901 resultados para behind-the-counter-lääkkeet
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RESUMO - Actualmente, a diabetes mellitus é a doença crónica que representa o maior desafio aos sistemas de saúde, e é um importante problema de saúde pública, tanto no que concerne ao crescente aumento do número de pessoas afectadas pela doença, incapacidade, morbilidade e mortalidade prematura, como nos custos envolvidos no controlo e tratamento das suas complicações. Nesse sentido, e consciente do grande peso económico e epidemiológico que a diabetes mellitus acarreta, este trabalho versa sobre: (1) identificar a prevalência da diabetes mellitus, em 2010, na região do Alto Alentejo; (2) conhecer as evidências sobre as intervenções e cuidados prestados aos diabéticos desta região; e (3) analisar os custos directos com o internamento hospitalar, cujo diagnóstico principal foi a diabetes, no ano 2010, nesta região. Através deste estudo, constatamos que a diabetes, na região do Alto Alentejo, no universo dos diabéticos identificados (n=8.767), representou uma prevalência de 7,7 diabéticos por 100 habitantes. Quanto ao género, a prevalência é superior no sexo feminino (8,1%), em relação ao sexo masculino (7,2%). A média da idade foi de 67,5 anos, e verificou-se que a diabetes aumenta em grande escala com a idade, encontrando-se uma taxa de prevalência superior em idades acima dos 60 anos. Referente ao seguimento dos cuidados de saúde prestados pela ULS aos doentes com diabetes mellitus, fica muito aquém do que as Guidelines definem, para os cuidados prestados a estes doentes, tanto em termos de seguimento da própria doença, como na prevenção das suas complicações. Em relação ao internamento hospitalar, em 2010, registaram-se 255 episódios cujo diagnóstico principal foi a diabetes mellitus (250.xx), correspondendo estes casos a um total de 761.990€. A demora média de internamento foi de 10 dias (11,5 para o sexo masculino e 8,5 para o sexo feminino) e, a média das idades situa-se nos 65,5 anos.
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Dissertação para obtenção do Grau de Doutor em Química Sustentável
Watershed-scale runoff routing and solute transport in a spatially aggregated hydrological framework
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Dissertation submitted in partial fulfillment of the requirements for the Degree of Master of Science in Geospatial Technologies
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The aim of this paper is to corn pare two technological dystopias: Emile Souvestre's Le Monde tel qu'il sera (1846) and Cordwainer Smith's "Alpha Ralpha Boulevard" (1961). Both texts present dystopian societies experienced by many of its inhabitants as being the best of possible worlds. The above authors question the massive use of technology, worry about what technology can do to human beings, how it can dehumanize them. They reveal serious social and moral concerns regarding the less privileged. These are excluded from the benefits of"Utopia" while making it possible. Both authors are childs of.. their time: they live in a period of national pride, they can see the shadows behind the luminous, the dangers resulting from human beings playing God with nature and humanity. Also, they are innovators: Souvestre announces dystopian science fiction and Smith renews with the genre announcing the New Wave movement in Anglo-American science fiction.
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INTRODUCTION: Hepatic disorders caused by dengue infection may progress to severe manifestations, including mortality and morbidity. Cytokines are involved in it, such as the migration inhibitory factor of macrophages (MIF), tumor necrosis factor (TNF), natural killer cells (NK), B lymphocytes, and macrophages. METHODS: This study was carried out from January to April 2007 at a public hospital from the Federal University of Mato Grosso do Sul, Campo Grande, Brazil. Sixty-eight patients were studied concerning hepatic alterations, with 56 reported having classic dengue, 6 with hemorrhagic dengue grade I, and 6 with hemorrhagic dengue grade II. RESULTS: Among the 56 with classic dengue, 83.3% had aspartate aminotransferase (AST) alterations, and 69.6% had altered alanine aminotransferase (ALT). For those with hemorrhagic dengue grade I, 100% had AST alterations, and 83.3% had altered ALT. All the patients with hemorrhagic dengue grade II had AST and ALT alterations. AST variations reached 22.0 and 907.0, with an average value of 164.6. For ALT, we found variations between 25.0 and 867.0, with an average value of 166.07. There had been statistical significance between dengue clinical shapes and hepatic function markers. CONCLUSIONS: We conclude that the infection was predominant in adults, females, and in those with low income and education. The liver enzymes were of larger amount in hemorrhagic dengue, but there was weak statistical evidence of the clinical manifestations and transaminases. Major signs and clinical symptoms were fever, headache, myalgia, arthralgia, weakness, severe pain behind the eyes, and rashes.
