976 resultados para Patent citation
Resumo:
INTRODUCTION: Peripheral embolism is frequently related to a cardiac source of embolism. Transesophageal echocardiography (TEE) is a useful tool for identifying such sources. OBJECTIVES: Our laboratory has gained wide experience in TEE, with a large number of exams performed to search for a cardiac source of embolism. We therefore thought it would be useful to present our experience in the last 12 years following the introduction of the technique. METHODS: This was a retrospective study of 1110 consecutive patients undergoing TEE to search for a cardiac source of embolism, after an embolic event and a transthoracic echocardiogram. RESULTS: The patients' mean age was 53 +/- 14 years, 52% male. There was peripheral embolism in 5% of cases and cerebral embolism in the remainder. The exam identified a potential embolic source in 35.6% of cases, the most frequent diagnoses being intracardiac shunt at the atrial level (9.5%), atrial septal aneurysm (ASA) (6.6%), intracardiac thrombi (6.4%) and atherosclerotic plaques in the thoracic aorta (9.6%). The presence of ASA was frequently associated with patent foramen ovale (27%), which was more frequent in younger patients. Overall, we identified a cardiac source of embolism more often in elderly patients, with a predominance of atherosclerotic plaques in the aorta. ETE was more frequently diagnostic in patients with peripheral embolism, but there were no differences in terms of etiology. CONCLUSIONS: TEE is very useful to search for cardiac sources of embolism, especially in younger patients, in whom causes potentially treatable surgically or percutaneously can be identified. In elderly patients, therapeutic strategy will probably not be changed by the findings (mostly thrombi and atherosclerotic plaques). The presence of ASA and embolic events makes it essential to perform a thorough search by TEE for intracardiac shunts, which are frequently associated.
Resumo:
Presented at 23rd International Conference on Real-Time Networks and Systems (RTNS 2015). 4 to 6, Nov, 2015, Main Track. Lille, France.
Resumo:
The present study was undertaken to assess the effect of the crude extract of Cleome droserifolia (CD) leaves on experimentally infected mice with Schistosoma mansoni. Two groups of mice, showing a patent infection of S. mansoni, one of them was daily treated with an alcoholic extract of CD leaves (0.31 g kg-1 body weight, i.p.) for 21 days. The schistosomicidal activity of the CD extract was evaluated, three weeks post-treatment, on some parasitological and histopathological aspects including worm load, oogram pattern, faecal eggs releasing and granuloma formation. In addition, serum thyroid hormones levels (tri-iodothyronine; T3 and tetra-iodo-thyronin; T4), serum total protein contents and hepatic reduced glutathione (GSH) were evaluated. Treatment using CD extract resulted in a weak reduction in worm burden (32.46%) and affected the viability of both mature and immature eggs as indicated by the increase in the percentage of dead eggs and the decrease in the percentage of live ones. In addition, a week post-treatment, eggs elimination was observed in the stool of the infected-treated group which was low compared to the infected group. There was a suppressive effect of the extract on granuloma formation that could be due to the antioxidant effect of the extract. These data are confirmed by increasing hepatic GSH, serum total proteins and thyroid hormone levels in the infected-treated group as compared to the infected group. Treatment significantly enhanced b globulin fractions of the protein. Based on these assumptions, CD extract has beneficial effects on thyroid hormones status and anti-schistosomiasis activity. The beneficial effects of CD extract could be related to its direct effects on the parasite, and secondary to its effect on the antioxidant capacity of the host. The present study could emphasize the precise mechanism (s) of CD extract protection.
Resumo:
The water-rat Nectomys squamipes is mostly important non-human host in schistosomiasis mansoni transmission in Brazil, due to its susceptibility, high abundance and water-contact pattern. During experimental infection of N. squamipes with Schistosoma mansoni, adult worms show phenotypic plasticity. This finding led us to investigate whether biological behavior is also affected. This was assessed comparing the biological characteristics of four S. mansoni strains: BE (State of Belém do Pará), CE (State of Pernambuco), CMO (State of Rio Grande do Norte) and SJ (State of São Paulo) using laboratory-bred N. squamipes. The infection was monitored by determination of the pre-patent period, fecal egg output, egg viability, intestinal egg count and, infectivity rate. No biological modification was observed in these parameters. Overall results highlight that N. squamipes was susceptible to several S. mansoni strains, suggesting that it might contribute to the maintenance of schistosomiasis mansoni in Brazil.
