Validation of a new reference values’s database for semiquantification of 123I‐FP‐CIT SPECT scans in one nuclear medicine department

The DatScanTM and its Semiquantification (SQ) can provide advantages in the diagnosis of Parkinsonian Syndromes (PS). To improve the SQ is recommended the creation of adapted database (DB) with reference values for the Nuclear Medicine Departments. Previously to this work was created a adapted database (DBRV) to Nuclear Medicine Department's protocol and population of Infanta Cristina's Hospital located in Badajoz, for patients between the ages of 60 and 75, and reference values of the SQ were calculated. Aim: To evaluate the discrimination capacity of a department's adapted DB reference's values of healthy controls for DatScanTM.

Clinical classification versus semiquantification with adapted reference values for 123I-FP-CIT SPECT in a nuclear medicine department

Semi quantification (SQ) in DaTScan® studies is broadly used in clinic daily basis, however there is a suspicious about its discriminative capability, and concordance with the diagnostic classification performed by the physician. Aim: Evaluate the discriminate capability of an adapted database and reference's values of healthy controls for the Dopamine Transporters (DAT) with 123I–FP-IT named DBRV adapted to Nuclear Medicine Department's protocol and population of Infanta Cristina's Hospital, and its concordance with the physician classification.

"Gestão Oficinal no Setor Automóvel” - Caso de estudo na AMC, Lda.

A indústria automóvel no que respeita à gestão oficinal de qualidade é uma referência de dimensão e nível mundial. O constante avanço da indústria automóvel, o ciclo de vida dos produtos (automóveis) cada vez mais curtos e a competitividade entre empresas, requer uma procura constante de novas ferramentas de melhoria na gestão oficinal. Neste trabalho, centrado na gestão oficinal no setor automóvel, procuram-se introduzir novas abordagens que visem combater o decréscimo da rentabilidade neste setor. Como se depreende do exposto anteriormente, o objetivo principal desta dissertação é propor e avaliar (validar) propostas de melhoria que visem o aumento da rentabilidade financeira da empresa AMC – Auto Mecânica de Cambra, Lda. Com vista à prossecução deste objetivo foram definidos os seguintes objetivos intercalares na AMC: - Análise e levantamento dos problemas; - Identificação de potenciais causas; - Formulação de ações de propostas de melhoria na gestão da empresa; - Programação das ações e avaliação de resultados alcançados; A estrutura definida nesta dissertação após a sua introdução no capítulo 1 centra-se no capítulo 2 na apresentação da empresa AMC, com a descrição dos problemas levantados atendendo às vertentes mais críticas. Seguidamente, no capítulo 3, com ferramentas de análise de problemas, serão encontradas as causas raiz destes problemas. Posteriormente no capítulo seguinte serão criados planos de ações para a resolução das causas. No capítulo 4 as ações serão implementadas e avaliadas para garantir a sua eficácia e eficiência. Por fim, no capítulo 5 são descritas as conclusões e os desenvolvimentos futuros enquadráveis com a melhoria contínua da AMC. Como conclusão, este trabalho, mostra que várias propostas de melhoria implementadas trouxeram ganhos efetivos para a empresa e que futuras propostas são potencialmente válidas num futuro próximo. Esta dissertação com ligação direta à AMC tem igualmente dados que podem ser extrapolados e adaptados a outras empresas do mesmo setor. O objetivo principal deste estudo é a análise e o levantamento dos problemas com a utilização de ferramentas tais como: Benchmarking, Diagrama causa-efeito, ciclo PDCA, análise de SWOT e indicadores operativos da oficina.

Calcareous nannofossil assemblages around the Pliensbachian/Toarcian boundary in the reference section of Peniche (Portugal)

The Pliensbachian/Toarcian boundary (Lower Jurassic) is well represented in the Lusitanian Basin (Portugal), mainly in the Peniche area, recorded by a marl/limestone series. Calcareous nannofossil assemblages are described herein, with the aim to contribute to the Toarcian GSSP definition. Marly samples were collected 3 m below and 7 m above this boundary and analysed for calcareous nannofossils. The main nannofossils observed were Biscutum finchii, B. grande, Calcivascularis jansae, Crepidolithus crassus, C. granulatus, C. impontus, Lotharingius hauffii, L. sigillatus, L. aff. L. velatus, Schizosphaerella spp. and Tubirhabdus patulus. This assemblage indicates that the Pliensbachian/Toarcian boundary in Peniche lies in the upper part of the NJ5b Subzone. Schizosphaerella and Lotharingius dominate the assemblage. The abundant occurrence of C. jansae and the common occurrence of B. grande indicate a strong Tethyan influence.

