Objetivos: Malformação de Chiari do tipo I (MC-I) é a principal doença malformativa congênita da junção craniovertebral, manifestando-se com ampla variedade de sinais e sintomas neurológicos. A melhor técnica cirúrgica a ser empregada no tratamento dos pacientes com malformação de Chiari do tipo I é ainda controversa. A descompressão das estruturas da fossa craniana posterior com plástica de ampliação dural é considerada procedimento padrão. Embora efetiva e de baixa morbidade, a craniectomia occipital isolada, sem abertura e ampliação dural, implica maior taxa de recidiva dos sintomas. Métodos que selecionam os pacientes quanto a necessidade da duroplastia não foram estabelecidos. O presente trabalho avalia a eficácia da mensuração intraoperatória da velocidade do fluxo do líquido cefalorraquidiano através da ultrassonografia (USG) na seleção da técnica cirúrgica a ser utilizada. Métodos: Foram analisados de forma prospectiva 49 pacientes submetidos à cirurgia para MC-I. A indicação de craniectomia da fossa posterior associada ou não à plástica de ampliação da dura-máter baseou-se na velocidade do fluxo do líquido cefalorraquidiano, mensurada pela ultrassonografia intraoperatória. Dor cervical, cefaleia e qualidade de vida foram avaliadas antes e após o tratamento cirúrgico. Resultados: Dos 49 pacientes incluídos, 36 pacientes (73%) apresentavam fluxo do líquido cefalorraquidiano superior a 3 cm/s e não foram submetidos a duroplastia ampliadora. Nos 13 (27%) pacientes com fluxo inicial inferior a 3 cm/s, indicou-se craniectomia occipital com duroplastia de ampliação. Não houve diferença significativa entre os dois grupos com relação aos parâmetros estudados. Conclusão: A ultrassonografia intraoperatória com avaliação da dinâmica e velocidade do fluxo do líquido cefalorraquidiano da junção craniovertebral auxilia a indicação de duroplastia durante descompressão da fossa craniana posterior em pacientes adultos com MC-I / Objectives: Chiari malformation Type I (CM-I) is the main congenital malformation disease of the craniovertebral junction, and may be responsible for a variety of neurological symptoms. The ideal surgical technique used to treat patients with CM-I is still controversial. Invasive procedures that enters CSF space and are associated with dural repair, are considered the gold standard. Although effective and less morbidity, isolated bone decompression without dural opening, implies greater recurrence of symptoms. Objective parameters to select patients, who need or not to have a duroplasty performed, have not been established. Our study evaluates the efficacy of intra-operative CSF flow measurement through the use of ultrasonography (USG) as a determining parameter in the selection of these patients. Methods: We analyzed prospectively 49 posterior fossa surgeries for patients with CM-I. Patients underwent decompressive surgery with or without opening of the dura mater after conducting USG intra-operatively with measured flow rate, being adopted 3cm/s flow rate as a determining value. The quality of life before and after surgery and the improvement of neck pain and headache were the parameters evaluated. Results: Of the 49 patients enrolled, 36 patients (73%) had adequate CSF flow above 3 cm / s and have not undergone duroplasty. In 13 (27%) patients with initial flow < 3 cm / s an opening in dura mater was performed together with duroplasty. There was no significant difference between the two groups regarding the parameters studied. Conclusion: Intraoperative ultrasound with measurement of CSF flow, having a flow of 3 cm / s as cut-off, allows the proper selection of patients with CM-I that can have a less invasive surgery with bone decompression without duroplasty

The Latin American centennial celebrations of independence (ca.1909-1925) constituted a key moment in the consolidation of national symbols and tropes, while also producing a renewed focus on transnational affinities that generated a series of discourses on continental unity. At the same time, a boom in archaeological explorations, within a general climate of scientific positivism, provided Latin Americans with new information about their ‘grandiose’ former civilisations, such as the Inca and the Aztec, which some then argued for as an American equivalent to ancient Greek and Egyptian cultures. These discourses moved from the political to the cultural sphere, themselves shaping ideas about Latin American national and continental identity. In the arts, and particularly in music, artists as a result began to move from using European techniques and depicting European themes, to produce an art that could be considered Latin American. This dissertation explores discourses surrounding the Inca in particular as a source for the creation of a ‘national’ and ‘continental’ art music during the first three decades of the twentieth century, with a concentration on ‘nationalist’ composers of Peru, Ecuador and Argentina. Three main topics bind together my analysis: interpretations of the Inca musical system, the postcolonial style called yaraví, and the composition of opera. To this end, I look into early twentieth-century writings on Inca music and its origins, investigate attempts to reconstruct it, describe how certain composers applied ‘Inca’ techniques into their own works, and consider how this music was perceived by local audiences. Ultimately, I argue that faced with the difficulties of constructing national unity at the time, the turn to Inca culture and music in pursuit of such unity could only succeed within particular intellectual circles, and that the idea that the Inca example could produce a ‘music of America’ would ultimately remain a utopia.

