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Search Results: 1 - 10 of 8977 matches for " Altamiro Reis;Lara "
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Tratamento cirúrgico para ectasia anulo-aórtica
García-Macedo, Ricardo;Kalil, Renato A. K;Prates, Paulo Roberto;Lucchese, Fernando A;Sant'Ana, Jo?o Ricardo;Pereira, Edemar M;Costa, Altamiro Reis;Lara, Raul Feck A;Nesralla, Ivo A;
Revista Brasileira de Cirurgia Cardiovascular , 1986, DOI: 10.1590/S0102-76381986000100007
Abstract: this is a report of 27 patients presenting annulo-aortic ectasia submitted to surgical correction with a composite valve-tube graft (bentall-de bono technique), between 1976 and 1985. twenty three (85.2%) had cystic medial necrosis, 3 (11,1%) were chronic aortic disections and 1 (3.7%) was luetic aortitis. age ranged from 29 to 64 years (m = 48). three were female and 24 male patients. the valves used were homologous dura maier in 7 cases, heterologous aorta in 9 and mechanical prosthesis in 11. functional class (nyha) was i-ii in 7 and iii-iv in 9 patients. there was 1 (3.7%) hospital death, due to bleeding and renal failure. significant early complications were represented by arrhythmias in 13 cases (48%) and bleeding in 3 (11%). in the late follow-up therev.were 9 deaths, due to: sudden death (2 patients, 7.4%), bleeding in reoperation (1 patient, 3.7%), hospital infection (1 patient, 3.7%), infectious endocarditis (1 patient, 3.7%) and accidental causes (2 patients, 7.4%). five patients (18.5%) needed reoperation in the late follow-up: 2 due to bioprosthetic failure, 2 for replacement of an infected dacron tube and 1 for repair of pseudo-aneurysm and periprosthetic leak. the actuarial survival curve showed a probability of 83.7% up to the 3rd. year, 61 % for the 5th. year and 42.7% from the 6th. to the 9th. year of follow-up. the 17 patients surviving are in functional class i-ii (nyha). the composite valve-dacron tube graft (bentall-de bono) technique for correction of annulo-aortic ectasia is associated with a low hospital mortality. the improvement in functional class is significant. there have been a small number of complications and the long term survival is very satisfactory.
Systemic hypertension in heart transplant recipients
Gus Miguel,Schiavo Nádia,Costa Altamiro Reis da
Arquivos Brasileiros de Cardiologia , 1999,
Exploring NoC Mapping Strategies: An Energy and Timing Aware Technique
Cesar Marcon,Ney Calazans,Fernando Moraes,Altamiro Susin,Igor Reis,Fabiano Hessel
Computer Science , 2007,
Abstract: Complex applications implemented as Systems on Chip (SoCs) demand extensive use of system level modeling and validation. Their implementation gathers a large number of complex IP cores and advanced interconnection schemes, such as hierarchical bus architectures or networks on chip (NoCs). Modeling applications involves capturing its computation and communication characteristics. Previously proposed communication weighted models (CWM) consider only the application communication aspects. This work proposes a communication dependence and computation model (CDCM) that can simultaneously consider both aspects of an application. It presents a solution to the problem of mapping applications on regular NoCs while considering execution time and energy consumption. The use of CDCM is shown to provide estimated average reductions of 40% in execution time, and 20% in energy consumption, for current technologies.
