Aspectos computacionais para inferência na distribuição gama generalizada

Pós-graduação em Matematica Aplicada e Computacional - FCT

Phase I clinical trial of cell therapy in patients with advanced chronic obstructive pulmonary disease: follow-up of up to 3 years

BACKGROUND Chronic obstructive pulmonary disease is a major inflammatory disease of the airways and an enormous therapeutic challenge. Within the spectrum of chronic obstructive pulmonary disease, pulmonary emphysema is characterized by the destruction of the alveolar walls with an increase in the air spaces distal to the terminal bronchioles but without significant pulmonary fibrosis. Therapeutic options are limited and palliative since they are unable to promote morphological and functional regeneration of the alveolar tissue. In this context, new therapeutic approaches, such as cell therapy with adult stem cells, are being evaluated.OBJECTIVE This article aims to describe the follow-up of up to 3 years after the beginning of a phase I clinical trial and discuss the spirometry parameters achieved by patients with advanced pulmonary emphysema treated with bone marrow mononuclear cells.METHODS Four patients with advanced pulmonary emphysema were submitted to autologous infusion of bone marrow mononuclear cells. Follow-ups were performed by spirometry up to 3 years after the procedure.RESULTS The results showed that autologous cell therapy in patients having chronic obstructive pulmonary disease is a safe procedure and free of adverse effects. There was an improvement in laboratory parameters (spirometry) and a slowing down in the process of pathological degeneration. Also, patients reported improvements in the clinical condition and quality of life.CONCLUSIONS Despite being in the initial stage and in spite of the small sample, the results of the clinical protocol of cell therapy in advanced pulmonary emphysema as proposed in this study, open new therapeutic perspectives in chronic obstructive pulmonary disease. It is worth emphasizing that this study corresponds to the first study in the literature that reports a change in the natural history of pulmonary emphysema after the use of cell therapy with a pool of bone marrow mononuclear cells.

Effect of ambulatory versus hospital treatment for gestational diabetes or hyperglycemia on infant mortality rates: a systematic review

CONTEXTO E OBJETIVO:Gestações complicadas pelo diabetes estão associadas com aumento das complicações neonatais e maternas. A complicação mais grave materna é o risco de desenvolver diabetes tipo 2 após 10-12 anos do parto. Para o controle rigoroso da glicose no sangue, as mulheres grávidas são tratadas de forma ambulatorial ou com internações hospitalares. O objetivo deste estudo é avaliar a efetividade do tratamento ambulatorial versus hospitalização em gestações complicadas por diabetes ou hiperglicemia.TIPO DE ESTUDO E LOCAL:Revisão sistemática conduzida em hospital universitário público.MÉTODOS:Uma revisão sistemática da literatura foi realizada e as principais bases de dados eletrônicas foram pesquisadas. A data da pesquisa mais recente foi 4 de setembro de 2011. Dois autores selecionaram independentemente os ensaios clínicos relevantes, avaliaram a qualidade metodológica e extraíram os dados.RESULTADOS:Apenas três estudos foram selecionados, com tamanho de amostra pequeno. Não houve diferença estatisticamente significativa entre o tratamento ambulatorial versus hospitalização em relação à mortalidade em nenhuma das subcategorias analisadas: mortes perinatais e neonatais, (risco relativo [RR] 0,65; 95% de intervalo de confiança [IC] 0,11-3,84, P = 0,63); morte neonatal (RR 0,29, IC 95% 0,01-6,07, P = 0,43), e óbitos infantis (RR 0,29, IC 95% 0,01-6,07, P = 0,43).CONCLUSÕES:Com base em estudos com risco de viés alto ou moderado, esta revisão demonstrou que não há diferença estatisticamente significante entre o tratamento ambulatorial comparado com o hospitalar na redução das taxas de mortalidade em gestações complicadas por diabetes ou hiperglicemia. Esta revisão sistemática também sugere a necessidade de mais ensaios clínicos randomizados sobre o assunto.

