Exames complementares de diagnóstico não invasivos na síndroma de Takotsubo

Trabalho final de mestrado integrado em Medicina área científica de Cardiologia, apresentado á Faculdade de Medicina da Universidade de CoimbraINTRODUÇÃO: A Cardiomiopatia de Takotsubo apresenta-se como uma disfunção aguda e transitória do ventrículo esquerdo, com hipercinésia do segmento basal e acinésia apical. Afeta principalmente mulheres na pós-menopausa, normalmente em consequência de um significativo stress emocional ou físico, continuando por esclarecer muitos dados da sua fisiopatologia. A sua apresentação clínica assemelha-se ao Enfarte Agudo do Miocárdio, contudo, não existe obstrução significativa das artérias coronárias. Definimos como OBJETIVOS desta revisão, a avaliação da utilidade prática dos meios complementares de diagnóstico não invasivos na Cardiomiopatia de Takotsubo, determinação das suas limitações e identificação de critérios que permitam um diagnóstico diferencial com o Enfarte Agudo do Miocárdio. MATERIAIS E MÉTODOS: Pesquisa bibliográfica na base de dados PubMed usando como palavras-chave Takotsubo cardiomyopathy, diagnosis e non invasive methods para as datas entre 2005 e 2012. DESENVOLVIMENTO/RESULTADOS: As publicações analisadas avaliaram os dados epidemiológicos, as características clínicas e antecedentes dos doentes, os possíveis mecanismos fisiopatológicos e o interesse do uso de exames complementares não invasivos (eletrocardiograma, biomarcadores cardíacos, ecocardiograma e ressonância magnética cardiovascular) com o objetivo de diagnosticar a Cardiomiopatia de Takotsubo, excluindo com segurança o Enfarte Agudo do Miocárdio. DISCUSSÃO: Atualmente não é possível realizar o diagnóstico de Cardiomiopatia de Takotsubo e excluir o Enfarte Agudo do Miocárdio, recorrendo apenas a exames complementares não invasivos, não existindo nenhum parâmetro que permita realizar um diagnóstico seguro. Perante um caso suspeito de Cardiomiopatia de Takotsubo considera-se ser necessário a realização de cateterismo cardíaco. O desconhecimento dos mecanismos fisiopatológicos, é uma limitação na orientação preventiva, diagnóstica e terapêutica dos doentesBackground: Takotsubo Cardiomyopathy is an acute and transitory dysfunction of the left ventricle, which results from a hyperkinesia of the basal segment and apical acinesia. It typically affects postmenopausal women subjected to significant emocional and physical stress, although it remains unclear the real pathophysiology of this illness. Its clinical presentation bears a resemblance to Acute Myocardial Infarction even though there is no significant blockage of coronary arteries. Objectives: Evaluate the clinical utility of non-invasive methods to diagnose Takotsubo Cardiomyopathy, but also determine their limitations and identify criteria that allow differential diagnosis with Acute Myocardial Infarction. Methods: Bibliographic research in PubMed using key-words Takotsubo cardiomyopathy, diagnosis and non invasive methods during the period of 2005 and 2012. Results: The analyzed documents evaluated epidemiology data, their clinical features and ill’s past medical history, the possible pathophysiology mechanism and the importance of non-invasive methods of diagnosis such as Electrocardiography, Cardiac Biomarkers, Echocardiography and Cardiac Magnetic Resonance assembling a definite diagnosis of Takotsubo Cardiomyopathy and excluding with conviction Acute Myocardial Infarction. Conclusion: Nowadays, it is not possible to diagnose Takotsubo Cardiomyopathy and exclude with certainty Acute Myocardial Infarction simply using non-invasive complementary methods since there are no parameters that provide an indubitable diagnose. Against a suspicious of Takotsubo Cardiomyopathy it is mandatory to perform a Cardiac Catheterization. The uncertainty of the pathophysiology mechanism in this illness is a limitation to preventive orientation, diagnosis and therapeutic approach

