942 resultados para DIAGNOSTIC-TOOL


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In this chapter, advanced characterization of membrane fouling as a diagnostic tool has been summarized to prevent membrane fouling. Physical, chemical and biological analyses as membrane autopsies are mainly utilized to better understand membrane foulant. The physical characterization gives structure, roughness, charge effect, strength and hydrophobicity of membrane fouling. The chemical methods provide qualitative and quantitative measurements of different inorganic and organic matter. The biological properties present the spatial biofilm distribution, structure of dominant microorganisms and isolation and identification of microorganisms. In addition, detailed membrane foulant types are reviewed in terms of structure, roughness, hydrophobicity, charge effect, strength, calcium, magnesium, aluminum, iron, silicate, particle, functional group, biopolymer, humic acid, polysaccharide, structural composition, biofilm structure, microorganism and foulant interaction.

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Context Early pulmonary infection in children with cystic fibrosis leads to increased morbidity and mortality. Despite wide use of oropharyngeal cultures to identify pulmonary infection, concerns remain over their diagnostic accuracy. While bronchoalveolar lavage (BAL) is an alternative diagnostic tool, evidence for its clinical benefit is lacking.

Objective To determine if BAL-directed therapy for pulmonary exacerbations during the first 5 years of life provides better outcomes than current standard practice relying on clinical features and oropharyngeal cultures.

Design, Setting, and Participants The Australasian Cystic Fibrosis Bronchoalveolar Lavage (ACFBAL) randomized controlled trial, recruiting infants diagnosed with cystic fibrosis through newborn screening programs in 8 Australasian cystic fibrosis centers. Recruitment occurred between June 1, 1999, and April 30, 2005, with the study ending on December 31, 2009.

Interventions BAL-directed (n=84) or standard (n=86) therapy until age 5 years. The BAL-directed therapy group underwent BAL before age 6 months when well, when hospitalized for pulmonary exacerbations, if Pseudomonas aeruginosa was detected in oropharyngeal specimens, and after P aeruginosa eradication therapy. Treatment was prescribed according to BAL or oropharyngeal culture results.

Main Outcome Measures Primary outcomes at age 5 years were prevalence of P aeruginosa on BAL cultures and total cystic fibrosis computed tomography (CF-CT) score (as a percentage of the maximum score) on high-resolution chest CT scan.

Results Of 267 infants diagnosed with cystic fibrosis following newborn screening, 170 were enrolled and randomized, and 157 completed the study. At age 5 years, 8 of 79 children (10%) in the BAL-directed therapy group and 9 of 76 (12%) in the standard therapy group had P aeruginosa in final BAL cultures (risk difference, −1.7% [95% confidence interval, −11.6% to 8.1%]; P=.73). Mean total CF-CT scores for the BAL-directed therapy and standard therapy groups were 3.0% and 2.8%, respectively (mean difference, 0.19% [95% confidence interval, −0.94% to 1.33%]; P=.74).

Conclusion Among infants diagnosed with cystic fibrosis, BAL-directed therapy did not result in a lower prevalence of P aeruginosa infection or lower total CF-CT score when compared with standard therapy at age 5 years.

Trial Registration anzctr.org.au Identifier: ACTRN12605000665639

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There is paucity of data regarding hydrocarbon exposure of tropical fish species inhabiting the waters near oil and gas platforms on the Northwest Shelf of Australia. A comprehensive field study assessed the exposure and potential effects associated with the produced water (PW) plume from the Harriet A production platform on the northwest shelf in a local reef species, Stripey seaperch (Lutjanus carponotatus). This field study was a continuation of an earlier pilot study which concluded that there were “warning signs” of potential biological effects on fish populations exposed to PW. A 10-day field caging study was conducted deploying 15 individual fish into 6 separate steel cages set 1-m subsurface at 3 stations in a concentration gradient moving away from the platform. A battery of biomarkers were evaluated including hepatosomatic index (HSI), total cytochrome P450, bile metabolites, CYP1A-, CYP2K- and CYP2M-like proteins, cholinesterase (ChE) activity, and histopathology of liver and gill tissues. Water column and PW effluent samples was also collected. Results confirmed that PAH metabolites in bile, CYP1A-, CYP2K-, and CYP2M-like proteins and liver histopathology provided evidence of significant exposure and effects after 10 days at the near-field site (~200 m off the Harriet A platform). Hepatosomatic index, total cytochrome P450, and ChE did not provide site-specific differences by day 10 of exposure to PW. CYP proteins were shown by principal component analysis (PCA) to be the best diagnostic tool for determining exposure and associated biological effects of PW on L. carponotatus. Using a suite of biomarkers has been widely advocated as a vital component in environmental risk assessments worldwide. This study demonstrates the usefulness of biomarkers for assessing the Harriet A PW discharge into Australian waters with broader applications for other PW discharges. This approach has merit as a valuable addition to environmental management strategies for protecting Australia’s tropical environment and its rich biodiversity.

