Text in Afrikaans / Die kerklike diens van genesing bet deur die geskiedenis uitgestaan as een van die aktiwiteite van die kerk van Jesus Christus wat vanwee verskillende redes voortdurend in die brandpunt was. Die afgelope dekades is gekenmerk deur die toename van gelowiges uit verskillende denominasies en groepe wat by die nadenke oor en beoefening van die diens van genesing in die kerk betrokke geraak bet. Die toename bet meegebring dat die kerklike diens van genesing op verskillende wyses (praktyke) beoefen is en dat verskillende redes as regverdiging daarvoor aangebied is. Onderliggend hieraan le bepaalde teoriee waarvan die beoefenaars soms bewus was, en soms nie. Die huidige navorsing ondersoek die teoriee en praxes van verskillende genesingsbedienings binne 'n bepaalde akademiese en kerklike raamwerk. In die verband is 'n vergelykende studie deur middel van 'n kwalitatiewe ondersoek na die werk van twee uiteenlopende instansies gedoen, naamlik die London Healing Mission ( wat onder toesig van die Anglikaanse kerk funksioneer en daarom 'n vaste tradisie bet), en die Vineyard Christian Fellowship van Boise, in die VSA, wat 'n jong gemeente is, en by die sogenaamde 'Third Wave' beweging inpas. Die teoriee en praktyk van elke bediening word in die studie ge!dentifiseer en met mekaar vergelyk. Uit hierdie vergelyking word verskillende gevolgtrekkings gemaak, onder andere oor die bestaansreg van die kerklike diens van genesing en die formaat wat dit behoort aan te neem. Sekere opmerkinge word op grond van die navorsingsresultate gemaak wat in die Pinkster, Charismatiese en Gerefonneerde kerke asook vir die kerk in die algemeen, van waarde kan wees. Die navorsingsresultate word gebruik om 'n bedieningsmodel vir die genesingsbediening in die kerk te ontwerp. Die ondersoek word afgesluit met aanbevelings met die oog op moontlike toekomstige navorsing. / Throughout history the healing ministry has been one of the outstanding activities of the church of Jesus Christ which remained continuously and for various reasons the focal point of attention. The past decades were characterized by an escalation of believers from different denominations and groups who became involved in the meditation and practicing of the healing ministry in the church. This escalation has resulted in the healing ministry being practiced in multiple ways and various reasons being given as justification for doing so. This was done in the presence of underlying theories of which the practitioners were either consciously or subconsciously aware or unaware of. The present research explores the theories and practices of the healing ministry within a particular academic and ecclesiastical context. A comparative study was undertaken by means of a qualitative investigation covering the work of two divergent institutions namely: The London Healing Mission (which is supervised by the Anglican Church and therefore has a specific tradition) and the Vineyard Christian Fellowship, Boise, USA, which is a 'new' congregation and fits in with the so called Third Wave movement. The theories and practices of both these ministries are identified and compared with one another. Various conclusions are reached through this comparison, referring amongst others to the healing ministry's right of existence and the format in which it should be practiced. Remarks that are being·made with regard to the results of the research should be of value to the Pentecostal, Charismatic and Reformed churches in particular, but to the Church in general as well. These results are also used to design a ministering model for the healing ministry. The study concludes with certain recommendations for possible future research. / Philosophy, Practical and Systematic Theology / Th. D. (Praktiese Teologie)

A patent is an intellectual property right granted as a reward for the labours of the inventor so as to commercially exploit the invention in return for disclosure of the invention. The benefits of the patent system find perfect expression in the employment situation since the employer is better equipped to exploit the invention through provision of resources and capital whereas the employee is provided with an opportunity to develop his technical know-how. A comparative study of the laws pertaining to employee inventions in the United Kingdom, Federal Republic of Germany and the United States of America reveals a variety of approaches to the subject of employee inventions. The approach of the South African law on the subject is inadequate and legal reform is a necessity. The recommendations for such reform encapsulates a blend of the best features of each of the three national approaches to employee inventions. / Mercentile Law / LL. M. (Law)

Made available in DSpace on 2015-07-22T20:49:20Z (GMT). No. of bitstreams: 0 Previous issue date: 2008-07-30 / Introdução: A Terapia por Contensão Induzida (TCI) ou Constraint-induced Movement Therapy é uma intervenção que tem como objetivo a recuperação do membro superior afetado de pacientes hemiparéticos devido à lesão encefálica. É aplicada através de um tratamento intensivo durante duas semanas consecutivas, com seis horas diárias de exercícios e uso de uma tipóia, durante 90% do dia, no membro superior não-afetado. O ganho motor da TCI é validado através das escalas funcionais de avaliação do membro superior (EFAMS) Wolf Motor Function Test (WMFT) e Action Research Arm Test (ARAT). Objetivo: Realizar uma análise comparativa entre ambas as EFAMS. Métodos: As EFAMS foram aplicadas em quatro períodos distintos em 17 pacientes com o diagnóstico de acidente vascular cerebral isquêmico, que realizaram individualmente a TCI durante duas semanas com seis horas diárias de exercícios e após foi feito uma análise comparativa entre as EFAMS em relação ao tempo de aplicação, tempo de preparação da mesa, reprodutibilidade e análise fatorial. Resultados: Diminuição no escore da EFAMS WMFT e aumento no escore da EFAMS ARAT pós TCI, não houve variação significativa dos