1000 resultados para Hipertensió -- Tractament


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This paper presents a case study that explores the advantages that can be derived from the use of a design support system during the design of wastewater treatment plants (WWTP). With this objective in mind a simplified but plausible WWTP design case study has been generated with KBDS, a computer-based support system that maintains a historical record of the design process. The study shows how, by employing such a historical record, it is possible to: (1) rank different design proposals responding to a design problem; (2) study the influence of changing the weight of the arguments used in the selection of the most adequate proposal; (3) take advantage of keywords to assist the designer in the search of specific items within the historical records; (4) evaluate automatically thecompliance of alternative design proposals with respect to the design objectives; (5) verify the validity of previous decisions after the modification of the current constraints or specifications; (6) re-use the design records when upgrading an existing WWTP or when designing similar facilities; (7) generate documentation of the decision making process; and (8) associate a variety of documents as annotations to any component in the design history. The paper also shows one possible future role of design support systems as they outgrow their current reactive role as repositories of historical information and start to proactively support the generation of new knowledge during the design process

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[eng] The article describes the experience of organising the archive of the monastery of Saint Benedict of Montserrat, an institution that currently holds one of the most important collections of Catalan monastic history: that of the first Clarisses in Barcelona. The author comments about the major phases of the project and then reflects on the context for studying and managing an archive of this type.

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Es presenten les necessitats documentals de les televisions locals, fent especial èmfasi en el material audiovisual de caràcter informatiu, ja que és el bloc de programació amb més demanda de documentació per a cobrir requeriments informatius, però atenent també altres tipus de documentació. Es fan recomanacions quant al tractament, la gestió i l¿ús de la documentació produïda, i es descriu el procés documental, tenint presents les particularitats de la televisió local pel que fa a recursos econòmics, tècnics i humans respecte altres models de televisió.

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El desenvolupament dels recursos electrònics d¿accés remot, amb unes característiques ben diferents dels materials que tradicionalment han omplert els prestatges de les biblioteques, ha accelerat la revisió de les normatives de descripció i de catalogació i dels principis mateixos en què es basen. Es repassa l¿estat actual de la revisió de les normes pel que fa a les publicacions seriades i es comenten alguns problemes del tractament catalogràfic deles revistes en línia.

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Information and communication technologies enabled cultural and scientific patrimony -and information in general- to be presented in digital format, as well as in traditional analogical formats. The response was immediate and since the decade of the 1990s different projects have been designed to guarantee permanent access to the digital production -retrieval, storage, handling, preservation and dissemination. This article presents an international overview of existing models of national digital repositories, a name given to these projects that are normally generated by national libraries with a common objective: ensuring that web pages are always accessible.

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Information and communication technologies enabled cultural and scientific patrimony -and information in general- to be presented in digital format, as well as in traditional analogical formats. The response was immediate and since the decade of the 1990s different projects have been designed to guarantee permanent access to the digital production -retrieval, storage, handling, preservation and dissemination. This article presents an international overview of existing models of national digital repositories, a name given to these projects that are normally generated by national libraries with a common objective: ensuring that web pages are always accessible.

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First, we examine the context of creation of special collection units in libraries, and the reasons why libraries compile archive materials and collections. Second, we focus on the techniques used in library environments to describe archive materials and collections and to guarantee their accessibility. We examine the models used in the United States and the United Kingdom to describe and access these materials, and the cooperative projects launched in these two countries in the past few years. Finally, we offer a preliminary analysis of how these types of materials are currently dealt with in Catalan libraries, and issue some recommendations to improve their archiving and access.

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First, we examine the context of creation of special collection units in libraries, and the reasons why libraries compile archive materials and collections. Second, we focus on the techniques used in library environments to describe archive materials and collections and to guarantee their accessibility. We examine the models used in the United States and the United Kingdom to describe and access these materials, and the cooperative projects launched in these two countries in the past few years. Finally, we offer a preliminary analysis of how these types of materials are currently dealt with in Catalan libraries, and issue some recommendations to improve their archiving and access.

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Aquest article estudia la vegetació dels sembrats (classe Secalietea Br.-Bl. 1952) de la Baixa Cerdanya i zones adjacents mitjançant el mètode fitocenològic i fa un repàs d'aquest tipus de comunitats a la Catalunya extramediterrània. Els sembrats dels terrenys àcids són referits a l'associació Scleranthetum anuui Br.-Bl. 1915, de l'aliança Scleranthion annui, força rara a la Cerdanya. Pel que fa a les comunitats neutròfiles, adscrites a l'aliança Caucalidion lappulae, discutim de primer el tractament sintaxonòmic rebut per aquest tipus de vegetació als Pirineus i altres zones peninsulars en treballs precedents. Hi reconeixem tres associacions: Kickxio-Nigelletum gallicae Fanlo 1988, coneguda només dels Pirineus centrals; Violo-Legousietum Hybridae O. Bolòs 1959, estesa pels Prepirineus calcaris i la Catalunya central; i Biforo radiantis-Centaureetum cyani Vigo, Carreras, Carrillo et I. Soriano, ass nova, dins de la qual proposem d'incloure les comunitats cerdanes

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En trabajos anteriores se ha constatado que varios aceros al carbono hipoeutectoides, en estado de temple, presentan valores del módulo de Young inferiores a los correspondientes en estado de revenido. En todos los casos la determinación se ha realizado mediante ultrasonidos. En concreto, para el acero C22E (EN 10083), el módulo se incrementa ligeramente desde 209 GPa (material templado) hasta 211 GPa (revenido a 650 °C), para el acero C45E el módulo aumenta desde 199 GPa hasta 211 GPa (revenido a 500 °C) y para el acero C55E el módulo varía desde 202 GPa hasta 209 GPa para el acero revenido a 650 °C. El presente trabajo se centra en la caracterización estructural de los tres aceros mencionados a los distintos estados de tratamiento térmico, utilizando las técnicas de microscopía óptica de reflexión y microscopía electrónica de barrido, y se propone una explicación de la variación del módulo a partir del comportamiento de las dislocaciones y su interacción con átomos de soluto y con otras dislocaciones.