Fatores de risco e morbimortalidade associados à fibrila??o atrial no pós-operatório de cirurgia cardíaca
Silva, Rogério Gomes da;Lima, Gustavo Glotz de;Laranjeira, Andréia;Costa, Altamiro Reis da;Pereira, Edemar;Rodrigues, Rubem;
Arquivos Brasileiros de Cardiologia , 2004, DOI: 10.1590/S0066-782X2004001400002
Abstract: objective: to determine the incidence of atrial fibrillation in the postoperative period of cardiac surgery, its impact on morbidity, mortality, and hospital stay, and to analyze the risk factors in the pre, trans, and postoperative periods. method: contemporary cohort study with 158 adult patients undergoing cardiac surgery, of whom those with atrial fibrillation in the preoperative period were excluded. the patients were assessed with continuous cardiac monitoring and daily electrocardiograms. any episode of irregular rhythm with the presence of f waves of variable morphology and amplitude was considered atrial fibrillation. results: the general incidence of atrial fibrillation was 28.5%, being 21.6% for revascularized patients and 44.3% for those undergoing valvular repair. factors independently associated with atrial fibrillation were left heart failure in the preoperative period (p=0.05; rc=2.2), total fluid balance (p=0.01; rc=1.0), duration of surgery (p=0.03; rc=1.01) [and other associated factors, age > 70 years, aortic valvular disease, psychomotor agitation, length of installation of the drains, pulmonary congestion and respiratory insufficiency in the postoperative period]. the use of beta-blockers (p=0.01; rc=0.3) was a protective factor. atrial fibrillation in the postoperative period was associated with an increase in the length of hospital stay (16.9±12.3 days versus 9.2±4.0 days, p<0.001) and a greater incidence of stroke or postoperative death (p=0.02). conclusion: the incidence of atrial fibrillation in the postoperative period of cardiac surgery was high and caused a significant increase in morbidity, mortality, and the length of hospital stay. among the independent risk factors, excessive fluid balance is significant. the use of beta-blockers was identified as a protective factor.
Análise de indicadores da saúde materno-infantil: paralelos entre Portugal e Brasil
Reis, Zilma Silveira Nogueira;Pereira, Altamiro Costa;Correia, Ricardo Jo?o Cruz;Freitas, José Alberto Silva;Cabral, Ant?nio Carlos Vieira;Bernardes, Jo?o;
Revista Brasileira de Ginecologia e Obstetrícia , 2011, DOI: 10.1590/S0100-72032011000900003
Abstract: purpose: to analyze comparatively the conditions of birth in portugal and brazil from 1975 to 2007. methods: indicators of maternal and child health: rates of maternal death and neonatal mortality, cesarean rate and public spending on health were retrospectively collected from electronic databases of health information from the unified health system (datasus) and the national institute of statistics of portugal (ine), among others. their values were descriptively analyzed in terms of trends and the temporal sanitary scenarios were presented and discussed, comparing, when possible, the information from the two countries. results: births in portugal were characterized by lower maternal mortality (12.2x76.2/100.000) and neonatal mortality (2.2x14.6/1000), compared to brazil, considering the average of the years from 2004 to 2007. the history of the conquest of maternal and child indicators of excellence in portugal involved a phase that paralleled the significant socio-economic improvements and the increasing contribution of public health, followed by another from the 1990s, involving better equipped health care units. in brazil, rates of maternal and neonatal mortality are declining, but satisfactory values have not yet been achieved. the historical difference in the amount of social spending on health, both in current and historical values, was a crucial difference between countries. despite the disparities in maternal and neonatal outcomes, cesarean section rates were equally ascendant (34.5% in portugal and 45.5% in brazil), considering the average for the period from 2004 to 2007. conclusion: the indicators of maternal and neonatal death in portugal and brazil have aligned themselves to social, economic and contributions of public investments in health. the increasing rates of caesarean section do not explain the discrepancies in maternal and neonatal outcome between countries.
On student engagement in whole-class oral interaction: from classroom discourse and sociocultural aspects to implications for language learning On student engagement in whole-class oral interaction: from classroom discourse and sociocultural aspects to implications for language learning
Douglas Altamiro Consolo
Ilha do Desterro , 2008,
Abstract: This article reports on a study on classroom interaction in an EFL context in Brazil. The study, of an ethnographic nature, analyses recorded lessons, interviews and questionnaires answered by the students. The social rules governing classroom interaction usually determine an asymmetrical relationship between the teacher and the students, though it may be possible, according to the data obtained, to create an atmosphere of co-operation in which interaction may occur within less asymmetrical verbal patterns. This atmosphere, determined by linguistic, pedagogical, psychological and social factors, favours student language production. The data suggest connections between the students’ views of classroom language learning, their engagement in classroom discourse, and possible implications for (foreign) language development. Este artigo relata um estudo sobre intera o em sala de aula em um contexto de inglês como língua estrangeira, no Brasil. O estudo, de natureza etnográfica, analisa aulas gravadas, entrevistas e questionários respondidos pelos alunos. As regras sociais que permeiam a intera o em sala de aula geralmente determinam uma rela o assimétrica entre professor e alunos, embora seja possível, com base nos dados obtidos, criar-se uma atmosfera de coopera o, na qual uma intera o caracterizada por padr es verbais menos assimétricos possa ocorrer. Tal atmosfera, determinada por fatores lingüísticos, pedagógicos, psicológicos e sociais, favorece a produ o verbal dos alunos. Os dados sugerem rela es entre as vis es dos alunos sobre aprendizagem de línguas, seu engajamento no discurso de sala de aula e possíveis implica es para o desenvolvimento da competência em língua estrangeira.
