931 resultados para Cases reials


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Al llarg del segle XVI es produí de manera lenta i heterogènia la progressiva introducció al Principat de les formes artístiques del Renaixement italià. Tradicionalment, a Catalunya, igual que a la resta del territori europeu, havia estat la noblesa, com a estament més proper al poder reial, la principal protagonista en el procés de comitència de les obres de més envergadura, moltes d"elles plantejades amb un sentit àulic que pretenia manifestar el predomini polític i econòmic de què havia gaudit d"antuvi aquest segment de la societat. Tanmateix, amb l"arribada a casa nostra dels nous corrents artístics renaixentistes es produí una certa inflexió en aquesta tendència, i hom pot observar com, a la fi del segle XVI i, sobretot, al llarg del segle XVII, aparegueren en l"escena del mercat artístic alts funcionaris reials, magistrats i juristes que, adherits al modern corrent de pensament humanista, dugueren a terme un important exercici de promoció i finançament d"empreses arquitectòniques, escultòriques i pictòriques seguidores dels preceptes renaixentistes. El present estudi analitza en quins termes es produí aquest relleu de patrocini artístic i repassa alguns casos ben emblemàtics.

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[cat] En aquest article es repassa l'activitat del mestre de cases Bernat Gual, des que va signar un contracte d'aprenentatge amb el mestre d'aixa Domingo Ferrer, l'any 1405, fi ns que desapareix de la documentació municipal, l'any 1453. En aquests quaranta-vuit anys d'activitat, Gual es va fer càrrec de grans obres (com ara l'assut de Xerta-Tivenys), però també d'una gran quantitat de petits treballs, sempre al servei del Consell de la Ciutat. La seva tasca s'emmarca en el context arquitectònic de la Tortosa medieval, determinat per la catedral i el palau del bisbe, però també pel Pont de Barques, una important infraestructura de fusta que era conservada per artesans especialitzats.

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Background: Trichothiodistrophy (TTD) is a rare autosomal recessive condition that is characterized by a specific congenital hair shaft dysplasia caused by deficiency of sulfur associated with a wide spectrum of multisystem abnormalities. In this article, we study clinical, microscopic, and ultrastructural findings of 20 patients with TTD with the aim to add further insights regarding to this rare condition. Additionally, analyses of our results are compared with those extracted from the literature in order to enhance its comprehensibility. Materials and Methods: Twenty cases of TTD were included: 7 from Mexico and 14 from Spain. Clinical, microscopic, scanning electron microscopy (SEM) studies and X-ray microanalysis (XrMa) were carried out in all of them. Genetic studies were performed in all seven Mexican cases. Patients with xeroderma pigmentosum and xeroderma pigmentosum/TTD-complex were excluded. Results: Cuticular changes and longitudinal crests of the hair shaft were demonstrated. These crests were irregular, disorganized, following the hair longest axis. Hair shaft sulfur deficiency was disposed discontinuously and intermittently rather than uniformly. This severe decrease of sulfur contents was located close to the trichoschisis areas. Only five patients did not show related disturbances. Micro-dolichocephaly was observed in five cases and represented the most frequent facial dysmorphism found. It is also remarkable that all patients with urologic malformations also combined diverse neurologic disorders. Moreover, three Mexican sisters demonstrated the coexistence of scarce pubic vellus hair, developmental delay, onychodystrophy, and maxillar/mandibullar hypoplasia. Conclusions: TTD phenotype has greatly varied from very subtle forms to severe alterations such as neurologic abnormalities, blindness, lamellar ichthyosis and gonadal malformations. Herein, a multisystem study should be performed mandatorily in patients diagnosed with TTD.

