Safety Assessment of Potentially Inappropriate Medications (PIM) use in Older People and the Factors Associated with Hospital Admission

Purpose: Potentially Inappropriate Medications (PIM) use in elderly people may be responsible for the development of Adverse Drug Reaction (ADR) which, when severe, leads to hospital admissions. Objectives: to estimate the prevalence of elderly who had used PIM before being admitted to hospital and to identify the risk factors and the hospitalizations related to ADR arising from PIM. Methods: A descriptive and cross-sectional study was performed in the internal medicine ward of a teaching hospital (Brazil), in 2008. With the aid of a validated form, patients aged >= 60 years, with length of hospital stay >= 24 hours, were interviewed about drugs taken prior to the hospital admission and the complaints/reasons for hospitalization. Results: 19.1% (59/308) of older patients had taken PIM before hospital admission and in 4.9%; there were a causal relation between the PIM taken and the complaint reported. PIM responsible for admissions were: amiodarone, amitriptyline, cimetidine, clonidine, diazepam, digoxin, estrogen, fluoxetine, lorazepam, short-acting nifedipine and propranolol. 47.0% of the clinical manifestations of PIM-related ADR were: dizziness, fatigue, digoxin toxicity and erythema. Only polypharmacy was detected as a risk factor for the occurrence of ADR of PIM (p = 0.02). Conclusion: PIM use in elderly people is not a risk factor for ADR-related hospital admission. Probably, severe ADR, which lead to hospitalizations of older people, can be explained by idiosyncratic response or the predisposition of these patients to develop adverse drug events, whether or not drugs are classed as PIM.

Ler em tempo livre durante o Estado Novo: A função do suplemento infantil Pim-Pam-Pum na formação da criança

RESUMO: Esta dissertação tem como objectivo compreender a influência da ideologia do Estado Novo nos conteúdos inseridos no suplemento infantil Pim-Pam-Pum. Visa ainda relacionar, num determinado momento temporal o suplemento infantil de um dos jornais mais lidos da época O Século, com a ideologia do Estado Novo. Procura identificar os valores incutidos nos números a analisar no Pim-Pam-Pum num período de dois anos. O período histórico em análise do suplemento infantil Pim-Pam-Pum compreende os exemplares entre 1953 a 1955. Como principais conclusões do estudo retira-se que o suplemento infantil procurava educar o seu público de forma lúdica. Por outro lado, transmitia e incutia em colaboração com a família os principais valores salazaristas. A imprensa escrita passa a ser uma arma de propaganda ideológica do Estado Novo numa tentativa de conter informação desfavorável ao regime perante as pressões internas e externas. Com a institucionalização da censura após a segunda Guerra Mundial, a vigilância e o exame das publicações dos organismos competentes em colaboração com a própria auto-censura dos jornalistas, simplificou-se. No entanto a imprensa procurou cumprir com a sua missão de divulgação cultural e lúdica através de jornais diários, revistas e suplementos infantis. ABSTRACT:The aim of this dissertation is to understand the influence of the ideology of the "Estado Novo" in the contents inserted in the children's supplement Pim-Pam-Pum. It also aims to relate, in a certain historical period, the children’s supplement of one of the most important newspapers of the time, "O Século", with the ideology of the "Estado Novo". In addition, it intends to identify the values ingrained in the numbers to be analysed in Pim-Pam-Pum in a period of two years. The period under analysis of the children's supplement Pim-Pam-Pum includes the numbers from 1953 to 1955. One of the main conclusions of this study is that the children's aforementioned supplement aimed to educate its audience in a joyful manner. On the other hand, it transmitted as well as inculcated with the families’ collaboration the main Salazarist values. The press becomes a weapon of ideological propaganda of the "Estado Novo" in an attempt to keep harmful information to the regime from the internal and external pressures. With the institucionalization of censorship after the Second World War, the careful surveillance of publications by the competent and relevant organisms in collaboration with the censorship made by the journalists themselves, was simplified. However, the press tried to accomplish its mission of cultural and playful diffusion by means of newspapers, magazines and children's supplements.

Melhoria na gestão de compras em uma indústria do Pólo Industrial de Manaus (PIM)

Dissertação de mestrado em Engenharia e Gestão Industrial

PIM place & ghost application

Actualment, el Servei d'Informàtica de l'Escola d'Enginyeries (SIEE) s'enfronta a dos problemes: l'augment del nombre d'alumnes, mantenint el mateix número d'ordinadors per fer les pràctiques i, d'altra banda, el també creixent nombre d'aplicacions que s'han desenvolupat i es desenvolupen per resoldre les necessitats generades pels mateixos alumnes. Aquest projecte neix amb la voluntat de solucionar aquests problemes, creant per un costat un aula de màquines virtuals i per altra banda crear un aplicatiu web, que servirà de framework i contenidor de futures aplicacions, on es pugui connectar de manera senzilla amb les màquines virtuals.

