Implante de eletrodo em veia ázigos: uma opção terapêutica para limiar de desfibrilação elevado

A avaliação do limiar de desfibrilação (DFT) durante o implante do cardioversor-desfibrilador (CDI) é uma etapa relevante do procedimento, uma vez que, em até 16% dos pacientes, podemos encontrar elevados DFT. Relatamos o caso de um paciente portador de cardiomiopatia dilatada (CMPD) idiopática submetido a implante de CDI biventricular. Durante o procedimento, apresentou elevado DFT e se mostrou resistente às modalidades terapêuticas usuais. Optamos pelo implante de eletrodo de desfibrilação em veia ázigos, com resolução do quadro.

Prevalência de Síndrome Metabólica em Idosos e Concordância entre Quatro Critérios Diagnósticos

Fundamento: A Síndrome Metabólica (SM) é uma agregação de fatores de risco que aumenta a incidência de eventos cardiovasculares e Diabete Melito (DM). O envelhecimento da população vem acompanhado de maior prevalência de SM, que varia dependendo da população estudada e do critério diagnóstico utilizado. Objetivo: Determinar a prevalência de SM em idosos por quatro critérios diagnósticos e a concordância entre esses. Métodos: Estudo transversal realizado em 243 indivíduos acima de 60 anos (180 mulheres) em Niterói (RJ). Foram avaliados através de exame clínico glicemia jejum, insulinemia jejum, perfil lipídico e medidas antropométricas - peso, estatura, circunferência abdominal e relação cintura/quadril. A prevalência de SM foi estimada utilizando critérios diagnósticos da Organização Mundial da Saúde (OMS) modificado, National Cholesterol Education Program - Adult Treatment Panel III (NCEP-ATPIII), International Diabetes Federation (IDF) e Joint Interim Statement (JIS). Resultados: A prevalência foi elevada pelos quatro critérios, OMS (51,9%), NCEP-ATPIII (45,2%), IDF (64,1%) e JIS (69,1%), e a concordância entre os critérios diagnósticos pelo índice kappa foi moderada em quase todas as comparações OMS vs. IDF (k = 0,47; intervalo de confiança (IC) 95%, 0,35 - 0,58); OMS vs. NCEP-ATPIII (k = 0,51; IC 95%, 0,40 - 0,61); OMS vs. JIS (k = 0,45; IC 95%, 0,33 - 0,56); IDF vs. NCEP-ATPIII (k = 0,55, IC 95%, 0,45 - 0,65) e NCEP-ATPIII vs. JIS (k = 0,53; IC 95%, 0,43 - 0,64), exceto entre IDF vs. JIS (K= 0,89; IC 95%, 0,83 - 0,95), considerada boa. Conclusão: A prevalência de SM foi elevada pelos quatro critérios diagnósticos, principalmente pelo JIS. Houve uma boa concordância entre os critérios JIS e IDF e moderada entre os outros.

Efeito da velocidade de operação do arado de discos, de arrasto, na componente longitudinal do esforço tratório, em solo de classe textural areia

O presente trabalho foi realizado com o propósito de estudar o efeito do aumento de velocidade sobre os valores da componente longitudinal do esforço tratório. Foi usado um arado de discos, de arrasto. Para a medição da componente longitudinal do esforço tratório foi utilizado um dispositivo de acoplamento na barra do trator, onde foi inserido um dinamômetro eletromecânico PIAB. Os ensaios foram realizados, em condições de campo, em um solo de classe textural areia. As velocidades de deslocamento foram em número de 4:2,86 km/h, 3,61 km/h, 4,74 km/h e 6,64 km/h. Nas condições em que foram realizados os ensaios, determinou-se a seguinte equação: K = 2,64 v + 62,88, sendo K = força específica média em kgf/dm² e v = velocidade de deslocamento em km/h.

Internal promotion versus external recruitment: evidence in industrial plants

An analysis is carried out in a sample of 738 industrial plants of the determining factors in the use of internal promotion of blue-collar workers to middle managers and skilled technicians as against their external recruitment. The use of internal promotion is positively correlated with variables indicative of the efforts made by plants to measure employees' skills, and to a lesser extent, with the level of specificity of investments in human capital made by blue-collar workers. Contrary to what was expected, variables related with the use and efficiency of other incentive systems have no significant influence on the increased or decreased use of internal promotion. These results are initial evidence that internal promotions are used to protect and favour specific investments, especially those made by firms in order to discover their workers' skills.