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Background: Trichothiodistrophy (TTD) is a rare autosomal recessive condition that is characterized by a specific congenital hair shaft dysplasia caused by deficiency of sulfur associated with a wide spectrum of multisystem abnormalities. In this article, we study clinical, microscopic, and ultrastructural findings of 20 patients with TTD with the aim to add further insights regarding to this rare condition. Additionally, analyses of our results are compared with those extracted from the literature in order to enhance its comprehensibility. Materials and Methods: Twenty cases of TTD were included: 7 from Mexico and 14 from Spain. Clinical, microscopic, scanning electron microscopy (SEM) studies and X-ray microanalysis (XrMa) were carried out in all of them. Genetic studies were performed in all seven Mexican cases. Patients with xeroderma pigmentosum and xeroderma pigmentosum/TTD-complex were excluded. Results: Cuticular changes and longitudinal crests of the hair shaft were demonstrated. These crests were irregular, disorganized, following the hair longest axis. Hair shaft sulfur deficiency was disposed discontinuously and intermittently rather than uniformly. This severe decrease of sulfur contents was located close to the trichoschisis areas. Only five patients did not show related disturbances. Micro-dolichocephaly was observed in five cases and represented the most frequent facial dysmorphism found. It is also remarkable that all patients with urologic malformations also combined diverse neurologic disorders. Moreover, three Mexican sisters demonstrated the coexistence of scarce pubic vellus hair, developmental delay, onychodystrophy, and maxillar/mandibullar hypoplasia. Conclusions: TTD phenotype has greatly varied from very subtle forms to severe alterations such as neurologic abnormalities, blindness, lamellar ichthyosis and gonadal malformations. Herein, a multisystem study should be performed mandatorily in patients diagnosed with TTD.

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As a discipline, logic is arguably constituted of two main sub-projects: formal theories of argument validity on the basis of a small number of patterns, and theories of how to reduce the multiplicity of arguments in non-logical, informal contexts to the small number of patterns whose validity is systematically studied (i.e. theories of formalization). Regrettably, we now tend to view logic 'proper' exclusively as what falls under the first sub-project, to the neglect of the second, equally important sub-project. In this paper, I discuss two historical theories of argument formalization: Aristotle's syllogistic theory as presented in the "Prior Analytics", and medieval theories of supposition. They both illustrate this two-fold nature of logic, containing in particular illuminating reflections on how to formalize arguments (i.e. the second sub-project). In both cases, the formal methods employed differ from the usual modern technique of translating an argument in ordinary language into a specially designed symbolism, a formal language. The upshot is thus a plea for a broader conceptualization of what it means to formalize.

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OBJETIVO: Analisar os dados referentes a uma grande série de casos de traumas cardiovasculares exclusivamente civil operados em um único centro de trauma brasileiro. MÉTODO: Trata-se de um estudo de coorte, prospectivo, descritivo e analítico registrados entre os anos de 1998 - 2005. RESULTADOS: No período foram operados 1000 casos que acometeram principalmente homens jovens devido a armas de fogo, armas brancas/vidros e trauma contuso e cuja topografia das lesões se deu na seguinte ordem: abdominais, cervicais, torácicas e extremidades. As três síndromes mais comuns a admissão foram: hemorrágica, isquêmica e hemorrágica/isquêmica. No entanto, 34.6% dos pacientes estavam em choque hipovolêmico grave e em 85% da casuística havia lesões não cardiovasculares associadas. A maioria dos pacientes foi submetida a tratamento cirúrgico sem propedêutica específica, mas 14% destes foram reoperados devido à síndrome compartimental, trombose aguda e/ou hemorragia grave. A taxa de amputação foi de 5.5% e da mortalidade de 7.5%, estando correlacionada com choque hipovolêmico grave ou síndrome da resposta inflamatória sistêmica. Lesões CCV isoladas ocorreram em 15% dos casos com taxa de letalidade global de 41%, sendo 22% venosa, 47% arterial e 81% cardíaca, proporcionando diferença significativa entre lesões cardíacas versus arteriais e venosas associadas (p = 0,01; odds ratio de 7.37) e lesões arteriais versus venosas (p = 0,01; odds ratio de 3.17). CONCLUSÃO: Esta grande série de casos demonstrou ser o homem jovem o mais acometido devido principalmente à violência interpessoal e os acidentes automobilísticos, que envolvem na maioria das vezes as extremidades, associadas com lesões em outros órgãos ou sistemas. Os fatores preditivos de mau prognóstico foram choque hipovolêmico, lesão de grandes vasos arteriais e lesão cardíaca.

