Withdrawal of maintenance therapy for cytomegalovirus retinitis in AIDS patients exhibiting immunological response to HAART

BACKGROUND: Before the introduction of highly active antiretroviral therapy (HAART), CMV retinitis was a common complication in patients with advanced HIV disease and the therapy was well established; it consisted of an induction phase to control the infection with ganciclovir, followed by a lifelong maintenance phase to avoid or delay relapses. METHODS: To determine the safety of CMV maintenance therapy withdrawal in patients with immune recovery after HAART, 35 patients with treated CMV retinitis, on maintenance therapy, with CD4+ cell count greater than 100 cells/mm³ for at least three months, but almost all patients presented these values for more than six months and viral load < 30000 copies/mL, were prospectively evaluated for the recurrence of CMV disease. Maintenance therapy was withdrawal at inclusion, and patients were monitored for at least 48 weeks by clinical and ophthalmologic evaluations, and by determination of CMV viremia markers (antigenemia-pp65), CD4+/CD8+ counts and plasma HIV RNA levels. Lymphoproliferative assays were performed on 26/35 patients. RESULTS: From 35 patients included, only one had confirmed reactivation of CMV retinitis, at day 120 of follow-up. No patient returned positive antigenemia tests. No correlation between lymphoproliferative assays and CD4+ counts was observed. CONCLUSION: CMV retinitis maintenance therapy discontinuation is safe for those patients with quantitative immune recovery after HAART.

Integration of the project team in the classic maintenance cycle

A manutenção é uma área extremamente importante, principalmente na indústria. Devidamente organizada, permitirá um fluxo produtivo devidamente planeado e executado, que permitirá a qualquer empresa manter o nível de facturação desejado e o prazo de entrega acordado com os clientes. De outra forma, poderá originar o caos. No entanto, os desafios de gestão da produção mais correntes, nomeadamente através do Lean Manufacturing, passam a exigir um pouco mais do que uma simples manutenção. Torna-se obrigatório fazer análises económicas que permitam averiguar quando cada equipamento passa a exigir custos de manutenção excessivos, os quais poderão obrigar a um recondicionamento mais acentuado do equipamento, o qual pode passar inclusivamente por uma melhoria da sua performance. Nestes casos, terá que existir uma “cumplicidade” entre a Direcção de Produção e a Manutenção, no sentido de averiguar o melhor momento para proceder a uma melhoria do equipamento, numa perspectiva de funcionamento global em linha de produção, adaptando-o à performance que será exigida ao conjunto. Neste domínio, o Projecto passa a prestar um serviço valiosíssimo à empresa, integrando-se no conjunto Produção + Manutenção, criando valor na intervenção, através do desenvolvimento de um trabalho que permite não só repor o estado natural da produção, mas sim promover uma melhoria sustentada da mesma. Este trabalho pretende reflectir e avaliar a relevância do Projecto neste tipo de operações, contribuindo de uma forma sistemática e sustentada para a melhoria contínua dos processos de fabrico. É apresentado um caso de estudo que pretende validar todo o desenvolvimento anteriormente realizado na matéria.

Aircraft Engines Maintenance Costs and Reliability: An Appraisal of the Decision Process to Remove an Engine for a Shop Visit Aiming at Minimum Maintenance Unit Cost

Dissertação apresentada como requisito parcial para obtenção do grau de Mestre em Estatística e Gestão de Informação.

Implementação, documentação e avaliação da aplicação de Lean Maintenance no Sistema de Armas Epsilon

Dissertação para obtenção do Grau de Mestre em Engenharia Mecânica

In vitro maintenance of Angiostrongylus costaricensis does not provide physiological conditions for egg laying

Fifteen pairs (male/female) of Angiostrongylus costaricensis were kept in vitro in Waymouth medium for three days to evaluate the amount and duration of egg laying. At 24, 48 and 72 hours, the mean egg counts were 321, 24 and 4 eggs/10 microliters, respectively. Most of the eggs were eliminated within the first 24 hours, suggesting they are expelled under non-physiological conditions. These results indicate that in vitro conditions are not appropriate for drug trials of egg-laying inhibitors for treatment of abdominal angiostrongylosis.

Basic sanitation, socioeconomic conditions, and degree of risk for the presence and maintenance of malaria in a low-transmission area in the Brazilian Amazon

ABSTRACTINTRODUCTION:This study aimed to evaluate basic sanitation and socioeconomic indicators, reported cases of malaria, and risk of contracting malaria in the Ananindeua municipality, State of Pará.METHODS:Data on basic sanitation and socioeconomic dimensions were taken from the Brazilian Institute of Geography and Statistics [ Instituto Brasileiro de Geografia e Estatística (IBGE)] 2010 census. Epidemiological malaria information was taken from the Epidemiological Malaria Surveillance Information System [ Sistema de Informação de Vigilância Epidemiológica de Malária (SIVEP/Malaria)], between 2003 and 2013 of the Ministry of Health and from the SIVEP/Malaria forms of the municipality's Endemic Diseases Unit for 2,013 cases.RESULTS:Our data do not confirm the correlation among indicators of basic sanitation, socioeconomic conditions, and water supply with malaria cases. Of the 1,557 cases evaluated, most were caused by Plasmodium vivax , with rare cases of Plasmodium falciparum and mixed infections. There were 756 notifications in 2003. The number of reported cases was sharply reduced between 2006 and 2012, but a 142-case outbreak occurred in 2013. Ananindeua municipality's Annual Parasite Index indicated low risk in 2003 and no risk in other years, and the 2,013 cases were predominantly male individuals aged ≥40 years.CONCLUSIONS:Our data confirm the non-endemicity of malaria in the Ananindeua municipality, as the Annual Parasite Indices described for the years 2004-2013 classify it as a risk-free area. However, the 2013 outbreak indicates the need to strengthen prevention, surveillance, and control activities to reduce the risk of new outbreaks and consequent economic and social impacts on the population.

