930 resultados para proposed
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Background: Duplex ultrasound scanning (DUS) is the method of choice for diagnosis of deep vein thrombosis (DVT). However, only a few studies have performed prospective serial DUS after an acute episode of DVT to assess its evolution. This study aimed to report our experience using DUS combined with a thrombosis score (TS) and a newly proposed vein diameter variation index (VDVI) to evaluate the rate of resolution of DVT by assessing and quantifying the early stages of vein recanalization in proximal vein segments within 6 months after an episode of acute lower extremity DVT.Methods: Twelve patients with first episode of acute lower extremity DVT confirmed by DUS as occurring in <= 10 days after the onset of venous thrombosis symptoms were followed up prospectively for 6 months. TS and VDVI were calculated at 1, 3, and 6 months to assess vein recanalization. Intra-thrombus arteriovenous fistula formation was also investigated and related to the recanalization process.Results: Seven (58%) women were included, with a total cohort median age of 53.5 +/- 19 years. The left lower extremity was affected in 7 (58%) patients. DVT was diagnosed in 55 proximal vein segments. All patients had proximal DVT, with involvement of the external iliac, femoral, and popliteal veins. After 6 months, there was a significant decrease in TS and increase in VDVI (P < 0.001) in all proximal vein segments assessed, indicating thrombus regression. The more distal the DVT was, the faster was the VDVI increase, with most popliteal veins being recanalized at 3 months (P < 0.001). Intra-thrombus arteriovenous fistula was identified in 50% of patients at 1 month while on anticoagulation.Conclusions: The combined use of two different DUS-based assessment tools, TS and the proposed VDVI, provided an effective method to prospectively assess vein recanalization rates after an episode of acute lower extremity DVT in this series of patients and may allow a correct evaluation of DVT and its resolution or progression.
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Bovine tuberculosis (TB) is a serious disease with animal health, public health, and international trade consequences. The cooperative Federal-State-industry effort to eradicate bovine TB from cattle in the United States has made significant progress since the program’s inception in 1917. However, the goal of eradication remains elusive. This proposed action plan presents Veterinary Services’ (VS’) current thinking about changes we are considering for the TB program to address our current challenges. This action plan will: 1. Reduce the introduction of TB into the U.S. national herd from imported animals and wildlife by: o Applying additional requirements to cattle imports from Mexico o Enhancing efforts to mitigate risks from wildlife 2. Enhance TB surveillance by: o Crafting a comprehensive national surveillance plan o Accelerating diagnostic test development to support surveillance 3. Increase options for managing TB-affected herds by: o Conducting epidemiological investigations and assessing individual herd risk o Applying whole-herd depopulation judiciously and developing alternative control strategies o Applying animal identification (ID) standards to meet animal ID needs 4. Modernize the regulatory framework to allow VS to focus resources where the disease exists 5. Transition the TB program from a State classification system to a science-based zoning approach to address disease risk To succeed, this new approach will require VS’ continued partnership with State animal health and wildlife officials, other Federal agencies, industry, international partners, academia, and other stakeholders. Successful partnerships will allow us to use available resources efficiently to achieve program objectives and protect our nation’s herd. Implementation of the VS proposed action plan will benefit Federal and State animal health officials, the regulated industries, and producers by allowing a more rapid response that employs up-to-date science and can adapt rapidly to changing situations.
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Addition of three species to the list is recommended based on recent literature. (Orcaella brevirostris) has been split into the Irrawaddy dolphin (O. brevirostris) and the Australian snubfin dolphin (O. heinsohni). Sotalia fluviatilis has been split into the riverine tucuxi (S. fluviatilis) and the marine "costero" (S. guianensis). Evidence to support both of these splits is convincing, and we recommend that they be recognized in the list. The existence of the Bryde's-whale-like species described in 2003 as Balaenoptera omurai has been confirmed with additional genetic (nuclear) data. While the species clearly exists, the nomenclature is still unsettled because the genetic identity of the holotype specimen of Balaenoptera edeni has not yet been determined. However, the name B. omurai is gaining wide usage in application to the new species, and we propose that it be used provisionally by the Scientific Committee pending the genetic identification of the B. edeni holotype. We recommend that India be urged to facilitate the identification. We recommend continued use of the name Balaenoptera edeni provisionally for both the "ordinary" large form and the small coastal form, recognizing that further genetic and morphological research may justify recognition of two species: B. brydei and B. edeni. We also recommend that any new specimen be referred to B. omurai only after its mtDNA has been sequenced and found to support the identification.
