Expressão imuno-histoquímica do ativador de plasminogênio do tipo uroquinase e seu receptor em carcinoma epidermoide de língua oral e sua relação com parâmetros clínico-patológicos

Squamous cell carcinoma (SCC ) is the most common malignancy of the oral cavity (OSCC), with a high mortality rate. Due to this, the discovery of biomarkers that facilitate the understanding of the biological behavior of the tumor and improve treatment is necessary. Urokinase type plasminogen activator (uPA) and its receptor, uPAR, are responsible for the proteolysis of structures of the basement membrana and extracellular matrix, facilitating tumor invasion. This study aims to assess the immuno expression of these proteins in 46 cases of squamous cell carcinoma of the oral tongue (OTSCC). These results were related to the presence of metastasis, clinical TNM staging, locoregional recurrence, outcome of the lesion and histological grading. Immunostaining of each case was evaluated semiquantitatively, in the front of invasion and center of the tumor, in which scores were assigned: 0 (0% of positive cells), 1 (1-10% of positive cells), 2 (11 -50% positive cells) and 3 (more than 50% positive cells). The expression of uPA was observed in 93.5% (n=43) of the cases in the front of invasion, with predominance of score 2 (n=16; 34.8%) and in 67.9% (n=31) of the cases in the center of the tumor, with predominance of score 1 (n=15; 32.6%). Overall, the immunoexpression of uPA was not associated with clinical parameters. Regarding the malignant histological grading, a higher expression of uPA was observed in cases of high-grade malignancy comp ared to low-grade malignancy (p=0.05). Regarding the morphological parameters, increased expression of uPA was observed in the worst mode of invasion (p=0.03 ). The expression of uPAR was observed in 73.9% of cases in the front of invasion, with a predominance of score 1 (n=21; 45.6 %), and in 47.5% (n=21) of the cases in the center of the tumor, with a predominance of score 0 (n=25; 54.4%). Although no statistical differences were observed in relation to lymph node metastasis, clinical TNM staging, outcome, and histological grading, there was a higher expression of uPAR in cases with locoregional recurrence (p=0.04). Regarding the tumor intra -localization, it was observed an increased expression of uPA and uPAR at the front of invasion in relation to the center of the tumor (p<0.001). Regarding the correlation between uPA and uPAR, there was no statistical sign ificance. Based on these results, it is suggested that uPA and uPAR are involved in the progression of CELO, mainly in the deeper region of the tumor.

Medical Assistance in Dying in Canada: An Ethical Analysis of Conscientious and Religious Objections

Article

Polymorphism of cutaneous human papillomaviruses

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Medical Assistance in Dying in Canada: An Ethical Analysis of Conscientious and Religious Objections

Article

Polymorphism of cutaneous human papillomaviruses

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Implications de l’hétérogénéité comportementale et biologique pour la vaccination contre les virus du papillome humain au niveau de la population : modélisation mathématique, revue systématique et méta-analyse