Psoriasis: correlation between severity index (PASI) and quality of life index (DLQI) in patients assessed before and after systemic treatment

BACKGROUND: Psoriasis is a chronic inflammatory disease of the skin that affects patients of all ages and both genders. The impact of the disease on quality of life is greater among patients with moderate to severe psoriasis. OBJECTIVE: to establish a correlation between the psoriasis area and severity index (PASI) and the Dermatology Life Quality Index (DLQI) based on a quality of life questionnaire adapted to the Brazilian context for patients with plaque psoriasis before and after systemic treatment. METHODS: This was a cross-sectional, descriptive study of psoriasis patients who did not undergo treatment or who manifested clinical activity of the disease. Patients were evaluated according to the PASI and the quality of life questionnaire adapted to the Brazilian context before and 60 days after systemic treatment. RESULTS: Thirty-five patients participated in the study. Twenty-six were men, with a mean age of 46 years. There was no correlation between the PASI and the quality of life questionnaire adapted to the Brazilian context, but there was a correlation between the PASI and some items of the quality of life questionnaire adapted to the Brazilian context, such as jobs involving public contact. CONCLUSION: The non-correlation between the PASI and the quality of life questionnaire adapted to the Brazilian context in this work may be associated with a history of chronic disease, which implies greater acceptance of the illness, or may be related to the low income and social status of the patients studied. The correlation observed among patients with careers involving public contact suggests that some professions are more impacted by the disease. It may be necessary to adapt the quality of life questionnaire to patients with a low income and cultural and social limitations. The small sample size (n=35 patients) and the short follow-up period of 60 days were some of the limitations of this work.

Proposal to utilize simplified Swensen protocol in diagnosis of isolated pulmonary nodule

Background: The problem of diagnosing whether a solitary pulmonary nodule is benign or malignant is even greater in developing countries due to a higher prevalence of infectious diseases. These infections generate a large number of patients who are generally asymptomatic and with a pulmonary nodule that cannot be accurately defined as having benign or malignant etiology.Purpose: To verify the percentages of benign versus malignant non-calcified nodules, the length of time after contrast agent injection is spiral computed tomography (CT) most sensitive and specific, and whether three postcontrast phases are necessary.Material and Methods: We studied 23 patients with solitary pulmonary nodules identified on chest radiographs or CT. Spiral scans were obtained with Swensen protocol, but at 3, 4, and 5 min after contrast injection onset. Nodules were classified as benign or malignant by histopathological examination or by an absence or presence of growth after 2 years of follow-up CT.Results: Of the 23 patients studied, 18 (78.2%) showed a final diagnosis of benign and five (21.7%) malignant nodules. Despite the small sample size, we obtained results similar to those of Swensen et al., with 80.0% sensitivity, 55.5% specificity, and 60.8% accuracy. Four minutes gave the greatest mean enhancement in both malignant and benign lesions.Conclusion: Small non-calcified benign nodules were much more frequent than malignant nodules. The best time for dynamic contrast-enhanced CT density analysis was 4 min postcontrast. As well as saving time and money, this simplified Swensen protocol with only precontrast and 4 min postcontrast phases also reduces patient exposure to ionizing radiation.

