Influence of female sex and fertile age on neuromyelitis optica spectrum disorders.

PubMed

Borisow, Nadja; Kleiter, Ingo; Gahlen, Anna; Fischer, Katrin; Wernecke, Klaus-Dieter; Pache, Florence; Ruprecht, Klemens; Havla, Joachim; Krumbholz, Markus; Kümpfel, Tania; Aktas, Orhan; Ringelstein, Marius; Geis, Christian; Kleinschnitz, Christoph; Berthele, Achim; Hemmer, Bernhard; Angstwurm, Klemens; Weissert, Robert; Stellmann, Jan-Patrick; Schuster, Simon; Stangel, Martin; Lauda, Florian; Tumani, Hayrettin; Mayer, Christoph; Zeltner, Lena; Ziemann, Ulf; Linker, Ralf A; Schwab, Matthias; Marziniak, Martin; Then Bergh, Florian; Hofstadt-van Oy, Ulrich; Neuhaus, Oliver; Winkelmann, Alexander; Marouf, Wael; Rückriem, Lioba; Faiss, Jürgen; Wildemann, Brigitte; Paul, Friedemann; Jarius, Sven; Trebst, Corinna; Hellwig, Kerstin

2017-07-01

Gender and age at onset are important epidemiological factors influencing prevalence, clinical presentation, and treatment response in autoimmune diseases. To evaluate the impact of female sex and fertile age on aquaporin-4-antibody (AQP4-ab) status, attack localization, and response to attack treatment in patients with neuromyelitis optica (NMO) and its spectrum disorders (neuromyelitis optica spectrum disorder (NMOSD)). Female-to-male ratios, diagnosis at last visit (NMO vs NMOSD), attack localization, attack treatment, and outcome were compared according to sex and age at disease or attack onset. A total of 186 NMO/SD patients (82% female) were included. In AQP4-ab-positive patients, female predominance was most pronounced during fertile age (female-to-male ratio 23:1). Female patients were more likely to be positive for AQP4-abs (92% vs 55%; p < 0.001). Interval between onset and diagnosis of NMO/SD was longer in women than in men (mean 54 vs 27 months; p = 0.023). In women, attacks occurring ⩽40 years of age were more likely to show complete remission ( p = 0.003) and better response to high-dose intravenous steroids ( p = 0.005) compared to woman at >40 years. Our data suggest an influence of sex and age on susceptibility to AQP4-ab-positive NMO/SD. Genetic and hormonal factors might contribute to pathophysiology of NMO/SD.

Spectrum of MRI brain lesion patterns in neuromyelitis optica spectrum disorder: a pictorial review.

PubMed

Wang, Kevin Yuqi; Chetta, Justin; Bains, Pavit; Balzer, Anthony; Lincoln, John; Uribe, Tomas; Lincoln, Christie M

2018-06-01

Neuromyelitis optica is a neurotropic autoimmune inflammatory disease of the central nervous system traditionally thought to exclusively involve the optic nerves and spinal cord. With the discovery of the disease-specific aquaporin-4 antibody and the increasing recognition of clinical and characteristic imaging patterns of brain involvement in what is now termed neuromyelitis optica spectrum disorder (NMOSD), MRI now plays a greater role in diagnosis of NMOSD based on the 2015 consensus criteria and in distinguishing it from other inflammatory disorders, particularly multiple sclerosis (MS). Several brain lesion patterns are highly suggestive of NMOSD, whereas others may serve as red flags. Specifically, long corticospinal lesions, hemispheric cerebral white matter lesions and periependymal lesions in the diencephalon, dorsal brainstem and white matter adjacent to lateral ventricles are typical of NMOSD. In contrast, juxtacortical, cortical, or lesions perpendicularly oriented to the surface of the lateral ventricle suggests MS as the diagnosis. Ultimately, a strong recognition of the spectrum of MRI brain findings in NMOSD is essential for accurate diagnosis, and particularly in differentiating from MS. This pictorial review highlights the spectrum of characteristic brain lesion patterns that may be seen in NMOSD and further delineates findings that may help distinguish it from MS.

Paraneoplastic Neuromyelitis Optica Spectrum Disorder Associated With Metastatic Carcinoid Expressing Aquaporin-4

PubMed Central

Figueroa, Michelle; Guo, Yong; Tselis, Alexandros; Pittock, Sean J.; Lennon, Vanda A.; Lucchinetti, Claudia F.; Lisak, Robert P.

2014-01-01

IMPORTANCE Reports of neuromyelitis optica spectrum disorder (NMOSD) occurring in the setting of neoplasia suggest that aquaporin-4 autoimmunitymay in some cases have a paraneoplastic basis. OBSERVATIONS In this case report, we describe a patient with NMOSD whose test results were seropositive for aquaporin-4 IgG and who had a hepatic metastasis from a small-bowel neuroendocrine tumor. The tumor cells expressed aquaporin-4 immunoreactivity. She presented to the Neurology Department at Wayne State University with bilateral leg weakness, ascending paresthesias, and decreased sensation. CONCLUSIONS AND RELEVANCE This case extends the context of NMOSD as a paraneoplastic disorder. PMID:24733266

Enhancing Brain Lesions during Acute Optic Neuritis and/or Longitudinally Extensive Transverse Myelitis May Portend a Higher Relapse Rate in Neuromyelitis Optica Spectrum Disorders.

PubMed

Orman, G; Wang, K Y; Pekcevik, Y; Thompson, C B; Mealy, M; Levy, M; Izbudak, I

2017-05-01

Neuromyelitis optica spectrum disorders are inflammatory demyelinating disorders with optic neuritis and/or longitudinally extensive transverse myelitis episodes. We now know that neuromyelitis optica spectrum disorders are associated with antibodies to aquaporin-4, which are highly concentrated on astrocytic end-feet at the blood-brain barrier. Immune-mediated disruption of the blood-brain barrier may manifest as contrast enhancement on brain MR imaging. We aimed to delineate the extent and frequency of contrast enhancement on brain MR imaging within 1 month of optic neuritis and/or longitudinally extensive transverse myelitis attacks and to correlate contrast enhancement with outcome measures. Brain MRIs of patients with neuromyelitis optica spectrum disorders were evaluated for patterns of contrast enhancement (periependymal, cloudlike, leptomeningeal, and so forth). The Fisher exact test was used to evaluate differences between the proportion of contrast enhancement in patients who were seropositive and seronegative for aquaporin-4 antibodies. The Mann-Whitney test was used to compare the annualized relapse rate and disease duration between patients with and without contrast enhancement and with and without seropositivity. Brain MRIs of 77 patients were evaluated; 59 patients (10 males, 49 females) were scanned within 1 month of optic neuritis and/or longitudinally extensive transverse myelitis attacks and were included in the analysis. Forty-eight patients were seropositive, 9 were seronegative, and 2 were not tested for aquaporin-4 antibodies. Having brain contrast enhancement of any type during an acute attack was significantly associated with higher annualized relapse rates ( P = .03) and marginally associated with shorter disease duration ( P = .05). Having periependymal contrast enhancement was significantly associated with higher annualized relapse rates ( P = .03). Brain MRIs of patients with neuromyelitis optica spectrum disorders with contrast

Epidemiology of neuromyelitis optica in Latin America

PubMed Central

Alvarenga, MP; Schimidt, Sergio

2017-01-01

A major development over the past two decades was the recognition of recurrent neuromyelitis optica (NMO) as a particular central nervous system disorder different from multiple sclerosis (MS). Here we reviewed the epidemiology of NMO in Latin America (LATAM). A predominance of a mixed population is found in this region. Recurrent NMO in black women was described in the Caribbean Islands and in Rio de Janeiro. The prevalence of NMO in LATAM varied from 0.37/100,000 (Volta Redonda city) to 4.2/100,000 inhabitants (Caribbean Islands). NMO differs significantly from MS with respect to gender, ethnicity, morbidity and genetic susceptibility. An association of the HLA DRB1*03 alleles with NMO was described in the French Antilles, Ribeirão Preto, Rio de Janeiro and Mexico. It is not common to find familial forms of NMO. NMO represents 11.8% of all inflammatory idiopathic diseases in South America (SA). In SA, the highest frequency of NMO occurs in African Brazilian young women. The overall relative frequency of NMO among MS cases in this region was 14%, decreasing following a north-south gradient, which parallels the percentage of nonwhite people. PMID:28979797

Neuromyelitis optica: Application of computer diagnostics to historical case reports.

PubMed

Garcia Reitboeck, Pablo; Garrard, Peter; Peters, Timothy

2017-01-01

The retrospective diagnosis of illnesses by medical historians can often be difficult and prone to bias, although knowledge of the medical disorders of historical figures is key to the understanding of their behavior and reactions. The recent application of computer diagnostics to historical figures allows an objective differential diagnosis to be accomplished. Taking an example from clinical neurology, we analyzed the earliest reported cases of Devic's disease (neuromyelitis optica) that commonly affects the optic nerve and spinal cord and was previously often confused with multiple sclerosis. We conclude that in most identified cases the software concurred with the contemporary physicians' interpretation, but some claimed cases either had insufficient data to provide a diagnosis or other possible diagnoses were suggested that had not been considered. Computational methods may, therefore, help historians to diagnose the ailments of historical figures with greater objectivity.

Association of anti-aquaporin-4 antibody-positive neuromyelitis optica with myasthenia gravis.

PubMed

Uzawa, Akiyuki; Mori, Masahiro; Iwai, Yuhta; Kobayashi, Makoto; Hayakawa, Sei; Kawaguchi, Naoki; Kuwabara, Satoshi

2009-12-15

We describe 2 patients who developed anti-aquaporin-4 antibody-positive neuromyelitis optica (NMO) following the development of anti-acetylcholine receptor antibody-positive myasthenia gravis (MG). A literature review of 13 similar cases in addition to the present 2 cases of NMO with MG showed predominance among Asian women and frequent development of NMO following thymectomy for MG. Moreover, in one of our patients, serial assays of anti-aquaporin-4 antibody and anti-acetylcholine receptor antibody were performed. Accumulating evidence for the coexistence of NMO and MG suggests that a common immunopathogenesis of NMO and MG may exist, and the association of NMO with MG may be more frequent than hitherto believed.

Immunopathogenesis in Myasthenia Gravis and Neuromyelitis Optica

PubMed Central

Wang, Zhen; Yan, Yaping

2017-01-01

Myasthenia gravis (MG) and neuromyelitis optica (NMO) are autoimmune channelopathies of the peripheral neuromuscular junction (NMJ) and central nervous system (CNS) that are mainly mediated by humoral immunity against the acetylcholine receptor (AChR) and aquaporin-4 (AQP4), respectively. The diseases share some common features, including genetic predispositions, environmental factors, the breakdown of tolerance, the collaboration of T cells and B cells, imbalances in T helper 1 (Th1)/Th2/Th17/regulatory T cells, aberrant cytokine and antibody secretion, and complement system activation. However, some aspects of the immune mechanisms are unique. Both targets (AChR and AQP4) are expressed in the periphery and CNS, but MG mainly affects the NMJ in the periphery outside of CNS, whereas NMO preferentially involves the CNS. Inflammatory cells, including B cells and macrophages, often infiltrate the thymus but not the target—muscle in MG, whereas the infiltration of inflammatory cells, mainly polymorphonuclear leukocytes and macrophages, in NMO, is always observed in the target organ—the spinal cord. A review of the common and discrepant characteristics of these two autoimmune channelopathies may expand our understanding of the pathogenic mechanism of both disorders and assist in the development of proper treatments in the future. PMID:29312313

Aquaporin-4 antibody positive neuromyelitis optica spectrum disorder associated with esophageal cancer.

PubMed

Kon, Tomoya; Ueno, Tatsuya; Suzuki, Chieko; Nunomura, Jinichi; Igarashi, Shohei; Sato, Tsugumi; Tomiyama, Masahiko

2017-08-15

Autoimmune diseases are sometimes associated with neoplasms. A 70-year-old Japanese woman with myelitis, seropositive for aquaporin-4 (AQP4) antibody, was diagnosed with neuromyelitis optica spectrum disorder (NMOSD); thereafter an esophageal squamous cell carcinoma was identified. Immunohistochemically, her cancer was anti-AQP4 antibody negative. Her symptoms, imaging findings and AQP4 titer markedly improved with corticosteroid and anti-cancer therapies. Although AQP4 may be a paraneoplastic antigen, paraneoplastic syndrome could not be definitively diagnosed in this case. Nevertheless, this is the first report of an association between AQP4 antibody-seropositive NMOSD and esophageal cancer. The possibility of underlying malignancy should be considered in patients diagnosed with NMOSD. Copyright © 2017 Elsevier B.V. All rights reserved.

Differential diagnosis of neuromyelitis optica spectrum disorders

PubMed Central

Kim, Sung-Min; Kim, Seong-Joon; Lee, Haeng Jin; Kuroda, Hiroshi; Palace, Jacqueline; Fujihara, Kazuo

2017-01-01

Neuromyelitis optica spectrum disorder (NMOSD) is an inflammatory disorder of the central nervous system (CNS) mostly manifesting as optic neuritis and/or myelitis, which are frequently recurrent/bilateral or longitudinally extensive, respectively. As the autoantibody to aquaporin-4 (AQP4-Ab) can mediate the pathogenesis of NMOSD, testing for the AQP4-Ab in serum of patients can play a crucial role in diagnosing NMOSD. Nevertheless, the differential diagnosis of NMOSD in clinical practice is often challenging despite the phenotypical and serological characteristics of the disease because: (1) diverse diseases with autoimmune, vascular, infectious, or neoplastic etiologies can mimic these phenotypes of NMOSD; (2) patients with NMOSD may only have limited clinical manifestations, especially in their early disease stages; (3) test results for AQP4-Ab can be affected by several factors such as assay methods, serologic status, disease stages, or types of treatment; (4) some patients with NMOSD do not have AQP4-Ab; and (5) test results for the AQP4-Ab may not be readily available for the acute management of patients. Despite some similarity in their phenotypes, these NMOSD and NMOSD-mimics are distinct from each other in their pathogenesis, prognosis, and most importantly treatment. Understanding the detailed clinical, serological, radiological, and prognostic differences of these diseases will improve the proper management as well as diagnosis of patients. PMID:28670343

New Insights into Neuromyelitis Optica

PubMed Central

Kim, Woojun; Kim, Su-Hyun

2011-01-01

Neuromyelitis optica (NMO) is an idiopathic inflammatory disorder of the central nervous system (CNS) that preferentially affects the optic nerves and spinal cord. In Asia, NMO has long been considered a subtype of multiple sclerosis (MS). However, recent clinical, pathological, immunological, and imaging studies have suggested that NMO is distinct from MS. This reconsideration of NMO was initially prompted by the discovery of a specific antibody for NMO (NMO-IgG) in 2004. NMO-IgG is an autoantibody that targets aquaporin-4 (AQP4), the most abundant water channel in the CNS; hence, it was named anti-AQP4 antibody. Since it demonstrated reasonable sensitivity and high specificity, anti-AQP4 antibody was incorporated into new diagnostic criteria for NMO.The spectrum of NMO is now known to be wider than was previously recognized and includes a proportion of patients with recurrent, isolated, longitudinally extensive myelitis or optic neuritis, and longitudinally extensive myelitis or optic neuritis associated with systemic autoimmune disease or with brain lesions typical of NMO. In this context, a new concept of "NMO spectrum disorders" was recently introduced. Furthermore, seropositivity for NMO-IgG predicts future relapses and is recognized as a prognostic marker for NMO spectrum disorders. Humoral immune mechanisms, including the activation of B-cells and the complement pathway, are considered to play important roles in NMO pathogenesis. This notion is supported by recent studies showing the potential pathogenic role of NMO-IgG as an initiator of NMO lesions. However, a demonstration of the involvement of NMO-IgG by the development of active immunization and passive transfer in animal models is still needed. This review focuses on the new concepts of NMO based on its pathophysiology and clinical characteristics. Potential management strategies for NMO in light of its pathomechanism are also discussed. PMID:22087205

Chloride imbalance is involved in the pathogenesis of optic neuritis in neuromyelitis optica.

PubMed

Akaishi, Tetsuya; Takahashi, Toshiyuki; Himori, Noriko; Takeshita, Takayuki; Nakazawa, Toru; Aoki, Masashi; Nakashima, Ichiro

2018-07-15

Chloride imbalance between the serum and the cerebrospinal fluid (CSF) has been recently shown to exist in the acute phase of neuromyelitis optica (NMO). In this report, we studied the relation between the quotient of chloride (Q Cl ) and the severity of optic neuritis (ON) in NMO patients. There was a positive correlation (R = 0.67; p < 0.05) between Q Cl and the length of ON-lesion. The visual prognosis also showed a positive correlation with Q Cl in the acute phase (R = 0.58; p < 0.05). These results support the theory that chloride imbalance between serum and CSF may trigger the ON in NMO spectrum disorders. Copyright © 2018 Elsevier B.V. All rights reserved.

A Case of Transient Pulmonary Interstitial Lesions in Aquaporin-4-positive Neuromyelitis Optica Spectrum Disorder.

PubMed

Asato, Yuko; Kamitani, Toshiaki; Ootsuka, Kuniyuki; Kuramochi, Mizuki; Nakanishi, Kozo; Shimada, Tetsuya; Takahashi, Toshiyuki; Misu, Tatsuro; Aoki, Masashi; Fujihara, Kazuo; Kawabata, Yoshinori

2018-05-18

We herein report the case of a 76-year old man with aquaporin-4-Immunoglobulin-G (AQP4-IgG)-positive neuromyelitis optica spectrum disorder (NMOSD), in whom transient interstitial pulmonary lesions developed at the early stage of the disease. Chest X-ray showed multiple infiltrative shadows in both upper lung fields, and computed tomography revealed abnormal shadows distributed randomly in the lungs. Surgical lung biopsy showed features of unclassifiable interstitial pneumonia, characterized by various types of air-space organization, which resulted in obscure lung structure. This is the first report to describe the pathological findings of interstitial pneumonia, which may represent a rare extra-central nervous system complication of NMOSD.

Catálogo de Radio-Fuentes Opticas con Astrolabio Fotoeléctrico PAII

NASA Astrophysics Data System (ADS)

Manrique, W. T.; Podestá, R. C.; Alonso, E.; Actis, E. V.; Pacheco, A. M.; Bustos, G.; Lizhi, L.; Zezhi, W.; Fanmiao, Z.; Hongqi, W.; Perdomo, R.

Usando los datos observados en San Juan con el Astrolabio Fotoeléctrico PAII desde Febrero de 1992 hasta Marzo de 1997, se ha realizado el Catálogo de Radio-Fuentes Opticas de San Juan conteniendo 69 estrellas. Las observaciones de las posiciones de las radio-fuentes están realizadas para la época y equinoccio J2000,0 y en un sistema cercano al del FK5. Las precisiones medias son ± 2,2 ms y ± 0,"035 en ascensión recta y declinación respectivamente. Las magnitudes de las estrellas son desde 0,9 a 10,7 . Las declinaciones son desde --2,5 grados a --60 grados. La época media es 1995,1. Se muestran también los resultados comparados con el Catálogo Hiparcos.

Endocrinopathies in paediatric-onset neuromyelitis optica spectrum disorder with aquaporin 4 (AQP4) antibody.

PubMed

Hacohen, Yael; Messina, Silvia; Gan, Hoong-Wei; Wright, Sukhvir; Chandratre, Saleel; Leite, Maria Isabel; Fallon, Penny; Vincent, Angela; Ciccarelli, Olga; Wassmer, Evangeline; Lim, Ming; Palace, Jacqueline; Hemingway, Cheryl

2018-04-01

The involvement of the diencephalic regions in neuromyelitis optica spectrum disorder (NMOSD) may lead to endocrinopathies. In this study, we identified the following endocrinopathies in 60% (15/25) of young people with paediatric-onset aquaporin 4-Antibody (AQP4-Ab) NMOSD: morbid obesity ( n = 8), hyperinsulinaemia ( n = 5), hyperandrogenism ( n = 5), amenorrhoea ( n = 5), hyponatraemia ( n = 4), short stature ( n = 3) and central hypothyroidism ( n = 2) irrespective of hypothalamic lesions. Morbid obesity was seen in 88% (7/8) of children of Caribbean origin. As endocrinopathies were prevalent in the majority of paediatric-onset AQP4-Ab NMOSD, endocrine surveillance and in particular early aggressive weight management is required for patients with AQP4-Ab NMOSD.

Neuromyelitis optica immunoglobulin G in Chinese patients detected by immunofluorescence assay on a monkey brain substrate.

PubMed

Long, Youming; Hu, Xueqiang; Peng, Fuhua; Lu, Zhengqi; Wang, Yuge; Yang, Yu; Qiu, Wei

2012-01-01

Serum neuromyelitis optica immunoglobulin G (NMO-IgG) is used as a biomarker to differentiate between neuromyelitis optica (NMO) and multiple sclerosis (MS). However, the original assay is expensive and complex and shows low sensitivity. Here, we investigated the potential of NMO-IgG detection using an indirect immunofluorescence (IIF) assay on monkey brains. NMO-IgG seroprevalence was determined in 168 samples by an IIF assay on a monkey brain substrate. The data were compared with those from a standard mouse brain IIF assay using McNemar and kappa tests. Thirty-one of 50 (62%) NMO patients, 7 of 18 (38.9%) longitudinally extensive transverse myelitis patients, 6 of 57 (10.5%) MS patients, and 5 of 10 (50%) optic neuritis patients were seropositive for NMO-IgG. None of the acute partial transverse myelitis patients (n = 3) or healthy controls (n = 20) was positive. Thus, the sensitivity of the test was 62% for the patients with clinically definite NMO. The specificity was 89.5%, considering the 57 MS patients as the control group. The modified IIF assay on monkey brains and the standard IIF assay based on mouse brains were not significantly different (McNemar test; p = 1.000). The two assays were concordant in 39 seropositive samples and 100 seronegative samples (kappa test; kappa = 0.592, p < 0.0001). Although the modified IIF monkey brain assay was no better than the standard mouse brain IIF assay, we affirmed that NMO-IgG is a sensitive and specific biomarker to differentiate between NMO and MS. Copyright © 2011 S. Karger AG, Basel.

Neuromyelitis optica in pregnancy complicated by posterior reversible encephalopathy syndrome, eclampsia and fetal death.

PubMed

Igel, Catherine; Garretto, Diana; Robbins, Matthew S; Swerdlow, Michael; Judge, Nancy; Dayal, Ashlesha

2015-03-01

Neuromyelitis optica (NMO) is a demyelinating syndrome characterized by optic neuritis and acute myelitis with poor recovery and a progressive course. We report a poor outcome complicated by posterior reversible encephalopathy syndrome (PRES) and eclampsia and review available literature and current evidence for anticipation of adverse fetal and maternal effects. After a pregnancy complicated by multiple admissions for painful NMO exacerbations, a primiparous patient with seropositive NMO presented at 31 + 3/7 weeks with eclampsia, HELLP and subsequent fetal death. MRI confirmed PRES. NMO may be associated with eclampsia and leads to adverse maternal and fetal outcomes. Posited mechanisms include antibody-mediated placental damage and a heightened risk of eclampsia-associated PRES. Further characterization of the course of NMO and its relationship with pregnancy outcomes in larger series would be invaluable.

Neuromyelitis Optica in Pregnancy Complicated by Posterior Reversible Encephalopathy Syndrome, Eclampsia and Fetal Death

PubMed Central

Igel, Catherine; Garretto, Diana; Robbins, Matthew S; Swerdlow, Michael; Judge, Nancy; Dayal, Ashlesha

2015-01-01

Neuromyelitis optica (NMO) is a demyelinating syndrome characterized by optic neuritis and acute myelitis with poor recovery and a progressive course. We report a poor outcome complicated by posterior reversible encephalopathy syndrome (PRES) and eclampsia and review available literature and current evidence for anticipation of adverse fetal and maternal effects. After a pregnancy complicated by multiple admissions for painful NMO exacerbations, a primiparous patient with seropositive NMO presented at 31 + 3/7 weeks with eclampsia, HELLP and subsequent fetal death. MRI confirmed PRES. NMO may be associated with eclampsia and leads to adverse maternal and fetal outcomes. Posited mechanisms include antibody-mediated placental damage and a heightened risk of eclampsia-associated PRES. Further characterization of the course of NMO and its relationship with pregnancy outcomes in larger series would be invaluable. PMID:25584107

Evoked potentials are useful for diagnosis of neuromyelitis optica spectrum disorder.

PubMed

Ohnari, Keiko; Okada, Kazumasa; Takahashi, Toshiyuki; Mafune, Kosuke; Adachi, Hiroaki

2016-05-15

Neuromyelitis optica spectrum disorder (NMOSD) has been differentiated from relapsing-remitting multiple sclerosis (RRMS) by clinical, laboratory, and pathological findings, including the presence of the anti-aquaporin 4 antibody. Measurement of evoked potentials (EPs) is often used for the diagnosis of RRMS, although the possibility of applying EPs to the diagnosis of NMOSD has not been investigated in detail. Eighteen patients with NMOSD and 28 patients with RRMS were included in this study. The patients' neurological symptoms and signs were examined and their EPs were recorded. Characteristic findings were absence of visual evoked potentials and absence of motor evoked potentials in the lower extremities in patients with NMOSD, and a delay in these potentials in patients with RRMS. Most patients with NMOSD did not present abnormal subclinical EPs, whereas many patients with RRMS did. None of the patients with NMOSD showed abnormalities in auditory brainstem responses. NMOSD can be differentiated from RRMS by EP data obtained in the early stages of these diseases. Copyright © 2016 Elsevier B.V. All rights reserved.

Autoimmune AQP4 channelopathies and neuromyelitis optica spectrum disorders.

PubMed

Hinson, Shannon R; Lennon, Vanda A; Pittock, Sean J

2016-01-01

Neuromyelitis optica (NMO) spectrum disorders (SD) represent an evolving group of central nervous system (CNS)-inflammatory autoimmune demyelinating diseases unified by a pathogenic autoantibody specific for the aquaporin-4 (AQP4) water channel. It was historically misdiagnosed as multiple sclerosis (MS), which lacks a distinguishing biomarker. The discovery of AQP4-IgG moved the focus of CNS demyelinating disease research from emphasis on the oligodendrocyte and myelin to the astrocyte. NMO is recognized today as a relapsing disease, extending beyond the optic nerves and spinal cord to include brain (especially in children) and skeletal muscle. Brain magnetic resonance imaging abnormalities, identifiable in 60% of patients at the second attack, are consistent with MS in 10% of cases. NMOSD-typical lesions (another 10%) occur in AQP4-enriched regions: circumventricular organs (causing intractable nausea and vomiting) and the diencephalon (causing sleep disorders, endocrinopathies, and syndrome of inappropriate antidiuresis). Advances in understanding the immunobiology of AQP4 autoimmunity have necessitated continuing revision of NMOSD clinical diagnostic criteria. Assays that selectively detect pathogenic AQP4-IgG targeting extracellular epitopes of AQP4 are promising prognostically. When referring to AQP4 autoimmunity, we suggest substituting the term "autoimmune aquaporin-4 channelopathy" for the term "NMO spectrum disorders." Randomized clinical trials are currently assessing the efficacy and safety of newer immunotherapies. Increasing therapeutic options based on understanding the molecular pathogenesis is anticipated to improve the outcome for patients with AQP4 channelopathy. © 2016 Elsevier B.V. All rights reserved.

Seronegative Neuromyelitis Optica: A Case Report of a Hispanic Male

PubMed Central

Badri, Nabeel; Teleb, Mohamed; Syed, Saad; Wardi, Miraie; Porres-Aguilar, Mateo; Cruz-Flores, Salvador

2016-01-01

Abstract Neuromyelitis optica (NMO) is a rare disease, common in white females and rarely reported in Hispanic males. It is usually associated with recurrent demyelinating spectrum that is autoimmune in nature. The diagnosis is usually confirmed by antibody biomarkers; however, they can be negative and lead to more dilemma in diagnosis. Furthermore, the course of disease and prognosis are different in seronegative as compared to seropositive NMO. Treatment is similar in both subgroups with new approaches under investigation for seronegative NMO patients. We present an interesting case of a 37-year-old Hispanic male who presented with sudden onset of lower extremity weakness, numbness, blurry vision, and urinary retention. Magnetic resonance imaging (MRI) of the thoracic spine showed multiphasic demyelinating process involving the thoracic spinal cord. His brain MRI also revealed changes suggesting optic neuritis. The patient met the criteria for diagnosis of NMO by having optic neuritis and myelitis by imaging studies despite having negative aquaporin-4 antibodies (AQP4-Ab). His condition improved after plasma exchange. NMO can be difficult to distinguish from acute multiple sclerosis in the early stages of the disease. Having AQP4-Ab testing is important for diagnosis with imaging studies; however, negative antibody results cannot exclude the diagnosis, but rather group it in seronegative subtype. Ongoing studies and research suggest that seronegative NMO might have a different pathophysiology, manifestation, and prognosis. PMID:27403130

High-risk syndrome for neuromyelitis optica: a descriptive and comparative study.

PubMed

Collongues, N; Marignier, R; Zéphir, H; Blanc, F; Vukusic, S; Outteryck, O; Fleury, M; Ruet, A; Borgel, F; Thouvenot, E; Moreau, T; Defer, G; Derache, N; Pelletier, J; Audoin, B; Debouverie, M; Labauge, P; Gout, O; Camu, W; Brassat, D; Brochet, B; Vermersch, P; Confavreux, C; de Seze, J

2011-06-01

Neuromyelitis optica (NMO) frequently begins with a monofocal episode of optic neuritis or myelitis. A concept named high-risk syndrome (HRS) for NMO has been proposed for patients with monofocal episodes and NMO-IgG antibodies. To describe HRS patients and compare them with NMO patients. We identified 30 patients with HRS: 18 with extensive myelitis (HRM) and 12 with optic neuritis (HRON), in a database pooling patients from 25 centres in France. Clinical, laboratory/magnetic resonance imaging (MRI) data and outcome were analysed and compared with a national cohort of 125 NMO patients extracted from the same database. Mean follow-up was 4.8 years. Mean age at onset was 42.8 years (range: 12.4-70) with a female:male ratio of 0.9. Asymptomatic lesions were report on visual evoked potentials in 4/8 tested HRM patients and on spinal cord MRI in 2/7 HRON patients. Three patients died, two owing to a cervical lesion. HRS and NMO patients had similar clinical/paraclinical data, except for a predominance of men in the HRS group and a later mean age at onset in the HRM subgroup. The description of HRS patients is compatible with a monofocal form of NMO. Asymptomatic lesions could be included in a new set of NMO diagnostic criteria.

Differentiation of Neuromyelitis Optica from Multiple Sclerosis on Spinal Magnetic Resonance Imaging

PubMed Central

Khan, Majid; Schlakman, Bruce; Penman, Alan; Gatlin, Joseph; Herndon, Robert

2012-01-01

In order to examine the accuracy of magnetic resonance imaging (MRI)–based diagnosis of neuromyelitis optica (NMO) versus multiple sclerosis (MS), we performed a retrospective, rater-blinded review of 29 cases of NMO and 30 cases of MS using the criteria of long (more than three vertebral levels), continuous lesions with a central cord location for NMO and more peripheral and patchy lesions for MS. Using these criteria, two raters were able to distinguish the two conditions with a good degree of confidence, particularly when the imaging was performed at the time of an acute cord attack. The sensitivity and specificity for diagnosis of NMO were 86.2% and 93.3%, respectively, for Rater A and 96.4% and 78.6%, respectively, for Rater B, with a kappa value of 0.72. Thus there are significant differences in lesion characteristics that allow the distinction on spinal cord imaging between MS and NMO with a moderately high degree of confidence. The location of the lesion as evident on MRI of the spine can be regarded as a distinguishing diagnostic feature between MS and NMO. PMID:24453753

Neuromyelitis optica: association with paroxysmal painful tonic spasms.

PubMed

Carnero Contentti, E; Leguizamón, F; Hryb, J P; Celso, J; Pace, J L Di; Ferrari, J; Knorre, E; Perassolo, M B

2016-10-01

Paroxysmal painful tonic spasms (PPTS) were initially described in multiple sclerosis (MS) but they are more frequent in neuromyelitis optica (NMO). The objective is to report their presence in a series of cases of NMO and NMO spectrum disorders (NMOSD), as well as to determine their frequency and clinical features. We conducted a retrospective assessment of medical histories of NMO/NMOSD patients treated in 2 hospitals in Buenos Aires (Hospital Durand and Hospital Álvarez) between 2009 and 2013. Out of 15 patients with NMOSD (7 with definite NMO and 8 with limited NMO), 4 presented PPTS (26.66%). PPTS frequency in the definite NMO group was 57.14% (4/7). Of the 9 patients with longitudinally extensive transverse myelitis (LETM), 44.44% (9/15) presented PPTS. Mean age was 35 years (range, 22-38 years) and all patients were women. Mean time between NMO diagnosis and PPTS onset was 7 months (range, 1-29 months) and mean time from last relapse of LETM was 30 days (range 23-40 days). LETM (75% cervicothoracic and 25% thoracic) was observed by magnetic resonance imaging (MRI) in all patients. Control over spasms and pain was achieved in all patients with carbamazepine (associated with gabapentin in one case). No favourable responses to pregabalin, gabapentin, or phenytoin were reported. PPTS are frequent in NMO. Mean time of PPTS onset is approximately one month after an LETM relapse, with extensive cervicothoracic lesions appearing on the MRI scan. They show an excellent response to carbamazepine but little or no response to pregabalin and gabapentin. Prospective studies with larger numbers of patients are necessary in order to confirm these results. Copyright © 2014 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Systematic review of the published data on the worldwide prevalence of John Cunningham virus in patients with multiple sclerosis and neuromyelitis optica.

PubMed

Paz, Sonia Patricia Castedo; Branco, Luciana; Pereira, Marina Alves de Camargo; Spessotto, Caroline; Fragoso, Yara Dadalti

2018-01-01

John Cunningham virus (JCV) is a polyoma virus that infects humans, mainly in childhood or adolescence, and presents no symptomatic manifestations. JCV can cause progressive multifocal leukoencephalopathy (PML) in immunosuppressed individuals, including those undergoing treatment for multiple sclerosis (MS) and neuromyelitis optica (NMO). PML is a severe and potentially fatal disease of the brain. The prevalence of JCV antibodies in human serum has been reported to be between 50.0 and 90.0%. The aim of the present study was to review worldwide data on populations of patients with MS and NMO in order to establish the rates of JCV seropositivity in these individuals. The present review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and used the following search terms: "JCV" OR "JC virus" AND "multiple sclerosis" OR "MS" OR "NMO" OR "neuromyelitis optica" AND "prevalence." These terms were searched for both in smaller and in larger clusters of words. The databases searched included PubMed, MEDLINE, SciELO, LILACS, Google Scholar, and Embase. After the initial selection, 18 papers were included in the review. These articles reported the prevalence of JCV antibodies in the serum of patients with MS or NMO living in 26 countries. The systematic review identified data on 29,319 patients with MS/NMO and found that 57.1% of them (16,730 individuals) were seropositive for the anti-JCV antibody (range, 40.0 to 69.0%). The median worldwide prevalence of JCV among adults with MS or NMO was found to be 57.1%.

Acute-Onset Severe Occipital Neuralgia Associated With High Cervical Lesion in Patients With Neuromyelitis Optica Spectrum Disorder.

PubMed

Hayashi, Yuichi; Koumura, Akihiro; Yamada, Megumi; Kimura, Akio; Shibata, Toshirou; Inuzuka, Takashi

2017-07-01

To address occipital neuralgia in patients with neuromyelitis optica spectrum disorder (NMOSD). NMOSD is an inflammatory demyelinating disease that commonly presents with pain; however, headache symptoms have received little attention. We presented three cases of NMOSD in which the patients experienced acute-onset, severe, and steroid-responsive occipital neuralgia. All patients provided consent to use their demographic and imaging data retrospectively. In all three cases, MRI revealed a new high-intensity area in the cervical cord at the C1-C3 level of the spine, which was diminished in two of the three cases after corticosteroid pulse therapy. Our cases support the recognition of NMOSD as a cause of secondary headache. As patients with NMOSD experience severe occipital neuralgia, a relapse should be considered and a cervical MRI should be performed. © 2017 American Headache Society.

Thalamic Atrophy Contributes to Low Slow Wave Sleep in Neuromyelitis Optica Spectrum Disorder.

PubMed

Su, Lei; Han, Yujuan; Xue, Rong; Wood, Kristofer; Shi, Fu-Dong; Liu, Yaou; Fu, Ying

2016-12-01

Slow wave sleep abnormality has been reported in neuromyelitis optica spectrum disorder (NMOSD), but mechanism for such abnormality is unknown. To determine the structural defects in the brain that account for the decrease of slow wave sleep in NMOSD patients. Thirty-three NMOSD patients and 18 matched healthy controls (HC) were enrolled. Polysomnography was used to monitor slow wave sleep and three-dimensional T1-weighted MRIs were obtained to assess the alterations of grey matter volume. The percentage of deep slow wave sleep decreased in 93% NMOSD patients. Compared to HC, a reduction of grey matter volume was found in the bilateral thalamus of patients with a lower percentage of slow wave sleep (FWE corrected at cluster-level, p < 0.05, cluster size > 400 voxels). Furthermore, the right thalamic fraction was positively correlated with the decrease in the percentage of slow wave sleep in NMOSD patients (p < 0.05, FDR corrected, cluster size > 200 voxels). Our study identified that thalamic atrophy is associated with the decrease of slow wave sleep in NMOSD patients. Further studies should evaluate whether neurotransmitters or hormones which stem from thalamus are involved in the decrease of slow wave sleep.

A case of seropositive Neuromyelitis Optica in a paediatric patient with co-existing acute nephrotic syndrome.

PubMed

Volkman, Thomas; Hemingway, Cheryl

2017-11-01

Neuromyelitis optica (NMO) and NMO spectrum disorder (NMOSD) is a rare relapsing autoimmune disease of the central nervous system constituting less than 1% of demyelinating diseases (Jeffery and Buncic, 1996). It preferentially affects the optic nerves and spinal cord, with the brain parenchyma generally spared. Demyelinating lesions are characterised by longitudinally extensive transverse myelitis (LETM) and often longitudinally extensive optic neuritis. Following the discovery of a novel pathogenic antibody, Aquaporin 4 in 2004 (Lennon et al., 2004) this disease has been seen as a separate entity from Multiple Sclerosis (MS). We report the case of a severe AQP4 IgG case of NMO in a 10 year old child. This case unusually had a coexisting diagnosis of acute nephrotic syndrome which has only been reported once previously in the literature 2 . This article will examine some of the treatment challenges and the spectrum of co-existing autoimmune disease in NMOSD. Copyright © 2017. Published by Elsevier B.V.

Effectiveness of multi-disciplinary rehabilitation for patients with Neuromyelitis Optica

PubMed Central

Nechemia, Yael; Moreh, Elior; Weingarden, Harold; Bloch, Ayala; Givon, Uri; Vaknin-Dembinsky, Adi; Schwartz, Isabella; Meiner, Zeev

2016-01-01

Introduction Neuromyelitis optica (NMO), previously considered a subtype of multiple sclerosis (MS), is now known to be a unique disorder associated with autoantibodies against aquaporin-4. The rehabilitation protocols for MS have been applied to NMO, without specific measures of efficacy. Purpose The evaluation of the effectiveness of an MS type inpatient rehabilitation program for patients with NMO. Patient and Methods Retrospective chart reviews of 15 inpatients with NMO and 32 inpatients with MS. Clinical severity was assessed by the Expanded Disability Status Scale (EDSS), functional assessments were scored using the Functional Independence Measure (FIM), the Montebello Rehabilitation Factor Score (MRFS), and the Functional Ambulation Category (FAC). There was a higher percentage of women in the NMO group (87% vs 56% P = 0.003). The MS group had significantly more cognitive and communication deficits (P = 0.003 and P = 0.00001). No significant differences were found in admission FIM, EDSS and FAC scores. Results Both groups benefitted, however at discharge, the NMO group showed greater improvement in FIM scores (NMO admission 79 ± 24, discharge 98 ± 21; MS admission 80 ± 28, discharge 89 ± 28); and lower EDSS score (NMO from 7.2 ± 1.4 to 6.3 ± 1.4; MS from 7.4 ± 1.4 to 7 ± 1.5). Conclusions Inpatient multidisciplinary rehabilitation programs available for the patients with MS may be successfully implemented for patients with NMO. PMID:26446695

White Matter Atrophy and Cognitive Dysfunctions in Neuromyelitis Optica

PubMed Central

Blanc, Frederic; Noblet, Vincent; Jung, Barbara; Rousseau, François; Renard, Felix; Bourre, Bertrand; Longato, Nadine; Cremel, Nadjette; Di Bitonto, Laure; Kleitz, Catherine; Collongues, Nicolas; Foucher, Jack; Kremer, Stephane; Armspach, Jean-Paul; de Seze, Jerome

2012-01-01

Neuromyelitis optica (NMO) is an inflammatory disease of central nervous system characterized by optic neuritis and longitudinally extensive acute transverse myelitis. NMO patients have cognitive dysfunctions but other clinical symptoms of brain origin are rare. In the present study, we aimed to investigate cognitive functions and brain volume in NMO. The study population consisted of 28 patients with NMO and 28 healthy control subjects matched for age, sex and educational level. We applied a French translation of the Brief Repeatable Battery (BRB-N) to the NMO patients. Using SIENAx for global brain volume (Grey Matter, GM; White Matter, WM; and whole brain) and VBM for focal brain volume (GM and WM), NMO patients and controls were compared. Voxel-level correlations between diminished brain concentration and cognitive performance for each tests were performed. Focal and global brain volume of NMO patients with and without cognitive impairment were also compared. Fifteen NMO patients (54%) had cognitive impairment with memory, executive function, attention and speed of information processing deficits. Global and focal brain atrophy of WM but not Grey Matter (GM) was found in the NMO patients group. The focal WM atrophy included the optic chiasm, pons, cerebellum, the corpus callosum and parts of the frontal, temporal and parietal lobes, including superior longitudinal fascicle. Visual memory, verbal memory, speed of information processing, short-term memory and executive functions were correlated to focal WM volumes. The comparison of patients with, to patients without cognitive impairment showed a clear decrease of global and focal WM, including brainstem, corticospinal tracts, corpus callosum but also superior and inferior longitudinal fascicles. Cognitive impairment in NMO patients is correlated to the decreased of global and focal WM volume of the brain. Further studies are needed to better understand the precise origin of cognitive impairment in NMO patients

European Ancestry Predominates in Neuromyelitis Optica and Multiple Sclerosis Patients from Brazil

PubMed Central

Santos, Antônio Carlos; Lana-Peixoto, Marco Aurélio; Rocha, Cristiane Franklin; Brito, Maria Lucia; de Oliveira, Enedina Maria Lobato; Bichuetti, Denis Bernardi; Gabbai, Alberto Alan; Diniz, Denise Sisterolli; Kaimen-Maciel, Damacio Ramon; Comini-Frota, Elizabeth Regina; Vieira Wiezel, Claudia E.; Muniz, Yara Costa Netto; da Silva Costa, Roberta Martins; Mendes-Junior, Celso Teixeira; Donadi, Eduardo Antônio; Barreira, Amilton Antunes; Simões, Aguinaldo Luiz

2013-01-01

Background Neuromyelitis optica (NMO) is considered relatively more common in non-Whites, whereas multiple sclerosis (MS) presents a high prevalence rate, particularly in Whites from Western countries populations. However, no study has used ancestry informative markers (AIMs) to estimate the genetic ancestry contribution to NMO patients. Methods Twelve AIMs were selected based on the large allele frequency differences among European, African, and Amerindian populations, in order to investigate the genetic contribution of each ancestral group in 236 patients with MS and NMO, diagnosed using the McDonald and Wingerchuck criteria, respectively. All 128 MS patients were recruited at the Faculty of Medicine of Ribeirão Preto (MS-RP), Southeastern Brazil, as well as 108 healthy bone marrow donors considered as healthy controls. A total of 108 NMO patients were recruited from five Neurology centers from different Brazilian regions, including Ribeirão Preto (NMO-RP). Principal Findings European ancestry contribution was higher in MS-RP than in NMO-RP (78.5% vs. 68.7%) patients. In contrast, African ancestry estimates were higher in NMO-RP than in MS-RP (20.5% vs. 12.5%) patients. Moreover, principal component analyses showed that groups of NMO patients from different Brazilian regions were clustered close to the European ancestral population. Conclusions Our findings demonstrate that European genetic contribution predominates in NMO and MS patients from Brazil. PMID:23527051

IL2RA Allele Increases Risk of Neuromyelitis Optica in Southern Han Chinese.

PubMed

Dai, Yongqiang; Li, Jin; Zhong, Xiaonan; Wang, Yuge; Qiu, Wei; Lu, Zhengqi; Wu, Aimin; Bao, Jian; Peng, Fuhua; Hu, Xueqiang

2013-11-01

Neuromyelitis optica (NMO) and multiple sclerosis (MS) are chronic neuro-inflammatory diseases believed to arise from complex interactions between environmental and genetic factors. Recently, single nucleotide polymorphisms (SNPs) in interleukin (IL)-2 and -7 receptor alpha genes have been identified as novel susceptibility alleles for MS in genome-wide association studies. However, similar research on NMO is limited. We aimed to investigate the association of IL2RA SNPs rs2104286 and rs12722489 and IL7RA SNP rs6897932 with Southern Han Chinese NMO and MS patients. Frequencies of the three SNPs were examined in Southern Han Chinese mS cases (n=78), NMS cases (n=67) and controls (n=133) using sequencing-based typing. The rs2104286(G) frequency in the IL2RA gene was significantly higher in NMO patients than in controls (p(uncorr)=0.013, p(corr)=0.026, OR:1.942, 95%CI:1.146-3.291). The rs2104286 G allele in IL2RA is present at higher frequencies in NMO patients than in healthy controls within a Southern Han Chinese population. Les allèles IL2RA augmentent le risque de neuromyélite optique chez les Chinois Han du sud.

CFHR1-Modified Neural Stem Cells Ameliorated Brain Injury in a Mouse Model of Neuromyelitis Optica Spectrum Disorders.

PubMed

Shi, Kaibin; Wang, Zhen; Liu, Yuanchu; Gong, Ye; Fu, Ying; Li, Shaowu; Wood, Kristofer; Hao, Junwei; Zhang, Guang-Xian; Shi, Fu-Dong; Yan, Yaping

2016-11-01

A major hurdle for effective stem cell therapy is ongoing inflammation in the target organ. Reconditioning the lesion microenvironment may be an effective way to promote stem cell therapy. In this study, we showed that engineered neural stem cells (NSCs) with complement factor H-related protein 1, a complement inhibitor protein, can attenuate inflammatory infiltration and immune-mediated damage of astrocytes, an important pathogenic progress in patients with neuromyelitis optica spectrum disorders. Furthermore, we demonstrated that transplantation of the complement factor H-related protein 1-modified NSCs effectively blocked the complement activation cascade and inhibited formation of the membrane attack complex, thus contributing to the protection of endogenous and transplanted NSC-differentiated astrocytes. Therefore, manipulation of the lesion microenvironment contributes to a more effective cell replacement therapeutic strategy for autoimmune diseases of the CNS. Copyright © 2016 by The American Association of Immunologists, Inc.

Antibody response against HERV-W env surface peptides differentiates multiple sclerosis and neuromyelitis optica spectrum disorder.

PubMed

Arru, Giannina; Sechi, Elia; Mariotto, Sara; Farinazzo, Alessia; Mancinelli, Chiara; Alberti, Daniela; Ferrari, Sergio; Gajofatto, Alberto; Capra, Ruggero; Monaco, Salvatore; Deiana, Giovanni A; Caggiu, Elisa; Mameli, Giuseppe; Sechi, Leonardo A; Sechi, Gian Pietro

2017-01-01

A specific humoral immune response against HERV-W envelope surface (env-su) glycoprotein antigens has been reported in serum of patients with multiple sclerosis (MS). However, it has not been evaluated to date in patients with neuromyelitis optica spectrum disorder (NMOSD). The objective of this paper is to investigate whether antibody (Ab) response against HERV-W env-su antigenic peptides differs between NMOSD and MS. Serum samples were collected from 36 patients with NMOSD, 36 patients with MS and 36 healthy control individuals (HCs). An indirect ELISA was set up to detect specific Abs against HERV-W env-su peptides. Our data showed that two antigenic peptides, particularly HERV-Wenv 93-108 and HERV-Wenv 248-262, were statistically significantly present only in serum of MS compared to NMOSD and HCs. Thus, the specific humoral immune response against HERV-W env-su glycoprotein antigens found in MS is widely missing in NMOSD. Increased circulating serum levels of these HERV-W Abs may be suitable as additional biomarkers to better differentiate MS from NMOSD.

Th17 Cells Pathways in Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorders: Pathophysiological and Therapeutic Implications

PubMed Central

Passos, Giordani Rodrigues Dos; Sato, Douglas Kazutoshi; Becker, Jefferson; Fujihara, Kazuo

2016-01-01

Several animal and human studies have implicated CD4+ T helper 17 (Th17) cells and their downstream pathways in the pathogenesis of central nervous system (CNS) autoimmunity in multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD), challenging the traditional Th1-Th2 paradigm. Th17 cells can efficiently cross the blood-brain barrier using alternate ways from Th1 cells, promote its disruption, and induce the activation of other inflammatory cells in the CNS. A number of environmental factors modulate the activity of Th17 pathways, so changes in the diet, exposure to infections, and other environmental factors can potentially change the risk of development of autoimmunity. Currently, new drugs targeting specific points of the Th17 pathways are already being tested in clinical trials and provide basis for the development of biomarkers to monitor disease activity. Herein, we review the key findings supporting the relevance of the Th17 pathways in the pathogenesis of MS and NMOSD, as well as their potential role as therapeutic targets in the treatment of immune-mediated CNS disorders. PMID:26941483

Sjögren syndrome and neuromyelitis optica spectrum disorder co-exist in a common autoimmune milieu.

PubMed

Carvalho, Diogo C; Tironi, Tauana S; Freitas, Denise S; Kleinpaul, Rodrigo; Talim, Natalia C; Lana-Peixoto, Marco A

2014-08-01

The relationship between Sjögren's syndrome (SS) and neuromyelitis optica spectrum disorder (NMOSD) is not completely understood. We report two patients with both conditions and review 47 other previously reported cases meeting currently accepted diagnostic criteria, from 17 articles extracted from PubMed. Out of 44 patients whose gender was informed, 42 were females. Mean age at onset of neurological manifestation was 36.2 years (10-74). Serum anti-AQP4-IgG was positive in 32 patients, borderline in 1, and negative in 4. Our Case 1 was seronegative for AQP4-IgG and had no non-organ-specific autoantibodies other than anti-SSB antibodies. Our Case 2 had serum anti-AQP4, anti-SSA/SSB, anti-thyreoglobulin and anti-acethylcholine-receptor antibodies, as well as clinical hypothyreoidism, but no evidence of myasthenia gravis. Our Cases and others, as previously reported in literature, with similar heterogeneous autoimmune response to aquaporin-4, suggest that SS and NMO co-exist in a common autoimmune milieu which is not dependent on aquaporin-4 autoimmunity.

Long-term MRI findings in neuromyelitis optica: seropositive versus seronegative patients.

PubMed

Kıyat-Atamer, A; Ekizoğlu, E; Tüzün, E; Kürtüncü, M; Shugaiv, E; Akman-Demir, G; Eraksoy, M

2013-05-01

Neuromyelitis optica (NMO) is a severe demyelinating inflammatory disorder associated with serum antibodies against aquaporin 4 (AQP4-Ab). A significant number of patients with NMO remain seronegative over time. Long-term observational magnetic resonance imaging (MRI) studies of the CNS in patients with NMO are rare or of limited duration. The objective of this study is to determine long-term MRI characteristics of seropositive and seronegative patients, and assess possible overlap with multiple sclerosis (MS). Clinical and radiological characteristics of 28 patients with NMO at onset and of 17 patients after an average follow-up time of 9 years were recorded. Fifty percent of patients were seropositive for AQP4-Ab. Onset and final brain/spinal MRI scans were retrospectively analysed and compared. Significantly more patients in the seronegative group had brain lesions at onset. Spinal lesions of seropositive patients were longer and showed increased cord swelling at onset MRI scans. After the follow-up time the differences between both groups disappeared. Patients in the seropositive group tended to develop brain lesions over time. No patient fulfilled Barkhof's or McDonald's radiological criteria for MS at onset or over time. Brain MRI features show differences between seropositive and seronegative patients at time of onset in NMO, but differences between groups vanish over time. None of the AQP4-negative patients fulfill radiological MS criteria on a long-term basis, suggesting that seronegative NMO constitutes an independent entity. © 2012 The Author(s) European Journal of Neurology © 2012 EFNS.

Gender effect on neuromyelitis optica spectrum disorder with aquaporin4-immunoglobulin G.

PubMed

Kim, Sung-Min; Waters, Patrick; Woodhall, Mark; Kim, Yoo-Jin; Kim, Jin-Ah; Cheon, So Young; Lee, Sehoon; Jo, Seong Rae; Kim, Dong Gun; Jung, Kyeong Cheon; Lee, Kwang-Woo; Sung, Jung-Joon; Park, Kyung Seok

2017-07-01

Neuromyelitis optica spectrum disorder with aquaporin4-immunoglobulin G (NMOSD-AQP4) is an inflammatory disease characterised by a high female predominance. However, the effect of gender in patients with NMOSD-AQP4 has not been fully evaluated. The aim of this study was to determine the effect of gender in clinical manifestations and prognosis of patients with NMOSD-AQP4. The demographics, clinical and radiological characteristics, pattern reversal visual evoked potential (VEP) test results, and prognosis of 102 patients (18 males) with NMOSD-AQP4 were assessed. Male patients had a higher age at onset (48.7 vs 41 years, p = 0.037) and less optic neuritis as the onset attack (17% vs 44%, p = 0.026), higher tendency to manifest as isolated myelitis over the follow-up period (67% vs 28%, p = 0.005), fewer optic neuritis attacks per year (0.08 vs 0.27, p < 0.001), and shorter relative P100 latency on VEP testing (97.1% vs 108.3%, p = 0.001). Moreover, male gender was significantly associated with the absence of optic neuritis attacks over the follow-up period independent of their age of onset. In NMOSD-AQP4 patients, gender impacts on disease onset age and site of attack. This may be an important clue in identifying NMOSD-AQP4 patients with limited manifestations as well as in predicting their clinical courses.

Pregnancy in neuromyelitis optica spectrum disorder: A multicenter study from South China.

PubMed

Huang, Yanlu; Wang, Yuge; Zhou, Yifan; Huang, Qiao; Sun, Xiaobo; Chen, Chen; Fang, Ling; Long, Youming; Yang, Hui; Wang, Honghao; Li, Caixia; Lu, Zhengqi; Hu, Xueqiang; Kermode, Allan G; Qiu, Wei

2017-01-15

This study aimed to assess the effect of pregnancy on the course of neuromyelitis optica spectrum disorder (NMOSD), and the effect of this disease on pregnancy outcomes. Consecutive patients with NMOSD were recruited between September 2015 and April 2016 at an outpatient clinic from four referral institutes in South China. Demographic, clinical, and pregnancy data were retrieved by questionnaires to analyze the association between NMOSD and pregnancy, as well as the potential risk factors for relapse. Among 249 patients with NMOSD, 55 had pregnancy-related attacks. The annual relapse rate in the first (3.20±6.82) and second (3.25±3.32) 3-month postpartum periods was marginally higher than that before pregnancy (1.44±0.92, p=0.682) and during pregnancy (1.23±1.32, p=0.758). The Kurtzke Expanded Disability Status Scale score increased from 1.55±0.38 before pregnancy to 2.88±2.14 at postpartum (p<0.001). NMOSD significantly increased the premature birth rate in patients after disease onset (8.33%) compared with before disease onset (1.95%, p=0.025). Multivariate analysis showed that negative anti-aquaporin-4 IgG, concomitance with autoimmune diseases/antibodies, and no treatment in remission were risk factors of recurrence. Our study shows a significant association between pregnancy and NMOSD in the Chinese population. Larger scale prospective studies are warranted in the future. Copyright © 2016 Elsevier B.V. All rights reserved.

Neuromyelitis optica IgG stimulates an immunological response in rat astrocyte cultures.

PubMed

Howe, Charles L; Kaptzan, Tatiana; Magaña, Setty M; Ayers-Ringler, Jennifer R; LaFrance-Corey, Reghann G; Lucchinetti, Claudia F

2014-05-01

Neuromyelitis optica (NMO) is a primary astrocyte disease associated with central nervous system inflammation, demyelination, and tissue injury. Brain lesions are frequently observed in regions enriched in expression of the aquaporin-4 (AQP4) water channel, an antigenic target of the NMO IgG serologic marker. Based on observations of disease reversibility and careful characterization of NMO lesion development, we propose that the NMO IgG may induce a dynamic immunological response in astrocytes. Using primary rat astrocyte-enriched cultures and treatment with NMO patient-derived serum or purified IgG, we observed a robust pattern of gene expression changes consistent with the induction of a reactive and inflammatory phenotype in astrocytes. The reactive astrocyte factor lipocalin-2 and a broad spectrum of chemokines, cytokines, and stress response factors were induced by either NMO patient serum or purified IgG. Treatment with IgG from healthy controls had no effect. The effect is disease-specific, as serum from patients with relapsing-remitting multiple sclerosis, Sjögren's, or systemic lupus erythematosus did not induce a response in the cultures. We hypothesize that binding of the NMO IgG to AQP4 induces a cellular response that results in transcriptional and translational events within the astrocyte that are consistent with a reactive and inflammatory phenotype. Strategies aimed at reducing the inflammatory response of astrocytes may short circuit an amplification loop associated with NMO lesion development. Copyright © 2014 Wiley Periodicals, Inc.

Abnormal brain function in neuromyelitis optica: A fMRI investigation of mPASAT.

PubMed

Wang, Fei; Liu, Yaou; Li, Jianjun; Sondag, Matthew; Law, Meng; Zee, Chi-Shing; Dong, Huiqing; Li, Kuncheng

2017-10-01

Cognitive impairment with the Neuromyelitis Optica (NMO) patients is debated. The present study is to study patterns of brain activation in NMO patients during a pair of task-related fMRI. We studied 20 patients with NMO and 20 control subjects matched for age, gender, education and handedness. All patients with NMO met the 2006 Wingerchuk diagnostic criteria. The fMRI paradigm included an auditory attention monitoring task and a modified version of the Paced Auditory Serial Addition Task (mPASAT). Both tasks were temporally and spatially balanced, with the exception of task difficulty. In mPASAT, Activation regions in control subjects included bilateral superior temporal gyri (BA22), left inferior frontal gyrus (BA45), bilateral inferior parietal lobule (BA7), left cingulate gyrus (BA32), left insula (BA13), and cerebellum. Activation regions in NMO patients included bilateral superior temporal gyri (BA22), left inferior frontal gyrus (BA9), right cingulate gyrus (BA32), right inferior parietal gyrus (BA40), left insula (BA13) and cerebellum. Some dispersed cognition related regions are greater in the patients. The present study showed altered cerebral activation during mPASAT in patients with NMO relative to healthy controls. These results are speculated to provide further evidence for brain plasticity in patients with NMO. Copyright © 2017 Elsevier B.V. All rights reserved.

Early indicators of relapses vs pseudorelapses in neuromyelitis optica spectrum disorder

PubMed Central

Kessler, Remi A.; Mealy, Maureen A.

2016-01-01

Objective: The purpose of this study was to review cases of neuromyelitis optica spectrum disorder (NMOSD) relapses and pseudorelapses to identify early features that differentiate between them at onset of symptoms. Methods: This was a retrospective analysis of 74 hospitalizations of patients with NMOSD who were admitted to the Johns Hopkins Hospital for workup and treatment of a presumed relapse. Standard workup included MRI and blood and urine testing for metabolic and infectious etiologies. The gold standard for a relapse was defined as new or worsening symptoms and a change in neurologic examination correlating with a new or enhancing MRI lesion. A pseudorelapse was a clinical exacerbation with similar symptoms and signs but the MRI was negative, and workup identified an alternative cause for the symptoms that, when treated, resulted in the improvement of neurologic symptoms. Factors considered to be early predictors of relapses vs pseudorelapses were analyzed using the Fisher test. Results: Among 74 NMOSD hospitalizations for presumed relapse, 57 were confirmed relapses while 17 had a negative MRI and an identifiable cause of pseudorelapse. The most common causes of pseudorelapse were infection, pain, and dysautonomia. The only early predictor that reliably differentiated relapse from pseudorelapse among this NMOSD patient population was vision loss (p = 0.039). Race, sex, presentations of weakness, numbness, and bowel/bladder dysfunction, white blood cell count, and urinary tract infection were not different among patients with relapses vs pseudorelapses. Conclusions: Vision loss in NMOSD is strongly suggestive of a true relapse vs a pseudorelapse. Pseudorelapses localized to the spinal cord in patients with previous myelitis presented similarly to true relapses and could only be ruled out by a negative MRI. PMID:27508210

Imbalance in multiple sclerosis and neuromyelitis optica: association with deep sensation disturbance.

PubMed

Demura, Yutaka; Kinoshita, Masako; Fukuda, Osamu; Nose, Shouzou; Nakano, Hitoshi; Juzu, Akira; Murase, Nagako; Yamamoto, Kenji

2016-12-01

Abnormality in balance is one of the most important causes of gait disturbance which has a direct impact to disability and medical cost in multiple sclerosis (MS) and neuromyelitis optica (NMO). However, characteristics of imbalance in these two diseases have not been fully elucidated. The aim of this study was to evaluate the degree and features of imbalance using stabilography, the degree of deep sensation disturbance using tibial nerve somatosensory evoked potentials (SEP), and their association with clinical impairment, in patients with MS and NMO. Seven NMO patients and seven MS patients with balance disturbance were examined. The relationship among stabilography measurements representing the degree and features of imbalance, height-adjusted P38 peak latency of SEP, and neurological functional disability, were analyzed. Stabilography evaluation showed a significantly severer degree of imbalance in NMO than in MS. Romberg quotient of the patients with brainstem lesions was significantly larger than those without them. In all patients, length of excursion per second significantly correlated positively with anterio-posterior-axis power spectra at intermediate frequency band. In all patients and in NMO, P38 peak latency adjusted by height significantly correlated positively with anterio-posterior-axis power spectra at intermediate frequency band. These findings suggest that the degree of imbalance of MS and NMO possibly correlate with deep sensation disturbance, which could be evaluated by anterio-posterior-axis power spectra at intermediate frequency band by stabilography. Severer imbalance in NMO than MS may be associated with the severe longitudinally extensive spinal cord lesions.

A case of neuromyelitis optica spectrum disorder (NMOSD) with Sjögren's syndrome manifested only brain involvement by preceding parotitis.

PubMed

Furukawa, Takahiro; Matsui, Naoko; Tanaka, Keiko; Izumi, Yuishin; Kaji, Ryuji

2017-02-25

A 33 year-old woman presented with intentional incontinence, motor aphasia, supranuclear gaze palsy, and spasticity after parotitis. Brain magnetic resonance images (MRI) showed abnormal signaling in long corticospinal tract involving internal capsules and cerebral peduncles, middle cerebellar peduncle, and frontal subcortical white matter lesions. She had a long history of dry eye and mouth. Immunoserological study showed that she was positive for anti-SS-A, aquaporin 4 (AQP4), and AQP5 antibodies. She clinically showed not only Sjögren's syndrome but also neuromyelitis optica spectrum disorder (NMOSD) without optic neuritis or myelitis. She responded to steroid followed by plasma exchange dramatically. Thereafter, the relapse of brain lesion was once detected while tapering of steroid, but her symptoms have been stable for several years after administration of immunosuppressant. This case suggested that salivary gland inflammation might be associated with the pathogenesis of NMOSD.

Neuromyelitis optica and the evolving spectrum of autoimmune aquaporin-4 channelopathies: a decade later

PubMed Central

Pittock, Sean J.; Lucchinetti, Claudia F.

2015-01-01

The discovery of AQP4-IgG (a pathogenic antibody that targets the astrocytic water channel aquaporin-4) as the first sensitive and specific biomarker for any inflammatory central nervous system demyelinating disease, has shifted emphasis from the oligodendrocyte and myelin to the astrocyte as a central immunopathogenic player. Neuromyelitis optica (NMO) spectrum disorders (SD) represent an evolving spectrum of IDDs extending beyond the optic nerves and spinal cord to include the brain (especially in children) and, rarely, muscle. NMOSD typical brain lesions are located in areas that highly express the target antigen, AQP4, including the circumventricular organs (accounting for intractable nausea and vomiting) and the diencephalon (accounting for sleep disorders, endocrinopathies, and syndrome of inappropriate antidiuresis). Magnetic resonance imaging (MRI) brain abnormalities fulfill Barkoff criteria for multiple sclerosis in up to 10% of patients. As the spectrum broadens, the importance of highly specific assays that detect pathogenic AQP4-IgG targeting extracellular epitopes of AQP4 cannot be overemphasized. The rapid evolution of our understanding of the immunobiology of AQP4 autoimmunity necessitates continuing revision of NMOSD diagnostic criteria. Here, we describe scientific advances that have occurred since the discovery of NMO-IgG in 2004 and review novel targeted immunotherapies. We also suggest that NMOSDs should now be considered under the umbrella term autoimmune aquaporin-4 channelopathy. PMID:26096370

Rituximab monitoring and redosing in pediatric neuromyelitis optica spectrum disorder

PubMed Central

Nosadini, Margherita; Alper, Gulay; Riney, Catherine J.; Benson, Leslie A.; Mohammad, Shekeeb S.; Ramanathan, Sudarshini; Nolan, Melinda; Appleton, Richard; Leventer, Richard J.; Deiva, Kumaran; Brilot, Fabienne; Gorman, Mark P.; Waldman, Amy T.; Banwell, Brenda

2016-01-01

Objective: To study rituximab in pediatric neuromyelitis optica (NMO)/NMO spectrum disorders (NMOSD) and the relationship between rituximab, B cell repopulation, and relapses in order to improve rituximab monitoring and redosing. Methods: Multicenter retrospective study of 16 children with NMO/NMOSD receiving ≥2 rituximab courses. According to CD19 counts, events during rituximab were categorized as “repopulation,” “depletion,” or “depletion failure” relapses (repopulation threshold CD19 ≥10 × 106 cells/L). Results: The 16 patients (14 girls; mean age 9.6 years, range 1.8–15.3) had a mean of 6.1 events (range 1–11) during a mean follow-up of 6.1 years (range 1.6–13.6) and received a total of 76 rituximab courses (mean 4.7, range 2–9) in 42.6-year cohort treatment. Before rituximab, 62.5% had received azathioprine, mycophenolate mofetil, or cyclophosphamide. Mean time from rituximab to last documented B cell depletion and first repopulation was 4.5 and 6.8 months, respectively, with large interpatient variability. Earliest repopulations occurred with the lowest doses. Significant reduction between pre- and post-rituximab annualized relapse rate (ARR) was observed (p = 0.003). During rituximab, 6 patients were relapse-free, although 21 relapses occurred in 10 patients, including 13 “repopulation,” 3 “depletion,” and 4 “depletion failure” relapses. Of the 13 “repopulation” relapses, 4 had CD19 10–50 × 106 cells/L, 10 had inadequate monitoring (≤1 CD19 in the 4 months before relapses), and 5 had delayed redosing after repopulation detection. Conclusion: Rituximab is effective in relapse prevention, but B cell repopulation creates a risk of relapse. Redosing before B cell repopulation could reduce the relapse risk further. Classification of evidence: This study provides Class IV evidence that rituximab significantly reduces ARR in pediatric NMO/NMOSD. This study also demonstrates a relationship between B cell repopulation

Differentiating neuromyelitis optica from other causes of longitudinally extensive transverse myelitis on spinal magnetic resonance imaging

PubMed Central

Pekcevik, Yeliz; Mitchell, Charles H; Mealy, Maureen A; Orman, Gunes; Lee, In H; Newsome, Scott D; Thompson, Carol B; Pardo, Carlos A; Calabresi, Peter A; Levy, Michael; Izbudak, Izlem

2016-01-01

Background Although spinal magnetic resonance imaging (MRI) findings of neuromyelitis optica (NMO) have been described, there is limited data available that help differentiate NMO from other causes of longitudinally extensive transverse myelitis (LETM). Objective To investigate the spinal MRI findings of LETM that help differentiate NMO at the acute stage from multiple sclerosis (MS) and other causes of LETM. Methods We enrolled 94 patients with LETM into our study. Bright spotty lesions (BSL), the lesion distribution and location were evaluated on axial T2-weighted images. Brainstem extension, cord expansion, T1 darkness and lesion enhancement were noted. We also reviewed the brain MRI of the patients during LETM. Results Patients with NMO had a greater amount of BSL and T1 dark lesions (p < 0.001 and 0.003, respectively). The lesions in NMO patients were more likely to involve greater than one-half of the spinal cord’s cross-sectional area; to enhance and be centrally-located, or both centrally- and peripherally-located in the cord. Of the 62 available brain MRIs, 14 of the 27 whom were NMO patients had findings that may be specific to NMO. Conclusions Certain spinal cord MRI features are more commonly seen in NMO patients and so obtaining brain MRI during LETM may support diagnosis. PMID:26209588

Frequency of brain MRI abnormalities in neuromyelitis optica spectrum disorder at presentation: A cohort of Latin American patients.

PubMed

Carnero Contentti, Edgar; Daccach Marques, Vanessa; Soto de Castillo, Ibis; Tkachuk, Veronica; Antunes Barreira, Amilton; Armas, Elizabeth; Chiganer, Edson; de Aquino Cruz, Camila; Di Pace, José Luis; Hryb, Javier Pablo; Lavigne Moreira, Carolina; Lessa, Carmen; Molina, Omaira; Perassolo, Monica; Soto, Arnoldo; Caride, Alejandro

2018-01-01

Brain magnetic resonance imaging (BMRI) lesions were classically not reported in neuromyelitis optica (NMO). However, BMRI lesions are not uncommon in NMO spectrum disorder (NMOSD) patients. To report BMRI characteristic abnormalities (location and configuration) in NMOSD patients at presentation. Medical records and BMRI characteristics of 79 patients with NMOSD (during the first documented attack) in Argentina, Brazil and Venezuela were reviewed retrospectively. BMRI abnormalities were observed in 81.02% of NMOSD patients at presentation. Forty-two patients (53.1%) showed typical-NMOSD abnormalities. We found BMRI abnormalities at presentation in the brainstem/cerebellum (n = 26; 32.9%), optic chiasm (n = 16; 20.2%), area postrema (n = 13; 16.4%), thalamus/hypothalamus (n = 11; 13.9%), corpus callosum (n = 11; 13.9%), periependymal-third ventricle (n = 9; 11.3%), corticospinal tract (n = 7; 8.8%), hemispheric white matter (n = 1; 1.2%) and nonspecific areas (n = 49; 62.03%). Asymptomatic BMRI lesions were more common. The frequency of brain MRI abnormalities did not differ between patients who were positive and negative for aquaporin 4 antibodies at presentation. Typical brain MRI abnormalities are frequent in NMOSD at disease onset. Copyright © 2017 Elsevier B.V. All rights reserved.

Fiber-optic components for optical communicatios and sensing =

NASA Astrophysics Data System (ADS)

Marques, Carlos Alberto Ferreira

Nos ultimos anos, a Optoelectronica tem sido estabelecida como um campo de investigacao capaz de conduzir a novas solucoes tecnologicas. As conquistas abundantes no campo da optica e lasers, bem como em comunicacoes opticas tem sido de grande importancia e desencadearam uma serie de inovacoes. Entre o grande numero de componentes opticos existentes, os componentes baseados em fibra optica sao principalmente relevantes devido a sua simplicidade e a elevada de transporte de dados da fibra optica. Neste trabalho foi focado um destes componentes opticos: as redes de difraccao em fibra optica, as quais tem propriedades opticas de processamento unicas. Esta classe de componentes opticos e extremamente atraente para o desenvolvimento de dispositivos de comunicacoes opticas e sensores. O trabalho comecou com uma analise teorica aplicada a redes em fibra e foram focados os metodos de fabricacao de redes em fibra mais utilizados. A inscricao de redes em fibra tambem foi abordado neste trabalho, onde um sistema de inscricao automatizada foi implementada para a fibra optica de silica, e os resultados experimentais mostraram uma boa aproximacao ao estudo de simulacao. Tambem foi desenvolvido um sistema de inscricao de redes de Bragg em fibra optica de plastico. Foi apresentado um estudo detalhado da modulacao acustico-optica em redes em fibra optica de silica e de plastico. Por meio de uma analise detalhada dos modos de excitacao mecanica aplicadas ao modulador acustico-optico, destacou-se que dois modos predominantes de excitacao acustica pode ser estabelecidos na fibra optica, dependendo da frequencia acustica aplicada. Atraves dessa caracterizacao, foi possivel desenvolver novas aplicacoes para comunicacoes opticas. Estudos e implementacao de diferentes dispositivos baseados em redes em fibra foram realizados, usando o efeito acustico-optico e o processo de regeneracao em fibra optica para varias aplicacoes tais como rapido multiplexador optico add-drop, atraso de grupo

Patterns of Antibody Binding to Aquaporin-4 Isoforms in Neuromyelitis Optica

PubMed Central

Mader, Simone; Lutterotti, Andreas; Di Pauli, Franziska; Kuenz, Bettina; Schanda, Kathrin; Aboul-Enein, Fahmy; Khalil, Michael; Storch, Maria K.; Jarius, Sven; Kristoferitsch, Wolfgang; Berger, Thomas; Reindl, Markus

2010-01-01

Background Neuromyelitis optica (NMO), a severe demyelinating disease, represents itself with optic neuritis and longitudinally extensive transverse myelitis. Serum NMO-IgG autoantibodies (Abs), a specific finding in NMO patients, target the water channel protein aquaporin-4 (AQP4), which is expressed as a long (M-1) or a short (M-23) isoform. Methodology/Principal Findings The aim of this study was to analyze serum samples from patients with NMO and controls for the presence and epitope specificity of IgG and IgM anti-AQP4 Abs using an immunofluorescence assay with HEK293 cells expressing M-1 or M-23 human AQP4. We included 56 patients with definite NMO (n = 30) and high risk NMO (n = 26), 101 patients with multiple sclerosis, 27 patients with clinically isolated syndromes (CIS), 30 patients with systemic lupus erythematosus (SLE) or Sjögren's syndrome, 29 patients with other neurological diseases and 47 healthy controls. Serum anti-AQP4 M-23 IgG Abs were specifically detected in 29 NMO patients, 17 patients with high risk NMO and two patients with myelitis due to demyelination (CIS) and SLE. In contrast, IgM anti-AQP4 Abs were not only found in some NMO and high risk patients, but also in controls. The sensitivity of the M-23 AQP4 IgG assay was 97% for NMO and 65% for high risk NMO, with a specificity of 100% compared to the controls. Sensitivity with M-1 AQP4 transfected cells was lower for NMO (70%) and high risk NMO (39%). The conformational epitopes of M-23 AQP4 are the primary targets of NMO-IgG Abs, whereas M-1 AQP4 Abs are developed with increasing disease duration and number of relapses. Conclusions Our results confirm M-23 AQP4-IgG Abs as reliable biomarkers in patients with NMO and high risk syndromes. M-1 and M-23 AQP4-IgG Abs are significantly associated with a higher number of relapses and longer disease duration. PMID:20463974

Early and extensive spinal white matter involvement in neuromyelitis optica.

PubMed

Hayashida, Shotaro; Masaki, Katsuhisa; Yonekawa, Tomomi; Suzuki, Satoshi O; Hiwatashi, Akio; Matsushita, Takuya; Watanabe, Mitsuru; Yamasaki, Ryo; Suenaga, Toshihiko; Iwaki, Toru; Murai, Hiroyuki; Kira, Jun-Ichi

2017-05-01

Studies of longitudinally extensive spinal cord lesions (LESCLs) in neuromyelitis optica (NMO) have focused on gray matter, where the relevant antigen, aquaporin-4 (AQP4), is abundant. Because spinal white matter pathology in NMO is not well characterized, we aimed to clarify spinal white matter pathology of LESCLs in NMO. We analyzed 50 spinal cord lesions from eleven autopsied NMO/NMO spectrum disorder (NMOSD) cases. We also evaluated LESCLs with three or fewer spinal cord attacks by 3-tesla MRI in 15 AQP4 antibody-positive NMO/NMOSD patients and in 15 AQP4 antibody-negative multiple sclerosis (MS) patients. Pathological analysis revealed seven cases of AQP4 loss and four predominantly demyelinating cases. Forty-four lesions from AQP4 loss cases involved significantly more frequently posterior columns (PC) and lateral columns (LC) than anterior columns (AC) (59.1%, 63.6%, and 34.1%, respectively). The posterior horn (PH), central portion (CP), and anterior horn (AH) were similarly affected (38.6%, 36.4% and 31.8%, respectively). Isolated perivascular inflammatory lesions with selective loss of astrocyte endfoot proteins, AQP4 and connexin 43, were present only in white matter and were more frequent in PC and LC than in AC (22.7%, 29.5% and 2.3%, P corr  = 0.020, and P corr  = 0.004, respectively). MRI indicated LESCLs more frequently affected PC and LC than AC in anti-AQP4 antibody-seropositive NMO/NMOSD (86.7%, 60.0% and 20.0%, P corr  = 0.005, and P corr  = 0.043, respectively) and AQP4 antibody-seronegative MS patients (86.7%, 73.3% and 33.3%, P corr  = 0.063, and P corr  = 0.043, respectively). PH, CP and AH were involved in 93.3%, 86.7% and 73.3% of seropositive patients, respectively, and in 53.3%, 60.0% and 40.0% of seronegative patients, respectively. NMO frequently and extensively affects spinal white matter in addition to central gray matter, especially in PC and LC, where isolated perivascular lesions with astrocyte endfoot

Cognitive performance of neuromyelitis optica patients: comparison with multiple sclerosis.

PubMed

Vanotti, Sandra; Cores, Evangelina Valeria; Eizaguirre, Barbara; Melamud, Luciana; Rey, Raúl; Villa, Andrés

2013-06-01

The aim of the present research was to investigate cognitive pattern of patients with neuromyelitis optica (NMO) and to compare it with multiple sclerosis (MS) patients' performance. Fourteen NMO, 14 relapsing remitting multiple sclerosis (RRMS), and 14 healthy control patients participated in the investigation. Neuropsychological functions were evaluated with the Brief Repeatable Neuropsychological Battery for MS; Symbol Digit Modalities Test; Digit Span; and Semantic Fluency. Fifty-seven percent of NMO patients and 42.85% of the MS ones had abnormal performance in at least two cognitive tests. The NMO Group showed abnormal performance in verbal fluency, verbal and visual memories, with greater attention deficits. NMO patients outperformed healthy control in the paced auditory serial addition test (PASAT). However, no difference was found between NMO and RRMS patients. The NMO Group showed more dysfunction in attention and verbal fluencies than in verbal and visual memories. When compared with the MS patients, a similar dysfunction pattern was found. O objetivo da presente pesquisa foi investigar o padrão cognitivo de pacientes com neuromielite óptica (NMO) e compará-lo com o desempenho de pacientes com esclerose múltipla (EM). Métodos: Quatorze pacientes com NMO, 14 com esclerose múltipla recorrente remitente (EMRR) e 14 participantes do Controle saudáveis participaram da presente investigação. As funções neuropsicológicas foram avaliadas com a Bateria Breve de Testes Neuropsicológicos de Rao, Teste Símbolo Digit e a Fluência Semântica. Resultados: Cinquenta e sete por cento dos pacientes com NMO e 42,85% daqueles com EM apresentaram desempenho anormal em pelo menos dois testes cognitivos. O Grupo NMO apresentarou desempenho anormal na fluência verbal e nas memórias visual e verbal, com maiores déficits de atenção. Pacientes com NMO superaram os controles saudáveis em PASAT. No entanto, não foi encontrada diferença entre os pacientes com

Quantitative Susceptibility Mapping Indicates a Disturbed Brain Iron Homeostasis in Neuromyelitis Optica - A Pilot Study.

PubMed

Doring, Thomas Martin; Granado, Vanessa; Rueda, Fernanda; Deistung, Andreas; Reichenbach, Juergen R; Tukamoto, Gustavo; Gasparetto, Emerson Leandro; Schweser, Ferdinand

2016-01-01

Dysregulation of brain iron homeostasis is a hallmark of many neurodegenerative diseases and can be associated with oxidative stress. The objective of this study was to investigate brain iron in patients with Neuromyelitis Optica (NMO) using quantitative susceptibility mapping (QSM), a quantitative iron-sensitive MRI technique. 12 clinically confirmed NMO patients (6 female and 6 male; age 35.4y±14.2y) and 12 age- and sex-matched healthy controls (7 female and 5 male; age 33.9±11.3y) underwent MRI of the brain at 3 Tesla. Quantitative maps of the effective transverse relaxation rate (R2*) and magnetic susceptibility were calculated and a blinded ROI-based group comparison analysis was performed. Normality of the data and differences between patients and controls were tested by Kolmogorov-Smirnov and t-test, respectively. Correlation with age was studied using Spearman's rank correlation and an ANCOVA-like analysis. Magnetic susceptibility values were decreased in the red nucleus (p<0.01; d>0.95; between -15 and -22 ppb depending on reference region) with a trend toward increasing differences with age. R2* revealed significantly decreased relaxation in the optic radiations of five of the 12 patients (p<0.0001; -3.136±0.567 s-1). Decreased relaxation in the optic radiation is indicative for demyelination, which is in line with previous findings. Decreased magnetic susceptibility in the red nucleus is indicative for a lower brain iron concentration, a chemical redistribution of iron into less magnetic forms, or both. Further investigations are necessary to elucidate the pathological cause or consequence of this finding.

Diagnosis and management of Neuromyelitis Optica Spectrum Disorder (NMOSD) in Iran: A consensus guideline and recommendations.

PubMed

Sahraian, Mohammad Ali; Moghadasi, Abdorreza Naser; Azimi, Amir Reza; Asgari, Nasrin; H Akhoundi, Fahimeh; Abolfazli, Roya; Alaie, Shekoofeh; Ashtari, Fereshteh; Ayromlou, Hormoz; Baghbanian, Seyed Mohammad; Moghadam, Nahid Beladi; Fatehi, Farzad; Foroughipour, Mohsen; Langroodi, Hamidreza Ghalyanchi; Majdinasab, Nastaran; Nickseresht, Alireza; Nourian, Abbas; Shaygannejad, Vahid; Torabi, Hamid Reza

2017-11-01

Neuromyelitis Optica Spectrum Disorder (NMOSD) is a relapsing neuro inflammatory disease of the central nervous system that typically presents with optic neuritis or myelitis and may cause severe disability. The diagnostic criteria have been updated and several immunosuppressive agents have been demonstrated to prevent acute exacerbations. As the disease rarely develops in a progressive course, management of acute attacks and proper prevention of exacerbations may change the long term out-come and prevent future disability. Consensus recommendations and guidelines will help the physicians to improve their practice and unify the treatment approaches in different communities. In order to develop a national consensus and recommendations for the diagnosis and management of NMOSD in Iran, a group of neurologists with long term experience in management of NMOSD were gathered to develop this consensus based on available national and international data. The primary draft was prepared and discussed to suggest the most appropriate treatment for these patients. We propose strategies for early diagnosis and treatment for prevention of relapses and minimizing consequences of attacks as a primary therapeutic goal. Attacks are currently treated with intravenous corticosteroids and, in refractory cases, with plasma exchange. All participants agreed on preventive treatment with currently available immunosuppressive agents such as azothioprin, rituximab and mycofenolate mofetil based on previous positive data in NMOSD in order to reduce attack frequency. The current consensus reviews the previous data and provides the clinicians with practical recommendations and advices for the diagnosis and management of NMOSD based on scientific data and clinical experience. Copyright © 2017 Elsevier B.V. All rights reserved.

Contribuciones tecnicas para la medida de la contaminacion electromagnetica de microondas. Estudio en diversas poblaciones

NASA Astrophysics Data System (ADS)

Segura Garcia, Jaume

La contaminacion ambiental por campos electromagneticos ha resultado ser en estos ultimos anos uno de los problemas mas acuciantes del panorama tecnologico y de salud publica. En el primero de los casos porque las inversiones realizadas son enormes y en el segundo porque cada vez es mayor el numero de articulos, "technical reports" e informes medicos que afirman la existencia de una cierta causalidad, aunque sea debil, entre los campos electromagneticos y ciertos cuadros sintomatologicos. En nuestro caso, hemos dedicado bastantes esfuerzos a investigar el llamado "sindrome de radiofrecuencia / microondas", denominado asi en la literatura cientifica por presentarse en operarios de estaciones de radar y en trabajadores de potentes emisoras de radio y television. En esta memoria presentamos un resumen del trabajo realizado durante los ultimos anos en la medida de la contaminacion electromagnetica ambiental asociado a las comunicaciones inalambricas. En ella se recogen los fundamentos fisicos y propiedades de las ondas electromagneticas, la tecnologia empleada en los sistemas de telefonia celular y los antecedentes relativos a la investigacion de la interaccion de las ondas electromagneticas con organismos vivos. Se desarrolla un procedimiento de medida que ha conducido a la elaboracion de los primeros "mapas de radiofrecuencia" similares, en el aspecto descriptivo, a los mapas de ruido desarrollados en el area de la contaminacion acustica. Por ultimo, se analiza la respuesta subjetiva de los residentes, personas que viven en el entorno de cobertura de las estaciones base de telefonia movil y que se ven sometidos a determinados niveles de radiacion electromagnetica, con el fin de situar este fenomeno al nivel que le corresponde en el ambito de la respuesta subjetiva ciudadana.

Development of a patient-centred conceptual framework of health-related quality of life in neuromyelitis optica: a qualitative study.

PubMed

Methley, Abigail M; Mutch, Kerry; Moore, Perry; Jacob, Anu

2017-02-01

Neuromyelitis optica (NMO) is an auto-immune disease that can cause severe visual and mobility impairments. Research on health-related quality of life (HRQoL) in NMO is scarce, limiting knowledge on factors influencing HRQoL and support needs. This study provides the first qualitative exploration of HRQoL in NMO, conducted to provide a conceptual framework for the development of an NMO patient-reported outcome measure. Fifteen people with NMO (aged 18-74; 11 women, 4 men) participated in semi-structured interviews; data were analysed using constant comparative analysis. HRQoL in NMO is a multifaceted concept incorporating highly subjective perceptions of normality and meaning. Four major themes were identified: impact of physical symptoms on daily living, utilizing support to achieve independence, expectations for life and meaningful roles in life and purpose. Themes highlighted the importance of perceived normality, and its relationship to attaining life goals comparable to peers, as underpinning evaluations of HRQoL. Many people with severe disability reported a high HRQoL, suggesting the inappropriateness of assuming a negative HRQoL on the basis of an individual's neurological impairment. These findings further the conceptual understanding of HRQoL in NMO, informing patient-care approaches and the development of an NMO-specific patient-reported outcome measure. © 2015 The Authors. Health Expectation published by John Wiley & Sons Ltd.

Short-segment transverse myelitis lesions in a cohort of Latin American patients with neuromyelitis optica spectrum disorders.

PubMed

Carnero Contentti, Edgar; Daccach Marques, Vanessa; Soto de Castillo, Ibis; Tkachuk, Verónica; Antunes Barreira, Amilton; Armas, Elizabeth; Chiganer, Edson; de Aquino Cruz, Camila; Di Pace, José Luis; Hryb, Javier Pablo; Lavigne Moreira, Carolina; Lessa, Carmen; Molina, Omaira; Perassolo, Mónica; Soto, Arnoldo; Caride, Alejandro

2018-05-22

Multicenter retrospective study. The aim was to determine the frequency and magnetic resonance imaging (MRI) features of short-segment transverse myelitis (STM) in patients with neuromyelitis optica spectrum disorders (NMOSD) during a myelitis attack. Latin American diagnostic centres (Neuroimmunology Unit). A multicenter study from Argentina, Brazil and Venezuela was performed. Seventy-six patients with NMOSD were included. We analyzed 346 attacks and reviewed spinal cord MRIs performed within 30 days from spinal attack onset. Sagittal and axial characteristics on cervical and thoracic MRI (1.5 tesla) were observed. Demographics, clinical, serological, and disability data were collected. Among the 76 patients with NMOSD, isolated STM was observed in 8% (n = 6), multisegmental lesions (longitudinally extensive transverse myelitis (LETM) + STM) in 28% (n = 21; 13 had at least one STM), LETM in 42% (n = 32), and normal spinal MRI in 22% (n = 17). However, isolated STM was increased by 10% in patients with NMOSD with spinal lesions (6 out of 59) with mean attacks of 2.5 (±0.83) and last follow-up expanded disability status scale (EDSS) of 3.1 (±2.63). Positive aquaporin 4 antibodies (AQP4-ab) were found in 50%. Upper-cervical lesion was most frequently observed (5 out of 6). Myelitis was preceded by ON in all isolated patients with STM. Only one had a positive gadolinium lesion and none of these had asymptomatic spinal cord lesion. Isolated STM does not exclude NMOSD diagnosis. Therefore, APQ4-ab testing could be useful during a myelitis attack with STM.

Longitudinally extensive transverse myelitis in neuromyelitis optica: a prospective study of 13 Caucasian patients and literature review.

