Marcos Acayaba's Architecture and Technical domain

Atualmente muitos arquitetos têm demonstrado certa deficiência no desenvolvimento e detalhamento de soluções construtivas. O artigo mostra a relação do arquiteto com a questão da técnica, desde o início do processo projetual até a obra construída, a partir da experiência de Marcos Acayaba, que se destaca por desenvolver soluções conceituais e espaciais intimamente atreladas a um rigoroso tratamento técnico, transitando por diversos materiais e sistemas construtivos. São apontados fatores determinantes que, embasados pelos estudos dos projetos e seus recursos construtivos, demonstram que o domínio técnico pode ser um importante instrumento para o pensar e o fazer arquitetônico.Actualmente, muchos arquitectos han demostrado cierta deficiencia en el desarrollo y detalle de soluciones constructivas. El artículo muestra la relación del arquitecto con la técnica, desde el comienzo del proceso de diseño hasta la obra completa, con la experiencia de Marcos Acayaba, que se destaca por desarrollar soluciones espaciales y conceptuales estrechamente vinculadas a un riguroso tratamiento técnico, haciendo uso de diversos materiales y sistemas constructivos. Son destacados factores determinantes que, con los estudios de los proyectos sus recursos constructivos, se demuestra que el conocimiento técnico puede ser una herramienta importante para el pensar y el hacer arquitectura.Currently many architects have showed some deficiency at the development and at the construction solution's detailing on the performance of several contemporary architects. This article shows the architect's relationship with the technique itself, since the beginning of the design process until the constructed building, starting from the architect Marcos Acayaba's experience, who outstand for developing conceptual and space solutions strongly connected to a rigorous technical treatment, transiting among several materials and building systems. Determinant issues are pointed and, based on the projects studies, show that the technical domain might be an important instrument to thinking and caring through of the architect

Avaliação da qualidade do sono em pacientes com rinossinusite crônica submetidos à cirurgia endoscópica nasossinusal : uma meta-análise

Introdução: A rinossinusite crônica pode levar a uma má qualidade do sono nos indivíduos afetados. A cirurgia endoscópica nasal tem sido indicada para pacientes com rinossinusite crônica, resulta em melhoria da qualidade de vida, mas ainda não se sabe se há melhoria semelhante na qualidade do sono após o procedimento cirúrgico. Objetivo: Estimar a qualidade do sono em pacientes com rinossinusite crônica após serem submetidos à cirurgia endoscópica nasossinusal. Método: A busca na literatura foi feita nas bases de dados indexadas PubMed, Embase, Lilacs, SciELO, Google Scholar, Web of Science, Scopus, Banco de Teses e Dissertações da Capes, Cochrane Library, Clinical Trials e na literatura cinzenta. Foram incluídos estudos que relataram a qualidade do sono de pacientes com rinossinusite crônica após ser submetidos à cirurgia endoscópica nasossinusal, com base em questionários que avaliaram a qualidade de vida. Dois pesquisadores conduziram independentemente a seleção e extração dos estudos. O modelo de efeitos aleatórios foi escolhido para conduzir a meta-análise que foi feita com o pacote estatístico STATA, versão 11. Resultados: No total, 4 estudos e 509 indivíduos foram incluídos na revisão sistemática. Melhora na qualidade do sono foi observada em 90% dos pacientes. Houve melhora (em média, de 57% a 67%) em cada um dos cinco sintomas relacionados à qualidade do sono. Os resultados da meta-análise apresentaram alta heterogeneidade. Conclusões: Esta revisão mostra que uma grande porcentagem de indivíduos relata melhoria na qualidade do sono após a cirurgia endoscópica nasossinusal.Introduction: Chronic rhinosinusitis can lead to poor sleep quality in affected individuals. Endoscopic nasal surgery has been indicated for patients with chronic rhinosinusitis, resulting in improved quality of life, but it is still unknown if there is a similar improvement in sleep quality after the surgical procedure. Objective: To estimate the sleep quality of patients with chronic rhinosinusitis after undergoing endoscopic sinus surgery. Methods: The literature search was conducted in the indexed databases PubMed, Embase, Lilacs, SciELO, Google Scholar, Web of Science, Scopus, Database of Thesis and Dissertations of CAPES, Cochrane Library, Clinical Trials and in the grey literature. It included studies that reported the sleep quality of patients with chronic rhinosinusitis after undergoing endoscopic sinus surgery based on questionnaires assessing quality of life. Two researchers independently conducted the study selection and extraction. The random effects model was chosen to conduct the meta-analysis that was performed using the statistical package STATA, version 11. Results: Overall, 4 studies and 509 subjects were included in the systematic review. Improved sleep quality was observed in 90% of the patients. There was an improvement (on average, from 57% to 67%) in each of the five symptoms related to sleep quality. The results of the meta-analysis revealed high heterogeneity. Conclusions: This review shows that a large percentage of patients report improved sleep quality after endoscopic sinus surgery

