Regulation of human mesenchymal stem cell osteogenesis by specific surface density of fibronectin: a gradient study

 The success of synthetic bone implants requires good interface between the material and the host tissue. To study the biological relevance of fi bronectin (FN) density on the osteogenic commitment of human bone marrow mesenchymal stem cells (hBMMSCs), human FN was adsorbed in a linear density gradient on the surface of PCL. The evolution of the osteogenic markers alkaline phosphatase and collagen 1 alpha 1 was monitored by immunohistochemistry, and the cytoskeletal organization and the cell-derived FN were assessed. The functional analysis of the gradient revealed that the lower FN-density elicited stronger osteogenic expression and higher cytoskeleton spreading, hallmarks of the stem cell commitment to the osteoblastic lineage. The identifi cation of the optimal FN density regime for the osteogenic commitment of hBM-MSCs presents a simple and versatile strategy to signifi cantly enhance the surface properties of polycaprolactone as a paradigm for other synthetic polymers intended for bone-related applications.

Sustainability assessment of envelope wall solutions using MAXergy methodology

Projeto de investigação integrado de International Master in Sustainable Built Environment

Lewis Score - Prognostic value in patients with isolated small bowel Crohn's disease

Background and aims: Small bowel capsule endoscopy (SBCE) allows mapping of small bowel inflammation in Crohn’s disease (CD). We aimed to assess the prognostic value of the severity of inflammatory lesions, quantified by the Lewis score (LS), in patients with isolated small bowel CD. Methods: A retrospective study was performed in which 53 patients with isolated small bowel CD were submitted to SBCE at the time of diagnosis. The Lewis score was calculated and patients had at least 12 months of follow-up after diagnosis. As adverse events we defined disease flare requiring systemic corticosteroid therapy, hospitalization and/or surgery during follow-up. We compared the incidence of adverse events in 2 patient subgroups, i.e. those with moderate or severe inflammatory activity (LS =790) and those with mild inflammatory activity (135 = LS < 790). Results: The LS was =790 in 22 patients (41.5%), while 58.5% presented with LS between 135 and 790. Patients with a higher LS were more frequently smokers (p = 0.01), males (p = 0017) and under immunosuppressive therapy (p = 0.004). In multivariate analysis, moderate to severe disease at SBCE was independently associated with corticosteroid therapy during follow-up, with a relative risk (RR) of 5 (p = 0.011; 95% confidence interval [CI] 1.5–17.8), and for hospitalization, with an RR of 13.7 (p = 0 .028; 95% CI 1.3–141.9). Conclusion: In patients with moderate to severe inflammatory activity there were higher prevalences of corticosteroid therapy demand and hospitalization during follow-up. Thus, stratifying the degree of small bowel inflammatory activity with SBCE and LS calculation at the time of diagnosis provided relevant prognostic value in patients with isolated small bowel CD.

Are apolipoproteins A and B better than lipoproteins for assessing risk of obstructive coronary heart disease?

OBJECTIVE: To evaluate whether apolipoproteins A-I (Apo A-I) and B (Apo B) have, higher ensitivity (SN), specificity (SP) and positive predictive value (PPV) than lipoproteins (LP), total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), and triglycerides (TGL) in assessing the risk of coronary heart disease (CHD). METHODS: This is a transversal case-control study of 241 patients, who were divided into two groups: 1) 145 patients with CHD, and 2) 96 patients without coronary disease. A model of logistic regression to evaluate the relation between the LPs and CHD was developed in which variables with a p-alpha <0.1 were included. RESULTS: Apo A-I levels were higher in the patients without CHD, (OR 2.08, CI 1.20-3.57). There were no statistical differences between the values of Apo A-I and the remaining lipid fractions (Apo A-I: 67%; Apo B: 100%; PPV: TC= 71%; TGC=71%; HDL=71%; LDL=71%). The costs of the tests in Reais were as follows: Apo A-I: R$ 56.60; Apo B-100: R$ 56.60; TC: R$ 9.94; HDL: R$ 21.30; LDL: R$ 28.40; TGL: R$ 14.20. CONCLUSION: Levels of Apo A-I and Apo B have no advantage over conventional lipoproteins in predicting the risk of CHD, despite the statistical association between Apo A-I and CHD; in addition, their costs are higher than those of the conventional lipoproteins.

