CO19 168. Impacto de la hipertensión pulmonar en la evolución de los ancianos sometidos a sustitución valvular aórtica

ObjetivoEstudiar la influencia de la hipertensión pulmonar (HTP) en la evolución de los ancianos sometidos a sustitución valvular aórtica (SVA).Material y métodosDesde octubre de 1999 hasta noviembre de 2009, 517 ancianos (rango 70-87 años) fueron sometidos a SVA. Trescientos cincuenta y cinco (68,7%) enfermos (grupo I) tenían hipertensión pulmonar (ligera 157; moderada 149; grave 49) frente a 162 (31,3%) (grupo II) con presiones pulmonares normales. El seguimiento medio fue de 4,3 años.ResultadosLa edad media fue de 76,4±3,9 años. La fibrilación auricular (29,5 vs 5,6%; p=0,001) y la insuficiencia mitral moderada preoperatorias (13,7 vs 5,1%; p=0,003) fueron más frecuentes en el grupo I. La mortalidad hospitalaria fue 4,3%, siendo significativamente superior en los pacientes con HTP (I: 5,7% vs II: 0,8%; p=0,027). Los pacientes con HTP moderada (7,3%) o grave (13,9%) tuvieron una mortalidad significativamente superior a la de los pacientes con HTP ligera (1,7%) (p=0,016). La supervivencia actuarial a los 5 años, de los pacientes dados de alta, aunque superior en los pacientes sin HTP (I: 80,9% vs II: 90,6%; p=0,162), no alcanzó significación. La HTP moderada-grave se asoció de manera independiente a la mortalidad hospitalaria (odds ratio [OR]: 2,07; p=0,015), pero no a una menor supervivencia en el seguimiento.ConclusionesLa HTP moderada-grave es un factor de riesgo independiente de mortalidad hospitalaria en los ancianos sometidos a SVA. Su influencia en la supervivencia a medio plazo es menos clara

A terceirização trabalhista e as responsabilidades do fornecedor e do tomador dos serviços : um enfoque multidisciplinar

Examina a questão do trabalho humano e o local de seu exercício. Aponta as causas da terceirização e discute os aspectos referentes a sua legalidade e ilegalidade. Examina a responsabilidade na terceirização lícita, bem como a terceirização trabalhista e a relação processual

Search for jet extinction in the inclusive jet-pT spectrum from proton-proton collisions at s=8 TeV

Published by the American Physical Society under the terms of the Creative Commons Attribution 3.0 License. Further distribution of this work must maintain attribution to the author(s) and the published articles title, journal citation, and DOI.The first search at the LHC for the extinction of QCD jet production is presented, using data collected with the CMS detector corresponding to an integrated luminosity of 10.7  fb−1 of proton-proton collisions at a center-of-mass energy of 8 TeV. The extinction model studied in this analysis is motivated by the search for signatures of strong gravity at the TeV scale (terascale gravity) and assumes the existence of string couplings in the strong-coupling limit. In this limit, the string model predicts the suppression of all high-transverse-momentum standard model processes, including jet production, beyond a certain energy scale. To test this prediction, the measured transverse-momentum spectrum is compared to the theoretical prediction of the standard model. No significant deficit of events is found at high transverse momentum. A 95% confidence level lower limit of 3.3 TeV is set on the extinction mass scale

Searches for electroweak neutralino and chargino production in channels with Higgs, Z, and W bosons in pp collisions at 8 TeV

Searches for supersymmetry (SUSY) are presented based on the electroweak pair production of neutralinos and charginos, leading to decay channels with Higgs, Z, and W bosons and undetected lightest SUSY particles (LSPs). The data sample corresponds to an integrated luminosity of about 19.5 fb(-1) of proton-proton collisions at a center-of-mass energy of 8 TeV collected in 2012 with the CMS detector at the LHC. The main emphasis is neutralino pair production in which each neutralino decays either to a Higgs boson (h) and an LSP or to a Z boson and an LSP, leading to hh, hZ, and ZZ states with missing transverse energy (E-T(miss)). A second aspect is chargino-neutralino pair production, leading to hW states with E-T(miss). The decays of a Higgs boson to a bottom-quark pair, to a photon pair, and to final states with leptons are considered in conjunction with hadronic and leptonic decay modes of the Z and W bosons. No evidence is found for supersymmetric particles, and 95% confidence level upper limits are evaluated for the respective pair production cross sections and for neutralino and chargino mass values

In vitro estimation of pressure drop across tracheal tubes during high-frequency percussive ventilation

Tracheal tubes (TT) are used in clinical practice to connect an artificial ventilator to the patient's airways. It is important to know the pressure used to overcome tube impedance to avoid lung injury. Although high-frequency percussive ventilation (HFPV) has been increasingly used, the mechanical behavior of TT under HFPV has not yet been described. Thus, we aimed at characterizing in vitro the pressure drop across TT (\u394PTT) by identifying the model that best fits the measured pressure-flow (P-V\u307) relationships during HFPV under different working pressures (PWork), percussive frequencies and mechanical loads. Three simple models relating \u394PTT and flow (V\u307) were tested. Model 1 is characterized by linear resistive [Rtube\u2009 c5\u2009V\u307(t)] and inertial [I\u2009\ub7\u2009V\u308(t)] terms. Model 2 takes into consideration Rohrer's approach [K1\ub7\u2009V\u307(t) + K2\u2009 c5V\u307(t)] and inertance [I\u2009\ub7V\u308(t)]. In model 3 the pressure drop caused by friction is represented by the non-linear Blasius component [Kb\ub7 V\u307(1.75)(t)] and the inertial term [I\ub7\u2009V\u308(t)]. Model 1 presented a significantly higher root mean square error of approximation than models 2 and 3, which were similar. Thus, model 1 was not as accurate as the latter, possibly due to turbulence. Model 3 presented the most robust resistance-related coefficient. Estimated inertances did not vary among the models using the same tube. In conclusion, in HFPV \u394PTT can be easily calculated by the physician using model 3