Safety and efficacy of recombinant alpha(1)-antitrypsin therapy in cystic fibrosis.

Neutrophil elastase (NE) is thought to be the most important protease which damages the cystic fibrosis (CF) lung. Attempts have been made to suppress this activity using the plasma-derived inhibitor, alpha1-antitrypsin (AAT). In this pilot study, the safety and efficacy of inhaled recombinant human AAT (rAAT) as a treatment for CF were investigated. Thirty-nine patients participated in a prospective, double-blinded, randomized, placebo-controlled phase II trial to examine the effect of rAAT (500, 250, and 125 mg) on sputum NE activity. Sputum myeloperoxidase (MPO), interleukin-8, tumor necrosis factor receptors, sputum and plasma NE/AAT complexes, and safety parameters were also measured. Subjects were randomized to receive nebulized treatment once a day for 4 weeks, followed by 2–4 weeks with no study treatment, and then a 2-week rechallenge phase. Trends toward a reduction in NE activity were observed in patients treated with 500 mg and 250 mg of rAAT compared to placebo. Sputum NE/AAT complex and MPO levels were lower on rAAT compared to placebo. No major adverse events and, in particular, no allergic reactions to rAAT were observed. Although significant differences between rAAT and placebo for sputum NE activity were not observed, some improvements were found for secondary efficacy variables. This study demonstrated that nebulized rAAT is safe and well-tolerated, but has a limited effect on NE activity and other markers of inflammation. Pediatr Pulmonol.

The relationship of clinical and inflammatory markers to outcome in stable patients with cystic fibrosis

Decreased survival in patients with cystic fibrosis has been related to FEV1, BMI, and infection with Burkholderia cepacia complex (BCC). We have assessed the relationship of blood, sputum, and urine inflammatory markers to lung function, BMI, colonization with B cenocepacia (Bc), and patient survival. Thirty-nine stable cystic fibrosis (CF) patients (10 with Bc) were enrolled in a study to determine the effect of alpha-1-antitrypsin on airways inflammation. Pre-treatment measurements were used in this study. Demographics, sputum microbiology, heart rate, oxygen saturation, lung function were recorded. Blood samples were obtained for white blood count (WBC), C-Reactive Protein (CRP), and plasma neutrophil elastase/AAT complexes (pNEC). Neutrophil elastase (NE), neutrophil elastase/AAT complexes (sNEC), interleukin-8 (IL-8), TNF-receptor 1 (sTNFr), and myeloperoxidase (MPO) were measured in sputum and urinary desmosine concentration determined. Patients with Bc had significantly higher levels of pNEC, 332?±?91.4 ng/ml (mean?±?SEM) versus 106?±?18.2 ng/ml (P?=?0.0005) and sNEC, 369?±?76.6 ng/ml versus 197?±?36.0 ng/ml compared to those who were not. Five deaths were reported at the end of 1 year, (four with Bc) (P?=?0.011). Patients who subsequently died had significantly lower lung function FEV1, 1.2?±?0.2 L versus 2.0?±?0.1 L (P?=?0.03) and FVC, 2?±?0.3 L versus 3.1?±?0.2 L (P?=?0.01), compared to those that survived. There was significantly higher NE activity, 3.6?±?1.6 U/ml versus 1.5?±?0.6 U/ml (P?=?0.03), pNEC, 274?±?99 ng/ml versus 142?±?30 ng/ml (P?=?0.05), MPO, 163?±?62 mcg/ml versus 54?±?6.9 mcg/ml (P?=?0.03), and urinary desmosines 108?±?19.9 pM/mg creatinine versus 51.1?±?3.3 pM/mg creatinine (P?=?0.001), in those patients who subsequently died compared to those that survived. These data suggest there is increased neutrophil degranulation in patients infected with Bc and these patients have a poor outcome.

Efficacité et toxicité de l'eugénol administré à des doses anesthésiantes chez des grenouilles Xenopus laevis.