escores entre os períodos pré e pós TCI das EFAMS, diminuição do tempo de preparação da mesa e aplicação de ambas as EFAMS pós TCI e a análise fatorial detectou dois e três componentes qualitativos na EFAMS ARAT e WMFT, respectivamente. Conclusões: Ambas as EFAMS conseguem mensurar o ganho motor da TCI, com alta reprodutibilidade, sendo que o tempo de aplicação e preparação da mesa é menor na EFAMS ARAT e somente a EFAMS WMFT apresenta o componente qualitativo “lateralidade”. / The Constraint-induced Movement therapy (CIMT) is an intervention which main goal is the recuperation of affected upper extremity in hemiparetic patients with acquired encephalic lesion. Its protocol consists by an intensive treatment of two consecutive weeks with six hours of exercises and the wear of arm sling in non affected upper arm during 90% of daily activities. The motor improvement of CIMT is validity by the functional evaluation scales of upper extremity (FESUE) Wolf Motor Function Test (WMFT) and Action Research Arm Test (ARAT). Objective: Realize a comparative analysis between both scales. Methodology: The FESUE had been applied during four different times in 17 patients with diagnosis of ischemic stroke, who made individually the CIMT during two weeks and six hours of exercises and after made a comparative analysis between the FESUE by time for application, time for preparation of the table, reproducibility and factorial analysis. Results: Decreased in score of FESUE WMFT and increased in score of FESUE ARAT after CIMT, no significant variation in the score between before and after CIMT of the FESUE, decreased in time to preparation the table and application of FESUE in both scales and the factorial analysis showed two and three qualitative components in FESUE ARAT and WMFT, respectively. Conclusions: Both FESUE can measure the therapeutics gains of CIMT, with high reproducibility, but the time for application and preparation of the table are minor in FESUE ARAT and only the FESUE WMFT shows the qualitative component “laterality”. / TEDE / BV UNIFESP: Teses e dissertações

Notre recherche porte sur l'analyse linguistique du verbe français et ses correspondants dans la langue arabe, dans le cadre d'une approche contrastive et comparative, pour leur intégration dans le système informatique NooJ pour une application de traduction automatique. Dans la première partie, nous avons présenté les assises théoriques sur lesquelles nous avons fondé notre étude des caractéristiques sémantico-syntaxiques des classes verbales de mouvement et de communication et qui sont essentiellement la théorie des classes d'objets de Gaston Gross et la classification des verbes français de JD & FD-C. Selon ces deux théories déjà présentées dans cette partie, nous allons faire une comparaison entre les prédicats des deux classes avec leurs correspondants en langue arabe dont nous avons donné déjà ses caractéristiques linguistiques, dans le troisième chapitre de cette partie.Dans la deuxième partie, nous avons suivi une démarche analytique mais en même temps comparative entre les deux systèmes verbaux : français-arabe. Dans le premier chapitre, nous avons effectué une comparaison entre les modes et les temps dans les deux langues. Dans les deux derniers chapitres, nous avons étudié les spécificités sémantico-syntaxiques des deux classes de communication et de mouvement entrée/sortie dont le sujet est humain [N0hum] selon la classification des « verbes français (LVF) » de JD & FD-C. Par cette analyse sémantico-syntaxique, nous avons essayé de démonter les différents patrons syntaxiques des deux classes avec la précision pour chaque type syntaxique la nature sémantique et le type de ses arguments nécessaires sans oublier de donner pour chaque prédicat son équivalent en langue arabe et faire une comparaison entre la structure argumentale des verbes français et celle des verbes arabes, pour en ressortir enfin les ressemblances et les divergences entre les deux systèmes verbaux. Et enfin, dans la troisième partie, nous avons essayé de montrer toutes les étapes nécessaires pour l'élaboration de notre application de traduction automatique en utilisant la plate-forme NooJ. Dans cette étape, nous avons créé :1/ Deux dictionnaires bilingues des verbes de communication et de mouvement. 2/ Des grammaires formelles pour la réalisation de la phase d'analyse et de reconnaissance des patrons syntaxiques des prédicats de la classe C et la classe E. 3/ Des grammaires de traduction des verbes à la forme affirmative ou négative aux temps convenables tout en précisant les règles de flexion et de l'accord en genre et en nombre selon les normes de la langue arabe.A la sortie de notre outil de traduction, nous trouvons des verbes traduits et fléchis en arabe et qui respectent les règles de la langue cible. / This research focuses on the linguistic analysis of the French verb and its correspondents in Arabic, using a contrastive and comparative approach, to integrate them into the NooJ computer system for an application of machine translation. In the first part, we have presented the theoretical foundations on which we have based our study of the semantic-syntactic characteristics of the verb classes of motion and of communication and which are essentially the Theory of the Classes of Objects of Gaston Gross and the classification of the French verbs by JD & FD-C. According to these two theories already presented in this section, we will make a comparison between the predicates of the two classes with their correspondents in Arabic to which we have already given their linguistic characteristics in the third chapter of this part. In the second part, we have followed an analytical but at the same time comparative approach between the two verb systems: French-Arabic. In the first chapter, we have compared the modes and tenses in both languages. In the last two chapters, we have studied the semantic-syntactic input / output specificities of the two classes of communication and of motion whose subject is human [N0hum] according to the classification of the French verbs (LVF) of JD & FD­ C . [n this semantic-syntactic analysis, we have tried to disassemble the different syntactic patterns of the two classes, by indicating, for each syntactic type, the semantic nature and the type of its necessary arguments without forgetting to give to each predicate its equivalent in Arabic and to make a comparison between the argumentative structure of the French verbs and that of the Arabic verbs, in order finally to corne out with the similarities and the divergences between the two verb systems.And finally, in the third part, we have tried to show al! the necessary steps for the development of our application of machine translation using the NooJ platform .In this step, we have created:1/ Two bilingual dictionaries of communication and motion verbs. 