Concreto autoadensável: estudos de dosagem e validação de campo

[PT] Concretos autoadensáveis (CAA) apresentam características de alta fluidez em seu estado fresco, fluindo com relativa facilidade mesmo em elementos esbeltos ou com alta densidade de armadura, dispensando a necessidade de adensamento mecânico. No estado endurecido apresenta propriedades superiores ao concreto tradicional, como a resistência à compressão, maior integridade dos elementos e maior durabilidade e vida útil. Este trabalho apresenta estudo de dosagem experimental de misturas de CAA e suas caracterizações nos estados fresco e endurecido, bem como a validação em campo por meio de sua aplicação em paredes esbeltas de concreto. Os CAA foram produzidos com cimento CP V ARI RS, areia fina natural, agregado basáltico britado com diâmetro máximo de 9,5mm e aditivos químicos. Os CAA produzidos experimentalmente, enquadraram-se como autoadensáveis nos testes de espalhamento pelo cone de Abrams, tempo de viscosidade plástica aparente, habilidade passante pela caixa L com utilização de três barras, viscosidade plástica aparente pelo funil V.Formagini, S.; Barreto, L.; Schanoski, P.; Riva, G. (2018). Concreto autoadensável: estudos de dosagem e validação de campo. En HAC 2018. V Congreso Iberoamericano de hormigón autocompactable y hormigones especiales. Editorial Universitat Politècnica de València. 425-424. https://doi.org/10.4995/HAC2018.2018.5277OCS42542

BEM-ESTAR ANIMAL: DOS CONCEITOS À REALIDADE

In this review, we provide a brief retrospective history of the science of animal welfare and recognize the sentience of non-human animals; however, we emphasize that crucial problems remain regarding how to define and measure animal welfare. In general, the use of physiological measures to assess welfare is discouraged. Furthermore, there is a theoretical background for measures of stress, but not for welfare states because life may not be at risk. Instead, a preference or choice-based approach, which is based on the animal decision, is recommended. To this end, welfare is discussed and then contrasted with disease, health, stress and distress. In addition, the importance of prospective capacities for the welfare of human and non-human animals is discussed.Después de una breve retrospectiva histórica de la ciencia del bienestar animal, en este artículo reconocemos la capacidad de sentir en animales no-humanos; pero enfatizamos que un problema crucial aun persiste al definir y medir el bienestar animal. Desalentamos el uso de medidas fisiológicas para evaluar el bienestar. Argumentamos que hay bases teóricas suficientes para tales patrones en el caso del estrés, pero no en el caso del bienestar, porque en este caso la vida puede no estar en riesgo. En contrapartida, defendemos un abordaje basado en la preferencia o escogencia de los animales, la cual está basada en la decisión del animal. Por tal razón, el bienestar es discutido y contrastado con enfermedad, salud, estrés y destres. Además de esto, la importancia de capacidades prospectivas es discutida en relación al bienestar de animales humanos y no-humanos.Após uma breve retrospectiva histórica da ciência do bem-estar animal, neste artigo reconhecemos a senciência em animais não-humanos; mas enfatizamos que problemas crucias permanecem para definirmos e medirmos o bem-estar animal. Desencorajamos o uso de medidas fisiológicas para avaliar bem-estar. Argumentamos que há substrato teórico suficiente para tais padrões no caso do estresse, mas não no caso do bem-estar, porque neste caso a vida pode não estar em risco. Em contrapartida, defendemos uma abordagem baseada na preferência ou escolha dos animais, a qual baseia-se na decisão do animal. Para tanto, o bem-estar é discutido e, então, contrastado com doença, saúde, estresse e distresse. Além disso, a importância de capacidades prospectivas é discutida em relação ao bem-estar de animais humanos e não-humanos

The Interpretation Of The Figure Of The Prophet Jonah By Michelangelo On The Ceiling Of The Sistine Chapel: Anatomical Urological Vision.