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Currently in clinic, people use hematoxylin and eosin stain (H&E stain) and immunohistochemistry methods to identify the generation and genre of cancers for human pathological samples. Since these methods are inaccurate and time consuming, developing a rapid and accurate method to detect cancer is urgently demanded. In our study, binding peptides for lung cancer cell line A549 were identified using bacteria surface display method. With those binding peptides for A549 cells on the surface, the fluorescent bacteria (Escherichia coli with stably expressed green fluorescent protein) were served as specific detecting reagents for the diagnosis of cancers. The binding activity of peptide-fluorescent bacteria complex was confirmed by detached cancer cells, attached cancer cells and mice tumor xenograft samples. A unique fixation method was developed for peptide-bacteria complex in order to make this complex more feasible for the clinic use. This peptide-fluorescent bacteria complex has great potential to become a new diagnostic tool for clinical application.

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Few studies have examined longitudinal associations between fish consumption and depression; none have defined depression using a diagnostic tool. We investigated whether fish consumption was associated with fewer new depression episodes in a national study of Australian adults. In 2004–2006, 1,386 adults aged 26–36 years (38% males) completed a 127-item (9 fish items) food frequency questionnaire. Fish intake was examined continuously (times/week) and dichotomously (reference group: <2 times/week). During 2009–2011, the lifetime version of the Composite International Diagnostic Interview was administered by telephone. New episodes of major depression/dysthymic disorder (since baseline) were defined using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. During follow-up, 160 (18.8%) women and 70 (13.1%) men experienced depression. For women, each additional weekly serving of fish consumed at baseline decreased the risk of having a new depressive episode by 6% (adjusted relative risk = 0.94, 95% confidence interval: 0.87, 1.01). Women who ate fish ≥2 times/week at baseline had a 25% lower risk of depression during follow-up than those who ate fish <2 times/week (adjusted relative risk = 0.75, 95% confidence interval: 0.57, 0.99). Reverse causation was also suggested but appeared to be restricted to persons with recent depression. Fish consumption was not associated with depression in men. These findings provide further evidence that fish consumption may be beneficial for women's mental health.

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Purpose – Drawing on the resource-based view (RBV), the purpose of this paper is to develop a framework and instrument to measure the organisational capabilities of university schools/ departments. In doing so, this study provides evidence of the way competitive resources are bundled to generate organisational capabilities that give university schools/departments a sustainable competitive advantage. Design/methodology/approach – A questionnaire to measure the resources that contribute to the capabilities of university schools/departments was developed. Constructs were determined, and the questionnaire was refined based on an analysis of responses from 166 Heads of schools/departments across all 39 Australian public universities. Findings – Heads conceive of the development of capabilities within their schools/departments along the core operating functions of research, teaching, and networking. Reliability and supplementary analysis confirm these constructs have strong convergent and discriminant validity as well as internal consistency. Research limitations/implications – The findings confirm that effective management and coordination of research, teaching, and networking with important stakeholders are keys to success. The framework and instrument developed in this paper also provides the opportunity to investigate university performance through the perspective of the RBV, which will enhance the understanding of the determinants of universities’ performance. Practical implications – The framework and questionnaire developed in this study can be utilised by Heads as a diagnostic tool to gain an understanding of their department’s/school’s organisational capabilities in the areas of research, teaching, and networking. Originality/value – This paper is the first study to develop a framework and questionnaire to measure organisational capabilities for university academic schools/departments.

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BACKGROUND: We describe Pseudomonas aeruginosa acquisitions in children with cystic fibrosis (CF) aged ≤5-years, eradication treatment efficacy, and genotypic relationships between upper and lower airway isolates and strains from non-CF sources. METHODS: Of 168 CF children aged ≤5-years in a bronchoalveolar lavage (BAL)-directed therapy trial, 155 had detailed microbiological results. Overall, 201/271 (74%) P. aeruginosa isolates from BAL and oropharyngeal cultures were available for genotyping, including those collected before and after eradication therapy. RESULTS: Eighty-two (53%) subjects acquired P. aeruginosa, of which most were unique strains. Initial eradication success rate was 90%, but 36 (44%) reacquired P. aeruginosa, with genotypic substitutions more common in BAL (12/14) than oropharyngeal (3/11) cultures. Moreover, oropharyngeal cultures did not predict BAL genotypes reliably. CONCLUSIONS: CF children acquire environmental P. aeruginosa strains frequently. However, discordance between BAL and oropharyngeal strains raises questions over upper airway reservoirs and how to best determine eradication in non-expectorating children.