2/ Formal grammars for the realization of the analysis phase and the recognition of the syntactic patterns of the predicates of class C and class E. 3/ Grammars of translation of verbs in the affirmative or negative form at the appropriate tenses, while specifying the rules of inflection and agreement in gender and number according to the standards of Arabic. At the output of our translation tool, we have found translated and inflected Arabic verbs that respect the rules of the target language.

Les 10 000 agences de voyages en Allemagne et les 4 000 agences de voyages en France marquent le paysage touristique des deux pays et jouent un rôle important dans la distribution des prestations touristiques. Nous nous sommes interrogée sur la dynamique des agences de voyages en Allemagne et en France et sur les facteurs qui peuvent potentiellement expliquer leur dynamique hétérogène. La France se trouve dans une situation d'exception concernant la dynamique de ses agences de voyages : contrairement à beaucoup d'autres pays, le nombre d'agences de voyages françaises n'a pas diminué dans la dernière décennie. Ainsi, cela donne lieu à une remise en question de la relation fréquemment décrite comme causale entre la croissance de l'e-tourisme et la diminution du nombre d'agences de voyages. Au travers des méthodes quantitatives et qualitatives, nous avons comparé les facteurs juridiques, spatiaux, numériques et culturels qui influencent la structure des agences de voyages dans les deux pays. Cela nous a permis de montrer que les différences dans la législation affectent la structure des agences de voyages. Les agences de voyages françaises peuvent également jouer un rôle dans le tourisme réceptif de proximité (contrairement à ce qui se passe en Allemagne) de sorte que les facteurs spatiaux dans les deux pays présentent des différences. Notre étude indique aussi que l'e-tourisme entraîne une augmentation du nombre d'agences de voyages spécialisées. Enfin, il s'avère que les différences culturelles entre les clients des agences de voyages des deux pays sont plus faibles qu'attendues, aussi nous avons montré à travers l'étude d'exemples, que la presse touristique en particulier, crée des images erronées et participe à renforcer les stéréotypes de différenciation qui perdurent entre les deux pays. / The 10,000 travel agencies in Germany and 4,000 travel agencies in France shape the tourist landscape and play an important role for the tourism industry in both countries. We analyse the development of the number of travel agencies in France and Germany in order to identify factors that may explain the heterogeneity of the two systems. In this context, France can be seen as an exception: in comparison to many other countries, the number of French travel agencies has not decreased during the last decade. Thus, the French system challenges the relationship (often considered a causal one) between the rise of e-tourism and the decrease of travel agencies. By means of quantitative and qualitative methods we compare legal, spatial, technological and cultural factors in the two countries. We show that differences in the legislation affect the travel agency structure. Furthermore, French travel agencies are more likely to have a receptive character which means that spatial factors of the two countries can be different. Our study also indicates that e-tourism leads to a growth of specialized travel agencies. Furthermore, cultural differences between travel agency customers are smaller than expected. We present examples which demonstrate that the tourism press conveys a misleading impression regarding this topic and reinforces stereotypes. / Die 10 000 Reisebüros in Deutschland und 4 000 Reisebüros in Frankreich formen die touristische Landschaft und spielen eine wichtige Rolle im Vertrieb touristischer Dienstleistungen. Wir analysieren die Reisebürodynamik in Frankreich und Deutschland und identifizieren Faktoren, welche die heterogene Entwicklung der beiden Systeme erklären können. Frankreich eignet sich dabei als Vergleichsland, da die Anzahl französischer Reisebüros im Vergleich zu vielen anderen Ländern in der letzten Dekade nicht abgenommen hat. Das gibt Anlass, den häufig als kausal beschriebenen Zusammenhang zwischen der Zunahme des e-Tourismus und der Abnahme der Anzahl Reisebüros zu hinterfragen. Mit Hilfe von quantitativen und qualitativen Methoden vergleichen wir politisch-juristische, räumliche, technische und kulturelle Einflussfaktoren auf die Reisebürostruktur der beiden Länder. Wir zeigen auf, dass vor allem Unterschiede in der Gesetzeslage die Reisebürostruktur beeinflussen. Auβerdem nehmen französische Reisebüros in Teilen eine rezeptive Rolle ein, so dass die räumlichen Einflussfaktoren Unterschiede aufweisen. Unsere Studie weist darauf hin, dass der e-Tourismus eine Profilschärfung der Reisebüros in Richtung Spezialist bewirkt. Die kulturellen Unterschiede zwischen den Reisebürokunden der beiden. Länder sind kleiner als erwartet. Wir zeigen anhand von Beispielen, dass hier die touristische Fachpresse einen falschen Eindruck erweckt und Stereitypen zwischen den beiden Ländern verstärkt.

