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Influência da posição do orifício de saída e do tipo da ponta do cateter sobre o risco de complicações mecânicas e infecciosas e sobrevida da técnica em pacientes em diálise peritoneal / Influence of the position of the exit site and the type of catheter tip on the risk of mechanical and infectious complications and survival of the technique in patients on peritoneal dialysisBanin, Vanessa Burgugi [UNESP] 30 May 2017 (has links)
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Previous issue date: 2017-05-30 / Introdução: As complicações mecânicas e infecciosas associadas ao cateter de dialise peritoneal representam as principais causas de falência da técnica. Tais complicações podem estar associadas às configurações intra e extraperitoneal do cateter. Objetivo: comparar complicações mecânicas e infecciosas, além de sobrevida da técnica entre cateteres de Tenckhoff implantados com Orifício de Saída (OS) voltado para baixo e OS voltado para cima e cateteres de Swan Neck (ponta reta e ponta coil). Metodologia: estudo prospectivo randomizado que comparou complicações mecânicas (translocações) e infecciosas (peritonites e infecções de orifício de saída) entre cateteres divididos de maneira randomizada em quatro grupos: Tenkhoff OS baixo, Tenckhoff OS cima, Swan Neck ponta reta e Swan Neck ponta coil. Os grupos foram seguidos pelo período de um ano. O implante foi realizado pela equipe da Nefrologia utilizando a técnica de Seldinger. Resultados: no período de agosto de 2013 a fevereiro de 2016 foram implantados 107 cateteres em 96 pacientes. As características clinicas e demográficas foram semelhantes entre os pacientes nos quatro grupos. A análise da curva de sobrevida pelo método de Kaplan-Meier não mostrou diferenças para o tempo livre do primeiro episódio de infecção de OS (p=0,19) ou peritonite (p=0,29) entre os quatro grupos. Observamos no entanto, menor tempo livre até o primeiro episódio de translocação (p=0,03), menor sobrevida do cateter (p=0,001) e menor sobrevida da técnica (p=0,02) no grupo Tenckhoff OS baixo. A análise múltipla mostrou que o fator associado com falência do cateter foi a presença de translocações. Em um segundo modelo, quando excluído translocações, o cateter Tenckhoff OS baixo se associou com maior risco de falência do cateter. Conclusão: o cateter de Tenckhoff reto com OS voltado para baixo foi associado com menor tempo livre até o primeiro episódio de translocação, além de menor sobrevida do cateter e da técnica. É provável que a atuação da força de resiliência possa ter sido responsável pelos resultados observados nesse estudo. / Background: The mechanical and infectious complications associated with the peritoneal dialysis catheter represent the main causes of technique failure. Such complications may be associated with the intra- and extra-peritoneal configurations of the catheter. Purpose: The objectives of this study were to compare infectious and mechanical complications and technique survival among four randomized groups of PD catheters: straight Tenckhoff catheters implanted with downward Exit Site (ES), straight Tenckhoff implanted with upward ES, Swan-Neck coil tip and Swan-Neck straight tip. Methods: A prospective randomized trial comparing mechanical (translocations) and infectious (peritonitis and exit-site infection) complications between catheters randomly divided into four groups: Tenkhoff downward ES, Tenckhoff upward ES, Swan Neck straight tip and Swan Neck coil tip. The four groups were followed for one year. The implant was performed by the Nephrology team using the Seldinger technique. Results: In the period from August 2013 to February 2016, 107 catheters were implanted in 96 patients. The baseline demographics characteristics were similar among the groups. Analysis of the Kaplan-Meier survival curve showed no difference in the free time of the first episode of ES infection (p = 0.19) or peritonitis (p = 0.29) among the four groups. We observed, however, less free time for the first episode of translocation (p = 0.03), lower catheter survival (p = 0.001) and lower technique survival (p = 0.02) in the Tenckhoff downward ES group. Multiple analysis showed that the factor associated with catheter failure was the presence of translocations. When we excluded translocations from the model the Tenckhoff downward ES was associated with catheter failure. Conclusions: Straight Tenckhoff catheter implanted employing donward tunnel-tract and ES direction is associated with less free time until the first translocation episode, lower catheter and technique survival. It is likely that the performance of resilience force may have been responsible for the results observed in this study.