Drug resistance of M. Tuberculosis isolated from patients with HIV infection seen at an AIDS Reference Center in São Paulo, Brazil

M. tuberculosis-positive cultures were obtained from 228 patients seen in our service and drug sensitivity assays were carried out from January 1992 to December 1994. A survey of the medical records of these patients showed resistance to one or more drugs in 47 (20.6%), 25 of whom (10.9%), who reported previous treatment, were considered to have acquired resistance. Among the antecedents investigated, only previous treatment and alcoholism were the factors independently associated with the occurrence of resistance. The survival of patients with resistant strains was lower than that of patients attacked by non-resistant M. tuberculosis. We conclude that in the present series M. tuberculosis resistance to tuberculostatic agents was predominantly of the acquired type.

Using perspective schema and a reference model to design the ETL process

Dissertação apresentada para a obtenção do Grau de Doutor em Informática

Methodology for collaborative enterprise reference ontology building

Dissertation presented at Faculdade de Ciências e Tecnologia of Universidade Nova de Lisboa to obtain the Master degree in Electrical Engineering and Computer Science

Análise de Capacidade Processo Inspeção Visual

Este trabalho foi realizado no âmbito do Mestrado em Engenharia Mecânica, especialização em Gestão Industrial, do Instituto Superior de Engenharia do Porto. O estudo foi desenvolvido na Continental Mabor – Indústria de Pneus S.A., sendo analisado o processo de Inspeção Visual dos pneus. Face à atual conjuntura de mercado, as empresas devem estar munidas de dados detalhados e precisos relativos aos seus processos produtivos. A Capacidade instalada apresenta-secomo um parâmetro determinante na medida em que condiciona diretamente a resposta a solicitações de clientes. Esta é fortemente influenciada pelo Layout fabril, pelo que a otimização do mesmo é fundamental numa perspetiva de ganho de Capacidade produtiva. O relatório iniciou-se com a determinação do Tempo Previsto da operação segundo o referencial REFA. Seguidamente quantificaram-se as atuais perturbações através de auditorias ao processo. Deste modo obteve-se uma Capacidade instalada de 59380 pneus/dia. A análise das perturbações desenvolveu-se a partir de um diagrama causa-efeito, no qual foram identificadas diversas potenciais causas, classificadas posteriormente por uma equipa experiente e conhecedora do processo. Assim, conhecidas as perturbações de maior impacto, foi apresentada uma solução de Layout que visou a sua minimização. O ganho estimado, em termos de Capacidade, após a implementação da solução proposta é de 3000 pneus/dia. Este ganho de 5% é significativo na medida em que é obtido sem a necessidade de aquisição de novos equipamentos nem de área fabril adicional. É expectável que esta implementação proporcione ainda melhorias no processo produtivo subsequente - Uniformidade, especificamente na alimentação do mesmo. A quantificação desta melhoria, na sequência deste trabalho, apresenta-se como uma oportunidade de estudo futuro.

Bacillary angiomatosis: description of 13 cases reported in five reference centers for AIDS treatment in Rio de Janeiro, Brazil

The aim of this case series was to describe the clinical, laboratory and epidemiological characteristics and the presentation of bacillary angiomatosis cases (and/or parenchymal bacillary peliosis) that were identified in five public hospitals of Rio de Janeiro state between 1990 and 1997; these cases were compared with those previously described in the medical literature. Thirteen case-patients were enrolled in the study; the median age was 39 years and all patients were male. All patients were human immunodeficiency virus type 1 (HIV-1) infected and they had previous or concomitant HIV-associated opportunistic infections or malignancies diagnosed at the time bacillary angiomatosis was diagnosed. Median T4 helper lymphocyte counts of patients was 96 cells per mm³. Cutaneous involvement was the most common clinical manifestation of bacillary angiomatosis in this study. Clinical remission following appropriate treatment was more common in our case series than that reported in the medical literature, while the incidence of relapse was similar. The frequency of bacillary angiomatosis in HIV patients calculated from two of the hospitals included in our study was 1.42 cases per 1000 patients, similar to the frequencies reported in the medical literature. Bacillary angiomatosis is an unusual opportunistic pathogen in our setting.

