944 resultados para Delay in Diagnosis


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Universidade Estadual de Campinas . Faculdade de Educação Física

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Leishmaniasis is a neglected disease and endemic in developing countries. A lack of adequate and definitive chemotherapeutic agents to fight against this infection has led to the investigation of numerous compounds. The aim of this study was to investigate the effect of RT-01, an organotellurane compound presenting biological activities, in 2 experimental systems against Leishmania amazonensis. The in vitro system consisted of promastigotes and amastigotes forms of the parasite, and the in vivo system consisted of L. amazonensis infected BALB/c mice, an extremely susceptible mouse strain. The compound proved to be toxic against promastigotes and amastigotes. The study also showed that treatment with RT-01 produces an effect similar to that treatment with the reference antimonial drug, Glucantime, in L. amazonensis infected mice. The best results were obtained following RT-01 intralesional administration (720 mu g/kg/day); mice showed significant delay in the development of cutaneous lesions and decreased numbers of parasites obtained from the lesions. Significant differences in tissue pathology consisted mainly of no expressive accumulation of inflammatory cells and well-preserved structures in the skin tissue of RT-01-treated mice compared with expressive infiltration of infected cells replacing the skin tissue in lesions of untreated mice. These findings highlight the fact that the apparent potency of organotellurane compounds, together with their relatively simple structure, may represent a new avenue for the development of novel drugs to combat parasitic diseases.

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AIM: To evaluate effects of pre- and postnatal protein deprivation and postnatal recovery on the myenteric plexus of the rat esophagus. METHODS: Three groups of young Wistar rats (aged 42 d) were studied: normal-fed (N42), protein-deprived (D42), and protein-recovered (R42). The myenteric neurons of their esophagi were evaluated by histochemical reactions for nicotinamide adenine dinucleotide (NADH), nitrergic neurons (NADPH)-diaphorase and acetylcholinesterase (AChE), immunohistochemical reaction for vasoactive intestinal polypeptide (VIP), and ultrastructural analysis by transmission electron microscopy. RESULTS: The cytoplasms of large and medium neurons from the N42 and R42 groups were intensely reactive for NADH. Only a few large neurons from the D42 group exhibited this aspect. NADPH detected in the D42 group exhibited low reactivity. The AChE reactivity was diffuse in neurons from the D42 and R42 groups. The density of large and small varicosities detected by immunohistochemical staining of VIP was low in ganglia from the D42 group. In many neurons from the D42 group, the double membrane of the nuclear envelope and the perinuclear cisterna were not detectable. NADH and NADPH histochemistry revealed no group differences in the profile of nerve cell perikarya (ranging from 200 to 400 mu m(2)). CONCLUSION: Protein deprivation causes a delay in neuronal maturation but postnatal recovery can almost completely restore the normal morphology of myenteric neurons. (C) 2010 Baishideng. All rights reserved.

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We establish the existence of mild solutions for a class of impulsive second-order partial neutral functional differential equations with infinite delay in a Banach space. (C) 2009 Published by Elsevier Ltd

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We establish existence of mild solutions for a class of abstract second-order partial neutral functional differential equations with unbounded delay in a Banach space.

