Patente farmacêutica: especificidades e tutela

Dissertação de mestrado em Direito dos Contratos e da Empresa

Mobilidade geográfica dos trabalhadores e implicações processuais

Dissertação de mestrado em Direito Judiciário

Mediação Penal Juvenil: um novo paradigma de resposta à delinquência

Dissertação de mestrado em Direito Judiciário (Direitos Processuais e Organização Judiciária)

As Inteligências Múltiplas no processo de ensino-aprendizagem de ELE

Relatório de estágio de mestrado em Ensino de Inglês e Espanhol no 3º Ciclo do Ensino Básico e no Ensino Secundário

Certificação ISO 9001 e Gestão de Recursos Humanos: precedentes e consequentes: estudo de caso das Unidades de Serviços Certificadas da Universidade do Minho

Dissertação de mestrado em Gestão de Recursos Humanos

Aortopulmonary window. Clinical and surgical assessment of 18 cases

OBJECTIVE: Aortopulmonary window (APW) is an uncommon congenital malformation. Its clinical presentation is dependent on the size of the defect and on the associated lesions. We evaluated our experience with this anomaly and compared it with 296 cases reported in the literature. METHODS: Retrospective study of 18 patients diagnosed as having APW (age range from 13 days to 31 years, 13 (72.2%) females), divided into two groups: Group A (GA): 10 patients with isolated APW, and Group B (GB): 8 patients with associated lesions. RESULTS: Heart failure occurred in 14 patients, and cyanosis in 3: 2 from GB (tetralogy of Fallot - TF, and double outlet right ventricle - DORV), and one from GA with pulmonary hypertension. In 5 patients from GA the diagnosis of mitral regurgitation was made based on a systolic murmur and LV hypertrophy on the EKG. In GB, clinical findings were determined by the associated defect. Diagnosis was established by echocardiography in 11 (61.2%) of the patients. In 3 patients, a wrong diagnosis of mitral regurgitation was made, in 1 a patent ductus arteriosus was diagnosed and in 3 others, the diagnosis of APW was masked by other important associated defects (2 cases of DORV and 1 case of TF). The diagnosis was made by catheterization in 3 (16.6%) patients, by surgery in 3 (16.6%) and by necropsy in 1 (5.5%). Corrective surgery was performed in 14 (77.7%) patients, with one immediate death and good long-term follow-up in the remaining patients. CONCLUSION: APW can be confused with other defects. Clinical findings, associated with an adequate echocardiogram can provide the information for the correct diagnosis.

Cultura e mudança organizacional: o caso da Petratex S.A

Dissertação de mestrado em Estudos de Gestão

Final report - EngageBook: touch, read and play

This  report  intends  to  give  a  detailed  notion  about  the  entire  project  development  from  its  publications to communications; from the workshops to the software and BridgingBook patent. To make it clear we followed the Tasks timeline as presented in our proposal, adjusting dates, when they were changed. Because we followed a double take in prototyping/software development, we will also repeat some of the tasks in order to give information about each different phase and its dimensions, in an autonomous way.

Remission of heart failure through endoluminal repair of femoral arteriovenous fistula with the use of a covered stent

We report the case of a 21-year-old male with high-output heart failure due to a femoral arteriovenous fistula caused by a firearm wound. A new balloon expandable stent covered with polytetrafluorethylene was implanted in the artery to occlude the arteriovenous fistula. The fistula was immediately occluded and the artery remained patent. On the following day, the patient felt much better, with no symptoms of heart failure. Additional follow-up is required to assure the usefulness of this less invasive procedure in the treatment of arteriovenous fistulas.

Clinical impact of transesophageal echocardiography in patients with stroke without clinical evidence of cardiovascular sources of emboli

OBJECTIVE: The purpose of this study is to evaluate the impact of transeophageal echocardiography on management of patients at low-risk for cardiogenic embolism to prevent new potential cardiovascular sources of emboli. METHODS: We studied 69 patients with ischemic stroke at low-risk for cardiogenic embolism. Transeophageal echocardiography was performed to access: left atrium enlargement; communication or aneurysm of the interatrial septum; patent foramen ovale; spontaneous echo contrast or intracavitary thrombi; the presence of intraaortic atherosclerotic plaques or thrombi; significant valvar morphologic alteration or dysfunction; left ventricle enlargement, hypertrophy, or contractile abnormality. Transesophageal echocardiography altered clinical management, and we adopted anticoagulant therapy or another procedure apart from the use of acetylsalicylic acid. RESULTS: Transeophageal echocardiography detected at least one abnormality in 40 cases (58%). Clinical conduct was adjusted after the performance of transesophageal echocardiography in 11 patients (15.9%); anticoagulation was added in 10 cases and surgical correction in one patient. CONCLUSION: Transeophageal echocardiography was a very useful tool in the secondary prevention for stroke in patients at low risk for cardiogenic embolism.

