. The highest probabilities of dropout of the follow-up were associated with current smoking, relative risk of 1.46 (1.04-2.06); educational level equal to or below 5 years of schooling, relative risk of 1.52 (1.11-2.08); and hypertension duration below 5 years, relative risk of 1.78 (1.28-2.48). Age increase was associated with a higher probability of follow-up with a relative risk of 0.98 (0.97-0.99). CONCLUSION: We identified a group at risk for dropping out the follow-up, which comprised patients with a lower educational level, a recent diagnosis of hypertension, and who were smokers. We think that measures assuring adherence to treatment should be directed to this group of patients.

Intra-His bundle block: clinical, electrocardiographic, and electrophysiologic characteristics

OBJECTIVE: To assess the clinical, electrocardiographic, and electrophysiologic characteristics of patients (pt) with intra-His bundle block undergoing an electrophysiologic study (EPS). METHODS: We analyzed the characteristics of 16 pt with second-degree atrioventricular block and symptoms of syncope or dyspnea, or both, undergoing conventional EPS. RESULTS: Intra-His bundle block was documented in 16 pt during an EPS. In 15 (94%) pt, the atrioventricular block was recorded in sinus rhythm; 4 (25%) pt had intra-His Wenckebach phenomenon, which correlated with Mobitz I (MI) atrioventricular block on the electrocardiogram. Seven (44%) pt had 2:1 atrioventricular block, 2 of whom were asymptomatic (12.5%). One (6%) pt had intra- and infra-His bundle block. Clinically, 11 (68%) pt had syncope or presyncope, 3 (18%) had dyspnea on exertion, and 2 (12.5%) were asymptomatic. Eight (50%) pt had bundle-branch block as follows: 4 (25%) pt had left bundle-branch block, and 4 (25%) had right bundle-branch block. Left anterosuperior divisional block was observed in 3 pt (19%), 2 of whom with associated right bundle-branch block. CONCLUSION: Intra-His bundle block was observed in 11% of the pt with second-degree atrioventricular block, syncope or presyncope, or both, it being the most frequent clinical presentation. Intra-His bundle block was more common in the elderly (> 60 years) and among females. The most frequent electrocardiographic presentations were second-degree Mobitz I or type 2:1 atrioventricular block.

Enumeratio plantarum Horti regii botanici berolinensis altera.Auctore dr. H. F. Link ...

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Enumeratio plantarum Horti regii botanici berolinensis altera.Auctore dr. H. F. Link ...

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White-coat hypertension and normotension in the League of Hypertension of the Hospital das Clínicas, FMUSP: prevalence, clinical and demographic characteristics

OBJECTIVE: To assess the prevalence of white-coat normortension, white-coat hypertension, and white-coat effect. METHODS: We assessed 670 medical records of patients from the League of Hypertension of the Hospital das Clínicas of the Medical School of the University of São Paulo. White-coat hypertension (blood pressure at the medical office: mean of 3 measurements with the oscillometric device ³140 or ³90 mmHg, or both, and ambulatory blood pressure monitoring mean during wakefulness < 135/85) and white-coat normotension (office blood pressure < 140/90 and blood pressure during wakefulness on ambulatory blood pressure monitoring ³ 135/85) were analyzed in 183 patients taking no medication. The white-coat effect (difference between office and ambulatory blood pressure > 20 mmHg for systolic and 10 mmHg for diastolic) was analyzed in 487 patients on treatment, 374 of whom underwent multivariate analysis to identify the variables that better explain the white-coat effect. RESULTS: Prevalence of white-coat normotension was 12%, prevalence of white-coat hypertension was 20%, and prevalence of the white-coat effect was 27%. A significant correlation (p<0.05) was observed between white-coat hypertension and familial history of hypertension, and between the white-coat effect and sex, severity of the office diastolic blood pressure, and thickness of left ventricular posterior wall. CONCLUSION: White-coat hypertension, white-coat normotension, and white-coat effect should be considered in the diagnosis of hypertension.