PubMed

Bălaşa, Rodica; Maier, Smaranda; Bajko, Zoltan; Motataianu, Anca; Crişan, Alexandra; Bălaşa, Adrian

2015-12-01

Neuromyelitis optica (NMO) is a homogenous disease that can be diagnosed by an association of clinical, neuroimaging and serological aspects. We analysed our 4 years NMO series with longitudinally extensive transverse myelitis (LETM) during the disease course. We included consecutive adult Caucasian patients who were diagnosed with definite NMO, or cases of NMO-IgG seropositive LETM considered as limited forms of NMO. Patients included were negative for other diseases (autoimmune, infectious, etc.). We report the Expanded Disability Status Scale (EDSS), brain and spine MRI, CSF, NMO-IgG, treatment, motor and visual outcome. Thirteen cases fulfilled the inclusion criteria, and the mean follow-up period was 3.74 ± 1.8 years. The initial motor deficit was severe with the mean value of motor functional parameter of 4.46 ± 1 and improved at discharge to 2.53 ± 1.4 (p < 0.001). With treatment, the outcome after LETM attack was good in 10 patients, with a significant improvement of the EDSS mainly upon motor deficit, while visual function had a very slight amelioration. The CSF analysis was normal in 8 cases; spinal MRI showed evidence of LETM in all patients while brain MRI was normal in 7. NMO-IgG is a biomarker for NMO that is of diagnostic value in cases of isolated LETM. LETM has a better outcome than ON in NMO Caucasians. Spinal MRI is essential for NMO diagnosis in the presence of LETM and the absence of multiple brain MRI lesions. Maintenance immunosuppressive therapy reduces the frequency of attacks.

Comparative brain stem lesions on MRI of acute disseminated encephalomyelitis, neuromyelitis optica, and multiple sclerosis.

PubMed

Lu, Zhengqi; Zhang, Bingjun; Qiu, Wei; Kang, Zhuang; Shen, Liping; Long, Youming; Huang, Junqi; Hu, Xueqiang

2011-01-01

Brain stem lesions are common in patients with acute disseminated encephalomyelitis (ADEM), neuromyelitis optica (NMO), and multiple sclerosis (MS). To investigate comparative brain stem lesions on magnetic resonance imaging (MRI) among adult patients with ADEM, NMO, and MS. Sixty-five adult patients with ADEM (n = 17), NMO (n = 23), and MS (n = 25) who had brain stem lesions on MRI were enrolled. Morphological features of brain stem lesions among these diseases were assessed. Patients with ADEM had a higher frequency of midbrain lesions than did patients with NMO (94.1% vs. 17.4%, P<0.001) and MS (94.1% vs. 40.0%, P<0.001); patients with NMO had a lower frequency of pons lesions than did patients with MS (34.8% vs. 84.0%, P<0.001) and ADEM (34.8% vs. 70.6%, P = 0.025); and patients with NMO had a higher frequency of medulla oblongata lesions than did patients with ADEM (91.3% vs. 35.3%, P<0.001) and MS (91.3% vs. 36.0%, P<0.001). On the axial section of the brain stem, the majority (82.4%) of patients with ADEM showed lesions on the ventral part; the brain stem lesions in patients with NMO were typically located in the dorsal part (91.3%); and lesions in patients with MS were found in both the ventral (44.0%) and dorsal (56.0%) parts. The lesions in patients with ADEM (100%) and NMO (91.3%) had poorly defined margins, while lesions of patients with MS (76.0%) had well defined margins. Brain stem lesions in patients with ADEM were usually bilateral and symmetrical (82.4%), while lesions in patients with NMO (87.0%) and MS (92.0%) were asymmetrical or unilateral. Brain stem lesions showed various morphological features among adult patients with ADEM, NMO, and MS. The different lesion locations may be helpful in distinguishing these diseases.

Comparative Brain Stem Lesions on MRI of Acute Disseminated Encephalomyelitis, Neuromyelitis Optica, and Multiple Sclerosis

PubMed Central

Kang, Zhuang; Shen, Liping; Long, Youming; Huang, Junqi; Hu, Xueqiang

2011-01-01

Background Brain stem lesions are common in patients with acute disseminated encephalomyelitis (ADEM), neuromyelitis optica (NMO), and multiple sclerosis (MS). Objectives To investigate comparative brain stem lesions on magnetic resonance imaging (MRI) among adult patients with ADEM, NMO, and MS. Methods Sixty-five adult patients with ADEM (n = 17), NMO (n = 23), and MS (n = 25) who had brain stem lesions on MRI were enrolled. Morphological features of brain stem lesions among these diseases were assessed. Results Patients with ADEM had a higher frequency of midbrain lesions than did patients with NMO (94.1% vs. 17.4%, P<0.001) and MS (94.1% vs. 40.0%, P<0.001); patients with NMO had a lower frequency of pons lesions than did patients with MS (34.8% vs. 84.0%, P<0.001) and ADEM (34.8% vs. 70.6%, P = 0.025); and patients with NMO had a higher frequency of medulla oblongata lesions than did patients with ADEM (91.3% vs. 35.3%, P<0.001) and MS (91.3% vs. 36.0%, P<0.001). On the axial section of the brain stem, the majority (82.4%) of patients with ADEM showed lesions on the ventral part; the brain stem lesions in patients with NMO were typically located in the dorsal part (91.3%); and lesions in patients with MS were found in both the ventral (44.0%) and dorsal (56.0%) parts. The lesions in patients with ADEM (100%) and NMO (91.3%) had poorly defined margins, while lesions of patients with MS (76.0%) had well defined margins. Brain stem lesions in patients with ADEM were usually bilateral and symmetrical (82.4%), while lesions in patients with NMO (87.0%) and MS (92.0%) were asymmetrical or unilateral. Conclusions Brain stem lesions showed various morphological features among adult patients with ADEM, NMO, and MS. The different lesion locations may be helpful in distinguishing these diseases. PMID:21853047

Prevalence of neuromyelitis optica spectrum disorder in the multi-ethnic Penang Island, Malaysia, and a review of worldwide prevalence.

PubMed

Hor, Jyh Yung; Lim, Thien Thien; Chia, Yuen Kang; Ching, Yee Ming; Cheah, Chun Fai; Tan, Kenny; Chow, Han Bing; Arip, Masita; Eow, Gaik Bee; Easaw, P E Samuel; Leite, M Isabel

2018-01-01

Neuromyelitis optica spectrum disorder (NMOSD) occurs worldwide in all ethnicities. Recently, population-based studies have shown that NMOSD is more common among non-White populations. There is scarce data about NMOSD prevalence in South East Asian populations. (1) A population-based study was undertaken to estimate NMOSD prevalence in the multi-ethnic Penang Island, Malaysia, comprising Chinese, Malays, and Indians. Medical records of NMOSD patients followed up at the Penang General Hospital (the neurology referral centre in Penang Island) were reviewed. The 2015 diagnostic criteria of the International Panel for NMO Diagnosis were used for case ascertainment. (2) A review of population-based prevalence studies of NMOSD worldwide was carried out. PubMed and conference proceedings were searched for such studies. Of the 28 NMOSD patients, 14 were residents of Penang Island on prevalence day [13 (93%) Chinese and one (7%) Malay]. All 14 patients were females and aquaporin 4 seropositive. The prevalence of NMOSD in Penang Island was 1.99/100,000 population; according to ethnicities, the prevalence in Chinese was significantly higher than in Malays (3.31/100,000 vs 0.43/100,000, respectively, p = 0.0195). Based on our and other population-based studies, among Asians, East Asian origin populations (Chinese and Japanese) appear to have higher NMOSD prevalence than other Asian ethnic groups. Worldwide, Blacks seem to have the highest NMOSD prevalence. More studies in different geographical regions and ethnic groups will be useful to further inform about potential factors in NMOSD pathogenesis. Copyright © 2017 Elsevier B.V. All rights reserved.

Analysis of brain and spinal cord lesions to occult brain damage in seropositive and seronegative neuromyelitis optica.

PubMed

Sun, Jie; Sun, Xianting; Zhang, Ningnannan; Wang, Qiuhui; Cai, Huanhuan; Qi, Yuan; Li, Ting; Qin, Wen; Yu, Chunshui

2017-09-01

According to aquaporin-4 antibody (AQP4-Ab), neuromyelitis optica (NMO) can be divided into seropositive and seronegative subgroups. The purpose of this study was to a) compare the distribution of spinal cord and brain magnetic resonance imaging (MRI) lesions between seropositive and seronegative NMO patients; b) explore occult brain damage in seropositive and seronegative NMO patients; and c) explore the contribution of visible lesions to occult grey and white matter damage in seropositive and seronegative NMO patients. Twenty-two AQP4-Ab seropositive and 14 seronegative NMO patients and 30 healthy controls were included in the study. Two neuroradiologists independently measured the brain lesion volume (BLV) and the length of spinal cord lesion (LSCL) and recorded the region of brain lesions. The normal-appearing grey matter volume (NAGM-GMV) and white matter fractional anisotropy (NAWM-FA) were calculated for each subject to evaluate occult brain damage. The seropositive patients displayed more extensive damage in the spinal cord than the seronegative patients, and the seronegative group had a higher proportion of patients with brainstem lesions (28.57%) than the seropositive group (4.55%, P=0.064). Both NMO subgroups exhibited reduced NAGM-GMV and NAWM-FA compared with the healthy controls. NAGM-GMV was negatively correlated with LSCL in the seropositive group (r s =-0.444, P=0.044) and with BLV in the seronegative group (r s =-0.768, P=0.002). NAWM-FA was also negatively correlated with BLV in the seropositive group (r s =-0.682, P<0.001). Our findings suggest that the occult brain damage in these two NMO subgroups may be due to different mechanisms, which need to be further clarified. Copyright © 2017 Elsevier B.V. All rights reserved.

Iron and Non-iron Related Characteristics of Multiple Sclerosis and Neuromyelitis Optica Lesions at 7T MRI

PubMed Central

Chawla, Sanjeev; Kister, Ilya; Wuerfel, Jens; Brisset, Jean-Christophe; Liu, Saifeng; Sinnecker, Tim; Dusek, Petr; Haacke, E. Mark; Paul, Friedemann; Ge, Yulin

2016-01-01

Background and Purpose To investigate the potential of ultra-high field MR imaging to distinguish multiple sclerosis (MS) from neuromyelitis optica (NMO) and to characterize tissue injury associated with iron pathology within lesions. Methods Twenty-one MS and 21 NMO patients underwent 7T high-resolution 2D-gradient-echo (GRE-T2*) and 3D-susceptibility weighted imaging (SWI). An in-house developed algorithm was used to reconstruct quantitative susceptibility mapping (QSM) from SWI. Lesions were classified as ‘iron laden’ if they demonstrated hypointensity on GRE-T2*- weighted images and/or SWI, and hyperintensity on QSM. Lesions were considered ‘non-iron laden’ if they were hyperintense on GRE-T2* and isointense or hyperintense on QSM. Results Of 21 MS patients, 19 (90.5%) demonstrated atleast one QSM-hyperintense lesion and 11/21 (52.4%) patients harbored iron-laden lesions. No QSM-hyperintense or iron-laden lesions were observed in any of the NMO patients. Iron-laden and non iron-laden lesions could each be further characterized into two distinct patterns based on lesion signal and morphology on GRE-T2*/SWI and QSM. In MS, the majority of lesions (n=262, 75.9% of all lesions) were hyperintense on GRE-T2* and isointense on QSM (Pattern A), while a small minority (n=26, 7.5% of all lesions) were hyperintense on both GRE-T2* and QSM (Pattern B). Iron laden lesions (n=57, 16.5% of all lesions) were further classified as ‘nodular’ (n=22, 6.4%, Pattern C) or ‘ring-like’ (n=35, 10.1%, Pattern D). Conclusions Ultra-high field MRI may be useful in distinguishing MS from NMO. Different patterns related to iron and non-iron pathology may provide in vivo insights into pathophysiology of lesions in MS. PMID:27012298

Only Follow-Up of Memory B Cells Helps Monitor Rituximab Administration to Patients with Neuromyelitis Optica Spectrum Disorders.

PubMed

Lebrun, Christine; Cohen, Mikael; Rosenthal-Allieri, Maria Alessandra; Bresch, Saskia; Benzaken, Sylvia; Marignier, Romain; Seitz-Polski, Barbara; Ticchioni, Michel

2018-06-07

Neuromyelitis optica spectrum disorders (NMOSD) are identified as a spectrum of inflammatory demyelinating disorders involving the brain, spinal cord and optic nerves. These disorders require early diagnosis and highly active immunosuppressive treatment. Rituximab (RTX) has demonstrated efficacy in limiting relapse in NMOSD when using several administration schedules. We questioned if the CD19+ CD27+ memory B cell count was a more reliable marker to monitor RTX administration than the RTX plasma level and CD19+ B cell count. We analyzed 125 blood samples from 17 NMOSD patients treated with RTX and also measured the level of anti-aquaporine-4 antibodies (anti-AQP-4 Abs), human anti-chimeric antibodies to the murine fragment of RTX (HACA-RTX Abs), and the RTX concentration. The mean follow-up time of the cohort was 7.4 (2-16) years. All patients improved with a mean EDSS going from 4 (1-8.5) to 2.7 (1-5.5). The mean interval between RTX infusions was 9.6 months with identification of prolonged responders. Total CD19+ B cell detection with the routine technique did not correlate to re-emergence of CD19+ CD27+ memory B cells. The RTX residual concentration did not correlate with the CD19+ CD27+ memory B cell count or with anti-RTX antibody production. In contrast to total CD19+ cell, detected with the routine technique, CD19+ CD27+ memory B cells are a reliable marker for biological relapse and allow a decrease in the frequency of infusions.

Marked central nervous system pathology in CD59 knockout rats following passive transfer of Neuromyelitis optica immunoglobulin G.

PubMed

Yao, Xiaoming; Verkman, Alan S

2017-02-17

Neuromyelitis optica spectrum disorders (herein called NMO) is an inflammatory demyelinating disease of the central nervous system in which pathogenesis involves complement-dependent cytotoxicity (CDC) produced by immunoglobulin G autoantibodies targeting aquaporin-4 (AQP4-IgG) on astrocytes. We reported evidence previously, using CD59 -/- mice, that the membrane-associated complement inhibitor CD59 modulates CDC in NMO (Zhang and Verkman, J. Autoimmun. 53:67-77, 2014). Motivated by the observation that rats, unlike mice, have human-like complement activity, here we generated CD59 -/- rats to investigate the role of CD59 in NMO and to create NMO pathology by passive transfer of AQP4-IgG under conditions in which minimal pathology is produced in normal rats. CD59 -/- rats generated by CRISPR/Cas9 technology showed no overt phenotype at baseline except for mild hemolysis. CDC assays in astrocyte cultures and cerebellar slices from CD59 -/- rats showed much greater sensitivity to AQP4-IgG and complement than those from CD59 +/+ rats. Intracerebral administration of AQP4-IgG in CD59 -/- rats produced marked NMO pathology, with astrocytopathy, inflammation, deposition of activated complement, and demyelination, whereas identically treated CD59 +/+ rats showed minimal pathology. A single, intracisternal injection of AQP4-IgG in CD59 -/- rats produced hindlimb paralysis by 3 days, with inflammation and deposition of activated complement in spinal cord, optic nerves and brain periventricular and surface matter, with most marked astrocyte injury in cervical spinal cord. These results implicate an important role of CD59 in modulating NMO pathology in rats and demonstrate amplification of AQP4-IgG-induced NMO disease with CD59 knockout.

Complement activating antibodies to myelin oligodendrocyte glycoprotein in neuromyelitis optica and related disorders

PubMed Central

2011-01-01

Background Serum autoantibodies against the water channel aquaporin-4 (AQP4) are important diagnostic biomarkers and pathogenic factors for neuromyelitis optica (NMO). However, AQP4-IgG are absent in 5-40% of all NMO patients and the target of the autoimmune response in these patients is unknown. Since recent studies indicate that autoimmune responses to myelin oligodendrocyte glycoprotein (MOG) can induce an NMO-like disease in experimental animal models, we speculate that MOG might be an autoantigen in AQP4-IgG seronegative NMO. Although high-titer autoantibodies to human native MOG were mainly detected in a subgroup of pediatric acute disseminated encephalomyelitis (ADEM) and multiple sclerosis (MS) patients, their role in NMO and High-risk NMO (HR-NMO; recurrent optic neuritis-rON or longitudinally extensive transverse myelitis-LETM) remains unresolved. Results We analyzed patients with definite NMO (n = 45), HR-NMO (n = 53), ADEM (n = 33), clinically isolated syndromes presenting with myelitis or optic neuritis (CIS, n = 32), MS (n = 71) and controls (n = 101; 24 other neurological diseases-OND, 27 systemic lupus erythematosus-SLE and 50 healthy subjects) for serum IgG to MOG and AQP4. Furthermore, we investigated whether these antibodies can mediate complement dependent cytotoxicity (CDC). AQP4-IgG was found in patients with NMO (n = 43, 96%), HR-NMO (n = 32, 60%) and in one CIS patient (3%), but was absent in ADEM, MS and controls. High-titer MOG-IgG was found in patients with ADEM (n = 14, 42%), NMO (n = 3, 7%), HR-NMO (n = 7, 13%, 5 rON and 2 LETM), CIS (n = 2, 6%), MS (n = 2, 3%) and controls (n = 3, 3%, two SLE and one OND). Two of the three MOG-IgG positive NMO patients and all seven MOG-IgG positive HR-NMO patients were negative for AQP4-IgG. Thus, MOG-IgG were found in both AQP4-IgG seronegative NMO patients and seven of 21 (33%) AQP4-IgG negative HR-NMO patients. Antibodies to MOG and AQP4 were predominantly of the IgG1 subtype, and were able to

Astrocytic autoantibody of neuromyelitis optica (NMO-IgG) binds to aquaporin-4 extracellular loops, monomers, tetramers and high order arrays

PubMed Central

Iorio, Raffaele; Fryer, James P.; Hinson, Shannon R.; Fallier-Becker, Petra; Wolburg, Hartwig; Pittock, Sean J.; Lennon, Vanda A.

2012-01-01

The principal central nervous system (CNS) water channel, aquaporin-4 (AQP4), is confined to astrocytic and ependymal membranes and is the target of a pathogenic autoantibody, neuromyelitis optica (NMO)-IgG. This disease-specific autoantibody unifies a spectrum of relapsing CNS autoimmune inflammatory disorders of which NMO exemplifies the classic phenotype. Multiple sclerosis and other immune-mediated demyelinating disorders of the CNS lack a distinctive biomarker. Two AQP4 isoforms, M1 and M23, exist as homotetrameric and heterotetrameric intramembranous particles (IMPs). Orthogonal arrays of predominantly M23 particles (OAPs) are an ultrastructural characteristic of astrocytic membranes. We used high-titered serum from 32 AQP4-IgG-seropositive patients and 85 controls to investigate the nature and molecular location of AQP4 epitopes that bind NMO-IgG, and the influence of supramolecular structure. NMO-IgG bound to denatured AQP4 monomers (68% of cases), to native tetramers and high order arrays (90% of cases), and to AQP4 in live cell membranes (100% of cases). Disease-specific epitopes reside in extracellular loop C more than in loops A or E. IgG binding to intracellular epitopes lacks disease specificity. These observations predict greater disease specificity and sensitivity for tissue-based and cell-based serological assays employing “native” AQP4 than assays employing denatured AQP4 and fragments. NMO-IgG binds most avidly to plasma membrane surface AQP4 epitopes formed by loop interactions within tetramers and by intermolecular interactions within high order structures. The relative abundance and localization of AQP4 high order arrays in distinct CNS regions may explain the variability in clinical phenotype of NMO spectrum disorders. PMID:22906356

Validation of the Modified Fatigue Impact Scale and the relationships among fatigue, pain and serum interleukin-6 levels in patients with neuromyelitis optica spectrum disorder.

PubMed

Masuda, Hiroki; Mori, Masahiro; Uzawa, Akiyuki; Uchida, Tomohiko; Ohtani, Ryohei; Kobayashi, Shigeo; Kuwabara, Satoshi

2018-02-15

Fatigue and pain are disabling symptoms in patients with neuromyelitis optica spectrum disorder (NMOSD). The Modified Fatigue Impact Scale (MFIS) has not yet been validated in patients with NMOSD, and anti-interleukin-6 (IL-6) receptor antibody was reported to decrease pain and fatigue in patients with NMOSD. The aim of this study was to validate MFIS and to investigate the relationships among fatigue, pain and serum IL-6 levels in patients with NMOSD. MFIS and the Multidimensional Fatigue Inventory (MFI), an established scale for fatigue, were administered to patients with NMOSD and age- and sex-matched healthy controls (HCs). The Pain Effects Scale score and serum IL-6 levels were also measured in patients with NMOSD. Correlations among clinical characteristics, laboratory data and each score were investigated. To validate MFIS in patients with NMOSD, MFIS was administered twice within 4days from the first administration. Fifty-one patients answered the first MFIS, and 26 patients answered the second MFIS. There was no difference between the first and second MFIS scores. Patients with NMOSD had higher MFIS and MFI scores than HCs. No correlations were observed between serum IL-6 levels and either score. MFIS was validated in patients with NMOSD. Serum IL-6 levels may not be involved in the pathogenesis of fatigue and pain in patients with NMOSD. Copyright © 2017 Elsevier B.V. All rights reserved.

Inhibitor(s) of the classical complement pathway in mouse serum limit the utility of mice as experimental models of neuromyelitis optica.

PubMed

Ratelade, Julien; Verkman, A S

2014-11-01

Neuromyelitis optica (NMO) is an inflammatory demyelinating disease of the central nervous system in which anti-aquaporin-4 (AQP4) autoantibodies (AQP4-IgG) cause damage to astrocytes by complement-dependent cytotoxicity (CDC). Various approaches have been attempted to produce NMO lesions in rodents, some involving genetically modified mice with altered immune cell function. Here, we found that mouse serum strongly inhibits complement from multiple species, preventing AQP4-IgG-dependent CDC. Effects of mouse serum on complement activation were tested in CDC assays in which AQP4-expressing cells were incubated with AQP4-IgG and complement from different species. Biochemical assays and mass spectrometry were used to characterize complement inhibitor(s) in mouse serum. Sera from different strains of mice produced almost no AQP4-IgG-dependent CDC compared with human, rat and guinea pig sera. Remarkably, addition of mouse serum prevented AQP4-IgG-dependent CDC caused by human, rat or guinea pig serum, with 50% inhibition at <5% mouse serum. Hemolysis assays indicated that the inhibitor(s) in mouse serum target the classical and not the alternative complement pathway. We found that the complement inhibitor(s) in mouse serum were contained in a serum fraction purified with protein-A resin; however, the inhibitor was not IgG as determined using serum from IgG-deficient mice. Mass spectrometry on the protein A-purified fraction produced several inhibitor candidates. The low intrinsic complement activity of mouse serum and the presence of complement inhibitor(s) limit the utility of mouse models to study disorders, such as NMO, involving the classical complement pathway. Copyright © 2014 Elsevier Ltd. All rights reserved.

Role of the H-bond between L53 and T56 for Aquaporin-4 epitope in Neuromyelitis Optica.

PubMed

Pisani, Francesco; Simone, Laura; Gargano, Concetta Domenica; De Bellis, Manuela; Cibelli, Antonio; Mola, Maria Grazia; Catacchio, Giacomo; Frigeri, Antonio; Svelto, Maria; Nicchia, Grazia Paola

2017-03-01

Aquaporin-4 (AQP4) is the CNS water channel organized into well-ordered protein aggregates called Orthogonal Arrays of Particles (OAPs). Neuromyelitis Optica (NMO) is an autoimmune disease caused by anti-OAP autoantibodies (AQP4-IgG). Molecular Dynamics (MD) simulations have identified an H-bond between L53 and T56 as the key for AQP4 epitope and therefore of potential interest for drug design in NMO field. In the present study, we have experimentally tested this MD-prediction using the classic mutagenesis approach. We substituted T56 with V56 and tested this mutant for AQP4 aggregates and AQP4-IgG binding. gSTED super-resolution microscopy showed that the mutation does not affect AQP4 aggregate dimension; immunofluorescence and cytofluorimetric analysis demonstrated its unaltered AQP4-IgG binding, therefore invalidating the MD-prediction. We later investigated whether AQP4, expressed in Sf9 insect and HEK-293F cells, is able to correctly aggregate before and after the purification steps usually applied to obtain AQP4 crystal. The results demonstrated that AQP4-IgG recognizes AQP4 expressed in Sf9 and HEK-293F cells by immunofluorescence even though BN-PAGE analysis showed that AQP4 forms smaller aggregates when expressed in insect cells compared to mammalian cell lines. Notably, after AQP4 purification, from both insect and HEK-293F cells, no aggregates are detectable by BN-PAGE and AQP4-IgG binding is impaired in sandwich ELISA assays. All together these results indicate that 1) the MD prediction under analysis is not supported by experimental data and 2) the procedure to obtain AQP4 crystals might affect its native architecture and, as a consequence, MD simulations. In conclusion, given the complex nature of the AQP4 epitope, MD might not be the suitable for molecular medicine advances in NMO. Copyright © 2016. Published by Elsevier B.V.

Patient-reported outcome measure for neuromyelitis optica: pretesting of preliminary instrument and protocol for further development in accordance with international guidelines.

PubMed

Moore, P; Jackson, C; Mutch, K; Methley, A; Pollard, C; Hamid, S; Jacob, A

2016-09-30

This study outlines the development of a patient-reported outcome measure (PROM), an instrument to obtain self-reported health status for neuromyeltis optica (NMO), a disabling neurological condition. Development was conducted in accordance with international guidance for PROMs including systematic review of existing literature, item generation guided by qualitative interviews, health-related quality of life conceptual framework and clinical expert panel and cognitive interviews with NMO patients. Participants were identified through a national NMO clinic in a tertiary NHS neurosciences service. 15 individuals with NMO participated in cognitive interviews requiring review and ranking of proposed PROM items and qualitative feedback on content, layout and response options. Participants endorsed the draft instrument as reflecting their experience of the condition and as being easy to understand. Rating and ranking of item relevance and importance reduced the draft instrument from 106 to 48 items. Participant feedback on overlapping items eliminated a further 2 items and resulted in a preliminary instrument of 46 items. As a direct result of participant feedback ordering of the 10 domains was revised, a 4 option Likert scale was employed and a 4-week recall period for impact of symptoms was selected. A 46-item instrument developed in accordance with international PROM development guidelines through literature review, developed by subject matter experts and refined through pretesting examining content validity provides a preliminary measure for assessing patient-report of health status in NMO. Further evaluation is proposed including sensitivity to clinical change, and international contributions to evaluating the measure are encouraged. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Cognitive impairment in neuromyelitis optica spectrum disorders: A comparison of the Wechsler Adult Intelligence Scale-III and the Wechsler Memory Scale Revised with the Rao Brief Repeatable Neuropsychological Battery.

PubMed

Fujimori, Juichi; Nakashima, Ichiro; Baba, Toru; Meguro, Yuko; Ogawa, Ryo; Fujihara, Kazuo

2017-12-01

Approximately 55% of patients with neuromyelitis optica spectrum disorder (NMOSD) show cognitive impairment as evaluated using the Rao Brief Repeatable Neuropsychological Battery (BRBN), but this frequency appears to be higher than the frequency of specific brain lesions in NMOSD. We studied whether cognitive impairment could be observed in NMOSD patients with no or minor non-specific brain lesions. We evaluated cognitive function in 12 NMOSD and 14 MS patients using the Wechsler Adult Intelligence Scale-III (WAIS-III), the Wechsler Memory Scale-Revised (WMS-R), and the BRBN. We judged as cognitively impaired patients whose scores were below the average by 2 standard deviations or greater in 2 or more cognitive domains. Cognitive impairment was observed in 5 MS patients (35.7%) and in the only NMOSD patient (8.3%) with symptomatic brain lesions, but not in the other NMOSD patients who had no or minor non-specific brain lesions. Meanwhile, 5 NMOSD (41.7%) and 4 MS (28.6%) patients who had normal cognition according to the WAIS-III and WMS-R were assessed as cognitively impaired by the BRBN (which is not standardized for age). Cognitive function in NMOSD patients with no or mild non-specific brain lesions was preserved according to the WAIS-III and WMS-R.

Importance of Regular and Maintenance Therapy Adherence in Neuromyelitis Optica (NMO): Lessons from a Repeating Relapse Case

PubMed Central

Miao, Jing; Aboagye, Doreen E.; Chulpayev, Boris; Liu, Lin; Ishkanian, Gary; Kolanuvada, Bangaruraju; Alaie, Dariush; Petrillo, Richard L.

2018-01-01

Patient: Female, 58 Final Diagnosis: NMO Symptoms: New-onset right leg weakness and pain Medication: — Clinical Procedure: Progressive and recurring Specialty: Neurology Objective: Rare disease Background: Neuromyelitis optica (NMO) is a rare demyelinating disease of the central nervous system; NMO predominantly affects the spinal cord and optic nerves. The diagnosis is based on history, clinical presentation, seropositive NMO-IgG antibody, and notably, exclusion of other diseases. Despite the absence of definitive therapeutic strategies for NMO, methylprednisolone pulse therapy and plasma exchange are used for acute phase treatment, while immunosuppressive agent(s) are recommended to prevent relapses and improve prognosis. Here, we report a repeating relapse NMO case due to lack of regular and maintenance therapy. Case Report: A 58-year-old female with chronic NMO presented with a three-day history of new-onset right leg weakness and pain. The patient was diagnosed with NMO three years ago and presented with her fourth attacks. During her initial diagnosis, she was initiated on steroids. One year later, she developed the first relapse and was treated with steroids and rituximab, leading to 1.5-year remission. After the second relapse, steroids and rituximab was still given as maintenance therapy, but was not followed. Thus, the third relapse occurred in five months. During this hospitalization, she received initially high-dose solumedrol (1 g daily for five days) in addition to gabapentin 100 mg (gradually increased to 300 mg) three times a day for muscle spasms. Due to worsening of paresthesia and hemiparesis, it was decided to place her on plasma exchange treatment. After two plasma exchanges, the patient’s condition was improved and she regained strength in her lower extremity. She completed five more cycles of plasma exchange, and was then discharged on steroid therapy (prednisone 20 mg daily for 10 days then taper) as maintenance therapy and with follow

[Proportion and significance of CD1d(hi)CD5⁺CD19⁺ regulatory B cell in peripheral blood of patients with neuromyelitis optica].

PubMed

Yang, Fen; Huang, Dehui; Cheng, Chen; Wu, Weiping

2015-03-01

To detect the proportion of CD1d(hi)CD5⁺CD19⁺ regulatory B cells (Bregs) in peripheral blood of the patients with neuromyelitis optica (NMO), and explore whether CD1d(hi)CD5⁺CD19⁺ Bregs can play a role as a biomarker in the diagnosis of NMO versus multiple sclerosis (MS). Flow cytometry was performed to detect the proportion of CD1d(hi)CD5⁺CD19⁺ Bregs in peripheral blood from 44 cases of NMO, 38 cases of MS, and 30 healthy controls. The serum level of aquaporin-4 antibody (AQP4-Ab) of patients with NMO was detected by indirect immunofluorescence assay. The proportion of CD1d(hi)CD5⁺CD19⁺ Bregs in CD19⁺ B cells and lymphocytes was significantly lower in NMO group than in MS and control groups; however, there was no significant difference between MS group and control group. The proportion of CD1d(hi)CD5⁺CD19⁺ Bregs in CD19⁺ B cells and lymphocytes was lower in AQP4-Ab-positive NMO patients than in AQP4-Ab-negative NMO patients, and the difference was statistically significant. CD1d(hi)CD5⁺CD19⁺ Bregs may be a biomarker in the differential diagnosis of NMO versus MS.

Study of the Generation of Intense Pulsed Electron Beams Using Glow Discharges

DTIC Science & Technology

1988-02-01

de Investigaciones Opticas, Rep. Argentina. (2) On leave from PROFET (UNCPBA) Programa de Fisica Experimental Tandil, Rep. Argentina. (3) Edwards... de Investigaciones Opticas, (CIC-BA) Rep. Argentina. Section III-D. Measurements of the plasma density andB. T. Szapiro is on leave from Programa de ...discussed. The radial profiles Szapiro was supported by a fellowship from the Universidad Nacional de show the presence of a high-current-density

Large-Scale in-House Cell-Based Assay for Evaluating the Serostatus in Patients with Neuromyelitis Optica Spectrum Disorder Based on New Diagnostic Criteria.

PubMed

Kim, Yeseul; Kim, Gayoung; Kong, Byung Soo; Lee, Ji Eun; Oh, Yu Mi; Hyun, Jae Won; Kim, Su Hyun; Joung, AeRan; Kim, Byoung Joon; Choi, Kyungho; Kim, Ho Jin

2017-04-01

The detection of aquaporin 4-IgG (AQP4-IgG) is now a critical diagnostic criterion for neuromyelitis optica spectrum disorder (NMOSD). To evaluate the serostatus of NMOSD patients based on the 2015 new diagnostic criteria using a new in-house cell-based assay (CBA). We generated a stable cell line using internal ribosome entry site-containing bicistronic vectors, which allow the simultaneous expression of two proteins (AQP4 and green fluorescent protein) separately from the same RNA transcript. We performed in-house CBA using serum from 386 patients: 178 NMOSD patients diagnosed according to the new diagnostic criteria without AQP4-IgG, 63 high risk NMOSD patients presenting 1 of the 6 core clinical characteristics of NMOSD but not fulfilling dissemination in space, and 145 patients with other neurological diseases, including 66 with multiple sclerosis. The serostatus of 111 definite and high risk NMOSD patients were also tested using a commercial CBA kit with identical serum to evaluate the correlation between the 2 methods. All assays were performed by two independent and blinded investigators. Our in-house assay yielded a specificity of 100% and sensitivities of 80% (142 of 178) and 76% (48 of 63) when detecting definite- and high risk NMOSD patients, respectively. The comparison with the commercial CBA kit revealed a correlation for 102 of the 111 patients: no correlation was present in 7 patients who were seronegative using the commercial method but seropositive using the in-house method, and in 2 patients who were seropositive using the commercial method but seronegative using the in-house method. These results demonstrate that our in-house CBA is a highly specific and sensitive method for detecting AQP4-IgG in NMOSD patients. Copyright © 2017 Korean Neurological Association

Neuromyelitis Optica

MedlinePlus

... from cell to cell. NMO is different from multiple sclerosis (MS). Attacks are usually more severe in NMO ... from cell to cell. NMO is different from multiple sclerosis (MS). Attacks are usually more severe in NMO ...

Comparative study of quality of life, anxiety, depression, and fatigue among patients with neuromyelitis optica spectrum disorder and multiple sclerosis: The first report from Iran.

PubMed

Barzegar, Mahdi; Badihian, Shervin; Mirmosayyeb, Omid; Ashtari, Fereshteh; Jamadi, Maryam; Emami, Shohreh; Jahani, Leila; Safavi, Armaghan; Shaygannejad, Vahid

2018-05-01

Neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS) are associated with reduced Health Related Quality of Life (HRQOL). To the best of our knowledge, change of HRQOL in patients with NMOSD has not been yet measure in Iran. The objective of this study was to assess HRQOL in NMOSD and MS patients and identify related factors METHODS: A cross sectional study of 41 patients with NMOSD and 136 age and sex-match MS patients was performed. A series of questionnaires including Persian validated questionnaires on HRQOL (SF-36), fatigue (MFIS), depression (BDI-II), anxiety (HAM-A) and sleep quality (PSQI) were record. All demographic variables, socioeconomic status and clinical data were also obtained. Student's T test and Mann-Whitney U test used to compare variables between groups and multivariate regression analysis applied to assay predictor factors. The mean scores of mental (MCS) and physical (PCS) components of QOL were statistically lower in patients with NMOSD compare with MS patients (β = -4.49, P = 0.004; β = -3.52, P = 0.015). Multivariate analysis indicated fatigue, depression and anxiety were independent, significant predictor of MCS (β = -0.229, P = 0.002; β = -0.229, P = 0.002; β = -0.258, P = 0.020 respectively). However, PCS was significantly predicted by fatigue (β = -0.258 P < 0.001), solely. These findings indicate NMOSD patients have lower HRQOL in compare to patients with MS. Also, screening and treatment of fatigue as the most important predictor for HRQOL is necessary. Copyright © 2018. Published by Elsevier B.V.

Avaliação do conhecimento de pacientes diabéticos sobre medidas preventivas do pé diabético em Maringá (PR)

PubMed Central

Carlesso, Guilherme Pereira; Gonçalves, Mariana Helena Barboza; Moreschi, Dorival

2017-01-01

Resumo Contexto O atual envelhecimento da população tem gerado maior predominância de doenças crônicas, como o diabetes, a qual está associada a um risco elevado de complicações crônicas e agudas. Entre essas, o pé diabético (PD) destaca-se por possuir alta incidência e grande poder mutilador. Objetivo Avaliar o conhecimento da população diabética das Unidades Básicas de Saúde (UBS) de Maringá (PR) sobre a prevenção do PD. Métodos Estudo descritivo, quantitativo, tipo inquérito por entrevista. A população estudada foi composta por 80 portadores de diabetes, cadastrados em UBS de Maringá (PR). A coleta de dados buscou levantar dados sociodemográficos e epidemiológicos, bem como as atitudes de controle do diabetes e do autocuidado para prevenção do PD. Resultados Do total de entrevistados, nove não realizavam qualquer tipo de exame para controle do diabetes e a renda mensal predominante foi de até um salário mínimo. O grau de escolaridade e a renda mensal não se mostraram relevantes em relação ao conhecimento de cuidados preventivos do PD e nem uma maior adesão a hábitos de vida saudáveis. O cuidado com o PD tende a melhorar à medida que exista uma compreensão mais clara dos fatores que conduzem à perda do membro e um crescente consenso sobre a gestão de vários aspectos clínicos do cuidado com o pé. Conclusão Existe uma falta de aprendizado das medidas preventivas, mesmo nos pacientes com algum nível de instrução, o que induz a uma prática deficiente de cuidados.

Increased occurrence of anti-AQP4 seropositivity and unique HLA Class II associations with neuromyelitis optica (NMO), among Muslim Arabs in Israel.

PubMed

Brill, Livnat; Mandel, Micha; Karussis, Dimitrios; Petrou, Panayiota; Miller, Keren; Ben-Hur, Tamir; Karni, Arnon; Paltiel, Ora; Israel, Shoshana; Vaknin-Dembinsky, Adi

2016-04-15

Previous studies have revealed different human leukocyte antigen (HLA) associations in multiple sclerosis (MS) and neuromyelitis optica (NMO), further discriminating these two demyelinating pathological conditions. In worldwide analyses, NMO and opticospinal MS are represented at higher proportions among demyelinating conditions in African, East-Asian and Latin American populations. There are currently no data regarding the prevalence of NMO in Middle East Muslims. The population in Israel is diverse in many ways, and includes subpopulations, based on religion and ethnicity; some exhibit genetic homogeneity. In Israel, the incidence of MS is lower in the Muslim population than the Jewish population and Muslims carry different allele frequency distribution of HLA haplotypes. To evaluate the occurrence of anti-AQP4 seropositivity in the Israeli Muslim population among patients with central nervous system (CNS) demyelinating conditions; and to identify the HLA DR and DQ profiles of Muslim Arab Israeli patients with NMO spectrum of diseases (NMOSD). The prevalence of anti-AQP4 seropositivity was analyzed in 342 samples, obtained from patients with various CNS demyelinating conditions and in a validation set of 310 samples. HLA class II alleles (HLA-DRB1 and DQB1) were examined in DNA samples from 35 Israeli Muslim Arabs NMO patients and compared to available data from 74 Israeli Muslim controls. Our data reveal a significantly increased prevalence of anti-AQP4 seropositivity, indicative of NMOSD, in Muslim Arab Israeli patients with initial diagnosis of a CNS demyelinating syndrome. In this population, there was a positive association with the HLA-DRB1*04:04 and HLA-DRB1*10:01 alleles (p=0.03), and a strong negative association with the HLA-DRB1*07 and HLA-DQB1*02:02 alleles (p=0.003, p=0.002). Our findings indicate a possibly increased prevalence of NMOSD in Muslim Arabs in Israel with distinct (positive and negative) HLA associations. Further studies in patients with

Screening prostate cancer using a portable near infrared scanning imaging unit with an optical fiber-based rectal probe

NASA Astrophysics Data System (ADS)

Pu, Yang; Wang, Wubao; Tang, Guichen; Budansky, Yury; Sharonov, Mikhail; Xu, Min; Achilefu, Samuel; Eastham, James A.; Alfano, Robert R.

2012-01-01

A portable near infrared scanning polarization imaging unit with an optical fiber-based rectal probe, namely Photonic Finger, was designed and developed o locate the 3D position of abnormal prostate site inside normal prostate tissue. An inverse algorithm, Optical Tomography using Independent Component Analysis (OPTICA) was improved particularly to unmix the signal from targets (cancerous tissue) embedded in a turbid medium (normal tissue) in the backscattering imaging geometry. Photonic Finger combined with OPTICA was tested to characterize different target(s) inside different tissue medium, including cancerous prostate tissue embedded by large piece of normal tissue.

Optica aperture synthesis

NASA Astrophysics Data System (ADS)

van der Avoort, Casper

2006-05-01

Optical long baseline stellar interferometry is an observational technique in astronomy that already exists for over a century, but is truly blooming during the last decades. The undoubted value of stellar interferometry as a technique to measure stellar parameters beyond the classical resolution limit is more and more spreading to the regime of synthesis imaging. With optical aperture synthesis imaging, the measurement of parameters is extended to the reconstruction of high resolution stellar images. A number of optical telescope arrays for synthesis imaging are operational on Earth, while space-based telescope arrays are being designed. For all imaging arrays, the combination of the light collected by the telescopes in the array can be performed in a number of ways. In this thesis, methods are introduced to model these methods of beam combination and compare their effectiveness in the generation of data to be used to reconstruct the image of a stellar object. One of these methods of beam combination is to be applied in a future space telescope. The European Space Agency is developing a mission that can valuably be extended with an imaging beam combiner. This mission is labeled Darwin, as its main goal is to provide information on the origin of life. The primary objective is the detection of planets around nearby stars - called exoplanets- and more precisely, Earth-like exoplanets. This detection is based on a signal, rather than an image. With an imaging mode, designed as described in this thesis, Darwin can make images of, for example, the planetary system to which the detected exoplanet belongs or, as another example, of the dust disk around a star out of which planets form. Such images will greatly contribute to the understanding of the formation of our own planetary system and of how and when life became possible on Earth. The comparison of beam combination methods for interferometric imaging occupies most of the pages of this thesis. Additional chapters will treat related subjects, being experimental work on beam combination optics, a description of a novel formalism for aberration retrieval and experimental work on nulling interferometry. The Chapters on interferometric imaging are organized in such a way that not only the physical principles behind a stellar interferometer are clear, but these chapters also form a basis for the method of analysis applied to the interferometers - -or rather beam combination methods- under consideration. The imaging process in a stellar interferometer will be treated as the inversion of a linear system of equations. The definition of interferometric imaging in this thesis can be stated to be the reconstruction of a luminosity distribution function on the sky, that is, in angular measure, larger than the angular diffraction limited spot size -or Point-Spread Function (PSF)- of a single telescope in the array and that contains, again in angular measure, spatial structure that is much smaller than the PSF of a single telescope. This reconstruction has to be based on knowledge of the dimensions of the telescope array and the detector. The detector collects intensity data that is formed by observation of the polychromatic luminosity distribution on the sky and is deteriorated by the quantum-nature of light and an imperfect electronic detection process. Therefore, the imaging study presented in this thesis can be regarded to be a study on the signal characteristics of various interferometers while imaging a polychromatic wide-field stellar source. The collection of beam combination methods under consideration consists of four types. Among these are two well-known types, having either co-axially combined beams as in the Michelson-Morley experiment to demonstrate the existence of ether, or beams that follow optical paths as if an aperture mask were placed in front of a telescope, making the beams combine in the focus of that telescope, as suggested by Fizeau. For separated apertures rather than an aperture mask, these optical paths are stated to be homothetic. In short, these two types will be addressed as the Michelson or the Homothetic type. The other two types are addressed as Densified and Staircase. The first one is short for densified pupil imaging, an imaging technique very similar to the Homothetic type, be it that the natural course of light after the aperture mask is altered. However, the combination of the beams of light is again in focus. The Staircase method is an alternative to the co-axial Michelson method and lends its name from the fact that a staircase-shaped mirror is placed in an intermediate focal plane after each telescope in the array, before combining the beams of light co-axially. This addition allows stellar imaging as with the Michelson type, with the advantage of covering a large field-of-view. The details of these methods will intensively be discussed in this thesis, but the introduction of them at this point allows a short list of results, found by comparing them for equal imaging tasks. Homothetic imagers are best suited for covering a wide field-of-view, considering the information content of the interferometric signals these arrays produce. The large number of detectors does not seem to limit the imaging performance in the presence of noise, due to the high ratio of coherent versus incoherent information in the detector signal. The imaging efficiency of a Michelson type array is also high, although -considering only polychromatic wide-field imaging tasks- the ratio of coherent versus incoherent information in the detected signals is very low. This results in very large observation times needed to produce images comparable to those obtained with a Homothetic array. A detailed presentation of the characteristics of the detected signals in a co-axial Michelson array reveal that such signals, obtained by polychromatic observation of extended sources, have fringe envelope functions that do not allow Fourier-spectroscopy to obtain high-resolution spectroscopic information about such a source. For the Densified case, it is found that this method can indeed provide an interferometric PSF that is more favorable than a homothetic PSF, but only for narrow-angle observations. For polychromatic wide-field observations, the Densified-PSF is field-dependent, for which the image reconstruction process can account. Wide-field imaging using the favorable properties of the Densified-PSF can be performed, by using special settings of the delay or optical path length difference between interferometer arms and including observations with several settings of delay in the observation data. The Staircase method is the second best method for the imaging task under consideration. The discontinuous nature of the staircase-shaped mirrors does not give rise to a discontinuous reconstructed luminosity distribution or non-uniformly covered spatial frequencies. The intrinsic efficiency of the interferometric signal in this type of interferometer is worse than that of the other co-axial method, although the ratio of coherent versus incoherent signal in the data -the length of the fringe packet in one intensity trace-e- is nearly ultimate. The inefficiency is overwhelmingly compensated for by the very short observation time needed. Besides numerical studies of interferometer arrays, one interferometric imager was also studied experimentally. A homothetic imager was built, comprising three telescopes with fully separated beam relay optics. The pointing direction, the location and the optical path length of two of the three beams are electronically controllable. The beams can be focused together to interfere, via a beam combiner consisting of curved surfaces. This set-up allows to measure the required accuracies at which certain optical elements have to be positioned. Moreover, this set-up demonstrates that without knowledge of the initial pointing directions, locations and optical path lengths of the beams, the situation of homothesis can be attained, solely based on information from the focal plane of the set-up. Further experiments show that the approximation of exact homothesis is limited by the optical quality of the beam combiner optics. Parallel to the experiments on homothesis, a study was performed to evaluate the use of the Extended Nijboer-Zernike (ENZ) formalism for analysis of multiple aperture optical systems. It is envisaged that an aberration retrieval algorithm, provided with the common focus of a homothetic array, can be used to detect misalignment of or even aberrations in the sub-apertures of the sparse synthetic aperture. The ENZ formalism is a powerful tool to describe the focal intensity profile in an optical imaging system, imaging a monochromatic point source through a pupil that is allowed to have a certain transmission profile and phase aberration function over the pupil. Moreover, the formalism allows calculation of intensity profiles outside the best-focus plane. With the intensity information of several through-focus planes, enough information is available to reconstruct the pupil function from it. The formalism is described, including the reconstruction algorithm. Although very good results are obtained for general pupil functions, the results for synthetic pupil functions are not very promising. The detailed description of the ENZ-aberration retrieval reveals the origin of the breakdown of the retrieval process. Finally, a description of experiments on nulling interferometry is given, starting with the presentation of an experimental set-up for three-beam nulling. A novel strategy for polychromatic nulling is treated here, with the goal of relieving the tight phase constraint on the spectra in the individual beams. This theoretically allows broad band-nulling with a high rejection ratio without using achromatic phase shifters. The disappointing results led to an investigation of the spectra of the individual beams. The origin of the unsatisfactory level of the rejection ratio is found in the spectral unbalance of the beams. Before branching off, the beams have an equal spectrum. Then, the encounter of different optical elements with individually applied coatings, the control of beam-power per beam and finally the beam coupling into a single-mode fiber, apparently alter the spectra in such a way that the theoretically achievable level of the rejection ratio cannot be reached. The research described in this thesis provides onsets for research in several areas of interest related to aperture synthesis and guidelines concerning the design of synthetic telescopes for imaging. As such, this research contributes to the improvement of instrumentation for observational astronomy, in particular for stellar interferometry. While nulling interferometry is the detection technique that allows a space telescope array such as ESA-Darwin to identify exoplanets, optical aperture synthesis imaging is the technique that can make images of the planetary systems to which these exoplanets belong. Moreover, many objects can be observed that represent earlier versions of our planetary system, our Sun and even our galaxy, the Milky Way. Observing these objects might answer questions about the origins of the Earth itself and the life on it.

CONFERENCE NOTE: CETO—Centro de Ciências e Tecnologias Opticas, Trends in Optical Fibre Metrology and Standards

NASA Astrophysics Data System (ADS)

1994-01-01

requirements of the new generation of analogue and digital fibre optical systems, which require sophisticated measurement techniques employing complex instruments unique to optical measurements. The school will foster and enhance the interaction between material, devices, systems, and standards-oriented R&D communities, as well as between engineers concerned with design and manufacturers of systems and instrumentation. Topics Review of optical fibre communication technology and systems Measurement techniques for fibre characterization: Reliability and traceability Reference fibres and calibration artefacts Ribbon fibres Mechanical and environmental testing Fibre reliability Polarimetric measurements Passive components characterization: Splices and connectors Couplers, splitters, taps and WDMs Optical fibres and isolators WDM technologies and applications: WDM technologies Tunable optical filters Fibre amplifiers and sources: Performances and characterization Design and standards Nonlinear effects Subsystem design and standards: Design and fabrication techniques Performance degradation and reliability Evaluation of costs/performance/technology Sensors IR - optical fibres Plastic fibres Instrumentation Registration Participation free of charge for postgraduate students, with some grants available for travel and lodging expenses. All correspondence should be addressed to: Secretariat, Trends in Optical Fibre Metrology and Standards, a/c Prof. Olivério D D Soares, Centro de Ciências e Tecnologias Opticas, Lab. Fisica - Faculdade de Ciências, Praça Gomes Teixeira, P-4000 Porto, Portugal. Tel: 351-2-310290, 351-2-2001648; Fax: 351-2-319267.

PREFACE: International Conference on Control and Synchronization of Dynamical Systems (CSDS-2005)

NASA Astrophysics Data System (ADS)

Pisarchik, Alexander N.

2005-01-01

This volume of Journal of Physics: Conference Series contains selected articles by the participants at the International Conference on Control and Synchronization of Dynamical Systems (CSDS-2005) organized by Centro de Investigaciones en Optica (CIO) in cooperation with the Society for Industrial and Applied Mathematics (SIAM), which was held in Leon, Guanajuato, Mexico on 4-7 October 2005. CSDS-2005 featured the latest research in nonlinear dynamics concentrating on the theory of control and synchronization of complex systems and its applications in different areas of science and engineering, including optics, electronics, mechanics, chemistry, medicine, economy, communication, etc. The conference brought together leading researchers, both theoreticians and experimentalists, from different fields of science and provided an excellent opportunity for sharing ideas and problems among specialists in controlling dynamical systems and synchronization. The meeting served a dual purpose: to expose the scientific community to the cutting edge of forefront research done by leaders in this area from as many as 25 countries and to attract the attention of Mexican researchers to this field of science. These proceedings are intended to be a record of this conference and to serve as a reference for future research which the conference hopes to have initiated. After the pioneering work on controlling chaos of E Ott, C Grebogi and J Yorke appeared in Physical Review Letters in 1990, the number of works on this topic grew tremendously. Our extensive bibliographic search among 110 peer reviewed journals yielded more than 1500 papers on controlling chaos and more than 2500 on synchronization of chaotic systems published during the last decade. The numbers of publications are still at their peaks that began to saturate, in 1998 and 2003, respectively. It is my pleasure to acknowledge the contribution of the program and organizing committees, the funding agencies and cooperating

The spectral sensitivity of the human short-wavelength sensitive cones derived from thresholds and color matches.

PubMed

Stockman, A; Sharpe, L T; Fach, C

1999-08-01

We used two methods to estimate short-wave (S) cone spectral sensitivity. Firstly, we measured S-cone thresholds centrally and peripherally in five trichromats, and in three blue-cone monochromats, who lack functioning middle-wave (M) and long-wave (L) cones. Secondly, we analyzed standard color-matching data. Both methods yielded equivalent results, on the basis of which we propose new S-cone spectral sensitivity functions. At short and middle-wavelengths, our measurements are consistent with the color matching data of Stiles and Burch (1955, Optica Acta, 2, 168-181; 1959, Optica Acta, 6, 1-26), and other psychophysically measured functions, such as pi 3 (Stiles, 1953, Coloquio sobre problemas opticos de la vision, 1, 65-103). At longer wavelengths, S-cone sensitivity has previously been over-estimated.

The optical properties of smoke-protective devices.

DOT National Transportation Integrated Search

1978-10-01

Optical properties of 13 smoke-protective devices were determined. The devices tested comprised 8 goggles and 5 fullface oxygen masks (3 rigid one-piece masks and 2 flexible hoods). Those properties evaluated were: (i) light transmission, (ii) optica...

Energy-resolved attosecond interferometric photoemission from Ag(111) and Au(111) surfaces

NASA Astrophysics Data System (ADS)

Ambrosio, M. J.; Thumm, U.

2018-04-01

Photoelectron emission from solid surfaces induced by attosecond pulse trains into the electric field of delayed phase-coherent infrared (IR) pulses allows the surface-specific observation of energy-resolved electronic phase accumulations and photoemission delays. We quantum-mechanically modeled interferometric photoemission spectra from the (111) surfaces of Au and Ag, including background contributions from secondary electrons and direct emission by the IR pulse, and adjusted parameters of our model to energy-resolved photoelectron spectra recently measured at a synchrotron light source by Roth et al. [J. Electron Spectrosc. 224, 84 (2018), 10.1016/j.elspec.2017.05.008]. Our calculated spectra and photoelectron phase shifts are in fair agreement with the experimental data of Locher et al. [Optica 2, 405 (2015), 10.1364/OPTICA.2.000405]. Our model's not reproducing the measured energy-dependent oscillations of the Ag(111) photoemission phases may be interpreted as evidence for subtle band-structure effects on the final-state photoelectron-surface interaction not accounted for in our simulation.

Optic Neuropathy Associated with Primary Sjögren's Syndrome: A Case Series.

PubMed

Bak, Eunoo; Yang, Hee Kyung; Hwang, Jeong-Min

2017-04-01

To determine the diverse clinical features of optic neuropathy associated with primary Sjögren's syndrome in Korean patients. Five women with acute and/or chronic optic neuropathy who were diagnosed as primary Sjögren's syndrome were retrospectively evaluated. Primary Sjögren's syndrome was diagnosed by signs and symptoms of keratoconjunctivitis sicca, positive serum anti-Ro/SSA and/or anti-La/SSB antibodies, and/or minor salivary gland biopsy. All patients underwent a complete ophthalmologic examination. Among the five patients diagnosed as optic neuropathy related to primary Sjögren's syndrome, four patients had bilateral optic neuropathy and one patient was unilateral. The clinical course was chronic in three patients and one of them showed acute exacerbation and was finally diagnosed with neuromyelitis optica spectrum disorder. The other two patients presented as acute optic neuritis and one was diagnosed with neuromyelitis optica spectrum disorder. Sicca symptoms were present in four patients, but only two patients reported these symptoms before the onset of optic neuropathy. Patients showed minimal response to systemic corticosteroids or steroid dependence, requiring plasmapheresis in the acute phase and immunosuppressive agents for maintenance therapy. Optic neuropathy associated with primary Sjögren's syndrome may show variable clinical courses, including acute optic neuritis, insidious progression of chronic optic atrophy, or in the context of neuromyelitis optica spectrum disorders. Optic neuropathy may be the initial manifestation of primary Sjögren's syndrome without apparent sicca symptoms, which makes the diagnosis often difficult. The presence of specific antibodies including anti-Ro/SSA, anti-La/SSB, and anti-aquaporin-4 antibodies are supportive for the diagnosis and treatment in atypical cases of optic neuropathy.

Peripatetic and Euclidean theories of the visual ray.

PubMed

Jones, A

1994-01-01

The visual ray of Euclid's Optica is endowed with properties that reveal the concept to be an abstraction of a specific physical account of vision. The evolution of a physical theory of vision compatible with the Euclidean model can be traced in Peripatetic writings of the late fourth and third centuries B.C.

Classification of shiga toxin-producing escherichia coli (STEC) serotypes with hyperspectral microscope imagery

USDA-ARS?s Scientific Manuscript database

Non-O157:H7 Shiga toxin-producing Escherichia coli (STEC) strains such as O26, O45, O103, O111, O121 and O145 are recognized as serious outbreak to cause human illness due to their toxicity. Since a conventional microbiological method for cell counting is laborious and time-consuming process, optica...

Dynamical Imaging using Spatial Nonlinearity

DTIC Science & Technology

2014-01-29

643. [5] R. Heintzmann, C. Cremer , Lateral modulated excitation microscopy: Improvement of resolution by using a diffraction grating, Proceedings...by stochastic optical reconstruction microscopy (STORM), Nat Methods, 3 ( 2006 ) 793-795. [14] E. Betzig, G.H. Patterson, R. Sougrat, O.W. Lindwasser...Science, 313 ( 2006 ) 1642-1645. [15] W. Lukosz, M. Marchand, Optischen Abbildung Unter Überschreitung der Beugungsbedingten Auflösungsgrenze, Optica

Gregory [Gregorie], James (1638-75)

NASA Astrophysics Data System (ADS)

Murdin, P.

2000-11-01

Scottish mathematician and optician, born in Aberdeen. Gregory described in Optica Promota a design (which he never realized) for the first practical reflecting telescope in which a perforated primary concave parabolic mirror converges the light to the focus of a concave ellipsoidal secondary mirror. The light is reflected back to the ellipsoid's second focus behind the main mirror. A real image ...

Special Session on Adaptive Optics in Russia and China. Volume 23

DTIC Science & Technology

1995-01-01

Fisica Aplicada. Universidad de Cantabria. 39005. SANTANDER. SPAIN. Tel: 42-201445. Fax: 42-201402. 1.- INTRODUCTION To estimate the centroid of a light...Lia M. Zerbino ##, Eduardo Aguirre +, Anibal P. Laquidara ++ and Mario-Garavaglia ft. Centro de Investigaciones Opticas (CIOp) CC 124 Correo Central...Professor at Universidad Nacional dt La Plata and CONICET Engiuneer. C (lOp belongs to Consejo Nacional de Investigaciones Cientificas y Ticnicas (CONICET

Hydroxycholesterol Levels in the Serum and Cerebrospinal Fluid of Patients with Neuromyelitis Optica Revealed by LC-Ag+CIS/MS/MS and LC-ESI/MS/MS with Picolinic Derivatization: Increased Levels and Association with Disability during Acute Attack

PubMed Central

Park, Ki Duk; Park, Kyung Seok; Lee, Kwang-Woo; Kim, Sung-Min; Lee, Jaeick

2016-01-01

Neuromyelitis optica (NMO) is an inflammatory demyelinating disease of the central nervous system (CNS). Hydroxycholesterols (OHCs), metabolites of CNS cholesterol, are involved in diverse cellular responses to inflammation and demyelination, and may also be involved in the pathogenesis of NMO. We aimed to develop a sensitive and reliable method for the quantitative analysis of three major OHCs (24S-, 25-, and 27-OHCs), and to evaluate their concentration in the cerebrospinal fluid (CSF) and serum of patients with NMO. The levels of the three OHCs in the serum and CSF were measured using liquid chromatography-silver ion coordination ionspray tandem mass spectrometry and liquid chromatography-electrospray ionization tandem mass spectrometry with picolinyl ester derivatization, respectively. The linear range was 5–250 ng/mL for 24S- and 27-OHC, and 0.5–25 ng/mL for 25-OHC in serum, and was 0.1–5 ng/mL for 24S- and 27-OHC, and 0.03–1 ng/mL for 25-OHC in CSF. Precision and accuracy were 0.5%–14.7% and 92.5%–109.7%, respectively, in serum, and were 0.8%–7.7% and 94.5%–119.2%, respectively, in CSF. Extraction recovery was 82.7%–90.7% in serum and 68.4%–105.0% in CSF. When analyzed in 26 NMO patients and 23 control patients, the 25-OHC (0.54 ± 0.96 ng/mL vs. 0.09 ± 0.04 ng/mL, p = 0.032) and 27-OHC (2.68 ± 3.18 ng/mL vs. 0.68 ± 0.25 ng/mL, p = 0.005) were increased in the CSF from NMO patients. When we measured the OHCCSF index that controls the effects of blood–brain barrier disruption on the level of OHC in the CSF, the 27-OHCCSF index was associated with disability (0.723; 95% confidence interval (CI)– 0.181, 0.620; p = 0.002), while the 24-OHCCSF index (0.518; 95% CI– 1.070, 38.121; p = 0.040) and 25-OHCCSF index (0.677; 95% CI– 4.313, 18.532; p = 0.004) were associated with the number of white blood cells in the CSF of NMO patients. Our results imply that OHCs in the CNS could play a role in the pathogenesis of NMO. PMID:27942009

Zucchi, Niccolo (1586-1670)

NASA Astrophysics Data System (ADS)

Murdin, P.

2000-11-01

Born in Parma, Italy, became a Jesuit, and in 1608, or perhaps 1616, used a lens to observe the image produced by a concave mirror, the first reflecting telescope. He described it in a book Optica Philosophica, in 1652. He was the first to observe the spots on Jupiter, in 1630. In about 1640, he is reported to have examined spots on Mars, as discovered by Fontana, but this must be regarded skepti...

Hypothalamic demyelination causing panhypopituitarism.

PubMed

Dixon-Douglas, Julia; Burgess, John; Dreyer, Michael

2018-05-01

Hypothalamic involvement in multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) is rare and endocrinopathies involving the hypothalamic-pituitary axis in patients with demyelinating conditions have rarely been reported. We present two cases of MS/NMOSD with associated hypothalamic-pituitary involvement and subsequent hypopituitarism, including the first report of a patient with hypothalamic demyelination causing panhypopituitarism. Differential diagnoses, including alemtuzumab-related and primary pituitary pathology are discussed. © 2018 Royal Australasian College of Physicians.

Enhanced Backscattering from Rough Surfaces

DTIC Science & Technology

1991-10-18

experimental results M. Nieto-Vesperinas and J. A. Sinchez-Gfi Insuituto de Optica. Consejo Superior de Investigaciones Cientificas, c/Serrono 1221. Madrid...2A7, UK I Division de Fisica Aplicada, CICESE, Apdo. Postal 2732 Ensenada, Baja California, Mexico Instituto de Optics, CSIC, Serrano 121, Madrid 2806...extracted as a de - is less than two for the copolarized case because of the scriptive parameter of the curves, and the variation of contribution of single

The Threat of Latin America Populism

DTIC Science & Technology

2010-04-07

Minister), August 14,2008, httpJ/www.cavallo.corn.ar/?p=173 , (accessed December 29, 2009). 38 1NV AP, " Tecnologia de Avanzada a Medida, Argentina.ar...December 5, 2008, http ://www.argentina.ar/ es/ciencia-y-educacion/C343 -invap- tecnologia -de-avanzada -a- medida.php (accessed December 15, 2009...ch_vez_obliga_a_)a_tv_por_cable_a_sumarse_a_)a_cade na nacion/ INV AP, " Tecnologia de Avanzada a Medida, Argentina.ar, December 5, 2008, http

Time-Resolved and Spectroscopic Three-Dimensional Optical Breast Tomography

DTIC Science & Technology

2008-04-01

Appendix 1. Each raw image was then cropped to select out the information-rich region, and binned to enhance the signal-to-noise ratio. All the binned...component analysis, near infrared (NIR) imaging, optical mammography , optical imaging using independent component analysis (OPTICA). I. INTRODUCTION N EAR...merging 5 × 5 pixels into one to enhance the SNR, resulting in a total of 352 images of 54 × 55 pixels each. All the binned images corresponding to

Determinacion de Caracteristicas Opticas del Telescopio OAN150

NASA Astrophysics Data System (ADS)

Galan, M. J.; Cobos, F. J.

1987-05-01

En el Observatorio de Calar Alto, en Almería, España, está ubicado un telescopio de 15O-cms de diámetro -construído por REOSC- perteneciente al Observatorio Astronómico Nacional, con sede en Madrid, España. La infraestructura técnica del OAN ha sido tradicionalmente débil y actualmente se está haciendo un esfuerzo por fortalecerla. Existe una información muy limitada del telescopio en general; de su óptica en particular se conocían los valores de los parámetros principales pero sin saber si éstos corresponden a valores teóricos ó de construcción. Por ello se consideró necesario iniciar una investigación para conocer en detalle los valores reales de las componentes ópticas del telescopio, obteniéndose algunos resultados de interés. El primario del telescopio OANl5O es aproximadamente F/3 y el siste ma en su conjunto es F/8.2, con su sistema corrector de campo. En términos generales, la imagen es satisfactoria en todo el campo y, sin sistema corrector, la imagen axial también es buena. En un futuro muy cercano se piensa diseñar instrumentación adicional para este telescopio. Conocer con mayor precisión sus características puede ser de gran utilidad para tal fin, pues se efectúan los cálculos considerando conjuntamente al telescopio y al instrumento.

[Myelitis as a differential diagnosis of spinal cord tumors].

PubMed

Vermersch, P; Outteryck, O; Ferriby, D; Zéphir, H

2017-11-01

Myelitis is common, related to multiple aetiologies and constitute in some cases a differential diagnosis for spinal cord tumors. Our objective was to review the clinical and paraclinical aspects of the main aetiologies of myelitis. These aetiologies will be reviewed based on data not only from the scientific literature but also from our personal experience reported in different cohorts of patients. Multiple sclerosis is the main cause of partial myelitis in young adults. Neuromyelitis optica is now a well-known specific entity frequently revealed by a transverse myelitis. The diagnosis is based on specific criteria, including the presence of anti-NMO antibodies. In our cohorts, approximately 12 % of the patients admitted for an acute or subacute myelitis were related to infections, mainly of a viral origin. Patients with myelitis must be screened for systemic diseases. As for neuromyelitis optica, patients with myelitis related to a systemic disease should be treated in emergency. Acute myelitis is sometimes the first symptom of a systemic lupus or of a sarcoidosis. Sjögren syndrome can mimic myelitis related to primary progressive multiple sclerosis. Spinal cord imaging contributes greatly to defining the myelitis. In most cases, a routine clinical and paraclinical examination and the follow-up of the patients can contribute to establishing the aetiology of a myelitis. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

An Electron-Beam Controlled Semiconductor Switch

DTIC Science & Technology

1989-11-01

of the Seventeenth Power Modulator Symposium, Seattle, WA, pp. 214-218. 1986. 21. Bovino , L., ’ioumans,R., Weiner, H., Burke, T . , "Optica lly... Bovino , R. Youmans, M. Weiner, and T. Burke, ’ ’Optically Co ntrolled Semiconducto r Switch for ~lulti-~legawatt Rep-Rated Pulse r s ," Conf. Record...p. 615. (II 1 W. N. Carr, IEEE Trans. Electron Devices, vol. ED-12, p. 531 , 1965. (121 T. Burke, M. Weiner. L. Bovino , and R. Youmans, in Proc

Laboratory for X-Ray Optics

DTIC Science & Technology

1993-04-29

Kearney, "El uso de las pelfculas delgadas en la optica de rayos - x ," Proc. Symposium on the Physics of Superlattices, May 1991, in press. 6. J.M...Bolling Air Force Base ELEMENT NO. NO. NO ACCESSION NO Washin ton, D.C. 20332- //( ~ ~ C 11. TITLE (Incluft Security Claw ffation) [ TLaboratory for X ...three years under contract AFOSR-90-O 140, "Laboratory for X -Ray O.ptics. Duig thspro we concenrae our effrt in two areas: 1) grwth of epitaxial

Astronomy at School: Measurements of the Earth-Moon Distance. (Spanish Title: Astronomía en la Escuela: Medición de la Distancia Tierra-Luna.) Astronomia na Escola: Medida da Distância Terra-Lua

NASA Astrophysics Data System (ADS)

Paolantonio, Santiago; Pintado, Olga I.

2006-12-01

The aim of this project is to approach High School students to Science. We propose to measure the Earth-Moon distance using the parallax. The observation and measurements techniques and all the calculations needed are described in this paper. The results obtained in a test experience realized during 2003 are presented. This test shows that this is a feasible project and also shows which things needed to be improved. Se plantea la propuesta de un proyecto educativo dirigido al Nivel Medio de enseñanza, consistente en la determinación de la distancia Tierra - Luna por paralaje. Se describen las técnicas de observación, mediciones y cálculos. Se proporcionan a continuación los resultados obtenidos en la experiencia piloto realizada en el 2003, la que permitió comprobar la factibilidad de llevar a cabo la propuesta, así como perfeccionar los diferentes aspectos involucrados en la misma. Propomos neste trabalho um projeto educativo dirigido ao Ensino Médio que consiste na determinação da distância Terra-Lua pelo efeito da paralaxe. As técnicas de observação, medidas e cálculos auxiliares são descritos, e os resultados obtidos numa experiência-teste realizada no ano de 2003 apresentados. Este último teste permitiu comprovar a viabilidade de execução da proposta e aperfeiçoar diversos aspectos da mesma.

Low-Cost Space Structure (LCSS) Experiment. Volume I of II.

DTIC Science & Technology

1996-06-01

Cell Multiline laser - 2 100 Hold spots at BSM2 (tilts optica Tilt spots fixed offset path of (1/segment) w.r.t. 1 segment only) each other with off...Piston/Fine Piston Sensor Multiline Laser 3 Piston 1 BSM2 (pistons LEC segment w.r.t. optical path of other to 1 segment only) increase sharpness 7 LGSS...independent steering and pistoning of one beamline with respect to the other with the fixed mirror M2 and tilt/piston mirror BSM2 pair. The telescope

Feedback-induced bistability of an optically levitated nanoparticle: A Fokker-Planck treatment

NASA Astrophysics Data System (ADS)

Ge, Wenchao; Rodenburg, Brandon; Bhattacharya, M.

2016-08-01

Optically levitated nanoparticles have recently emerged as versatile platforms for investigating macroscopic quantum mechanics and enabling ultrasensitive metrology. In this paper we theoretically consider two damping regimes of an optically levitated nanoparticle cooled by cavityless parametric feedback. Our treatment is based on a generalized Fokker-Planck equation derived from the quantum master equation presented recently and shown to agree very well with experiment [B. Rodenburg, L. P. Neukirch, A. N. Vamivakas, and M. Bhattacharya, Quantum model of cooling and force sensing with an optically trapped nanoparticle, Optica 3, 318 (2016), 10.1364/OPTICA.3.000318]. For low damping, we find that the resulting Wigner function yields the single-peaked oscillator position distribution and recovers the appropriate energy distribution derived earlier using a classical theory and verified experimentally [J. Gieseler, R. Quidant, C. Dellago, and L. Novotny, Dynamic relaxation of a levitated nanoparticle from a non-equilibrium steady state, Nat. Nano. 9, 358 (2014), 10.1038/nnano.2014.40]. For high damping, in contrast, we predict a double-peaked position distribution, which we trace to an underlying bistability induced by feedback. Unlike in cavity-based optomechanics, stochastic processes play a major role in determining the bistable behavior. To support our conclusions, we present analytical expressions as well as numerical simulations using the truncated Wigner function approach. Our work opens up the prospect of developing bistability-based devices, characterization of phase-space dynamics, and investigation of the quantum-classical transition using levitated nanoparticles.

JPRS Report, West Europe

DTIC Science & Technology

1988-03-24

EN QUE MEDIDA CONSIDERA USTED QUE LA POLITICA DE...TOTAL (%) 1.7 15.9 28.9 24.8 27.8 1.0 iCREE USTED QUE CAMBIARA LA POLITICA DEL GOBIERNO COMO CONSECUENCIA DE ESTE CONGRESO EN POLITICA ...NS/NCY?.<.(7^ L&X. LA POLITICA QUE DESARROLLA EL PSOE, 4EN QUE MEDIDA CREE USTED QUE BENEFICIA A LA MUJER ? Mucho .Mi)

Pure spinal multiple sclerosis: A possible novel entity within the multiple sclerosis disease spectrum.

PubMed

Schee, Jie Ping; Viswanathan, Shanthi

2018-05-01

We identified five female patients retrospectively with relapsing short-segment partial myelitis whose clinical and paraclinical features were suggestive of cord involvement of multiple sclerosis (MS)-type albeit not rigidly fulfilling the 2017 McDonald criteria. Notably, these patients had not developed any typical MS-like brain lesions despite repeated neuroimaging assessments over years. Comprehensive work-up for differential diagnoses of MS and other causes of transverse myelitis particularly neuromyelitis optica spectrum disorders had been consistently negative on longitudinal follow-up. Thus, we postulate a possible entity of pure spinal MS which may represent a novel forme fruste within the MS disease spectrum.

Montaje Experimental de Optica Adaptiva con Tecnología FPGA

NASA Astrophysics Data System (ADS)

Rodriguez Brizuela, F.; Verasay, J. P.; Recabarren, P.

An experimental platform based on FPGA devices, dedicated to implement active and adaptive optic software in HDL has been developed. The devel- oped assembly is the first of a series of works focused on this important area of instrumental astronomy. The exposed development is part of a Final Project of Electronic Engineering of the National University of Cordoba. FULL TEXT IN SPANISH

Multiple Sclerosis in Malaysia: Demographics, Clinical Features, and Neuroimaging Characteristics

PubMed Central

Viswanathan, S.; Rose, N.; Masita, A.; Dhaliwal, J. S.; Puvanarajah, S. D.; Rafia, M. H.; Muda, S.

2013-01-01

Background. Multiple sclerosis (MS) is an uncommon disease in multiracial Malaysia. Diagnosing patients with idiopathic inflammatory demyelinating diseases has been greatly aided by the evolution in diagnostic criterion, the identification of new biomarkers, and improved accessibility to neuroimaging in the country. Objectives. To investigate the spectrum of multiple sclerosis in Malaysia. Methods. Retrospective analysis with longitudinal follow-up of patients referred to a single tertiary medical center with neurology services in Malaysia. Results. Out of 245 patients with idiopathic inflammatory demyelinating disease, 104 patients had multiple sclerosis. Female to male ratio was 5 : 1. Mean age at onset was 28.6 ± 9.9 years. The Malays were the predominant racial group affected followed by the Chinese, Indians, and other indigenous groups. Subgroup analysis revealed more Chinese having neuromyelitis optica and its spectrum disorders rather than multiple sclerosis. Positive family history was reported in 5%. Optic neuritis and myelitis were the commonest presentations at onset of disease, and relapsing remitting course was the commonest disease pattern observed. Oligoclonal band positivity was 57.6%. At disease onset, 61.5% and 66.4% fulfilled the 2005 and 2010 McDonald's criteria for dissemination in space. Mean cord lesion length was 1.86 ± 1.65 vertebral segments in the relapsing remitting group as opposed to 6.25 ± 5.18 vertebral segments in patients with neuromyelitis optica and its spectrum disorders. Conclusion. The spectrum of multiple sclerosis in Malaysia has changed over the years. Further advancement in diagnostic criteria will no doubt continue to contribute to the evolution of this disease here. PMID:24455266

Review of the novelties from the 31st ECTRIMS Congress, 2015, presented at the 8th Post-ECTRIMS meeting.

PubMed

Fernandez, O; Rodriguez-Antiguedad, A; Olascoaga, J; Oreja-Guevara, C; Prieto, J M; Mendibe-Bilbao, M M; Garcia-Merino, J A; Ramio-Torrenta, Ll; Ginestal, R; Meca-Lallana, J E; Romero-Pinel, L; Munoz, D; Saiz, A; Calles-Hernandez, M C; Izquierdo, G; Villar, L M; Oliva-Nacarino, P; Arnal-Garcia, C; Comabella, M; Brieva, Ll; Arroyo, R; Montalban, X

2016-06-16

Renowned national specialists in multiple sclerosis (MS) met, for the eighth year in a row, to give details of the latest novelties presented at the last ECTRIMS Congress 2015, which are included in this review. One of the highlights at this Congress was the new classification of the phenotypes of MS. Both the diagnostic criteria of the neuromyelitis optica spectrum and the problems involved in the differential diagnosis derived from the lack of definition of the radiological spectrum were reviewed. The microbiota comes to the fore as a possible factor determining the disease, together with extrinsic factors such as tobacco, salt ingestion or vitamin D deficiency. Advances made in immunomodulation are driving the progress being made in the treatment of MS. Ocrelizumab is the first treatment with positive results in the primarily progressive forms and tocilizumab, a drug product for rheumatoid arthritis, stands out as a potential candidate for the treatment of neuromyelitis optica. Certain antibiotics and vitamins could also play a role in the treatment of MS. In this edition of the Congress special attention was paid to personalised therapy. To date, 11 drugs have been approved for use in Europe. There is a need for therapeutic algorithms that help us to choose the best treatment for each patient. Likewise, we need to be able to identify, in the early stages of the disease, the risk of developing disability, so as to be able to design therapeutic strategies. To do so, molecular biomarkers and other predictive tools are required. The problems that still exist in software technology in magnetic resonance hinder its application in daily clinical practice.

Latin America Report.

DTIC Science & Technology

1985-08-16

mitad de los encuestados cree que es posible detener el alza del costo de vida. Key to Chart 1: 1. Is it possible to check the rise in the cost of...Interesante a tener en cuenta es que a medida que se eleva el nivel educativo, los consultados se sienten beneficiados por las nuevas medidas...Unfamiliar names rendered phonetically or transliterated are enclosed in parentheses. Words or names preceded by a ques - tion mark and enclosed in

Care of an undocumented immigrant

PubMed Central

Beresford, H. Richard

2014-01-01

Summary This commentary addresses the care of an undocumented immigrant with neuromyelitis optica in the context of a state law designed to deny state-funded medical services to individuals whose presence in the United States is unlawful. It considers specific circumstances in which the law would permit or require medical care for undocumented persons in state medical facilities, including a duty to “stabilize” an “emergency medical condition” and the provision of care necessary to “protect life or safety.” It also addresses dilemmas clinicians may experience when faced with an apparent tension between their professional ethical obligations and legal rules aimed at enforcing immigration policies. PMID:29443225

Ethical considerations when counseling patients about stem cell tourism.

PubMed

Tsou, Amy

2015-02-01

Worldwide, many clinics market stem-cell based interventions often touted as effective for many diseases including spinal cord injury, multiple sclerosis (MS), and other neurodegenerative diseases. These clinics and their expensive, unproven treatments continue to fuel the practice of stem cell tourism. Given concerns about patient exploitation and safety, how should the physician engage a patient who wants to pursue such treatments? This article presents the case of a patient with neuromyelitis optica interested in pursuing expensive stem cell injections abroad. This article describes stem cell tourism along with some of the ethical issues physicians should consider, while also providing practical resources that physicians may employ to educate and engage patients in making an informed decision.

Múltiples estados de desorden en el etanol sólido

NASA Astrophysics Data System (ADS)

Fernández-Perea, R.

El diagrama de fases del etanol por debajo de los 169 K será presentado. Se mostrará que el etanol puede solidificarse en tres fases con diversos niveles de desorden,(como un vidrio(G), como un vidrio orientacional (OG) y como un cristal de fase rotora (RP)) además de en una fase totalmente cristalina. Las estructuras de estas tres fases serán presentadas tal y como se deducen a partir de diversas medidas de difracción de neutrones al igual que las proporciones de los isómeros de dicho material en las fases desordenadas y se compararán con los resultados de la fase cristalina y del líquido superenfriado. Igualmente diversas medidas sobre su dinámica serán presentadas, tanto de dispersión de neutrones, como de capacidad calorífica y de medidas dieléctricas y comparadas con modelos teóricos y simulaciones para tratar de explicar los procesos de relajación observados y las transiciones entre las diversas fases.

Ground Demonstration of Planetary Gas Lidar Based on Optical Parametric Amplifier

NASA Technical Reports Server (NTRS)

Numata, Kenji; Riris, Haris; Li, Steve; Wu, Stewart; Kawa, Stephen R.; Krainak, Michael; Abshire, James

2012-01-01

We report on the development effort of a nanosecond-pulsed optical parametric amplifier (OPA) for remote trace gas measurements for Mars and Earth. The OPA output has high spectral purity and is widely tunable both at near-infrared and mid-infrared wavelengths, with an optical-optica1 conversion efficiency of up to approx 39 %. Using this laser source, we demonstrated open-path measurements of CH4 (3291 nm and 1651 nm), CO2 (1573 nm), H2O (1652 nm), and CO (4764 nm) on the ground. The simplicity, tunability. and power scalability of the OPA make it a strong candidate for general planetary lidar instruments, which will offer important information on the origins of the planet's geology, atmosphere, and potential for biology,

NMOSD triggered by yellow fever vaccination - An unusual clinical presentation with segmental painful erythema.

PubMed

Schöberl, F; Csanadi, E; Eren, O; Dieterich, M; Kümpfel, T

2017-01-01

Neuromyelitis Optica Spectrum Disorder (NMOSD) is an immune-mediated disease of the central nervous system with the presence of aquaporin 4-antibodies (AQP4-abs) in most cases. We describe a patient who developed NMOSD after a yellow fever vaccination. He presented to us with an unusual painful erythema Th7-9 triggered by touch in the respective skin area due to a cervical spinal cord lesion affecting the dorsolateral parts of C6/7. To our knowledge, this is the first case of NMOSD with such a clinical presentation expanding the clinical spectrum of NMOSD. It is important to be aware of that a yellow fever vaccination can trigger NMOSD. Copyright © 2016 Elsevier B.V. All rights reserved.

Biomarkers in the evolution of multiple sclerosis.

PubMed

Berger, Thomas

2017-11-01

Nonimaging biomarkers can be applied in differential diagnosis, evaluation of disease progression and therapy monitoring of multiple sclerosis (MS). Presence of oligoclonal IgG bands in cerebrospinal fluid is a diagnostic element and a negative predictor of MS evolution. AQP4 antibodies are pathogenic and diagnostic for neuromyelitis optica spectrum disorder. Antibodies to myelin oligodendrocyte glycoprotein develop in about 50% of predominantly pediatric patients with acute disseminated encephalomyelitis, but their possible role in pathogenesis is unknown. Currently, there are no individualized biomarkers suitable to track disease progression. Neutralizing antibodies against IFN-β, natalizumab and daclizumab arise with variable frequency and reduce treatment efficacy. The anti-John Cunningham virus antibody index has potential as a biomarker for risk of progressive multifocal leukoencephalopathy.

Resolution enhancement in a double-helix phase engineered scanning microscope (RESCH microscope) (Presentation Recording)

NASA Astrophysics Data System (ADS)

Jesacher, Alexander; Ritsch-Marte, Monika; Piestun, Rafael

2015-08-01

Recently we introduced RESCH microscopy [1] - a scanning microscope that allows slightly refocusing the sample after the acquisition has been performed, solely by performing appropriate data post-processing. The microscope features a double-helix phase-engineered emission point spread function in combination with camera-based detection. Based on the principle of transverse resolution enhancement in Image Scanning Microscopy [2,3], we demonstrate similar resolution improvement in RESCH. Furthermore, we outline a pathway for how the collected 3D sample information can be used to construct sharper optical sections. [1] A. Jesacher, M. Ritsch-Marte and R. Piestun, accepted for Optica. [2] C.J.R. Sheppard, "Super-resolution in Confocal imaging," Optik, 80, 53-54 (1988). [3] C.B. Müller and J. Enderlein "Image Scanning Microscopy," Phys. Rev. Lett. 104, 198101 (2010).

Opportunistic infections of the retina in patients with aquaporin-4 antibody disease.

PubMed

George, Jithin S; Leite, Maria Isabel; Kitley, Joanna L; Jones, Nicola; Cortes, Nicholas; Donati, Matthew; Matthews, Bethan Non; Calladine, Daniel; Hillier, Charles; Yusuf, Imran H; Munneke, Robert; Patel, Chetan K; Palace, Jacqueline A; Elston, John S

2014-11-01

Patients with neuromyelitis optica who have aquaporin-4 antibodies are being identified and receiving immunosuppressant treatment earlier and more aggressively as a result of increasing awareness of the importance of preventing relapses responsible for the high morbidity and mortality associated with the disease. To our knowledge, opportunistic retinal infection in patients with aquaporin-4 antibodies who are receiving immunosuppressants has not been reported to date. We describe 2 patients with aquaporin-4 antibodies who were receiving conventional doses of first-line immunosuppressive therapy. Both patients presented with vision loss that was initially thought to be optic neuritis attacks. The subsequent diagnoses were ocular toxoplasmosis and cytomegalovirus retinitis. Retinal opportunistic infections can occur in patients with aquaporin-4 antibodies who are receiving relatively low levels of immunosuppression, may mimic optic neuritis, and are a potentially reversible cause of vision loss when treated promptly.

Aquaporins: important but elusive drug targets

PubMed Central

Verkman, Alan S.; Anderson, Marc O.; Papadopoulos, Marios C.

2014-01-01

The aquaporins (AQPs) are a family of small, integral membrane proteins that facilitate water transport across the plasma membranes of cells in response to osmotic gradients. Data from knockout mice support the involvement of AQPs in epithelial fluid secretion, cell migration, brain oedema and adipocyte metabolism, which suggests that modulation of AQP function or expression could have therapeutic potential in oedema, cancer, obesity, brain injury, glaucoma and several other conditions. Moreover, loss-of-function mutations in human AQPs cause congenital cataracts (AQP0) and nephrogenic diabetes insipidus (AQP2), and autoantibodies against AQP4 cause the autoimmune demyelinating disease neuromyelitis optica. Although some potential AQP modulators have been identified, challenges associated with the development of better modulators include the druggability of the target and the suitability of the assay methods used to identify modulators. PMID:24625825

Los plaguicidas y la contaminacion del medio ambiente Venezolano

USGS Publications Warehouse

Stickel, L.F.; Stickel, W.H.

1972-01-01

RESUMEN DE RECOMENDACIONES Recomendaciones para el Programa de Investigacion: 1. Establecer un sistema de muestreo biologico para detectar los niveles tendencias de los productos quimicos toxicos en un peque?o numero de si tios representativos. 2. Mantener continua vigilancia de la contaminacion ambiental, mediante la seleccion acertadamente dirigida de las zonas afectadas y de las fuentes de contaminacion. 3. Realizar estudios acerca de las poblaciones de animales silvestres, y del exito de los procesos reproductivos de las especies o grupos clayes de animales que se consideran mas gravemente afectados. 4. Preparar recomendaciones para una accion gubernamental de proteccion al hombre, a la fauna silvestre y al medio ambiente. Recomendaciones para la Accion Administrativa: 1. Establecer limites a la tolerancia de los residuos de plaguicidas en los alimentos. Constituye una medida clave para disminuir la contaminacion ambiental. 2. Establecer normas de calidad del agua para las corrientes, represas, la gos y otros cuerpos. Es la segunda medida clave para reducir la contaminacion del ambiente 3. Exigir un tratamiento adecuado de los efluentes industriales, especialmente antes de que se construyan las nuevas plantas. 4. Exigir a los agricultores que en el uso de plaguicidas sigan los consejos tecnicos autorizados y negar a los vendedores el derecho a recomendar productos por su cuenta. 5. Tomar medidas para recoger y eliminar los recipientes y sobrantes de los plaguicidas.

Intraoperative body temperature control: esophageal thermometer versus infrared tympanic thermometer.

PubMed

Poveda, Vanessa de Brito; Nascimento, Ariane de Souza

2016-01-01

To verify the correlation between temperature measurements performed using an infrared tympanic thermometer and an esophageal thermometer during the intraoperative period. A longitudinal study of repeated measures was performed including subjects aged 18 years or older undergoing elective oncologic surgery of the digestive system, with anesthesia duration of at least 1 hour. Temperature measurements were performed simultaneously by a calibrated esophageal thermometer and by a calibrated infrared tympanic thermometer, with laboratory reading precision of ±0.2ºC. The operating room temperature remained between 19 and 21ºC. The study included 51 patients, mostly men (51%), white (80.4%). All patients were kept warm by a forced-air heating system, for an average of 264.14 minutes (SD = 87.7). The two temperature measurements showed no different behavior over time (p = 0.2205), however, tympanic measurements were consistently 1.24°C lower (p<0.0001). The tympanic thermometer presented reliable results but reflected lower temperatures than the esophageal thermometer. Verificar a correlação entre as medidas de temperatura realizadas por meio de um termômetro timpânico por infravermelho e por um termômetro esofágico, durante o período intraoperatório. Realizou-se um estudo longitudinal, de medidas repetidas, incluindo sujeitos com idade igual ou superior a 18 anos, submetidos à cirurgia oncológica eletiva do sistema digestório, com duração da anestesia de, no mínimo, 1 hora. As medidas de temperatura eram realizadas, ao mesmo tempo, por meio de um termômetro esofágico calibrado e por termômetro timpânico por infravermelho calibrado, com precisão de leitura em laboratório de ±0,2ºC. A temperatura da sala operatória permaneceu entre 19 e 21ºC. Foram incluídos 51 pacientes, em sua maioria homens (51%), brancos (80,4%). Todos os pacientes foram aquecidos com o sistema de ar forçado aquecido, em média por 264,14 minutos (DP = 87,7). As duas

Perfis de temperatura eletrônica em regiões HII

NASA Astrophysics Data System (ADS)

Copetti, M. V. F.

2003-08-01

As flutuações de temperatura eletrônica em regiões HII, inicialmente propostas para explicar as discrepâncias entre os valores de temperatura obtidos por diferentes métodos, têm sido apontadas como a causa mais provável das enormes diferenças encontradas entre as abundâncias químicas medidas através de linhas excitadas colisionalmente e de linhas de recombinação. Recentemente têm sido reportadas tentativas de detecção e quantificação diretas das flutuações de temperatura eletrônica através de medidas ponto a ponto, obtidas por meio de espectroscopia de fenda longa, das razões de linhas [OIII]l4263/l5007 e [NII]l5755/l6584, principais sensores de temperatura. Neste trabalho, utilizamos o código numérico de fotoionização Cloudy para avaliar a confiabilidade desse procedimento. Concluímos que, para valores de densidade eletrônica e de temperatura efetiva da estrela ionizante típicos das regiões HII, os perfis superficiais de temperatura obtidos via medidas do sensor [OIII]l4263/l5007 são bons traçadores dos gradientes internos de temperatura eletrônica. Já os perfis de temperatura eletrônica medidos por meio da razão [NII]l5755/l6584 não reproduzem os gradientes verdadeiros de temperatura.