L’eugénol permet d’induire une anesthésie chirurgicale chez la grenouille africaine à griffes (Xenopus laevis) sans causer de lésions chez des grosses grenouilles (90-140g). Le premier objectif de la présente étude était de déterminer la durée de l’anesthésie et d’évaluer la dépression du système nerveux central ainsi que les changements de saturation en oxygène et de fréquence cardiaque chez des petites (7.5 ± 2.1 g) et moyennes (29.2 ± 7.4 g) grenouilles Xenopus laevis en fonction du temps d’exposition à un bain d’eugénol de 350 µL/L. Suite à une immersion de 5 ou 10 minutes, la réponse au test à l’acide acétique, au réflexe de retrait et au réflexe de retournement était absente pendant 1 heure (petites grenouilles) et 0,5 heure (moyennes) et l’anesthésie chirurgicale durait au maximum 15 et 30 minutes chez les petites et moyennes grenouilles respectivement. La saturation en oxygène n’était pas affectée de façon significative, mais la fréquence cardiaque était diminuée jusqu’à 1 heure post-immersion dans les deux groupes. Le deuxième objectif était de déterminer la toxicité de l’eugénol chez des grenouilles de taille moyenne après une ou trois administrations à une dose anesthésique, avec ou sans période de récupération d’une semaine. Histologiquement, il y avait de l’apoptose tubulaire rénale et des membranes hyalines pulmonaires après une administration, et de la nécrose hépatique et des hémorragies dans les tissus adipeux après trois administrations. Ces résultats suggèrent que le poids corporel est un paramètre important à considérer lors de l’anesthésie de grenouilles Xenopus laevis par immersion dans l’eugénol.

La sabiduría como competencia gerencial

Aunque el concepto de sabiduría ha sido ampliamente estudiado por expertos de áreas como la filosofía, la religión y la psicología, aún enfrenta limitaciones en cuanto a su definición y evaluación. Por esto, el presente trabajo tiene como objetivo, formular una definición del concepto de sabiduría que permita realizar una propuesta de evaluación del concepto como competencia en los gerentes. Para esto, se realizó un análisis documental de tipo cualitativo. De esta manera, se analizaron diversos textos sobre la historia, las definiciones y las metodologías para evaluar tanto la sabiduría como las competencias; diferenciando la sabiduría de otros constructos y analizando la diferencia entre las competencias generales y las gerenciales para posteriormente, definir la sabiduría como una competencia gerencial. Como resultado de este análisis se generó un prototipo de prueba denominado SAPIENS-O, a través del cuál se busca evaluar la sabiduría como competencia gerencial. Como alcances del instrumento se pueden identificar la posibilidad de medir la sabiduría como competencia en los gerentes, la posibilidad de dar un nuevo panorama a las dificultades teóricas y empíricas sobre la sabiduría y la posibilidad de facilitar el estudio de la sabiduría en ambientes reales, más específicamente en ambientes organizacionales.

Retraso mental : conducta adaptativa y transición a la vida adulta. Evaluación del programa educativo de las aulas de aprendizaje de tareas de Álava.

