901 resultados para death certification
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PURPOSE: The purpose of this study was to identify the possible alteration in the thickness of the epithelium basal membrane of the vocal cords and correlate it with the cause of death. METHOD: Larynxes collected from adult autopsies during the period of 1993 to 2001 were utilized. We used the hematoxylin-eosin and periodic acid-Schiff staining methods for the morphological and morphometric analysis. RESULTS: Sixty-six vocal cords were analysed; increased thickness was identified in 14 cases (21.2%), with equal proportions between the genders. Increased vocal-cord thickness was more frequent in patients of the white ethnicity (12 cases, 85.7%). Respiratory alterations were found in 10 (71.4%) of the cases with increased vocal-cord thickness. Of the patients that were maintained with mechanical ventilation before death, 7 (18.4%) had thickening of the basal membrane. Among the smokers, 9 (19.63%) had basal membrane thickening. CONCLUSION: No statistically significant differences were found between the cases in which the cause of death was related to respiratory diseases as compared to non-respiratory diseases and the thickening of the basal membrane of the vocal cords. However, new studies are needed in order to verify the etiopathogenesis of this thickening.
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This paper addresses the growing difficulties automobile manufacturers face within their after sales business: an increasing number of trade obstacles set up by import countries discriminates against the foreign suppliers and impedes the international sales of genuine parts. The purpose of the study is to explore the emergence of trade restrictive product certification systems, which affect spare parts exports of automobile manufacturers. The methodology used includes review of the literature and an empirical study based on qualitative interviews with representatives of major stakeholders of the automotive after sales business. Relevant key drivers, which initiate the introduction of technical regulations in importing countries, are identified and analysed to evaluate their effect on the emerging trade policy. The analysis of the key drivers outlines that several interacting components, such as the global competitiveness of the country, macroeconomic and microeconomic factors, and certain country-specific variables induce trade restrictive product certification systems. The findings allow for an early detection of the emergence of product certification systems and provide a means to early recognise the risks and opportunities for the sales of automotive spare parts in the automakers’ target markets. This allows the manufacturers to react immediately and adapt in time to the upcoming changes.
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With increasing business competitiveness, companies have sought to adapt their processes and / or products to worldwide established quality standards in order to achieve a greater share of consumers having as favorable aspect the quality assurance of the products and/or services provided. It was observed that companies of different sizes have different challenges regarding the certification however, the degree of difficulty is the same for all of them. The objective of this paper is to verify the reasons for the implementation of ISO 9001, the obstacles encountered during the implementation, the benefits arising from the use of the quality management system and the degree of difficulty to implement this standard. This work was developed based on a survey involving companies certified with ISO 9001:2008 from the productive sector of sugar, ethanol and derivatives of sugarcane, located in all Brazilian states. It was observed that companies of different sizes have different challenges regarding the certification however the degree of difficulty is the same for all of them. Thus, we believe that expected results represent a very important contribution to examining the reasons, benefits and difficulties of the ISO 9001 to both, the companies and certification bodies, and to researchers.
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OBJECTIVE: To determine in arrhythmogenic right ventricular cardiomyopathy the value of QT interval dispersion for identifying the induction of sustained ventricular tachycardia in the electrophysiological study or the risk of sudden cardiac death. METHODS: We assessed QT interval dispersion in the 12-lead electrocardiogram of 26 patients with arrhythmogenic right ventricular cardiomyopathy. We analyzed its association with sustained ventricular tachycardia and sudden cardiac death, and in 16 controls similar in age and sex. RESULTS: (mean ± SD). QT interval dispersion: patients = 53.8±14.1ms; control group = 35.0±10.6ms, p=0.001. Patients with induction of ventricular tachycardia: 52.5±13.8ms; without induction of ventricular tachycardia: 57.5±12.8ms, p=0.420. In a mean follow-up period of 41±11 months, five sudden cardiac deaths occurred. QT interval dispersion in this group was 62.0±17.8, and in the others it was 51.9±12.8ms, p=0.852. Using a cutoff > or = 60ms to define an increase in the degree of the QT interval dispersion, we were able to identify patients at risk of sudden cardiac death with a sensitivity of 60%, a specificity of 57%, and positive and negative predictive values of 25% and 85%, respectively. CONCLUSION: Patients with arrhythmogenic right ventricular cardiomyopathy have a significant increase in the degree of QT interval dispersion when compared with the healthy population. However it, did not identify patients with induction of ventricular tachycardia in the electrophysiological study, showing a very low predictive value for defining the risk of sudden cardiac death in the population studied.
