A new surgical approach for treating dilated cardiomyopathy with mitral regurgitation

OBJECTIVE: To evaluate the early outcome of mitral valve prostheses implantation and left ventricular remodeling in 23 patients with end-stage cardiomyopathy and secondary mitral regurgitation (NYHA class III and IV). METHODS: Mitral valvular prosthesis implantation with preservation of papillary muscles and chordae tendinae, and plasty of anteriun cuspid for remodeling of the left ventricle. RESULTS: The surgery was performed in 23 patients, preoperative ejection fraction (echocardiography) varied from 13% to 44% (median: 30%). In 13 patients associated procedures were performed: myocardial revascularization (9), left ventricle plicature repair (3) and aortic prosthese implantation (1). Early deaths (2) occurred on the 4th PO day (cardiogenic shock) and on the 20th PO day (upper gastrointestinal bleeding), and a late death in the second month PO (ventricular arrhythmia). Improvement occurred in NYHA class in 82.6% of the patients (P<0.0001), with a survival rate of 86.9% (mean of 8.9 months of follow-up). CONCLUSION: This technique offers a promising therapeutic alternative for the treatment of patients in refractory heart failure with cardiomyopathy and secondary mitral regurgitation.

Valorization of eucalyptus wood by glycerol-organosolv pretreatment within the biorefinery concept: an integrated and intensified approach

The efficient utilization of lignocellulosic biomass and the reduction of production cost are mandatory to attain a cost-effective lignocellulose-to-ethanol process. The selection of suitable pretreatment that allows an effective fractionation of biomass and the use of pretreated material at high-solid loadings on saccharification and fermentation (SSF) processes are considered promising strategies for that purpose. Eucalyptus globulus wood was fractionated by organosolv process at 200 C for 69 min using 56% of glycerol-water. A 99% of cellulose remained in pretreated biomass and 65% of lignin was solubilized. Precipitated lignin was characterized for chemical composition and thermal behavior, showing similar features to commercial lignin. In order to produce lignocellulosic ethanol at high-gravity, a full factory design was carried to assess the liquid to solid ratio (3e9 g/g) and enzyme to solid ratio (8e16 FPU/g) on SSF of delignified Eucalyptus. High ethanol concentration (94 g/L) corresponding to 77% of conversion at 16FPU/g and LSR ¼ 3 g/g using an industrial and thermotolerant Saccharomyces cerevisiae strain was successfully produced from pretreated biomass. Process integration of a suitable pretreatment, which allows for whole biomass valorization, with intensified saccharification-fermentation stages was shown to be feasible strategy for the co-production of high ethanol titers, oligosaccharides and lignin paving the way for cost-effective Eucalyptus biorefinery.

Priming of a DNA metabarcoding approach for species identification and inventory in marine macrobenthic communities

Dissertação de mestrado em Molecular Genetics

An evolutionary approach to the use of Petri net based models: from parallel controllers to HW/SW co-design

"A workshop within the 19th International Conference on Applications and Theory of Petri Nets - ICATPN’1998"

A UML-based approach for modeling industrial control applications

The main purpose of the poster is to present how the Unified Modeling Language (UML) can be used for diagnosing and optimizing real industrial production systems. By using a car radios production line as a case study, the poster shows the modeling process that can be followed during the analysis phase of complex control applications. In order to guarantee the continuity mapping of the models, the authors propose some guidelines to transform the use cases diagrams into a single object diagram, which is the main diagram for the next phases of the development.

Transradial approach for coronary interventions

OBJECTIVE: To assess the feasibility and safety of coronary interventions performed through the radial artery. METHODS: We studied 103 patients with ages from 38 to 86 years (57±8.7), 90 (87%) males, and: radial pulse with a good amplitude, presence of ulnar pulse, a good collateral flow through the palmar arch assessed with the Allen's test. RESULTS: The vascular approach was obtained in 97 (94%) patients, 88 (91%) treated electively and 9 (9%) during acute myocardial infarction, for primary angioplasty; 56 (64%) unstable angina; 22 (25%) stable angina; 10 (11%) were asymptomatic, 6 referred for recanalization of chronic occlusion and 4 silent ischemia in the first week after acute myocardial infarction. We approached 107 arteries: anterior descending artery, 49 (46%); right coronary artery, 27 (25%); circumflex artery, 25 (23%); diagonal artery, 6 (6%); and 2 saphenous vein bypass grafts. We treated 129 lesions: 80 (62%) B2 type; 23 (18%) B1 type; 17 (13%) C type; and 9 (7%). A type. There were 70 stents , and 59 balloon angioplasties performed. Thirty-two (33%) patients used GP IIb/IIIa inhibitors. The mean duration of the elective procedure was 42.3±12.8 min. Success, correct stent deployment and residual lesion <20%, was reached in 100% of the lesions treated with stent implantation; arterial dilation with residual lesion <50% was obtained in 96% of the lesions treated with transluminal coronary angioplasty (TCA). Complications, were: 1 (1.0%) non-Q-wave acute myocardial infarction; 2 (2%) hematomas in the forearm; and 2 losses of radial pulse. CONCLUSION: Radial artery aproach is practical and safe for percutaneous coronary interventions there was a low incidence of complications.