The commissioning instrument for the Gran Telescopio Canarias: made in Mexico

NASA Astrophysics Data System (ADS)

Cuevas, Salvador; Sánchez, Beatriz; Bringas, Vicente; Espejo, Carlos; Flores, Rubén; Chapa, Oscar; Lara, Gerardo; Chavoya, Armando; Anguiano, Gustavo; Arciniega, Sadot; Dorantes, Ariel; Gonzalez, José L.; Montoya, Juan M.; Toral, Rafael; Hernández, Hugo; Nava, Roberto; Devaney, Nicolas; Castro, Javier; Cavaller, Luis; Farah, Alejandro; Godoy, Javier; Cobos, Francisco; Tejada, Carlos; Garfias, Fernando

2006-02-01

In March 2004 was accepted in the site of Gran Telescopio Canarias (GTC) in La Palma Island, Spain, the Commissioning Instrument (CI) for the GTC. During the GTC integration phase, the CI will be a diagnostic tool for performance verification. The CI features four operation modes-imaging, pupil imaging, Curvature Wave-front sensing (WFS), and high resolution Shack-Hartmann WFS. This instrument was built by the Instituto de Astronomia UNAM in Mexico City and the Centro de Ingenieria y Desarrollo Industrial (CIDESI) in Queretaro, Qro under a GRANTECAN contract after an international public bid. Some optical components were built by Centro de Investigaciones en Optica (CIO) in Leon Gto and the biggest mechanical parts were manufactured by Vatech in Morelia Mich. In this paper we made a general description of the CI and we relate how this instrument, build under international standards, was entirely made in Mexico.

New biological agents in the treatment of multiple sclerosis.

PubMed

Buc, M

2018-01-01

Multiple sclerosis (MS) is an inflammatory disease induced by autoimmune processes. Their understanding has resulted in an introduction of biological agents to its treatment. Interferon beta and glatiramer acetate have been in clinical practice for more than 20 years. Nowadays, novel biologics, which target molecules involved in immunopathological processes more specifically have entered the scene. They are represented by monoclonal antibodies binding to molecules VLA4 (natalizumab), CD20 (ocrelizumab), CD52 (alemtuzumab) or alpha subunit of IL-2 receptor (daclizumab) or by small molecules such as those modulating the receptors involved in regulation of lymphocyte migration (fingolimod, ozanimod) or in induction of lymphopenia by apoptosis (dimethyl fumarate, cladribine). In the article, we shortly describe their efficacies, adverse reactions and perspectives of a future development in MS biologics. A treatment of neuromyelitis optica by monoclonal antibodies (rituximab, aquaporumab) is given too (Tab. 1, Fig. 2, Ref. 71).

The usefulness of immunotherapy in pediatric neurodegenerative disorders: A systematic review of literature data.

PubMed

Vitaliti, Giovanna; Tabatabaie, Omidreza; Matin, Nassim; Ledda, Caterina; Pavone, Piero; Lubrano, Riccardo; Serra, Agostino; Di Mauro, Paola; Cocuzza, Salvatore; Falsaperla, Raffaele

2015-01-01

Immunotherapeutic strategies to treat neurodegenerative disorders have inspired the scientific community. The aim of our review is to address the translational aspects of neuroimmunology to describe the efficacy of immunotherapy in the treatment of pediatric neurodegenerative disorders. In the studies we analyzed IVIG were found to be efficient in the treatment of post-streptococcal neurodegenerative disorders, even if in PANDAS, plasma-exchange (PE) showed a higher efficiency. IVIG were also successfully used in ADEM and Guillan-Barré syndrome. In Sydenham Chorea the use of methylprednisolone was found in most cases as efficient as IVIG, while in Tourette's Syndrome, Colecoxib was successfully used in one patient. Pediatric Multiple Sclerosis seems to respond better to immunosuppressant agents (Mitoxantrone, Cyclophosphamide, Natalizumab), as well as Neuromyelitis optica (Rituximab, Mycofenolate). The importance of this review relies in the attempt to draw standardized guidelines for immunotherapy in pediatric neurodegeneratve disorders.

The usefulness of immunotherapy in pediatric neurodegenerative disorders: A systematic review of literature data

PubMed Central

Vitaliti, Giovanna; Tabatabaie, Omidreza; Matin, Nassim; Ledda, Caterina; Pavone, Piero; Lubrano, Riccardo; Serra, Agostino; Di Mauro, Paola; Cocuzza, Salvatore; Falsaperla, Raffaele

2015-01-01

Immunotherapeutic strategies to treat neurodegenerative disorders have inspired the scientific community. The aim of our review is to address the translational aspects of neuroimmunology to describe the efficacy of immunotherapy in the treatment of pediatric neurodegenerative disorders. In the studies we analyzed IVIG were found to be efficient in the treatment of post-streptococcal neurodegenerative disorders, even if in PANDAS, plasma-exchange (PE) showed a higher efficiency. IVIG were also successfully used in ADEM and Guillan-Barré syndrome. In Sydenham Chorea the use of methylprednisolone was found in most cases as efficient as IVIG, while in Tourette's Syndrome, Colecoxib was successfully used in one patient. Pediatric Multiple Sclerosis seems to respond better to immunosuppressant agents (Mitoxantrone, Cyclophosphamide, Natalizumab), as well as Neuromyelitis optica (Rituximab, Mycofenolate). The importance of this review relies in the attempt to draw standardized guidelines for immunotherapy in pediatric neurodegeneratve disorders PMID:26266339

Confidence Intervals for Omega Coefficient: Proposal for Calculus.

PubMed

Ventura-León, José Luis

2018-01-01

La confiabilidad es entendida como una propiedad métrica de las puntuaciones de un instrumento de medida. Recientemente se viene utilizando el coeficiente omega (ω) para la estimación de la confiabilidad. No obstante, la medición nunca es exacta por la influencia del error aleatorio, por esa razón es necesario calcular y reportar el intervalo de confianza (IC) que permite encontrar en valor verdadero en un rango de medida. En ese contexto, el artículo plantea una forma de estimar el IC mediante el método de bootstrap para facilitar este procedimiento se brindan códigos de R (un software de acceso libre) para que puedan realizarse los cálculos de una forma amigable. Se espera que el artículo sirva de ayuda a los investigadores de ámbito de salud.

Estudo de não gaussianidade nas anisotropias da RCF medidas Wmap

NASA Astrophysics Data System (ADS)

Andrade, A. P. A.; Wuensche, C. A.; Ribeiro, A. L. B.

2003-08-01

A investigação do campo de flutuações da Radiação Cósmica de Fundo (RCF) pode oferecer um importante teste para os modelos cosmológicos que descrevem a origem e a evolução das flutuações primordiais. De um lado, apresenta-se o modelo inflacionário que prevê um espectro de flutuações adiabáticas distribuídas segundo uma gaussiana e, de outro, os modelos de defeitos topológicos (dentre outros) que descrevem um mecanismo para a geração de flutuações de isocurvatura que obedecem a uma distribuição não gaussiana. Este trabalho tem como objetivo caracterizar traços do modelo não gaussiano de campo misto (entre flutuações adiabáticas e de isocurvatura) nos mapas do Wilkinson Microwave Anisotropy Probe (WMAP). Simulações das anisotropias da RCF no contexto de mistura indicam traços marcantes na distribuição das flutuações de temperatura, mesmo quando consideradas pequenas contribuições do campo de isocurvatura (da ordem de 0.001). O efeito da mistura entre os campos resulta na transferência de potência de flutuações em escalas angulares intermediárias para flutuações em pequenas escalas angulares. Este efeito pode ser caracterizado pela relação entre as amplitudes dos primeiros picos acústicos no espectro de potência da RCF. Neste trabalho, investigamos a contribuição do campo de isocurvatura, no contexto de mistura, sobre as observações recentes da RCF realizadas pelo WMAP. As previsões do modelo de campo misto, uma vez confrontadas com as observações em pequenas escalas angulares, podem ajudar a revelar a natureza das flutuações primordiais.

The FRD and transmission of the 270-m GRACES optical fiber link and a high numerical aperture fiber for astronomy

NASA Astrophysics Data System (ADS)

Pazder, John; Fournier, Paul; Pawluczyk, Rafal; van Kooten, Maaike

2014-07-01

We report results of the extensive development work done on the 270-m optical fiber link for the GRACES project and a preliminary investigations into a high numerical aperture fiber for astronomy. The Gemini Remote Access CFHT ESPaDOnS Spectrograph (GRACES) is an instrumentation experiment to link ESPaDOnS, a bench-mounted highresolution optical spectrograph at CFHT, to the Gemini-North telescope with an optical fiber link. A 270-m fiber link with less than 14% Focal Ratio Degradation (FRD) has been developed jointly by HIA and FiberTech Optica for the experiment. A preliminary study has been conducted by HIA into a high numerical aperture fiber (0.26 numerical aperture) with the intended application of wide field optical spectrographs fiber fed from the telescope prime focus. The Laboratory test results of FRD, transmission, and stability for the GRACES fiber link and preliminary FRD measurements of the high numerical aperture fiber tests are reported.

Antibacterial Activity Of ternary semiconductor compounds AgInSe2 Nanoparticles Synthesized by Simple Chemical Method

NASA Astrophysics Data System (ADS)

Shehab, A. A.; Fadaam, S. A.; Abd, A. N.; Mustafa, M. H.

2018-05-01

In this objective AgInSe2Nanoparticles (AgInSe2 NPs) were prepared by a simple chemical method (SCM). The optica structural l and morphological properties of the synthesized AgInSe2 NPs swere investigated by using UVVI absorption atomic force microscopy AFMmf, Fourier Transform Infrared Spectroscopy and x-ray diffraction. The resistance of bacteria represents a trouble and the outlook for the use of antibiotics in the future until now uncertain. Measures must be taken to decrease this problem. Antibacterial activity of the AgInSe2 nanoparticles were exposed against several pathogenic bacteriaa including Klebsiella pneumonia KPa, Staphylococcus aureus, Bacillus subtili, Enterobacter Cloacae and Esherichia Coliby. Using a good spread method the results showed that AgInSe2 NPs had inhibitory effect versus some pathogenic bacteria with suppression area 18, 14 and 17 mm for SAgInSe2 NPs had an inhibitory effect against S Bacillus Subtilis 11 mm K EnterobactercCloacae 12 mm.

Identifying the Location in the Host Galaxy of Short GRB 1111l7A with the Chandra Sub- Arcsecond Position

NASA Technical Reports Server (NTRS)

Sakamoto, Takanori; Troja, E.; Aoki, K.; Guiriec, S.; Im, M.; Leloudas, G.; Malesani, D.; Melandri, A.; deUgartePostigo, A.; Urata, Y.;

Telescopio San Pedro Mártir Observatory preliminary design and project approach

NASA Astrophysics Data System (ADS)

Teran, Jose; Lee, William H.; Richer, Michael G.; Sánchez, Beatriz S.; Urdaibay, David; Hill, Derek; Adriaanse, David; Hernandez-Limonchi, Regina

2016-07-01

The Instituto de Astronomia of the Universidad Nacional Autónoma de México (UNAM) along with Instituto Nacional de Astrofisica, Optica y Electronica, the University of Arizona and the Smithsonian Astrophysical Observatory are developing the Telescopio San Pedro Mártir (TSPM) project, a 6.5m diameter optical telescope. M3 Engineering and Technology Corp. (M3) is the design and construction management firm responsible for all site infrastructure, enclosure and support facilities. The Telescopio San Pedro Mártir project (TSPM) will be located within the San Pedro Mártir National Park in Baja California, Mexico at 2,830 m. above sea level, approximately 65 km. east of the Pacific Ocean, 55km west of the Sea of Cortes (Gulf of California) and 180km south of the United States and México border. The aim of the paper is to present the preliminary design of the site infrastructure, enclosure and support facilities to date and share the design and construction approach.

Aquaporins in Clinical Medicine

PubMed Central

Verkman, A.S.

2012-01-01

The aquaporins are a family of membrane water channels, some of which also transport glycerol. They are involved in a wide range of physiological functions (including water/salt homeostasis, exocrine fluid secretion, and epidermal hydration) and human diseases (including glaucoma, cancer, epilepsy, and obesity). At the cellular level, aquaporin-mediated osmotic water transport across cell plasma membranes facilitates transepithelial fluid transport, cell migration, and neuroexcitation; aquaporin-mediated glycerol transport regulates cell proliferation, adipocyte metabolism, and epidermal water retention. Genetic diseases caused by loss-of-function mutations in aquaporins include nephrogenic diabetes insipidus and congenital cataracts. The neuroinflammatory demyelinating disease neuromyelitis optica is marked by pathogenic autoantibodies against astrocyte water channel aquaporin-4. There remain broad opportunities for the development of aquaporin-based diagnostics and therapeutics. Disease-relevant aquaporin polymorphisms are beginning to be explored. There is great promise in the development of small-molecule aquaporin modulators for therapy of some types of refractory edema, brain swelling, neuroinflammation, glaucoma, epilepsy, cancer, pain, and obesity. PMID:22248325

The profile of patients followed at the Neuroimmunology Clinic at UNIFESP: 20 years analysis.

PubMed

Bichuetti, Denis Bernardi; Falcão, Alessandra Billi; Boulos, Fernanda de Castro; Morais, Marilia Mamprim de; Lotti, Claudia Beatriz de Campos; Fragomeni, Manuela de Oliveira; Campos, Maria Fernanda; Souza, Nilton Amorim de; Oliveira, Enedina Maria Lobato

2015-04-01

To describe the clinical activities at the Neuroimmunology Clinic of the Universidade Federal de São Paulo (UNIFESP) from 1994 to 2013. The final diagnosis of all patients that attended the center was reviewed and established upon specific guidelines for each disease. The number of total appointments and extra clinical activities (reports and prescriptions) were also analyzed, as are part of routine activities. 1,599 patients attended the Clinic from 1994 to 2013: 816 with multiple sclerosis (MS), 172 with clinical isolated syndromes, 178 with neuromyelitis optica (NMO), 216 with other demyelinating disease, 20 with metabolic disorder, 42 with a vascular disease and 155 with other or undetermined diagnosis. A mean 219 outpatient visits and 65 extra clinical activities were performed monthly. We identified that 15% of patients seen have NMO. As patients with NMO have a more severe disease than MS, this data may be important for planning local health care policies.

Energy levels, wavelengths, and radiative transition probabilities for the Na-like ions with 38 [le] Z [le] 45

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ying Zhang; Qiren Zhu; Shoufu Pan

1992-11-01

The investigation by Z.-Q Zhang et al. (Acta Optica Sinica 11, 193, 1991) shows that it is possible to realize soft X-ray lasing in the water window 23.3-43.8 [Angstrom] with the Na-like recombination scheme, which requires a lower pumping power at a high-power laser facility than that with other schemes. The fine-structure levels with n [le] 15 and l [le] 6 in Na-like ions with 38 [le] Z [le] 45 and the probabilities for radiative transitions between these levels are calculated using the multiconfiguration Dirac-Fock approach. The calculations show that the wavelengths of the anticipated laser transitions 6 f-4d andmore » 6g-4f in the Na-like ions with 38 [le] Z [le] 43 and 5f-4d and 5g-4f in the Na-like ions with 40 [le] Z [le] 45 lie in the region of the water window.« less

[Roles of Aquaporins in Brain Disorders].

PubMed

Yasui, Masato

2015-06-01

Aquaporin (AQP) is a water channel protein that is expressed in the cell membranes. AQPs are related to several kinds of human diseases such as cataract. In the mammalian central nervous system (CNS), AQP4 is specifically expressed in the astrocyte membranes lining the perivascular and periventricular structures. AQP4 plays a role in the development of brain edema associated with certain brain disorders. Neuromyelitis optica (NMO) is a demyelinating disorder, and patients with NMO develop autoimmune antibodies against AQP4 in their serum. Therefore, AQP4 is involved in NMO pathogenesis. A new concept referred to as "glymphatic pathway" has been recently proposed to explain the lymphatic system in the CNS. Dysfunction of the "glymphatic pathway" may cause several neurodegenerative diseases and mood disorders. Importantly, AQP4 may play a role in the "glymphatic pathway". Further investigation of AQP4 in CNS disorders is necessary, and a new drug against AQP4 is expected.

Acerca de las ratas y los ratones

EPA Pesticide Factsheets

Hay muchas especies de roedores, entre ellas, la ardilla, la ardilla listada, el castor, el perro de la pradera, la rata y el ratón. Se puede ver las medidas más importantes para eliminar y prevenir las infestaciones causadas por roedores.

Tecnicas avanzadas de medida en intensimetria acustica para la caracterizacion de materiales aislantes

NASA Astrophysics Data System (ADS)

Munuera Saura, Gregorio

The measurement rate of acoustic reduction (R) in an insulating material is determined in special designed enclosures according to UNE EN ISO 140-1 standard. The construction of a testing room that complies with the standards requires a significant financial investment, that too often can not be provided by general machinery manufacturers. The outdoor machines have to be designed considering the noise emission limits established in the European Directive 2000/14, making the installment of insulating materials in enclosures of machines necessary. Suppliers of insulating materials for industrial use does not normally provide the insulating properties of their products, which are often obtained from rock wool, polyethylene, polyurethane, synthetic rubber, etc. It is difficult to test these materials that are characterized by low density surface in a room standardized test procedure that is based on the measurement of sound pressure. The main problem is getting the validation of the measurement when the rate of acoustic reduction is relatively low, as in the case of materials mentioned above. An alternative procedure is proposed in this Doctoral Thesis based on the measurement of sound intensity. The vector nature of this parameter allows just the flow of energy through a given surface to be measured. The validation of the measurement is achieved with the highest degree of accuracy by applying the criteria included in the standard UNE EN ISO 9614. A steel plate 6 mm thick incorporated with a sound source for amplification of a pink noise signal is designed for carrying out the tests. Faced with the source is placed a piece of material to test. The source is connected and the transmitted sound intensity is measured with a probe consisting of two microphones located opposite one another. Previously it has been determined the flow of acoustic energy that impinges on the piece. The difference between the two measures provides directly the rate of acoustic reduction. The main advantage of the described test procedure is that it can be done in a room with normal dimensions and without specific conditioning. The vibroacoustic behaviour of the testing box and its influence on the measures is another important aspect to be considered. A test of modal analysis has been carried out with a steel plate similar to the enclosures of the box. A mathematical model based on the Statistical Energy Analysis SEA has been developed to estimate the paths of energy transmission from the sound source to the point of measurement with the sound intensity probe. The commercial software AUTOSEA2 LT is used. General conclusions regarding the alternative method of measurement and specific ones related to the capacity of insulation of the tested materials have been obtained. As for the general conclusions, the limitations of measuring with the intensity probe at low and high frequencies have been proved, validating measurements with an accuracy of 0.5 dB according to the criteria set forth in the standard UNE EN ISO 9614 Part 3 have been obtained, and a new test procedure for easy determination of the rate of acoustic reduction of an insulating material with low density surface has been established. Finally, the devised procedure allows future developments in the field of vibroacoustics, such as the application of the principle of reciprocity and the determination of acoustic impedance of materials by application of techniques for measuring of acoustics intensity.

The Absolute Measurement of Beta Activities; SOBRE LA MEDIDA ABSOLUTA DE ACTIVIDADES BETA

DOE Office of Scientific and Technical Information (OSTI.GOV)

Del Rio, C.S.; Reynaldo, O.J.; Mayquez, E.R.

1956-01-01

A new method for the absolute beta counting of solid samples is given. The measurements are made with an inside Geiger-Muller tube of new construction. The backscattering correction, when using an "infinite" thick mounting, is discussed and results for different materials given. (auth)

Estudio Sobre Portadores Cronicos de Salmonellas en Manipuladores de Alimentos de la Ciudad de Iquitos (Study of Chronic Salmonella Carriers in Food Handlers in the City of Iquitos)

DTIC Science & Technology

1990-01-01

muy desfavorables de las medidas sanita- riast puede ocasionar cpid~cmias de ficbre tifoidea en Iquitos. [I- Io rclerente a los anaisk bdcteriol6gico...hajo porcentaje dc portadores cr6nicos es significativo, porque es uno de los medios que permite rnantener la endemia de la Fiebre tifoides o Salmone

Field technique of permeability tests in highly fissured limestone strata

NASA Astrophysics Data System (ADS)

Al-Salihi, Adnan; Asaad, Abdulah

2002-05-01

Résumé.L'étude de dispositifs de dénoyage est nécessaire pour l'amélioration de sites avant la construction de certaines structures. L'étude de dispositifs de dénoyage efficaces exige d'estimer la valeur du coefficient de perméabilité in situ. Les relations disponibles pour estimer le coefficient de perméabilité ont été développées sur la base de mesures et de conditions de terrain limitées, et les prédictions varient de plusieurs ordres de grandeur. C'est pourquoi il est nécessaire de réaliser des mesures de perméabilité sur le terrain et de déterminer la relation qui permet le meilleur ajustement de ces mesures avant l'étude du dispositif de dénoyage pour des conditions locales et géologiques spécifiques. Ce papier présente des mesures de perméabilité sur le terrain dans des niveaux calcaires complexes chaotiques et diagénétisés. Il propose également une analyse comparative de plusieurs relations disponibles dans la littérature destinées à prédire le coefficient de perméabilité in situ. L'analyse est faite en conditions permanentes et non permanentes. Les résultats montrent que la valeur du coefficient de perméabilité dépend du niveau de la nappe, qui est affecté par le régime de marées. On montre que l'équation de l'US Navy donne la meilleure corrélation avec les mesures de terrain. Resumen.El diseño de sistemas de desecado es necesario para mejorar las condiciones de un emplazamiento antes de la construcción de determinadas estructuras. El diseño de un sistema eficiente de desecado requiere de la estimación del valor de la permeabilidad in-situ. Las relaciones disponibles para tal fin han sido desarrolladas bajo condiciones y medidas de campo limitadas; sus predicciones varían en algunos órdenes de magnitud. Por tanto, es necesario tomar medidas de permeabilidad en campo y determinar la relación que reproduce mejor dichas medidas como paso previo al diseño de un sistema de desecado en condiciones geol

Evidence of iridescence in TiO2 nanostructures. A probably photonic effect

NASA Astrophysics Data System (ADS)

Rey-Gonzalez, Rafael; Quiroz, Heiddy P.; Barrera-Patiño, Claudia; Dussan, Anderson; Grupo de Optica e Informacion Cuantica Collaboration; Grupo de Materiales Nanoestructutrados y sus Aplicaciones Collaboration

In this work, we present a study of optical properties of titanium dioxide nanotubes (TiO2). Nanotubes were obtained by electrochemical anodization method, using ethylene glycol solutions containing different amounts of water and fluoride. A complex structure is observed between nanotubes and Ti foils on surface when nanotubes are released from the sheet. These forms can be associated with replicas or marks in surface of the Ti foil. The optical response of replicas is studied by Uv-Vis spectrophotometry using white light and varying the angle of the incident light. Absorbance measurements reveal that these replicas exhibit a shift towards lower values of lambda when the angle of the incident light increases of 200 to 600. These changes may be associated with iridescent effects in this material. The concavity of the replicas in association with air could be generating photonic-like effects. Using a 2D model of replicas - air system, the photonic band structures are found through a plane wave approach. Correlations between photonic properties and iridescent effects are explored. Grupo de Optica e Informacion Cuantica.

Anti-aquaporin-4 autoantibodies in systemic lupus erythematosus persist for years and induce astrocytic cytotoxicity but not CNS disease.

PubMed

Alexopoulos, Harry; Kampylafka, Eleni I; Fouka, Penelope; Tatouli, Ioanna; Akrivou, Sofia; Politis, Panagiotis K; Moutsopoulos, Haralampos M; Tzioufas, Athanasios G; Dalakas, Marinos C

2015-12-15

Anti-aquaporin-4 autoantibodies are specific for the neuromyelitis optica spectrum disorders (NMOSD) and they have also been described in patients with systemic lupus erythematosus (SLE) with neurological signs consistent with NMOSD. Our objective was to test for the presence and pathogenicity of anti-AQP4 antibodies in SLE patients without neurological disease. Sera from 89 non-CNS-SLE patients were screened for anti-AQP4 autoantibodies. Two of the 89 patients were positive. Archived samples dating back 11 years were also positive. A brain and spinal cord MRI did not reveal any NMOSD-compatible lesions. An in vitro cytotoxicity assay showed that either sera or purified IgG from these patients induced a complement-mediated damage in cultured astrocytes comparable to antibodies obtained from typical NMO patients. We conclude that AQP4-antibodies can be present in SLE patients and persist for many years, without concurrent clinical or radiological NMOSD signs. It is unclear why the anti-AQP4 antibodies did not induce CNS disease. Copyright © 2015 Elsevier B.V. All rights reserved.

A case of anti aquapolin-4 antibody positive myelitis with hyperhidrosis, following herpes zoster.

PubMed

Suda, Machiko; Tsutsumiuchi, Michiko; Uesaka, Yoshikazu; Hayashi, Nobukazu

2017-01-31

We report an acute myelitis in a 53-year-old woman that occurred in 7 days after the diagnosis of Th5-6 herpes zoster. Clinical examination revealed hyperhidrosis of left side of her face, neck, arm and upper chest. She also had muscle weakness of her left leg and sensory impairment for light touch and temperature in her chest and legs. Spinal cord MRI demonstrated a longitudinal T 2 -hyperintense lesion extending from Th1 to 7. In the axial imaging, the lesion dominantly located in the left side gray matter. Hyperhidrosis, weakness and sensory impairment were improved after intravenous therapy with acyclovir and methylprednisolone. VZV (varicella zoster virus) IgG index of the cerebrospinal fluid was high and serological anti aquaporin-4 antibodies were positive at the time of the admission. This case had both characteristics of VZV myelitis and neuromyelitis optica spectrum disorder. Myelitis relapsed 19 months after the first attack. We believe that sympathetic hyper reactivity due to thoracic spinal cord lesion was responsible for the hyperhidrosis in our patient.

Rare inflammatory diseases of the white matter and mimics of multiple sclerosis and related disorders.

PubMed

Tardieu, Marc; Deiva, Kumaran

2013-12-01

The spectra of white matter neuroinflammatory diseases and pathological processes inducing inflammatory lesions in the white matter of the central nervous system are wider in children than in adults. The definitions of multiple sclerosis (MS) and of the related clinically isolated syndromes (CIS) and acute disseminated encephalomyelitis (ADEM) have been recently revised leading to a new consensus definition. However, other entities with similarities to these diseases may also develop with monophasic or relapsing white matter inflammation. These conditions include congenital immunogenetic diseases (such as hemophagocytic lymphohistiocytosis), vasculitis, and autoantibody-mediated encephalopathies (Hashimoto encephalopathy, encephalitis with anti-N-methyl-D-aspartate receptor antibodies and neuromyelitis optica). Moreover, infectious diseases, such as Lyme disease, tumors (oligodendroglioma and lymphoma), and even genetic or metabolic diseases should also be considered if the clinical course of the disease does not follow the typical pattern for ADEM or MS. This short review describes these different entities and provides information for the differential diagnosis of inflammatory diseases of the white matter. Georg Thieme Verlag KG Stuttgart · New York.

[Nosology and etiologies of acute longitudinally extensive transverse myelitis].

PubMed

Collongues, N; Papeix, C; Zéphir, H; Audoin, B; Cotton, F; Durand-Dubief, F; Vukusic, S; Brassat, D; Laplaud, D; Marignier, R

2014-01-01

Acute transverse myelitis had many names and definitions, based primarily on clinical criteria. The role of MRI in the exploration of myelitis has increased recently after the individualization of neuromyelitis optica (NMO) in 2004. This approach has enabled clarification of the diagnostic and prognostic value of acute longitudinally extensive transverse myelitis (LETM), defined by an extensive T2 lesion affecting three vertebral segments in the sagittal plane. The limitations of this definition, the multiplicity of terms used to characterize it as well as the large number of etiologies associated with it led our group of experts to clarify its etiology and nosology. We conducted a national survey on this subject in order to propose a new definition of LETM. Additional first- and second-intention examinations were determined according to the clinical context. Infectious/para-infectious, inflammatory or paraneoplastic causes can thus be identified. To determine within a short time the cause of LETM is essential, since most of its causes are severe and require urgent treatment. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

The large millimeter telescope/el Gran Telescopio Milimétrico: a new instrument for astrobiology.

PubMed

Irvine, William M; Carramiñana, Alberto; Carrasco, Luis; Schloerb, F Peter

2003-12-01

The Instituto Nacional de Astrofísica, Optica y Electrónica in Mexico and the University of Massachusetts in the U.S.A. are collaborating to build the world's largest radio telescope that operates at short millimeter wavelengths. This facility, known as the Large Millimeter Telescope (LMT) or el Gran Telescopio Milimétrico (GTM), is being sited at an altitude of 4600 m on Volcan Sierra Negra in the Mexican state of Puebla. The telescope will be a fully steerable dish with a diameter of 50 m and a surface consisting of 180 panels that are actively adjusted under computer control to correct for deformations due to gravity and temperature gradients. Instruments will include focal plane arrays to image both continuum and spectral line emission from celestial sources. The LMT/GTM will be an extremely powerful facility for studies encompassing almost all areas of astronomy, including astrobiology. In particular, the high sensitivity, angular resolution, and mapping speed will enable detailed investigations of the organic chemistry of interstellar molecular clouds, protoplanetary disks, and comets.

Eosinophils in Autoimmune Diseases

PubMed Central

Diny, Nicola L.; Rose, Noel R.; Čiháková, Daniela

2017-01-01

Eosinophils are multifunctional granulocytes that contribute to initiation and modulation of inflammation. Their role in asthma and parasitic infections has long been recognized. Growing evidence now reveals a role for eosinophils in autoimmune diseases. In this review, we summarize the function of eosinophils in inflammatory bowel diseases, neuromyelitis optica, bullous pemphigoid, autoimmune myocarditis, primary biliary cirrhosis, eosinophilic granulomatosis with polyangiitis, and other autoimmune diseases. Clinical studies, eosinophil-targeted therapies, and experimental models have contributed to our understanding of the regulation and function of eosinophils in these diseases. By examining the role of eosinophils in autoimmune diseases of different organs, we can identify common pathogenic mechanisms. These include degranulation of cytotoxic granule proteins, induction of antibody-dependent cell-mediated cytotoxicity, release of proteases degrading extracellular matrix, immune modulation through cytokines, antigen presentation, and prothrombotic functions. The association of eosinophilic diseases with autoimmune diseases is also examined, showing a possible increase in autoimmune diseases in patients with eosinophilic esophagitis, hypereosinophilic syndrome, and non-allergic asthma. Finally, we summarize key future research needs. PMID:28496445

Meningitis determined by oligosymptomatic dengue virus type 3 infection: report of a case.

PubMed

Soares, C N; Cabral-Castro, M J; Peralta, J M; Freitas, M R G; Puccioni-Sohler, M

2010-02-01

Dengue infection is a mosquito-borne disease caused by a flavivirus, and is recognized in over 100 countries with 2.5 billion people living in areas of risk. Neurological manifestations such as encephalitis, myelitis, Guillain-Barré syndrome, cranial nerve palsies, neuromyelitis optica, and encephalomyelitis have been recognized as clinical consequences of dengue infection. Meningitis is a rare complication. We report the case of a 24-year-old woman who presented with fever, headache, and nuchal rigidity without the typical symptoms of dengue infection. Cerebrospinal fluid analysis showed lymphocytic pleocytosis with a normal glucose value and negative bacterial and fungal cultures. The etiology of meningitis was confirmed by positive dengue PCR in the serum. This case report highlights dengue infection as a potential cause of meningitis in endemic areas. Also, meningitis can be the first manifestation of the infection. Dengue should be investigated even in the absence of a typical picture of the infection. Copyright 2009 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Channelopathies.

PubMed

Kim, June-Bum

2014-01-01

Channelopathies are a heterogeneous group of disorders resulting from the dysfunction of ion channels located in the membranes of all cells and many cellular organelles. These include diseases of the nervous system (e.g., generalized epilepsy with febrile seizures plus, familial hemiplegic migraine, episodic ataxia, and hyperkalemic and hypokalemic periodic paralysis), the cardiovascular system (e.g., long QT syndrome, short QT syndrome, Brugada syndrome, and catecholaminergic polymorphic ventricular tachycardia), the respiratory system (e.g., cystic fibrosis), the endocrine system (e.g., neonatal diabetes mellitus, familial hyperinsulinemic hypoglycemia, thyrotoxic hypokalemic periodic paralysis, and familial hyperaldosteronism), the urinary system (e.g., Bartter syndrome, nephrogenic diabetes insipidus, autosomal-dominant polycystic kidney disease, and hypomagnesemia with secondary hypocalcemia), and the immune system (e.g., myasthenia gravis, neuromyelitis optica, Isaac syndrome, and anti-NMDA [N-methyl-D-aspartate] receptor encephalitis). The field of channelopathies is expanding rapidly, as is the utility of molecular-genetic and electrophysiological studies. This review provides a brief overview and update of channelopathies, with a focus on recent advances in the pathophysiological mechanisms that may help clinicians better understand, diagnose, and develop treatments for these diseases.

Recurrent longitudinal extensive transverse myelitis in a neuro-Behçet syndrome treated with infliximab.

PubMed

Uygunoğlu, Uğur; Pasha, Maarya; Saip, Sabahattin; Siva, Aksel

2015-01-01

Spinal cord involvement is not common, but can be seen in neuro-Behçet's syndrome (NBS). The major site of involvement is the cervical spinal cord with the myelitis-like inflammatory lesions continuing more than two segments, and extending to the brainstem. A 30-year-old male patient who has been followed with a diagnosis of Behçet's syndrome admitted to our neurology department clinically and radiologically suggestive of recurrent and extensive longitudinal myelitis. His anti-aquaporine antibody was negative. Because of insufficient effect of azathioprine, cyclophosphamide, and corticosteroids, infliximab was started. His clinical and radiological status is stationary for 3 years under infliximab treatment. Myelitis such as that occurring in our patient may have a similar presentation like neuromyelitis optica (NMO), which should therefore be included in differential diagnosis. Myelitis observed in both NMO and NBS shows spinal cord lesions longer than three or more vertebrae. Anti-aquaporine antibody must be evaluated in all patients presenting with longitudinal myelitis. Anti-tumor necrosis factor agent infliximab might be an alternative treatment in severe form of NBS such as myelitis. In our case, successful treatment of recurrent and extensive longitudinal transverse myelitis in NBS with infliximab was demonstrated.

[Neuro-ophthalmology: the eye as a window to the brain].

PubMed

Kesler, Anat

2013-02-01

Neuro-ophthalmology focuses on the diagnosis and treatment of visual disorders related to the neurological system rather than the globe itself. Being a subspecialty of both neurology and ophthalmology, it requires specialized training and expertise in diseases of the eye, brain, nerves and muscles. Commonly encountered pathologies in neuro-ophthalmology include: optic neuropathies (such as optic neuritis and ischemic optic neuropathy), visual field loss (transient, constant, unexplained), transient visual loss, unspecified visual disturbances, diplopia, abnormal eye movements, thyroid eye disease, myasthenia gravis, anisocoria, and eyelid abnormalities. The current issue of "Harefuah" is dedicated to contemporary knowledge in neuro-opthalmology, and spans from studies of neuromyelitis optica (NMO), ischemic optic neuropathies, and optic neuropathies induced by phosphodiesterase inhibitors, to the management of sight-threatening carotid-cavernous fistulas, and more. These studies emphasize the importance of an interdisciplinary treatment team consisting of a neuro-ophthalmologist, a neuro-radiologist, and sometimes, even a neuro-surgeon. Such an approach may prove to be beneficial to the patient, by optimizing follow-up and treatment decisions. This issue emphasizes how a correct and timely diagnosis is of paramount significance in patients with neuro-ophthalmological disorders.

Autoantibody-induced internalization of CNS AQP4 water channel and EAAT2 glutamate transporter requires astrocytic Fc receptor.

PubMed

Hinson, Shannon R; Clift, Ian C; Luo, Ningling; Kryzer, Thomas J; Lennon, Vanda A

2017-05-23

Aquaporin-4 (AQP4) water channel-specific IgG distinguishes neuromyelitis optica (NMO) from multiple sclerosis and causes characteristic immunopathology in which central nervous system (CNS) demyelination is secondary. Early events initiating the pathophysiological outcomes of IgG binding to astrocytic AQP4 are poorly understood. CNS lesions reflect events documented in vitro following IgG interaction with AQP4: AQP4 internalization, attenuated glutamate uptake, intramyelinic edema, interleukin-6 release, complement activation, inflammatory cell recruitment, and demyelination. Here, we demonstrate that AQP4 internalization requires AQP4-bound IgG to engage an astrocytic Fcγ receptor (FcγR). IgG-lacking Fc redistributes AQP4 within the plasma membrane and induces interleukin-6 release. However, AQP4 endocytosis requires an activating FcγR's gamma subunit and involves astrocytic membrane loss of an inhibitory FcγR, CD32B. Interaction of the IgG-AQP4 complex with FcγRs triggers coendocytosis of the excitatory amino acid transporter 2 (EAAT2). Requirement of FcγR engagement for internalization of two astrocytic membrane proteins critical to CNS homeostasis identifies a complement-independent, upstream target for potential early therapeutic intervention in NMO.

Autoantibody-induced internalization of CNS AQP4 water channel and EAAT2 glutamate transporter requires astrocytic Fc receptor

PubMed Central

Hinson, Shannon R.; Clift, Ian C.; Luo, Ningling; Kryzer, Thomas J.; Lennon, Vanda A.

2017-01-01

Aquaporin-4 (AQP4) water channel-specific IgG distinguishes neuromyelitis optica (NMO) from multiple sclerosis and causes characteristic immunopathology in which central nervous system (CNS) demyelination is secondary. Early events initiating the pathophysiological outcomes of IgG binding to astrocytic AQP4 are poorly understood. CNS lesions reflect events documented in vitro following IgG interaction with AQP4: AQP4 internalization, attenuated glutamate uptake, intramyelinic edema, interleukin-6 release, complement activation, inflammatory cell recruitment, and demyelination. Here, we demonstrate that AQP4 internalization requires AQP4-bound IgG to engage an astrocytic Fcγ receptor (FcγR). IgG-lacking Fc redistributes AQP4 within the plasma membrane and induces interleukin-6 release. However, AQP4 endocytosis requires an activating FcγR’s gamma subunit and involves astrocytic membrane loss of an inhibitory FcγR, CD32B. Interaction of the IgG–AQP4 complex with FcγRs triggers coendocytosis of the excitatory amino acid transporter 2 (EAAT2). Requirement of FcγR engagement for internalization of two astrocytic membrane proteins critical to CNS homeostasis identifies a complement-independent, upstream target for potential early therapeutic intervention in NMO. PMID:28461494

Anti-MOG antibody-positive ADEM following infectious mononucleosis due to a primary EBV infection: a case report.

PubMed

Nakamura, Yoshitsugu; Nakajima, Hideto; Tani, Hiroki; Hosokawa, Takafumi; Ishida, Shimon; Kimura, Fumiharu; Kaneko, Kimihiko; Takahashi, Toshiyuki; Nakashima, Ichiro

2017-04-19

Anti-Myelin oligodendrocyte glycoprotein (MOG) antibodies are detected in various demyelinating diseases, such as pediatric acute disseminated encephalomyelitis (ADEM), recurrent optic neuritis, and aquaporin-4 antibody-seronegative neuromyelitis optica spectrum disorder. We present a patient who developed anti-MOG antibody-positive ADEM following infectious mononucleosis (IM) due to Epstein-Barr virus (EBV) infection. A 36-year-old healthy man developed paresthesia of bilateral lower extremities and urinary retention 8 days after the onset of IM due to primary EBV infection. The MRI revealed the lesions in the cervical spinal cord, the conus medullaris, and the internal capsule. An examination of the cerebrospinal fluid revealed pleocytosis. Cell-based immunoassays revealed positivity for anti-MOG antibody with a titer of 1:1024 and negativity for anti-aquaporin-4 antibody. His symptoms quickly improved after steroid pulse therapy followed by oral betamethasone. Anti-MOG antibody titer at the 6-month follow-up was negative. This case suggests that primary EBV infection would trigger anti-MOG antibody-positive ADEM. Adult ADEM patients can be positive for anti-MOG antibody, the titers of which correlate well with the neurological symptoms.

Autoimmune encephalopathies

PubMed Central

Leypoldt, Frank; Armangue, Thaís; Dalmau, Josep

2014-01-01

Over the last 10 years the continual discovery of novel forms of encephalitis associated with antibodies to cell-surface or synaptic proteins has changed the paradigms for diagnosing and treating disorders that were previously unknown or mischaracterized. We review here the process of discovery, the symptoms, and the target antigens of twelve autoimmune encephatilic disorders, grouped by syndromes and approached from a clinical perspective. Anti-NMDAR encephalitis, several subtypes of limbic encephalitis, stiff-person spectrum disorders, and other autoimmune encephalitides that result in psychosis, seizures, or abnormal movements are described in detail. We include a novel encephalopathy with prominent sleep dysfunction that provides an intriguing link between chronic neurodegeneration and cell-surface autoimmunity (IgLON5). Some of the caveats of limited serum testing are outlined. In addition, we review the underlying cellular and synaptic mechanisms that for some disorders confirm the antibody pathogenicity. The multidisciplinary impact of autoimmune encephalitis has been expanded recently by the discovery that herpes simplex encephalitis is a robust trigger of synaptic autoimmunity, and that some patients may develop overlapping syndromes, including anti-NMDAR encephalitis and neuromyelitis optica or other demyelinating diseases. PMID:25315420

Channelopathies

PubMed Central

Kim, June-Bum

2014-01-01

Channelopathies are a heterogeneous group of disorders resulting from the dysfunction of ion channels located in the membranes of all cells and many cellular organelles. These include diseases of the nervous system (e.g., generalized epilepsy with febrile seizures plus, familial hemiplegic migraine, episodic ataxia, and hyperkalemic and hypokalemic periodic paralysis), the cardiovascular system (e.g., long QT syndrome, short QT syndrome, Brugada syndrome, and catecholaminergic polymorphic ventricular tachycardia), the respiratory system (e.g., cystic fibrosis), the endocrine system (e.g., neonatal diabetes mellitus, familial hyperinsulinemic hypoglycemia, thyrotoxic hypokalemic periodic paralysis, and familial hyperaldosteronism), the urinary system (e.g., Bartter syndrome, nephrogenic diabetes insipidus, autosomal-dominant polycystic kidney disease, and hypomagnesemia with secondary hypocalcemia), and the immune system (e.g., myasthenia gravis, neuromyelitis optica, Isaac syndrome, and anti-NMDA [N-methyl-D-aspartate] receptor encephalitis). The field of channelopathies is expanding rapidly, as is the utility of molecular-genetic and electrophysiological studies. This review provides a brief overview and update of channelopathies, with a focus on recent advances in the pathophysiological mechanisms that may help clinicians better understand, diagnose, and develop treatments for these diseases. PMID:24578711

Pattern Recognition of the Multiple Sclerosis Syndrome

PubMed Central

Stewart, Renee; Healey, Kathleen M.

2017-01-01

During recent decades, the autoimmune disease neuromyelitis optica spectrum disorder (NMOSD), once broadly classified under the umbrella of multiple sclerosis (MS), has been extended to include autoimmune inflammatory conditions of the central nervous system (CNS), which are now diagnosable with serum serological tests. These antibody-mediated inflammatory diseases of the CNS share a clinical presentation to MS. A number of practical learning points emerge in this review, which is geared toward the pattern recognition of optic neuritis, transverse myelitis, brainstem/cerebellar and hemispheric tumefactive demyelinating lesion (TDL)-associated MS, aquaporin-4-antibody and myelin oligodendrocyte glycoprotein (MOG)-antibody NMOSD, overlap syndrome, and some yet-to-be-defined/classified demyelinating disease, all unspecifically labeled under MS syndrome. The goal of this review is to increase clinicians’ awareness of the clinical nuances of the autoimmune conditions for MS and NMSOD, and to highlight highly suggestive patterns of clinical, paraclinical or imaging presentations in order to improve differentiation. With overlay in clinical manifestations between MS and NMOSD, magnetic resonance imaging (MRI) of the brain, orbits and spinal cord, serology, and most importantly, high index of suspicion based on pattern recognition, will help lead to the final diagnosis. PMID:29064441

New developments in the treatment of optic neuritis

PubMed Central

Jenkins, Thomas M; Toosy, Ahmed T

2010-01-01

Acute optic neuritis (ON) has various etiologies. The most common presentation is inflammatory, demyelinating, idiopathic, or “typical” ON, which may be associated with multiple sclerosis. This must be differentiated from “atypical” causes of ON, which differ in their clinical presentation, natural history, management, and prognosis. Clinical “red flags” for an atypical cause of ON include absent or persistent pain, exudates and hemorrhages on fundoscopy, very severe, bilateral, or progressive visual loss, and failure to recover. In typical ON, steroids shorten the duration of the attack, but do not influence visual outcome. This is in contrast to atypical ON associated with conditions such as sarcoidosis and neuromyelitis optica, which require aggressive immunosuppression and sometimes plasma exchange. The visual prognosis of typical ON is generally good. The prognosis in atypical ON is more variable. New developments aimed at designing better treatments for patients who fail to recover are discussed, focusing on recent research elucidating mechanisms of damage and recovery in ON. Future therapeutic directions may include enhancing repair processes, such as remyelination or adaptive neuroplasticity, or alternative methods of immunomodulation. Pilot studies investigating the safety and proof-of-principle of stem cell treatment are currently underway. PMID:28539768

JPRS Report, Reference Aid: Glossary of Acronyms and Abbreviations of Spain

DTIC Science & Technology

1988-12-01

Emigraciön INSS Instituto Nacional de la Seguridad Social INTA Instituto Nacional de Tecnica Aeroespacial INTUSA Industrias Turisticas, S. A. INUR...Marconi Espafiola, S. A. META (plan de) Modernizaciön del Ejercito de Tierra MFCS Medidas destinadas a Fomentar la Confianza y Seguridad MIL...Favored-Nations System S/R (S/Ref.) su referenda your reference SS Seguridad Social SSUPC Sistema de Seguimiento de Uso de la Celula Social

Traveling Along a Zipline

DTIC Science & Technology

2011-03-01

resultados se obtienen al equilibrar las fuerzas en las direcciones horizontal y vertical, de modo que el tratamiento es accesible para mayores de física...masa. A medida que aumenta el peso del ciclista de 0 a, las trayectorias de manera uniforme interpolar entre una catenaria y una elipse. Estos...an algebraic equation. Keywords: Zipline, curved spacetime, force balance, catenary. Resumen La trayectoria de un jinete lentamente atravesando

Las Matematicas: Lenguaje Universal. Nivel 3: La Medida (Mathematics: A Universal Language. Level 3: Measurement).

ERIC Educational Resources Information Center

Dissemination and Assessment Center for Bilingual Education, Austin, TX.

This is one of a series of student booklets designed for use in a bilingual mathematics program in grades 6-8. The general format is to present each page in both Spanish and English. The mathematical topics in this booklet include liquid, dry, linear, weight, and time measures. (MK)

Impact of Different Normality Thresholds for 24-hour ABPM at the Primary Health Care Level.

PubMed

Grezzana, Guilherme Brasil; Moraes, David William; Stein, Airton Tetelbon; Pellanda, Lucia Campos

2017-02-01

desfechos cardiovasculares. Médicos da atenção primária à saúde (APS) devem estar preparados para atuar adequadamente na prevenção de fatores de risco cardiovascular. No entanto, as taxas de pacientes com pressão arterial (PA) controlada continuam baixas. O impacto da reclassificação do diagnóstico de hipertensão pela utilização da monitorização ambulatorial da PA (MAPA) de 24 horas pode levar a diferentes decisões médicas na APS. Avaliar a concordância entre as PAs medidas por método convencional por médicos da APS e por MAPA de 24 horas, considerando diferentes limiares de normalidade para a MAPA de 24 horas de acordo com as recomendações da V Diretriz Brasileira de MAPA e da Diretriz da Sociedade Europeia de Hipertensão. Estudo transversal com 569 pacientes hipertensos. A PA foi medida inicialmente por médicos da APS e, posteriormente, pela MAPA de 24 horas. As medidas foram obtidas de forma independente entre os dois métodos. Os alvos terapêuticos para a PA convencional seguiram as orientações do Eighth Joint National Committee (JNC 8), das V Diretrizes Brasileiras de MAPA e das Diretrizes Europeias de Hipertensão de 2013. Foi observada uma acurácia de 54,8% (intervalo de confiança de 95% [IC95%] 0,51 - 0,58%) para a PA aferida de forma convencional quando comparada à obtida com a MAPA de 24 horas, além de uma sensibilidade de 85% (IC95% 80,8 - 88,6%), especificidade de 31,9% (IC95% 28,7 - 34,7%) e kappa de 0,155, quando consideradas as Diretrizes Europeias de Hipertensão. Quando utilizados limiares mais rígidos para caracterizar a PA como "normal" pela MAPA, foi identificada uma acurácia de 45% (IC95% 0,41 - 0,47%) pela medida convencional quando comparada à obtida pela MAPA de 24 horas, além de uma sensibilidade de 86,7% (IC95% 0,81 - 0,91%), especificidade de 29% (IC95% 0,26 - 0,30%) e kappa de 0,103. As medidas de PA avaliadas pelos médicos da APS apresentaram baixa acurácia quando comparadas às medidas pela MAPA de 24

Distinct brain imaging characteristics of autoantibody-mediated CNS conditions and multiple sclerosis.

PubMed

Jurynczyk, Maciej; Geraldes, Ruth; Probert, Fay; Woodhall, Mark R; Waters, Patrick; Tackley, George; DeLuca, Gabriele; Chandratre, Saleel; Leite, Maria I; Vincent, Angela; Palace, Jacqueline

2017-03-01

Brain imaging characteristics of MOG antibody disease are largely unknown and it is unclear whether they differ from those of multiple sclerosis and AQP4 antibody disease. The aim of this study was to identify brain imaging discriminators between those three inflammatory central nervous system diseases in adults and children to support diagnostic decisions, drive antibody testing and generate disease mechanism hypotheses. Clinical brain scans of 83 patients with brain lesions (67 in the training and 16 in the validation cohort, 65 adults and 18 children) with MOG antibody (n = 26), AQP4 antibody disease (n = 26) and multiple sclerosis (n = 31) recruited from Oxford neuromyelitis optica and multiple sclerosis clinical services were retrospectively and anonymously scored on a set of 29 predefined magnetic resonance imaging features by two independent raters. Principal component analysis was used to perform an overview of patients without a priori knowledge of the diagnosis. Orthogonal partial least squares discriminant analysis was used to build models separating diagnostic groups and identify best classifiers, which were then tested on an independent cohort set. Adults and children with MOG antibody disease frequently had fluffy brainstem lesions, often located in pons and/or adjacent to fourth ventricle. Children across all conditions showed more frequent bilateral, large, brainstem and deep grey matter lesions. MOG antibody disease spontaneously separated from multiple sclerosis but overlapped with AQP4 antibody disease. Multiple sclerosis was discriminated from MOG antibody disease and from AQP4 antibody disease with high predictive values, while MOG antibody disease could not be accurately discriminated from AQP4 antibody disease. Best classifiers between MOG antibody disease and multiple sclerosis were similar in adults and children, and included ovoid lesions adjacent to the body of lateral ventricles, Dawson's fingers, T1 hypointense lesions (multiple

JPRS Report West Europe

DTIC Science & Technology

1988-08-31

C27 A entrevista esclareceu sobre os principals problemas do pais? (3) Cavaco justificou bem as medidas tomadaspeloGoverno? (4) fc 5) . M e...do. My personal wishes did not lie in returning to 16 rue de la loi [prime minister’s residence]. [Question] It was not psychologically very astute...Spokesman on Role in Opposition 36190009 Brussels LA LIBRE BELGIQUE in French 14/15 May 88 p 4 [Interview with Jose Daras, head of the ECOLO- AGALEV

Helicobacter pylori and autoimmune disease: Cause or bystander

PubMed Central

Smyk, Daniel S; Koutsoumpas, Andreas L; Mytilinaiou, Maria G; Rigopoulou, Eirini I; Sakkas, Lazaros I; Bogdanos, Dimitrios P

2014-01-01

Helicobacter pylori (H. pylori) is the main cause of chronic gastritis and a major risk factor for gastric cancer. This pathogen has also been considered a potential trigger of gastric autoimmunity, and in particular of autoimmune gastritis. However, a considerable number of reports have attempted to link H. pylori infection with the development of extra-gastrointestinal autoimmune disorders, affecting organs not immediately relevant to the stomach. This review discusses the current evidence in support or against the role of H. pylori as a potential trigger of autoimmune rheumatic and skin diseases, as well as organ specific autoimmune diseases. We discuss epidemiological, serological, immunological and experimental evidence associating this pathogen with autoimmune diseases. Although over one hundred autoimmune diseases have been investigated in relation to H. pylori, we discuss a select number of papers with a larger literature base, and include Sjögrens syndrome, rheumatoid arthritis, systemic lupus erythematosus, vasculitides, autoimmune skin conditions, idiopathic thrombocytopenic purpura, autoimmune thyroid disease, multiple sclerosis, neuromyelitis optica and autoimmune liver diseases. Specific mention is given to those studies reporting an association of anti-H. pylori antibodies with the presence of autoimmune disease-specific clinical parameters, as well as those failing to find such associations. We also provide helpful hints for future research. PMID:24574735

Recurrent longitudinal extensive transverse myelitis in a neuro-Behçet syndrome treated with infliximab

PubMed Central

Uygunoğlu, Uğur; Pasha, Maarya; Saip, Sabahattin; Siva, Aksel

2015-01-01

Background Spinal cord involvement is not common, but can be seen in neuro-Behçet's syndrome (NBS). The major site of involvement is the cervical spinal cord with the myelitis-like inflammatory lesions continuing more than two segments, and extending to the brainstem. Case A 30-year-old male patient who has been followed with a diagnosis of Behçet's syndrome admitted to our neurology department clinically and radiologically suggestive of recurrent and extensive longitudinal myelitis. His anti-aquaporine antibody was negative. Because of insufficient effect of azathioprine, cyclophosphamide, and corticosteroids, infliximab was started. His clinical and radiological status is stationary for 3 years under infliximab treatment. Discussion Myelitis such as that occurring in our patient may have a similar presentation like neuromyelitis optica (NMO), which should therefore be included in differential diagnosis. Myelitis observed in both NMO and NBS shows spinal cord lesions longer than three or more vertebrae. Anti-aquaporine antibody must be evaluated in all patients presenting with longitudinal myelitis. Anti-tumor necrosis factor agent infliximab might be an alternative treatment in severe form of NBS such as myelitis. Conclusion In our case, successful treatment of recurrent and extensive longitudinal transverse myelitis in NBS with infliximab was demonstrated. PMID:24673549

Upgrade of goniospectrophtometer GEFE for near-field scattering and fluorescence radiance measurements

NASA Astrophysics Data System (ADS)

Bernad, Berta; Ferrero, Alejandro; Pons, Alicia; Hernanz, M. L.; Campos, Joaquín.

2015-03-01

The goniospectrophotometer GEFE, designed and developed at IO-CSIC (Instituto de Optica, Agencia Estatal Consejo Superior de Investigaciones Cientificas), was conceived to measure the spectral Bidirectional Reflectance Distribution Function (BRDF) at any pair of irradiation and detection directions. Although the potential of this instrument has largely been proved, it still required to be upgraded to deal with some important scattering features for the assessment of the appearance. Since it was not provided with a detector with spatial resolution, it simply could not measure spectrophotometric quantities to characterize texture through the Bidirectional Texture Function (BTF) or translucency through the more complex Bidirectional Scattering-Surface Reflectance Distribution Function (BSSRDF). Another requirement in the GEFE upgrading was to provide it with the capability of measuring fluorescence at different geometries, since some of the new pigments used in industry are fluorescent, which can have a non-negligible impact in the color of the product. Then, spectral resolution at irradiation and detection had to be available in GEFE. This paper describes the upgrading of the goniospectrophotometer GEFE, and its new capabilities through the presentation of sparkle and goniofluorescence measurements. In addition, the potential of the instrument to evaluate translucency by the measurement of the BSSRDF is briefly discussed.

Clinical features and sera anti-aquaporin 4 antibody positivity in patients with demyelinating disorders of the central nervous system from Tianjin, China.

PubMed

Yang, Chun-Sheng; Zhang, Da-Qi; Wang, Jing-Hua; Jin, Wei-Na; Li, Min-Shu; Liu, Jie; Zhang, Cun-Jin; Li, Ting; Shi, Fu-Dong; Yang, Li

2014-01-01

To investigate the clinical characteristics and sera anti-aquaporin 4 (AQP4) antibody positivity in patients with inflammatory demyelinating disorders (IDDs) of the central nervous system (CNS) in Tianjin, China. We retrospectively evaluated 234 patients with IDDs including neuromyelitis optica (NMO), recurrent optic neuritis (rON), longitudinally extensive transverse myelitis (LETM), clinically isolated syndrome (CIS), and multiple sclerosis (MS) groups. Sera from 217 patients were determined for AQP4-Ab. The clinical characteristics and sera anti-AQP4 positivity were compared. The IDDS comprised 63 MS, 51 NMO, 56 LETM, 10 rON, and 54 CIS. Compared with MS, NMO had a higher frequency of occurrence in women, intractable hiccup and nausea (IHN), medullospinal lesion, longitudinally extensive spinal cord lesions (LESCL) and bilateral ON, disease onset at a later age, and worsening residual disability. AQP4-Ab-positive rates were 84.1% and 69% in NMO and NMO spectrum disorders (NMOSD), respectively, whereas it was undetectable in all of the MS sera samples. We comprehensively contrast the distinct clinical features of MS, NMO, and NMOSD in our center. A sensitive AQP4-Ab assay is necessary for the early diagnosis of NMOSD in our patients. Neither medullospinal lesion nor IHN is unique in NMO. © 2013 John Wiley & Sons Ltd.

High Spatial Resolution Imaging Mass Spectrometry of Human Optic Nerve Lipids and Proteins

NASA Astrophysics Data System (ADS)

Anderson, David M. G.; Spraggins, Jeffrey M.; Rose, Kristie L.; Schey, Kevin L.

2015-06-01

The human optic nerve carries signals from the retina to the visual cortex of the brain. Each optic nerve is comprised of approximately one million nerve fibers that are organized into bundles of 800-1200 fibers surrounded by connective tissue and supportive glial cells. Damage to the optic nerve contributes to a number of blinding diseases including: glaucoma, neuromyelitis optica, optic neuritis, and neurofibromatosis; however, the molecular mechanisms of optic nerve damage and death are incompletely understood. Herein we present high spatial resolution MALDI imaging mass spectrometry (IMS) analysis of lipids and proteins to define the molecular anatomy of the human optic nerve. The localization of a number of lipids was observed in discrete anatomical regions corresponding to myelinated and unmyelinated nerve regions as well as to supporting connective tissue, glial cells, and blood vessels. A protein fragment from vimentin, a known intermediate filament marker for astrocytes, was observed surrounding nerved fiber bundles in the lamina cribrosa region. S100B was also found in supporting glial cell regions in the prelaminar region, and the hemoglobin alpha subunit was observed in blood vessel areas. The molecular anatomy of the optic nerve defined by MALDI IMS provides a firm foundation to study biochemical changes in blinding human diseases.

The contemporary spectrum of multiple sclerosis misdiagnosis: A multicenter study.

PubMed

Solomon, Andrew J; Bourdette, Dennis N; Cross, Anne H; Applebee, Angela; Skidd, Philip M; Howard, Diantha B; Spain, Rebecca I; Cameron, Michelle H; Kim, Edward; Mass, Michele K; Yadav, Vijayshree; Whitham, Ruth H; Longbrake, Erin E; Naismith, Robert T; Wu, Gregory F; Parks, Becky J; Wingerchuk, Dean M; Rabin, Brian L; Toledano, Michel; Tobin, W Oliver; Kantarci, Orhun H; Carter, Jonathan L; Keegan, B Mark; Weinshenker, Brian G

2016-09-27

To characterize patients misdiagnosed with multiple sclerosis (MS). Neurologists at 4 academic MS centers submitted data on patients determined to have been misdiagnosed with MS. Of 110 misdiagnosed patients, 51 (46%) were classified as "definite" and 59 (54%) "probable" misdiagnoses according to study definitions. Alternate diagnoses included migraine alone or in combination with other diagnoses 24 (22%), fibromyalgia 16 (15%), nonspecific or nonlocalizing neurologic symptoms with abnormal MRI 13 (12%), conversion or psychogenic disorders 12 (11%), and neuromyelitis optica spectrum disorder 7 (6%). Duration of misdiagnosis was 10 years or longer in 36 (33%) and an earlier opportunity to make a correct diagnosis was identified for 79 patients (72%). Seventy-seven (70%) received disease-modifying therapy and 34 (31%) experienced unnecessary morbidity because of misdiagnosis. Four (4%) participated in a research study of an MS therapy. Leading factors contributing to misdiagnosis were consideration of symptoms atypical for demyelinating disease, lack of corroborative objective evidence of a CNS lesion as satisfying criteria for MS attacks, and overreliance on MRI abnormalities in patients with nonspecific neurologic symptoms. Misdiagnosis of MS leads to unnecessary and potentially harmful risks to patients. Misinterpretation and misapplication of MS clinical and radiographic diagnostic criteria are important contemporary contributors to misdiagnosis. © 2016 American Academy of Neurology.

Comparison of 6-mercaptopurine with 6-thioguanine for the analysis of thiopurine S-methyltransferase activity in human erythrocyte by LC-MS/MS.

PubMed

Mei, Shenghui; Li, Xindi; Gong, Xiaoqing; Zhang, Xiaoyi; Li, Xingang; Yang, Li; Zhu, Leting; Zhou, Heng; Liu, Yonghong; Zhou, Anna; Zhang, Xinghu; Zhao, Zhigang

2017-09-01

Thiopurines (TPDs) are first-line drugs in treating neuromyelitis optica spectrum disorders (NMOSD). Evaluation of thiopurine S-methyltransferase activity (TPMT), a major determinant of TPD toxicity, before TPD treatment using 6-mercaptopurine (6-MP) and 6-thioguanine (6-TG) as substrate was suggested. However, the equivalent of the two substrates in TPMT activity evaluation was unknown, and an alternative substrate was required in TPMT activity evaluation in patients who were already taking 6-MP or 6-TG. Before evaluating the agreement of 6-MP and 6-TG in TPMT activity measurement in patients with NMOSD, the affinity of the two substrates for the active center of TPMT should be established. A computer-based simulation indicated that 6-MP and 6-TG had similar affinities for the two active sites of TPMT. According to the guidelines, an LC-MS/MS method was developed and validated to evaluate the TPMT activity in human erythrocyte hemolysate using 6-MP or 6-TG as substrates via 1 h incubation at 37°C. The method was applied in 81 patients with NMOSD. Evaluated by Bland-Altman plot, 6-methylmercaptopurine and 6-methylthioguanine represented TPMT activities were in agreement with each other. Further studies are warranted to confirm the results. Copyright © 2017 John Wiley & Sons, Ltd.

Disturbed Glucose Metabolism in Rat Neurons Exposed to Cerebrospinal Fluid Obtained from Multiple Sclerosis Subjects

PubMed Central

Mathur, Deepali; María-Lafuente, Eva; Ureña-Peralta, Juan R.; Sorribes, Lucas; Hernández, Alberto; Casanova, Bonaventura; López-Rodas, Gerardo; Coret-Ferrer, Francisco; Burgal-Marti, Maria

2017-01-01

Axonal damage is widely accepted as a major cause of permanent functional disability in Multiple Sclerosis (MS). In relapsing-remitting MS, there is a possibility of remyelination by myelin producing cells and restoration of neurological function. The purpose of this study was to delineate the pathophysiological mechanisms underpinning axonal injury through hitherto unknown factors present in cerebrospinal fluid (CSF) that may regulate axonal damage, remyelinate the axon and make functional recovery possible. We employed primary cultures of rat unmyelinated cerebellar granule neurons and treated them with CSF obtained from MS and Neuromyelitis optica (NMO) patients. We performed microarray gene expression profiling to study changes in gene expression in treated neurons as compared to controls. Additionally, we determined the influence of gene-gene interaction upon the whole metabolic network in our experimental conditions using the Search Tool for the Retrieval of Interacting Genes/Proteins (STRING) program. Our findings revealed the downregulated expression of genes involved in glucose metabolism in MS-derived CSF-treated neurons and upregulated expression of genes in NMO-derived CSF-treated neurons. We conclude that factors in the CSF of these patients caused a perturbation in metabolic gene(s) expression and suggest that MS appears to be linked with metabolic deformity. PMID:29267205

High-performance dispersive Raman and absorption spectroscopy as tools for drug identification

NASA Astrophysics Data System (ADS)

Pawluczyk, Olga; Andrey, Sam; Nogas, Paul; Roy, Andrew; Pawluczyk, Romuald

2009-02-01

Due to increasing availability of pharmaceuticals from many sources, a need is growing to quickly and efficiently analyze substances in terms of the consistency and accuracy of their chemical composition. Differences in chemical composition occur at very low concentrations, so that highly sensitive analytical methods become crucial. Recent progress in dispersive spectroscopy with the use of 2-dimensional detector arrays, permits for signal integration along a long (up to 12 mm long) entrance slit of a spectrometer, thereby increasing signal to noise ratio and improving the ability to detect small concentration changes. This is achieved with a non-scanning, non-destructive system. Two different methods using P&P Optica high performance spectrometers were used. High performance optical dispersion Raman and high performance optical absorption spectroscopy were employed to differentiate various acetaminophen-containing drugs, such as Tylenol and other generic brands, which differ in their ingredients. A 785 nm excitation wavelength was used in Raman measurements and strong Raman signals were observed in the spectral range 300-1800 cm-1. Measurements with the absorption spectrometer were performed in the wavelength range 620-1020 nm. Both Raman and absorption techniques used transmission light spectrometers with volume phase holographic gratings and provided sufficient spectral differences, often structural, allowing for drug differentiation.

Viruses and Multiple Sclerosis

PubMed Central

Owens, Gregory P.; Gilden, Don; Burgoon, Mark P.; Yu, Xiaoli; Bennett, Jeffrey L.

2012-01-01

Multiple sclerosis (MS) is a chronic demyelinating disorder of unknown etiology, possibly caused by a virus or virus-triggered immunopathology. The virus might reactivate after years of latency and lyse oligodendrocytes, as in progressive multifocal leukoencephalopathy, or initiate immunopathological demyelination, as in animals infected with Theiler’s murine encephalomyelitis virus or coronaviruses. The argument for a viral cause of MS is supported by epidemiological analyses and studies of MS in identical twins, indicating that disease is acquired. However, the most important evidence is the presence of bands of oligoclonal IgG (OCBs) in MS brain and CSF that persist throughout the lifetime of the patient. OCBs are found almost exclusively in infectious CNS disorders, and antigenic targets of OCBs represent the agent that causes disease. Here, the authors review past attempts to identify an infectious agent in MS brain cells and discuss the promise of using recombinant antibodies generated from clonally expanded plasma cells in brain and CSF to identify disease-relevant antigens. They show how this strategy has been used successfully to analyze antigen specificity in subacute sclerosing panencephalitis, a chronic encephalitis caused by measles virus, and in neuromyelitis optica, a chronic autoimmune demyelinating disease produced by antibodies directed against the aquaporin-4 water channel. PMID:22130640

Spirituality and Cultural Identification Among Latino and Non-Latino College Students

PubMed Central

Campesino, Maureen; Belyea, Michael; Schwartz, Gary

2010-01-01

no Latinos en ambas medidas de perspectivas espirituales. Medidas de comportamiento auto-reportadas, como la frecuencia de oración, también estuvieron más altas en el grupo Latino. La identificación con la cultura Latina fue el único vaticinador de las calificaciones de la EPEL. Los resultados de este estudio indican que la espiritualidad entre Latinos tiene significados específicos al contexto del grupo cultural. Estas conclusiones tienen implicaciones para las investigaciones de enfermería que involucran la conceptualización y medida de la espiritualidad entre grupos multiétnicos. PMID:20165566

Spirituality and Cultural Identification Among Latino and Non-Latino College Students.

PubMed

Campesino, Maureen; Belyea, Michael; Schwartz, Gary

2009-01-01

Latinos en ambas medidas de perspectivas espirituales. Medidas de comportamiento auto-reportadas, como la frecuencia de oración, también estuvieron más altas en el grupo Latino. La identificación con la cultura Latina fue el único vaticinador de las calificaciones de la EPEL. Los resultados de este estudio indican que la espiritualidad entre Latinos tiene significados específicos al contexto del grupo cultural. Estas conclusiones tienen implicaciones para las investigaciones de enfermería que involucran la conceptualización y medida de la espiritualidad entre grupos multiétnicos.

Intensive care unit team perception of palliative care: the discourse of the collective subject.

PubMed

Gulini, Juliana El Hage Meyer de Barros; Nascimento, Eliane Regina Pereira do; Moritz, Rachel Duarte; Rosa, Luciana Martins da; Silveira, Natyele Rippel; Vargas, Mara Ambrosina de Oliveira

2017-05-25

To learn the perception of health professionals in an intensive care unit towards palliative care. This was a descriptive and qualitative study based on the converging care approach conducted at an intensive care unit in the South of Brazil. Semi-structured interviews were used to investigate the understanding of the professionals about palliative care in this unit. The data were organized and analyzed using the discourse of the collective subject method with the help of Qualiquantisoft® software. Participants included 37 professionals (12 nurses, 11nursing technicians, 5 physical therapists and 9 doctors). The key ideas extracted from the interviews were: care in the end stage of life that avoids futile measures; comfort care; lack of standardized care and lack of team training. The professionals perceived palliative care as appropriate in the last stages of life, with no need for futile treatment or as comfort measures. However, they are aware of the lack of standardization and lack of capacity building in this area, which leads them to conceive palliative care as terminal care, and measures are recommended to break with this stigma. Conhecer a percepção dos profissionais de saúde de uma Unidade de Terapia Intensiva acerca do cuidado paliativo. Pesquisa descritiva, qualitativa do tipo Convergente Assistencial realizada em uma Unidade de Terapia Intensiva da região sul do Brasil. Utilizou-se de entrevista semiestruturada que investigou o entendimento e a compreensão sobre cuidado paliativo nesta unidade. Os dados foram organizados e analisados pela técnica do discurso do sujeito coletivo com auxílio do software Qualiquantisoft®. Participaram do estudo 37 profissionais (12 enfermeiros, 11 técnicos de enfermagem, cinco fisioterapeutas e nove médicos). As ideias centrais extraídas dos relatos: cuidado na fase terminal da vida sem medidas fúteis; cuidados de conforto; falta uniformizar a assistência e falta capacitação para a equipe. Os profissionais

Design and Implementation of A DICOM PACS With Secure Access Via Internet

DTIC Science & Technology

2001-10-25

which we have called SINFIM ( Sistema de INFormación de Imágenes Médicas). This system permits the automatic acquisition of DICOM images [2] [3...1] MA. Martínez, AJR. Jiménez, BV. Medina, LJ. Azpiroz. “Los Sistemas PACS”. [Last access 08/12/2000]. Available URL http://itzamna.uam.mx...junio, por el que se aprueba el Reglamento de medidas de seguridad de los ficheros automatizados que contengan datos de carácter personal” (Boletín Oficial del Estado, número 151, de 25 de junio de 1999)

Management of disease-modifying treatments in neurological autoimmune diseases of the central nervous system.

PubMed

Salmen, A; Gold, R; Chan, A

2014-05-01

The therapeutic armamentarium for autoimmune diseases of the central nervous system, specifically multiple sclerosis and neuromyelitis optica, is steadily increasing, with a large spectrum of immunomodulatory and immunosuppressive agents targeting different mechanisms of the immune system. However, increasingly efficacious treatment options also entail higher potential for severe adverse drug reactions. Especially in cases failing first-line treatment, thorough evaluation of the risk-benefit profile of treatment alternatives is necessary. This argues for the need of algorithms to identify patients more likely to benefit from a specific treatment. Moreover, paradigms to stratify the risk for severe adverse drug reactions need to be established. In addition to clinical/paraclinical measures, biomarkers may aid in individualized risk-benefit assessment. A recent example is the routine testing for anti-John Cunningham virus antibodies in natalizumab-treated multiple sclerosis patients to assess the risk for the development of progressive multi-focal leucoencephalopathy. Refined algorithms for individualized risk assessment may also facilitate early initiation of induction treatment schemes in patient groups with high disease activity rather than classical escalation concepts. In this review, we will discuss approaches for individiualized risk-benefit assessment both for newly introduced agents as well as medications with established side-effect profiles. In addition to clinical parameters, we will also focus on biomarkers that may assist in patient selection. © 2013 British Society for Immunology.

Demyelinating diseases in Asia.

PubMed

Ochi, Hirofumi; Fujihara, Kazuo

2016-06-01

The present review aims to discuss the recent advances in inflammatory demyelinating diseases of the central nervous system in Asia. Prevalence of multiple sclerosis (MS) in Asia is lower than that in Western countries, although it has been increasing recently. Meanwhile, there seems to be no major difference in neuromyelitis optica (NMO) prevalence in various regions or ethnicities. Thus, the ratios of NMO/NMO spectrum disorder (NMOSD) to MS are higher in Asia as compared with Western countries, indicating that the differential diagnosis between NMO/NMOSD and MS is a major challenge in Asia. Although the detection of aquaporin-4 (AQP4)-antibody is critical in distinguishing NMO/NMOSD from MS, some patients with NMO/NMOSD phenotype are seronegative for AQP4-antibody, and a fraction of those patients possess autoantibody against myelin oligodendrocyte glycoprotein. The clinical profile of Asian MS seems to be essentially similar to that in Western MS after careful exclusion of NMO/NMOSD, although some unique genetic and/or environmental factors may modify the disease in Asians. MS prevalence has been low but is increasing in Asia. In contrast, NMO/NMOSD prevalence seems relatively constant in the world. Asian MS is not fundamentally different from Western MS, but some genetic and/or environmental differences may cause some features unique to Asian patients.

[Pathomechanism of Autoantibody Production in the Nervous System Diseases].

PubMed

Shimizu, Fumitaka; Kanda, Takashi

2018-04-01

Antibodies to different brain and peripheral nerve proteins have recently been found to be associated with several different autoimmune diseases. They can bind to either neuronal or non-neuronal antigens and may have a pathogenic role by themselves or in synergy with other inflammatory mediators after penetrating the blood-brain barrier or the blood-nerve barrier. In this review, we will describe the association with the impairment of immune tolerance, innate immunity, and autoantibody production of myasthenia gravis (MG), systemic lupus erythematosus (SLE), and Guillain-Barré syndrome (GBS). Impairment of central tolerance, which is characterized by the repertoire selection of immature T-lymphocytes in the thymus, is seen in patients with MG who are positive for anti-Ach R antibodies. Impairment of peripheral tolerance due to activation of autoreactive T-cells and suppression of regulatory T-cells is seen in SLE. In addition, molecular mimicry between the lipooligosaccharides of Campylobacter jejuni and gangliosides of the peripheral nerves results in the production of anti-gangliosides antibodies in GBS. Next, we will describe the antibody-mediated pathology in neuromyelitis optica and anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. The binding of anti-aquaporin-4 antibodies or anti-NMDAR antibodies to their respective targets initiates target internalization and complement- or antibody-dependent cellular cytotoxicity of the target cells. Further understanding of antibody-mediated pathology may suggest novel therapeutic strategies.

Enhanced accumulation of Kir4.1 protein, but not mRNA, in a murine model of cuprizone-induced demyelination.

PubMed

Nakajima, Mitsunari; Kawamura, Takuya; Tokui, Ryuji; Furuta, Kohei; Sugino, Mami; Nakanishi, Masayuki; Okuyama, Satoshi; Furukawa, Yoshiko

2013-11-06

Two channel proteins, inwardly rectifying potassium channel 4.1 (Kir4.1) and water channel aquaporin-4 (AQP4), were recently identified as targets of an autoantibody response in patients with multiple sclerosis and neuromyelitis optica, respectively. In the present study, we examined the expression patterns of Kir4.1 and AQP4 in a mouse model of demyelination induced by cuprizone, a copper chelator. Demyelination was confirmed by immunohistochemistry using an anti-proteolipid protein antibody in various brain regions, including the corpus callosum, of cuprizone-fed mice. Activation of microglial and astroglial cells was also confirmed by immunohistochemistry, using an anti-ionized calcium binding adapter molecule and a glial fibrillary acidic protein antibody. Western blot analysis revealed the induction of Kir4.1 protein, but not AQP4, in the cortex of cuprizone-fed mice. Immunohistochemical analysis confirmed the Kir4.1 protein induction in microvessels of the cerebral cortex. Real-time polymerase chain reaction analysis revealed that mRNA levels of Kir4.1 and AQP4 in the cortex did not change during cuprizone administration. These findings suggest that enhanced accumulation of Kir4.1 protein in the brain with an inflammatory condition facilitates the autoantibody formation against Kir4.1 in patients with multiple sclerosis. © 2013 Published by Elsevier B.V.

An undergraduate program for astronomy in México

NASA Astrophysics Data System (ADS)

Bravo-Alfaro, Hector; Migenes, Victor

Astronomy in Mexico has an ancient tradition, reinforced during the XXth century by groups working in theoretical and observational astronomy. During the 90s, the Great Millimeter Telescope (a single 50-m antenna) has been approved, and a 6-m infrared telescope is under study. Graduate and undergraduate programs must be improved to prepare future Mexican and Latin American astronomers to take advantage of these facilities. To meet the challenge, two traditional Mexican programs (Instituto de Astronomia-UNAM and Instituto Nacional de Astrofisica, Optica y Electronica-INAOE) are updating their graduate programs for. Similarly, the Departamento de Astronomia de la Universidad de Guanajuato is joining physicists in the first undergraduate program in Mexico in Physics and Engineering with an option in Astrophysics. This will prepare students so that they can choose between industry, academia or national laboratories, either in Physics or Astronomy. Jobs in academia have been scarce; many students had to give up their goals after one or two postdoctoral positions. Graduate and undergraduate programs must adjust, by broadening the scope of present programs so that students are better prepared for other job opportunities. We present a BSc program designed by astronomers and physicists to try to address some of these concerns and prepare the students for either continuing with graduate studies or finding employment in an ever-changing job market.

Espectroscopia multi-objeto e imageamento de Abell 586 com GMOS - o estado dinâmico de um aglomerado de galáxias com arcos gravitacionais

NASA Astrophysics Data System (ADS)

Cypriano, E. S.; Sodré, L., Jr.; Kneib, J.-P.; Campusano, L.

2003-08-01

Nesse trabalho é apresentado um estudo do conteúdo de massa do aglomerado de galáxias A586 (z = 0.171) bem como sua distribuição espacial. Isso foi feito a partir de dados de espectroscopia multi-objeto e imageamento obtidos com o instrumento GMOS acoplado ao telescópio Gemini-Norte. A massa desse aglomerado foi estudada a partir da posição dos seus arcos gravitacionais (lentes fortes), da medida estatística da distorção na forma das galáxias de fundo (lentes fracas) e através da dispersão de velocidades de uma amostra de cerca de 30 galáxias pertencentes ao aglomerado (teorema do virial). Os dois primeiros métodos não dependem do estado dinâmico do aglomerado, enquanto que o terceiro sim. Desse modo, comparando seus resultados pode-se estimar o grau de relaxamento desse sistema. Dados de raios X presentes na literatura também serão incluídos nessa análise. Nossos resultados preliminares a partir das técnicas de lentes fracas, mostram que, supondo que a distribuição de massa desse aglomerado seja a de uma esfera isotérmica, espera-se que ele apresente uma dispersão de velocidades de 1330+/-78 km s-1, em contradicao com medidas similares feitas por Dahle et al. 2002 que encontram valores tão altos quanto 1680 km s-1. Já o estudo dinâmico resultou numa dispersão de velocidades de ~950 km s-1.

Fotometria WHBY |o lll|/HB de Regiones H 11 Y la HISTORIA de la Formacion ESTELAR Reciente EN la PEQUENA NUBE de Magallanes

NASA Astrophysics Data System (ADS)

Copetti, M. V. F.; Dottori, H. A.

1987-05-01

El ancho equivalente WHβ de la linea de Hβ en emisión y la razón [0 III]/Hβ del par λλ4959, 50 7 A del [0111], fueron medidos en 23 regiones HII de la Peque˜a Nube de Magallanes, por medio de la fotometría fotoeléctrica a través de un sistema de tres filtros interferenciales: dos Hβ , con bandas pasantes de 100 y 30 A, y un [0111] centrado en 5000 A y con banda pasante de 50 A. Las observaciones fueron realizadas con los telescopios de 1.60-m y 0.60-m del Laboratorio Nacional de Astrofísica, Brasópolis, Brasil. Fueron escogidos diafragmas suficientemente grandes para captar la radiación integrada de cada región HII. Las medidas fueron calibradas por comparación a un conjunto de nebulosas planetarias con flujos absolutos bien definidos. A través de la comparación entre los datos observacionales y modelos evolutivos de WHβ y [0 III] /Hβ (Copetti et al.1986', Astr. and Ap., 156, 111), las edades de las regiones HIl fueron estimadas. Basada en la distribución espacial de las edades de regiones HIl, la historia de la formación estelar reciente en la Pequeña Nube de Magallanes es analizada. La similitud de las medidas de WH&beta y [OIII]/WHβ entre las regiones H II observadas sugiere que hubo una explosión de formación estelar a 4±1 x106 años en la Pequeña Nube de Magallanes. (Parcialmente financiado por CNPq).

Baseline demographics, clinical features, and treatment protocols of 240 patients with optic neuropathy: experiences from a neuro-ophthalmological clinic in the Aegean region of Turkey.

PubMed

Karti, Omer; Karti, Dilek Top; Kilic, İlay Hilal; Gokcay, Figen; Celebisoy, Nese

2017-12-19

To analyze the demographic patterns, clinical characteristics, and treatment protocols of optic neuropathies. The hospital data of patients with optic neuropathy admitted to the Department of Neuro-ophthalmology in a tertiary referral center in Turkey between January 2010 to January 2017 were retrospectively analyzed. Demographic patterns, clinical features, treatment protocols, and the natural disease courses were assessed. The total number of patients with optic neuropathy seen over this period was 240, which consist of 43 with idiopathic optic neuritis (17.9%), 40 with multiple sclerosis-related optic neuritis (16.7%), 12 with chronic relapsing inflammatory optic neuritis (5.0%), 12 with atypical optic neuritis (5.0%), 11 with neuromyelitis optica spectrum disorders-related optic neuritis (4.6%), 90 with non-arteritic ischemic optic neuropathy (37.5%), 4 with arteritic ischemic optic neuropathy (1.7%), 10 with traumatic optic neuropathy (4.1%), 6 with compressive optic neuropathy (2.5%), and 12 with mitochondrial optic neuropathy [9 with toxic optic neuropathy (3.7%) and 3 with Leber's hereditary optic neuropathy (1.2%)]. There were 101 males (42%) and 139 females (58%). The mean age was 43.34 ± 15.86 years. This study reported the demographics, clinical characteristics, and treatment protocols of optic neuropathies in a neuro-ophthalmology specialty clinic at a tertiary referral center in Turkey during the past decade. The data may be useful in assessing the global status of optic neuropathies.

The binding property of a monoclonal antibody against the extracellular domains of aquaporin-4 directs aquaporin-4 toward endocytosis.

PubMed

Huang, Ping; Takai, Yoshiki; Kusano-Arai, Osamu; Ramadhanti, Julia; Iwanari, Hiroko; Miyauchi, Takayuki; Sakihama, Toshiko; Han, Jing-Yan; Aoki, Masashi; Hamakubo, Takao; Fujihara, Kazuo; Yasui, Masato; Abe, Yoichiro

2016-09-01

Neuromyelitis optica (NMO), an autoimmune disease of the central nervous system, is characterized by an autoantibody called NMO-IgG that recognizes the extracellular domains (ECDs) of aquaporin-4 (AQP4). In this study, monoclonal antibodies (mAbs) against the ECDs of mouse AQP4 were established by a baculovirus display method. Two types of mAb were obtained: one (E5415A) recognized both M1 and M23 isoforms, and the other (E5415B) almost exclusively recognized the square-array-formable M23 isoform. While E5415A enhanced endocytosis of both M1 and M23, followed by degradation in cells expressing AQP4, including astrocytes, E5415B did so to a much lesser degree, as determined by live imaging using fluorescence-labeled antibodies and by Western blotting of lysate of cells treated with these mAbs. E5415A promoted cluster formation of AQP4 on the cell surface prior to endocytosis as determined by immunofluorescent microscopic observation of bound mAbs to astrocytes as well as by Blue native PAGE analysis of AQP4 in the cells treated with the mAbs. These observations clearly indicate that an anti-AQP4-ECDs antibody possessing an ability to form a large cluster of AQP4 by cross-linking two or more tetramers outside the AQP4 arrays enhances endocytosis and the subsequent lysosomal degradation of AQP4.

Surface characterization protocol for precision aspheric optics

NASA Astrophysics Data System (ADS)

Sarepaka, RamaGopal V.; Sakthibalan, Siva; Doodala, Somaiah; Panwar, Rakesh S.; Kotaria, Rajendra

2017-10-01

In Advanced Optical Instrumentation, Aspherics provide an effective performance alternative. The aspheric fabrication and surface metrology, followed by aspheric design are complementary iterative processes for Precision Aspheric development. As in fabrication, a holistic approach of aspheric surface characterization is adopted to evaluate actual surface error and to aim at the deliverance of aspheric optics with desired surface quality. Precision optical surfaces are characterized by profilometry or by interferometry. Aspheric profiles are characterized by contact profilometers, through linear surface scans to analyze their Form, Figure and Finish errors. One must ensure that, the surface characterization procedure does not add to the resident profile errors (generated during the aspheric surface fabrication). This presentation examines the errors introduced post-surface generation and during profilometry of aspheric profiles. This effort is to identify sources of errors and is to optimize the metrology process. The sources of error during profilometry may be due to: profilometer settings, work-piece placement on the profilometer stage, selection of zenith/nadir points of aspheric profiles, metrology protocols, clear aperture - diameter analysis, computational limitations of the profiler and the software issues etc. At OPTICA, a PGI 1200 FTS contact profilometer (Taylor-Hobson make) is used for this study. Precision Optics of various profiles are studied, with due attention to possible sources of errors during characterization, with multi-directional scan approach for uniformity and repeatability of error estimation. This study provides an insight of aspheric surface characterization and helps in optimal aspheric surface production methodology.

Evaluation of idiopathic transverse myelitis revealing specific myelopathy diagnoses.

PubMed

Zalewski, Nicholas L; Flanagan, Eoin P; Keegan, B Mark

2018-01-09

To evaluate specific myelopathy diagnoses made in patients with suspected idiopathic transverse myelitis (ITM). A total of 226 patients 18 years and older were referred to Mayo Clinic Neurology for suspected ITM from December 1, 2010, to December 31, 2015. Electronic medical records were reviewed for detailed clinical presentation and course, laboratory and electrophysiologic investigations, and neuroimaging to determine the etiology. Current diagnostic criteria for ITM and alternative myelopathy diagnoses were applied. All cases where any discrepancy was suspected from the final reported clinical diagnosis were reviewed by each author and a consensus final diagnosis was made. The diagnostic criteria for ITM were met in 41 of 226 patients (18.1%). In 158 patients (69.9%), an alternative specific myelopathy diagnosis was made: multiple sclerosis or clinically isolated syndrome, 75; vascular myelopathy, 41; neurosarcoidosis, 12; neuromyelitis optica spectrum disorder, 12; myelin oligodendrocyte glycoprotein myelopathy, 5; neoplastic, 4; compressive, 3; nutritional, 3; infectious, 2; and other, 2. A myelopathy was not confirmed in 27 patients. Time from symptom onset to final clinical diagnosis in patients without ITM was a median of 9 months (range 0-288). Fifty-five patients (24%) required treatment changes according to their final clinical diagnosis. The majority of patients with suspected ITM have an alternative specific myelopathy diagnosis. A presumptive diagnosis of ITM can lead to premature diagnostic conclusions affecting patient treatment. Copyright © 2017 American Academy of Neurology.

Weathering resistance of thin plasma polymer films on pre-coated steel =

NASA Astrophysics Data System (ADS)

Serra, Ricardo Gil Henriques

O trabalho apresentado teve origem no projecto de investigacao “Tailored Thin Plasma Polymers Films for Surface Engineering of Coil Coated Steel”, financiado pelo Programa Europeu ECSC Steel Research. Sistemas de aco galvanizado pre-pintado em banda a base de poliester e poliuretano foram submetidos a um processo de polimerizacao por plasma onde um filme fino foi depositado de modo a modificar as propriedades de superficie. Foram usados reactores de catodo oco, microondas e radio frequencia para a deposicao do polimero fino. Os sistemas preparados foram analisados de modo a verificar a influencia do processo de polimerizacao por plasma na alteracao das propriedades barreira dos sistemas pre-pintados em banda. Foi estudado o efeito dos diferentes passos do processo de polimerizacao por plasma, bem como o efeito de diferentes variaveis operatorias. A mistura precursora foi variada de modo a modificar as propriedades da superficie de modo a poder vir a obter maior hidrofobicidade, maior resistencia a marcas digitais, bem como maior facilidade de limpeza. Os testes foram conduzidos em solucao de NaCl 0,5 M. Para o trabalho foram usadas tecnicas de analise da morfologia da superficie como Microscopia de Forca Atomica e Microscopia Electronica de Varrimento. As propriedades electroquimicas dos sistemas foram estudadas por Espectroscopia de Impedancia Electroquimica. A estrutura dos filmes gerados no processo de polimerizacao por plasma foi caracterizada por Microscopia de Transmissao Electronica. A modificacao das propriedades opticas devido ao processo de polimerizacao por plasma foi tambem obtida.