Gross Motor Deficits in Children Prenatally Exposed to Alcohol: A Meta-analysis

BACKGROUND AND OBJECTIVES: Gross motor (GM) deficits are often reported in children with prenatal alcohol exposure (PAE), but their prevalence and the domains affected are not clear. The objective of this review was to characterize GM impairment in children with a diagnosis of fetal alcohol spectrum disorder (FASD) or moderate to heavy maternal alcohol intake.METHODS: A systematic review with meta-analysis was conducted. Medline, Embase, Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, PEDro, and Google Scholar databases were searched. Published observational studies including children aged 0 to <= 18 years with (1) an FASD diagnosis or moderate to heavy PAE, or a mother with confirmed alcohol dependency or binge drinking during pregnancy, and (2) GM outcomes obtained by using a standardized assessment tool. Data were extracted regarding participants, exposure, diagnosis, and outcomes by using a standardized protocol. Methodological quality was evaluated by using Strengthening the Reporting of Observational Studies in Epidemiology guidelines.RESULTS: The search recovered 2881 articles of which 14 met the systematic review inclusion criteria. The subjects' mean age ranged from 3 days to 13 years. Study limitations included failure to report cutoffs for impairment, nonstandardized reporting of PAE, and small sample sizes. The meta-analysis pooled results (n = 10) revealed a significant association between a diagnosis of FASD or moderate to heavy PAE and GM impairment (odds ratio: 2.9; 95% confidence interval: 2.1-4.0). GM deficits were found in balance, coordination, and ball skills. There was insufficient data to determine prevalence.CONCLUSIONS: The significant results suggest evaluation of GM proficiency should be a standard component of multidisciplinary FASD diagnostic services.

Distributional potential of the Triatoma brasiliensis species complex at present and under scenarios of future climate conditions

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Gene expression profiling in leiomyosarcomas and undifferentiated pleomorphic sarcomas: SRC as a new diagnostic marker

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Efeito do treinamento com pesos nos distúrbios do sono e na qualidade de vida de pacientes com demência de Alzheimer

The Alzheimer's dementia (AD) is the most prevalent form of dementia in the elderly. Among the harmful changes arising from the DA, there may be sleep disturbance and impaired quality of life. Physical activity is an important non-pharmacological feature that would provide positive effects for the treatment of disease. However, there are still few studies that clarify the effects of resistance training in this population. Thus, the present study has as objective analyzes the effects of the resistance training in sleep disturbance and quality of life of patients with AD. Participated in this study 22 patients with clinical diagnosis of AD divided into two groups: Training Group (TG) and Social Interaction Group (SIG). The subjects of TG underwent a resistance training protocol, appropriate to the individual conditions, during three days no consecutive in the week, with duration of 60 minutes each session, for 16 weeks. The SIG won't participate in any systematized physical activity, but they realized other activities, such as reading, poetry, hiking and painting, among others. This protocol also was realized three times in week for 16 weeks, with duration of 60 minutes each session. Both groups were assessed at the beginning of the program and after 16 weeks. For the assessment of sleep disturbance was used the Mini Sleep Questionnaire and to assess of quality of life was used the Scale for Assessment of Quality of Life in Alzheimer's disease (QL), versions: patient, caregiver, family and the final score. Due to the scalar nature of the data and small sample, all variables were analyzed by nonparametric statistics. The U-Mann Whitney test, Wilcoxon test and Spearman correlation test was used, except for the Modified Baecke... (Complete abstract click electronic access below)