Schwannoma maligno dos seios paranasais

Faculdade de Medicina (FMD

The sphenopalatine artery: a surgical challenge in epistaxis

O conhecimento anatomocirúrgico da artéria esfenopalatina (AEP) e de seus ramos é de fundamental importância para o sucesso no tratamento endoscópico da epistaxe posterior. Contudo, essa complexa variação anatômica da irrigação da cavidade nasal ainda é um desafio cirúrgico. OBJETIVO: Descrever a anatomia endoscópica da AEP em cadáveres humanos. CASUÍSTICA E MÉTODOS: Estudo de coorte histórica com corte transversal de abril de 2010 a agosto de 2011. Foi descrita a presença da crista etmoidal da lâmina perpendicular do osso palatino, a localização do forame esfenopalatino principal (FEP) e acessório (FEA) e quantificados os ramos que emergem dos forames. RESULTADOS: Foram analisadas 56 fossas nasais. A crista etmoidal estava presente em 96% dos casos e na maioria das vezes anterior ao FEP. O FEP se localizava na transição do meato médio para o meato superior em todos os casos. O FEA estava presente em 12 casos. Foi mais prevalente a presença de um único tronco arterial bilateral na emergência do FEP (43%). Em outros casos, observaram-se três (n = 8) e dois (n = 5) troncos arteriais, emergindo do FEP bilateralmente. Observou-se que na maioria dos casos um único tronco se emergia do FEA. CONCLUSÕES: A anatomia da artéria esfenopalatina é bastante variável. O conhecimento das possíveis variações anatômicas implica no sucesso do tratamento da epistaxe grave.Knowledge on the anatomy of the sphenopalatine artery (SPA) and its branches is fundamental for the success of the endoscopic treatment of posterior epistaxis. However, the complex anatomical variations seen in the irrigation of the nasal cavity poses a significant surgical challenge. OBJECTIVE: This paper aims to describe the endoscopic anatomy of the SPA in human cadavers. MATERIALS AND METHODS: This is a contemporary cross-sectional cohort study carried out between April 2010 and August 2011. The presence of the ethmoidal crest on the lamina perpendicular to the palatine bone and the location of the principal sphenopalatine foramen (PSF) and the accessory sphenopalatine foramen (ASF) were analyzed in 28 cadavers, and the branches emerging from the foramens were counted. RESULTS: Fifty-six nasal fossae were analyzed. The ethmoidal crest was present in 96% of the cases and was located anteriorly to the PSF in most cases. The PSF was located in the transition area between the middle and the superior meatus in all cases. The ASF was seen in 12 cases. Most nasal fossae (n = 12) presented a single bilateral arterial trunk emerging from the PSF. In other cases, three (n = 8) or two (n = 5) arterial trunks emerged bilaterally from the PSF. In most cases, the SPA emerged as a single trunk from the ASP. CONCLUSIONS: The anatomy of the SPA is highly variable. The success of the treatment for severe epistaxis relies heavily on adequate knowledge of the possible anatomical variations of the sphenopalatine artery

