Síndrome de Melkersson-Rosenthal : um diagnóstico a ponderar numa doente com edema do lábio

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

Public Procurement Law and Health care: From Theory to Practice. Research Paper in Law, 2/2010

From the Introduction. This contribution will focus on the core question if, how and to what extent the EU procurement rules and principles (may) affect the national health care systems. We start our analysis by summarizing the applicable EU public procurement legislation, principles and soft law and its exact scope in relation to health care. (section 2). Subsequently, we turn to the parties in a contract, subject to procurement rules in the field of health care, addressing both the definition of contracting authorities and relevant case law (section 3). This will then lead to an analysis of possible justifications for not holding a tender procedure in the field of health care (section 4). Finally, we illustrate the impact of EU public procurement rules on health care by analysing a Dutch case study, in which the question whether public hospitals in the Netherlands qualify as contracting authorities in terms of the Public Sector Directive stood central (section 5). Our conclusions will follow in section 6.

Interconnector Investment for a Well-Functioning Internal Market: What EU regime of regulatory incentives? Bruges European Economic Research (BEER) Papers 18/October 2010

Sufficient cross‐border electricity transmission infrastructure is a pre‐requisite for a functioning European internal market for electricity. Also, the achievement of the EU’s energy policy objectives – sustainability, competitiveness and security of supply – critically depends on adequate investment in physical interconnections between the member states. Mainly focusing on the “regulatory path”, this paper assesses different ways to achieve a sufficient level of interconnector investment. In a first step, economic analysis identifies numerous impediments to interconnector investment adding up to an “interconnector investment failure”. Reflecting on the proper regulatory design of an EU framework able to overcome the interconnector investment failure, a number of recommendations are put forward:  All congestion rents should be channeled into interconnector building. Unused rents should be transferred to a European interconnector fund supervised by an EU agency.  Even though inherently sub‐optimal, merchant transmission investment can be used as a means to put pressure on regulated transmission system operators (TSO) that do not deliver. An EU agency should have exclusive competence on merchant interconnector exemptions.  A European TSO organization should be entrusted with supra‐national network planning, supervised by an EU agency.  The agency should decide on investment cost reallocation for interconnector projects that yield strong externalities. Payments could be settled via a European interconnector fund.  In case of non‐compliance with the supra‐national network plan, the EU agency should have the right to organize a tender – financed by the European interconnector fund – in order to get the “missing link” built. Assessing the existing EU regulatory framework, the efforts of the 2009 “third energy package” to fill the “regulatory gap” with new EU bodies – ACER and ENTSO‐E – are acknowledged. However, striking holes in regulatory framework are spotted, notably with regard to the use of congestion rents, interconnector cost allocation, and the distribution of decision making powers on new infrastructure exemptions A discussion of the TEN‐E interconnector funding scheme shows that massive funding can be an interim solution to the problem of insufficient interconnection capacities while overcoming the political deadlock on sensible regulatory topics such as interconnector cost allocation. The paper ends with policy recommendations.

Cozinha a baixa temperatura:

A dissertação “Cozinha a Baixa Temperatura: Aplicação ao caso da Confeção de Carne de Novilho” inicia-se pelo enquadramento histórico e respetiva conceptualização. São enumerados e explicados os intervenientes e procedimentos na Cozinha a Baixa Temperatura-Cozinha em Vácuo. Enquanto estudo, a cozinha a baixa temperatura foi alvo de críticas positivas no que confere aos benefícios nutricionais, à maximização das potencialidades do produto (conservação, textura, sabor, entre outros…), ao incremento das vantagens organizacionais e económicas (gestão de cozinhas/restaurantes); alertando para o fato de que um incorreto embalamento comprometerá as vantagens da técnica em estudo, ou seja são enumerados ainda todos os requisitos necessários a uma correta e eficaz cozinha em vácuo. Os diferentes tipos de cozinha a vácuo são igualmente abordados (indireta e dupla cozedura), bem como a influência da relação existente entre o tempo e a temperatura e as consequentes modificações químicas e fisiológicas. No intuito de introduzir uma vertente prática e enquanto projeto pessoal e profissional foi desenvolvida uma máquina para cozinhar a baixa temperatura (roner). Neste âmbito foram enumerados os materiais utilizados e explicado o seu funcionamento. Porque conceber um roner implica testá-lo, foi então decidido utilizar carne de vitela (capitação 100gr) durante 1 hora com temperaturas entre os 54 ºC e os 70 ºC. Foram realizados testes de textura em todas as amostras de carne recorrendo ao texturómetro TA XT Plus e respetivo software para o tratamento dos resultados. Em suma, analisando os resultados obtidos, a relação tempo e temperatura origina modificações químicas e fisiológicas na carne, ou seja uma carne a 54 ºC aporta uma menor gelatinização do colagénio originando uma carne menos macia, de tom rosa avermelhado, onde se dá uma menor contração das fibras musculares e que consequentemente origina uma menor quantidade de sucos expelidos da carne; já o contrário acontece numa confeção a 60 ºC, em que se verifica um tom rosa uniforme onde acontece uma maior contração das fibras musculares originando uma maior quantidade de sucos expelidos pela carne. Os resultados dos ensaios instrumentais de textura mostraram que a carne confecionada a 60 ºC se apresentou menos firme e menos dura, e portanto mais macia.