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Dětský hrdina v současné literatuře a filmu pro děti a mládež / The Children´s hero in the contemporary literature and film for childrenHAFERNÍKOVÁ, Eva January 2010 (has links)
The thesis deals with the representation of children hero characters in the contemporary literature and movies for children and young people. The theoretical part of the thesis deals with the influence of media and particular children fantasy heroes, Harry Potter and Isabella Swan. The practical part finds out children{\crq}s and students{\crq} opinions about media, books, movies and preferred and not preferred children heroes{\crq} qualities.
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O Padrão de ondas no lago Guaíba e sua influência nos processos de sedimentaçãoNicolodi, João Luiz January 2007 (has links)
O Lago Guaíba configura-se como o grande depositário das águas de uma bacia hidrográfica que engloba boa parte do centro e nordeste do estado, estendendo-se por uma área aproximada de 84.700 km2 que abrange mais de 250 municípios, entre eles a capital do Estado. São 496 km2 de superfície onde diversos usos e atividades têm seu palco, como por exemplo; navegação, recreação, extração de areia e, a mais importante delas, o abastecimento de água de boa parte da região metropolitana de Porto Alegre. Mesmo com essa relevância, poucos são os estudos referentes à dinâmica sedimentar do lago, sendo que a maioria trata da distribuição e textura dos sedimentos, e raros são aqueles que fazem menção ao padrão de ondas e suas relações com a ressuspensão destes sedimentos e suas conseqüências. A presente pesquisa analisa as características das ondas incidentes no Lago Guaíba quanto a seus principais parâmetros; altura significativa (Hs), período (T), direção de propagação e suas relações com a ressuspensão de sedimentos junto ao fundo. Para tanto, o SWAN (Simulating Waves Nearshore), software que utiliza técnicas de modelagem matemática, foi validado e aplicado, tendo como principais parâmetros de entrada a batimetria do lago, a direção, velocidade e freqüência de incidência de ventos na região (entre os anos 1996 e 1997), além de correntes, nível d’água, densidade, freqüências máximas e mínimas, entre outros. Já os parâmetros de saída (altura significativa da onda, período, direção de propagação e velocidade orbital) foram inseridos no Sistema de Informações Geográficas IDRISI e trabalhados de forma a inferir o padrão de ondas incidentes no lago e suas interações com a ressuspensão de sedimentos de fundo, caracterizando a profundidade de início do regime de fluxo turbulento e delimitando a área de atuação da turbulência vinculada ao transporte de sedimentos. As maiores ondas modeladas atingiram 0,55 m em alguns pontos do lago, principalmente quando de ventos soprando dos quadrantes S e SE e em intensidades superiores a 7 m/s. Em linhas gerais as ondas acompanham os padrões de intensidade e direção do vento, atingindo os valores máximos aproximadamente entre 1 e 2 horas após os picos de velocidade dos ventos. Em situações de maior intensidade de ventos as ondas levaram aproximadamente 2 horas para atingirem 0,10 m, já com ventos fracos a moderados este tempo é de aproximadamente 3 horas. Além de velocidade e direção, a regularidade dos ventos mostrou-se relevante na geração e propagação de ondas no Guaíba. Características geomorfológicas referentes à geometria, batimetria e o fetch do lago também são importantes, fato evidenciado quando da análise de cinco estações de controle sob um mesmo regime de ventos; a diferença entre a altura das ondas chegou a mais de 0,40 m entre porções distintas do lago. Além disso, há o processo de refração das ondas que causa um rápido alinhamento da zona de rebentação de tal maneira que ela tende a ser paralela a linha de praia. Os parâmetros que estabelecem as condições deposicionais no Guaíba são controlados pelo nível de energia das ondas incidentes e pelas correntes. Pode-se afirmar que em função das pequenas profundidades e baixas velocidades médias das correntes de fundo, o transporte de sedimentos finos é particularmente governado pelas ondas, uma vez que as mesmas são responsáveis pela inserção dos sedimentos na coluna d’água. As ondas incidentes no Guaíba têm potencial para gerar turbulência junto ao fundo em diferentes situações. Entretanto, a profundidade máxima não excede a 1,9 m para ventos do quadrante S e velocidades da ordem de 11 m/s. Já a espessura da camada limite onde se verifica inicio do fluxo turbulento apresenta valores bastante reduzidos, entre 0,02 a 1 cm. Os ambientes de sedimentação do lago foram mapeados e assim classificados: 1) Fundo Deposicional (51% da área do lago); 2) Fundo Transicional (41%) e 3) Fundo Erosional ou de não Deposição (8%). Estas condições foram espacializadas em um modelo temporal que relacionou as informações sobre velocidade orbital e a freqüência de incidência de ondas quanto à sua direção, derivadas dos resultados modelados pelo SWAN ao longo do período estudado. Pode-se afirmar que o Guaíba é um grande importador de sedimentos, uma vez que a superfície de fundo com deposição é mais significativa que a superfície de fundo com erosão, condição esta que ocorre a profundidades inferiores a 1,5 m. A situação de deposição do material transportado na coluna d’água ocorre quando da