Laboratory assessment of the hypertensive individual. Value of the main guidelines for high blood pressure

OBJECTIVE: To determine if abnormal laboratory findings are more common in individuals with hypertension and in those with other risk factors, such as obesity, smoking and alcohol ingestion. METHODS: A study was carried out in the general outpatient clinics of a university hospital (145 individuals without previous diagnosis of hypertension) and the following variables were assessed: high blood pressure (as defined by the VI Joint National Committee on Prevention, Detection and Treatment of High Blood Pressure - VI JNC), obesity [calculated using body mass index (BMI)], tobacco use, and alcoholic ingestion. The laboratory examinations consisted of the following tests: hemogram, glycemia, uric acid, potassium, total/HDL-fraction cholesterol, triglycerides, calcium and creatinine. RESULTS: High blood pressure was not associated with a higher number of abnormal laboratory tests. Hypertensive individuals with a BMI > or = 25kg/m² or normotensive obese individuals, however, had a higher frequency of diabetes (12X), hypertriglyceridemia (3X), and hypercholesterolemia (2X), as compared with hypertensive individuals with BMI <25kg/m² and preobese/normal weight normotensive individuals. CONCLUSION: High blood pressure is not associated with a higher frequency of abnormal laboratory tests. The association of high blood pressure and obesity, however, increases the detection of diabetes and dyslipidemias.

A importância dos espaços verdes para a promoção de Guimarães a capital verde da Europa

Relatório de estágio de mestrado em Geografia (área de especialização em Planeamento e Gestão do Território)

Predictive value of clinical and electrophysiological variables in patients with chronic chagasic cardiomyopathy and nonsustained ventricular tachycardia

OBJECTIVE: Risk stratification of patients with nonsustained ventricular tachycardia (NSVT) and chronic chagasic cardiomyopathy (CCC). METHODS: Seventy eight patients with CCC and NSVT were consecutively and prospectively studied. All patients underwent to 24-hour Holter monitoring, radioisotopic ventriculography, left ventricular angiography, and electrophysiologic study. With programmed ventricular stimulation. RESULTS: Sustained monomorphic ventricular tachycardia (SMVT) was induced in 25 patients (32%), NSVT in 20 (25.6%) and ventricular fibrillation in 4 (5.1%). In 29 patients (37.2%) no arrhythmia was inducible. During a 55.7-month-follow-up, 22 (28.2%) patients died, 16 due to sudden death, 2 due to nonsudden cardiac death and 4 due to noncardiac death. Logistic regression analysis showed that induction was the independent and main variable that predicted the occurrence of subsequent events and cardiac death (probability of 2.56 and 2.17, respectively). The Mantel-Haenszel chi-square test showed that survival probability was significantly lower in the inducible group than in the noninductible group. The percentage of patients free of events was significantly higher in the noninducible group. CONCLUSION: Induction of SMVT during programmed ventricular stimulation was a predictor of arrhythmia occurrence cardiac death and general mortality in patients with CCC and NSVT.

Arrhythmogenic cardiomyopathy of the right ventricle. Predictive value of QT interval dispersion to assess arrhythmogenic risk and sudden death

OBJECTIVE: To determine in arrhythmogenic right ventricular cardiomyopathy the value of QT interval dispersion for identifying the induction of sustained ventricular tachycardia in the electrophysiological study or the risk of sudden cardiac death. METHODS: We assessed QT interval dispersion in the 12-lead electrocardiogram of 26 patients with arrhythmogenic right ventricular cardiomyopathy. We analyzed its association with sustained ventricular tachycardia and sudden cardiac death, and in 16 controls similar in age and sex. RESULTS: (mean ± SD). QT interval dispersion: patients = 53.8±14.1ms; control group = 35.0±10.6ms, p=0.001. Patients with induction of ventricular tachycardia: 52.5±13.8ms; without induction of ventricular tachycardia: 57.5±12.8ms, p=0.420. In a mean follow-up period of 41±11 months, five sudden cardiac deaths occurred. QT interval dispersion in this group was 62.0±17.8, and in the others it was 51.9±12.8ms, p=0.852. Using a cutoff > or = 60ms to define an increase in the degree of the QT interval dispersion, we were able to identify patients at risk of sudden cardiac death with a sensitivity of 60%, a specificity of 57%, and positive and negative predictive values of 25% and 85%, respectively. CONCLUSION: Patients with arrhythmogenic right ventricular cardiomyopathy have a significant increase in the degree of QT interval dispersion when compared with the healthy population. However it, did not identify patients with induction of ventricular tachycardia in the electrophysiological study, showing a very low predictive value for defining the risk of sudden cardiac death in the population studied.

