Influence of emphysema distribution on pulmonary function parameters in COPD patients

Objective: To evaluate the impact that the distribution of emphysema has on clinical and functional severity in patients with COPD. Methods: The distribution of the emphysema was analyzed in COPD patients, who were classified according to a 5-point visual classification system of lung CT findings. We assessed the influence of emphysema distribution type on the clinical and functional presentation of COPD. We also evaluated hypoxemia after the six-minute walk test (6MWT) and determined the six-minute walk distance (6MWD). Results: Eighty-six patients were included. The mean age was 65.2 ± 12.2 years, 91.9% were male, and all but one were smokers (mean smoking history, 62.7 ± 38.4 pack-years). The emphysema distribution was categorized as obviously upper lung-predominant (type 1), in 36.0% of the patients; slightly upper lung-predominant (type 2), in 25.6%; homogeneous between the upper and lower lung (type 3), in 16.3%; and slightly lower lung-predominant (type 4), in 22.1%. Type 2 emphysema distribution was associated with lower FEV1 , FVC, FEV1 /FVC ratio, and DLCO. In comparison with the type 1 patients, the type 4 patients were more likely to have an FEV1 < 65% of the predicted value (OR = 6.91, 95% CI: 1.43-33.45; p = 0.016), a 6MWD < 350 m (OR = 6.36, 95% CI: 1.26-32.18; p = 0.025), and post-6MWT hypoxemia (OR = 32.66, 95% CI: 3.26-326.84; p = 0.003). The type 3 patients had a higher RV/TLC ratio, although the difference was not significant. Conclusions: The severity of COPD appears to be greater in type 4 patients, and type 3 patients tend to have greater hyperinflation. The distribution of emphysema could have a major impact on functional parameters and should be considered in the evaluation of COPD patients.

O que pensam os jornalistas sobre seu papel no enfrentamento das mudanças climáticas: as percepções dos profissionais da Gazeta do Povo no Paraná, Brasil

Este artigo tem como objetivo analisar as percepções sobre enfrentamento das mudanças climáticas dos jornalistas que participaram do processo de produção de notícias sobre este assunto no jornal Gazeta do Povo, o de maior circulação no estado do Paraná, sul do Brasil, no ano de 2013, e relacioná-las com a função social do jornalismo e suas potencialidades no que tange à governança dos riscos climáticos, especialmente no nível local. A análise apresentada faz parte da pesquisa de doutorado da primeira autora que pretende concatenar as diferentes etapas do circuito da notícia pensando na comunicação, percepção e governança atreladas a questão climática. Neste texto nos centramos na discussão do papel da imprensa e do próprio profissional diante do problema das alterações do clima, concluindo que os respondentes atribuem funções sociais significativas à imprensa, mas não se veem como elementos-chave na promoção da governança climática, atribuindo mais responsabilidades a outros setores e justificando suas limitações a partir de normas e critérios profissionais.

Molecular mass distribution of materials solubilized by xylanase treatment of Douglas-Fir kraft pulp

Irgazyme, a commercial xylanase preparation from Trichoderma longibrachiatum, and xylanase D a purified enzyme from Trichoderma harzianum E58 were tested for their ability to enhance peroxide bleaching of Douglas-fir (Pseudotsuga menziesii) kraft pulp. A treatment with Irgazyme caused a much larger increase in brightness than did xylanase D. A double xylanase treatment with Irgazyme, before and after peroxide bleaching, resulted in the highest final brightness. Alkaline extraction increased the brightness of Douglas-fir brownstock. Treatment with Irgazyme released more lignin and carbohydrates than did xylanase D. The molecular mass of the lignin extracted from Irgazyme-treated brownstock was much larger than that from the control pulp. The lignin-like macromolecules directly solubilized from peroxide bleached pulps were substantially larger than those solubilized from the brownstock, irrespective of whether they were produced during xylanase or control treatments. This indicates that different kinds of materials were solubilized when a xylanase treatment was applied at different points in the bleaching sequence and raises concerns about the role of lignin entrapment in the mechanism by which xylanase enhances peroxide bleaching.

As restrições à liberdade de testar

Dissertação de mestrado em Direito das Crianças, Família e Sucessões

Factors associated with the donation and non-donation of embryos for research: a systematic review

Background: Systematic knowledge on the factors that influence the decisions of IVF users regarding embryo donation for research is a core need for patient-centred policies and ethics in clinical practice. However, no systematic review has been provided on the motivations of patients who must decide embryo disposition. This paper fills this gap, presenting a systematic review of quantitative and qualitative studies, which synthesizes the current body of knowledge on the factors and reasons associated with IVF patients’ decisions to donate or not to donate embryos for research. Methods: A systematic search of studies indexed in PubMed, ISIWoK and PsycINFO, published before November 2013, was conducted. Only empirical, peer-reviewed, full-length, original studies reporting data on factors and reasons associated with the decision concerning donation or non-donation of embryos for research were included. Eligibility and data extraction were performed by two independent researchers and disagreements were resolved by discussion or a third reviewer, if required. The main quantitative findings were extracted and synthesized and qualitative data were assessed by thematic content analysis. Results: A total of 39 studies met the inclusion criteria and were included in the review. More than half of the studies (n ¼ 21) used a quantitative methodology, and the remaining were qualitative (n ¼ 15) or mixed-methods (n ¼ 3) studies. The studies were derived mainly from European countries (n ¼ 18) and the USA(n ¼ 11). The proportion of IVF users who donated embryos for research varied from 7% in a study in France to 73% in a Swiss study. Those who donate embryos for research reported feelings of reciprocity towards science and medicine, positive views of research and high levels of trust in the medical system. They described their decision as better than the destruction of embryos and as an opportunity to help others or to improve health and IVF treatments. The perception of risks, the lack of information concerning research projects and the medical system and the conceptualization of embryos in terms of personhood were the most relevant motives for not donating embryos for research. Results relating to the influence of sociodemographic characteristics and reproductive and gynaecological history were mostly inconclusive. Conclusions: Three iterative and dynamic dimensions of the IVF patients’ decision to donate or not to donate embryos for research emerged from this review: the hierarquization of the possible options regarding embryo disposition, according to the moral, social and instrumental status attributed to embryos; patients’ understanding of expectations and risks of the research on human embryos; and patients’ experiences of information exchange and levels of trust in the medical-scientific institutions.