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Background: The optimal interval between neoadjuvant chemoradiation therapy (CRT) and surgery in the treatment of patients with distal rectal cancer is controversial. The purpose of this study is to evaluate whether this interval has an impact on survival. Methods and Materials: Patients who underwent surgery after CRT were retrospectively reviewed. Patients with a sustained complete clinical response (cCR) 1 year after CRT were excluded from this study. Clinical and pathologic characteristics and overall and disease-free survival were compared between patients undergoing surgery 12 weeks or less from CRT and patients undergoing surgery longer than 12 weeks from CRT completion and between patients with a surgery delay caused by a suspected cCR and those with a delay for other reasons. Results: Two hundred fifty patients underwent surgery, and 48.4% had CRT-to-surgery intervals of 12 weeks or less. There were no statistical differences in overall survival (86% vs. 81.6%) or disease-free survival rates (56.5% and 58.9%) between patients according to interval (<= 12 vs. >1 2 weeks). Patients with intervals of 12 weeks or less had significantly higher rates of Stage III disease (34% vs. 20%; p = 0.009). The delay in surgery was caused by a suspected cCR in 23 patients (interval, 48 +/- 10.3 weeks). Five-year overall and disease-free survival rates for this subset were 84.9% and 51.6%, not significantly different compared with the remaining group (84%; p = 0.96 and 57.8 %; p = 0.76, respectively). Conclusions: Delay in surgery for the evaluation of tumor response after neoadjuvant CRT is safe and does not negatively affect survival. These results support the hypothesis that shorter intervals may interrupt ongoing tumor necrosis. (C) 2008 Elsevier Inc.

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Antimicrobial therapy is one of the main stones of sepsis therapy. A recent study of septic shock patients showed that each hour of delay in antimicrobial administration during the ensuing 6 h after the onset of hypotension was associated with a decrease in survival rates. However, many questions regarding the impact of infection caused by antimicrobial-resistant pathogens on the mortality of patients with sepsis still need to be clarified. There is a lack of fair studies in the literature. Most studies have had inadequate sample size, inadequate adjustment for predictors of adverse outcomes, and inadequate definition of appropriate antibiotic therapy. Despite the fact that appropriate therapy is essential to treat sepsis, it seems that severity of underlying diseases and comorbidities are more important than resistance, although the studies were not well designed to examine the real impact of resistance on outcome. Finally, new technologies such as microarray that can identify different microorganisms, genes of resistance, and virulence in a few hours might have a great impact on the treatment of sepsis due to antimicrobial-resistant pathogens in the future.

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Chronic pelvic pain (CPP) is a common and complex disease whose cause is often clinically inexplicable, with consequent difficulty in diagnosis and treatment. Patients with CPP have high levels of anxiety and depression, with a consequent impairment of their quality of life. The objective of this study was to determine the prevalence of anxiety and depression and their impact on the quality of life of women with CPP. A cross-sectional controlled study was conducted on 52 patients with CPP and 54 women without pain. Depression and anxiety were evaluated by the Hospital Anxiety and Depression Scale, and quality of life was evaluated by the World Health Organization Quality of life Whoqol-bref questionnaire. Data were analysed statistically by the Mann-Whitney U-test, the Fisher exact test, chi-square test and Spearman correlation test. The prevalence of anxiety was 73% and 37% in the CPP and control groups, respectively, and the prevalence of depression was 40% and 30% respectively. Significant differences between groups were observed in the physical, psychological and social domains. Patients with higher anxiety and depression scores present lower quality of life scores. The fact that DPC is a syndromic complex, many patients enter a chronic cycle of search for improvement of medical symptoms. The constant presence of pain may be responsible for affective changes in dynamics, family, social and sexual. Initially the person is facing the loss of a healthy body and active, to a state of dependence and limitations. In this study, patients with higher scores of anxiety and depression scores had lower quality of life and patients with lower scores of anxiety and depression had scores of quality of life. These results show that perhaps the depression and anxiety may be related to the negative impact on quality of life of these patients. In view of this association, we emphasise the importance of a specific approach to the treatment of anxiety and depression together with clinical treatment to improve the quality of life of these patients.