Objectifs : Dans plusieurs pays la couverture vaccinale contre les virus du papillome humain (VPH) est associée aux déterminants sociaux des comportements sexuels et la participation au dépistage du cancer du col utérin. Ces vaccins protègent uniquement contre certains types de VPH, donc leur impact futur sur les VPH nonvaccinaux demeure incertain. L’hétérogénéité comportementale entre individus et biologique entre types de VPH affectera l’efficacité populationnelle de la vaccination contre les VPH. Les objectifs spécifiques de cette thèse étaient 1) de modéliser comment une couverture vaccinale inégale entre filles préadolescentes qui différeront selon leur activité sexuelle et leur participation au dépistage du cancer du col affectera l’efficacité populationnelle de la vaccination, 2) faire une synthèse et comparer les estimés d’efficacité croisée des vaccins contre les VPH dans des populations ADN-négatives aux VPH et 3) d’identifier, avec la modélisation, les devis d’étude épidémiologique qui réduisent les biais dans l’estimation des interactions biologiques entre types de VPH. Méthode : Nous avons utilisé des modèles de transmission dynamique et une revue systématique de la littérature pour répondre aux objectifs. 1) Nous avons modélisé une couverture vaccinale inégale entre filles qui différeront selon leur activité sexuelle et leur participation au dépistage, et examiné les changements postvaccination dans l’inégalité dans la prévalence des VPH et l’incidence des carcinomes malpighien (SCC) du col de l’utérus entre femmes ayant différents comportements. 2) Nous avons effectué une revue systématique et méta-analyse des efficacités croisées des vaccins contre les VPH estimées dans des populations ADNnégatives aux VPH. 3) Nous avons développé des modèles de transmission dynamique et d’interaction de deux types de VPH pour simuler les études épidémiologiques d’interactions entre les VPH. Résultats : Pour l’objectif 1), notre modèle de transmission prédit que l’efficacité populationnelle du vaccin dépendra de la distribution du vaccin dans la population. Après la vaccination, les inégalités absolues dans l’incidence de l’infection et des SCC entre groupes de femmes qui diffèrent selon leur activité sexuelle et leur participation au dépistage devraient diminuer. Inversement, les inégalités relatives pourraient augmenter si les femmes plus sexuellement actives et celles qui ne se font jamais dépister ont une couverture vaccinale moins élevée que les autres. Le taux d’incidence des SCC demeurera élevé chez les femmes qui ne sont jamais dépistées après la vaccination. L’efficacité croisée vaccinale et les interactions biologiques entre VPH ne sont pas encore assez bien caractérisées pour pouvoir prédire l’impact du vaccin sur les types de VPH nonvaccinaux. Pour l’objectif 2), notre méta-analyse des essais cliniques des vaccins suggère que le vaccin bivalent a une efficacité croisée significativement plus élevée que le quadrivalent contre les infections persistantes et lésions précancéreuses avec les VPH-31, 33 et 45. Les essais cliniques plus longs estiment une efficacité croisée plus faible. La modélisation des études épidémiologiques d’interactions pour l’objectif 3) montre que l’estimation des interactions biologiques entre types de VPH dans les études épidémiologiques est systématiquement biaisée par la corrélation entre le temps à risque d’infection avec un type de VPH et le temps à risque d’infection avec d’autres types de VPH. L’ajustement pour des marqueurs d’activité sexuelle ne réussit pas à contrôler ce biais. Une mesure valide des interactions biologiques entre types de VPH peut être obtenue uniquement avec des études épidémiologiques prospectives qui restreignent les analyses à des individus susceptibles ayant des partenaires sexuels infectés. Conclusion : L’hétérogénéité comportementale entre individus et l’hétérogénéité biologique entre VPH affecteront l’efficacité populationnelle du vaccin contre les VPH. Dans les contextes où les déterminants sociaux des comportements sexuels et la participation au dépistage sont aussi associés à la couverture vaccinale chez les préadolescentes, l’inégalité relative dans l’incidence des SCC risque d’augmenter. Ces comportements demeureront des facteurs de risque importants du cancer du col à l’avenir. L’effet à long terme du vaccin sur les types de VPH non-vaccinaux demeure incertain. Quoique nos résultats suggèrent que les vaccins offrent une efficacité croisée contre certains types de VPH, celle-ci pourrait diminuer après quelques années. Des interactions compétitives entre VPH pourraient exister malgré les associations observées entre les incidences des infections VPH, donc une augmentation post-vaccination de la prévalence des VPH non-vaccinaux demeure possible. Des devis d’analyse plus complexes sont nécessaires pour mesurer de façon valide les interactions biologiques entre les VPH dans les études épidémiologiques.