Clinical characteristics of optic neuritis in Hong Kong population: 10-year review.

PubMed

Choy, Bonnie Nga Kwan; Ng, Alex Lap Ki; Lai, Jimmy Shiu Ming

2018-04-01

To review the clinical course of adult patients with acute optic neuritis over 10 years in Hong Kong, and the results were compared with other studies among Asian and Caucasian patients. This study retrospectively analysed the clinical features of 38 adult patients (51 eyes) presented with optic neuritis in a Hong Kong hospital over 10 years (2001-2010). Optic neuritis had a female predominance (68%). The mean age of presentation was 40 years old. Disc swelling (39%) was more common compared to the optic neuritis treatment trial (ONTT). The recovery time ranged from no recovery to 5 years, with a mean of 6.0 months. However, vision continued to deteriorate despite initial improvement in 45% of patients. Only 11.8% of the eyes attained final visual acuity (VA) of 1.0 or better, while 31.4% had VA 0.1 or worse. Multiple sclerosis or neuromyelitis optica only occurred in 10.4% of patients. Three of our patients who did not receive any treatment showed faster recovery than the average. Optic neuritis in Hong Kong is mostly a clinically isolated syndrome. Our patients presented at a later age and showed a worse visual outcome. Corticosteroid according to ONTT protocol remained our mainstay of treatment although it did not benefit our patients as much as ONTT study. More work on the long-term prognosis and treatment strategies is worthwhile among Chinese optic neuritis patients.

Speckle correlation resolution enhancement of wide-field fluorescence imaging (Conference Presentation)

NASA Astrophysics Data System (ADS)

Yilmaz, Hasan

2016-03-01

Structured illumination enables high-resolution fluorescence imaging of nanostructures [1]. We demonstrate a new high-resolution fluorescence imaging method that uses a scattering layer with a high-index substrate as a solid immersion lens [2]. Random scattering of coherent light enables a speckle pattern with a very fine structure that illuminates the fluorescent nanospheres on the back surface of the high-index substrate. The speckle pattern is raster-scanned over the fluorescent nanospheres using a speckle correlation effect known as the optical memory effect. A series of standard-resolution fluorescence images per each speckle pattern displacement are recorded by an electron-multiplying CCD camera using a commercial microscope objective. We have developed a new phase-retrieval algorithm to reconstruct a high-resolution, wide-field image from several standard-resolution wide-field images. We have introduced phase information of Fourier components of standard-resolution images as a new constraint in our algorithm which discards ambiguities therefore ensures convergence to a unique solution. We demonstrate two-dimensional fluorescence images of a collection of nanospheres with a deconvolved Abbe resolution of 116 nm and a field of view of 10 µm × 10 µm. Our method is robust against optical aberrations and stage drifts, therefore excellent for imaging nanostructures under ambient conditions. [1] M. G. L. Gustafsson, J. Microsc. 198, 82-87 (2000). [2] H. Yilmaz, E. G. van Putten, J. Bertolotti, A. Lagendijk, W. L. Vos, and A. P. Mosk, Optica 2, 424-429 (2015).

Measurement of soluble CD59 in CSF in demyelinating disease: Evidence for an intrathecal source of soluble CD59.

PubMed

Zelek, Wioleta M; Watkins, Lewis M; Howell, Owain W; Evans, Rhian; Loveless, Sam; Robertson, Neil P; Beenes, Marijke; Willems, Loek; Brandwijk, Ricardo; Morgan, B Paul

2018-02-01

CD59, a broadly expressed glycosylphosphatidylinositol-anchored protein, is the principal cell inhibitor of complement membrane attack on cells. In the demyelinating disorders, multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD), elevated complement protein levels, including soluble CD59 (sCD59), were reported in cerebrospinal fluid (CSF). We compared sCD59 levels in CSF and matched plasma in controls and patients with MS, NMOSD and clinically isolated syndrome (CIS) and investigated the source of CSF sCD59 and whether it was microparticle associated. sCD59 was quantified using enzyme-linked immunosorbent assay (ELISA; Hycult; HK374-02). Patient and control CSF was subjected to western blotting to characterise anti-CD59-reactive materials. CD59 was localised by immunostaining and in situ hybridisation. CSF sCD59 levels were double those in plasma (CSF, 30.2 ng/mL; plasma, 16.3 ng/mL). Plasma but not CSF sCD59 levels differentiated MS from NMOSD, MS from CIS and NMOSD/CIS from controls. Elimination of microparticles confirmed that CSF sCD59 was not membrane anchored. CSF levels of sCD59 are not a biomarker of demyelinating diseases. High levels of sCD59 in CSF relative to plasma suggest an intrathecal source; CD59 expression in brain parenchyma was low, but expression was strong on choroid plexus (CP) epithelium, immediately adjacent the CSF, suggesting that this is the likely source.

Different patterns of longitudinal brain and spinal cord changes and their associations with disability progression in NMO and MS.

PubMed

Liu, Yaou; Duan, Yunyun; Huang, Jing; Ren, Zhuoqiong; Liu, Zheng; Dong, Huiqing; Weiler, Florian; Hahn, Horst K; Shi, Fu-Dong; Butzkueven, Helmut; Barkhof, Frederik; Li, Kuncheng

2018-01-01

To investigate the longitudinal spinal cord and brain changes in neuromyelitis optica (NMO) and multiple sclerosis (MS) and their associations with disability progression. We recruited 28 NMO, 22 MS, and 20 healthy controls (HC), who underwent both spinal cord and brain MRI at baseline. Twenty-five NMO and 20 MS completed 1-year follow-up. Baseline spinal cord and brain lesion loads, mean upper cervical cord area (MUCCA), brain, and thalamus volume and their changes during a 1-year follow-up were measured and compared between groups. All the measurements were also compared between progressive and non-progressive groups in NMO and MS. MUCCA decreased significantly during the 1-year follow-up in NMO not in MS. Percentage brain volume changes (PBVC) and thalamus volume changes in MS were significantly higher than NMO. MUCCA changes were significantly different between progressive and non-progressive groups in NMO, while baseline brain lesion volume and PBVC were associated with disability progression in MS. MUCCA changes during 1-year follow-up showed association with clinical disability in NMO. Spinal cord atrophy changes were associated with disability progression in NMO, while baseline brain lesion load and whole brain atrophy changes were related to disability progression in MS. • Spinal cord atrophy progression was observed in NMO. • Spinal cord atrophy changes were associated with disability progression in NMO. • Brain lesion and atrophy were related to disability progression in MS.

Segmentation of microcystic macular edema in Cirrus OCT scans with an exploratory longitudinal study

NASA Astrophysics Data System (ADS)

Swingle, Emily K.; Lang, Andrew; Carass, Aaron; Al-Louzi, Omar; Saidha, Shiv; Prince, Jerry L.; Calabresi, Peter A.

2015-03-01

Microcystic macular edema (MME) is a term used to describe pseudocystic spaces in the inner nuclear layer (INL) of the human retina. It has been noted in multiple sclerosis (MS) as well as a variety of other diseases. The processes that lead to MME formation and their change over time have yet to be explained sufficiently. The low rate at which MME occurs within such diverse patient groups makes the identification and consistent quantification of this pathology important for developing patient-specific prognoses. MME is observed in optical coherence tomography (OCT) scans of the retina as changes in light reflectivity in a pattern suggestive of fluid accumulations called pseudocysts. Pseudocysts can be readily identified in higher signal-to-noise ratio (SNR) images, however pseudocysts can be indistinguishable from noise in lower SNR scans. In this work, we expand upon our earlier MME identification methods on Spectralis OCT scans to handle lower quality Cirrus OCT scans. Our approach uses a random forest classifier, trained on manual segmentation of ten subjects, to automatically detect MME. The algorithm has a true positive rate for MME identification of 0.95 and a Dice score of 0.79. We include a preliminary longitudinal study of three patients over four to five years to explore the longitudinal changes of MME. The patients with relapsing-remitting MS and neuromyelitis optica appear to have dynamic pseudocyst volumes, while the MME volume appears stable in the one patient with primary progressive MS.

A case of MOG antibody-positive bilateral optic neuritis and meningoganglionitis following a genital herpes simplex virus infection.

PubMed

Nakamura, Masataka; Iwasaki, Yuko; Takahashi, Toshiyuki; Kaneko, Kimihiko; Nakashima, Ichiro; Kunieda, Takenobu; Kaneko, Satoshi; Kusaka, Hirofumi

2017-10-01

Myelin oligodendrocyte glycoprotein (MOG) antibody-positive optic neuritis (ON) and myelitis are recognized as important differential diagnosis of aquaporin-4 (AQP4) antibody-positive neuromyelitis optica (NMO)/NMO spectrum disorder (NMOSD). Similar to NMO/NMOSD associated with AQP4 antibodies, preceding infections have been reported in patients with MOG antibody-positive ON. This is the first report of bilateral ON following a herpes simplex virus (HSV) infection associated with a positive MOG antibody. A 41-year-old man who initially presented with genital herpes developed allodynia in the Th2-Th5 and Th8-L2 areas, urinary retention, and painful visual loss in the left eye. Ophthalmological evaluation and brain magnetic resonance imaging (MRI) revealed bilateral ON. A spinal MRI showed leptomeningeal enhancement from the thoracic to lumbar vertebrae and abnormal enhancement of the L3 to S3 dorsal root ganglia without a change in intramedullary signals. Following treatment with acyclovir and steroid pulse, he fully recovered. Serum anti-AQP4 antibodies were negative, but anti-MOG antibodies were positive. Finally, he was diagnosed with MOG antibody-positive bilateral ON and meningoganglionitis following an HSV infection. Our case supports a relationship between anti-MOG antibodies and ON triggered by an HSV infection. Clinicians should thus consider testing for MOG antibodies in patients with post-infectious neurological symptoms due to an HSV infection. Copyright © 2017 Elsevier B.V. All rights reserved.

A nationwide survey of pediatric acquired demyelinating syndromes in Japan

PubMed Central

Yamaguchi, Y.; Kira, R.; Ishizaki, Y.; Sakai, Y.; Sanefuji, M.; Ichiyama, T.; Oka, A.; Kishi, T.; Kimura, S.; Kubota, M.; Takanashi, J.; Takahashi, Y.; Tamai, H.; Natsume, J.; Hamano, S.; Hirabayashi, S.; Maegaki, Y.; Mizuguchi, M.; Minagawa, K.; Yoshikawa, H.; Kira, J.; Kusunoki, S.; Hara, T.

2016-01-01

Objective: To investigate the clinical and epidemiologic features of pediatric acquired demyelinating syndromes (ADS) of the CNS in Japan. Methods: We conducted a nationwide survey and collected clinical data on children with ADS aged 15 years or younger, who visited hospitals between 2005 and 2007. Results: Among 977 hospitals enrolled, 723 (74.0%) responded to our inquiries and reported a total of 439 patients as follows: 244 with acute disseminated encephalomyelitis (ADEM), 117 with multiple sclerosis (MS), 14 with neuromyelitis optica (NMO), and 64 with other ADS. We collected and analyzed detailed data from 204 cases, including those with ADEM (66), MS (58), and NMO (10). We observed the following: (1) the estimated annual incidence rate of pediatric ADEM in Japan was 0.40 per 100,000 children (95% confidence interval [CI], 0.34–0.46), with the lowest prevalence in the north; (2) the estimated prevalence rate of MS was 0.69 per 100,000 children (95% CI, 0.58–0.80), with the lowest prevalence in the south; (3) NMO in Japan was rare, with an estimated prevalence of 0.06 per 100,000 children (95% CI, 0.04–0.08); and (4) the sex ratio and mean age at onset varied by ADS type, and (5) male/female ratios correlated with ages at onset in each ADS group. Conclusions: Our results clarify the characteristic clinical features of pediatric ADS in the Japanese population. PMID:27742816

Microcystic macular oedema in optic neuropathy: case series and literature review.

PubMed

Kessel, Line; Hamann, Steffen; Wegener, Marianne; Tong, Jessica; Fraser, Clare L

2018-05-25

Cavitations in the inner nuclear layer associated with severe optic atrophy and loss of retinal ganglion cells have clinically been termed microcystic macular oedema (MME). We describe a case series of MME in patients of all ages but predominantly younger patients with a wide range of optic atrophies ranging from acute onset optic disc drusen associated ischemic optic neuropathy to slowly progressive disease as glaucoma. There were no physical distinctions between MME in different causes of optic atrophy suggesting a common causative mechanism. We reviewed the literature on MME and it appears that MME is associated with more severe visual loss, and is more common in hereditary optic neuropathies and neuro-myelitis optica spectrum disease rather than in patients with optic atrophy secondary to multiple sclerosis and glaucoma. Three main causative mechanisms have been proposed, including increased vitreal traction on the macular as the ganglion cells are lost. Others have suggested that trans-synaptic loss of cells in the inner nuclear layer causes formation of empty spaces or cavities. Finally, some have hypothesized a disturbance in the fluid homeostasis of the inner retina as Müller cells are lost or their function is impaired. There are no known treatments of MME. In conclusion, MME seems to be a marker of severe optic nerve atrophy irrespective of the underlying cause. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Anatomy of the eye from the view of Ibn Al-Haitham (965-1039). The founder of modern optics.

PubMed

Unal, Nedim; Elcioglu, Omur

2009-03-01

Ibn Al-Haitham (known as Alhazen in Latin [965 Basra, Iraq-1039, Cairo, Egypt]) was a scientist who played an important role in the middle age Islam world. He wrote many books and novels, but only 90 of them are known. His main book Kitab al-Manazir was translated into Western languages in the late twelfth century, and in the early thirteenth century. In this book, he formulated many hypotheses on optical science. The book, which is also known as Optic treasure (opticae thesaurus), affected many famous Western scientists. He became an authority until the seventeenth century in the Eastern and Western countries. Roger Bacon (1212-1294), who made radical changes in the Western optical traditions, reconfirmed Ibn Al-Haitham's findings. Ibn al-Haitham began his book Kitab al-Manazir with the anatomy and physiology of the eye. He specifically described cornea, humor aqueous, lens, and corpus vitreum. He examined the effect of light on seeing. He caused changes in the prevailing ideas of his age, and suggested that light came from objects, not from the eye. He provided information regarding the optic nerve, retina, iris, and conjunctiva. He showed the system of the eye as a dioptric, and the relations between the parts of the eye. It is understood that he mastered all knowledge on the structure of the eye in his century. The best proof of this is the eye picture that he drew.

Victimization, perception of insecurity, and changes in daily routines in Mexico.

PubMed

Ávila, María Elena; Martínez-Ferrer, Belén; Vera, Alejandro; Bahena, Alejandro; Musitu, Gonzalo

2016-10-03

To analyze the relationships between victimization, perception of insecurity, and changes in routines. The 8,170 subjects of both sexes (49.9% women and 50.1% men) aged between 12 and 60 years, selected from a proportional stratified sampling, participated in this study. The measuring instrument was an adaptation of the National Survey on Victimization and Perception of Public Security. Chi-square tests were performed. The results show significant differences on victimization and sex regarding perception of insecurity, restrictions on everyday activities, and protection measures. 13.1% of those interviewed claimed to have been victims of a crime in the past 12 months. 52.7% of women considered their municipality as unsafe or very unsafe. In the case of men, this percentage was 58.2%. Female victims reported significant restrictions in everyday activities when compared to non-victims. In relation to men, the percentage of victims with a high restriction of activities was higher in male victims than non-victims. In the group of victimized women, the segment of women who opted for increased measures of protection against crime was larger than expected, while those of non-victims who took less protective measures was lower than expected. These same results were observed in the group of men. The experience of victimization implies a greater perception of insecurity. However, the climate of insecurity is widespread in a large number of citizens. Gender differences in a high-crime environment show the importance of investigating in depth the roles of both genders in the perception of insecurity and changes in routines. Analizar las relaciones existentes entre victimización, percepción de inseguridad y cambios en las rutinas. Participaron en este estudio 8,170 sujetos de ambos sexos (49.9% mujeres y 50.1% hombres) de entre 12 y 60 años, seleccionados a partir de un muestro estratificado proporcional. El instrumento de medida fue una adaptación de la Encuesta Nacional

Measurement of the area of venous ulcers using two software programs.

PubMed

Eberhardt, Thaís Dresch; Lima, Suzinara Beatriz Soares de; Lopes, Luis Felipe Dias; Borges, Eline de Lima; Weiller, Teresinha Heck; Fonseca, Graziele Gorete Portella da

2016-12-19

as mensurações, existe excelente correlação intraclasse e de concordância entre os softwares, os quais parecem ser mais precisos na mensuração de feridas com área > 10 cm². o uso de ambos os softwares é indicado para a mensuração de úlceras venosas, parecendo ser mais precisos quando utilizados para mensurar feridas com área > 10 cm². comparar la medida del área de úlceras venosas por medio de los softwares AutoCAD(r) e Image Tool. se trata de un estudio de evaluación de reproducibilidad de pruebas, realizado en un ambulatorio de angiología de un hospital universitario. Los datos fueron recolectados de 21 pacientes con úlceras venosas, en el período de marzo a julio de 2015, por medio de formulario de recolección y fotografías de las heridas. Cinco enfermeros (evaluadores) del Grupo de Estudios de Lesiones de Piel del hospital participaron de la investigación. Las heridas fueron medidas en ambos softwares. Los datos fueron analizados por medio de: Coeficiente de correlación intraclase, Coeficiente de correlación de concordancia y Procedimiento de Bland y Altman. La investigación respetó los aspectos éticos de acuerdo con la legislación vigente. los tamaños de las úlceras presentaron gran amplitud, sin embargo, sin diferencia significativa entre las medidas; existe excelente correlación intraclase y de concordancia entre los softwares, los que parecen ser más precisos en medidas de heridas con área > 10 cm². el uso de ambos softwares es indicado para medir úlceras venosas, pareciendo ser más precisos cuando utilizados para medir heridas con área > 10 cm².

Identificação de radiofontes puntiformes presentes na região observada pelo telescópio BEAST

NASA Astrophysics Data System (ADS)

Oliveira, M. S.; Wuensche, C. A.; Leonardi, R.; Tello, C.

2003-08-01

Radiofontes extragalácticas são um dos principais contaminantes nas medidas da Radiação Cósmica de Fundo (RCF) em freqüências abaixo de 200 GHz. O estudo de seu comportamento espectral permite determinar a contribuição destas fontes às anisotropias intrísincas da RCF. Um dos experimentos recentes concebidos para estudar a RCF é o BEAST (Background Emission Anisotropy Scanning Telescope), cujos primeiros resultados foram publicados em fevereiro de 2003. Nos últimos meses, geramos mapas do céu nas freqüências de 30 GHz e 41 GHz, para um total de 648 horas de observação entre julho e outubro de 2002. Identificamos 4 fontes puntiformes extragalácticas na região do céu situada entre 0h < RA < 24 h e +32° < DEC < +42°, com relação S/R > 4,3 e situadas a pelo menos 25° acima do Plano Galáctico. Suas contrapartidas em 5 GHz, segundo o catálogo GB6, são: J1613+3412, J1635+3808, J0927+3902 e J1642+3948. Estas fontes também foram identificadas pelo satélite WMAP sendo que três coincidem com as observadas pelo BEAST dentro da incerteza do feixe do telescópio e a quarta encontra-se bastante próxima (J1613+3412), embora não seja coincidente. As estimativas preliminares de fluxos obtidas para esses objetos são, respectivamente, 0,51; 0,97; 1,08 e 1,6 Jy em 41 GHz. Usando estes resultados e medidas de fluxos em outras frequências existentes na literatura, apresentamos uma estimativa dos índices espectrais destes objetos no intervalo de frequências entre 4,85 GHz e 41 GHz.

Extensión del Formalismo de Orbitales de Defecto Cuántico al tratamiento del efecto Stark (SQDO).

NASA Astrophysics Data System (ADS)

Menéndez, J. M.; Martín, I.; Velasco, A. M.

El estudio experimental de las interacciones de átomos Rydberg altamente excitados con campos eléctricos ha experimentado un creciente interés durante las dos últimas décadas debido, en gran medida, al desarrollo de nuevas técnicas para crear y estudiar átomos Rydberg en el laboratorio. Acompañando a estas nuevas técnicas experimentales, es necesario el desarrollo de modelos teóricos que nos permitan contrastar sus medidas y conocer mejor los fundamentos de los mismos. Desde el punto de vista teórico el conocimiento del desdoblamiento de los niveles energéticos de un átomo en función de la magnitud del campo eléctrico aplicado (lo que se conoce como mapa Stark) es el mejor punto de partida para la descripción del sistema y un prerrequisito fundamental para el cálculo de distintas propiedades atómicas en presencia del campo eléctrico tales como intensidades de transición, umbrales de ionización de campo eléctrico, tiempos de vida, posición y anchura de cruces evitados, etc. En este trabajo presentamos la adaptación del método de orbitales de defecto cuántico [1,2,3] al tratamiento del efecto Stark (SQDO) [4] y su aplicación al cálculo de los desdoblamientos energéticos y fuerzas de oscilador de estados Rydberg en los átomos de Li, Na y K. El propósito de este estudio es, por un lado, desarrollar métodos fiables para la determinación de propiedades atómicas en presencia de campos eléctricos y, por otro, mostrar la fiabilidad de las funciones de onda QDO en la descripción del efecto Stark en sistemas atómicos.

PubMed

Prieto Bohórquez, Signed Esperanza; Rodríguez Velásquez, Javier Oswaldo; Correa Herrera, Catalina; Pardo Oviedo, Juan Mauricio; Ardila, Javier

2018-03-23

Introducción: una ley exponencial se ha hallado para los sistemas dinámicos caóticos cardiacos, logrando cuantificar las diferencias entre dinámicas cardiacas normales y  patológicas.Metodología: Se analizaron 120 registros electrocardiográficos, 40 correspondían a sujetos dentro de los límites de normalidad y 80 con diferentes patologías. Para cada holter se analizaron los atractores generados con los datos durante 18 horas y durante toda la dinámica. Se calculó la dimensión fractal del atractor y su ocupación espacial. A estas medidas se aplicó la evaluación matemática diagnostica desarrollada previamente, comparando la evaluación para 18 horas y para todo el registro; finalmente se calculó la sensibilidad, especificidad y coeficiente Kappa.Resultados: Para las dinámicas normales los espacios de ocupación en la rejilla Kp estuvieron entre 200 y 381 en la evaluación de la totalidad del holter, y entre 201 y 384 en la evaluación durante 18 horas, mostrando la cercanía en las medidas, lo que permite que la disminución en el tiempo de la evaluación sea consistente, esta misma cercanía se observó para las dinámicas enfermas y agudas.Conclusión: Se evidenció la aplicabilidad clínica en 18 horas de la ley exponencial en la dinámica cardiaca caótica asociada a arritmias mostrando ser de utilidad para la predicción de la evolución hacia estados agudos de la dinámica.

Eventos de Desconexao na Cauda de Plasma do Cometa P/Halley

NASA Astrophysics Data System (ADS)

Voelzke, M. R.; Fahr, H. J.

2001-08-01

Observacoes cometárias e de vento solar sao comparadas com o propósito de determinar-se as condicoes do vento solar associadas aos eventos de desconexao (DEs) observados em caudas de plasma cometárias. Os dados cometários sao provenientes do The International Halley Watch Atlas of Large-Scale Phenomena. A análise visual sistemática das imagens do atlas revelou, entre outras estruturas morfológicas, 47 DEs ao longo da cauda de plasma do P/Halley. Estes 47 DEs registrados em 47 imagens distintas permitiram a descoberta de 19 origens de DEs, ou seja, o tempo em que as desconexoes iniciaram foi calculado. Os dados do vento solar sao provenientes de medidas feitas in situ pela sonda espacial IMP-8, as quais foram usadas para elaborar a variacao da velocidade do vento solar, densidade e pressao dinâmica durante o intervalo analisado. O presente trabalho compara as atuais teorias conflitantes, baseadas nos mecanismos de formacao, com o intuito de explicar o fenômeno cíclico dos DEs, ou seja, os efeitos de producao iônica, os efeitos de pressao e os efeitos de reconexao magnética sao analisados. Para cada uma das 19 origens de DEs comparou-se a densidade com a respectiva velocidade do vento solar com o intuito de determinar-se uma possível correlacao entre estas origens e os efeitos de pressao dinâmica. Quando da ocorrência de 6 origens de DEs o IMP-8 nao realizou medidas, nos outros 13 casos 10 origens (77%) mostraram uma anticorrelacao entre velocidade e densidade e apenas 3 (23%) revelaram uma tendência similar entre velocidade e densidade. Portanto, a análise inicial demonstra uma fraca correlacao entre as origens dos DEs e os efeitos de pressao.

Usefulness of the Diagnosis "Decreased Cardiac Output (00029)" in Patients With Chronic Heart Failure.

PubMed

Rojas Sánchez, Lyda Zoraya; Hernández Vargas, Juliana Alexandra; Trujillo Cáceres, Silvia Juliana; Roa Díaz, Zayne Milena; Jurado Arenales, Adriana Milena; Toloza Pérez, Yesith Guillermo

2017-10-01

To determine the clinical and construct validity of the nursing diagnosis "decreased cardiac output" (DCO) in patients with chronic heart failure. Cross-sectional study. A total of 200 people were studied. The defining characteristics with the highest prevalence were as follows: arrhythmia (62.5%) and fatigue (61.5%). Adjustment measures such as infit and outfit were maintained between 0.50 and 1.56 and the total variance explained by the measures was 29.3%. This study determined the clinical validity of the nursing diagnosis DCO. Regarding construct validity, adjustment of the defining characteristics to the Rasch model was observed. This study improves the evidence-based practice of nursing and strengthened the role of the nurse who leads care to this population. Determinar la validez clínica y de constructo del diagnóstico de enfermería "Disminución del Gasto Cardíaco" en pacientes con falla cardíaca crónica. MÉTODOS: Estudio de corte transversal. Un total de 200 pacientes fueron estudiados. Las características definitorias con las mayores prevalencias fueron: arritmia (62.5%) y fatiga (61.5%). Medidas de ajuste como el infit y outfit se mantuvieron entre 0.50 y 1.56. El total de la varianza explicada por las medidas fue de 29.3%. Este estudio determinó la validez clínica del diagnóstico de enfermería "Disminución del Gasto Cardíaco". En cuanto a la validez de constructo, se observó que 19 de las 21 características definitorias se ajustaron al modelo Rasch. IMPLICACIONES PARA LA PRÁCTICA DE ENFERMERÍA: Este estudio mejora la práctica basada en la evidencia de enfermería y fortalece el rol de las enfermeras que lideran el cuidado en esta población. © 2016 NANDA International, Inc.

HOW TO EVALUATE SCIENTIFIC PRODUCTION.

PubMed

Antunes, Alberto Azoubel

2015-01-01

To conduct a critical analysis of the two main bibliometric indexes used by science: the impact factor and the H index. Research was conducted on PubMed using the keywords: impact factor, Bibliometrics and H index. The citations of articles tend to follow a curve in which the articles published in a given year increase sharply to a peak occurring between two and six years after its publication. From this peak citations decline over time. The analysis of the scientific merit should not be based on only in bibliometric measure, but in the association of various parameters. The impact factor and the H index is mainly based on the number of citations of scientific papers, and this parameter, although important, should not be used alone, nor overvalued in the evaluation of teaching merit. Realizar análise crítica dos dois principais índices bibliométricos utilizados pela ciência: o fator de impacto e o índice H. Foi realizada pesquisa no Pubmed utilizando as palavras-chave: impact factor, bibliometrics, H index. As citações dos artigos tendem a seguir uma curva em que os artigos publicados em determinado ano aumentam agudamente para um pico que ocorre entre dois e seis anos após sua publicação. A partir deste pico, as citações declinam ao longo do tempo. A análise do mérito científico não deve ser baseada em apenas uma medida bibliométrica, mas em associação de medidas. O FI e o índice H se baseiam fundamentalmente no número de citações dos artigos científicos, e este parâmetro, apesar de importante, não deve ser utilizado sozinho e tampouco supervalorizado na avaliação do mérito docente.

Prediction uncertainty of plume characteristics derived from a small number of measuring points

NASA Astrophysics Data System (ADS)

French, H. K.; van der Zee, S. E. A. T. M.; Leijnse, A.

sensibles à la dimension du panache en fonction de la distance entre les différents points de mesure. Afin de réduire les erreurs de prédiction de la variance, la distance entre les points de mesure doit être inférieure au double de l'écart-type du panache examiné. La dimension totale de l'ensemble doit couvrir une étendue de plusieurs écarts-types du panache pour éviter qu'une partie de la matière échappe à la zone surveillée. Des simulations numériques du panache en dispersion (les calculs de comparaison sont basés sur 9000 nœuds avec 30 points de mesure) montrent que le centre vertical et le centre horizontal de la matière dispersée ont été bien prédits à tous les degrés d'hétérogénéité, de même que pour les variances horizontales. Les variances verticales ont été plus sensibles aux erreurs de prédiction, mais les estimations étaient du même ordre de grandeur que les valeurs réelles. Resumen Un número pequeño de puntos de medida puede producir un sesgo en la caracterización en campo del flujo y transporte de solutos en la zona no saturada. La simulación de transporte advectivo (no difusivo) de un penacho Gaussiano a travs de un conjunto de 30 puntos de medida regularmente distribuidos revelan fluctuaciones temporales regulares de los momentos espaciales del penacho. Una distribución irregular de puntos de medida predijo a su vez fluctuaciones irregulares, más alejadas de la realidad, por lo que se recomienda el uso de esquemas de muestreo regulares. Los momentos espaciales fueron sensibles a la relación entre tamaño del penacho y distancia entre puntos de medida. Para reducir los errores en la predicción de la varianza, la distancia entre puntos de observación debe ser menor que dos veces la desviación estándar del penacho. El tamaño del área muestreada debe cubrir varias desviaciones estándar del penacho para evitar perder parte de la masa. Las simulaciones numricas en un penacho dispersivo, comparando los c

Performance of the SciBar cosmic ray telescope (SciCRT) toward the detection of high-energy solar neutrons in solar cycle 24

NASA Astrophysics Data System (ADS)

Sasai, Yoshinori; Nagai, Yuya; Itow, Yoshitaka; Matsubara, Yutaka; Sako, Takashi; Lopez, Diego; Itow, Tsukasa; Munakata, Kazuoki; Kato, Chihiro; Kozai, Masayoshi; Miyazaki, Takahiro; Shibata, Shoichi; Oshima, Akitoshi; Kojima, Hiroshi; Tsuchiya, Harufumi; Watanabe, Kyoko; Koi, Tatsumi; Valdés-Galicia, Jose Francisco; González, Luis Xavier; Ortiz, Ernesto; Musalem, Octavio; Hurtado, Alejandro; Garcia, Rocio; Anzorena, Marcos

2014-12-01

We plan to observe solar neutrons at Mt. Sierra Negra (4,600 m above sea level) in Mexico using the SciBar detector. This project is named the SciBar Cosmic Ray Telescope (SciCRT). The main aims of the SciCRT project are to observe solar neutrons to study the mechanism of ion acceleration on the surface of the sun and to monitor the anisotropy of galactic cosmic-ray muons. The SciBar detector, a fully active tracker, is composed of 14,848 scintillator bars, whose dimension is 300 cm × 2.5 cm × 1.3 cm. The structure of the detector enables us to obtain the particle trajectory and its total deposited energy. This information is useful for the energy reconstruction of primary neutrons and particle identification. The total volume of the detector is 3.0 m × 3.0 m × 1.7 m. Since this volume is much larger than the solar neutron telescope (SNT) in Mexico, the detection efficiency of the SciCRT for neutrons is highly enhanced. We performed the calibration of the SciCRT at Instituto Nacional de Astrofisica, Optica y Electronica (INAOE) located at 2,150 m above sea level in Mexico in 2012. We installed the SciCRT at Mt. Sierra Negra in April 2013 and calibrated this detector in May and August 2013. We started continuous observation in March 2014. In this paper, we report the detector performance as a solar neutron telescope and the current status of the SciCRT.

Changes of Colonic Bacterial Composition in Parkinson's Disease and Other Neurodegenerative Diseases.

PubMed

Gerhardt, Sara; Mohajeri, M Hasan

2018-06-01

In recent years evidence has emerged that neurodegenerative diseases (NDs) are strongly associated with the microbiome composition in the gut. Parkinson's disease (PD) is the most intensively studied neurodegenerative disease in this context. In this review, we performed a systematic evaluation of the published literature comparing changes in colonic microbiome in PD to the ones observed in other NDs including Alzheimer's disease (AD), multiple system atrophy (MSA), multiple sclerosis (MS), neuromyelitis optica (NMO) and amyotrophic lateral sclerosis (ALS). To enhance the comparability of different studies, only human case-control studies were included. Several studies showed an increase of Lactobacillus , Bifidobacterium , Verrucomicrobiaceae and Akkermansia in PD. A decrease of Faecalibacterium spp., Coprococcus spp., Blautia spp., Prevotella spp. and Prevotellaceae was observed in PD. On a low taxonomic resolution, like the phylum level, the changes are not disease-specific and are inconsistent. However, on a higher taxonomic resolution like genus or species level, a minor overlap was observed between PD and MSA, both alpha synucleinopathies. We show that standardization of sample collection and analysis is necessary for ensuring the reproducibility and comparability of data. We also provide evidence that assessing the microbiota composition at high taxonomic resolution reveals changes in relative abundance that may be specific to or characteristic of one disease or disease group, and might evolve discriminative power. The interactions between bacterial species and strains and the co-abundances must be investigated before assumptions about the effects of specific bacteria on the host can be made with certainty.

Computer-based diagnosis of illness in historical persons.

PubMed

Peters, T J

2013-01-01

Retrospective diagnosis of illness in historical figures is a popular but somewhat unreliable pastime due to the lack of detailed information and reliable reports about clinical features and disease progression. Modern computer-based diagnostic programmes have been used to supplement historical documents and accounts, offering new and more objective approaches to the retrospective investigations of the medical conditions of historical persons. In the case of King George III, modern technology has been used to strengthen the findings of previous reports rejecting the popular diagnosis of variegate porphyria in the King, his grandson Augustus d'Esté and his antecedent King James VI and I. Alternative diagnoses based on these programmes are indicated. The Operational Criteria in Studies of Psychotic Illness (OPCRIT) programme and the Young mania scale have been applied to the features described for George III and suggest a diagnosis of bipolar disorder. The neuro-diagnostic programme SimulConsult was applied to Augustus d'Esté and suggests a diagnosis of neuromyelitis optica rather than acute porphyria with secondarily multiple sclerosis, as proposed by others. James VI and I's complex medical history and the clinical features of his behavioural traits were also subjected to SimulConsult analysis; acute porphyria was rejected and the unexpected diagnosis of attenuated (mild) Lesch-Nyhan disease offered. A brief review of these approaches along with full reference listings to the methodology including validation are provided. Textual analysis of the written and verbal outputs of historical figures indicate possible future developments in the diagnosis of medical disorders in historical figures.

HYPOCRETIN/OREXIN AND NARCOLEPSY NEW BASIC AND CLINICAL INSIGHTS

PubMed Central

NISHINO, Seiji; OKURO, Masashi; KOTORII, Nozomu; ANEGAWA, Emiko; ISHIMARU, Yuji; MATSUMURA, Mari; KANBAYASHI, Takashi

2009-01-01

Narcolepsy is a chronic sleep disorder, characterized by excessive daytime sleepiness (EDS), cataplexy, hypnagogic hallucinations, and sleep paralysis. Both sporadic (95%) and familial (5%) forms of narcolepsy exist in humans. The major pathophysiology of human narcolepsy has been recently discovered based on the discovery of narcolepsy genes in animals; the genes involved in the pathology of the hypocretin/orexin ligand and its receptor. Mutations in hypocretin-related genes are rare in humans, but hypocretin-ligand deficiency is found in a large majority of narcolepsy with cataplexy. Hypocretin ligand deficiency in human narcolepsy is likely due to the postnatal cell death of hypocretin neurons. Although tight association between human leukocyte antigen (HLA) association and human narcolepsy with cataplexy suggests an involvement of autoimmune mechanisms, this has not yet been proven. Hypocretin deficiency is also found in symptomatic cases of narcolepsy and EDS with various neurological conditions, including immune-mediated neurological disorders, such as Guillain-Barre syndrome, MA2-positive paraneoplastic syndrome and neuromyelitis optica (NMO) related disorder. These findings likely have significant clinical relevance and for understanding the mechanisms of hypocretin cell death and choice of treatment option. These series of discoveries in humans lead to the establishment of the new diagnostic test of narcolepsy (i.e. low cerebrospinal fluid [CSF] hypocretin-1 levels for narcolepsy with cataplexy and narcolepsy due to medical condition). Since a large majority of human narcolepsy patients are ligand deficient, hypocretin replacement therapy may be a promising new therapeutic option, and animal experiments using gene therapy and cell transplantations are in progress. PMID:19555382

Medida de los beneficios económicos de la integridad ecológica del Río Mameyes en Puerto Rico

Treesearch

Armando Gonzalez-Caban; John Loomis

1999-01-01

Se realizó una valoración de contingencia a través de una encuesta en persona de los jefes de familia puertorriqueños, de abril a agosto de 1995, para estimar su consentimiento-parapagar por la preservación de niveles de agua en el Río Mameyes, y evitar la construcción de la represa propuesta...

Short version of the Depression Anxiety Stress Scale-21: is it valid for Brazilian adolescents?

PubMed

Silva, Hítalo Andrade da; Passos, Muana Hiandra Pereira Dos; Oliveira, Valéria Mayaly Alves de; Palmeira, Aline Cabral; Pitangui, Ana Carolina Rodarti; Araújo, Rodrigo Cappato de

2016-01-01

To evaluate the interday reproducibility, agreement and validity of the construct of short version of the Depression Anxiety Stress Scale-21 applied to adolescents. The sample consisted of adolescents of both sexes, aged between 10 and 19 years, who were recruited from schools and sports centers. The validity of the construct was performed by exploratory factor analysis, and reliability was calculated for each construct using the intraclass correlation coefficient, standard error of measurement and the minimum detectable change. The factor analysis combining the items corresponding to anxiety and stress in a single factor, and depression in a second factor, showed a better match of all 21 items, with higher factor loadings in their respective constructs. The reproducibility values for depression were intraclass correlation coefficient with 0.86, standard error of measurement with 0.80, and minimum detectable change with 2.22; and, for anxiety/stress: intraclass correlation coefficient with 0.82, standard error of measurement with 1.80, and minimum detectable change with 4.99. The short version of the Depression Anxiety Stress Scale-21 showed excellent values of reliability, and strong internal consistency. The two-factor model with condensation of the constructs anxiety and stress in a single factor was the most acceptable for the adolescent population. Avaliar a reprodutibilidade interdias, a concordância e a validade do construto da versão reduzida da Depression Anxiety Stress Scale-21 aplicada a adolescentes. A amostra foi composta por adolescentes de ambos os sexos, com idades entre 10 e 19 anos, recrutados de escolas e centros esportivos. A validade de construto foi realizada por análise fatorial exploratória, e a confiabilidade foi calculada para cada construto, por meio de coeficiente de correlação intraclasse, erro padrão de medida e mudança mínima detectável. A análise fatorial combinando os itens correspondentes a ansiedade e estresse em um

Optic neuritis: Observation and experience at a tertiary care hospital in Qassim region, Saudi Arabia

PubMed Central

Alamgir, Mohammad Jawad; Ali, Syed Abrar; Hamdy, Nermin Aly; Khan, Moin Zafar; Mohammad, Elgamri E

2017-01-01

Objectives: Optic neuritis (ON) can occur in isolation or association with multiple sclerosis (MS) or neuromyelitis optica. ON, is seen more commonly in Caucasians and interaction is found to exist between ethnic origin and the latitude at which the patient grows up. At present limited information is available about the profile of ON in Saudi patients. We aimed to analyze the records of ON patients, in regard to their presentation, natural history, treatment outcome, and risk and association with MS. Whether, ON in Saudi patients behaves differently from the Western and Asian patients? Methods: In this retrospective observational study; we retrieved the data from the medical records of the patients with ON, who attended the ophthalmology and neurology services of King Fahad Specialist Hospital Buraidah, Al Qassim, Saudi Arabia, from period 2006 to 2012. Results: We recorded data of 60 patients of ON; 38 females (63.3%) and 22 males (36.7%). Color vision was affected in 66.7% of cases. Vision in the affected eye was 20/200 or worse in 74.97 % of our cases. Magnetic resonance imaging (MRI) brain revealed multiple lesions in 55% of cases; most of them developed MS on follow-up. Only 48.3% of patients had received systemic steroids. Vision improved in 85% of our cases. Conclusion: Most of our patients had idiopathic ON, and almost 85% had good visual recovery, in this regard our study is comparable with such studies done in other Asian countries. On the other hand, 55% of our patients had multiple MRI brain lesions, a high risk and association of MS, almost similar to the Western Europe and North American ON patients. PMID:29114192

Optic neuritis: Observation and experience at a tertiary care hospital in Qassim region, Saudi Arabia.

PubMed

Alamgir, Mohammad Jawad; Ali, Syed Abrar; Hamdy, Nermin Aly; Khan, Moin Zafar; Mohammad, Elgamri E

2017-01-01

Optic neuritis (ON) can occur in isolation or association with multiple sclerosis (MS) or neuromyelitis optica. ON, is seen more commonly in Caucasians and interaction is found to exist between ethnic origin and the latitude at which the patient grows up. At present limited information is available about the profile of ON in Saudi patients. We aimed to analyze the records of ON patients, in regard to their presentation, natural history, treatment outcome, and risk and association with MS. Whether, ON in Saudi patients behaves differently from the Western and Asian patients? In this retrospective observational study; we retrieved the data from the medical records of the patients with ON, who attended the ophthalmology and neurology services of King Fahad Specialist Hospital Buraidah, Al Qassim, Saudi Arabia, from period 2006 to 2012. We recorded data of 60 patients of ON; 38 females (63.3%) and 22 males (36.7%). Color vision was affected in 66.7% of cases. Vision in the affected eye was 20/200 or worse in 74.97 % of our cases. Magnetic resonance imaging (MRI) brain revealed multiple lesions in 55% of cases; most of them developed MS on follow-up. Only 48.3% of patients had received systemic steroids. Vision improved in 85% of our cases. Most of our patients had idiopathic ON, and almost 85% had good visual recovery, in this regard our study is comparable with such studies done in other Asian countries. On the other hand, 55% of our patients had multiple MRI brain lesions, a high risk and association of MS, almost similar to the Western Europe and North American ON patients.

Aquaporin-4 antibody titration in NMO patients treated with rituximab: A retrospective study.

PubMed

Valentino, Paola; Marnetto, Fabiana; Granieri, Letizia; Capobianco, Marco; Bertolotto, Antonio

2017-03-01

We undertook an observational retrospective study to investigate the usefulness of aquaporin-4 (AQP4) antibodies (Ab) titration in the management of patients with neuromyelitis optica (NMO) treated with rituximab (RTX) by studying (1) the correlation between AQP4-Ab titer and disease activity, (2) the influence of RTX on antibody levels, and (3) the association between AQP4-Ab levels and responsiveness to RTX. A cell-based assay was used for AQP4-Ab titration in 322 serum samples from 7 patients with NMO treated with RTX (median follow-up 65 months), according to a treatment-to-target approach. Serum samples were collected every month following standardized procedures. (1) In group analysis, AQP4-Ab titers correlated with the disease activity, showing higher titers during and preceding relapses than during remission. However, in individual analysis, an increase in AQP4-Ab titers and CD19+ B cells did not always precede a relapse. (2) A reduction of AQP4-Ab titers in the short-term and long-term period was observed during RTX treatment. (3) Reduction of AQP4-Ab titers was observed in responder patients both 3 months after RTX infusion and in the long-term follow-up. In one nonresponder patient, AQP4-Ab levels never decreased during the treatment period. Titration of AQP4-Abs could be useful in the clinical management of patients with NMO treated with RTX: titration before each reinfusion and 3 months after each reinfusion may provide information about responsiveness to RTX. Although a relationship among AQP4-Ab levels, disease activity, and response to RTX was observed, the usefulness of AQP4-Ab titration to predict relapses is limited.

Paediatric acquired demyelinating syndromes: incidence, clinical and magnetic resonance imaging features.

PubMed

Absoud, Michael; Lim, Ming J; Chong, Wui K; De Goede, Christian G; Foster, Katharine; Gunny, Roxana; Hemingway, Cheryl; Jardine, Philip E; Kneen, Rachel; Likeman, Marcus; Nischal, Ken K; Pike, Michael G; Sibtain, Naomi A; Whitehouse, William P; Cummins, Carole; Wassmer, Evangeline

2013-01-01

Changing trends in multiple sclerosis (MS) epidemiology may first be apparent in the childhood population affected with first onset acquired demyelinating syndromes (ADSs). We aimed to determine the incidence, clinical, investigative and magnetic resonance imaging (MRI) features of childhood central nervous system ADSs in the British Isles for the first time. We conducted a population active surveillance study. All paediatricians, and ophthalmologists (n = 4095) were sent monthly reporting cards (September 2009-September 2010). International Paediatric MS Study Group 2007 definitions and McDonald 2010 MS imaging criteria were used for acute disseminated encephalomyelitis (ADEM), clinically isolated syndrome (CIS) and neuromyelitis optica (NMO). Clinicians completed a standard questionnaire and provided an MRI copy for review. Card return rates were 90%, with information available for 200/222 positive notifications (90%). After exclusion of cases, 125 remained (age range 1.3-15.9), with CIS in 66.4%, ADEM in 32.0% and NMO in 1.6%. The female-to-male ratio in children older than 10 years (n = 63) was 1.52:1 (p = 0.045). The incidence of first onset ADS in children aged 1-15 years old was 9.83 per million children per year (95% confidence interval [CI] 8.18-11.71). A trend towards higher incidence rates of ADS in children of South Asian and Black ethnicity was observed compared with White children. Importantly, a number of MRI characteristics distinguished ADEM from CIS cases. Of CIS cases with contrast imaging, 26% fulfilled McDonald 2010 MS diagnostic criteria. We report the highest surveillance incidence rates of childhood ADS. Paediatric MS diagnosis at first ADS presentation has implications for clinical practice and clinical trial design.

Wavefront coding for fast, high-resolution light-sheet microscopy (Conference Presentation)

NASA Astrophysics Data System (ADS)

Olarte, Omar E.; Licea-Rodriguez, Jacob; Loza-Alvarez, Pablo

2017-02-01

Some biological experiments demand the observation of dynamics processes in 3D with high spatiotemporal resolution. The use of wavefront coding to extend the depth-of-field (DOF) of the collection arm of a light-sheet microscope is an interesting alternative for fast 3D imaging. Under this scheme, the 3D features of the sample are captured at high volumetric rates while the light sheet is swept rapidly within the extended DOF. The DOF is extended by coding the pupil function of the imaging lens by using a custom-designed phase mask. A posterior restoration step is required to decode the information of the captured images based on the applied phase mask [1]. This hybrid optical-digital approach is known as wavefront coding (WFC). Previously, we have demonstrated this method for performing fast 3D imaging of biological samples at medium resolution [2]. In this work, we present the extension of this approach for high-resolution microscopes. Under these conditions, the effective DOF of a standard high NA objective is of a few micrometers. Here we demonstrate that by the use of WFC, we can extend the DOF more than one order of magnitude keeping the high-resolution imaging. This is demonstrated for two designed phase masks using Zebrafish and C. elegans samples. [1] Olarte, O.E., Andilla, J., Artigas, D., and Loza-Alvarez, P., "Decoupled Illumination-Detection Microscopy. Selected Optics in Year 2105," in Optics and Photonics news 26, p. 41 (2015). [2] Olarte, O.E., Andilla, J., Artigas, D., and Loza-Alvarez, P., "Decoupled illumination detection in light sheet microscopy for fast volumetric imaging," Optica 2(8), 702 (2015).

Pain in patients with transverse myelitis and its relationship to aquaporin 4 antibody status.

PubMed

Kong, Yazhuo; Okoruwa, Helen; Revis, Jon; Tackley, George; Leite, Maria Isabel; Lee, Michael; Tracey, Irene; Palace, Jacqueline

2016-09-15

Pain in transverse myelitis has been poorly studied. The aim of the study was to investigate the relationship between transverse myelitis related pain and disability, quality of life, anxiety and depression, cognitive-affective states in neuromyelitis optica (NMO) patients and aquaporin4 antibody status (AQP4-Ab +ve as positive and AQP4-Ab -ve as negative). Transverse myelitis patients (44 in total; 29 AQP4-Ab +ve and 15 AQP4-Ab -ve) completed questionnaires including Pain Severity Index (PSI), Pain Catastrophising Scale (PCS), Hospital Anxiety and Depression Scale (HADS), Short Form-36 quality of life (SF-36 QOL). Clinical details such as disability, gender, age and spinal cord lesion type (short or long lesion) were noted. Correlation and multiple linear regression tests were performed using these clinical scores. Pain was found to be correlated strongly with quality of life in both groups but only correlated with disability in the AQP4-Ab +ve group. PCS, HADS and EDMUS were found to be highly correlated with pain severity using partial correlation, however, a stronger relationship between pain severity and PCS was found in the AQP4-Ab -ve group. Multiple regression analysis showed that pain severity was the most important factor for quality of life but not disability or anxiety and depression symptoms in the whole patient group. We confirm that pain is an important symptom of transverse myelitis and has more influence on quality of life than disability despite health services being predominantly focused on the latter. There may be different factors associated with pain between AQP4-Ab +ve and -ve patients. Copyright © 2016 Elsevier B.V. All rights reserved.

Low-Level Lasers as an Adjunct in Periodontal Therapy in Patients with Diabetes Mellitus

PubMed Central

Kesić, Ljiljana; Mihailović, Dragan; Jovanović, Goran; Antić, Slobodan; Brkić, Zlata

2012-01-01

Abstract Background Diabetes mellitus (DM) increases the risk of periodontitis, and severe periodontitis often coexists with severe DM. The proposed dual pathway of tissue destruction suggests that control of chronic periodontal infection and gingival inflammation is essential for achieving long-term control of DM. The purpose this study is to evaluate the effects of low-level laser therapy (LLLT) by exfoliative cytology in patients with DM and gingival inflammation. Subjects and Methods Three hundred patients were divided in three equal groups: Group 1 consisted of patients with periodontitis and type 1 DM, Group 2 of patients with periodontitis and type 2 DM, and Group 3 of patients with periodontitis (control group). After oral examination, smears were taken from gingival tissue, and afterward all of the patients received oral hygiene instructions, removal of dental plaque, and full-mouth scaling and root planing. A split-mouth design was applied; on the right side of jaws GaAlAs LLLT (670 nm, 5 mW, 14 min/day) (model Mils 94; Optica Laser, Sofia, Bulgaria) was applied for five consecutive days. After the therapy was completed, smears from both sides of jaws were taken. The morphometric analysis was done using the National Institutes of Health Image software program and a model NU2 microscope (Carl Zeiss, Jena, Germany). Results Investigated parameters were significantly lower after therapy compared with values before therapy. After therapy on the side subjected to LLLT, there was no significantly difference between patients with DM and the control group. Conclusions It can be concluded that LLLT as an adjunct in periodontal therapy reduces gingival inflammation in patients with DM and periodontitis. PMID:22928615

Evidence-based guideline: clinical evaluation and treatment of transverse myelitis: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology.

PubMed

Scott, T F; Frohman, E M; De Seze, J; Gronseth, G S; Weinshenker, B G

2011-12-13

To assess the evidence for diagnostic tests and therapies for transverse myelitis (TM) and make evidence-based recommendations. A review of the published literature from 1966 to March 2009 was performed, with evidence-based classification of relevant articles. Level B recommendations: neuromyelitis optica (NMO)-immunoglobulin G (IgG) antibodies should be considered useful to determine TM cause in patients presenting with clinical acute complete transverse myelitis (ACTM) features. The presence of NMO-IgG antibodies (aquaporin-4-specific antibodies) should be considered useful in determining increased TM recurrence risk. Level C recommendations: in suspected TM, distinction between ACTM or acute partial transverse myelitis may be considered useful to determine TM etiology and risk for relapse (more common with APTM). Age and gender may be considered useful to determine etiology in patients presenting with TM syndrome, with spinal infarcts seen more often in older patients and more female than male patients having TM due to multiple sclerosis (MS). Brain MRI characteristics consistent with those of MS may be considered useful to predict conversion to MS after a first partial TM episode. Longer spinal lesions extending over >3 vertebral segments may be considered useful in determining NMO vs MS. CSF examination for cells and oligoclonal bands may be considered useful to determine the cause of the TM syndrome. Plasma exchange may be considered in patients with TM who fail to improve after corticosteroid treatment. Rituximab may be considered in patients with TM due to NMO to decrease the number of relapses. Level U recommendations: there is insufficient evidence to support or refute the efficacy of other TM therapies or the usefulness of ethnicity to determine the cause of a subacute myelopathy.

Association between demyelinating disease and autoimmune rheumatic disease in a pediatric population.

PubMed

Amorim, Ana Luiza M; Cabral, Nadia C; Osaku, Fabiane M; Len, Claudio A; Oliveira, Enedina M L; Terreri, Maria Teresa

Multiple sclerosis (MS) and neuromyelitis optica (NMO) are demyelinating diseases of the central nervous system. Autoimmunity in patients with demyelinating disease and in their families has been broadly investigated and discussed. Recent studies show a higher incidence of rheumatic autoimmune diseases among adult patients with MS or NMO and their families, but there are no studies in the pediatric population. To evaluate an association of MS and NMO with autoimmune rheumatic diseases in pediatric patients. 22 patients younger than 21 years old with MS or NMO diagnosed before the age of 18 years were evaluated regarding epidemiological data, clinical presentation, association with autoimmune diseases, family history of autoimmune diseases, laboratory findings, imaging studies and presence of auto-antibodies. Among the patients studied, there was a prevalence of females (68.1%). The mean age of symptoms onset was 8 years and 9 months and the mean current age was 16 years and 4 months. Two patients (9%) had a history of associated autoimmune rheumatic disease: one case of juvenile dermatomyositis in a patient with NMO and another of systemic lupus erythematosus in a patient with MS. Three patients (13%) had a family history of autoimmunity in first-degree relatives. Antinuclear antibody was found positive in 80% of patients with NMO and 52% of patients with MS. About 15% of antinuclear antibody-positive patients were diagnosed with rheumatologic autoimmune diseases. Among patients with demyelinating diseases diagnosed in childhood included in this study there was a high frequency of antinuclear antibody positivity but a lower association with rheumatologic autoimmune diseases than that observed in studies conducted in adults. Copyright © 2016 Elsevier Editora Ltda. All rights reserved.

Um estudo espectrofotométrico da variável cataclísmica V3885 Sgr

NASA Astrophysics Data System (ADS)

Ribeiro, F. M. A.; Diaz, M. P.

2003-08-01

Variáveis Cataclísmicas são sistemas binários cerrados compostos de uma anã vermelha que transfere matéria para uma anã branca, em sistemas não magnéticos ocorre a formação de um disco de acresção em torno da anã branca. V3885 Sgr é uma variável cataclísmica classificada como sendo do tipo nova-like. É apresentado um estudo espectrofotométrico de V3885 Sgr de alta resolução temporal feito na região do visível. A região observada é centrada em Ha e abrange também a linha de HeI 6678. O primeiro resultado obtido neste estudo é a determinação do período orbital a partir de medidas da velocidade radial da linha de Ha como sendo 0,20716071(22) dias, resolvendo inconsistências quanto a esse valor na literatura e definindo uma efeméride a longo prazo para o sistema. Com este período e as medidas de velocidade radial do perfil de linha de Ha foi construído um diagrama de massas, através do qual restringimos as massas das componentes estelares do sistema e limitamos a inclinação orbital do sistema. Foram construídos diagramas de Greenstein para as linhas de Ha e HeI, onde os espectros médios em cada intervalo de fase são representados lado a lado em escala de cinza, indicando a existência de uma emissão intensa proveniente da parte posterior do disco. A partir da tomografia Doppler obtivemos perfis de emissividade radial para o disco tanto para a linha de Ha como para HeI. Os resultados obtidos são comparados com os de outros sistemas estudados com a mesma técnica. Serão apresentados também resultados da tomografia de flickering para o sistema.

[Not Available].

PubMed

Campos Jara, Christian; Delgado Floody, Pedro; Caamaño Navarrete, Felipe; Guzmán Guzmán, Iris; Cesp Barría, Mauricio; Jerez Mayorga, Daniel; Alarcón Hormazábal, Manuel; Osorio Poblete, Aldo

2016-07-19

Antecedentes: la prevalencia de obesidad infantil ha aumentado considerablemente en Chile y el mundo, presentando asociación negativa con el rendimiento físico. Objetivo: el propósito del estudio fue determinar el rendimiento físico en escolares y asociarlos a los niveles de sobrepeso, obesidad y riesgo cardiometabólico.Material y métodos: 342 escolares, entre 11 y 16 años de edad, participaron del estudio, un 44,2% correspondió a mujeres y un 55,8% a hombres. Se evaluaron las siguientes variables: peso, índice de masa corporal, porcentaje de masa grasa, contorno cintura, razón cintura estatura, Test de salto largo, Test de abdominales, Test de flexo-extensiones de brazo, Test de Cafra y Test de Navette.Resultados: s e observó que los escolares con sobrepeso y obesidad (48,3%) mostraron un incremento significativo en las medidas antropométricas, así como una disminución en todas las variables que determinan rendimiento físico. En el análisis de los Test de Cafra y Navette, se observó que la presencia de la alteración de al menos uno de ellos se asoció con riesgo cardiometabólico (OR= 9,29, p<0,001), mientras que la presencia de la alteración de los dos test se asocia fuertemente con la presencia de sobrepeso y obesidad (OR = 11,8, p = 0,003) y con riesgo cardiometabólico (OR = 30, 1, p<0,001).Conclusión: Los escolares con obesidad presentaron disminución en todas las variables que determinaron el rendimiento físico y fue la alteración capacidad cardiorrespiratoria medida a través de los Test de Cafra y Navette los que presentaron mayor asociación y significativa con el sobrepeso, obesidad y riesgo cardiometabólico.

Análise cinemática bi-dimensional dos núcleos de NGC 4051 e NGC 4941

NASA Astrophysics Data System (ADS)

Barbosa, F. K. B.; Storchi-Bermagnn, T.; Schmitt, H. R.; Cid Fernandes, R.; Winge, C.

2003-08-01

Estudos recentes da cinemática da região dentro de 1 kpc do núcleo de galaxias Seyfert próximas usando espectroscopia de fenda longa com alta resolução espacial (~ 100 pc ou melhores) encontraram uma queda na dispersão de velocidades nas regiões centrais dentro de um raio de ~ 300 pc do núcleo. Essa queda vem sendo tentativamente explicada por um cenário evolutivo em que um evento de formação estelar recente cria as estrelas da região central em um disco de dimensões 300 pc. Desde sua criação, tais estrelas não tiveram tempo de "virializar", ou seja, seguir a distribuição radial de dispersões de velocidades determinada pelo campo gavitacional da galáxia e, portanto, a dispersão de velocidades medida nessa região do bojo acaba sendo menor do que a dispersão medida nas vizinhanças. No presente trabalho investigamos a cinemática estelar no núcleo das galáxias Seyfert NGC 4051 e NGC 4941 usando o tripleto do Ca ii (8500 Å) em absorção. Os dados foram obtidos com o IFU GMOS no telescópio Gemini. O elemento de resolução espacial nas galáxias é da ordem de 30 pc. No intervalo espectral coberto pelo espectrografo a linha [S iii] (9068 Å) também é visível, o que permite estudar a cinemática do gás na mesma região. Serão apresentados mapas bi-dimensionais da velocidade e dispersão de velocidades das estrelas e do gás, além de imagens na linha [S iii] que mapeia o gás de alta excitação.

PREVENCION DE VIH PARA MUJERES HISPANAS DE 50 AÑOS Y MÁS

PubMed Central

Villegas, N.; Cianelli, R.; Ferrer, L.; Kaelber, L.; Peragallo, N.; Yaya, Alexandra O.

2012-01-01

Introducción Las mujeres Hispanas de 50 años y más (MHC) son una minoría en Estados Unidos que está a elevado riesgo de adquirir VIH y son el grupo menos estudiado en lo que respecta a salud, características sociales y de comportamiento sexual. Objetivo Investigar los factores que incrementan el riesgo de VIH en las MHC con el propósito de desarrollar o adaptar una intervención apropiada para la “edad y la cultura "de este grupo de mujeres. Metodología Estudio descriptivo de corte transversal con una muestra de 50 MHC, sexualmente activas y que residían en Miami, Florida, Estados Unidos. Se utilizó un cuestionario estructurado administrado por entrevistadores entrenados y bilingües (inglés/español). Las participantes fueron reclutadas en diferentes lugares en el Sur de Florida. Para el análisis de los datos se utilizó estadística descriptiva, tanto medidas de tendencia central como medidas de dispersión. Resultados La edad promedio de las MHC fue de 55,7 ± 6 años (rango 50–76 años). Todas las MHC estaban en la menopausia. Prevención del VIH Las MHC reportaron niveles medios de conocimientos sobre VIH y comunicación con la pareja. En la muestra se reportó la presencia de síntomas depresivos, violencia en la pareja, actitudes negativas hacia las personas viviendo con VIH y baja percepción de riesgo de adquirir VIH. Las MHC mencionaron necesidades de aprendizaje en tópicos relacionados con prevención de VIH y cambios de la edad. Conclusión Las MHC están a riesgo de adquirir VIH y tienen necesidades especiales en términos de educación sobre prevención de VIH. PMID:25242862

Adolescentes: comportamento e risco cardiovascular

PubMed Central

da Costa, Ivelise Fhrideraid Alves Furtado; Medeiros, Carla Campos Muniz; da Costa, Fernanda Dayenne Alves Furtado; de Farias, Camilla Ribeiro Lima; Souza, Diogo Rodrigues; Adriano, Wellington Sabino; Simões, Mônica Oliveira da Silva; Carvalho, Danielle Franklin

2017-01-01

Resumo Contexto Os benefícios para a saúde decorrentes da prática regular de atividade física estão bem documentados. Entretanto, são raros os estudos associando essa prática ao comportamento sedentário e ao risco cardiovascular em adolescentes. Objetivos Pretende-se avaliar a prática de atividade física, o comportamento sedentário e a associação com o risco cardiovascular mensurado pelo escore Pathobiological Determinants of Atherosclerosis in Youth (PDAY). Métodos Estudo transversal desenvolvido nas escolas públicas estaduais de Campina Grande, PB, Brasil, com 576 adolescentes de 15 a 19 anos, incluindo variáveis socioeconômicas, demográficas, de estilo de vida e clínicas. Os dados foram coletados através de formulário validado, antropometria, aferição da pressão arterial e exames laboratoriais. Foram utilizadas medidas descritivas, teste do qui-quadrado de Pearson e regressão logística binomial. Trabalhou-se com o SPSS 22.0 se adotou intervalo de confiança de 95%. Resultados A idade média foi de 16,8 anos. A maioria dos adolescentes era do sexo feminino (66,8%), não branco (78.7%) e pertencente às classes C, D e (69,1%). Quanto ao sedentarismo e à insuficiência de atividade física, as prevalências foram de 78,1% e 60,2%, respectivamente. De acordo com o escore PDAY, 10,4% dos adolescentes apresentaram alto risco cardiovascular; 31,8% risco intermediário; e 57,8%, risco baixo. Verificou-se que PDAY esteve associado ao sexo e à adiposidade abdominal. Conclusões Ficou comprovado que adiposidade abdominal e sexo masculino representam importantes fatores de risco cardiovascular em adolescentes. Considerando-se a presença de um fator de risco modificável, medidas preventivas voltadas ao estilo de vida são essenciais. PMID:29930648

Vitamina D y riesgo de preeclampsia: revisión sistemática y metaanálisis.

PubMed

Serrano-Díaz, Norma Cecilia; Gamboa-Delgado, Edna Magaly; Domínguez-Urrego, Clara Lucía; Vesga-Varela, Andrea Liliana; Serrano-Gómez, Sergio Eduardo; Quintero-Lesmes, Doris Cristina

2018-05-01

Introducción. Cada vez son más los hallazgos sobre la relación entre las concentraciones de vitamina D en el ser humano y diversas condiciones clínicas. Hay una gran cantidad de estudios que informan sobre dicha asociación, especialmente con complicaciones obstétricas, incluidas la preeclampsia y la diabetes mellitus de la gestación, entre otras, pero sus resultados todavía no son definitivos, por lo que se requieren estudios de intervención de calidad que confirmen la relación de la vitamina D con dichos resultados.Objetivo. Revisar la información plasmada en estudios en torno al papel de la vitamina D materna y el desarrollo de la preeclampsia.Materiales y métodos. La metodología usada siguió las recomendaciones de la guía Cochrane para la elaboración de revisiones sistemáticas y de la guía del grupo Meta-analysis of Observational Studies in Epidemiology (MOOSE) para los metaanálisis. La búsqueda incluyó estudios observacionales y ensayos clínicos controlados.Resultados. Los niveles bajos de vitamina D, medida con el examen de 25-hidroxivitamina D, son comunes en el embarazo. Los resultados de esta revisión sistemática y del metaanálisis sugieren una asociación inversa entre los niveles de vitamina D y el desarrollo de preeclampsia. Hubo heterogeneidad en los estudios en cuanto a su diseño, población y ubicación geográfica, así como a las definiciones de exposición y resultado. Los ensayos clínicos controlados aleatorizados se excluyeron del metaanálisis.Conclusión. Se encontró una asociación inversa que sugiere que, a mayores concentraciones de vitamina D, menor es la probabilidad de desarrollar preclampsia, a pesar de la heterogeneidad de la medida global en este tipo de análisis.

Concepts and measures of patient empowerment: a comprehensive review.

PubMed

Cerezo, Paloma Garcimartín; Juvé-Udina, Maria-Eulália; Delgado-Hito, Pilar

2016-01-01

Analyze the definitions and dimensions of empowerment. Identify the strengths and weaknesses of empowerment measures based on the conceptual model. This was a comprehensive literature review of publications on the MEDLINE and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. Twenty-nine articles were selected. Seventeen definitions and seven dimensions of empowerment, and 10 empowerment measures were selected. Empowerment can be seen as an enabling process involving a shift in the balance of power, or as an outcome of this process. The dimensions reflect outcome indicators, such as participation in decision-making and control, and process indicators, such as knowledge acquisition and coping skills. Six of the tools analyzed by this study could be said to provide a robust measure of patient empowerment. we propose a definition of empowerment that helps to deepen understanding of the term and, therefore, its operationalization. Analizar definiciones y dimensiones de empoderamiento. Identificar fortalezas y debilidades de los instrumentos de medida de empoderamiento respecto al modelo conceptual. Revisión integrativa de la literatura en las bases de datos MEDLINE y Cumulative Index to Nursing and Allied Health Literature (CINAHL). Fueram seleccionados 29 artículos . Se identificaron 17 definiciones, 7 propuestas de dimensiones y 10 instrumentos de medida. Empoderamiento puede ser un proceso de capacitación o habilitación en el que se transfiere el poder de un individuo a otro, o bien un resultado producto de ese proceso. Las dimensiones reflejan indicadores de resultados como son la participación en la toma de decisiones y tomar el control, e indicadores relativos al proceso como son la adquisición de conocimientos y las habilidades de afrontamiento. De los instrumentos analizados seis son los instrumentos que presentan mayor robustez. Se propone una definición de empoderamiento que puede ayudar a mejorar la comprensión del t

Proyecto para la medición sistemática de seeing en CASLEO

NASA Astrophysics Data System (ADS)

Fernández Lajus, E.; Forte, J. C.

La calidad del seeing astronómico es ciertamente uno de los parámetros mas importantes que caracterizan el sitio de un observatorio. Por tanto se desea determinar si el alto valor de seeing observado con el telescopio de 2.15 m se debe a efectos internos y/o del entorno a la cupula o si se debe simplemente al seeing propio del lugar. El actual mecanismo de refrigeración del espejo primario del 2.15, parece haber mejorado notablemente la calidad del seeing. Sin embargo se hace necesario saber hasta que punto el valor del seeing puede ser mejorado. La primera etapa del proyecto consistió en la puesta a punto del telescopio emplazado para este propósito y la adquisición de las primeras medidas tentativas de seeing.

In vivo subjective and objective longitudinal chromatic aberration after bilateral implantation of the same design of hydrophobic and hydrophilic intraocular lenses.

PubMed

Vinas, Maria; Dorronsoro, Carlos; Garzón, Nuria; Poyales, Francisco; Marcos, Susana

2015-10-01

To measure the longitudinal chromatic aberration in vivo using psychophysical and wavefront-sensing methods in patients with bilateral implantation of monofocal intraocular lenses (IOLs) of similar aspheric design but different materials (hydrophobic Podeye and hydrophilic Poday). Instituto de Optica, Consejo Superior de Investigaciones Cientificas, Madrid, Spain. Prospective observational study. Measurements were performed with the use of psychophysical (480 to 700 nm) and wavefront-sensing (480 to 950 nm) methods using a custom-developed adaptive optics system. Chromatic difference-of-focus curves were obtained from best-focus data at each wavelength, and the longitudinal chromatic aberration was obtained from the slope of linear regressions to those curves. The longitudinal chromatic aberration from psychophysical measurements was 1.37 diopters (D) ± 0.08 (SD) (hydrophobic) and 1.21 ± 0.08 D (hydrophilic). From wavefront-sensing, the longitudinal chromatic aberration was 0.88 ± 0.07 D and 0.73 ± 0.09 D, respectively. At 480 to 950 nm, the longitudinal chromatic aberration was 1.27 ± 0.09 D (hydrophobic) and 1.02 ± 0.13 D (hydrophilic). The longitudinal chromatic aberration was consistently higher in eyes with the hydrophobic IOL than in eyes with the hydrophilic IOL (a difference of 0.16 D and 0.15 D, respectively). Similar to findings in young phakic eyes, the longitudinal chromatic aberration from the psychophysical method was consistently higher than from wavefront-sensing, by 0.48 D (35.41%) for the hydrophobic IOL and 0.48 D (39.43%) for the hydrophilic IOL. Longitudinal chromatic aberrations were smaller with hydrophilic IOLs than with hydrophobic IOLs of the same design. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Aquaporin-4 in brain and spinal cord oedema.

PubMed

Saadoun, S; Papadopoulos, M C

2010-07-28

Brain oedema is a major clinical problem produced by CNS diseases (e.g. stroke, brain tumour, brain abscess) and systemic diseases that secondarily affect the CNS (e.g. hyponatraemia, liver failure). The swollen brain is compressed against the surrounding dura and skull, which causes the intracranial pressure to rise, leading to brain ischaemia, herniation, and ultimately death. A water channel protein, aquaporin-4 (AQP4), is found in astrocyte foot processes (blood-brain border), the glia limitans (subarachnoid cerebrospinal fluid-brain border) and ependyma (ventricular cerebrospinal fluid-brain border). Experiments using mice lacking AQP4 or alpha syntrophin (which secondarily downregulate AQP4) showed that AQP4 facilitates oedema formation in diseases causing cytotoxic (cell swelling) oedema such as cerebral ischaemia, hyponatraemia and meningitis. In contrast, AQP4 facilitates oedema elimination in diseases causing vasogenic (vessel leak) oedema and therefore AQP4 deletion aggravates brain oedema produced by brain tumour and brain abscess. AQP4 is also important in spinal cord oedema. AQP4 deletion was associated with less cord oedema and improved outcome after compression spinal cord injury in mice. Here we consider the possible routes of oedema formation and elimination in the injured cord and speculate about the role of AQP4. Finally we discuss the role of AQP4 in neuromyelitis optica (NMO), an inflammatory demyelinating disease that produces oedema in the spinal cord and optic nerves. NMO patients have circulating AQP4 IgG autoantibody, which is now used for diagnosing NMO. We speculate how NMO-IgG might produce CNS inflammation, demyelination and oedema. Since AQP4 plays a key role in the pathogenesis of CNS oedema, we conclude that AQP4 inhibitors and activators may reduce CNS oedema in many diseases. Copyright (c) 2010 IBRO. Published by Elsevier Ltd. All rights reserved.

Challenges in randomized controlled trials and emerging multiple sclerosis therapeutics.

PubMed

Huang, DeRen

2015-12-01

The remarkable global development of disease-modifying therapies (DMTs) specific for multiple sclerosis (MS) has significantly reduced the frequency of relapse, slowed the progression of disability, and improved the quality of life in patients with MS. With increasing numbers of approved DMTs, neurologists in North America and Europe are able to present multiple treatment options to their patients to achieve a better therapeutic outcome, and in many cases, no evidence of disease activity. MS patients have improved accessibility to various DMTs at no or minimal out-of-pocket cost. The ethical guidelines defined by the Edinburgh revision of the Declaration of Helsinki strongly discourage the use of placebo control groups in modern MS clinical trials. The use of an active comparator control group increases the number of participants in each group that is essential to achieve statistical significance, thus further increasing the difficulty of completing randomized controlled trials (RCTs) for the development of new MS therapies. There is evidence of a high prevalence of MS and a large number of patients in Asia. The belief of the existence of Asian types of MS that are distinct from Western types, and regulatory policies are among the reasons why DMTs are limited in most Asian countries. Lack of access to approved DMTs provides a good opportunity for clinical trials that are designed for the development of new MS therapies. Recently, data from RCTs have demonstrated excellent recruitment of participants and the completion of multi-nation and single-nation MS trials within this region. Recent studies using the McDonald MS diagnostic criteria carefully excluded patients with neuromyelitis optica (NMO) and NMO spectrum disorder, and demonstrated that patients with MS in Asia have clinical characteristics and treatment responses similar to those in Western countries.

Evaluation of aquaporin-4 antibody assays

PubMed Central

Waters, Patrick J.; Pittock, Sean J.; Bennett, Jeffrey L.; Jarius, Sven; Weinshenker, Brian G.; Wingerchuk, Dean M.

2015-01-01

Aquaporin-4 (AQP4) is a water channel protein that is most highly, but not exclusively, expressed in the central nervous system. In 2005 AQP4 was shown to be the antigenic target of neuromyelitis optica-immunoglobulin G (NMO-IgG, or AQP4-IgG), an antibody found specifically in patients with NMO and in formes frustes of NMO, such as longitudinally extensive transverse myelitis (LETM) or optic neuritis (ON). This discovery facilitated the clinical, pathological, and radiological distinction of NMO and the spectrum of NMO-related disorders from classical multiple sclerosis. In addition to its use as a diagnostic tool, AQP4-IgG predicts a high risk of relapse in patients with a clinically isolated syndrome of either LETM or ON. As disability in NMO is attack-related, early diagnosis and treatment are predicted to have a major effect on long-term disability. Thus, the importance of sensitive and specific assays to detect AQP4-IgG cannot be overstated. Both academic institutions and commercial companies have developed assays to identify AQP4-IgG in patients’ sera or cerebrospinal fluid. Both AQP4 isoforms from different species have been used as the antigenic target in the form of frozen tissue sections in indirect immunofluorescence assays, partially purified protein for fluorescence immunoprecipitation assay, radioimmunoprecipita-tion assay or enzyme-linked immunosorbent assay, or transfected into cells for cell based assays or flow cytometry. We carried out a systematic review of the literature reporting different methodologies used to identify AQP4-IgG, examine whether longitudinal AQP4-IgG titers predict relapses in seropositive patients, and attempt to establish a reasonable timeframe for retesting negative serum samples. PMID:27840658

Challenging AQP4 druggability for NMO-IgG antibody binding using molecular dynamics and molecular interaction fields.

PubMed

Mangiatordi, Giuseppe Felice; Alberga, Domenico; Siragusa, Lydia; Goracci, Laura; Lattanzi, Gianluca; Nicolotti, Orazio

2015-07-01

Neuromyelitis optica (NMO) is a multiple sclerosis-like immunopathology disease affecting optic nerves and the spinal cord. Its pathological hallmark is the deposition of a typical immunoglobulin, called NMO-IgG, against the water channel Aquaporin-4 (AQP4). Preventing NMO-IgG binding would represent a valuable molecular strategy for a focused NMO therapy. The recent observation that aspartate in position 69 (D69) is determinant for the formation of NMO-IgG epitopes prompted us to carry out intensive Molecular Dynamics (MD) studies on a number of single-point AQP4 mutants. Here, we report a domino effect originating from the point mutation at position 69: we find that the side chain of T62 is reoriented far from its expected position leaning on the lumen of the pore. More importantly, the strength of the H-bond interaction between L53 and T56, at the basis of the loop A, is substantially weakened. These events represent important pieces of a clear-cut mechanistic rationale behind the failure of the NMO-IgG binding, while the water channel function as well as the propensity to aggregate into OAPs remains unaltered. The molecular interaction fields (MIF)-based analysis of cavities complemented MD findings indicating a putative binding site comprising the same residues determining epitope reorganization. In this respect, docking studies unveiled an intriguing perspective to address the future design of small drug-like compounds against NMO. In agreement with recent experimental observations, the present study is the first computational attempt to elucidate NMO-IgG binding at the molecular level, as well as a first effort toward a less elusive AQP4 druggability. Copyright © 2015 Elsevier B.V. All rights reserved.

Aquaporin-4 antibodies in patients treated with natalizumab for suspected MS

PubMed Central

Gahlen, Anna; Trampe, Anne-Kathrin; Haupeltshofer, Steffen; Ringelstein, Marius; Aktas, Orhan; Berthele, Achim; Wildemann, Brigitte; Gold, Ralf; Jarius, Sven

2017-01-01

Objective: To evaluate (1) the frequency of aquaporin-4 antibody (AQP4-ab)-seropositive cases among patients treated with natalizumab (NAT) and previously diagnosed with MS (MSNAT) in a nationwide cohort, (2) the clinical course of NAT-treated AQP4-ab–seropositive neuromyelitis optica spectrum disorder (NMOSD) patients (NMONAT), (3) AQP4-ab titers in NMONAT and AQP4-ab–seropositive NMOSD treated with other immunotherapies (NMOIT), and (4) immune mechanisms influencing disease activity in NMONAT. Methods: MSNAT serum samples were retrospectively screened with a cell-based assay for AQP4-IgG and titers determined by ELISA. The annualized relapse rate (ARR) and disability progression were assessed. Serum levels of proinflammatory cytokines (interleukin [IL]-1β, IL-4, IL-6, IL-8, IL-10, IL-17, IL-21, and interferon [IFN]-γ) and the chemokine CXCL-10 of NMONAT patients identified in this (n = 4) and a previous study (n = 5) were measured by cytometric bead array and ELISA. Results: Of the 1,183 MSNAT patients (851 female, median 9 NAT infusions), only 4 (0.33%; 3 female, 1 male) had AQP4-IgG. Of these, 2 fulfilled the 2006 NMO criteria and all met the 2015 NMOSD criteria. The ARR was higher in NMONAT vs MSNAT (p = 0.0182). All 4 NMONAT patients had relapses and 2 had an increase of disability. AQP4-ab titers were higher in NMONAT (n = 9) vs NMOIT (n = 13; p = 0.0059). IL-8, IL-1β, and IFN-γ serum levels were significantly higher, and CXCL-10 was significantly lower in NMONAT vs NMOIT. Conclusions: Misdiagnosis of NMOSD with MS is rare. NAT was not able to control disease activity in NMONAT patients, who had higher serum levels of AQP4-IgG and proinflammatory cytokines than patients with NMOSD treated with other immunotherapies. PMID:28642888

Diagnostic algorithm for relapsing acquired demyelinating syndromes in children.

PubMed

Hacohen, Yael; Mankad, Kshitij; Chong, W K; Barkhof, Frederik; Vincent, Angela; Lim, Ming; Wassmer, Evangeline; Ciccarelli, Olga; Hemingway, Cheryl

2017-07-18

To establish whether children with relapsing acquired demyelinating syndromes (RDS) and myelin oligodendrocyte glycoprotein antibodies (MOG-Ab) show distinctive clinical and radiologic features and to generate a diagnostic algorithm for the main RDS for clinical use. A panel reviewed the clinical characteristics, MOG-Ab and aquaporin-4 (AQP4) Ab, intrathecal oligoclonal bands, and Epstein-Barr virus serology results of 110 children with RDS. A neuroradiologist blinded to the diagnosis scored the MRI scans. Clinical, radiologic, and serologic tests results were compared. The findings showed that 56.4% of children were diagnosed with multiple sclerosis (MS), 25.4% with neuromyelitis optica spectrum disorder (NMOSD), 12.7% with multiphasic disseminated encephalomyelitis (MDEM), and 5.5% with relapsing optic neuritis (RON). Blinded analysis defined baseline MRI as typical of MS in 93.5% of children with MS. Acute disseminated encephalomyelitis presentation was seen only in the non-MS group. Of NMOSD cases, 30.7% were AQP4-Ab positive. MOG-Ab were found in 83.3% of AQP4-Ab-negative NMOSD, 100% of MDEM, and 33.3% of RON. Children with MOG-Ab were younger, were less likely to present with area postrema syndrome, and had lower disability, longer time to relapse, and more cerebellar peduncle lesions than children with AQP4-Ab NMOSD. A diagnostic algorithm applicable to any episode of CNS demyelination leads to 4 main phenotypes: MS, AQP4-Ab NMOSD, MOG-Ab-associated disease, and antibody-negative RDS. Children with MS and AQP4-Ab NMOSD showed features typical of adult cases. Because MOG-Ab-positive children showed notable and distinctive clinical and MRI features, they were grouped into a unified phenotype (MOG-Ab-associated disease), included in a new diagnostic algorithm. © 2017 American Academy of Neurology.

CSF free light chain identification of demyelinating disease: comparison with oligoclonal banding and other CSF indexes.

PubMed

Gurtner, Kari M; Shosha, Eslam; Bryant, Sandra C; Andreguetto, Bruna D; Murray, David L; Pittock, Sean J; Willrich, Maria Alice V

2018-02-19

Cerebrospinal fluid (CSF) used in immunoglobulin gamma (IgG) index testing and oligoclonal bands (OCBs) are common laboratory tests used in the diagnosis of multiple sclerosis. The measurement of CSF free light chains (FLC) could pose as an alternative to the labor-intensive isoelectric-focusing (IEF) gels used for OCBs. A total of 325 residual paired CSF and serum specimens were obtained after physician-ordered OCB IEF testing. CSF kappa (cKFLC) and lambda FLC (cLFLC), albumin and total IgG were measured. Calculations were performed based on combinations of analytes: CSF sum of kappa and lambda ([cKFLC+cLFLC]), kappa-index (K-index) ([cKFLC/sKFLC]/[CSF albumin/serum albumin]), kappa intrathecal fraction (KFLCIF) {([cKFLC/sKFLC]-[0.9358×CSF albumin/serum albumin]^[0.6687×sKFLC]/cKFLC)} and IgG-index ([CSF IgG/CSF albumin]/[serum IgG/serum albumin]). Patients were categorized as: demyelination (n=67), autoimmunity (n=53), non-inflammatory (n=50), inflammation (n=38), degeneration (n=28), peripheral neuropathy (n=24), infection (n=13), cancer (n=11), neuromyelitis optica (n=10) and others (n=31). cKFLC measurement used alone at a cutoff of 0.0611 mg/dL showed >90% agreement to OCBs, similar or better performance than all other calculations, reducing the number of analytes and variables. When cases of demyelinating disease were reviewed, cKFLC measurements showed 86% clinical sensitivity/77% specificity. cKFLC alone demonstrates comparable performance to OCBs along with increased sensitivity for demyelinating diseases. Replacing OCB with cKFLC would alleviate the need for serum and CSF IgG and albumin and calculated conversions. cKFLC can overcome challenges associated with performance, interpretation, and cost of traditional OCBs, reducing costs and maintaining sensitivity and specificity supporting MS diagnosis.

Analysis of prognostic factors associated with longitudinally extensive transverse myelitis.

PubMed

Sepúlveda, María; Blanco, Yolanda; Rovira, Alex; Rio, Jordi; Mendibe, Mar; Llufriu, Sara; Gabilondo, Iñigo; Villoslada, Pablo; Castilló, Joaquin; Corral, Juan; Ayuso, Teresa; Iñiguez, Cristina; Santos, Sonia; Guijarro, Cristina; Ramió-Torrentà, Lluis; Sempere, Angel P; Olascoaga, Javier; Graus, Francesc; Montalban, Xavier; Saiz, Albert

2013-05-01

The aim of this study is to report the clinical profile and outcome of longitudinally extensive transverse myelitis (LETM). We prospectively studied adult patients who presented with LETM from January 2008 to December 2011. Information on demographic, clinical course, magnetic resonance imaging (MRI) and outcome was collected. HLA-DRB1 genotype was compared with those of 225 normal controls and patients with MS (228) and neuromyelitis optica (NMO) (22). In total, 23 patients (16 female) with a median age of 44.5 years (range: 20-77 years) were included. Most (74%) had moderate-severe disability at nadir (48% non-ambulatory), normal/non-multiple sclerosis (MS) brain MRI (96%) and a median MRI cord lesion of 5 vertebral segments (range: 3-19). Laboratory analysis showed cerebrospinal fluid pleocytosis (45%), NMO-IgG (9%), antinuclear antibodies (70%), and genotype HLA-DRB1*13 (57%). The frequency of DRB1*13 genotype was higher compared with controls (p=0.002), MS (p=0.001) and NMO (p=0.003) patients. After a median follow-up of 32 months, one patient converted to MS, two had relapsing LETM with NMO-IgG, and 20 remained as idiopathic with recurrences in four (20%). Twelve (52%) patients recovered with minimal disability (Expanded Disability Status Scale (EDSS) ≤2.5) and three (13%) remained wheelchair dependent. Disability at nadir was associated with the final outcome and extension of the spinal cord lesion with risk of recurrence. Recurrence was not associated with worse outcome. Inflammatory LETM is mostly idiopathic with a good outcome. It includes a relatively homogenous group of patients with an overrepresentation of the HLA-DRB1*13 genotype. EDSS at nadir is a predictor of the final outcome and extension of the myelitis of the recurrence risk.

Adaptive Remote-Sensing Techniques Implementing Swarms of Mobile Agents

DOE Office of Scientific and Technical Information (OSTI.GOV)

Asher, R.B.; Cameron, S.M.; Loubriel, G.M.

1998-11-25

In many situations, stand-off remote-sensing and hazard-interdiction techniques over realistic operational areas are often impractical "and difficult to characterize. An alternative approach is to implement an adap- tively deployable array of sensitive agent-specific devices. Our group has been studying the collective be- havior of an autonomous, multi-agent system applied to chedbio detection and related emerging threat applications, The current physics-based models we are using coordinate a sensor array for mukivanate sig- nal optimization and coverage as re,alized by a swarm of robots or mobile vehicles. These intelligent control systems integrate'glob"ally operating decision-making systems and locally cooperative learning neural net- worksmore » to enhance re+-timp operational responses to dynarnical environments examples of which include obstacle avoidance, res~onding to prevailing wind patterns, and overcoming other natural obscurants or in- terferences. Collectively',tkensor nefirons with simple properties, interacting according to basic community rules, can accomplish complex interconnecting functions such as generalization, error correction, pattern recognition, sensor fusion, and localization. Neural nets provide a greater degree of robusmess and fault tolerance than conventional systems in that minor variations or imperfections do not impair performance. The robotic platforms would be equipped with sensor devices that perform opticaI detection of biologicais in combination with multivariate chemical analysis tools based on genetic and neural network algorithms, laser-diode LIDAR analysis, ultra-wideband short-pulsed transmitting and receiving antennas, thermal im- a:ing sensors, and optical Communication technology providing robust data throughput pathways. Mission scenarios under consideration include ground penetrating radar (GPR) for detection of underground struc- tures, airborne systems, and plume migration and mitigation. We will describe our

Molecular mimicry as a mechanism for food immune reactivities and autoimmunity.

PubMed

Vojdani, Aristo

2015-01-01

The mucosal immune system is constantly exposed to challenges from the antigenic substances found in food and released from the body's own microbial flora. The body's normal tolerance to friendly antigenic substances can be disrupted by a number of factors, such as disease, injury, shock, trauma, surgery, drugs, blood transfusion, environmental triggers, etc. When this disruption happens, the ingestion of foods containing antigenic substances that have compositions similar to those of the body's autoantigens can result in the production of antibodies that react not only against the food antigens but also the body's own tissues. This response is known as food autoimmune reactivity. Between 7% and 10% of the world's population suffers from some form of autoimmune disease. Each patient's antibodies, both immunoglobulin A (IgA) + immunoglobulin M (IgM) in the saliva and immunoglobulin G (IgG) and IgA in the blood must be examined to give a complete picture of food immune reactivity. A host of health problems and autoimmune disorders have increasingly become associated with some of the most commonly consumed foods in the world, such as wheat and milk. Many of these problems can be traced to molecular mimicry. The peptide sequences of foods such as milk and wheat are similar to those of human molecules, such as myelin oligodendrocyte glycoprotein, human islet cell tissue, and human aquaporin 4 (AQP4). This similarity can result in cross-reactivity that leads to food autoimmunity and even autoimmune disorders, such as multiple sclerosis (MS), celiac disease (CD), and neuromyelitis optica. Further research is needed to determine what other foods have dangerous sequence similarities to human tissues and what methods are available to test for the autoantibodies resulting from these molecular, mimicry-induced misfires of the immune system. The identification and removal of corresponding food triggers can then be used as the basis of therapy.

Life-threatening hypokalemia following rapid correction of respiratory acidosis.

