A Diplomacia Económica Portuguesa e a Internacionalização da Banca : Estudo de Caso

Mestrado em Ciências EconómicasO conteúdo económico da diplomacia tem vindo a ser ampliado por força do movimento da globalização e pela integração da vertente económica em todos os sectores da sociedade. Esta vertente da diplomacia tem vindo a tornar-se cada vez mais num instrumento fundamental da actividade externa dos Estados e dos interesses de um país. Deste modo, aquela procura adaptar-se às circunstâncias actuais da economia portuguesa, o que obriga ao alargamento de funções e objectivos diplomáticos. Num contexto de mudança e de crescimento económico a internacionalização tornou-se num imperativo estratégico para qualquer banco. Os bancos portugueses procuram internacionalizar-se para mercados que apresentem vantagens competitivas globais ou específicas, ao mesmo tempo que têm vindo a desempenhar um papel primordial no apoio à internacionalização das empresas nacionais. Neste sentido, o presente trabalho procura analisar a evolução do modelo de diplomacia económica definido pelos diferentes governos e a internacionalização da banca portuguesa, que tem tido um papel muito relevante para o desenvolvimento económico do país, com a finalidade de constatar se existe relação entre estas duas temáticas.The economic contents of diplomacy have been expanding as a result of the strength in the globalization movement and the integration of economic aspects in all the sectors of society. This particular type of diplomacy has become increasingly a fundamental tool of the external activity of the states and of the interests of a country. Thus, it seeks to adapt to the present situation of the Portuguese economy, forcing a widening of diplomatic roles and objectives. In a context of changing and economic growth, the internationalization has become a strategic imperative for any bank. The Portuguese banks seek to internationalize in global financial markets that show global or specific competitive advantages, and at the same time a primordial role in supporting the internationalization of national companies. With this purpose, the present essay hopes to analyze the evolution of the economic diplomacy model defined by the different governments and the internationalization of Portuguese banking, which has played a major role on the economic development of the country, in order to find if exists a connection between this two topics

VARIANTE ANATÓMICA DA ARTÉRIA HEPÁTICA: IMPORTÂNCIA DO PLANEAMENTO PRÉ-OPERATÓRIO

Anatomic variations of the hepatic artery are not uncommon and may lead to iatrogenic injuries during pancreatoduodenectomy (PD). Two classifications (Michels’ and Hiatt’s) have been used to describe the different variations. Ligation of an aberrant hepatic artery may result in life-threatening complications, such as liver necrosis. Preoperative imaging is crucial for detection of these variations.As variações anatómicas da artéria hepática não são incomuns e podem levar a lesões iatrogénicas durante a duodenopancreatectomia. Duas classificações (Michels´e Hiatt´s) têm sido usadas para descrever as diferentes variações conhecidas. A laqueação da artéria hepática aberrante pode resultar em complicações graves, como necrose hepática. O estudo cuidado das imagens pré-operatórias é crucial para a deteção destas variações. &nbsp

Penile prosthesis implantation in an academic institution in Latin America

PURPOSE: We performed a retrospective study to analyze the effectiveness of implantable penile prostheses in the treatment of erectile dysfunction. MATERIALS AND METHODS: This study included 249 patients who received implants between 2001 and 2008. A total of 139 patients who underwent penile prosthesis implantation were interviewed. RESULTS: Approximately half of patients had previously used oral drugs before implantation of the prosthesis. About 45% had diabetes, 25.9% had previously undergone radical prostatectomy (RP), and 64% had hypertension. Exchange was performed in 5.7% for fracture, inadequate size, or extrusion. A total of 24.5% of men had immediate postoperative pain, 7.9% had local infection, and 8.6% had other complications. Patients who had previously undergone RP were 3.2 times more likely to experience a postoperative complication than patients who had not (p = 0.061). Eighty-nine (64%) patients returned to having sex as they had before being diagnosed with ED. Ninety-two of the men (66.2%) had sexual intercourse one to two times per week. One hundred twenty patients (86.3%) rated their level of satisfaction as good, excellent or very good, which was similar to the percentage of partners. The mean follow-up was 40 months. CONCLUSION: Higher rates of postoperative infections and mechanical problems with the implant were found in this study as compared to other studies, which was probably associated with the relative lack of experience of the trainees who were performing the surgeries. Patients with a history of RP or diabetes mellitus prior to implantation were at higher risk of postoperative complications

