Characterisation of grafted supports used for solid-phase synthesis

A series of 'pellicular' type supports were fabricated by direct gamma-radiation-mediated graft polymerisation of styrene onto polypropylene, followed by aminomethylation. Raman spectroscopy was used for measuring the level of penetration of polystyrene graft into polypropylene, and other structural features such as density of graft and depth of functionalisation. The kinetics of the coupling of fluorenylmethylcarbamate (Fmoc)-labelled amino acids, to the aminomethylated polystyrene grafts have been measured by UV absorption followed cleavage of the Fmoc chromophore. The Raman spectroscopy results showed that for this series of experiments the calculated rate coefficient for coupling of Fmoc-labelled amino acids was primarily dependent on graft thickness, but was also influenced by the proportion of polystyrene graft to polypropylene. In general, it was also shown that with increasing loading capacity of support the calculated rate coefficient for amino-acid coupling decreased correspondingly. In addition, a support that had both a high rate coefficient and a high loading capacity was prepared from polypropylene base material with a co-continuous porous structure (high surface area). (C) 2003 Society of Chemical Industry.

Comparative study of the radiation-induced grafting of styrene onto poly(tetrafluoroethylene-co-perfluoropropylvinyl ether) and polypropylene substrates. I: Kinetics and structural investigation

A comparative study has been made of the radiation grafting of styrene onto poly(tetrafluoroethylene-co-perfluoropropyl vinyl ether) (PFA) and polypropylene (PP) substrates, using the simultaneous irradiation method. Effects of grafting conditions such as monomer concentrations, type of solvent, dose rate and irradiation dose on the grafting yield were investigated. Under the same grafting conditions it was found that a higher degree of grafting of styrene was obtained using a mixture of dichloromethane/methanol solvents for PFA and methanol for PP and the degree of grafting was higher in PP than in PFA at all doses. However, the micro-Raman spectroscopy analysis of the graft revealed that, for the same degree of grafting, the penetration depth of the grafted polystyrene into the substrate was higher in PFA than in PP substrates. In both polymers the crystallinity was hardly affected by the grafting process and the degree of crystallinity decreased slightly with grafting dose. The dependence of the initial rate of grafting on the dose rate and the monomer concentration was found to be 0.6 and 1.4 order for PFA and 0.15 and 2.2 for PP, respectively. The degree of grafting increased with increasing radiation dose in both polymers. However, the grafting yield decreased with an increase in the dose rate. The increase in the overall grafting yield for PFA and PP was accompanied by a proportional increase in the penetration depth of the graft into the substrates. (C) 2003 Society of Chemical Industry.

Investigation of the vapor-phase grafting of styrene onto PFA

Poly(tetrafluoroethylene-co-perfluoropropyI vinyl ether), PFA, was grafted with styrene from the vapor phase using a simultaneous radiation grafting method. The graft yields were measured as a function of the dose and dose rate and were found to be initially linearly dependent on the dose and independent of the dose rate up to dose rates of similar to3 kGy/h. However, at a dose rate of 6.2 kGy/h, the slope of the yield-grafting time plot decreased. Raman depth profiles of the grafts showed that the polystyrene concentrations were greatest near the surface of the grafted samples and decreased with depth. The maximum penetration depth of the graft depended on the radiation dose for a fixed dose rate. Fmoc-Rink loading tests showed that the grafts displayed superior loading compared to grafts prepared from bulk styrene or from styrene solutions other than methanol.

Rootstocks resistant to Meloidogyne incognita and compatibility of grafting in net melon