Influence of grinding operations on surface integrity and chloride induced stress corrosion cracking of stainless steels

Stainless steels were developed in the early 20th century and are used where both the mechanical properties of steels and corrosion resistance are required. There is continuous research to allow stainless steel components to be produced in a more economical way and be used in more harsh environments. A necessary component in this effort is to correlate the service performance with the production processes. The central theme of this thesis is the mechanical grinding process.  This is commonly used for producing stainless steel components, and results in varied surface properties that will strongly affect their service life. The influence of grinding parameters including abrasive grit size, machine power and grinding lubricant were studied for 304L austenitic stainless steel (Paper II) and 2304 duplex stainless steel (Paper I). Surface integrity was proved to vary significantly with different grinding parameters. Abrasive grit size was found to have the largest influence. Surface defects (deep grooves, smearing, adhesive/cold welding chips and indentations), a highly deformed surface layer up to a few microns in thickness and the generation of high level tensile residual stresses in the surface layer along the grinding direction were observed as the main types of damage when grinding stainless steels. A large degree of residual stress anisotropy is interpreted as being due to mechanical effects dominating over thermal effects. The effect of grinding on stress corrosion cracking behaviour of 304L austenitic stainless steel in a chloride environment was also investigated (Paper III). Depending on the surface conditions, the actual loading by four-point bend was found to deviate from the calculated value using the formula according to ASTM G39 by different amounts. Grinding-induced surface tensile residual stress was suggested as the main factor to cause micro-cracks initiation on the ground surfaces. Grinding along the loading direction was proved to increase the susceptibility to chloride-induced SCC, while grinding perpendicular to the loading direction improved SCC resistance. The knowledge obtained from this work can provide a reference for choosing appropriate grinding parameters when fabricating stainless steel components; and can also be used to help understanding the failure mechanism of ground stainless steel components during service.

Squamous cell carcinoma of the renal pelvis with stones and inferior vena cava infiltration. Case report

We report a rare case of a 50 year old man with renal squamous cell carcinoma (SCC) who first came to our attention with renal colic and fever not responding to antibiotic or analgesic treatment. He had a long history of kidney stones, but had not undergone any imaging in the last 5 years. Physical examination revealed tenderness and a palpable mass in the right flank and lumbar region. A whole body CT scan was performed, revealing an 11 cm mass in the right kidney infiltrating the inferior vena cava. There were areas of calcification within the mass and multiple stones within the renal pelvis. The tumor was considered unsuitable for resection according to radiological and clinical criteria. The mass was biopsied percutaneously under CT guidance and histological examination revealed squamous cell carcinoma of the renal pelvis. The patient was treated with neoadjuvant chemotherapy and embolization of the renal artery. He died one month after diagnosis. To our knowledge this is the second reported case in the world of renal SCC infiltrating the inferior vena cava and with kidney stones.

Ativos de conhecimento e inovação em um serviço hospitalar de cirurgia cardiovascular

Na literatura acadêmica sobre inovação em serviços o tema da aprendizagem se destaca como um processo capaz de alavancar capacidades dinâmicas da empresa a curto, médio e longo prazo através da criação e transmissão do conhecimento. Os resultados desse processo podem impactar positivamente o desempenho da organização e melhorar seu posicionamento entre os concorrentes. Com objetivo de contribuir para o debate nesta área, este trabalho tem como objetivo principal identificar evidências empíricas sobre ativos de conhecimento capazes de sustentar a inovação e impulsionar a vantagem competitiva do Serviço de Cirurgia Cardiovascular (SCC) do Hospital de Clínicas de Porto Alegre (HCPA). Vantagem competitiva é tratada neste trabalho como a capacidade de se distinguir de outros serviços de atendimento médico na área, identificando o que confere vantagem na disputa por investimentos públicos em inovações e tecnologias. Assim, a ideia central deste artigo é evidenciar a capacidade operacional/funcional que distingue o SCC dos outros serviços em termos de ativos de conhecimento gerados. Neste sentido, foram realizadas entrevistas semiestruturadas com o médico responsável pelo SCC e análise documental de aspectos relevantes em relação ao processo de aprendizagem e produção de conhecimento no SCC utilizando as seguintes fontes: (a) publicações da equipe presentes no currículo Lattes; (b) linhas de pesquisas em que o SCC atua, apresentadas nos sites do HPCA e do Programa de Pós Graduação em Cardiologia e Cirurgia Cardiovascular da Faculdade de Medicina da Universidade Federal do Rio Grande do Sul; e (c) redes de conhecimento médico especializado onde estão inseridos, que estão discriminadas no site da Rede Nacional de Terapia Celular. Os ativos do conhecimento foram classificados pela taxonomia proposta por Li and Tsai (2009). A dinâmica de circulação dos ativos de conhecimento observados neste estudo de caso foi analisada através do modelo teórico de Gallouj (2002) para inovações em serviços de saúde intensivos na produção de conhecimento. Os resultados obtidos demonstraram dois aspectos essenciais no processo de aprendizagem do serviço de saúde investigado: (a) o incremento cumulativo das capacidades tecnológicas únicas do SCC, as quais sustentam sua diferenciação no setor de forma única; e (b) inovação de procedimentos cirúrgicos de alta complexidade diretamente relacionados com sua capacidade dinâmica para responder rapidamente à volatilidade ambiental onde o SCC está inserido. Tais dados se caracterizam como relevantes para compreender de que forma um serviço desta natureza pode gerenciar seu conhecimento, aumentando seu impacto nas estratégias de vantagem competitiva sustentável.

