835 resultados para transcatheter aortic valve replacement
Resumo:
The dual path of insertion concept for removable partial denture (RPD) design may be used in esthetically demanding situations. When compared to conventional RPDs, the main advantage of this design is the minimal use of clasps. This clinical report describes the treatment of a patient with an anterior maxillary edentulous area using a dual path RPD. The diagnostic cast was surveyed to ensure the adequacy of the undercuts on the mesial surfaces of the anterior abutments, where rigid minor connectors were placed. Inverted V-shaped canine cingulum rest seats were prepared to provide resistance to tooth movement during function. The dual path RPD concept allows excellent esthetic results, minimizes tooth preparation, and reduces the tendency toward plaque accumulation in a Kennedy class IV partially edentulous arch. © 2008 by The American College of Prosthodontists.
Resumo:
Triplicate groups of juvenile suribim were fed for 183 days one of four different isonitrogenous (47.6% crude protein) and isolipidic (18.7% lipid) diets formulated using three different lipid sources: 100% fish oil (FO, diet 1); 100% pig lard (L, diet 2); 100% soybean oil (SO, diet 3), and FO/L/SO (1:1:1, w/w/w; diet 4). The tissue levels of fatty acids 18:2n - 6 and 18:3n - 3 decreased relative to corresponding dietary fatty acid values. The 20:5n - 3 and 22:6n - 3 composition of muscle and liver neutral lipids were linearly correlated with corresponding dietary fatty acid composition. In contrast, the 22:6n - 3 composition of the brain and eye were similar among treatments. The 22:6n - 3 level was enriched in all tissues, particularly in the neural tissues. Similar results were observed for tissue polar lipids: fatty acids content reflected dietary composition, with the exception of the 22:6n - 3 level, which showed enrichment and no differences between groups. Given these results, the importance of the biochemical functions (transport and/or metabolism) of 22:6n - 3 in the development of the neural system of surubim warrants further investigation. © Springer Science+Business Media B.V. 2008.
Resumo:
Open surgical repair of complex abdominal aortic aneurysms requires more extensive dissection and aortic clamping above the renal or mesenteric arteries. Although results of open surgical series have shown variation, morbidity and mortality is higher compared with infrarenal aortic aneurysm repair. Potential complications include renal insufficiency, mesenteric ischemia, multisystem organ failure, and death. Although endovascular treatment with fenestrated and branched endografts might potentially decrease the risk of complications and mortality, its role is not yet defined and the technology is not widely available. Issues related to durability of the procedure and secondary interventions might limit its application to patients with higher risk or those with hostile anatomy. This article summarizes the clinical results of open surgical repair of pararenal abdominal aortic aneurysms to provide a benchmark for comparison with results of endovascular treatment, using fenestrated and branched techniques. © Annals of Vascular Surgery Inc.
Resumo:
Myxomatous mitral valve degeneration (MMVD) or endocardiosis is a heart valve disease that occurs in many mammalian species, especially in humans, dogs and pigs. Nitric oxide (NO) plays an important role in the MMVD development. NO can be indirectly evaluated by the nitric-oxide synthase (NOS) expression and by the histochemical reaction of nicotinamide adenine dinucleotide phosphate-diaphorase (NADPH-d). The aim of this study was to evaluate NOS activity, by NADPH-d reaction, in the anterior leaflet of dogs with regular mitral valves and in those with MMVD, as well as in young swine and old females, comparing the reaction level with the degree of endocardiosis disease and also the histological alterations. Twelve mitral valves of dogs and 22 of swine were used for the research. All the valves were macroscopically analyzed for the occurrence or not of endocardiosis. They were fixed in a 4% paraformaldehyde, exposed to NADPH-d reaction, routinely processed and microscopically evaluated for the detection of mucopolysaccharides (MPS) deposition, collagen degeneration, fibrosis and level of endocardiosis. In dogs, relation was observed between higher intensity of the NADPH-d reaction, higher endocardiosis degree, MPS deposition as well as the collagen degeneration. No alteration in color was observed in pigs ́ valves during NADPH-d reaction. In conclusion, NO works in canine mitral valve remodeling extracellular matrix and plays an important role in endocardiosis disease. In swine, the lack of reaction reinforces the absence of macroscopical endocardiosis lesions, suggesting restrict NO action or major differences in the structures of swine valves.
