Refluxo Vesicoureteral primário na infância: tratamento conservador versus intervenção cirúrgica

Introdução: A associação entre refluxo vesicoureteral primário e infecções do trato urinário pode acarretar em dano renal permanente. Há, na literatura, a tendência de cura espontânea deste refluxo em crianças e marcante declínio na indicação do tratamento cirúrgico. Objetivo: Estudar a evolução dos refluxos vesicoureterais primários associados a quadros de infecções urinárias de repetição, em pacientes do serviço de Nefrologia Pediátrica da nossa instituição, avaliando os casos nos quais houve cura mediante tratamento conservador apenas, e aqueles nos quais foi necessária a intervenção cirúrgica. Métodos: Analisamos os prontuários dos pacientes com infecções urinárias de repetição associadas ao diagnóstico de refluxo vesicoureteral primário. Os dados coletados diziam respeito aos parâmetros: sexo, idade do diagnóstico da primeira infecção urinária, idade do diagnóstico de RVU, número de infecções urinárias, grau de refluxo, resultado da urocultura, função renal, cicatrizes renais, outras malformações do trato urinário e intervenção cirúrgica ou conservadora. A Análise estatística foi descritiva e realizada com o programa SPSS. Resultados: Dentro do subgrupo de pacientes com graus IV e V, notou-se 63,6% dos casos evoluindo para intervenção cirúrgica e 36,4%, para resolução por intervenção conservadora. Naqueles com graus I, II e III, 38,5% evoluíram para tratamento cirúrgico, contra 61,5%, para resolução por conduta conservadora. Dentre os pacientes com presença de refluxo vesicoureteral bilateralmente,72,7% tiveram evolução cirúrgica. Não se observou relação entre o grau de refluxo e a presença de cicatrizes renais. Conclusão: Pacientes com refluxo vesicoureteral de baixo grau e infecções urinárias de repetição tendem à resolução espontânea do refluxo, com boa evolução renal a longo prazo, de forma que a indicação cirúrgica fica reservada aos refluxos de alto grau ou com outras complicações clínicas.

Influência do tamanho na germinação e no vigor de sementes de milheto (Pennisetum americanum (L.) Leeke)

O milheto é uma gramínea anual de sementes pequenas, com grande diversidade de tamanho, e com dificuldade, às vezes, do estabelecimento da população adequada de plantas. Este experimento objetivou verificar a influência do tamanho da semente de milheto sobre sua germinação e vigor. Foram utilizados quatro lotes de sementes (I, II, III e IV), classificados em quatro tamanhos, através de peneiras de malha quadrada, sendo: peneira 1 ≥ 2,00mm, peneira 2: 1,68 a 2,00mm, peneira 3: 1,41 a 1,68mm, peneira 4: 0,71 a 1,41mm e mais uma porção do lote original (testemunha), que constituíram os tamanhos. Foram realizados os testes de: peso de 1000 sementes, germinação inicial e após seis meses de armazenamento (TGI e TGII, respectivamente) e vigor (primeira contagem do teste de germinação e condutividade elétrica das sementes). Utilizou-se o delineamento experimental inteiramente casualizado, com quatro repetições por tratamento. As sementes de peneira 4 apresentaram menores pesos de 1000 sementes para todos os lotes, menores valores de germinação para o TGI, em todos os lotes, e para o TGII nos lotes II e IV. Para o vigor (primeira contagem do teste de germinação) observou-se menor valor para peneira 4, nos lotes I, II e IV; enquanto para a condutividade, a peneira 4 apresentou maior valor para todos os lotes, indicando pior qualidade fisiológica dessas sementes. Concluiu-se que a germinação e o vigor das sementes de milheto são influenciados pelo seu tamanho; sementes maiores são de melhor qualidade do que as menores.

Survey, survival and control of Alternaria alternata in wheat seeds

The fungus Alternaria alternata was quantified in 75 wheat seed samples collected from three different regions of southern Brazil for Cropping and Use Value (CUV) I, II and III. Fungal presence was evaluated in two hundred disinfested seeds per sample before sowing in a potato-dextrose-agar medium + antibiotic (PDA+A). Fungus survival was evaluated every 45 days for 180 days for three seed batches from six wheat cultivars stored in propylene bags in a storehouse, with air temperature varying between 18 to 22 °C and relative air humidity around 60%. The efficacy of carboxin+thiram, difenoconazol, thiram, triadimenol, triticonazol and triticonazol + iprodione fungicides to control A. alternata was determined. A. alternata was detected in all the samples with an incidences of 39.6 %, 38.8% and 35.9% for the CUV I, CUV II and CUV III regions, respectively. The highest mean incidence of the fungus was found in the CUV I region, the coolest and most humid, and was significantly different from the other two regions. The average reduction in A. alternata viability in the wheat cultivar seeds was 49.5% during the 180 days of storage (inter-harvest period), demonstrating that infected seeds are the primary inoculum source for the fungus. The triticonazol + iprodione fungicide mixture efficiently controls A. alternata.