Resumo:
To observe the effects of the parasitic infection on the biology of B. tenagophila, field and laboratory populations of this mollusk from Itariri, in Vale do Ribeira, Brazil, were experimentally infected. Each mollusk received 10 miracidia of Schistosoma mansoni (SJ lineage) and was observed throughout the parasite's development. The biological variables were compared according to the criteria "group" and "infectious phase". The main damage caused by the parasitic infection manifested itself in reproduction, longevity and lesions on the shell of the mollusks in the patent phase. An infection rate of 58.8% was observed. Microanatomical study of the mollusk's digestive gland and ovotestis revealed the presence of evolving larval forms and cercariae. It was concluded that the effects of the parasitic infection on both populations were moderate, despite the low survival rate of the infected mollusks, the damage did not prevent either reproduction or the elimination of cercariae, which continued for a long time.
Resumo:
Os autores apresentam o caso clínico de uma doente de 35 anos, sexo feminino, que recorreu ao hospital da área da residência por parésia do membro superior direito, tendo sido diagnosticado AVC isquémico por Ressonância Magnética Nuclear Cranio-Encefálica (RMN-CE). A investigação da fonte embólica levou ao diagnóstico, por ecocardiograma transesofágico, de foramen oval patente (FOP), com shunt direito-esquerdo espontâneo. Em Maio de 2009 foi efectuado encerramento percutâneo do FOP com dispositivo bioreabsorvível “BioSTAR®”, sob controlo ecocardiográfico. Efectuou ecocardiograma transtorácico após o primeiro, terceiro e sexto mês pós-procedimento e ecocardiograma transesofágico aos nove meses, mostrando sempre adequada colocação do dispositivo, sem presença de shunt residual, sem qualquer intercorrência clínica durante este período. Os autores discutem a importância do desenvolvimento de dispositivos bioabsorvíveis para encerramento de FOP, e as suas vantagens em comparação com os dispositivos sintéticos previamente utilizados.
Resumo:
A persistência de canal arterial hemodinamicamente significativo (PCAHS) é uma patologia frequente em recém-nascidos de muito baixo peso. O objectivo deste estudo foi identificar fatores de risco e morbilidades associadas à PCAHS no recém-nascido de muiot baixo peso com idade gestacional de 27 e 31 semanas. Estudaram-se os recém-nascidos(RN) com idade gestacional entre 27 e 31 semans e peso de nascimento inferior a 1500 gramas, admitidos numa unidade de cuidados intensivos neonatais entre 2010 e 2012. Realizou-se um estudo caso-coorte, tendo-se identificado os casos com diagnóstico ecográfico de PCAHS e uma amostra sistemática de RN sem diagnóstico de PCAHS (coorte de controlos). Foram explorados por regressão logística modelos preditivos da ocorrência de PACHS e da sua contribuição para a principal morbilidade neonatal. Nos três anos de estudo, a incidência de PACHS foi de 15%, intervalo de confiança (IC) 95% 11,3 - 19,5. A análise dos 44 RN com PACHS e dos 60 sem PACHS identificou como melhores preditores de PACHS a necessidade de ventilação venosa invasiva (odds ratio (OR) 3.65: IC95%1, 268 - 10,479: p=0,016) e a administração de surfatante (OR ajustado 4,52; IC95% 1,738-11,735; p=0,002); a PACHS mostrou ser significativa no modelo preditivo de leucomalácia periventricular (LPV) (OR ajustado 4,42: IC95% 1,621-12,045; p=0,004). Os resultados obtidos sugerem que estratégias preventivas e terapêuticas que permitam a redução da necessidade de administração de surfatante e de ventilação mecânica invasiva podem reduzir o risco de PCAHS. A PCAHS está positivamente associada à incidência de LPV.
Resumo:
An investigation was made about the influence of environment temperature on the infectivity of flagellate of T. cruzi Peru sample in triatomine feces by periconjuntival instilation in albino mice. The results demonstrate that infection, measured by patent parasitemia decreases when fecal suspension is maintained at 30ºC. The possible implication of these findings in relation to transmission of T. cruzi to human, in field, is briefty discussed.
