Caracterização de uma população portuguesa com miocardiopatia hipertrófica seguida num hospital terciário artigo científico

Trabalho final do 6º ano médico com vista à atribuição de grau de mestre no âmbito do ciclo de estudos de mestrado integrado em medicina, apres. à Faculdade de Medicina de CoimbraIntrodução – A miocardiopatia hipertrófica é a doença cardíaca genética mais comum, definida pela presença de hipertrofia miocárdica inexplicada. Possui um espectro clínico muito amplo, podendo os doentes permanecer assintomáticos durante toda a vida ou, pelo contrário, apresentar sintomas severos como síncope, insuficiência cardíaca congestiva e fibrilhação auricular. A morte súbita cardíaca é a complicação mais séria e o diagnóstico pode ser estabelecido pela observação ecocardiográfica de hipertrofia 15 mm em qualquer segmento miocárdico, mais frequentemente no septo interventricular. Objectivos – Caracterização clínica e ecocardiográfica de uma população portuguesa com diagnóstico de miocardiopatia hipertrófica, seguida num hospital terciário. Metodologia – Foram analisados os parâmetros dos ecocardiogramas transtorácicos (modo M, 2D, Doppler) de 74 doentes com miocardiopatia hipertrófica realizados entre 1999 e 2008 no serviço de Cardiologia dos Hospitais da Universidade de Coimbra. Em 2009 foi realizado um follow-up a 34 (45,9%) desses doentes, tendo sido avaliada a existência de sintomas associados à miocardiopatia hipertrófica, hospitalização devido a problemas cardiovasculares decorrentes da doença, medicação cardiovascular habitual e história familiar sugestiva. Resultados – Os exames analisados demonstraram prevalência de um grau importante de hipertrofia do septo interventricular (espessura média 17,5±4,7 mm) e de dilatação da aurícula esquerda (diâmetro médio 47,4±8,9 mm). Verificou-se também, numa proporção considerável, alterações da válvula mitral: insuficiência (73%) e movimento sistólico anterior (43,2%) que provocava obstrução dinâmica do fluxo de saída do ventrículo esquerdo em 41,9%, suficiente para produzir um gradiente significativo, cujo valor médio apurado foi 55,6±31,9 mmHg. A análise da distribuição segmentar da hipertrofia miocárdica permitiu verificar que o segmento mais frequentemente atingido era o septo interventricular (95,9%) e que em cerca 3 de 40% dos doentes apenas um segmento miocárdico se encontra hipertrofiado, sendo a proporção idêntica à obtida para 3 ou mais segmentos afectados. O follow-up permitiu observar que em 94,1% os doentes apresentavam sintomatologia relacionada com a miocardiopatia hipertrófica, nomeadamente dispneia de esforço (79,4%), palpitações (73,5%), tonturas (52,9%) e precordialgia (38,2%). Em 32,4% dos casos foram reportados antecedentes familiares sugestivos e foi referida história de hospitalização devida a causa cardiovascular em 18 casos (52,9%). Grande parte dos doentes (91,2%) efectuava medicação cardiovascular, estando a maioria medicada com bloqueadores beta-adrenérgicos e/ou bloqueadores dos canais de cálcio. Conclusões – Este estudo revelou que a população analisada apresenta, de forma genérica, características similares às de populações integradas em estudos internacionais, assim como o follow-up demonstrou resultados que encontram suporte em trabalhos publicados.Background – Hypertrophic cardiomyopathy is the most common genetic cardiac disease, defined by the presence of unexplained myocardiac hypertrophy. There is a wide clinical spectrum, ranging from patients who are asymptomatic throughout their lives to severe symptoms such as syncope, congestive heart failure and atrial fibrillation. Sudden cardiac death is the most serious complication and the diagnosis may be established by echocardiographic observation of hypertrophy 15 mm in any myocardial segment, mostly the interventricular septum. Objective – Clinical and echocardiographic characterization of a Portuguese population diagnosed with hypertrophic cardiomyopathy, attended in a tertiary center. Methods – We analyzed the echocardiographic exams (M-mode, 2D, Doppler) of 74 patients with hypertrophic cardiomyopathy performed between 1999 and 2008 at the Department of Cardiology of the Coimbra University Hospital. In 2009, 34 (45.9%) patients were followedup and it was assessed the existence of hypertrophic cardiomyopathy associated symptoms, cardiovascular-related hospitalization, usual cardiovascular medication and suggestive familiar history. Results – The analyzed exams demonstrated an important degree of interventricular septum hypertrophy (average thickness 17.5±4.7 mm) and left atrial enlargement (average diameter 47.4±8.9 mm). Mitral valve abnormalities were observed in a considerable proportion of patients: insufficiency (73%) and systolic anterior motion (43.2%) which leaded to dynamic left ventricular outflow obstruction (41.9%), sufficient to produce a significant gradient (average registered value 55.6±31.9 mmHg). The myocardial hypertrophy segmental distribution analysis showed that the most frequently affected segment was the interventricular septum (95.9%), about 40% of the patients had only one hypertrophied segment and an identical percentage had 3 or more affected segments. The clinical follow-up revealed that 94.1% of the patients presented hypertrophic cardiomyopahty associated symptomatology, namely exertion dyspnea (79.4%), palpitations (73.5%), dizziness (52.9%) and chest pain (38.2%). In 32.4% of the cases suggestive family history was reported and 18 (52.9%) cases registered prior cardiovascular-related hospitalization. A very significant percentage of patients (91.2%) were under cardiovascular medication, mostly with beta-adrenergic blockers and/or calcium channel blockers. Conclusions – This study revealed that the analyzed population has, generically, similar characteristics of those studied in international investigations, as well as the follow-up data are supported by many published papers