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This study aimed to evaluate the parameters established in COFEN Resolution 293/04 concerning nursing staff dimensioning in adult intensive care units (AICU). The research was conducted in six hospitals in Sao Paulo City. The daily quantitative average of professionals needed for patient care was calculated according to the parameters established by COFEN. The obtained results were compared with the existing number of daily staff members in these units. It was observed that the proportions recommended by COFEN for the nurse category are superior to those used in the hospitals studied, which represents a challenge for Brazilian nursing. Mean care time values were found appropriate and represent important standards for dimensioning the minimum number of professionals in AICU. This study contributed to the validation of the parameters indicated in Resolution 293/04 for nursing staff dimensioning in the AICU.
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STUDY BY MASS SPECTROMETRY OF SOLUTIONS OF [HYDROXY(TOSYLOXY)IODO]BENZENE: PROPOSED DISPROPORTIONATION MECHANISMS. Solutions of [hydroxy(tosyloxy)iodo]benzene (HTIB or Koser's reagent) in acetonitrile were analyzed using high resolution electrospray ionization mass spectrometry (ESI-MS) and electrospray ionization tandem mass spectrometry (ESI-MS/MS) under different conditions. Several species were characterized in these analyses. Based on these data, mechanisms were proposed for the disproportionation of the iodine(III) compounds in iodine(V) and iodine(I) species.
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Objective: (1) To investigate the incidence of laryngeal involvement in a large series of patients with pemphigus vulgaris, using endoscopic examination, (2) to describe the lesions, and (3) to establish a classification of laryngeal involvement in pemphigus vulgaris based on the location of the lesions. Study design: Prospective study. Methods: A total of 40 sequentially treated pemphigus vulgaris patients, diagnosed using clinical, histological and immunofluorescence criteria, were evaluated for laryngeal manifestations using endoscopic examination. The results were used to establish a graded classification of laryngeal involvement according to the location of the lesions. Results: Active laryngeal lesions (ulcers or blisters) were found in 16 patients (40 per cent). Of these, 37.5 per cent were classified as grade I, 20 per cent as grade II, 20 per cent as grade III and 17.5 per cent as grade IV. Conclusion: Laryngeal involvement is common in pemphigus vulgaris and must be considered at the point of diagnosis. Grade I lesions are the most frequent.
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Abstract Background Obstructive sleep apnea (OSA) is a respiratory disease characterized by the collapse of the extrathoracic airway and has important social implications related to accidents and cardiovascular risk. The main objective of the present study was to investigate whether the drop in expiratory flow and the volume expired in 0.2 s during the application of negative expiratory pressure (NEP) are associated with the presence and severity of OSA in a population of professional interstate bus drivers who travel medium and long distances. Methods/Design An observational, analytic study will be carried out involving adult male subjects of an interstate bus company. Those who agree to participate will undergo a detailed patient history, physical examination involving determination of blood pressure, anthropometric data, circumference measurements (hips, waist and neck), tonsils and Mallampati index. Moreover, specific questionnaires addressing sleep apnea and excessive daytime sleepiness will be administered. Data acquisition will be completely anonymous. Following the medical examination, the participants will perform a spirometry, NEP test and standard overnight polysomnography. The NEP test is performed through the administration of negative pressure at the mouth during expiration. This is a practical test performed while awake and requires little cooperation from the subject. In the absence of expiratory flow limitation, the increase in the pressure gradient between the alveoli and open upper airway caused by NEP results in an increase in expiratory flow. Discussion Despite the abundance of scientific evidence, OSA is still underdiagnosed in the general population. In addition, diagnostic procedures are expensive, and predictive criteria are still unsatisfactory. Because increased upper airway collapsibility is one of the main determinants of OSA, the response to the application of NEP could be a predictor of this disorder. With the enrollment of this study protocol, the expectation is to encounter predictive NEP values for different degrees of OSA in order to contribute toward an early diagnosis of this condition and reduce its impact and complications among commercial interstate bus drivers.