Leveiden keskimerkintöjen liikenneturvallisuusvaikutusten arviointi

Tämän raportin tavoitteena oli käsitellä leveiden keskimerkintöjen liikenneturvallisuusvaikutuksia, toteuttaa mielipidekysely kantatie 54 kokeiluosuuden vaikutusalueella sekä esitellä aiemmin tehdyt tutkimukset ja leveiden keskimerkintöjen taustaa. Raportin on laatinut Eino Lahtinen Hämeen ammattikorkeakoulusta opinnäytetyönään. Työn taustateoriaksi syvennyttiin leveiden keskimerkintöjen historiaan Suomessa ja ulkomailla sekä Suomessa tehtyihin tutkimuksiin aiheesta. Suomessa ja ulkomailla on havaittu jo vuosikymmenten ajan korkealuokkaisten teiden liikenneturvallisuuden heikentyneen liikenteen lisääntyessä. Kohtaamis- ja ohitusonnettomuuksien jäljet ovat usein raakaa katseltavaa ja luettavaa. Huoli kohtaamis- ja ohitusonnettomuuksien määristä ja niiden vakavuuksista painostaa etsimään ratkaisuja tämän kaltaisten onnettomuuksien vähentämiseksi. Tästä syystä on 1980-luvulta lähtien aktiivisesti etsitty liikenneturvallisuutta parantavia kustannustehokkaita ratkaisuja. Visuaalisia vaikutuksia arvioidessa havaittiin jo varhain kaistan leveyden visuaalisen kaventamisen johtavan ajonopeuksien laskuun, joka vähentää onnettomuuksia ja niiden vakavuuksia. Yhdeksi ratkaisuksi esitettiin leveää keskimerkintää, josta on ollut erilaisia kokeiluja ulkomailla 1996 ja Suomessa 2009 lähtien. Työn tuloksena voidaan esittää, että leveiden keskimerkintöjen vaikutukset ajokäyttäytymiseen ovat melko vähäiset, sillä lähes puolet kyselyyn vastanneista ei havainnut muutosta omassa tai muiden ajokäyttäytymisessä. Työn perusteella arvioidaan, että leveät keskimerkinnät vähensivät henkilövahinkoon johtaneita ohitus-, kohtaamis- ja vasemmalle suistumisonnettomuuksia 17 – 21 %. Tutkimuksen perusteella voidaan todeta, että leveitä keskimerkintöjä käytettäessä on varmistuttava riittävästä piennarleveydestä (vähintään 1 m). Leveää keskimerkintää voidaan käyttää alueilla, jossa tien päällysteen leveys on vähintään 10 m, KVL vähintään 1500 ajon/vrk ja tiejakson pituus vähintään 10 km. Leveän keskialueen tulisi olla metrin levyinen.

Promoting Healthy Lifestyles with Personalized, APOE Genotype Based Health Information: The Effects on Psychological-, Health Behavioral and Clinical Factors