A detailed analysis in the iconography and pictorial appearance of the scene of the Prophet Jonah painted by the artist Michelangelo Buonarroti (1475-1564) on the ceiling of the Sistine Chapel between the years 1508 and 1512. Literature review on the Italian Renaissance period and the life of Michelangelo Buonarroti and analysis of historical aspects of the evolution of studies of human anatomy in this period and the works of the artist. A comparative analysis of the representation of the figure of the fish on the left thigh of Jonah with a cross section of penis shows a curious similarity. The pictorial and iconographic analysis reveals an intensity of light on the pubic area and the position of the prophet with the legs spread apart and left hand placed on this region. A tube-shaped cloth covers the region and the angel at the side seems to be looking at this anatomical region of Jonah. In fact, sets of iconographic and pictorial relate to the deciphered code. This description helps to confirm the relationship of the Renaissance art with the human anatomy; science has been much studied in this period. The design of a cross section of the penis is revealed with the two cavernous bodies with the septum between them and the spongy body. Considering the circumstances in which Michelangelo had painted, subjectivity was fundamental due to religious motivations added to the vigorous implications of a limited scientific knowledge typical of that era.38317-22; discussion 32

The interpretation of the figure of the prophet Jonah by Michelangelo on the ceiling of the sistine chapel : anatomical urological vision

A detailed analysis in the iconography and pictorial appearance of the scene of the "Prophet Jonah" painted by the artist Michelangelo Buonarroti (1475-1564) on the ceiling of the Sistine Chapel between the years 1508 and 1512. Literature review on the Italian Renaissance period and the life of Michelangelo Buonarroti and analysis of historical aspects of the evolution of studies of human anatomy in this period and the works of the artist. A comparative analysis of the representation of the figure of the fish on the left thigh of "Jonah" with a cross section of penis shows a curious similarity. The pictorial and iconographic analysis reveals an intensity of light on the pubic area and the position of the prophet with the legs spread apart and left hand placed on this region. A tube-shaped cloth covers the region and the angel at the side seems to be looking at this anatomical region of "Jonah". In fact, sets of iconographic and pictorial relate to the deciphered code. This description helps to confirm the relationship of the Renaissance art with the human anatomy; science has been much studied in this period. The design of a cross section of the penis is revealed with the two cavernous bodies with the septum between them and the spongy body. Considering the circumstances in which Michelangelo had painted, subjectivity was fundamental due to religious motivations added to the vigorous implications of a limited scientific knowledge typical of that era38

Governança em ONGs: Um Ensaio Teórico

O presente trabalho é motivado pela seguinte pergunta: por que se utilizar de práticas e nomenclaturas empregadas nas empresas, como é o caso da governança corporativa, no estudo da gestão social? O fato é que, em se tratando de sistemas regulatórios, nos últimos dois séculos, não houve um desenvolvimento harmônico entre as organizações públicas, privadas e do terceiro setor (SANTOS, 2000, p.56). O artigo tem como objetivo geral abordar os fundamentos teóricos no campo da governança em ONGs, para ampliar o conhecimento sobre as particularidades do terceiro setor quanto à governança. Para tanto: (a) fez-se uma revisão da literatura sobre governança no terceiro setor; (b) apontou-se a contextualização e relevância do tema na atualidade; e (c) demonstrou-se a razão de se aplicar normas e conceitos regulatórios típicos de empresas, como o tema da governança corporativa, às ONGs. Concluiu-se que, apesar das críticas teórico-conceituais que existem em relação às ONGs utilizarem essas normas e conceitos amplamente empregados nas empresas, pelo risco de serem influenciadas com a cosmovisão do mercado, é melhor insistir em práticas de governança corporativa nas ONGs, porque mesmo as causas nobres não podem deixar de contar com instrumentos que garantam a correta aplicação dos recursos