1.- Analizar el estado de la cuestión con relación a la definición, el diagnóstico y la clasificación del retraso mental. 2.- Describir la etapa de transición de las personas con retraso mental y las características de la situación que viven en su paso de la adolescencia a la vida adulta. 3.- Evaluar el programa del itinerario educativo que ofrece el Gobierno Vasco a los alumnos que presentan retraso mental y se encuentran en la etapa de transición de la adolescencia a la vida adulta, las Aulas de Aprendizaje de Tareas. 17 alumnos. Fases de trabajo: 1.- Contacto y reuniones : una primera reunión con el responsable de Educación Especial del Gobierno Vasco por medio de la cual surge el proyecto de la evaluación de las AAT. 2.- Estudio de documentos, y selección y elaboración de instrumentos de recogida de datos. 3.- Estancia y recogida de datos. 4.- Registro y análisis de datos. 1.- Cuestionarios para recabar opiniones sobre aspectos relacionados con el programa. 2.- Inventario para la Planificación de Servicios y Programación Individual ICAP, para evaluar la conducta adaptativa. 3.- Inventario de Destrezas Adaptativas CALS, para evaluar la conducta adaptativa. 4.- La Escala de Autodeterminación Arc, para valorar el grado de conducta autodeterminada. La observación: es una técnica para la obtención de información acerca de los procesos de enseñanza llevados a cabo por los profesores de aula, sobre todo en el ámbito de la discapacidad. Finalidad: el análisis de conductas espontáneas de uno o varios sujetos en un determinado entorno. El programa de las AAT no muestra toda la eficacia que cabría esperar. Sin embargo, presenta las condiciones adecuadas para seguir impartiéndose y es valorado de forma positiva por los destinatarios y agentes.. 1.- A pesar de que se ha avanzado en la delimitación de las características distintivas de la población con RM, aún no es suficiente el consenso alcanzado respecto a la conceptualización del constructo, la operativización de los elementos que los constituyen y la intervención más adecuada para estas personas. 2.- La concepción sobre el RM adopta una visión evolutiva y es decisiva la etapa de transición a la vida adulta, ya que las competencias adquiridas por la persona hasta ese momento condicionan su capacidad para hacer frente a las demandas que la vida adulta le va a plantar. 3.- La elaboración del PTI y PEI tiene gran transcendencia en la planificación del futuro del alumno, por lo que es imprescindible su participación e implicación en el diseño y desarrollo de estos programas. 4.- La evaluación de los programas es una medida fundamental para obtener certezas de que se han ofrecido servicios que responden a criterios de calidad que las personas merecen.

Sällskapsdjurs effekt på beteendeproblem hos äldre med demenssjukdom : En systematisk litteraturstudie

Syftet med studien var att studera hur sällskapsdjur kan påverka demenssjukas beteendeproblem och vara ett komplement till medicinsk behandling med lugnande läkemedel hos patienter med demens.Studien genomfördes som en systematisklitteraturstudie. Metoden författarna använde sig av var att de valde ut 9 stycken vetenskapliga artiklar från år 1999-2009 som hittats i olika databaser och referenslistor. Artiklarna analyserades genom att texten delades upp i de olika kategorierna lugnade effekt/oro, aggression, kontakt/beröring och läkemedelsanvändande. Resultatet visade att beteendeproblemen som aggression och oro, i flera av studierna blev bättre i sällskapsdjurs närvaro, men bara under den tiden som deltagarna fick animal assisted therapy (AAT). När deltagarna blev utan AAT försämrades deras beteendeproblem igen. Olika slags typer av sällskapsdjur användes vid behandling med AAT. Hunden visades vara det sällskapsdjur som användes mest. Slutsatsen blev att de flesta studierna visade på en positiv effekt på närheten av ett sällskapsdjur inom demensvården. Alla studier kunde inte visa på en signifikant skillnad men vårdpersonals upplevelse var att de demenssjuka hade en tendens till förbättrande av sina beteendeproblem.

Djurens påverkan på den äldreslivskvalitet : En systematisk litteraturstudie

Syfte: Syftet med denna systematiska litteraturstudie var att beskriva hur djur påverkade livskvalitet hos äldre. Metod: Artikelsökning utfördes via databaserna; CINAHL, SCOPUS och sökmotorn ELIN. För att artiklarna skulle få vara med i studien var kravet att de skulle vara publicerade mellan åren 2000 - 2010 och skrivna på engelska eller svenska. Sammanlagt ligger 14 vetenskapliga artiklar till grund för resultatet i denna systematiska litteraturstudie. Huvudresultat: Flertalet studier visade att Animal Assisted Activity (AAA) och Animal Assisted Therapy (AAT) främjade sociala interaktioner mellan äldre individer, lindrade känslor av ensamhet samt hade positiv effekt vid depression. Vidare kunde AAT ha en gynnsam effekt på apatiska symtom och äldres humör. Slutsats: Djur i vården var ett välkommet avbrott för de äldre och medförde en positiv attityd gentemot djuren. Djur i vården kunde bidra till glädje hos äldre individer och ha en positiv påverkan på den äldres ensamhet och depressiva symtom. Även sociala interaktioner främjades och den äldre individen stimulerades på flera plan.

