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Search Results: 1 - 10 of 33416 matches for " Paulo Ernando;Lima "
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Skeletonized left internal thoracic artery is associated with lower rates of mediastinitis in diabetic patients
, Michel Pompeu Barros de Oliveira;Soares, Evelyn Figueira;Santos, Cecília Andrade;Figueiredo, Omar Jacobina;Lima, Renato Oliveira Albuquerque;Escobar, Rodrigo Renda;Rueda, Fábio Gon?alves de;Ferraz, Paulo Ernando;Lima, Ricardo Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2011, DOI: 10.1590/S0102-76382011000200007
Abstract: background: mediastinitis is a serious complication of median sternotomy and is associated to significant morbidity and mortality. diabetes is a feared risk factor for mediastinitis and viewed with caution by cardiovascular surgeons. objective: to identify risk factors for mediastinitis in diabetics undergoing cabg surgery with use of unilateral ita in the division of cardiovascular surgery of pronto socorro cardiológico de pernambuco - procape. methods: retrospective study of 157 diabetics operated between may 2007 and april 2010. nine preoperative variables, five intraoperative variables and seven postoperative variables possibly involved in the development of postoperative mediastinitis were evaluated. univariate and multivariate logistic regression analyses were applied. results: the incidence of mediastinitis was 7% (n=11), with a lethality rate of 36.1% (n=4). variables associated with increased risk of mediastinitis were: use of pedicled ita (or 8.25, 95% ci 2.03 to 66.10, p=0.016), postoperative renal complications (or 5.10, 95% ci 1.03 to 25.62, p=0.049) and re-operation (or 7.45, 95% ci 1.24 to 42.17, p=0.023). in multivariate analysis using backward logistic regression, only one variable remained as independent risk factor: use of pedicled ita (or 7.64, 95% ci 1.95 to 61.6, p=0.048), in comparison to skeletonized ita. conclusions: we suggest that diabetics should be considered for strategies to minimize risk of infection. in diabetics that undergo unilateral ita, the problem seems to be related to how ita is harvested. diabetics should always be considered for use of skeletonized ita.
Estudo comparativo entre cirurgia de revasculariza??o miocárdica com e sem circula??o extracorpórea em mulheres
, Michel Pompeu Barros de Oliveira;Lima, Leonardo Pontual;Rueda, Fábio Gon?alves de;Escobar, Rodrigo Renda de;Cavalcanti, Paulo Ernando Ferraz;Thé, Emmanuel Callou da Silva;Escobar, Mozart Augusto Soares de;Lima, Ricardo de Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2010, DOI: 10.1590/S0102-76382010000200018
Abstract: background: it has been well documented that women have higher morbidity and mortality rates than men following coronary artery bypass graft (cabg) surgery. in view of this evidence, it is necessary to know if there is benefit to off-pump cabg surgery in women in comparison to on-pump cabg. objectives: compare outcomes between off-pump cabg and on-pump cabg in women. methods: retrospective study. our investigation analyzes comparatively clinical profile, thirteen procedure complications and mortality of a population of 941 consecutive women undergoing cabg surgery (549 off-pump and 392 on-pump) at two hospitals for the period january 2000 to december 2005. results: mortality rate for women undergoing off-pump cabg surgery is lower than for women undergoing on-pump surgery, however, not statistically significant (3.1% vs 5.3%; p=0.134). the complication rates analyzed (hemorrhagic shock, neurologic, respiratory, acute renal failure, adult respiratory distress syndrome, septicemia, pneumonia, atrial fibrillation) were lower (significant statistically difference) for women off-pump than women on-pump, with the exception of low cardiac output and wound infection. conclusions: evidence suggests that off-pump cabg surgery may be better for women than on-pump cabg surgery because it appears to reduce morbimortality rates. ten of 13 complications investigated demonstrated an advantage for women undergoing off-pump surgery relative to those receiving on-pump surgery.