Financial integration, productivity and capital accumulation

Understanding the mechanism through which financial globalization affects economic performance is crucial for evaluating the costs and benefits of opening financial markets. This paper is a first attempt at disentangling the effects of financial integration on the two main determinants of economic performance: productivity (TFP) and investments. I provide empirical evidence from a sample of 93 countries observed between 1975 and 1999. The results suggest that financial integration has a positive direct effect on productivity, while it spurs capital accumulation only with some delay and indirectly, since capital follows the rise in productivity. I control for indirect effects of financial globalization through banking crises. Such episodes depress both investments and TFP, though they are triggered by financial integration only to a minor extent.

Inter-group conflict and intra-group punishment in an experimental contest game

We study how conflict in a contest game is influenced by rival parties being groups and by group members being able to punish each other. Our main motivation stems from the analysis of socio-political conflict. The relevant theoretical prediction in our setting is that conflict expenditures are independent of group size and independent of whether punishment is available or not. We find, first, that our results contradict the independence of group-size prediction: conflict expenditures of groups are substantially larger than those of individuals, and both are substantially above equilibrium. Towards the end of the experiment material losses in groups are 257% of the predicted level. There is, however, substantial heterogeneity in the investment behaviour of individual group members. Second, allowing group members to punish each other after individual contributions to the contest effort are revealed leads to even larger conflict expenditures. Now material losses are 869% of the equilibrium level and there is much less heterogeneity in individual group members' investments. These results contrast strongly with those from public goods experiments where punishment enhances efficiency and leads to higher material payoffs.

Is sociality driven by the costs of dispersal or the benefits of philopatry? A role for kin-discrimination mechanisms.

The role of ecological constraints in promoting sociality is currently much debated. Using a direct-fitness approach, we show this role to depend on the kin-discrimination mechanisms underlying social interactions. Altruism cannot evolve under spatially based discrimination, unless ecological constraints prevent complete dispersal. Increasing constraints enhances both the proportion of philopatric (and thereby altruistic) individuals and the level of altruistic investments conceded in pairwise interactions. Familiarity-based discrimination, by contrast, allows philopatry and altruism to evolve at significant levels even in the absence of ecological constraints. Increasing constraints further enhances the proportion of philopatric (and thereby altruistic) individuals but not the level of altruism conceded. Ecological constraints are thus more likely to affect social evolution in species in which restricted cognitive abilities, large group size, and/or limited period of associative learning force investments to be made on the basis of spatial cues.

Economic effects of road accessibility in the Pyrenees: user perspective

At present, Spain faces one of the key moments in planning the future design of the infrastructure network. As a consequence of the critical role played by haulage in intra-European trade, the most important investments are those that guarantee that road haulage traffic can move freely at the borders. That is why it is necessary to make serious evaluations of the economic and social profitability of these investments. Normally the most significant social benefit of investment projects in transport infrastructure is time saving, which in turn changes traffic intensity. In this article we analyse the changes in the user excess caused by public investment in transport infrastructure planned by the Spanish government and which will be located on the border between Spain and France. In particular, we study the increase in network user surplus for HGV traffic in the Spanish and French border zones in the Pyrenees.

Gestión de cambios y proyectos

Moltes inversions corporatives actuals són destinades a la millora de la gestió del canvi. Aquestes inversions són motivades per una carència històrica entre el conjunt recursos humans i les noves tecnologies tal com va reflexar l'estudi del MIT en 1992. L’objectiu del projecte és analitzar la gestió del canvi i projectes des d’un put de vista poc conegut per els enginyers. Direcció de l'equip humà, Procés de qualitat industrial, Programació extrema, Anàlisi de la cobertura dels Sistemes d’informació d’una companyia segons la seva estructura i estratègia empresarial, El mercat i les seves forces competitives, el retorn de la inversió, el cicle PDCA d’un projecte d’inversió, entre d’altres.

Political Risk, Economic Integration, and the Foreign Direct Investment Decision

In this paper we analyse the impact of policy uncertainty on foreign direct investment strategies. We also consider the impact of economic integration upon FDI decisions. The paper follows the real options approach, which allows investigating the value to a firm of waiting to invest and/or disinvest, when payoffs are stochastic due to political uncertainty and investments are partially reversible. Across the board we find that political uncertainty can be very detrimental to FDI decisions while economic integration leads to an increasing benefit of investing abroad.