Diagnostic value of the tilt-table test for the assessment of syncope in children and adolescents

OBJECTIVE - To assess the diagnostic value, the characteristics, and feasibility of tilt-table testing in children and adolescents. METHODS - From August 1991 to June 1997, we retrospectively assessed 94 patients under the age of 18 years who had a history of recurring syncope and presyncope of unknown origin and who were referred for tilt-table testing. These patients were divided into 2 groups: group I (children) - 36 patients with ages ranging from 3 to 12 (mean of 9.19±2.31) years; group II (adolescents) - 58 patients with ages ranging from 13 to 18 (mean of 16.05±1.40) years. We compared the positivity rate, the type of hemodynamic response, and the time period required for the test to become positive in the 2 groups. RESULTS - The positivity rates were 41.6 % and 50% for groups I and II, respectively. The pattern of positive hemodynamic response that predominated in both groups was the mixed response. The mean time period required for the test to become positive was shorter in group I (11.0±7.23 min) than in group II (18.44±7.83 min). No patient experienced technical difficulty or complications. CONCLUSION - No difference was observed in regard to feasibility, positivity rate, and pattern of positive response for the tilt-table test in children and adolescents. Pediatric patients had earlier positive responses.

Exploitation of Ashbya gossypii for the production of high-value products from glycerol feedstocks

Dissertação de mestrado em Bioengenharia

Prognostic value of technetium-99m-labeled single-photon emission computerized tomography in the follow-up of patients after their first myocardial revascularization surgery

OBJECTIVE: To assess the prognostic value of Technetium-99m-labeled single-photon emission computerized tomography (SPECT) in the follow-up of patients who had undergone their first myocardial revascularization. METHODS: We carried out a retrospective study of 280 revascularized patients undergoing myocardial scintigraphy under stress (exercise or pharmacological stress with dipyridamole) and at rest according to a 2-day protocol. A set of clinical, stress electrocardiographic and scintigraphic variables was assessed. Cardiac events were classified as "major" (death, infarction, unstable angina) and "any" (major event or coronary angioplasty or new myocardial revascularization surgery). RESULTS: Thirty-six major events occurred as follows: 3 deaths, 11 infarctions, and 22 unstable anginas. In regard to any event, 22 angioplasties and 7 new surgeries occurred in addition to major events, resulting a total of 65 events. The sensitivity of scintigraphy in prognosticating a major event or any event was, respectively, 55% and 58%, showing a negative predictive value of 90% and 83%, respectively. Diabetes mellitus, inconclusive stress electrocardiography, and a scintigraphic visualization of left ventricular enlargement were significant variables for the occurrence of a major event. On multivariate analysis, abnormal myocardial scintigraphy was a predictor of any event. CONCLUSION: Myocardial perfusion tomography with Technetium-99m may be used to identify high-risk patients after their first myocardial revascularization surgery.

Value of the radiological study of the thorax for diagnosing left ventricular dysfunction in Chagas' disease

OBJECTIVE: To determine the value of the radiological study of the thorax for diagnosing left ventricular dilation and left ventricular systolic dysfunction in patients with Chagas' disease. METHODS: A cross-sectional study of 166 consecutive patients with Chagas' disease and no other associated diseases. The patients underwent cardiac assessment with chest radiography and Doppler echocardiography. Sensitivity, specificity, and positive and negative predictive values of chest radiography were calculated to detect left ventricular dysfunction and the accuracy of the cardiothoracic ratio in the diagnosis of left ventricular dysfunction with the area below the ROC curve. The cardiothoracic ratio was correlated with the left ventricular ejection fraction and the left ventricular diastolic diameter. RESULTS: The abnormal chest radiogram had a sensitivity of 50%, specificity of 80.5%, and positive and negative predictive values of 51.2% and 79.8%, respectively, in the diagnosis of left ventricular dysfunction. The cardiothoracic ratio showed a weak correlation with left ventricular ejection fraction (r=-0.23) and left ventricular diastolic diameter (r=0.30). The area calculated under the ROC curve was 0.734. CONCLUSION: The radiological study of the thorax is not an accurate indicator of left ventricular dysfunction; its use as a screening method to initially approach the patient with Chagas' disease should be reevaluated.

El valor razonable como concepto vinculado a la pertinencia del valor. Fair value as a concept related to value relevance.