Development of autonomous maintenance in a furniture company

This article presents a work performed in the maintenance department of a furniture company in Portugal, in order to develop and implement autonomous maintenance. The main objective of the project was related to the objective to increase and make effective the autonomous maintenance tasks performed by production operators, and in this way avoiding unplanned downtime due to equipment failures. Although some autonomous maintenance tasks were already carried out within the company, a preliminary study revealed weaknesses in the application of this tool. In the initial phase of this pilot project, the main problems encountered at the level of autonomous maintenance were related to the lack of time to carry out these tasks, showing that the stipulated procedures were far from the real needs of the company. To solve these problems a pilot project was conducted, making several changes in the performance of autonomous maintenance tasks, making them standard and adapted to reality of each production line. There was a general improvement in the factory indicators, and essentially there was a behavioral change, since the operators felt that their opinions were taking into account and began to understand the importance of small tasks performed by them.

Fuzzy maintenance costs of a wind turbine pitch control device

This paper deals with the problem of estimation maintenance costs for the case of the pitch controls system of wind farms turbines. Previous investigations have estimated these costs as (traditional) “crisp” values, simply ignoring the uncertainty nature of data and information available. This paper purposes an extended version of the estimation model by making use of the Fuzzy Set Theory. The results alert decision-makers to consequent uncertainty of the estimations along with their overall level, thus improving the information given to the mainte-nance support system.

maintenance model for systems with phase-type distributed times to failure

Magdeburg, Univ., Fak. für Mathematik, Diss., 2010

Assessing the role of Piccolo and Bassoon zinc finger domains on synapse vesicle recycling and maintenance

Magdeburg, Univ., Fak. für Naturwiss., Diss., 2013

Maintenance of rattlesnakes in captivity / by James B. Murphy and Barry L. Armstrong.

no.3 (1978)

Comprehensive Expression Analyses of Neural Cell-Type-Specific miRNAs Identify New Determinants of the Specification and Maintenance of Neuronal Phenotypes.

MicroRNAs (miRNAs) have been shown to play important roles in both brain development and the regulation of adult neural cell functions. However, a systematic analysis of brain miRNA functions has been hindered by a lack of comprehensive information regarding the distribution of miRNAs in neuronal versus glial cells. To address this issue, we performed microarray analyses of miRNA expression in the four principal cell types of the CNS (neurons, astrocytes, oligodendrocytes, and microglia) using primary cultures from postnatal d 1 rat cortex. These analyses revealed that neural miRNA expression is highly cell-type specific, with 116 of the 351 miRNAs examined being differentially expressed fivefold or more across the four cell types. We also demonstrate that individual neuron-enriched or neuron-diminished RNAs had a significant impact on the specification of neuronal phenotype: overexpression of the neuron-enriched miRNAs miR-376a and miR-434 increased the differentiation of neural stem cells into neurons, whereas the opposite effect was observed for the glia-enriched miRNAs miR-223, miR-146a, miR-19, and miR-32. In addition, glia-enriched miRNAs were shown to inhibit aberrant glial expression of neuronal proteins and phenotypes, as exemplified by miR-146a, which inhibited neuroligin 1-dependent synaptogenesis. This study identifies new nervous system functions of specific miRNAs, reveals the global extent to which the brain may use differential miRNA expression to regulate neural cell-type-specific phenotypes, and provides an important data resource that defines the compartmentalization of brain miRNAs across different cell types.

Associations of short-term particle and noise exposures with markers of cardiovascular and respiratory health among highway maintenance workers

BACKGROUND: Highway maintenance workers are constantly and simultaneously exposed to traffic-related particle and noise emissions, and both have been linked to increased cardiovascular morbidity and mortality in population-based epidemiology studies. OBJECTIVES: We aimed to investigate short-term health effects related to particle and noise exposure. METHODS: We monitored 18 maintenance workers, during as many as five 24-hour periods from a total of 50 observation days. We measured their exposure to fine particulate matter (PM2.5), ultrafine particles, noise, and the cardiopulmonary health endpoints: blood pressure, pro-inflammatory and pro-thrombotic markers in the blood, lung function and fractional exhaled nitric oxide (FeNO) measured approximately 15 hours post-work. Heart rate variability was assessed during a sleep period approximately 10 hours post-work. RESULTS: PM2.5 exposure was significantly associated with C-reactive protein and serum amyloid A, and negatively associated with tumor necrosis factor α. None of the particle metrics were significantly associated with von Willebrand factor or tissue factor expression. PM2.5 and work noise were associated with markers of increased heart rate variability, and with increased HF and LF power. Systolic and diastolic blood pressure on the following morning were significantly associated with noise exposure after work, and non-significantly associated with PM2.5. We observed no significant associations between any of the exposures and lung function or FeNO. CONCLUSIONS: Our findings suggest that exposure to particles and noise during highway maintenance work might pose a cardiovascular health risk. Actions to reduce these exposures could lead to better health for this population of workers.