Model of single-sized endotracheal tube for adults

Simular diferentes diâmetros de tubos endotraqueais e verificar os aspectos fluidinâmicos, considerando medições de fluxo e resistência. Foi utilizado um software de fluidinâmica para calcular o fluxo médio e a resistência das vias aéreas nos tubos endotraqueais com diâmetro de 6,0, 7,0, 7,5, 8,0, 9,0 e 10,0mm, em temperatura corporal normal e pressão constante. As mesmas medidas foram realizadas na fusão dos primeiros 22cm de um tubo endotraqueal de 9,0 e 10,0mm de diâmetro, com a parte terminal em 12cm de um tubo endotraqueal de 6,0 e 7,0mm de diâmetro. A fusão dos primeiros 22cm de um tubo endotraqueal de diâmetro 10,0 mm com a parte terminal em 12cm de um tubo endotraqueal de 6,0mm de diâmetro, preservando o comprimento total de 34cm, gerou fluxo médio e resistência de vias aéreas semelhantes aos de um tubo endotraqueal convencional de 7,5mm. Um tubo endotraqueal de tamanho único pode facilitar a intubação endotraqueal, sem causar aumento de resistência na via aérea1814To simulate different diameters of endotracheal tubes and to verify the fluid dynamics aspects by means of flow and resistance measurements. Fluid dynamics software was used to calculate mean flow and airway resistance in endotracheal tube with a diameter of 6.0, 7.0, 7.5, 8.0, 9.0 and 10.0mm at normal body temperature and under constant pressure. The same measurements were taken in the fusion of the first 22cm of a 9.0mm endotracheal tube with 10.0mm diameter, and with the end part in 12cm of a 6.0mm endotracheal tube with 7.0mm diameter. The fusion of the first 22cm of an endotracheal tube of 10.0mm diameter with the terminal part in 12cm of an endotracheal tube of 6.0mm diameter, preserving the total length of 34cm, generated average flow and airway resistance similar to that of a conventional 7.5mm endotracheal tube. This simulation study demonstrates that a single-sized endotracheal tube may facilitate endotracheal intubation without causing increased airway resistance

Management Of Salivary Gland Adenoid Cystic Carcinoma: Institutional Experience Of A Case Series.

Salivary gland tumor management requires long-term follow-up because of tumor indolence and possible late recurrence and distant metastasis. Adenoid cystic carcinoma (ACC) accounts for 10-15% of such tumors. The aim here was to evaluate surgical and clinical management, staging and follow-up of ACC patients in one academic institution. Retrospective study at Head and Neck Service, Universidade Estadual de Campinas. Data on 21 patients treated between 1993 and 2003 were reviewed. Management utilized clinical staging, histology and imaging. Major salivary gland tumor extent was routinely assessed by preoperative ultrasonography. Diagnosis, surgery type, margin type (negative/positive), postoperative radiotherapy and recurrence (presence/absence) were evaluated. There were eleven major salivary gland tumors (52.3%), seven submandibular and four parotid. Ten patients (47.7%) had minor salivary gland ACC (all in palate), while the submandibular was the most frequently affected major one. Diagnoses were mostly via fine-needle aspiration (FNA) and incision biopsy. Frozen sections were used for six patients. There was good ultrasound/FNA correlation. Sixteen (76%) had postoperative radiotherapy. One (4.7%) died from ACC and five now have recurrent disease: three (14.2%) locoregional and two (9.5%) distant metastases. Adenoid cystic carcinoma has locally aggressive behavior. In 21 cases, of ACC, the facial nerve was preserved in all except in the few with gross tumor involvement. Treatment was defined from physical examination, imaging, staging and histology.12426-3

Eficácia do balonete do tubo endotraqueal sobre a traqueia: aspectos físicos e mecânicos

