Radiation-induced optic neuropathy is a rare complication (prevalence less than 1%) following radiotherapy of the sellar region. However, the vasculopathy in Cushing's disease predisposes to radiation-induced injury. We report the case of a 24-year-old man with Cushing's disease since he was 16. The hormonal study including bilateral inferior petrosal sinus catheterization diagnosed a pituitary right lesion, but imagiology was always negative. He underwent a transsphenoidal microadenomectomy and the pathological study showed the presence of corticotrophic hyperplasia but no adenoma. Secondary hypothyroidism and hypogonadism as well as permanent diabetes insipidus were diagnosed and because the patient was not cured he underwent a second transsphenoidal total hypophysectomy. After that and because he was still hypercortisolemic, pituitary external irradiation was given in a total dose of 6000 rad. Six months later he developed progressive bilateral visual loss. Cerebral MR revealed focal enhancement of the enlarged optic nerves and chiasm, associated with demyelination areas of the posterior visual pathways. Treatment was tried first with high doses of corticosteroids and later with anticoagulants-heparin EV. 1000 U/h during 7 days followed by warfarin, but unsuccessfully, probably because the patient was already amaurotic at the beginning of the last treatment.

Developing a low-cost wireless energy meter with power quality measurements for smart grid applications represents a significant advance in efficient and accurate electric energy monitoring. In increasingly complex and interconnected electric systems, this device will be essential for a wide range of applications, such as smart grids, by introducing a real-time energy monitoring system. In light of this, smart meters can offer greater opportunities for sustainable and efficient energy use and improve the utilization of energy sources, especially those that are nonrenewable. According to the 2020 International Energy Agency (IEA) report, nonrenewable energy sources represent 65% of the global supply chain. The smart meter developed in this work is based on the ESP32 microcontroller and easily accessible components since it includes a user-friendly development platform that offers a cost-effective solution while ensuring reliable performance. The main objective of developing the smart meters was to enhance the software and simplify the hardware. Unlike traditional meters that calculate electrical parameters by means of complex circuits in hardware, this project performed the calculations directly on the microcontroller. This procedure reduced the complexity of the hardware by simplifying the meter design. Owing to the high-performance processing capability of the microcontroller, efficient and accurate calculations of electrical parameters could be achieved without the need for additional circuits. This software-driven approach with simplified hardware led to benefits, such as reduced production costs, lower energy consumption, and a meter with improved accuracy, as well as updates on flexibility. Furthermore, the integrated wireless connectivity in the microcontroller enables the collected data to be transmitted to remote monitoring systems for later analysis. The innovative feature of this smart meter lies in the fact that it has readily available components, along with the ESP32 chip, which results in a low-cost smart meter with performance that is comparable to other meters available on the market. Moreover, it is has the capacity to incorporate IoT and artificial intelligence applications. The developed smart meter is cost effective and energy efficient, and offers benefits with regard to flexibility, and thus represents an innovative, efficient, and versatile solution for smart grid applications.

Da-Dalton DCN ou DCC -Diâmetro crânio-nádega ou diâmetro crânio-caudal FDA -Food and Drug Administration

Developing a low-cost wireless energy meter with power quality measurement for smart grid applications represents a significant advancement in efficient and accurate electrical energy monitoring.In increasingly complex and interconnected electrical systems, this device is essential in various applications, such as smart grids, enabling real-time energy usage monitoring. In such a context, smart meters expand the possibilities for sustainable and efficient energy use and promote better utilization of energy sources, especially non-renewable ones. According to the 2020 International Energy Agency (IEA) research, non-renewable energy sources represent 65% of the global total. The smart meter developed in this work is built based on the ESP32 microcontroller and easily accessible components, using a user-friendly development platform that offers a cost-effective solution while ensuring reliable performance. The main objective of the smart meter development was to enhance the software and simplify the hardware. Unlike traditional meters that perform electrical parameter calculations using complex hardware circuits, this project performed the calculations directly on the microcontroller. This approach reduced the complexity of the hardware, simplifying the meter’s design. With the high-performance processing capability of the microcontroller, efficient and accurate calculations of electrical parameters were achieved without the need for additional circuits. This software-driven approach with simplified hardware brought benefits such as reduced production costs, lower energy consumption, and increased meter development and updates flexibility. Furthermore, the integrated wireless connectivity in the microcontroller enables the transmission of collected data to remote monitoring systems for later analysis. The developed smart meter offers cost, energy efficiency, and flexibility benefits. It represents an innovative, efficient, and versatile solution for smart grid applications.

Objetivo: Proporcionar o acompanhamento farmacoterapêutico (AFT) a pacientes do ambulatório de Insuficiência Cardíaca de um Hospital Universitário no Sul do país, além de avaliá-los quanto a sua adesão ao tratamento medicamentoso antes e após realização do AFT. Metodologia: Foram acompanhados durante um período de 5 meses com encontros quinzenais, um total de 14 pacientes adultos, de ambos os sexos, participantes de um programa interdisciplinar em reabilitação cardiorrespiratória. Utilizou-se um formulário adaptado da metodologia Dáder, objetivando investigar, registrar e solucionar os problemas relacionados a sua farmacoterapia. Resultados: A idade média dos pacientes foi de 69,8 ± 7,9 com prevalência do sexo feminino (71,4%). Ao todo foram prescritos 40 diferentes medicamentos, distribuídos em 25 classes terapêuticas. Destas, 92,85% dos pacientes faziam uso de Betabloqueadores (BB), 85,71% de Antagonista da aldosterona (AA) e 71,42% utilizavam diurético de alça. Identificou-se 112 problemas relacionados aos medicamentos (PRM), sendo mais recorrente o de interação medicamentosa. Observou-se uma redução do percentual de pacientes que não aderiram ao tratamento medicamentoso, passando de 85,71% para 35,71% ao final do AFT. Conclusão: Com base nos dados obtidos, é possível perceber que a prática da atenção farmacêutica (ATENFAR) foi efetiva, pois o AFT possibilitou identificar PRM, e, através desses dados, realizar as intervenções necessárias. Além das interações medicamentosas identificadas e corrigidas, o seguimento destas intervenções culminou em um aumento de 50% de pacientes aderentes à terapia medicamentosa, reafirmando a importância da atuação do farmacêutico junto à equipe interdisciplinar podendo assim contribuir para uma melhor qualidade de vida dos pacientes com IC.