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Search Results: 1 - 10 of 12846 matches for " Montera Marcelo Westerlund "
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Valor prognóstico do teste de caminhada de seis minutos na insuficiência cardíaca
Rubim, Valéria Siqueira Martins;Drumond Neto, Cantídio;Romeo, José Luiz Martins;Montera, Marcelo Westerlund;
Arquivos Brasileiros de Cardiologia , 2006, DOI: 10.1590/S0066-782X2006000200007
Abstract: objective: this study aimed to assess the true usefulness of the six-minute walk test as a prognostic indicator and its contribution to clinical practice with heart failure patients. methods: in order to investigate the actual value of the six-minute walk test as an objective measure of mortality probability in patients with heart failure, the test was applied to 179 stable patients (120 men and 59 women, mean age 58.32 ± 12.7 years, with nyha class ii and iii heart failure and an ejection fraction (lvef) of 34.91 ± 12.4%). patients were instructed to walk for 6 minutes and then, four hours later, underwent a conventional exercise stress test (as per naughton protocol). patients were followed for an average of eighteen months. results: the average distance walked was 521.11 ± 76.1 meters. during the follow-up period, 66 patients (36.9%) died. there was a significant correlation between the distance walked during the test and mortality (p < 0.0001). the logistic regression model identified the distance walked during the test as the most important independent predictor of mortality (p = 0.0001). a distance shorter than 520 meters identified the patients with an increased probability of death. there was a significant correlation between the number of metabolic equivalents (mets) measured during the conventional exercise stress testing and mortality rate (p = 0.0001). conclusion: the six-minute walk test is a simple, safe and powerful method to assess the prognosis of patients with nyha class ii and iii heart failure. it is an objective examination that may replace the conventional ergometric test for the prognostic evaluation of these patients.
Valor prognóstico do teste de caminhada de seis minutos na insuficiência cardíaca
Rubim Valéria Siqueira Martins,Drumond Neto Cantídio,Romeo José Luiz Martins,Montera Marcelo Westerlund
Arquivos Brasileiros de Cardiologia , 2006,
Abstract: OBJETIVOS: Este estudo objetivou avaliar a utilidade do teste de caminhada de seis minutos como indicador prognóstico e sua contribui o na prática clínica diária de pacientes com insuficiência cardíaca. MéTODOS: O teste de caminhada de seis minutos foi administrado a 179 pacientes (120 homens, 59 mulheres; idade média de 58,32 ± 12,7 anos), portadores insuficiência cardíaca nas classes II e III da New York Heart Association (NYHA), com fra o de eje o do ventrículo esquerdo de 34,91 ± 12,4%. Os pacientes realizaram o teste de caminhada de seis minutos e, 4 horas depois, o teste ergométrico convencional sob o Protocolo de Naughton limitado por sintomas, e foram acompanhados por um período médio de dezoito meses. RESULTADOS: A distancia média percorrida no teste de caminhada seis minutos foi de 521,11 ± 76,1 metros. Durante o acompanhamento, 66 pacientes (36,9%) morreram. Houve uma correla o significativa entre a distancia percorrida no teste de caminhada de seis minutos e a mortalidade (p < 0,0001). O modelo de regress o logística identificou a distancia percorrida durante o teste de caminhada de seis minutos como o mais forte indicador independente de mortalidade (p = 0,0001). A distancia caminhada menor que 520 metros identificou os pacientes com maior probabilidade de óbito. O número de equivalentes metabólicos alcan ados no teste ergométrico convencional também correlacionou-se significativamente com a mortalidade (p = 0,0001). CONCLUS O: O teste de caminhada de seis minutos é um método simples, seguro e potente de avalia o prognóstica de portadores de insuficiência cardíaca nas classes II e III da NYHA. é um exame objetivo, que pode substituir o teste ergométrico convencional na avalia o prognóstica desses pacientes.
Correla??o do colágeno intersticial miocárdico do septo do ventrículo direito com a fun??o ventricular em pacientes com cardiomiopatia isquêmica
Montera, Marcelo Westerlund;Drumond, Cantídio;Takiya, Cristina;Mesquita, Cláudio Tinoco;Dohmann, Hans Fernando R.;Mady, Charles;
Arquivos Brasileiros de Cardiologia , 2009, DOI: 10.1590/S0066-782X2009000100009
Abstract: background: myocardial collagen content influences ventricular relaxation, contraction, and morphology. its relationship with ventricular function in patients (pts) with ischemic cardiomyopathy (icmp) has not yet been fully studied in humans. objective: to assess the relationship between interstitial collagen content in non-infarcted areas of the right ventricular septum and ventricular function in icmp. methods: 31 pts with coronary artery disease were divided into four groups as follows:the control group consisted of 7 pts with normal left (lvef) and right (rvef) ventricular ejection fraction (group c); group 1: 5 patients with rvef < 40%; group 2: 9 pts with lvef < 40%; and group 3, 10 pts with biventricular dysfunction. rvef and lvef were measured by radionuclide angiography. for quantitative analysis of interstitial collagen volume fraction (cvf), endomyocardial biopsy specimens were taken from the right ventricle and stained with picrosirius red. results: mean cvf was significantly higher in group 3, compared with the control group and with groups 1 and 2 (30.2 ± 7.9% vs. 6.8 ± 3.3% vs. 15.8 ± 4.1% vs. 17.5±7.7%, respectively; p =0.0001). it was also significantly higher in patients belonging to group 2, compared with those in the control group (17.5 ± 7.7% vs. 6.8 ± 3.3%, p =0.0001). cvf was inversely correlated with rvef (r = - 0.50, p = 0.003) and lvef (r = -0.70, p = 0.0001). conclusion: in icmp, cvf is elevated in non-infarcted areas of the right ventricular septum and inversely correlated with right and left ventricular function.