Organization of construction activity in medieval Portugal: a comparative approach

This paper aims to identify and characterize the organizational models of construction site and building activity in late fifteenth and early sixteenth centuries, through the analysis of specific Portuguese case studies, related with important buildings financed by the royal power. This paper also intends to develop a comparative analysis between those different organizational models, identifying the main features of each one, as well as their similarities and differences. In this sense, we intend to present a comparative analysis between the two main models of organization of the construction site, through a methodology of crossing different types of sources, including written ones, such as books of accounts, but also iconographic and material sources, as well as the buildings and monuments still preserved today. In terms of written sources, the construction site accounting books allow us to study several specific aspects of the construction process, but also allow us to infer the organizational models of the construction activity.

Vermiculite bio-barriers for Cu and Zn remediation: an eco-friendly approach for freshwater and sediments protection

The increase in heavy metal contamination in freshwater systems causes serious environmental problems in most industrialized countries, and the effort to find ecofriendly techniques for reducing water and sediment contamination is fundamental for environmental protection. Permeable barriers made of natural clays can be used as low-cost and eco-friendly materials for adsorbing heavy metals from water solution and thus reducing the sediment contamination. This study discusses the application of permeable barriers made of vermiculite clay for heavy metals remediation at the interface between water and sediments and investigates the possibility to increase their efficiency by loading the vermiculite surface with a microbial biofilm of Pseudomonas putida, which is well known to be a heavy metal accumulator. Some batch assays were performed to verify the uptake capacity of two systems and their adsorption kinetics, and the results indicated that the vermiculite bio-barrier system had a higher removal capacity than the vermiculite barrier (?34.4 and 22.8 % for Cu and Zn, respectively). Moreover, the presence of P. putida biofilm strongly contributed to fasten the kinetics of metals adsorption onto vermiculite sheets. In open-system conditions, the presence of a vermiculite barrier at the interface between water and sediment could reduce the sediment contamination up to 20 and 23 % for Cu and Zn, respectively, highlighting the efficiency of these eco-friendly materials for environmental applications. Nevertheless, the contribution of microbial biofilm in open-system setup should be optimized, and some important considerations about biofilm attachment in a continuous-flow system have been discussed.

Psychological approach to endometriosis: Women's pain experience and quality of life improvement

Endometriosis is a chronic condition affecting 10 to15% of women in childbearing age. Understanding the impact of this disease on women’s well-being is still a challenge, namely to intervene. Pain is the most current and troublesome symptom. Although medical treatments for pain relief are effective, recurrence rate remains significant, calling for a better understanding and development of new approaches for pain management. A group Cognitive Behavioral Therapy (CBT) for management of associated co-morbidities is suggested, paying special attention to Chronic Pelvic Pain (CPP). CBT design can be grounded on information collected from focus groups and a one-group exploratory trial. Evaluation of therapy effectiveness is possible to be performed by comparing group CBT to Usual Care (UC) and Support Group (SG) in a randomized controlled trial. Research in this area could represent an important step in providing a solution to the management of endometriosis and, to the best of our knowledge, the first national psychological approach for its understanding and treatment.

Implications of the Hemodynamic Optimization Approach Guided by Right Heart Catheterization in Patients with Severe Heart Failure

OBJECTIVE: To report the hemodynamic and functional responses obtained with clinical optimization guided by hemodynamic parameters in patients with severe and refractory heart failure. METHODS: Invasive hemodynamic monitoring using right heart catheterization aimed to reach low filling pressures and peripheral resistance. Frequent adjustments of intravenous diuretics and vasodilators were performed according to the hemodynamic measurements. RESULTS: We assessed 19 patients (age = 48±12 years and ejection fraction = 21±5%) with severe heart failure. The intravenous use of diuretics and vasodilators reduced by 12 mm Hg (relative reduction of 43%) pulmonary artery occlusion pressure (P<0.001), with a concomitant increment of 6 mL per beat in stroke volume (relative increment of 24%, P<0.001). We observed significant associations between pulmonary artery occlusion pressure and mean pulmonary artery pressure (r=0.76; P<0.001) and central venous pressure (r=0.63; P<0.001). After clinical optimization, improvement in functional class occurred (P< 0.001), with a tendency towards improvement in ejection fraction and no impairment to renal function. CONCLUSION: Optimization guided by hemodynamic parameters in patients with refractory heart failure provides a significant improvement in the hemodynamic profile with concomitant improvement in functional class. This study emphasizes that adjustments in blood volume result in imme-diate benefits for patients with severe heart failure.