Resumo:
Anderson-Fabry disease is an X-linked defect of glycosphingolipid metabolism. Progressive renal insufficiency is a major source of morbidity, additional complications result from cardio- and cerebro-vascular involvement. Survival is reduced among affected males and symptomatic female carriers. To evaluate the effectiveness and safety of enzyme replacement therapy compared to other interventions, placebo or no interventions, for treating Anderson-Fabry disease. We searched 'Clinical Trials' on The Cochrane Library, MEDLINE, EMBASE, LILACS and the Cystic Fibrosis and Genetic Disorders Group's Inborn Errors of Metabolism Trials Register (date of the most recent search: 11 September 2012). The original search was performed in September 2008.Date of the most recent search of the Cystic Fibrosis and Genetic Disorders Group's Inborn Errors of Metabolism Trials Register: 11 September 2012. Randomized controlled trials of agalsidase alfa or beta in participants diagnosed with Anderson-Fabry disease. Two authors selected relevant trials, assessed methodological quality and extracted data. Six trials comparing either agalsidase alfa or beta in 223 participants fulfilled the selection criteria.Both trials comparing agalsidase alfa to placebo reported on globotriaosylceramide concentration in plasma and tissue; aggregate results were non-significant. One trial reported pain scores, there was a statistically significant improvement for participants receiving treatment at up to three months, mean difference -2.10 (95% confidence interval (CI) -3.79 to -0.41); at up to five months, mean difference -1.90 (95% CI -3.65 to -0.15); and at up to six months, mean difference -2.00 (95% CI -3.66 to -0.34). There was a significant difference in pain-related quality of life at over five months and up to six months, mean difference -2.10 (95% CI -3.92 to -0.28) but not at other time-points. Neither trial reported deaths.One of the three trials comparing agalsidase beta to placebo reported on globotriaosylceramide concentration in plasma and tissue and showed significant improvement: kidney, mean difference -1.70 (95% CI -2.09 to -1.31); heart, mean difference -0.90 (95% CI -1.18 to -0.62); and composite results (renal, cardiac, and cerebrovascular complications and death), mean difference -4.80 (95% CI -5.45 to -4.15). There was no significant difference between groups for death; no trials reported on pain.Only one trial compared agalsidase alfa to agalsidase beta. There was no significant difference between the groups for any adverse events, risk ratio 0.36 (95% CI 0.08 to 1.59), or any serious adverse events; risk ratio 0.30; 95% CI 0.03 to 2.57). Six small, poor quality randomised controlled trials provide no robust evidence for use of either agalsidase alfa and beta to treat Anderson-Fabry disease.
Resumo:
This experiment compared growth, body composition, plasma IGF-I and leptin, and reproductive development of beef heifers receiving or not recombinant bovine ST (BST) beginning after weaning until the first breeding season. Fifty Angus × Hereford heifers (initial BW = 219 ± 2 kg; initial age = 208 ± 2 d), weaned at approximately 6 mo of age, were assigned to the experiment (d 0 to 210). On d 0, heifers were ranked by initial BW and age and assigned to 1) treatment with BST or 2) saline control. Heifers assigned to the BST treatment received subcutaneous (s.c.) injections containing 250 mg of sometribove zinc whereas control heifers received a 5-mL s.c. injection of 0.9% saline every 14 d. Treatments were initiated on d 14 and last administered on d 196. Heifers were maintained on separate pastures harvested for hay the previous summer according to treatment and received grass and alfalfa hay at a rate to provide a daily amount of 7.0 and 1.0 kg of DM per heifer, respectively. Heifer shrunk BW was collected on d 1 and 211 for heifer ADG calculation. Blood samples were collected weekly from d 0 to 210 for determination of plasma progesterone to estimate puberty attainment as well as plasma concentrations of IGF-I and leptin in selected samples. On d 0, 63, 133, and 189, heifers were evaluated for intramuscular marbling, LM depth, and backfat thickness via real-time ultrasonography. No treatment effects were detected (P = 0.27) for heifer ADG (0.49 vs. 0.51 kg/d for control and BST heifers, respectively; SEM = 0.02). Mean backfat thickness was lesser (P < 0.01) in BST heifers compared with control cohorts (3.56 vs. 3.92 mm, respectively; SEM = 0.08). Heifers receiving BST had greater plasma IGF-I concentrations compared with control cohorts 7 d after treatment administration (treatment × day interaction; P < 0.01). Mean plasma leptin concentrations were lesser (P = 0.05) in BST heifers compared with control cohorts (1.82 vs. 2.03 ng/mL, respectively; SEM = 0.07). Onset of puberty was hastened in BST heifers compared with control cohorts (treatment x day interaction; P = 0.04). In summary, a greater proportion of BST heifers reached puberty during the experiment compared with control cohorts, despite lesser plasma leptin concentrations, backfat thickness, and similar ADG. Hence, circulating IGF-I was positively associated with hastened puberty attainment independently of growth rate, circulating leptin concentrations, and body fat content of replacement beef heifers. © 2013 American Society of Animal Science. All rights reserved.
