Changes in non-22-kilodalton (kDa) isoforms of growth hormone (GH) after administration of 22-kDa recombinant human GH in trained adult males

GH is being used by elite athletes to enhance sporting performance. To examine the hypothesis that exogenous 22-kDa recombinant human GH (rhGH) administration could be detected through suppression of non-22-kDa isoforms of GH, we studied seventeen aerobically trained males (age, 26.9 +/- 1.5 yr) randomized to rhGH or placebo treatment (0.15 IU/kg/day for 1 week). Subjects were studied at rest and in response to exercise (cycle-ergometry at 65% of maximal work capacity for 20 min). Serum was assayed for total GH (Pharmacia IRMA and pituitary GH), 22-kDa GH (2 different 2-site monoclonal immunoassays), non-22-kDa GH (22-kDa GH-exclusion assay), 20-kDa GH, and immunofunctional GH. In the study, 3 h after the last dose of rhGH, total and 22-kDa GH concentrations were elevated, reflecting exogenous 22-kDa GH. Non-22-kDa and 20-kDa GH levels were suppressed. Regression of non-22-kDa or 20-kDa GH against total or 22-kDa GH produced clear separation of treatment groups. In identical exercise studies repeated between 24 and 96 h after cessation of treatment, the magnitude of the responses of all GH isoforms was suppressed (P < 0.01), but the relative proportions were similar to those before treatment. We conclude: 1) supraphysiological doses of rhGH in trained adult males suppressed exercise-stimulated endogenous circulating isoforms of GH for up to 4 days; 2) the dearest separation of treatment groups required the simultaneous presence of high exogenous 22-kDa GH and suppressed 20-kDa or non-22-kDa GH concentrations; and 3) these methods may prove useful in detecting rhGH abuse in athletes.

Contributo da análise ergonómica do trabalho para o estudo de acidentes de trabalho em enfermeiros no serviço de urgência

Mestrado em Segurança e Higiene no Trabalho.

The impact of leprosy on health-related quality of life

INTRODUCTION: Leprosy is a potentially disabling infectious disease that evolves into emotional issues due to the prejudice that persists about the illness. The endemic has declined substantially with multidrug therapy (MDT) in the 80's; however, new demands associated with the reduction of stigma and the improvement of the affected people's quality of life have emerged. In Brazil, leprosy is still a public health problem. Piauí is the second state in the Northeast in prevalence and detection, and Teresina is a hyperendemic city. This study aimed to analyze the health-related quality of life (HRQoL) of people in treatment for leprosy in Teresina/PI. METHODS: An observational study was conducted using the SF-36 (a specific questionnaire for assessing quality of life), which sought the determinants of poor quality of life among people with leprosy, outlining the sociodemographic, clinical, and epidemiological characteristics of the 107 patients interviewed. RESULTS: The correlations between the variables showed five determinants of HRQoL: late diagnosis, multibacillary forms, reactions, disability diagnosis grade II, and prejudice. The profile of the participants showed that leprosy still affects the lower social classes in historically endemic areas, causing high percentages of secondary injuries that compromise the work capacity and quality of life of the affected people, perpetuating the stigma associated with the disease. CONCLUSIONS: The study reinforces the need to implement more effective strategies of disease control, due to the development of severe and disabling forms of leprosy is directly related to poor HRQoL in the same cured patient.

Comparação de diferentes métodos de avaliação da capacidade de carga de pavimentos rodoviários

