Abstract: Objective: to associate the absence of family support and the brown race with systemic arterial hypertension. Method: Cross-sectional study described according to the Strengthening the Reporting of Observational studies in Epidemiology, with physically active elderly women aged ≥ 60 years and volunteers who did not complete the evaluation steps were excluded. Family support, arterial hypertension and race / color were reported in the questionnaires, functional decline was identified by the left calf perimeter and the Timed Up and Go test. Results: 82 volunteers were evaluated, hypertensive (54.9%), without family support (26.8%), mixed race (41.5%), risks of declining dynamic balance (24.4%) and for sarcopenia ( 45.1%). The association was observed between absence of family support and arterial hypertension (p<0.05), a negative and significant correlation was observed between the variable race / brown color with arterial hypertension [ρ= -0.305; p <0.01] and showed to be a protective factor [OR= 0.22; IC95% OR 0.38-0.90; p <0.01], positive and significant correlation between family support with arterial hypertension [ρ = 0.217; p <0.05], however, the absence of family support was found to be a risk factor [OR= 3.28; IC95% OR 1.04-10.38; p <0.05]. Conclusion: The prevalence of arterial hypertension in elderly women without family support is high, this being a risk factor, race / brown skin has been shown to be a protective factor for arterial hypertension, the functional decline pointed out by the advancement of sarcopenia and balance dynamic did not show any association or correlation with arterial hypertension;

Resumen: Objetivo: asociar la ausencia de apoyo familiar y la raza morena con la hipertensión arterial sistémica. Método: Estudio transversal descrito según el Fortalecimiento del Informe de Estudios Observacionales en Epidemiología, con mujeres mayores físicamente activas de ≥ 60 años y voluntarios que no completaron los pasos de evaluación fueron excluidos. El apoyo familiar, la hipertensión arterial y la raza / color se informaron en los cuestionarios, el deterioro funcional se identificó mediante el perímetro de la pantorrilla izquierda y la prueba Timed Up and Go. Resultados: se evaluaron 82 voluntarios, hipertensos (54,9%), sin apoyo familiar (26,8%), mestizos (41,5%), riesgo de deterioro del equilibrio dinámico (24,4%) y de sarcopenia (45,1%). Se observó asociación entre ausencia de apoyo familiar e hipertensión arterial (p <0.05), se observó una correlación negativa y significativa entre la variable raza / color marrón con hipertensión arterial [ρ = -0.305; p <0.01] y demostró ser un factor protector [OR = 0.22; IC95% OR 0,38-0,90; p <0,01], correlación positiva y significativa entre apoyo familiar con hipertensión arterial [ρ = 0,217; p <0.05], sin embargo, se encontró que la ausencia de apoyo familiar era un factor de riesgo [OR = 3.28; IC95% OR 1,04-10,38; p <0,05]. Conclusión: La prevalencia de hipertensión arterial en mujeres ancianas sin apoyo familiar es alta, siendo este un factor de riesgo, se ha demostrado que la piel de raza / morena es un factor protector para la hipertensión arterial, el deterioro funcional señalado por el avance de la sarcopenia y el equilibrio. dinámica no mostró asociación o correlación con la hipertensión arterial.

Resumo:  Objetivo: associar a ausência do apoio familiar e a raça parda com a hipertensão arterial sistêmica. Método: Estudo transversal descrito conforme o Strengthening the Reporting of Observational studies in Epidemiology, com idosas fisicamente ativas com idade ≥ 60 anos e foram excluídas voluntárias que não concluíram as etapas avaliativas. O apoio familiar, a hipertensão arterial e a raça/cor foram informados nos questionários, o declínio funcional foi identificado pela perimetria da panturrilha esquerda e o teste Timed Up and Go. Resultados: Foram avaliadas 82 voluntárias, hipertensas (54,9%), sem apoio familiar (26,8%), raça parda (41,5%), riscos de declínio do equilíbrio dinâmico (24,4%) e para sarcopenia (45,1%). A associação foi observada entre ausência de apoio familiar e hipertensão arterial (p<0,05), foi observada correlação negativa e significativa entre a variável raça/cor parda com hipertensão arterial [ρ= -0,305; p<0,01] e apresentou ser fator de proteção [OR= 0,22; IC95% OR= 0,38-0,90; p<0,01], correlação positiva e significativa entre apoio familiar com hipertensão arterial [ρ= 0,217; p<0,05], porem, a ausência de apoio familiar foi verificado como fator de risco [OR= 3,28; IC95% OR= 1,04-10,38; p<0,05].Conclusão: A prevalência de hipertensão arterial em idosas sem o apoio familiar é alta sendo este um fator de risco, a raça/cor parda demostrou-se ser um fator de proteção para a hipertensão arterial, o declínio funcional apontadas pelo avanço da sarcopenia e equilíbrio dinâmico não apresentaram associação e nem correlação com a hipertensão arterial

