38 research outputs found
Banks and sovereigns: an econometric analysis of an entangled relationship
In this discussion OLS regressions are used to study the factors that influence sovereign yield spreads and domestic bank indeces for a set of euro area countries. The results show that common factors explain changes in bank indeces better than in the yields. Moreover, although there is some country differentiation, a common pattern among all is visible. A contemporary spillover effect between banks and sovereigns emerged after bank bailouts and became stronger with the burst of the sovereign debt crisis. The vicious cycle between the two has contributed to the escalation of spreads and to painful austerity measures.UNL - NSB
A utilização da calculadora gráfica na aula de matemática: um estudo com alunos do 12º ano no âmbito das funções
Pretende-‐se
dar
a
conhecer
um
estudo
que
foi
realizado
com
alunos
do
12º
ano
e
que
teve
como
principal
objectivo
compreender
em
que
situações,
porquê
e
como
é
que
os
alunos
utilizam
a
calculadora
gráfica
na
resolução
de
questões
no
âmbito
do
estudo
de
Funções
no
12º
ano
de
escolaridade.
Tratou-‐se
de
uma
investigação
de
natureza
qualitativa,
optando-‐se
pela
realização
de
estudos
de
caso.
Constatámos
que
existem
diversos
factores
que
influenciam
a
utilização
ou
não
da
calculadora
gráfica
por
parte
dos
alunos,
nomeadamente
as
preferências
pessoais
dos
alunos,
mas
sobretudo
o
tipo
de
questões
que
lhes
são
propostas
e
a
cultura
da
sala
de
aula,
em
particular
as
mensagens
transmitidas
pelo
professor
e
as
abordagens
às
resoluções
de
exercícios
que
este
privilegia
CULTURA PROFISSIONAL DOS PROFESSORES: DA TEORIA DE ANDY HARGREAVES À REALIDADE VIVENCIADA NA ESCOLA
This article draws on Hargreaves' (1998) theory of teachers' different professional cultures and aims to provide evidence related to how collaborative work is perceived in schools, by teachers and leaders, and what practices are associated with it. Simultaneously, it allows us to reflect on the predominant professional culture among teachers. The modality used was the case study, inserted in a qualitative methodology, privileging the interpretative dimension of the participants over the reality experienced / perceived. Data were collected in 2018/2019 through document analysis and interviews with six elementary school teachers who teach at a private education institution in Lisbon, Portugal. The results allow us to conclude that teachers' work generally takes on forms of collaboration at a superficial level and they are concentrated in the same department. Although collaborative practices have also been identified, the results indicate the predominance of a “balkanized culture”.Este artículo se basa en la teoría de Hargreaves (1998) sobre las diferentes culturas profesionales de los profesores y pretende presentar evidencias sobre cómo se percibe el trabajo colaborativo en los centros educativos, así como sobre las prácticas asociadas al mismo, permitiendo reflexionar sobre la cultura profesional predominante entre los profesores. El método utilizado fue el estudio de casos, dentro de una metodología cualitativa, privilegiando la dimensión interpretativa de los participantes sobre la realidad vivida / percibida. Los datos se recogieron en el año escolar de 2018/2019, mediante el análisis de documentos y entrevistas con seis profesores de Portugal. Los resultados nos llevan a la conclusión de que el trabajo entre iguales es una forma de colaboración a nivel superficial, y tiene lugar sobre todo entre profesores del mismo departamento. Aunque también se han identificado prácticas de colaboración, los resultados indican que predomina una cultura esencialmente "balcanizada”.O presente artigo tem por base a teoria de Hargreaves (1998) sobre as diferentes culturas profissionais dos professores e pretende apresentar evidências sobre a forma como o trabalho colaborativo é percecionado nas escolas, bem como sobre práticas que lhe estão associadas, permitindo refletir sobre a cultura profissional predominante entre os docentes. A modalidade utilizada foi o estudo de caso, inserida numa metodologia qualitativa, privilegiando-se a dimensão interpretativa dos participantes sobre a realidade vivenciada/percecionada. Os dados foram recolhidos no ano letivo de 2018/2019, por meio de análise documental e entrevista a seis professores do Ensino Fundamental que lecionam numa instituição de ensino particular em Lisboa, Portugal. Os resultados levam-nos a concluir que o trabalho entre pares se reveste de formas de colaboração a um nível superficial, e acontece maioritariamente entre docentes do mesmo departamento. Embora também tenham sido identificadas práticas de colaboração, os resultados indiciam predominar uma cultura, essencialmente, “balcanizada”
Allergological evaluation of a dog population in a veterinary immuno-allergology consultation: What correlates in a canine model
Introduction: Allergic dermatitis (AD) is the most common canine pruritic condition in veterinary dermatology. Allergic dermatitis to flea bites presents the highest prevalence, followed by atopic dermatitis and food AD. This study aimed to identify possible correlation between data from clinical signs, intradermal tests (IDT) and specific IgE levels, which are used in dog AD assessment. Methods: Fifty five dogs from the Veterinary Hospital of the University of Évora (Portugal) and Rof Codina University Hospital (Lugo, Spain) outpatient consultations were studied by means of clinical inquiry, IDT and specific IgE determination. Thirty five of the patients belonged to predisposed breeds, 30 were females and 25 males. Forty one (74%) were indoor.