Due to the few studies about grafting in net melon, in order to obtain better control of soil pathogens, the aim of the present study was to evaluate 16 genotypes of Cucurbitaceae: Benincasa hispida, Luffa cylindrica, pumpkin 'Jacarezinho', pumpkin 'Menina Brasileira', squash 'Exposição', squash 'Coroa', pumpkin 'Canhão Seca', pumpkin 'Squash', pumpkin 'Enrrugado Verde', pumpkin 'Mini Paulista', pumpkin 'Goianinha', watermelon 'Charleston Gray', melon 'Rendondo Gaucho', melon 'Redondo Amarelo', cucumber 'Caipira HS' and cucumber 'Caipira Rubi', regarding to compatibility of grafting in net melon and resistance to Meloidogyne incognita, based on the reproduction factor (RF), according to Oostenbrink (1966). To assess resistance, the seedlings were transplanted to ceramic pots and inoculated with 300/mL eggs and/or second stage juveniles of M. incognita. At 50 days after transplanting, the plants were removed from the pots and the resistance was evaluated. The compatibility between resistant rootstock and grafts of net melon was determined by performing simple cleft grafting, in a commercial net melon hybrid of great market acceptance and susceptible to M. incognita (Bonus no. 2). The genotypes Luffa cylindrica, pumpkin 'Goianinha', pumpkin 'Mini-Paulista', melon 'Redondo Amarelo', watermelon 'Charleston Gray' are resistant to the nematode M. incognita. The better compatibilities occurred with the rootstocks melon 'Amarelo', which presented 100% of success, followed by pumpkin 'Mini-Paulista' with 94%. On the other hand, Sponge gourd, watermelon 'Charleston Gray' and pumpkin 'Goianinha' showed low graft take percentages of 66%, 62% and 50%, respectively.

Variáveis psicológicas e percepção do estado de saúde em indivíduos submetidos a ressincronização cardíaca

A insuficiência cardíaca afecta cerca de 261 mil pessoas em Portugal constituindo um problema de saúde pública. Pretendemos avaliar aspectos associados à recuperação do estado de saúde nesta síndrome, em particular a esperança, o afecto e a felicidade. Recorremos a um estudo longitudinal com 128 indivíduos sintomáticos com má fracção de ejecção do ventrículo esquerdo. Utilizámos um questionário para caracterizar os aspectos sóciodemográficos, clínicos e funcionais, o Kansas City Cardiomiopathy Questionnaire (KCCQ) para avaliar a qualidade de vida, a Subjective Hapiness Scale (SHS) para a felicidade, a HOPE Scale (HOPE) para a esperança e a Positive And Negative Afect Schedule (PANAS) para o afecto. Os questionários de caracterização sócio-demográfica, clínica e funcional, KCCQ e o SHS foram aplicados em três momentos: no internamento, prévio à instituição de terapêutica médica na sua totalidade e ao terceiro e sexto mês após a intervenção médica, na consulta externa. A maioria dos participantes eram homens em classe III da classificação da New York Heart Association com etiologia isquémica. No internamento e antes da terapêutica médica, observámos que a esperança, a felicidade e o afecto se relacionaram com a qualidade de vida, a felicidade e o afecto positivo com a esperança. No período avaliado foram submetidos a: terapia de ressincronização cardíaca (n=52), cardioversor-desfibrilhador implantável (n=44), cirurgia valvular com revascularização do miocárdio (n=14), optimização terapêutica farmacológica (n=10), transplante cardíaco (n=8). Foram significativos os resultados da qualidade de vida, da classificação da New York Heart Association, do exercício físico, da fracção de ejecção do ventrículo esquerdo e das arritmias cardíacas (estrasístoles e taquicardias ventriculares). A felicidade foi preditora da qualidade de vida e da funcionalidade. O afecto negativo foi preditor da satisfação com a insuficiência cardíaca. Concluímos da importância das variáveis positivas a par dos procedimentos médicos no tratamento das pessoas com insuficiência cardíaca. ABSTRACT - Heart failure affects about 261 000 people in Portugal constituting a public health problem. We intend to evaluate aspects of the health recovery in this syndrome, in particular hope, affection and happiness. We used a longitudinal study with 128 symptomatic patients with poor ejection fraction of left ventricle. We used a questionnaire to characterize the socio-demographic, clinical and functional aspects, the Kansas City Cardiomiopathy Questionnaire (KCCQ) to assess the quality of life, the Subjective Happiness Scale (SHS) for happiness, the HOPE Scale (HOPE) for hope and the Positive And Negative Affect Schedule (PANAS) for affection. The questionnaires of sociodemographic, clinical and functional KCCQ and SHS were applied on three occasions: on admission, prior to the execution of medical therapy in its totality and in the third and sixth months after medical intervention in the outpatient. Most of the participants were men in Class III New York Heart Association classification with ischemic etiology. At admission and before medical therapy, we observed that the hope, happiness and affection were related to the quality of life, happiness and positive affect with hope. Over the studied period were submitted to: cardiac resynchronization therapy (n=52), implantable cardioverter-defibrillator (n=44), valvular surgery with coronary artery bypass graft surgery (n=14), optimizing drug therapy (n=10), heart transplant (n=8). The significant results were the quality of life, the New York Heart Association classification, the exercise, the ejection fraction and left ventricular cardiac arrhythmias (ventricular tachycardia and estrasistoles). Happiness was a predictor of quality of life and functionality. The negative affect was a predictor of satisfaction with heart failure. We concluded that the positive variables and the medical procedures were important in treating people with heart failure.

