A garantia do direito à segurança social numa sociedade de risco

Tese de doutoramento em ciências jurídicas públicas

Paraplegia following intraaortic balloon circulatory assistance

Intraaortic balloon counterpulsation is frequently used in patients experiencing severe ventricular dysfunction following maximal drug therapy. However, even with the improvement of percutaneous insertion techniques, the procedure has always been followed by vascular, infectious, and neurological complications. This article describes a case of paraplegia due to intraaortic balloon counterpulsation in the postoperative period of cardiac surgery.

Synthesis and biological evaluation of mono and bis-naphthalimide derivatives against SH-SY5Y, human brain cancer cells

Dissertação de mestrado em Medicinal Chemistry

Evaluation of inflammatory response induced by different types of daily contact lenses

Dissertação de mestrado em Genética Molecular

Treatment of atrial fibrillation with radiofrequency ablation and simultaneous multipolar mapping of the pulmonary veins

OBJECTIVE: To demonstrate the feasibility and safety of simultaneous catheterization and mapping of the 4 pulmonary veins for ablation of atrial fibrillation. METHODS: Ten patients, 8 with paroxysmal atrial fibrillation and 2 with persistent atrial fibrillation, refractory to at least 2 antiarrhythmic drugs and without structural cardiopathy, were consecutively studied. Through the transseptal insertion of 2 long sheaths, 4 pulmonary veins were simultaneously catheterized with octapolar microcatheters. After identification of arrhythmogenic foci radiofrequency was applied under angiographic or ultrasonographic control. RESULTS: During 17 procedures, 40 pulmonary veins were mapped, 16 of which had local ectopic activity, related or not with the triggering of atrial fibrillation paroxysms. At the end of each procedure, suppression of arrhythmias was obtained in 8 patients, and elimination of pulmonary vein potentials was accomplished in 4. During the clinical follow-up of 9.6±3 months, 7 patients remained in sinus rhythm, 5 of whom were using antiarrhythmic drugs that had previously been ineffective. None of the patients had pulmonary hypertension or evidence of stenosis in the pulmonary veins. CONCLUSION: Selective and simultaneous catheterization of the 4 pulmonary veins with microcatheters for simultaneous recording of their electrical activity is a feasible and safe procedure that may help ablation of atrial fibrillation.

Glossopharyngeal Neuralgia Associated with Cardiac Syncope

Glossopharyngeal neuralgia is an uncommon condition that has rarely been described in association with syncope. We report here 2 cases of glossopharyngeal neuralgia in elderly patients. Both were male and underwent temporary pacemaker insertion to prevent syncopal episodes. We discuss the clinical and surgical treatment of glossopharyngeal neuralgia, the role of cardiac stimulation, and the possible physiopathological mechanism of the associated cardiac disturbances.

Processo de socialização organizacional:integração dos professores recém-enquadrados numa Escola do Interior de Angola

Dissertação de Mestrado em Sociologia das Organizações e do Trabalho

Los objetos técnicos y los organismos tecnificados. Reflexiones filosóficas, estéticas y políticas sobre la técnica. Technical objects and technified organisms. Philosophical, aesthetical and political approaches on technique