Mediastinite no pós-operatório de cirurgia cardiovascular: análise de 1038 cirurgias consecutivas
, Michel Pompeu Barros de Oliveira;Silva, Débora Oliveira;Lima, érika Nibbering de Souza;Lima, Ricardo de Carvalho;Silva, Frederico Pires Vasconcelos;Rueda, Fábio Gon?alves de;Escobar, Rodrigo Renda de;Cavalcanti, Paulo Ernando Ferraz;
Revista Brasileira de Cirurgia Cardiovascular , 2010, DOI: 10.1590/S0102-76382010000100008
Abstract: objective: to report the incidence of mediastinitis in cardiovascular surgery postoperation. methods: the records of all 1038 patients who underwent cardiovascular surgical procedures between may/2007 and june/2009 were reviewed. all operations were performed in division of cardiovascular surgery of pronto socorro cardiológico de pernambuco - procape. results: the complication occurred within, on average, 13 days after operation, in total of 25 (2.4%), eight (32%) deaths occurred. several risk factors mediastinitis were identified: 56% diabetes, 56% smokers, 20% obeses, 16% with chronic obstructive pulmonary disease and 8% of chronic renal failure. mediastinitis were reported in 21 (84%) cases of patients submitted to coronary artery bypass grafting, being associated to major risk of infection development (ic 3.448.30, p=0.0001). high rates of complications were observed: respiratory insufficiency (44%), stroke (16%), cardiogenic shock (12%), acute renal failure (28%), pulmonary infection (36%), multiple organs failure (16%) and esternal deiscence (48%). bacterial cultures of exudates were positive in 84% of patients; staphylococcus aureus was the most responsible pathogen (28.8%). conclusion: mediastinitis stays a serious surgical complication and difficult management in cardiovascular surgery postoperation. the disease stays with low incidence, but still with high lethality. coronary bypass was associated to major risk of infection development.
Skeletonized internal thoracic artery is associated with lower rates of mediastinitis in elderly undergoing coronary artery bypass grafting surgery
, Michel Pompeu Barros de Oliveira;Santos, Cecília Andrade;Figueiredo, Omar Jacobina;Lima, Renato Oliveira Albuquerque;Ferraz, Paulo Ernando;Soares, Alexandre Magno Macário Nunes;Bezerra, Pablo César Lustosa Barros;Martins, Wendell Nunes;Lima, Ricardo de Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2011, DOI: 10.5935/1678-9741.20110053
Abstract: background and objectives: mediastinitis is a serious complication of median sternotomy and is associated to significant morbidity and mortality. the aim of this study is to identify which option of harvesting internal thoracic artery (ita), pedicled or skeletonized, is associated with lower rates of mediastinitis after coronary artery bypass grafting surgery (cabg) in elderly, in the division of cardiovascular surgery of procape. methods: retrospective study of 160 elderly who underwent consecutive cabg between may 2007 and june 2011. eleven preoperative variables, four intraoperative variables and eight postoperative variables possibly involved in the development of postoperative mediastinitis were evaluated between two groups: cabg with skeletonized ita (n=80) and pedicled ita (n=80). univariate and multivariate logistic regression analyses were applied. results: the incidence of mediastinitis was 6.8% (n=11), with a lethality rate of 54.5% (n=6). the skeletonized ita group were more exposed than pedicled ita group to obesity (n=12 vs. n=4; 15% vs. 5%; p=0.035) and multiple transfusions (n=25 vs. n=11; 31.2% vs. 13.7%; p=0.008). the pedicled ita group presented a greater risk of mediastinitis after cabg than skeletonized ita group (n=10 vs. n=1; 12.5% vs. 1.2%; unadjusted or 11.3; 95% ci 1.4 - 241.5; p=0.008). in multivariate analysis, this difference maintained statistically significant (adjusted or 5.2; 95% ci 1.5-495.8; p=0.012), being considered an independent association. conclusions: we suggest that elderly should be considered for strategies to minimize risk of infection. in elderly that undergo unilateral ita, the problem seems to be related to how ita is harvested. elderly should always be considered for use of skeletonized ita.