Introduction: The inflation pressure of the endotracheal tube cuff can cause ischemia of the tracheal mucosa at high pressures; thus, it can cause important tracheal morbidity and tracheal microaspiration of the oropharyngeal secretion, or it can even cause pneumonia associated with mechanical ventilation if the pressure of the cuff is insufficient. Objective: In order to investigate the effectiveness of the RUSCH® 7.5 mm endotracheal tube cuff, this study was designed to investigate the physical and mechanical aspects of the cuff in contact with the trachea. Methods: For this end, we developed an in vitro experimental model to assess the flow of dye (methylene blue) by the inflated cuff on the wall of the artificial material. We also designed an in vivo study with 12 Large White pigs under endotracheal intubation. We instilled the same dye in the oral cavity of the animals, and we analyzed the presence or not of leakage in the trachea after the region of the cuff after their deaths (animal sacrifice). All cuffs were inflated at the pressure of 30 cmH2O. Results: We observed the passage of fluids through the cuff in all in vitro and in vivo experimental models. Conclusion: We conclude that, as well as several other cuff models in the literature, the RUSCH® 7.5 mm tube cuffs are also not able to completely seal the trachea and thus prevent aspiration of oropharyngeal secretions. Other prevention measures should be taken.The inflation pressure of the endotracheal tube cuff can cause ischemia of the tracheal mucosa at high pressures, thus, it can cause important tracheal morbidity and tracheal microaspiration of the oropharyngeal secretion, or it can even cause pneumonia a294552558SEM INFORMAÇÃOSEM INFORMAÇÃODobell, A.R., The origins of endotracheal ventilation (1994) Ann Thorac Surg, 58 (2), pp. 578-584Mehta, S., Tracheal tube cuff pressure (1989) Anaesthesia, 44 (12), pp. 1001-1002Mehta, S., Mickiewicz, M., Pressure in large volume, low pressure cuffs: Its significance, measurement and regulation (1985) Intensive Care Med, 11 (5), pp. 267-272Luna, C.M., Legarreta, G., Esteva, H., Laffaire, E., Jolly, E.C., Effect of tracheal dilatation and rupture on mechanical ventilation using a low-pressure cuff tube (1993) Chest, 104 (2), pp. 639-640Bernhard, W.N., Yost, L., Turndorf, H., Danziger, F., Cuffed tracheal tubes--physical and behavioral characteristics (1982) Anesth Analg, 61 (1), pp. 36-41Nordin, U., The trachea and cuff-induced tracheal injury. An experimental study on causative factors and prevention (1977) Acta Otolaryngol Suppl, 345, pp. 1-71Sole, M.L., Su, X., Talbert, S., Penoyer, D.A., Kalita, S., Jimenez, E., Evaluation of an intervention to maintain endotracheal tube cuff pressure within therapeutic range (2011) Am J Crit Care, 20 (2), pp. 109-117Benumof, J.L., Cooper, S.D., Quantitative improvement in laryngoscopic view by optimal external laryngeal manipulation (1996) J Clin Anesth, 8 (2), pp. 136-140Keller, C., Brimacombe, J., Boehler, M., Loeckinger, A., Puehringer, F., The influence of cuff volume and anatomic location on pharyngeal, esophageal, and tracheal mucosal pressures with the esophageal tracheal combitube (2002) Anesthesiology, 96 (5), pp. 1074-1077Cooper, J.D., Grillo, H.C., The evolution of tracheal injury due to ventilatory assistance through cuffed tubes: A pathologic study (1969) Ann Surg, 169 (3), pp. 334-348Seegobin, R.D., Van Hasselt, G.L., Endotracheal cuff pressure and tracheal mucosal blood flow: Endoscopic study of effects of four large volume cuffs (1984) Br Med J (Clin Res Ed), 288 (6422), pp. 965-968Joseph, N.M., Sistla, S., Dutta, T.K., Badhe, A.S., Parija, S.C., Ventilator-associated pneumonia: A review (2010) Eur J Intern