Aston Martin Lagonda case study

This project is divided between a case study about Aston Martin Lagonda (AML) and the correspondent Teaching Note. AML is a centenary luxury auto brand known for the exceptional design and power of its cars and the recurrent financial difficulties. After going public on the London Stock Exchange, AML faced poor operational performance and financial distress, leading to a rescue finance at the beginning of 2020. The Case Study raises questions about the reasons to take the company public, the IPO valuation, the factors that led AML close to bankruptcy, the impact of financial distress, and the rescue deal

The impact of attribution modelling in luxury e-commerce : attribution model simulation

Project Work presented as the partial requirement for obtaining a Master's degree in Information Management, specialization in Information Systems and Technologies ManagementLuxurious goods started to be sold in online stores at a slow pace, but today the market has grown and it is working at high speed and has great potential. In fashion world exclusivity is the main word and along with the creation of online stores by luxurious brands, it is necessary to advertise them to the right audience and at the right time. So, companies tend to apply their marketing budget in multiple channels (search, email, display, affiliate and social networks) and because there are multiple ways to reward each channel, companies need to decide which Attribution Models they will use when rewarding affiliates. Using a well-known andmulti-brand seller as an allied to better understand advertise in ecommerce websites, this project will be based in a real database in order to create accurate simulations and to get the best model for similar companies. The simulations created for this project were based in almost two hundred and fifty thousand conversions and more than two million interactions with the e-commerce website.Inicialmente, os bens de luxo começaram por ser vendidos em lojas online a um ritmo consideravelmente lento, sendo que, atualmente, já é possível ver um rápido crescimento do mercado e o seu grande potencial. Neste mundo em que "exclusividade"é palavra chave e com, cada vez mais, marcas a lançar as suas próprias lojas online, é imperativo atrair o público certo, no momento certo. Desta forma, as empresas tendem a aplicar o orçamento de marketing em vários canais (pesquisa, e-mail, display, redes de afiliados, ou até em redes sociais). Como é possível utilizar diferentes Modelos de Atribuição para definir recompensas, as empresas necessitam de selecionar qual o que deve ser utilizado para premiar cada um desses canais. Através da parceria com uma empresa do setor de luxo, cujas vendas se baseiam em produtos de diversas marcas conhecidas mundialmente, foi possível utilizar neste projecto, desde início, uma base de dados real. Desta forma, foi possível criar simulações precisas de forma a obter o melhor modelo para empresas como esta, tendo sido baseadas em quase duzentas e cinquenta mil conversões e mais de dois milhões de interações geradas na loja eletrónica da empresa