The Influence of Planting Periods on Herbivore and Natural Enemy Abundance on Yellow Sticky Traps in Bt Maize Fields

This research was funded by the Spanish Ministry of Economy, Industry and Competitiveness project AGL2014-53970-C2-1-R. and AGL2017-84127-R. Gemma Clemente-Orta was funded by the grant BES-2015-072378 from the Ministry of Science, Innovation, and Universities.Knowledge of the insect densities during crop development is necessary for adopting appropriate measures for the control of insect pests and minimizing yield losses. Within integrated pest management programs, crop rotation has been carried out in recent years, but this current trend delays the planting period for Bt maize. The small amount of available information regarding the influence of sowing Bt maize early or late on the seasonal abundance of herbivores prompted us to study these aspects in two current common planting periods in northeastern Spain in 52 maize fields over three consecutive years. We sampled the fields planted on different dates with sticky yellow traps. Our results show that only the abundances of herbivore thrips, other than Frankliniella occidentalis, and Syrphidae were significantly different between the two planting periods. Moreover, when we performed yearly analyses, we found significant effects of the planting period on Coccinellidae and Chrysopidae in 2015 and on Aeolothrips sp. in 2016 and 2017. In most of the taxa, the abundance peaks in earlier growth stages, which is related to pollination (before or during). Only the abundances of Stethorus punctillum and Syrphidae peak later in the season. In addition, F. occidentalis, aphids, Syrphidae, and Coccinellidae registered higher abundance in fields sown in the late planting period. These results highlight the effects of sowing in different planting periods on insect dynamics in Bt maize and can be used to identify the abundance of certain pests and natural enemies in specific phenological stages of maize, which may allow producers to adopt better-integrated management and thus avoid reaching the level of economic damage.Spanish Government AGL2014-53970-C2-1-R AGL2017-84127-RMinistry of Science, Innovation, and Universities BES-2015-07237

Análise económica e financeira de um projeto de turismo e prestação de serviços geológicos em Viseu : estudo de caso