Aspectos psicossociais associados à percepção da dor pós-operatória em indivíduos submetidos a cirurgia coronária

Objectivo: Identificar os factores psicossociais que influenciam a percepção da dor pós-operatória em doentes submetidos a cirurgia de revascularização do miocárdio (CRM). Material e Métodos: Estudo exploratório correlacional de 91 doentes (71 homens e 20 mulheres) submetidos a CRM (pontagem aortocoronária) por esternotomia). A idade média era de 63,8 ± 9,6 anos (entre 39 e 84). Foram utilizados os seguintes instrumentos: Escala Analógica Visual às 24, 48 e 96 horas do pós-operatório; Questionário de Caracterização Demográfica; Mental Health Inventory de 5 itens; Percepção de Saúde Geral (SF-36); Escala de Expectativas de Dor; Escala de Percepção de Apoio; Escala de Expectativas de Auto-eficácia; Satisfação com o tratamento, médicos e enfermeiros (American Pain Society Questionnaire) aplicados às 96 horas após a cirurgia. Resultados: Os doentes que apresentaram expectativas elevadas de dor, percepcionaram maior apoio, apresentaram níveis elevados de auto-eficácia para lidar com a dor ou, se pertenciam ao sexo masculino, sentiram menos dor. De igual modo, os doentes que apresentaram melhor saúde mental, percepcionaram a sua saúde como boa e os doentes que expressaram maior satisfação com o tratamento sentiram menos dor. A dor não foi influenciada pela idade, grau de escolaridade ou pela satisfação com a conduta de médicos e enfermeiros. Conclusão: Após as primeiras 48 horas do pós-operatório, a experiência de dor é influenciada por factores psicossociais, em oarticular pela expectativa de dor, expectativa de auto-eficácia, apoio percebido, percepção da saúde geral, percepção de saúde mental e satisfação com o tratamento para a dor. Perante os resultados, evidencia-se a necessidade de conjugar conhecimentos no sentido de dar respostas mais alargadas e de carácter multidisciplinar no tratamento da dor pós-operatória em CRM devendo, a par de outros aspectos, focar-se na gestão das expectativas dos doentes. ABSTRACT - Objective: To identify the psychological factors that influence post-surgery pain perception in patients undergoing coronary artery bypass graft surgery (CABG). Methods: This was an exploratory correlational study of 91 patients (71 men and 20 women) who underwent CABG (aortocoronary anastomosis) by sternotomy. Mean age was 63.8 ± 9.6 years (between 39 and 84). The following instruments were used: visual analogical scales at 24, 48 and 96 hours of post-surgery; demographic characteristics survey; pain expectations scale; perceived support scale; self-efficacy scale, Mental Inventory (5 items); health perception scale; and satisfaction with treatment, doctors and nurses (American Pain Society questionnaire) at 96 hours after surgery. Results: Patients who had presented high expectations of pain, perceived more support, presented high levels of self-efficacy to deal with pain or were male, felt less pain. Furthermore, patients who presented better mental health, perceived their general health as being good, or expressed greater satisfaction with treatment, felt less pain. Pain was not influenced by age, level of education or satisfaction with doctors and nurses. Conclusion: After the first 48 hours following surgery, the pain experience is influenced by psychosocial factors, in particular by expectation of pain and of self-efficacy, perceived support, perception of general and mental health, and satisfaction with pain treatment. The results confirm the need to bring together different kinds of knowledge for a broad, multidisciplinary approach to postoperative CABG pain treatment, focusing, along with other aspects, on management of patients’ expectations.