Study of the efficacy of Korean Red Ginseng in the treatment of erectile dysfunction

Aim: To examine the treatment efficacy of Korean Red Ginseng (KRG) in impotent men with erectile dysfunction (ED). Methods: A total of 60 patients presenting mild or mild to moderate ED were enrolled in a double-blind, placebo-controlled study in which the efficacies of KRG and a placebo were compared. the patients received either 1 000 mg (3 times daily) of KRG or a placebo. Results: the five-item version of the International Index of Erectile Function (IIEF-5) score after the treatment was significantly higher in the KRG group compared with that before the treatment (from 16.4 +/- 2.9 to 21.0 +/- 6.3, P 0.05). in the KRG group, 20 patients (66.6%), reported improved erection, significant in the global efficacy question (P 0.05). Conclusion: Our data show that KRG can be an effective alternative to the invasive approaches for treating male ED.Univ São Paulo, Div Urol Clin, Sector Sexual Med, São Paulo, BrazilUniversidade Federal de São Paulo, Discipline Urol, São Paulo, BrazilUniversidade Federal de São Paulo, Discipline Urol, São Paulo, BrazilWeb of Scienc

Intracavernous injection in the treatment of erectile dysfunction after radical prostatectomy: an observational study

CONTEXT: Despite the recent improvements in performing radical retropubic prostatectomy that have led to a considerable decrease in the complication rate, erectile dysfunction still represents a major problem. Moreover, less invasive treatment options that are emerging for erectile dysfunction have not shown satisfactory results in managing these patients. OBJECTIVE: To study the efficacy and side effects of self-injection therapy in the treatment of men who had become impotent after undergoing radical prostatectomy due to prostate cancer, over a study period of 96 months. DESIGN: Observational study. SETTING: University Referral Center. PARTICIPANTS: 168 patients with erectile dysfunction, aged 43 to 78 years old, who underwent radical retropubic prostatectomy due to localized prostate cancer. PROCEDURES: The patients were treated with self-injection therapy using papaverine, phentolamine and prostaglandin E1, at home. RESULTS: This study showed an acceptable 94.6% success rate, with no life-threatening complications. In addition to this, our series presented a 13.1% cure rate with this therapy. CONCLUSION: Self-injection therapy with papaverine, phentolamine and prostaglandin E1 is effective and safe in the treatment of erectile dysfunction after radical prostatectomy.CONTEXTO: Apesar do recente avanço técnico na realização da prostatectomia radical retropúbica, que levou a queda no índice de complicações, a disfunção erétil ainda é um problema importante. Além disso, as novas opções (menos invasivas) de tratamento da disfunção erétil não mostram resultados satisfatórios nesse grupo de pacientes. OBJETIVO: Avaliar a eficácia e efeitos colaterais da auto-injeção no tratamento da disfunção erétil causada pela prostatectomia radical, durante 96 meses. TIPO DE ESTUDO: Estudo observacional. LOCAL: Universidade Federal de São Paulo (UNIFESP)/Escola Paulista de Medicina. PARTICIPANTES: 168 pacientes com disfunção erétil, entre 43 e 78 anos, submetidos a prostatectomia radical retropúbica, devido a câncer localizado da próstata. PROCEDIMENTOS: Os pacientes foram tratados com auto-injeção utilizando a associação de papaverina, fentolamina e prostaglandina E1 em casa. RESULTADOS: O índice de sucesso foi de 94,6% com complicações bastante discretas. Além disso, tivemos um índice de cura de 13,1% nesse estudo. CONCLUSÕES: A auto-injeção com papaverina, fentolamina e prostaglandina E1 é eficaz e segura no tratamento da disfunção erétil causada pela prostatectomia radical.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Urology DepartmentUNIFESP, EPM, Urology DepartmentSciEL