Abstract: Executing projects according to its estimated cost and schedule is fundamental to guarantee the economic and financial viability of the businesses associated with them. In this context, the estimated duration of an activity is very important for the development of the project schedule and budget. Therefore, determining the main factors that contribute to labor productivity becomes imperative. This research identified the main factors affecting labor productivity in construction projects around the world. Then, it was verified the pertinence of these factors to the Brazilean industry . The 56 factors identified were prioritized, according to the importance index, and categorized into four main groups: management, labor, external and technological. Factors such as: poor material management, lack of construction manager’s leadership, site supervision inefficiency, strikes and lack of tools are at the top of the list. It was also observed the balance between the management, technological and external groups. Finally, when compared to researches carried out in other countries, there is a reasonable correlation between the results identified by this research and those found by previous researches.

Resumen: Ejecutar los proyectos de acuerdo a su costo y cronograma estimados es fundamental para garantizar la viabilidad económica y financiera de los negocios asociados a ellos. En este contexto, la duración estimada de una actividad es muy importante para el desarrollo del cronograma y el presupuesto del proyecto. Por lo tanto, es imperativo comprender los factores que contribuyen a la productividad laboral. Esta investigación identificó los principales factores que afectan la productividad laboral en proyectos de construcción en todo el mundo. Luego, se verificó la pertinencia de estos factores en la industria brasileña. Los 56 factores identificados fueron priorizados, según el índice de importancia, y categorizados en cuatro grandes grupos: gerencial, laboral, externo y tecnológico. Factores como: mala gestión de materiales, falta de liderazgo del gerente de construcción, ineficiencia en la supervisión del sitio, huelgas y falta de herramientas están en la parte superior de la lista. También se observó el equilibrio entre los grupos gerencial, tecnológico y externo. Finalmente, cuando se compara con investigaciones realizadas en otros países, existe una correlación significativa entre los resultados identificados por esta investigación y los encontrados por investigaciones anteriores.

ABSTRACT Ovarian cancer spleen metastases are uncommon. The case of a 62-year-old patient is presented, consultation for stitch-like abdominal pain in the left hypochondrium, the same operation as an annex total hysterectomy 1 year ago with definitive histopathological report of moderate to poorly differentiated infiltrating adenocarcinoma grade II to III of right ovary. Ultrasound: enlarged spleen with nodular image inside; CT scan: enlargement of the spleen at the expense of parenchymal lesion. Videolaparoscopic splenectomy is performed. Pathological anatomy: poorly differentiated epithelioid tumors. Conclusion: in the treatment of spleen metastases, as the only site of metastases, laparoscopic surgery is indicated to avoid complications.

RESUMEN Las metástasis al bazo por cáncer de ovario son infrecuentes. Se presenta el caso de una paciente de 62 años, consulta por dolor abdominal tipo puntada en hipocondrio izquierdo, la misma operada de anexo histerectomía total 1 año atrás con reporte histopatológico definitivo de adenocarcinoma infiltrante moderada a pobremente diferenciado grado II a III de Ovario derecho. Ecografía: bazo aumentado de tamaño con imagen nodular en su interior; TAC: aumento de tamaño del bazo a expensas de lesión parenquimatosa. Se realiza esplenectomía videolaparoscópica. Anatomía patológica: tumores epitelioides pobremente diferenciado. Conclusión: en el tratamiento de las metástasis al bazo, como único sitio de metástasis, la cirugía laparoscópica está indicada para evitar complicaciones.