Assistência circulatória com oxigena??o por membrana extracorpórea (ECMO) no adulto: um conceito falido ou esquecido?
Colafranceschi, Alexandre Siciliano;Monteiro, Andrey José de Oliveira;Canale, Leonardo Secchin;Campos, Luiz Antonio de Almeida;Montera, Marcelo Westerlund;Silva, Paulo Roberto Dutra da;Fernandes, Marcelo Ramalho;Pinto, Alexandre de Araújo;Molas, Stelmar Moura;Mesquita, Evandro Tinoco;
Arquivos Brasileiros de Cardiologia , 2008, DOI: 10.1590/S0066-782X2008001300006
Abstract: background: the extracorporeal membrane oxygenation (ecmo) has been used in the neonatal and childhood periods with excellent results. the adult experience has been modest with inferior immediate results. the intermediate survival, however, has been promising. we have been using the extracorporeal membrane oxygenation for temporary mechanical circulatory support of adults that present with acute refractory cardiogenic shock in our institution. there is no other published experience of the use of this system in this scenario in brazil. objective: to describe our experience with the use of the extracorporeal membrane oxygenation for circulatory support in adults. methods: retrospective analysis of the medical files of patients submitted to the implant of extracorporeal membrane oxygenation system for circulatory assistance in acute and refractory cardiogenic shock. results: eleven patients (63,5yo; 45,5%male) were considered for analysis from 2005 to 2007. median support time was 77 hours (10-240h) and 5 patients have survived 30 days (45,5%). two patients were subsequently submitted to prolonged paracorporeal circulatory assistance. mortality on ecmo (6 patients) was due to multiple organ failure (66,6%) and refractory bleeding (33,4%). conclusion: ecmo system is an option to be used in acute refractory cardiogenic shock as a bridge to recovery or selecting patients that might benefit from prolonged paracorporeal assist devices (bridge to bridge).
Avalia??o do perfil arritmogênico ventricular de pacientes com miocardiopatia dilatada e fra??o de eje??o diminuída
Maia, Ivan G.;Drumond Neto, Cantidio;Montera, Marcelo;Costa, Lilian Soares da;Alves, Paulo A. G.;
Arquivos Brasileiros de Cardiologia , 1998, DOI: 10.1590/S0066-782X1998000400001
Abstract: purpose: to evaluate the arrhythmogenic profile of patients with dilated cardiomyopathy of low ejection fraction and its prognostic significance. methods: data from 40 patients (30 males; mean age: 52±13 years) were analysed including ventricular arrhythmias (24h - holter monitoring), autonomic balance from heart rate variability in time domain (rmssd and pnn50 indexes), ventricular late potentials (signal averaged electrocardiogram (ecg)) and dispersion of ventricular repolarization measured from 12-lead ecg. results: there was a high prevalence of ventricular arrhythmias with at least one episode of nonsustained ventricular tachycardia (vt) in 60% of the patients. depressed vagal activity was observed in more than half of the patients. in only 30% of the patients the signal-averaged ecg was positive. the dispersion of ventricular repolarization ranged from 20 to 100ms. the presence of >30 ventricular premature beats or nonsustained vt on holter monitoring was the most significant predictor of cardiac death and sudden cardiac death with a relative risk of 1.9 and 3.2, respectively (p= 0.01 and 0.000). conclusion: in this study population it was noted that patients with dilated cardiomyopathy and low ejection fraction had an abnormal electrical and autonomic cardiac behaviour. these findings could represent risk factors for the ocurrence of life-threatening arrhythmias or fatal events.
