A admissibilidade de alegação e conhecimento de factos supervenientes em sede de recurso cível

A questão objeto de estudo é a de saber se é admissível às partes alegar e ao tribunal conhecer de factos essenciais supervenientes que se prendam com o mérito da causa, em sede de recurso cível. Para o efeito consideramos factos supervenientes aqueles que ocorram ou sejam conhecidos posteriormente ao encerramento da discussão em 1.ª instância. De fora do nosso objeto ficam os factos velhos, os de conhecimento oficioso, os relativos a pressupostos processuais, os notórios, bem como os factos não essenciais, uma vez que a discussão em torno da sua admissibilidade ou não é bastante mais pacífica. Segundo o entendimento tradicional na doutrina e segundo a Jurisprudência amplamente maioritária em Portugal, salvo o caso excecional em que exista acordo entre as partes, o tribunal de recurso só pode conhecer de factos supervenientes que foram alegados até ao encerramento da discussão em 1.ª instância. Como fundamento para esta orientação é utilizado essencialmente o princípio da estabilidade da instância e a consideração de que em Portugal vigora um sistema de recursos de reponderação. Perfilhamos outra orientação. A nosso ver a estabilidade da instância nem sempre se deve impor e na verdade o sistema de recursos português não é de pura reponderação. Baseando-nos na remissão legal prevista no art.º 663.º, n.º 2, que determina a aplicação em recurso do art.º 611.º, e tendo em vista a economia processual e a verdade material, consideramos admissível a alegação e o conhecimento de factos essenciais supervenientes relativos ao mérito da causa em sede de recurso, desde que respeitadas algumas limitações. Não existindo acordo entre as partes, devem admitir-se os factos supervenientes desde que, no caso concreto, não se verifique uma perturbação inconveniente para o julgamento do pleito, sendo que esta é uma ponderação que ficará a cargo do julgador. As partes deverão ainda agir de boa fé e deverá ser assegurado o contraditório.The question object of study is to know if is admissible to the parties allege and to the court decide about essential supervenient facts concerning the substance of the case, in civil appeal. To this end we consider supervening facts those which occur or are known after the close of the discussion in judicial court. Outside of our object are old facts, facts of its own motion, facts concerning the procedural prerequisites and notorious facts, as well as non-essential facts, once the discussion on their admissibility or not is much more peaceful. According to the traditional understanding of the doctrine and according to the majority Jurisprudence in Portugal, unless the exceptional case where there is agreement between the parties, the appellate court can only take cognizance of supervenient facts which were alleged until the end of the discussion in judicial court. As a foundation for this orientation is essentially used the principle of stability of the proceedings and the fact that in Portugal there is an appeal for reweighting system. We follow another orientation. We believe the stability of the proceedings should not always be imposed and also that the portuguese appeals system is not pure reweighting. Based on the legal remission provided in the art.º 663.º, n.º 2, which determines the application on appeal of the art.º 611, and in view of procedural economy and the material fact, we consider admissible the allegation and knowledge of essential supervenient facts concerning the substance of the case on appeal, as long as some limitations are respected. In case of no agreement between the parties, the supervenient facts must be admitted as long as, in the particular case, there is not an inconvenient disturbance of the dispute, and this is a consideration that shall be judge’s responsibility. The parties must also act in good faith and the contradictory must be ensured

Sensores inerciais na avaliação motora da Doença de Parkinson em pacientes submetidos à Palidotomia - um estudo piloto

A Doença de Parkinson é um distúrbio neurodegenerativo de grande impacto global, apesar dos avanços recentes ainda necessita de aprimoramento nos métodos de avaliação das alterações motoras. Este trabalho teve como objetivo avaliar um sistema (hardware e software) capaz de quantificar de forma precisa o tremor em pacientes com a doença de Parkinson submetidos à Palidotomia. Foi avaliado o Valor Absoluto Médio (MAV - Mean Absolute Value) da atividade involuntária de três pacientes submetidos à cirurgia de palidotomia nos cenários pré e pós-operatório. O Valor Absoluto Médio da atividade involuntária obtido por meio do dispositivo proposto (TREMSEN) apresentou boa correlação com os achados clínicos, bem como os achados já descritos em estudos anteriores. O presente estudo mostrou que as alterações da MAV estavam sempre relacionadas positivamente com tremor ou negativamente com bradicinesia e rigidez, ou eventualmente em ambos. Também se observou a tendência à maior influência do tremor sobre a MAV do que bradicinesia e rigidez. A correlação positiva entre os valores aferidos pelo dispositivo TREMSEN e o resultado clínico dos pacientes abre portas para aplicação futura da tecnologia, tais como avaliação precisa e objetiva dos distúrbios motores, monitoramento contínuo e monitoramento à distânciaParkinson's Disease is a neurodegenerative disorder and an important source of disability worldwide. Despite recent advances, it remains necessary improvements in the assessment of motor changes. The objective of this study was to evaluate a system (hardware and software) capable of precisely quantifying tremor in patients with Parkinson's Disease undergoing ablative surgery. The Mean Absolute Value (MAV) of involuntary activity of three patients undergoing pallidotomy was evaluated in the pre and postoperative scenarios. The Mean Absolute Value of involuntary activity (obtained through the proposed device - TREMSEN) presents a good clinical correlation, as observed in previous studies. The present study revealed that MAV changes were always positively related to tremor or negatively related to bradykinesia and rigidity, possibly both. In addition, there was a trend towards greater influence of tremor on the MAV than bradykinesia and rigidity. The positive correlation between TREMSEN device and the clinical outcome of patients brings possibility to future application of the technology, such as accurate and objective assessment of motor disorders, continuous monitoring, and remote monitoring39 f