Towards criterion validity in classroom language analysis: methodological constraints of metadiscourse and inter-rater agreement
Douglas Altamiro Consolo
Alfa : Revista de Linguística , 2001,
Abstract: This paper reports on a process to validate a revised version of a system for coding classroom discourse in foreign language lessons, a context in which the dual role of language (as content and means of communication) and the speakers' specific pedagogical aims lead to a certain degree of ambiguity in language analysis. The language used by teachers and students has been extensively studied, and a framework of concepts concerning classroom discourse well-established. Models for coding classroom language need, however, to be revised when they are applied to specific research contexts. The application and revision of an initial framework can lead to the development of earlier models, and to the re-definition of previously established categories of analysis that have to be validated. The procedures followed to validate a coding system are related here as guidelines for conducting research under similar circumstances. The advantages of using instruments that incorporate two types of data, that is, quantitative measures and qualitative information from raters' metadiscourse, are discussed, and it is suggested that such procedure can contribute to the process of validation itself, towards attaining reliability of research results, as well as indicate some constraints of the adopted research methodology.
Reopera??es após cirurgia de Bentall-De Bono para ectasia anulo-aórtica
Kalil, Renato A. K;Garcia-Macedo, Ricardo;Prates, Paulo Roberto;Lucchese, Fernando A;Sant'Anna, Jo?o Ricardo;Lara, Raul F. A;Costa, Altamiro R;Daudt, Nestor S;Pereira, Edemar M;Nesralla, Ivo A;
Revista Brasileira de Cirurgia Cardiovascular , 1988, DOI: 10.1590/S0102-76381988000200003
Abstract: a major surgical problem is imposed when late complications occur in patients submitted previously to aortic root replacement by the bentall-de bono technique. during an 11 years period, from january 1976 to december 1986, 37 patients had aortic root replacement with valved conduits and 5 presented late complications (13.5%) requiring a new operation. the lesions were: biological valve degeneration, infective endocarditis and suture leaks leading to pseudo aneurysm, peritubular leakage and hemolysis. there was 1 systemic embolization with an infected vegetation. the 5 patients were re-operated, with 1 surgical death (20%), in a case presenting fungal endocarditis (aspergillus), due to uncontroled bleeding. the remaining 4 had an uneventful hospital course. there was 1 late death during a surgical exploratory thoracic procedure. the remaining 3 patients enjoy a normal active life. one of these still has a small peritubular leakage causing mild aortic regurgitation and hemolysis. the surgical procedure consisted of dacron tube replacement preserving the implanted valve prostheses in the 2 cases with infective endocarditis. two ruptures biological valves were replaced by methalic disc valves. in this situation, the dacron tubes were preserved and the valves approached through a longitudinal incision in the tube. the suture leaks were corrected with direct isolated mattress sutures. late re-operations may be required after aortic root replacement with composite valve-tube grafts. they can be performed at an acceptable surgical risk. the technique should be as conservative as possible and directed to the causing lesions, preserving the remaining structures. a methalic prosthesis should be the first choice for the primary procedure, in order to avoid late tissue degeneration.