ABSTRACT Solid pseudopapillary tumor of the pancreas is uncommon with low malignant potential. The case of a 17-year-old woman is presented for consultation due to insidious abdominal pain of moderate intensity; no significant findings on the physical exam; Abdominal ultrasound reports a solid nodular image of 8x6 cm in the body and tail of the pancreas with a central and peripheral vascular signal to the color Doppler. A contrast-enhanced tomography is performed, showing a large tumor that covers the body and tail of the pancreas approximately 10x8cm with projection, to splenic hilum. Mass resection and histopathological examination confirmed the diagnosis of pseudopapillary tumor of the pancreas. Conclusion: Pseudopapillary neoplasm of the pancreas is a rare condition, which requires surgical intervention. Careful monitoring is necessary for the early detection of recurrence and metastasis.

RESUMEN El tumor pseudopapilar sólido del páncreas es poco frecuente de bajo potencial maligno. Se presenta el caso de una mujer de 17 años de edad acude a consulta por dolor abdominal de inicio insidioso de moderada intensidad; sin hallazgossignificativos en el examen físico; la ecografía abdominal informa imagen nodular sólida de 8x6 cm en cuerpo y cola de páncreas con señal vascular central y periférica al Doppler color, se realiza tomografía con contraste de abdomen en donde se evidencia gran tumoración que abarca cuerpo y cola del páncreas aproximadamente 10x8cm con proyección al hilio esplénico. La resección de la masa y el examen histopatológico confirmaron el diagnóstico de tumor pseudopapilar del páncreas. Conclusión: la neoplasia pseudopapilar del páncreas es una condición rara, que requiere intervención quirúrgica. Es necesario un seguimiento minucioso para la detección temprana de la recurrencia y metástasis.

ABSTRACT The main cause of primary hyperaldosteronism is aldosteronoma, which is an adenoma of the aldosterone-secreting adrenal cortex; it usually occurs at the age of 30 to 60 years, with a predominance in women in a 1.5: 1 ratio. Most of the time it is unilateral, but in rare cases it can be bilateral (8%). Suspect aldosteronoma in patients with hypertension, hypokalemia and metabolic alkalosis, as well as in patients with a family history of primary hyperaldosteronism, incidentaloma and hypertension, and in the evaluation of all secondary hypertension. We report the case of a female patient of 51 years of age, who consulted for paresthesia of upper and lower limbs, hypertension treated with four antihypertensive drugs, one-year evolution Laboratorially hypokalemia is verified, for which aldosterone dosage is requested returned in high values; TAC with contrast is requested, where a right suprarenal tumor is evident. Aldosteronoma or Conn syndrome was diagnosed based on the increased serum aldosterone concentrations and abdominal computed axial tomography that showed a right suprarenal tumor. The patient was treated with laparoscopic adrenalectomy and the pathology study confirmed an adrenal adenoma.

RESUMEN La principal causa de hiperaldosteronismo primario es el aldosteronoma, que es un adenoma de la corteza suprarrenal secretor de aldosterona; generalmente ocurre a la edad de 30 a 60 años, con predominio en mujeres en relación 1.5:1. La mayoría de las veces es unilateral, pero en raras ocasiones puede ser bilateral (8%). Hay que sospechar aldosteronoma en los pacientes que presentan hipertensión, hipocalemia y alcalosis metabólica, así como en los pacientes con antecedente familiar de hiperaldosteronismo primario, incidentaloma e hipertensión, y en la evaluación de toda hipertensión secundaria. Se reporta el caso de una paciente de sexo femenino de 51 años de edad, que consulta por parestesia de miembros superiores e inferiores, hipertensión arterial tratada con cuatro drogas antihipertensivas, de un año de evolución.Laboratorialmente se constata hipocalemia, por lo cual se solicita dosaje de aldosterona retornado en valores elevados; se solicita TAC con contraste en donde se evidencia un tumor suprarrenal derecha. Se diagnosticó aldosteronoma o síndrome de Conn con base en las concentraciones incrementadas de aldosterona sérica y tomografía axial computada abdominal que evidenció un tumor suprarrenal derecho.La paciente fue tratada con adrenalectomía laparoscópica y el estudio de patología confirmó un adenoma suprarrenal.