Estudo dos processos linfoproliferativos cutâneos de células B objetivando demonstrar a difícil distinção diagnóstica entre os linfomas cutâneos e pseudolinfomas. Foram avaliados 38 casos de processos linfoproliferativos cutâneos de células B. Foi realizada revisão de prontuários médicos e exames anátomo-patológicos. Foram estudados 25 casos de linfomas cutâneos, 7 de pseudolinfomas e 6 casos onde não foi possível a distinção diagnóstica entre as entidades em estudo. As características clínicas, histológicas e imunoistoquímicas foram descritas para cada grupo. A análise estatística foi realizada demonstrando a similaridade entre os linfomas cutâneos e os pseudolinfomas / Study of cutaneous B-cell lymphoproliferative process with the purpose of demonstrating the difficulty of distinguishing between cutaneous lymphomas and pseudolymphomas. 38 cases of cutaneous B-cell lymphoproliferative processes were evaluated. A review of medical records and histophatologic material was performed. The study comprised 25 cases of cutaneous lymphomas, 7 cases of pseudolymphomas and 6 cases where a diagnosis distinguishing between the entities in study was not possible. It described clinical, histophatologic and immunohistochemical characteristics of each group. A statistical analysis showing the similarity between lymphomas and pseudolymphomas was performed

O transplante hepático com a técnica convencional envolve a ressecção da veia cava inferior retrohepática como parte da hepatectomia do receptor e conseqüente clampeamento da mesma acima e abaixo do fígado, bem como o clampeamento da veia porta durante a fase anepática. Este procedimento pode se caracterizar por alterações hemodinâmicas importantes, disfunção renal e maior sangramento em áreas de dissecção submetidas a um regime de maior pressão. Pacientes idosos, previamente instáveis do ponto de vista hemodinâmico ou muito graves, gealmente, não toleram esta situação. Para evitar estes distúrbios, um \"bypass\" venovenoso, é habitualmente utilizado, permitindo com que o sangue da veia porta e da veia cava inferior retorne à circulação sistêmica através da veia axilar. O \"bypass\" venovenoso, foi adotado por muitos centros transplantadores como procedimento de rotina, enquanto outros empregavam este apenas quando o clampeamento da veia cava inferior determinasse grave alteração hemodinâmica, buscando assim, redução do custo, do tempo de operação e das complicações em função do uso \"bypass\", tais como: hipotermia, coagulopatia e fenômenos tromboembólicos. Outra alternativa técnica, que consiste na preservação da veia cava inferior durante a hepatectomia foi descrita com o intuito de preservar o fluxo na veia cava inferior durante a fase anepática. Além disto, uma anastomose porto-cava temporária pode ser confeccionada para evitar o clampeamento da veia porta e conseqüente congestão esplâncnica. O objetivo deste estudo foi comparar os resultados imediatos do transplante hepático com preservação da veia cava inferior e anastomose porto-cava temporária, ou com o uso do \"bypass\" venovenoso. De outubro de 1999 a outubro de 2001, 104 pacientes submetidos ao transplante hepático foram analisados retrospectivamente. O \"bypass\" venovenoso foi utilizado em 50 pacientes e a técnica de \"piggy back\" em 54. Ambos os grupos foram comparáveis em termos de idade, sexo, diagnóstico e grau de função hepática pré-operatória. Nosso estudo demonstrou não haver diferença entre as duas técnicas em relação à duração da hepatectomia, à duração da operação e à necessidade de transfusão de hemoderivados. Observou-se uma fase anepática mais breve e um menor tempo de permanência na unidade de terapia intensiva no período pós operatório dos pacientes submetidos à técnica que reserva a veia cava inferior, além disto o estudo aponta para uma tendência à redução no tempo de internação, no índice de insuficiência renal pós-operatória e para um melhor funcionamento do enxerto quando os fluxos da veia cava inferior e da veia porta são preservados. / The liver transplant with conventional technique involves the resection of the retrohepatic inferior vena cava as part of the recipient hepatectomy and consequent clamping of the same above and below the liver, as well as the clamping of the portal vein during the anhepatic phase. This procedure can be characterized by critical hemodynamic alterations, renal disfunction and greater bleeding in dissection areas submitted to higher pressure conditions. Elderly patients, previously unstable on a hemodynamic point of view or in very serious conditions, usually do not tolerate this situation. In order to avoid these disturbances, a venovenous bypass is commonly applied, allowing blood from the portal vein and inferior vena cava to return to the systemic circulation through the axilar vein. The venovenous bypass has been adopted by many transplant centers as a routine procedure, while others have applied this procedure only when clamping of the inferior vena cava determines a serious hemodynamic alteration, eeking, in this way, cost cutting, reduction of operation time and complications caused by usage of the bypass, such as: hypothermy, coagulopathy and romboembolic phenomenae. Another technical alternative, which consists of preservation of the inferior vena cava during the hepatectomy was described