Mestrado Bolonha em Contabilidade, Fiscalidade e Finanças EmpresariaisNos dias de hoje, um dos temas mais atuais e relevantes para as empresas prende-se com o desenvolvimento sustentável, sendo, nesse âmbito, um dos principais fatores a ter em conta quando estas definem os seus objetivos estratégicos. No passado, foram analisados variadíssimos projetos, desenvolvidos por grandes, médias ou pequenas empresas que já se encontram estabelecidas no mercado e veem-se afirmando ao longo dos anos. No entanto, neste caso concreto, irá ser analisado um projeto desenvolvido por um tipo de empresas peculiar, mas cada vez mais comum no mercado, as startups. Assim, este estudo pretende explorar a vertente económica e financeira relativa a um projeto de turismo geológico e de prestação de serviços desenvolvido por uma empresa de Viseu, de forma a analisar a sua sustentabilidade, fazer um plano de negócios para potenciar o projeto de forma a que tenha um crescimento sustentado nos próximos anos, bem como estudar o impacto causado na sociedade. Antes da elaboração do plano de negócios, foram realizadas diversas entrevistas com um dos fundadores da startup, que por motivos de confidencialidade e concorrência me pediu para não divulgar o nome da empresa, de forma a poder conhecer o projeto e a realidade do meio em que está inserida. Os resultados obtidos após a elaboração das principais demonstrações financeiras, ainda que sejam previsionais, revelaram que este projeto tem bastante potencial. Para além disso, o VAL foi positivo, a TIR foi relativamente superior à taxa de atualização dos cash-flows e o PRI está dentro dos próximos cinco anos, período para o qual foi feita a análise, quer se verifique um cenário realista, pessimista ou otimista, ou seja, este projeto tem tudo para dar certo se for explorado de forma inteligente.Nowadays, one of the most current and relevant topics for companies is sustainable development, which is, in this context, one of the main factors to be considered when they define their strategic objectives. In the past, a wide range of projects were analyzed, developed by large, medium or small companies that are already established in the market and have been asserting themselves over the years. However, in this specific case, will be analyzed a project developed by a peculiar type of company, which is increasingly common in the market, the companies called start-ups. Thus, this study intends to explore the economic and financial aspect of a geological tourism and services provisional project developed by a company from Viseu, in order to analyze its sustainability, make a business plan for enhance the project so that it has a sustained growth in the coming years, as well as study their impact on society Before preparing the business plan, several interviews were made out with the main members and founders of the start-up, who, for reasons of confidentiality and competition, asked me to not disclose the name of the company, in order to know the project and the reality of the environment in which it is inserted. The results obtained after analyzing the main financial statements, even if they are provisional, revealed that this project has a lot of potential. In addition, the NPV was positive, the IRR was much higher than the cash flow update rate and the investment payback period is within the next five years, the period for which the analysis was carried out, whether there is a realistic, pessimistic or optimistic scenario, so, that means this project has everything to succeed, if exploited intelligently.info:eu-repo/semantics/publishedVersio

Análisis del grado de rigidez de la unión pilar-zapata tipo cáliz en estructuras de hormigón armado para edificios agro-industriales por el método de los elementos finitos

Dentro de la edificación agroindustrial, las estructuras prefabricadas de hormigón son de uso extendido por su rapidez de ejecución y su resistencia a ambientes adversos, como los que se producen en instalaciones ganaderas. Dentro de estas estructuras, la unión más comúnmente utilizada entre el pilar prefabricado y la zapata es el sistema de cáliz, en el que el pilar se introduce en un hueco practicado en la zapata para constituir la unión entre ambos. Las características de esta unión determinan su rigidez, y por tanto su comportamiento como empotramiento o como articulación, en función del contacto que se establezca entre ambos y de la profundidad de introducción del pilar en el cáliz. En este trabajo se realiza un estudio del comportamiento de dicha unión mediante su modelización por el método de los elementos finitos. Para ello, se propone un modelo de pilar y zapata en elementos finitos, sometido a cargas y condiciones de contorno de las mismas características que aquellas a las que estaría sometido un modelo real, y se evalúa su validez frente a los métodos clásicos elástico-lineales utilizados en el cálculo de este tipo de estructuras. Una vez validado el modelo, se analiza el comportamiento de la unión con respecto a los desplazamientos en el pilar, y se obtienen una serie de conclusiones en cuanto a la influencia que la profundidad de empotramiento, el tipo de contacto establecido y las cargas aplicadas tienen sobre la rigidez de dicha unión, y sobre su comportamiento empotrado o articulado

Community Structure and Composition of Social Wasps (Hymenoptera: Vespidae) in Different Vegetation Types in São Paulo, Brazil