Results: In 82% of cases first clinical signs appeared before the age of 3 years and 24% even before 1 year old. In 70% of the individuals clinical signs included itching, which was generalized in 66%, with 78% of paw licking and chewing. Clinical profile showed seasonal worsening in 64% of cases. From the 69.1% of dogs already presenting with dermatitis, 50% also presented external otitis and 28.9% self-inflicted alopecia. "Intense itching" was found in 10.5%, "medium itching" in 81.6% and “mild itching” in 5.26% of the patients. Prevalence of positive IDT was 37.3 % to Lep d, 29.41% to Der f, 27.5% to Der p, 25.5% to Dac g and 21.6% to Malassezia sp. From the 37 dogs submitted to food IDT, 40.5% revealed positive to beef, 27% to chicken, 27% to porc and 5.4% to lamb. Specific IgE > 150 EAU was found in 84% of dogs to indoor allergen sources and in 68% to pollens. A negative correlation was found between an outdoor life and the intensity (p = 0.033) and precocity (p = 0.026) of clinical signs. Sensitization to pollens was found positively correlated with the seasonality of clinical signs (p = 0.001) and the positivity for Dac g (p = 0.007). The prevalence of chronic otitis correlated positively with alopecia and reactivity to Lep d (p = 0.008), Plantago lanceolata (p = 0.026) and Platanus acerifolia (p = 0.017). There was no correlation between the results of ITD and specific IgE.
Conclusion: We can conclude that correlation between different clinical signs and positive testing for some allergenic sources may occur, as well as between sensitization to pollens and the beginning, the intensity and the seasonality of dog patient clinical signs
House-dust mite allergy: mapping of Dermatophagoides pteronyssinus allergens for dogs by two-dimensional immunoblotting
Specific immunotherapy has shown to be very useful for allergy control in dogs, with a common
success rate ranging from 65% to 70%. However, this efficacy could probably be improved and the identification
of individual allergomes, with the choice of more adequate molecular allergen pools for specific immunotherapy,
being the strategy
Fulminant Emphysematous Hepatitis – A Rare Cause of Septic Shock
Emphysematous hepatitis is a rare entity characterized by the replacement of hepatic parenchyma by gas, leading to acute liver failure. Often it occurs in patients with diabetes mellitus, liver disease or a recent history of abdominal surgery. We present a case of emphysematous hepatitis in a 74-year-old man with no recognizable risk factors. Despite the early broad-spectrum antimicrobial therapy and supportive care, the condition progressed to a fatal outcome, as seen in other case reports. Early recognition of this condition and rapid and aggressive management may improve patient outcomes
ROTURA DE ANEURISMA DA AORTA ABDOMINAL NA ERA DO TRATAMENTO ENDOVASCULAR — VALIDAÇÃO UNICÊNTRICA DE 2 ALGORITMOS DE PREVISÃO DE RISCO
Introdução: Atualmente, o aneurisma da aorta abdominal em rotura (AAAr) continua a apresentar uma elevada taxa de mortalidade associada e consequentemente a decisão de prosseguir ou recusar tratamento cirúrgico é extremamente complexa. Os algoritmos de previsão de risco de mortalidade por AAAr desenvolvidos antes da globalização do tratamento endovascular de aneurisma da aorta abdominal (EVAR) em rotura tiveram a sua validade questionada numa era em que quer a cirurgia aberta (CA) quer o EVAR estão disponíveis. Em 2017, foram publicados dois novos algoritmos de previsão de risco, ambos baseados em variáveis clínicas facilmente obtidas e validados numa população submetida quer a CA quer a EVAR. O objetivo deste trabalho foi descrever a evolução da experiência no tratamento de AAAr na nossa instituição e validar a aplicabilidade dos algoritmos supracitados na nossa prática.