Proposi??o de técnica endocavitária para remodelamento ventricular esquerdo
NESRALLA, Ivo A.;SANT'ANNA, Jo?o Ricardo M.;PRATES, Paulo R.;TEIXEIRA FILHO, Guaracy F.;WENDER, Orlando;COSTA, Altamiro R.;SANTOS, Marisa S.;PEREIRA, Edemar M.;LARA, Raul F.;SANTOS, Ari Tadeu;
Revista Brasileira de Cirurgia Cardiovascular , 1997, DOI: 10.1590/S0102-76381997000200008
Abstract: left ventricular remodeling by partial ventriculectomy is a recent proposition for palliation in dilated cardiomyopathy when cardiac transplantation is contraindicated. this procedure carries a high morbimortality due to myocardial ischemia, necrosis and arrhythmias. this paper presents a technique for endocavitary left ventricular remodeling which maintains the hearts morpho-functional architecture without myocardial resection. under extracorporeal circulation and hypothermic cardioplegia, a left atriotomy is done, the anterior mitral leaflet removed and a triangular shaped bovine pericardial graft (aproximately 2 x 6 x 6 cm) is implanted inside the left ventricular cavity with 3-0 polipropilene anclosed in dacron felt. the graft is sutured in a divergent way from the apex to the mitral ring, at the middle of the septum and at the posterior papillary muscle. this produces an internal plication with ventricular cavity reduction. myocardium and coronary circulation are preserved. the base of the triangular graft is sutured to the mitral annulus and the mitral bioprosthesis is implanted. the procedure was employed in 8 patients with dilated cardiomyopathy, not candidates to transplantation, 2 females and 6 males, ranging from 24 to 58 years. five had mitral regurgitation. all were in hospital, at class iv (nyha). mortality was 25% (2 cases): 1 in the hospital and 1 at 3 months p.o. the table shows the echocardiographic parameters for lv function: pré-operative post-operative cardiac output (l/min) 2,6 ± 0,4 3,8 ± 0,7 p<0,001 cardiac index 1,9 ± 0,9 2,7 ± 0,6 p<0,005 ejection fraction 21,5 ± 4,0 37,8 ± 1,2 p<0,05 intracavitary left ventricular remodeling presented a satisfactory result related to mortality and morbidity, with functional improvement over the short term. longer follow-up is needed to evaluate its role, which might be a bridge to transplantation. a limitation exists in the necessity for replacing the mitral valve.
Fatores de risco hospitalar para implante de bioprótese valvar de pericárdio bovino
De Bacco, Mateus W.;Sant'Anna, Jo?o Ricardo M.;De Bacco, Gustavo;Sant'Anna, Roberto T.;Santos, Marisa F.;Pereira, Edemar;Costa, Altamiro Reis da;Prates, Paulo Roberto;Kalil, Renato A. K.;Nesralla, Ivo A.;
Arquivos Brasileiros de Cardiologia , 2007, DOI: 10.1590/S0066-782X2007001400009
Abstract: background: identification of preoperative heart valve surgery risk factors aim to improve surgical outcomes with the possibility to offset conditions related to increased morbidity and mortality. objective: intent of this study is to identify hospital risk factors in patients undergoing bovine pericardial bioprosthesis implantation. methods: retrospective study including 703 consecutive patients who underwent implantation of at least one st. jude medical-biocor? bovine pericardial bioprosthesis between september 1991 and december 2005 at the rio grande do sul cardiology institute; 392 were aortic, 250 were mitral and 61 were mitroaortic. characteristics analyzed were gender, age, body mass index, nyha (new york heart association) functional class, ejection fraction, valve lesions, systemic hypertension, diabetes mellitus, kidney function, arrhythmias, prior heart surgery, coronary artery bypass graft, tricuspid valve surgery and elective, urgent or emergency surgery. main outcome was in-hospital mortality. relationship between risk factors and in-hospital mortality was analyzed using logistic regression. results: were 101 (14.3%) in-hospital deaths. characteristics with significant relationship to increased mortality were female gender (p<0.001), age over 70 years (p=0.004), atrial fibrillation (p=0.006), diabetes mellitus (p=0.043), creatinine > 2.4mg/dl (p=0.004), functional class iv (p<0.001), mitral valve lesion (p<0.001), previous heart surgery (p=0.005), tricuspid valve surgery (p<0.001) and emergency surgery (p<0.001). conclusion: mortality rate observed is accepted by literature and is justifiable due to the high prevalence of risk factors, showing an increased significance level for female gender, age above 70, functional class iv, tricuspid valve repairs and emergency surgery. offsetting these factors could contribute to reduced in-hospital mortality for valve surgery.
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