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O câncer colorretal é um tumor maligno freqüente no mundo ocidental. É o terceiro em freqüência e o segundo em mortalidade nos países desenvolvidos. No Brasil está entre as seis neoplasias malignas mais encontradas e a quinta em mortalidade. Dos tumores colorretais, aproximadamente 40% estão localizados no reto. A sobrevida, em cinco anos, dos pacientes operados por câncer do reto varia entre 40% e 50%, estando os principais fatores prognósticos, utilizados na prática clínica corrente, baseados em critérios de avaliação clínico-patológicos. A avaliação das alterações morfométricas e densimétricas nas neoplasias malignas tem, recentemente, sido estudadas e avaliadas através da análise de imagem digital e demonstrado possibilidades de utilização diagnóstica e prognóstica. A assinatura digital é um histograma representativo de conjuntos de características de textura da cromatina do núcleo celular obtida através da imagem computadorizada. O objetivo deste estudo foi a caracterização dos núcleos celulares neoplásicos no adenocarcinoma primário de reto pelo método da assinatura digital e verificar o valor prognóstico das alterações nucleares da textura da cromatina nuclear para esta doença. Foram avaliados, pelo método de análise de imagem digital, 51 casos de pacientes operados no Hospital de Clínicas de Porto Alegre (HCPA) entre 1988 e 1996 e submetidos à ressecção eletiva do adenocarcinoma primário de reto, com seguimento de cinco anos pós-operatório, ou até o óbito antes deste período determinado pela doença, e 22 casos de biópsias normais de reto obtidas de pacientes submetidos a procedimentos endoscópicos, para controle do método da assinatura digital. A partir dos blocos de parafina dos espécimes estocados no Serviço de Patologia do HCPA, foram realizadas lâminas coradas com hematoxilina e eosina das quais foram selecionados 3.635 núcleos dos adenocarcinomas de reto e 2.366 núcleos dos controles da assinatura digital, totalizando 6.001 núcleos estudados por análise de imagem digital. De cada um destes núcleos foram verificadas 93 características, sendo identificadas 11 características cariométricas com maior poder de discriminação entre as células normais e neoplásicas. Desta forma, através da verificação da textura da cromatina nuclear, foram obtidos os histogramas representativos de cada núcleo ou conjunto de núcleos dos grupos ou subgrupos estudados, também no estadiamento modificado de Dukes, dando origem às assinaturas digitais correspondentes. Foram verificadas as assinaturas nucleares, assinaturas de padrão histológico ou de lesões e a distribuição da Densidade Óptica Total. Houve diferença significativa das características entre o grupo normal e o grupo com câncer, com maior significância para três delas, a Área, a Densidade Óptica Total e a Granularidade nuclear. Os valores das assinaturas médias nucleares foram: no grupo normal 0,0009 e nos estadiamentos; 0,9681 no A, 4,6185 no B, 2,3957 no C e 2,1025 no D e diferiram com significância estatística (P=0,001). A maior diferença do normal ocorreu no subgrupo B de Dukes-Turnbull. As assinaturas nucleares e de padrão histológico mostraram-se distintas no grupo normal e adenocarcinoma, assim como a distribuição da Densidade Óptica Total a qual mostra um afastamento progressivo da normalidade no grupo com câncer. Foi possível a caracterização do adenocarcinoma de reto, que apresentou assinaturas digitais específicas. Em relação ao prognóstico, a Densidade Óptica Total representou a variável que obteve o melhor desempenho, além do estadiamento, como preditor do desfecho.