There is an increasing demand for individualized, genotype-based health advice. The general population-based dietary recommendations do not always motivate people to change their life-style, and partly following this, cardiovascular diseases (CVD) are a major cause of death in worldwide. Using genotype-based nutrition and health information (e.g. nutrigenetics) in health education is a relatively new approach, although genetic variation is known to cause individual differences in response to dietary factors. Response to changes in dietary fat quality varies, for example, among different APOE genotypes. Research in this field is challenging, because several non-modifiable (genetic, age, sex) and modifiable (e.g. lifestyle, dietary, physical activity) factors together and with interaction affect the risk of life-style related diseases (e.g. CVD). The other challenge is the psychological factors (e.g. anxiety, threat, stress, motivation, attitude), which also have an effect on health behavior. The genotype-based information is always a very sensitive topic, because it can also cause some negative consequences and feelings (e.g. depression, increased anxiety). The aim of this series of studies was firstly to study how individual, genotype-based health information affects an individual’s health form three aspects, and secondly whether this could be one method in the future to prevent lifestyle-related diseases, such as CVD. The first study concentrated on the psychological effects; the focus of the second study was on health behavior effects, and the third study concentrated on clinical effects. In the fourth study of this series, the focus was on all these three aspects and their associations with each other. The genetic risk and health information was the APOE gene and its effects on CVD. To study the effect of APOE genotype-based health information in prevention of CVD, a total of 151 volunteers attended the baseline assessments (T0), of which 122 healthy adults (aged 20 – 67 y) passed the inclusion criteria and started the one-year intervention. The participants (n = 122) were randomized into a control group (n = 61) and an intervention group (n = 61). There were 21 participants in the intervention Ɛ4+ group (including APOE genotypes 3/4 and 4/4) and 40 participants in the intervention Ɛ4- group (including APOE genotypes 2/3 and 3/3). The control group included 61 participants (including APOE genotypes 3/4, 4/4, 2/3, 3/3 and 2/2). The baseline (T0) and follow-up assessments (T1, T2, T3) included detailed measurements of psychological (threat and anxiety experience, stage of change), and behavioral (dietary fat quality, consumption of vegetables, - high fat/sugar foods and –alcohol, physical activity and health and taste attitudes) and clinical factors (total-, LDL- HDL cholesterol, triglycerides, blood pressure, blood glucose (0h and 2h), body mass index, waist circumference and body fat percentage). During the intervention six different communication sessions (lectures on healthy lifestyle and nutrigenomics, health messages by mail, and personal discussion with the doctor) were arranged. The intervention groups (Ɛ4+ and Ɛ4-) received their APOE genotype information and health message at the beginning of the intervention. The control group received their APOE genotype information after the intervention. For the analyses in this dissertation, the results for 106/107 participants were analyzed. In the intervention, there were 16 participants in the high-risk (Ɛ4+) group and 35 in the low-risk (Ɛ4-) group. The control group had 55 participants in studies III-IV and 56 participants in studies I-II. The intervention had both short-term (≤ 6 months) and long-term (12 months) effects on health behavior and clinical factors. The short-term effects were found in dietary fat quality and waist circumference. Dietary fat quality improved more in the Ɛ4+ group than the Ɛ4- and the control groups as the personal, genotype-based health information and waist circumference lowered more in the Ɛ4+ group compared with the control group. Both these changes differed significantly between the Ɛ4+ and control groups (p<0.05). A long-term effect was found in triglyceride values (p<0.05), which lowered more in Ɛ4+ compared with the control group during the intervention. Short-term effects were also found in the threat experience, which increased mostly in the Ɛ4+ group after the genetic feedback (p<0.05), but it decreased after 12 months, although remaining at a higher level compared to the baseline (T0). In addition, Study IV found that changes in the psychological factors (anxiety and threat experience, motivation), health and taste attitudes, and health behaviors (dietary, alcohol consumption, and physical activity) did not directly explain the changes in triglyceride values and waist circumference. However, change caused by a threat experience may have affected the change in triglycerides through total- and HDL cholesterol. In conclusion, this dissertation study has given some indications that individual, genotypebased health information could be one potential option in the future to prevent lifestyle-related diseases in public health care. The results of this study imply that personal genetic information, based on APOE, may have positive effects on dietary fat quality and some cardiovascular risk markers (e.g., improvement in triglyceride values and waist circumference). This study also suggests that psychological factors (e.g. anxiety and threat experience) may not be an obstacle for healthy people to use genotype-based health information to promote healthy lifestyles. However, even in the case of very personal health information, in order to achieve a permanent health behavior change, it is important to include attitudes and other psychological factors (e.g. motivation), as well as intensive repetition and a longer intervention duration. This research will serve as a basis for future studies and its information can be used to develop targeted interventions, including health information based on genotyping that would aim at preventing lifestyle diseases. People’s interest in personalized health advices has increased, while also the costs of genetic screening have decreased. Therefore, generally speaking, it can be assumed that genetic screening as a part of the prevention of lifestyle-related diseases may become more common in the future. In consequence, more research is required about how to make genetic screening a practical tool in public health care, and how to efficiently achieve long-term changes.

Biblia sacra, pars.

BIBLIA SACRA

Biblia sacra, pars III.

Avec prologues et « capitula ». Job (2) ; Tobias (20) ; Judith (27v) ; Esther (37) ; Macchab. I-II (46v) ; Ezechiel (84v) ; XII Proph. min. (122) ; Isaias (151v). — Epist. Pauli, depuis Rom. I, 1, jusqu'à Philipp. 21, et depuis Hebr. II, 18, jusqu'à la fin, avec Epist. ad Laodicenses (184v).

Vetus Testamentum (fin). Novum Testamentum

Ce volume a été relié avec le ms. Latin 50 pour former une bible complète (cf. Berger, Hist. de la Vulg., 401), mais il semble que ces deux manuscrits ont été réalisés séparément, à une date et par un atelier différent. (F. Avril, Dix siècles d'enluminure italienne, notice 11). Avec prologues, arguments et « capitula ». Psalmi (1) ; Proverbia (13v) ; Ecclesiastes (20) ; Cant. canticorum (22v) ; Sapientia (24) ; Ecclesiasticus (29v) ; Oratio Salomonis (42v) ; Paralip. I-II (43) ; Job (62) ; Tobias (69) ; Judith (72) ; Esther (76) ; Esdras I-II (80) ; Macchab. I-II (87v). — Evangeliorum canones (103) ; Evang. Matthaei (106), Marci (112v), Lucae (117v), Johannis (125) ; Actus Apost. (131v) ; VII Epist. canon. (142), Apocalypsis (147v) ; Concordia Epist. Pauli (153) ; XIV Epist. Pauli (154) ; Epist. ad Laodicenses (addit. du XIIe s.) (176). — Quelques leçons indiquées en marge.