Outpatient versus inpatient treatment for acute pulmonary embolism

Background: Pulmonary embolism (PE) is a common life-threatening cardiovascular condition, with an incidence of 23 to 69 new cases per 100,000 people per year. Outpatient treatment instead of traditional inpatient treatment in selected non-high-risk patients with acute PE might provide several advantages, such as reduction of hospitalizations, substantial cost saving and an improvement in health-related quality of life. Objectives: To compare the efficacy and safety of outpatient versus inpatient treatment for acute PE for the outcomes of all-cause and PE-related mortality; bleeding; and adverse events such as hemodynamic instability, recurrence of PE and patients'satisfaction.Search methodsThe Cochrane Peripheral Vascular Diseases Group Trials Search Co-ordinator (TSC) searched the Specialised Register (last searched October 2014) and the Cochrane Central Register of Controlled Trials (CENTRAL; 2014, Issue 9). The TSC also searched clinical trials databases. The review authors searched LILACS (last searched November 2014). Selection criteria: Randomized controlled trials of outpatient versus inpatient treatment in people diagnosed with acute PE. Data collection and analysis: Two review authors selected relevant trials, assessed methodological quality, and extracted and analyzed data. Main results: We included one study, involving 339 participants. We ranked the quality of the evidence as very low due to not blinding the outcome assessors, the small number of events with imprecision in the confidential interval (CI), the small sample size and it was not possible to verify publication bias. For all outcomes, the CIs were wide and included clinically significant treatment effects in both directions: short-term mortality (30 days) (RR 0.33, 95% CI 0.01 to 7.98, P = 0.49), long-term mortality (90 days) (RR 0.98, 95% CI 0.06 to 15.58, P = 0.99), major bleeding at 14 days (RR 4.91, 95% CI 0.24 to 101.57, P = 0.30) and 90 days (RR 6.88, 95% CI 0.36 to 134.14, P = 0.20), recurrent PE within 90 days (RR 2.95, 95% CI 0.12 to 71.85, P = 0.51) and participant satisfaction (RR 0.97, 95% CI 0.92 to 1.03, P = 0.30). PE-related mortality, minor bleeding, and adverse course such as hemodynamic instability and compliance were not assessed by the single included study. Authors' conclusions: Current very low quality evidence from one published randomized controlled trial did not provide sufficient evidence to assess the efficacy and safety of outpatient versus inpatient treatment for acute PE in overall mortality, bleeding and recurrence of PE adequately. Further well-conducted research is required before informed practice decisions can be made.

Análise dinâmica não-linear de um sistema não-ideal, utilizando amortecedor magneto-reológico

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Tower as magnetic antipinning core in a small superconducting sample

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Morphological changes of the intestinal mucosa of broilers and layers as affected by fasting before sample collection

The present study aimed at evaluating the histo-morphological changes resulting from different fasting periods before the collection of tissue samples in different segments of the small intestine (duodenum, jejunum and ileum) of 7-d-old male chicks of a broiler and a layer strain. A completely randomized experimental design in in a 2x7 factorial arrangement, being two strains with different growth rates (Ross 308 and HyLine® W36) and seven fasting periods (0, 2, 4, 6, 8, 10 and 12 hours ), with six replicates, totaling 84 birds. The comparison of the morphometrics of the duodenum, jejunum and ileum of broiler and layer chicks demonstrated faster digestive tract development in broilers relative to layers. The fasting period caused morphological changes in the liver and small and large intestines in both strains. Therefore, it must be highlighted that in studies involving organ weights and intestinal morphometrics, birds must not be submitted to fasting before tissue collection.

Structural modifications in stretch-induced crystallization in PVDF films as measured by small-angle X-ray scattering

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Mass fractal characteristics of silica sonogels as determined by small-angle x-ray scattering and nitrogen adsorption

A sample series of silica sonogels was prepared using different water-tetraethoxysilane molar ratio (r(w)) in the gelation step of the process in order to obtain aerogels with different bulk densities after the supercritical drying. The samples were analyzed by means of small-angle x-ray-scattering (SAXS) and nitrogen-adsorption techniques. Wet sonogels exhibit mass fractal structure with fractal dimension D increasing from similar to2.1 to similar to2.4 and mass-fractal correlation length xi diminishing from similar to13 nm to similar to2 nm, as r(w) is changed in the nominal range from 66 to 6. The process of obtaining aerogels from sonogels and heat treatment at 500degreesC, in general, increases the mass-fractal dimension D, diminishes the characteristic length xi of the fractal structure, and shortens the fractal range at the micropore side for the formation of a secondary structured particle, apparently evolved from the original wet structure at a high resolution level. The overall mass-fractal dimension D of aerogels was evaluated as similar to2.4 and similar to2.5, as determined from SAXS and from pore-size distribution by nitrogen adsorption, respectively. The fine structure of the secondary particle developed in the obtaining of aerogels could be described as a surface-mass fractal, with the correlated surface and mass-fractal dimensions decreasing from similar to2.4 to similar to2.0 and from similar to2.7 to similar to2.5, respectively, as the aerogel bulk density increases from 0.25 (r(w)=66) up to 0.91 g/cm(3) (r(w)=6).