Erectile disfunction in obstrutive sleep apnea syndrome - prevalence and determinants

Mestrado Integrado em MedicinaMaster Degree in Medicin

INCIDENTES EM SESSÕES DE HEMODIÁLISE À BEIRA LEITO EM UNIDADES DE TERAPIA INTENSIVA

Objetivo: analizar las incidencias durante las sesiones de hemodiálisis a pie de cama, realizadas en las Unidades de Cuidados Intensivos. Método: estudio transversal, retrospectivo, desarrollado en Unidades de Cuidados Intensivos de Goiânia, Brasil. Entre marzo y abril de 2018 se realizó un análisis de las incidencias identificadas en las sesiones de hemodiálisis a pie de cama. Se realizó un análisis descriptivo para los datos categóricos y para los continuos, la media y la desviación estándar de la media. Resultados: Se analizaron 873 sesiones y se registraron 563 incidentes. Entre los notificados, 259 (46%) eran inherentes al tratamiento. El cuasi accidente fue el tipo de incidente más frecuente, generando retraso en el inicio de la sesión, y no obtuvo apoyo del equipo multiprofesional (p<0,05). En 132 (56,12%) de las circunstancias notificables, el profesional trabajó más de 12 horas ininterrumpidas (p<0,05). Conclusión: el análisis de los resultados permite que los estudiantes y los expertos del área establezcan estrategias de mejora para el servicio.Objective: to analyze incidents during bedside hemodialysis sessions held in Intensive Care Units. Method: cross-sectional, retrospective study, developed in Intensive Care Units of Goiânia, Brazil. Analysis of incidents identified in bedside hemodialysis sessions was performed between March and April 2018. Descriptive analysis was performed for categorical data and for continuous data, mean and standard deviation of the mean. Results: 873 sessions were analyzed, and 563 incidents were recorded. Among those reported, 259 (46%) were inherent to the treatment. Near miss was the most frequent type of incident, generating delay in the beginning of the session, and no support from the multi-professional team (p<0.05). In 132 (56.12%) of the notifiable circumstances, the professional worked for more than 12 uninterrupted hours (p<0.05). Conclusion: the analysis of the results allows students and experts in the area to subsidize improvement strategies for the service.Objetivo: analisar incidentes durante sessões de hemodiálise à beira leito, realizadas em Unidades de Terapia Intensiva. Método: estudo transversal, retrospectivo, desenvolvido em Unidades de Terapia Intensiva de Goiânia, Brasil. Foi realizada análise de incidentes identificados em sessões de hemodiálise à beira leito, entre março e abril de 2018. Foi realizada análise descritiva para os dados categóricos e para os contínuos, média e desvio-padrão da média. Resultados: foram analisadas 873 sessões e registrados 563 incidentes. Dentre os notificados, 259 (46%) foram inerentes ao tratamento. O near miss foi o tipo de incidente de maior frequência, gerando atraso no início da sessão, e não obtiveram apoio da equipe multiprofissional (p<0,05). Em 132 (56,12%) das circunstâncias notificáveis, o profissional trabalhava por mais de 12 horas ininterruptas (p<0,05). Conclusão: a análise dos resultados permite que estudantes e expertises da área subsidiem estratégias de melhoria para o serviço

Arbustus unedo essence: morphological and genetic characterization of the strawberry tree of Castelo de Paiva

O medronheiro é um arbusto da região mediterrânica que pode ser encontrada por todo o país. Ao contrário do que verifica na região sul do país, no concelho de Castelo de Paiva é atribuída uma reduzida importância económica a esta espécie. Com o intuito de preservar e potenciar a produção desta espécie e contribuir para a dinamização da economia do concelho, procedeu-se à caracterização morfológica e genética de uma amostra da população de medronheiros de Castelo de Paiva. A caracterização morfológica e genética foi realizada para um total de 10 genótipos. Para tal recolheram-se 70 folhas aleatoriamente em cada árvore. Em 40 folhas mediu-se o comprimento, largura, comprimento do pedúnculo, peso fresco, peso seco e determinou-se a área foliar. Dos caracteres morfológicos analisados, aqueles que se revelaram mais úteis na distinção dos vários genótipos foram: comprimento do pedúnculo, peso fresco e peso seco. As restantes 30 folhas foram utilizadas para a caracterização genética. Esta caracterização foi realizada recorrendo a um marcador de DNA, ISSR. Os 5 primeiros exemplaresutilizados na técnica de ISSR demonstraram-se polimórficos. Os resultados da caracterização genética sugerem que a variabilidade genética na população é média a alta.The strawberry tree is a shrub native in the Mediterranean region and it can be found throughout Portugal. Unlike the case in the southern region of the country, in Castelo de Paiva a minor economic importance is given to this species. In order to preserve, to enhance the production of this species and to contribute to the boosting of the economy of the region, we proceeded to the characterization of a small sample population of this fruit tree of Castelo de Paiva in what concerns to its morphology and genetics. The morphological and genetic characterization was performed for a total of 10 genotypes. For this, 70 leaves were randomly collected from each tree. For 40 leaves, it was measured the length, the width, the peduncle length, the wet weight, the dry weight and determined the leaf area. Of the morphological characteristics analyzed, the ones that proved most useful in distinguishing the various genotypes were: the length peduncle, the wet weight and the dry weight. The remaining 30 leaves were used in the genetic characterization. This characterization was performed using a DNA marker, the ISSR. The 5 primers used in the ISSR technique proved to be polymorphic. The results from the genetic characterization suggest that variability in population genetics is medium to high

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

The variant selection in the transformation from austenite to martensite in samples of maraging-350 steel

AbstractExperiments have been conducted to study the variant selection phenomenon in the transformation from austenite to martensite in maraging-350 steel. The transformation of austenite to martensite in maraging steels occurs at temperatures below 300°C depending on the alloy chemical composition. The transformation to martensite in these steels occurs regardless of the cooling rate. In these steels, the reverted austenite presents the same crystallographic texture of the mother austenite. Samples of maraging-350 were austenitized at 860°C inside a furnace attached to a tension test machine and then cooled in the furnace until the temperature of 600°C and 400°C. At these temperatures samples were deformed by compression with 10% reduction in height. After deformation the applied force was removed and samples were cooled to room temperature in air. A second group of samples was subjected to the same austenitization and cooled until 300°C when it was applied a compressive stress with magnitude below the yield strength. With the force applied, the samples were air cooled to room temperature. EBSD analysis was performed in cross-section of samples to determine the influence of plastic deformation before the transformation and also the influence of a stress in the elastic regime in the selection of variants of martensite. Measured pole figures were compared with calculated ones using the phenomenological martensite transformation concept associated with Patel–Cohen model

Tensile properties of duplex UNS S32205 and lean duplex UNS S32304 steels and the influence of short duration 475 ºC aging

Duplex stainless steels are high strength and corrosion resistant steels extensively used in the petrochemical and chemical industries. The aging at 475 ºC for long periods of time provokes embrittlement and deterioration of corrosion resistance. However, short duration aging at 475 ºC may be used as heat treatment to improve mechanical resistance with small decrease in the other properties. In this work the flow stress curves of lean duplex UNS S32304 and duplex UNS S32205 steels were modeled with Hollomon's equation and work hardening exponents (n) were determined. The analyses were conducted in specimens annealed and heat treated at 475 ºC for short periods of time. The aging at 475 ºC for 4 hours, 8 hours and 12 hours promoted significant hardening with small decrease of ductility. The work hardening exponents of both steels were compared, being higher in the duplex steel than in the lean duplex grade