Social wasps participate in food webs, act as biological control agents in small crops and the natural environment, and act as potential pollinators. The objective of this study was to carry out an inventory of social wasps in five phytophysiognomies with different degrees of anthropogenic disturbance in São Paulo, Brazil. The collections were performed by active search and attractive traps to survey social wasps. We collected wasp for one year with collection campaigns every other month totaling six campaigns for site. We collected a total of 913 individuals representing 31 species and eight genera. The species with the highest abundances were Agelaia pallipes and Agelaia vicina. The highest richness of social wasps was found in the riparian forest and regenerating Cerrado. We conclude that social wasp richness and diversity varies according to habitat vegetation characteristics and that these effects are likely mediated by resulting differences in the provision of resources and nesting locations among the different environments. The areas in this study have suffered considerable vegetation loss due to common farming practices, however, the existing fragments are still capable of hosting a rich social wasp fauna

Effects of including endurance and speed sessions withinsmall-sided soccer games periodization on physical fitness

The main aim of this study was to analyse the effects of including additional speed and endurance sessions during small-sided games (SSG) training periodization on physical fitness in professional soccer players. Sixteen outfield players (age = 25.6 +/- 7.6 years) who competed in the First Division of a European League participated in this study. Players were randomly assigned to perform only the SSG periodization (G-SSG group) or to add endurance and speed training contents to the SSG (ES-SSG group). Before and after the 6-week experimental period, a Yo-Yo Intermittent Recovery Test level 1 (YYIR1) and a 40 m sprinting test were performed. Rating of perceived exertion (RPE) was also measured after each training session. The G-SSG group showed a large improvement in the YYIR1 performance (p = 0.018-0.028; ES = 0.521-0.576) after the training programme, whereas no significant changes were observed for the ES-SSG group (p = 0.763-1.000; ES = 0.000-0.014). In addition, no significant differences (p > 0.05, ES = 0.005-361, trivial to small) in sprint performance at 5 and 10 m intervals up to 40 m were observed at post-training in comparison to pre-training evaluation in G-SSG and ES-SSG groups. No significant differences (p > 0.05) between groups were observed at baseline in the YYIR1 test. The 6-week SSG training supported with only six endurance and speed training sessions was no more effective than well-organized SSG alone for improving running endurance in professional soccer players.The project leading to these results has received funding from "La Caixa" Foundation (ID 100010434) and La Caja de Burgos, under agreement LCF/PR/PR18/51130008. The authors gratefully acknowledge the support of a Spanish government subproject Mixed method approach on performance analysis (in training and competition) in elite and academy sport [PGC2018-098742-B-C33] (2019-2021) [del Ministerio de Ciencia, Innovacion y Universidades (MCIU), la Agencia Estatal de Investigacion (AEI) y el Fondo Europeo de Desarrollo Regional (FEDER)], that is part of the coordinated project New approach of research in physical activity and sport from mixed methods perspective (NARPAS_MM) [SPGC201800X098742CV0]

Comunicación móvil: actores y producción de contenidos en Cataluña

El presente artículo presenta los resultados de una investigación realizada durante el año 2008 donde se describen los actores y contenidos de la comunicación móvil producidos en Cataluña. La comunicación móvil, además de ser uno de los sectores más dinámicos de la economía global, está transformando diferentes aspectos de la vida social, desde las formas de relacionarse hasta los procesos de producción, distribución y analiconsumo cultural. La investigación traza un primer mapa de la situación, propone una serie de categorías de análisis y sienta las bases para futuros estudios más específicos sobre la comunicación móvil en Cataluña.This article presents the findings of a research carried out in 2008 to identify the actors and contents of mobile communication produced in Catalonia. Mobile communication, one of the most dynamic sectors of the global economy, is changing different aspects of social life, from relationship models to cultural production, distribution and consumer processes. The research draws a situation map, proposes a series of analytical categories and opens the field for more specific analysis of mobile communication in Catalonia in the future