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Metabolic Syndrome (MetS) is associated with increased risk of morbi-mortality, thus the characterization of the population magnitude of this syndrome is critical for allocating health care. However, prevalence estimates of MetS in the same population could differ depending on the definition used. Therefore, we compared the prevalence of the MetS using definitions proposed by: National Cholesterol Education Panel Revised (NCEP) and International Diabetes Federation (IDF) 2009 in a Japanese-Brazilians community (131 individuals, age 57 ± 16 years, 1st and 2nd generation). All individuals went through a clinical and laboratorial evaluation for assessment of weigh, height, waist circumference, blood pressure, triglycerides, HDL-cholesterol and fasting plasma glucose. The prevalence of MetS was 26.7% (n = 35) and 37.4% (n = 49) under the NCEP and IDF definitions, respectively. Despite higher blood pressure measurements, waist circumference and serum triglyceride levels and lower HDL cholesterol levels (p < 0.01), individuals identified with MetS did not show increased blood glucose levels. IDF definition classified 14 individuals (10.7%) with MetS that were not classified under the NCEP and 35 individuals were identified with MetS by both criteria. We observed, in this group, more severe lipid disorders, compared to individuals identified only under the IDF definition, and the BMI and waist circumference (p = 0.01; p = 0.006, respectively) were lower. In conclusion, the IDF revised criteria, probably because of the ethnic specific values of waist circumference, was able to identify a larger number of individuals with MetS. However, our data suggesting that additional studies are necessary to define best MetS diagnostic criteria in this population.
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This study aimed to evaluate the parameters established in COFEN Resolution 293/04 concerning nursing staff dimensioning in adult intensive care units (AICU). The research was conducted in six hospitals in São Paulo City. The daily quantitative average of professionals needed for patient care was calculated according to the parameters established by COFEN. The obtained results were compared with the existing number of daily staff members in these units. It was observed that the proportions recommended by COFEN for the nurse category are superior to those used in the hospitals studied, which represents a challenge for Brazilian nursing. Mean care time values were found appropriate and represent important standards for dimensioning the minimum number of professionals in AICU. This study contributed to the validation of the parameters indicated in Resolution 293/04 for nursing staff dimensioning in the AICU.
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The present thesis aims at proving the importance of cultural and literary contexts in the practice of translation: I shall show that, in the case of Northern Irish crime fiction, knowledge of both Northern Irish history and culture as well as of the genre of crime fiction are essential prerequisites for the production of a “responsible” translation. I will therefore offer a brief overview of the history of crime and detective fiction and its main subgenres; some of the most important authors and works will be presented as well, in an analysis that goes from the early years of the genre to the second half of the 20th century. I will then move the focus to Northern Ireland, its culture and its history, and particular attention will be paid to fiction writing in Ireland and Northern Ireland, with a focus on the peculiar phenomenon of “Troubles Trash”. I will tackle the topic of Northern Irish literature and present the contemporary scene of Northern Irish crime fiction; the volume from which the texts for the translation have been taken will be presented, namely Belfast Noir. Subsequently the focus will move on the theoretical framework within which the translations were produced: I will present a literary review of the most significative developments in Translation Studies, with particular attention to the “cultural turn” that has characterised this subject since the 1960s. I will then highlight the phenomenon of “realia” in translation and analyse the approaches of different scholars to the translation of culture-bound references. The final part represents the culmination and practical application of all that was presented in the previous sections: I will discuss the translation of culture-bound references according to the strategies presented in Chapter 4, referring to the proposed translations of two stories. Such analysis aims to show that not only expert linguistic knowledge, but also cultural awareness and a wide literary background are needed in order to make conscious choices in translation.
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Newborn screening (NBS) for Cystic Fibrosis (CF) has been introduced in many countries, but there is no ideal protocol suitable for all countries. This retrospective study was conducted to evaluate whether the planned two step CF NBS with immunoreactive trypsinogen (IRT) and 7 CFTR mutations would have detected all clinically diagnosed children with CF in Switzerland.
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Lipoxygenases are nonheme-iron proteins that catalyze the oxygenation of polyunsaturated fatty acids to give conjugated diene hydroperoxides. For example, soybean lipoxygenase-1 (SBLO-1) converts linoleate into 13-(S)-hydroperoxy-9(Z),11(E)-octadecadienoate (13(S)-HPOD). Although the crystal structure of SBLO-1 has been determined, it is still unclear how the substrate binds at the active site. This absence of knowledge makes it difficult to understand the role of the enzyme during catalysis of the reaction. We hypothesize that SBLO-1 binds linoleate ¿tail-first¿, so that the methyl terminus is within a hydrophobic pocket deep within the enzyme. It is believed that the hydrophobic residue phenylalanine-557 at this site has stabilizing interactions with the terminal methyl group on linoleate. To test this hypothesis, we have developed a synthetic pathway that will yield linoleate analogs with longer fatty acid chains by 1 and 2 more carbons at the alkyl terminus. These substrates will be analyzed through kinetic assays done in combination with wild type SBLO-1 and mutants in which we have replaced phenylalanine-557 with valine.