Métodos: Os dados clínicos de todos os doentes admitidos entre 2010 a 2016 com o diagnóstico de AAAr foram avaliados retrospetivamente e foi realizada análise estatística usando SPSS V.22.
Resultados: Foi incluído um total de 71 doentes, 19 dos quais submetidos a EVAR e 52 a CA. Houve um aumento significativo ao longo do tempo de procedimentos de EVAR, e em 2015 a taxa anual de EVAR excedeu a de CA. A população de pacientes submetidos a EVAR e CA é sobreponível em fatores como género, idade e co-morbilidades com exceção do tabagismo, mais comum no grupo EVAR (73,7% Vs 36,5%; p = 0,005). Não foram registrados casos de morte intraoperatória no grupo EVAR, por oposição a 17% no grupo CA (p = 0,049). A mortalidade aos 30 dias atingiu 49% no grupo CA e 31,6% no grupo EVAR (p> 0,05). Vários preditores de mortalidade pré-operatórios foram identificados: tabagismo (p = 0,005), instabilidade hemodinâmica pré-operatória (p = 0,003) e razão internacional normalizada (INR) à admissão (p <0,0001). Identificou-se como preditor de mortalidade pós-operatório a instabilidade hemodinâmica pós-operatória (p<0,0001) Realizou-se uma regressão logística binária e concluiu-se que o INR elevado e a instabilidade pós-operatória foram preditores de risco independentes de outcome (p <0,05). Os modelos de previsão de mortalidade supracitados foram aplicados à nossa população e a mortalidade estimada correlacionou- se significativamente com a mortalidade real (mortalidade estimada 41% e 45,3% Vs mortalidade real 45%, ambos com p <0,0001). A correlação de Pearson foi aplicada para comparar os scores e concluiu um coeficiente de correlação de 0.775 (p <0,001), descrevendo uma correlação linear positiva significativa entre scores.
Conclusões: Nos últimos anos, o EVAR tornou-se cada vez mais o procedimento de escolha para rAAA na nossa instituição. Nesta população, ambos os algoritmos de previsão de pontuação foram aplicados retrospetivamente e ambos previram com acuidade a mortalidade na população estudada (p <0,001)
Predictive factors of venous stenting failure: a systematic review
OBJECTIVE: Venous stenting of iliocaval obstructions has become a more frequent procedure over the last two decades. In-stent stenosis and thrombosis are potential complications, causing one of the main causes of symptoms recurrence and impacting quality of life. The aim of this review is to report on the impact of venous stent patency loss, as well on risk factors and management.
METHODS: A systematic review was conducted according to the recommendations of the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) statement.
RESULTS: After a literature search, 12 studies (two prospective and 10 retrospective studies) were included in the analysis. A total of 1981 patients (34.1% male) and 2388 limbs (63.6% left side) were assessed. Mean age was 43.5 years (range 16-99).
Indication for stenting included deep venous thrombosis (DVT) (4%), post-thrombotic syndrome (PTS) (18.8%) and non-thrombotic iliac vein lesions (NIVLs) (77.2%). Regarding treatment, most patients were submitted to angioplasty and stenting only (87%). Associated catheter directed thrombolysis or mechanical thrombectomy was performed when indicated (8.4%), and in the remaining an AVF/endophlebetomy was performed (4.6%).
Primary, primary assisted and secondary patency rates at one year ranged from 68-100%, 79-90% and 85.8-100%, respectively. Reported anticoagulation duration after stenting ranged from 1-12 months. In one study involving only patients treated for NIVLs, no anticoagulation was prescribed, and antithrombotic therapy was continued for three months. Follow-up strategies included clinical and imagiological control with a mean follow-up of 19.7 months.