Can therapy dogs evoke awareness of one's past and present life in persons with Alzheimer's disease?

BACKGROUND: Persons with Alzheimer's disease (AD) sometimes express themselves through behaviours that are difficult to manage for themselves and their caregivers, and to minimise these symptoms alternative methods are recommended. For some time now, animals have been introduced in different ways into the environment of persons with dementia. Animal-Assisted Therapy (AAT) includes prescribed therapy dogs visiting the person with dementia for a specific purpose. AIM: This study aims to illuminate the meaning of the lived experience of encounters with a therapy dog for persons with Alzheimer's disease. METHOD: Video recorded sessions were conducted for each visit of the dog and its handler to a person with AD (10 times/person). The observations have a life-world approach and were transcribed and analysed using a phenomenological hermeneutical approach. RESULTS: The result shows a main theme 'Being aware of one's past and present existence', meaning to connect with one's senses and memories and to reflect upon these with the dog. The time spent with the dog shows the person recounting memories and feelings, and enables an opportunity to reach the person on a cognitive level. CONCLUSIONS: The present study may contribute to health care research and provide knowledge about the use of trained therapy dogs in the care of older persons with AD in a way that might increase quality of life and well-being in persons with dementia. IMPLICATIONS FOR PRACTICE: The study might be useful for caregivers and dog handlers in the care of older persons with dementia.

Validação interlaboratorial do teste de polarização fluorescente para o diagnóstico sorológico da brucelose bovina

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

Fases e criticalidade no modelo ashkin - teller de três cores

The usual Ashkin-Teller (AT) model is obtained as a superposition of two Ising models coupled through a four-spin interaction term. In two dimension the AT model displays a line of fixed points along which the exponents vary continuously. On this line the model becomes soluble via a mapping onto the Baxter model. Such richness of multicritical behavior led Grest and Widom to introduce the N-color Ashkin-Teller model (N-AT). Those authors made an extensive analysis of the model thus introduced both in the isotropic as well as in the anisotropic cases by several analytical and computational methods. In the present work we define a more general version of the 3-color Ashkin-Teller model by introducing a 6-spin interaction term. We investigate the corresponding symmetry structure presented by our model in conjunction with an analysis of possible phase diagrams obtained by real space renormalization group techniques. The phase diagram are obtained at finite temperature in the region where the ferromagnetic behavior is predominant. Through the use of the transmissivities concepts we obtain the recursion relations in some periodical as well as aperiodic hierarchical lattices. In a first analysis we initially consider the two-color Ashkin-Teller model in order to obtain some results with could be used as a guide to our main purpose. In the anisotropic case the model was previously studied on the Wheatstone bridge by Claudionor Bezerra in his Master Degree dissertation. By using more appropriated computational resources we obtained isomorphic critical surfaces described in Bezerra's work but not properly identified. Besides, we also analyzed the isotropic version in an aperiodic hierarchical lattice, and we showed how the geometric fluctuations are affected by such aperiodicity and its consequences in the corresponding critical behavior. Those analysis were carried out by the use of appropriated definitions of transmissivities. Finally, we considered the modified 3-AT model with a 6-spin couplings. With the inclusion of such term the model becomes more attractive from the symmetry point of view. For some hierarchical lattices we derived general recursion relations in the anisotropic version of the model (3-AAT), from which case we can obtain the corresponding equations for the isotropic version (3-IAT). The 3-IAT was studied extensively in the whole region where the ferromagnetic couplings are dominant. The fixed points and the respective critical exponents were determined. By analyzing the attraction basins of such fixed points we were able to find the three-parameter phase diagram (temperature £ 4-spin coupling £ 6-spin coupling). We could identify fixed points corresponding to the universality class of Ising and 4- and 8-state Potts model. We also obtained a fixed point which seems to be a sort of reminiscence of a 6-state Potts fixed point as well as a possible indication of the existence of a Baxter line. Some unstable fixed points which do not belong to any aforementioned q-state Potts universality class was also found

Indicator-free electrochemical DNA hybridization biosensor

A new electrochemical hybridization biosensor protocol without an external indicator is described. The biosensor format involves the immobilization of inosine-substituted (guanine-free) probe onto the carbon paste transducer, and a direct chronopotentiometric detection of the duplex formation by the appearance of the guanine oxidation peak of the target. Such a use of the intrinsic DNA electrochemical response for monitoring hybridization events offers several advantages (over the common use of external indicators), including the appearance of a new peak, a Aat background, or simplicity. A 4 min short hybridization period allows a detection limit around 120 ng/ml. Performance characteristics of the sensor are described along with future prospects. (C) 1998 Elsevier B.V. B.V. All rights reserved.