Development of a urinary lithiasis localizer mechanism to couple ultrasound and extracorporeal lithotripsy equipment in canine model

INTRODUCTION: Due to the evolution of extracorporeal lithotripsy equipment (ESWL) and presently, the fact that most part of the equipment does not present ultrasound to localize urinary calculi, a system that allows adapting ultrasound equipment to ESWL equipment was developed, disposing only of fluoroscopy. Thus, this equipment was developed and was tested in urinary stones in canine models, to check its precision in relation to fluoroscopy. METHOD: Seven male dogs were utilized with the introduction, in the bladder through the ureteral route, of chalkstones, with initial localization by fluoroscopy, with a further ultrasound coincidence check localization of the vesical stones, being submitted to ESWL with a 3-hour, 21 days and 60 days follow-up after the procedure. RESULTS: Success of localization in all animals was verified presenting elimination of stones in the first micturitions, after ESWL. No complications were verified in those animals for 60 days. CONCLUSION: We verified that this equipment can lead to an update of the equipment that use only fluoroscopy, increasing in this way, their technical capacity in the treatment of urinary calculi, mainly in cases of non-radiopaque stones.UNIFESP Paulista School of Medicine Department of UrologyUniversity of São Paulo Faculty of MedicineUNIFESP, Paulista School of Medicine Department of UrologySciEL

Acute scrotum

O escroto agudo, caracterizado pela presença de dor local intensa, edema e alteração da consistência das estruturas da bolsa testicular, constitui uma urgência urológica e corresponde a 0,5% dos atendimentos nos serviços de emergência. As causas mais freqüentes de escroto agudo são os processos inflamatórios locais (orquiepididimites) e vasculares isquêmicos (torção testicular), cujo diagnóstico diferencial nem sempre é feito de forma simples. Nesse sentido, dois exames podem evidenciar as alterações locais, incluindo o fluxo sanguíneo: o ultrassom Doppler e a cintilografia escrotal. A ultrassonografia com Doppler do escroto constitui exame pouco invasivo, de custo acessível, alta disponibilidade, rápida execução e elevada sensibilidade (cerca de 90%) e especificidade (99%). Por outro lado, a cintilografia escrotal permite definir com precisão a irrigação dos testículos, porém demanda maior tempo e não é disponível na maioria dos serviços. Quando com esses recursos propedêuticos o diagnóstico final permanece incerto, a exploração cirúrgica é indicada e deve ser realizada sem demora, de modo a permitir a preservação testicular nos casos de torção do cordão.Acute scrotum always represents a clinical emergency and is seen in 0,5% of patients attending acute care units. The main cause of acute scrotum are inflammatory conditions of the testis or epididymis and testicular torsion. Based on clinical evaluation the differential diagnosis between these two conditions can be challenging. In order to proper evaluate patients with acute scrotum we can resort to Doppler ultrasound or scrotal scintigraphy that have the ability to depict local anomalies or decreased blood flow. The Doppler ultrasound is a less invasive test, performed quickly and with low costs, easily available and with a high sensitivity (around 90%) and specificity (about 99%). On the other hand scrotal scintigraphy allows for precise depiction of testicular blood irrigation but is a slow procedure and less available in the clinical setting. When the proper diagnosis can not be made safely with the aforementioned tests, immediate surgical exploration must be performed in order to avoid definitive testicular loss associated to spermatic cord torsion

Efficacy and safety of flexible-dose oral sildenafil citrate (Viagra((R))) in the treatment of erectile dysfunction in Brazilian and Mexican men