PubMed

Hammond, Kendra; You, David; Collins, Eileen G; Leehey, David J; Laghi, Franco

2013-01-01

A 56-year-old woman with a history of paraplegia and chronic pain due to neuromyelitis optica (Devic's syndrome) was admitted to a spinal cord injury unit for management of a sacral decubitus ulcer. During the hospitalization, she required emergency transfer to the intensive care unit (ICU) because of progressive deterioration of respiratory muscle function, severe respiratory acidosis, obtundation and hypotension. Upon transfer to the ICU, arterial blood gas revealed severe acute-on-chronic respiratory acidosis (pH 7.00, PCO2 120 mm Hg, PO2 211 mm Hg). The patient was immediately intubated and mechanically ventilated. Intravenous fluid boluses of normal saline (10.5 L in about 24 h) and vasopressors were started with rapid correction of hypotension. In addition, she was given hydrocortisone. Within 40 min of initiation of mechanical ventilation, there was improvement in acute respiratory acidosis. Sixteen hours later, however, the patient developed life-threatening hypokalemia (K(+) of 2.1 mEq/L) and hypomagnesemia (Mg of 1.4 mg/dL). Despite aggressive potassium supplementation, hypokalemia continued to worsen over the next several hours (K(+) of 1.7 mEq/L). Urine studies revealed renal potassium wasting. We reason that the recalcitrant life-threatening hypokalemia was caused by several mechanisms including total body potassium depletion (chronic respiratory acidosis), a shift of potassium from the extracellular to intracellular space (rapid correction of respiratory acidosis with mechanical ventilation), increased sodium delivery to the distal nephron (normal saline resuscitation), hyperaldosteronism (secondary to hypotension plus administration of hydrocortisone) and hypomagnesemia. We conclude that rapid correction of respiratory acidosis, especially in the setting of hypotension, can lead to life-threatening hypokalemia. Serum potassium levels must be monitored closely in these patients, as failure to do so can lead to potentially lethal consequences

The intrinsic pathogenic role of autoantibodies to aquaporin 4 mediating spinal cord disease in a rat passive-transfer model

PubMed Central

Geis, Christian; Ritter, Christian; Ruschil, Christoph; Weishaupt, Andreas; Grünewald, Benedikt; Stoll, Guido; Holmoy, Trygve; Misu, Tatsuro; Fujihara, Kazuo; Hemmer, Bernhard; Stadelmann, Christine; Bennett, Jeffrey L.; Sommer, Claudia; Toyka, Klaus V.

2015-01-01

Neuromyelitis optica (NMO) is causally linked to autoantibodies (ABs) against aquaporin 4 (AQP4). Here, we focused on the pathogenic effects exclusively mediated by human ABs to AQP4 in vivo. We performed cell-free intrathecal (i.th.) passive transfer experiments in Lewis rats using purified patient NMO immunoglobulin G (IgG) and various recombinant human anti-AQP4 IgG-ABs via implanted i.th. catheters. Repetitive application of patient NMO IgG fractions and of recombinant human anti-AQP4 ABs induced signs of spinal cord disease. Magnetic resonance imaging (MRI) revealed longitudinal spinal cord lesions at the site of application of anti-AQP4 IgG. Somatosensory evoked potential amplitudes were reduced in symptomatic animals corroborating the observed functional impairment. Spinal cord histology showed specific IgG deposition in the grey and white matter in the affected areas. We did not find inflammatory cell infiltration nor activation of complement in spinal cord areas of immunoglobulin deposition. Moreover, destructive lesions showing axon or myelin damage and loss of astrocytes and oligodendrocytes were all absent. Immunoreactivity to AQP4 and to the excitatory amino acid transporter 2 (EAAT2) was markedly reduced whereas immunoreactivity to the astrocytic marker glial fibrillary acid protein (GFAP) was preserved. The expression of the NMDA-receptor NR1 subunit was down-regulated in areas of IgG deposition possibly induced by sustained glutamatergic overexcitation. Disease signs and histopathology were reversible within weeks after stopping injections. We conclude that in vivo application of ABs directed at AQP 4 can induce a reversible spinal cord disease in recipient rats by inducing distinct histopathological abnormalities. These findings may be the experimental correlate of “penumbra-like” lesions recently reported in NMO patients adjacent to effector-mediated tissue damage. PMID:25542977

The intrinsic pathogenic role of autoantibodies to aquaporin 4 mediating spinal cord disease in a rat passive-transfer model.

PubMed

Geis, Christian; Ritter, Christian; Ruschil, Christoph; Weishaupt, Andreas; Grünewald, Benedikt; Stoll, Guido; Holmoy, Trygve; Misu, Tatsuro; Fujihara, Kazuo; Hemmer, Bernhard; Stadelmann, Christine; Bennett, Jeffrey L; Sommer, Claudia; Toyka, Klaus V

2015-03-01

Neuromyelitis optica (NMO) is causally linked to autoantibodies (ABs) against aquaporin 4 (AQP4). Here, we focused on the pathogenic effects exclusively mediated by human ABs to AQP4 in vivo. We performed cell-free intrathecal (i.th.) passive transfer experiments in Lewis rats using purified patient NMO immunoglobulin G (IgG) and various recombinant human anti-AQP4 IgG-ABs via implanted i.th. catheters. Repetitive application of patient NMO IgG fractions and of recombinant human anti-AQP4 ABs induced signs of spinal cord disease. Magnetic resonance imaging (MRI) revealed longitudinal spinal cord lesions at the site of application of anti-AQP4 IgG. Somatosensory evoked potential amplitudes were reduced in symptomatic animals corroborating the observed functional impairment. Spinal cord histology showed specific IgG deposition in the grey and white matter in the affected areas. We did not find inflammatory cell infiltration nor activation of complement in spinal cord areas of immunoglobulin deposition. Moreover, destructive lesions showing axon or myelin damage and loss of astrocytes and oligodendrocytes were all absent. Immunoreactivity to AQP4 and to the excitatory amino acid transporter 2 (EAAT2) was markedly reduced whereas immunoreactivity to the astrocytic marker glial fibrillary acid protein (GFAP) was preserved. The expression of the NMDA-receptor NR1 subunit was downregulated in areas of IgG deposition possibly induced by sustained glutamatergic overexcitation. Disease signs and histopathology were reversible within weeks after stopping injections. We conclude that in vivo application of ABs directed at AQP 4 can induce a reversible spinal cord disease in recipient rats by inducing distinct histopathological abnormalities. These findings may be the experimental correlate of "penumbra-like" lesions recently reported in NMO patients adjacent to effector-mediated tissue damage. Copyright © 2014 Elsevier Inc. All rights reserved.

Development and validation of the Hospitality Axiological Scale for Humanization of Nursing Care.

PubMed

Galán González-Serna, José María; Ferreras-Mencia, Soledad; Arribas-Marín, Juan Manuel

2017-08-03

instrumento desenvolvido apresentou uma validade adequada e uma consistência interna elevada. Com base na consistência de suas propriedades psicométricas, é possível afirmar que a escala proporciona uma medida confiável da hospitalidade. Também foi possível determinar as dimensões ou fontes que a compõem: o respeito, a responsabilidade, a qualidade e o cuidado transpessoal. desarrollar y validar una escala que permita evaluar la actitud enfermera ante la hospitalidad para la humanización de enfermería. Participantes: la muestra la componen 499 profesionales de enfermería y estudiantes de los dos últimos niveles académicos de la titulación de Grado en Enfermería. mediante abordaje metodológico, se ha desarrollado y validado un instrumento para evaluar valores éticos relacionados con la hospitalidad. Posteriormente, se ha formulado un modelo de medida de las dimensiones que conforman el constructo hospitalidad. la Escala Axiológica de la Hospitalidad ha mostrado una alta consistencia interna, con un Alfa de Cronbach=0.901. La validación del instrumento de medida se realizó mediante las técnicas de análisis factorial, exploratorio y confirmatorio, que presentaron unos buenos índices de bondad de ajuste. el instrumento desarrollado ha presentado una adecuada validez y una alta consistencia interna. Sus adecuadas propiedades psicométricas permiten afirmar que la escala aporta una medición fiable de la hospitalidad. También ha permitido determinar las dimensiones o fuentes que la conforman: el respeto, la responsabilidad, la calidad y el cuidado transpersonal.

Foot length measurements of newborns of high and low risk pregnancies.

PubMed

Salge, Ana Karina Marques; Rocha, Érika Lopes; Gaíva, Maria Aparecida Munhoz; Castral, Thaíla Correa; Guimarães, Janaína Valadares; Xavier, Raphaela Maioni

2017-03-09

Comparing foot length measurements of newborns in high and low risk pregnancies at a public hospital in Goiânia, GO, Brazil. A cross-sectional study carried out between April, 2013 and May, 2015, with a sample consisting of 180 newborns; 106 infants of women from high-risk pregnancies and 74 of women from low-risk pregnancies. Data were descriptively analyzed. Foot length measurement was performed using a stiff transparent plastic ruler, graduated in millimeters. The length of both feet was measured from the tip of the hallux (big toe) to the end of the heel. A statistically significant relationship was found between the foot length and newborn's weight, between the cephalic and thoracic perimeters in the high-risk group and between the cephalic perimeter in the control group. There is a need for creating cut-off points to identify newborns with intrauterine growth disorders using foot length. Comparar as medidas do comprimento hálux-calcâneo de recém-nascidos em gestações de alto e baixo risco em um hospital público de Goiânia, GO. Estudo transversal, realizado no período de abril de 2013 a maio de 2015, cuja amostra constituiu-se de 180 recém-nascidos, 106 filhos de mulheres com gestação de alto risco e 74 de mulheres com gestação de baixo risco. Os dados foram analisados descritivamente. A medida do comprimento hálux-calcâneo foi realizada utilizando-se de régua plástica transparente rígida, graduada em milímetros. Foram medidos ambos os pés, aferindo-se o comprimento da ponta do hálux até a extremidade do calcâneo. Foi encontrada relação estatisticamente significante entre o comprimento hálux-calcâneo e o peso do recém-nascido, entre os perímetros cefálico e torácico no grupo de alto risco e entre o perímetro cefálico no grupo controle. Existe necessidade da criação de pontos de corte para identificar recém-nascidos com desvios de crescimento intrauterino utilizando-se do comprimento hálux-calcâneo. Comparar las mediciones

Arboviruses emerging in Brazil: challenges for clinic and implications for public health.

PubMed

Donalisio, Maria Rita; Freitas, André Ricardo Ribas; Zuben, Andrea Paula Bruno Von

2017-04-10

Arboviruses have been emerging in different parts of the world due to genetic changes in the virus, alteration of the host and vector population dynamics, or because of anthropogenic environmental factors. These viruses' capacity for adaptation is notable, as well as the likelihood of their emergence and establishment in new geographic areas. In Brazilian epidemiologic scenario, the most common arboviruses are DENV, CHIKV, and ZIKV, although others may spread in the country. Little is yet known of the impact of viral co-circulation, which would theoretically result in more intense viremia or other immunological alterations that could trigger autoimmune diseases, such as Guillain-Barré syndrome. The impact on morbidity and mortality intensifies as extensive epidemics lead to a high number of affected individuals, severe cases, and implications for health services, mainly due to the absence of treatment, vaccines, and effective prevention and control measures. RESUMO Notifica-se a emergência de arboviroses em diferentes regiões do planeta em decorrência de mudanças genéticas no vírus, alteração da dinâmica populacional de hospedeiros e vetores ou por fatores ambientais de origem antropogênica. É notável a capacidade de adaptação desses vírus e a possibilidade de emergirem e se estabelecerem em novas áreas geográficas. No contexto epidemiológico brasileiro, os arbovírus de maior circulação são DENV, CHIKV e ZIKV, embora existam outros com potencial de disseminação no País. O impacto da cocirculação viral ainda é pouco conhecido, a qual teoricamente resultaria em viremias mais intensas ou outras alterações imunológicas que poderiam ser o gatilho para doenças autoimunes, como a síndrome de Guillain-Barré. O impacto na morbidade e mortalidade se intensifica à medida que extensas epidemias pressupõem grande número de indivíduos acometidos, casos graves e implicações sobre os serviços de saúde, principalmente diante da aus

Dinámica global en galaxias elípticas

NASA Astrophysics Data System (ADS)

Pérez, M. J.; Cincotta, P. M.; Giordano, C. M.

Con el propósito de determinar propiedades dinámicas globales en sistemas triaxiales no integrables, utilizamos una nueva herramienta conocida como ``Mean Exponential Growth factor of Nearby Orbits'' (MEGNO), introducida por Cincotta y Simó (2000). Esta técnica no sólo resulta eficiente para investigar ambas componentes del espacio fase, regular y caótica, sino que también, provee una medida de la hiperbolicidad en el dominio caótico que coincide con la dada por el Lyapunov Characteristic Number (LCN). Previamente este método ha sido aplicado al estudio de modelos simples, y últimamente en el campo de la Mecánica Celeste, al estudio de sistemas planetarios extrasolares. En esta presentación, ilustraremos algunas de las propiedades más importantes del MEGNO, aplic& acute;andolo al potencial tridimensional de Stäckel perturbado.

Estudio polarimétrico de NGC 104 (47 Tucanae)

NASA Astrophysics Data System (ADS)

Forte, J. C.; Bassino, L. P.; Vega, E. I.; Cellone, S.; Pellizza, L.; Méndez, M.

Se presentan observaciones polarimétricas en el Visual y sin filtro para 72 estrellas, 14 zonas de referencia y el núcleo del cúmulo globular NGC 104. Las medidas, hechas en el CASLEO con el nuevo polarimétro CASPROF, muestran un comportamiento complejo que incluye: a) dos componentes de polarización a lo largo de la visual; b) signos de envolturas polvorientas en 8 de 10 estrellas variables de largo período pertenecientes al cúmulo c) media docena de estrellas con alta polarización residual (P> 0.20 %) originada probablemente en scattering. Estas estrellas se encuentran próximas a una estructura extendida, coincidente con la región central del cúmulo, detectada en observaciones IRAS. Las observaciones son consistentes con la presencia de pequeñas cantidades de polvo originada en procesos de pérdida de masa.

[What can doctors do to moderate healthcare costs?

PubMed

Lifshitz, Alberto; Celis, Miguel Ángel; Moreno, Mucio; Gas, Héctor Aguirre; Halabe, José; Jasso, Luis; Arrieta, Óscar; Burgos, Rubén; Campillo, Carlos; de la Llata, Manuel; Domínguez, Judith; Islas, Sergio; Plancarte, Ricardo; Reyes, Alejandro; Soda, Antonio; Verásteguio, Emma; Sotelo, Julio

Los costos de la atención médica pueden alcanzar niveles tales que marginen a algunos pacientes de los beneficios del avance científico y tecnológico. Las razones de estos elevados costos son diversas y en la mayoría de los casos no está en manos de los médicos moderarlos. En este escrito se proponen algunas acciones que los médicos podemos realizar para disminuir los costos de la atención médica. La magnitud del ahorro que se puede alcanzar con estas medidas es modesta, puesto que la mayor parte de los costos no dependen de los médicos, pero se trata de ofrecer nuestra contribución. Evitar todo lo superfluo: no más medicamentos ni estudios que los estrictamente necesarios, sin medicina defensiva; y no ceder ante la presión de pacientes y familiares para que se prescriban pruebas o medicamentos inútiles.

Nuevas observaciones de 3C10 con el VLA*: estudio de la expansión

NASA Astrophysics Data System (ADS)

Reynoso, E. M.; Moffett, D. A.:; Dubner, G. M.; Giacani, E. B.; Reynolds, S. P.; Goss, W. M.; Dickel, J.

Se presentan nuevos resultados sobre la expansión del remanente de la supernova de Tycho a lo largo de un intervalo de 10.9 años, comparando nuevas observaciones tomadas con el VLA a 1375 y 1635 MHz durante 1994 y 1995, con observaciones previas realizadas entre 1983 y 1984 (Dickel y col. ~1991 AJ 101, 2151), usando las mismas configuraciones, anchos de banda, calibradores y tiempos de integración. El coeficiente de expansión se calcula para sectores radiales de 4o de ancho cada uno, ajustando la correlación cruzada de las derivadas de los perfiles promedio para cada época. A partir de la expansión medida, se estima el índice (parámetro de expansión) de la ley potencial R∝ tm como m≡ d ln R/d ln t . Este valor se compara con coeficientes teóricos para diferentes fases evolutivas de remanentes de supernova.

Spin-Transfer-Torque Nano-Oscillators: Fabrication, Characterization and Dynamics

NASA Astrophysics Data System (ADS)

Costa, Jose Diogo Teixeira Barbosa

Este trabalho aborda algumas propriedades magneticas e estruturais de nanoparticulas de oxidos e oxidos-hidroxidos de ferro crescidos em matrizes hibridas orgânicas-inorgânicas. As matrizes hibridas, denominadas di-ureasils e obtidas pelo processo sol-gel, sao compostas por uma rede siliciosa ligada covalentemente por pontes ureia a cadeias orgânicas de diferente peso molecular. A estrutura local dos di-ureasils nao dopados esta modelada como grupos de dominios siliciosos com dimensoes nanometricas, estruturalmente correlacionados no seio de uma matriz rica em polimero. Neste trabalho mostra-se que os di-ureasils permitem o crescimento controlado de oxidos e oxidos-hidroxidos de ferro, incluindo a magnetite, maguemite, oxihidroxinitrato de ferro e ferrihidrite. O crescimento das nanoparticulas de ferrihidrite da-se em condicoes acidas a superficie dos dominios siliciosos, junto aos grupos carbonilo, que funcionam como pontos de nucleacao. Desse modo da-se uma nucleacao heterogenea, onde o tamanho das nanoparticulas depende da concentracao de ferro (entre 1 e 6% em massa), sendo a concentracao de particulas constante. As propriedades magneticas das nanoparticulas de ferrihidrite revelam a existencia de interaccoes antiferromagneticas e de momentos descompensados. A contribuicao destas duas componentes nas curvas de magnetizacao em funcao do campo magnetico pode ser separada usando um metodo aqui proposto, o que permite um adequado estudo da evolucao do momento magnetico com a temperatura. O estudo das propriedades magneticas dinâmicas das particulas de ferrihidrite, atraves de susceptibilidade ac, medidas de relaxacao e medidas de efeito Mossbauer, permitiu estudar a evolucao das interaccoes dipolares em funcao da concentracao de ferro, bem como determinar a distribuicao de barreiras de energia de anisotropia no caso em que essas interaccoes sao desprezaveis. E apresentado um novo metodo para comparacao desta distribuicao com a distribuicao de tamanhos, que

Structural and Magnetic Studies on Iron Oxide Nanoparticles in Hybrid Matrices =

NASA Astrophysics Data System (ADS)

Silva, Nuno Joao de Oliveira

Este trabalho aborda algumas propriedades magneticas e estruturais de nanoparticulas de oxidos e oxidos-hidroxidos de ferro crescidos em matrizes hibridas orgânicas-inorgânicas. As matrizes hibridas, denominadas di-ureasils e obtidas pelo processo sol-gel, sao compostas por uma rede siliciosa ligada covalentemente por pontes ureia a cadeias orgânicas de diferente peso molecular. A estrutura local dos di-ureasils nao dopados esta modelada como grupos de dominios siliciosos com dimensoes nanometricas, estruturalmente correlacionados no seio de uma matriz rica em polimero. Neste trabalho mostra-se que os di-ureasils permitem o crescimento controlado de oxidos e oxidos-hidroxidos de ferro, incluindo a magnetite, maguemite, oxihidroxinitrato de ferro e ferrihidrite. O crescimento das nanoparticulas de ferrihidrite da-se em condicoes acidas a superficie dos dominios siliciosos, junto aos grupos carbonilo, que funcionam como pontos de nucleacao. Desse modo da-se uma nucleacao heterogenea, onde o tamanho das nanoparticulas depende da concentracao de ferro (entre 1 e 6% em massa), sendo a concentracao de particulas constante. As propriedades magneticas das nanoparticulas de ferrihidrite revelam a existencia de interaccoes antiferromagneticas e de momentos descompensados. A contribuicao destas duas componentes nas curvas de magnetizacao em funcao do campo magnetico pode ser separada usando um metodo aqui proposto, o que permite um adequado estudo da evolucao do momento magnetico com a temperatura. O estudo das propriedades magneticas dinâmicas das particulas de ferrihidrite, atraves de susceptibilidade ac, medidas de relaxacao e medidas de efeito Mossbauer, permitiu estudar a evolucao das interaccoes dipolares em funcao da concentracao de ferro, bem como determinar a distribuicao de barreiras de energia de anisotropia no caso em que essas interaccoes sao desprezaveis. E apresentado um novo metodo para comparacao desta distribuicao com a distribuicao de tamanhos, que

The Teaching of Astronomy in Uruguay. (Spanish Title: La Enseñanza de la Astronomía en Uruguay.) O Ensino da Astronomia no Uruguai

NASA Astrophysics Data System (ADS)

Pintos Ganón, Reina; Fernández, Julio Angel

2008-07-01

We present in this work the development of astronomy in Uruguay since the colony times up to the present, stressing in particular those aspects related to the formal as well as informal teaching of astronomy. The first antecedents of astronomical studies in our country go back to the beginnings of the XVIIIth century related to the scientific expeditions from Europe coming to our shores. The teaching of astronomy was generalized at the high school level as soon as the end of the XIXth century, while itsintroduction at the university level happened much later, around the middle of the last century. We analyze the current situation of this subject, its problems, and some measures to strengthen its development. Se presenta en este trabajo el desarrollo de la astronomía en el Uruguay desde la época colonial hasta el presente, destacando en particular los aspectos vinculados a su enseñanza tanto formal como informal. Los primeros antecedentes de estudios astronómicos datan de la época colonial relacionados con las expediciones científicas del Viejo Mundo que llegaban a nuestras costas. La enseñanza de la Astronomía se generalizó en el ámbito de los estudios secundarios ya a fines del siglo XIX, mientras que en la Universidad su arribo fue mucho más tardío, a mediados del siglo pasado. Se analiza la situación actual de esta disciplina, sus problemas, y algunas medidas para fortalecer su desarrollo. Apresentamos, neste trabalho, o desenvolvimento da Astronomia no Uruguai desde a época colonial até o presente, destacando em particular os aspectos vinculados ao seu ensino tanto formal quanto informal. Os primeiros antecedentes de estudos astronômicos em nosso país datam da época colonial relacionados com as expedições científicas do Velho Mundo que chegavam às nossas costas. O ensino da Astronomia se generalizou no âmbito dos estudos secundários já no final do século XIX, enquanto que sua introdução na universidade foi muito mais tardia, em

Protocol for a multicentre randomiSed controlled TRial of IntraVEnous immunoglobulin versus standard therapy for the treatment of transverse myelitis in adults and children (STRIVE)

PubMed Central

Absoud, M; Gadian, J; Hellier, J; Brex, P A; Ciccarelli, O; Giovannoni, G; Kelly, J; McCrone, P; Murphy, C; Palace, J; Pickles, A; Pike, M; Robertson, N; Jacob, A; Lim, M

2015-01-01

Introduction Transverse myelitis (TM) is an immune-mediated disorder of the spinal cord which causes motor and sensory disturbance and limited recovery in 50% of patients. Standard treatment is steroids, and patients with more severe disease appear to respond to plasma exchange (PLEX). Intravenous immunoglobulin (IVIG) has also been used as an adjunct to steroids, but evidence is lacking. We propose the first randomised control trial in adults and children, to determine the benefit of additional treatment with IVIG. Methods and analysis 170 adults and children aged over 1 year with acute first episode TM or neuromyelitis optica (with myelitis) will be recruited over a 2.5-year period and followed up for 12 months. Participants randomised to the control arm will receive standard therapy of intravenous methylprednisolone (IVMP). The intervention arm will receive the above standard therapy, plus additional IVIG. Primary outcome will be a 2-point improvement on the American Spinal Injury Association (ASIA) Impairment scale at 6 months postrandomisation by blinded assessors. Additional secondary and tertiary outcome measures will be collected: ASIA motor and sensory scales, Kurtzke expanded disability status scale, International Spinal Cord Injury (SCI) Bladder/Bowel Data Set, Client Services Receipt Index, Pediatric Quality of Life Inventory, EQ-5D, SCI Pain and SCI Quality of Life Data Sets. Biological samples will be biobanked for future studies. After 6-months' follow-up of the first 52 recruited patients futility analysis will be carried out. Health economics analysis will be performed to calculate cost-effectiveness. After 6 months’ recruitment futility analysis will be performed. Ethics and dissemination Research Ethics Committee Approval was obtained: 14/SC/1329. Current protocol: v3.0 (15/01/2015). Study findings will be published in peer-reviewed journals. Trial registration numbers This study is registered with EudraCT (REF: 2014

Tilt and decentration of intraocular lenses in vivo from Purkinje and Scheimpflug imaging. Validation study.

PubMed

de Castro, Alberto; Rosales, Patricia; Marcos, Susana

2007-03-01

To measure tilt and decentration of intraocular lenses (IOLs) with Scheimpflug and Purkinje imaging systems in physical model eyes with known amounts of tilt and decentration and patients. Instituto de Optica Daza de Valdés, Consejo Superior de Investigaciones Científicas, Madrid, Spain. Measurements of IOL tilt and decentration were obtained using a commercial Scheimpflug system (Pentacam, Oculus), custom algorithms, and a custom-built Purkinje imaging apparatus. Twenty-five Scheimpflug images of the anterior segment of the eye were obtained at different meridians. Custom algorithms were used to process the images (correction of geometrical distortion, edge detection, and curve fittings). Intraocular lens tilt and decentration were estimated by fitting sinusoidal functions to the projections of the pupillary axis and IOL axis in each image. The Purkinje imaging system captures pupil images showing reflections of light from the anterior corneal surface and anterior and posterior lens surfaces. Custom algorithms were used to detect the Purkinje image locations and estimate IOL tilt and decentration based on a linear system equation and computer eye models with individual biometry. Both methods were validated with a physical model eye in which IOL tilt and decentration can be set nominally. Twenty-one eyes of 12 patients with IOLs were measured with both systems. Measurements of the physical model eye showed an absolute discrepancy between nominal and measured values of 0.279 degree (Purkinje) and 0.243 degree (Scheimpflug) for tilt and 0.094 mm (Purkinje) and 0.228 mm (Scheimpflug) for decentration. In patients, the mean tilt was less than 2.6 degrees and the mean decentration less than 0.4 mm. Both techniques showed mirror symmetry between right eyes and left eyes for tilt around the vertical axis and for decentration in the horizontal axis. Both systems showed high reproducibility. Validation experiments on physical model eyes showed slightly higher accuracy

Development of techniques in magnetic resonance and structural studies of the prion protein

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bitter, Hans-Marcus L.

2000-07-01

imaging at ultra-low fields is realized by incorporating the high sensitivities of a dc superconducting quantum interference device (SQUID) with the high polarizations attainable through optica11y pumping 129Xe gas.« less

Differential diagnosis of multiple sclerosis.

PubMed

Fadil, Halim; Kelley, Roger E; Gonzalez-Toledo, Eduardo

2007-01-01

There are a number of illnesses that can mimic multiple sclerosis (MS). This pretty much includes any pathological process that can reflect injury to the central nervous system either in a transient or progressive basis. Typically, MS presents itself in individuals in their teens up to their late 30s. On occasion, however, one can see MS present in patients in their 60s. However, in retrospect, many of these patients might have had subtle manifestations of MS in their younger years. Visual obscuration or visual loss can be a manifestation of retinal ischemia, retinal migraine, or optic neuritis which might or might not evolve into a clinical picture compatible with MS. Cranial neuropathy, long tract signs, sensory disturbance, and/or gait ataxia can be related to a number of different processes such as illicit drug use, neurosarcoidosis, neuro-Behcet's disease, neuroborreliosis, HIV-related disease, neurosyphilis, vascular occlusive disease including vasculitis, connective tissue disorders, acute disseminated encephalomyelitis (ADEM), idiopathic transverse myelitis, neuromyelitis optica (NMO), or tropical spastic paraparesis. In addition, a constellation of symptoms, with questionable objective findings, along with normal MRI imaging, normal CSF results, and normal evoked response testing, when indicated, might identify a conversion disorder or possibly malingering. There are now established criteria for the diagnosis of MS, but initial presentations can be less than "textbook" in nature. With the advent of immunomodulating therapy, it has become more important to diagnose MS more effectively earlier on in the course of the illness. Prior to specific therapy for MS, astute clinicians did not necessarily move with alacrity to establish the diagnosis in patients with subtle or transient manifestations. This was in recognition of the fact that little could be offered to alter the course of the illness and a number of patients might never experience further problems if

High resolution retinal scanning reveals regional structural differences between MS and NMOSD optic neuritis regardless of antibody status.

PubMed

Bertsch-Gout, Marcel; Loeb, Richard; Finch, Ashley K; Javed, Adil; Bernard, Jacqueline

2018-01-15

There is a need for biomarkers that can classify optic neuritis (ON) attacks as belonging to either neuromyelitis optica spectrum disorder with optic neuritis (NMOSD-ON) or relapsing remitting multiple sclerosis with optic neuritis (MS-ON). This study uses spectral domain optical coherence tomography (SD-OCT) data to perform a preliminary contrast between NMOSD-ON and MS-ON by analyzing peripapillary retinal nerve fiber layer and intra-macular layer patterns of injury. In this cross-sectional study, we used SD-OCT to obtain peripapillary retinal nerve fiber layer and intra-macular layer data for 26 NMOSD-ON, 25 MS-ON, and 26 healthy control (HC) age-matched eyes. Additionally, sub-comparisons compared 11 NMOSD-ON eyes that were seronegative for IgG antibodies against aquaporin 4 (NMOSD-ON (-)) and 16 NMOSD-ON eyes that were seropositive (NMOSD-ON (+)) to age-matched MS-ON eyes. Layer thicknesses were assessed using an automated algorithm and were then statistically compared using generalized estimating equations to account for inter-eye correlations. Selective thinning was found in the pRNFL, mRNFL, and GCL in NMOSD-ON compared to MS-ON. Thinning in the pRNFL nasal sector was found to persist in both NMOSD-ON (-) (P=0.017) and NMOSD-ON (+) (P=0.021) compared to MS-ON. Thinning in the mRNFL temporal sector was found to persist in NMOSD-ON (+) compared to MS-ON. Diffuse thinning was found in the pRNFL, mRNFL, GCL and IPL in NMOSD-ON compared to HC, and while diffuse thinning was also found in the GCL and IPL in MS-ON compared to HC, selective thinning was found in the pRNFL and mRNFL. The nasal region of the pRNFL may be capable of distinguishing between NMOSD-ON and MS-ON regardless of antibody status. Additionally, NMOSD-ON may cause more profound nasal axonal and inferior arcuate neuronal degeneration compared to MS-ON. Copyright © 2017 Elsevier B.V. All rights reserved.

Metabolomics reveals distinct, antibody-independent, molecular signatures of MS, AQP4-antibody and MOG-antibody disease.

PubMed

Jurynczyk, Maciej; Probert, Fay; Yeo, Tianrong; Tackley, George; Claridge, Tim D W; Cavey, Ana; Woodhall, Mark R; Arora, Siddharth; Winkler, Torsten; Schiffer, Eric; Vincent, Angela; DeLuca, Gabriele; Sibson, Nicola R; Isabel Leite, M; Waters, Patrick; Anthony, Daniel C; Palace, Jacqueline

2017-12-06

The overlapping clinical features of relapsing remitting multiple sclerosis (RRMS), aquaporin-4 (AQP4)-antibody (Ab) neuromyelitis optica spectrum disorder (NMOSD), and myelin oligodendrocyte glycoprotein (MOG)-Ab disease mean that detection of disease specific serum antibodies is the gold standard in diagnostics. However, antibody levels are not prognostic and may become undetectable after treatment or during remission. Therefore, there is still a need to discover antibody-independent biomarkers. We sought to discover whether plasma metabolic profiling could provide biomarkers of these three diseases and explore if the metabolic differences are independent of antibody titre. Plasma samples from 108 patients (34 RRMS, 54 AQP4-Ab NMOSD, and 20 MOG-Ab disease) were analysed by nuclear magnetic resonance spectroscopy followed by lipoprotein profiling. Orthogonal partial-least squares discriminatory analysis (OPLS-DA) was used to identify significant differences in the plasma metabolite concentrations and produce models (mathematical algorithms) capable of identifying these diseases. In all instances, the models were highly discriminatory, with a distinct metabolite pattern identified for each disease. In addition, OPLS-DA identified AQP4-Ab NMOSD patient samples with low/undetectable antibody levels with an accuracy of 92%. The AQP4-Ab NMOSD metabolic profile was characterised by decreased levels of scyllo-inositol and small high density lipoprotein particles along with an increase in large low density lipoprotein particles relative to both RRMS and MOG-Ab disease. RRMS plasma exhibited increased histidine and glucose, along with decreased lactate, alanine, and large high density lipoproteins while MOG-Ab disease plasma was defined by increases in formate and leucine coupled with decreased myo-inositol. Despite overlap in clinical measures in these three diseases, the distinct plasma metabolic patterns support their distinct serological profiles and confirm that these

Um supressor de fundo térmico para a câmara infravermelha CamIV

NASA Astrophysics Data System (ADS)

Jablonski, F.; Laporte, R.

2003-08-01

O ângulo sólido subtendido pelos pixels na câmara infravermelha do NexGal (CamIV) que operamos no OPD/LNA contém contribuições provenientes do sistema de coleta de fluxo propriamente dito - sendo esta a parte que interessa para as medidas astronômicas - e contribuições da obstrução central, sistema de suporte do espelho secundário e região exterior à pupila de entrada do telescópio. Estas últimas contribuições são devi-das à emissão de corpo negro à temperatura ambiente e aumentam exponencialmente para comprimentos de onda maiores que 2 micra (banda K, no infravermelho próximo). Embora a resultante pode ser quantificada e subtraída dos sinais relevantes, sua variância se adiciona à variância do sinal, e pode ser facilmente a contribuição domi-nante para a incerteza final das medidas, tornando ineficiente o processo de extração de informação e degradando a sensibilidade da câmara. A maneira clássica de resolver esse problema em sistemas ópticos que operam no infravermelho, onde os efeitos da emissão térmica do ambiente são importantes, é restringir o ângulo sólido subtendido pelos pixels individuais exclusivamente aos raios provenientes do sistema óptico. Para tanto, projeta-se uma imagem real, bastante reduzida, da pupila de entrada do sistema óptico num anteparo que transmita para o sistema de imageamento só o que interessa, bloqueando as contribuições das bordas externas à pupila de entrada, obstrução central do telescópio e sistema de suporte. Como a projeção é realizada em ambiente criogênico, a contribuição térmica espúria é efetivamente eliminada. Nós optamos por um sistema do tipo Offner para implementar na prática esta função. Trata-se de um sistema baseado em espelhos esféricos, bastante compacto e ajustado por construção. A opção por espelhos do mesmo material que o sistema de suporte (Alumínio) minimiza a dilatação diferencial, crítica nesse tipo de aplicação. Apresentamos as solu

Novel materials based on chitosan, its derivatives and cellulose fibres

NASA Astrophysics Data System (ADS)

Fernandes, Susana Cristina de Matos

estabilidade termica do que os correspondentes filmes sem reforco. Outra abordagem deste trabalho envolveu o revestimento de folhas de papel de E. globulus com quitosano e dois derivados, um derivado fluorescente e um derivado soluvel em agua, numa maquina de revestimentos ('maquina de colagem') a escala piloto. Este estudo envolveu inicialmente a deposicao de 1 a 5 camadas do derivado de quitosano fluorescente sobre as folhas de papel de forma a estudar a sua distribuicao nas folhas em termos de espalhamento e penetracao, atraves de medicoes de reflectância e luminescencia. Os resultados mostraram que, por um lado, a distribuicao do quitosano na superficie era homogenea e que, por outro lado, a sua penetracao atraves dos poros do papel cessou apos tres deposicoes. Depois da terceira camada verificou-se a formacao de um filme continuo de quitosano sobre a superficie do papel. Estes resultados mostram que este derivado de quitosano fluorescente pode ser utilizado como marcador na optimizacao e compreensao de mecanismos de deposicao de quitosano em papel e outros substratos. Depois de conhecida a distribuicao do quitosano nas folhas de papel, estudou-se o efeito do revestimento de quitosano e do seu derivado soluvel em agua nas propriedades finais do papel. As propriedades morfologicas, mecânicas, superficiais, opticas, assim como a permeabilidade ao ar e ao vapor de agua, a aptidao a impressao e o envelhecimento do papel, foram exaustivamente avaliadas. De uma forma geral, os revestimentos com quitosano e com o seu derivado soluvel em agua tiveram um impacto positivo nas propriedades finais do papel, que se mostrou ser dependente do numero de camadas depositadas. Os resultados tambem mostraram que os papeis revestidos com o derivado soluvel em agua apresentaram melhores propriedades opticas, aptidao a impressao e melhores resultados em relacao ao envelhecimento do que os papeis revestidos com quitosano. Assim, o uso de derivados de quitosano soluveis em agua em processos de

Dual-porosity modeling of groundwater recharge: testing a quick calibration using in situ moisture measurements, Areuse River Delta, Switzerland

NASA Astrophysics Data System (ADS)

Alaoui, Abdallah; Eugster, Werner

sensitivité ont montré que l'investigation de la couverture du sol est suffisante pour l'estimation locale de la RN du fait que l'eau traversant le plan du flux nul se trouverait sous la zone des racines et échapperait à l'évapotranspiration. La RN simulée sur les 0.70 m du sol sous les conditions d'équilibre était de 364 mm, ce qui est comparable aux mesures. Se propone un método sencillo para calibrar el modelo de doble porosidad "MACRO" mediante medidas in-situ obtenidas por TDR durante un breve ensayo de infiltración (2,8 horas), con el objetivo de estimar la recarga local al acuífero. Ésta ha sido modelada de dos formas: considerando los 3 m de suelo no saturado y empleando sólo desde la capa superior hasta el plano de flujo nulo (de 0 a 0,70 m). Se compara la recarga modelada con la recarga local medida en campo, la cual fue de 313 mm durante un ciclo anual (del 15 de octubre de 1990 al 15 de octubre de 1991). Las mejores simulaciones corresponden a la hipótesis de columna entera no saturada en condiciones de equilibrio, excluyendo el efecto de macroporos (valor de 330 mm), mientras que el resultado obtenido para condiciones de no equilibrio en la recarga local está sobreestimado (378 mm). Los análisis de sensibilidad muestran que la investigación del horizonte superior del suelo es suficiente para estimar la recarga local en este caso, ya que el agua almacenada por debajo de esta profundidad parece estar fuera del alcance típico de las raíces de la vegetación y no puede ser evapotranspirada. La recarga modelada en condiciones de equilibrio para la capa superior de 0,70 m de espesor es de 364 mm, valor aceptable respecto a las medidas.

[Not Available].

PubMed

Fernández Castillo, Rafael; Cañadas de la Fuente, Gustavo R; Cañadas de la Fuente, Guillermo A; De la Fuente Solana, Emilia Inmaculada; Esteban de la Rosa, Rafael José; Bravo Soto, Juan

2016-07-19

Introducción: la obesidad y el sobrepeso presentan efectos adversos sobre la salud, lo que contribuye a la aparición de enfermedades metabólicas y cardiovasculares que ponen en peligro la integridad del injerto.Objetivo: investigar la influencia del IMC pretrasplante renal sobre el funcionamiento del injerto renal al año de trasplante mediante el estudio de cuatro métodos distintos de medir la filtración glomerular.Material y métodos: en este trabajo se ha seguido a 1.336 pacientes de ambos sexos trasplantados renales; se les realizaron mediciones pretrasplante y postrasplante de parámetros bioquímicos, mediciones antropométricas y función renal mediante medidas de filtrado glomerular.Resultados: a mayor índice de masa corporal pretrasplante se produce una disminución del filtrado glomerular medido por cuatro métodos distintos, así como mayor porcentaje de rechazos.Conclusiones: un IMC elevado pretrasplante contribuye a la disfunción del injerto, a una disminución del filtrado glomerular y a complicaciones del injerto en el primer año postrasplante.

Guidelines for Clinical Practice: Hymenoptera sting allergy in children: 2017 update

PubMed

2017-10-01

Las picaduras por himenópteros son frecuentes en la infancia. La mayoría producen reacciones locales, consecuencia de un mecanismo inflamatorio, no alérgico, no tienen progresión y se resuelven con simples medidas terapéuticas. Las reacciones más extensas, generalmente, están asociadas a mecanismos alérgicos, mediados por inmunoglobulina E. Su máxima expresión, la anafilaxia, presenta síntomas cutáneos, respiratorios, cardiovasculares, digestivos y/o neurológicos, con riesgo de muerte. La prevalencia de anafilaxia en pacientes con mastocitosis sistémica es más alta. La familia Hymenoptera, que incluye hormigas coloradas, abejas y avispas, es la causante de las picaduras de mayor riesgo, potencialmente fatales. Los pilares del diagnóstico son la historia clínica, la identificación del insecto, y las pruebas diagnósticas cutáneas y/o in vitro interpretadas por el especialista en Alergia e Inmunología. La inmunoterapia con veneno es el tratamiento de elección para prevenir reacciones anafilácticas por picaduras de himenópteros.

A correlação índice espectral vs. luminosidade em QSOs e suas implicações

NASA Astrophysics Data System (ADS)

Garcia-Rissmann, A.

2003-08-01

Estudos de variabilidade de núcleos ativos já demonstraram ser comum o fato de seu contínuo óptico/UV tornar-se mais "duro" à medida que a luminosidade aumenta. Essa tendência ocorre tanto de forma individual quanto global, e pode ter implicações importantes (1) para estudos fotométricos de variabilidade conduzidos numa banda fixa no referencial do observador, comparando objetos a diferentes redshifts, e (2) no cálculo da correção K, com consequente impacto na determinação de massas de buracos negros e bojos de galáxias hospedeiras (através da relação de Magorrian). Confirmo aqui as correlações positivas entre o índice espectral e a luminosidade óptica, utilizando dados espectroscópicos de 11 QSOs monitorados no Brasil e no Chile, durante ~2 anos. O estudo é complementado com parâmetros extraídos de espectros e de dados fotométricos públicos de quasares. Destaco ainda as diferenças observadas em tais correlações para objetos do tipo radio-loud e radio-quiet. Este projeto é financiado pelo I. Milênio/CNPq.

CSF cytokine profile in MOG-IgG+ neurological disease is similar to AQP4-IgG+ NMOSD but distinct from MS: a cross-sectional study and potential therapeutic implications.

PubMed

Kaneko, Kimihiko; Sato, Douglas Kazutoshi; Nakashima, Ichiro; Ogawa, Ryo; Akaishi, Tetsuya; Takai, Yoshiki; Nishiyama, Shuhei; Takahashi, Toshiyuki; Misu, Tatsuro; Kuroda, Hiroshi; Tanaka, Satoru; Nomura, Kyoichi; Hashimoto, Yuji; Callegaro, Dagoberto; Steinman, Lawrence; Fujihara, Kazuo; Aoki, Masashi

2018-06-06

To evaluate cerebrospinal fluid (CSF) cytokine profiles in myelin oligodendrocyte glycoprotein IgG-positive (MOG-IgG+) disease in adult and paediatric patients. In this cross-sectional study, we measured 27 cytokines in the CSF of MOG-IgG+ disease in acute phase before treatment (n=29). The data were directly compared with those in aquaporin-4 antibody-positive (AQP4-IgG+) neuromyelitis optica spectrum disorder (NMOSD) (n=20), multiple sclerosis (MS) (n=20) and non-inflammatory controls (n=14). In MOG-IgG+ disease, there was no female preponderance and the ages were younger (mean 18 years, range 3-68; 15 were below 18 years) relative to AQP4-IgG+ NMOSD (41, 15-77) and MS (34, 17-48). CSF cell counts were higher and oligoclonal IgG bands were mostly negative in MOG-IgG+ disease and AQP4-IgG+ NMOSD compared with MS. MOG-IgG+ disease had significantly elevated levels of interleukin (IL)-6, IL-8, granulocyte-colony stimulating factor and granulocyte macrophage-colony stimulating factor, interferon-γ, IL-10, IL-1 receptor antagonist, monocyte chemotactic protein-1 and macrophage inflammatory protein-1α as compared with MS. No cytokine in MOG-IgG+ disease was significantly different from AQP4-IgG+ NMOSD. Moreover many elevated cytokines were correlated with each other in MOG-IgG+ disease and AQP4-IgG+ NMOSD but not in MS. No difference in the data was seen between adult and paediatric MOG-IgG+ cases. The CSF cytokine profile in the acute phase of MOG-IgG+ disease is characterised by coordinated upregulation of T helper 17 (Th17) and other cytokines including some Th1-related and regulatory T cells-related ones in adults and children, which is similar to AQP4-IgG+ NMOSD but clearly different from MS. The results suggest that as with AQP4-IgG+ NMOSD, some disease-modifying drugs for MS may be ineffective in MOG-IgG+ disease while they may provide potential therapeutic targets. © Article author(s) (or their employer(s) unless otherwise stated in the text of the

Antibodies to myelin oligodendrocyte glycoprotein in idiopathic optic neuritis.

PubMed

Nakajima, Hideki; Motomura, Masakatsu; Tanaka, Keiko; Fujikawa, Azusa; Nakata, Ruka; Maeda, Yasuhiro; Shima, Tomoaki; Mukaino, Akihiro; Yoshimura, Shunsuke; Miyazaki, Teiichiro; Shiraishi, Hirokazu; Kawakami, Atsushi; Tsujino, Akira

2015-04-02

To investigate the differences of clinical features, cerebrospinal fluid (CSF), MRI findings and response to steroid therapies between patients with optic neuritis (ON) who have myelin oligodendrocyte glycoprotein (MOG) antibodies and those who have seronegative ON. We recruited participants in the department of neurology and ophthalmology in our hospital in Japan. We retrospectively evaluated the clinical features and response to steroid therapies of patients with ON. Sera from patients were tested for antibodies to MOG and aquaporin-4 (AQP4) with a cell-based assay. Between April 2009 and March 2014, we enrolled serial 57 patients with ON (27 males, 30 females; age range 16-84 years) who ophthalmologists had diagnosed as having or suspected to have ON with acute visual impairment and declined critical flicker frequency, abnormal findings of brain MRI, optical coherence tomography and fluorescein fundus angiography at their onset or recurrence. We excluded those patients who fulfilled the diagnostic criteria of neuromyelitis optica (NMO)/NMO spectrum disorders (NMOSD), MS McDonald's criteria, and so on. Finally we defined 29 patients with idiopathic ON (14 males, 15 females, age range 16-84 years). 27.6% (8/29) were positive for MOG antibodies and 3.4% (1/29) were positive for AQP4. Among the eight patients with MOG antibodies, five had optic pain (p=0.001) and three had prodromal infection (p=0.179). Three of the eight MOG-positive patients showed significantly high CSF levels of myelin basic protein (p=0.021) and none were positive for oligoclonal band in CSF. On MRIs, seven MOG-positive patients showed high signal intensity on optic nerve, three had a cerebral lesion and one had a spinal cord lesion. Seven of the eight MOG-positive patients had a good response to steroid therapy. Although not proving primary pathogenicity of anti-MOG antibodies, the present results indicate that the measurement of MOG antibodies is useful in diagnosing and treating ON

A Single Amino Acid Substitution Prevents Recognition of a Dominant Human Aquaporin-4 Determinant in the Context of HLA-DRB1*03:01 by a Murine TCR

PubMed Central

Arellano, Benjamine; Hussain, Rehana; Miller-Little, William A.; Herndon, Emily; Lambracht-Washington, Doris; Eagar, Todd N.; Lewis, Robert; Healey, Don; Vernino, Steven; Greenberg, Benjamin M.; Stüve, Olaf

2016-01-01

Background Aquaporin 4 (AQP4) is considered a putative autoantigen in patients with Neuromyelitis optica (NMO), an autoinflammatory disorder of the central nervous system (CNS). HLA haplotype analyses of patients with NMO suggest a positive association with HLA-DRB1* 03:01. We previously showed that the human (h) AQP4 peptide 281–300 is the dominant immunogenic determinant of hAQP4 in the context of HLA-DRB1*03:01. This immunogenic peptide stimulates a strong Th1 and Th17 immune response. AQP4281-300-specific encephalitogenic CD4+ T cells should initiate CNS inflammation that results in a clinical phenotype in HLA-DRB1*03:01 transgenic mice. Methods Controlled study with humanized experimental animals. HLA-DRB1*03:01 transgenic mice were immunized with hAQP4281-300, or whole-length hAQP4 protein emulsified in complete Freund’s adjuvant. Humoral immune responses to both antigens were assessed longitudinally. In vivo T cell frequencies were assessed by tetramer staining. Mice were followed clinically, and the anterior visual pathway was tested by pupillometry. CNS tissue was examined histologically post-mortem. Flow cytometry was utilized for MHC binding assays and to immunophenotype T cells, and T cell frequencies were determined by ELISpot assay. Results Immunization with hAQP4281-300 resulted in an in vivo expansion of antigen-specific CD4+ T cells, and an immunoglobulin isotype switch. HLA-DRB1*03:01 TG mice actively immunized with hAQP4281-300, or with whole-length hAQP4 protein were resistant to developing a neurological disease that resembles NMO. Experimental mice show no histological evidence of CNS inflammation, nor change in pupillary responses. Subsequent analysis reveals that a single amino acid substitution from aspartic acid in hAQP4 to glutamic acid in murine (m)AQP4 at position 290 prevents the recognition of hAQP4281-300 by the murine T cell receptor (TCR). Conclusion Induction of a CNS inflammatory autoimmune disorder by active immunization of

Bright-dark rogue wave in mode-locked fibre laser (Conference Presentation)

NASA Astrophysics Data System (ADS)

Kbashi, Hani; Kolpakov, Stanislav; Martinez, Amós; Mou, Chengbo; Sergeyev, Sergey V.

2017-05-01

Bright-Dark Rogue Wave in Mode-Locked Fibre Laser Hani Kbashi1*, Amos Martinez1, S. A. Kolpakov1, Chengbo Mou, Alex Rozhin1, Sergey V. Sergeyev1 1Aston Institute of Photonic Technologies, School of Engineering and Applied Science Aston University, Birmingham, B4 7ET, UK kbashihj@aston.ac.uk , 0044 755 3534 388 Keywords: Optical rogue wave, Bright-Dark rogue wave, rogue wave, mode-locked fiber laser, polarization instability. Abstract: Rogue waves (RWs) are statistically rare localized waves with high amplitude that suddenly appear and disappear in oceans, water tanks, and optical systems [1]. The investigation of these events in optics, optical rogue waves, is of interest for both fundamental research and applied science. Recently, we have shown that the adjustment of the in-cavity birefringence and pump polarization leads to emerge optical RW events [2-4]. Here, we report the first experimental observation of vector bright-dark RWs in an erbium-doped stretched pulse mode-locked fiber laser. The change of induced in-cavity birefringence provides an opportunity to observe RW events at pump power is a little higher than the lasing threshold. Polarization instabilities in the laser cavity result in the coupling between two orthogonal linearly polarized components leading to the emergence of bright-dark RWs. The observed clusters belongs to the class of slow optical RWs because their lifetime is of order of a thousand of laser cavity roundtrip periods. References: 1. D. R. Solli, C. Ropers, P. Koonath,and B. Jalali, Optical rogue waves," Nature, 450, 1054-1057, 2007. 2. S. V. Sergeyev, S. A. Kolpakov, C. Mou, G. Jacobsen, S. Popov, and V. Kalashnikov, "Slow deterministic vector rogue waves," Proc. SPIE 9732, 97320K (2016). 3. S. A. Kolpakov, H. Kbashi, and S. V. Sergeyev, "Dynamics of vector rogue waves in a fiber laser with a ring cavity," Optica, 3, 8, 870, (2016). 5. S. Kolpakov, H. Kbashi, and S. Sergeyev, "Slow optical rogue waves in a unidirectional fiber laser

Two-way multi-band optical/IR transmission measurements in the Persian Gulf coastal region

NASA Astrophysics Data System (ADS)

de Jong, Arie N.; Fritz, Peter J.

2005-10-01

The atmospheric conditions in the Persian Gulf region are significantly different from other places in the world. The particle size distribution may vary daily and during the day. The aerosols can contribute to the amount of rainfall over land, important for the nations around the Gulf. In 2004 NASNGSFC and NRL (Naval Research Laboratory) introduced a proposal to improve the modelling of aerosol transport for the Persian Gulf area. The proposal included a measurement campaign in the UAE (United Arabian Emirates), held in the summer/fall of 2004, sponsored by the DWRS (Department of Water Resources Studies) in Abu Dhabi: UAEz (Unified Aerosol Experiment in the UAE). In this campaign NASA installed a number of multi-spectral sun-photometers at various locations in the UAE (http://aeronet.gsfc.nasa.gov). NRL installed ground based and airborne particle samplers. In addition, TNO (the Netherlands) installed its multi-band opticaUIR transmissometer, in order to collect horizontal, path-integrated transmission data. This device provides additional information on the scattering behaviour of the aerosols compared to the other instruments, which either integrate scattering over the full vertical path (the NASA sun-photometers, providing the Aerosol Optical Depth (AOD)) or sample the particles in-situ (the NRL particle samplers, providing size distribution and composition). This paper deals with our transmission measurement set-up, which was located in a coastal area near Abu Dhabi. This location allowed the investigation of the local variability of the atmospheric conditions: from desert dust to pollution, such as fossil fuel and biomass burning, depending on the wind direction. For logistic reasons a set-up was chosen with a retro-reflector. This choice implies consequences for the calibration procedure and measurement accuracy, which are discussed in detail. Also the effects of path-inhomogeneity and scintillation for such a two-way set-up are considered. Results are

Concept of coherence of learning physical optics

NASA Astrophysics Data System (ADS)

Colombo, Elisa M.; Jaen, Mirta; de Cudmani, Leonor C.

1995-10-01

The aim of the actual paper is to enhance achievements of the text 'Optica Fisica Basica: estructurada alrededor del concepto de coherencia luminosa' (in English 'Basic Physical Optics centered in the concept of coherence'). We consider that this book is a very worth tool when one has to learn or to teach some fundamental concepts of physical optics. It is well known that the topics of physical optics present not easy understanding for students. Even more they also present some difficulties for the teachers when they have to introduce them to the class. First, we think that different phenomena like diffraction and polarization could be well understood if the starting point is a deep comprehension of the concept of interference of light and, associated with this, the fundamental and nothing intuitive concept of coherence of the light. In the reference text the authors propose the use of expression 'stable interference pattern of no uniform intensity' instead of 'pattern of interference' and 'average pattern of uniform untested' instead of 'lack of interference' to make reference that light always interfere but just under restrictive conditions it can be got temporal and spatial stability of the pattern. Another idea we want to stand out is that the ability to observe a 'stable interference pattern of no uniform intensity' is associated not only with the coherence of the source but also with the dimensions of the experimental system and with the temporal and spatial characteristics of the detector used - human eye, photographic film, etc. The proposal is well support by quantitative relations. With an alternate model: a train of waves with a finite length of coherence, it is possible to get range of validity of models, to decide when a source could be considered a 'point' or 'monochromatic' or 'remote', an 'infinite' wave or a train of waves, etc. Using this concept it is possible to achieve a better understanding of phenomena like the polarization of light. Here, it

Frequency of Aquaporin-4 Immunoglobulin G in Longitudinally Extensive Transverse Myelitis With Antiphospholipid Antibodies.

PubMed

Guerra, Hilda; Pittock, Sean J; Moder, Kevin G; Fryer, James P; Gadoth, Avi; Flanagan, Eoin P

2018-04-11

Antiphospholipid (aPL) antibodies have historically been postulated to cause a poorly understood inflammatory myelitis. Neuromyelitis optica spectrum disorder (NMOSD) causes an inflammatory longitudinally extensive transverse myelitis (LETM). In 2004, aquaporin-4 immunoglobulin G (AQP4-IgG) was first reported as a highly specific (>99%) serum diagnostic biomarker of NMOSD, distinguishing it from other disorders (eg, multiple sclerosis). We sought to assess the frequency of AQP4-IgG (and thus NMOSD diagnosis) in LETM with aPL antibodies. We searched Mayo Clinic records (from January 1, 1996, through December 31, 2014) for patients with (1) LETM and (2) aPL or β 2 -glycoprotein I antibodies and (3) a serum sample available. AQP4-IgG was evaluated in the 24 included patients and in 20 controls with aPL antibodies but without myelitis. Seropositivity for AQP4-IgG was confirmed in 11 of 24 patients with LETM (46%), confirming an AQP4-IgG-seropositive NMOSD diagnosis rather than aPL-associated LETM. Six of 11 AQP4-IgG-seropositive patients (54%) were initially diagnosed as having aPL/lupus-associated myelitis. Recurrent LETM was exclusive to AQP4-IgG-seropositive patients (P=.003). Alternative diagnoses assigned to the remaining 13 AQP4-IgG-seronegative patients included idiopathic transverse myelitis (n=5), seronegative NMOSD (n=2), spinal cord infarct attributed to aPL antibodies (n=2), spinal cord sarcoidosis (n=1), varicella-zoster virus myelitis (n=1), postinfectious myelitis (n=1), and multiple sclerosis (n=1). All 20 controls were seronegative for AQP4-IgG. Clotting disorders occurred in 36% of patients (4 of 11) with LETM with both aPL antibodies and AQP4-IgG. AQP4-IgG should be tested in all patients with LETM and aPL antibodies because AQP4-IgG-seropositive NMOSD accounts for almost half of all cases. Clotting disorders are common in patients with LETM with dual positivity for AQP4-IgG and aPL antibodies. Copyright © 2018 Mayo Foundation for Medical Education

Las Matematicas: Lenguaje Universal. Grados Intermedios, Nivel 5b: Medida Lineal, Perimetro y Area (Mathematics: A Universal Language. Intermediate Grades, Level 5b: Linear Measure, Perimeter and Area).

ERIC Educational Resources Information Center

Dissemination and Assessment Center for Bilingual Education, Austin, TX.

This is one of a series of student booklets designed for use in a bilingual mathematics program in grades 6-8. The general format is to present each page in both Spanish and English. The mathematical topics in this booklet include measurement, perimeter, and area. (MK)

Fotometria de grupos compactos de galáxias no infravermelho próximo

NASA Astrophysics Data System (ADS)

Brasileiro, F.; Mendes de Oliveira, C.

2003-08-01

Apresentamos medidas nas bandas J, H e K de cerca de 90 galáxias em 34 grupos compactos. Através da combinação dos novos dados, com dados obtidos na literatura para a banda B, investigamos como as luminosidades, cores, tamanhos e massas das galáxias em grupos compactos foram afetadas por processos dinâmicos, e como essas diferem de galáxias em ambientes menos densos. Uma comparação dos novos valores obtidos com aqueles listados no catálogo 2MASS, mostram que para 50 galáxias estudadas em comum, as diferenças nas magnitudes J, H e K estão dentro dos erros fotométricos. Através da construção dos diagramas de cor (J-H x H-K e B-H x J-K), percebemos que as galáxias em grupos compactos ocupam posições no diagrama diferentes das posições de galáxias em campo ou em aglomerados, sendo mais parecidas com as posições ocupadas por galáxias HII, ou com excesso de poeira, acreditamos que tal deslocamento é derivado do aumento da taxa de formação estelar.

Um satélite brasileiro para observação do diâmetro solar

NASA Astrophysics Data System (ADS)

Emilio, M.; Leister, N. V.; Benevides Soares, P.; Teixeira, R.; Kuhn, J.

2003-08-01

Propomos uma missão espacial para medir a forma e o diâmetro solar com o objetivo de ajudar a determinar o potencial gravitacional do Sol e a sua rotação com precisão, testar modelos teóricos de variação de energia e pela primeira vez medir os modos g de oscilação. As observações serão obtidas através do instrumento denominado APT (Astrometric and Photometric Telescope) descrito por Kuhn(1983). A sensibilidade do instrumento é de 0,2 mas em 27 dias para as observações do diâmetro solar feitas a cada minuto. Esta é uma missão de três anos de duração e pode complementar as medidas que serão feitas pelo satélite PICARD (a ser lançado em 2007). Outros parâmetros físicos podem ser obtidos com as mesmas imagens o que certamente interessará à comunidade de física solar. Um primeiro contato foi realizado com a agência espacial brasileira que pretende lançar um satélite científico a cada dois anos.

Cinética Química: el laboratorio

NASA Astrophysics Data System (ADS)

Cabañas Galán, B.

La interpretación de las transformaciones químicas que se producen en la atmósfera requiere un profundo conocimiento de la cinética, productos y mecanismos de reacción de las posibles interacciones que pueden ocurrir entre las distintas especies presentes en ella. Información cuantitativa de este tipo es un prerrequisito para la construcción de modelos numéricos adecuados que expliquen el comportamiento químico-físico de la atmósfera. Esta información se obtiene a partir de experimentos realizados en laboratorios y por tanto independiente de medidas atmosféricas, por lo que los modelos atmosféricos derivados de ellos, pueden usarse para diagnosticar y predecir adecuadamente el comportamiento atmosférico. En esta exposición se recogen las técnicas experimentales más extendidas para la obtención de datos cinéticos así como los métodos de análisis de datos más utilizados en el estudio de las distintas reacciones de interés atmosférico. Se analizan sus características generales así como su adecuación a los distintos tipos de reacciones.

Estudo de cavidade reentrante supercondutora a ser utilizada nos transdutores paramétricos do detector brasileiro de ondas gravitacionais Mario Schenberg

NASA Astrophysics Data System (ADS)

Ribeiro, K. L.; Furtado, S. R.; Aguiar, O. D.; Frajuca, C.

2003-08-01

Cavidades reentrantes de nióbio vêm sendo utilizadas pelo grupo Australiano nos transdutores eletromecânicos paramétricos do detector de ondas gravitacionais Niobè. Esses transdutores paramétricos são ativados por um sinal AC na faixa de microondas (banda X), que é modulado pelo sinal mecânico da vibração da antena esférica, com a variação de um parâmetro, que, no caso, é a capacitância da cavidade. Nós estudamos esse tipo de cavidade, com o objetivo de transformá-la de reentrante aberta para reentrante fechada, de forma a utilizá-la nos transdutores paramétricos do detector brasileiro Mario Schenberg. O desempenho do transdutor depende de alguns parâmetros da cavidade, como a sua Figura de Mérito (Q elétrico) e o seu acoplamento elétrico com o circuito externo. Neste trabalho mostramos a medida do Q elétrico como função do acoplamento, do acabamento superficial interno e do vazamento de microondas da cavidade, e mostramos o desempenho esperado para o detector Mario Schenberg usando uma cavidade supercondutora reentrante fechada de nióbio.

Fontes binárias supermoles de raios X

NASA Astrophysics Data System (ADS)

Pires, A. M.; Janot Pacheco, E.

2003-08-01

Estuda-se as características físicas das fontes supermoles (de raios X (SSS), utilizando dados ópticos e em altas energias, no âmbito de um trabalho de IC. Trata-se de binárias que apresentam espectro X muito mole, baixas temperaturas e altas luminosidades bolométricas. Esse sistemas são compostos por uma anã branca realizando fusão em sua superfície, a partir de matéria perdida pela estrela companheira. Os resíduos de fusão se acumulam na superfície da anã branca, e essa pode ultrapassar o limite de Chadrasekhar, produzir um colapso gravitacional, sendo esse um dos cenários propostos para as explosões de SN Ia. Apresentamos nesta comunicação o estado da arte das características físicas das fontes SSS, situando-as no âmbito das VCs. Procuramos também situar esses objetos em relação às variáveis galácticas V Sge, na medida em que os dois grupos apresentam certas caracerísticas bastante semelhantes.A metodologia adotada é aquela pedagógico-cognitiva clássica de um trabalho de IC na área de ciências exatas.

Depth of the base of the Jackson aquifer, based on geophysical exploration, southern Jackson Hole, Wyoming, USA

NASA Astrophysics Data System (ADS)

Nolan, Bernard T.; Campbell, David L.; Senterfit, Robert M.

ées ont été krigées afin d'estimer la profondeur de la base de la formation aquifère dans la partie sud de Jackson Hole. Les cartes d'isovaleurs d'estimation krigées indiquent que la profondeur de la base de la formation aquifère de Jackson est faible dans la partie centrale de la zone d'étude à l'est et à l'ouest des monts Gros Ventre, plus grande dans le secteur ouest près de la zone faillée de Teton, et faible sur la bordure sud de Jackson Hole. Les profondeurs estimées vont de 30m au sud, près des confluences des rivières Spring et Flat avec la rivière Snake, à 210m à l'ouest près de la ville de Wilson (Wyoming). Resumen Se llevó a cabo una campaña geofísica para determinar la profundidad del basamento de un acuífero libre en la zona sur de Jackson Hole, Wyoming, EEUU. USA. Medidas audio-magnetotelúricas (ATM) en 77 lugares de la zona de estudio dieron lugar a registros de resistividad eléctrica del subsuelo, que se usaron para inferir los cambios litológicos con la profundidad. Los depósitos superficiales, saturados y no consolidados de edad cuaternaria, el acuífero de Jackson, forman una capa de resistencia geoeléctrica entre 100-600ohm-m. La profundidad media de la base del acuífero de Jackson se estima en unos 61m (200pies), a partir de 62 registros con medidas suficientes. Los valores ATM fueron krigeados para obtener una medida de la profundidad del basamento del acuífero en la zona sur de Jackson Hole. Los mapas de isoprofundidades obtenidos por krigeado indican que el acuífero es poco profundo en la parte central de la zona de estudio, cerca de los Gros Ventre Buttes orientales y occidentales, más profundo al oeste, cerca del sistema de fallas de Teton, y menos profundo en el borde sur de Jackson Hole. Las profundidades van desde 30m (100pies) en el sur, en la confluencia entre los desfiladeros Spring y Flat con el Río Snake, hasta 210m (700pies) al oeste, cerca de la ciudad de Wilson, Wyoming.

Study of hydrogen in phthalocyanine semiconductors using muSR technique =

NASA Astrophysics Data System (ADS)

Duarte, Joao Pedro Piroto Pereira

Este trabalho apresenta um estudo experimental dos semicondutores organicos Ftalocianina (H2Pc), Ftalocianina de Zinco (ZnPc) e Ftalocianina de Cobre (CuPc) por tecnicas de µSR, tendo-se obtido informacao detalhada sobre a estrutura electronica dos estados de carga formados pelo muao positivo nos tres compostos, e sobre as interaccoes dinamicas a que esses estados se encontram sujeitos. Os resultados do estudo indicam que nas ftalocianias com caracter nao magneticas H2Pc e ZnPc se da a formacao de tres radicais muonicos paramagneticos distintos. A estrutura hiperfina destes radicais, referidos como estados I, II e III, foi caracterizada atraves da medida dos parametros de acoplamento hipefino em conjunto com a parameterizacao da sua dependencia com a temperatura. Uma quarta componente paramagnetica do sinal µSR foi tambem identificada, mas sobre a qual nao foi possivel retirar conclusoes definitivas quanto a sua origem. Verificou-se que os parametros de acoplamento hiperfino isotropicos dos tres estados identificados se encontram numa regiao de valores entre os 100 e os 150MHz para os estados I e II, enquanto que para o estado III esta quantidade toma valores em torno de 10 MHz. A estrutura electronica de todos os estados possui simetria axial, caracterizada por parametros dipolares de cerca de 15MHz para os estados I e II, e 20MHz para o estado III. A origem dos estados I e II foi determinada como sendo devida a adicao de muonio a uma das ligacoes duplas existentes nos aneis benzenicos da periferia das moleculas de ftalocianina recorrendo a calculos de estrutura electronica, tendo-se verificado a existencia de um acoplamento entre a interaccao hiperfina desses estados e modos vibracionais desses aneis. A problematica da localizacao do estado III tambem foi abordada, tomando-se como hipotese mais provavel uma posicao intersticial entre duas moleculas de ftalocianina. O estudo das interaccoes dinamicas de spin destes tres estados revelou que o estado III esta

EVALUATION OF THE THORACOABDOMINAL MOBILITY OF OBESE SUBJECTS IN PRE-BARIATRIC SURGERY.

PubMed

Veloso, Ana Paula Limongi Richardelli; Cusmanich, Karla Garcez

, seguindo um protocolo de exercícios, reavaliando e comparado as medidas pré e pós a intervenção. Apresentaram correlação positiva a mobilidade abdominal no volume total de todos os participantes (p=0,010) e também para todas as medidas na mensuração do volume residual nos três níveis (p=0,000). Comparando os sexos, no volume total, a cirtometria abdominal maior das mulheres (p=0,015) quando comparada a dos homens e no volume residual, significância tanto para os homens quanto para as mulheres em todas as mensurações (p=0,000). Obesos que se submeteram ao tratamento fisioterapêutico durante o período pré-operatório, tiveram dinâmica respiratória melhorada pelo aumento da mobilidade da caixa torácica e pela melhora da consciência respiratória.

Earth and Heavens: Two Separate Universes? (Spanish Title: Tierra y Cielos: ¿Dos Universos Separados?) Terra e Céus: Dois Universos Separados?

NASA Astrophysics Data System (ADS)

Carrascosa, Jaime; Gil-Pérez, Daniel; Solbes, Jordi; Vilches, Amparo

2005-12-01

The study of gravitation constitutes an exceptional occasion to show the richness and complexity of science and technology, contemplating, among other things: the problematic situations which are at the heart of the scientific knowledge, the difficulties encountered in the construction of knowledge and, especially, the necessity of overcoming "common-sense evidence" that proclaimed the existence of an insurmountable barrier between Earth and Heavens, hindering scientific development during many centuries. In this paper we present a program of activities to orient the study of Gravitation atUpperHigh School, favoring students' participation in the reconstruction of this first scientific revolution and giving them the opportunity to see the importance of Astronomy both in the history of science and today. El estudio de la gravitación constituye una ocasión excepcional para mostrar la ciencia y la tecnología en toda su riqueza y complejidad, considerando, entre otros aspectos:

Seizures and Encephalitis in Myelin Oligodendrocyte Glycoprotein IgG Disease vs Aquaporin 4 IgG Disease.

PubMed

Hamid, Shahd H M; Whittam, Dan; Saviour, Mariyam; Alorainy, Amal; Mutch, Kerry; Linaker, Samantha; Solomon, Tom; Bhojak, Maneesh; Woodhall, Mark; Waters, Patrick; Appleton, Richard; Duddy, Martin; Jacob, Anu

2018-01-01

Antibodies to myelin oligodendrocyte glycoprotein IgG (MOG-IgG) are increasingly detected in patients with non-multiple sclerosis-related demyelination, some of whom manifest a neuromyelitis optica (NMO) phenotype. Cortical involvement, encephalopathy, and seizures are rare in aquaporin 4 antibody (AQP4-IgG)-related NMO in the white European population. However, the authors encountered several patients with seizures associated with MOG-IgG disease. To compare incidence of seizures and encephalitis-like presentation, or both between AQP4-IgG-positive and MOG-IgG-positive patients. Retrospective case series of all patients who were seropositive for MOG-IgG (n = 34) and the last 100 patients with AQP4-IgG disease (NMO spectrum disorder) seen in the NMO service between January 2013 and December 2016, and analysis was completed January 4, 2017. All patients were seen in a tertiary neurological center, The Walton Centre NHS Foundation Trust in Liverpool, England. The difference in seizure frequency between the AQP4-IgG-positive and MOG-IgG-positive patient groups was determined. Thirty-four patients with MOG-IgG disease (20 female) with a median age at analysis of 30.5 years (interquartile range [IQR], 15-69 years), and 100 AQP4-IgG-positive patients (86 female) with a median age at analysis of 54 years (IQR, 12-91 years) were studied. Most patients were of white race. Five of the 34 patients with MOG-IgG (14.7%) had seizures compared with 1 patient with AQP4-IgG (2-sided P < .008, Fisher test). On magnetic resonance imaging, all 5 MOG-IgG-positive patients had inflammatory cortical brain lesions associated with the seizures. In 3 of the 5 MOG-IgG-positive patients, seizures occurred as part of the index event. Four of the 5 presented with encephalopathy and seizures, and disease relapsed in all 5 patients. Four of these patients were receiving immunosuppressant medication at last follow-up, and 3 continued to take antiepileptic medication. In contrast, the only

Clinical outcomes and predictive factors related to good outcomes in plasma exchange in severe attack of NMOSD and long extensive transverse myelitis: Case series and review of the literature.

PubMed

Aungsumart, Saharat; Apiwattanakul, Metha

2017-04-01

To investigate the predictive factors associated with good outcomes of plasma exchange in severe attacks through neuromyelitis optica spectrum disorder (NMOSD) and long extensive transverse myelitis (LETM). In addition, to review the literature of predictive factors associated with the good outcomes of plasma exchange in central nervous system inflammatory demyelinating diseases (CNS IDDs). Retrospective study in 27 episodes of severe acute attacks myelitis and optic neuritis in 24 patients, including 20 patients with NMOSD seropositive, 1 patient with NMOSD seronegative and 3 patients with LETM. Plasma exchange was performed, reflecting poor responses to high-dose intravenous methylprednisolone (IVMP) therapy. The outcomes of the present study were the functional outcome improvements at 6 months after plasma exchange. The predictive factors of good outcomes after plasma exchange were determined in this cohort, and additional factors reported in the literature were reviewed. Plasma exchange was performed in 16 spinal cord attacks and 11 attacks of optic neuritis. Twenty patients were female (83%). The median age of the patients at the time of plasma exchange was 41 years old. The median disease duration was 0.6 years. The AQP4-IgG status was positive in 20 patients (83%). Plasma exchange following IVMP therapy led to a significant improvement in 81% of the cases after 6 months of follow up. A baseline Expanded Disability Status Scale (EDSS) score ≤6 before the attack was associated with significant improvement at 6 months (p=0.02, OR 58.33, 95%CI 1.92-1770). In addition, we reviewed the evidence for factors associated with good outcomes of plasma exchange in CNS IDDs, classified according to pre-plasma exchange, post-plasma exchange, and radiological features. Plasma exchange following IVMP therapy is effective as a treatment for patients experiencing a severe attack of NMOSD or LETM. The factors associated with good outcomes after plasma exchange in CNS IDDs are

Pulse compressor with aberration correction

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mankos, Marian

In this SBIR project, Electron Optica, Inc. (EOI) is developing an electron mirror-based pulse compressor attachment to new and retrofitted dynamic transmission electron microscopes (DTEMs) and ultrafast electron diffraction (UED) cameras for improving the temporal resolution of these instruments from the characteristic range of a few picoseconds to a few nanoseconds and beyond, into the sub-100 femtosecond range. The improvement will enable electron microscopes and diffraction cameras to better resolve the dynamics of reactions in the areas of solid state physics, chemistry, and biology. EOI’s pulse compressor technology utilizes the combination of electron mirror optics and a magnetic beam separatormore » to compress the electron pulse. The design exploits the symmetry inherent in reversing the electron trajectory in the mirror in order to compress the temporally broadened beam. This system also simultaneously corrects the chromatic and spherical aberration of the objective lens for improved spatial resolution. This correction will be found valuable as the source size is reduced with laser-triggered point source emitters. With such emitters, it might be possible to significantly reduce the illuminated area and carry out ultrafast diffraction experiments from small regions of the sample, e.g. from individual grains or nanoparticles. During phase I, EOI drafted a set of candidate pulse compressor architectures and evaluated the trade-offs between temporal resolution and electron bunch size to achieve the optimum design for two particular applications with market potential: increasing the temporal and spatial resolution of UEDs, and increasing the temporal and spatial resolution of DTEMs. Specialized software packages that have been developed by MEBS, Ltd. were used to calculate the electron optical properties of the key pulse compressor components: namely, the magnetic prism, the electron mirror, and the electron lenses. In the final step, these results were

Lanthanide oxide and phosphate nanoparticles for thermometry and bimodal imaging =

NASA Astrophysics Data System (ADS)

Debasu, Mengistie Leweyehu

Nesta tese relatam-se estudos de fotoluminescencia de nanoparticulas de oxidos e fosfatos dopados com ioes trivalentes de lantanideos, respectivamente, nanobastonetes de (Gd,Eu)2O3 e (Gd,Yb,Er)2O3 e nanocristais de (Gd,Yb,Tb)PO4, demonstrando-se tambem aplicacoes destes materiais em revestimentos inteligentes, sensores de temperatura e bioimagem. Estuda-se a transferencia de energia entre os sitios de Eu3+ C2 e S6 dos nanobastonetes Gd2O3. A contribuicao dos mecanismos de transferencia de energia entre sitios para o tempo de subida 5D0(C2) e descartada a favor da relaxacao directa 5D1(C2) 5D0(C2) (i.e., transferencia de energia entre niveis). O maior tempo de decaimento do nivel 5D0(C2) nos nanobastonetes, relativamente ao valor medido para o mesmo material na forma de microcristais, e atribuido, quer a existencia de espacos livres entre nanobastonetes proximos (factor de enchimento ou fraccao volumica), quer a variacao do indice de refraccao efectivo do meio em torno dos ioes Eu3+. A dispersao de nanobastonetes de (Gd,Eu)2O3 em tres resinas epoxi comerciais atraves da cura por UV permite obter nanocompositos epoxi- (Gd,Eu)2O3. Relatam-se estudos cineticos e das propriedades termicas e de fotoluminescencia destes nanocompositos. Estes, preservam as tipicas propriedades de emissao do Eu3+, mostrando o potencial do metodo de cura por UV para obter revistimentos inteligentes e fotoactivos. Considera-se um avanco significativo a realizacao de uma nanoplataforma optica, incorporando aquecedor e termometro e capaz de medir uma ampla gama de temperaturas (300-2000 K) a escala nano, baseada em nanobastonetes de (Gd,Yb,Er)2O3 (termometros) cuja superficie se encontra revestida com nanoparticulas de ouro. A temperature local e calculada usando, quer a distribuicao de Boltzmann (300-1050 K) do racio de intensidades da conversao ascendente 2H11=2!4I15=2/4S3=2!4I15=2, quer a lei de Planck (1200-2000 K) para uma emissao de luz branca atribuida a radiacao do corpo negro

The Orientation of Gastric Biopsy Samples Improves the Inter-observer Agreement of the OLGA Staging System.

PubMed

Cotruta, Bogdan; Gheorghe, Cristian; Iacob, Razvan; Dumbrava, Mona; Radu, Cristina; Bancila, Ion; Becheanu, Gabriel

2017-12-01

Evaluation of severity and extension of gastric atrophy and intestinal metaplasia is recommended to identify subjects with a high risk for gastric cancer. The inter-observer agreement for the assessment of gastric atrophy is reported to be low. The aim of the study was to evaluate the inter-observer agreement for the assessment of severity and extension of gastric atrophy using oriented and unoriented gastric biopsy samples. Furthermore, the quality of biopsy specimens in oriented and unoriented samples was analyzed. A total of 35 subjects with dyspeptic symptoms addressed for gastrointestinal endoscopy that agreed to enter the study were prospectively enrolled. The OLGA/OLGIM gastric biopsies protocol was used. From each subject two sets of biopsies were obtained (four from the antrum, two oriented and two unoriented, two from the gastric incisure, one oriented and one unoriented, four from the gastric body, two oriented and two unoriented). The orientation of the biopsy samples was completed using nitrocellulose filters (Endokit®, BioOptica, Milan, Italy). The samples were blindly examined by two experienced pathologists. Inter-observer agreement was evaluated using kappa statistic for inter-rater agreement. The quality of histopathology specimens taking into account the identification of lamina propria was analyzed in oriented vs. unoriented samples. The samples with detectable lamina propria mucosae were defined as good quality specimens. Categorical data was analyzed using chi-square test and a two-sided p value <0.05 was considered statistically significant. A total of 350 biopsy samples were analyzed (175 oriented / 175 unoriented). The kappa index values for oriented/unoriented OLGA 0/I/II/III and IV stages have been 0.62/0.13, 0.70/0.20, 0.61/0.06, 0.62/0.46, and 0.77/0.50, respectively. For OLGIM 0/I/II/III stages the kappa index values for oriented/unoriented samples were 0.83/0.83, 0.88/0.89, 0.70/0.88 and 0.83/1, respectively. No case of OLGIM IV

Informe: Agua potable - la EPA necesita adoptar medidas adicionales para garantizar que los pequeños sistemas de agua comunitarios señalados como graves infractores logren cumplir con las normas

EPA Pesticide Factsheets

Informe #16-P-0108, 22 de Marzo de 2016. La EPA puede proteger mejor al público del agua potable contaminada, lo que incluye a casi 200,000 personas en Puerto Rico que todavía carecen de agua potable segura.

Astronomy in the Classroom: Why? (Spanish Title: Astronomía en la Clase: ¿Por Qué?) Astronomia na Sala de Aula: Por Quê?

NASA Astrophysics Data System (ADS)

Daros Gama, Leandro; Bagdonas Henrique, Alexandre

2010-07-01

There are many discussions about the relevance of the topics covered in classes. One subject in particular is the focus of this essay: astronomy. In what sense and to what extent it would be worth to teach it in science or other kind of classes? In this paper we discuss some aspects of the advantages of dealing with this area of knowledge in schools, taking into account the epistemological and axiological dimensions of astronomy, in light of the vision of science as an intelligent dialogue with the world (Bachelard), in addition to the "problematization" knowledge of Paulo Freire. We propose that in fact the Astronomy does not need to be seen as just a new set of contents to be taught, but appears as a set of motivational contents for historical-philosophical discussions, and permit the discussion of concepts of other disciplines. Numerosas discusiones se están llevando a cabo acerca de la pertinencia de los temas tradicionalmente tratados en las clases. Uno de los temas, en particular, es el foco de este ensayo: la astronomía. ¿En qué sentido y en qué medida sería conveniente tratarla en clase, ya sea en clases de ciencias naturales, específicamente en las de astronomía o asignaturas afines? Elaboramos en este artículo algunos aspectos de las ventajas de tratar esta área del conocimiento en las escuelas, teniendo en cuenta las dimensiones epistemológica y axiológica de la astronomía, a la luz de la visión de la ciencia como un diálogo inteligente con el mundo (Bachelard), además de la propuesta del conocimiento "problematizador" de Paulo Freire. Proponemos que en realidad la astronomía no tiene por qué ser vista sólo como un nuevo conjunto de contenidos que se enseñan, sino que aparece como un conjunto de temas de motivación para el debate histórico-filosófico y para permitir la discusión de los conceptos típicos de otras disciplinas. Muitas discussões vêm acontecendo sobre a relevância dos temas abordados em sala de aula. Um tema, em

Impact of respiratory therapy in vital capacity and functionality of patients undergoing abdominal surgery.

PubMed

Fernandes, Shanlley Cristina da Silva; Santos, Rafaella Souza Dos; Giovanetti, Erica Albanez; Taniguchi, Corinne; Silva, Cilene Saghabi de Medeiros; Eid, Raquel Afonso Caserta; Timenetsky, Karina Tavares; Carnieli-Cazati, Denise

2016-01-01

To evaluate the vital capacity after two chest therapy techniques in patients undergoing abdominal surgical. A prospective randomized study carried out with patients admitted to the Intensive Care Unit after abdominal surgery. We checked vital capacity, muscular strength using the Medical Research Council scale, and functionality with the Functional Independence Measure the first time the patient was breathing spontaneously (D1), and also upon discharge from the Intensive Care Unit (Ddis). Between D1 and Ddis, respiratory therapy was carried out according to the randomized group. We included 38 patients, 20 randomized to Positive Intermittent Pressure Group and 18 to Volumetric Incentive Spirometer Group. There was no significant gain related to vital capacity of D1 and Ddis of Positive Intermittent Pressure Group (mean 1,410mL±547.2 versus 1,809mL±692.3; p=0.979), as in the Volumetric Incentive Spirometer Group (1,408.3mL±419.1 versus 1,838.8mL±621.3; p=0.889). We observed a significant improvement in vital capacity in D1 (p<0.001) and Ddis (p<0.001) and in the Functional Independence Measure (p<0.001) after respiratory therapy. The vital capacity improvement was not associated with gain of muscle strength. Chest therapy, with positive pressure and volumetric incentive spirometer, was effective in improving vital capacity of patients submitted to abdominal surgery. Avaliar a capacidade vital comparando duas técnicas de fisioterapia respiratória em pacientes submetidos à cirurgia abdominal. Estudo prospectivo e randomizado realizado com pacientes admitidos em Unidade de Terapia Intensiva após cirurgia abdominal. Verificamos a capacidade vital, a força muscular por meio da escala do Medical Research Council e funcionalidade pela Medida de Independência Funcional no primeiro momento em que o paciente encontrava-se em respiração espontânea (D1) e na alta da Unidade de Terapia Intensiva (Dalta). Entre D1 e Dalta, foi realizada a fisioterapia respirat

Satisfaction with medication in coronary disease treatment: psychometrics of the Treatment Satisfaction Questionnaire for Medication.

PubMed

Liberato, Ana Carolina Sauer; Rodrigues, Roberta Cunha Matheus; São-João, Thaís Moreira; Alexandre, Neusa Maria Costa; Gallani, Maria Cecília Bueno Jayme

2016-06-07

ão através da Morisky Self-Reported Measure of Medication Adherence Scale [Medida de Auto-Relato de Adesão ao Tratamento Medicamentoso] e proporção de aderência. Os efeitos Teto e Chão foram analisados considerando os 15% piores e 15% melhores escores possíveis obtidos no TSQM; Praticidade foi avaliada pelo tempo gasto na aplicação do TSQM durante a entrevista; Aceitabilidade foi verificada pela proporção de itens não respondidos e participantes que responderam todos os itens; Confiabilidade foi verificada com o coeficiente alfa de Cronbach e Validade através da validade de construto convergente entre o TSQM e as medidas de adesão. o TSQM foi facilmente aplicado. O efeito teto foi encontrado no domínio efeitos colaterais e o efeito chão foi encontrado nos domínios efeitos colaterais e satisfação global. Evidência de confiabilidade foi próxima de satisfatória em todos os domínios. A validade de construto convergente foi parcialmente apoiada. a versão brasileira do TSQM apresenta evidência de aceitabilidade e praticidade embora sua validade tenha sido pouco apoiada e consistência interna adequada foi observada em um domínio. testar las propiedades psicométricas de la versión brasileña del Treatment Satisfaction Questionnaire for Medication - TSQM (versión 1.4), considerando los efectos techo y suelo, factibilidad, aceptabilidad, confiabilidad y validez. participantes con enfermedad coronaria (n=190) fueron reclutados de una clínica ambulatoria de cardiología en un hospital universitario en el sudeste de Brasil y entrevistados para evaluar su satisfacción con la medicación con el TSQM (versión 1.4) y su adhesión con la Morisky Self-Reported Measure of Medication Adherence Scale y proporción de adhesión. Los efectos techo y suelo fueron analizados considerando los 15% peores y mejores puntuaciones en el TSQM; la factibilidad fue evaluada por el tiempo gasto durante las entrevistas de TSQM; la aceptabilidad por la proporción de ítems no

Seguridad del paciente en Radioterapia Intraoperatoria: Impacto de los elementos controlados por el Radiofisico

NASA Astrophysics Data System (ADS)

Tarjuelo, Juan Lopez

tambien se uso para estudiar la estabilidad de las camaras de ionizacion mencionadas. Se realizo la dosimetria in vivo en 45 pacientes con MOSFET reforzados mobile TN-502RDM-H, pelicula radiocromica Gafchromic MD-55-2, y se elaboro un modelo teorico para explicar los datos. Por ultimo, al precisarse el uso en RIO de la simulacion virtual y del calculo de la dosis absorbida en el paciente virtual, se ha ilustrado este apartado con la aceptacion y el estado de referencia inicial del planificador de tratamientos modulados con calculo de Monte Carlo Elekta Monaco. Para ello se utilizaron la camara de ionizacion TW31016-0104 y la matriz seven29 de PTW-Freiburg, pelicula radiocromica Gafchromic EBT-2, y diferentes maniquies. Resultados: El FMEA identifico 57 modos de fallo y efectos potenciales. No se experimentaron sucesos relativos a una administracion inadecuada de la dosis absorbida. Se identificaron las revisiones dobles y por un par como claves para reducir los riesgos asociados al equipo de profesionales involucrado en la RIO. Se identificaron tambien oportunidades de mejora con el uso de la automatizacion y el enclavamiento. En cuanto al SPC, los indices de capacidad del proceso abarcaron de 1,6 a 9,3 para un nivel de especificaciones del +/-2%. Las intervenciones simuladas alcanzaron del 2% al 34% de las sesiones de medida. Las camaras de ionizacion Farmer derivaron en direcciones opuestas en un periodo de 6 anos; aunque ello no se aprecio en los informes de calibracion del laboratorio acreditado. No derivo la camara PPC-40. En la dosimetria in vivo, las medidas de los MOSFET no se desviaron significativamente de las medidas con pelicula. Los valores centrales de las dosis absorbidas quedaron entre la dosis absorbida prescrita y la maxima, con lo que indicaron un tratamiento correcto del lecho tumoral. Las anchuras de los intervalos de confianza de las dosis absorbidas esperadas segun el modelo teorico al nivel del 95% abarcaron del 8,6% al 14,7%. Las verificaciones de

Procedures for measuring and verifying gastric tube placement in newborns: an integrative review.