ABSTRACT Introduction: Hernia is one of the most frequent pathologies in general surgery. There are many surgical techniques to repair it. Since the advent of laparoscopic surgery, inguinal hernia repair presents challenges and results comparable to the open technique. Objetive: To describe the efficiency of the preperitoneal transabdomino technique (TAPP) and open Lichtenstein-type in the treatment of inguinal hernia in the general surgery service of the Hospital Nacional de Itaugua in the period from August 2017 to August 2018. Methodology: Observational, descriptive, retrospective cross-sectional study; a direct systematic review of medical records with diagnosis of inguinal hernia was performed; the follow-up of the patients was carried out in the post-operative controls by office. Results: 92 patients underwent surgery, of which 51 (55%) had Lichtenstein-type hernioplasties and 41 (44.5%) laparoscopic video hernioplasty, TAPP technique. 95% of the total patients had a hospital stay of 2 days. 96% of the Lichtenstein repairs and 80% of the TAPP lasted from 31 to 90 minutes. There was no intraoperative complication. The main postoperative complication of Lichtenstein-type repair was the hematoma of the operative wound (15%); in the repair by TAPP was the chronic inguinal pain (5%) and the hematoma of the operative wound (5%). The return to productive activities was 53% in the third week for the Lichtenstein technique and 78% in the first week for the TAPP technique. Conclusion: The hospital stay was 2 days in 95% of the cases; the operative time was 31 to 90 minutes. Only post-operative complications, with very low percentage in both and the return to daily activities were faster with the TAPP technique.

RESUMEN Introduccion: La hernia es una de las patologías más frecuentes en cirugía general. Existen muchas técnicas quirúrgicas para la reparación de ella. Desde el advenimiento de la cirugía laparoscópica, la reparación de la hernia inguinal presenta desafíos y resultados comparables con la técnica abierta. Objetivo: Describir la eficiencia de las tecnicas videolaparoscopica transabdomino preperitoneal (TAPP) y abierta tipo Lichtenstein en el tratamiento de la hernia inguinal en el servicio de cirugía general del Hospital Nacional de Itauguá en el periodo comprendido entre agosto del 2017 hasta agosto de 2018. Metodologia: Estudio observacional, descriptivo, retrospectivo de corte transversal; se realizó revisión sistemática directa de expedientes médicos con diagnóstico de hernia inguinal; el seguimiento de los pacientes se realizó en los controles post operatorios por consultorio. Resultados: Fueron intervenidos 92 pacientes de los cuales 51 (55%) se realizaron hernioplastias tipo Lichtenstein y 41 (44.5%) hernioplastia videolaparoscopica técnica TAPP. El 95% del total de pacientes tuvo una estancia hospitalaria de 2 días. El 96% de las reparaciones tipo Lichtenstein y el 80% de las TAPP tuvieron una duración de 31 a 90 minutos. No hubo complicación intraoperatoria. La principal complicación post operatoria de la reparación tipo Lichtenstein fue el hematoma de la herida operatoria (15%); en la reparación por TAPP fue el dolor inguinal crónico (5%) y el hematoma de la herida operatoria (5%). El retorno a las actividades productiva fue 53% en la tercera semana para la técnica de Lichtenstein y 78% en la primera semana para la técnica TAPP. Conclusión: La estancia hospitalaria fue 2 días en el 95% de los casos, el tiempo operatorio fue de 31 a 90 minutos. Solo complicaciones post operatorias, con muy bajo porcentaje en ambas y el retorno a las actividades cotidianas fue más rápida con la técnica TAPP.