Effect of a sardine supplement on C-reactive protein in patients receiving hemodialysis

Objective - The study evaluated the effect of a canned sardine supplement in C-reactive protein (CRP) in patients on hemodialysis (HD) and the compliance and adherence to this supplement. Design - This was a quasi-experimental study: Participants with a serum CRP of 5 mg/dL or less volunteered to consume a sardine supplement or were maintained on the usual cheese/ham sandwich supplement. Setting - The study took place in two outpatient dialysis units in Lisbon, Portugal. Patients - The study comprised 63 patients receiving maintenance HD three times per week for at least 6 months and an initial CRP concentration of 5 mg/dL or less. Exclusion criteria included the presence of graft vascular access or history of cancer. Intervention - After a 4-week washout period, the nutritional intervention included a canned sardine sandwich for the case group (n = 31) and a cheese or ham sandwich for the control group (n = 32), to be ingested during each routine HD session, 3 times per week, for 8 weeks. Main outcome measure - Serum levels of high-sensitivity CRP were the outcome measure. Results - Only 65 patients from the invited 186 patients met the inclusion criteria and agreed to eat the sardine sandwich supplement three times per week and were involved in the study. A significant proportion of 48% (n = 31, case group) consumed the sardine sandwich supplement three times per week for 8 weeks, fulfilling the requirements and completing the study. The present investigation showed that a sardine sandwich supplement had no effect on CRP levels among patients on HD. However, when participants were stratified according to tertiles of CRP distribution values at baseline, a reduction in CRP levels was found for those in the higher tertile, being higher for the case group (P = .047). Although diabetic patients were excluded from the analysis (eight in the sardine supplementation group and seven in the control group) a significant CRP reduction was found (P = .034). Conclusion - Although a supplement of low-dose n-3 long-chain polyunsaturated fatty acids had no effect on the plasma high-sensitivity CRP of the supplemented group, a reduction in CRP levels was found when patients were stratified for tertiles of CRP (for the upper tertile) and diabetic status (for nondiabetic patients). These findings need to be further confirmed. This canned sardine supplement was accepted by an important proportion of patients, enhancing diet variety and contributing for a greater n-3 long-chain polyunsaturated fatty acids eicosapentaenoic acid and docosahexaenoic acid intake.

Outbreak of persistent cutaneous abscesses due to Mycobacterium chelonae after mesotherapy sessions, Lima, Peru

Outbreaks of rapidly growing mycobacteria have been occasionally described. The article reports an outbreak of cutaneous abscesses due to Mycobacterium chelonae following mesotherapy in Lima, Peru. From December 2004 through January 2005, 35 subjects who had participated in mesotherapy training sessions presented with persistent cutaneous abscesses. Thirteen (37%) of these suspected cases consented to underwent clinical examination. Skin punch-biopsies were collected from suspicious lesions and substances injected during mesotherapy were analyzed. Suspected cases were mainly young women and lesions included subcutaneous nodules, abscesses and ulcers. Mycobacterium chelonae was isolated from four patients and from a procaine vial. In conclusion, it is important to consider mesotherapy as a potential source of rapidly growing mycobacteria infections.

Cyclosporine versus tacrolimus: cost-effectiveness analysis for renal transplantation in Brazil

OBJECTIVE To analyze the cost-effectiveness of treatment regimens with cyclosporine or tacrolimus, five years after renal transplantation.METHODS This cost-effectiveness analysis was based on historical cohort data obtained between 2000 and 2004 and involved 2,022 patients treated with cyclosporine or tacrolimus, matched 1:1 for gender, age, and type and year of transplantation. Graft survival and the direct costs of medical care obtained from the National Health System (SUS) databases were used as outcome results.RESULTS Most of the patients were women, with a mean age of 36.6 years. The most frequent diagnosis of chronic renal failure was glomerulonephritis/nephritis (27.7%). In five years, the tacrolimus group had an average life expectancy gain of 3.96 years at an annual cost of R$78,360.57 compared with the cyclosporine group with a gain of 4.05 years and an annual cost of R$61,350.44.CONCLUSIONS After matching, the study indicated better survival of patients treated with regimens using tacrolimus. However, regimens containing cyclosporine were more cost-effective.