Comparação entre a relação PCR/albumina e o índice prognóstico inflamatório nutricional (IPIN)

Objetivo: Simplificar o cálculo do índice prognóstico inflamatório nutricional (IPIN) empregando número menor de variáveis com conseqüente redução do custo da análise. Materiais e métodos: Foram estudados 54 pacientes e 12 indivíduos-controle com 48 ± 20 (média ± dp) anos de idade. As principais patologias dos pacientes eram: doença arterial periférica (22), pênfigo foliáceo (7), doença inflamatória intestinal (7), trauma (6) e pós-operatório de ortognatia (3). Foram obtidas amostras de sangue periférico, colhidas em jejum para dosagens de proteínas positivas (+) e negativas (-) de fase aguda (PFA) pelo método nefelométrico. Proteína C reativa (PCR), alfa-1-glicoproteína-ácida (alfa-1-GA), alfa-1-antitripsina (alfa-1-AT) e ceruloplasmina (CER) foram as PFA+ e albumina (Alb), transtiretina (TTR), transferrina (TF) e proteína ligadora do retinol (RBP) foram as representantes das PFA-. Esses valores foram analisados quanto à associação de correlação isolada ou associadamente na fórmula do índice prognóstico inflamatório e nutricional (IPIN = PCR + alfa-1-GA / Alb + TTR). de acordo com o índice prognóstico inflamatório e nutricional, os pacientes foram classificados em grupo-controle (G1); pacientes sem infecção/inflamação (IPIN < 1, G2) ou com risco de inflamação/infecção (IPIN > 1, G3). em seguida os pacientes do G3 foram subdivididos em baixo risco (G3A, n = 16); médio risco ( G3B, n = 10); alto risco (G3C, n = 6) e com risco de morte (G3D, n = 11). Os resultados foram correlacionados entre si (teste de Spearman) ou submetidos às comparações entre grupos (teste de Kruskall-Wallis). Resultados: Houve relação significativa entre as variáveis PCR ´ alfa-1-GA (r = 0,49), Alb ´ TTR (r = 0,60), Alb ´ RBP (r = 0,58), Alb ´ TF (r = 0,39), TTR ´ RBP (r = 0,56) e TTR´ TF (r = 0,43) e as melhores relações encontradas entre PFA+ e PFA- foram: PCR ´ Alb (r = - 0,71), PCR ´ TTR (r = - 0,54), PCR ´ TF (r = - 0,39) e alfa-1-GA ´ Alb (r = - 0,35). Os valores do IPIN mostraram a diferenciação G3 > (G1 = G2) e G3 > G3A. Entre todas as proteínas dosadas apenas PCR, Alb e TTR discriminaram os grupos: sendo G3 > (G1= G2) para PCR e G3< (G1= G2) para Alb e TTR. Apenas PCR, TTR e TF discriminaram a morbimortalidade com G3D > G3A (para PCR) e G3D < G3A (para TTR e TF). PCR/Alb e IPIN apresentaram concordância de valores para os riscos de complicações. Conclusão: Assim, conclui-se pela possibilidade de substituição do IPIN pela relação PCR/albumina, mais simples e de menor custo, mantendo-se o mesmo poder e sensibilidade para diagnóstico dos graus de risco de complicações.

Soropositividade para brucelose em suínos em abatedouros

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

Avaliação fisiológica e comportamental de cães utilizados em terapia assistida por animais (TAA)

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

Adherence in vitro of Candida albicans to plasma treated acrylic resin. Effect of plasma parameters, surface roughness and salivary pellicle

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