Med, 21 (5), pp. 360-368Dave, M.H., Koepfer, N., Madjdpour, C., Frotzler, A., Weiss, M., Tracheal fluid leakage in benchtop trials: Comparison of static versus dynamic ventilation model with and without lubrication (2010) J Anesth, 24 (2), pp. 247-252Lucangelo, U., Zin, W.A., Antonaglia, V., Petrucci, L., Viviani, M., Buscema, G., Effect of positive expiratory pressure and type of tracheal cuff on the incidence of aspiration in mechanically ventilated patients in an intensive care unit (2008) Crit Care Med, 36 (2), pp. 409-413Young, P.J., Burchett, K., Harvey, I., Blunt, M.C., The prevention of pulmonary aspiration with control of tracheal wall pressure using a silicone cuff (2000) Anaesth Intensive Care, 28 (6), pp. 660-665Dave, M.H., Frotzler, A., Spielmann, N., Madjdpour, C., Weiss, M., Effect of tracheal tube cuff shape on fluid leakage across the cuff: An in vitro study (2010) Br J Anaesth, 105 (4), pp. 538-543Pavlin, E.G., Vannimwegan, D., Hornbein, T.F., Failure of a high-compliance low-pressure cuff to prevent aspiration (1975) Anesthesiology, 42 (2), pp. 216-219Macrae, W., Wallace, P., Aspiration around high-volume, low-pressure endotracheal cuff (1981) Br Med J (Clin Res Ed), 283 (6301), p. 1220Windsor, H.M., Shanahan, M.X., Cherian, K., Chang, V.P., Tracheal injury following prolonged intubation (1976) Aust N Z J Surg, 46 (1), pp. 18-25Lewis, F.R., Jr., Schiobohm, R.M., Thomas, A.N., Prevention of complications from prolonged tracheal intubation (1978) Am J Surg, 135 (3), pp. 452-457Servin, S.O., Barreto, G., Martins, L.C., Moreira, M.M., Meirelles, L., Neto, J.A., Atraumatic endotracheal tube for mechanical ventilation (2011) Rev Bras Anestesiol, 61 (3), pp. 311-319Lima, L.C., Avelar, S.F., Westphal, F.L., Lima, I., Lung nodule, tracheal stenoses and coronary disease: How to approach when are all associated to? (2007) Rev Bras Cir Cardiovasc, 22 (3), pp. 359-361Conti, M., Pougeoise, M., Wurtz, A., Porte, H., Fourrier, F., Ramon, P., Management of postintubation tracheobronchial ruptures (2006) Chest, 130 (2), pp. 412-418Marjot, R., Pressure exerted by the laryngeal mask airway cuff upon the pharyngeal mucosa (1993) Br J Anaesth, 70 (1), pp. 25-29. , Erratum in: Br J Anaesth. 1993;70(6):711Peták, F., Janosi, T.Z., Myers, C., Fontao, F., Habre, W., Impact of elevated pulmonary blood flow and capillary pressure on lung responsiveness (2009) J Appl Physiol (1985), 107 (3), pp. 780-786Iglesias, J.L., Lanoue, J.L., Rogers, T.E., Inman, L., Turnage, R.H., Physiologic basis of pulmonary edema during intestinal reperfusion (1998) J Surg Res, 80 (2), pp. 156-163Dullenkopf, A., Gerber, A., Weiss, M., Fluid leakage past tracheal tube cuffs: Evaluation of the new Microcuff endotracheal tube (2003) Intensive Care Med, 29 (10), pp. 1849-1853Lomholt, N., A device for measuring the lateral wall cuff pressure of endotracheal tubes (1992) Acta Anaesthesiol Scand, 36 (8), pp. 775-778Young, P.J., Pakeerathan, S., Blunt, M.C., Subramanya, S., A low-volume, low-pressure tracheal tube cuff reduces pulmonary aspiration (2006) Crit Care Med, 34 (3), pp. 632-639Blunt, M.C., Young, P.J., Patil, A., Haddock, A., Gel lubrication of the tracheal tube cuff reduces pulmonary aspiration (2001) Anesthesiology, 95 (2), pp. 377-381Sanjay, P.S., Miller, S.A., Corry, P.R., Russell, G.N., Pennefather, S.H., The effect of gel lubrication on cuff leakage of double lumen tubes during thoracic surgery (2006) Anaesthesia, 61 (2), pp. 133-137A pressão de insuflação do balonete (cuff) do tubo endotraqueal tanto pode causar isquemia de mucosa traqueal em pressões elevadas, e assim ocasionar morbidade traqueal importante, quanto pode causar microaspiração traqueal de secreção de orofaringe ou,