The youth's guide in Zion ; and Holy Mother's promises /

Appendix: p. [1] at end.

Ten plays for boys,

Not wanted - a wife / E.B. Fenn -- The freedom of the press / G.M. Baker -- The great elixir / G.M. Baker -- The humors of the strike / G.M. Baker --My uncle othe captain / G.M. Baker -- New broom sweeps clean / G.M. Baker -- A tender attachment / G.M. Baker -- Dizzy's dilemmas / C.I. Brown -- Hypnotism / N. Bent -- Shakespeare's Julius Caesar / L. Warren.

Chapters of Erie : and other essays.

The greater portion of the essays is reprinted from the "Westminister Review" and the "North American Review".

Songs of Ireland : 100 most popular Irish songs /

For voice and piano.

Financial pamphlets

A collection of miscellaneous pamphlets on finance.

Remains of Nithsdale and Galloway song: with historical and traditional notices relative to the manners and customs of the peasantry.

Almost wholly the work of Allan Cunningham, who supplied Cromek with original poems, disguised as old ballads, etc. Whether Cromek suspected the imposition is not clear. cf. Dict. nat. biog. and D. Hogg, Life of A. Cunningham. 1875 (esp. p. 49-, & 79)

El Grupo de Curas en Opción Preferencial por los Pobres : Los herederos del Movimiento de Sacerdotes para el Tercer Mundo

Esta tesina se centra en el estudio del Grupo de Curas en Opción Preferencial por los Pobres (cuya sigla es "CPP"), como colectivo de sacerdotes "herederos del Movimiento de Sacerdotes para el Tercer Mundo". Surgido en la posdictadura Argentina, en la segunda mitad de los años 80, el CPP es un grupo de carácter nacional que desde entonces ha decidido orientar su acción pastoral al servicio de los sectores populares. Dado que con sus posiciones y su praxis el CPP ha buscado tender un puente hacia la experiencia previa del MSTM y de la "teología de la liberación", este trabajo ofrece, en primer lugar, un repaso histórico sobre las transformaciones y disputas en la Iglesia Católica Argentina desde los años sesenta del siglo XX, como marco para pensar el papel que este colectivo en particular ha jugado a partir de 1986 en dicha institución. En segundo lugar, como hasta el presente este colectivo no había recibido la atención de nuestras disciplinas, se realiza una reconstrucción detallada de los caminos que condujeron a la constitución del Grupo, sus primeros encuentros, su dinámica interna de funcionamiento y un análisis de las preocupaciones centrales de sus intervenciones públicas. Por último, se repasa su situación actual, cuáles son sus perspectivas y qué rol desempeñan hoy respecto de la Iglesia local, el gobierno argentino recientemente electo y del papado de Jorge Bergoglio

El Grupo de Curas en Opción Preferencial por los Pobres : Los herederos del Movimiento de Sacerdotes para el Tercer Mundo