New percutaneous techniques for perforating the pulmonary valve in pulmonary atresia with intact ventricular septum

We report new percutaneous techniques for perforating the pulmonary valve in pulmonary atresia with intact ventricular septum, in 3 newborns who had this birth defect. There was mild to moderate hypoplastic right ventricle, a patent infundibulum, and no coronary-cavitary communications. We succeeded in all cases, and no complications related to the procedure occurred. The new coaxial radiofrequency system was easy to handle, which simplified the procedure. Two patients required an additional source of pulmonary flow (Blalock-Taussig shunt) in the first week after catheterization. All patients had a satisfactory short-term clinical evolution and will undergo recatheterization within 1 year to define the next therapeutic strategy. We conclude that this technique may be safely and efficiently performed, especially when the new coaxial radiofrequency system is used, and it may become the initial treatment of choice in select neonates with pulmonary atresia and intact ventricular septum.

Surgical myocardial revascularization without extracorporeal circulation

OBJECTIVE: To assess the immediate postoperative period of patients undergoing myocardial revascularization without extracorporeal circulation with different types of grafts. METHODS: One hundred and twelve patients, 89 (79.5%) of whom were males, were revascularized without extracorporeal circulation. Their ages ranged from 39 to 85 years. The criteria for indicating myocardial revascularization without extracorporeal circulation were as follows: revascularized coronary artery caliber > 1.5 mm, lack of intramyocardial trajectory on coronary angiography, noncalcified coronary arteries, and tolerance of the heart to the different rotation maneuvers. RESULTS: Myocardial revascularization without extracorporeal circulation was performed in 112 patients. Three were converted to extracorporeal circulation, which required a longer hospital stay but did not impact mortality. During the procedure, the following events were observed: atrial fibrillation in 10 patients, ventricular fibrillation in 4, total transient atrioventricular block in 2, ventricular extrasystoles in 58, use of a device to retrieve red blood cells in 53, blood transfusion in 8, and arterial hypotension in 89 patients. Coronary angiography was performed in 20 patients on the seventh postoperative day when the grafts were patent. CONCLUSION: Myocardial revascularization without extracorporeal circulation is a reproducible technique that is an alternative for treating ischemic heart disease.

Initial experience in Brazil with the Helex septal occluder for percutaneous occlusion of atrial septal defects

OBJECTIVE: To evaluate the initial clinical experience with the Helex septal occluder for percutaneous closure of atrial septal defects. METHODS: Ten patients underwent the procedure, 7 patients with ostium secundum atrial septal defects (ASD) with hemodynamic repercussions and 3 patients with pervious foramen ovale (PFO) and a history of stroke. Mean age was 33.8 years and mean weight was 55.4 kg. Mean diameter by transesophageal echocardiography and mean stretched ASD diameter were 11.33 ± 3.3mm, and 15.2 ± 3.8mm, respectively. The Qp/Qs ratio was 1.9 ± 0.3 in patients with ASD. RESULTS: Eleven occluders were placed because a patient with 2 holes needed 2 devices. It was necessary to retrieve and replace 4 devices in 3 patients. We observed immediate residual shunt (< 2mm) in 4 patients with ASD, and in those with patent foramen ovale total occlusion of the defect occurred. No complications were noted, and all patients were discharged on the following day. After 1 month, 2 patients with ASD experienced trivial residual shunts (1mm). In 1 patient, we observed mild prolapse in the proximal disk in the right atrium, without consequences. CONCLUSION: The Helex septal occluder was safe and effective for occluding small to moderate atrial septal defects. Because the implantation technique is demanding, it requires specific training of the operator. Even so, small technical failures may occur in the beginning of the learning curve, but they do not involve patient safety.