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Field lab: Consumer insights
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The obligate intracellular bacterium Chlamydia trachomatis is a human pathogen of major public health significance. Strains can be classified into 15 main serovars (A to L3) that preferentially cause ocular infections (A-C), genital infections (D-K) or lymphogranuloma venereum (LGV) (L1-L3), but the molecular basis behind their distinct tropism, ecological success and pathogenicity is not welldefined. Most chlamydial research demands culture in eukaryotic cell lines, but it is not known if stains become laboratory adapted. By essentially using genomics and transcriptomics, we aimed to investigate the evolutionary patterns underlying the adaptation of C. trachomatis to the different human tissues, given emphasis to the identification of molecular patterns of genes encoding hypothetical proteins, and to understand the adaptive process behind the C. trachomatis in vivo to in vitro transition. Our results highlight a positive selection-driven evolution of C. trachomatis towards nichespecific adaptation, essentially targeting host-interacting proteins, namely effectors and inclusion membrane proteins, where some of them also displayed niche-specific expression patterns. We also identified potential "ocular-specific" pseudogenes, and pointed out the major gene targets of adaptive mutations associated with LGV infections. We further observed that the in vivo-derived genetic makeup of C. trachomatis is not significantly compromised by its long-term laboratory propagation. In opposition, its introduction in vitro has the potential to affect the phenotype, likely yielding virulence attenuation. In fact, we observed a "genital-specific" rampant inactivation of the virulence gene CT135, which may impact the interpretation of data derived from studies requiring culture. Globally, the findings presented in this Ph.D. thesis contribute for the understanding of C.trachomatis adaptive evolution and provides new insights into the biological role of C. trachomatishypothetical proteins. They also launch research questions for future functional studies aiming toclarify the determinants of tissue tropism, virulence or pathogenic dissimilarities among C. trachomatisstrains.
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This paper studies the main differences in accounting standards of the International Accounting Standards Board (IASB) between small and large companies, materialised in the dissimilarities between the International Financial Reporting Standard for Small and Medium-sized Entities and the full International Financial Reporting Standards, as of 2010. Another element of this project is the analysis of the reasons behind the differences between the two aforementioned frameworks, which intends to expose the rationale and the mindset that led to an adaptation of the full standards in a stand-alone document designed for small companies.
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A estética dentária tem recebido bastante enfoque nos últimos anos, particularmente devido à importância a que a população atribui à aparência estética do sorriso. É, assim, desejado um sorriso o mais branco possível e que de preferência seja fácil de obter, eficaz, rápido, económico e que seja o menos invasivo possível. Com vista a satisfazer esta necessidade, surgiu no mercado uma grande diversidade de produtos Over the Counter (OTC). Os produtos OTC podem ser facilmente adquiridos por qualquer pessoa a um baixo custo. Contudo, a maioria destes produtos têm concentrações do agente ativo bastante superiores aos níveis considerados seguros pela Comissão Europeia (CE). Muitos autores têm demostrado preocupação em relação à segurança e consequentes efeitos no esmalte dentário devido ao possível uso abusivo destes produtos. Mais precisamente, a obsessão por dentes brancos pode constituir uma patologia, na qual os produtos de branqueamento dentário são constantemente aplicados pelo paciente, sem qualquer supervisão médica. Nos casos mais graves pode causar lesões na cavidade oral, induzindo efeitos adversos severos tais como sensibilidade dentária, redução da microdureza e aumento da rugosidade do dente. O objetivo deste estudo in vitro é avaliar se o grau de mineralização e o teor elementar do esmalte dentário são alterados aquando o branqueamento dentário com dois produtos de branqueamento OTC diferentes, excedendo as recomendações indicadas pelos fabricantes. De forma a realizar este estudo, foram usados dezassete dentes. Foram realizados dois protocolos: no primeiro protocolo foram aplicados dois produtos diferentes (Teeth Whitening Home Kit e White! – Bingo-UK) por um período de 39 dias. Para cada produto foram selecionadas seis espécimes aleatoriamente, tendo as condições experimentais sido idênticas. No segundo protocolo, cinco espécimes foram tratadas com o produto (WHITE! -Bingo-UK) por um período de 5 dias. Ambos produtos foram adquiridos em sites online. Entre cada aplicação todos os espécimes foram conservados em saliva humana. O conteúdo elementar de cada espécime, antes e após o branqueamento foi obtido com recurso à espetroscopia por fluorescência de raios X dispersiva em energia (EDXRF) e a banda do fosfato (PO43-) foi avaliada com espetroscopia Raman. Em relação ao primeiro protocolo, 7 dias após o branqueamento a desmineralização estudada foi significativa (p <0,01), sendo que após os 39 dias de tratamento o aumento do grau de desmineralização (GD) parece ser permanente. As amostras no segundo protocolo demostraram resultados semelhantes relativamente ao GD, mas em diferentes momentos.