Resumo:
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Resumo:
The gerbil is a rodent considered a good model for studies of prostatic morphophysiology under different experimental conditions. Studies involving castration and steroidal blockers of aged gerbils showed that the glandular epithelium persists after long-term therapy, preventing the organ atrophy. Thus, the objective of this study was to evaluate the phenotypic characteristics and behavior of prostatic epithelial cells that remained after different periods of hormone ablation in aged gerbils. The identification of elements that influenced the survival of this cell type was performed by morphometric, nuclear phenotypes, ultrastructural and immune histochemical analysis. The most significant responses to treatment, by analyzing morphometric features, were observed during the first three time points (day 1, day 3, and day 7), after which there appeared to be an adjustment of the gland to the hormone ablation. All treatments led to changes in the state of chromatin condensation, DNA methylation pattern and phenotypic changes indicated cell senescence. Additionally, an increase in the basal cells seemed to guarantee self-renewal properties to the epithelium. These data indicate that changes occur at many levels, including gene expression and nuclear architecture in the epithelial cells, when aging and steroidal blockade are associated. These aspects are important when considering castration-resistant prostate cancer, a malignant tumor posing difficult therapeutic intervention. © 2013 Elsevier GmbH. All rights reserved.
Resumo:
This paper proposes a straightforward compromising method to determine the output power of all committed units during the scheduling time horizon. Unlike the conventional methods that work based on a constant pollution control cost (CPCC), this method works based on the system topology such as demand, minimum cost and minimum output emission of the system. In order to have a meaningful compromise between costs and emission in economic and emission dispatch (EED) problem, a flexible pollution control cost (FPCC) is proposed. Also a dynamic economic emission dispatch (DEED) approach is considered where the ramping constraints couple the scheduling hours; the inclusion of valve-point effect makes the DEED modeling more practical. The validity and effectiveness of the unproblematic FPCC approach is verified through an IEEE 30-bus test system with 6 unit for the 6-hour scheduling horizon. © 2013 IEEE.
Resumo:
Pós-graduação em Engenharia Mecânica - FEG
Resumo:
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Resumo:
Mucopolysaccharidosis type I (MPS I) is a rare lysosomal disorder caused by deficiency of alpha-L-iduronidase. Few clinical trials have assessed the effect of enzyme replacement therapy (ERT) for this condition. We conducted an exploratory, open-label, non-randomized, multicenter cohort study of patients with MPS I. Data were collected from questionnaires completed by attending physicians at the time of diagnosis (T1; n = 34) and at a median time of 2.5 years later (T2; n = 24/34). The 24 patients for whom data were available at T2 were allocated into groups: A, no ERT (9 patients; median age at T1 = 36 months; 6 with severe phenotype); B, on ERT (15 patients; median age at T1 = 33 months; 4 with severe phenotype). For all variables in which there was no between-group difference at baseline, a delta of ≥ ± 20% was considered clinically relevant. The following clinically relevant differences were identified in group B in T2: lower rates of mortality and reported hospitalization for respiratory infection; lower frequency of hepatosplenomegaly; increased reported rates of obstructive sleep apnea syndrome and hearing loss; and stabilization of gibbus deformity. These changes could be due to the effect of ERT or of other therapies which have also been found more frequently in group B. Our findings suggest MPS I patients on ERT also receive a better overall care. ERT may have a positive effect on respiratory morbidity and overall mortality in patients with MPS I. Additional studies focusing on these outcomes and on other therapies should be performed.
Resumo:
Mucopolysaccharidoses (MPS) are rare lysosomal disorders caused by the deficiency of specific lysosomal enzymes responsible for glycosaminoglycan (GAG) degradation. Enzyme Replacement Therapy (ERT) has been shown to reduce accumulation and urinary excretion of GAG, and to improve some of the patients' clinical signs. We studied biochemical and molecular characteristics of nine MPS patients (two MPS I, four MPS II and three MPS VI) undergoing ERT in northern Brazil. The responsiveness of ERT was evaluated through urinary GAG excretion measurements. Patients were screened for eight common MPS mutations, using PCR, restriction enzyme tests and direct sequencing. Two MPS I patients had the previously reported mutation p.P533R. In the MPS II patients, mutation analysis identified the mutation p.R468W, and in the MPS VI patients, polymorphisms p.V358M and p.V376M were also found. After 48 weeks of ERT, biochemical analysis showed a significantly decreased total urinary GAG excretion in patients with MPS I (p < 0.01) and MPS VI (p < 0.01). Our findings demonstrate the effect of ERT on urinary GAG excretion and suggest the adoption of a screening strategy for genotyping MPS patients living far from the main reference centers.