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Chagas` disease and idiopathic achalasia patients have similar impairment of distal esophageal motility. In Chagas` disease, the contractions occurring in the distal esophageal body are similar after wet or dry swallows. Our aim in this investigation was to evaluate the effect of wet swallows and dry swallows on proximal esophageal contractions of patients with Chagas` disease and with idiopathic achalasia. We studied 49 patients with Chagas` disease, 25 patients with idiopathic achalasia, and 33 normal volunteers. We recorded by the manometric method with continuous water perfusion the pharyngeal contractions 1 cm above the upper esophageal sphincter and the proximal esophageal contractions 5 cm from the pharyngeal recording point. Each subject performed in duplicate swallows of 3-mL and 6-mL boluses of water and dry swallows. We measured the time between the onset of pharyngeal contractions and the onset of proximal esophageal contractions (pharyngeal-esophageal time [ PET]), and the amplitude, duration, and area under the curve (AUC) of proximal esophageal contractions. Patients with Chagas` disease and with achalasia had longer PET, lower esophageal proximal contraction amplitude, and lower AUC than controls (P <= 0.02). In Chagas` disease, wet swallows caused shorter PET, higher amplitude, and higher AUC than dry swallows (P <= 0.03). There was no difference between swallows of 3- or 6-mL boluses. There was no difference between patients with Chagas` disease and with idiopathic achalasia. We conclude that patients with Chagas` disease and with idiopathic achalasia have a delay in the proximal esophageal response and lower amplitude of the proximal esophageal contractions.

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A field experiment compared two rice (Oryza sativa L.) cropping systems: paddy or raised beds with continuous furrow irrigation; and trialled four cultivars: Starbonnet, Lemont, Amaroo and Ceysvoni, and one test line YRL39; that may vary in adaptation to growth on raised beds. The grain yield of rice ranged from 740 to 1250 g/m(2) and was slightly greater in paddy than on raised beds. Although there were early growth responses to fertilizer nitrogen on raised beds, the crop nitrogen content at maturity mostly exceeded 20 g/m(2) in both systems, so nitrogen was unlikely to have limited yield. Ceysvoni yielded best in both systems, a result of good post-anthesis growth and larger grain size, although its whole-grain mill-out percentage was poor relative to the other cultivars. Starbonnet and Lemont yielded poorly on raised beds, associated with too few tillers and too much leaf area. When grown on raised beds all cultivars experienced a delay in anthesis resulting in more tillers, leaf area and dry weight at anthesis, and probably a greater yield potential. The growth of rice after anthesis, however, was similar on raised beds and in paddy, so reductions in harvest index and grain size on raised beds were recorded. The data indicated that water supply was not a major limitation to rice growth on raised beds, but slower crop development was an issue that would affect the use of raised beds in a cropping system, especially in rice-growing areas where temperatures are too cool for optimal crop development. (C) 2001 Elsevier Science B.V. All rights reserved.

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Drought frequently reduces grain yield of rainfed lowland rice. A series of experiments were conducted in drought-prone northeast Thailand to study the magnitude and consistency of yield responses of diverse, rainfed lowland rice genotypes to drought stress environments and to examine ways to identify genotypes that confer drought resistance. One hundred and twenty-eight genotypes were grown under non-stress and four different types of drought stress conditions. The relationship of genotypic variation in yield under drought conditions to genetic yield potential, flowering time and flowering delay, and to a drought response index (DRI) that removed the effect of potential yield and flowering time on yield under stress was examined. Drought stress that developed prior to flowering generally delayed the time of flowering of genotypes, and the delay in flowering was negatively associated with grain yield, fertile panicle percentage and filled grain percentage. Genotypes with a longer delay in flowering time had extracted more water during the early drought period, and as a consequence, had higher water deficits. They were consistently associated with a larger yield reduction under drought and in one experiment with a smaller DRI. Genotypes, however, responded differently to the different drought stress conditions and there was no consistency in the DRI estimates for the different genotypes across the drought stress experiments. The results indicate that with the use of irrigated-control and drought test environments, genotypes with drought resistance can be identified by using DRI or delay in flowering. However, selections will differ depending on the type of drought condition. The inconsistency of the estimates in DRI and flowering delay across different drought conditions reflects the nature of the large genotype-by-environment interactions observed for grain yield under various types of drought in rainfed lowland conditions. (C), 2002 Elsevier Science B.V. All rights reserved.