inexistência de fluxo turbulento, ou quando o mesmo é insignificante junto ao fundo (com potencial de ressuspensão de sedimentos em até 7 dias por ano, ou 2% do tempo analisado). Como forma de contribuir à gestão ambiental da região, foram gerados subsídios referentes ao potencial de concentração de material particulado em suspensão. Este potencial foi definido em função do percentual de tempo, ao longo do ano, em que a ressuspensão de sedimentos de fundo gerada por ondas pode incrementar os níveis de poluição nos locais onde a água é atualmente captada para o abastecimento público no município de Porto Alegre. / Guaíba Lake is the main destination of the water coming from a river basin which encompasses a major part of the center and northeast of Rio Grande do Sul state, extending over some 84,700 square km and reaching more than 250 municipalities, including the state capital. This adds up to a 496 sq. km area, where several functions and activities occur, such as navigation, recreation, sand extraction, and, most important of all, water supply to a large part of the metropolitan Porto Alegre area. Despite this relevance, few studies have been conducted on the lake’s sedimentary dynamics, with most of them addressing sediment distribution and textures, and even fewer mentioning wave pattern and its connection with the ressuspension of these sediments and its consequences. This research examines the characteristics of Lake Guaíba’s waves with regard to their main parameters; significant wave height (Hs), period (T), direction of wave propagation and its connections with the ressuspension of sediments at the bottom. To this end, SWAN (Simulating Waves Nearshore) a type of software using mathematical modeling techniques, has been validated and applied, with its main inputs being the lake’s bathymetry, direction, wind speed and frequency in the region (between 1996 and 1997) in addition to currents, water level, density, and maximum and minimum frequencies, among others. Output parameters (significant wave height, period, direction of wave propagation, and orbital motion) were inserted in the IDRISI Geographic Information System and studied so as to infer the lake’s wave pattern and its interactions with the ressuspension of bottom sediments, characterizing depth at the beginning of the turbulent flow and encircling the area of turbulence linked to transport of sediments. The highest waves modeled reached 0.55 m in a few points of the lake, particularly when winds were blowing from the S and SE quadrants with an intensity of over 7 m/sec. Generally speaking, waves follow wind intensity and direction patterns, and reach maximum values in about 1 to 2 hours after wind speed peaks. Whenever winds were stronger, waves took some 2 hours to reach 0.10 m, but with weak to moderate winds, they took around 3 hours. In addition to speed and direction, wind regularity proved relevant in generating and propagating waves on Lake Guaíba. Geomorphologic characteristics as regards the lake’s geometry, bathymetry and fetch are likewise important, as was verified when five control stations were analyzed under a same wind pattern; the difference between wave height exceeded 0.40 m among distinctive parts of the lake. In addition, there is a wave refraction process, which causes a fast alignment to the breaker zone, so that it tends to be parallel to the shoreline. The parameters establishing Lake Guaíba’s depositional environment are controlled by the energy level of the existing waves and currents. It can be stated that, as a result of small depths and low average speeds of the bottom currents, the transport of fine sediments is particularly governed by the waves, since it is the waves that add sediments to the water column. The Guaíba waves can potentially generate bottom turbulence in different situations. However, the maximum depth does not exceed 1.9 m with S quadrant winds and speeds of about 11 m/s. On the other hand, the thickness of the bordering layer where the turbulent flow begins has very low values, between 0.02 to 1 cm. The lake’s sediment environments were mapped and rated as follows: 1) Depositional Environment (51% of the lake); 2) Transitional Environment (41%); and 3) Erosional or Non- Depositional Environment (8%). Such conditions were spatialized in a time model which linked information on orbital motion and frequency of wave occurrence as to direction, obtained from the SWAN-modeled results throughout the period under study. It can be stated that Lake Guaíba is a major importer of sediments, since its depositional environment area is more significant than its erosional environment area, and this situation occurs at depths of less than 1.5 m. Deposition of matter carried in the water column occurs when there is no turbulent flow, or when it is insignificant to the environment (with a sediments ressuspension potential of up to 7 days a year, or 2% of the time analyzed). As a contribution to the region’s environmental management, subsidies have been created with relation to the concentration of particulate suspended matter. This potential has been defined as a percentage of time, throughout the year, in which the wave-created ressuspension of environment sediments can increase the pollution levels at places where water is currently captured for public supply in the Porto Alegre area.