ABSTRACT Hydatid disease is an infection, usually of the liver, cause by larval forms of tapeworms of the genus Echinococcus, and characterized by the development of expanding cysts. It frequently affects young adults, from agricultural and livestock regions. Considered endemic in South America, with incidence points in Argentina and Uruguay. Low incidence in our country. Presenting most commonly in the liver and lung in its cystic form. Objective: The purpose of this work is to establish the management and treatment of hepatic hydatidosis in patients attending the Hospital Nacional de Itauguá in the period from 2014 to 2018 Material and methods: Observational, descriptive, retrospective cross-sectional study. The data were obtained from the Clinical Histories of patients with Hepatic Hydatidosis from the archives of the Hospital Nacional de Itauguá. Results: We studied 17 patients, of which 64.7% belonged to the female gender, with an average age of 44.8(13.8, were observed 14.06 days of hospitalization on average, 29.4% patients of the study were from the city of Paraguarí, 82.4% would have consulted for abdominal pain, 70.6% used ultrasound as a diagnostic method, 70.6% underwent a laparotomy and 23.5% presented a complication postsurgical Conclusion: The majority of patients with this pathology correspond to women, from urban areas, presenting abdominal pain, diagnosed by ultrasound in whom both were practiced open surgery and a minimally invasive approach.

RESUMEN La hidatidosis es una zoonosis de distribución mundial producida por las larvas de Echinococcus granulosus. Afecta frecuentemente a adultos jóvenes, de regiones agrícolas y ganaderas. Considerada endémica en América del Sur, con puntos de incidencia en Argentina y Uruguay. De baja incidencia en nuestro país. Presentándose en su forma quística más comúnmente en hígado y pulmón. Objetivos: El propósito de este trabajo es establecer el manejo y tratamiento de la hidatidosis hepática en los pacientes que concurren al Hospital Nacional de Itauguá en el periodo de 2014 al 2018. Material y métodos: Estudio observacional, descriptivo, retrospectivo de corte transversal. Los datos fueron obtenidos de las Historias Clínicas de pacientes con Hidatidosis Hepática de los archivos del Hospital Nacional de Itauguá. Resultados: Se estudiaron a 17 pacientes, de los cuales el 64,7% pertenecían al género femenino, con edad media de 44,8(13,8, ser observo 14,06 días de internación en promedio, de los pacientes el 29,4% fueron procedentes de la ciudad de Paraguarí, el 82,4% habrían consultado por dolor abdominal, como examen complementario 70,6% había utilizado la ecografía como método de diagnostico, en donde el 70,6% fue sometido a laparotomía y el 23,5% presentó complicación postquirúrgica. Conclusión: La mayoría de los pacientes con esta patología corresponde a mujeres, predominio en zona urbana, siendo el dolor abdominal el principal motivo de consulta y diagnosticados por ecografía recibiendo tratamiento quirúrgico tanto laparotómico como abordaje mínimamente invasivo (percutáneo).

Resumo Introdução: A avaliação do resultado cirúrgico medido pela satisfação do paciente ou qualidade de vida é muito importante, especialmente na cirurgia plástica, uma especialidade na qual há um crescente interesse na avaliação de resultados por auto‐relato. Objetivo: O objetivo deste estudo foi realizar a tradução, a adaptação transcultural e a validação do questionário "The Utrecht questionnaire for outcome assessment in aesthetic rhinoplasty", do inglês para português. Método: Estudo retrospectivo envolvendo 50 pacientes submetidos a rinoplastia comparando o período pré‐operatório com a situação atual (mínimo de 6 meses e máximo de 24 meses de pós‐operatório). A análise estatística foi realizada para avaliar a consistência interna, confiabilidade teste‐reteste, validade e capacidade de resposta. Resultados: Nenhum paciente recebeu pontuação negativa na escala visual analógica ao comparar a aparência pré‐ e pós‐operatória. A melhora pós‐operatória na escala visual analógica revelou uma curva gaussiana de distribuição normal, com melhora média de 4,44 pontos. A confiabilidade teste‐reteste mostrou uma correlação positiva entre a resposta pós‐operatória e o mesmo questionário repetido noventa e seis horas depois. A consistência interna foi alta (valor do alfa de Cronbach: pré‐operatório = 0,88; pós‐operatório = 0,86). Os autores observaram uma melhora significante nas respostas para todas as questões individuais na fase pós‐operatória em comparação com a situação pré‐operatória (teste t de Student – p < 0,05). Conclusão: A versão em português do "The Utrecht questionnaire for outcome assessment in aesthetic rhinoplasty" é um instrumento válido para avaliar os resultados do paciente após a cirurgia de rinoplastia.