Estudio de los mensajes de control del protocolo multicast PIM SM

OPNET es una herramienta de simulación de redes muy potente, donde se puede configurar cualquier tipo de red existente. Esta herramienta nos ayuda a “probar” sin tener que montar ninguna red física, una gran ventaja sobre todo para protocolos experimentales o para el diseño de los mismos. En este proyecto se utiliza el OPNET para explotar el protocolo multicast PIM-SM. Se establecerá un modelo de red, donde estarán configurados los nodos de forma estratégica para intentar extraer el máximo de información del comportamiento en esta situación del protocolo PIM-SM.

Factors Affecting Cancer Behavior with Special Reference to Lymphatic Vessels, Macrophages, EGFR, and Pim-1 in Colorectal Cancer

Syövän käyttäytymiseen ja ennusteeseen vaikuttavat monet tekijät, muun muassa muutokset syöpäsoluissa sekä kasvainta ympäröivässä mikroympäristössä. Tutkimuksen tavoitteena oli tutkia uusia prediktiivisiä ja prognostisia ennustetekijöitä syöpäsoluissa (EGFR geenikopiomäärä, EGFR, onkogeeni pim-1) sekä syöpäkasvaimen mikroympäristöön kuuluvissa imuteissä (CLEVER-1, podoplaniini), makrofageissa (CD68, CLEVER-1) ja T lymfosyyteissä (CD3) kolorektaalisyövässä. Lisäksi tutkittiin imuteiden molekulaarisia ominaisuuksia tarkemmin (CD73, LYVE-1, podoplaniini) kuten myös lymfosyyttien ja dendriittisolujen liikennöintiä imuteissä. Tutkimustulokset osoittavat että korkea Pim-1 ekspressiotaso, suuri peritumoraalinen CD68+ makrofagimäärä sekä varhaisen vaiheen taudissa suuri CLEVER-1+ peritumoraalinen makrofagimäärä ovat hyvän ennusteen tekijöitä kolorektaalisyövässä. Metastaattisessa taudissa sen sijaan suuri määrä CLEVER-1+ makrofageja, sekä intra- että peritumoraalisesti, liittyy huonoon tautiennusteeseen. EGFR geenikopiomäärä, EGFR proteiinipitoisuuden ohjaaman hopea in situ hybridisaatiomenetelmän avulla määritettynä, ennusti vastetta anti-EGFR hoidolle metastaattisessa kolorektaalisyövässä tarkemmin kuin nykyisin rutiinisti käytössä oleva KRAS määritys. Lisäksi havaittiin että imutiet ovat monimuotoisia imutiemarkkeri ekspressionsa suhteen sekä normaali- että syöpäkudoksissa. CD73 molekyylin funktio imuteissä poikkesi selvästi molekyylin funktiosta verisuonissa. Yhteenvetona voidaan todeta että kolorektaalisyövän ennusteeseen vaikuttavien tekijöiden merkitys vaihtelee taudin levinneisyysasteen sekä imuteiden että makrofagien sijainnin perusteella. Korkea Pim-1 ilmentyminen on yhteydessä hyvään kolorektaalisyöpäennusteeseen. Lisäksi EGFR geenikopiomäärä osoittautui lupaavaksi uudeksi prediktiiviseksi ennustetekijäksi KRAS villintyypin metastaattista kolorektaalisyöpää sairastavilla potilailla.

Pim-1 kinase inhibits the activation of reporter gene expression in Elk-1 and c-Fos reporting systems but not the endogenous gene expression: an artifact of the reporter gene assay by transient co-transfection

We have studied the molecular mechanism and signal transduction of pim-1, an oncogene encoding a serine-threonine kinase. This is a true oncogene which prolongs survival and inhibits apoptosis of hematopoietic cells. In order to determine whether the effects of Pim-1 occur by regulation of the mitogen-activated protein kinase pathway, we used a transcriptional reporter assay by transient co-transfection as a screening method. In this study, we found that Pim-1 inhibited the Elk-1 and NFkappaB transcriptional activities induced by activation of the mitogen-activated protein kinase cascade in reporter gene assays. However, Western blots showed that the induction of Elk-1-regulated expression of endogenous c-Fos was not affected by Pim-1. The phosphorylation and activation of neither Erk1/2 nor Elk-1 was influenced by Pim-1. Also, in the gel shift assay, the pattern of endogenous NFkappaB binding to its probe was not changed in any manner by Pim-1. These data indicate that Pim-1 does not regulate the activation of Erk1/2, Elk-1 or NFkappaB. These contrasting results suggest a pitfall of the transient co-transfection reporter assay in analyzing the regulation of transcription factors outside of the chromosome context. It ensures that results from reporter gene expression assay should be verified by study of endogenous gene expression.

Presentación del material multimedia 'Pim Pam, exercicis de polirítmia'.

Resumen tomado del autor. Incluye imágenes y material anexo