focusing preservation of the inferior vena cava flow during the anhepatic phase. Besides, a temporary portocaval shunt can be made to avoid clamping of the portal vein and consequently splanchnic congestion. The objective of this study was compare the immediate results of the liver transplantation with inferior vena cava preservation and temporary portocaval shunt or using the venovenous bypass. From October 1999 to October 2001, 104 patients submitted to an liver transplantat were analyzed retrospectively. The venovenous bypass was applied in 50 patients and the \"piggy back\" technique in 54. Both groups were comparable in terms of age, gender, diagnosis and preoperative hepatic conditions. Our study has demonstrated that there was no difference between the two techniques in relation to the hepatectomy and operation time and the need of hemoderivate transfusion. As a result, a shorter anhepatic phase was observed, as well as a shorter stay in intensive care unit during the postoperative period, in relation to patients submitted to the technique that preserves the inferior vena cava. Additionally, the study points out a trend towards reduction of hospital stay, postoperative renal insufficiency, and a better graft function when the inferior cava and portal veins are preserved.

Submitted by Cláudia Bueno (claudiamoura18@gmail.com) on 2015-10-15T19:58:50Z No. of bitstreams: 2 Tese - NELSON RASSI - 2014.pdf: 2531801 bytes, checksum: 4a281a91c2ca563e8fead55207f00d61 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Cláudia Bueno (claudiamoura18@gmail.com) on 2015-10-15T20:31:04Z (GMT) No. of bitstreams: 2 Tese - NELSON RASSI - 2014.pdf: 2531801 bytes, checksum: 4a281a91c2ca563e8fead55207f00d61 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2015-10-15T20:31:04Z (GMT). No. of bitstreams: 2 Tese - NELSON RASSI - 2014.pdf: 2531801 bytes, checksum: 4a281a91c2ca563e8fead55207f00d61 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2014-09-13 / Background: The number of patients with Type 2 Diabetes Mellitus (T2DM) in Brazil has, in recent decades, increased substantially and insulin therapy is often necessary in a large portion of this population in order to achieve appropriate glycemic control. Objective: To evaluate glycemic control achieved with recombinant human insulin NPH - Gansulin and compares it with human NPH insulin - Humulin N® in patients with Type 2 Diabetes Mellitus. Subjects and methods: A prospective, double-blind, randomized, parallel, single center with 37 individuals with type 2 diabetes using insulin NPH insulin. For statistical analyzes were used: the multiple comparison test of Tukey-Kramer test, Wilcoxon paired comparison test and Chi- Square. It was regarded level of significance value lower than 5% (p<0.05). Results: Insulins NPH and Humulin Gansulin showed similar reductions in HbA1c at the end of the study compared to baseline. Initial HbA1c 7.91% in the Humulin group was reduced to 6.56% (p<0.001) at the end of the study whereas in the Gansulin the glycated hemoglobin was reduced from 8.18% to 6.65% (p<0.001). At the end of the study there was no significant difference between the glycated hemoglobin levels (p=0.2410), fasting blood glucose (p=0.9257) and glucose at bedtime (p=0.3906) between the two types of insulin. Regarding the number of hypoglycemic events, there was no significant difference between the two insulins and no severe hypoglycemic episodes were recorded. Conclusion: The NPH Gansulin (Insuneo N®) presented glycemic control similar to that presented by human insulin Humulin N® in patients with DM2. It was considered level of significance value less than 5%. / Fundamento: O número de pacientes com Diabetes Mellitus Tipo 2 (DM2) no Brasil tem, nas últimas décadas, aumentado substancialmente e a terapia insulínica é necessária em uma grande parcela desta população com a finalidade de adquirir controle glicêmico adequado. Objetivo: Avaliar o controle glicêmico obtido com a insulina humana recombinante NPH – Gansulin e compará-la com o da insulina humana NPH – Humulin N® em pacientes com Diabetes Mellitus Tipo 2 (DM2). Sujeitos e métodos: Estudo prospectivo, duplo cego, randomizado, paralelo e monocêntrico com 37 indivíduos portadores de diabetes tipo 2, em uso de insulina NPH. Para as análises estatísticas foram utilizados: o teste de comparações múltiplas de Tukey-Kramer, o teste de comparação pareada de Wilcoxon e o teste Chi-Square. Foi considerado como nível de significância o valor inferior a 5% (p<0,05). Resultados: As insulinas NPH Humulin e Gansulin apresentaram reduções semelhantes da HbA1c ao final do estudo, quando comparadas aos valores iniciais. A HbA1c inicial de 7,91% do grupo Humulin foi reduzida para 6,56% (p<0,001), enquanto que na do Gansulin, a redução foi de 8,18% para 6,65% (p<0,001). Ao final do estudo não houve diferença significativa entre os valores de hemoglobina glicada (p=0,2410), glicemia jejum (p=0,9257) e glicemia ao deitar (p=0,3906) entre os dois tipos de insulina. Em relação ao número de eventos hipoglicêmicos, não se observou diferença significativa entre as duas insulinas e não foram registrados episódios hipoglicêmicos graves. Conclusão: A insulina NPH Gansulin apresentou controle glicêmico semelhante ao apresentado pela insulina humana Humulin N® em pacientes com DM2.

