Effect of GaAIAs low-level laser therapy on the healing of human palate mucosa after connective tissue graft harvesting: randomized clinical trial

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Evidências à intervenção de enfermagem controle de infecção da classificação das intervenções de enfermagem: orientação e ensino sobre a lavagem das mãos

Pós-graduação em Enfermagem - FMB

Estudo e análise de sistemas de refrigeração industrial integrados a plantas de processo químico

This work approaches the analysis of industrial refrigeration systems applied to a chemical processing industry that, in this case, consists of refrigeration machines, cooling tower system, cold water system and brine system. In this study it is highlighted the function and characteristics of different systems, including the main components, the most important features, their functionality and best practices. The motivation for this work is the fact that refrigeration systems are essential in many industrial processes, presenting a high energy consumption that is related to a significant parcel of production costs. It has aimed to understand the case studied in order to evaluate the energy efficiency of systems and to compare with Carnot efficiency and best available technologies. The assessment aims to identify irregularities, find opportunities and propose solutions that increases the performance of equipment and the overall system efficiency. Therefore, the studies intend to reduce the operation costs and generate gains for the company

Estudo e análise de sistemas de refrigeração industrial integrados a plantas de processo químico

This work approaches the analysis of industrial refrigeration systems applied to a chemical processing industry that, in this case, consists of refrigeration machines, cooling tower system, cold water system and brine system. In this study it is highlighted the function and characteristics of different systems, including the main components, the most important features, their functionality and best practices. The motivation for this work is the fact that refrigeration systems are essential in many industrial processes, presenting a high energy consumption that is related to a significant parcel of production costs. It has aimed to understand the case studied in order to evaluate the energy efficiency of systems and to compare with Carnot efficiency and best available technologies. The assessment aims to identify irregularities, find opportunities and propose solutions that increases the performance of equipment and the overall system efficiency. Therefore, the studies intend to reduce the operation costs and generate gains for the company

Early transplantation of human immature dental pulp stem cells from baby teeth to golden retriever muscular dystrophy (GRMD) dogs: Local or systemic?

Background:The golden retriever muscular dystrophy (GRMD) dogs represent the best available animal model for therapeutic trials aiming at the future treatment of human Duchenne muscular dystrophy (DMD). We have obtained a rare litter of six GRMD dogs (3 males and 3 females) born from an affected male and a carrier female which were submitted to a therapeutic trial with adult human stem cells to investigate their capacity to engraft into dogs muscles by local as compared to systemic injection without any immunosuppression. Methods Human Immature Dental Pulp Stem Cells (hIDPSC) were transplanted into 4 littermate dogs aged 28 to 40 days by either arterial or muscular injections. Two non-injected dogs were kept as controls. Clinical translation effects were analyzed since immune reactions by blood exams and physical scores capacity of each dog. Samples from biopsies were checked by immunohistochemistry (dystrophin markers) and FISH for human probes. Results and Discussion We analyzed the cells' ability in respect to migrate, engraftment, and myogenic potential, and the expression of human dystrophin in affected muscles. Additionally, the efficiency of single and consecutive early transplantation was compared. Chimeric muscle fibers were detected by immunofluorescence and fluorescent in situ hybridisation (FISH) using human antibodies and X and Y DNA probes. No signs of immune rejection were observed and these results suggested that hIDPSC cell transplantation may be done without immunosuppression. We showed that hIDPSC presented significant engraftment in GRMD dog muscles, although human dystrophin expression was modest and limited to several muscle fibers. Better clinical condition was also observed in the dog, which received monthly arterial injections and is still clinically stable at 25 months of age. Conclusion Our data suggested that systemic multiple deliveries seemed more effective than local injections. These findings open important avenues for further researches.

Ensemble forecasting in the Mediterranean sea

A new methodology is being devised for ensemble ocean forecasting using distributions of the surface wind field derived from a Bayesian Hierarchical Model (BHM). The ocean members are forced with samples from the posterior distribution of the wind during the assimilation of satellite and in-situ ocean data. The initial condition perturbations are then consistent with the best available knowledge of the ocean state at the beginning of the forecast and amplify the ocean response to uncertainty only in the forcing. The ECMWF Ensemble Prediction System (EPS) surface winds are also used to generate a reference ocean ensemble to evaluate the performance of the BHM method that proves to be eective in concentrating the forecast uncertainty at the ocean meso-scale. An height month experiment of weekly BHM ensemble forecasts was performed in the framework of the operational Mediterranean Forecasting System. The statistical properties of the ensemble are compared with model errors throughout the seasonal cycle proving the existence of a strong relationship between forecast uncertainties due to atmospheric forcing and the seasonal cycle.