Esta tesina se centra en el estudio del Grupo de Curas en Opción Preferencial por los Pobres (cuya sigla es "CPP"), como colectivo de sacerdotes "herederos del Movimiento de Sacerdotes para el Tercer Mundo". Surgido en la posdictadura Argentina, en la segunda mitad de los años 80, el CPP es un grupo de carácter nacional que desde entonces ha decidido orientar su acción pastoral al servicio de los sectores populares. Dado que con sus posiciones y su praxis el CPP ha buscado tender un puente hacia la experiencia previa del MSTM y de la "teología de la liberación", este trabajo ofrece, en primer lugar, un repaso histórico sobre las transformaciones y disputas en la Iglesia Católica Argentina desde los años sesenta del siglo XX, como marco para pensar el papel que este colectivo en particular ha jugado a partir de 1986 en dicha institución. En segundo lugar, como hasta el presente este colectivo no había recibido la atención de nuestras disciplinas, se realiza una reconstrucción detallada de los caminos que condujeron a la constitución del Grupo, sus primeros encuentros, su dinámica interna de funcionamiento y un análisis de las preocupaciones centrales de sus intervenciones públicas. Por último, se repasa su situación actual, cuáles son sus perspectivas y qué rol desempeñan hoy respecto de la Iglesia local, el gobierno argentino recientemente electo y del papado de Jorge Bergoglio

Female Exiles in Language: Reading for New Poetic Subjects in Modern and Contemporary Feminist Experimental Poetry

Thesis (Ph.D.)--University of Washington, 2016-06

Prolotherapy injections, saline injections, and exercises for chronic low-back pain: A randomized trial

Objectives. To assess the efficacy of a prolotherapy injection and exercise protocol in the treatment of chronic nonspecific low back pain. Design. Randomized controlled trial with two- by- two factorial design, triple- blinded for injection status, and single- blinded for exercise status. Setting. General practice. Participants. One hundred ten participants with nonspecific low- back pain of average 14 years duration were randomized to have repeated prolotherapy ( 20% glucose/ 0.2% lignocaine) or normal saline injections into tender lumbo- pelvic ligaments and randomized to perform either flexion/ extension exercises or normal activity over 6 months. Main outcome measures: Pain intensity ( VAS) and disability scores ( Roland- Morris) at 2.5, 4, 6, 12, and 24 months. Results. Follow- up was achieved in 96% at 12 months and 80% at 2 years. Ligament injections, with exercises and with normal activity, resulted in significant and sustained reductions in pain and disability throughout the trial, but no attributable effect was found for prolotherapy injections over saline injections or for exercises over normal activity. At 12 months, the proportions achieving more than 50% reduction in pain from baseline by injection group were glucose- lignocaine: 0.46 versus saline: 0.36. By activity group these proportions were exercise: 0.41 versus normal activity: 0.39. Corresponding proportions for > 50% reduction in disability were glucose- lignocaine: 0.42 versus saline 0.36 and exercise: 0.36 versus normal activity: 0.38. There were no between group differences in any of the above measures. Conclusions. In chronic nonspecific low- back pain, significant and sustained reductions in pain and disability occur with ligament injections, irrespective of the solution injected or the concurrent use of exercises.

Minimal disease activity for rheumatoid arthritis: A preliminary definition

Agreement on response criteria in rheumatoid arthritis (RA) has allowed better standardization and interpretation of clinical trial reports. With recent advances in therapy, the proportion of patients achieving a satisfactory state of minimal disease activity (MDA) is becoming a more important measure with which to compare different treatment strategies. The threshold for MDA is between high disease activity and remission and, by definition, anyone in remission will also be in MDA. True remission is still rare in RA; in addition, the American College of Rheumatology definition is difficult to apply in the context of trials. Participants at OMERACT 6 in 2002 agreed on a conceptual definition of minimal disease activity (MDA): "that state of disease activity deemed a useful target of treatment by both the patient and the physician, given current treatment possibilities and limitations." To prepare for a preliminary operational definition of MDA for use in clinical trials, we asked rheumatologists to assess 60 patient profiles describing real RA patients seen in routine clinical practice. Based on their responses, several candidate definitions for MDA were designed and discussed at the OMERACT 7 in 2004. Feedback from participants and additional on-site analyses in a cross-sectional database allowed the formulation of 2 preliminary, equivalent definitions of MDA: one based on the Disease Activity Score 28 (DAS28) index, and one based on meeting cutpoints in 5 out the 7 WHO/ILAR core set measures. Researchers applying these definitions first need to choose whether to use the DAS28 or the core set definition, because although each selects a similar proportion in a population, these are not always the same patients. In both MDA definitions, an initial decision node places all patients in MDA who have a tender joint count of 0 and a swollen joint count of 0, and an erythrocyte sedimentation rate (ESR) no greater than 10 mm. If this condition is not met: center dot The DAS28 definition places patients in MDA when DAS28