Dissertação de mestrado integrado em Engenharia Civil

Acute hypersensitivity pneumonitis in a paint quality controller : a case report

Introduction: Isocyanates are sensitizing chemicals used in various industries such as polyurethane foam production or paint-related purposes. Acting as haptens recognized by T-lymphocytes, they can cause allergic asthma and rarely hypersensitivity pneumonitis (HP). We aim to present a case report of acute HP due to hexamethylene diisocyanate (HDI) in a paint quality controller, a profession not generally considered at a high risk for work-related Isocyanates exposure. Case report: A 30-yr-old otherwise healthy female, light smoker working as a paint quality controller developed shortness of breath, malaise, sweating and chills at workplace six hours after handling a HDI-based hardener. Upon admission to emergency department, symptoms had progressed to severe respiratory failure. HR computer tomography (HRCT) showed bilateral ground-glass attenuation without pleural effusion. Rapid clinical and radiological improvement occurred under facial oxygen supply and systemic steroid therapy. Occupational medicine investigations revealed regular handling of HDI using latex gloves without respiratory protection. Assessment at workplace showed insufficient air renewal (1.5 times per hour), inadequate local aspiration and HDI exposure at levels of 1-4.25 ppb/m3 (Swiss Occupation Exposure Limit 5 ppb/m3). Biological monitoring after identical work procedure executed by a co-worker showed HDI exposure (5.1 micrograms hexamethylene diamine/g creatinine). Resumption of work was disadvised because of the life-threatening event. Discussion: The diagnosis of occupational HP is highly supported by classical findings on imagery and typical symptoms occurring within approved latency interval, associated with rapid clinical improvement. Although neither broncho-alveolar lavage nor specific IgG diagnosis (en route) were performed during the acute episode, various blood tests managed to rule out evidence of an infection or autoimmune disease. Other causes of HP seem unlikely as the patient did not have any recurrence of symptoms since absence from work. Workplace evaluation provided significant information on HDI exposure and allowed substantial recommendations to diminish Isocyanate exposure for the 20 still healthy laboratory co-workers. Although the entryways (air or skin) and precise mechanism of toxicity remain unclear, the present case clearly shows that Isocyanates may trigger acute HP in susceptible workers in a profession not generally considered at a high risk.

Cross-coding from the Swiss Disability Insurance listing to the ICIDH.

It has been suggested that converting, via a process of cross-coding, the listing used by the Swiss Disability Insurance (SDI) for their statistics into codes of the International Classification of Impairments, Disabilities, and Handicaps (ICIDH) would improve the quality and international comparability of disability statistics for Switzerland. Using two different methods we tested the feasibility of this cross-coding on a consecutive sample of 204 insured persons, examined at one of the medical observation centres of the SDI. Cross-coding is impossible, for all practical purposes, in a proportion varying between 30% and 100%, depending on the method of cross-coding, the level of disablement and the required quality of the resulting codes. Failure is due to lack of validity of the SDI codes: diseases are poorly described, consequences of diseases (disability and handicap, including loss of earning capacity), insufficiently described or not at all. Assessment of disability and handicap would provide necessary information for the SDI. It is concluded that the SDI should promote the use of the ICIDH in Switzerland, especially among medical practitioners whose assessment of work capacity is the key element in the decision to award benefits or propose rehabilitation.

"S'il vous plaît docteur, mettez-moi en arrêt"! Certificats médicaux pour raisons psychologiques ["Doctor please, give me a sick leave"!: medical certificates for psychological reasons].

General practitioners are regularly called to evaluate the psychological work capacity of patients. The implicit motivation behind the explicit reason for requesting a sick leave is linked to the subject's history and the way he transfers it in his professional life. An incapacity to work harbours a variety of challenges for the patient, the physician and their relationship. In order to get a better understanding of all the issues at stake, the doctor should understand the significances that represents the work to the patient and the consequences of a sick leave and its associated transference and countertransference issues.

Distribuição Espacial da Susceptibilidade à Erosão Hídrica nas Bacias das Ribeiras de Picos e Seca (Santiago, Cabo Verde)

Os processos de erosão hídrica em Cabo Verde são os mais marcantes da dinâmica actual das vertentes, pois são os mais comuns e que afectam áreas extensasdurante a curta estação húmida de três meses. A ocorrência de episódios chuvosos concentrados no tempo e com uma evidente irregularidade espacial permitem umaacentuada erosividade das precipitações, marcada por uma forte irregularidade regional. A forte variabilidade das formas de relevo, a diversidade da natureza das unidadesgeológicas e a multiplicidade de ocupação do solo favorecem condições deerodibilidade muito contrastadas no espaço. O objectivo deste trabalho é estabelecer um modelo desusceptibilidade à erosão hídricaem função de factores geomorfológicos (declive, perfil e traçado das vertentes eerodibilidade das unidades litológicas e dos materiais de cobertura), climáticos(intensidade pluviométrica) e de ocupação do solo para as bacias das ribeiras dos Picose Seca. Os resultados foram obtidos com recurso ao ambiente de Sistemas deInformação Geográfica (SIG). Este trabalho surge na sequência de outros já realizadospelos autores, onde se apresentaram as condições de erodibilidade e erosividade paraáreas mais restritas da Ilha de Santiago. O modelo de susceptibilidade à erosão hídrica resultou do cruzamento dos mapas dedeclives, de perfil e do traçado das vertentes, obtidos a partir do modelo digital deterreno (DTM), do mapa geológico, da distribuição espacial da intensidadepluviométrica e da densidade de ocupação do solo, tendo em conta que são estas asprincipais condicionantes de erosão hídrica, referidas pelos autores que estudaram estaregião. Cada um destes mapas foi reclassificado com base numa análise qualitativa dograu de erodibilidade, sendo atribuído um número de ordem a cada classe, em função da sua susceptibilidade à erosão hídrica, conforme foi localmente reconhecido. Verifica-se que as áreas de maior susceptibilidade à erosão hídrica são as do sectorsudeste da bacia da Ribeira Seca e as vertentes dos principais vales da bacia da Ribeira dos Picos, onde se encontram as unidades geológicas mais friáveis, os declives mais acentuados e onde predominam sectores das vertentes de traçado côncavo, a que seassocia pontualmente a mais elevada intensidade pluviométrica.