Introdução: Atualmente, muito tem se estudado a respeito de a esquizofrenia e do transtorno afetivo-bipolar (TAB) pertencerem a um continuum de sinais e sintomas que caracterizam o espectro da psicose, com etiologias que se sobrepõem parcialmente. O estudo comparativo de crianças filhas de pacientes com esquizofrenia e com transtorno bipolar pode ajudar na compreensão do quanto à vulnerabilidade para o desenvolvimento dessas patologias se assemelha e em quais momentos se diferencia. Os objetivos deste estudo foram comparar crianças e adolescentes em risco para esquizofrenia, para transtorno bipolar e um grupo sem risco para estes transtornos em relação a: 1) presença de problemas de saúde mental, diagnóstico psiquiátrico, competência social, quociente intelectual (QI); 2) associação entre presença de diagnóstico ou sintomas psiquiátricos nas crianças e a presença de diagnóstico psiquiátrico materno (esquizofrenia ou transtorno bipolar do humor), gravidade do diagnóstico materno, complicações obstétricas, nível socioeconômico dos pais, escolaridade da mãe. Métodos: Foi realizado estudo transversal comparando filhos de mulheres com diagnóstico de esquizofrenia e transtorno afetivo bipolar, segundo critérios do DSM-IV, e filhos de mulheres sem transtornos mentais graves, na faixa etária de 6 a 18 anos. Os instrumentos utilizados para avaliação da psicopatologia das crianças e adolescentes foram o Child Behavior Checklist (CBCL), Youth Self Report (YSR) e o Schedule for affective disorders and schizophrenia for school aged children-lifetime version (KSADS- PL). A psicopatologia das mães foi avaliada com o uso da escala Structured Clinical Interview for DSM-IV Disorders (SCID-I/P) e o funcionamento/gravidade destas mulheres com a Global Assessment of Functioning (GAF). Para a avaliação do QI e funcionamento social das crianças foram utilizados as escalas Wechsler Abbreviated Scale of Intelligence (WASI) e Children\'s Global Assessment Scale (CGAS) respectivamente. O nível socioeconômico foi avaliado com o uso da escala da Associação Brasileira de Empresas de Pesquisa (ABEP) e um instrumento contendo dados demográficos e de gestação e parto foi criado para ser utilizado neste estudo. Resultados: Foram incluídos no estudo 67 filhos de mães com esquizofrenia, 65 filhos de mães com transtorno bipolar e 63 controles. Os filhos de mulheres com transtorno bipolar apresentaram maior prevalência de problemas comportamentais que os outros grupos, com maior prevalência tanto de problemas de internalização quanto de externalização, e apresentaram maior prevalência de diagnóstico de transtorno de déficit de atenção e hiperatividade e de transtorno de conduta. Os filhos de mulheres com esquizofrenia apresentaram pior eficiência intelectual quando comparados aos jovens em risco para transtorno bipolar, e pior ajustamento social quando comparados aos controles. Foi detectada uma diferença na presença de comportamentos agressivos entre os gêneros no grupo em risco para esquizofrenia. Os meninos em risco para esquizofrenia apresentaram prevalência muito menor de comportamentos agressivos que as meninas deste grupo e que tanto meninas quanto meninos dos demais grupos. Os fatores que se associaram à presença de problemas comportamentais nestas crianças e adolescentes além do diagnóstico materno foram: gravidade da doença materna, moradia com a mãe, ter sofrido riscos pela presença de psicopatologia materna, nível socioeconômico, escolaridade da mãe, possuir pai com problemas com uso de álcool ou outras substâncias, intercorrências durante a gestação e parto, mãe não ter sido internada durante crise na gestação. Conclusões: Os filhos de mães com TAB apresentaram mais problemas comportamentais e diagnósticos psiquiátricos, enquanto os filhos de mulheres com esquizofrenia apresentaram mais prejuízos cognitivos e de competência social e funcional. Contribuindo, assim, para a discussão de que as duas patologias possam ser entendidas como entidades diagnósticas distintas na medida em que diferenças aparecem nos jovens vulneráveis a elas / Introduction: Nowadays a lot has been studied about schizophrenia and bipolar affective disorder being part of a continuum of signals and symptoms which characterize the spectrum of psychosis, with etiologies that are partially superseded. The comparative study of children who were sons of patients with schizophrenia and bipolar disorder can help understanding how much this vulnerability for these pathologies development is similar and in what moments it differs. The aims of this study have been to compare children and adolescents at risk for schizophrenia, bipolar disorder and a group without risk for these disorders in relation to: 1) The presence of mental health problems, psychiatric diagnosis, social competence, intelligence quotient; 2) The association between diagnosis presence or psychiatric symptoms in children and the presence of maternal psychiatric diagnosis (schizophrenia or mood bipolar disorder), severity of maternal diagnosis, obstetric complications, socioeconomic level, mother\'s educational level. Methods: A cross-sectional study has been done comparing the sons of women with schizophrenia and bipolar disorder, according to DSM-IV criteria, and sons of women without severe mental disorder, within the age group of 6 to 18. The instruments used for the evaluation of the children\'s and adolescents\' psychopathology were the Child Behavior Checklist (CBCL), the Youth Self Report (YSR) and the Schedule for affective disorders and schizophrenia for school aged children-lifetime version (KSADS-PL). The psychopathology of the mothers was evaluated with the use of the scale Structured Clinical Interview for DSM-IV Disorders (SCID) and the functioning/severity of these women with Global Assessment of Functioning (GAF). For the evaluation of the intelligence quotient and children social function were used Wechsler Abbreviated Scale of Intelligence (WASI) and Children\'s Global Assessment Scale (CGAS) respectively. The socioeconomic level was evaluated with the use of the scale from Associação Brasileira de Empresas de Pesquisa (ABEP) and an instrument containing demographic data and gestation/childbirth was created to be used in this study. Results: 67 sons of schizophrenic mothers were included in the study, 65 sons of mothers with bipolar disorder and 63 controls. The sons of women with bipolar disorder presented higher prevalence of behavior problems compared to the other groups, with a higher prevalence of both internalization and externalization problems, and they also presented higher diagnosis prevalence of attention deficit /hyperactivity disorder, and conduct disorder. The sons of women with schizophrenia presented worst intellectual efficiency when compared to youngsters with risk of bipolar disorder, and worst social adjustment when compared to the controls. A difference in the presence of aggressive behavior was detected among the genders in the group at risk for schizophrenia. Boys at risk for schizophrenia presented a much smaller prevalence of aggressive behavior compared to the girls in this group and also compared to boys and girls from the other groups. Besides the maternal diagnosis, the factors which were associated to the presence of behavior problems in these children and adolescents were: severity of the maternal disease, sharing residence with the mother, having suffered risk because of the presence of maternal psychopathology, socioeconomic level, mother\'s educational level, father who has a history of alcohol or other substance abuse, complications during gestation and childbirth, mother not being hospitalized when suffering a psychiatric crisis during pregnancy. Conclusions: The sons of mothers with bipolar disorder presented more behavior problems and psychiatric diagnosis, while the sons of mothers suffering from schizophrenia presented more cognitive, social and functional competence impairments. This conclusion corroborates for the discussion that both pathologies may be understood as distinct diagnostic entities insofar as differences appear in the youngsters who are vulnerable to them

OBJETIVOS: Comparar as respostas do Teste de Esforço Cardiopulmonar (TECP) em imersão, numa esteira subaquáticas, com as de solo; investigar e entender o desempenho cardiorrespiratório de coronariopatas (DAC) durante esforço em imersão comparando-os aos do grupo de indivíduos saudáveis. Entender os procedimentos, materiais e equipamentos necessários na realização do teste em imersão e na coleta de dados reprodutíveis e confiáveis. MÉTODOS: O estudo contou com 40 indivíduos, sendo: 20 pacientes com diagnóstico médico de DAC, 63,7 ± 8,89 anos de idade e classificação I e II segundo New York Heart Association (NYHA) e 20 sujeitos saudáveis, 64,7 ± 7,09 anos; realizaram dois testes ergoespirométricos em uma instalação equipada com esteira no solo, piscina aquecida, esteira subaquática, analisador de gases e Eletrocardiograma (ECG). Foi calculado o Poder Estatístico do teste para ANOVA com erro beta de 0.861. Por ser um exame normatizado tecnicamente e reconhecidamente seguro, o primeiro teste foi realizado em esteira no solo de 3 a 7 dias deste, o segundo teste foi realizado em esteira subaquática com imersão ao nível do manúbrio, em uma piscina com temperatura controlada entre 33 e 34°C. Os dados foram coletados em 5 momentos expressivos: 1- Repouso; 2- Limiar Anaeróbio; 3- Ponto de Compensação Respiratória; 4- Esforço Máximo e 5- Recuperação. RESULTADOS: A análise de variância deste estudo revelou haver efeito principal para DAC nas variáveis: FC, VO2 e VCO2; (p > 0.01) em relação ao ambiente. O teste em imersão apresentou significância nas variáveis FC, VO2, VCO2 e VO2/FC (p > 0.01). As interações com estágio caracterizam o comportamento dos sujeitos ao longo do experimento e neste contexto, as variáveis PEB, FC, VO2, VCO2 e