Nuove sonde fluorescenti per lo studio e la quantificazione del magnesio totale intracellulare

Sebbene il magnesio sia essenziale per la maggior parte dei processi biologici, si conosce ancora poco sulla sua distribuzione e compartimentalizzazione intracellulare, soprattutto a causa dell’inadeguatezza delle tecniche attualmente disponibili. Per questo motivo, particolare interesse ha recentemente suscitato una famiglia di molecole fluorescenti, diaza-18-crown-6 8-idrossichinoline (DCHQ1 e suoi derivati), che mostrano un’alta specificità e affinità per il magnesio (superiore a quella delle sonde commerciali), che consente di mappare il magnesio totale intracellulare. L’approccio sintetico alle molecole DCHQ è stato ottimizzato mediante riscaldamento alle microonde: con questa nuova metodica è stato possibile sintetizzare una famiglia di derivati con caratteristiche di fluorescenza, uptake, ritenzione e localizzazione intracellulare potenziate rispetto alla capostipite DCHQ1. Il derivato acetometossi estere (DCHQ3), idrolizzato dalle esterasi cellulari, ha mostrato un miglior uptake e ritenzione intracellulare; le lunghe catene laterali alchiliche della sonda DCHQ4, invece, hanno conferito a questo derivato maggiore lipofilicità e, di conseguenza, maggiore affinità per le membrane; con l’inserimento di gruppi laterali aromatici, infine, si sono ottenute due sonde (DCHQ5 e DCHQ6) molto fluorescenti e altamente ritenute all’interno delle cellule anche dopo i lavaggi. Il derivato fenilico DCHQ5 si è dimostrato, inoltre, utilizzabile anche per saggi fluorimetrici quantitativi del magnesio totale in campioni cellulari molto piccoli; in più, grazie all’alta ritenzione cellulare, è stato usato per monitorare e quantificare l’efflusso di magnesio attraverso la membrana plasmatica in risposta a stimolazione con cAMP. I risultati presentati in questa tesi mostrano che i DCHQ-derivati potranno rappresentare in futuro uno strumento versatile per lo studio della distribuzione e dell’omeostasi del magnesio cellulare. In particolare la sonda DCHQ5 ha mostrato l’ulteriore peculiarità di essere eccitabile sia nell’UV che nel visibile, e potrebbe essere quindi utilizzata con successo in un’ampia varietà di misure di fluorescenza, fornendo un contributo importante per la comprensione del ruolo di questo importante elemento.

Higher-order perturbative relativistic corrections to energies and properties

Relativistic effects need to be considered in quantum-chemical calculations on systems including heavy elements or when aiming at high accuracy for molecules containing only lighter elements. In the latter case, consideration of relativistic effects via perturbation theory is an attractive option. Among the available techniques, Direct Perturbation Theory (DPT) in its lowest order (DPT2) has become a standard tool for the calculation of relativistic corrections to energies and properties.In this work, the DPT treatment is extended to the next order (DPT4). It is demonstrated that the DPT4 correction can be obtained as a second derivative of the energy with respect to the relativistic perturbation parameter. Accordingly, differentiation of a suitable Lagrangian, thereby taking into account all constraints on the wave function, provides analytic expressions for the fourth-order energy corrections. The latter have been implemented at the Hartree-Fock level and within second-order Møller-Plesset perturbaton theory using standard analytic second-derivative techniques into the CFOUR program package. For closed-shell systems, the DPT4 corrections consist of higher-order scalar-relativistic effects as well as spin-orbit corrections with the latter appearing here for the first time in the DPT series.Relativistic corrections are reported for energies as well as for first-order electrical properties and compared to results from rigorous four-component benchmark calculations in order to judge the accuracy and convergence of the DPT expansion for both the scalar-relativistic as well as the spin-orbit contributions. Additionally, the importance of relativistic effects to the bromine and iodine quadrupole-coupling tensors is investigated in a joint experimental and theoretical study concerning the rotational spectra of CH2BrF, CHBrF2, and CH2FI.

Accuracy of diagnostic tests for clinically suspected upper extremity deep vein thrombosis: a systematic review

The best available test for the diagnosis of upper extremity deep venous thrombosis (UEDVT) is contrast venography. The aim of this systematic review was to assess whether the diagnostic accuracy of other tests for clinically suspected UEDVT is high enough to justify their use in clinical practise and to evaluate if any test can replace venography.

An AMSTAR assessment of the methodological quality of systematic reviews of oral healthcare interventions published in the Journal of Applied Oral Science (JAOS)

Systematic reviews are not an assembly of anecdotes but a distillation of current best available evidence on a particular topic and as such have an important role to play in evidence-based healthcare. A substantial proportion of these systematic reviews focus on interventions, and are able to provide clinicians with the opportunity to understand and translate the best available evidence on the effects of these healthcare interventions into clinical practice. The importance of systematic reviews in summarising and identifying the gaps in evidence which might inform new research initiatives is also widely acknowledged. Their potential impact on practice and research makes their methodological quality especially important as it may directly influence their utility for clinicians, patients and policy makers. The objectives of this study were to identify systematic reviews of oral healthcare interventions published in the Journal of Applied Oral Science (JAOS) and to evaluate their methodological quality using the evaluation tool, AMSTAR.