PubMed

Dias, Flávia de Souza Barbosa; Emidio, Suellen Cristina Dias; Lopes, Maria Helena Baena de Moraes; Shimo, Antonieta Keiko Kakuda; Beck, Ana Raquel Medeiros; Carmona, Elenice Valentim

2017-07-10

de duas distâncias morfológicas e os de aplicação de duas fórmulas, uma baseada no peso e outra na altura. Para técnicas de verificação do posicionamento, encontrou-se traçado eletromagnético, atividade elétrica do diafragma, detecção de CO2, solução de índigo carmim, ausculta do epigástrio, aspiração de secreção gástrica, inspeção da cor, avaliação de pH, enzimas e bilirrubina. o método de mensuração que utiliza as medidas do nariz ao lóbulo da orelha ao ponto médio entre apêndice xifoide e cicatriz umbilical apresenta melhores evidências. As equações baseadas em peso e altura necessitam ser testadas experimentalmente. O retorno de secreção na aspiração da sonda, avaliação da cor e do pH da secreção são indicadores confiáveis na identificação do posicionamento da sonda gástrica, e são as técnicas atualmente indicadas. investigar, en la literatura, evidencias sobre procedimientos de medición de la sonda gástrica en recién nacidos y de verificación de su posicionamiento, procedimientos alternativos al examen radiológico. revisión integradora de la literatura en las bases Biblioteca Cochrane, LILACS, CINAHL, EMBASE, MEDLINE y Scopus, utilizando los descriptores "intubación gastrointestinal" y "recién nacido" en artículos originales. diecisiete publicaciones fueron incluidas y categorizadas en "método de medición" o "técnica de verificación del posicionamiento". Como métodos de medición, fueron encontrados los de medida de dos distancias morfológicas y los de aplicación de dos fórmulas (una basada en el peso y otra en la altura). Para las técnicas de verificación del posicionamiento, se encontró: trazado electromagnético, actividad eléctrica del diafragma, detección de CO2, solución de índigo carmín, auscultación del epigastrio, aspiración de secreción gástrica, inspección del color, evaluación de pH, enzimas y bilirrubina. el método de medición que utiliza las medidas de la nariz al l

[Transverse myelitis associated with toxocariasis and the importance of locally produced antibodies for diagnosis].

PubMed

Ural, Serap; Özer, Behiye; Gelal, Fazıl; Dirim Erdoğan, Derya; Sezak, Nurbanu; Balık, Recep; Demirdal, Tuna; Korkmaz, Metin

2016-07-01

Toxocariasis caused by Toxocara canis or less frequently by T.catis is a common parasitic infection worldwide. Clinical spectrum in humans can vary from asymptomatic infection to serious organ disfunction depending on the load of parasite, migration target of the larva and the inflammatory response of the host. Transverse myelitis (TM) due to toxocariasis is an uncommon illness identified mainly as case reports in literature. In this report, a case of TM who was diagnosed as neurotoxocariasis by serological findings has been presented. A 44-year-old male patient complained with backache was diagnosed as TM in a medical center in which he has admitted two years ago, and treated with pregabalin and nonsteroidal drugs for six months. Because of the progression of the lesions he readmitted to another center and treated with high dose steroid therapy for three months. After six months of follow up, improvement has been achieved, however, since his symptoms reccurred in the following year he was admitted to our hospital. Magnetic resonance imaging (MRI) examination revealed a TM in a lower segment of spinal cord. He was suffering with weakness and numbness in the left lower extremity. There was no history of rural life or contact with cats or dogs in his anamnesis. Physical examination revealed normal cranial nerve functions, sensory and motor functions. There has been no pathological reflexes, and deep tendon reflexes were also normal. Laboratory findings yielded normal hemogram and biochemical tests, negative PPD and parasitological examination of stool were negative for cysts and ova. Viral hepatitis markers, anti-HIV, toxoplasma-IgM, CMV-IgM, rubella-IgM, EBV-VCA-IgM, VDRL, Brucella tube agglutination, echinococcus antibody, autoantibody tests and neuromyelitis optica test were negative. Examination of CSF showed 20 cells/mm3 (mononuclear cells), 45 mg/dl protein and normal levels of glucose and chlorine. In both serum and CSF samples of the patient Toxocara

Change in corneal aberrations after cataract surgery with 2 types of aspherical intraocular lenses.

PubMed

Marcos, Susana; Rosales, Patricia; Llorente, Lourdes; Jiménez-Alfaro, Ignacio

2007-02-01

To study the effect of cataract surgery through 3.2 mm superior incisions on corneal aberrations with 2 types of monofocal intraocular lenses (IOLs) with an aspherical design. Instituto de Optica, Consejo Superior de Investigaciones Científicas, and Fundación Jiménez Díaz, Madrid, Spain. Corneal topography of 43 eyes was obtained before and after small corneal incision cataract surgery. Twenty-two eyes had implantation of a Tecnis Z9000 silicone IOL (Advanced Medical Optics) and 21 had implantation of an AcrySof IQ SN60WF acrylic IOL (Alcon Research Labs) using the recommended injector for each IOL type. The intended incision size (3.2 mm) was similar in the 2 groups. Corneal aberrations were estimated using custom-developed algorithms (based on ray tracing) for 10.0 mm and 5.0 mm pupils. Comparisons between preoperative and postoperative measurements and across the groups were made for individual Zernike terms and root-mean-square (RMS) wavefront error. The RMS (excluding tilt and defocus) did not change in the AcrySof IQ group and increased significantly in the Tecnis group with the 10.0 mm and 5.0 mm pupil diameters. Spherical aberration and coma-like terms did not change significantly; however, vertical astigmatism, vertical trefoil, and vertical tetrafoil changed significantly with surgery with the 10.0 mm and 5.0 mm pupil diameters (P<.0005). The induced wave aberration pattern for 3rd- and higher-order aberrations consistently showed a superior lobe, resulting from a combination of positive vertical trefoil (Z(3)(-3)) and negative tetrafoil (Z(4)(4)). The mean vertical astigmatism increased by 2.47 microm +/- 1.49 (SD) and 1.74 +/- 1.44 microm, vertical trefoil increased by 1.81 +/- 1.19 microm and 1.20 +/- 1.34 microm, and tetrafoil increased by -1.10 +/- 0.78 microm and -0.89 +/- 0.68 microm in the Tecnis group and AcrySof IQ group, respectively. There were no significant differences between the corneal aberrations in the 2 postoperative groups

Time reversal optical tomography and decomposition methods for detection and localization of targets in highly scattering turbid media

NASA Astrophysics Data System (ADS)

Wu, Binlin

New near-infrared (NIR) diffuse optical tomography (DOT) approaches were developed to detect, locate, and image small targets embedded in highly scattering turbid media. The first approach, referred to as time reversal optical tomography (TROT), is based on time reversal (TR) imaging and multiple signal classification (MUSIC). The second approach uses decomposition methods of non-negative matrix factorization (NMF) and principal component analysis (PCA) commonly used in blind source separation (BSS) problems, and compare the outcomes with that of optical imaging using independent component analysis (OPTICA). The goal is to develop a safe, affordable, noninvasive imaging modality for detection and characterization of breast tumors in early growth stages when those are more amenable to treatment. The efficacy of the approaches was tested using simulated data, and experiments involving model media and absorptive, scattering, and fluorescent targets, as well as, "realistic human breast model" composed of ex vivo breast tissues with embedded tumors. The experimental arrangements realized continuous wave (CW) multi-source probing of samples and multi-detector acquisition of diffusely transmitted signal in rectangular slab geometry. A data matrix was generated using the perturbation in the transmitted light intensity distribution due to the presence of absorptive or scattering targets. For fluorescent targets the data matrix was generated using the diffusely transmitted fluorescence signal distribution from the targets. The data matrix was analyzed using different approaches to detect and characterize the targets. The salient features of the approaches include ability to: (a) detect small targets; (b) provide three-dimensional location of the targets with high accuracy (~within a millimeter or 2); and (c) assess optical strength of the targets. The approaches are less computation intensive and consequently are faster than other inverse image reconstruction methods that

The effect of a self-constructed material on children's physical activity during recess.

PubMed

Méndez-Giménez, Antonio; Cecchini, José-Antonio; Fernández-Río, Javier

2017-06-26

To analyze whether an intervention supported by free play with a self-constructed material increases the level of physical activity of students during recess. The participants were 166 children of third to sixth grade, between nine and 12 years old (average = 10.64; SS = 1.13). An experimental project was conducted with pre-test and post-test measurement, and a control group. Experimental group participants built cardboard paddles (third and fourth) and flying rings (fifth and sixth), a material they used freely for one week during recess. ActiGraph-GT3X accelerometers were used to measure physical activity. An ANOVA of repeated measures was used to find differences between groups and genders. Significant intervention effects were found in the analyzed variables: sedentary activity (F = 38.19; p < 0.01), light (F = 76.56; p < 0.01), moderate (F = 27.44; p < 0.01), vigorous (F = 61.55; p < 0.01), and moderate and vigorous (F = 68.76; p < 0.01). Significant gender differences were shown (time × group × gender) for moderate (F = 6.58; p < 0.05) and vigorous (F = 5.51; p < 0.05) activity. The self-constructed material is effective to increase the physical activity levels of children during recess; it decreases sedentary activity and light physical activity and increases the time devoted to moderate physical activity and vigorous physical activity, both in boys and in girls. The boys had an increase in vigorous physical activity and the girls in moderate physical activity. Due to its low cost, this strategy is recommended for administrators and teachers to increase the physical activity of children during recess. Analizar si una intervención basada en el juego libre con material autoconstruido aumenta el nivel de actividad física de los escolares durante el recreo. Participaron 166 niños de tercero a sexto de educación primaria, de entre nueve y 12 años de edad (media = 10,64; DE = 1,13). Se realizó un diseño experimental con medidas pretest y postest, y un

Relaciones hidrogeologicas y medioambientales entre el mar mediterraneo, El saladar y el acuifero de agua amarga (provincia de alicante). Incidencia de las explotaciones de las desaladoras de alicante I Y II Y medidas correctoras

NASA Astrophysics Data System (ADS)

Manteca, Ivan Alhama

The Agua Amarga coastal aquifer, located in the south of Alicante province, has been subjected to successive anthropogenic actions: salt works activity (1925-1975) and water withdrawal to supply the Alicante I and II desalination plants (since 2003). These interventions have influenced the salinity and the flow regime. Due to the existence of a salt marsh of ecological interest linked to the aquifer, the 'Mancomunidad de los Canales del Taibilla' (agency responsible for the desalination plants) designed a piezometric network for monitoring piezometry and electrical conductivity (in operation since May 2008). Soil humidity and piezometrics levels have been recovered by means of a seawater pouring programme over the salt marsh (since December 2009),which represents the third anthropic intervention. In this memoria, we investigate the Agua Amarga coastal aquifer to develop a physical conceptual model. Firstly, the study area is characterized in relation to climatology, geology, geomorphology and hydrogeology, using published information, describing, in addition, the desalination plants catchment system. Next, based on hydrogeological studies prior to the start up of the desalination plants, the aquifer is characterized: type, lithology, hydraulic parameters, thickness, surface extension, etc. Water quantity relating to rainfall, water withdrawal and pourings over the salt marsh, have been integrated in conjunction with data from monthly piezometric campaigns. In adittion, in order to gain insight into the groundwater mixing processes, chemical and isotope analyses were carried out on meteoric water and groundwater samples taken at different locations. The results were used to elaborate a conceptual physical model and a water budget. As an extension tool to understand processes and assess aquifer management, a 3-D fluid-flow and solute-transport model is designed with SEAWAT. Also, the 2-D physical characterization of scenarios with seawater intrusion and salt flats is presented. Finally, after describing ecological values of the salt marsh, the effect of the seawater pouring programme on aquifer piezometry and salinity is studied, assessing the possibility of applying this pilot scheme to other scenarios.

Measurement of the branching ratio for the doubly cabibbo suppressed decay D + → + K -K +K +; Medida da razao de ramificacao do Decaimento D + → + K -K +K + duplamente suprimido por cabibbo (in Portuguese)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Silva Carvalho, Hendly da

In this thesis, we performed a study for the decay modes D + → + K -K +K + and D + s → + K -K +K +, using the data collected by the E791, a hadroproduction of charm experiment at Fermilab. The D + → + K -K +K + decay is doubly Cabibbo suppressed while the D + s → + K -K +K + decay is singly Cabibbo suppressed. We found 11.6 +- 3.9 events in the D + mass region and 8.9 +- 3.3 in the D + s mass region. The D + →more » + K -K +K + branching ratio is measured to be (3.7 +- 1.3 +- 0.6) x 10 -4 while the D + → + K -K +K + branching ratio relative to D + s → + K -K +K + is measured to be (4.2 +- 1.5 +- 0.6) x 10 -2.« less

Factores socio-económicos asociados a la percepción de situación socioeconómica entre adultos mayores de dos países latinoamericanos

PubMed Central

Brenes-Camacho, Gilbert

2014-01-01

El objetivo principal del artículo es estudiar la asociación entre la percepción subjetiva sobre la situación económica propia y una serie de medidas objetivas de bienestar socioeconómico –fuentes de ingresos, tenencia de vivienda, nivel educativo y transferencias familiares informales de dinero- entre adultos mayores de dos países Latinoamericanos: México y Costa Rica. Los datos se obtienen de las primeras rondas de dos encuestas sobre envejecimiento: CRELES para Costa Rica y ENASEM para México. La variable dependiente más importante se obtiene de las respuestas a las pregunta “¿Cómo califica su situación económica actual?” en Costa Rica y “¿Diría usted que su situación económica es…?” en México. Para ambas encuestas, las respuestas se codificaron en forma binaria; el código 0 representa las categorías Excelente, Muy buena y Buena, y el código 1 representa a las categorías Regular y Mala. Se encontró que el ingreso por jubilación es un importante determinante de la percepción de bienestar en ambos países. En Costa Rica, el ingreso del cónyuge y la tenencia de vivienda son importantes predictores de la percepción de bienestar, mientras que en México, los ingresos por transferencias están fuertemente asociados con dicha percepción. PMID:25360057

Programmed home visits by nursing professionals to older adults: prevention or treatment?1

PubMed Central

Dios-Guerra, Caridad; Carmona-Torres, Juan Manuel; Ruíz-Gándara, África; Muñoz-Alonso, Adoración; Rodríguez-Borrego, María-Aurora

2015-01-01

OBJETIVOS: conocer la repercusión de la visita domiciliaria de los profesionales en enfermería a personas de 65 años o más, pluripatológicas, en morbimortalidad. MÉTODO: estudio retrospectivo caso-control por auditoria de historias clínicas. Muestreo aleatorio. Variables principales morbilidad, mortalidad; descriptivas: visitas de la enfermera, filiación, datos clínicos y socio sanitarios. Análisis por medidas de tendencia central, dispersión, posición, tabulación, frecuencias relativas, absolutas; no paramétricas, contrastes χ2; Wilcoxon-Mann-Whitney. RESULTADOS: se estudiaron a 1743 pacientes, de ellos 199 recibieron visita domiciliaria; la edad media de quien recibe visita es de 81,99 años; estos presentan mayor número de patologías de media 3,76; habitan en domicilio particular, si bien en conjunto presentan más institucionalización que los controles; el 50% no tiene identificado el Cuidador Principal; es mayor el número de visitas de las enfermeras a los pacientes que viven en residencias (p < 0,001). El 50% de casos no tiene plan de cuidados, con relación significativa (p < 0,001). No existen diferencias significativas en tiempo de vida entre los casos y los controles. CONCLUSIÓN: la visita domiciliaria del profesional en enfermería no repercute en la morbimortalidad; visita a los pacientes cuando ya ha aparecido el problema de salud, no hay datos de prevención. PMID:26312638

Incorporando a variabilidade no processo de identificação do modelo de máximo global no Grade of Membership (GoM): considerações metodológicas

PubMed Central

Guedes, Gilvan Ramalho; Siviero, Pamila Cristina Lima; Caetano, André Junqueira; Machado, Carla Jorge; Brondízio, Eduardo

2012-01-01

A disponibilidade de bases de dados cada vez mais complexas e multidimensionais é um dos principais motivadores para o aumento do número de estudos que utilizam análises multivariadas baseadas em lógica de conjuntos nebulosos. Apesar da disseminação do método Grade of Membership nos trabalhos empíricos brasileiros da área de ciências sociais e saúde, questões relativas à identificabilidade e estabilidade dos parâmetros finais estimados pelo programa GoM 3.4 não foram suficientemente aprofundadas. Dada a relevância de se obterem parâmetros únicos e estáveis, Guedes et al. (2010) propuseram um procedimento empírico para localizar um modelo de máximo global (MG) com parâmetros estáveis. Entretanto, seu localizador de MG não incorpora qualquer medida de variabilidade. Neste artigo, tal limitação é contornada por meio da utilização de uma estatística de ponderação – Máximo Global Ponderado (MGP) – semelhante ao coeficiente de variação. Esse indicador busca não penalizar de forma desproporcional situações nas quais os desvios médios, apesar de diferentes de zero, são muito pequenos. Apresentam-se evidências de que o localizador MGP reduz a distância do modelo identificado à real estrutura latente dos dados em análise, quando comparados ao modelo identificado pelo localizador não ponderado, MG. PMID:23293402

Gap plasmon-based metasurfaces: fundamentals and applications (Conference Presentation)

NASA Astrophysics Data System (ADS)

Pors, Anders

2016-04-01

simultaneous control of the amplitude and phase of reflected light allow us to perform calculus operations, such as differentiation and integration, on the incident light [5], which signifies the possibility to do optical signal processing using GSP-based metasurfaces. References: 1. A. Pors and S. I. Bozhevolnyi, "Gap plasmon-based phase-amplitude metasurfaces: material constraints", Opt. Mater. Express 5, 2448-2458 (2015). 2. A. S. Roberts, A. Pors, O. Albrektsen, and S. I. Bozhevolnyi, "Subwavelength plasmonic color printing for ambient use", Nano Lett. 14, 783-787 (2014). 3. A. Pors, M. G. Nielsen, T. Bernardin, J.-C. Weeber, and S. I. Bozhevolnyi, "Efficient unidirectional polarization-controlled excitation of surface plasmon polaritons", Light: Sci. Applications 3, e197 (2014). 4. A. Pors, M. G. Nielsen, and S. I. Bozhevolnyi, "Plasmonic metagratings for simultaneous determination of Stokes parameters", Optica 2, 716-723 (2015). 5. A. Pors, M. G. Nielsen, and S. I. Bozhevolnyi, "Analog computing using reflective plasmonic metasurfaces", Nano Lett. 15, 791-797 (2015).

Investigacion educativa. El sistema escolar en sus diferentes niveles, factores que favorecen o frenan su eficacia y medidas de superacion (Educational Research. The Educational System at Different Levels; Factors Promoting or Hindering Its Efficiency; Possible Improvements.

ERIC Educational Resources Information Center

Jimenez Lozano, Blanca; And Others

This document is an English-language abstract (Approximately 1,500 words) of a study on educational research in Mexico. Chapter one discusses the importance of educational research, in terms of its role both in scientific and technical development; it should use scientific methods so that it will have solid foundations. Chapter two is a survey of…

Comparação de modelos para o cálculo de perturbações orbitais devidas à maré terrestre

NASA Astrophysics Data System (ADS)

Vieira Pinto, J.; Vilhena de Moraes, R.

2003-08-01

Aplicações recentes de satélites artificiais com finalidades geodinâmicas requerem órbitas determinadas com bastante precisão. Em particular marés terrestres influenciam o potencial terrestre causando perturbações adicionais no movimento de satélites artificiais, as quais tem sido medidas por diversos processos. A atração exercida pela lua e pelo sol sobre a terra produz deslocamentos elásticos em seu interior e uma protuberância em sua superfície. O resultado é uma pequena variação na distribuição da massa na terra, consequentemente no geopotencial. As perturbações nos elementos orbitais de satélites artificiais terrestres devidas a maré terrestre podem ser estudadas a partir das equações de Lagrange, considerando-se um conveniente potencial. Por outro lado, como tem sido feito pelo IERS, as mudanças induzidas pela maré terrestre no geopotencial podem ser convenientemente modeladas como variações nos coeficientes Cnm e Snm do geopotencial. As duas teorias ainda não foram comparados para um mesmo satélite. Neste trabalho são apresentadas e comparadas as variações de longo período e seculares nas perturbações orbitais devidas à maré terrestre, calculadas por um modelo simples, o de Kozai, e pelo modelo do IERS. Resultados preliminares mostram, para os satélites SCD2 e CBERS1, e para a Lua em movimento elíptico e precessionando, as perturbações seculares no argumento do perigeu e na longitude do nodo ascendente.

[Not Available].

PubMed

Latorre-Román, Pedro Ángel; Martínez-López, Emilio José; Ruiz-Ariza, Alberto; Izquierdo-Rus, Tomás; Salas-Sánchez, Jesús; García-Pinillos, Felipe

2016-06-30

Objetivo: el objetivo de este estudio es evaluar las propiedades psicométricas del cuestionario de disfrute por el ejercicio físico (PACES) en adolescentes con sobrepeso y obesidad.Métodos: participaron 139 adolescentes con sobrepeso y obesidad: 91 niñas (edad = 13,85 ± 1,92 años; índice de masa corporal [IMC] = 26,83 ± 3,16 kg/m2) y 48 niños (edad = 14,29 ± 1,62 años; IMC = 28,31 ± 3,74 kg/m2). Para analizar el disfrute por la actividad física se empleó el cuestionario Physical Activity Enjoyment Scale (PACES).Resultados: los resultados del análisis factorial exploratorio y confirmatorio han mostrado una estructura de dos factores; a su vez el PACES presenta una consistencia interna muy alta (alfa de Cronbach = 0,908). La fiabilidad test-retest indica una buena concordancia temporal (Spearman rho = 0,815, p < 0,001). Por último, el PACES en adolescentes con sobrepeso y obesidad manifiesta una validez convergente adecuada con la intencionalidad de ser activo (MIFA), la atracción por la actividad física (CAPA), la resistencia cardiorrespiratoria y los pliegues suprailiacoy subescapular.Conclusión: los resultados confirman que el PACES es una medida válida y fiable del disfrute por la actividad física en adolescentes con sobrepeso y obesidad. El disfrute por la actividad física puede ser relevante en la participación de los adolescentes con sobrepeso y obesidad en estas actividades.

Prevalencia de alteraciones en la interfase vitreoretiniana detectadas mediante tomografía de coherencia óptica de dominio espectral.

PubMed

Jacob, Julie; Stalmans, Peter

2017-07-11

Objetivo: El objetivo principal del presente estudio consistió en determinar la prevalencia de los cambios en la interfase vitreomacular (IVM) mediante tomografía de coherencia óptica (OCT) en la población general. En segundo lugar, se describieron otros cambios de la OCT. Métodos: Las anomalías en la IVM se diagnosticaron mediante OCT y se distribuyeron de acuerdo con la clasificación del grupo International Vitreomacular Traction Study (estudio internacional de tracción vitreomacular, IVTS, por sus siglas en inglés) y se dividieron en 3 grados según John et al. [Retina 2014;34:442-446]. Resultados: La prevalencia calculada de anomalías vitreomaculares en la población belga de ≥50 años fue del 1,17% [intervalo de confianza (IC 0,38-3,62)] en el caso de tracción vitreomacular (TVM) focal de grado 1; del 0,39% (IC 0,05-2,76) en el caso de TVM focal de grado 2; del 8,17% (IC 5,33-12,53) en el caso de adhesión vitreomacular focal; y del 17,9% (IC 13,41-23,9) en el caso de adhesión vitreomacular difusa. Conclusiones: Se presentó la prevalencia de anomalías vitreomaculares en un estudio de cohortes belga. Estos resultados concuerdan en gran medida con los datos presentados previamente sobre la prevalencia de la TVM. Un conocimiento correcto sobre la epidemiología de las alteraciones en la IVM y un diagnóstico temprano permitirán una intervención satisfactoria. © 2017 S. Karger AG, Basel.

Accuracy of the Defining Characteristics of the Nursing Diagnosis Hypothermia in Newborns.

PubMed

de Aquino, Wislla Ketlly Menezes; Lopes, Marcos Venícios de Oliveira; da Silva, Viviane Martins; Fróes, Nathaly Bianka Moraes; de Menezes, Angélica Paixão; Almeida, Aline de Aquino Peres; Sobreira, Bianca Alves

2017-09-18

To analyze the accuracy of the defining characteristics of hypothermia in newborns and to verify associations between defining characteristics and clinical variables. A cross-sectional accuracy study with statistical analysis. Slow capillary refill, decrease in ventilation, peripheral vasoconstriction, and insufficient weight gain were the defining characteristics with the highest specificity values, while slow gastric emptying, skin cool to touch, irritability, and bradycardia were the defining characteristics with the highest values for both sensitivity and specificity. Slow gastric emptying, skin cool to touch, irritability, and bradycardia are good clinical indicators to infer initial stages of hypothermia and to confirm its presence. Accuracy measures may contribute to the improvement of the diagnostic inferential process. Analisar acurácia das características definidoras de Hipotermia em recém-nascidos e identificar a associação delas com variáveis clínicas. MÉTODO: Estudo de acurácia transversal com análise estatística. Preenchimento capilar lento, diminuição da ventilação, vasoconstrição periférica e ganho de peso insuficiente apresentaram valores altos de especificidade enquanto esvaziamento gástrico lento, pele fria, irritabilidade e bradicardia apresentaram valores elevados de sensibilidade e especificidade. CONCLUSÃO: Esvaziamento gástrico lento, pele fria, irritabilidade e bradicardia são úteis para inferir estágios iniciais de hipotermia e para confirmação diagnóstica. IMPLICAÇÕES PARA PRÁTICA DE ENFERMAGEM: Medidas de acurácia podem contribuir para o processo de inferência do diagnóstico hipotermia. © 2017 NANDA International, Inc.

Collective strategy for facing occupational risks of a nursing team.

PubMed

Loro, Marli Maria; Zeitoune, Regina Célia Gollner

2017-03-09

To socialize an educational action through the process of group discussion and reflection, with the aim to increase the care of nursing workers in facing occupational risks. A qualitative descriptive study using the Convergent Care Research modality with nursing staff working in an emergency department of a hospital in the northwest region of the state of Rio Grande do Sul, Brazil. Data collection was carried out through educational workshops and information was processed using content analysis, resulting in two thematic categories: A look at the knowledge and practices about occupational risks in nursing; and adherence to protective measures by the nursing team against occupational risks. Twenty-four (24) workers participated in the study. When challenged to critically look at their actions, the subjects found that they relate the use of safety devices to situations in which they are aware of the patient's serological status. Subjects' interaction, involvement and co-responsibility in the health education process were determinant for their reflection on risky practices. They also had the potential to modify unsafe behaviors. Socializar uma ação educativa, por meio de um processo de discussão e reflexão em grupo, com vistas a ampliar o cuidado dos trabalhadores de enfermagem frente aos riscos ocupacionais. Estudo qualitativo, descritivo na modalidade Pesquisa Convergente Assistencial, com trabalhadores da equipe de enfermagem que atuavam no pronto atendimento de um hospital da região noroeste do estado do Rio Grande do Sul. A coleta de dados foi realizada por meio de oficinas educativas, e o tratamento das informações, por análise de conteúdo, resultando em duas categorias temáticas: Um olhar direcionado a saberes e práticas sobre riscos ocupacionais na enfermagem e Adesão às medidas de proteção pela equipe de enfermagem frente aos riscos ocupacionais. Integraram o estudo 24 trabalhadores. Ao serem desafiados a olhar criticamente sobre seu fazer, os

The Palliative Outcome Scale (POS) applied to clinical practice and research: an integrative review.

PubMed

Rugno, Fernanda Capella; Carlo, Marysia Mara Rodrigues do Prado De

2016-08-15

to identify and evaluate the evidence found in the international scientific literature on the application of the Palliative Outcome Scale (POS) in clinical practice and research in Palliative Care (PC). integrative literature review, through the search of publications in journals indexed in PubMed / MEDLINE, LILACS, SciELO and CINAHL databases, between the years 1999 and 2014. the final sample consisted of 11 articles. In the data analysis, the articles were classified into 2 units of analysis (studies using the POS as a resource in research and studies using the POS in clinical practice), in which the information was presented in the form of sub-themes related to publications of the selected studies, highlighting the synthesis of the results. POS emerged as an important tool for measuring outcomes to assess the quality of life of patients and families, of the quality of care provided and the PC service organization. The international scientific literature on the application of POS proved to be relevant to the advancement and consolidation of the field of knowledge related to PC. identificar e avaliar as evidências encontradas na literatura científica internacional, referentes à aplicação da Palliative Outcome Scale (POS) na prática clínica e nas pesquisas em Cuidados Paliativos (CPs). revisão integrativa da literatura, por meio da busca de publicações nos periódicos indexados nas bases de dados PubMed/MEDLINE, LILACS, SciELO e CINAHL, entre os anos de 1999 e 2014. a amostra final do estudo constituiu-se de 11 artigos. Na análise dos dados, os artigos foram classificados em 2 unidades de análise (estudos que utilizam a POS como recurso na pesquisa e estudos que utilizam a POS na prática clínica), nas quais as informações foram apresentadas na forma de subtemas referentes às publicações dos estudos selecionados, com destaque para a síntese dos resultados. a POS se destacou como um importante instrumento de medidas de resultados para a avalia

A systematic review and meta-analysis on the longitudinal relationship between eating pathology and depression.

PubMed

Puccio, Francis; Fuller-Tyszkiewicz, Matthew; Ong, Deborah; Krug, Isabel

2016-05-01

estos 42 estudios, se realizaron meta-análisis de multinivel de efectos aleatorios en 30 estudios elegibles. Los resultados del meta-análisis mostraron que la alimentación patológica era un factor de riesgo para depresión (rm=0.13) y que la depresión era un factor de riesgo para la alimentación patológica (rm=0.16). Los análisis de meta-regresión mostraron que estos efectos eran significativamente más fuertes para estudios que operacionalizaban la alimentación patológica como un diagnóstico de trastorno de la conducta alimentaria versus síntomas de alimentación patológica, y para los estudios que operacionalizaban la medida respectiva de resultado como una variable categórica (e.g., un diagnóstico de trastorno o cuando los síntomas estaban "presentes"/"ausentes") versus una medida continua. Los resultados mostraron que en relación al tipo de alimentación patológica, el efecto de un diagnóstico de trastorno de la conducta alimentaria y síntomas bulímicos en la depresión era significativamente más fuerte para participantes más jóvenes. DISCUSIÓN: La alimentación patológica y la depresión son factores de riesgo concurrentes uno para el otro, lo que sugiere que la investigación futura se beneficiaría de identificar factores que son etiológicos al desarrollo de ambos constructos. © 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2016;49:439-454). © 2015 Wiley Periodicals, Inc.

Zarit Burden Interview Psychometric Indicators Applied in Older People Caregivers of Other Elderly.

PubMed

Bianchi, Mariana; Flesch, Leticia Decimo; Alves, Erika Valeska da Costa; Batistoni, Samila Sathler Taveres; Neri, Anita Liberalesso

2016-11-28

to derive psychometric indicators of construct validity and internal consistence of the Zarit Burden Interview scale for caregivers, describing associations of the scale with metrics related to care demands, coping strategies and depression in aged caregivers. crosscutting descriptive and correlational study. The convenience sample was composed by a hundred and twenty one senior caregivers (Avg=70.5 ± 7.2 years, 73% women). They answered a questionnaire to check the physical and cognitive demands of care, the Zarit Burden Interview (ZBI), the California Inventory of Coping Strategies and the Geriatric Depression Scale (GDS-15). ZBI showed good internal consistency and also for the three factors emerging from factor analysis, explaining 44% of variability. ZBI is positively related with objective care demands (p < 0.001), depression (p = 0.006) and use of dysfunctional coping strategies (p = 0.0007). ZBI is of interest to be applied to aged caregivers and the association of higher degrees of burden, dysfunctional coping and depression show a vulnerability scenario that may affect to older people taking care of other elderly. derivar indicadores psicométricos de validade de construto e consistência interna da escala de sobrecarga de cuidadores de Zarit Burden Interview e descrever associações desta com medidas referentes às demandas de cuidado, estratégias de enfrentamento e depressão em cuidadores idosos. estudo descritivo, transversal e correlacional. Cento e vinte e um cuidadores idosos (M= 70,5 ± 7,2 anos, 73% feminino) compuseram uma amostra de conveniência e responderam a um protocolo de pesquisa para levantamento de demandas de cuidado de natureza física e cognitiva, à Zarit Burden Interview (ZBI), ao Inventário de Estratégias de Enfrentamento da Califórnia e à Escala de Depressão Geriátrica (GDS-15). a ZBI revelou bons índices de consistência interna e para os três fatores resultantes da análise fatorial, os quais explicaram 44% da

[Not Available].

PubMed

Flores Navarro-Pérez, Carmen; González-Jiménez, Emilio; Schmidt-RioVilla, Jacqueline; Meneses-Echávez, José Francisco; Correa-Bautista, Jorge Enrique; Correa-Rodríguez, María; Ramírez-Vélez, Robinson

2016-07-19

Objetivos: los objetivos de este estudio fueron analizar el nivel nutricional en una población de niños y adolescentes colombianos y determinar la posible relación entre el nivel nutricional y el estado nutricional según el índice de masa corporal (IMC) y la circunferencia de cintura (CC).Material y métodos: estudio transversal en 6.383 niños y adolescentes de entre 9 y 17,9 años de edad, de Bogotá, Colombia. Se aplicó de manera autodiligenciada el cuestionario Krece Plus validado en el estudio enKid como indicador del nivel nutricional con las categorías alto (test ≥ 9), medio (test 6-8) y bajo (test ≤ 5). Se tomaron medidas de peso, talla, CC, y se calculó el IMC como marcadores del estado nutricional.Resultados: de la población general, el 57,9% eran chicas (promedio de edad 12,7 ± 2,3 años). En todas las categorías del IMC, más del 50% de chicos y chicas siguen una dieta de muy baja calidad, que empeora progresivamente con el avance en edad. En ambos sexos, se observaron tendencias entre un nivel nutricional muy bajo con el desarrollo de sobrepeso. Asimismo, la obesidad abdominal por CC se relacionó con una puntuación baja en el Krece Plus en ambos sexos.Conclusiones: en escolares de Bogotá, una dieta de muy baja calidad se relacionó con alteraciones del estado nutricional (IMC y CC), especialmente entre chicas y adolescentes. Estos resultados deben alentar el desarrollo de intervenciones orientadas a mejorar los hábitos nutricionales entre los escolares colombianos.

Introduccion a la hidraulica de aguas subterraneas : un texto programado para auto-ensenanza

USGS Publications Warehouse

Bennett, Gordon D.

1987-01-01

Este ' texto programado esta diseflado para ayudarle a comprender la teoria de la hidniulica de aguas subterraneas por medio de la auto-enseflanza. La instrucci6n programada es un enfoque a una materia, un metodo de aprender;que no elimina el esfuerzo mental del proceso de aprendizaje. Algunas secciones de este programa necesitan solamente ser leidas; otras tendrian que ser elaboradas con lapiz y papel. Algunas preguntas pueden ser contestadas directamente; otras requieren calculos. A medida que se avanza en el texto, tendra que consultar frecuentemente textos o referencias sobre matematicas, mecanica de fluidos e hidrologia. En cada una de las ocho partes del texto, inicie el programa de instrucci6n leyendo la Secci6n 1. Elija una respuesta a la pregunta al final de la secci6n y dirijase a la nueva secci6n indicada al lado de la respuesta escogida. Si su respuesta fue correcta, pase a la secci6n que contiene materia nueva y otra pregunta, y proceda tal como en la Secci6n 1. Si su respuesta no fue correcta, dirijase a la secci6n que contiene explicaciones adicionales sobre el tema anterior y que le indica volver a la pregunta inicial e intentar de nuevo. En este caso, valdra Ia pena repasar el material de la secci6n anterior. Continue de esta man era en el programa hasta que llegue a Ia secci6n que indica el final de la parte. Observe que aunque las secciones estan en orden numerico en cada una de las ocho partes, por lo general, usted no procedeni en secuencia numerica (Secci6n 1 ala Secci6n 2, etc.) de principia a fin.

ACTITUDES HACIA LA COMUNICACIÓN SEXUAL ENTRE PADRES/MADRES Y ADOLESCENTES EN PUERTO RICO*

PubMed Central

Fernández, Ana Michelle; McFarlane, Melvin Negrón; González, Ricardo; Díaz, Leslie; Betancourt-Díaz, Elba; Cintrón-Bou, Francheska; Varas-Díaz, Nelson; Villarruel, Antonia

2017-01-01

RESUMEN La comunicación sobre sexualidad entre padres/madres y adolescentes enfrenta dificultades particulares producto de factores socioculturales. Este estudio tuvo como objetivo documentar las actitudes de padres/madres y adolescentes hacia la comunicación sobre temas de sexualidad. Los resultados emanan de la medición inicial del Proyecto Cuídalos. Los datos de este estudio forman parte de un estudio amplio que evaluó un módulo interactivo basado en la web para mejorar comunicación sobre temas de salud entre padres/madres y adolescentes entre 13–17 años. En este artículo, reportamos datos basales que contestaron los/as participantes sobre comodidad al hablar sobre temas de salud sexual. La muestra, de los datos aquí expuestos, estuvo compuesta por 458 diadas de madres/padres y sus hijos/as adolescentes (n=916). Se realizó análisis de frecuencias y medidas de tendencia central con los datos obtenidos inicialmente. La edad promedio de los adolescentes fue de 15 años, de los que un 15% se encontraban activos sexualmente. Los/as adolescentes tienen mejor disposición que los/as padres/madres para hablar sobre sexualidad. Sin embargo, los/as padres/madres entienden que comparten suficiente información sobre temas relacionados a la sexualidad. Los/as padres/madres y adolescentes reportaron algún grado de dificultad e incomodidad al hablar sobre métodos específicos de prevención. Los resultados destacan la necesidad de incorporar a los/as padres/madres en intervenciones con adolescentes sobre temas de salud sexual. En Puerto Rico es necesario desarrollar programas dirigidos a minimizar las conductas sexuales de alto riesgo en jóvenes. PMID:28736599

Nursing workload for cancer patients under palliative care.

PubMed

Fuly, Patrícia Dos Santos Claro; Pires, Livia Márcia Vidal; Souza, Claudia Quinto Santos de; Oliveira, Beatriz Guitton Renaud Baptista de; Padilha, Katia Grillo

2016-01-01

To verify the nursing workload required by cancer patients undergoing palliative care and possible associations between the demographic and clinical characteristics of the patients and the nursing workload. This is a quantitative, cross-sectional, prospective study developed in the Connective Bone Tissue (TOC) clinics of Unit II of the Brazilian National Cancer Institute José Alencar Gomes da Silva with patients undergoing palliative care. Analysis of 197 measures of the Nursing Activities Score (NAS) revealed a mean score of 43.09% and an association between the performance status of patients undergoing palliative care and the mean NAS scores. The results of the study point to the need to resize the team of the unit. The NAS has proven to be a useful tool in oncologic clinical units for patients undergoing palliative care. Verificar a carga de trabalho de enfermagem requerida por pacientes com câncer sob cuidados paliativos e possíveis associações entre as características demográficas e clínicas dos pacientes e a carga de trabalho de enfermagem. Trata-se de um estudo de abordagem quantitativa, transversal, prospectivo, desenvolvido na clínica de Tecido Ósseo Conectivo (TOC) da Unidade II do Instituto Nacional de Câncer José Alencar Gomes da Silva, com pacientes em cuidados paliativos. A análise de 197 medidas do Nursing Activities Score (NAS) revelou um escore médio de 43,09% e uma associação entre a performance status de pacientes em cuidados paliativos com os valores médios do NAS. Os resultados do estudo apontam para a necessidade de redimensionamento da equipe da Unidade. O NAS mostrou-se um instrumento passível de utilização em unidades clínicas oncológicas, com pacientes em cuidados paliativos.

Pain assessment and management in patients undergoing endovascular procedures in the catheterization laboratory.

PubMed

Hilário, Thamires de Souza; Santos, Simone Marques Dos; Kruger, Juliana; Goes, Martha Georgina; Casco, Márcia Flores; Rabelo-Silva, Eneida Rejane

2017-05-25

To describe how pain is assessed (characteristic, location, and intensity) and managed in clinical practice in patients undergoing endovascular procedures in the catheterization laboratory setting. Cross-sectional study with retrospective data collection. Overall, 345 patients were included; 116 (34%) experienced post-procedural pain; in 107 (92%), pain characteristics were not recorded; the location of pain was reported in 100% of patients, and its intensity in 111 (96%); management was largely pharmacologic; of the patients who received some type of management (n=71), 42 (59%) underwent reassessment of pain. The location and intensity of pain are well reported in clinical practice. Pharmacologic pain management is still prevalent. Additional efforts are needed to ensure recording of the characteristics of pain and its reassessment after interventions. Describir cómo se evalúa el dolor (características, localización e intensidad) y su manejo en la práctica clínica en pacientes sometidos a procedimientos endovasculares en el laboratorio de cateterización. Estudio transversal con recolección retrospectiva de datos. En total, se incluyeron 345 pacientes; 116 (34%) experimentaron dolor post-procedimiento; en 107 (92%), no se registraron las características del dolor; la localización del dolor se informó en el 100% de los pacientes, y su intensidad en 111 (96%); el manejo fue en gran medida farmacológico; de los pacientes que recibieron algún tipo de tratamiento (n=71), 42 (59%) fueron sometidos a reevaluación del dolor. La ubicación y la intensidad del dolor se informan bien en la práctica clínica. El manejo farmacológico del dolor sigue siendo frecuente. Se necesitan esfuerzos adicionales para asegurar el registro de las características del dolor y su reevaluación después de las intervenciones.

Relation of maximum blood pressure during exercise and regular physical activity in normotensive men with left ventricular mass and hypertrophy. MARATHOM Investigators. Medida de la Actividad fisica y su Relación Ambiental con Todos los Lípidos en el HOMbre.

PubMed

Molina, L; Elosua, R; Marrugat, J; Pons, S

1999-10-15

The relation between maximum systolic blood pressure (BP) during exercise and left ventricular (LV) mass is controversial. Physical activity also induces LV mass increase. The objective was to assess the relation between BP response to exercise and LV mass in normotensive men, taking into account physical activity practice. A cross-sectional study was performed. Three hundred eighteen healthy normotensive men, aged between 20 and 60 years, participated in this study. The Minnesota questionnaire was used to assess physical activity practice. An echocardiogram and a maximum exercise test were performed. LV mass was calculated and indexed to body surface area. LV hypertrophy was defined as a ventricular mass index > or =134 g/m2. BP was measured at the moment of maximum effort. Hypertensive response was considered when BP was > or =210 mm Hg. In the multiple linear regression model, maximum systolic BP was associated with LV mass index and correlation coefficient was 0.27 (SE 0.07). Physical activity practice and age were also associated with LV mass. An association between hypertensive response to exercise and LV hypertrophy was observed (odds ratio 3.16). Thus, BP response to exercise is associated with LV mass and men with systolic BP response > or =210 mm Hg present a 3-times higher risk of LV hypertrophy than those not reaching this limit. Physical activity practice is related to LV mass, but not to LV hypertrophy.

Kinetics of Hypotension during 50 Sessions of Resistance and Aerobic Training in Hypertensive Patients: a Randomized Clinical Trial.

PubMed

Damorim, Igor Rodrigues; Santos, Tony Meireles; Barros, Gustavo Willames Pimentel; Carvalho, Paulo Roberto Cavalcanti

2017-04-01

tempo e do tipo de treinamento em hipertensos. Foram recrutados 69 hipertensos com idade média de 63,4 ± 2,1 anos, randomizados em um grupo de treinamento de força (n = 32) e outro de treinamento aeróbio (n = 32). Foram realizadas medidas antropométricas e testes de uma repetição máxima (1RM). A pressão arterial (PA) foi medida antes de cada sessão de treinamento com um aparelho de pressão digital de braço. As 50 sessões de treinamento foram categorizadas em quintis. Para comparar o efeito da redução da PA entre os métodos de treinamentos (between), utilizamos análise de covariância (ANCOVA) bifatorial ajustada para os valores de PA pré-intervenção. As diferenças entre os momentos foram estabelecidas por análise de variância (ANOVA) unifatorial. As reduções na PA sistólica (PAS) e diastólica (PAD) foram de 6,9 mmHg e 5,3 mmHg, respectivamente, com o treinamento de força e 16,5 mmHg e 11,6 mmHg, respectivamente, com o treinamento aeróbio. A cinética hipotensiva da PAS apresentou reduções significativas até a 20ª sessão em ambos os grupos. Observou-se estabilização da PAD na 20ª sessão com o treinamento de força e na 10ª sessão com o aeróbio. São necessárias 20 sessões de treinamento de força ou aeróbio para alcance dos benefícios máximos de redução da PA. Os métodos investigados proporcionaram padrões cinéticos adaptativos distintos ao longo das 50 sessões.

Validation of an instrument for evaluating health care services to ostomized people.

PubMed

Moraes, Juliano Teixeira; Amaral, Carlos Faria Santos; Borges, Eline Lima; Ribeiro, Mauro Souza; Guimarães, Eliete Albano Azevedo

2016-12-08

to develop and validate an array of analysis and judgment for the evaluation of Health Care Services of people with stomas. cross-sectional study in 28 health facilities in the state of Minas Gerais. A descriptive analysis of the instrument and a study of its psychometric properties were performed. We used the Delphi technique for the validation of content and appearance. A psychometric analysis was carried out through the study of the reliability and validity of the measures obtained with the instrument. it was possible to construct an array analysis and judgment with 16 components (with scores from zero to five) grouped according to size and structure and process considered essential to evaluate the service. The results achieved in the reliability for structure and process, through the Cronbach alpha coefficient (α = 0.771 and α = 0.809, respectively), and the validity of content and construct demonstrated good internal consistency and satisfactory validity. An exploratory factor analysis indicated the item "main activity performed in the unit" as a limitation of the scale. the study provides a new tool for the evaluation of structure and process of Health Care Services of a Person with a stoma. desenvolver e validar uma matriz de análise e julgamento para a avaliação de Serviços de Atenção à Saúde da Pessoa Estomizada. estudo seccional em 28 unidades de saúde do estado de Minas Gerais. Foi realizada uma análise descritiva do instrumento e um estudo das suas propriedades psicométricas. Para a validação de conteúdo e de aparência foi utilizada a técnica Delphi. A análise psicométrica foi realizada por meio do estudo da confiabilidade e validade das medidas obtidas com o instrumento. foi possível construir uma matriz de análise e julgamento com 16 componentes (pontuados com escores de zero a cinco) agrupados de acordo com as dimensões estrutura e processo considerados fundamentais para a avaliação do serviço. Os resultados alcançados para

Anxiety, depression, resilience and self-esteem in individuals with cardiovascular diseases.

PubMed

Carvalho, Isabela Gonzales; Bertolli, Eduarda Dos Santos; Paiva, Luciana; Rossi, Lidia Aparecida; Dantas, Rosana Aparecida Spadoti; Pompeo, Daniele Alcalá

2016-11-28

to analyze the relationship between anxiety and depression symptoms, resilience and self-esteem with sociodemographic and clinical characteristics; correlate resilience and self-esteem with age and duration of the disease; check associations between anxiety and depression with measures of resilience and self-esteem among individuals with cardiovascular diseases. correlational study conducted in a large university hospital in the interior of the state of São Paulo, Brazil. The population was composed of adult inpatients with cardiovascular diseases. A non-probabilistic consecutive sample was composed of 120 patients. Variables of interest were assessed using the Hospital Anxiety and Depression Scale, Resilience Scale, and Rosenberg Self-Esteem Scale. anxiety and depression symptoms were present in 32.5% and 17.5% of the patients, respectively, and were associated with the female sex (p = 0.002; p = 0.022). Manifestations of depression were associated with the presence of comorbidities (p = 0.020). More resilient patients did not present depression symptoms (p < 0.001) and anxious women were more resilient (p = 0.042). The highest scores regarding self-esteem were present in patients with anxiety and depression. Men presented higher resilience and lower self-esteem compared to women. patients with anxiety and depression were less resilient but presented higher self-esteem. analisar as relações entre os sintomas ansiosos e depressivos, resiliência e autoestima com as características sociodemográficas e clínicas; correlacionar resiliência e autoestima com a idade e o tempo da doença; analisar associações entre ansiedade e depressão com as medidas de resiliência e autoestima em indivíduos com doenças cardiovasculares. estudo correlacional, realizado em Hospital de Ensino de grande porte do interior do Estado de São Paulo. A população era constituída por pacientes adultos internados com doenças cardiovasculares. Uma amostra consecutiva e não probabil

Spatial distribution of tuberculosis in a municipality in the interior of São Paulo, 2008-2013.

PubMed

Fusco, Alcione Pereira Biffi; Arcêncio, Ricardo Alexandre; Yamamura, Mellina; Palha, Pedro Fredemir; Reis, Amanda Alessandra Dos; Alecrim, Tatiana Ferraz de Araújo; Protti, Simone Teresinha

2017-06-05

to describe the epidemiological clinical profile of tuberculosis and analyze the spatial distribution of cases in a municipality in the state of São Paulo. descriptive and ecological study of cases of tuberculosis through the records in an information system. Descriptive statistics were used to calculate central tendency (mean) and chi-square test, with Yates correction or Fisher exact test, when necessary. The Kernel technique was also used to calculate the occurrence densities of tuberculosis cases, using a radius of 1000 meters. Type I error was set at 5%. 299 cases of tuberculosis were identified, with 290 (96.98%) being geocoded. The majority of these were male (n = 212; 70.91%), median age 40 years, and the pulmonary clinical form was predominant (n = 244, 81.60%). The distribution occurred in a non-random manner, observing important areas of the municipality with a higher density of cases of the disease. the study evidenced an epidemiological profile of tuberculosis cases similar to those in the literature; however, their distribution does not occur in a random manner, pointing to specific population groups that require greater management and planning of health services for the control of tuberculosis. caracterizar o perfil clínico epidemiológico da tuberculose (TB) e analisar a distribuição espacial dos casos em município paulista. estudo descritivo e ecológico dos casos de tuberculose registrados em um sistema de informação. Recorreu-se à estatística descritiva com cálculo de medidas de tendência central (média) e aplicação do teste qui-quadrado, com correção de Yates ou teste exato de Fisher, quando necessários. Aplicou-se ainda a técnica de Kernel para o cálculo das densidades de ocorrência dos casos da TB, utilizando um raio de 1000 metros. Fixou-se o erro tipo I em 5%. identificou-se 299 casos de TB, sendo geocodificados 290 (96,98%). A maioria destes foi do sexo masculino (n=212; 70,91%), idade mediana 40 anos, sendo a forma cl

Spatial patterns of carbon, biodiversity, deforestation threat, and REDD+ projects in Indonesia

PubMed Central

Murray, Josil P; Grenyer, Richard; Wunder, Sven; Raes, Niels; Jones, Julia PG

2015-01-01

del Carbono, la Biodiversidad, la Amenaza de Deforestación y los Proyectos REDD+ en Indonesia Resumen Actualmente hay preocupación por que las Emisiones Reducidas de la Deforestación y Degradación del Bosque (REDD+, en inglés) puedan fallar en la entrega de co–beneficios potenciales de la biodiversidad si se enfocan en áreas de alto carbono. Exploramos los traslapes espaciales entre los stocks de carbono, la biodiversidad, las amenazas proyectadas de deforestación y la ubicación de proyectos REDD+ en Indonesia, un país tropical a la vanguardia del desarrollo REDD+. Para la biodiversidad, reunimos datos sobre la distribución de vertebrados terrestres (hábitats de anfibios, mamíferos, aves y reptiles) y plantas (modelos de distribución de especies para ocho familia). Después investigamos la congruencia entre las diferentes medidas de la riqueza de la biodiversidad y los stocks de carbono en la escala nacional y sub–nacional. Finalmente mapeamos proyectos REDD+ activos e investigamos la densidad de carbono y la riqueza potencial de la biodiversidad y modelamos presiones de deforestación dentro de estos bosques en relación con áreas protegidas y no protegidas. Hubo poco traslape interno entre los diferentes hotspots (el 10% más rico de las celdas) de riqueza de especies. Tampoco hubo congruencia espacial consecuente entre los stocks de carbono y las medidas de la biodiversidad: una correlación negativa débil en la escala nacional enmascaró las relaciones altamente variables y no-lineales isla por isla. Los proyectos REDD+ actuales estuvieron ubicados preferencialmente en áreas con una riqueza total de especies y con una riqueza de especies amenazadas más altas pero con densidades de carbono más bajas que en las áreas protegidas y los bosques sin protección. Aunque un cuarto del área total de estos proyectos REDD+ está bajo una presión de deforestación relativamente alta, la mayoría del área REDD+ no lo está. Por lo menos en Indonesia

Reliability and construct validity of the Instrument to Measure the Impact of Valve Heart Disease on the Patient's Daily Life.

PubMed

Anjos, Daniela Brianne Martins Dos; Rodrigues, Roberta Cunha Matheus; Padilha, Kátia Melissa; Pedrosa, Rafaela Batista Dos Santos; Gallani, Maria Cecília Bueno Jayme

2016-12-19

édio de 9,9 minutos e com 110% de respostas, respectivamente. Constatados efeitos teto e chão para todos os domínios, principalmente efeito chão. A confiabilidade foi testada por meio do teste-teste de repetição, obtendo-se evidências de estabilidade temporal da medida. Foram constatadas correlações negativas significantes de moderada a forte magnitude entre o escore da questão genérica sobre o impacto da doença e os escores do IDCV, o que aponta para validade de construto convergente do instrumento. o Instrumento para Mensuração do Impacto da Doença no Cotidiano do Valvopata apresentou evidências de confiabilidade e validade quando aplicado em pacientes com valvopatia. evaluar la viabilidad, aceptabilidad y los efectos techo y suelo, estimar la confiabilidad y verificar la validez de constructo convergente del Instrumento para Medir el Impacto en lo Cotidiano (IDCV) del sujeto con valvulopatías mitral y/o aórtica. los datos fueron obtenidos de 86 pacientes con valvulopatías por medio de tres etapas: una entrevista presencial para caracterización sociodemográfica y clínica y las otras dos realizadas por medio de contacto telefónico para las aplicaciones del instrumento (test y test de repetición). en cuanto a la viabilidad y aceptabilidad, el instrumento fue aplicado con un tiempo promedio de 9,9 minutos y con 110% de respuestas, respectivamente. Fueron constatados los efectos techo y suelo para todos los dominios, principalmente el efecto suelo. La confiabilidad fue comprobada por medio del test de repetición, obteniéndose evidencias de estabilidad temporal de la medida. Fueron constatadas correlaciones negativas significativas de moderada a fuerte magnitud entre el puntaje de la pregunta genérica sobre el impacto de la enfermedad y los puntajes del IDCV, lo que apunta para la validez de constructo convergente del instrumento. el instrumento para medir el impacto de la valvulopatía en lo cotidiano del sujeto, presentó evidencias de

Effective tobacco control measures: agreement among medical students.

PubMed

Martins, Stella Regina; Paceli, Renato Batista; Bussacos, Marco Antônio; Fernandes, Frederico Leon Arrabal; Prado, Gustavo Faibischew; Lombardi, Elisa Maria Siqueira; Terra-Filho, Mário; Santos, Ubiratan Paula

2017-01-01

To determine the level of agreement with effective tobacco control measures recommended by the World Health Organization and to assess the attitudes toward, knowledge of, and beliefs regarding smoking among third-year medical students at University of São Paulo School of Medicine, located in the city of São Paulo, Brazil. Between 2008 and 2012, all third-year medical students were invited to complete a self-administered questionnaire based on the Global Health Professionals Student Survey and its additional modules. The study sample comprised 556 students. The level of agreement with the World Health Organization recommendations was high, except for the components "received smoking cessation training" and "raising taxes is effective to reduce the prevalence of smoking". Most of the students reported that they agree with banning tobacco product sales to minors (95%), believe that physicians are role models to their patients (84%), and believe that they should advise their patients to quit cigarette smoking (96%) and using other tobacco products (94%). Regarding smoking cessation methods, most of the students were found to know more about nicotine replacement therapy than about non-nicotine therapies (93% vs. 53%). Only 37% of the respondents were aware of the importance of educational antismoking materials, and only 31% reported that they believe in the effectiveness of encouraging their patients, during medical visits. In our sample, the prevalence of current cigarette smoking was 5.23%; however, 43.82% of the respondents reported having experimented with water-pipe tobacco smoking. Our results revealed the need to emphasize to third-year medical students the importance of raising the prices of and taxes on tobacco products. We also need to make students aware of the dangers of experimenting with tobacco products other than cigarettes, particularly water-pipe tobacco smoking. Determinar o grau de concordância com medidas eficazes de controle do tabaco

Taking a look to promoting health and complications' prevention: differences by context.

PubMed

Freire, Rosa Maria de Albuquerque; Landeiro, Maria José Lumini; Martins, Maria Manuela Ferreira Pereira da Silva; Martins, Teresa; Peres, Heloísa Helena Ciqueto

2016-08-08

potenciais do paciente (p=0.001) e supervisão das atividades que concretizam as intervenções de enfermagem e as atividades que delegam (p=0.003). os enfermeiros realizam atividades de promoção da saúde e prevenção de complicações, porém, não de forma sistemática e as práticas profissionais diferem com relação ao contexto. Este estudo é relevante na medida em que pode promover a conscientização dos enfermeiros para a necessidade de reforçar práticas de qualidade. conocer y comparar las practicas de promoción de la salud y prevención de complicaciones, de los enfermeros que ejercen en el contexto de hospitales y en cuidados de atención primaria de salud. estudio descriptivo, exploratorio y transversal, desarrollado con 474 enfermeros, seleccionados por muestreo de conveniencia. Se utilizó un cuestionario que integra dos categorías de enunciados descriptivos de la calidad del ejercicio profesional de los enfermeros. El estudio fue aprobado en comité de ética. la mayoría de los enfermeros eran del sexo femenino (87,3%) con una edad promedio de 35,5 años. Se encontraron mayor cantidad de prácticas de estos enfermeros en cuidados primarios en relación a la promoción de estilos de vida saludable (<0.001) y referencia de situaciones problemáticas para otros profesionales (p=0.039). También se encontraron más prácticas de los enfermeros de hospital en relación a identificación de problemas potenciales del paciente (p=0.001) y supervisión de las actividades que concretan las intervenciones de enfermería y las actividades que delegan (p=0.003). los enfermeros realizan actividades de promoción de salud y prevención de complicaciones, sin embargo, no en forma sistemática, y las prácticas varían en relación al contexto. Este estudio es relevante en la medida que puede promover la concientización de los enfermeros para la necesidad de reforzar prácticas de calidad.

The effects of acupressure on labor pains during child birth: randomized clinical trial.

PubMed

Mafetoni, Reginaldo Roque; Shimo, Antonieta Keiko Kakuda

2016-08-08

ções, por 20 minutos, e a intensidade da dor avaliada por meio de uma Escala Analógica Visual (EAV). as médias de dor pela EAV não foram diferentes nos três grupos na admissão (p-valor=0,0929), porém foram menores no grupo de acupressão imediatamente após (p-valor=<0,0001) e com 1 h do tratamento (p-valor=0,0001) ao se comparar com placebo e controle. a acupressão no ponto sanyinjiao se mostrou uma medida útil no alívio da dor, não invasiva e um meio de melhorar a qualidade dos cuidados a parturiente. Registro: RBR-9mhs8r. analizar los efectos de la acupresión, en el punto sanyinjiao, sobre el dolor en la fase activa del trabajo de parto, en embarazadas atendidas en maternidad pública. ensayo clínico controlado y aleatorio, simple ciego y de carácter pragmático. Fueron seleccionadas 156 mujeres con edad gestacional ≥ 37 semanas, dilatación cervical ≥ 4 cm y con dos o más contracciones en 10 minutos. Las embarazadas fueron divididas aleatoriamente en tres grupos en un hospital universitario del interior del estado de Sao Paulo, Brasil, para recibir acupresión, placebo o participar como control. La acupresión fue aplicada en el punto sanyinjiao durante las contracciones, por 20 minutos; la intensidad del dolor fue evaluada por medio de una Escala Analógica Visual (EAV). los promedios del dolor por la EAV no fueron diferentes en los tres grupos en la admisión (valor p=0,0929), sin embargo fueron menores en el grupo de acupresión inmediatamente después (valor p=<0,0001) y también después de 1 hora del tratamiento (valor p=0,0001) al compararse con el placebo y control. la acupresión en el punto sanyinjiao se mostró una medida útil en el alivio del dolor, no invasiva y un medio de mejorar la calidad de los cuidados la parturienta. Registro: RBR-9mhs8r.

Assessment and management of pain in newborns hospitalized in a Neonatal Intensive Care Unit: a cross-sectional study.

PubMed

Sposito, Natália Pinheiro Braga; Rossato, Lisabelle Mariano; Bueno, Mariana; Kimura, Amélia Fumiko; Costa, Taine; Guedes, Danila Maria Batista

2017-09-12

to determine the frequency of pain, to verify the measures adopted for pain relief during the first seven days of hospitalization in the Neonatal Intensive Care Unit and to identify the type and frequency of invasive procedures to which newborns are submitted. cross-sectional retrospective study. Out of the 188 hospitalizations occurred during the 12-month period, 171 were included in the study. The data were collected from the charts and the presence of pain was analyzed based on the Neonatal Infant Pain Scale and on nursing notes suggestions of pain. For statistical analysis, the Statistical Package for the Social Sciences was used, and the significance level was set at 5%. there was at least one record of pain in 50.3% of the hospitalizations, according to the pain scale adopted or nursing note. The newborns underwent a mean of 6.6 invasive procedures per day. Only 32.5% of the pain records resulted in the adoption of pharmacological or non-pharmacological intervention for pain relief. newborns are frequently exposed to pain and the low frequency of pharmacological or non-pharmacological interventions reinforces the undertreatment of this condition. determinar a frequência de dor e verificar as medidas realizadas para seu alívio durante os sete primeiros dias de internação na Unidade de Terapia Intensiva Neonatal, bem como identificar o tipo e frequência de procedimentos invasivos aos quais os recém-nascidos foram submetidos. estudo retrospectivo transversal. Das 188 internações ocorridas no período estipulado de 12 meses, 171 foram incluídas na pesquisa. Os dados foram coletados a partir dos prontuários e a presença de dor foi analisada tanto com base na escala de dor Neonatal Infant Pain Scale quanto mediante anotação de enfermagem sugestiva de dor. Para análise estatística, utilizou-se o programa Statistical Package for the Social Sciences, adotando-se nível de significância de 5%. em 50,3% das internações houve ao menos um registro de dor

Learning about the Sky from the Environment: An Experience Working Along One Year with Students of Elementary Education. (Spanish Title: Aprendiendo sobre EL Cielo Desde el Entorno: Una Experiencia Trabajando Durante un Año Junto a Estudiantes del Primario.) Aprendendo sobre o Céu a Partir do Entorno: Uma Experiência de Trabalho ao Longo de um Ano com Alunos de Ensino Fundamental

NASA Astrophysics Data System (ADS)

Longhini, Marcos Daniel; Gomide, Hanny Angeles

2014-12-01

percepción limitada que los estudiantes tienen de su alrededor la cual, sin embargo, se expandió debido a las actividades llevadas a cabo, sobre todo en relación con la Luna. Trabajar con medidas sistemáticas revela el manejo cuidadoso de los datos para que sean comprensibles para los estudiantes, así como el trabajo con las sombras para que comprendan primero como se forman estas para después trabajarlas en Astronomía. Por último, llegamos a la conclusión de que el proceso desarrollado consistió en una etapa inicial de una obra que debe ser profundizado en los años posteriores de la formación de estos estudiantes. Projeto de pesquisa desenvolvido com 95 alunos do 6º ano do Ensino Fundamental de uma escola pública estadual de Uberlândia, Minas Gerais. Foi um trabalho contínuo, de fevereiro a dezembro de 2013, o qual levou os alunos a participarem de atividades de observação do entorno, dentre ele, o céu, analisando as mudanças ocorridas. Focamos no estudo das variações de temperaturas, chuvas, duração do dia, variações do tamanho das sombras e mudanças nos aspectos da Lua. Nosso foco de análise centrou-se em discutir os conhecimentos que os referidos alunos tinham acerca dos temas indicados no início e ao término da implementação da proposta. Os resultados mostraram a percepção limitada que os estudantes possuem de seu entorno, todavia, ampliada em função das atividades desenvolvidas, principalmente no que se refere à Lua. O trabalho com medidas sistemáticas revela o cuidado no tratamento dos dados para que eles se tornem compreensíveis aos alunos, assim como o trabalho com as sombras sinaliza para que os alunos primeiramente compreendam como as sombras são formadas para depois trabalhar isso em Astronomia. Por fim, concluímos que o processo vivido constituiu-se em uma etapa inicial de um trabalho que deve ser estimulado para os anos subsequentes da formação desses alunos.

Auriculotherapy to reduce anxiety and pain in nursing professionals: a randomized clinical trial.

PubMed

Kurebayashi, Leonice Fumiko Sato; Turrini, Ruth Natalia Teresa; Souza, Talita Pavarini Borges de; Marques, Carolina Felicio; Rodrigues, Renata Tavares Franco; Charlesworth, Karen

2017-04-06

to evaluate the effectiveness of the auricular protocol (APPA) in reducing pain and anxiety and improving the quality of life of the nursing staff of a hospital. randomized clinical trial with an initial sample of 180 professionals divided into 4 groups Control (G1), Seed (G2), Needle (G3) and Tape (G4). The evaluation instruments were the State-Trait Anxiety Inventory, Pain Visual Analog Scale and Quality of Life instrument, applied at the start and after five and 10 sessions (five weeks). Descriptive statistics, analysis of variance (ANOVA) and Cohen's d Index were used in the analysis. there was a statistical difference (p < 0.05) for anxiety according to the repeated measures ANOVA, with better results for the G3 in the final assessment (Cohen's d index 1.08/17% reduction). There was a reduction of pain of 36% in G3 and 24% in G2 and a 13% increase in the mental aspect of quality of life for the G3, although without statistical significance. the APPA protocol reduced the anxiety levels of nursing staff after 10 sessions. Further studies are, however, suggested with new populations and in different contexts so that the results can be confirmed. RBR-5pc43m. avaliar a efetividade do protocolo auricular para redução de ansiedade, dor (APPA) e melhoria de qualidade de vida em equipe de Enfermagem de um hospital. ensaio clínico randomizado com amostra inicial de 180 profissionais divididos em 4 grupos Controle (G1), Semente (G2), Agulha (G3) e Fita Adesiva (G4). Os instrumentos de avaliação foram o Inventário de Ansiedade Traço-Estado, Escala Visual Analógica de dor e instrumento de Qualidade de Vida, aplicados no início, depois de cinco e 10 sessões (cinco semanas). Na análise utilizou-se a estatística descritiva, a análise de variância (ANOVA) e o Índice d de Cohen. houve diferença estatística (p < 0,05) para a ansiedade segundo ANOVA de medidas repetidas, com melhores resultados para o G3 na última avaliação (índice d de Cohen 1,08/17% de redu

MANAGEMENT OF ACUTE SEVERE ULCERATIVE COLITIS: A CLINICAL UPDATE.

PubMed

Sobrado, Carlos Walter; Sobrado, Lucas Faraco

2016-01-01

azathioprine. A surgical procedure is indicated for selected cases. A colite aguda grave é emergência médica, potencialmente letal e o seu tratamento permanece ainda nos dias de hoje um desafio para o clínico e cirurgião. A corticoterapia intravenosa introduzida no arsenal terapêutico na década de 50 permanece como primeira linha de tratamento, e nos pacientes refratários a tal medida, a terapia de resgate pode ser com medidas clínicas ou colectomia de urgência. Avaliar os resultados da terapia de resgate medicamentosa (ciclosporina, infliximabe e tracolimus), suas indicações e resultados, e sugerir um guia prático para abordagem clínica. Foi realizada revisão na literatura utilizando as bases Medline/Pubmed, Cochrane Library, Scielo, e informações adicionais em sites institucionais de interesse cruzando os descritores: colite aguda grave, colite fulminante e tratamento. O tratamento da colite aguda grave tem evitado a colectomia em 60- 70% dos casos, desde que iniciado precocemente e com acompanhamento multidisciplinar. A ciclosporina intravenosa apesar de seus efeitos adversos, tem sido indicada naqueles casos mais graves com risco iminente de colectomia, pela sua rapidez de ação, meia-vida curta, e não aumentar os riscos de complicações cirúrgicas. A terapia com infliximabe tem sido reservada para os casos menos graves e naqueles em uso ou já expostos a imunossupressores (AZA/6-MP). A facilidade terapêutica, seus bons resultados a curto e médio prazo, a possibilidade de terapia de manutenção e também por agir como "ponte" para ação de imunossupressores (AZA/6-MP) tem recentemente favorecido a indicação de biológicos. A colectomia fica reservada para casos que não apresentaram resposta a terapia de resgate após cinco a sete dias de tratamento e nas complicações (megacólon tóxico, hemorragia profusa e perfuração). s: Os pacientes com boa resposta à terapia de resgate e não submetidos à operações de urgência, deverão ser

Characterisation of gas and particle emissions from wildfires =

NASA Astrophysics Data System (ADS)

Vicente, Ana Margarida Proenca

carbono orgânico e elementar (tecnica termo-optica), ioes soluveis em agua (cromatografia ionica) e elementos (espectrometria de massa com plasma acoplado por inducao ou analise instrumental por ativacao com neutroes). A especiacao orgânica foi obtida por cromatografia gasosa acoplada a espectrometria de massa apos extracao com recurso a varios solventes e separacao dos extratos orgânicos em diversas classes de diferentes polaridades atraves do fracionamento com silica gel. Tendo em conta que a estimativa das emissoes dos incendios florestais requer um conhecimento de fatores de emissao apropriados para cada biocombustivel, a base de dados abrangente obtida neste estudo e potencialmente util para atualizar os inventarios de emissoes. Tem vindo a ser observado que a fase de combustao latente sem chama, a qual pode ocorrer simultaneamente com a fase de chama e durar varias horas ou dias, pode contribuir para uma quantidade consideravel de poluentes atmosfericos, pelo que os fatores de emissao correspondentes devem ser considerados no calculo das emissoes globais de incendios florestais. Devido a falta de informacao detalhada sobre perfis quimicos de emissao, a base de dados obtida neste estudo pode tambem ser util para a aplicacao de modelos no recetor no sul da Europa. (Abstract shortened by ProQuest.).

San Pedro Martir Telescope: Mexican design endeavor

NASA Astrophysics Data System (ADS)

Toledo-Ramirez, Gengis K.; Bringas-Rico, Vicente; Reyes, Noe; Uribe, Jorge; Lopez, Aldo; Tovar, Carlos; Caballero, Xochitl; Del-Llano, Luis; Martinez, Cesar; Macias, Eduardo; Lee, William; Carramiñana, Alberto; Richer, Michael; González, Jesús; Sanchez, Beatriz; Lucero, Diana; Manuel, Rogelio; Segura, Jose; Rubio, Saul; Gonzalez, German; Hernandez, Obed; García, Mary; Lazaro, Jose; Rosales-Ortega, Fabian; Herrera, Joel; Sierra, Gerardo; Serrano, Hazael

2016-08-01

The Telescopio San Pedro Martir (TSPM) is a new ground-based optical telescope project, with a 6.5 meters honeycomb primary mirror, to be built in the Observatorio Astronomico Nacional on the Sierra San Pedro Martir (OAN-SPM) located in Baja California, Mexico. The OAN-SPM has an altitude of 2830 meters above sea level; it is among the best location for astronomical observation in the world. It is located 1830 m higher than the atmospheric inversion layer with 70% of photometric nights, 80% of spectroscopic nights and a sky brightness up to 22 mag/arcsec2. The TSPM will be suitable for general science projects intended to improve the knowledge of the universe established on the Official Mexican Program for Science, Technology and Innovation 2014-2018. The telescope efforts are headed by two Mexican institutions in name of the Mexican astronomical community: the Universidad Nacional Autonoma de Mexico and the Instituto Nacional de Astrofisica, Optica y Electronica. The telescope has been financially supported mainly by the Consejo Nacional de Ciencia y Tecnologia (CONACYT). It is under development by Mexican scientists and engineers from the Center for Engineering and Industrial Development. This development is supported by a Mexican-American scientific cooperation, through a partnership with the University of Arizona (UA), and the Smithsonian Astrophysical Observatory (SAO). M3 Engineering and Technology Corporation in charge of enclosure and building design. The TSPM will be designed to allow flexibility and possible upgrades in order to maximize resources. Its optical and mechanical designs are based upon those of the Magellan and MMT telescopes. The TSPM primary mirror and its cell will be provided by the INAOE and UA. The telescope will be optimized from the near ultraviolet to the near infrared wavelength range (0.35-2.5 m), but will allow observations up to 26μm. The TSPM will initially offer a f/5 Cassegrain focal station. Later, four folded Cassegrain and

A multicentre randomiSed controlled TRial of IntraVEnous immunoglobulin compared with standard therapy for the treatment of transverse myelitis in adults and children (STRIVE).

PubMed

Absoud, Michael; Brex, Peter; Ciccarelli, Olga; Diribe, Onyinye; Giovannoni, Gavin; Hellier, Jennifer; Howe, Rosemary; Holland, Rachel; Kelly, Joanna; McCrone, Paul; Murphy, Caroline; Palace, Jackie; Pickles, Andrew; Pike, Michael; Robertson, Neil; Jacob, Anu; Lim, Ming

2017-05-01

Transverse myelitis (TM) is an immune-mediated disorder of the spinal cord that affects adults and children and that causes motor, sensory and autonomic dysfunction. There is a prolonged recovery phase, which may continue for many years. Neuromyelitis optica (NMO) is an uncommon relapsing inflammatory central nervous system condition in which TM can be the first presenting symptom. As TM and NMO affect many patients in the prime of their working life, the disorder can impose a significant demand on health resources. There are currently no robust controlled trials in children or adults to inform the optimal treatment of TM. However, treatment with intravenous immunoglobulin (IVIG) is being effectively used in the management of a range of neurological conditions. Although other interventions such as plasma exchange (PLEX) in addition to intravenous (IV) methylprednisolone therapy can be beneficial in TM, PLEX is costly and technically challenging to deliver in the acute setting. IVIG is more readily accessible and less costly. To evaluate whether additional and early treatment with IVIG is of extra benefit in TM compared with standard therapy with IV steroids. A multicentre, single-blind, parallel-group randomised controlled trial of IVIG compared with standard therapy for the treatment of TM in adults and children. Patients aged ≥ 1 year diagnosed with either acute first-onset TM or first presentation of NMO. Target recruitment was 170 participants (85 participants per arm). Participants were randomised 1 : 1 to treatment with IV methylprednisolone only or treatment with IV methylprednisolone plus 2 g/kg of IVIG in divided doses within 5 days of the first commencement of steroid therapy. Primary outcome measure - American Spinal Injury Association (ASIA) Impairment Scale at 6 months post randomisation, with a good outcome defined by a two-grade change. Secondary and tertiary outcome measures - ASIA motor and sensory scales, Expanded Disability Status Scale

Analisis experimental de la propagacion en redes de area corporal para la banda de ultra wideband. experimental characterization of the propagation in ultra wideband body area networks

NASA Astrophysics Data System (ADS)

Garcia Serna, Ruben Gregorio

Diferentes dispositivos capaces de obtener informacion sobre parametros fisiologicos, cinematicos o contextuales del cuerpo pueden interconectarse de manera inalambrica dando lugar a las denominadas Redes de Area Corporal Inalambricas (WBAN, Wireless Body Area Networks). De entre las posibles tecnologias para establecer los enlaces, Ultra Wideband (UWB) esta captando cada vez un mayor interes debido a caracteristicas tales como el bajo nivel de potencia de transmision requerido (bajo nivel de exposicion a campos electromagneticos), el alto ancho de banda disponible y la alta resolucion temporal/espacial. El diseno de sistemas centrados en el cuerpo requiere de modelos de canal que describan de manera precisa la propagacion de senales en este tipo de entornos. Esta tesis se plantea con el objetivo de contribuir al estudio experimental de la propagacion en sistemas centrados en el cuerpo operando en la banda UWB. En primer lugar, se presenta un marco introductorio a las redes WBAN, sus elementos constitutivos, bandas de frecuencia, estandarizacion y modelos de canal. Ademas, se introducen los fundamentos de la tecnologia UWB y sus aplicaciones en este area. Seguidamente, se analiza en terminos de las perdidas de propagacion y la dispersion de retardo la propagacion en el canal off-body entre un transmisor fijo y un dispositivo receptor colocado sobre la superficie del cuerpo de un sujeto. Se considera la influencia de diferentes aspectos, tales como el entorno de medidas, la posicion de colocacion de una antena sobre el cuerpo y la postura adoptada por un sujeto. Finalmente, se analiza el canal de propagacion in-body considerando el movimiento relativo entre dos dispositivos causado por efecto de la respiracion. Las condiciones de propagacion en el interior del cuerpo se emulan por medio de un phantom liquido para UWB y la caracterizacion se plantea tanto en frecuencia, en terminos del modelado de la forma y el ensanchamiento del espectro Doppler, como en tiempo, por

PubMed

Hernández Mosqueira, Claudio; Hernández Vasquez, Dagoberto; Caniuqueo Vargas, Alexis; Castillo Quezada, Humberto; Fernandes Da Silva, Sandro; Pavez-Adasme, Gustavo; Martínez Salazar, Cristian; Cárcamo-Oyarzún, Jaime; Fernandes Filho, José

2016-11-29

Introducción: Chile en las últimas décadas ha experimentado un cambio en su perfil epidemiológico nutricional, pasando de una situación caracterizada por una elevada prevalencia de desnutrición y enfermedades infecciosas/parasitarias a otro completamente distinto, en donde las enfermedades crónicas y degenerativas presentan una elevada prevalencia.Objetivo: el objetivo del estudio es elaborar tablas de referencia de aspectos antropométricos y de condición física en estudiantes varones de 10 a 14 años de la ciudad de Chillán.Método: estudio descriptivo de corte transversal. La muestra se compone de 1250 varones con edades entre los 10 y 14 años. Para la confección de las tablas de referencia se utilizó estadística descriptiva y estas fueron divididas en cinco clasificaciones desde muy malo, malo, media, bueno y muy bueno, teniendo como parámetro la edad.Resultados: observamos niveles importantes de sobrepeso que se asociaron con bajo desempeño físico, lo que plantea la urgencia de realizar un seguimiento en el tiempo con herramientas de fácil aplicación como la presente batería; con el fin de detectar a tiempo a los niños que tienen bajos niveles de condición física y tomar medidas orientadas a estimular o mejorar la capacidad física como factores protectores de promoción de la salud y como ayuda en la prevención de enfermedades crónicas relacionadas con el sobrepeso u obesidad.Conclusión: en este trabajo se han establecido valores de referencia para posteriores estudios en cuanto a la condición física orientada a la salud en estudiantes varones de 10 a 14 años de la ciudad de Chillán, que permitirán evaluar e interpretar correctamente la condición física orientada a la salud de este grupo etario.

Validation of the adherence questionnaire for Brazilian chronic kidney disease patients under hemodialysis.

PubMed

Lins, Silvia Maria de Sá Basilio; Leite, Josete Luzia; Godoy, Simone de; Fuly, Patrícia Dos Santos Claro; Araújo, Silvia Teresa Carvalho de; Silva, Ítalo Rodolfo

2017-01-01

To validate the evaluation questionnaire on adherence of chronic kidney disease (CKD) patients under hemodialysis. We verified the following psychometric properties of the instrument: reliability (stability and internal consistency) and validity (face, content, and construct). The intraclass correlation coefficient reached a value of 0.98 for the adherence questions and 0.91 for the perception questions. Regarding the kappa of the 14 questions examined, 12 had a value > 0.8, whereas the Cronbach's alpha had a value of 0.57. Experts ensured the face and content validity of the instrument, giving it an overall content validity index of 0.96. Construct validity, analyzed by Mann-Whitney test, was achieved as all domains showed a significant association with p<0.01. We verified, by the presented results, that the instrument has been validated for use in Brazil. Validar o questionário de avaliação sobre a adesão do portador de doença renal crônica em hemodiálise. Foram verificadas as seguintes propriedades psicométricas do instrumento: confiabilidade (estabilidade e consistência interna) e validade (de face, de conteúdo e de construto). O coeficiente de correlação intraclasse atingiu valor de 0,98 para as questões de adesão e 0,91 para as questões de percepção. Quanto ao kappa das 14 questões analisadas, 12 obtiveram um valor > 0,8. Já o alfa de Cronbach obteve valor de 0,57. Os especialistas asseguraram a validade de face e de conteúdo do instrumento, conferindo-lhe um índice de validade de conteúdo global de 0,96. A validade de construto, analisada por meio do teste de Mann-Whitney, foi alcançada na medida em que todos os domínios apresentaram uma associação significativa com p < 0,01. Verifica-se, pelos resultados apresentados, que o instrumento foi validado para uso no Brasil.

Application of botulinum toxin to treat sialorrhea in amyotrophic lateral sclerosis patients: a literature review.

PubMed

Oliveira, Ademar Francisco de; Silva, Gêssyca Adryene de Menezes; Almeida, Débora Milenna Xavier

2016-01-01

Amyotrophic lateral sclerosis is a progressive and fatal neurodegenerative disease characterized by the degeneration of motor neurons, which are the central nervous system cells that control voluntary muscle movements. The excessive salivation (sialorrhea) is present in approximately 50% of amyotrophic lateral sclerosis cases. Thus, some alternative therapeutic methods are sought, such as anticholinergic drugs and surgery. Recently the use of botulinum toxin applied at a midpoint of the salivary glands, often guided by ultrasound, have demonstrated positive results. The objective was to review the literature to demonstrate an alternative method to treatments of sialorrhea in patients with amyotrophic lateral sclerosis. In recent studies, the efficacy of botulinum toxin is confirmed, although new applications are required. Since the side effects are negligible, this is an alternative to treat amyotrophic lateral sclerosis, and other patients with diseases that present sialorrhea. RESUMO Esclerose lateral amiotrófica é uma doença neurodegenerativa progressiva e fatal, caracterizada pela degeneração dos neurônios motores, as células do sistema nervoso central que controlam os movimentos voluntários dos músculos. A salivação excessiva (sialorreia) está presente em cerca de 50% dos casos de esclerose lateral amiotrófica. Dessa forma, surgem medidas terapêuticas alternativas como drogas anticolinérgicas e cirurgia, e recentemente, o uso da toxina botulínica, aplicada em um ponto central das glândulas salivares, muitas vezes guiado por ultrassonografia, demostrou resultados positivos. Objetivou-se revisar a literatura no intuito de demonstrar um método alternativo aos tratamentos de sialorreia em pacientes com esclerose lateral amiotrófica. Em estudos recentes, a eficácia do tratamento com toxina botulínica foi confirmada e, mesmo requerendo novas aplicações, os efeitos colaterais são ínfimos. Ela surge então como alternativa não só ao

Impacto metabólico e inflamatorio de una comida rica en grasas saturadas y su relación con la obesidad abdominal.

PubMed

Alayón, Alicia Norma; Rivadeneira, Ana Patricia; Herrera, Carlos; Guzmán, Heidy; Arellano, Dioneris; Echeverri, Isabella

2018-05-01

Introducción. La etapa posprandial se asocia con el incremento de marcadores relacionados con el riesgo cardiovascular, cuya intensidad depende del estado metabólico.Objetivo. Determinar el impacto de la ingestión de una comida rica en grasas saturadas sobre el perfil metabólico e inflamatorio y su relación con la obesidad abdominal.Materiales y métodos. Se hizo un ensayo clínico en 42 individuos (21 con obesidad abdominal). Se midieron, en sangre, la glucosa, la insulina, el perfil lipídico, la proteína C reactiva, los lipopolisacáridos y la interleucina 6, en ayunas y después de la ingestión.Resultados. Además de la obesidad, se registró la presencia de resistencia a la insulina y de niveles elevados de triacilglicéridos y proteína C reactiva en ayunas. Asimismo, se detectaron niveles posprandiales más elevados de glucosa, insulina y triacilglicéridos. La interleucina 6 disminuyó en el grupo de personas sin obesidad y los lipopolisacáridos aumentaron en ambos grupos.Conclusión. La ingestión de una comida rica en grasas saturadas produjo un mayor impacto en las variables glucémicas en el grupo con obesidad y, aunque afectó de forma similar los lípidos en ambos grupos, el incremento de triacilglicéridos fue mayor en presencia de una concentración basal elevada y promovió el aumento de lipopolisacáridos. El estado inflamatorio basal y posprandial afectó en mayor medida al grupo con obesidad. El momento posprandial reflejó el estado más frecuente de los individuos en un día normal y permitió evidenciar la capacidad de respuesta metabólica frente a la ingestión de alimentos, así como los estados tempranos de riesgo metabólico.

The threat of disease increases as species move toward extinction.

PubMed

Heard, Matthew J; Smith, Katherine F; Ripp, Kelsey; Berger, Melanie; Chen, Jane; Dittmeier, Justin; Goter, Maggie; McGarvey, Stephen T; Ryan, Elizabeth

2013-12-01

At local scales, infectious disease is a common driver of population declines, but globally it is an infrequent contributor to species extinction and endangerment. For species at risk of extinction from disease important questions remain unanswered, including when does disease become a threat to species and does it co-occur, predictably, with other threats? Using newly compiled data from the International Union for Conservation of Nature (IUCN) Red List, we examined the relative role and co-occurrence of threats associated with amphibians, birds, and mammals at 6 levels of extinction risk (i.e., Red List status categories: least concern, near threatened, vulnerable, endangered, critically endangered, and extinct in the wild/extinct). We tested the null hypothesis that the proportion of species threatened by disease is the same in all 6 Red List status categories. Our approach revealed a new method for determining when disease most frequently threatens species at risk of extinction. The proportion of species threatened by disease varied significantly between IUCN status categories and linearly increased for amphibians, birds, and all species combined as these taxa move from move from least concern to critically endangered. Disease was infrequently the single contributing threat. However, when a species was negatively affected by a major threat other than disease (e.g., invasive species, land-use change) that species was more likely to be simultaneously threatened by disease than species that had no other threats. Potential drivers of these trends include ecological factors, clustering of phylogenetically related species in Red List status categories, discovery bias among species at greater risk of extinction, and availability of data. We echo earlier calls for baseline data on the presence of parasites and pathogens in species when they show the first signs of extinction risk and arguably before. La Amenaza de Enfermedades Incrementa a Medida que las Especies se

Comunicación de pareja y VIH en mujeres en desventaja social

PubMed Central

Rosina Cianelli, A.; Lilian Ferrer, L.; Margarita Bernales, S.; Natalia Villegas, R.

2009-01-01

Introducción La epidemia de VIH y SIDA se ha diseminado rápidamente a nivel mundial tendiendo a la feminización, pauperización y heterosexualización. La comunicación de pareja en torno el VIH es descrita como uno de los factores protectores en la adquisición de esta enfermedad, favoreciendo la adopción de conductas sexuales seguras tales como la negociación de pareja y la utilización de preservativo, consideróndose como un pilar fundamental en la incorporación de medidas de autocuidado en la sexualidad femenina. Objetivo Determinar el nivel de comunicación de pareja en torno al VIH en mujeres chilenas en desventaja social. Metodología Cuatrocientas noventa y seis mujeres contestaron la entrevista inicial de la investigación “Testing an HIV/AIDS Prevention Intervention for Chilean Women” (RO1 TW 006977 PI Cianelli). Se utilizó la escala “Health protective sexual communication scale (HPC)” (0–10 puntos). Se realizó un análisis descriptivo utilizando el programa SPSS 16.0. Resultados El promedio del nivel de comunicación de pareja fue de 3,26 ± 2,7 puntos con la pareja principal, de 2,52 ± 2,48 puntos con una segunda pareja y de 0 puntos con una tercera pareja. Los temas de menor comunicación entre las parejas fueron el uso de preservativo y la realización del test para VIH antes de tener relaciones sexuales. Conclusión Las mujeres de la muestra presentan bajos niveles de comunicación de pareja en relación a VIH con todas sus parejas sexuales. Son necesarias estrategias que potencien este tópico dentro de las intervenciones de prevención de VIH y SIDA de manera de fortalecer la adopción de conductas de autocuidado en torno al tema. PMID:19936328

Scientific evidence of dockworker illness to nursing clinical reasoning.

PubMed

Almeida, Marlise Capa Verde de; Cezar-Vaz, Marta Regina

2016-04-01

To identify scientific evidence of occupational illness of dockworkers published in the literature. systematic review of the literature, developed according to the Cochrane method. The databases searched were: Cochrane, LILACS, MEDLINE/PubMed, CINAHL and SciELO. Studies from 1988 to 2014 were selected. The data were analyzed according to the level of evidence and Strengthening the Reporting of Observational Studies in Epidemiology. We included 14 studies, in which 11 (78.6%) were from international journals. The year of 2012 showed greater number of studies. All studies were classified as: Level of Evidence 4, highlighting lung cancer, musculoskeletal and ischemic diseases, causal link in chemical risks. The development of preventive measures should especially include chemical exposure of workers applying the clinical reasoning of nurses' environmental knowledge to care for illnesses. Identificar evidências científicas de adoecimento ocupacional do trabalhador portuário publicadas na literatura. Revisão sistemática da literatura, construída conforme o método Cochrane. As bases de dados pesquisadas foram Cochrane, LILACS, MEDLINE/PubMed, CINAHL e SciELO. Foram selecionados artigos publicados de 1988 a 2014. Os dados foram analisados conforme o Nível de Evidência e Strengthening the Reporting of Observational Studies in Epidemiology. Foram selecionadas 14 publicações, das quais 11 (78,6%) de revistas internacionais. O ano de 2012 reuniu maior número de publicações no período de estudo. Todas as publicações pertenciam ao Nível de Evidência 4, destacando o câncer pulmonar, doenças osteomusculares e isquêmicas, com nexo causal nos riscos químicos. A elaboração de medidas preventivas deve prever especialmente a exposição química do trabalhador, aplicando ao raciocínio clínico do enfermeiro um conhecimento ambiental para a assistência aos adoecimentos.