Vetus Testamentum, pars III.

Avec prologues et « capitula ». Judith (1) ; Esther (17) ; Macchab. I-II (32v) ; Esdras I-II, et addit. marg., IV, VIII, 20-36 (96v) ; Baruch (124). F. I et II Fragments de Bible et de Graduel noté (notation catalane) (XIIe s.), avec note en catalan (XVIe s.).

Biblia sacra.

Avec prologues et arguments. Genesis (7v), etc. — Oratio Manasse (167) ; Esdras I-III (167v), etc. — Macchab. I-II, avec prologues de RABAN MAUR (353v, 354). — Evang. Matthaei (377), etc. — XIV Epist. Pauli (421v) ; Actus Apost. (448v) ; VII Epist. canon. (462) ; Apocalypsis (467v). — Interpretationes nominum hebraicorum : « Aaz, apprehendens... — ... consiliatores eorum. » (473v). — « Ordo librorum presentis voluminis. » (513v).

Biblia sacra.

Avec prologues et arguments. Genesis (6), etc. — Oratio Manasse (170v) ; Esdras I-III (171v), etc. — Macchab. I-II, avec prologues de RABAN MAUR (360v). — Evang. Matthaei (382v), etc. — XIV Epist. Pauli (426) ; Actus Apost. (452v) etc. — Interpretationes nominum hebraicorum : « Aaz, apprehendens... — ... consiliatores eorum. » (477) ; « Abba, pater, Marci XIIII... — ... zizaniam. » (519). F. 1 et 2 Listes des livres de la Bible (XIIIe s.). F. 526 Liste des chefs d'Israël, de Moïse à Salomon, avec renvois à la Bible.

Biblia Ludovici XI regis Franciae.

Avec quelques prologues, arguments et « capitula ». Genesis, sans prologue (2), etc. — Reg. I-IV (82) ; Isaias (125v) ; Jeremias (140v) ; Jeremiae Lament. et Oratio (157v, 159v) ; Ezechiel (160) ; Daniel, I, 1-XIV, 41 (175v) ; XII Proph. min. (181) ; Job (193v), etc. — Ecclesiasticus (239v) ; Oratio Salomonis (252v) ; Paralip. I-II (253v) ; Oratio Manasse (273) ; Esdras I-II (273v) ; Esther (282) ; Tobias (286) ; Judith (289) ; Macchab. I-II (293v). — Evang. Matthaei (311v), Marci (321v), Lucae (328v-329, 338-343v, 336-337, 330), Johannis (331-335v, 344-346) ; Actus Apost. (347) ; VII Epist. canon. (358) ; Apocalypsis (364v) ; XIV Epist. Pauli (370v).

Biblia sacra.

Avec prologues et arguments. Genesis (3v), etc. — Oratio Manasse (158v) ; Esdras I-III (159), etc. — Macchab. I-II, avec prologues de RABAN MAUR (320). — Evang. Matthaei (340v), etc. — XIV Epist. Pauli (381v) ; Actus Apost. (406v), etc. — Interpretationes nominum hebraicorum : « Aaz, apprehendens... — ... consiliatores eorum. » (432). — « Liber ystorialis et florum totius Novi et Antiqui Testamenti. In Genesi sunt L capitula. In primo... — ... In XXVIII (Act. Apost.)... quidam crediderunt et quidam non. » (474). F. 430v et 431 En marge, recettes de médecine (XIVe-XVe s.). F. 431v Table des livres de la Bible (XIVe s.).

Biblia sacra.

Avec prologues et arguments. Genesis (4v), etc. — Oratio Manasse (198v) ; Esdras I-III (199), etc. — Macchab.I-II, avec prologues de RABAN MAUR (418), — Evang. Matthaei (443), etc. — XIV Epist. Pauli (492) ; Actus Apost. (522), etc. — Interpretationes nominum hebraicorum : « Aaz, apprehendens... — consiliatores eorum. » (550). F. 603v Vers mnémotechniques sur les livres de la Bible : « Primus adest Genesis... » (XVIe s.). F. 604 Table des livres de la Bible (XIVe-XVe s.).

Biblia sacra. III

Proverbia (1v), etc. — Macchab. I-II, avec prologues de RABAN MAUR (258v).