Pre-hospital chest drainage: presention one-way valve mechanism

BACKGROUND: The purpose of this study is to present an one-way valve mechanism to replace the underwater seal for pleural drainage, currently used in the prehospital attendance, as well as document preliminary results of its initial use at SAMUCampinas/ SP/Brasil. METHODS: Twenty two pleural drains with the valve were carried out, all of these in prehospital environment, in patients who suffered thoracic trauma or spontaneous pneumothorax, in a prospective not randomized trial. RESULTS: The total volume output drained through the valve ranged from 0 to 1500 ml, mean 700 ± 87,4 ml, in an average time lag of 18 minutes (± 1,1 minutes - ranging from 8 to 26 minutes). The initial and final cardiac frequency was 120 ± 2,7 bpm and 100 ± 2 bpm (p 0,00), respectively , whereas the initial respiratory frequency was 24 ± 0,8 ipm and the final was 15 ± 0,3 ipm (p 0,03). Only two mechanical failures were registered, one of which was corrected by the substitution of the defective valve, showing a 95,4% success ratio. CONCLUSION: Taking into account the initial and final physical examination, as well as the output quantification, it can be concluded that the valve is efficient and functional, and safe in the pre-hospital emergencies.O objetivo do presente estudo é apresentar um mecanismo de válvula unidirecional para substituição do selo de água na drenagem pleural tubular fechada, em ambiente pré-hospitalar, bem como registrar os resultados de seu uso inicial no SAMU-Campinas/SP/Brasil. MÉTODO: Foram realizadas 22 (vinte e duas) drenagens pleurais com válvula em doentes vítimas de traumatismo ou pneumotórax espontâneo, todos em ambiente pré-hospitalar, de forma prospectiva, não randomizada. RESULTADOS: O débito total de líquidos através da válvula variou de zero a 1500 ml, com média de 700 ± 87,4 ml, para um tempo de percurso em média de 18 ± 1,1 minutos, variando de 8 a 26 minutos. A frequência cardíaca inicial foi 120 ± 2,7 bpm e final de 100 ± 2 bpm (p 0,00) e a frequência respiratória inicial foi 24 ± 0,8 ipm e o valor final foi de 15 ± 0,3 ipm (p 0,03). Houve apenas duas falhas mecânicas do sistema e uma foi corrigida pela substituição da mesma, trazudindo num índice de sucesso de 95,4% neste trabalho. CONCLUSÃO: Levando em conta exame físico inicial com o exame físico final, bem como pela quantificação de débitos, concluímos que a válvula mostrou-se eficiente e funcionante, e que é segura para o uso em urgências pré-hospitalares.BACKGROUND: The purpose of this study is to present an one-way valve mechanism to replace the underwater seal for pleural drainage, currently used in the prehospital attendance, as well as document preliminary results of its initial use at SAMUCampinas/ SP/Brasil. METHODS: Twenty two pleural drains with the valve were carried out, all of these in prehospital environment, in patients who suffered thoracic trauma or spontaneous pneumothorax, in a prospective not randomized trial. RESULTS: The total volume output drained through the valve ranged from 0 to 1500 ml, mean 700 ± 87,4 ml, in an average time lag of 18 minutes (± 1,1 minutes - ranging from 8 to 26 minutes). The initial and final cardiac frequency was 120 ± 2,7 bpm and 100 ± 2 bpm (p 0,00), respectively , whereas the initial respiratory frequency was 24 ± 0,8 ipm and the final was 15 ± 0,3 ipm (p 0,03). Only two mechanical failures were registered, one of which was corrected by the substitution of the defective valve, showing a 95,4% success ratio. CONCLUSION: Taking into account the initial and final physical examination, as well as the output quantification, it can be concluded that the valve is efficient and functional, and safe in the pre-hospital emergencies332101106The purpose of this study is to present an one-way valve mechanism to replace the underwater seal for pleural drainage, currently used in the prehospital attendance, as well as document preliminary results of its initial use at SAMUCampinas/ SP/Brasil. METHODS: Twenty two pleural drains with the valve were carried out, all of these in prehospital environment, in patients who suffered thoracic trauma or spontaneous pneumothorax, in a prospective not randomized trial. RESULTS: The total volume output drained through the valve ranged from 0 to 1500 ml, mean 700 ± 87,4 ml, in an average time lag of 18 minutes (± 1,1 minutes - ranging from 8 to 26 minutes). The initial and final cardiac frequency was 120 ± 2,7 bpm and 100 ± 2 bpm (p 0,00), respectively , whereas the initial respiratory frequency was 24 ± 0,8 ipm and the final was 15 ± 0,3 ipm (p 0,03). Only two mechanical failures were registered, one of which was corrected by the substitution of the defective valve, showing a 95,4% success ratio. CONCLUSION: Taking into account the initial and final physical examination, as well as the output quantification, it can be concluded that the valve is efficient and functional, and safe in the pre-hospital emergencie