Resumo:
The ex utero intrapartum treatment is a rare surgical procedure performed in cases of expected postpartum fetal airway obstruction. The technique lies on a safe establishment of a patent airway during labor in anticipation of a critical respiratory event, without interrupting maternal-fetal circulation. Anesthetic management is substantially different from that regarding standard cesarean delivery and its main goals include uterine relaxation, fetal anesthesia and preservation of placental blood flow. We present the case of an ex utero intrapartum treatment procedure performed on a fetus with a large cervical lymphangioma and prenatal evidence of airway compromise. Modifications to the classic ex utero intrapartum treatment management strategies were successfully adopted and will be discussed in the following report.
Resumo:
A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics
Resumo:
A Work Project, presented as part of the requirements for the Award of a Masters Degree in Management from the NOVA – School of Business and Economics
Resumo:
Dissertation presented to Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa for obtaining the master degree in Membrane Engineering
Resumo:
Philander frenata and Didelphis marsupialis harbor parasitism by Trypanosoma cruzi without developing any apparent disease and on the contrary to D. marsupialis, P. frenata maintains parasitism by T. cruzi II subpopulations. Here we compared the humoral immune response of the two didelphids naturally and experimentally infected with T. cruzi II group, employing SDS-PAGE/Western blot techniques and by an Indirect immunofluorescence assay. We also studied the histopathological pattern of naturally and experimentally infected P. frenata with T. cruzi. P. frenata sera recognized more antigens than D. marsupialis, and the recognition pattern did not show any change over the course of the follow up of both didelphid species. Polypeptides of 66 and 90kDa were the most prominent antigens recognized by both species in the soluble and enriched membrane fractions. P. frenata recognized intensely also a 45kDa antigen. Our findings indicate that: 1) there were no quantitative or qualitative differences in the patent or subpatent phases in the recognition pattern of P. frenata; 2) the significant differences in the recognition pattern of parasitic antigens by P. frenata and D. marsupialis sera suggest that they probably "learned" to live in harmony with T. cruzi by different strategies; 3) although P. frenata do not display apparent disease, tissular lesions tended to be more severe than has been described in D. marsupialis; and 4) Both didelphids probably acquired infection by T. cruzi after their evolutionary divergence.
Resumo:
Poster (and extended abstract) presented at the 13th International Conference "Libraries in the Digital Age (LIDA 2014)" held on 16-20th June, University of Zadar, Zadar, Croatia
Resumo:
RESUMO: Este é o relatório de um estágio realizado na Autoridade de Saúde Local de Bolonha com o objectivo de desenvolver capacidades e competências na área de projectos orientados para a avaliação com base epidemiológica. As prescrições de anti-depressivos aumentaram consideravelmente em todo o mundo durante as últimas décadas. O uso cada vez maior dos agentes mais dispendiosos desempenha um papel na subida do custo dos tratamentos. A Autoridade de Saúde Local de Bolonha implementou um processo de auditoria com o objectivo de melhorar a adequação das prescrições de pacientes externos, centrando-se em dois anti-depressivos de marca ainda protegidos por patente, Escitalopram e Duloxetine. Os Departamentos de Cuidados de Saúde Primários e de Cuidados de Saúde Mental, assim como o Departamento Farmacêutico e a Unidade de Gestão Clínica, estiveram envolvidos na fase de planeamento da auditoria. O grupo da auditoria, maioritariamente composto por médicos de clínica geral e psiquiatras, reuniu e analisou provas da eficácia e segurança dos anti-depressivos. Os dados sobre as prescrições das Unidades de Cuidados de Saúde Primários e dos Centros de Saúde Mental Comunitários da Autoridade de Saúde Local (866.294 habitantes) foram comparados, em particular as taxas de consumo de Escitalopram e Duloxetine. O grupo da auditoria definiu os standards a serem abordados, os indicadores a serem avaliados e as medidas a empreender para atingir os objectivos definidos. As directrizes do NICE sobre a depressão foram escolhidas como referência. O objectivo da auditoria foi definido como evitar o Escitalopram e Duloxetine como medicamentos de primeira escolha num tratamento anti-depressivo. De modo a verificar a eficácia das medidas empreendidas foi seleccionado um indicador, consistindo numa redução de 25% das prescrições de ambos os anti-depressivos na prática clínica de pacientes externos e numa redução de 20% da