Molecular Dynamics Simulations of the d(TAT) Triple Helix

Molecular dynamics (MD) simulations have been used to study the dynamical and time-averaged characteristics of the DNA triple helix d(T)10âd(A)10âd(T)10. The structures sampled during the trajectory resemble closely the B-type model for the DNA triplex proposed on the basis of NMR data, although there are some subtle differences. Alternative P- and A-type conformations for the triplex, suggested from X-ray experiments, are not predicted to contribute significantly to the structure of the DNA triplex in solution. Comparison with the best available experimental data supports the correctnes of the MD-generated structures. The analysis of the collected data gives a detailed picture of the characteristics of triple-helix DNA. A new and interesting pattern of hydration, specific for triplex DNA, is an important observation. The results suggest that molecular dynamics can be useful for the study of novel nucleic acid structures.

Allogeneic stem cell transplant in adult patients with acute myelogenous leukemia: a systematic analysis of international guidelines and recommendations

In patients with acute myelogenous leukemia, published guidelines and treatment recommendations are usually the basis for starting the work-up process for allogeneic transplant. However, only consistent recommendations would allow a standardized clinical practice. We conducted a comprehensive systematic literature search to identify and evaluate the best available evidence from controlled clinical trials. In addition, recommendations given by leading organizations in the USA and Europe were analyzed. The following aspects were selected for systematic comparison: factors for risk assessment and categorization, role of type of donor, significance of allogeneic transplant in first or second complete remission and in relapse/progressive disease; and role of reduced intensity conditioning regimens. In conclusion, the recommendations for the use of allogeneic transplant given by the literature and by published guidelines are inconsistent and will need clarification.

Current state of evidence on 'off-label' therapeutic options for systemic lupus erythematosus, including biological immunosuppressive agents, in Germany, Austria and Switzerland--a consensus report

Systemic lupus erythematosus (SLE) can be a severe and potentially life-threatening disease that often represents a therapeutic challenge because of its heterogeneous organ manifestations. Only glucocorticoids, chloroquine and hydroxychloroquine, azathioprine, cyclophosphamide and very recently belimumab have been approved for SLE therapy in Germany, Austria and Switzerland. Dependence on glucocorticoids and resistance to the approved therapeutic agents, as well as substantial toxicity, are frequent. Therefore, treatment considerations will include 'off-label' use of medication approved for other indications. In this consensus approach, an effort has been undertaken to delineate the limits of the current evidence on therapeutic options for SLE organ disease, and to agree on common practice. This has been based on the best available evidence obtained by a rigorous literature review and the authors' own experience with available drugs derived under very similar health care conditions. Preparation of this consensus document included an initial meeting to agree upon the core agenda, a systematic literature review with subsequent formulation of a consensus and determination of the evidence level followed by collecting the level of agreement from the panel members. In addition to overarching principles, the panel have focused on the treatment of major SLE organ manifestations (lupus nephritis, arthritis, lung disease, neuropsychiatric and haematological manifestations, antiphospholipid syndrome and serositis). This consensus report is intended to support clinicians involved in the care of patients with difficult courses of SLE not responding to standard therapies by providing up-to-date information on the best available evidence.

Fractional flow reserve-guided PCI versus medical therapy in stable coronary disease

The preferred initial treatment for patients with stable coronary artery disease is the best available medical therapy. We hypothesized that in patients with functionally significant stenoses, as determined by measurement of fractional flow reserve (FFR), percutaneous coronary intervention (PCI) plus the best available medical therapy would be superior to the best available medical therapy alone.

Hereditary angioedema (HAE) in children and adolescents--a consensus on therapeutic strategies

Hereditary angioedema due to C1 inhibitor (C1 esterase inhibitor) deficiency (types I and II HAE-C1-INH) is a rare disease that usually presents during childhood or adolescence with intermittent episodes of potentially life-threatening angioedema. Diagnosis as early as possible is important to avoid ineffective therapies and to properly treat swelling attacks. At a consensus meeting in June 2011, pediatricians and dermatologists from Germany, Austria, and Switzerland reviewed the currently available literature, including published international consensus recommendations for HAE therapy across all age groups. Published recommendations cannot be unconditionally adopted for pediatric patients in German-speaking countries given the current approval status of HAE drugs. This article provides an overview and discusses drugs available for HAE therapy, their approval status, and study results obtained in adult and pediatric patients. Recommendations for developing appropriate treatment strategies in the management of HAE in pediatric patients in German-speaking countries are provided.Conclusion Currently, plasma-derived C1 inhibitor concentrate is considered the best available option for the treatment of acute HAE-C1-INH attacks in pediatric patients in German-speaking countries, as well as for short-term and long-term prophylaxis.