Made available in DSpace on 2014-12-17T14:27:19Z (GMT). No. of bitstreams: 1 AlbaPA_DISSERT.pdf: 3496293 bytes, checksum: d86c02201d4d443edbdc2e098b5b7616 (MD5) Previous issue date: 2010-12-17 / The current study presents an analysis about the automation of the lawsuits in Brazil, which opens a new direction to be followed by the National Secretary of Justice, applied indistinctively to the civil, criminal and labor lawsuits, as well as to the special court houses at any degree of juridisdiction. It treats, specifically, about the transition from the classic lawsuit with bureaucratic aspects to the electronic one, based on the simplicity of the functions, the quality of the oral and the readiness. The light of the constitutional principle of the reasonable duration of the lawsuit, while fundamental rigth of the defendant and, under de protection of the democratic guarantee, it investigates, from the theory of the fundamental rights to the reform movement of the lawsiut, in the scenery of the alien law and national law, the latter, mostly because it has the automation as a necessary improvement claimed by modernity, yet without forgetting of the humane character inherent to the criminal lawsuit. It faces the issue of of the disruption of the paradigm of the written formality of the Brazilian lawsuit, the problem of the resistance to the new automized method, the use of the video conference for the inquest of the witnesses as well as for the questioning of the defendant, the advancements of the virtual lawsuit on the Superior Courts, Federal Supreme Court and Superior Court of Justice, it treats also about the role of the National Council of Justice - CNJ - to uniformize the legal proceedings in the country. Without neglecting the effective respect to the fundamental rights, it focuses the cultural change necessary so that the electronic technology can be, in fact, in the indictment system, the means to reach with excellency the citizenship by the simplification of the legal proceedings, transposing the baseless bureaucracy and assuring an effective judicial service assistance in order to have a better quality of life / O presente estudo apresenta uma an?lise acerca da informatiza??o do processo judicial no Brasil, que inaugura uma nova dire??o a ser seguida pelo Judici?rio nacional, com aplica??o indistinta aos processos civil, penal e trabalhista, bem como aos juizados especiais, em qualquer grau de jurisdi??o. Trata, especificamente, da transmuda??o do processo penal cl?ssico com tra?os burocr?ticos para o processo eletr?nico, embasado na simplicidade dos atos, oralidade e celeridade. ? luz do princ?pio constitucional da dura??o razo?vel do processo penal, enquanto direito fundamental do acusado e, sob o manto democr?tico garantista, investiga, desde a teoria dos direitos fundamentais ao movimento reformista do processo penal, no panorama do direito alien?gena e nacional, este, notadamente por ter a informatiza??o como uma otimiza??o necess?ria reclamada pela modernidade, sem, todavia, olvidar-se do car?ter humanista inerente ao processo criminal. Enfrenta a quest?o do rompimento do paradigma da formalidade estrita do processo penal brasileiro, o problema da resist?ncia ao novo m?todo informatizado, o uso da videoconfer?ncia tanto para a inquiri??o de testemunhas quanto para o interrogat?rio do acusado, os avan?os do processo virtual nos Tribunais Superiores Supremo Tribunal Federal e Superior Tribunal de Justi?a -, al?m do papel do Conselho Nacional de Justi?a - CNJ para a uniformiza??o procedimental no pa?s. Sem descurar do efetivo respeito aos direitos fundamentais, enfoca a mudan?a cultural imprescind?vel para que a tecnologia eletr?nica seja, de fato, no sistema acusat?rio brasileiro, o meio para se alcan?ar com excel?ncia a cidadania pela simplifica??o dos atos processuais, transpondo a burocracia infundada e assegurando a efetiva presta??o jurisdicional para uma melhor qualidade de vida