Development of biocompatible and “smart” porous structures using CO2-assisted processes

Dissertação apresentada para a obtenção do grau de Doutor em Engenharia Química, especialidade Engenharia da Reacção Química, pela Universidade Nova de Lisboa, Faculdade de Ciências e Tecnologia

Gender in the allocation of organs in kidney transplants: meta-analysis

OBJECTIVE To analyze whether gender influence survival results of kidney transplant grafts and patients.METHODS Systematic review with meta-analysis of cohort studies available on Medline (PubMed), LILACS, CENTRAL, and Embase databases, including manual searching and in the grey literature. The selection of studies and the collection of data were conducted twice by independent reviewers, and disagreements were settled by a third reviewer. Graft and patient survival rates were evaluated as effectiveness measurements. Meta-analysis was conducted with the Review Manager® 5.2 software, through the application of a random effects model. Recipient, donor, and donor-recipient gender comparisons were evaluated.RESULTS : Twenty-nine studies involving 765,753 patients were included. Regarding graft survival, those from male donors were observed to have longer survival rates as compared to the ones from female donors, only regarding a 10-year follow-up period. Comparison between recipient genders was not found to have significant differences on any evaluated follow-up periods. In the evaluation between donor-recipient genders, male donor-male recipient transplants were favored in a statistically significant way. No statistically significant differences were observed in regards to patient survival for gender comparisons in all follow-up periods evaluated.CONCLUSIONS The quantitative analysis of the studies suggests that donor or recipient genders, when evaluated isolatedly, do not influence patient or graft survival rates. However, the combination between donor-recipient genders may be a determining factor for graft survival.

Força Muscular Isocinética após Reconstrução do Ligamento Cruzado Anterior – Influência do Tipo de Enxerto (Osso-Tendão-Osso/Isquio-Tibiais)

Introdução: É reconhecida a importância do ligamento cruzado anterior (LCA) no funcionamento normal do joelho. Em caso de rotura ligamentar, nomeadamente em desportos com marcada solicitação dos movimentos de rotação do joelho, é justificada a necessidade de reconstrução do LCA na maioria dos casos. Objetivo (s): Avaliar a influência do tipo de enxerto na reconstrução do ligamento cruzado anterior na força muscular isocinética, assim como na funcionalidade e sintomas após 6 meses. Métodos: Estudo transversal analítico, constituído por 20 indivíduos voluntários do sexo masculino, que haviam sido submetidos a uma ligamentoplastia do cruzado anterior, pelo mesmo cirurgião, seguido de uma intervenção individualizada por um fisioterapeuta. Em 10 indivíduos, o procedimento cirúrgico foi realizado com enxerto do tendão rotuliano (grupo OTO), e nos restantes 10 com enxerto do semitendinoso e gracilis (grupo STG). Como forma de avaliar a Força Muscular Isocinética (Peak Torque, Trabalho Total Muscular, ratio Isquiotibiais/Quadricipite), foi utilizado o Dinamómetro Isocinético Biodex. A avaliação foi efectuada apenas aos 6 meses após o procedimento cirúrgico. Para observação da funcionalidade, amplitude de movimento e sintomas, utilizou-se o questionário International Knee Documentation Committee (IKDC). Resultados: Foi possível observar que entre os grupos apenas se observaram diferenças significativas no peak torque de extensão a 180º no membro não lesado (p=0,019). Contudo, foi observada uma tendência para o grupo OTO apresentar um maior défice no peak torque e trabalho total muscular em extensão. Comparativamente ao membro contra-lateral, o membro lesado apresentou valores significativamente inferiores na maioria das variáveis ( p < 0,05). Conclusão: Após 6 meses de pós-cirúrgico com reabilitação de fisioterapia, não foi possível apontar qual o enxerto que garante uma melhor recuperação da força muscular. Aos 6 meses, ambos os grupos ainda apresentaram limitações musculares, quando comparados com o lado contra-lateral. Relativamente ao rácio isquiotibiais/quadricípite, assim como no IKDC, não se observaram diferenças entre os dois tipos de enxertos.