El presente proyecto se propone como parte inicial de una investigación sobre la relación entre naturaleza/cultura/técnica. Tradicionalmente la naturaleza y la cultura se han considerado como ámbitos diferenciados y opuestos. Y es en esta distinción donde la técnica adquiere un lugar central. El pensamiento occidental sobre la técnica ha recibido diversas interpretaciones: desde una subordinación con respecto al conocimiento verdadero (episteme) en la filosofía clásica, un optimismo sobre la técnica como posibilidad de dominación de la naturaleza en el Renacimiento y la Ilustración, y la ambigüedad y desasosiego romántico (Mitcham, 1979). Durante el siglo XX se distinguen dos posiciones antagónicas sobre la técnica. Por un lado, una actitud “crítica” donde pueden identificarse los trabajos de filósofs de diferentes tradiciones como Ortega y Gasset (1939), Heidegger (1954), Mumford (1971) Ellul (1960) y la Escuela de Frankfurt. Por otro lado, una filosofía de la técnica “ingenieril” que consiste en el análisis de la tecnología como un paradigma de pensamiento y acción humana. Esta dicotomía ha sido interpretada por Eco como “apocalípticos e integrados”. Más allá de las mencionadas diferencias, lo que tienen en común ambas posiciones es que parten de una dicotomía entre cultura y naturaleza. Nuestra perspectiva rechaza esta dicotomía, por el contrario, evidenciamos una creciente imbricación entre ambas donde las fronteras entre una y otra se hacen difusas. La noción de “objeto técnico” propuesta por Simondon (2007) hace referencia a la inserción del objeto técnico en la cultura, donde debe reconocerse la “realidad humana” presente en el mismo. Ahora bien, esto no significa “humanizar el objeto técnico”, sino más bien indagar sobre el lugar que este ocupa en la cultura como también establecer su relación con la naturaleza. En el siglo XVII el hombre mismo es reinterpretado como máquina (La Mettrie, 2000). En la actualidad pueden identificarse dos tendencias en la concepción de la técnica: los «humanos-máquinas» y las «máquinas-humanas», en otras palabras, la disposición del humano hacia la máquina y la tendencia de la máquina hacia lo humano. No obstante, ambas posiciones siguen manteniendo una distinción taxonómica entre el cuerpo –o lo orgánico- y lo maquínico, lo que implica una consideración de esta relación de manera extrínseca. Frente a esta tensión Haraway propone el concepto de cyborg: «un organismo cibernético» (1995). Los desarrollos tecnológicos han producido una modificación tal en la vida de los seres orgánicos en los cuales ya no puede concebirse su cuerpo independientemente de la tecnología. Esto conduce a replantear la distinción entre “animales/hombres/máquinas”, entendiendo a los mismos como expresiones de naturaleza, cultura y tecnología respectivamente. Nuestra investigación parte de la hipótesis que la técnica diluye diferencias de orden natural y cultural a través de los objetos técnicos que son productos culturales. La estética se ocupa de la percepción sensible del mundo no puede eludir su dimensión técnica. Al margen de la crítica a la “Industria cultural” consideramos relevante la aproximación de Benjamin al problema de la técnica porque aborda la imbricación antes mencionada en el campo de la percepción. Según Benjamin la irrupción de la técnica al mismo tiempo que posibilita una estetización de la política que confluye en el fascismo como punto extremo también abre la posibilidad de desmontar la ideología del progreso infinito (1967). Una integración entre aproximaciones estéticas y políticas a la técnica Flusser (1983) propone la “caja negra” como metáfora de la técnica contemporánea. Su propuesta es la “apertura de la caja negra” que consiste en tomar conocimiento del funcionamiento del dispositivo. Nuestra propuesta de investigación aborda la técnica desde una consideración filosófica/estética/política, donde redefiniremos la técnica partiendo de la imbricación entre cultura y naturaleza. This project will set the basis for a sustained research on the relation nature/culture/technique. They have been traditionally considered as separate and even opposite fields. And it is on the brink of this distinction where technique plays a central role. In Western thought technique has received many interpretations since the beginnings of philosophy: from a subordination to true knowledge (episteme) in classic philosophy, or the optimism which sees in technique the possibility of dominating nature in the Renaissance and in the Enlightenment, to the Romantic ambiguity and uneasiness towards technological change (Mitcham, 1979). During the twentieth century two opposed approach on technique prevail. On one hand, a “critical” attitude such defines the work of philosophers of different traditions such as Ortega y Gasset (1939), Heidegger (1954), Mumford (1971) Ellul (1960) and the Frankfurt School. On the other hand there is an “engineering” philosophy of technique that consists in the analisis of technology as a paradigm to understand human action and thought. Besides their differences, both positions have in common a dichotomy between nature and culture. We reject such dichotomy. On the contrary we consider there is a growing intertwinement between both which blurs the borders of the concepts. Simondon’s notion of “technical object” refers to the insertion of the technique in culture where the “human reality” in it must be recognised. This does not imply “humanising the technical object”, but investigate on the role it plays on culture and establishing its relation to nature. To articulate this relation we will work with unorthodox approaches on technique such as Benjamin (1967), Flusser (1983) and others. The hypothesis of our project is that the traditional distinction of “animal/man/machine” must be re-thought, therefore raising the question on the blurring line between nature, culture and technique and its effects in philosophy, politics and aesthetics.

Survival and Predictive Factors of Lethality in Hemodyalisis: D/I Polymorphism of The Angiotensin I-Converting Enzyme and of the Angiotensinogen M235T Genes