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OBJECTIVE: To analyze the trends in mortality due to circulatory diseases in men and women aged > or = 30 years in Brazil from 1979 to 1996. METHODS: We analyzed population count data obtained from the IBGE Foundation and mortality data obtained from the System of Information on Mortality of the DATASUS of the Ministry of Health. RESULTS: Circulatory diseases, ischemic heart disease, and cerebrovascular disease were the major causes of death in men and women in Brazil. The standardized age coefficient for circulatory disease in men aged > or = 30 years ranged from 620 to 506 deaths/100,000 inhabitants and in women from 483 to 383 deaths/100,000 inhabitants for the years 1979 and 1996, respectively. In men, the mean coefficient for the period was 586.25 deaths with a significant trend towards a decrease (P<0.001) and a decline of 8.25 deaths/year. In women, the mean coefficient for the period was 439.58 deaths, a significant trend towards a decrease (P<0.001) and a rate of decline of 7.53 deaths/year. The same significant trend towards a decrease in death (P<0.001) was observed for ischemic heart disease and cerebrovascular disease. Risk of death from these causes was always higher for men of any age group (P<0.001). Cerebrovascular disease was the primary cause of death in women. CONCLUSION: Although circulatory diseases have been the major cause of mortality in men and women in the Brazilian population, with a greater participation by cerebrovascular diseases, a trend towards a decrease in the risk of death from these causes is being observed.
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OBJECTIVE: To assess the trends of the risk of death due to circulatory (CD), cerebrovascular (CVD), and ischemic heart diseases (IHD) in 11 Brazilian capitals from 1980 to 1998. METHODS: Data on mortality due to CD, CVD and IHD were obtained from the Brazilian Health Ministry, and the population estimates were calculated by interpolation with the Lagrange method based on census data from 1980 and 1991 and the population count of 1996. The trends were analyzed with the multiple linear regression method. RESULTS: CD showed a trend towards a decrease in most capitals, except for Brasília, where a mild increase was observed. The cities of Porto Alegre, Curitiba, Rio de Janeiro, Cuiabá, Goiânia, Belém, and Manaus showed a decrease in the risk of death due to CVD and IHD, while the city of Brasília showed an increase in CVD and IHD. The city of São Paulo showed a mild increase in IHD for individuals of both sexes aged 30 to 39 years and for females aged 40 to 59 years. In the cities of Recife and Salvador, a reduction in CD was observed for all ages and both sexes. In the city of Recife, however, an increase in IHD was observed at younger ages (30 to 49 years), and this trend decreased until a mild reduction (-4%) was observed in males ³ 70 years. CONCLUSION: In general, a reduction in the risk of death due to CD and an increase in IHD were observed, mainly in the cities of Recife and Brasília.
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OBJECTIVE: To study the factors associated with the risk of in-hospital death in acute myocardial infarction in the Brazilian public health system in Rio de Janeiro, Brazil. METHODS: Sectional study of a sample with 391 randomly drawn medical records of the hospitalizations due to acute myocardial infarction recorded in the hospital information system in 1997. RESULTS: The diagnosis was confirmed in 91.7% of the cases; 61.5% males; age = 60.2 ± 2.4 years; delta time until hospitalization of 11 hours; 25.3% were diabetic; 58.1% were hypertensive; 82.6% were in Killip I class. In-hospital mortality was 20.6%. Thrombolysis was used in 19.5%; acetylsalicylic acid (ASA) 86.5%; beta-blockers 49%; angiotensin-converting enzyme (ACE) inhibitors 63.3%; calcium channel blockers 30.5%. Factors associated with increased death: age (61-80 years: OR=2.5; > 80 years: OR=9.6); Killip class (II: OR=1.9; III: OR=6; IV: OR=26.5); diabetes (OR=2.4); ventricular tachycardia (OR=8.5); ventricular fibrillation (OR=34); recurrent ischemia (OR=2.7). The use of ASA (OR=0.3), beta-blockers (OR=0.3), and ACE inhibitors (OR=0.4) was associated with a reduction in the chance of death. CONCLUSION: General lethality was high and some interventions of confirmed efficacy were underutilizated. The logistic model showed the beneficial effect of beta-blockers, and ACE inhibitors on the risk of in-hospital death.