Demographic characteristics of the population undergoing cine coronary angiography at the Instituto do Coração of the Medical School of USP from 1986 to 1995

OBJECTIVE: To obtain information about the profile and behavior of a population with ischemic heart disease undergoing cine coronary angiography and to determine disease severity. METHODS: Retrospective study assessing patients hospitalized at InCor from 1986 to 1995, in which the variables age, sex, and number of major coronary arteries with obstruction degree > 40% were analyzed. RESULTS: We studied 18,221 patients and observed a significant increase in the number of females (22.8% to 25.2%, P=0.001) and an increase in age (57.1±29.3 to 60.4±10.7 years, P=0.0001). A significant increase in the incidence of multivessel disease was observed, which was more frequent among males (69.2% and 64.5%) and among the older patients (59.8±9.8 and 56.8±10.7 years, P=0.0001). A reduction in the incidence of single-vessel disease was also observed (66.2% vs 69.2% and 33.8% vs 30.5%, respectively, P<0.0001). CONCLUSION: A change in the profile of the population studied was observed as follows: patients undergoing cine coronary angiography at InCor were older, had a greater number of impaired major coronary arteries, and the number of females affected increased, leading to indices suggestive of a poorer prognosis.

Conceptualização de um projecto urbano

Dissertação apresentada na Universidade de Lisboa - Faculdade de Arquitetura, para obtenção do Grau de Mestre em Arquitetura.

Cidade de Miradouro

Dissertação apresentada na Universidade de Lisboa - Faculdade de Arquitetura, para obtenção do Grau de Mestre em Arquitetura.

A study of the interaction between national and corporate culture in a selection of Irish based companies

This research studies the phenomenon of national and corporate culture. National culture is the culture the members of a country share and corporate culture is a subculture which members of an organisation share (Schein, 1992). The objective of this research is to reveal if the employees within equivalent Irish and American companies share the same corporate and national culture and to ascertain if, within each company, there is a link between national culture and corporate culture. The object of this study is achieved by replicating research which was conducted by Shing (1997) in Taiwan. Hypotheses and analytical tools developed by Shing are employed in the current study to allow comparison of results between Shing’s study and the current study. The methodology used, called for the measurement and comparison of national and corporate culture in two equivalent companies within the same industry. The two companies involved in this study are both located in Ireland and are of American and Irish origin. A sample of three hundred was selected and the response rate was 54%. The findings from this research are: (1) The two companies involved had different corporate cultures, (2) They had the same national culture, (3) There was no link between national culture and corporate culture within either company, (4) The findings were not similar to those of Shing (1997). The implication of these findings is that national and corporate culture are separate phenomena therefore corporate culture is not a response to national culture. The results of this research are not reflected in the finding’s of Shing (1997), therefore they are context specific. The core recommendation for management is that, corporate culture should take account of national culture. This is because although employees recognise the espoused values of corporate culture (Schein, 1992), they are at the same time influenced by a much stronger force, their national culture.

Socially integrative customer service (SICS) : identification of a symbiotic link with corporate social responsibility

The aim of this study is to answer the research question "can customer service be revitalised through identification of a symbiotic relationship with social responsibility, linked by people-centricity?" The concept of customer service remains weak and there has been a lack of attention to the underlying purpose: "to serve". To strengthen the theory the humanistic nature of the concept should be revised. Fundamental to this argument is the question of who is a customer? To fully discover the scope of the concept requires a broader or more specifically a societal view. Herein the theme of social corporate responsibility is critical to the recognition of the customer service network (CSN). This suggestion in isolation is useful but structural. Another aspect must be identified to validate the "service" ethos. Through this reasoning the relational theme (RT) provides for a mechanism for this to be achieved. Therefore the theory of socially integrative customer service is based on broadening and deepening the customer service concept. This study is illustrated in the context of the grocery retail sector in the Republic of Ireland. Four case studies are presented, three based on company-wide and in-store research and a fourth is a cross-company study. Results across companies indicate acceptance of the research question and show evidence to validate SICS. There is scope to further develop SICS and to build on the CSN and the RT. Finally the concept of SICS provides for a diverse basis for further research. This theory does no purport to cause a paradigm shift but does add innovation to the body of knowledge. As is the hallmark of good theoretical development, the author has aimed to keep the philosophy simple.

Statistical Characteristics of Flash Flood in Georgia

Results are presented from the analysis of observations data on flash flood in Georgia over a period of 45 years, from 1961 to 2005, provided of the of Hydro-meteorology Service of Georgia.

Bioclimatic Characteristics of Recreational Zones – Important Component of the Passport of the Health Resort – Tourist Potential of Georgia

მოყვანილია საკურორტო-ტურისტული პოტენციალის პასპორტის ძირითადი მაჩვენებლების აღწერილობა. განსაკუთრებული ყურადღება ეთმობა ბიოკლიმატურ პარამეტრებს. მოყვანილია პრაქტიკული მაგალითები აღნიშნული პარამეტრების გამოყენებისა საქართველოს ზოგიერთი საკურორტო-ტურისტული რაიონების ბიოკლიმატური პირობების შესაფასებლად.