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Objective: To evaluate the characteristics of thyroid carcinoma cases treated at a reference hospital for cancer between 2008 and 2010.Methods: we studied 807 cases and analyzed the following clinicopathologic variables: symptoms, risk factors, diagnostic tests, staging, histological type, treatment performed and complications.Results: Females were more affected, with 660 cases (82%). The average age at diagnosis was 44.5 years. Prior exposure to ionizing radiation was reported by 22 (3%) patients, a family history of thyroid cancer by 89 (11%), and 289 (36%) individuals reported other types of cancer in the family. The fine needle aspiration biopsy was the main parameter for surgical indication and was suggestive of carcinoma in 463 patients (57%). Papillary carcinoma was the most common histological type, with 780 cases (96.6%). There were 728 (90%) total thyroidectomies, 43 (5.3%) reoperations or partial thyroidectomies followed by totalization, 23 (2.8%) extended thyroidectomies and only 13 (1.6%) partial thyroidectomies (lobectomy with isthmectomy). Neck dissection associated with thyroidectomy was done in 158 patients (19.5%). We observed a predominance of tumors classified as T1 in 602 (74.6%) patients. Transient hypocalcemia was the most frequent complication.Conclusion: The results show that the worldwide increase in the incidence of thyroid cancer has changed the profile of patients seen at a referral service. In addition, there were changes in the type of surgical treatment used, with increased use of total thyroidectomy in relation to partial and subtotal ones, and decreased use of elective neck dissections.

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Objective: To analyze and discuss the clinical data, diagnosis and treatment of a number of patients with cystic dilatation of the common bile duct of a Brazilian pediatric hospital.Methods: We analyzed 30 patients treated at the Martagão Gesteira Institute of Pediatrics and Child Care of the Federal University of Rio de Janeiro for 23 years ,with statistical analysis of epidemiological data, clinical manifestations, diagnosis, treatment and postoperative outcome.Results: We observed a marked female predominance (73.4% of cases), the diagnosis being made in the first decade of life in 90% of patients. The most prevalent clinical manifestation was jaundice (70% of cases) and the classic triad of choledochal cyst was not observed. Abdominal ultrasound was the first imaging examination performed, with a sensitivity of 56.6%, with diagnostic definition in 17 children. Two patients (6.6%) had prenatal diagnosis. All patients underwent surgical treatment, cyst resection with Roux-en-Y hepaticojejunostomy being performed in 80% of cases. The incidence of postoperative complications was 13.3% and the mortality rate was 6.6%, ie two patients were diagnosed with Caroli's disease.Conclusion: The non-observance of the classic triad of choledochal cyst suggests that its incidence is lower than that reported in the medical literature. The surgical treatment of choledochal cysts, with resection and bilioenteric anastomosis, is safe even for small children.

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Objective : To characterize patients with chronic subdural hematoma undergoing surgery and to identify prognostic indicators. Methods : We conducted a retrospective analysis of patients diagnosed with chronic subdural hematoma (CSDH) undergoing surgical treatment. We analyzed: age, period from trauma to diagnostic imaging, pre and postoperative Glasgow coma scale, type of surgery, associated comorbidities, use of postoperative drainage and outpatient treatment. Results : The sample consisted of 176 patients, 126 male and 50 female patients (ratio 2.5 : 1), ages ranged from six months to 97 years, with an average of 59.3 years. CSDH was caused by trauma in 52% of patients, with the time from trauma to imaging averaging 25.05 days; 37.7% were hypertensive patients and 20% had a neurological disease. Eighty-five (48.3%) patients were elderly and altered consciousness was present in 63% of cases. Of the 91 (51.7%) non-elderly patients, 44% presented with headache, altered consciousness occurred in 40% and motor abnormalities in 27.5%. The CSDH was located on the right in 41%, left in 43% and bilaterally in 16% of patients. Conclusion : the change of consciousness was the most common clinical alteration in the elderly and headache in non-elderly. The most associated comorbidity was the arterial hypertension and the most frequent cause, head trauma. The trepanation with two oriffices associated with a closed drainage system was the most used operating, with high efficacy and low complication rate.