Abstract Introduction: The evaluation of surgical outcomes measured by patient satisfaction or quality of life is very important, especially in plastic surgery. There is increasing interest in self-reporting outcomes evaluation in plastic surgery. Objective: The aim of this study was to perform the translation, cross-cultural adaptation and validation of "The Utrecht questionnaire for outcome assessment in aesthetic rhinoplasty" from English to Portuguese. Methods: Retrospective study involving 50 patients undergoing to rhinoplasty comparing the preoperative period with the current postoperative situation (minimum 6 months and maximum 24 months postoperatively). Statistical analysis was performed to assess internal consistency, test-retest reliability, validity and responsiveness. Results: No patients received a negative score on the visual analogue scale comparing preoperative and postoperative appearance. The postoperative improvement on the visual analogue scale revealed a Gaussian curve of normal distribution with a mean improvement of 4.44 points. The test-retest reliability showed a positive correlation between the postoperative response and the same questionnaire repeated ninety-six hours later. The internal consistency was high (Cronbach's alpha value: Preoperative = 0.88; Postoperative = 0.86). The authors observed a significant improvement in response for all individual questions in the postoperative phase as compared with preoperative situation (t-student test - p < 0.05). Conclusion: The Portuguese version of "The Utrecht questionnaire for outcome assessment in aesthetic rhinoplasty" is a valid instrument to assess patients' outcomes following rhinoplasty surgery.

The aim of this work was to study the corrosion process of new aluminium alloy AA2524-T3 (Solution Heat Treated and Cold Worked), which is a promising substitute of the base line AA2024-T3 for aircrafts fabrication, by global and localised techniques in sodium chloride medium (0.05 mol L-1 NaCl). The open circuit potential results revealed a stochastic evolution of pitting events and to the resulting variations in the ratio of passive/active areas and/or cathode/anode, which may be related to the presence of different types of intermetallics. The cyclicvoltammetry showed that the corrosion potential (Ecorr) and the pit nucleation potential (E pit) values are quite similar (approximately -0.525 V). The results of EIS show that the corrosion rate is quite stable, with no tendency to increase or decrease for longer immersion periods. The results of SVET were in agreement with the results obtained by EIS technique, showing strong anodic activity on the surface with no repassivation along the whole immersion time. Besides, corrosion process led to significant surface degradation after 24h.

Resumo O presente trabalho avalia a influência de adições entre 10 e 25% de CO2 como gases de proteção a base de argônio (Ar) nas propriedades mecânicas e resistência à corrosão de juntas soldadas pelo processo FCAW no aço inoxidável duplex (AID) UNS S31803 fazendo uso de arame eletrodo E2209T1-4. Sob estas condições o efeito da participação de 2% de oxigênio (O2) na mistura foi também levado em consideração. Ensaios mecânicos de tração e impacto Charpy, assim como de microdureza nas fases austenita e ferrita foram realizados em diversos locais das juntas assim produzidas. Paralelamente foram efetuados ensaios de corrosão para determinação da temperatura critica de pites (CPT) e perda de massa por unidade de área baseando-se nas especificações das normas ASTM G150 e G48, respectivamente. O estudo foi complementado com análises metalográficas mediante o emprego de diversos reagentes quantificando-se as fases presentes, assim como revelando características microestruturais nas condições supracitadas. Os valores das propriedades mecânicas obtidos nas juntas analisadas foram satisfatórios quando comparadas com valores normativos assim como de trabalhos publicados recentemente. Contudo, constatou-se ainda um aumento da CPT nas juntas soldadas com o emprego de gases com teores crescentes de CO 2. Finalmente observou-se, que dentre as juntas soldadas estudadas, aquelas obtidas utilizando-se a mistura com composição de 73%Ar+25%CO2 +2%O2, apresentou o melhor desempenho, tanto no que tange às propriedades mecânicas, quanto na resistência à corrosão. Os resultados obtidos permitem considerar a utilização de outras misturas gasosas na soldagem destes aços inoxidáveis com o processo FCAW, atém das indicadas normativamente, visando a grande demanda na construção e montagem de diversos componentes desta família de aço inoxidáveis na indústria offshore.