VO2/FC (p > 0.01) mostraram interações significantes entre estágio e ambiente. Em adição, há interação significante entre etiologia e estágio para as variáveis FC, VO2 e VCO2 (p > 0.01). DAC e saudáveis possuem comportamentos diferentes no decorrer dos estágios do experimento em relação a estas variáveis. Alterações eletrocardiográficas compatíveis com isquemia miocárdica ou arritmia não foram observadas e a Pressão Arterial Sistólica e Diastólica (PAS/D) não se alterou significativamente. Os indivíduos deste estudo tiveram percepção de esforço na Escala de Borg menor na água em todos os estágios do que em terra (p > 0.01). CONCLUSÃO: Os achados deste estudo mostram que os procedimentos operacionais, materiais e equipamentos utilizados no TECP em piscina produziram dados reprodutíveis, confiáveis e que atenderam as determinações estabelecidas no \"Clinician´s Guide to Cardioplulmonary Exercice Testing in Adults\". O esforço foi bem tolerado por todos os participantes, sem ocorrência de evento adverso. As diferenças estatísticas observadas nos testes na água contra os de solo nos levam a entender que o exercício em imersão pode ser realizado por pacientes com DAC e que os efeitos fisiológicos da imersão não causam qualquer risco para este grupo. Conclui-se também que por ser reprodutível e confiável, o teste em imersão pode ser adotado para prognosticar capacidades individuais de pacientes coronariopatas ao exercício dinâmico em piscina / OBJECTIVES: To compare responses to a Cardiopulmonary Exercise Test (CPX) conducted in water, (on a underwater treadmill), with the responses to the same tests conducted on land, (on a land treadmill); to investigate and assess the cardiorespiratory performance of coronary artery disease (CAD) patients while immersed in warm water when compared to the performance of healthy individuals; to assess the procedures, feasibility, resources and equipment required for conducting a CPX in individuals in water so as to collect reliable and replicable data. METHODS: The sample was comprised by 40 subjects, 20 of whom diagnosed with coronary artery disease (CAD) and aged 63.7 ± 8.89, functional class I and II (in compliance with the New York Heart Association [NYHA]), and 20 healthy subjects aged 64.7 ± 7.09. Two CPX tests were conducted in a facility equipped with a land treadmill, a warm pool, an underwater treadmill, a gas analyzer and an electrocardiogram (ECG) device. The statistical significances were calculated through a ANOVA test with (1 - beta) power of 0.861. As CPX is technically regulated and acknowledged as safe the first test was conducted on a land treadmill and the second test was conducted 3-7 days later on an underwater treadmill. Subjects were submerged in a temperature-controlled pool (33-34oC) with water at manubrium level. Data were collected at 5 relevant test stages or cardiorespiratory levels: 1- Rest; 2- Anaerobic Threshold (AT); 3- Respiratory Compensation Point (RCP); 4- Maximum Effort (ME); and 5- Recovery (R). FINDINGS: ANOVA analysis showed a major significance for CAD subjects regarding variables HB, VO2 and VCO2 (p < 0.01) in relation to the environment. The test performed with submerged patients showed some significance for variables HB, VO2, VCO2 and VO2/HB (p < 0.01). The stages for data collected featured the subjects performance throughout this experiment, and within the given context, variables RPE, HB, VO2, VCO2 and VO2/HB (p < 0.01) showed significant interactions between test stage and environment. Additionally, there was a significant interaction between the etiology and the test stage for variables HB, VO2 and VCO2 (p < 0.01). CAD patients and healthy subjects showed different performances throughout the test stages in relation to the referred variables. Electrocardiographic (ECG) changes that are compatible with myocardial ischemia or arrhythmia were not observed. Systolic and diastolic blood pressure (SDBP) did not show significant changes. The subjects of this study showed lower rates of Borg\'s perceived exertion scale in the water than at every one of the test stages on land (p < 0.01). CONCLUSION: This study show that the procedures, resources and equipment used during CPX conducted in a warm pool demonstrated to be feasible and yielded replicable and reliable data, which complied with the provisions of the \"Clinician´s Guide to Cardiopulmonary Exercise Testing in Adults\". The effort exerted was well tolerated by all the participants without any adverse events. Statistical differences observed in water versus on land allow us to conclude that patients with CAD are able to carry out physical activities in water and that the physiological effects of immersion do not present any risk for such patients. We may also conclude that given its replicability and reliability, CPX conducted in water may be used to diagnose and to estimate the exertion capability of CAD patients to perform dynamic exercise in a warm pool