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RESUMO: O cancro do pulmão (LC), uma das principais causas de mortalidade relacionada com cancro em Portugal, pode levar à formação de metástases hematogénicas. A adesão das células tumorais ao endotélio é considerada um dos passos fundamentais envolvidos na metástase. Em células sanguíneas, esta adesão é mediada por ligandos de E-selectina (E-SL), glicoproteínas ou glicolípidos decorados principalmente com sialyl-Lewis x (sLex) e sialyl-Lewis a (sLea). Tem sido descrito a expressão destes antigénios em LC, contudo o seu papel funcional em permitir a adesão das células de LC ao endotélio é ainda pouco compreendido. Foram analisadas amostras emparelhadas normais e tumorais de pacientes com cancro de pulmão de não-pequenas células (NSCLC) e três linhas celulares de LC. Immunoblotting assays com anti-sLex/sLea e molécula quimérica de E-selectina demonstraram que tecidos tumorais de LC sobreexpressam significativamente E-SL e resultados de citometria de fluxo demonstraram uma expressão elevada de E-SL nas linhas celulares. Para compreender o mecanismo da sobreexpressão de E-SL em tecidos tumorais e linhas celulares de LC, foi analisada a expressão de genes envolvidos na biossíntese de E-SL, nomeadamente FUT3, FUT4, FUT6, FUT7, ST3GAL3, ST3GAL4, ST3GAL6, β4GALT1, GCNT1 e GALNT3. Observou-se a sobreexpressão das fucosiltransferases FUT3, FUT6 e FUT7 em tecidos tumorais de LC e FUT3 em linhas celulares de LC, sendo que neste último, esta expressão é correlacionada com um aumento da adesão das células de LC às selectinas endoteliais. Foi observado que uma baixa expressão de FUT4 em tecidos tumorais está associada com estadios menos avançados de NSCLC. Foram analisadas ainda proteínas decoradas com sLex/sLea, tendo-se identificado como E-SL o antigénio carcinoembrionário em NSCLC. Em resumo, esta tese contribuiu para uma melhor compreensão das alterações glicosídicas e moléculas que podem influenciar a progressão tumoral do LC, podendo permitir identificar futuramente novos biomarcadores de diagnóstico/prognóstico e potenciais alvos terapêuticos para o NSCLC.--------------------------ABSTRACT: Lung cancer (LC), one of the major causes of mortality related to cancer in Portugal, may lead to hematogenous metastasis. Adhesion of cancer cells to endothelium is considered one of the crucial steps involved in metastasis. In blood cells, this adhesion is initiated by endothelial selectin ligands (E-SL) that are glycoproteins or glycolipids decorated mostly with sialyl-Lewis x (sLex) and sialyl-Lewis a (sLea). While LC has been described as expressing these sialyl Lewis antigens, its functional role in allowing LC adhesion to endothelium is still poorly understood. We analyzed paired tumor and normal tissues samples from non-small cell lung cancer (NSCLC) patients and three LC cell lines. Immunoblotting assays with anti-sLex/sLea and E-selectin chimera demonstrated that LC tumor tissues significantly overexpress E-SL and flow cytometry results indicated that E-SL are also abundantly expressed in LC cell lines. To understand the mechanism behind the overexpression of E-SL in LC tissues and cell lines, we analyzed the expression of genes involved in its biosynthesis, namely FUT3, FUT4, FUT6, FUT7, ST3GAL3, ST3GAL4, ST3GAL6, β4GALT1, GCNT1 and GALNT3. It was observed the overexpression of fucosyltransferases FUT3, FUT6 and FUT7 in LC tumor tissues and FUT3 in LC cell lines, being this last one correlated with an increased reactivity of the LC cells to endothelial selectins. It was described that low expression of FUT4 in tumor tissues is correlated with early stages of NSCLC. We also analyzed scaffolds proteins of sLex/sLea and it was identified the carcinoembryonic antigen as an E-SL in NSCLC. In summary, this thesis contributed to a better understanding of the glycosidic changes and molecules that can influence tumor progression of LC, allowing identifying in the future new diagnosis/prognosis biomarkers and potential therapeutic targets for NSCLC.
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Tax evasion and fraud threaten the economic and social objectives of modern tax systems, precluding the state funding for the satisfaction of collective needs and the fair distribution of wealth, being a violation of basic principles and values of our society. In tax law, to give tax administration the necessary powers to supervise and control the information provided by taxpayers and combat tax evasion and fraud, over the last years the grounds for a derogation of bank secrecy without judicial authorization have been extended, which raises some constitutional compatibility issues. Similarly, this tendency of making this legal regime more flexible and increasing automatic exchange of information has been followed by the European Union and the international community. Banking secrecy, as a professional secrecy, is an instrument to protect the right to privacy but also appears as an anti-abuse and repressive mechanism of evasive and fraudulent behaviors. Because of the conflict of interests will always be necessary to make a practical agreement between them, ensuring the legality and the due guarantees of the taxpayers but also an effective way to combat tax evasion and fraud. Bank secrecy cannot be one method to, behind the right to privacy, taxpayers practice illegal activities. But the practice of these irregular conducts also does not justify a total annihilation of the right to banking secrecy, uncovering all documents and bank information’s. Although considering the legislative changes, the administrative derogation of bank secrecy will always be what the tax administration does of it.