Attitudes on the ethics of tax evasion : a brazilian survey

Mestrado em FinançasO objetivo principal desta dissertação é avaliar as atitudes dos brasileiros em relação à ética da evasão fiscal e, num segundo nível, analisar a influência de diversas variáveis sociodemográficas na ética fiscal. O estudo da ética no Brasil é relevante, dados os inúmeros casos mediáticos na media mundial envolvendo corrupção e evasão fiscal, como a operação Lava Jato, a operação dos Zelotes, entre outros. Por forma a analisar este importante tópico, foi efetuado um questionário sobre temas como a economia paralela, a moral tributária, confiança nas instituiçoes e ética fiscal. A amostra incidiu sobre 227 inquiridos de variadas áreas profissionais, nomeadamente da área financeira, área juridica, marketing, saúde, entre outros. Os resultados obtidos indicam a existência de um elevado nível de ética fiscal dos contribuintes brasileiros. Foi possível concluir que a idade e o género são fatores determinante para o nível de ética fiscal, com as mulheres e os individuos entre os 30 e os 44 anos a apresentarem os maiores niveis de ética, respetivamente, o que vai de acordo com a maioria da literatura analisada nesta dissertação. O presente estudo permitiu igualmente concluir que os empregados por conta de outrem apresentam os maiores niveis de ética fiscal. Por outro lado, não foi possível constatar diferenças entre pessoas religiosas e não religiosas em relação ao seu nível de ética fiscal. De forma a ter uma imagem mais completa da ética fiscal no Brasil, seria interessante alargar a amostra, incluindo pessoas com diferentes níveis de escolaridade, por exemplo.The main objective of this dissertation is to assess the attitudes of Brazilians towards the ethics of tax evasion and on a second level to analyze the influence of several socio-demographic variables on tax ethics. The study of tax ethics in Brazil is relevant, given the numerous cases involving corruption and tax evasion, such as the Operação Lava Jato, Operação dos Zelotes, among others. To analyze this important topic, a questionnaire was carried out on topics such as the shadow economy problem, tax morals, institutional confidence and tax ethics. The sample consisted of 227 respondents from various professional areas, including finance, legal, marketing, health, among others. The results obtained indicate the existence of a high level of tax ethics among Brazilian taxpayers. It was possible to conclude that age and gender are determining factors for the level of tax ethics, with women and individuals between 30-44 years old presenting the highest levels of ethics, respectively. The study also concluded that non-self-employed people possess the highest levels of tax ethics. On the other hand, it was not possible to ascertain differences between religious and non-religious people concerning their level of tax ethics. It would be interesting to expand the sample, by including people with different educational levels, for example, as a way of completing the study of the tax ethics of Brazilian taxpayers.info:eu-repo/semantics/publishedVersio

A survey on automatic habitat mapping

Habitat mapping can help assess the health of an ecosystem but the task is not always straightforward as, depending on the environment to be mapped, data types can be very different, such as marine and land habitats where in one case you can use sonar images and in the other satellite pictures. In this survey we explore works that used machine learning models when performing habitat mapping.Peer Reviewe

Designing decision support tools for Mediterranean forest ecosystems management: a case study in Portugal

Original ArticleThe effectiveness of Mediterranean forest ecosystem management calls for the conceptualization and implementation of adequate decision support tools. The proposed decision support system encompasses a management information system, a prescription simulator, a constraint generator and a set of management models designed to solve decision problems. Emphasis is on the architecture of the prescription simulator and its linkage to the three other modules, as well as on methods for reporting and visualizing solutions. Results are discussed for a real world test case – Serra de Grândola, a management area with about 18 600 ha comprising 860 cork oak (Quercus suber L.) land units. Cork oak silviculture adds complexity to the traditional forest management problem. Results show that the devised system is able to address effectively the integration of ecosystem data, silviculture, growth-and-yield and management models. They further suggest that the proposed system architecture may help address the complexity of Mediterranean ecosystem management problemsinfo:eu-repo/semantics/publishedVersio

Johnson & Johnson equity report –J&J fundamentally underappreciated

This report was prepared by Gonçalo André and Tomás Branco, two Master in Finance students of Nova School of Business and Economics (“Nova SBE”), within the context of the Field Lab –Equity Research. The goal was to evaluate Johnson & Johnson’s intrinsic value. Therefore, a thorough analysis of its operating segments and industries was conducted. Our valuation model resulted in a share price of $166.00, which led to the conclusion that J&J is trading below its fair value. In addition, it was measured how sensitive the model is to changes in its underlying assumptions and to J&J’s future operating results

The recent dynamics of the stock exchange in Brazil

Abstract. This study is a literary analysis with the purpose of verifying the dynamic relation of the São Paulo stock exchange index with some macroeconomic variables, between January 2014 and August 2017, when Brazil was going through a serious political crisis, in which the economic activity was affected and therefore the stock market. Thus, these relationships are evaluated by the Johansen Cointegration Test to precisely verify the long-term relationship between the Brazilian stock market and the other variables. And the results indicate a negative weight of inflation expectations, interest rates and public debt, while the exchange rate and economic activity positively affect the stock market index.Keywords. Stock price, Index of the São Paulo Stock Exchange, Johansen Cointegration Test.JEL. C13, E44, G12