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A series of experiments were conducted in drought-prone northeast Thailand to examine the magnitude of yield responses of diverse genotypes to drought stress environments and to identify traits that may confer drought resistance to rainfed lowland rice. One hundred and twenty eight genotypes were grown under non-stress and four different types of drought stress conditions. Under severe drought conditions, the maintenance of PWP of genotypes played a significant role in determining final grain yield. Because of their smaller plant size (lower total dry matter at anthesis) genotypes that extracted less soil water during the early stages of the drought period, tended to maintain higher PWP and had a higher fertile panicle percentage, filled grain percentage and final grain yield than other genotypes. PWP was correlated with delay in flowering (r = -0.387) indicating that the latter could be used as a measure of water potential under stress. Genotypes with well-developed root systems extracted water too rapidly and experienced severe water stress at flowering. RPR which showed smaller coefficient of variation was more useful than root mass density in identifying genotypes with large root system. Under less severe and prolonged drought conditions, genotypes that could achieve higher plant dry matter at anthesis were desirable. They had less delay in flowering, higher grain yield and higher drought response index, indicating the importance of ability to grow during the prolonged stress period. Other shoot characters (osmotic potential, leaf temperature, leaf rolling, leaf death) had little effect on grain yield under different drought conditions. This was associated with a lack of genetic variation and difficulty in estimating trait values precisely. Under mild stress conditions (yield loss less than 50%), there was no significant relationship between the measured drought characters and grain yield. Under these mild drought conditions, yield is determined more by yield potential and phenotype than by drought resistant mechanisms per se. (C) 2002 Elsevier Science B.V. All rights reserved.

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Functional knowledge of the physiological basis of crop adaptation to stress is a prerequisite for exploiting specific adaptation to stress environments in breeding programs. This paper presents an analysis of yield components for pearl millet, to explain the specific adaptation of local landraces to stress environments in Rajasthan, India. Six genotypes, ranging from high-tillering traditional landraces to low-tillering open-pollinated modern cultivars, were grown in 20 experiments, covering a range of nonstress and drought stress patterns. In each experiment, yield components (particle number, grain number, 100 grain mass) were measured separately for main shoots, basal tillers, and nodal tillers. Under optimum conditions, landraces had a significantly lower grain yield than the cultivars, but no significant differences were observed at yield levels around 1 ton ha(-1). This genotype x environment interaction for grain yield was due to a difference in yield strategy, where landraces aimed at minimising the risk of a crop failure under stress conditions, and modem cultivars aimed at maximising yield potential under optimum conditions. A key aspect of the adaptation of landraces was the small size of the main shoot panicle, as it minimised (1) the loss of productive tillers during stem elongation; (2) the delay in anthesis if mid-season drought occurs; and (3) the reduction in panicle productivity of the basal tillers under stress. In addition, a low investment in structural panicle weight, relative to vegetative crop growth rate, promoted the production of nodal tillers, providing a mechanism to compensate for reduced basal tiller productivity if stress occurred around anthesis. A low maximum 100 grain mass also ensured individual grain mass was little affected by environmental conditions. The strategy of the high-tillering landraces carries a yield penalty under optimum conditions, but is expected to minimise the risk of a crop failure, particularly if mid-season drought stress occurs. The yield architecture of low-tillering varieties, by contrast, will be suited to end-of-season drought stress, provided anthesis is early. Application of the above adaptation mechanisms into a breeding program could enable the identification of plant types that match the prevalent stress patterns in the target environments. (C) 2003 E.J. van Oosterom. Published by Elsevier Science B.V. All rights reserved.