Synthesis of Iodinated Naphthoquinones Using Morpholine-Iodine Complex

artículo (arbitrado)--Universidad de Costa Rica. Escuela de Química, 2004. Este documento es privado debido a limitaciones de derechos de autor.

Srbski narodni sabor u Sremskim Karlovcima godine 1869 /

Mode of access: Internet.

The interplay between neuronal activity and actin dynamics mimic the setting of an LTD synaptic tag

Persistent forms of plasticity, such as long-term depression (LTD), are dependent on the interplay between activity-dependent synaptic tags and the capture of plasticity-related proteins. We propose that the synaptic tag represents a structural alteration that turns synapses permissive to change. We found that modulation of actin dynamics has different roles in the induction and maintenance of LTD. Inhibition of either actin depolymerisation or polymerization blocks LTD induction whereas only the inhibition of actin depolymerisation blocks LTD maintenance. Interestingly, we found that actin depolymerisation and CaMKII activation are involved in LTD synaptic-tagging and capture. Moreover, inhibition of actin polymerisation mimics the setting of a synaptic tag, in an activity-dependent manner, allowing the expression of LTD in non-stimulated synapses. Suspending synaptic activation also restricts the time window of synaptic capture, which can be restored by inhibiting actin polymerization. Our results support our hypothesis that modulation of the actin cytoskeleton provides an input-specific signal for synaptic protein capture.

Mastite: importância do maneio, ambiente e animal. Plano de prevenção, controlo e impacto na quantidade e qualidade do leite

No presente relatório são caracterizadas e descritas as atividades desenvolvidas durante o estágio curricular na vertente da importância do maneio, ambiente e animal no controlo das mastites. Contempla ainda uma revisão bibliográfica e estudo de caso sobre a problemática das mastites na exploração. No estudo de caso procurou avaliar-se a influência do maneio, ambiente e animal no controlo das mastites e o impacto que estas representam na quantidade e na qualidade do leite. Foi ainda realizado estudo em 30 bovinos, identificados como animais problema, com recolha de amostras de leite para análise de antibiograma com deteção de agente. Foi implementado um plano de prevenção e controlo de mastites que consistiu na implementação de medidas de higiene e maneio dos animais, implementação de operações de rotinas de ordenha, implementação de medidas preventivas com recurso a vacinação e estabelecimentos de protocolos de tratamentos para os animais com patologias associadas às mastites. Os resultados obtidos foram muito positivos, diminuindo de forma drástica a incidência de mastites de 20% para 5% anual e consequentemente, uma melhoria considerável da quantidade de leite (22 para 33 L/vaca/dia) e na qualidade do leite (CCS <300 000 cel/mL) produzido; Abstract: Mastitis: Importance of management, environment and animal. Plan for the prevention, control and impact on the quantity and quality of milk This report characterize and describe the activities carried out during the traineeship in the aspect of the importance of management, environment and animal in the control of mastitis. There is also a literature and a case study on the problem of mastitis on the farm review. In the case study we sought to evaluate the influence of management, environment and animal in the control of mastitis and the impact that they represent in the quantity and quality of milk. A study was also carried out in 30 cattle, identified as problem animals, with milk samples for antibiotic susceptibility analysis with agent detection. It was implemented a mastitis prevention and control plan with the implementation of hygiene measures and husbandry of animals, implementation of milking routine operations, and implementing preventive measures using vaccination and treatment protocols establishment for animal diseases associated with mastitis. The results were very positive, decreasing dramatically the incidence of 20% mastitis to 5% per year and hence a considerable improvement of the quantity (22 to 33 L/cow/day) and quality ( SCC <300,000 cells/mL) of milk produced.