Post-procedural stent re-stenosis was reported in 121 limbs (5.1%) and stent occlusion in 81 limbs (3.4%); the latter was distributed as follows: 11.1% after DVT, 77.8% PTS and 11.1% NIVLs. A total of 186 re-interventions were performed in symptomatic patients.
The prognostic factor most consistently associated with stent failure was thrombotic inflow veins. Other reported
factors were incomplete thrombolysis and age younger than 40 years. Stent placement below the inguinal ligament, type of stent and anticoagulation regimen do not seem to affect stent patency.
CONCLUSION: Regarding venous lesions of the lower limbs, a selective approach and planning should focus on identification of risk factors for stent failure. It is noteworthy that most stent occlusions occur in post-thrombotic limbs. Stent failure continued after 6 months, emphasizing the importance of an extended surveillance especially on these patients
Aortoiliac occlusive disease: open or endo? – a narrative review
INTRODUCTION: Aortoiliac occlusive disease (AIOD) can be treated using either open surgical revascularization (OSR) or endovascular revascularization (ER).
METHODS: A Medline search was performed in order to identify articles focused on the treatment of aortoiliac occlusive disease. Additional articles of scientific interest for the purpose of this non-systematic review were included by cross-referencing.
RESULTS: There are a few articles reporting direct results between both techniques based on retrospective or prospective single center or multicenter studies. In the majority of studies, primary patency is generally better for surgery in comparison to ER, but at a cost of more postoperative complications, with higher rates of respiratory failure and wound infection in the open group. On the other hand, endovascular recanalization is related to higher rates of limb ischemia/thrombosis, renal dysfunction and reinterventions. In the presence of femoral artery calcified disease, the hybrid approach should be considered.
CONCLUSIONS: Endovascular treatment is a suitable alternative for extensive AIOD and can be accomplished in a less invasive manner, with most midterm outcomes comparable with open reconstruction. Surgery should be reserved for multilevel calcified disease and after endovascular failure
TRAUMATIC POPLITEAL ARTERY INJURY – A RARE LESION THAT CAN'T BE MISSED
Introduction: Traumatic popliteal artery injury is a rare clinical entity, but it is the most common cause of amputation in injured extremities.
The aim of this study was to report the incidence of popliteal artery injury after knee trauma and report therapeutic management and results.
Methods and material: ICD-10/ ICD-9 codes (S85.0/904.41; S83.1/836.5; S83.4; S83.5; S72,4/821.2; S82,1/823.0) were used to identify patients admitted with popliteal artery injury and/or knee trauma at our tertiary center from 1/1/2010 to 31/5/2021. A statistical analysis was realized using the SPSS program version27.
Results: At our center from 1/1/2010 to 31/5/2021 535 patients were admitted due to knee trauma (28 with knee dislocation and 507 with fracture close to the knee) and 9 patients with popliteal artery injury (seven males, median age 39.0 years) The mechanism of PAI was motorcycle (4) or bicycle (1) or work (1) accidents (4); one fall, one running over and one iatrogenic injury.
The incidence of PAI after knee trauma was 1.5%, after knee dislocation 17.9% and 0.8% after fracture close to the knee. Regarding associated injuries, four patients had severe soft tissue damage, two had venous injuries and two had nerve disruptions.
The median ischemic time was 6.0 hours and mean vascular surgical time was 2.4 hours.
Regarding vascular treatment, eight patients were submitted to bypass surgery and one was treated conservatively. Therapeutic fasciotomies were performed in three patients.
No primary amputations were performed. A secondary major amputation was performed in one patient.
The mean hospital length of stay was 24.9 days and mortality was 0%.
Three patients returned to their normal activity level and six were limited in their daily activity.
Discussion/Conclusion: The risk of PAI after knee dislocation is higher than after knee fracture (17,9% vs 0.8% in our study, and 3,4-8,2% vs 0,2 % in Swedish registration), so orthopedic surgeons must be aware of that increased risk, to avoid missing this diagnosis.
The amputation rate in our serie was lesser than the Swedish registration and the United States National Trauma Data Bank (11% vs 28% and 14,5%, respectively). However, it ́s still a high rate
considering that it mostly affects a young and active population and only 33.3% patients return to a normal life.
A multidisciplinary approach is essential to decrease ischemia time and to promote a holistic treatment