Abstract The present work evaluates the influence of additions between 10 and 25% of CO2 in argon-based shielded gases on the mechanical properties and corrosion resistance of welded joints by the FCAW process in duplex stainless steel (DSS) UNS S31803 using electrode wire E2209T1-4. Under these conditions the effect of the 2% O2 addition in the mixture was also taken into account. Mechanical tensile test, Charpy toughness and microhardness in the austenite and ferrite phases were carried out in several places of the joints thus produced. Besides, corrosion tests were carried out to determine the critical pitting temperature (CPT) and mass loss per unit area based on the specifications of ASTM G150 and G48, respectively. The study was complemented with metallographic analyzes using several reagents, quantifying the present phases, as well as revealing microstructural characteristics in the studied conditions. The mechanical properties values obtained in the analyzed joints were satisfactory when compared with normative values as well in recently published works. However, it was also observed a CPT increase value in the joints welded with the use of gases with higher levels of CO2. Finally, it was observed that, among the welded joints studied, those obtained using the mixture with composition of 73% Ar + 25% CO2 + 2% O2, presented the best performance, both with regard to mechanical properties and the corrosion resistance. The results allow determinates the use of other gaseous mixtures in the welding of DSS with the FCAW process, in addition to the normative one, in view of the great demand in the construction and assembly of several components of this stainless steel family in the offshore industry.

A paraplegia é uma complicação devastadora e reconhecida da cirurgia de reparação do aneurisma da aorta toracoabdominal, tendo os sistemas de drenagem de líquido cefalorraquidiano emergido como uma medida importante para melhorar o outcome neurológico. O protocolo elaborado na nossa instituição é constituído por documentos que orientam a colocação do sistema de drenagem, a sua manutenção, o manuseio e os objetivos hemodinâmicos para o intra-operatório e pós-operatório, as intervenções a serem tomadas no caso de ocorrência de algum défice neurológico e as normas para a retirada do catéter de drenagem em segurança. É imperativo a familiarização dos diferentes membros da equipa médica e de enfermagem com as normas de utilização deste sistema. O objetivo principal é a otimização da abordagem destes doentes de modo a melhorar o outcome neurológico e minimizar o risco de complicações.

Paraplegia is a devastating and well recognized complication of thoracoabdominal aortic aneurysm repair surgery, with cerebrospinal fluid drainage systems emerging as an important measure to improve neurological outcome. The protocol elaborated by the authors consists of several documents that guide the placement of the drainage system, its maintenance, the handling and the hemodynamic goals for the intraoperative and postoperative period, the interventions to be taken in case of neurological deficit and the withdrawal of the drainage catheter with safety. It is imperative to familiarize the different members of the medical and nursing teams with the usage rules of this system. The main objective is to optimize the approach of these patients in order to improve their neurological outcome and to minimize the risk of complications.

Summary Intraductal papilloma mucinous neoplasm (NIPM) was first described in 1982 by Ohashi as a neoplasm of the pancreas characterized by a proliferation of neoplastic mucinous cells that form papillae and cause dilatation of the main duct or its branches. It most frequently affects the male sex between 60 and 70 years, with symptoms of chronic pancreatitis or recurrent acute pancreatitis and is preferably located in the head and uncinate process. The treatment of these neoplasms located in the head or uncinate process of the pancreas is the duodenum cephalic pancreatectomy. We report one patient, with a cystic lesion of the head of symptomatic pancreas.

Resumen La neoplasia Intraductal papilomucinosa (NIPM) fue descrita por primera vez en 1982 por Ohashi, como una neoplasia del páncreas caracterizada por una proliferación de células neoplásicas mucinosas, que forman papilas y causan dilatación del ducto principal o sus ramas. Afecta con mayor frecuencia al sexo masculino entre 60 y 70 años, con síntomas de pancreatitis crónica o pancreatitis aguda recidivante y se localiza preferentemente en la cabeza y proceso uncinado. El tratamiento de estas neoplasias ubicada en la cabeza o proceso uncinado de páncreas es la duodeno pancreatectomía cefálica. Reportamos una paciente, con una lesión quística de cabeza de páncreas sintomática.