Nasal involvement in obstructive sleep apnea syndrome

Numerous studies have reported an association between nasal obstruction and obstructive sleep apnea syndrome (OSAS), but the precise nature of this relationship remains to be clarified. This paper aimed to summarize data and theories on the role of the nose in the pathophysiology of sleep apnea as well as to discuss the benefits of surgical and medical nasal treatments. A number of pathophysiological mechanisms can potentially explain the role of nasal pathology in OSAS. These include the Starling resistor model, the unstable oral airway, the nasal ventilatory reflex, and the role of nitric oxide (NO). Pharmacological treatment presents some beneficial effects on the frequency of respiratory events and sleep architecture. Nonetheless, objective data assessing snoring and daytime sleepiness are still necessary. Nasal surgery can improve the quality of life and snoring in a select group of patients with mild OSAS and septal deviation but is not an effective treatment for OSA as such. Despite the conflicting results in the literature, it is important that patients who are not perfectly adapted to CPAP are evaluated in detail, in order to identify whether there are obstructive factors that could be surgically corrected

Rhinoscleroma

INTRODUÇÃO: Rinoscleroma é uma doença infecciosa crônica do tipo granulomatosa causada pela bactéria Klebsiella rhinoscleromatis. Acomete a mucosa do trato respiratório, mais frequentemente o nariz. É considerada endêmica em determinadas regiões com África e América Central, porém é rara no Brasil. O acometimento nasal ocorre em 3 fases: catarral, granulomatosa e cicatricial. Em todo o seu curso a doença apresenta sintomatologia inespecífica, daí a dificuldade em ser diagnosticada. Seu diagnóstico é estabelecido através de cultura ou pelo encontro de células de Mikulicz ou corpúsculo de Russel no estudo anatomopatológico. O tratamento consiste em antibioticoterapia por longo período, associada ou não a cirurgia. OBJETIVO: Este relato tem por objetivo ilustrar um caso de rinoscleroma em uma paciente jovem com queixa de obstrução nasal bilateral de longa data e cefaleia. O intuito é alertar os otorrinolaringologistas para o diagnóstico desta doença rara, que se apresenta com sintomas inespecíficos e semelhantes a inúmeras patologias que acometem a região nasal.INTRODUCTION: Rhinoscleroma is a chronic granulomatous infectious disease, caused by the bacterium Klebsiella rhinoscleromatis. Affects the respiratory tract mucosa, more frequent in the nose. Is considered endemic in certain regions like Africa and Central America, but is rare in Brazil. The nasal involvement occurs in 3 phases: catarrhal, granulomatous and sclerotic stage. In all its course the disease presents nonspecific symptoms, and because of that, the difficulty of being diagnosed. Its diagnosis is established by culture or by the meeting of Mikulicz cell or Russel corpuscles in the anatomopathological study. The treatment consists in a long-term antibiotic, associated or not to a surgery. OBJECTIVE: This report aims ilustrate a case of rhinoscleroma in a female young patient complaining of bilateral nasal obstruction, long standing and headache. The intent is alert the otorhinolaringologists in diagnosing this rare disease, which presents itself with nonspecific symptoms as like numerous pathologies that affect the nasal region

Is dry climate related to hospital admission for epistaxis?