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O citomegalovírus (CMV), está entre os principais agentes infecciosos que acometem pacientes transplantados renais. A infecção por CMV está relacionada ao status sorológico do doador e receptor, bem como o tipo e intensidade da imunossupressão utilizada. A infecção, e em especial a doença citomegálica, determinam aumento da morbi-mortalidade após o transplante. O espectro da doença varia desde formas assintomáticas até a doença sistêmica grave com comprometimento de vários órgãos. A doença por CMV é diagnosticada através da evidência laboratorial de infeção, associada a quadro clínico compatível. A técnica da antigenemia identifica a presença do antígeno viral p65 em leucócitos do sangue periférico através de reação de imunoperoxidase utilizando-se anticorpos monoclonais. O objetivo principal deste trabalho foi o de determinar a incidência de infecção por CMV em uma coorte de pacientes transplantados renais usando a antigenemia como ferramenta diagnóstica. Secundariamente buscou-se avaliar o impacto desta infecção nas sobrevidas dos pacientes e dos enxertos em 6 anos de acompanhamento. No período de inclusão no estudo, janeiro de 1994 a fevereiro de 1995, foram realizados 74 transplantes renais na Santa Casa de Porto Alegre–RS. As amostras de sangue para a detecção da antigenemia foram obtidas semanalmente durante a internação hospitalar e posteriormente, sempre que houvesse suspeita clínica de infecção por citomegalovírus. Das 229 amostras analisadas, 51 (22,3%) foram positivas, em 24 pacientes, dos quais 41,6% (10/24) evoluíram de forma assintomática, 33,3% (8/24) apresentaram sintomas leves, e 25% (6/24) desenvolveram sintomas compatíveis com doença citomegálica. Desta forma, coorte estudada, a incidência de infecção e doença por CMV foram de 33,3% e 8,4%, respectivamente. Não houve associação entre as doses de imunossupressores, o uso de anticorpos monoclonais e número de episódios de rejeição com o desenvolvimento de infecção e doença por CMV. Nos transplantes realizados com doadores vivos, a incidência de infecção por CMV nos receptores de rins de doadores com sorologia positiva foi 61,9%, e nos receptores de doadores com sorologia negativa foi 14,3% (p=0,005). Os transplantes com receptores com sorologia negativa transplantados com rins de doadores soropositivos apresentaram incidência significativamente maior de infecção (75%) e doença (75%) por CMV do que os receptores com sorologia positiva transplantados com órgãos de doadores com soronegativos, 13,3% e 0%, respectivamente (p<0,05). A sensibilidade da antigenemia em detectar os pacientes que desenvolveram doença citomegálica foi de 100% e a especificidade foi 72,7%, com valor preditivo positivo de 25% e valor preditivo negativo de 100%. No grupo de pacientes que apresentou doença por CMV, ao término do seguimento, ocorreu um número significativamente mais elevado de perdas do enxerto (85%) do que no grupo de pacientes em que a infecção foi assintomática (29%), acarretando impacto negativo nas curvas de sobrevida de enxertos e pacientes (LogRank; p<0,05). A antigenemia mostrou ser uma ferramenta diagnóstica importante no manejo dos pacientes transplantados renais, possibilitando o diagnóstico precoce da infecção e auxiliando na identificação dos pacientes infectados que estão sob maior risco de desenvolvimento da doença.

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Este trabalho investiga basicamente a validade do Teste Illinois de Habilidades Psicolinguísticas -ITPA -instrumento de avaliação do desenvolvimento da linguagem infantil. Seus autores, S. Kirk e J.J. McCarthy (1961), utilizam o referencial teórico proposto por C. Osgood (1957), a ele incorporando o modelo derivado da Teoria da Informação, o que permite que, na prática clínica, o ITPA possa ser incluído no processo psicodiagnóstico como instrumento de avaliação dos problemas da comunicação em crianças entre três e dez anos. Os objetivos que conduzem e orientam o trabalho apresentado podem ser definidos em três níveis: 1) O que trata dos constructos e suas interrelaç6es -análise crítica da validade teóricado ITPA; 2) O que avalia sua condição de instrumento diagnóstico do desempenho escolar -sensibilidade discriminante do rendimento acadêmico; 3) O que trata da eficácia da prática psicopedagógica proposta pelo mesmo instrumento. O estudo sobre a validade teórica foi realizado com 931 crianças entre três e dez anos de idade, em processo de escolarização, frequentando creches, jardins de infância ou classes regulares da Rede de Ensino do Primeiro Grau no Município do Rio de Janeiro. Utilizou-se a técnica da Análise Fatorial, complementada por uma abordagem lógica que comprovaram algumas das dimensões propostas pelo referencial teórico de Kirk e McCarthy. Para a validade diagnóstica foram avaliadas 71 crianças com dificuldades no desempenho acadêmico, expressas através de conceitos de insuficiência ou deficiência de rendimento e seus resultados foram comparados com os de um subgrupo, aleatoriamente constituído de crianças que participaram do estudo anterior. Utilizou-se a técnica da Análise Discriminante chegando-se à seguinte conclusão: embora a validade de constructo do IIPA não tenha sido completamente confirmada num nível diagnóstico os resultados permitem identificar, com baixa margem de erro, as crianças que pertencem a um ou outro dos grupos de contraste. Quanto ao terceiro nível, foi feita ampla-revelação bibliográfica sobre investigações efetuadas com este instrumento no Brasil e no Exterior. Visou-se avaliar a eficácia da prática psicopedagógica utilizada quando desenvolvida à luz dos recursos de intervenção que o IIPA propõe. Concluiu-se que as pesquisas, até o presente momento efetuadas, não são suficientes para formar um juízo mais seguro da praxis educativa destinada à reabilitação das crianças com problemas da comunicação - o que constitui impedimento a seu desempenho acadêmico - em função das controvérsias que tais pesquisas apresentam.