Anteromedial positioning of the femoral tunnel in anterior cruciate ligament reconstruction is the best option to avoid revision: a single surgeon registry

Abstract Purpose The aim of the study is to compare the risk of revision of single-bundle hamstring anterior cruciate ligament (ACL) reconstruction between the anteromedial, transtibial and outside-in techniques. Methods This cohort study was based on data from a single surgeon’s registry. Patients who underwent primary single-bundle ACL reconstruction with hamstring tendon using the anteromedial portal, transtibial and outside-in technique, operated between 1 November 2003 to 31 December 2016, were eligible for inclusion. A minimum follow-up of 2 years was used, and the end-point of the study was revision surgery. Results The total number of registered surgeries identified was 665; 109 were excluded, and 556 was the final sample. The overall revision rate was 8.7%. The transtibial technique presented 14/154 [9.9%] of revisions, the transportal 11/96 [11.4%] and the outside-in 22/306 [7.2%]. Separating the outside-in group into central outside-in and anteromedial (AM) outside-in, 18/219 [8.2%] was found for the central outside-in and 4/87 [4.5%] for the AM outside-in technique. Statistical evaluation of the first comparison (transtibial vs. transportal vs. outside-in) obtained p = (n.s.) The second comparison (transtibial vs. central transportal vs. central outside-in vs. AM outside-in, p = (n.s). Placement was also evaluated: high anteromedial placement (transtibial) vs. central (transportal and central outside-in technique) vs. AM placement (AM outside-in). The high AM placement presented 14/154 [9.9%] of revision, the central placement 29/315 [9.2%] and the AM placement 4/87 [4.5%], p = (n.s.) The AM placement was also compared with the other placements (high and central AM), p = (n.s.) Conclusion Based on the registry of a single surgeon during 14 years of ACL reconstruction, the placement of the femoral tunnel in the high anteromedial region was associated with a rupture rate of 9.9%, central placement with 9.2% and anteromedial placement with 4.5%

Implementing an epilepsy surgery center. Initial experience at a university hospital in Brazil

ABSTRACT Epilepsy is a serious neurological condition, often without a full and effective treatment. In some cases, surgery is beneficial, despite being underused. Our aim herein is to describe the implementation of an epilepsy surgery center in a federal university hospital, sharing the initial experience gained, as well as describing the main challenges and first results. Methods: Experience report of an epilepsy surgery center implementation. Retrospective review of 13 drug-resistant patients who underwent surgical treatment. Results: Thirteen patients underwent surgical epilepsy treatment, five patients categorized as the International League Against Epilepsy class 1, two in class 2, three in class 3, zero in class 4, and two in class 5; with a 30.76% complication rate. Conclusion: Despite the challenges, it was possible to implement an epilepsy surgery center with favorable results and acceptable incidence of complications, which were not higher than the incidences found in more experienced centers

Anterior Cruciate and Anterolateral Ligament Reconstruction Using Hamstring and Peroneus Longus Tendons: Surgical Technique Description

The main objective of this study is to describe a surgical technique that combines intra- and extra-articular techniques using the semitendinosus, gracilis, and peroneus longus to perform reconstruction of the anterior cruciate ligament and anterolateral ligament. This technique offers a more stable, fast, low-cost, and widely accessible procedure and consists of drilling 3 tunnels—1 femoral and 2 tibial tunnels—in which the grafts are fixed with interference screws. The fact that the peroneus longus graft is long and thick allows for robust reconstruction of the aforementioned ligaments

Implementing an epilepsy surgery center. Initial experience at a university hospital in Brazil

<div><p>ABSTRACT Epilepsy is a serious neurological condition, often without a full and effective treatment. In some cases, surgery is beneficial, despite being underused. Our aim herein is to describe the implementation of an epilepsy surgery center in a federal university hospital, sharing the initial experience gained, as well as describing the main challenges and first results. Methods: Experience report of an epilepsy surgery center implementation. Retrospective review of 13 drug-resistant patients who underwent surgical treatment. Results: Thirteen patients underwent surgical epilepsy treatment, five patients categorized as the International League Against Epilepsy class 1, two in class 2, three in class 3, zero in class 4, and two in class 5; with a 30.76% complication rate. Conclusion: Despite the challenges, it was possible to implement an epilepsy surgery center with favorable results and acceptable incidence of complications, which were not higher than the incidences found in more experienced centers.</p></div