Resumo Introdução: A avaliação do desfecho de cirurgia medido pela satisfação ou qualidade de vida do paciente é muito importante, especialmente em cirurgia plástica. Existe um interesse crescente na autoavaliação de desfechos nesta especialidade cirúrgica. Objetivo: O objetivo deste estudo foi determinar a satisfação do paciente em relação à aparência e função do nariz com o uso de um questionário validado, antes e depois da cirurgia de rinoplastia. Método: Estudo prospectivo realizado em um centro terciário. Todas as cirurgias de rinoplastia feitas em adultos entre fevereiro de 2013 e agosto de 2014 foram incluídas. Muitos pacientes foram submetidos à cirurgia nasal adicional, como septoplastia ou turbinoplastia. Os procedimentos cirúrgicos e as características dos pacientes também foram registrados. Resultados: Entre 113 pacientes, 107 completaram os questionários e o período de acompanhamento. A análise da avaliação do desfecho de rinoplastia (ADR) no pré-operatório e pós-operatório mostrou uma melhoria significativa após 3 e 6 meses em questões funcionais e estéticas (p < 0,01). No pré-operatório, os pacientes ansiosos e inseguros apresentaram um escore pior (p < 0,05). A diferença na melhoria dos escores não foi significativa quando os grupos foram divididos com base em outros procedimentos nasais, cirurgia primária ou revisão e abordagem aberta versus fechada. Conclusão: Verificou-se que pacientes com menor grau de alfabetização estavam mais satisfeitos com o procedimento. A cirurgia de rinoplastia melhorou significativamente a qualidade de vida do paciente quanto à função e ao aspecto do nariz.

Abstract Introduction: Evaluation of surgery outcome measured by patient satisfaction or quality of life is very important, especially in plastic surgery. There is increasing interest in self-reporting outcomes evaluation in plastic surgery. Objective: The aim of our study was to determine patient satisfaction in regard to nose appearance and function with the use of a validated questionnaire, before and after rhinoplasty surgery. Methods: A prospective study was realized at a tertiary centre. All rhinoplasty surgeries performed in adults between February 2013 and August 2014 were included. Many patients underwent additional nasal surgery such as septoplasty or turbinoplasty. The surgical procedures and patients' characteristics were also recorded. Results: Among 113 patients, 107 completed the questionnaires and the follow-up period. Analysis of pre-operative and post-operative Rhinoplasty Evaluation Outcome showed a significant improvement after 3 and 6 months in functional and aesthetic questions (p < 0.01). In the pre-operative, patients anxious and insecure had a worse score (p < 0.05). Difference in improvement of scores was not significant when groups were divided on basis of other nasal procedures, primary or revision surgery and open versus closed approach. Conclusion: We found that patients with lower literacy degree were more satisfied with the procedure. Rhinoplasty surgery significantly improved patient quality of life regarding nose function and appearance.

ABSTRACT Colorectal cancer (CRC) accounts for 9.7% of all cancers with 1.4 million new cases diagnosed each year. 19-31% of CRC patients develop colorectal liver metastases, and 23-38% develop extra-hepatic disease1. 15-25% will be presented synchronously and 25-40% will metachronously2. Surgical resection is the only potentially curative treatment and, in the case of synchronous metastases, the debate is whether to resect simultaneously, before or after the primary tumor3-4.

RESUMEN El cáncer colorrectal representa 9,7% de todos los cánceres con 1,4 millones de nuevos casos diagnosticados cada año en el mundo 19-31% de los pacientes desarrollan metástasis hepáticas de cáncer colorrectal y 23-38% desarrollan enfermedad extrahepática1 15-25% se presentarán de forma sincrónica y 25-40% serán metacrónicas2. La resección quirúrgica es el único tratamiento potencial-mente curativo, en el caso de las metástasis sincrónicas, se debate si se deben resecar simultáneamente, antes o después del tumor primario3-4.