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In this paper, the expression for the cost of capital is derived when net and replacement investments exhibit differences in their effective prices due to a different fiscal treatment. It is shown that, contrary to previous results in the literature, the cost of capital should be constructed under an opportunity cost criterion rather than a historical one. This result has some important economic consequences, since the optimizing firm will take into account not only the effective price for the new investments but also consider the opportunity cost of replacing them.

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Western societies can reduce avoidable mortality and morbidity by better understanding the relationship between obesity and chronic disease. This paper examines the joint determinants of obesity and of heart disease, diabetes, hypertension, and elevated cholesterol. It analyzes a broadly representative Spanish dataset, the 1999 Survey on Disabilities, Impairments and Health Status, using a health production theoretical framework together with a seemingly unrelated probit model approach that controls for unobserved heterogeneity and endogeneity. Its findings provide suggestive evidence of a positive and significant, although specification-dependent, association between obesity and the prevalence of chronic illness

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In this paper, the expression for the cost of capital is derived when net and replacement investments exhibit differences in their effective prices due to a different fiscal treatment. It is shown that, contrary to previous results in the literature, the cost of capital should be constructed under an opportunity cost criterion rather than a historical one. This result has some important economic consequences, since the optimizing firm will take into account not only the effective price for the new investments but also consider the opportunity cost of replacing them.

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Antecedentes: Las aplicaciones de radiofrecuencia durante la ablación de la fibrilación auricular (FA) producen dolor y ansiedad. El tratamiento habitual se basa en la administración de analgésicos y sedación. La sedación intensa puede producir inestabilidad hemodinámica y desaturaciones.Objetivos: Comparar la incidencia de desaturaciones en relación a la utilización de dos protocolos distintos de tratamiento del dolor durante la ablación de FA. Uno de los protocolos está basado en la sedación con propofol (protocolo 1) y el otro en la analgesia intensa (protocolo 2).Resultados: Hemos analizado los datos de recogidos durante el procedimiento en un grupo de 43 pacientes tratados según el protocolo 1 y otro grupo de 43 pacientes tratados según el protocolo 2. Las variables analizadas han sido: la desaturación máxima, la dosis media de propofol y la dosis media de fentanilo. Las dosis de propofol necesarias en los pacientes del protocolo 1 han sido mayores que con el protocolo 2 (2,4±1,4mg/kg vs 1,7±0,5 mg/kg; p=0,005). La dosis de fentanilo en los pacientes del protocolo 1 han sido menores que en los del protocolo 2 (35,4±17,3mg vs 51,1±18,6mg vs; p<0,001). El 83,65% de los pacientes del protocolo 2 se mantuvo por encima del 94% de saturación frente al 58,1% de pacientes del protocolo 1. Conclusiones: Con el tratamiento basado en la analgesia para los procedimientos de ablación de FA se consigue que una menor proporción de pacientes tengan desaturaciones.

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Background Patients with cirrhosis in ChildPugh class C or those in class B who have persistent bleeding at endoscopy are at high risk for treatment failure and a poor prognosis, even if they have undergone rescue treatment with a transjugular intrahepatic porto - systemic shunt (TIPS). This study evaluated the earlier use of TIPS in such patients. Methods We randomly assigned, within 24 hours after admission, a total of 63 patients with cirrhosis and acute variceal bleeding who had been treated with vasoactive drugs plus endoscopic therapy to treatment with a polytetrafluoroethylene-covered stent within 72 hours after randomization (early-TIPS group, 32 patients) or continuation of vasoactive-drug therapy, followed after 3 to 5 days by treatment with propranolol or nadolol and long-term endoscopic band ligation (EBL), with insertion of a TIPS if needed as rescue therapy (pharmacotherapyEBL group, 31 patients). Results During a median follow-up of 16 months, rebleeding or failure to control bleeding occurred in 14 patients in the pharmacotherapyEBL group as compared with 1 patient in the early-TIPS group (P=0.001). The 1-year actuarial probability of remaining free of this composite end point was 50% in the pharmacotherapyEBL group versus 97% in the early-TIPS group (P<0.001). Sixteen patients died (12 in the pharmacotherapyEBL group and 4 in the early-TIPS group, P=0.01). The 1-year actuarial survival was 61% in the pharmacotherapyEBL group versus 86% in the early-TIPS group (P<0.001). Seven patients in the pharmacotherapyEBL group received TIPS as rescue therapy, but four died. The number of days in the intensive care unit and the percentage of time in the hospital during follow-up were significantly higher in the pharmacotherapyEBL group than in the early-TIPS group. No significant diferences were observed between the two treatment groups with respect to serious adverse events. Conclusions In these patients with cirrhosis who were hospitalized for acute variceal bleeding and at high risk for treatment failure, the early use of TIPS was associated with signif icant reductions in treatment failure and in mortality. (Current Controlled Trials number, ISRCTN58150114.)