A 12-week, double-blind, placebo-controlled, multicenter study evaluated the efficacy and safety of flexible-dose sildenafil citrate (Viagra((R))) treatment (25, 50 or 100 mg) in Brazilian and Mexican men with erectile dysfunction (ED) of broad-spectrum etiology. Efficacy was assessed on the basis of responses to the 15-item International Index of Erectile Function (IIEF) questionnaire, completed at baseline and after 12 weeks of treatment. At end point, mean scores for all IIEF domains of sexual function (erectile function, orgasmic function, sexual desire, intercourse satisfaction and overall satisfaction) were significantly (P < 0.0001) higher in the sildenafil group (n = 109) than in the placebo group (n = 105). These findings confirm the significant increases in frequency of penetration and frequency of maintained erections reported previously. Sildenafil treatment was well tolerated. the most common adverse events were headache and flushing. in conclusion, sildenafil is a well-tolerated and effective treatment for ED of broad-spectrum etiology in Latin American men.Hosp Albert Einstein, BR-01250000 São Paulo, BrazilTorre Hosp Angeles del Pedregal, Consultorio 827, MexicoFac Ciencias Med Santa Casa, Porto Alegre, RS, BrazilHosp Clin Cuiritiba, Curitiba, Parana, BrazilUniv Estadual Campinas, Fac Ciencias Med, Campinas, SP, BrazilClin Rio Claro, Rio Claro, SP, BrazilUniv Estadual Rio de Janeiro, Fac Med, Rio de Janeiro, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, São Paulo, BrazilHosp Servidor Publ Estadual, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, São Paulo, BrazilWeb of Scienc

Alterações pressoricas apos litotricia extracorporea em pacientes normotensos

Orientador: Ubirajara FerreiraDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências MédicasResumo: Com o objetivo de avaliar as alterações nos níveis pressóricos causadas pela litotrícia extracorpórea por ondas de choque, 102 pacientes normotensos, com idade entre 5 e 81 anos, mediana de 40 anos, portadores de litíase renal foram acompanhados por um período mediano de 22 mêses após o tratamento. Os pacientes foram divididos em grupo I: 61 pacientes do sexo masculino, e grupo II: 41 pacientes do sexo feminino. A avaliação desses pacientes foi feita através da medida da pressão diastólica e da pressão arterial média, antes e depois da litotrícia. Consideramos hipertensão arterial quando a pressão diastólica se mantinha acima de 90 mmHg, por um período mínimo de duas semanas. A quantida.de de impulsos administrados para cada paciente variou a 6000, mediana de 4000 impulsos, a uma intensidade mediana de 1250 18,IKV. Concluimos que a incidência de hipertensão arterial pós litotrícia extracorpórea por ondas de choque foi de 3,92%, semelhante e da população normal. Apesar disso a medida da pressão diastólica foi estatisticamente superior em ambos os grupos após o tratamento. Nos pacientes do sexo masculino, a pressão diastólica se elevou de 79,67. mmHg para 81,47 mmHg, e no sexo feminino variou de 76,28 mmHg para 79,26 mmHg. Da mesma maneira, a pressão arterial média foi igualmente superior no sexo feminino, indo de 89,88 mmHg' para 91,75 mmHg. Já nos pacientes masculinos a diferença não foi estatisticamente significante, apesar de aumentar de 94,5 mmHg para 95,8 mmHgAbstract: To evaluate the blood pressure changes caused by extracorporeal shock wave lithotripsy 102 patients 5 to 81 years old (mean age 40 years) with normal blood pressure and kidney lithiasis were monitored during a mean period of 22 months. There were 61 male (group 1) and 41 female (group 2) patients. Patients were evaluated by measurement of the diastolic pressure and the average arterial pressure before and after lithotripsy. Hypertension was considered when the diastolic pressure was greater than 90 mm.Hg for 2 weeks. The amount of shock waves applied in each case ranged from 1,250 to 6,000, with a mean of 4,000 shock waves at a median intensity of 18.1 kv. The incidence of hypertension after extracorporeal shock wave lithotripsy was 3.92%, which is similar to that of a normal population, although the diastolic pressure was statistically higher after treatment in both groups. In the male patients the diastolic pressure increased from 79.67 (+-9.7) to 81.47 (+-1O. 1) mm. Hg and female patients in ranged from 76.28 (+- 8.3) to 79.26 (+-9.9) mm. Hg. Similarly, the average arterial pressure was equally higher in the female group, ranging from 89.88 to 91.75 mm Hg. In the male group the difference was not statistically significant, despite an increase from 94.5 to 95.8 mm. HgMestradoMestre em Cirurgi