Predicting risk of atrial fibrillation after heart valve surgery: evaluation of a Brazilian risk score
, Michel Pompeu Barros de Oliveira;Sá, Marcus Villander Barros de Oliveira;Albuquerque, Ana Carla Lopes de;Silva, Belisa Barreto Gomes da;Siqueira, José Williams Muniz de;Brito, Phabllo Rodrigo Santos de;Ferraz, Paulo Ernando;Lima, Ricardo de Carvalho;
Revista Brasileira de Cirurgia Cardiovascular , 2012, DOI: 10.5935/1678-9741.20120017
Abstract: objective: the aim of this study is to evaluate the applicability of a brazilian score for predicting atrial fibrillation (af) in patients undergoing heart valve surgery in the division of cardiovascular surgery of pronto socorro cardiológico de pernambuco - procape (recife, pe, brazil). methods: retrospective study involving 491 consecutive patients operated between may/2007 and december/2010. the registers contained all the information used to calculate the score. the outcome of interest was af. we calculated association of model factors with af (univariate analysis and multivariate logistic regression analysis), and association of risk score classes with af. results: the incidence of af was 31.2%. in multivariate analysis, the four variables of the score were predictors of postoperative af: age >70 years (or 6.82; 95%ci 3.34-14.10; p<0.001), mitral valve disease (or 3.18; 95%ci 1.83-5.20; p<0.001), no use of beta-blocker or discontinuation of its use in the postoperative period (or 1.63; 95%ci 1.05-2.51; p=0.028), total fluid balance > 1500 ml at first 24 hours (or 1.92; 95%ci 1.28-2.88; p=0.002). we observed that the higher the risk class of the patient (low, medium, high, very high), the greater is the incidence of postoperative af (4.2%; 18.1%; 30.8%; 49.2%), showing that the model seems to be a good predictor of risk of postoperative af, in a statistically significant association (p<0.001). conclusions: the brazilian score proved to be a simple and objective index, revealing a satisfactory predictor of development of postoperative af in patients undergoing heart valve surgery at our institution.
RORTY, Richard; NYSTROM, Derek; PUCKETT, Kent. Contra os patr es, contra as oligarquias: uma conversa com Richard Rorty. Luiz Henrique de Araújo Dutra (trad.). S o Paulo: Unesp, 2006. 96p. ISBN: 8571396914
Ernando Melo
Revista Organiza??es em Contexto , 2006,
Abstract: S o abordados a história intelectual e o trabalho acadêmico Rorty, filósofo norte-americano, nascido em 1931, os efeitos da globaliza o, a vida, o vigor, o que foi e quais as origens da esquerda americana, recuperando o pensamento de Walt Whitman e John Dewey. Já foi o tempo em que Richard Rorty poderia ser considerado o enfant-terrible da filosofia norte-americana. O pensador iconoclasta, visto por tantos de seus pares como a própria personifica o da heterodoxia, transformouse, ele mesmo, em um dos componentes obrigatórios do mainstream; n o por ter obtido vitória inconteste sobre seus oponentes, mas por ser reconhecido como um dos interlocutores inevitáveis da tradi o.
Influence of CDW Recycled Aggregate on Drying Shrinkage of Mortar  [PDF]
Paulo Roberto Lopes Lima, Monica Batista Leite
Open Journal of Civil Engineering (OJCE) , 2012, DOI: 10.4236/ojce.2012.22009
Abstract: The use of fine recycled aggregates as raw material in the production of mortars appears as a good alternative to minimize waste disposal, so as to reduce natural resources consumption and to find and supply suitable substitutes for natural aggregates. However, the use of this alternative material in a safe way must be carried out by a wide investigation of its long term behavior. In this way, this paper will examine the mechanical strength, physical properties and drying shrinkage of mortar, which use recycled fine aggregates that have originated from construction and demolition waste (CDW) containing mortar (55%), ceramic (26%) and concrete (16%). Two natural mortars, made with natural sand, were produced with cement/sand ratios of 1:4 and 1:8 (by weight) and a fixed consistency index of 260 +10 mm. Recycled mortar was produced with 50% of substitution rate, in volume, of natural aggregate by recycled one. Results show that recycled mortars present higher total porosity, absorption rate and drying shrinkage than reference mortar.