a systematic review and meta-analysis

Purpose: To determine the effects of maturation stage (eg, classified in the same intervention protocol as early-, and late-mature) on linear sprinting speed adaptations to plyometric jump training (PJT) in youth (aged <18 years) male team sports players. Patients and Methods: Eligibility criteria was determined based on PICOS: (P) healthy youth male team sport players classified in the same intervention protocol in ≥2 maturation-related categories, based on a recognized maturation stage-determination method, including (but not limited to) Tanner stage; peak height velocity (eg, Mirwald method); radiography-based method (eg, Fels method); (I) athletes exposed to PJT with a minimum of 4 weeks duration; (C) athletes non-exposed to PJT (non-dedicated intervention, ie, only field-based regular training) or performing a parallel intervention not-related with PJT organized by maturation levels; (O) sprinting speed (eg, time, maximal sprint speed) measured in any linear sprint test trajectories before and after the intervention; (S) only randomized controlled and/or parallel trials. Searches were conducted on December 2021 in EMBASE, PubMed, Scopus, SPORTDiscus and Web of Science, restricted to Portuguese, Spanish and English languages, with no restrictions regarding publication date, and no filters applied. The PEDro scale was used to assess the risk of bias in the included studies. Meta-analysis was computed using the inverse variance random-effects model. The significance level was set at p < 0.05. Results: The search identified 1219 titles. From those, four studies were selected for qualitative and quantitative synthesis. Four studies provided data for sprinting performance, involving 10 experimental and 8 control groups showing a small effect of trained participants on sprinting performance (ES = 0.31; p = 0.064; I2 = 41.3%) when compared to controls. No significant moderator effect was noted for somatic maturity (p = 0.473 between groups). Conclusion: PJT had no significant effect on sprinting performance, although the inclusion criteria partially may explain that.9E1A-F9DD-3EB8 | Filipe Manuel ClementeN/

Effects of a 10-Week Combined Coordination and Agility Training Program on Young Male Soccer Players

The current literature has shown how working on coordination and agility produces effects on specific aspects in team sports. The purpose of this study was to examine the effects of a ten-week coordination training program applied to soccer on different tests that evaluate speed (30 m speed test), agility (Illinois Agility Test (IAT)) and lower body strength (countermovement jump (CMJ)). Forty U16 male soccer players from two nonprofessional teams (twenty in the control group (CG) (aged = 14.70 ± 0.47, body weight = 60.15 ± 8.07 kg, height = 1.71 ± 0.06 m) and twenty in the experimental group (EG) (aged = 14.50 ± 0.51, body weight = 58.08 ± 9.78 kg, height = 1.69 ± 0.06 m)) performed a combined coordination and agility program during 10 min every training day (3 days a week) for 10 weeks. The results of this study showed that coordination training produced adaptations in the power (CMJ of EG (p = 0.001)) and agility capacities (IAT of EG (p = 0.002)) of young soccer players, but not on speed performance at longer distances (CG, p = 0.20 and EG, p = 0.09). Despite the benefits of the training program, a combination of training methods that includes power, agility, speed, and strength can enhance such improvements.Football Connection (FOOC) (Marca No. 4.073.379)

Enfoques actuales para la enseñanza del patrimonio y la cultura local a estudiantes de turismo

This work presented responds to new trends in Higher Education aimed at the search for active learning by students. In this sense, a Didactic Alternative is proposed for the teaching of culture and local heritage from the subject Cuban Cultural Heritage currently applied to students of the Regular Day Course of the Faculty of Tourism of the University of Havana, which is part of Management of knowledge and innovation. It consists of four basic methodological steps and is based on the most current pedagogical theories. Some results as part of this research are also exposed.El trabajo que se presenta responde a las nuevas tendencias en la Educación Superior encaminadas a la búsqueda de un aprendizaje desarrollador por parte de los estudiantes. En este sentido se propone una Alternativa Didáctica para la enseñanza de la cultura y el patrimonio local desde la asignatura Patrimonio Cultural de Cuba aplicada actualmente a estudiantes del Curso Regular Diurno de la Facultad de Turismo de la Universidad de La Habana lo que es parte de la Gestión del conocimiento y la innovación. La misma consta de cuatro pasos metodológicos básicos y se sustenta en las más actuales teorías pedagógicas. Se exponen además algunos resultados alcanzados como parte de esta investigación