Background: End-stage kidney disease patients continue to have markedly increased cardiovascular disease morbidity and mortality. Analysis of genetic factors connected with the renin-angiotensin system that influences the survival of the patients with end-stage kidney disease supports the ongoing search for improved outcomes. Objective: To assess survival and its association with the polymorphism of renin-angiotensin system genes: angiotensin I-converting enzyme insertion/deletion and angiotensinogen M235T in patients undergoing hemodialysis. Methods: Our study was designed to examine the role of renin-angiotensin system genes. It was an observational study. We analyzed 473 chronic hemodialysis patients in four dialysis units in the state of Rio de Janeiro. Survival rates were calculated by the Kaplan-Meier method and the differences between the curves were evaluated by Tarone-Ware, Peto-Prentice, and log rank tests. We also used logistic regression analysis and the multinomial model. A p value ≤ 0.05 was considered to be statistically significant. The local medical ethics committee gave their approval to this study. Results: The mean age of patients was 45.8 years old. The overall survival rate was 48% at 11 years. The major causes of death were cardiovascular diseases (34%) and infections (15%). Logistic regression analysis found statistical significance for the following variables: age (p = 0.000038), TT angiotensinogen (p = 0.08261), and family income greater than five times the minimum wage (p = 0.03089), the latter being a protective factor. Conclusions: The survival of hemodialysis patients is likely to be influenced by the TT of the angiotensinogen M235T gene.

Aortic Counterpulsation Therapy in Patients with Advanced Heart Failure: Analysis of the TBRIDGE Registry

Abstract Background: The use of aortic counterpulsation therapy in advanced heart failure is controversial. Objectives: To evaluate the hemodynamic and metabolic effects of intra-aortic balloon pump (IABP) and its impact on 30-day mortality in patients with heart failure. Methods: Historical prospective, unicentric study to evaluate all patients treated with IABP betwen August/2008 and July/2013, included in an institutional registry named TBRIDGE (The Brazilian Registry of Intra-aortic balloon pump in Decompensated heart failure - Global Evaluation). We analyzed changes in oxygen central venous saturation (ScvO2), arterial lactate, and use of vasoactive drugs at 48 hours after IABP insertion. The 30-day mortality was estimated by the Kaplan-Meier method and diferences in subgroups were evaluated by the Log-rank test. Results: A total of 223 patients (mean age 49 ± 14 years) were included. Mean left ventricle ejection fraction was 24 ± 10%, and 30% of patients had Chagas disease. Compared with pre-IABP insertion, we observed an increase in ScvO2 (50.5% vs. 65.5%, p < 0.001) and use of nitroprusside (33.6% vs. 47.5%, p < 0.001), and a decrease in lactate levels (31.4 vs. 16.7 mg/dL, p < 0.001) and use of vasopressors (36.3% vs. 25.6%, p = 0.003) after IABP insertion. Thirty-day survival was 69%, with lower mortality in Chagas disease patients compared without the disease (p = 0.008). Conclusion: After 48 hours of use, IABP promoted changes in the use of vasoactive drugs, improved tissue perfusion. Chagas etiology was associated with lower 30-day mortality. Aortic counterpulsation therapy is an effective method of circulatory support for patients waiting for heart transplantation.

Cotribuição ao estudo das domácias na ordem Rubiales

In this paper domatia of 53 species of the families Caprifoliaceae, Valerianaceae, Dispsaceae and Adoxaceae, all of the Order Rubiales, were studied. In fifteen species belonging to five genera the author found domatia. They were of two types, in the "touffe de poils" and "em pochette", in accordance with the CHEVALIER e CHESNAIS Domatia Classification (1941). Only two species had domatia of the type "em pochette" and the other thirteen had domatia in "touffe de poils" or variations of this type. The author found in this paper, by the first time, domatia in the insertion of the pinna with the rachis in Valeriana scandens L. var. genuina e Valerianopsis sp., and in the place between leaf lets and petiole in Valeriana acutifolia and Valeriana sp.

Charakterisierung von Kartoffelpflanzen mit reduzierter THT-Genexpression

Diese Masterarbeit wurde im Verlauf des Sommersemesters 2014 am Leibniz Institut für Pflanzenbiochemie (IPB) in Halle angefertigt. Gegenstand dabei war die Charakterisierung von Kartoffelpflanzen (Solanum tuberosum cv Désirée), welche durch RNA-Interferenz reduzierte Mengen der Tyramin-Hydroxyzimtsäure-Transferase (THT) besaßen. Durch Southern- und Northern-Blot-Analysen wurden die korrekte Insertion als auch der RNAi-Effekt überprüft und bestätigt. Infizierte Blätter und die dazugehörenden Infektionstropfen wurden in Methanol gelöst und massenspektrometrisch nachgewiesen. Darauf aufbauend wurde das Wachstum von Phytophthora infestans auf transformierten Linien untersucht, wobei dessen Biomasse nach 3-tägiger Infektion durch qPCR bestimmt wurde. Während der Betreuung der transformierten Linien in Sterilkultur wurde ein Phänotyp ersichtlich. Nach Dokumentation der äußeren Erscheinungen und nach Prüfung auf Einfluss von Pathogenen, wurden diese Pflanzen für Knollenversuche im Gewächshaus ausgepflanzt und analysiert. Zuletzt wurde die Sequenz von THT analysiert und kloniert, woraufhin drei Fragmente generiert wurden, welche für weitere Versuche genutzt werden können.