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A pesquisa se caracteriza pela abordagem plurimetodológica do tipo qualitativa/quantitativa, e tem como objetivo investigar de que maneira se constroem as estratégias de conciliação entre a formação esportiva e escolar em atletas de elite que servem às seleções brasileiras masculinas de basquetebol Sub 17 e Sub 19. O estudo se organizou em três capítulos. Do tipo “estado do conhecimento”, o primeiro capítulo tem por objetivo mapear as produções acadêmicas que tratam da conciliação entre formação escolar e formação esportiva. Utiliza como fonte a base de dados Scielo para busca nacional e o Portal Periódicos Capes para busca internacional. Foram encontrados 17 artigos distribuídos em 13 periódicos. Os dados foram classificados/analisados por meio de indicadores bibliométricos, como distribuição anual, distribuição por revista, relação autoral e origem demográfica. Para análise também foram levados em consideração uma tese de doutorado, três dissertações de mestrado e três trabalhos apresentados em congresso, além de um número especial de periódico, não localizado nas bases escolhidas. Mostra que a preocupação com o tema surge na Europa e nos Estados Unidos, na década de 70, e que, no Brasil, essa questão passa a ser abordada nos anos 2000. Demonstra tentativas de conciliação entre as formações realizadas em países da Europa, Estados Unidos e Brasil, além da importância da família e do pertencimento de classes sociais na possibilidade de priorização a uma das formações envolvidas. O segundo capítulo, de natureza quali-quantitativa, investiga as estratégias utilizadas pelos atletas convocados em 2013 para as seleções brasileiras de basquetebol masculinas de base Sub 17 e Sub 19 anos, quanto às possíveis conciliações entre formação esportiva e escolar. Busca, ainda, compreender a influência das convocações para as seleções nacionais nos índices de escolaridade desses atletas de elite, como abandono, atraso e repetência escolar. A pesquisa mostra que esse grupo de atletas de elite apresenta médias de repetência, abandono e atraso escolar maiores que as médias nacionais. O terceiro capítulo analisa o entendimento desse grupo de jovens atletas em relação à formação escolar ou, ainda, se um possível desinteresse do grupo pelo modelo atual de escola se daria apenas pelo fato de serem esportistas de elite. Para isso, recorre às possibilidades de investigação oriundas da segunda metade do questionário utilizado como instrumento para adotar uma metodologia de livre associação de palavras direcionadas a partir de quatro palavras indutoras (estruturas semânticas), a saber: “treinar”, “estudar”, “ir a escola” e “competir”. Essa associação livre é usualmente utilizada como suporte teórico/metodológico em pesquisas que investigam representação social (ACOSTA, 2005). Ao dar visibilidade a essas questões nota-se que a posição desses atletas, em relação à escola, não difere das encontradas em outras pesquisas que tratam de jovens inseridos no ensino médio. A falta de significado do que se aprende na escola em relação ao que eles desejam desenvolver como atividade laboral, faz com que a escola seja entendida como monótona, mas, ao mesmo tempo, necessária, caso seus projetos de formação esportiva não aconteçam.

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Objectivo: Verificar se existem alterações no padrão de recrutamento do transverso do abdómen/oblíquo interno, recto abdominal e oblíquo externo em indivíduos com história de dor lombopélvica aguda. Métodos: Foi realizado um estudo do tipo observacional, analítico e transversal, cuja amostra consistia num grupo de 15 indivíduos que nunca tiveram dor lombopélvica e por outro de 14 indivíduos do sexo feminino que tiveram pelo menos episódio de dor lombopélvica aguda nos últimos 6 meses. Foi recolhida e avaliada por electromiografia de superfície a actividade dos músculos acima referenciados e do deltóide, durante os movimentos rápidos de flexão, abdução e extensão do ombro. Analisou-se e foi comparado entre os dois grupos o padrão de recrutamento dos músculos abdominais. O teste de Mann-Whitney foi utilizado para comparar a média do tempo de activação muscular entre os dois grupos. O teste de Friedman foi efectuado para comparar o tempo de activação entre os músculos avaliados em cada direcção de movimento (com nível de significância de 5%). Resultados: Registou-se um atraso na activação do transverso do abdómen no movimento de flexão e abdução do ombro e ainda perda da activação independente entre os músculos superficiais e profundos estudados. Conclusão: O padrão de recrutamento dos músculos abdominais associado ao movimento do ombro encontra-se alterado em indivíduos com história de dor lombopélvica aguda.