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Objective: this study aims to explore the experience of Brazilian surgeons on Unintentionally Retained Foreign Bodies (RFB) after surgical procedures. Methods: A questionnaire was sent to surgeons by electronic mail, between March and July 2012. The questions analyzed their experience with foreign bodies (FB), foreign bodies' types, clinical manifestations, diagnoses, risk factors and legal implications. Results: in the 2872 eligible questionnaires, 43% of the surgeons asserted that they had already left FB and 73% had removed FB in one or more occasions, totalizing 4547. Of these foreign bodies, 90% were textiles, 78% were discovered in the first year and 14% remained asymptomatic. Among doctors with less than five years after graduation, 36% had already left a FB. The most frequently surgical procedures mentioned were the elective (57%) and routine (85%) ones. Emergency (26%), lack of counting (25%) and inadequate conditions of work contributed (12.5%) to the occurrence. In 46% of the cases patients were alerted about the FB, and 26% of them sued the doctors or the institution. Conclusions: challenging medical situations, omission of security protocols and inadequate work conditions contributed to RFB. However, RFB occurs mostly in routine procedures such as cesarean or cholecystectomy, and at the beginning of the professional career, highlighting, particularly in poorest countries, the need for primary prevention. Textiles predominated causing clinical repercussions and they were diagnosed in the first postoperative months. Surgeons were sued in 11.3% of the RFB cases.

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PURPOSE: To verify the predictors of intravasation rate during hysteroscopy.METHODS: Prospective observational study (Canadian Task Force classification II-1). All cases (n=200 women; 22 to 86 years old) were treated in an operating room setting. Considering respective bag overfill to calculate water balance, we tested two multiple linear regression models: one for total intravasation (mL) and the other for absorption rate (mL.min-1). The predictors tested (independent variables) were energy (mono/bipolar), tube patency (with/without tubal ligation), hysterometry (cm), age≤50 years, body surface area (m2), surgical complexity (with/without myomectomy) and duration (min).RESULTS: Mean intravasation was significantly higher when myomectomy was performed (442±616 versus 223±332 mL; p<0.01). In the proposed multiple linear regression models for total intravasation (adjusted R2=0.44; p<0.01), the only significant predictors were myomectomy and duration (p<0.01).In the proposed model for intravasation rate (R2=0.39; p<0.01), only myomectomy and hysterometry were significant predictors (p=0.02 and p<0.01, respectively).CONCLUSIONS: Not only myomectomy but also hysterometry were significant predictors of intravasation rate during operative hysteroscopy.

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The intellectual property (IP) environment in China is still very immature. There are several problems in legal, political, economic, social-cultural, competitive and labor environment which have hindered IP legal enforcement. Under such circumstances, IP misappropriation is a major concern especially for foreign small and medium-sized enterprises (SMEs) doing business in China. These circumstances require foreign companies, no matter whether they are multinational corporations (MNCs) or SMEs and have own manufacturing in China or not, to take strong IP actions. Therefore, the purpose of this study is to discuss how IP can be protected in China in the case of outsourcing and in the case of own manufacturing. The comparison will consider the process of outsourcing and own manufacturing consisting two stages: preparation stage and operation stage. In order to clarify the conceptual arguments, two illustrative case studies were studied. The case data bases on two semi-structured interviews of the managing directors, field notes and archival data. The findings propose that attention in IP protection should be given to following issues: integrating IP strategy into the company’s business strategy, protecting the most critical knowledge, regarding IP steps as a whole in the protection mechanism and making IP strategy as proactive as possible. The major difference between outsourcing and own manufacturing in IP protection is in the operation stage. Besides, the findings also provide managerial advice on IP protection, e.g. foreign managers should be prepared for IP risks in China, they should establish an own IP protection mechanism which matches the company’s situation and they should consider IP protection as an on-going process.