Energy from waste (EfW): a feasibility study on the economic and the environmental co-benefits of biogas production within rural communities

Energy from waste (E/W) technologies in the form o f biogas plants, CHP plants and other municipal solid waste (MSW) conversion technologies, have been gaining steady ground in the provision o f energy throughout Europe and the UK. Urban Waste Water Treatment Plants (UWWTP) are utilising much o f the same biochemical processes common to these E/W plants. Previous studies on Centralised Anaerobic Digestion (CAD) within Ireland found that the legislative and economic conditions were not conducive to such an operation on the grounds o f low energy price for electric and heat energy, and due to the restrictive nature o f the allowable feedstocks. Recent changes to the Irish REFIT tariff on energy produced from Anaerobic digestion; alterations to the regulation o f the allowable use o f animal by products(ABP); the recent enactment o f the Renewable Energy D irective (09/28/EC) and a subsequent review o f the draft Biowaste Directive (2001) required that the issue o f decentralised energy production in Ireland be reassessed. In this instance the feasibility study is based on a extant rural community, centred around the village o f Woodford Co Galway. The review found that the prevailing conditions were now such that it was technically and economically feasible for this biochemical process to provide energy and waste treatment facilities at the above location. The review also outlines the last item which is preventing this process from becoming achievable, specifically the lack o f a digestate regulation on land spreading which deals specifically with biowaste. The study finds that the implementation o f the draft EU biowaste regulations, with amendments for Cr and Hg levels to match the proposed Irish regulation for compost, would ensure that Ireland has some o f the most restrictive regulations in Europe for this application. The delay in completing this piece o f legislation is preventing national energy and waste issues from being resolved in a planned and stepwise fashion. A proposed lay out for the new Integrated Waste from Energy Plant (IW/EP) is presented. Budget economic projections and alternative revenue streams are outlined. Finally a review o f the national policies regarding the Rural Development Plan (RDP), the Rural Planning Guidelines (RPG) and the National Renewable Energy Action Plan (NREAP) are examined against the relevant EU directives.

Potentially viable solar powered appliances cooling and distillation

Stand alone solar powered refrigeration and water desalination, two of the most popular and sought after applications of solar energy systems, have been selected as the topic of research for the works presented in this thesis. The water desalination system based on evaporation and condensation was found to be the most suitable one to be powered by solar energy. It has been established that highoutput fast-response solar heat collectors used to achieve high rates of evaporation and reliable solar powered cooling system for faster rates of condensation are the most important factors in achieving increased outputs in solar powered desalination systems. Comprehensive reviews of Solar powered cooling/refrigeration and also water desalination techniques have been presented. In view of the fact that the Institute of Technology, Sligo has a well-established long history of research and development in the production of state of the art high-efficiency fast-response evacuated solar heat collectors it was decided to use this know how in the work described in this thesis. For this reason achieving high rates of evaporation was not a problem. It was, therefore, the question of the solar powered refrigeration that was envisaged to be used in the solar powered desalination tofacilitate rapid condensation of the evaporated water that had to be addressed first. The principles of various solar powered refrigeration techniques have also been reviewed. The first step in work on solar powered refrigeration was to successfully modify a conventional refrigerator working on Platen-Munters design to be powered by highoutput fast-response evacuated solar heat collectors. In this work, which was the first ever successful attempt in the field, temperatures as low as —19°C were achieved in the icebox. A new approach in the use of photovoltaic technology to power a conventional domestic refrigerator was also attempted. This was done by modifying a conventional domestic refrigerator to be powered by photovoltaic panels in the most efficient way. In the system developed and successfully tested in this approach, the power demand has been reduced phenomenally and it is possible to achieve 48 hours of cooling power with exposure to just 7 hours of sunshine. The successful development of the first ever multi-cycle intermittent solar powered icemaker is without doubt the most exciting breakthrough in the work described in this thesis. Output of 74.3kg of ice per module with total exposure area of 2.88 m2, or 25.73kg per m2, per day is a major improvement in comparison to about 5-6kg of ice per m2 per day reported for all the single cycle intermittent systems. This system has then become the basis for the development of a new solar powered refrigeration system with even higher output, named the “composite” system described in this thesis. Another major breakthrough associated with the works described in this thesis is the successful development and testing of the high-output water desalination system. This system that uses a combination of the high-output fast-response evacuated solar heat collectors and the multi-cycle icemaker. The system is capable of producing a maximum of 141 litres of distilled water per day per module which has an exposure area of 3.24m2, or a production rate of 43.5 litres per m2 per day. Once again when this result is compared to the reported daily output of 5 litres of desalinated water per m per day the significance of this piece of work becomes apparent. In the presentation of many of the components and systems described in this thesis CAD parametric solid modelling has been used instead of photographs to illustrate them more clearly. The multi-cycle icemaker and the high-output desalination systems are the subject of two patent applications.