Introduction: Epistaxis constitutes the main otorhinolaryngological emergency and presents a potential risk to life in cases of severe bleeding. There seems to be a seasonal correlation of the climate to epistaxis and the opinions are divided about which meteorological factor is the main responsible for nasal bleeding. Objective: To describe the prevalence, distribution, characteristics and hospital admission for epistaxis and correlate them to the climate variation. To test the hypothesis that the dry climate is associated to the increase of severity and number of hospital admission for epistaxis. Method: Retrospective study of the cases of epistaxis treated and admitted in a Tertiary Hospital of the Federal District, in the period of five years (2003 to 2007). Correlation of climate variation data obtained at the National Institute of Meteorology (INMET). Results: 194 patients with severe epistaxis were admitted. The average number of monthly internments was of 3.2. The month of July presented the highest average with 4.8, while the month of January, the lowest, with one case per month. The months with a lower and higher level of moisture were August and December, with 43.8% and 77.1%, respectively. The maximum average temperature was of 26.9ºC and the minimum was of 17ºC. There was no statistically significant correlation between moisture and temperature and the number of severe epistaxis admissions (r=0.15, p=0.20). Conclusion: The month of July presented the highest number of hospital admissions for severe epistaxis and the month of August presents the lowest moisture. The dry climate didn't present a correlation with the increase of the severity and the number of hospital admissions for epistaxis

The quality of life among Otorhinolaryngology residents in Distrito Federal (Brazil) A qualidade de vida entre os residentes de Otorrinolaringologia do Distrito Federal

Otorhinolaryngology residents' quality of life must be investigated during medical residency. Work-related factors impacting their lives, such as depression, sleep deprivation and excessive work load may impact the well-being of these individuals. OBJECTIVE: To assess and discuss the quality of life of Otorhinolaryngology Resident Physicians in Distrito Federal (Reuni-ORL). MATERIALS AND METHODS: Cross-sectional study, the quality of life of each individual was assessed by means of a questionnaire specifically designed for this purpose - Whoqol-bref, proposed by the WHO. RESULTS: Males had better psychological scores when compared to females (p= 0. 013). Mean scores comparison among the years in residency were statistically significant only in the psychological domain when comparing the first and second years (p=0. 046), in which 2nd-year residents had the higher scores. CONCLUSIONS: Despite constant changes to the ENT program (Reuni-ORL) in the Distrito Federal, aiming at improving work and training conditions for residents, there still is a psychological burden in their first year of residencyA qualidade de vida dos residentes de otorrinolaringologia precisa ser estudada ao longo da residência médica. Fatores decorrentes deste trabalho, como depressão, privação do sono e excessiva carga horária, podem interferir no bem-estar destes indivíduos. OBJETIVO: Avaliar e discutir a qualidade de vida dos médicos residentes de Otorrinolaringologia do Distrito Federal (Reuni-ORL). MATERIAIS E MÉTODOS: Sob a forma de estudo transversal, a avaliação da qualidade de vida de cada participante foi realizada por meio de um questionário específico para este fim, o Whoqol-bref, proposto pela OMS. RESULTADOS: O sexo masculino apresentou pontuação melhor no domínio psicológico com relação ao sexo feminino (p= 0,013). A comparação das médias de pontuação entre os anos de residência foram estatisticamente significativas apenas no domínio psicológico em relação ao primeiro e segundo ano (p=0,046), na qual os R2 apresentaram a pontuação maior. CONCLUSÃO: Apesar de constantes adaptações do programa da Reuni-ORL no Distrito Federal, visando melhorias das condições de trabalho e de estudo de seus residentes, ainda há o desgaste psicológico do primeiro ano de residênci

STRUCTURAL PERFORMANCE OF MODULAR WOOD PANEL OF PLANTED FOREST AND PARTICLEBOARDS BASED ON SUGARCANE BAGASSE

The production and study of alternative material produced with lignocellulosic waste  to application in livestock production installation is not common in Brazil, however, is a great sustainable alternative as substitutes of conventional materials, therefore, the present study aimed to evaluate the structural performance of modular panel of homogeneous sugarcane bagasse particleboards and reforestation wood, by numerical and experimental analysis, with application prospect as lateral closure in cattle handling facilities. The evaluation of the modular panel performance was conducted by a numerical simulation by way of finite elements, in laboratory by soft body impact test, in situ, applied to a crowding pen of corral for cattle management. The results indicated good correlation among experimental and theoretical values and the modular panels met satisfactorily the proposed use as a lateral closure for cattle handling facilities