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Os protocolos de 5.361 necropsias de cães realizadas no Laboratório de Patologia Veterinária da Universidade Federal de Santa Maria de 1965 a 2006 foram revisados à procura de casos de cinomose. Seiscentos e oitenta e três casos (12,7%) da doença foram encontrados, dos quais 620 apresentavam sinais neurológicos. Desses 620, os seguintes dados foram recuperados para cada caso: idade, sinais clínicos, achados histopatológicos e presença ou não de doença concomitante. Faixas etárias foram classificadas como filhotes (até 1 ano), adultos (de 1 a 9 anos) e idosos (10 anos de idade ou mais). Lesões histológicas foram observadas em 565 (91,1%) dos 620 casos com sinais neurológicos de cinomose e em 554 desses casos a idade foi registrada no protocolo com a seguinte distribuição por faixa etária: 45,9% de filhotes, 51,4% de adultos e 2,7% de idosos. Os sinais neurológicos compreendiam um largo espectro de distúrbios motores, posturais e do comportamento, que podiam ocorrer juntos ou individualmente. Os sinais clínicos mais freqüentes foram mioclonia (38,4%), incooordenação motora (25,0%), convulsões (18,5%) e paraplegia (13,4%). Em 98,4% dos 565 cães com alterações histopatológicas no encéfalo, foram observadas desmielinização, encefalite não-supurativa ou uma combinação dessas duas lesões. Corpúsculos de inclusão foram observados em diferentes células de 343 dos 565 cães com alterações histopatológicas no encéfalo. Em 170 (49,6%) o tipo celular com inclusão não foi mencionado no protocolo; nos restantes, as inclusões foram vistas em astrócitos (94,8% dos casos), neurônios (3,5%), oligodendrócitos (1,1%) e células do epêndima (0,6%). Levando em consideração o tipo de lesões e as faixas etárias, casos com desmielinização e encefalite não-supurativa ocorreram em 40,0% dos filhotes, 51,2% dos adultos e 72,7% dos cães idosos. Somente desmielinização foi descrita em 48,4% dos filhotes, 41,3% dos adultos e 35,7% dos cães idosos. Somente encefalite não-supurativa foi descrita em 11,6% dos filhotes, 7,5% dos adultos e 7,1% dos cães idosos.

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The virulence mechanisms of avian pathogenic Escherichia coli (APEC) have been continually studied and are believed to be multi-factorial. Certain properties are primarily associated with virulent samples and have been identified in avian isolates. In this study a total of 61 E. coli, isolates from chicken flocks with respiratory symptomatology, were probed by Polimerase Chain Reation (PCR) for the presence of genes responsible for the adhesion capacity, P fimbria (papC) e F11 fimbria (felA), colicin production (cvaC), aerobactin presence (iutA), serum resistance (iss), temperature-sensitive hemagglutinin (tsh), and presence of K1 and K5 capsular antigens (kpsII). The iss gene was detected in 73,8%, tsh in 55,7%, iutA in 45,9%, felA in 39,3%, papC in 24,3%, cvaC in 23% and kpsII in18%.

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A retrospective study of 24 cases of papillomas in dogs was performed from January 2001 to March 2011. Additionally, immunohistochemistry (IHC) was used to characterize and evaluate the samples. We found that disease was observed more in mixed breed dogs, ages ranging from 6 months to 10 years (mean 3.1 years), and there was no gender predilection. The main lesion sites were the skin (75%), lips (16.7%), and eyelids (8.3%). Upon histological evaluation, we observed papillary exophytic proliferation of squamous epithelium and papillary endophytic proliferation (inverted) in 87.5% and 12.5% of cases, respectively. The tumors were characterized by spinous layer hyperplasia (87.5%) with koilocytes (70.8%) and intranuclear pale basophilic inclusions bodies (8.3%), prominent granular layer with large amounts of keratohyalin granules (95.8%), and hyperkeratosis in the stratum corneum (100%). Positive immunostaining for Papillomavirus was found in 83.3% of cases, which were distributed between the granular layer and the stratum corneum. These findings indicate the following: that papillomas in dogs are caused by Papillomavirus, the viral cytopathic effect induces epithelial lesions, viral particles are found inside the cell nuclei, and inclusions bodies are rare.