Avalia o do perfil arritmogênico ventricular de pacientes com miocardiopatia dilatada e fra o de eje o diminuída
Maia Ivan G.,Drumond Neto Cantidio,Montera Marcelo,Costa Lilian Soares da
Arquivos Brasileiros de Cardiologia , 1998,
Abstract: OBJETIVO: Avaliar o perfil arritmogênico ventricular de pacientes com miocardiopatia dilatada e fra o de eje o diminuída. MéTODOS: Estudo prospectivo em 40 pacientes com fra o de eje o média ao ecocardiograma de 32,5±2,1%, obtida pela análise do Holter de 24h, do balan o auton mico cardíaco, determinado por índices de variabilidade da freqüência cardíaca (rMSSD e pNN50), do eletrocardiograma (ECG) de alta resolu o (ECGAR) e do grau de dispers o da repolariza o ventricular determinado no ECG de superfície. Por regress o logística determinaram-se, a partir dos resultados, os preditores de risco para morte cardíaca e morte súbita. RESULTADOS: Observou-se na popula o envolvida uma elevada incidência de ectopias ventriculares isoladas, pareadas e de surtos n o sustentados de taquicardia ventricular. Pela análise do balan o auton mico notou-se depress o da atividade vagal cardíaca em mais da metade dos pacientes, sendo que apenas 30% apresentaram ECGAR positivo. O grau de dispers o temporal da repolariza o ventricular variou de 20 a 100ms. A presen a de >30 extra-sístoles isoladas por hora e de taquicardia ventricular n o sustentada ao Holter foram os preditores de risco com valores mais elevados para a morte cardíaca e morte súbita, com uma raz o de risco respectiva de 1,9 e 3,2 (p= 0,01 e 0,000). CONCLUS O: Foram observadas importantes altera es no comportamento elétrico e auton mico cardíaco, constituindo-se fatores de risco para a ocorrência de eventos arrítmicos graves ou fatais.
Genomics and Ethics: The Case of Cloned and/or Transgenic Animals
Béatrice de Montera
Comparative and Functional Genomics , 2003, DOI: 10.1002/cfg.243
Abstract: The point of the present study is to illustrate and, if possible, promote the existing link between genomics and ethics, taking the example of cloned and transgenic animals. These ‘new animals’ raise theoretical and practical problems that concern applied ethics. We will explore more particularly an original strategy showing that it is possible, starting from philosophical questioning about the nature of identity, to use a genomic approach, based on amplification fragment length polymorphism (AFLP) and methylation-sensitive amplification polymorphism (MSAP) detection, to provide useful tools to define more rigorously what cloned animals are, by testing their genetic and epigenetic identity. We expect from the future results of this combined approach to stimulate the creativity of the philosophical and ethical reflection about the impact of biotechnology on animals, and to increase scientific involvement in such issues.
A theory of turbulence based on scale relativity
Louis de Montera
Physics , 2013,
Abstract: The internal interactions of fluids occur at all scales therefore the resulting force fields have no reason to be smooth and differentiable. The release of the differentiability hypothesis has important mathematical consequences, like scale dependence and the use of a higher algebra. The law of mechanics transfers directly these properties to the velocity of fluid particles whose trajectories in velocity space become fractal and non-deterministic. The principle of relativity is used to find the form of the equation governing velocity in scale space. The solution of this equation contains a fractal and a non-fractal term. The fractal part is shown to be equivalent to the Lagrangian version of the Kolmogorov law of fully-developed and isotropic turbulence. It is therefore associated with turbulence, whereas the non-fractal deterministic term is associated with a laminar behavior. These terms are found to be balanced when the typical velocity reaches a level at which the Reynolds number is equal to one, in agreement with the empirical observations. The rate of energy dissipated by turbulence in a flow passing an obstacle that was only known from experiments can be derived theoretically from the equation's solution. Finally, a quantum-like equation in velocity space is proposed in order to find the probability of having a given velocity at a given location. It may eventually explain the presence of large scale coherent structures in geophysical turbulent flows, like jet-streams.
Categorizing the Growth Strategies of Small Firms
Seppo Leminen,Mika Westerlund
Technology Innovation Management Review , 2012,
Abstract: This study investigates the link between a small firm’s investment in R&D and its growth strategy. A firm’s growth strategy refers to the means by which the organization plans to achieve its objective to grow in volume and turnover. We categorize firm growth strategies into eight distinctive clusters: opportunity explorers, radical innovators, business developers, business expanders, profit makers, business rebuilders, stagnators, and downsizers. We argue that understanding a firm’s growth orientation provides a way to assess the returns of its R&D investments, because an organization’s intangible growth strategies and tangible inputs are connected.
Managing the Challenges of Becoming an Open Innovation Company: Experiences from Living Labs
Mika Westerlund,Seppo Leminen
Technology Innovation Management Review , 2011,
Abstract: High-technology firms have paved the way for user-driven innovations, but now even traditional industries are becoming increasingly open. This shift is a great challenge for companies with instituted practices, policies, and customer relationships. In this article, we identify four distinct steps in becoming an open innovation company based on our recent research into firms’ experiences with living lab experiments in the information and communication technology (ICT) sector. We describe these phases and illustrate the divergent roles that users play in each one. We conclude with a discussion on the differences between the management challenges of conventional development projects versus the open innovation model. For all firms that wish to become open innovators, we recommend that their managers promote an open organizational mindset and apply groupware that supports increased openness, because traditional project management tools are insufficient for open innovation.
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