Identificabilidade e estabilidade dos parâmetros no método Grade of Membership (GoM): considerações metodológicas e práticas

PubMed Central

Guedes, Gilvan Ramalho; Caetano, André Junqueira; Machado, Carla Jorge; Brondízio, Eduardo Sonewend

2011-01-01

O método Grade of Membership (GoM) tem sido cada vez mais utilizado por demógrafos brasileiros e tem a vantagem de possuir um parâmetro que mensura a heterogeneidade individual, com base nas correlações não-observáveis entre as categorias de resposta das variáveis de interesse, gerando um medida do grau de pertencimento de cada indivíduo a perfis extremos. Alguns autores, contudo, chamam atenção para questões importantes na calibragem dos modelos finais que utilizam o programa GoM versão 3.4, como o problema de identificabilidade – soluções múltiplas para parâmetros estimados. Neste artigo, é sugerido um procedimento capaz de identificar um modelo final com solução única que descreva os tipos puros mais fidedignos à base de dados, em uma tentativa de otimização. Para ilustrar esse processo, utilizou-se uma base de dados correspondente a um levantamento econômico e sociodemográfico de uma população de pequenos agricultores residentes ao longo da Rodovia Transamazônica, no Estado do Pará. Também identificou-se a existência de instabilidade nos parâmetros estimados pelo programa GoM 3.4, sendo proposto um método de estabilização de seus valores. Com esses procedimentos combinados, os usuários do programa GoM 3.4 poderão descrever sua base de dados de forma mais adequada e responder às críticas sobre questões de identificabilidade e estabilidade dos modelos resultantes. Essas soluções empíricas são relevantes por afetarem cálculos de prevalência e de incidência de eventos de interesse, além de trazerem consequências importantes sobre o ponto e o momento corretos para intervenções de políticas públicas ou de planejamento prospectivo em análises de projeção. PMID:21709732

Astronomia Motivadora no Ensino Fundamental

NASA Astrophysics Data System (ADS)

Melo, J.; Voelzke, M. R.

2008-09-01

O objetivo principal deste trabalho é procurar desenvolver o interesse dos alunos pelas ciências através da Astronomia. Uma pesquisa com perguntas sobre Astronomia foi realizada junto a 161 alunos do Ensino Fundamental, com o intuito de descobrir conhecimentos prévios dos alunos sobre o assunto. Constatou-se, por exemplo, que 29,3% da 6ª série responderam corretamente o que é eclipse, 30,0% da 8ª série acertaram o que a Astronomia estuda, enquanto 42,3% dos alunos da 5ª série souberam definir o Sol. Pretende-se ampliar as turmas participantes e trabalhar, principalmente de forma prática com: dimensões e escalas no Sistema Solar, construção de luneta, questões como dia e noite, estações do ano e eclipses. Busca-se abordar, também, outros conteúdos de Física tais como a óptica na construção da luneta, e a mecânica no trabalho com escalas e medidas, e ao utilizar uma luminária para representar o Sol na questão do eclipse, e de outras disciplinas como a Matemática na transformação de unidades, regras de três; Artes na modelagem ou desenho dos planetas; a própria História com relação à busca pela origem do universo, e a Informática que possibilita a busca mais rápida por informações, além de permitir simulações e visualizações de imagens importantes. Acredita-se que a Astronomia é importante no processo ensino aprendizagem, pois permite a discussão de temas curiosos como, por exemplo, a origem do universo, viagens espaciais a existência ou não de vida em outros planetas, além de temas atuais como as novas tecnologias.

PubMed

Ferrer Gómez, Mercedes; García Zafra, María Victoria; Cuenca Sánchez, Juan Ramón; Sánchez Romera, Juan Francisco; Aranda García, Ana; Rausell Rausell, Víctor José; Hernández Martínez, Antonio Miguel

2016-09-20

Introducción: en Murcia, y hasta 2010, la administración de la nutrición enteral domiciliaria (NED) dictaba cumplir la regulación marcada en cuanto a los facultativos con competencias para su prescripción.Objetivos: examinar aspectos esenciales de este recurso en el periodo 2007-2010, características de la muestra y evolución del coste, así como perspectivas de futuro.Métodos: estudio del perfil de la población NED en un área de salud específica. Selección de recetas facturadas de productos NED en el conjunto de la Región, clasificación por tipos y análisis de la evolución en importe y en envases para el periodo 2007-2010.Resultados: respecto al perfil de la muestra del Área I de Salud de la Región, la patología, vía de administración y tipo de nutrición más frecuentes resultaron, respectivamente, la enfermedad neurológica, la vía oral y la nutrición no específica. Por otro lado, el gasto sanitario en productos dietoterápicos, en el Servicio Murciano de Salud, aumentó alrededor del 50% entre los años 2007 y 2010. Tanto en envases como en importe, Murcia se sitúa por encima de la media nacional.Conclusiones: el perfil de la muestra no coincide con trabajos publicados en otras regiones. Este dato, junto a la posición de Murcia en gasto dietoterápico, y su evidente tendencia al alza en los años analizados, hace evidente la necesidad de medidas que mejoren la calidad de la NED en la Región de Murcia y, en caso de ser posible, conseguir alcanzar valores nacionales en relación con el consumo medio y el gasto.

Increase in quantity and quality of suitable areas for invasive species as climate changes.

PubMed

Bertelsmeier, Cleo; Luque, Gloria M; Courchamp, Franck

2013-12-01

As climatically suitable range projections become increasingly used to assess distributions of species, we recommend systematic assessments of the quality of habitat in addition to the classical binary classification of habitat. We devised a method to assess occurrence probability, captured by a climatic suitability index, through which we could determine variations in the quality of potential habitat. This relative risk assessment circumvents the use of an arbitrary suitability threshold. We illustrated our method with 2 case studies on invasive ant species. We estimated invasion potential of the destroyer ant (Monomorium destructor) and the European fire ant (Myrmica rubra) on a global scale currently and by 2080 with climate change. We found that 21.1% of the world's landmass currently has a suitable climate for the destroyer ant and 16% has a suitable climate for European fire ant. Our climatic suitability index showed that both ant species would benefit from climate change, but in different ways. The size of the potential distribution increased by 35.8% for the destroyer ant. Meanwhile, the total area of potential distribution remained the same for the European fire ant (>0.05%), but the level of climatic suitability within this range increased greatly and led to an improvement in habitat quality (i.e., of invasive species' establishment likelihood). Either through quantity or quality of suitable areas, both invasive ant species are likely to increase the extent of their invasion in the future, following global climate change. Our results show that species may increase their range if either more areas become suitable or if the available areas present improved suitability. Studies in which an arbitrary suitability threshold was used may overlook changes in area quality within climatically suitable areas and as a result reach incorrect predictions. Incremento de la Cantidad y Calidad de Áreas Idóneas para Especies Invasoras a Medida que Cambia el Clima. �

Astronomía Gamma desde El Leoncito

NASA Astrophysics Data System (ADS)

Rovero, A. C.; Colombo, E.; Sahade, J.; Weekes, T. C.

La astronomía gamma, en el extremo de energías detectadas hasta el presente, se encuentra en desarrollo en muchas partes del mundo y proporciona resultados sorprendentes a medida que la tecnología avanza en el desarrollo de nuevos detectores. La técnica Cherenkov Atmosférica es la utilizada para la detección, mediante telescopios en tierra, del efecto secundario causado por la radiación gamma de muy altas energías (E ≈ TeV). Por medio de telescopios o arreglos de detectores y utilizando la técnica mencionada, se han podido detectar algunas fuentes puntuales de mucha importancia astrofísica como la Nebulosa del Cangrejo y la galaxia de núcleo activo Markarian 421. El sistema instalado en San Juan, en cooperación con el grupo de Radiación Gamma del Observatorio Whipple, está constituído por tres colectores de 1.5m que registran pulsos de luz generados por las cascadas de partículas producidas por rayos cósmicos de todo tipo al entrar en la atmósfera terrestre. El sistema opera por barrido en ascención recta de la fuente observada que, para esta etapa del experimento, es el Centro Galáctico. Esta fuente extensa es conocida como emisor gamma de energías inferiores al TeV y ha sido observada anteriormente en este rango de energía desde el hemisferio norte pero con elevaciones bajas, situación no óptima para este tipo de técnica. Se presentan los primeros resultados del análisis de los datos obtenidos observando la región del Centro Galáctico, luego de dos años de observaciones, así como una descripción de la técnica Cherenkov Atmosférica y del equipo utilizado en la experiencia.

Análise sobre o Conhecimento de um Grupo de Alunos do Ensino Médio da Rede Estadual de São Paulo sobre Termos e Fenômenos Astronômicos do Cotidiano

NASA Astrophysics Data System (ADS)

de Oliveira, E. F.; Voelzke, M. R.; Amaral, L. H.

2007-08-01

Embora os Parâmetros Curriculares Nacionais do Ensino Médio (PCN-EM) e as orientações complementares a esses Parâmetros (PCN+) apontem a importância de uma abordagem significativa de conceitos relacionados à astronomia nas aulas de Física, muitos estudantes terminam o Ensino Médio (EM) sem compreender a razão de certos acontecimentos de origem celeste, ainda que estes façam parte de seu cotidiano. Este trabalho tem por objetivo analisar os conhecimentos básicos em astronomia dos alunos de EM da escola estadual Batista Renzi, bem como investigar os meios através dos quais estes conhecimentos foram adquiridos. Para tanto foi elaborado um questionário de múltipla escolha aplicado a 310 alunos distribuídos entre as três séries do EM dos períodos matutino e noturno. Dessa forma, observou-se que apenas 34,5% relacionaram as estações do ano à inclinação do eixo de rotação da Terra, 21,3% indicaram a influência gravitacional da Lua e do Sol como responsáveis pelo fenômeno das marés, 24,5% indicaram corretamente quais são os objetos celestes mais próximos da Terra, 36,1% identificaram ano-luz como uma medida de distância e 34,2% reconheceram uma estrela cadente como meteoro. Em contrapartida, 67,1% compreendiam a sucessão entre dia e noite, 73,9% identificaram o Sol como estrela e 52,3% relacionaram o Big Bang à origem do Universo. Além disso, foram comparadas as respostas de alunos de diferentes séries e períodos, observando-se, dentre outras coisas, que os estudantes do terceiro ano apresentam um percentual de acertos semelhante ao dos alunos do primeiro, caracterizando que a abordagem de tópicos relacionados à astronomia no EM não tem contribuído para uma maior compreensão dos fenômenos e conceitos.

Ultrasonic location system =

NASA Astrophysics Data System (ADS)

Albuquerque, Daniel Filipe

Esta tese apresenta um sistema de localizacao baseado exclusivamente em ultrassons, nao necessitando de recorrer a qualquer outra tecnologia. Este sistema de localizacao foi concebido para poder operar em ambientes onde qualquer outra tecnologia nao pode ser utilizada ou o seu uso esta condicionado, como sao exemplo aplicacoes subaquaticas ou ambientes hospitalares. O sistema de localizacao proposto faz uso de uma rede de farois fixos permitindo que estacoes moveis se localizem. Devido a necessidade de transmissao de dados e medicao de distancias foi desenvolvido um pulso de ultrassons robusto a ecos que permite realizar ambas as tarefas com sucesso. O sistema de localizacao permite que as estacoes moveis se localizem escutando apenas a informacao em pulsos de ultrassons enviados pelos farois usando para tal um algoritmo baseado em diferencas de tempo de chegada. Desta forma a privacidade dos utilizadores e garantida e o sistema torna-se completamente independente do numero de utilizadores. Por forma a facilitar a implementacao da rede de farois apenas sera necessario determinar manualmente a posicao de alguns dos farois, designados por farois ancora. Estes irao permitir que os restantes farois, completamente autonomos, se possam localizar atraves de um algoritmo iterativo de localizacao baseado na minimizacao de uma funcao de custo. Para que este sistema possa funcionar como previsto sera necessario que os farois possam sincronizar os seus relogios e medir a distancia entre eles. Para tal, esta tese propoe um protocolo de sincronizacao de relogio que permite tambem obter as medidas de distancia entre os farois trocando somente tres mensagens de ultrassons. Adicionalmente, o sistema de localizacao permite que farois danificados possam ser substituidos sem comprometer a operabilidade da rede reduzindo a complexidade na manutencao. Para alem do mencionado, foi igualmente implementado um simulador de ultrassons para ambientes fechados, o qual provou ser bastante

Groundwater for urban water supplies in northern China - An overview

NASA Astrophysics Data System (ADS)

Zaisheng, Han

Groundwater plays an important role for urban and industrial water supply in northern China. More than 1000 groundwater wellfields have been explored and installed. Groundwater provides about half the total quantity of the urban water supply. Complete regulations and methods for the exploration of groundwater have been established in the P.R. China. Substantial over-exploitation of groundwater has created environmental problems in some cities. Some safeguarding measures for groundwater-resource protection have been undertaken. Résumé Les eaux souterraines jouent un rôle important dans l'approvisionnement en eau des agglomérations et des industries du nord de la Chine. Les explorations ont conduit à mettre en place plus de 1000 champs de puits captant des eaux souterraines. Les eaux souterraines satisfont environ la moitié des besoins en eau des villes. Une réglementation complète et des méthodes d'exploration des eaux souterraines ont étéétablies en République Populaire de Chine. Une surexploitation très nette est à l'origine de problèmes environnementaux dans certaines villes. Des mesures ont été prises pour protéger la ressource en eau souterraine. Resumen El agua subterránea desempeña un papel importante en el suministro de agua para uso doméstico e industrial en la China septentrional. Se han explorado y puesto en marcha más de 1000 campos de explotación de aguas subterráneas, que proporcionan cerca de la mitad del total del suministro urbano. En la República Popular de China se han definido totalmente la legislación y la metodología para realizar estas explotaciones. La gran sobreexplotación en algunas ciudades ha creado algunos problemas medioambientales. Como consecuencia, se han llevado a cabo algunas medidas de protección de los recursos de aguas subterráneas.

Central Nervous System Idiopathic Inflammatory Demyelinating Disorders in South Americans: A Descriptive, Multicenter, Cross-Sectional Study.

PubMed

Papais-Alvarenga, Regina Maria; Vasconcelos, Claudia Cristina Ferreira; Carra, Adriana; de Castillo, Ibis Soto; Florentin, Sara; Diaz de Bedoya, Fernando Hamuy; Mandler, Raul; de Siervi, Luiza Campanella; Pimentel, Maria Lúcia Vellutini; Alvarenga, Marina Papais; Alvarenga, Marcos Papais; Grzesiuk, Anderson Kuntz; Gama Pereira, Ana Beatriz Calmon; Gomes Neto, Antonio Pereira; Velasquez, Carolina; Soublette, Carlos; Fleitas, Cynthia Veronica; Diniz, Denise Sisteroli; Armas, Elizabeth; Batista, Elizabeth; Hernandez, Freda; Pereira, Fernanda Ferreira Chaves da Costa; Siqueira, Heloise Helena; Cabeça, Hideraldo; Sanchez, Jose; Brooks, Joseph Bruno Bidin; Gonçalves, Marcus Vinicius; Barroso, Maria Cristina Del Negro; Ravelo, Maria Elena; Castillo, Maria Carlota; Ferreira, Maria Lúcia Brito; Rocha, Maria Sheila Guimarães; Parolin, Monica Koncke Fiuza; Molina, Omaira; Marinho, Patricia Beatriz Christino; Christo, Paulo Pereira; Brant de Souza, Renata; Pessanha Neto, Silvio; Camargo, Solange Maria das Graças; Machado, Suzana Costa; Neri, Vanderson Carvalho; Fragoso, Yara Dadalti; Alvarenga, Helcio; Thuler, Luiz Claudio Santos

2015-01-01

The idiopathic inflammatory demyelinating disease (IIDD) spectrum has been investigated among different populations, and the results have indicated a low relative frequency of neuromyelitis optica (NMO) among multiple sclerosis (MS) cases in whites (1.2%-1.5%), increasing in Mestizos (8%) and Africans (15.4%-27.5%) living in areas of low MS prevalence. South America (SA) was colonized by Europeans from the Iberian Peninsula, and their miscegenation with natives and Africans slaves resulted in significant racial mixing. The current study analyzed the IIDD spectrum in SA after accounting for the ethnic heterogeneity of its population. A cross-sectional multicenter study was performed. Only individuals followed in 2011 with a confirmed diagnosis of IIDD using new diagnostic criteria were considered eligible. Patients' demographic, clinical and laboratory data were collected. In all, 1,917 individuals from 22 MS centers were included (73.7% female, 63.0% white, 28.0% African, 7.0% Mestizo, and 0.2% Asian). The main disease categories and their associated frequencies were MS (76.9%), NMO (11.8%), other NMO syndromes (6.5%), CIS (3.5%), ADEM (1.0%), and acute encephalopathy (0.4%). Females predominated in all main categories. The white ethnicity also predominated, except in NMO. Except in ADEM, the disease onset occurred between 20 and 39 years old, early onset in 8.2% of all cases, and late onset occurred in 8.9%. The long-term morbidity after a mean disease time of 9.28±7.7 years was characterized by mild disability in all categories except in NMO, which was scored as moderate. Disease time among those with MS was positively correlated with the expanded disability status scale (EDSS) score (r=0.374; p=<0.001). This correlation was not observed in people with NMO or those with other NMO spectrum disorders (NMOSDs). Among patients with NMO, 83.2% showed a relapsing-remitting course, and 16.8% showed a monophasic course. The NMO-IgG antibody tested using indirect

Central Nervous System Idiopathic Inflammatory Demyelinating Disorders in South Americans: A Descriptive, Multicenter, Cross-Sectional Study

PubMed Central

Papais-Alvarenga, Regina Maria; Vasconcelos, Claudia Cristina Ferreira; Carra, Adriana; de Castillo, Ibis Soto; Florentin, Sara; Diaz de Bedoya, Fernando Hamuy; Mandler, Raul; de Siervi, Luiza Campanella; Pimentel, Maria Lúcia Vellutini; Alvarenga, Marina Papais; Papais Alvarenga, Marcos; Grzesiuk, Anderson Kuntz; Gama Pereira, Ana Beatriz Calmon; Gomes Neto, Antonio Pereira; Velasquez, Carolina; Soublette, Carlos; Fleitas, Cynthia Veronica; Diniz, Denise Sisteroli; Armas, Elizabeth; Batista, Elizabeth; Hernandez, Freda; Pereira, Fernanda Ferreira Chaves da Costa; Siqueira, Heloise Helena; Cabeça, Hideraldo; Sanchez, Jose; Brooks, Joseph Bruno Bidin; Gonçalves, Marcus Vinicius; Barroso, Maria Cristina Del Negro; Ravelo, Maria Elena; Castillo, Maria Carlota; Ferreira, Maria Lúcia Brito; Rocha, Maria Sheila Guimarães; Parolin, Monica Koncke Fiuza; Molina, Omaira; Marinho, Patricia Beatriz Christino; Christo, Paulo Pereira; Brant de Souza, Renata; Pessanha Neto, Silvio; Camargo, Solange Maria das Graças; Machado, Suzana Costa; Neri, Vanderson Carvalho; Fragoso, Yara Dadalti; Alvarenga, Helcio; Thuler, Luiz Claudio Santos

2015-01-01

The idiopathic inflammatory demyelinating disease (IIDD) spectrum has been investigated among different populations, and the results have indicated a low relative frequency of neuromyelitis optica (NMO) among multiple sclerosis (MS) cases in whites (1.2%-1.5%), increasing in Mestizos (8%) and Africans (15.4%-27.5%) living in areas of low MS prevalence. South America (SA) was colonized by Europeans from the Iberian Peninsula, and their miscegenation with natives and Africans slaves resulted in significant racial mixing. The current study analyzed the IIDD spectrum in SA after accounting for the ethnic heterogeneity of its population. A cross-sectional multicenter study was performed. Only individuals followed in 2011 with a confirmed diagnosis of IIDD using new diagnostic criteria were considered eligible. Patients’ demographic, clinical and laboratory data were collected. In all, 1,917 individuals from 22 MS centers were included (73.7% female, 63.0% white, 28.0% African, 7.0% Mestizo, and 0.2% Asian). The main disease categories and their associated frequencies were MS (76.9%), NMO (11.8%), other NMO syndromes (6.5%), CIS (3.5%), ADEM (1.0%), and acute encephalopathy (0.4%). Females predominated in all main categories. The white ethnicity also predominated, except in NMO. Except in ADEM, the disease onset occurred between 20 and 39 years old, early onset in 8.2% of all cases, and late onset occurred in 8.9%. The long-term morbidity after a mean disease time of 9.28±7.7 years was characterized by mild disability in all categories except in NMO, which was scored as moderate. Disease time among those with MS was positively correlated with the expanded disability status scale (EDSS) score (r=0.374; p=<0.001). This correlation was not observed in people with NMO or those with other NMO spectrum disorders (NMOSDs). Among patients with NMO, 83.2% showed a relapsing-remitting course, and 16.8% showed a monophasic course. The NMO-IgG antibody tested using indirect

DIETARY MANAGEMENT FOR DYSLIPIDEMIA IN LIVER TRANSPLANT RECIPIENTS.

PubMed

Pinto, Andressa S; Chedid, Marcio F; Guerra, Léa T; Cabeleira, Daiane D; Kruel, Cleber D P

2016-01-01

os efeitos de uma intervenção dietética no perfil lipídico de pacientes transplantados hepáticos dislipidêmicos em acompanhamento ambulatorial. Foram incluídos todos os pacientes adultos transplantados hepáticos com dislipidemia e em acompanhamento ambulatorial em nossa instituição. Avaliação antropométrica, anamnese alimentar, composição corporal (bioimpedância) e cálculo do metabolismo basal (calorimetria indireta) foram realizados. Pacientes foram atendidos por uma nutricionista e uma dieta individualizada baseada no metabolismo basal e consistindo de 25% do valor energético em gorduras totais e menos de 200 mg/dia de colesterol foi prescrita. Colesterol total (CT), HDL-colesterol (HDL), LDL-colesterol (LDL), triglicerídeos (TG) e medidas antropométricas foram medidos antes do início da dieta, sendo repetidos seis meses após o início da intervenção dietética. Cinquenta e três pacientes concluíram o seguimento e tinham idade 59±10 anos e 29 eram homens (51,8%). CT pré-intervenção=238,9±30; pós-intervenção=165,1±35, p<0.001; LDL pré-intervenção=154±33; pós-intervenção=90±29, p<0.001 e TG pré-intervenção=168, IQR=151-200; pós-intervenção=137, IQR=94-177, p=<0.001 sofreram modificações significativas seis meses após a intervenção. Antes do estudo, nenhum dos pacientes apresentava níveis séricos normais para o CT, e apenas 12 pacientes (22,7%) tinham níveis séricos ótimo ou quase ótimos para o LDL. Seis meses após o início da intervenção, 45 pacientes (84,9%) alcançaram níveis séricos normais de CT e 50 (94,4%) níveis séricos ótimos ou quase ótimos de LDL. Os níveis séricos de HDL e as medidas antropométricas não sofreram modificações significativas. Aconselhamento dietético com prescrição de dieta individualizada baseada no cálculo do metabolismo basal mostrou-se efetivo no manejo da dislipidemia em pacientes transplantados hepáticos em seguimento ambulatorial. Assim, todos os

Assessment of Management to Mitigate Anthropogenic Effects on Large Whales

PubMed Central

Van Der Hoop, Julie M; Moore, Michael J; Barco, Susan G; Cole, Timothy VN; Daoust, Pierre-Yves; Henry, Allison G; McAlpine, Donald F; McLellan, William A; Wimmer, Tonya; Solow, Andrew R

2013-01-01

sobre las ballenas a nivel de población, aunque no excluimos la posibilidad de éxito de medidas enfocadas a hábitats locales específicos que no estuvieron dentro de la resolución de nuestro análisis. No es claro como se relacionan con nuestros resultados las deficiencias en el diseño o implementación del manejo. Análisis como el que realizamos son cruciales para la evaluación crítica de decisiones para el manejo de vida silvestre, y los resultados de estos análisis pueden proporcionar directrices a los manejadores para que modifiquen medidas regulatorias y puedan ser aplicadas globalmente en temas de conservación relacionadas con mortalidad. PMID:23025354

Stages of change of behavior in women on a multi-professional program for treatment of obesity.

PubMed

Bevilaqua, Cheila Aparecida; Pelloso, Sandra Marisa; Marcon, Sonia Silva

2016-10-10

to ascertain the effectiveness of an intervention program in relation to anthropometric measurements and stage of readiness for behavioral change in women with excess weight. the intervention group (IG) was made up of 13 women, and the control group (CG), by 20. The intervention lasted 16 weeks, and included the practice of guided physical activity three times a week, and health education once a week. The application of the questionnaire on stage of readiness for behavioral change, and the anthropometric evaluations, were undertaken at two points - before and after the period of intervention. The statistical analysis involved tests of comparison and association. in general, at the first point, the participants in the two groups were predisposed to make changes in what they ate and in their physical activity. However, significant difference was only observed in relation to weight, body mass index (BMI), waist circumference and waist-hip ratio and readiness for change among the members of the intervention group. the intervention programmed was effective in weight loss, reduction of waist circumference and waist-hip ratio, and in changing behaviors related to the practicing of physical exercise and eating habits. verificar a efetividade de um programa de intervenção sobre medidas antropométricas e o estágio de prontidão para mudança de comportamento em mulheres com excesso de peso. o grupo intervenção (GI) foi constituído por 13 mulheres e o grupo controle por 20. A intervenção teve duração de 16 semanas e incluiu prática de atividade física orientada três vezes na semana e educação em saúde uma vez na semana. A aplicação do questionário de estágio de prontidão para mudança de comportamento e as avaliações antropométricas foram realizadas em dois momentos, antes e após o período de intervenção. A análise estatística envolveu testes de comparação e associação. em geral, no momento inicial, as participantes dos dois grupos estavam

Factors associated with mortality in patients undergoing coronary artery bypass grafting.

PubMed

Koerich, Cintia; Lanzoni, Gabriela Marcellino de Melo; Erdmann, Alacoque Lorenzini

2016-08-08

idade de 65 anos. O infarto agudo do miocárdio foi o diagnóstico de internação que apresentou maior representatividade. A maioria das intercorrências registradas durante a internação caracterizou-se por alterações do sistema cardiovascular e o maior tempo de internação teve relação direta com óbito por choque séptico. os dados fornecem subsídios para a enfermagem atuar com medidas preventivas e identificação precoce de intercorrências associadas à cirurgia de revascularização do miocárdio. Reforça-se a importância da utilização dos dados como indicadores de qualidade objetivando garantir um cuidado pautado em informações confiáveis que orientem gestores no planejamento da assistência ao paciente e dos serviços de saúde de alta complexidade. conocer los factores asociados a la mortalidad de pacientes sometidos a cirugía de revascularización del miocardio en un hospital de referencia cardiovascular en el estado de Santa Catarina. estudio cuantitativo, exploratorio, descriptivo y retrospectivo. Fueron analizados las fichas médicas de 1.447 pacientes, entre 2005 y 2013; las variables relacionadas estadísticamente fueron: perfil, diagnóstico de la internación, factores de riesgo para enfermedad arterial coronariana, complicaciones registradas en la internación, tiempo de internación y causa de la muerte. la tasa de mortalidad fue de 5,3%, en el período del estudio. Las muertes fueron más frecuentes en negros, sexo femenino y promedio de edad de 65 años. El infarto agudo del miocardio fue el diagnóstico de internación que presentó mayor representatividad. La mayoría de las complicaciones registradas durante la internación se caracterizó por alteraciones del sistema cardiovascular; el mayor tiempo de internación tuvo relación directa con muerte por choque séptico. los datos suministran informaciones para que la enfermería pueda actuar con medidas preventivas e identificar precozmente complicaciones asociadas a la cirug

Hydraulic properties and scale effects investigation in regional rock aquifers, south-western Quebec, Canada

NASA Astrophysics Data System (ADS)

Nastev, M.; Savard, M. M.; Lapcevic, P.; Lefebvre, R.; Martel, R.

subterránea sucede en los primeros metros de la secuencia rocosa. A escala regional se puede aplicar la aproximación equivalente de medios porosos. Las medidas de la conductividad hidrálica fueron comparadas con la escala de las pruebas del acuífero, expresadas con el volumen investigado del acuífero. Se desarrolló un proceso de interpolación simple para la conductividad hidráulica de campo, con base en la distancia entre las medidas de campo y los volúmenes probados del acuífero. La distribución regional de la conductividad hidráulica, para las unidades acuíferas fracturadas mayores, indica que la dolomita es más permeable mientras que la arenisca y las rocas cristalinas son las unidades menos permeables. L'article présente les propriétés hydrauliques d'un aquifère régional rocheux qui ont été mesurées dans le cadre d'un projet concernant l'estimation de la ressource en eau de la plaine de St. Lawrence située dans la partie sud-ouest de Quebec. Affin de comprendre le comportement de l'aquifère tant à l'échelle de fracture qu'à l'échelle régionale on a mené des investigations hydrauliques en utilisant des essais differents. À l'échelle locale l'écoulement est déterminé en principal par le système des fractures. Les résultats des essais d'injection au niveau constant ont montré une tendence de décroissance de la conductivité hydraulique avec la profondeur ce qui indique que l'écoulement ait lieu en principal dans les premiers mètres de la structure rocheuse. À l'échelle règionale on peut appliquer l'approche de milieux poreux equivalent. Les mesures de conductivité hydraulique ont été corrélées avec l'échelle des essais de pompage exprimée en termes de volume investigué de l'aquifère. On a mis au point une méthode simple d'interpolation pour le champ de la conductivité hydraulique basée sur la distance entre les essais in situ et les volume investigués de l'aquifère. La distribution règionale de la conductivit

Implementação de um algoritmo para a limpeza de mapas da RCFM

NASA Astrophysics Data System (ADS)

Souza, C. L.; Wuensche, C. A.

2003-08-01

A Radiação Cósmica de Fundo em Microondas (RCFM), descoberta por Penzias e Wilson em 1965, é uma das ferramentas mais poderosas para o estudo da cosmologia. Com a descoberta de flutuações de temperatura na RCFM, da ordem de uma parte em 105, pelo COBE (1992), uma nova era teve início. Nos últimos onze anos, diversos instrumentos fizeram novas medidas de alta precisão, refinando os resultados apresentados pelo COBE, culminando com os resultados recentes do satélite WMAP. A análise de dados da RCFM, especialmente no caso de experimentos com pequena cobertura do céu, apresenta uma série de dificuldades devido a emissões de contaminantes externos, tais como a emissão da Galáxia e de fontes pontuais, e de ruídos intrínsecos tanto ao sistema de detecção quanto à estratégia de observação do céu. Uma das soluções típicas para a filtragem de dados brutos de um experimento para medir flutuações de temperatura é aplicar um gabarito (template) e um filtro passa alta ao produzir mapas simplificados (sem considerar matrizes de correlação ou covariância). No caso de experimentos que utilizam detectores HEMT, essa combinação de filtros remove, satisfatoriamente, ruídos do tipo 1/f gerados pela instabilidade no ganho do detector acoplado ao movimento do instrumento, definido pela estratégia de observação. Entretanto, o sinal resultante medido, tanto em simulações quanto em séries temporais reais, sugere que parte do sinal cosmológico pode estar sendo removido junto com o ruído dos detectores. Este trabalho descreve as etapas para a produção de um mapa típico (simulado) e os testes preliminares de um algoritmo para remover ruídos do tipo 1/f introduzidos pela estratégia de observação sem prejudicar a qualidade do sinal cosmológico presente no mapa.

[Not Available].

PubMed

López Lirola, Emilia María; Iríbar Ibabe, María Concepción; Peinado Herreros, José María

2016-06-30

Introducción: la malnutrición en el anciano que ingresa en el hospital es bastante frecuente y condiciona no solo la extensión de la estancia hospitalaria, sino el pronóstico o la aparición de otras patologías. Su valoración puede basarse en medidas antropométricas, parámetros bioquímicosy test nutricionales.Objetivos: valorar si la circunferencia de pantorrilla es un indicador válido de desnutrición en el paciente anciano recién hospitalizado, analizando la posible influencia del sexo y la edad.Material y métodos: estudio descriptivo en 907 pacientes ancianos pluripatológicos a su ingreso en el hospital, con una edad media de 82,13 ± 7,08 años. Se han realizado determinaciones bioquímicas incluyendo recuento de linfocitos, colesterol total, transferrina y albúmina.Se aplicaron en cada paciente las escalas de cribado nutricional MNA, NRS y VGS. Finalmente se determinó la circunferencia de la pantorrilla.Resultados: los test nutricionales muestran un porcentaje de desnutrición medio del 75%. Los parámetros bioquímicos muestran un porcentaje de desnutrición que oscila del 63,4% al 76,7%, y la circunferencia de la pantorrilla un 74,2%. La prevalencia de desnutrición es mayor en mujeres, independientemente del parámetro utilizado en su determinación. El aumento en la edad, particularmente a partir de los 85 años, y con todos los parámetros analizados, también condiciona un mayor grado de desnutrición. Todos los parámetros estudiados se correlacionan con la circunferencia de la pantorrilla, estableciéndose el concepto "estar desnutrido" en el punto de corte de 29 cm, para ambos sexos y en todos los grupos de edad (sensibilidad 99,31%).Conclusiones: un 75% de la población anciana presenta desnutrición a su ingreso en el hospital. La circunferencia de la pantorrilla es un marcador de desnutrición en el anciano de fácil determinación y alta sensibilidad, independiente del sexo y la edad.

Reacciones de intercambio de carga

NASA Astrophysics Data System (ADS)

Errea, L. F.

Se discute la validez de diversas metodologías y su aplicación al estudio de procesos de intercambio de carga electrónico entre iones y blancos atómicos y moleculares. Para energías de impacto entre 0.05 y 5 eV / amu se emplea el método cuántico de la Coordenada de Reacción Común (CRC). A mayores energías, se utiliza el método semiclásico iconal con un desarrollo de la función de onda dinámica en estados moleculares adiabáticos, modificados con un factor de traslación común (FTC). Estos estados pueden obtenerse con cálculos ab initio o empleando potenciales modelo. Cuando la ionización compite con la transferencia de carga, la inclusión de pseudoestados en estos desarrollos permite calcular simultáneamente las secciones eficaces de ambos procesos. Otra técnica utilizada es el método estadístico CTMC. En el tratamiento de colisiones ión-molécula (diatómica) contrastamos la aplicabilidad de distintos métodos, desde la llamada aproximación Franck-Condon hasta un desarrollo en estados vibrónicos, pasando por la aproximación súbita vibro-rotacional, obteniéndose secciones eficaces de captura electrónica total y a estados individuales, así como secciones de excitación vibracional a estados ligados y del continuo (disociación). En todos los casos es necesario calcular superficies de energía y los correspondientes acoplamientos dinámicos entre los estados. La aplicación de estos métodos permite determinar el grado de contaminación de los haces por estados metaestables en un experimento dado, el cambio en los resultados con diferentes isótopos, la importancia de procesos de doble captura, seguida de explosión culombiana, todo ello con precisión comparable a la de medidas experimentales, para sistemas de interés en distintos tipos de plasmas.

Estrategia de Aprendizaje Basado en Problemas (ABP) para explorar las concepciones alternativas relacionadas al tema estados de agregacion de la materia en estudiantes de nivel elemental =

NASA Astrophysics Data System (ADS)

Rosado Olivieri, Wilda Y.

Gran parte de la investigacion acerca de la ensenanza de las ciencias se dedica a estudiar la forma o manera en que los estudiantes visualizan los conceptos cientificos. Para Driver (1983) esas ideas o concepciones se conocen como concepciones alternativas; las cuales pueden ocasionar dificultad para comprender los conceptos de las diferentes areas del conocimiento. El proposito de este estudio fue: (a) indagar como las distintas etapas del ABP permiten explorar las concepciones alternativas que poseen los estudiantes de nivel elemental acerca de los estados de agregacion de la materia y, (b) explorar en que medida el ABP permite identificar e incorporar las concepciones alternativas que poseen los estudiantes de nivel elemental con relacion al concepto de estados de agregacion de la materia para facilitar su aprendizaje. Con el fin de explorar las concepciones alternativas en el tema de los estados agregados de la materia se implanto la estrategia de Aprendizaje Basado en Problemas (ABP) con estudiantes de quinto grado de nivel elemental. Se utilizo la metodologia mixta con varias estrategias de recopilacion de datos, como una pre y pos prueba para elucidar el conocimiento previo y al mismo tiempo las concepciones alternativas sobre el tema bajo estudio y luego verificar el aprendizaje en los estudiantes. Asimismo, el uso de mapas conceptuales para determinar la profundidad del tema estudiado y el entrelazamiento de los conceptos Una tercera estrategia fue el grupo focal para tomar en cuenta la impresion de los estudiantes acerca del proyecto ABP. El aspecto colaborativo y cooperativo fue un factor fundamental, ya que el aprendizaje ocurrio en ese contexto educativo. Para los hallazgos de esta investigacion fue tan importante el conocimiento previo como los procesos que se generaban para que la adquisicion del mismo fuera de forma significativa y funcional (Escribano & Del Valle, 2010). La estrategia de ABP constituyo en este estudio una forma para indagar las

Detecção da fase impulsiva de uma explosão solar gigante até 405 GHz

NASA Astrophysics Data System (ADS)

Raulin, J.-P.; Makhmutov, V.; Kaufmann, P.; Pacini, A. A.; Luethi, T.; Hudson, H. S.; Gary, D. E.; Yoshimori, M.

2003-08-01

A explosão ocorrida no dia 25/08/2001 foi uma das mais intensas do presente ciclo solar em ondas de rádio de altas frequências. Foram medidas em ondas milimétricas e submilimétricas, aproximadamente, 105 e vários milhares de unidades de fluxo solar, respectivamente. Apresentamos um estudo deste evento em múltiplas frequências, desde microondas (1GHz), até ondas submilimétricas (405 GHz) detectadas pelo Telescópio Solar para ondas Submilimétricas (SST). Esta base de dados foi complementada utilizando-se o experimento Yohkoh, incluindo a emissão em raios-X duros e raios-g (até 100 MeV), e imagens em raios-X moles da região ativa envolvida. Enfocamos e discutimos principalmente os seguintes aspectos da fase impulsiva do evento: (i) as implicações deduzidas do espectro eletromagnético, obtido pela primeira vez até 405 GHz; (ii) a dinâmica da região ativa. Os resultados mostram que para explicar o espectro rádio observado, são necessários entre 3.5×1037 e 1.5×1039 elétrons acelerados acima de 20 keV em uma região de campo magnético entre 300 e 800 Gauss. A estimativa do fluxo de fótons que seria produzido por estes elétrons, mostra que grande parte deles não precipitou na baixa atmosfera. A evolução temporal da emissão em raios-X moles revela que a configuração magnética da região ativa foi muito dinâmica durante a fase impulsiva da explosão. Em particular, mostramos que a produção dos elétrons altamente energéticos foi iniciada junto com a aparição, na baixa coroa solar, de um novo sistema compacto de estruturas magnéticas. Este fato sugere que os locais de aceleração estão localizados na baixa atmosfera do Sol, como resultado da interação entre o novo sistema compacto e o campo magnético ambiente da região ativa.

Studies on magnetocaloric and magnetic coupling effects =

NASA Astrophysics Data System (ADS)

Amaral, Joao Cunha de Sequeira

O presente trabalho apresenta novas metodologias desenvolvidas para a analise das propriedades magneticas e magnetocaloricas de materiais, sustentadas em consideracoes teoricas a partir de modelos, nomeadamente a teoria de transicoes de fase de Landau, o modelo de campo medio molecular e a teoria de fenomeno critico. Sao propostos novos metodos de escala, permitindo a interpretacao de dados de magnetizacao de materiais numa perspectiva de campo medio molecular ou teoria de fenomeno critico. E apresentado um metodo de estimar a magnetizacao espontanea de um material ferromagnetico a partir de relacoes entropia/magnetizacao estabelecidas pelo modelo de campo medio molecular. A termodinamica das transicoes de fase magneticas de primeira ordem e estudada usando a teoria de Landau e de campo medio molecular (modelo de Bean-Rodbell), avaliando os efeitos de fenomenos fora de equilibrio e de condicoes de mistura de fase em estimativas do efeito magnetocalorico a partir de medidas magneticas. Efeitos de desordem, interpretados como uma distribuicao na interaccao magnetica entre ioes, estabelecem os efeitos de distribuicoes quimicas/estruturais nas propriedades magneticas e magnetocaloricas de materiais com transicoes de fase de segunda e de primeira ordem. O uso das metodologias apresentadas na interpretacao das propriedades magneticas de variados materiais ferromagneticos permitiu obter: 1) uma analise quantitativa da variacao de spin por iao Gadolinio devido a transicao estrutural do composto Gd5Si2Ge2, 2) a descricao da configuracao de cluster magnetico de ioes Mn na fase ferromagnetica em manganites da familia La-Sr e La-Ca, 3) a determinacao dos expoentes criticos β e δ do Niquel por metodos de escala, 4) a descricao do efeito da pressao nas propriedades magneticas e magnetocaloricas do composto LaFe11.5Si1.5 atraves do modelo de Bean-Rodbell, 5) uma estimativa da desordem em manganites ferromagneticas com transicoes de segunda e primeira ordem, 6) uma descricao de

PubMed

Torrado, Julio; Piazuelo, María Blanca; Ruiz, Irune; Izarzugaza, María Isabel; Camargo, María Constanza; Delgado, Alberto; Abdirad, Afshin; Correa, Pelayo

2010-01-01

ANTECEDENTES: El esófago de Barrett es una reconocida lesión precursora de adenocarcinoma esofágico. Aunque generalmente asociada al reflujo gastroesofágico, los mecanismos patogénicos de la enfermedad no son bien conocidos. El objetivo del presente estudio es explorar la historia natural e identificar marcadores de progreso del proceso precanceroso. MATERIAL Y M#ENTITYSTARTX000E9;TODOS: Se utilizaron cortes histológicos de 67 especímenes de esófago correspondientes a 14 pacientes con esófago de Barrett, a los que se siguió entre 1 - 9 años. Se clasificaron las lesiones en: esófago de Barrett sin displasia, indefinido para displasia o con displasia. Se evaluó la expresión de diferentes mucinas en las células caliciformes y en las columnares usando técnicas de histoquímica e inmunohistoquímica. RESULTADOS: En todos los casos se comprobó la presencia de metaplasia intestinal incompleta. Las células columnares dentro del epitelio metaplásico contenían mucinas neutras. A mayor severidad de la lesión se encontró significativamente menor expresión de sialomucinas en las células columnares (p de tendencia igual a 0,03). En sujetos con lesiones indefinidas para displasia se observó un mayor contenido de sulfomucinas en las células caliciformes (p=0,034) y de MUC2 en las células columnares (p=0,029) que en sujetos con esófago de Barrett sin displasia. Se observó expresión de la mucina intestinal MUC2 y de la mucina gástrica MUC5AC en todas las muestras. MUC6, una mucina de las glándulas profundas gástricas, se presentó ocasionalmente. CONCLUSI#ENTITYSTARTX000F3;N: La evaluación de los perfiles de mucinas en el esófago de Barrett sugiere una transición gradual del fenotipo del epitelio metaplásico a medida que la lesión avanza en el tiempo.

El fenotipo de las mucinas en el esófago de Barrett

PubMed Central

Torrado, Julio; Piazuelo, María Blanca; Ruiz, Irune; Izarzugaza, María Isabel; Camargo, María Constanza; Delgado, Alberto; Abdirad, Afshin; Correa, Pelayo

2011-01-01

Antecedentes El esófago de Barrett es una reconocida lesión precursora de adenocarcinoma esofágico. Aunque generalmente asociada al reflujo gastroesofágico, los mecanismos patogénicos de la enfermedad no son bien conocidos. El objetivo del presente estudio es explorar la historia natural e identificar marcadores de progreso del proceso precanceroso. Material y métodos Se utilizaron cortes histológicos de 67 especímenes de esófago correspondientes a 14 pacientes con esófago de Barrett, a los que se siguió entre 1 – 9 años. Se clasificaron las lesiones en: esófago de Barrett sin displasia, indefinido para displasia o con displasia. Se evaluó la expresión de diferentes mucinas en las células caliciformes y en las columnares usando técnicas de histoquímica e inmunohistoquímica. Resultados En todos los casos se comprobó la presencia de metaplasia intestinal incompleta. Las células columnares dentro del epitelio metaplásico contenían mucinas neutras. A mayor severidad de la lesión se encontró significativamente menor expresión de sialomucinas en las células columnares (p de tendencia igual a 0,03). En sujetos con lesiones indefinidas para displasia se observó un mayor contenido de sulfomucinas en las células caliciformes (p=0,034) y de MUC2 en las células columnares (p=0,029) que en sujetos con esófago de Barrett sin displasia. Se observó expresión de la mucina intestinal MUC2 y de la mucina gástrica MUC5AC en todas las muestras. MUC6, una mucina de las glándulas profundas gástricas, se presentó ocasionalmente. Conclusión La evaluación de los perfiles de mucinas en el esófago de Barrett sugiere una transición gradual del fenotipo del epitelio metaplásico a medida que la lesión avanza en el tiempo. PMID:21804831

Profile of Brazilian workers victims of occupational accidents with biological fluids.

PubMed

Miranda, Fernanda Moura D'Almeida; Cruz, Elaine Drehmer de Almeida; Félix, Jorge Cestari Vinícius; Kalinke, Luciana Puchalski; Mantovani, Maria de Fátima; Sarquis, Leila Maria Mansano

2017-01-01

To characterize the Brazilian workers victims of occupational accidents with biological fluids. Epidemiological and descriptive research, in which 284,877 notifications of the Notifiable Diseases Information System were analyzed between 2007 and 2014. We used Stata 13 for data analysis. The highest incidence density occurred in females with 0.8 cases per 1,000 workers/year (n = 222,042, 77.9%); in the age group of 20 to 24 years old, with 0.6 cases per 1,000 workers/year (n = 64,221, 23.3%); with some high school and some college, with 0.6 cases per 1,000 workers/year (n = 141,275, 49.6%). We found that these accidents occurred among 23 occupational subgroups. For the most part, the workers had an employment relationship and had issued the Occupational Accident Notification. It is necessary to rethink the measures of orientation to workers regarding the risks and relative prophylaxis for these accidents, with the aim of reducing them. Caracterizar os trabalhadores brasileiros vítimas de acidente de trabalho com fluidos biológicos. Pesquisa epidemiológica, descritiva, na qual foram analisadas 284.877 notificações do Sistema Nacional de Notificação de Agravos, entre 2007 e 2014. Utilizou-se Stata 13 para a análise dos dados. A maior densidade de incidência ocorreu no sexo feminino com 0,8 caso a cada 1.000 trabalhadores/ano (n = 222.042; 77,9%); na faixa etária de 20 a 24 anos com 0,6 caso a cada 1.000 trabalhadores/ano (n = 64.221; 23,3%); com Ensino Médio e Superior incompleto com 0,6 caso a cada 1.000 trabalhadores/ano (n = 141.275; 49,6%). Verificou-se que esses acidentes ocorreram entre 23 subgrupos ocupacionais. Em sua maioria, os trabalhadores possuíam vínculo empregatício e tiveram emitida a Comunicação de Acidente de Trabalho. Faz-se necessário repensar as medidas de orientação aos trabalhadores quanto aos riscos e profilaxia relativa para estes acidentes, visando reduzi-los ou diminui-los.

Correspondence Between NANDA International Nursing Diagnoses and Outcomes as Proposed by the Nursing Outcomes Classification.

PubMed

de Carvalho, Emilia Campos; Eduardo, Aline Helena Appoloni; Romanzini, Adilson; Simão, Talita Prado; Zamarioli, Cristina Mara; Garbuio, Danielle Cristina; Herdman, Tracy Heather

2018-01-01

The accurate identification of the nursing diagnoses and the corresponding measurement of their indicators will depend on the elements in the standardized language systems. To analyze the correspondence between elements of four NANDA-I nursing diagnoses and outcomes suggested by the nursing outcomes classification (NOC) for the resolution of these diagnoses. A methodological study consisting of cross-mapping was performed in the first stage between definitions, defining characteristics (DCs), and related factors (RFs) of impaired oral mucous membrane, impaired tissue integrity, spiritual distress, and delayed surgical recovery and outcome definitions and indicators to measure results of diagnoses resolution and an analysis of its relevance by experts in the second stage. It found partial correspondence between outcome indicators, DCs, RFs, and definitions. The data evidence the relevance of this review for a reliable application of these taxonomies and demonstrated partial correspondence between concepts analyzed. A identificação precisa dos diagnósticos de enfermagem e a medida correspondente dos seus indicadores dependerá dos elementos nos sistemas de linguagem padronizados. Foi analisar a correspondência entre os elementos de quatro NANDA-I diagnósticos de enfermagem e os resultados sugeridos pelo NOC para a resolução destes diagnósticos. MÉTODO: um estudo metodológico que consiste em cross-mapping foi realizado em uma primeira fase entre as definições, características definidoras e fatores relacionados de Mucosa oral prejudicada, Integridade tissular prejudicada, Sofrimento espiritual e Recuperação cirúrgica retardada e as definições dos resultados indicados para a resolução destes diagnósticos; na segunda fase, foi realizada uma análise desta concordância por especialistas. RESULTADOS: correspondência parcial entre as definições dos diagnósticos e dos resultados, características definidoras e fatores relacionados. CONCLUSÃO: Os

Work addiction and quality of life: a study with physicians.

PubMed

Azevedo, Walter Fernandes de; Mathias, Lígia Andrade da Silva Telles

2017-01-01

To evaluate the quality of life of physicians and investigate to what extent it is affected by work addiction. This is an exploratory, descriptive and cross-sectional study, conducted with 1,110 physicians. For data collection, we used a questionnaire with sociodemographic information, the World Health Organization Quality of Life BREF, and the Work Addiction Scale. Most physicians presented high quality of life. Female participants presented lower quality of life in the domains psychologic, environment and general (p<0.05). Quality of life was negatively correlated with the number of shifts (p<0.005). The higher the addiction to work, the lower the quality of life. The research allowed understanding the implications of work addiction in the quality of life. Further studies are required to support the development of strategies that improve health conditions and quality of life of medical professionals. Avaliar a qualidade de vida de médicos e investigar em que medida a adição ao trabalho a afeta. Trata-se de um estudo exploratório, descritivo e transversal, realizado com 1.110 médicos. Para coleta de dados, optou-se por utilizar um questionário contendo informações sociodemográficas, bem como aplicar o instrumento World Health Organization Quality of Life-BREF e a Escala de Adição ao Trabalho. Os médicos, em sua maioria, apresentaram alta qualidade de vida. Os participantes do sexo feminino tiveram menor qualidade de vida em relação aos homens nos domínios psicológico, meio ambiente e geral (p<0,05). A qualidade de vida correlacionou-se negativamente com o número de plantões (p<0,005), e quanto maior a adição ao trabalho, menor a qualidade de vida. A pesquisa permitiu o conhecimento das implicações da adição ao trabalho sobre a qualidade de vida. Novos estudos são necessários para subsidiar a elaboração de estratégias que melhorem a saúde e a qualidade de vida do profissional médico.

Patient safety: knowledge between multiprofessional residents.

PubMed

Oliveira, João Lucas Campos de; Silva, Simone Viana da; Santos, Pamela Regina Dos; Matsuda, Laura Misue; Tonini, Nelsi Salete; Nicola, Anair Lazzari

2017-01-01

To assess the knowledge of multiprofesional residents in health about the security of the patient theme. Cross-sectional study, quantitative, developed with graduate courses/residence specialties of health in a public university of Paraná, Brazil. Participants (n=78) answered a questionnaire containing nine objective questions related to patient safety. Data were analyzed using descriptive statistics, in proportion measures. The minimum 75% of correct answers was considered the cutoff for positive evaluation. The sample was predominantly composed of young people from medical programs. Almost half of the items evaluated (n=5) achieved the established positive pattern, especially those who dealt with the hand hygiene moments (98.8%) and goal of the Patient Safety National Program (92.3%). The identification of the patient was the worst rated item (37.7%). In the analysis by professional areas, only the Nursing reached the standard of hits established. Knowledge of the residents was threshold. Verificar o conhecimento de residentes multiprofissionais na área da saúde sobre o tema segurança do paciente. Estudo transversal, quantitativo, desenvolvido com pós-graduandos dos cursos/especialidades de residência da área da saúde de uma universidade pública do Paraná. Os participantes (n=78) responderam um questionário contendo nove questões objetivas relacionadas com a segurança do paciente. Os dados foram analisados por estatística descritiva, em medidas de proporção. O mínimo de 75% de acertos foi considerado ponto de corte para avaliação positiva. A amostra foi composta por profissionais predominantemente jovens, oriundos de programas médicos. Quase metade dos itens avaliados (n=5) alcançou o padrão de positividade estabelecido, com destaque para os que trataram dos momentos de higienização das mãos (98,8%) e o objetivo do Programa Nacional de Segurança do Paciente (92,3%). A identificação do paciente foi o pior item avaliado (37,7%). Na an

Massa do gás e das estrelas em aglomerados: eficiência da formação estelar

NASA Astrophysics Data System (ADS)

Laganá, T. F.; Lima Neto, G. B.

2003-08-01

Os aglomerados de galáxias apresentam um interesse especial para a cosmologia observacional. Eles são as maiores estruturas ligadas pela gravitação no Universo e relaxadas na região central. A comparação entre a massa do gás intra-aglomerado (responsável por ~25% da massa total, inferida a partir de observações em raios-X), a massa contida nas estrelas (i.e., nas galáxias) e a massa total (incluindo a matéria escura não bariônica), nos dá informações importantes sobre os processos de formação e evolução de aglomerados. Por exemplo, a razão entre a massa do gás e a massa total é uma medida da fração de bárions no Universo (razão entre a matéria bariônica e matéria escura) e, utilizando a densidade de bárions predita pela nucleosíntese primordial, podemos deduzir a densidade de matéria escura no Universo (cf. White et al. 1993). O objetivo deste trabalho é obter as razões entre as massas do gás, estelar (contida nas galáxias), e a total (massa dinâmica). As massas do gás e total são obtidas a partir das análises fotométrica e espectroscópica em raios-X enquanto que a massa estelar é obtida pela análise fotométrica das galáxias. Esta análise foi aplicada ao aglomerado Abell 496 observado pelo satélite XMM-Newton. A massa contida nas galáxias foi estimada a partir da função de luminosidade obtida por Durret et al. (2002). Para determinar as massas dinâmica e do gás nos precisamos determinar os perfis radiais de densidade e temperatura. Nós apresentaremos aqui estes resultados e suas implicações na eficiência da formação estelar em Abell 496.

Survey infravermelho do braço espiral de scuttum e da barra no centro galáctico

NASA Astrophysics Data System (ADS)

Amôres, E. B.; Lépine, J. R. D.

2003-08-01

O survey infravermelho consiste de observações utilizando a CAMIV no telescópio de 60 cm do LNA. Nosso principal objetivo é melhor caracterizar a população estelar dos braços espirais e de uma estrutura existente no centro galáctico que acreditamos ser devido à existência de uma barra, cujas extremidades estariam localizadas em longitudes galácticas l~23° e l~14°. As observações realizadas em vários filtros (imagens J, H e K) são particularmente importantes nas direções que tangenciam os braços espirais, desta forma, comparamos uma direção que atravessa um braço a uma direção próxima que não passa pelo braço, sendo que ambas possuem a mesma contribuição de contagens foreground. Nas missões realizadas até o presente, observamos a região na direção tangencial ao braço de Scuttum, com observações de l = 30.04° até l = 31.04°, a cada intervalo de longitude de 0.1°, para latitude galáctica de 0.0°, 0.25°, 0.50°. Para as regiões que acreditamos serem as extremidades da barra, observamos as faixas de longitude compreendidas entre -15° £ l £ -13° e 24° £ l £ 22° a cada intervalo de 0.25°, para latitude galáctica de 0.0° e 0.25°. As observações nos filtros J e H foram feitas com tempo de integração de 60s, na banda K, as observações foram feitas utilizando o filtro C1 com tempo de integração de aproximadamente 210 s (12x15s). Elaboramos diagramas cor-cor e cor-magnitude onde podemos verificar a existência de regiões com diferentes contagens e população estelar à medida que um braço espiral é atravessado.

Evolução temporal de discos circunstelares em estrelas Be

NASA Astrophysics Data System (ADS)

Fernandes, M. V. M.; Leister, N. V.; Levenhagen, R. S.

2003-08-01

A pesquisa do mecanismo que leva uma estrela do tipo Be a perder massa e formar um envelope circunstelar, nomeado como fenômeno Be, é uma questão em aberto, intrigante, e que adquire contornos interessantes em face às informações espectroscópicas de alta resolução. Nesta última década, consolida-se a idéia de que a forma destes envelopes é de tipo discóide, obedecendo a uma lei Kepleriana de velocidades, e mais ainda, recentemente há evidências de que a distribuição de matéria nestes discos pode assumir um caráter de anel. Medidas de algumas dimensões de discos circunstelares puderam ser obtidas pela análise de espectros de alta resolução e alta relação sinal-ruído para as estrelas Be: alpha Eri (HD 10144, B3Vpe), omicron And (HD 217675, B6IIIpe), e eta Cen (HD el972, B1.5Vne), no período dos anos de 1991 a 2001. Alguns modelos clássicos de envelope predizem uma distribuição de massa que decresce suavemente a partir da superfície estelar. Entretanto, considerando que a separação de picos de emissão em perfis de linhas do HeI e H-alpha, alargados por efeitos cinemáticos, é função do raio estelar e da velocidade rotacional projetada (vsini); nossos resultados sugerem a presença de um anel de matéria circunstelar, que aparece logo após a ejeção do material fotosférico, imediatamente acima da superfície estelar, e que se expande para raios maiores ao longo do tempo, eventualmente desconectando-se da superfície por uma região de densidade de matéria mínima. Tais interpretações revivem a idéia de que anéis de matéria circunstelar podem ser os responsáveis por algumas variabilidades em perfis de linhas de emissão, como as variações V/R.

Solid waste management in primary healthcare centers: application of a facilitation tool.

PubMed

Moreira, Ana Maria Maniero; Günther, Wanda Maria Risso

2016-08-18

internação e indicador de desempenho que pontua o atendimento à legislação vigente. Nas unidades estudadas, são gerados resíduos comuns (52-60%), infectantes/perfurocortantes (31-42%) e recicláveis (5-17%). As taxas médias de geração são: 0,09kg de resíduos totais/atendimento e 0,09kg de resíduos infectantes-perfurocortantes/procedimento. O atendimento à normativa, inicialmente de 26-30%, atingiu 30-38% um ano depois. o instrumento mostrou-se de fácil aplicação, contornando a existência de complexa gama de requisitos regulatórios vigentes, possibilitou identificar não conformidades, apontar medidas corretivas e avaliar o desempenho da gestão de resíduos. Nesse sentido, contribui para tomada de decisão e práticas gerenciais referentes aos resíduos, tarefas geralmente atribuídas a enfermeiros. Recomenda-se a aplicação do instrumento em unidades de saúde similares para estudos comparativos, e as adaptações necessárias para outros serviços de saúde. proponer un instrumento para facilitar el diagnóstico, elaboración y evaluación del plan de gestión de residuos en unidades básicas de salud y presentar la aplicación de los resultados en cuatro unidades seleccionadas. investigación descriptiva, cubriendo las etapas de la formulación/aplicación del instrumento propuesto y la evaluación de desempeño de la gestión de residuos en las unidades estudiadas. el instrumento está compuesto por cinco formularios; propuesta de indicadores específicos de la generación de residuos para las unidades de atención de salud sin hospitalización e indicador de desempeño que puntúa el cumplimiento de la legislación vigente. Los residuos que generan las unidades estudiadas son de tipo común (52-60%), infecciosos/punzocortantes (31-42%) y reciclables (5-17%). Las tasas promedio de generación son: total de residuos/atendimiento 0,09kg y 0,09kg de residuos infecciosos-punzocortantes/procedimiento. El cumplimiento de la normativa, inicialmente 26

A participatory approach to integrated aquifer management: The case of Guanajuato State, Mexico

NASA Astrophysics Data System (ADS)

Sandoval, Ricardo

de l'État s'est appliqué à développer une stratégie sur deux plans. Tout d'abord, des études hydrogéologiques de base et des modèles mathématiques d'écoulement et de transport de nappe ont été réalisés à partir d'un suivi d'ensemble des puits existants et d'une révision générale du contexte géologique de l'État. Ensuite, on a soutenu une structure de participation des usagers de l'eau aux actions de gestion de l'eau, à partir de la dissémination de l'information pour la mise en place de projets pilotes efficaces d'utilisation de l'eau, avec des aides financières, techniques et politiques de l'État. Simultanément, un effort coordonné en vue de l'achèvement de l'enregistrement des usagers de l'eau a été fait avec l'autorité fédérale, en même temps que d'autres mesures de soutien, telles que des programmes de formation et des campagnes de surveillance. Cet article présente une vue d'ensemble des réalisations de projets et des défis. Resumen El Estado de Guanajuato, situado en el centro de México, ocupa menos del 2% de la superficie del país. Tiene casi 17.000 pozos profundos, de los cuales se extrae cerca de 4.000 hm3/a, lo que supone un exceso de 1.000 hm3/a respecto a la recarga anual. Puesto que el agua es administrada a nivel federal en México, el gobierno del Estado afronta el reto de asegurar el desarrollo de la población sin disponer de medios formales de intervención. Dadas las limitaciones para aplicar políticas y medidas reguladoras, el programa del agua en el Estado tiene como objetivo principal la implantación de una doble estrategia. Por un lado, desarrollar estudios hidrogeológicos básicos y modelos matemáticos de flujo y transporte de los acuíferos, basándose en una campaña exhaustiva de pozos existentes y en una revisión del marco geológico del Estado. Por otro lado, promover-con soporte financiero, técnico y político-una estructura de participación de los usuarios en las acciones de gesti

"Estudio tribologico de aceros para moldes. Aplicacion al moldeo por inyeccion de polibutilentereftalato reforzado con fibra de vidrio"

NASA Astrophysics Data System (ADS)

Martinez Mateo, Isidoro Jose

fabricacion del molde, tienen una gran influencia sobre su comportamiento en servicio a lo largo de la vida util del molde. En la primera parte del presente estudio, a partir de ensayos punzon sobre disco, se ha determinado la relacion entre la resistencia al desgaste y la dureza de aceros para moldes obtenidos a partir de bloques de gran espesor, estudiando los principales mecanismos de desgaste que tienen lugar. A continuacion, con el fin de determinar el dano superficial que sufren los aceros para moldes en condiciones reales de inyeccion, se han estudiado distintos tipos de aceros utilizados comercialmente en moldes de inyeccion de polimeros y materiales compuestos, seleccionando las condiciones de operacion para determinar la variacion de la rugosidad superficial del acero en funcion del material inyectado, del numero de operaciones sucesivas de inyeccion y de la orientacion del flujo de inyeccion, mediante tecnicas de perfilometria optica y microscopia electronica de barrido. Ademas del dano superficial sufrido por el acero con el numero de piezas inyectadas, tambien se ha determinado la evolucion de la rugosidad superficial de los materiales inyectados, polibutilentereftalato (PBT) puro y materiales compuestos derivados de PBT por adicion de un 20 o un 50% en peso de fibra de vidrio. En el caso de las piezas inyectadas, se ha caracterizado su microestructura en funcion del flujo de inyeccion y de la densidad de fibra, se han determinado sus propiedades termicas y dinamico-mecanicas, asi como la variacion de la rugosidad superficial de las piezas inyectadas con el numero de operaciones de inyeccion y con la geometria de las distintas secciones de las piezas. Finalmente, se ha evaluado la resistencia a la abrasion de PBT reforzado con un 50% de fibra, en funcion del numero de piezas inyectadas y de la direccion de rayado con respecto a la orientacion del flujo de inyeccion.

Comportamiento del Helio en estrellas químicamente peculiares

NASA Astrophysics Data System (ADS)

Malaroda, S. M.; López García, Z.; Leone, F.; Catalano, F.

Las estrellas químicamente peculiares (CP) se caracterizan por tener deficiencias y sobreabundancias de algunos elementos químicos de hasta 106 veces la abundancia solar. Además presentan variaciones en las líneas espectrales. Se piensa que ello se debe a que los campos magnéticos presentes en este tipo de estrellas son principalmente dipolares, con un eje de simetría diferente del eje de rotación. La distribución de los elementos sobreabundantes y deficientes no es homogénea sobre la superficie estelar y las variaciones observadas serían una consecuencia directa de la rotación estelar. Entre los elementos con abundancia anómala se encuentra el Helio, cuyas líneas tienen intensidades que no son consistentes con una abundancia normal, que no puede ser determinada del modo usual, o sea, considerando una atmósfera con composición solar. Con el fin de determinar la abundancia de este elemento, se inició un estudio de estrellas anómalas de Helio, Hew y He strong. Además se determinarán las abundancias de otros elementos anómalos como ser el Si, Cr, Mg, Mn y Fe. Las mismas se determinan del modo tradicional, o sea: a) medida de los anchos equivalentes de las líneas de los distintos elementos analizados; b) adopción de la temperatura efectiva, gravedad y abundancia del Helio; c) cálculo del modelo de atmósfera d) comparación con las observaciones y reinicio de un proceso iterativo hasta lograr un acuerdo entre todos los parámetros analizados. Las observaciones se llevaron a cabo en el Complejo Astronómico El Leoncito. Se observaron setenta y ocho estrellas anómalas de Helio. En este momento se está procediendo a calcular las abundancias correspondientes a los distintos elementos químicos. Para ello se hace uso de los modelos de Kurucz, ATLAS9. Los cálculos NLTE de las líneas de Helio se llevan a cabo con el programa MULTI y se compararán con los realizados con el programa WIDTH9 de Kurucz (LTE), con el objeto de resaltar la importancia de

Glycemic control strategies and the occurrence of surgical site infection: a systematic review.

PubMed

Domingos, Caroline Maria Herrero; Iida, Luciana Inaba Senyer; Poveda, Vanessa de Brito

2016-01-01

ório beneficia a recuperação do paciente cirúrgico, destacando-se a atuação da equipe de enfermagem para a implantação bem-sucedida da medida.

Cost analysis of gully restoration in agricultural areas in Andalusia (Spain)

NASA Astrophysics Data System (ADS)

Castillo, Carlos; Taguas, Encarnación; Mora, Jose; Gómez, Jose Alfonso

2013-04-01

Cost optimization of soil conservation measures is essential in the agricultural sector where the farmers return of investment is usually small, and there is a high degree of uncertainty about yield. The main aims of this study are: 1) to assess the cost of check dams and revegetation measures for a wide range of situations on gully networks of Andalusia and 2) provide an estimation of the adequate budget requirements for the gully restoration at farms included in the public Incentive Program for Gully Control (IPGC) supported by the Junta de Andalucia (Spain). Firstly, a study was conducted to design the structures adapted to a wide variety of gully conditions (slope, width, height, unitary discharge) in the region of Andalusia, and check dam materials (concrete and gabions) taking into account conventional engineering stability criteria, recommendations in technical literature (Gómez et al., 2011) and principles of energy dissipation maximization (Castillo, 2012). In addition, the cost of the conservation measures was estimated by using current market prices of local resources (for interventions with farmers own means) and national construction prices list (if the works were hired to an external company). The cost of the interventions was expressed as a multivariate function of the gully characteristic by means of regression analysis to facilitate its use for budget estimation purposes. Finally, these equations were applied to the farms included in the IPGC database to provide an estimation of the adequate budget required for a successful implementation of this initiative, as well as to propose unitary indexes (i.e. cost per gully meter in the longitudinal profile or per square meter in plan view) that could serve as useful criteria for this, or future programs, to allocate resources to individual farms based on specific characteristics of the gully erosion problems they suffer. References Castillo, C. 2012. Metodología de medida de la erosión por cárcavas y

[Not Available].

PubMed

Baena González, Marta; Molina Recio, Guillermo

2016-06-30

Introducción: la disfagia es un síntoma que se refiere a la dificultad para mover el bolo alimentario desde la boca al estómago. A pesar de su relevancia y de la gravedad de sus posibles complicaciones, es poco conocida y estudiada. La prevalencia de la disfagia orofaríngea en enfermosde alzhéimer es de un 84% y puede originar complicaciones de gran trascendencia clínica como consecuencia de las alteraciones en la eficacia de la deglución, y en la seguridad de la misma.Objetivo: conocer el estado actual del conocimiento en relación al abordaje de la disfagia en enfermos de alzhéimer, localizando aquellos factores que permitan un diagnóstico precoz que facilite la prevención de complicaciones y la elección de la pauta de actuación más adecuada.Metodología: revisión sistemática. Estudios publicados entre 2005 y 2014 en inglés y castellano. Bases de datos: PubMed, Cochrane, Scopus, Elsevier, Scielo y Dialnet. Términos MeSH empleados: disfagia, dysphagia, alzheimer, modified y texture food.Resultados: el diagnóstico en los pacientes de alzhéimer se realiza mediante métodos clínicos y exploraciones complementarias como la videofluoroscopia, considerada como el estándar para el estudio de la disfagia orofaríngea, ya que permite identificar entre 1/3 y 1/4 de los pacientes que presentan aspiraciones silentes no diagnosticables clínicamente. Existen estrategias terapéuticas que incluyen cambios en el volumen y viscosidad del bolo, cambios posturales, maniobras deglutorias, procedimientos de rehabilitación y técnicas de incremento sensorial que han demostrado su eficacia, pero se trata de una labor compleja que exige un abordaje multidisciplinar para un correctodiagnóstico y tratamiento.Conclusiones: existe una escasa evidencia científica en el abordaje de la disfagia y un gran desconocimiento en cuanto a la alimentación de los enfermos de alzhéimer. Esta patología necesita una intervención multidisciplinar en la cual las medidas

Sistemas Correctores de Campo Para EL Telescopio Cassegrain IAC80

NASA Astrophysics Data System (ADS)

Galan, M. J.; Cobos, F. J.

1987-05-01

El proyecto de instrumentación de mayor importancia que ha tenido el Instituto de Astrofisica de Canarias en los últimos afios ha sido el diseflo y construcción del te1escopio IAC8O. Este requería del esfuerzo con junto en mec´nica, óptica y electrónica, lo que facilitó la estructuración y el crecimiento de los respectivos grupos de trabajo, que posteriormente se integraron en departamentos En su origen (1977), el telescopio IAC80 fue concebido como un sistema clásico tipo Cassegrain, con una razón focal F/i 1.3 para el sistema Casse grain y una razón focal F/20 para el sistema Coudé. Posteriormente, aunque se mantuvo la filosofia de que el sistema básico fuera el F/11.3, se consideró conveniente el diseño de secundarios para razones focales F/16 y F/32, y se eliminó el de F/20. Sin embargo, dada la importancia relativa que un foco estrictamente fotográfico tiene en un telescopio moderno, diseñado básicamente para fotometría fotoeléctrica y con un campo util mínimamente de 40 minutos de arco, se decídió Ilevar a cabo el diseño de un secundario F/8 con un sistema corrector de campo, pero que estuviera formado únicamente por lentes con superficies esféricas para que asl su construcción fuera posible en España ó en México. La creciente utilización de detectores bidimensionales para fines de investigación astron6mica y la viabilidad de que en un futuro cercano éstos tengan un área sensible cada vez mayor, hicieron atractiva la idea de tener diseñado un sistema corrector de campo para el foco primario (F/3), con un campo útil mínimo de un grado, y también con la limitante de que sus componentes tuvieron sólamente supérficies esféricas. Ambos diseños de los sis-temas correctores de campo se llevaron a cabo, en gran medida, como parte de un proyecto de colaboración e intercambio en el área de diseño y evaluación de sistemas ópticos.

Gastric wall changes after intragastric balloon placement: a preliminary experience.

PubMed

Périssé, Luís Gustavo Santos; Ecbc-Rj, Paulo Cézar Marques Périssé; Ribeiro, Kelson Ferreira

2016-01-01

: to evaluate the thickness of the gastric wall at the time of intra gastric balloon (IGB) placement, at the time of its withdrawal and one month after withdrawal. : fifteen morbidly obese patients underwent the introduction of IGB under general anesthesia. In all patients, there was infusion of 500ml of distilled water in the balloon for the test. Measurements of the thickness of the gastric wall were made in the antrum, body and proximal body, using a radial echoendoscope with a frequency of 12MHz and maximum zoom, and its own balloon inflated with 5ml of distilled water. : the presence of IGB led to increased wall thickness of the gastric body by expanding the muscle layer. These changes were apparently transient, since 30 days after the balloon withdrawal there was a tendency to return of the wall thickness values ​​observed before the balloon insertion. : the use of intragastric balloon for the treatment of obesity determines transient increase in the wall thickness of the gastric body caused by expanded muscle layer. avaliar a espessura da parede gástrica no momento do posicionamento do balão intragástrico (BIG), no momento de sua retirada e um mês após a retirada. quinze pacientes obesos mórbidos foram submetidos à introdução de BIG sob anestesia geral. Em todos os pacientes foi feita infusão de 500 ml de água destilada e o balão foi insuflado com 5ml de água destilada. As medidas da espessura da parede gástrica foram feitas no antro, corpo e corpo alto utilizando-se um ecoendoscópio radial com frequência de 12MHz e zoom máximo. a presença do BIG levou ao aumento da espessura da parede do corpo gástrico pelo aumento de espessura da sua camada muscular. Estas alterações são aparentemente transitórias já que após 30 dias da retirada do balão existiu uma tendência de retorno da espessura da parede aos valores observados antes do seu posicionamento. a utilização do balão intragástrico para tratamento da obesidade determina

PubMed

Valero Chávez, Francisco Javier; Luengo Pérez, Luis Miguel; Cubero Juánez, Javier

2016-09-20

Introducción: ante las nuevas implicaciones atribuidas a la vitamina D y la asociación con enfermedades tales como el cáncer, diabetes, enfermedades cardiovasculares, autoinmunes y mortalidad, no es de extrañar que se haya defendido la medición de los niveles de vitamina D en la población general. Sin embargo, no existen datos experimentales que demuestren la viabilidad y rentabilidad de la estrategia de cribado en la población y tampoco se ha comprobado la existencia de beneficios para la salud, por lo que en la actualidad solo es aconsejable la medida de 25 (OH) vitamina D en los grupos de personas de alto riesgo como indican las guías clínicas internacionales.Objetivos: analizar las peticiones de vitamina D comprobando si se adecuan a las guías clínicas.Métodos: realizamos un estudio descriptivo transversal en el Área de Salud de Badajoz (España) estudiando las peticiones de determinación de vitamina D durante 12 meses consecutivos (n = 3.907). En dicho estudio revisamos el diagnóstico de petición y la historia clínica del paciente para discriminar entre peticiones que se adecuaban a las guías clínicas y peticiones injustificadas. Por último, realizamos el estudio económico.Resultados: en nuestros resultados encontramos que casi un tercio de peticiones no se adecuaban a las guías clínicas, en patologías tales como diabetes, dislipemias e hipertensión en las que no está recomendada la medición de los niveles de vitamina D, por lo que suponía un exceso de gasto para el sistema sanitario. Gasto que se incrementa cada año, tanto es así que se ha producido un aumento en las peticiones de más del 1.000% en los últimos 6 años.Conclusiones: concluimos la necesidad de crear protocolos de petición de vitamina D que se ajusten a las guías clínicas hasta que existan más estudios experimentales sobre las nuevas implicaciones de la vitamina D y así conseguir una correcta utilización de los recursos económicos del hospital.

Analisis de Alteraciones EN la Imagen Debidas a Descolimacion de un Telescopio

NASA Astrophysics Data System (ADS)

Cobos, F. J.; Galan, M. J.

1987-05-01

Podemos considerar, en términos generales, que los espejos de un telescopio tienen una calidad óptica intrínseca, entendiendo por ésta la que se ha obtenido como resultado, fundamentalmente, de la destreza del personal del Taller Optico, que considerará terminadas las superficies ópticas cuando éstas satisfagan los requisitos de diseño y las pruebas de evaluación pertinentes. Debemos esperar que, una vez instalados los espejos en el telescopio, no se altere esta calidad de la óptica por un funcionamiento inadecuado de partes mecánicas del mismo. En los últimos años, en la medida que los problemas de infraestructuratura de nuestros Observatorios se han ido resolviendo, se ha hecho más patente la necesidad de llevar a la instrumentación existente al máximo de su potencial y parte esencial de ésta la conforman los mismos te lescopios. Mejorar la calidad óptica de las imágenes obtenidas con ellos ha hecho que sea prioritario el realizar una investigación más sistemática de sus características. Este trabajo ha tenido como objetivo primordial el usar un programa de diseño óptico, en el caso particular del telescopio UNAM212, con el fin de calcular y obtener gráficamente los diagramas de manchas de imagenes en foco y extrafocales, tanto con la óptica perfectamente alineada como descolimándola (mediante pequenos giros y descentramientos de los espejos). De esta manera, se hizo una evaluación de los efectos que estas alteraciones simuladas producirían en las imágenes focales y extra focales para así poder compararlas con las que realmente se han observado. Asimismo, se ha buscado información bibliográfica, en particular sobre los efectos de giros y descentramientos en las imágenes extrafocales, en lo que se ref iere a la falta de concentricidad de los círculos que forman la "dona" y a la distribución de intensidad luminosa en la misma. De ésta, l futuro un proceso que, haciendo uso de los detectores bidimensionales, nos permita Ilevar a

Correlação de longo alcance em sistemas binários de raios-x usando remoção de flutuações

NASA Astrophysics Data System (ADS)

Pereira, M. G.; Moret, M. A.; Zebende, G. F.; Nogueira, E., Jr.

2003-08-01

Neste trabalho é proposta uma metodologia de analise de series temporais de fontes astrofísicas, baseada no método proposto por Peng et al. (1994) e Liu et al. (1999), o qual consiste na idéia de que uma série temporal correlacionada pode ser mapeada por um processo de busca de auto-similaridades em diversas escalas de tempo n. Removendo as eventuais tendências e integrando o sinal observado, é obtida uma medida do desvio médio quadrático das flutuações do sinal integrado F(n)~na, onde a representa o fator de escala associado com a auto-similaridade da correlação de longo alcance do sinal. Baseado nos valores obtidos de a, é possível distinguir entre os casos de sinais não-correlacionados, tipo ruído branco (a = 0,5), sinal anti-persistentes (a < 0,5) e sinal persistente (a > 0,5). Usando esta metodologia, foram analisadas 129 curvas de luz de sistemas binários de raios-X, provenientes do banco de dados públicos de observações feitas pelo instrumento All Sky Monitor, a bordo do satélite Rossi X-Ray Timing Explorer (ASM-RXTE). Foram identificadas a presença de a'0,5 em mais de 90% dos sistemas estudados, implicando em dizer que as flutuações de intensidade observadas apresentam correlação de auto-similaridade, sem entretanto, indícios de apresentarem uma escala de tempo característica das flutuações de intensidade. Sistemas onde são observadas erupções (flares), apresentam sistematicamente a > 0,5, característica esta, possivelmente associada com persistência das flutuações de densidade de disco ou taxa de acréscimo de massa. Os sistemas com curvas de luz onde nao são observadas as erupções apresentam uma distribuição normal centrada em a~0,62+/-0,10. Referências ¾ Peng, C.-K., Buldyrev, S.V., Havlin, S., Simons, M., Stanley, H.E., e Goldberg, A.L., Phys. Rev. E, (49), 1685 (1994). ¾ Liu, Y., Gopikrishnan, P., Cizeau, P., Meyer, M., Peng,C.-K., e Stanley, H.E., Phys. Rev. E, (60), 1390 (1999).

Preclinical atherosclerosis at the time of pre-eclamptic pregnancy and up to 10 years postpartum: systematic review and meta-analysis.

PubMed

Milic, N M; Milin-Lazovic, J; Weissgerber, T L; Trajkovic, G; White, W M; Garovic, V D

2017-01-01

Ltd. La preeclampsia (PE) es un trastorno hipertensivo específico del embarazo que ha sido asociada con factores de riesgo cardiovascular y cambios vasculares, tales como aterosis aguda en los vasos sanguíneos de la placenta, similares a las primeras etapas de la aterosclerosis. El objetivo de este estudio fue determinar si las mujeres con PE han aumentado la carga aterosclerótica, según lo determinado por el espesor del complejo íntima-media de la arteria carótida (CIMT, por sus siglas en inglés), en comparación con las mujeres sin PE. MÉTODOS: Se realizó una revisión sistemática y un metaanálisis de estudios que reportaron el CIMT, una medida no invasiva de la aterosclerosis subclínica obtenida mediante ecografía, comparando mujeres con PE y mujeres sin ella. Solo se incluyeron estudios llevados a cabo durante el embarazo o durante la primera década después del parto, y en los que se midió el CIMT en la arteria carótida común. Se usaron las bases de datos de PubMed, EMBASE y Web of Science para identificar estudios publicados antes del 7 marzo de 2016. Dos revisores utilizaron formularios y protocolos preestablecidos para evaluar de forma independiente la elegibilidad de los estudios, a partir de los títulos y los resúmenes, y para realizar un cribado del texto completo, un resumen de los datos y una evaluación de calidad. La heterogeneidad se evaluó mediante el test estadístico I 2 . Se usó la diferencia de medias estandarizada (SMD, por sus siglas en inglés) como una medida de la magnitud del efecto. En el metaanálisis se incluyeron catorce estudios. Siete de los estudios se llevaron a cabo durante embarazos complicados por PE, 10 se realizaron hasta 10 años después del parto y tres incluyeron mediciones tomadas en ambos períodos. Las mujeres con PE tuvieron un CIMT significativamente mayor que aquellas que no la tenían, tanto en el momento del diagnóstico (SMD 1,10 (I 95%, 0,73-1,48), P <0,001) como en la primera década despu

Blood Pressure Treatment Adherence and Control after Participation in the ReHOT.

PubMed

Jesus, Nathália Silva de; Nogueira, Armando da Rocha; Pachu, Cacilda Oliveira; Luiz, Ronir Raggio; Oliveira, Glaucia Maria Moraes de

2016-11-01

órico e adesão ao tratamento. Do total de 96 pacientes reavaliados, apenas 52,1% foram identificados como tendo HAS controlada através da avaliação da MAPA e 31,3% apresentaram adesão pelo MMAS. Quando consideradas outras medidas da MAPA, verificou-se que 64,6% dos pacientes não apresentavam descenso noturno e 23% e 12,5% apresentavam efeito do avental branco e falso controle da PA, respectivamente. A escolaridade apresentou tendência a ser um fator determinante de falta de adesão (p = 0,05). O número de medicamentos e a HAS resistente (HAR) tiveram uma relação significativa com o controle da PA medida por MAPA (p = 0,009 e p = 0,001, respectivamente). A HAR teve relação significativa com o grupo G0 (sem controle e sem adesão, p = 0,012). Houve redução do controle da PA e da adesão pelo MMAS após pelo menos 6 meses de participação no ensaio clínico ReHOT.

Variations in hydraulic conductivity with scale of measurement during aquifer tests in heterogeneous, porous carbonate rocks

NASA Astrophysics Data System (ADS)

Schulze-Makuch, Dirk; Cherkauer, Douglas S.

rapport au niveau d'échelle au cours d'essais de nappe individuels, dans des roches carbonatées poreuses, hétérogènes du sud-est du Wisconsin (Etats-Unis). Les résultats obtenus indiquent que la conductivité hydraulique augmente en général au cours d'un essai individuel en même temps que le volume d'aquifère concerné augmente, et que le taux d'augmentation est le même que celui déterminé en utilisant différentes méthodes de mesures. Ainsi, le fait que la conductivité hydraulique dépende de l'échelle d'observation au cours d'essais uniques ne résulte pas de la méthode de mesure. Cette conclusion est confirmée par 22 essais de nappe sur 26 entrepris dans des unités carbonatées àécoulement poreux dominant dans l'aquifère. En revanche, cette dépendance du niveau d'échelle est probablement due aux hétérogénéités existant dans l'aquifère, conclusion confortée par une simulation. Tous les types de variations de conductivité hydraulique en fonction de l'échelle au cours d'essais de nappe peuvent être expliqués par un modèle conceptuel d'aquifère hétérogène simple constitué par des zones à forte conductivitéà l'intérieur d'une matrice à faible conductivité. Resumen Estudios previos han mostrado que la conductividad hidráulica (K) de un acuífero parece crecer con el volumen ensayado. Hasta ahora, estos estudios se han basado en la utilización de métodos distintos para la determinación de la conductividad hidráulica a cada escala de interés, lo que hace pensar en la posibilidad de que este aumento observado sea debido a la variación en el método de medida y no al cambio de escala. Este estudio analiza el valor de K en función de la escala a partir de ensayos individuales en rocas carbonatadas heterogéneas y porosas al sudeste de Wisconsin, EEUU. Los resultados de este estudio indican que la K obtenida en ensayos individuales crece generalmente al aumentar el volumen de acuífero implicado en el ensayo, y que la tasa de

Nurses' knowledge to identify early acute kidney injury.

PubMed

Nascimento, Roseli Aparecida Matheus do; Assunção, Murillo Santucci Cesar; Silva, João Manoel; Amendola, Cristina Prata; Carvalho, Taysa Martindo de; Lima, Emerson Quintino; Lobo, Suzana Margareth Ajeje

2016-01-01

To evaluate the knowledgeof nurses on early identification of acute kidney injury (AKI) in intensive care, emergency and hospitalization units. A prospective multi-center study was conducted with 216 nurses, using a questionnaire with 10 questions related to AKI prevention, diagnosis, and treatment. 57.2% of nurses were unable to identify AKI clinical manifestations, 54.6% did not have knowledge of AKI incidence in patients admitted to the ICU, 87.0% of the nurses did not know how to answer as regards the AKI mortality rate in patients admitted to the ICU, 67.1% answered incorrectly that slight increases in serum creatinine do not have an impact on mortality, 66.8% answered incorrectly to the question on AKI prevention measures, 60.4% answered correctly that loop diuretics for preventing AKI is not recommended, 77.6% answered correctly that AKI does not characterize the need for hemodialysis, and 92.5% said they had no knowledge of the Acute Kidney Injury Networkclassification. Nurses do not have enough knowledge to identify early AKI, demonstrating the importance of qualification programs in this field of knowledge. Avaliar o conhecimento do enfermeiro na identificação precoce da Injúria Renal Aguda (IRA) em Unidade de Terapia Intensiva, Unidade de Internação e Emergência. Estudo multicêntrico, prospectivo.Participaram do estudo 216 enfermeiros,por meio de questionário com 10 questões relacionadas à prevenção, ao diagnóstico e ao tratamento da IRA. 57,2% não souberam identificar as manifestações clínicas da IRA, 54,6% não têm conhecimento da incidência de IRA em pacientes internados na UTI, 87,0% dos enfermeiros não souberam responder ao índice de mortalidade de IRA em pacientes internados na UTI, 67,1% responderam incorretamente que aumentos discretos da creatinina sérica não têm impacto na mortalidade, 66,8% responderam incorretamente à questão sobre as medidas de prevenção da IRA, 60,4% acertaram quando responderam que não �

Anxiety in pregnancy: prevalence and associated factors.

PubMed

Silva, Mônica Maria de Jesus; Nogueira, Denismar Alves; Clapis, Maria José; Leite, Eliana Peres Rocha Carvalho

2017-08-28

prematuro (p=0,05), desejo materno em relação à gravidez (p=0,01), número de abortamentos (p=0,02), quantidade de cigarros consumidos diariamente (p=0,00) e uso de drogas (p=0,01) apresentaram associação estatisticamente significativa com a ocorrência da ansiedade na gravidez. A ansiedade se mostrou frequente na gestação. O conhecimento dos fatores associados a sua ocorrência oportuniza a elaboração de medidas preventivas na assistência pré-natal.

PATHOPHYSIOLOGY, DIAGNOSIS AND TREATMENTOF DUMPING SYNDROME AND ITS RELATION TO BARIATRIC SURGERY.

PubMed

Chaves, Yasmin da Silva; Destefani, Afrânio Côgo

ém pode ocasionar-se como consequência de danos no nervo vago. Seu diagnóstico é realizado primordialmente através da aplicação de questionários baseados em pontuações. O escore de Sigstad e questionário de Arts são meios válidos para avaliação da síndrome de dumping. A terapia inicial consiste na adoção de medidas dietéticas, ou fármacos administráveis de ação curta.

Nursing outcome "Severity of infection": conceptual definitions for indicators related to respiratory problems.

PubMed

Rodríguez-Acelas, Alba Luz; Reich, Rejane; de Abreu Almeida, Miriam; Oliveira Crossetti, Maria da Graça; de Fátima Lucena, Amália

2016-04-01

ção: expectoração purulenta, febre, hipotermia, instabilidade da temperatura, dor, colonização em cultura de expectoração, elevação na contagem das células brancas e depressão na contagem das células brancas. Conclusão. O estudo contribuiu para a compreensão dos termos utilizados no resultado enfermagem Gravidade de Infecção, de modo a aperfeiçoar e facilitar o uso da NOC, à medida que apresenta refinamento do ponto de vista conceitual dos indicadores selecionados, de modo a produzir melhores evidências científicas.

Evaluating pharmaceutical waste disposal in pediatric units.

PubMed

Almeida, Maria Angélica Randoli de; Wilson, Ana Maria Miranda Martins; Peterlini, Maria Angélica Sorgini

2016-01-01

saco amarelo (30,8%), ralo da pia (28,9%), caixa de perfurocortante com saco laranja (14,3%) e lixeira infectante com saco branco (10,1%). Não foi identificado descarte após a administração dos fármacos. Faz-se necessária a discussão de medidas que contribuam para a redução do volume de resíduos, com o intuito de engajar a atuação reflexiva da equipe e o descarte adequado.

EDITORIAL: Optical Fibre Sensors 18 (OFS-18)

NASA Astrophysics Data System (ADS)

Jones, Julian D. C.; Tatam, Ralph P.

