981 resultados para GLOMERULOSCLEROSIS FOCAL


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Given a Lorentzian manifold (M,g), a geodesic gamma in M and a timelike Jacobi field Y along gamma, we introduce a special class of instants along gamma that we call Y-pseudo conjugate (or focal relatively to some initial orthogonal submanifold). We prove that the Y-pseudo conjugate instants form a finite set, and their number equals the Morse index of (a suitable restriction of) the index form. This gives a Riemannian-like Morse index theorem. As special cases of the theory, we will consider geodesics in stationary and static Lorentzian manifolds, where the Jacobi field Y is obtained as the restriction of a globally defined timelike Killing vector field.

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We prove an estimate on the difference of Maslov indices relative to the choice of two distinct reference Lagrangians of a continuous path in the Lagrangian Grassmannian of a symplectic space. We discuss some applications to the study of conjugate and focal points along a geodesic in a semi-Riemannian manifold.

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Providing residential aged care is challenging because of the complexity of residents' health status, difficulties recruiting and retaining skilled staff, and financial and regulatory constraints. This paper discusses some of these challenges and describes an innovative model of care, termed 'The Tri-focal model of care'. This model was developed based on the concepts of 'partnership-centred care', 'positive work environment' and the need for evidence-based practice to underpin all aspects of care. It is envisaged that the implementation of this model will provide a rich learning environment that advances the teaching-nursing home concept and the quality of residential aged care.

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The β7 integrins α4β7 and Eβ7 play key roles in forming the gut-associated lymphoid tissue, and contribute to chronic inflammation. The α4β7 integrin-mediated adhesion of activated lymphocytes is largely due to a transient increase in avidity from ligand-induced clustering of α4β7 at the cell-surface. Here, we report that L and D enantiomers of a cell-permeable peptide YDRREY encompassing residues 735-740 of the cytoplasmic tail of the β7 subunit inhibit the adhesion of T cells to β7 integrin ligands. The YDRREY peptide abrogated mucosal addressin cell adhesion molecule-1-induced clustering of α4β7 on the surface of activated T cells. A mutated form of the YDRREY peptide carrying either single or double conservative mutations at Tyr735Phe and Tyr740Phe was unable to inhibit T cell adhesion, suggesting that both tandem tyrosines are critical for activity. The YDRREY peptide was bound and phosphorylated by focal adhesion kinase and src, which may serve to sequester cytoskeletal proteins to the cytoplasmic domain of 4β7. The quasi-palindromic sequence YDRREY within the β7 cytoplasmic tail constitutes a cell adhesion regulatory domain that modulates the interaction of β7-expressing leukocytes with their endothelial and epithelial ligands. Cell-permeable peptidomimetics based on this motif have utility as anti-inflammatory reagents for the treatment of chronic inflammatory disease.

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Multicentric carpal-tarsal osteolysis is a rare skeletal disorder characterized by osteolysis of the metacarpal, carpal, and tarsal bones and leading to crippling joint deformities. Progressive nephropathy occurs in more than half the cases. All previously reported series with renal biopsies showed only end-stage renal disease on histological examination because of the late presentation to nephrologists. Accurate diagnosis of the underlying renal pathological state therefore has not been possible. We report the first case in which early and sequential renal biopsies were performed. These show the renal lesion to be focal and segmental glomerulosclerosis, which was treated successfully with cyclosporine A.

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Aim: Most risk assessments and decisions in conservation are based on surrogate approaches, where a group of species or environmental indicators are selected as proxies for other aspects of biodiversity. In the focal species approach, a suite of species is selected based on life history characteristics, such as dispersal limitation and area requirements. Testing the validity of the focal species concept has proved difficult, due to a lack of theory justifying the underlying framework, explicit objectives and measures of success. We sought to understand the conditions under which the focal species concept has merit for conservation decisions. Location: Our model system comprised 10 vertebrate species in 39 patches of native forest embedded in pine plantation in New South Wales, Australia. Methods: We selected three focal species based on ecological traits. We used a multiple-species reserve selection method that minimizes the expected loss of species, by estimating the risk of extinction with a metapopulation model. We found optimal reserve solutions for multiple species, including all 10 species, the three focal species, for all possible combinations of three species, and for each species individually. Results: Our case study suggests that the focal species approach can work: the reserve system that minimized the expected loss of the focal species also minimized the expected species loss in the larger set of 10 species. How well the solution would perform for other species and given landscape dynamics remains unknown. Main conclusions: The focal species approach may have merit as a conservation short cut if placed within a quantitative decision-making framework, where the aspects of biodiversity for which the focal species act as proxies are explicitly defined, and success is determined by whether the use of the proxy results in the same decision. Our methods provide a framework for testing other surrogate approaches used in conservation decision-making and risk assessment. © 2013 John Wiley & Sons Ltd.

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A finalidade deste estudo foi desenvolver reflexão crítica sobre a experiência de enfermeiros plantonistas. Os objetivos foram: apreender como os enfermeiros plantonistas descrevem e interpretam seus conhecimentos e experiências sobre esta realidade; e refletir sobre possíveis caminhos para a superação dos problemas identificados. Este estudo foi qualitativo, utilizando-se a técnica de grupo focal. O grupo foi formado por treze enfermeiros plantonistas. O referencial metodológico foi o do Discurso do Sujeito Coletivo. Foram identificadas importantes dificuldades para a construção do trabalho coletivo e solidário: incompreensões entre o pessoal de enfermagem; entre enfermagem e outros profissionais que atuam no hospital; falta ou inadequação de materiais para a prestação de assistência; e ausência de apoio, dentre outras. Verificou-se a pertinência da criação de espaços comunicativos e de reflexão, visando o fortalecimento do coletivo profissional e a redução das angústias no trabalho do enfermeiro plantonista.