IDENTIFICACIÓN Y CARACTERIZACIÓN DEL PROBLEMA - HIPÓTESIS Según la NIC 39, el valor razonable es la cantidad por la que puede ser intercambiado un activo o cancelado un pasivo entre un comprador y un vendedor interesados y debidamente informados, en condiciones de independencia mutua. La definición del FASB (SFAC 7) es muy similar, y define el valor razonable como el monto mediante el que un activo podría ser enajenado en una transacción entre partes independientes, dispuestas a realizar la operación en situaciones diferentes a la de una liquidación o a la de una venta forzada. Puede apreciarse que esta definición de valor razonable es limitada porque, a excepción de escenarios que se correspondan con mercados perfectos y completos, el concepto puede abarcar valores de entrada, valores de salida y valores en uso, los cuales pueden ser muy diferentes (Beaver, 1987). El valor de entrada es el valor de adquisición o de reemplazo, el valor de salida es el precio al cual un activo puede ser vendido o liquidado, y el valor en uso es el valor incremental de una empresa atribuible a un activo (se correspondería con el valor presente mencionado anteriormente). Dado que el IASB y la FASB se ocupan de la valuación de activos que una empresa posee, y no de activos que serán adquiridos en un futuro, su definición de valor razonable debería ser interpretada desde la perspectiva del vendedor. Por lo tanto, el concepto de valor razonable que manejan el IASB y la FASB se asemeja a un valor de salida, tal como lo propusieron Chambers y Stirling hace bastantes años atrás.Planteado esto, lo que tratará de dilucidar este proyecto de investigación es si este concepto de valor razonable es realmente novedoso o es una simple regresión a los valores corrientes de salida defendidos por los autores de la década del setenta. OBJETIVOS GENERALES Y ESPECÍFICOS General Analizar si el concepto “valor razonable” tal como es definido por la normativa actual se corresponde con una definición novedosa o es una adaptación/modificación/regresión de conceptos ya existentes (valores corrientes de salida). Específicos Revisar la literatura específica desde el punto de vista de la teoría contable y las normas de las que dispone la profesión referidas a los siguientes aspectos: a) Valores corrientes b) Valor razonable MATERIALES Y MÉTODOS El análisis que se llevará a cabo comprenderá dos aspectos. El primero consiste en la revisión de la doctrina contable. Para ello se analizará bibliografía significativa y trabajos de eventos académicos relacionados con el valor razonable. En segundo término se revisará la normativa profesional a nivel nacional e internacional. Después de concluido con los pasos anteriores se analizará la novedad del concepto valor razonable y su semejanza con el valor corriente de salida planteado por los autores de la década del setenta. IMPORTANCIA DEL PROYECTO – IMPACTO Se pretende revisar si el concepto valor razonable planteado por la normativa actual resulta realmente novedoso o es una adaptación de viejos conceptos planteados en la década del setenta del siglo pasado. El proyecto resulta importante porque es un tema no desarrollado en la literatura, ni planteado en congresos. Se estima lograr material de publicación y presentación en eventos académicos. According to the NIC 39, fair value is the quantity for the one that can be exchanged an asset or cancelled a liability between a buyer and a seller interested and due informed, in conditions of mutual independence. The definition of the FASB (SFAC 7) is very similar, and defines fair value as the amount by means of which an assets might be alienated in a transaction between independent parts, ready to realize the operation in situations different from that of a liquidation or to that of a forced sale. This definition of reasonable value is limited because, with the exception of scenes that fit with perfect and complete markets, the concept can include values of entry, values of exit and values in use, which can be very different (Beaver, 1987). The value of entry is the value of acquisition or of replacement, the value of exit is the price to which an asset can be sold or liquidated, and the value in use is the incremental value of a company attributable to an asset. Provided that the IASB and the FASB deal with the appraisal of assets that a company possesses, and not of assets that will be acquired in a future, this definition of fair value should be interpreted from the perspective of the seller. Therefore, the concept of reasonable value that they handle the IASB and the FASB is alike a value of exit, as Chambers and Stirling proposed it enough years ago behind. We will review if the concept of "fair value" is really new or if it is an adaptation of old concepts.

What value can be attached to a concept of mystery and has it a place in contemporary Western culture?

The idea for this thesis arose from a chain of reactions first set in motion by a particular experience. In keeping with the contemporary need to deconstruct every phenomenon it seemed important to analyse this experience in the hope of a satisfactory explanation. The experience referred to is the aesthetic experience provoked by works of art. The plan for the thesis involved trying to establish whether the aesthetic experience is unique and individual, or whether it is one that is experienced universally. Each question that arises in the course of this exploration promotes a dialectical reaction. I rely on the history of aesthetics as a philosophical discipline to supply the answers. This study concentrates on the efforts by philosophers and critical theorists to understand the tensions between the empirical and the emotional, the individual and the universal responses to the sociological, political and material conditions that prevail and are expressed through the medium of art. What I found is that the history of aesthetics is full of contradictory evidence and cannot provide a dogmatic solution to the questions posed. In fact what is indicated is that the mystery that attaches to the aesthetic experience is one that can also apply to the spiritual or transcendent experience. The aim of this thesis is to support the contribution of visual art in the spiritual well being of human development and supports the uniqueness of the evaluation and aesthetic judgement by the individual of a work of art. I suggest that mystery will continue to be of value in the holistic development of human beings and this mystery can be expressed through visual art. Furthermore, this thesis might suggest that what could be looked at is whether a work of art may be redemptive in its affect and offset the current decline in affective religious practice.