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Ekonomický rozvoj jihoasijských zemí / Economic development of South Asian countriesChyšková, Kateřina January 2017 (has links)
Aim of this thesis is to empirically verify the validity of Rostows Stages of economic growth model and Solow-Swan model of economic growth realized by using statistical data South Asian countries reported. Theoretical part is devoted to characteristics of the growth models, explaining the assumptions theories work with and defining their origins and possible limitations. Practical part is focused on the analysis of statistical outputs newly industrialized Asian countries (Asian Tigers). The choice of selected data for analysis is justified. The data are further evaluated against expectations out of the Rostows and Solows theory of economic growth. The appropriateness of the growth models with regard to the territories is also evaluated.
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Hemodinâmica e efeitos respiratórios e sedativos da associação de detomidina e nalbufina pela via intramuscular em ovinos /Sousa, Élen Almeida Pedreira de. January 2019 (has links)
Orientador: Paulo Sergio Patto dos Santos / Resumo: Objetivou-se com este trabalho avaliar os efeitos na hemodinâmica, respiração, motilidade ruminal e sedação, da associação de detomidina e nalbufina em ovinos. Foram utilizados 8 ovinos hígidos, jovens, fêmeas ou machos, pesando 54,85 ± 20,31kg. Foi instalado na veia jugular esquerda um introdutor e, posteriormente, posicionado um cateter de Swan-Ganz com a extremidade distal alocada no lumen da artéria pulmonar. Foi administrado pela via intramuscular detomidina (10μg/kg) associado a nalbufina (0,1mg/kg). Foram avaliadas FC, PAS, PAD, PAM, PVC, PAPm, IC, IS, IRVS, FR, pH, PaO2, PaCO2, HCO3, TC, sedação e motilidade ruminal antes do início da administração dos fármacos (MB) e a cada quinze minutos após a aplicação durante sessenta minutos (M15, M30, M45 e M60). Houve redução do IC, FR e aumento da PAS, PAPm, temperatura central, PaCO2 e HCO3 após administração dos fármacos. A sedação foi considerada satisfatória durante 45 minutos. Com os resultados obtidos neste estudo, conclui-se que a neuroleptoanalgesia promovida pela associação de detomidina e nalbufina em ovinos, nas doses utilizadas, promove sedação satisfatória. As alterações hemodinâmicas, respiratórias e na motilidade ruminal observadas podem ser bem toleradas por animais sadios. / Abstract: The aim of this study was to evaluate the effects on hemodynamics, respiration, ruminal motility and sedation of the combination of detomidine and nalbuphine in sheep. Were used eight healthy young, female or male sheep, weighing 54.85 ± 20.31kg. A Percutaneous Sheath Introducer was placed in the left jugular vein and then a Swan-Ganz catheter was positioned with the distal port allocated to the lumen of the pulmonary artery. Association of detomidine (10µg/kg) and nalbuphine (0,1mg/kg) was administered intramuscular. HR, SAP, DAP, MAP, CVP, MPAP, CI, SI, SVRI, RR, pH, PaO2, PaCO2, HCO3, CT, sedation and ruminal motility before drug administration (MB) and at each fifteen minutes after application for sixty minutes (M15, M30, M45 and M60). There was a reduction in CI, RR and increase in SAP, mPAP, CT, PaCO2 and HCO3 after drug administration. Sedation was considered satisfactory for 45 minutes. The results of this study allowed us to conclude that neuroleptoanalgesia promoted by the association of detomidine and nalbuphine in sheep at the doses used, promotes satisfactory sedation for short procedures. The hemodynamic, respiratory and ruminal motility changes observed can be well tolerated by healthy animals. / Mestre
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高潮・3次元海浜流および漂砂の解析モデルの構築と実用化に関する研究田中, 和広 23 March 2021 (has links)
京都大学 / 新制・課程博士 / 博士(工学) / 甲第23149号 / 工博第4793号 / 新制||工||1750(附属図書館) / 京都大学大学院工学研究科社会基盤工学専攻 / (主査)教授 平石 哲也, 准教授 馬場 康之, 教授 森 信人 / 学位規則第4条第1項該当 / Doctor of Philosophy (Engineering) / Kyoto University / DFAM
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Problematika hodnocení a snížení dopadů tzv. černých labutí při uvádění nových léčiv na trh / Assessing and Reducing the Impact of so called Black Swans in Launching New MedicinesŽenatá, Lucie January 2017 (has links)
The diploma thesis is focused on the analysis and evaluation of risks in the introducing of new drug in the case of unexpected mass infections from the point of view of black swans. This thesis acquaints itself with the current state of the problematics, explains the terminology and meaning of black swans and gives examples of biological black swans. On the basis of the analysis and the available informations is proposed a risk assessment approach together with proposals how to reduce or eliminate possible risks.