Neoumbilicoplastia como op??o de reconstru??o umbilical nas dermolipectomias abdominais em ancora pós-gastroplastia
Cavalcanti, Ernando Luiz Ferraz;
Revista Brasileira de Cirurgia Plástica , 2010, DOI: 10.1590/S1983-51752010000300019
Abstract: introduction: anchor-line abdominoplasty after massive weight loss secondary to bariatric surgeries are increasingly being performed in our specialty. at the same time, the emergence of new techniques for umbilical reconstruction, as well as the evolution of existing ones has always add to the armamentarium of surgical specialty, in order to promote best levels of satisfaction and fewer complications. methods: this work of series of cases aims to describe the main results of the umbilicoplasty held at anchor-line abdominoplasty in 31 patients from january 2008 until july 2009, presenting technical details of neo-umbilicoplasty. as a secondary objective, describes the general characteristics and trans-operative population. variables analised: age, sex, bmi, incidence of hernias, part weight, duration of surgery and complications. results: the results show that the general characteristics, trans-operative data and complications are consistent with other published studies in the literature. conclusions: the technique of neo-umbilicoplasty proved to be an easy method of umbilical reconstruction with better cosmetic results than the tactic of umbilicoplasty for transposition, with fewer complications, a great satisfaction of the author and the patients. however, an analytical study on long-term would be necessary for these results can be extrapolated to the universe of ex-obese patients.
Mulheres e o abandono da figura paterna: considera??es teórico-clínicas a partir da psicologia analítica
Lima, Antonio Paulo Pinheiro;
Estudos de Psicologia (Campinas) , 2012, DOI: 10.1590/S0103-166X2012000500018
Abstract: the article seeks to demonstrate, by means of clinical vignettes, the negative consequences brought into women's lives by experiences of having been abandoned by the father figure. in this study, the theoretical benchmark was primarily analytical psychology, in addition to the psychoanalytic concepts of repetition compulsion and melancholy. there is also a description of the results achieved in cases treated with psychotherapy based on jungian clinical method. the achievements, in general, relate to greater psychic integration by these women, who were able to establish greater internal balance between the masculine and feminine polarities. that balance brought positive impacts to these women, such as improved self-esteem and greater sense of confidence, and made possible for them to experience healthier emotional relationships, based on a lower degree of submission and dependence.
THE SCEPTICISM IN DIDEROT OF MATURITY O CETICISMO NO DIDEROT DA MATURIDADE
Paulo Jonas Lima Piva
Philósophos : Revista de Filosofia , 2009, DOI: 10.5216/phi.v13i1.5442
Abstract: This paper completes a triad developed around the issue of scepticism in the enlightened thinking of Denis Diderot. The first one, entitled "The young Diderot and the scepticism of Thoughts", was published in the journal Two Points, in its edition devoted to the subject of scepticism (cf. PIVA, 2007), and was limited to an analysis of the problem of attitude sceptical on Thoughts philosophical, in 1746. The second, "The clearing of Diderot with scepticism", published in the journal Transformation (cf. PIVA, 2009), deals with two fundamental questions, this time on The tour of the sceptic or The boulevards, of 1747, latest book in that the scepticism is raised to prominence by encyclopedist, since two years later he finally surrenders to the atheistic materialism. They are: 1) the interpretation that develops Diderot's scepticism and 2) its position before him. In this paper we will examine the presence of scepticism in thought diderotiano of maturity, namely the period beginning in 1749 with the drafting of the Charter for the blind, considering how they and where it is addressed records in some of the most significant texts its philosophical maturity. Este artigo completa uma tríade elaborada em torno da quest o do ceticismo no pensamento iluminista de Denis Diderot. O primeiro deles, intitulado “O jovem Diderot e o ceticismo dos Pensamentos”, foi publicado na revista Dois Pontos, em sua edi o dedicada ao tema do ceticismo (cf. PIVA, 2007), e limitou-se a uma análise detida do problema da postura cética nos Pensamentos filosóficos, de 1746. O segundo, “O acerto de contas de Diderot com o ceticismo”, publicado na revista Transforma o (cf. PIVA, 2009), trata de duas quest es fundamentais, desta vez em O passeio do cético ou As alamedas, de 1747, último livro em que o ceticismo é evocado com destaque pelo enciclopedista, posto que dois anos depois ele se rende definitivamente ao materialismo ateu. S o elas: 1) a interpreta o que Diderot desenvolve do ceticismo e 2) a sua posi o diante dele. Neste artigo será examinada a presen a do ceticismo no pensamento diderotiano da maturidade, ou seja, no período que se inicia em 1749 com a reda o da Carta sobre os cegos, considerando de que modo e em que registros ele é abordado em alguns dos textos mais significativos da sua maturidade filosófica.
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