Oviposition behaviour of Gryon gallardoi (Hymenoptera, Scelionidae) on eggs of different ages of Spartocera dentiventris (Hemiptera, Coreidae)

The oviposition behaviour of Gryon gallardoi (Brèthes, 1914) on eggs of Spartocera dentiventris Mendonça Jr. (Berg, 1884) of different ages (2, 3, 4, 5, 6, 7, 8 and 12 days) was investigated. Groups of 12 eggs of each age were exposed to single females of G. gallardoi, and the oviposition behaviour was recorded under a stereomicroscope for two hours. Ten replicates were used for each age. In order to identify the moment the parasitoid egg was released inside the host, 1-day old eggs of S. dentiventris were exposed to G. gallardoi females, and the oviposition was interrupted at intervals of 20, 40, 60, 80, 100, 120, 140 and 160s after ovipositor insertion had initiated. Five behavioural steps were recorded: drumming, ovipositor insertion, marking, walking and resting. The average drumming and ovipositor insertion times increased with the host age (P<0.01). Ovipositor insertion usually occurred next to the longitudinal extremities of the host eggs. Marking took on average 19.5 ± 0.7s, and as walking and resting, was not affected by host age. Self-parasitism behaviour was observed in only 13.8 ± 2.3% of the eggs, being more evident with increasing patch depletion (reduction in non-parasitized eggs in the egg group, P<0.01), again with no variation due to changes in host egg age. For all ages tested, self-parasitized host eggs were less frequently contacted and accepted than non-parasitized ones (P<0.01). The parasitoid egg was released 137.0 ± 3.7s after ovipositor insertion. Spartocera dentiventris egg condition can lead to parasitoid behavioural changes, especially during the process of host choice and discrimination.

Diseño de un diplexor basado en resonadores BAW

Este proyecto plantea el diseño de un diplexor basado en resonadores BAW, pensado para aplicaciones de comunicaciones móviles. Éste permite a los terminales seleccionar los canales de uplink y downlink en sistemas que utilicen duplexado por división en frecuencia. Se plantean tres alternativas de diseño a partir de filtros implementados con resonadores BAW en una topología en escalera. Éstas serán evaluadas y comparadas considerando las pérdidas de inserción, el rechazo fuera de banda y las dimensiones de la estructura obtenida.

Non-assisted versus neuro-navigated and XperCT-guided external ventricular catheter placement: a comparative cadaver study.

BACKGROUND AND PURPOSE: Accurate placement of an external ventricular drain (EVD) for the treatment of hydrocephalus is of paramount importance for its functionality and in order to minimize morbidity and complications. The aim of this study was to compare two different drain insertion assistance tools with the traditional free-hand anatomical landmark method, and to measure efficacy, safety and precision. METHODS: Ten cadaver heads were prepared by opening large bone windows centered on Kocher's points on both sides. Nineteen physicians, divided in two groups (trainees and board certified neurosurgeons) performed EVD insertions. The target for the ventricular drain tip was the ipsilateral foramen of Monro. Each participant inserted the external ventricular catheter in three different ways: 1) free-hand by anatomical landmarks, 2) neuronavigation-assisted (NN), and 3) XperCT-guided (XCT). The number of ventricular hits and dangerous trajectories; time to proceed; radiation exposure of patients and physicians; distance of the catheter tip to target and size of deviations projected in the orthogonal plans were measured and compared. RESULTS: Insertion using XCT increased the probability of ventricular puncture from 69.2 to 90.2 % (p = 0.02). Non-assisted placements were significantly less precise (catheter tip to target distance 14.3 ± 7.4 mm versus 9.6 ± 7.2 mm, p = 0.0003). The insertion time to proceed increased from 3.04 ± 2.06 min. to 7.3 ± 3.6 min. (p < 0.001). The X-ray exposure for XCT was 32.23 mSv, but could be reduced to 13.9 mSv if patients were initially imaged in the hybrid-operating suite. No supplementary radiation exposure is needed for NN if patients are imaged according to a navigation protocol initially. CONCLUSION: This ex vivo study demonstrates a significantly improved accuracy and safety using either NN or XCT-assisted methods. Therefore, efforts should be undertaken to implement these new technologies into daily clinical practice. However, the accuracy versus urgency of an EVD placement has to be balanced, as the image-guided insertion technique will implicate a longer preparation time due to a specific image acquisition and trajectory planning.