variabilidade nas Unidades de Cuidados de Saúde Primários. O relatório retrospectivo pré-auditoria (Janeiro a Abril de 2012) revelou que os tratamentos com anti-depressivos para pacientes externos eram prescritos pelos médicos de clínica geral em mais de90% dos casos. As medidas da auditoria foram implementadas entre Novembro de 2012 e Maio de 2013. Algumas medidas relevantes foram integradas com a revisão da auditoria, tais como reuniões educacionais de pequena escala com os médicos de clínica geral e psiquiatras, visitas de apoio do assessor de prescrições da Autoridade de Saúde Local aos médicos de clínica geral e Centros de Saúde Mental Comunitários, panfletos para profissionais com informação retirada das directrizes clínicas do NICE, implementação de um serviço de consulta na Web para médicos de clínica geral sobre provas relativas a anti-depressivos. O relatório de feedback é aguardado em Novembro de 2013 depois de se verificar nos standards atingidos a eficácia das medidas implementadas. Foi realizada uma análise SWOT para comprovar as forças e fraquezas, as oportunidades e ameaças do processo. Como identificação de fraquezas poderá ser útil identificar estratégias relevantes para melhoria interna, para que o conhecimento das ameaças possa amortizar factores que possam ter impactos adversos que fujam ao controlo do Departamento de Saúde Mental. Uma melhor compreensão das forças e das oportunidades facilita a consecução dos objectivos estabelecidos no projecto. O primeiro, mas não o último, resultado deste processo consistiu numa maior integração entre os Cuidados de Saúde Primários e de Saúde Mental, permitindo assim que a Autoridade de Saúde Local coloque as alterações em prática.------------ABSTRACT: This is the report of a traineeship held in the Local Health Authority of Bologna with the aim to develop skills and competencies in the field of epidemiogically based evaluation oriented projects. Antidepressants prescriptions have considerably increased all over the world in the last decades. The increasing use of the most expensive agents plays a part in the rising cost of treatments. The Local Health Authority of Bologna has implemented an audit process aimed at improving the appropriateness of outpatient prescriptions focusing on the two branded antidepressants still protected by patent, Escitalopram and Duloxetine. The Primary Care and the Mental Health Care Departments, as well as the Pharmaceutical Department and the Clinical Governance Unit, were involved in the planning phase of the audit. The audit group, mainly composed of general practitioners and psychiatrists, collected and analyzed scientific evidence on effectiveness and safety of antidepressants. Data on prescriptions of Primary Care Units and Community Mental Health Centers of the Local Health Authority (866.294 inhabitants) were compared, in particular consumption rates of Escitalopram and Duloxetine. The audit group defined the standards to be addressed, the indicators to be evaluated and the actions aimed at reaching the defined goals. NICE guidelines on depression were chosen as reference. The aim of the audit was settled as avoiding Escitalopram and Duloxetine as first choice drugs starting an AD treatment. In order to check the efficacy of the actions undertaken an indicator was selected, consisting in a reduction of 25% of prescriptions of both ADs in outpatient practice and in a 20% reduction of To develop skills and competencies across Primary Care Units. The pre-audit retrospective report (January-April 2012) showed that outpatient antidepressant treatments were prescribed by GPs in over 90% of cases. Audit actions were implemented between November 2012 and May 2013. Some relevant actions have been integrated with the audit review, such as small-scale educational meetings with GPs and psychiatrists, outreach visits of the LHA prescribing adviser to GPs and CMHCs,leaflets for professionals with information extracted from NICE clinical guidelines, implementation of a web consultation service for GPs about evidence on antidepressants. The feedback report is expected in November 2013 after checking through the standards attained the effectiveness of actions implemented. A SWOT Analysis was carried out to evidence the strengths and weaknesses, opportunities and threats of the process. As identification of weaknesses may be useful to identify relevant strategies for internal improvement, so the knowledge of threats can amortize factors that may have adverse impacts beyond the control of the Mental Health Department. Better understanding of the strengths and the opportunities facilitates the achievement of the goals set in the project. The first and not least upshot of this process has consisted in further integration between Primary and Mental Health Care, thus enabling the LHA to put the change into practice.