Antibacterial properties of multifunctional coatings Ag-ZrCN for biomedical devices: a novel approach

PhD in Sciences Specialty in Physics

A multi–physics approach applied to masonry structures with non–hydraulic lime mortars

Tese de Doutoramento em Engenharia Civil (área de especialização em Engenharia de Estruturas).

Comparative study of the use of diltiazem as an antispasmodic drug in coronary angiography via the transradial approach

OBJECTIVE: To evaluate the impact of the use, prior to the procedure, of injectable diltiazem to prevent complications. METHODS: Between September 2000 and July 2001, 50 patients underwent transradial coronary angiography and were randomized to receive placebo (GI) or diltiazem (GII) through a catheter inserted into the radial artery. All patients received isosorbide mononitrate. Ultrasound analyses of the radial artery were performed before examination, 30 minutes afterwards, and 7 days afterwards to evaluate the flow, the diameter, and the artery output. RESULTS: The radial artery diameter of GI was 2.4± 0.5 mm before the procedure and 2.3±0.5 mm after 30 minutes (NS), whereas in GII the diameter was 2.2±0.3 mm before the examination and 2.5±0.4 mm 30 minutes after it (P<0.001). Radial artery output in group 1 was 7.3±5.l2 mL/min before the examination and 6.1±3.5 mL/min 30 minutes after the examination (NS), and GII had an increase of 5.9±2.5 mL/min before examination to 9.05± 7.78 mL/min after the examination (P=0.04). Complications (spasm, occlusion, and partial obstruction) occurred in 4 patients (17.4%) in GI and did not occur in GII (P=0.04). CONCLUSION: The study suggests a decrease in vascular complications through the transradial access for coronary angiography with the use of diltiazem as an antispasmodic drug, resulting in the significant increase in the diameter of the radial artery and radial artery output.

Aproximación al manejo de Nemátodos Fitófagos de los genéros nacobbus y meloidogyne en la Provincia de Córdoba: cultivos hortícolas y aromáticos. Approach to the management of phytophagous nematodes of de genera nacobbus and meloidogyne in the province of Córdoba: horticultural and aromatic crops.

El proyecto que se propone es continuación de investigaciones relacionadas con dos géneros de nematodos fitófagos de interés para cultivos hortícolas (Nacobbus y Meloidogyne) y plantas aromáticas (Meloidogyne) en la Provincia de Córdoba. Hasta el momento, los conocimientos sobre estos parásitos son limitados, de allí la justificación del tema propuesto. Se realizarán muestreos de los citados cultivos, desarrollados a campo y bajo cubierta, para identificar poblaciones de esos nematodos perjudiciales. Se caracterizará morfológicamente poblaciones de N. aberrans con el objeto de consolidar criterios que permitan su reconocimiento. Se llevarán a cabo estudios de relaciones nematodo-hospedador poniendo énfasis en aspectos para los cuales no existen antecedentes en el país. Por un lado, se evaluará el grado de susceptibilidad de diferentes cultivares de pimiento a la agresión de poblaciones de N. aberrans de reconocida patogenicidad para el cultivo. Por otro, se estudiará el efecto de la colonización de micorrizas arbusculares en raíces de tomate y pimiento, como agente que brindaría resistencia al ataque de N. aberrans. Cabe hacer notar que con respecto a la interacción del complejo representado por N. aberrans-planta-micorrizas no ha sido publicada información alguna a nivel mundial. La importancia del proyecto reside en la posibilidad de obtener datos originales, transferibles al sector de producción agrícola. Al mismo tiempo, contribuirá a definir estrategias alternativas de manejo de problemas ocasionados por nematodos fitófagos, basadas en aspectos biológicos y no en la utilización sistemática de agroquímicos contaminantes.

Silent voices : the recreational needs of disabled young people : an emancipatory approach

The recreational needs of young people with.disabilities in Sligo county were examined using an emancipatory approach that provided an accurate reflection on the perspectives of the disabled young people. The aim of this study included a comparison of access to and attitudes towards leisure activities as between disabled and non-disabled young people in the Sligo area. The hypothesis set out by the researcher was the expectation that findings would include a degree of disadvantage in access and participation in leisure activities for young people with disabilities vis a vis their counterparts. The way in which this was tested was by focus groups and interviews. This hypothesis was adequately proven along with an in-depth range of recommendations for improvement that were made by participants. The study’s emancipatory research methods ensured that the voice of the participants was heard regarding their recreational needs and the disabling barriers that needed to be removed.