Correlação entre o California Mastitis Test (CMT) e a Contagem de Células Somáticas (CCS) do leite de búfalas Murrah

O objetivo neste trabalho foi estimar as correlações entre o California Mastitis Test (CMT), a contagem células somáticas (CCS) e a produção de leite. Foram colhidas 544 amostras de leite de 38 búfalas em lactação nos anos de 2002 e 2003. O manejo de ordenha consistiu em uma ordenha diária, em que os tetos das búfalas eram desinfectados com solução de iodo, secos individualmente com papel toalha e submetidas à ordenha mecânica. O CMT foi realizado imediatamente após higienização dos tetos e as amostras de leite foram enviadas ao laboratório do DHVSP da Unesp/Botucatu, para realização da Contagem de Células Somáticas, em aparelho eletrônico Somacount 300. Foram efetuadas correlações entre Contagem de Células Somáticas, CMT, produção de leite, proteína, gordura e sólidos totais, que foram analisadas pelo SAEG (1997). A média de células somáticas foi de 63.380 células/mL, a produção diária de leite, de 4,07 ± 1,3 kg e a produção ajustada para os 270 dias, de 1214,25 ± 293,54 kg. Não foram encontradas correlações entre produção de leite, contagem de células somáticas e CMT. Para CCS e CMT, a correlação foi positiva e significativa (r = 0,53).

Review: Head and neck squamous cell carcinoma in sub-Saharan Africa

Aim Review the literature from 1990 to 2013 to determine known anatomic sites, risk factors, treatments, and outcomes of head and neck squamous cell carcinoma (HNSCC) in sub-Saharan Africa. Methods Using a systematic search strategy, literature pertaining to HNSCC in sub-Saharan Africa was reviewed and patient demographics, anatomic sites, histology, stage, treatment, and outcomes were abstracted. The contributions of human immunodeficiency virus (HIV), human papillomavirus (HPV) and behavioural risk factors to HNSCC in the region were assessed. Results Of the 342 papers identified, 46 were utilized for review, including 8611 patients. In sub-Saharan Africa, the oropharyngeal/oral cavity was found to be the most common site, with 7750 cases (90% of all cases). Few papers distinguished oropharyngeal from oral cavity, making identification of possible HPV-associated oropharyngeal squamous cell carcinoma (SCC) difficult. SCC of the nasopharynx, nasal cavity, or paranasal sinuses was identified in 410 patients (4.8% of all cases). Laryngeal SCC was found in 385 patients (4.5% of all cases), and only 66 patients (0.8% of all cases) with hypopharyngeal SCC were identified. In 862 patients with data available, 43% used tobacco and 42% used alcohol, and reported use varied widely and was more common in laryngeal SCC than that of the oropharyngeal/oral cavity. Toombak and kola nut use was reported to be higher in patients with HNSCC. Several papers reported HIV-positive patients with HNSCC, but it was not possible to determine HNSCC prevalence in HIV-positive compared to negative patients. Reports of treatment and outcomes were rare. Conclusions The oropharyngeal/oral cavity was by far the most commonly reported site of HNSCC reported in sub-Saharan Africa. The roles of risk factors in HNSCC incidence in sub-Saharan Africa were difficult to delineate from the available studies, but a majority of patients did not use tobacco and alcohol.