Amastigotes forms of Trypanosoma cruzi detected in a renal allograft

Trypanosoma cruzi, the causative agent of Chagas’disease assumes two distinct forms in vertebrate hosts: circulating trypomastigote and tissular amastigote. This latter form infects predominantly the myocardium, smooth and skeletal muscle, and central nervous system. The present work describes for the first time the detection of amastigote forms of T. cruzi in the renal parenchyma of a kidney graft recipient one month after transplantation. The patient was serologically negative for Chagas’disease and received no blood transfusion prior to transplant. The cadaver donor was from an endemic area for Chagas’disease. The recipient developed the acute form of the disease with detection of amastigote forms of T. cruzi in the renal allograft biopsy and circulating trypomastigote forms. The present report demonstrates that T. cruzi can infect the renal parenchyma. This mode of transmission warrants in endemic areas of Chagas’disease

Estudo de delaminação em compósitos de matriz polimérica

A aplicação do material compósito é neste momento bastante vasta, graças à combinação das suas características específicas, tais como, maior resistência específica e módulos específicos e melhor resistência à fadiga, quando comparados com os metais convencionais. Tais características, quando requeridas, tornam este material ideal para aplicações estruturais. Esta caminhada de sucesso iniciou desde muito cedo, quando o material compósito já era utilizado para fabrico de armas pelos mongóis e na construção civil pelos hebreus e egípcios, contudo, só a partir dos meados do século XX é que despertou interesses para aplicações mais modernas. Atualmente os materiais compósitos são utilizados em equipamentos domésticos, componentes elétricos e eletrónicos, passando por materiais desportivos, pela indústria automóvel e construção civil, até indústrias de grande exigência e visibilidade tecnológica como a aeronáutica, espacial e de defesa. Apesar das boas características apresentadas pelos materiais compósitos, no entanto, estes materiais têm tendência a perderem as suas propriedades quando submetidas a algumas operações de acabamento como a furação. A furação surge da necessidade de ligação de peças de um mesmo mecanismo. Os furos obtidos por este processo devem ser precisos e sem danos para garantir ligações de alta resistência e também precisas. A furação nos materiais compósitos é bastante complexa devido à sua heterogeneidade, anisotropia, sensibilidade ao calor e pelo facto de os reforços serem extremamente abrasivos. A operação de furação pode causar grandes danos na peça, como a delaminação a entrada, defeitos de circularidade do furo, danos de origem térmica e a delaminação à saída que se apresenta como o mais frequente e indesejável. Com base nesses pressupostos é que este trabalho foi desenvolvido de forma a tentar obter processos simples para determinação e previsão de danos em polímeros reforçados com fibras (de carbono neste caso) de forma a precavê-los. De forma a conseguir estes objetivos, foram realizados ensaios de início de delaminação segundo a proposta de Lachaud et al. e ensaios de pin-bearing segundo a proposta de Khashaba et al. Foram também examinadas extensões de danos de acordo com o modelo de Fator de delaminação ajustado apresentado por Davim et al. A partir dos ensaios, de pin-bearing, realizados foram analisadas influências do material e geometria da broca, do avanço utilizado na furação e de diferentes orientações de empilhamentos de placas na delaminação de laminados compósitos e ainda a influências dessas variáveis na força de rutura por pin-bearing. As principais conclusões tiradas daqui são que a delaminação aumenta com o aumento do avanço, o que já era esperado, as brocas em carboneto de tungsténio são as mais recomendas para a furação do material em causa e que a delaminação é superior para a placa cross-ply quando comparada com placas unidirecionais. Para a situação de ensaios de início de delaminação foram analisadas as influências da variação da espessura não cortada por baixo da broca/punção, de diferentes geometrias de brocas, da alteração de velocidade de ensaio e diferentes orientações de empilhamentos de placas na força de início de delaminação. Deste ensaio as principais conclusões são que a força de início de delaminação aumenta com o aumenta da espessura não cortada e a influência da velocidade de ensaio altera com a variação das orientações de empilhamento.