Moodleando en posgrado: uso del campus virtual y evaluación continuada

[spa] La adaptación al EEES ha implicado una reestructuración de los estudios universitarios promoviendo, entre otros, el uso de una evaluación continuada de los aprendizajes y de herramientas docentes virtuales en los nuevos grados. Estos cambios también pueden aplicarse en el posgrado, aunque hasta el momento, son pocas las experiencias al respecto. El presente trabajo muestra la opinión y los resultados obtenidos de los estudiantes de una asignatura de posgrado de un Máster Oficial Universitario URV-UB en el que se llevó a cabo evaluación continuada y se utilizó el Campus Virtual (CV) como herramienta de aprendizaje y participación activa. La aplicación del proyecto (2007PID/UB-14) se llevó a cabo en 4 fases: elaboración del aula, diseño de encuestas dirigidas a los estudiantes para obtener su opinión sobre la evaluación continuada y sus conocimientos en el uso de plataformas virtuales de forma previa al curso, gestión diaria del aula y seguimiento de las actividades propuestas y finalmente, evaluación del proyecto a través de indicadores cualitativos y cuantitativos derivados de las encuestas y de la propia aplicación virtual. Al inicio del curso la mayoría (93,75%) de los estudiantes prefería evaluación continuada y al final de éste el 100% estuvieron de acuerdo con el tipo de evaluación realizado. Respecto al CV, los estudiantes realizaron todas las actividades de autoevaluación voluntarias. La puntuación sobre la utilidad de todos los recursos del aula del CV fue muy elevada, siendo máxima la obtenida por los ejercicios de autoevaluación. En global, los estudiantes otorgaron al aula una puntuación de 8,1 sobre 10.

Moodleando en posgrado: uso del campus virtual y evaluación continuada

[spa] La adaptación al EEES ha implicado una reestructuración de los estudios universitarios promoviendo, entre otros, el uso de una evaluación continuada de los aprendizajes y de herramientas docentes virtuales en los nuevos grados. Estos cambios también pueden aplicarse en el posgrado, aunque hasta el momento, son pocas las experiencias al respecto. El presente trabajo muestra la opinión y los resultados obtenidos de los estudiantes de una asignatura de posgrado de un Máster Oficial Universitario URV-UB en el que se llevó a cabo evaluación continuada y se utilizó el Campus Virtual (CV) como herramienta de aprendizaje y participación activa. La aplicación del proyecto (2007PID/UB-14) se llevó a cabo en 4 fases: elaboración del aula, diseño de encuestas dirigidas a los estudiantes para obtener su opinión sobre la evaluación continuada y sus conocimientos en el uso de plataformas virtuales de forma previa al curso, gestión diaria del aula y seguimiento de las actividades propuestas y finalmente, evaluación del proyecto a través de indicadores cualitativos y cuantitativos derivados de las encuestas y de la propia aplicación virtual. Al inicio del curso la mayoría (93,75%) de los estudiantes prefería evaluación continuada y al final de éste el 100% estuvieron de acuerdo con el tipo de evaluación realizado. Respecto al CV, los estudiantes realizaron todas las actividades de autoevaluación voluntarias. La puntuación sobre la utilidad de todos los recursos del aula del CV fue muy elevada, siendo máxima la obtenida por los ejercicios de autoevaluación. En global, los estudiantes otorgaron al aula una puntuación de 8,1 sobre 10.

Sickness certification in primary care: a survey on views and practices among Swiss physicians.