PCR - based diagnosis to evaluate the performance of malaria reference centers

Although the Giemsa-stained thick blood smear (GTS) remains the gold standard for the diagnosis of malaria, molecular methods are more sensitive and specific to detect parasites and can be used at reference centers to evaluate the performance of microscopy. The description of the Plasmodium falciparum, P. vivax, P. malariae and P. ovale ssrRNA gene sequences allowed the development of a polymerase chain reaction (PCR) that had been used to differentiate the four species. The objective of this study was to determine Plasmodium species through PCR in 190 positive smears from patients in order to verify the quality of diagnosis at SUCEN's Malaria Laboratory. Considering only the 131 positive results in both techniques, GTS detected 4.6% of mixed and 3.1% of P. malariae infections whereas PCR identified 19.1% and 13.8%, respectively.

Clinical and epidemiological analysis of patients with HIV/AIDS admitted to a reference hospital in the northeast region of Brazil

The AIDS epidemic has become a worldwide phenomenon of enormous magnitude and extension, deeply transforming medical practices and public health initiatives. This retrospective survey aimed to analyze clinical and epidemiological characteristics of patients with HIV/AIDS admitted to the Institute of Tropical Diseases Natan Portella, Teresina, Piauí, Brazil, from January, 2001 through December, 2004. Of the 828 patients, 43% were from other states and 71.3% were men. Average patient age was 35.4 ± 11.5 years-old and 85.5% were illiterate or had primary education. The main form of exposure to HIV was heterosexual behavior (54.1%), while injectable drug use was confirmed by only 2.7% of registered cases. The most frequent infectious complications were candidiasis (42.4%) and pneumocystosis (22.2%). Sixty-eight cases (8.2%) of visceral leishmaniasis were registered. Using multivariate analysis, individuals aged over 40 years-old, patients with active tuberculosis, Pneumocystis carinii pneumonia and central nervous system cryptococcosis showed increased risk of death. In this study, young male adults with low educational levels predominated and the most frequent opportunistic infections were candidiasis and pneumocystosis.

ESTABLISHING THE REFERENCE RANGE FOR T LYMPHOCYTES SUBPOPULATIONS IN ADULTS AND CHILDREN FROM BRAZIL

SUMMARY In Brazil, the existing reference values for T-lymphocytes subsets are based on data originated in other countries. There is no local information on normal variation for these parameters in Brazilian adults and children. We evaluated the normal variation found in blood donors from five large Brazilian cities, in different regions, and in children living in Salvador, and Rio de Janeiro. All samples were processed by flow cytometry. The results were analyzed according to region, gender, and lifestyle of blood donors. A total of 641 adults (63% males), and 280 children (58% males) were involved in the study. The absolute CD3+, and CD4+ cells count were significantly higher for females (adults and children). Higher CD4+ cell count in adults was associated with smoking, while higher CD8+ count was found among female children. Higher counts, for all T-cells subsets, were detected in blood donors from southeast / south regions while those living in the northern region had the lowest values. Individuals from midwestern and northeastern regions had an intermediate count for all these cells subsets. However, these differences did not reach statistical significance. In Brazil, gender and smoking, were the main determinants of differences in T-lymphocytes reference values.

APPLICABILITY OF kDNA-PCR FOR ROUTINE DIAGNOSIS OF AMERICAN TEGUMENTARY LEISHMANIASIS IN A TERTIARY REFERENCE HOSPITAL

SUMMARYThis study evaluated the applicability of kDNA-PCR as a prospective routine diagnosis method for American tegumentary leishmaniasis (ATL) in patients from the Instituto de Infectologia Emílio Ribas (IIER), a reference center for infectious diseases in São Paulo - SP, Brazil. The kDNA-PCR method detected Leishmania DNA in 87.5% (112/128) of the clinically suspected ATL patients, while the traditional methods demonstrated the following percentages of positivity: 62.8% (49/78) for the Montenegro skin test, 61.8% (47/76) for direct investigation, and 19.3% (22/114) for in vitro culture. The molecular method was able to confirm the disease in samples considered negative or inconclusive by traditional laboratory methods, contributing to the final clinical diagnosis and therapy of ATL in this hospital. Thus, we strongly recommend the inclusion of kDNA-PCR amplification as an alternative diagnostic method for ATL, suggesting a new algorithm routine to be followed to help the diagnosis and treatment of ATL in IIER.

Pipelined analog-to-digital conversion using current-mode reference shifting

Dissertação para obtenção do grau de Mestre em Engenharia Electrotécnica e de Computadores