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The ovarian remnant syndrome (ORS) is an iatrogenic disorder in bitches and queens, which is characterized by recurrence of estrus following surgical spay, due to the presence of a piece of ovarian tissue within the abdominal cavity. In most cases, the remnant ovary is found in the right ovarian pedicle, due to its topographic position, deeper and more cranial than the left ovary. The main clinical signs of ORS in small animals are the heat behavior and the presence of vaginal swelling/secretion, especially in canines. The diagnosis should be performed by means of vaginal cytology when attraction of males is detected, serum estrogen and progesterone levels and/or by challenging test with GnRH or hCG administration. However, vaginal citology is the most suitable and less expensive diagnostic tool. Nowadays the treatment of choice is a new laparotomy or laparoscopy, followed by removal of the remnant ovarian tissue. The surgical treatment has more chances of success if it is performed in the diestrus (i.e., between 15 and 60 days after the detection of attraction of males). Furthermore, a careful and accurate surgical procedure aided by advanced visualization techniques during ovariohysterectomy or ovariectomy is the best way to prevent ORS in companion animals.

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Swallowing dynamics involves the coordination and interaction of several muscles and nerves which allow correct food transport from mouth to stomach without laryngotracheal penetration or aspiration. Clinical swallowing assessment depends on the evaluator's knowledge of anatomic structures and of neurophysiological processes involved in swallowing. Any alteration in those steps is denominated oropharyngeal dysphagia, which may have many causes, such as neurological or mechanical disorders. Videofluoroscopy of swallowing is presently considered to be the best exam to objectively assess the dynamics of swallowing, but the exam needs to be conducted under certain restrictions, due to patient's exposure to radiation, which limits periodical repetition for monitoring swallowing therapy. Another method, called cervical auscultation, is a promising new diagnostic tool for the assessment of swallowing disorders. The potential to diagnose dysphagia in a noninvasive manner by assessing the sounds of swallowing is a highly attractive option for the dysphagia clinician. Even so, the captured sound has an amount of noise, which can hamper the evaluator's decision. In that way, the present paper proposes the use of a filter to improve the quality of audible sound and facilitate the perception of examination. The wavelet denoising approach is used to decompose the noisy signal. The signal to noise ratio was evaluated to demonstrate the quantitative results of the proposed methodology. (C) 2007 Elsevier Ltd. All rights reserved.

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We use a tight-binding formulation to investigate the transmissivity and the currentvoltage (I_V) characteristics of sequences of double-strand DNA molecules. In order to reveal the relevance of the underlying correlations in the nucleotides distribution, we compare theresults for the genomic DNA sequence with those of arti_cial sequences (the long-range correlated Fibonacci and RudinShapiro one) and a random sequence, which is a kind of prototype of a short-range correlated system. The random sequence is presented here with the same _rst neighbors pair correlations of the human DNA sequence. We found that the long-range character of the correlations is important to the transmissivity spectra, although the I_V curves seem to be mostly inuenced by the short-range correlations. We also analyze in this work the electronic and thermal properties along an _-helix sequence obtained from an _3 peptide which has the uni-dimensional sequence (Leu-Glu-Thr- Leu-Ala-Lys-Ala)3. An ab initio quantum chemical calculation procedure is used to obtain the highest occupied molecular orbital (HOMO) as well as their charge transfer integrals, when the _-helix sequence forms two di_erent variants with (the so-called 5Q variant) and without (the 7Q variant) _brous assemblies that can be observed by transmission electron microscopy. The di_erence between the two structures is that the 5Q (7Q) structure have Ala ! Gln substitution at the 5th (7th) position, respectively. We estimate theoretically the density of states as well as the electronic transmission spectra for the peptides using a tight-binding Hamiltonian model together with the Dyson's equation. Besides, we solve the time dependent Schrodinger equation to compute the spread of an initially localized wave-packet. We also compute the localization length in the _nite _-helix segment and the quantum especi_c heat. Keeping in mind that _brous protein can be associated with diseases, the important di_erences observed in the present vi electronic transport studies encourage us to suggest this method as a molecular diagnostic tool

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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)