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El presente proyecto está dirigido a estudiar los mecanismos celulares y moleculares involucrados en la regulación de la población de lactotropas, como resultado del balance entre los procesos de proliferación y muerte celular correlacionados con la secreción de prolactina. Dentro de las vías de transducción de señales involucradas se determinará la activación de las diferentes isoformas de PKC utilizando inhibidores específicos y la participación de la vía MAPK-ERK1/2 en cultivos primarios adenohipofisarios y en la línea tumoral GH3B6. Además, se completará la caracterización morfológica y bioquímica de los diferentes procesos de muerte celular inducidos por bromocriptina en modelos de regresión de prolactinomas. Se incorporan al presente proyecto nuevas líneas de investigación dirigidas a estudiar la participación de receptores estrogénicos nucleares y de membrana sobre la actividad secretoria y proliferativa de células lactotropas. Se fija como objetivo la identificación de los mismos y su translocación intracelular en respuesta a estímulos específicos. Estas investigaciones se realizarán en cultivo primario de adenohipófisis, a nivel de microscopía electrónica y confocal. La participación de las isoformas alfa y beta de receptores estrogénicos intracelulares y de membrana en los efectos del estradiol sobre la proliferación y secreción de PRL se determinará mediante el uso de agonistas y antagonistas específicos en cultivo primario de adenohipófisis y de la línea GH3B6. Un tema de actualidad es el estudio de vías de señalización involucradas en las acciones del estrógeno en interacción con neuropéptidos o factores de crecimiento, estableciendo la interacción entre los receptores de membrana, además de posibles "crosstalk" entre diferentes rutas de transducción de señales. Como aporte a este tópico se propone estudiar los efectos genómicos y no genómicos del estradiol en interacción con TRH o FGF-2, modulando la actividad secretoria y proliferativa de las células lactotropas. Los datos obtenidos podrán contribuir al conocimiento de nuevas estrategias utilizadas para disminuir el crecimiento de tumores, inhibiendo moléculas claves como receptores de estrógenos, factores de crecimiento y algunas involucradas en las vías de señalización.
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En este trabajo se analizarán las características estructurales, cuantitativas y el proceso de muerte celular por apoptosis en el ovario de C. maculosa y C.picui con el objetivo de aportar conocimientos básicos a la biología reproductiva de estas aves. Cincuenta hembras adultas de cada especie se capturarán en el Dpto. Río Primero (Pcia. de Cba), R. Argentina, durante el ciclo reproductivo 2011-2012. Las muestras de ovarios se fijaran en Formalina Neutra pH 7.0, procesarán con la técnica de inclusión en parafina y colorearan con Hematoxilina /Eosina y Reacción Nuclear de Feulgen. Cinco muestras serán utilizadas para la determinación de muerte celular por apoptosis con la técnica de TUNEL. Se estudiarán las características morfohistológicas del ovario de C.maculosa y C. picui e identificarán, categorizarán y cuantificarán los folículos atrésicos no bursting (folículos atrésicos previtelogénicos y vcitelogénicos pequeños que conservan la integridad de la pared folicular) y bursting (folículos vitelogénicos mayores de 2 mm que liberar el contenido folicular por ruptura de la pared folicular) durante el ciclo reproductivo anual. Mediante la marcación de ADN fragmentado, se revelará la muerte celular por apoptosis en las células granulosas de los folículos atrésicos. Se compararán las semejanzas y diferencias estructurales y cuantitativas y el proceso de muerte celular en los folículos regresivos entre las dos especies. Los resultados de este trabajo representarán un importante aporte al conocimiento de la atresia folicular como así también a la muerte celular, un proceso estrechamente asociado a la misma, aún poco estudiado en el ovario de las aves. In this work we analyse the structural, quantitative and the process of the cell death by apoptosis in the ovary of Columba maculosa and Columbina picui in order of providing basic knowledge of reproductive biology of these birds. Fifty adult female of each species will be caught in the Río Primero (Pcia. Cba) R.Argentina, during 2011 - 2012. The ovarian samples will be fixed en neutral buffered Formalin (pH 7.0), processed with the technique of inclusion in paraffin and stained with Haematoxylin - Eosin, and nuclear Reaction of Feulgen. Five samples will be used to reveal cell death by apoptosis with the technique of TUNEL. Will be studied the morphohistological characteristics of ovary of both species, and identify, categorize and quantify the atretic follicles over the cycle, the non-bursting (pre-vitellogenic follicles and vitellogenic small < 2 mm, involution an without follicular rupture) and bursting (vitellogenic follicle > 2 mm in the which the yolk falls into the peritoneum due to rupture of with out put of the wall follicular). Will be revealed DNA fragmentation in the granulosa cells of the atretic follicles. Will compared the similaritues and differences in structure and quantitative and the cell death process by apoptosis in the regresive follicles, between the two species. The results of this study represent an important contribution to the knowledge of follicular atresia as well cell death a process closely associated with it and still poorly studied in the ovary of birds.
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Magdeburg, Univ., Fak. für Naturwiss., Diss., 2011