917 resultados para Doenças do Rim
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Renal involvement in Waldenström's macroglobulinaemia (WM) is very unusual when compared to multiple myeloma. We report a case of a patient who developed anuric acute kidney injury secondary to cast nephropathy, dependent on high-flux haemodialysis. Complementary study revealed the presence of blood IgM monoclonal gammopathy and a massive bone marrow lymphoplasmacytic infiltration. There were no osteolytic lesions and no clinical signs/symptoms of hyperviscosity syndrome. The diagnosis of WM was established and a dexamethasone plus cyclophosphamide regime was started, in addition to plasmapheresis. The patient partially recovered renal function allowing haemodialysis and plasmapheresis withdrawal. He remained asymptomatic with a good response to chemotherapy and 12 months after his renal function remained stable. This is a rare clinical case in which WM presented as an IgM cast nephropathy, which in turn is an extremely rare renal presentation of this equally rare haematological disorder.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
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Pós-graduação em Aquicultura - FCAV
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Pós-graduação em Anestesiologia - FMB
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In the decade since the destination branding literature emerged (see for example Pritchard & Morgan 1998, Dosen & Vransevic 1998), only a few books have been published. These are Morgan et al.’s (2002, 2004) edited volumes of international case studies and conceptual papers, and Baker’s (2007) practitioner perspective on branding small cities in the USA. This work by Stephanie Donald and John Gammack is the first research-based text related to destination branding, and is a welcome and timely addition to the field. In the foreword to the first issue of Place Branding and Public Policy, editor Simon Anholt (2004, p. 4) suggested “almost nobody agrees on what, exactly, branding means”, when he described place branding practice as akin to the Wild West. Indeed, this lack of theory was one of the motivators for the authors of this text. Tourism and the Branded City is part of Ashgate’s New Directions in Tourism Analysis series, edited by Dimitri Ioannides. The aim of the series is to address the gap in published theory underpinning the study of tourism, with a particular interest in non-business disciplines such as Sociology, Social Anthropology, Human and Social Geography, and Cultural Studies...
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Purpose. To compare radiological records of 90 consecutive patients who underwent cemented total hip arthroplasty (THA) with or without use of the Rim Cutter to prepare the acetabulum. Methods. The acetabulum of 45 patients was prepared using the Rim Cutter, whereas the device was not used in the other 45 patients. Postoperative radiographs were evaluated using a digital templating system to measure (1) the positions of the operated hips with respect to the normal, contralateral hips (the centre of rotation of the socket, the height of the centre of rotation from the teardrop, and lateralisation of the centre of rotation from the teardrop) and (2) the uniformity and width of the cement mantle in the 3 DeLee Charnley acetabular zones, and the number of radiolucencies in these zones. Results. The study group showed improved radiological parameters and were closer to the anatomic centre of rotation both vertically (1.5 vs. 3.7 mm, p<0.001) and horizontally (1.8 vs. 4.4 mm, p<0.001) and had consistently thicker and more uniform cement mantles (p<0.001). There were 2 radiolucent lines in the control group but none in the study group. Conclusion. The Rim Cutter resulted in more accurate placement of the centre of rotation of a cemented prosthetic socket, and produced a thicker, more congruent cement mantle with fewer radiolucent lines.
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The validity of the Multidimensional School Anger Inventory (MSAI) was examined with adolescents from 5 Pacific Rim countries (N ¼ 3,181 adolescents; age, M ¼ 14.8 years; 52% females). Confirmatory factor analyses examined configural invariance for the MSAI’s anger experience, hostility, destructive expression, and anger coping subscales. The model did not converge for Peruvian students. Using the top 4 loaded items for anger experience, hostility, and destructive expression configural invariance and partial metric and scalar invariances were found. Latent means analysis compared mean responses on each subscale to the U.S. sample. Students from other countries showed higher mean responses on the anger experience subscale (ds ¼ .37–.73). Australian (d ¼ .40) and Japanese students (d ¼ .21) had significantly higher mean hostility subscale scores. Australian students had higher mean scores on the destructive expression subscale (d ¼ .30), whereas Japanese students had lower mean scores (d ¼ 2.17). The largest latent mean gender differences (females lower than males) were for destructive expression among Australian (d ¼ 2.67), Guatemalan (d ¼ 2.42), and U.S. (d ¼ 2.66) students. This study supported an abbreviated, 12-item MSAI with partial invariance. Implications for the use of the MSAI in comparative research are discussed.
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Big Tobacco has been engaged in a dark, shadowy plot and conspiracy to hijack the Trans-Pacific Partnership Agreement (TPP) and undermine tobacco control measures – such as graphic health warnings and the plain packaging of tobacco products... In the context of this heavy lobbying by Big Tobacco and its proxies, this chapter provides an analysis of the debate over trade, tobacco, and the TPP. This discussion is necessarily focused on the negotiations of the free trade agreement – the shadowy conflicts before the finalisation of the text. This chapter contends that the trade negotiations threaten hard-won gains in public health – including international developments such as the WHO Framework Convention on Tobacco Control, and domestic measures, such as graphic health warnings and the plain packaging of tobacco products. It maintains that there is a need for regional trade agreements to respect the primacy of the WHO Framework Convention on Tobacco Control. There is a need both to provide for an open and transparent process regarding such trade negotiations, as well as a due and proper respect for public health in terms of substantive obligations. Part I focuses on the debate over the intellectual property chapter of the TPP, within the broader context of domestic litigation against Australia’s plain tobacco packaging regime and associated WTO disputes. Part II examines the investment chapter of the TPP, taking account of ongoing investment disputes concerning tobacco control and the declared approaches of Australia and New Zealand to investor-state dispute settlement. Part III looks at the discussion as to whether there should be specific text on tobacco control in the TPP, and, if so, what should be its nature and content. This chapter concludes that the plain packaging of tobacco products – and other best practices in tobacco control – should be adopted by members of the Pacific Rim.
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Doctors, surgeons, and physicians around the Pacific Rim should be concerned by the proposals revealed by WikiLeaks in the Trans-Pacific Partnership (TPP). One of the most controversial features of the TPP is the proposal to provide for patent protection in respect of medical procedures. As Public Citizen observed, ‘Health providers, including surgeons, could be liable for the methods they use to treat patients.’ The civil society group noted: ‘Essentially, except for when a surgeon uses her bare hands, surgical methods would be patentable under the U.S. proposal.’ The TPP takes a broad approach to patents and medicine; lacks appropriate safeguards; and fails to address larger questions about equity, development, and human rights. Such a measure could result in greater litigation against medical professionals; barriers to access to medical procedures for patients; and skyrocketing health costs.
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There has been much debate about the relationship between international trade, and intellectual property, the environment, biodiversity protection, and climate change. The Obama Administration has pushed such issues into sharp relief, with its advocacy for sweeping international trade agreements, such as the Trans-Pacific Partnership. There has been much public concern about the impact of the Pacific Rim Treaty upon the protection of the environment. In particular, there has been a debate about whether the Trans-Pacific Partnership will promote dirty fracking...