QUESTIONS UNDER STUDY: Studies from several countries (Scandinavia, United Kingdom) report that general practitioners (GPs) experience problems in sickness certification. Our study explored views of Swiss GPs towards sickness certification, their practice and experience, professional skills and problematic interactions with patients. METHODS: We conducted an online survey among GPs throughout Switzerland, exploring behaviour of physicians, patients and employers with regard to sickness certification; GPs' views about sickness certification; required competences for certifying sickness absence, and approaches to advance their competence. We piloted the questionnaire and disseminated it through the networks of the five Swiss academic institutes for primary care. RESULTS: We received 507 valid responses (response rate 50%). Only 43/507 GPs experienced sickness certification as problematic per se, yet 155/507 experienced problems in sickness certification at least once a week. The 507 GPs identified estimating a long-term prognosis about work capacity (64%), handling conflicts with patients (54%), and determining the reduction of work capacity (42%) as problematic. Over 75% would welcome special training opportunities, e.g., on sickness certifications during residency (93%), in insurance medicine (81%), and conflict management (80%). CONCLUSION: Sickness certification as such does not present a major problem to Swiss GPs, which contrasts with the experience in Scandinavian countries and in the UK. Swiss GPs did identify specific tasks of sickness certification as problematic. Training opportunities on sick-leave certification and insurance medicine in general were welcomed.

Estimointi ja taloudellinen ennustaminen IT-järjestelmien toimitusprojekteissa

Nykyään projektityö on erittäin yleistä katsomatta toimialaan tai yritysten kokoon. Projektiestimointi on olennainen osa onnistuneen hankkeen läpiviennissä. Työssä käsitellään projektin alkuvaiheessa tapahtuvaan arviontiprosessiin liittyvää teknistä ja taloudellista estimointia. Työssä perehdytään työmäärien estimointimenetelmiin sekä taloudellisen ennusteen rakentamiseen.

Avaliação do perfil de dissolução de medicamentos utilizando-se espectroscopia eletrônica multivariada

In this work the evaluation of the dissolution profile of captopril-hydrochlorothiazide and zidovudine-lamivudine associations were carried out by multivariate spectroscopic method. The models were developed by partial least square regression from 20 synthetic mixtures using mean-centered spectral data. The external validation was accomplished with 5 synthetic mixtures shown mean prevision error of about 1%. Good agreement was observed in the analyses of commercial drugs (content uniformity and dissolution profile), considering the results obtained by the standard chromatographic method, with prevision error lower than 10%.

Energy demand in citrus production under varied operational efficiency values

Citrus orchards are very important in Brazil, especially in São Paulo State, where occupy an area of 600,000 ha approximately. To identify sustainability degree of citrus production system, an energy analysis allows evaluating efficiency of direct and indirect applied inputs. Thus, this study aimed to evaluate citrus production system under energetic point of view, in which invested energy is paid back with citrus production; being compared within three scenarios for operational field efficiency. As result, by sensitivity analysis was determined that fuel was the main energy demander, followed by pesticides and fertilizers. In operational work capacity analysis, all combinations between efficiency (minimum, typical and maximum) and yield levels became positive in the seventh year, except for the combination minimum efficiency and 10 % less yield, positive in the eighth year. The best combination (maximum efficiency and 10 % more yield) has promoted investment payoff around the sixth and seventh year. By this study, it is possible to determine the total energy demand to produce citrus and indentify the applied inputs that need more attention by the decision-makers. Labor and seedlings can be ommited for further studies with citrus, since they were irrelevant. Management of agricultural machinery may pose an important role on decreasing environmental impact of citrus production.

Nutritional characteristics of biofortified common beans

Iron and zinc deficiency can cause anemia and alterations in the immune response and impair work capacity. To minimize this problem, biofortification has been developed to improve and/or maintain the nutritional status of the population. Beans are an important source of carbohydrates, proteins, and minerals. The objective of this study is to characterize biofortified beans, quantify the minerals in different cultivars, and determine mineral dialysis. Grains of raw and cooked beans were analyzed for moisture, protein, lipids, fiber, minerals, and in vitro availability using four treatments and one control. The data were analyzed using ANOVA, and the Tukey test (p<0.05). The chemical composition of the raw and cooked treatments showed a moisture content ranging from 13.4 to 81.4%, protein from 22.24 to 31.59%, lipids from 1.66 to 2.22%, fiber from 16.81 to 40.63%, carbohydrates from 27.80 to 34.78%, and ash from 4.1 to 4.82%. Different varieties of beans showed statistically significant differences in iron and zinc content compared to the control cultivar (Pérola). The iron content differed significantly from that of the Pérola cultivar in the raw treatment, while in the cooked treatment, the control cultivar did not differ from the Piratã. The same behavior was observed for the zinc content in both treatments. There was no significant difference between the cultivars in the treatments in terms of the content of the dialysis of Calcium (Ca), Iron (Fe), Magnesium (Mg), and Zinc (Zn).