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Riziko vodohospodářských staveb z pohledu tzv. černých labutí / Risk of hydraulic structures from the point of view of the so called “black swans”Hrabová, Kristýna January 2016 (has links)
The thesis is focused on the issue of black swans in the water structure. More detail risks and hazard dam. History has shown us that sophisticatedly structure as dam is not perfect. Failure can cause weather, natural disaster, bad chance or deliberate attack. A detailed analysis of the current situation, I mapped historic dam failure, which can cause black swan. In thesis is a reseach on knowledge of the population in this issue. Based on the analysis and obteined information was proposed measures to improve the situation.
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Petrology of the Ordovician Swan Peak Formation, Southeastern Idaho and North-Central UtahSchulingkamp, Warren J., II 01 May 1972 (has links)
The Swan Peak Formation in southeastern Idaho and north-central Utah is a sedimentary unit consisting of orthoquartzite, sandstone, siltite, shale, and limestone. The formation is divisible into three members, and the lower two members each are divisible into two informal lithologic subunits.
The lower member consists of a lower subunit of gray, calcareous sandy siltite composed of subangular to subrounded quartz grains cemented by quartz overgrowths, calcite, or iron oxide, and an upper subunit of black shale with minor interbedded silty quartzose sandstone and biomicrite (limestone).
The middle member consists of a lower subunit of interbedded pale green shale and yellowish brown silty orthoquartzite and an upper subunit of purple orthoquartzite. The brown orthoquartzite consists of well-sorted, well-rounded very fine sand- to silt-sized quartz grains cemented by quartz overgrowths which are in optical continuity with the grains they surround. The purple orthoquartzite consists of wellsorted, well-rounded, very fine to medium sand-sized quartz grains cemented by quartz overgrowths and hematite. Hematite gives the rock its purple color. gydroxylapatite is locally abundant.
The upper member is an orthoquartzite consisting of very fine to medium sand-sized, well-sorted, well-rounded quartz grains cemented by quartz overgrowths. The gastropod Murchisonia (Hormotoma) sp., the first body fossil found in the upper member, is reported.
Previous work has shown that the upper member of the Swan Peak Formation and the Eureka Quartzite are similar in lithology, stratigraphy, and trace fossils. The Eureka Quartzite in the Newfoundland Range is a very fine to medium sand-sized, well-sorted, well-rounded orthoquartzite cemented predominantly by quartz overgrowths, locally by dolomite. The petrographic similarities of the two units, shown in the present study, strengthens their proposed correlation.
High percentages of well rounded, polycrystalline and undulatory extinction quartz show that source areas for the Eureka Quartzite and Swan Peak Formation probably were immature sandstones or quartzites of Cambrian or Precambrian age, and./or exposed igneous or metamorphic rocks. The source for most of the sand probably was the Northwest Montana Uplift, although local sources along the Uinta Uplift undoubtedly played a minor role in supplying hydroxylapatite to the middle member and fine-grained elastics to the lower member.
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Stratigraphy and Environmental Analysis of the Swan Peak Formation and Eureka Quartzite, Northern UtahFrancis, George Gregory 01 May 1972 (has links)
The Swan Peak Formation in north-central Utah thickens westward, from zero feet near Logan to 687 feet in the Promontory Range. The unit is subdivided into three distinct members: 1) A lower member of interbedded shales, limestones, and quartzites; 2) A middle member of interbedded shales and brown quartzites; and 3) An upper member of white quartzites. The Swan Peak thins southward toward the east-west-trending Tooele Arch in the area of study; this thinning probably reflects both lesser deposition and greater subsequent erosion there than elsewhere. The lower member in northern Utah probably was deposited in shallow-shelf and/or transitional shorefaceshelf environments. The middle member represents shoreface to intertidal environments. Western miogeosynclinal equivalents of the lower and middle members are more carbonate-rich, the results of their more basinward position and thus greater distance from terrigenous sediment sources. The upper member was deposited in a shallow-shelf to intertidal environment by strong, predominantly south-flowing currents.
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