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OBJECTIVE: To evaluate the results of the laparoscopic technique in the treatment of adrenal pheochromocytoma. METHOD: Ten patients, 7 men and 3 women, between 10 and 67 years of age (mean 48) with pheochromocytoma underwent transperitoneal laparoscopic adrenalectomy and were evaluated retrospectively, based on clinical, laboratory, and pathological diagnosis. In all cases there was a solid unilateral adrenal tumor, 5 on the left side and 5 on the right side, whose greater diameter varied from 7 to 80 mm (mean 32). Nine of the 10 patients were chronically hypertensive or had already had hypertensive crises. One patient was normotensive, but presented metabolic alterations suggestive of adrenergic hyperfunction. RESULTS: No deaths occurred in this series. There were two (20%) conversions to open surgery, one due to venous bleeding and one due to the difficulty of dissection behind the vena cava in a patient presenting a partially retro-caval tumor. Surgical time in the 8 non-converted cases ranged from 70 to 215 minutes (mean 136). One patient (10%) received blood transfusion, and another (10%) presented two complications - acute renal failure and a subcutaneous infection. Both had been converted to open surgery. None of the non-converted cases was transfused or presented complications. Hospital discharge occurred between the 2nd and 11th post-operative day (mean 3). The pathological exam of the surgical specimens confirmed the diagnoses of pheochromocytoma in all 10 cases, one of them associated with an aldosterone-producing cortical tumor. CONCLUSIONS: Laparoscopic adrenalectomy for selected patients presenting pheochromocytoma is feasible and provides good results.
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In museum studies and history of art, what happens behind the scenes of museums stays relatively unseen and unspoken about. In the arts, generally speaking, what is dismissed as irrelevant (e.g. the realm of practices) is deliberately detached from what is thought to really matter; theory, discourse, content and meaning. Up till recently, backstage activities such as conservation practices are merely discussed among specialists and museum professionals. Only the outcomes of these discussions are sometimes – if at all – explicitly communicated to a larger public. Studies into the practices of contemporary art conservation however show that practices behind the scenes play an important role in the perpetuation of these artworks. What happens behind the scenes in terms of conservation has, in several ways, important effects on the ongoing life of these artworks in a museum context. Conservation practices, I argue, should therefore become a necessary part of museum studies and history of art. How can the working practices of conservators become more visible and transparent to a diversity of audiences, including researchers? And what does this mean in terms of research methodology?
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This master thesis has been developed during the internship in the Supervision Department of Supervision of the Intermediation and Market Structures of CMVM. My collaboration in such department was mainly focused on the derivatives market of the Iberian Electricity Market (MIBEL). MIBEL embodies two organized markets – the derivatives market in Portugal and the spot market in Spain The trading activity in the derivatives market of MIBEL is processed through the trading platform of the regulated market managed by OMIP, however, much of the negotiation is over-the-counter. The aim of this work is to describe the market from a legal and economic perspective and to analyse the evolution of the negotiation, namely the impact of OTC in the regulated market trading. To achieve this, I propose to analyse also MiFID and EMIR rules over derivative contracts and the role of central counterparties, as they both are important to the discussion. In parallel, we found that OTC transactions are considerably higher than those traded in the regulated market managed by OMIP, those findings can be justified by the contractual relationships based on trust already established between the partiesarties. Nevertheless, since 2011 this trend changed by an increase of the registered OTC. Thereafter, although the parties continued to trade bilaterally, these transactions were registered in a central counterparty in order to eliminate the inherent risks related to the OTC derivatives transactions. This change in the negotiation pattern may also be influenced by the mandatory reporting of transactions imposed by EMIR, that requires for some classes of derivatives the centralized clearing and for all other requires the implementation of risk mitigation techniques.
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In the present report I intend to study the Chinese higher education market and Chinese students’ rationales behind the selection of a foreign university, so as to propose simple, feasible, effective measures that will ultimately attract more Chinese students to Nova SBE. In order to do so, it was developed a qualitative research that lead to some interesting highlights, namely the fact that parents have a fairly large influence on the foreign school and country the student chooses. Regarding Nova SBE, the research revealed that Chinese students find courses and professors interesting, but they have difficulties in communicating with locals and claim that the school lacks a systematic, coordinated approach to their integration in the university, something that should start earlier in the process.