2007-10-01

The International Conference on Optical Fibre Sensors (OFS-18) was held in October 2006 in Cancún, Mexico, under the general chairmanship of Dr Alexis Mendez (MCH Engineering LLC, USA) and Dr Fernando Mendoza (Centro de Investigaciones en Optica, Mexico). 'OFS', as it has become known, is firmly established as the leading international conference for the optical fibre sensor community. Since its inception, in London in 1983, and under the leadership of an international steering committee independent of any learned society or professional institution, it has been held approximately every eighteen months. The venue nominally rotates from Europe, to the Americas, and thence to Asia and the Pacific. OFS-18 demonstrated the continuing vigour of the community, with some 250 papers presented, plus two workshops, with attendance as international as ever. In recent years, it has become a tradition to publish a post-conference special issue in the journal Measurement Science and Technology, and these special issues offer a representative sample of the current status of the field. In the nearly 25 years since OFS began, many of the early ideas and laboratory-based proof-of-principle experiments have led to highly developed instrumentation systems, and to successful commercial products. Perhaps the most mature of all of these technologies is the optical fibre gyroscope, with the fibre hydrophone a close second—originally developed for defence applications for which it is now established, but with increasing relevance to the oil and gas industry; electromagnetic sensors based on the Faraday and electro-optic effects are of growing significance in the power generation and distribution industry; whilst in-fibre grating-based sensors occupy an expanding niche in structural monitoring, especially in civil engineering. It is therefore appropriate that the first day of OFS was devoted to workshops on structural health monitoring, and to commemorate the 30th anniversary of the

Reframing HIV care: putting people at the centre of antiretroviral delivery

PubMed Central

Duncombe, Chris; Rosenblum, Scott; Hellmann, Nicholas; Holmes, Charles; Wilkinson, Lynne; Biot, Marc; Bygrave, Helen; Hoos, David; Garnett, Geoff

2015-01-01

érisée par quatre éléments de délivrance: (1) les types de services délivrés, (2) l’emplacement de la délivrance des services, (3) Les prestataires des services de santé et (4) la fréquence des services de santé. La façon dont ces éléments sont développés dans un cadre de prestation de services peut varier selon les pays et les populations, l’intention étant d’améliorer les résultats d’acceptabilité et des soins. Le but d’obtenir plus de personnes sous traitement avant qu’ils ne tombent malades nécessitera des modèles innovateurs de prestation à la fois pour dépistage et pour les soins. Comme les programmes VIH étendent l’éligibilité au traitement, beaucoup de gens qui entrent dans les soins ne seront pas des “malades- mais des éléments sains de la société, actifs et productifs. Afin de tenir le cadre à l’échelle, il sera important de: (1) définir les individus qui peuvent être traités par un cadre alternatif de prestation, (2) renforcer les systèmes de santé qui soutiennent la décentralisation, l’intégration et le transfert des tâches; (3) rendre la chaîne d’approvisionnement plus robuste et (4) investir dans des systèmes de données pour le suivi des patients et pour le suivi et l’évaluation du programme. Los servicios de atención del VIH durante el inicio de la primera etapa de rápida expansión del tratamiento y cuidados del VIH estaban basados en modelos clínicos existentes, comunes en lugares con abundancia de recursos y poco diferenciados en cuanto a necesidades individuales. Aquí se propone un nuevo marco para el tratamiento basado en intensidades variables de cuidados, hecho a medida según las necesidades específicas de los diferentes grupos de individuos a lo largo del tratamiento. La intensidad del servicio se caracteriza por cuatro componentes de entrega: (1) tipología de los servicios ofrecidos, (2) lugar de entrega de los servicios, (3) proveedor de los servicios sanitarios, y (4

Canada-United States-Mexico Trilateral Cooperation on Childhood Obesity Initiative.

PubMed

Rabadán-Diehl, Cristina; Safdie, Margarita; Rodin, Rachel

2016-08-01

exigen la formación de alianzas multisectoriales. Aprovechando las bases sentadas por una larga tradición de colaboración trilateral, el Canadá, los Estados Unidos y México formaron una alianza para controlar la epidemia creciente de obesidad infantil en la subregión norteamericana. Esta iniciativa colaborativa, que se conoce por Iniciativa de Cooperación Trilateral contra la Obesidad Infantil, es la primera iniciativa en la Región en tratar de hacer frente al problema de las enfermedades crónicas no transmisibles convocando a un grupo de expertos técnicos y de expertos en asuntos normativos, con el liderazgo y respaldo de los secretarios y ministros de salud de los países implicados. La Iniciativa tiene por objetivos aumentar los niveles de actividad física y reducir el sedentarismo mediante a) una mayor movilización social y participación ciudadana, b) medidas de extensión comunitaria y c) modificaciones de las zonas edificadas (construidas por el hombre). En el presente artículo se describen los antecedentes de la Iniciativa y su creación; las metas, actividades y medidas específicas que ha habido hasta ahora; y las oportunidades y los pasos que hay que dar en lo sucesivo. Esta información podría resultar útil para quienes estén formando otras alianzas encaminadas a controlar la obesidad infantil u otros problemas de salud pública complejos en la Región. RÉSUMÉ L'obésité de l'enfant est un problème de santé publique important dans les pays des Amériques. En 2014, les États Membres de l'Organisation Panaméricaine de la Santé (OPS) ont approuvé un Plan d'action pour la prévention de l'obésité chez les enfants et les adolescents pour combattre la prévalence de ce trouble dans la Région des Amériques. Les interventions énoncées dans ce plan régional sont multidimensionnelles et nécessitent des partenariats multisectoriels. S'appuyant sur une riche histoire de collaboration trilatérale fructueuse, le Canada, les États-Unis et

Characterisation of the hydrogeology of the Augustus River catchment, Western Australia

NASA Astrophysics Data System (ADS)

Wilkes, Shane M.; Clement, T. Prabhakar; Otto, Claus J.

acuíferos en rocas fracturadas dentro de la roca fresca. Los registros geofísicos aéreos y datos de las perforaciones han identificado un gran número de diques de dolerita que intersectan el emplazamiento. Se ha hallado venas de cuarzo fracturado a lo largo de los márgenes de los diques de dolerita. Medidas detalladas del nivel piezométrico y estimaciones de la eficiencia barométrica indican que los diques de dolerita y las venas de cuarzo fracturado afectan las direcciones del flujo de las aguas subterráneas, originando una fuerte conexión hidráulica entre todos los acuíferos e influenciando también a los mecanismos de recarga. Se ha establecido la importancia hidrogeológica de los diques de dolerita y de las venas de cuarzo fracturado mediante una combinación de medidas muy frecuentes del nivel piezométrico (cada 30 min), de la precipitación (cada 5 min) y de las fluctuaciones de la presión barométrica (cada 30 min). Se ha desarrollado un modelo conceptual para describir varias características hidrogeológicas del área de estudio. El modelo indica que las venas de cuarzo fracturado en los márgenes de los diques de dolerita constituyen un componente importante de la hidrogeología de cuencas con rocas meteorizadas.

Defining the Impact of Non-Native Species

PubMed Central

Jeschke, Jonathan M; Bacher, Sven; Blackburn, Tim M; Dick, Jaimie T A; Essl, Franz; Evans, Thomas; Gaertner, Mirijam; Hulme, Philip E; Kühn, Ingolf; Mrugała, Agata; Pergl, Jan; Pyšek, Petr; Rabitsch, Wolfgang; Ricciardi, Anthony; Richardson, David M; Sendek, Agnieszka; VilÀ, Montserrat; Winter, Marten; Kumschick, Sabrina

2014-01-01

ecosistemas causados por especies no-nativas; ayudar a entender cuáles aspectos de los debates científicos sobre especies no-nativas son debidos a definiciones diversas y cuáles representan un verdadero desacuerdo científico; y mejorar la comunicación entre científicos de diferentes disciplinas y entre científicos, administradores y quienes hacen las políticas. Por estas razones y basándonos en ejemplos tomados de la literatura, concebimos siete preguntas clave que caen en cuatro categorías: direccionalidad, clasificación y medida, cambios ecológicos o socio-económicos, y escala. Estas preguntas deberían ayudar en la formulación de definiciones claras y prácticas del impacto para encajar mejor con contextos científicos, de las partes interesadas o legislativos específicos. PMID:24779412

Mating opportunities in Sangalopsis veliterna females: Costs and benefits

PubMed Central

Hernández Duran, Linda C.; Fajardo Medina, Gonzalo E.; Fuentes Quinter, Luz S.; Martin, Oliver

2014-01-01

apareamiento. En este estudio, el efecto de la disponibilidad continua de diferente número de machos (1, 2, 4, 8) sobre la frecuencia de apareamiento de las hembras y los componentes del potencial reproductivo (fitness) fueron estimados al comparar el número de espermatóforos hallados en la bursa copulatrix (un estimado del número de copulas, pero no del número de machos involucrados en estas copulas), la longevidad de las hembras, número de huevos colocados (fecundidad) y proporción de huevos fecundados (fertilidad) en la polilla Sangalopsis veliterna Druce (Lepidóptera: Geometridae). Los resultados indican que no existen diferencias en la fertilidad ni en la fecundidad; sin embargo la longevidad aumentó a medida que se las hembras presentaron más de una cópula y de igual manera en algunos casos la fecundidad aumentó con varios apareamientos. PMID:25205137

Properties of self-assembled diluted magnetic semiconductor nanostructures =

NASA Astrophysics Data System (ADS)

Ankiewicz, Amelia Olga Goncalves

Este trabalho centra-se na investigacao da possibilidade de se conseguir um semicondutor magnetico diluido (SMD) baseado em ZnO. Foi levado a cabo um estudo detalhado das propriedades magneticas e estruturais de estruturas de ZnO, nomeadamente nanofios (NFs), nanocristais (NCs) e filmes finos, dopadas com metais de transicao (MTs). Foram usadas varias tecnicas experimentais para caracterizar estas estruturas, designadamente difraccao de raios-X, microscopia electronica de varrimento, ressonancia magnetica, SQUID, e medidas de transporte. Foram incorporados substitucionalmente nos sitios do Zn ioes de Mn2+ e Co2+ em ambos os NFs e NCs de ZnO. Revelou-se para ambos os ioes dopantes, que a incorporacao e heterogenea, uma vez que parte do sinal de ressonancia paramagnetica electronica (RPE) vem de ioes de MTs em ambientes distorcidos ou enriquecidos com MTs. A partir das intensidades relativas dos espectros de RPE e de modificacoes da superficie, demonstra-se ainda que os NCs exibem uma estrutura core-shell. Os resultados, evidenciam que, com o aumento da concentracao de MTs, a dimensao dos NCs diminui e aumentam as distorcoes da rede. Finalmente, no caso dos NCs dopados com Mn, obteve-se o resultado singular de que a espessura da shell e da ordem de 0.3 nm e de que existe uma acumulacao de Mn na mesma. Com o objectivo de esclarecer o papel dos portadores de carga na medicao das interaccoes ferromagneticas, foram co-dopados filmes de ZnO com Mn e Al ou com Co e Al. Os filmes dopados com Mn, revelaram-se simplesmente paramagneticos, com os ioes de Mn substitucionais nos sitios do Zn. Por outro lado, os filmes dopados com Co exibem ferromagnetismo fraco nao intrinseco, provavelmente devido a decomposicao spinodal. Foram ainda efectuados estudos comparativos com filmes de ligas de Zn1-xFexO. Como era de esperar, detectaram-se segundas fases de espinela e de oxido de ferro nestas ligas; todas as amostras exibiam curvas de histerese a 300 K. Estes resultados suportam a

Variabilidad de la Estación de Crecimiento en la Región Sur de Tamaulipas en condiciones climaticas actuales y futuras.

NASA Astrophysics Data System (ADS)

Medina-Barrios, M.; Conde-Alvarez, C.; Gay-Garcia, C.

2007-05-01

resultados serán utilizados por los administradores de las decisiones locales, para estrategias de manejo y para la difusión entre los habitantes, de tal manera que esto les permita establecer prioridades en las medidas de mitigación, y formular las posibilidades de adaptación.

Aging as a predictor of nursing workload in Intensive Care Unit: results from a Brazilian Sample.

PubMed

Ferretti-Rebustini, Renata Eloah de Lucena; Nogueira, Lilia de Souza; Silva, Rita de Cassia Gengo E; Poveda, Vanessa de Brito; Machado, Selma Pinheiro; Oliveira, Elaine Machado de; Andolhe, Rafaela; Padilha, Katia Grillo

2017-04-03

Verify if aging is an independent predictor of NW in ICU, according to age groups, and its predictive value as a determinant of NW in ICU. Study was conducted from 2012 to 2016. A convenience sample composed by patients (age ≥ 18) admitted to nine ICU belonging to a Brazilian hospital, was analyzed. Age was assumed as an independent variable and NW (measured by the Nursing Activities Score - NAS) as dependent. Linear regression model and ROC curve were used for the analysis. 890 participants (361 older people), mostly males (58.1%). The mean NAS score was higher among older participants in comparison to adults (p=0.004) but not within categories of aging (p=0.697). Age was responsible for 0.6% of NAS score. Each year of age increases NAS score in 0.081 points (p=0.015). However, age was not a good predictor of NAS score (AUC = 0.394; p=0.320). The care of older people in ICU is associated with an increase in NW, compared to adults. Aging can be considered an associated factor but not a good predictor of NW in ICU. Verificar si el envejecimiento es un predictor independiente de la Carga de Trabajo de Enfermería (CTE) en la Unidad de Cuidados Intensivos (UCI), según grupos etarios y su valor predictivo como determinante de la CTE en la UCI. Se analizó una muestra de conveniencia compuesta por pacientes (edad ≥ 18) ingresados en nueve UCI pertenecientes a un hospital brasileño. La edad se asumió como variable independiente y como variable dependiente la carga de trabajo de enfermería -medida por el sistema Nursing Activities Score (NAS) de puntuación de actividades de enfermería. Para el análisis, se utilizaron el modelo de regresión lineal y la curva ROC. 890 participantes (361 adultos mayores), en su mayoría varones (58,1%). La puntuación NAS promedio fue mayor entre los participantes adultos mayores en comparación con los adultos (p=0,004), pero no en las categorías de envejecimiento (p=0,697). La edad fue responsable del 0,6% de la puntuaci

Percepção astronómica de um grupo de alunos do ensino médio de uma escola da rede estadual de São Paulo

NASA Astrophysics Data System (ADS)

de Oliveria, E. F.; Voelzke, M. R.

2009-03-01

Sendo a Astronomia uma das cièncias mais antigas da humanidade, e considerando sua importáncia histórica e cultural, é de extrema releváncia que tópicos relacionados a ela sejam tratados nas escolas. Embora os Parámetros Curriculares Nacionais do Ensino Médio (PCN-EM) e as Orientaçiacute;es Complementares aos Parámetros (PCN+) apontem a importáncia de uma abordagem significativa de conceitos relacionados à Astronomia nas aulas de Física, muitos estudantes terminam o Ensino Médio (EM) sem compreender a razão de certos acontecimentos de origem celeste, ainda que estes façam parte de seu cotidiano e sejam alvos da curiosidade natural dos jovens. Da observação dessa curiosidade em alunos de uma escola pública paulista, na cidade de Suzano, surgiu o interesse em investigar os conhecimentos básicos em Astronomia dos alunos do Ensino Médio desta escola, constituindo-se este como principal objetivo desta pesquisa. Para tanto foi elaborado um questionário de múltipla escolha aplicado inicialmente a 34 alunos do primeiro ano e, posteriormente, a mais 310, distribuídos entre as très séries do Ensino Médio dos períodos matutino e noturno. Dessa forma, observou-se que 73,9% dos estudantes identificaram o Sol como sendo uma estrela, 67,1% mostraram compreender a sucessão entre dia e noite e 52,3% relacionaram o Big Bang à origem do Universo. Em contrapartida, apenas 34,5% relacionaram as estaçíes do ano à inclinação do eixo de rotação da Terra, 21,3% indicaram a influència gravitacional simultánea da Lua e do Sol como responsável pelo fenòmeno das marés, 24,5% indicaram corretamente quais são os objetos celestes mais próximos da Terra, 36,1% identificaram ano-luz como uma medida de distáncia e 34,2% reconheceram as estrelas cadentes como meteoros, evidenciando-se assim o pequeno discernimento dos estudantes quanto aos fenòmenos e termos astronòmicos do cotidiano. Além disso, foram comparadas as respostas de alun! os de diferentes s

Mechanical behaviour of AlSiC nano composites produced by ball milling and spark plasma sintering =

NASA Astrophysics Data System (ADS)

Buchheim, Claudia Sofia de Andrade Redondo Murilhas

Neste trabalho foram produzidos nanocompositos de AlSiC misturando aluminio puro com nano particulas de SiC com diâmetro de 45 - 55 nm, usando, de forma sequencial, a tecnica da metalurgia do po e a compactacao por "Spark Plasma Sintering". O composito obtido apresentava graos com 100 nm de diâmetro, encontrandose as particulas de SiC localizadas, principalmente, nas fronteiras de grao. O nanocomposito sob a forma de provetes cilindricos foi submetido a testes de compressao uniaxial e a testes de nanoindentacao para analisar a influencia das nanoparticulas de SiC, da fracao volumica de acido estearico e do tempo de moagem, nas propriedades mecânicas do material. Para efeitos de comparacao, utilizouse o comportamento mecânico do Al puro processado em condicoes similares e da liga de aluminio AA1050O. A tensao limite de elasticidade do nanocomposito com 1% Vol./Vol. de SiC e dez vezes superior a do AA1050. O refinamento de grao a escala nano constitui o principal mecanismo de aumento de resistencia mecânica. Na realidade, o Al nanocristalino sem reforco de particulas de SiC, apresenta uma tensao limite de elasticidade sete vezes superior a da liga AA1050O. A adicao de 0,5 % Vol./Vol. e de 1 % Vol./Vol. de SiC conduzem, respetivamente, ao aumento da tensao limite de elasticidade em 47 % e 50%. O aumento do tempo de moagem e a adicao de acido estearico ao po durante a moagem conduzem apenas a um pequeno aumento da tensao de escoamento. A dureza do material medida atraves de testes de nanoindentacao confirmaram os dados anteriores. A estabilidade das microestruturas do aluminio puro e do nanocomposito AlSiC, foi testada atraves de recozimento de restauracao realizado as temperaturas de 150 °C e 250 °C durante 2 horas. Aparentemente, o tratamento termico nao influenciou as propriedades mecânicas dos materiais, excepto do nanocomposito com 1 % Vol./Vol. de SiC restaurado a temperatura de 250 °C, para o qual se observou uma reducao da tensao limite de elasticidade

Diagnóstico y cinética de plasmas de NxOy y aire a baja presión. Aplicaciones atmosféricas

NASA Astrophysics Data System (ADS)

Tanarro Onrubia, Isabel

Los procesos cinéticos que tienen lugar en plasmas de óxidos de nitrógeno y de aire presentan relevancia en diferentes campos de investigación como son los relativos al control de contaminantes atmosféricos emitidos en procesos de combustión, a su formación en las superficies de las naves supersónicas y los vehículos espaciales al entrar en la atmósfera, o a su presencia en la ionosfera terrestre. En general, los fenómenos que tienen lugar en sistemas tan alejados del equilibrio termodinámico como los plasmas luminiscentes, son capaces de originar determinadas especies intermedias y productos finales de reacción a temperaturas y presiones mucho menores que las de otros procedimientos físico-químicos; y hacen posible reproducir y caracterizar en laboratorio ciertas especies inestables y mecanismos primordiales de la alta atmósfera. Por otra parte, las técnicas de resolución temporal aplicadas a plasmas modulados en amplitud resultan notablemente más sensibles que las medidas estacionarias para estimar la relevancia de los distintos mecanismos elementales o incluso para determinar sus constantes de velocidad. En este trabajo se presenta un estudio espectroscópico y espectrométrico comparativo de plasmas de óxidos de nitrógeno y de aire a baja presión (0.001-1 mbar) generados en descargas de cátodo hueco continuas o moduladas, y se propone un modelo cinético único y relativamente sencillo, que explica satisfactoriamente los comportamientos observados en todos ellos. Dicho modelo se basa en la resolución de un sistema de ecuaciones diferenciales dependientes del tiempo, que incluye los mecanismos elementales de disociación e ionización de los precursores y los productos, reacciones homogéneas entre especies atómicas, iónicas y moleculares, y reacciones heterogéneas. Al abordar estos sistemas, se constata una gran carencia de datos experimentales o teóricos sobre secciones eficaces o constantes de velocidad para las reacciones de

Smoking control: challenges and achievements.

PubMed

Silva, Luiz Carlos Corrêa da; Araújo, Alberto José de; Queiroz, Ângela Maria Dias de; Sales, Maria da Penha Uchoa; Castellano, Maria Vera Cruz de Oliveira

2016-01-01

muito promissor para atuar junto a seus pacientes e a população em geral. É preciso atuar com maior ímpeto em prol das políticas de saúde e das normas de convívio social que contribuem diretamente para melhorar a saúde e a vida. Nesse aspecto, os pneumologistas podem ter um papel de maior destaque na medida em que se envolvam com o tratamento dos fumantes, a aplicação da lei antifumo e as políticas de saúde relacionadas às doenças respiratórias.

Content validity of the Geriatric Health Assessment Instrument.

PubMed

Pedreira, Rhaine Borges Santos; Rocha, Saulo Vasconcelos; Santos, Clarice Alves Dos; Vasconcelos, Lélia Renata Carneiro; Reis, Martha Cerqueira

2016-01-01

Assess the content validity of the Elderly Health Assessment Tool with low education. The data collection instrument/questionnaire was prepared and submitted to an expert panel comprising four healthcare professionals experienced in research on epidemiology of aging. The experts were allowed to suggest item inclusion/exclusion and were asked to rate the ability of individual items in questionnaire blocks to encompass target dimensions as "not valid", "somewhat valid" or "valid", using an interval scale. Percent agreement and the Content Validity Index were used as measurements of inter-rater agreement; the minimum acceptable inter-rater agreement was set at 80%. The mean instrument percent agreement rate was 86%, ranging from 63 to 99%, and from 50 to 100% between and within blocks respectively. The Mean Content Validity Index score was 93.47%, ranging from 50 to 100% between individual items. The instrument showed acceptable psychometric properties for application in geriatric populations with low levels of education. It enabled identifying diseases and assisted in choice of strategies related to health of the elderly. Avaliar a validade de conteúdo do Instrumento de Avaliação da Saúde do Idoso com baixa escolaridade. Após a elaboração do instrumento de coleta de dados, o questionário foi submetido à avaliação de um comitê de especialistas, formado por quatro profissionais da área da saúde com experiência em pesquisas da epidemiologia do envelhecimento. Os especialistas puderam sugerir questões a serem incluídas/excluídas do instrumento, e avaliar cada bloco do questionário, observando se as dimensões a serem avaliadas foram abrangidas pelos itens do instrumento, em escala intervalar, como "não válida", "pouco válida" e "válida". Como medidas para avaliar o grau de concordância do instrumento, foram utilizados o porcentual de concordância e o Índice de Validade de Conteúdo. Considerou-se uma taxa aceitável de concordância o valor de

Measurement of the angular distribution of the electron from W → e = v decay, in p$$\\bar{p}$$ at √s = 1.8 TeV, as function of P$$T\\atop{W}$$; Medida de la distribucion angular del electron de W en e + neutrino en p$$\\bar{p}$$ a 1.8 TeV (in English;Spanish)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ramos, Manuel I. Martin

1996-10-07

The goal of this work was to study the behavior of the angular distribution of the electron form the decay of the W boson in a specific rest-frame of the W, the Collins-Soper frame. This thesis consists of four major divisions, each dealing with closely related themes: (a) Physics Background, (b) Description of the Hardware and General Software Tools, (c) Description of the Analysis and Specific Tools, and (d) Results and Conclusions. Each division is comprised of one or more chapters and each chapter is divided into sections and subsections.

Strategies for improving outcome of assisted reproduction in women with polycystic ovary syndrome: systematic review and meta-analysis.

PubMed

Kollmann, M; Martins, W P; Lima, M L S; Craciunas, L; Nastri, C O; Richardson, A; Raine-Fenning, N

2016-12-01

they reduce the incidence of OHSS without interfering with clinical pregnancy and live birth for women with PCOS. Additionally there is low-quality evidence pointing to a benefit of metformin supplementation on clinical pregnancy and live birth; and that ovulation induction and administration of estradiol seem to be equally effective for endometrial preparation before FET for women with PCOS. For all other interventions, the evidence is of very low quality, not allowing any meaningful conclusions to be drawn. Estrategias para mejorar el resultado de la reproducción asistida en mujeres con síndrome de ovario poliquístico: revisión sistemática y metaanálisis RESUMEN OBJETIVOS: Identificar, evaluar y resumir la evidencia actual sobre la eficacia de las estrategias para mejorar las técnicas de reproducción asistida en mujeres con síndrome de ovario poliquístico (SOP). MÉTODOS: Se realizó una búsqueda exhaustiva de literatura en las bases de datos médicas estándar. La última búsqueda electrónica se realizó en julio de 2015. Las medidas de resultado primarias fueron los nacimientos vivos/embarazos en curso y el síndrome de hiperestimulación ovárica (SHO). Las medidas de resultado secundarias fueron el embarazo confirmado ecográficamente y el aborto. Se cribaron 1021 registros, de los que se evaluaron por completo 173, para finalmente incluir 66 estudios en el análisis cuantitativo. Aunque se evaluaron muchas intervenciones diferentes, en general la calidad de los estudios fue baja. Se observó evidencia de calidad moderada de que no hay diferencias relevantes clínicamente en las tasas de nacimientos vivos/embarazos en curso (riesgo relativo (RR): 0,95 (IC 95%, 0,84-1,08)), o de embarazos confirmados ecográficamente (RR: 1,02 (IC 95%, 0,91-1,15)), cuando se comparan los protocolos de antagonistas y agonistas para la estimulación ovárica. Además, se encontró evidencia de baja calidad en que la metformina mejora las tasas de nacimientos vivos

Mixing against culture vs mixing against nature: ontologization of prohibited interethnic relationships.

PubMed

Roncarati, Alessandra; Pérez, Juan A; Ravenna, Marcella; Navarro-Pertusa, Esperanza

2009-02-01

ón consiste en la separación de algunos seres humanos de sus propias especies y en la reubicación de estos en otro medio ambiente, por ejemplo el de un animal. Nosotros suponemos basados en el famoso eslogan "igual pero diferente" que la representación social de una mixtura interracial es un fenómeno "antinatural". Se ha observado que relaciones sexuales entre personas de "razas" diferentes conllevan a un elevado nivel de ontologización. Desde una perspectiva biologista se explica esta mezcla racial en términos de un instinto natural o de impulsos animales ancestrales. En un experimento (N =  360) se presenta el caso de una mujer, que a pesar de estar en una relación estable, no es fiel a su pareja. En un dieseño con 2×3 factores se manipuló la identidad étnica-nacional de esta mujer (intragrupo español/italiano vs. exogrupo senegalés) y la identidad étnica-nacional de sus amantes (intragrupo español/italiano vs. exogrupo rumano vs. exogrupo senegalés). En general los resultados apoyan más claramente la hipótesis de la ontologización en condiciones interraciales, que la acostumbrada hipótesis relacionada con sesgos de favoritismo hacia el intragrupo y/o de discriminación hacia el exogrupo. Posteriormente se discutió en que medida un aproximación de tipo biologista posibilita una diferenciación a nivel humano, en términos de grupos culturales y grupos naturales, en "razas", de tal medida que relaciones sexuales interraciales son vistas como evidencia de un impulso salvaje e incontrolable, el cual estigmatiza a las personas envueltas en estas relaciones.

Cross-cultural adaptation and validation of the teamwork climate scale.

PubMed

Silva, Mariana Charantola; Peduzzi, Marina; Sangaleti, Carine Teles; Silva, Dirceu da; Agreli, Heloise Fernandes; West, Michael A; Anderson, Neil R

2016-08-22

To adapt and validate the Team Climate Inventory scale, of teamwork climate measurement, for the Portuguese language, in the context of primary health care in Brazil. Methodological study with quantitative approach of cross-cultural adaptation (translation, back-translation, synthesis, expert committee, and pretest) and validation with 497 employees from 72 teams of the Family Health Strategy in the city of Campinas, SP, Southeastern Brazil. We verified reliability by the Cronbach's alpha, construct validity by the confirmatory factor analysis with SmartPLS software, and correlation by the job satisfaction scale. We problematized the overlap of items 9, 11, and 12 of the "participation in the team" factor and the "team goals" factor regarding its definition. The validation showed no overlapping of items and the reliability ranged from 0.92 to 0.93. The confirmatory factor analysis indicated suitability of the proposed model with distribution of the 38 items in the four factors. The correlation between teamwork climate and job satisfaction was significant. The version of the scale in Brazilian Portuguese was validated and can be used in the context of primary health care in the Country, constituting an adequate tool for the assessment and diagnosis of teamwork. Adaptar e validar a escala Team Climate Invetory, de medida do clima de trabalho em equipe, para o idioma português, no contexto da atenção primária à saúde no Brasil. Estudo metodológico com abordagem quantitativa de adaptação transcultural (tradução, retrotradução, síntese, comitê de especialistas e pré-teste) e validação com 497 trabalhadores de 72 equipes da Estratégia Saúde da Família no município de Campinas, São Paulo. Verificou-se confiabilidade pelo alfa de Cronbach, validade de construto pela análise fatorial confirmatória pelo software SmartPLS e correlação com escala de satisfação no trabalho. Foi problematizado a sobreposição dos itens 9, 11 e 12 do fator participa

Is the Dark Side of the Moon Ever Illuminated by the Sun? (Breton Title: O Lado Escuro da Lua Nunca Apanha Sol?) El Lado Oscuro de la Luna Nunca Toma Sol?

NASA Astrophysics Data System (ADS)

Giovannini, Odilon; Pellenz, Daiana; Catelli, Francisco

2014-07-01

y los elementos básicos que componen una "respuesta correcta". Estas cuestiones se tratan inicialmente a partir de una revisión bibliográfica de la investigación en el área; seguidamente, y también sobre la base de ésta revisión, se propone un modelo didáctico que ejemplifica los movimientos relativos del sistema Tierra - Luna - Sol. Se describe a continuación una aplicación de este modelo en un entorno de aprendizaje con alumnos del ciclo primario. Los conceptos iniciales presentados en la literatura se confirman y las cuestiones planteadas por los estudiantes durante la implementación del modelo proporcionan evidencia de que se ha producido un aprendizaje significativo, al menos en cierta medida.

Background noise analysis in urban airport surroundings of Brazilian cities, Congonhas Airport, São Paulo.

PubMed

Scatolini, Fabio; Alves, Cláudio Jorge Pinto

2016-12-22

Exposure Level (SEL). Os parâmetros estatísticos foram calculados em intervalos de uma hora. Apenas quatro dos 15 locais avaliados apresentaram clara contribuição da operação de aeronaves no incômodo. Mesmo assim, é possível identificar ruído de fundo acima do regulamentar durante os períodos de baixa atividade ou de fechamento do aeroporto durante a noite. Todos os locais avaliados apresentaram ruído de fundo acima do regulamentar entre 7:00h e 21:00h. Nos intervalos entre 6:00h-6:59h e 21:00h-22:59h, os dados de monitoramento, quando analisados em conjunto com as atuais características operacionais do aeroporto, ainda possibilitam a elaboração de medidas mitigadoras adicionais.

PSYCHOLOGICAL PROFILE OF PATIENTS ELIGIBLE FOR BARIATRIC SURGERY.

PubMed

Ribeiro, Graziela Aparecida Nogueira de Almeida; Giampietro, Helenice Brizolla; Belarmino, Lídia Barbieri; Salgado-Júnior, Wilson

The psychologist who works in bariatric surgery has a role to receive, evaluate, prepare and educate the patient who will undergo the surgical procedure. Psychological evaluation becomes important in so far as allows us to obtain data on personal and familiar history and allow tracing of possible psychopathology. To collect data on psychological evaluations of patients in a bariatric surgery service of a public hospital in order to describe the psychological profile of patients in this service. Data were collected from 827 patients between 2001 and 2015, using data from an interview, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and Binge Eating Scale (BES). The mean age of patients before surgery was 39 years+/- 10, the mean BMI was 51 kg/m²+7, and most patients (81%) were female. The average score on the BDI was 14.8+8 and women had significantly higher scores than men. On the BAI the average score was 11+8 and on the ECAP was 14+8, both with no difference between groups. Psychosocial characteristics of the patients points to the significant presence of indicators of depression, with low levels of anxiety and binge eating. O psicólogo que atua na área da cirurgia bariátrica tem papel de acolher, avaliar, preparar e conscientizar o paciente que vai ser submetido ao procedimento cirúrgico. A avaliação psicológica reveste-se de importância na medida em que obtém dados sobre história pessoal e familiar, além do rastreio de possíveis alterações psicopatológicas. Analisar as avaliações psicológicas dos pacientes de um serviço de cirurgia bariátrica de um hospital público, buscando traçar o perfil psicológico dos pacientes deste serviço. Foram coletados dados de 827 pacientes entre 2001 e 2015, utilizando-se dados de uma entrevista, Inventário Beck de Depressão (BDI), Inventário Beck de Ansiedade (BAI) e Escala de Compulsão Alimentar Periódica (ECAP). A idade média dos pacientes antes da operação foi 39 anos+10 e o IMC m

Quality control method to measure predator evasion in wild and mass-reared Mediterranean fruit flies (Diptera: Tephritidae)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hendrichs, M.; Wornoayporn, V.; Hendrichs, J.

rapidamente por varias razones, incluyendo perdidas debidas a diferentes tipos de depredadores. Estudios anteriores conducidos en el campo, y en jaulas de campo, han confirmado que las cepas de machos de laboratorio tienen menos capacidad de evadir depredadores que los machos silvestres. Estos estudios involucran, sin embargo, una considerable cantidad de manipulacion y observacion de depredadores, por lo que no son adecuados para ser usados como medidas rutinarias en los programas de cria masiva. Aqui describimos un metodo sencillo de control de calidad usando aspiradores para medir agilidad en la mosca del Mediterraneo y mostramos que este parametro esta relacionado a la capacidad de la moscas a evadir a depredadores. Aunque aun es necesario refinar la estandarizacion de este metodo para permitir la comparacion entre cepas, los resultados confirman la importancia de tener un metodo rutinario para medir la capacidad de evasion de depredadores en cepas de cria de laboratorio de la mosca del Mediterraneo. Ademas de medir este parametro de control de calidad de los machos esteriles, el metodo descrito podria tambien ser usado para la seleccion sistematica de cepas con una mayor capacidad de evasion de depredadores. (author)« less

Sugammadex ED90 dose to reverse the rocuronium neuromuscular blockade in obese patients.

PubMed

Silva, Mauro Prado DA; Matsui, Christiano; Kim, Daniel Dongiou; Vieira, Joaquim Edson; Malheiros, Carlos Alberto; Mathias, Ligia Andrade Silva Telles

2017-01-01

to determine the ED90 (minimum effective dose in 90% of patients) of sugammadex for the reversal of rocuronium-induced moderate neuromuscular blockade (NMB) in patients with grade III obesity undergoing bariatric surgery. we conducted a prospective study with the biased coin up-and-down sequential design. We chosen the following doses: 2.0mg/Kg, 2.2mg/Kg, 2.4mg/Kg, 2.6mg/Kg, 2.8mg/Kg. The complete reversal of rocuronium-induced NMB considered a T4/T1 ratio ≥0.9 as measured by TOF. After induction of general anesthesia and calibration of the peripheral nerve stimulator and accelerometer, we injected rocuronium 0.6mg/kg. We administered propofol and remifentanil by continuous infusion, and intermittent boluses of rocuronium throughout the procedure. we evaluated 31 patients, of whom 26 had displayed successful reversal of the NMB with sugammadex, and failure in five. The mean time to complete moderate NMB reversal was 213 seconds (172-300, median 25-75%). The ED90 of sugammadex calculated by regression was 2.39mg/kg, with a 95% confidence interval of 2.27-2.46 mg/kg. the ED90 of sugammadex in patients with grade III obesity or higher was 2.39mg/kg. determinar a ED90 (dose mínima eficaz em 90% dos pacientes) de sugamadex para a reversão de bloqueio neuromuscular (BNM) moderado induzido pelo rocurônio em pacientes com obesidade grau III submetidos à cirurgia bariátrica. estudo prospectivo com o método de projeção sequencial para cima e para baixo da moeda enviesada. As seguintes doses foram escolhidas: 2,0mg/kg-1, 2,2mg/kg-1, 2,4mg/kg-1, 2,6mg/kg-1, 2,8mg/kg-1. A reversão completa de BNM induzido por rocurônio considerou uma relação T4/T1 ≥0,9 na medida do TOF. Após a indução da anestesia geral e calibração do estimulador de nervo periférico e acelerômetro, rocurônio 0,6mg/kg-1 foi injetado. Infusão contínua de propofol e remifentanil, e bolus intermitente de rocurônio foram injetados durante todo o procedimento. trinta e um pacientes foram

Effects of heparin and hyperbaric oxygenation on necrosis reduction in an animal model for degloving injuries.

PubMed

Menon, Douglas Neumar; Teixeira, Letícia; Paurosi, Natalha Bristot; Barros, Marcio Eduardo

2017-01-01

de 45mg/kg de alopurionol intraperitoneal. No sétimo dia os animais foram mortos e os retalhos cutâneos foram retirados e realizadas medidas das áreas total e necrótica, bem como cálculo da porcentagem da área de necrose. a média da porcentagem de necrose do grupo controle foi 56,03%; no grupo controle positivo, 51,36% (p≤0,45); no grupo da heparina, 42,10% (p≤0,07) e no grupo da oxigenoterapia hiperbárica, 31,58% (p≤0,01). tanto a oxigenoterapia hiperbárica quanto a terapia com heparina mostraram-se eficazes na redução do percentual de necrose no modelo estudado, embora neste trabalho apenas a oxigenação hiperbárica tenha demonstrado significância estatística.

Growth, lung function, and physical activity in schoolchildren who were very-low-birth-weight preterm infants.

PubMed

Winck, Aline Dill; Heinzmann-Filho, João Paulo; Schumann, Deise; Zatti, Helen; Mattiello, Rita; Jones, Marcus Herbert; Stein, Renato Tetelbom

2016-01-01

To compare somatic growth, lung function, and level of physical activity in schoolchildren who had been very-low-birth-weight preterm infants (VLBWPIs) or normal-birth-weight full-term infants. We recruited two groups of schoolchildren between 8 and 11 years of age residing in the study catchment area: those who had been VLBWPIs (birth weight < 1,500 g); and those who had been normal-birth-weight full-term infants (controls, birth weight ≥ 2,500 g). Anthropometric and spirometric data were collected from the schoolchildren, who also completed a questionnaire regarding their physical activity. In addition, data regarding the perinatal and neonatal period were collected from the medical records of the VLBWPIs. Of the 93 schoolchildren screened, 48 and 45 were in the VLBWPI and control groups, respectively. No significant differences were found between the groups regarding anthropometric characteristics, nutritional status, or pulmonary function. No associations were found between perinatal/neonatal variables and lung function parameters in the VLBWPI group. Although the difference was not significant, the level of physical activity was slightly higher in the VLBWPI group than in the control group. Among the schoolchildren evaluated here, neither growth nor lung function appear to have been affected by prematurity birth weight, or level of physical activity. Comparar o crescimento somático, a função pulmonar e o nível de atividade física entre escolares nascidos prematuros com muito baixo peso e escolares nascidos a termo e com peso adequado. Foram recrutados escolares com idade de 8 a 11 anos residentes na mesma área de abrangência do estudo: prematuros e com peso < 1.500 g e controles (nascidos a termo e com peso ≥ 2.500 g). Foram obtidas medidas antropométricas e espirométricas e aplicado um questionário sobre a atividade física. Além disso, foram coletadas informações do período perinatal/neonatal dos recém-nascidos com muito baixo peso (RNMBP

Analysis of the Economic Impact of Cardiovascular Diseases in the Last Five Years in Brazil.

PubMed

Siqueira, Alessandra de Sá Earp; Siqueira-Filho, Aristarco Gonçalves de; Land, Marcelo Gerardin Poirot

2017-07-01

ões de reais no ano de 2015, um aumento percentual de 17% no período de 2010 a 2015. Os custos estimados pela morte prematura por DCV representam 61% do total de custo por DCV, os custos diretos com internações e consultas foram de 22% e os custos pela perda da produtividade relacionados à doença foram de 15% do total. Os gastos com saúde no Brasil são estimados em 9,5% do PIB e o custo médio das DCV foi estimado em 0,7% do PIB. Os custos com DCV vêm aumentando significativamente nos últimos cinco anos. Estima-se que os custos por DCV aumentem à medida que a população brasileira envelhece e que a prevalência de DCV aumenta.

Erosion measurements by concentrated flow in olive orchard farms: a study case in a microcatchment under no-tillage with a grass spontaneous cover

NASA Astrophysics Data System (ADS)

Guzmán, Enrique; Taguas, Encarnación V.; Guzmán, Gema; Vanwalleghem, Tom; Gómez, José A.

2013-04-01

of gullies whereas the average length notably increased in the period 2011-2012 as a result of only one event that provoked 76% of sediment loads in the catchment. In addition to the grass cover, control measures in gullies would improve the sustainability in the farm, particularly because on the event scale, larger runoff coefficient than 50% were observed in the autumn due likely to the lack of cover and the low infiltration rates derived from no-tillage management. REFERENCES Castillo C. 2012. Metodología de medida de erosión por cárcavas y modelado de su control mediante diques de retención. Doctoral thesis: University of Córdoba, Córdoba (Spain). De Santisteban, L. M., J. Casalí, and J. J. López. 2006. Assessing soil erosion rates in cultivated areas of Navarre (Spain). Earth Surf. Process. Landforms 31: 487-506.

Nesting biology, morphological remarks, and description of the mature larva of Mellinus arvensis obscurus (Hymenoptera: Crabronidae) in Nepal

DOE Office of Scientific and Technical Information (OSTI.GOV)

Boesi, R.; Polidori, C.; Andrietti, F.

subespecie de la bien estudiada subespecie nominal. Mellinus arvensis obscurus nidifica a gran altitud, en terreno inclinado, con y sin vegetacion, expuesto en mayor o menor medida al sol y en agregaciones muy compactas. Durante la estacion lluviosa la hembras llevan a cabo pocos vuelos de aprovisonamiento. Las presas pertenecen al orden de los dipteros, aunque, en una ocasion se observo el aporte de una arana. Gran numero de las interacciones intraespecificas observadas sugieren un alto grado de intentos de usurpacion de nidos. Los enemigos naturales mas sobresalientes pertenecen al orden de los dipteros y a la familia de los formicidos. Del estudio morfologico del adulto, mencionaremos que la foma del terguito 1 y la escultura del cuerpo, en las hembras de las poblaciones del Nepal, son mas semejantes a los de las hembras de las poblaciones europeas que no a los de las japonesas. De la fase larvaria se describe el ultimo estado larvario, a la vez que se compara con la otra larva madura ya descrita del genero. Las diferencias entre ambas larvas maduras radican en la presencia/ausencia, numero o diferenciacion de las estructuras tegumentarias. El estudio finaliza concluyendo que los rasgos morfologicos son mas importantes, que los aspectos ecologicos y comportamentales, a la hora de establecer una separacion entre las dos subespecies (author)« less

Linking Indices for Biodiversity Monitoring to Extinction Risk Theory

PubMed Central

Mccarthy, Michael A; Moore, Alana L; Krauss, Jochen; Morgan, John W; Clements, Christopher F

2014-01-01

�ndices que reflejan el riesgo de extinción serían valiosos. Desarrollamos 3 índices de biodiversidad que se basan en modelos sencillos de viabilidad de población y que relacionan el riesgo de extinción con la abundancia. Basamos el primer índice en la media geométrica de la abundancia de especies, y el segundo en una media de poder más general. En el tercer índice integramos la media geométrica y la tendencia. Estos índices requieren los mismos datos que índices previos, pero también se relacionan directamente con el riesgo de extinción. La información de campo sobre mariposas y plantas de bosque, y los estudios experimentales de comunidades protozoarias, muestran que los índices se correlacionan con las tasas locales de extinción. Al aplicar el índice basado en la media geométrica sobre los datos globales de los cambios en la abundancia de aves, sugirió que la probabilidad de extinción promedio de aves ha incrementado aproximadamente 1% desde 1970 hasta 2009. Palabras Clave Índice de biodiversidad, media geométrica, medida de la biodiversidad, riesgo de extinción PMID:24820139

Plasma Total Antioxidant Capacity and Cardiometabolic Risk in Non-Obese and Clinically Healthy Young Adults.

PubMed

Costa, Jamille Oliveira; Vásquez, Cecília M Passos; Santana, Gleiciane de Jesus; Silva, Natanael de Jesus; Braz, Juciene de Matos; Jesus, Amélia M Ribeiro de; Silva, Danielle Góes da; Cunha, Luana Celina Seraphim; Barbosa, Kiriaque Barra Ferreira

2017-07-10

de 2013 e outubro de 2014. Parâmetros antropométricos, clínicos e bioquímicos foram medidos e analisados usando protocolos previamente padronizados e descritos na literatura. A medida da capacidade antioxidante total do plasma baseou-se na capacidade de todos os antioxidantes presentes na amostra (plasma) em inibir a oxidação do substrato oxidável ABTS (2,2-Azino-bis-(3-etilbenzotiazolina-6-sulfonato) a ABTS•+ pela metamioglobina. Aproximadamente 25% da amostra apresentaram mais de um componente do risco cardiometabólico. Valores baixos de HDL foram o componente mais prevalente. Em comparação à ausência de componentes, os indivíduos com pelo menos um componente apresentou valores mais altos de peso corporal, circunferência da cintura, pressão sanguínea diastólica, glicemia de jejum e razão colesterol total/HDL-c, e valores mais baixos de HDL-c (p < 0,05). A glicemia de jejum foi o único parâmetro que se associou com a capacidade antioxidante total (R2 = 0,10; β = 0,17; p = 0,001). A capacidade antioxidante total não foi capaz de predizer os componentes do risco cardiometabólico possivelmente devido ao estabelecimento de mecanismos compensatórios que se tornam ativados em condições fisiológicas.

Role of PAHO/WHO in eHealth Capacity Building in the Americas: Analysis of the 2011-2015 period.

PubMed

Novillo-Ortiz, David; D'Agostino, Marcelo; Becerra-Posada, Francisco

2016-08-01

Political will and adoption of measures toward the use of eHealth have been steadily increasing, facilitating mobilization of resources necessary to adopt and implement digital services that will make it possible to improve access, expand coverage, and increase financial efficiency of health care systems. Adoption of the Strategy and Plan of Action on eHealth of the Pan American Health Organization (PAHO) in 2011 by all Member States in the Region of the Americas has led the Region to major progress in this regard, including the following: creation of knowledge networks and development of information sources, establishment of eHealth sustainability models, support for development of electronic health records, promotion of standards on health data and related technologies that ensure exchange of information, use of mobile devices to improve health, and improvement in quality of care through telemedicine. This article details the main actions carried out by PAHO with regard to eHealth, specifically by the office of Knowledge Management, Bioethics, and Research in the 2011-2015 period (first period of implementation of the PAHO eHealth strategy and plan of action), which include research and capacity-building activities, development of technical guidelines, and formation of knowledge networks. RESUMEN La voluntad política y la adopción de medidas en relación con el uso de la eSalud han ido en aumento de forma constante, favoreciendo la movilización de los recursos necesarios a fin de adoptar y poner en marcha servicios digitales que permitan mejorar el acceso, ampliar la cobertura y aumentar la eficiencia financiera de los sistemas de atención de salud. Con la aprobación de la Estrategia y Plan de Acción de eSalud de la Organización Panamericana de la Salud (OPS) en 2011 por todos los Estados Miembros de la Región de las Américas, se han realizado importantes avances a este respecto en la Región, entre los que se destacan: la creación de redes de

METRICS DEVELOPMENT FOR THE QUALIS OF SOFTWARE TECHNICAL PRODUCTION.

PubMed

Scarpi, Marinho Jorge

2015-01-01

da Área Medicina III da CAPES, embasando a criação de proposta para métrica do tema, com vistas à avaliação quadrienal dos cursos de pós-graduação. A percepção de qualidade em uso do software pelo usuário resulta da efetividade, produtividade, segurança e satisfação proporcionada, que têm origem nas suas características de funcionalidade, confiabilidade, usabilidade, eficiência, manutenibilidade e portabilidade (métricas de qualidade em uso). Tal percepção depende do cenário de uso específico. A métrica de software deve ser incluída na produção intelectual do Documento de Área do programa, ponderando os resultados nas medidas de comportamento do sistema em avaliação de desempenho por usuários, considerando a somatória da pontuação favorável para as seis métricas de qualidade em uso (27 sub-itens, de 0 a 2 pontos cada) e a comprovação da percepção de qualidade (quatro itens, de 0 a 10 pontos cada). Será considerado muito bom (MB) de 85 a 94 pontos; bom (B) de 75 a 84 pontos; Regular (R) de 65 a 74 pontos; fraco (F) de 55 a 64 pontos; deficiente (D) < 55.

Translation and cross-cultural adaptation of the Clinical Competence Questionnaire for use in Brazil.

PubMed

Kwiatkoski, Danielle Ritter; Mantovani, Maria de Fátima; Pereira, Evani Marques; Bortolato-Major, Carina; Mattei, Ângela Taís; Peres, Aida Maris

2017-06-05

Questionnaire foi traduzido e adaptado a estudantes brasileiros, e as propriedades psicométricas da versão em português do questionário apresentaram consistência interna satisfatória quanto à amostra estudada. traducir y adaptar transculturalmente el Clinical Competence Questionnaire para uso de los estudiantes brasileños que concluyen la graduación en enfermería, así como para medir las propiedades psicométricas del cuestionario. estudio metodológico realizado en seis etapas: traducción del instrumento Clinical Competence Questionnaire, obtención de consenso de las traducciones, retrotraducción, análisis por el comité de especialistas, pretest y presentación del proceso de adaptación transcultural para los desarrolladores. Las propiedades psicométricas fueron medidas utilizando el alfa de Cronbach, coeficiente de correlación intraclase e índice de validez de contenido. el instrumento fue traducido, adaptado transculturalmente y su versión final estuvo constituida por 48 ítems. El coeficiente alfa de Cronbach fue de 0,90; el índice de concordancia de los ítems fue de 99% para los estudiantes y de 98% para los evaluadores. el Clinical Competence Questionnaire fue traducido y adaptado para uso de estudiantes brasileños; las propiedades psicométricas, de la versión en portugués del cuestionario, presentaron consistencia interna satisfactoria encontrada en la muestra estudiada.

[Injecting without getting infected: injectors' strategies to prevent HIV and HCV.

PubMed

Mateu-Gelabert, P; Friedman, S; Sandoval, M

2007-10-01

OBJETIVO: Desde principios de los noventa, en la ciudad de Nueva York se han implementado con éxito programas para reducir la incidencia del virus de la inmunodeficiencia humana (VIH) y, en menor medida, del virus de la hepatitis C (VHC). A pesar de ello, aproximadamente el 70% de los usuario de drogas inyectables (UDI) están infectados por el VHC. Queremos investigar cómo el 30% restante se las ha arreglado para no infectarse. El Staying safe (nombre original del estudio) explora los comportamientos y mecanismos que ayudan a evitar la infección por el VHC y el VIH a largo plazo. MATERIAL Y M#ENTITYSTARTX000E9;TODOS: Hemos utilizado el concepto de «desviación positiva» aplicado en otros campos de salud pública. Estudiamos las estrategias, prácticas y tácticas de prevención de aquellos UDI que, viviendo en contextos de alta prevalencia, se mantienen sin infectar por VIH y el VHC, a pesar de haberse inyectado heroína durante años. Los resultados preliminares presentados en este artículo incluyen el análisis de las entrevistas realizadas a 25 UDI (17 doble negativos, 3 doble positivos y 5 con infección por el VHC y sin infección por el VIH). Se usaron entrevistas semiestructuradas que exploraban con detalle la historia de vida de los sujetos, incluyendo su consumo de drogas, redes sociales, contacto con instituciones, relaciones sexuales y estrategias de protección y vigilancia. RESULTADOS: La intencionalidad es importante para no infectarse, especialmente durante períodos de involución (períodos donde hay un deterioro económico y/o social que llevan al que se inyecta a situaciones de mayor riesgo). Presentamos tres dimensiones independientes de intencionalidad que conllevan comportamientos que pueden ayudar a prevenir la infección: a) evitar «el mono» (síntomas de abstención) asegurando el acceso a la droga; b) «llevarlo bien» para no convertirse en un junkie y así evitar la «muerte social» y la falta de acceso a los recursos, y c

Pincharse sin infectarse: estrategias para prevenir la infección por el VIH y el VHC entre usuarios de drogas inyectables

PubMed Central

MATEU-GELABERT, P.; FRIEDMAN, S.; SANDOVAL, M.

2011-01-01

Resumen Objetivo Desde principios de los noventa, en la ciudad de Nueva York se han implementado con éxito programas para reducir la incidencia del virus de la inmunodeficiencia humana (VIH) y, en menor medida, del virus de la hepatitis C (VHC). A pesar de ello, aproximadamente el 70% de los usuario de drogas inyectables (UDI) están infectados por el VHC. Queremos investigar cómo el 30% restante se las ha arreglado para no infectarse. El Staying safe (nombre original del estudio) explora los comportamientos y mecanismos que ayudan a evitar la infección por el VHC y el VIH a largo plazo. Material y métodos Hemos utilizado el concepto de «desviación positiva» aplicado en otros campos de salud pública. Estudiamos las estrategias, prácticas y tácticas de prevención de aquellos UDI que, viviendo en contextos de alta prevalencia, se mantienen sin infectar por VIH y el VHC, a pesar de haberse inyectado heroína durante años. Los resultados preliminares presentados en este artículo incluyen el análisis de las entrevistas realizadas a 25 UDI (17 doble negativos, 3 doble positivos y 5 con infección por el VHC y sin infección por el VIH). Se usaron entrevistas semiestructuradas que exploraban con detalle la historia de vida de los sujetos, incluyendo su consumo de drogas, redes sociales, contacto con instituciones, relaciones sexuales y estrategias de protección y vigilancia. Resultados La intencionalidad es importante para no infectarse, especialmente durante períodos de involución (períodos donde hay un deterioro económico y/o social que llevan al que se inyecta a situaciones de mayor riesgo). Presentamos tres dimensiones independientes de intencionalidad que conllevan comportamientos que pueden ayudar a prevenir la infección: a) evitar «el mono» (síntomas de abstención) asegurando el acceso a la droga; b) «llevarlo bien» para no convertirse en un junkie y así evitar la «muerte social» y la falta de acceso a los recursos, y c) seguir sin

Accuracy of probabilistic and deterministic record linkage: the case of tuberculosis.

PubMed

Oliveira, Gisele Pinto de; Bierrenbach, Ana Luiza de Souza; Camargo, Kenneth Rochel de; Coeli, Cláudia Medina; Pinheiro, Rejane Sobrino

2016-08-22

partir da combinação de fragmentos das variáveis-chave com ou sem modificações (Soundex ou substring). Cada regra era formada por três ou mais fragmentos. Para a abordagem probabilística, foi necessário estabelecer ponto de corte para o escore, acima do qual os links seriam classificados automaticamente como pertencentes ao mesmo indivíduo. O ponto de corte foi obtido por meio do relacionamento da base de dados Sistema de Informação de Agravos de Notificação - Tuberculose com ela mesma, posterior revisão manual e curvas ROC e precision-recall. Foram calculadas a sensibilidade e especificidade para análise de acurácia. A acurácia variou de 87,2% a 95,2% para sensibilidade e 99,8% a 99,9% para especificidade para as técnicas probabilística e determinística, respectivamente. A presença de valores faltantes para as variáveis-chave e o baixo percentual da medida de similaridade para o nome e data de nascimento foram os principais responsáveis pela não identificação dos registros do mesmo indivíduo pelas técnicas utilizadas. As duas técnicas apresentam alta concordância para a classificação como par. Apesar de a técnica determinística ter identificado mais registros duplicados que a probabilística, a segunda recuperou registros não identificados pela primeira. A necessidade e a experiência do usuário devem ser consideradas para a escolha da técnica a ser utilizada.

Nanoparticulas basadas en complejos de Fe(II) con transicion de espin: sintesis, caracterizacion y aplicaciones en electronica molecular

NASA Astrophysics Data System (ADS)

Monrabal Capilla, Maria

Esta tesis doctoral esta organizada en 5 capitulos y esta destinada al estudio de sistemas de Fe (II) que presentan el fenomeno de la transicion de espin a escala nanometrica. El capitulo 1 contiene una introduccion general sobre materiales moleculares multifuncionales, destacando aquellos ejemplos mas importantes. Por otro lado, se explicara el fenomeno de la transicion de espin, tratando aspectos conceptuales, los antecedentes mas importantes y la situacion actual. En el capitulo 2 se describen los diferentes procesos existentes para la obtencion de diferentes tipos de nanoparticulas. Ademas, se presenta la sintesis y caracterizacion de nanoparticulas del polimero de coordinacion unidimensional [Fe(Htrz)2(trz)]BF4, obtenidas mediante el metodo de micelas inversas. Estas nanoparticulas, con una estrecha distribucion de tamanos centrada alrededor de los 11 nm, presentan una transicion de espin muy abrupta, con un ancho ciclo de histeresis termica de unos 40K. En el capitulo 3 se describe el proceso de modificacion del tamano de las nanoparticulas descritas en el capitulo anterior, llevado a cabo variando la proporcion de surfactante/H2O en el medio. Ademas, con el objetivo de modificar las propiedades magneticas de las nanoparticulas obtenidas en el capitulo 2, se lleva a cabo la sintesis de nanoparticulas de polimeros de la misma familia del [Fe(Htrz)2(trz)]BF4. En concreto se sintetizaron 3 nuevos tipos de nanoparticulas basadas en el polimero [Fe(Htrz)1-x(NH2trz)x](ClO4)2, siendo x = 0.05, 0.15 y 0.3, en cada caso. Estas nanoparticulas siguen presentando una estrecha distribucion de tamanos y una transicion de espin muy abrupta y con un ancho ciclo de histeresis. Ademas, se observa que este ciclo se desplaza a temperaturas mas proximas a la temperatura ambiente a medida que se aumenta el porcentaje de 4-amino-1, 2, 4- triazol en la muestra. Pero al mismo tiempo se produce una disminucion de la anchura de este ciclo. Por ultimo, en este capitulo se presenta la

Aging and health: Self-efficacy for Self-direction in Health Scale.

PubMed

Oliveira, Albertina L; Silva, José T; Lima, Margarida P

2016-07-04

Satisfação Com a Vida e a escala de Atividades Instrumentais da Vida Diária. A EAAS foi desenvolvida a partir dos construtos teóricos da autoeficácia e da aprendizagem autodirigida no âmbito do projeto europeu PALADIN, visando constituir um instrumento apto a avaliar até que ponto os seniores cuidam bem da sua saúde. A consistência interna encontrada foi de 0.87 (alfa de Cronbach) e as análises fatoriais confirmatórias permitiram encontrar um modelo próximo ao proposto teoricamente, indicando uma estrutura constituída por quatro dimensões: exercício físico, alimentação saudável, envolvimento em aprendizagens relativas à saúde e visitas a profissionais de saúde. Do ponto de vista psicométrico, o modelo em quatro fatores mostrou indicadores de ajustamento bastante satisfatórios. A Escala de Autoeficácia para a Autodireção na Saúde, com 16 itens, é adequada para avaliar em que medida os seniores têm confiança na sua capacidade para tomar conta da própria saúde, com elevado grau de autonomia.

Relationship Between Neck Circumference and Epicardial Fat Thickness in a Healthy Male Population.

PubMed

Küçük, Uğur; Küçük, Hilal Olgun; Cüce, Ferhat; Balta, Sevket

2016-09-01

subcutânea são limitados. Realizamos um estudo para determinar a associação entre a circunferência do pescoço e a espessura da gordura epicárdica em jovens saudáveis do sexo masculino, além de avaliar as suas correlações individuais com a adiposidade corporal geral e fatores de risco cardiometabólicos. Cem pacientes consecutivos do sexo masculino com idade igual ou superior a 18 anos e sem nenhuma condição médica importante e conhecida foram incluídos no estudo. Todos os participantes foram submetidos a um exame físico detalhado que incluiu medida da pressão arterial, peso, altura, razão cintura/quadril e circunferência do pescoço. Sangue foi coletado para determinação da glicemia de jejum e parâmetros lipídicos. Um exame ecocardiográfico padrão foi realizado com determinação adicional da espessura da gordura epicárdica. Entre os 100 participantes do estudo, a circunferência do pescoço mostrou correlação significativa com o peso, circunferência de cintura, IMC, glicemia e níveis séricos de colesterol total, lipoproteína de baixa densidade (LDL-colesterol) e triglicerídeos. Não foi observada correlação significativa entre a circunferência do pescoço e níveis de colesterol de alta densidade (HDL-colesterol). A circunferência do pescoço correlacionou moderadamente e positivamente com a espessura da gordura epicárdica à ecocardiografia. Entre pacientes com baixo risco cardiometabólico, o aumento da circunferência do pescoço foi associado a um aumento da espessura da gordura epicárdica.

Simulation of regional-scale groundwater flow in the Azul River basin, Buenos Aires Province, Argentina

NASA Astrophysics Data System (ADS)

Varni, Marcelo R.; Usunoff, Eduardo J.

, suggérant ainsi que la description par le modèle des relations rivière-nappe est correcte. Resumen Se ha utilizado el modelo MODFLOW, del Servicio Geológico de los Estados Unidos, para simular el flujo de agua subterránea en la cuenca del arroyo del Azul, Provincia de Buenos Aires, Argentina, con el objeto de evaluar el modelo hidrogeológico conceptual. Los niveles hidráulicos simulados ajustan satisfactoriamente con los niveles observados. Los resultados de la simulación indican que: (1) la recarga no es uniforme, sino que puede caracterizarse con tres zonas en las que sus valores decrecen en la medida en que decrece la pendiente, que guarda similitud con la distribución de suelos y características geomorfológicas y (2) la evapotranspiración sería mayor que la estimada en estudios previos, en los que se utilizó el método de Thornthwaite-Mather. La evapotranspiración estimada mediante la presente simulación concuerda con resultados de varios estudios independientes en la región. Respecto de la relación acuífero-río, existe un muy buen ajuste entre los aportes del acuífero al río simulados y los valores históricos de caudal base.

Healthy School, Happy School: Design and Protocol for a Randomized Clinical Trial Designed to Prevent Weight Gain in Children.

PubMed

Schuh, Daniela Schneid; Goulart, Maíra Ribas; Barbiero, Sandra Mari; Sica, Caroline D'Azevedo; Borges, Raphael; Moraes, David William; Pellanda, Lucia Campos

2017-06-01

, paralelo, de dois braços, conduzido em escolas públicas de ensino fundamental e médio no Brasil. Os participantes serão crianças e adolescentes entre 5 e 15 anos de idade, dos dois sexos. As intervenções se concentrarão em mudanças de estilo de vida, atividade física e educação nutricional. As atividades de intervenção ocorrerão mensalmente na sala de multimídia ou quadra de esportes das escolas. O grupo controle receberá as recomendações usuais através da escola. O desfecho primário será a mudança nas medidas antropométricas, como índice de massa corporal e os níveis de atividade física conforme o Questionário Internacional de Atividade Física. Esperamos que, após o estudo, as crianças aumentem o consumo de alimentos frescos, reduzam o consumo excessivo de alimentos açucarados e processados, e reduzam as horas gastas em atividades sedentárias. O propósito de iniciar a intervenção dietética nessa fase da vida é desenvolver o conhecimento que permitirá escolhas saudáveis, propiciando oportunidades para um melhor futuro para essa população.

Water fluoridation in Brazilian cities at the first decade of the 21st century.

PubMed

Frazão, Paulo; Narvai, Paulo Capel

2017-05-15

absoluta e relativa entre as categorias foram avaliadas por meio de indicadores de efeito e de impacto total. Foram obtidas informações para 5.558 municípios. A taxa de cobertura da fluoretação da água aumentou de 67,7% para 76,3%. Passaram a ser beneficiados pela medida 884 (15,9%) municípios, e 29,6 milhões de habitantes. Observou-se ampliação expressiva em municípios com < 10 mil habitantes (aumento de 21,0 pontos percentuais) e com IDH-M baixo ou muito baixo (17,7 pontos percentuais). A cobertura populacional da política pública aumentou 8,6%, sendo expressivas as reduções das desigualdades absoluta e relativa segundo o porte demográfico e o IDH-M. Quanto à taxa de cobertura municipal, houve também redução da desigualdade em todas as comparações com exceção da desigualdade absoluta entre as categorias de IDH-M. A política pública operou como fator de proteção sanitária no contexto das políticas de proteção social em curso no país.

Eventos de Desconexão no Cometa P/Halley sob a Ótica do Modelo de Reconexão Magnética

NASA Astrophysics Data System (ADS)

Voelzke, M. R.; Matsuura, O. T.

1998-08-01

531 imagens contidas no The International Halley Watch Atlas of Large-Scale Phenomena (Brandt et al., 1992) cobrindo o período de setembro de 1985 a julho de 1986 foram analisadas visando identificar, caracterizar as propriedades e correlacionar estruturas morfológicas da cauda de plasma do cometa P/Halley. A análise revelou 47 eventos de desconexão (DEs) (Niedner & Brandt, 1979; Jockers, 1985; Celnik et al., 1988; Delva et al., 1991). A análise completa de todas as imagens encontra-se publicada em Voelzke & Matsuura, 1998. A distribuição dos DEs na distância heliocêntrica apresenta um caráter bimodal possivelmente associado com a distribuição espacial das fronteiras de setor magnético do meio interplanetário. Os 47 DEs fotografados em 47 imagens distintas permitiram determinar 19 origens de DEs, ou seja, o instante em que supostamente o cometa cruzou a fronteira entre setores magnéticos do vento solar. Tais dados cometários foram comparados com dados do vento solar provenientes de medidas realizadas in situ pelas sondas IMP-8, ICE e PVO, que mediram a variação da velocidade do vento solar, da densidade e da pressão dinâmica durante o intervalo analisado. Os dados destas sondas espaciais em conjunto com os da sonda Vega 1 foram usados para determinar o tempo das passagens do lençol de corrente. Com base nos dados das sondas foram calculadas as coordenadas heliográficas retroativas do lençol de corrente na "superfície fonte" dos mapas sinóticos do campo magnético de Hoeksema, 1989. O cálculo retroativo é feito através de um modelo simples de expressão do vento solar com velocidade uniforme, sendo considerada a co-rotação da magnetosfera com o Sol. Este trabalho apresenta os resultados desta comparação e a análise cinemática da origem dos DEs, determinada sob a hipótese que o plasma desconectado de um dado DE afasta-se com velocidade constante do núcleo cometário (Voelzke & Matsuura, 1998) e compara esta análise com outras que

Thromboembolism and bleeding risk scores and predictors of cardiac death in a population with atrial fibrillation.

PubMed

Silva, Rose Mary Ferreira Lisboa da; Silva, Pollyana Ardavicius E; Lima, Marcos Correia; Sant'Anna, Lívia Tanure; Silva, Túlio Corrêa; Moreira, Pedro Henrique Vilela; Gandra, Robert Moreira; Cavalcanti, Túlio Ramos; Mourão, Plínio Henrique Vaz

2017-07-01

pts com FA, média de idade 58,1 anos; 161 mulheres; 96 pts com etiologia reumática. Os pts foram submetidos à avaliação clínica e laboratorial, ao cálculo dos escores de risco e ao seguimento clínico médio de 12,8 meses. 174 pts estavam em uso de varfarina. As médias dos escores HAS-BLED e ATRIA foram de 1,4 e de 1,2, respectivamente. O cálculo da fração dos valores da razão normalizada internacional dentro do intervalo terapêutico foi de 45,8%. Houve MC em 30 pts (9,9%) e 41 apresentaram algum tipo de hemorragia em decorrência do uso de varfarina. Pela análise univariada, houve significância estatística entre MC e FA permanente, pressões arteriais, disfunção sistólica, R2CHADS2, CCS, EHRA e HAS-BLED. Não houve associação com FA valvar. Por meio da análise multivariada, a pressão arterial sistêmica e da artéria pulmonar, a classificação CCS e a disfunção sistólica apresentavam significância estatística. Não houve associação entre MC e FA valvar. Os preditores independentes de MC foram medidas baixas de pressão arterial, escores mais elevados da classificação CCS e a presença de disfunção ventricular sistólica.

Prioritization of strategies to approach the judicialization of health in Latin America and the Caribbean.

PubMed

Pinzón-Flórez, Carlos Eduardo; Chapman, Evelina; Cubillos, Leonardo; Reveiz, Ludovic

2016-09-01

". Se categorizaron las estrategias según: gobernanza, prestación de servicios, recursos humanos, sistemas de información, financiación y productos médicos. Se incluyeron 64 estudios en los cuales se identificaron 50 estrategias, relacionadas con las sub-funciones y componentes de los sistemas de salud. De las 165 personas que respondieron la encuesta, el 80,0% tenían entre 35-64 años. La distribución de hombres y mujeres fue homogénea. La mitad de los respondientes fue de Colombia (20,0%), Uruguay (16,9%) y Argentina (12,7%). Se priorizaron mayormente las estrategias que abordaron los aspectos de generación de evidencia científica útil para toma de decisión según las necesidades de salud de la población, el empoderamiento para la sociedad, y la generación de espacios de discusión de las medidas de inclusión o exclusión de tecnologías de salud. Los tomadores de decisión de la rama ejecutiva y judicial priorizaron las preguntas que abordaron las estrategias que garantizaran la rendición de cuentas. Los resultados de este estudio contribuyen a la identificación de estrategias efectivas para el abordaje del fenómeno de la judicialización en salud, garantizando el derecho a la salud.

Evolution of the Astronomy Concepts Along Basic Education Cycle. (Breton Title: Evolução dos Conceitos de Astronomia no Decorrer da Educação Básica.) La Evolución de los Conceptos de Astronomía Durante la Educación Básica

NASA Astrophysics Data System (ADS)

Darroz, Luiz Marcelo; da Rosa, Cleci Werner; Becker da Rosa, Álvaro; Samudio Pèrez, Carlos Ariel

2014-07-01

learning of astronomy in basic education. Embora a astronomia seja considerada uma das ciências mais antigas da humanidade e ainda que a compreensão de seus conceitos tenha trazido enormes avanços para a Ciência e, consequentemente, para a sociedade, observa-se que uma parcela significativa de pessoas encontra-se à margem desses conhecimentos. De acordo com os Parâmetros Curriculares Nacionais para a Educação Básica, cabe à escola a difusão dos conceitos cientificamente corretos, entre eles os relacionados à área de astronomia. Pertinente a essa questão, apresenta-se uma pesquisa realizada com 140 estudantes do nono ano do ensino fundamental e com 120 estudantes da terceira série do ensino médio de quatro escolas da região de Passo Fundo/RS. Buscou-se averiguar, por meio de um questionário composto de questões abertas e de múltipla escolha, o conhecimento desse grupo de estudantes acerca de termos e fenômenos astronômicos básicos e, também, verificar se o índice de acertos cresce à medida que eles avançam nas diferentes e gradativas séries dos ensinos fundamental e médio. De modo geral, os resultados apresentados demonstram que o ensino de astronomia na educação básica enfrenta deficiências. Das 20 questões investigadas, em 17 os índices de acertos são semelhantes nas respostas dadas por estudantes de nível fundamental e médio, revelando que muitas concepções equivocadas permanecem ao longo da educação básica. Isso evidencia que tais temas não são - ou são pouco - abordados durante esses dois níveis de escolarização. Assim, conclui-se que a discussão dos conceitos relacionados com a astronomia deve receber maior ênfase na abordagem dos diferentes conteúdos, sendo necessária uma ação nacional em prol do seu ensino. Acredita-se que essa ação nacional deve estar apoiada em um pilar triplo de atores coletivos: comunidade científica, comunidade astronômica semiprofissional e comunidade escolar. Por fim, esse pilar seria

Revisiting an era in Germany from the perspective of adolescents in mother-headed single-parent families.

PubMed

Sharma, Deepali; Silbereisen, Rainer K

2007-02-01

ambiente familiar). Es más, se propuso la hipótesis de que los adolescentes de familias con padrastro manifestarían más efectos sociales y familiares negativos al compararse con adolescentes provenientes de los otros dos tipos de familias. La muestra, compuesta por 1302 adolescentes (M = 13.82 años, SD = 1.88), se reclutó en la ciudad de Leipzig al año siguiente de la unificación de Alemania, 1991. Los participantes respondieron a medidas de síntomas psicosomáticos, estrés, delincuencia, satisfacción por la vida, desempeño académico y variables relativas a la familia. Los análisis de covarianza aplicados, controlando el ingreso ajustado al tamaño de la familia, sugirieron que los adolescentes de familias de madre soltera tenían experiencias muy similares a las de aquéllos que vivían con sus padres biológicos en todas las medidas, excepto en la de evaluación del ambiente familiar. Los adolescentes que vivían en familias con padrastro informaron experiencias menos favorables. Los resultados son indicativos de que el contexto social en Alemania proporcionó aún más oportunidades que restricciones a las familias de madre soltera, a pesar de la unificación y el comienzo de las dificultades que ésta les impuso.

EFFECT OF SIZE OF INTESTINAL DIVERSIONS IN OBESE PATIENTS WITH METABOLIC SYNDROME SUBMITTED TO GASTRIC BYPASS.

PubMed

Ramos, Rafael Jacques; Mottin, Cláudio Corá; Alves, Letícia Biscaino; Benzano, Daniela; Padoin, Alexandre Vontobel

/m2) diabéticos com síndrome metabólica submetidos ao bypass gástrico em Y-de-Roux. Foram divididos em três grupos conforme a dimensão das alças intestinais: grupo 1, alça biliopancreática de 50 cm e alça alimentar de 100 cm; grupo 2, alça biliopancreática de 50 cm e alça alimentar de 150 cm e grupo 3, alça biliopancreática de 100 cm e alça alimentar de 150 cm. Foram avaliados os parâmetros que compõem a síndrome metabólica. Incluíram-se 63 pacientes, com média de idade de 44.7±9.4 anos. Todos eram diabéticos, 62 (98.4%) hipertensos e 51 (82.2%) dislipidêmicos. Os três grupos eram homogêneos em relação às variáveis estudadas. Em 24 meses houve remissão da hipertensão arterial sistêmica em 65% do grupo 1, 62.5% no grupo 2 e 68.4% no grupo 3. A remissão do diabete melito tipo 2 ocorreu em 85% dos pacientes do grupo 1, 83% no grupo 2, e 84% no grupo 3. Não houve diferença estatística na porcentagem de perda do excesso de peso entre os grupos e as medidas da cintura abdominal reduziram de forma homogênea em todos os grupos. A dimensão das alças também não influenciou na melhora da dislipidemia. A variação da dimensão das alças intestinais não influenciou na melhora da síndrome metabólica neste grupo de pacientes.

Establishing IUCN Red List Criteria for Threatened Ecosystems

PubMed Central

Rodríguez, Jon Paul; Rodríguez-Clark, Kathryn M; Baillie, Jonathan E M; Ash, Neville; Benson, John; Boucher, Timothy; Brown, Claire; Burgess, Neil D; Collen, Ben; Jennings, Michael; Keith, David A; Nicholson, Emily; Revenga, Carmen; Reyers, Belinda; Rouget, Mathieu; Smith, Tammy; Spalding, Mark; Taber, Andrew; Walpole, Matt; Zager, Irene; Zamin, Tara

2011-01-01

porque la Unión Internacional para la Conservación de la Naturaleza (UICN) ha desarrollado criterios objetivos, repetibles y transparentes para evaluar el riesgo de extinción que explícitamente separa la evaluación de riesgo de la definición de prioridades. En el IV Congreso Mundial de Conservación en 2008, el proceso comenzó a desarrollar e implementar estándares globales comparables para ecosistemas. Un grupo de trabajo establecido por la UICN ha formulado un sistema inicial de categorías y criterios cuantitativos, análogos a los utilizados para especies, para asignar niveles de amenaza a ecosistemas a niveles local, regional y global. Un sistema final requerirá de definiciones de ecosistemas; cuantificación del estatus de ecosistemas; identificación de las etapas de degradación y pérdida de los ecosistemas; medidas de riesgo (criterios) alternativas; umbrales de clasificación para esos criterios y métodos estandarizados para la realización de evaluaciones. El sistema deberá reflejar el nivel y tasa de cambio en la extensión, composición, estructura y funcionamiento de un ecosistema, y tener sus raíces conceptuales en la teoría ecológica y la investigación empírica. Sobre la base de esos requerimientos y la hipótesis de que el riesgo del ecosistema es una función del riesgo de las especies que lo componen, proponemos un conjunto de 4 criterios: declinaciones recientes en la distribución o funcionamiento ecológica, pérdida total histórica en la distribución o funcionamiento ecológico, distribución pequeña combinada con declinación, o distribución muy pequeña. La mayor parte del trabajo se ha concentrado en ecosistemas terrestres, pero también se requieren umbrales y criterios comparables para ecosistemas dulceacuícolas y marinos. Estos son los primeros pasos de un proceso de consulta internacional que llevará a una propuesta unificada que será presentada en el próximo Congreso Mundial de Conservación en 2012. PMID:21054525

Viability of gait speed test in hospitalized elderly patients.

PubMed

Martinez, Bruno Prata; Batista, Anne Karine Menezes Santos; Ramos, Isis Resende; Dantas, Júlio Cesar; Gomes, Isabela Barboza; Forgiarini, Luiz Alberto; Camelier, Fernanda Rosa Warken; Camelier, Aquiles Assunção

2016-01-01

metros (TVM6) em idosos hospitalizados. Estudo com medidas repetidas envolvendo idosos hospitalizados (idade ≥ 60 anos) que realizaram o TVM6 até o quinto dia de hospitalização, sendo capazes de andar sem auxílio e não apresentando dispneia ou dor que os incapacitasse para a realização dos testes. O TVM6 foi realizado sequencialmente três vezes, com período de descanso, em um corredor plano, e a velocidade de marcha foi calculada em metros/segundo. A reprodutibilidade foi avaliada pela comparação das médias, coeficientes de correlação intraclasse (CCI) e disposições gráficas de Bland-Altman. Foram avaliados 110 idosos avaliados com um total de 330 testes. Todos os participantes completaram todos os testes. As comparações entre as velocidades obtidas nos três testes realizados indicaram CCIs elevados e viés médio baixo pela disposição gráfica de Bland-Altman. Em relação à maior velocidade aferida, a correlação e a precisão foram maiores quando comparadas à obtida no terceiro teste (1,26 ± 0,44 m/s vs. 1,22 ± 0,44 m/s; CCI = 0,99; p = 0,001; viés médio = 0,04; e limites de concordância = -0,27 a 0,15). O TVM6 mostrou-se seguro e teve boa reprodutibilidade nessa amostra de idosos hospitalizados. A terceira aferição parece corresponder à velocidade máxima, já que duas primeiras subestimaram o desempenho real.

Is there a rationale for pulmonary rehabilitation following successful chemotherapy for tuberculosis?

PubMed

Muñoz-Torrico, Marcela; Rendon, Adrian; Centis, Rosella; D'Ambrosio, Lia; Fuentes, Zhenia; Torres-Duque, Carlos; Mello, Fernanda; Dalcolmo, Margareth; Pérez-Padilla, Rogelio; Spanevello, Antonio; Migliori, Giovanni Battista

2016-01-01

funcional (espirometria, pletismografia e DLCO), a gasometria arterial, a capacidade de realizar exercícios, as lesões (radiografia de tórax e TC) e a qualidade de vida justificam o esforço de se considerar o que deve ser feito quando os pacientes completam seu tratamento. Até onde sabemos, nenhuma revisão avaliou esse tópico de forma abrangente. Nosso objetivo foi revisar as evidências disponíveis e obter algumas conclusões sobre o futuro papel da fase de "tratamento pós-tuberculose", que irá potencialmente impactar milhões de casos todos os anos. Realizou-se uma revisão não sistemática da literatura tendo como base uma pesquisa no PubMed usando palavras-chave específicas (várias combinações dos termos "tuberculose", "reabilitação", "tuberculose multirresistente", "doença pulmonar", "doença pulmonar obstrutiva", e "medidas de volume pulmonar"). As listas de referências dos artigos principais foram recuperadas para melhorar a sensibilidade da busca. Foram selecionados manuscritos escritos em inglês, espanhol e russo. As principais áreas de interesse foram sequelas de tuberculose após diagnóstico e tratamento; "pulmão destruído"; avaliação funcional das sequelas; intervenções de reabilitação pulmonar (fisioterapia, oxigenoterapia de longo prazo e ventilação); e tuberculose multirresistente. As evidências encontradas sugerem que a tuberculose é definitivamente responsável por sequelas funcionais, principalmente causando um padrão obstrutivo na espirometria (mas também padrões restritivos e mistos) e que há razão para a reabilitação pulmonar. Fornecemos também uma lista de variáveis a serem discutidas em futuros estudos sobre reabilitação pulmonar em pacientes com sequelas pós-tuberculose.

Mapping opportunities and challenges for rewilding in Europe

PubMed Central

Ceaușu, Silvia; Hofmann, Max; Navarro, Laetitia M; Carver, Steve; Verburg, Peter H; Pereira, Henrique M

2015-01-01

de la vida silvestre (“rewilding”) representa una estrategia alternativa a esto. Desarrollamos un marco de trabajo para evaluar las oportunidades de reintroducción en diferentes dimensiones de naturaleza a lo largo de Europa. Mapeamos la luz artificial, la accesibilidad para humanos con base en la infraestructura de transporte, la proporción de productividad primaria (es decir, la productividad del ecosistema incautado por los humanos por medio de la agricultura o la silvicultura) y la divergencia de vegetación natural potencial en áreas que se proyecta estarán abandonadas para el 2040. A nivel continental, los niveles de luz artificial fueron bajos y la divergencia de vegetación natural potencial fue alta en las áreas de abandono. La importancia relativa de las medidas de naturaleza difirió regionalmente y estuvieron conectadas fuertemente a los contextos ambientales y socio-económicos locales. Las grandes áreas de abandono proyectado estuvieron localizadas frecuentemente en o alrededor de sitios Natura 2000. Con base en estos resultados, argumentamos que el manejo debería ser fabricado para restaurar los aspectos de la naturaleza que son carentes en cada región. Todavía quedan muchos obstáculos con respecto a la biodiversidad en Europa, pero las especies de megafauna ya se están recuperando. Para potenciar aún más la reintroducción a gran escala, el manejo de Natura 2000 necesitaría incorporar estrategias de reintroducción. Nuestro marco de trabajo puede aplicarse a la evaluación de las oportunidades de reintroducción y a los obstáculos en otras regiones del mundo, y nuestros resultados pueden guiar la redirección de los subsidios para manejar los sistemas socio-ecológicos. PMID:25997361

The genesis of the AIDS policy and AIDS Space in Brazil (1981-1989).

PubMed

Barros, Sandra Garrido de; Vieira-da-Silva, Ligia Maria

2016-07-21

para a formulação de uma política específica. O Espaço Aids constituiu-se como produto do encontro da trajetória de agentes de diversos campos sociais (médico, científico, político e burocrático). Um espaço específico de relações, que possibilitou a formulação de uma política para o controle da epidemia da aids, mas onde também estava em disputa a autoridade de falar sobre o significado da doença, suas formas de prevenção e tratamento. A análise mostrou como as estruturas (governos democráticos no estado de São Paulo e no âmbito nacional, com sanitaristas assumindo posições importantes) e a ausência de terapia específica contribuíram para que agentes sociais com disposições e formações diversas formulassem uma política que priorizou inicialmente a prevenção. A ascensão do movimento sanitário, a constituição do SUS e a dominância do campo médico no Espaço Aids contribuíram para a valorização do tratamento, como parte das medidas de controle da epidemia. Essas condições possibilitaram a formulação de uma política baseada na integralidade das ações, articulando prevenção e tratamento, na década seguinte, com importante participação da burocracia estatal e de pesquisadores.

NEW TECHNIQUE FOR OBESITY SURGERY: INTERNAL GASTRIC PLICATION TECHNIQUE USING INTRAGASTRIC SINGLE-PORT (IGS-IGP) IN EXPERIMENTAL MODEL.

PubMed

Müller, Verena; Fikatas, Panagiotis; Gül, Safak; Noesser, Maximilian; Fuehrer, Kirs Ten; Sauer, Igor; Pratschke, Johann; Zorron, Ricardo

2017-01-01

utilizando um dispositivo intragástrico de portal único em modelo experimental de suínos. Foram realizados 20 experimentos utilizando estômagos de cadáver de porco fresco em um instrutor laparoscópico. O procedimento foi realizado da seguinte forma em dez porcos: 1) medida de volume; 2) insuflação do estômago com CO2; 3) extroversão do estômago através do simulador e instalação do dispositivo de uma única via (Gelpoint Applied Mini) através de uma gastrotomia próxima ao piloro; 4) realização de quatro suturas de quatro pontos intra-gástricas com Prolene 2-0, desde o fundo gástrico até o antro; 5) medição do volume residual. A gastrectomia vertical foi também realizada em mais dez suínos e o volume gástrico pré e pós-procedimento foi medido. A técnica de plicatura gástrica interna foi realizada com sucesso nos dez experimentos com suínos. O tempo médio do procedimento foi de 27±4 min. Produziu redução do volume gástrico em média de 51%, e a gastrectomia vertical em média de 90% neste modelo suíno. A técnica de plicatura gástrica interna, utilizando um dispositivo intragástrico de uma única via, exigiu poucas habilidades para ser realizada, teve baixo tempo operatório e obteve boa redução (51%) do volume gástrico em um modelo experimental in vitro.

Assessment of Subclinical Doxorubicin-induced Cardiotoxicity in a Rat Model by Speckle-Tracking Imaging.

PubMed

Kang, Yu; Wang, Wei; Zhao, Hang; Qiao, Zhiqing; Shen, Xuedong; He, Ben

2017-07-10

cardiotoxicidade induzida por antraciclina é de vital importância para o equilíbrio entre o risco cardíaco e o potencial tratamento do câncer. Investigar se a análise por speckle-tracking pode fornecer uma medida sensível e precisa na detecção de lesão ventricular esquerda induzida por doxorrubicina. Ratos Wistar foram divididos em 4 grupos de 8 ratos cada, e doxorrubicina foi administrada intraperitonealmente em intervalos semanais de até 4 semanas. Grupo 1: 2,5 mg/kg/semana; Grupo 2: 3 mg/kg/semana; Grupo 3: 3,5 mg/kg/semana; Grupo 4: 4 mg/kg/semana. Foram utilizados 5 ratos adicionais como controles. As imagens ecocardiográficas foram obtidas na linha basal e 1 semana após a última dose do tratamento. Foram analisados o strain radial (Srad) e circunferencial (Scirc) e as taxas de strain radial (TSrad) e circunferencial (TScirc). Após o experimento, a troponina cardíaca I (cTnI) foi analisada e as amostras cardíacas foram avaliadas histologicamente. Após a exposição à doxorrubicina, a FEVE foi significativamente reduzida no grupo 4 (p = 0,006), mas permaneceu estável nos outros grupos. Entretanto, após o tratamento, os Srads foram reduzidos nos grupos 2, 3 e 4 (p < 0,05). A diminuição dos Srads foi correlacionada com cTnI (rho = -0,736, p = 0,000) e os escores de cardiomiopatia (rho = -0,797, p = 0,000). O strain radial pode fornecer um índice sensível e não-invasivo na detecção precoce da lesão miocárdica induzida pela doxorrubicina. As alterações do strain radial apresentaram correlação significativa com lesões miocárdicas e níveis séricos de troponina I cardíaca, indicando que esse parâmetro pode avaliar com precisão a gravidade da cardiotoxicidade.

Effect of Lactation on myocardial vulnerability to ischemic insult in rats.

PubMed

Askari, Sahar; Imani, Alireza; Sadeghipour, Hamidreza; Faghihi, Mahdieh; Edalatyzadeh, Zohreh; Choopani, Samira; Karimi, Nasser; Fatima, Sulail

2017-05-01

vulnerabilidade do miocárdio ao insulto isquêmico. Dezoito ratas foram divididas aleatoriamente em três grupos: isquemia-reperfusão (IR), no qual os corações de ratas virgens foram submetidos à IR (n = 6); lactantes, no qual as ratas amamentaram seus filhotes por 3 semanas e os corações maternos foram, em seguida, submetidos à IR (n = 6); e não lactantes, no qual os filhotes foram separados após o nascimento e os corações maternos foram submetidos à IR (n = 6). As medidas de desfecho incluíram frequência cardíaca (FC), pressão desenvolvida no ventrículo esquerdo (PDVE), duplo produto (DP), razão do tamanho do infarto sobre a área sob risco (TI/ASR %) e arritmias ventriculares - contração ventricular prematura (CVP) e taquicardia ventricular (TV). O TI/ASR foi substancialmente menor no grupo de lactantes quando comparado ao grupo de não lactantes (13,2 ± 2,5 versus 39,7 ± 3,5, p < 0,001) e ao grupo IR (13,2 ± 2,5 versus 34,0 ± 4,7, p < 0,05). A avaliação das arritmias ventriculares induzidas pela IR indicou que o número de CVPs compostas na isquemia, e o número e a duração das TVs na isquemia e nos primeiros 5 minutos de reperfusão no grupo de não lactantes foram significativamente (p < 0,05) mais elevados do que os encontrados nos grupos IR e de lactantes. A lactação induziu o aparecimento precoce de efeitos cardioprotetores, enquanto ratas que não foram permitidas a amamentar seus filhotes se mostraram mais suscetíveis à lesão miocárdica por IR.

HOW TO ACHIEVE AND MAINTAIN NOTE 6: POSTGRADUATE PROGRAM IN TRANSLATIONAL SURGERY - UNIFESP.

PubMed

Sabino-Neto, Miguel; Ferreira, Lydia Masako

2015-01-01

adequação às normas vigentes. Os pontos principais para alcançar e manter conceito 6 foram: : 1) produção regular de teses de mestrado e doutorado com distribuição adequada entre todos os orientadores; 2) tempo médio de titulação adequado, assim como rígida seleção do alunado que zera as desistências e cancelamentos; 3) produção de artigos científicos alta em revistas de impacto e com participação docente e discente na sua grande maioria; 4) aumento progressivo e substancial da captação de recursos e busca de patentes; 5) aumento progressivo dos intercâmbios internacionais com produção conjunta; 6) visibilidade através de novo site bilíngue e atualizado semanalmente; 7) inúmeras atividades de solidariedade em pesquisa, mas também em Serviços de Saúde para a população e mesmo no ensino básico; 8) rigorosa seleção dos alunos (através de análise de projeto, currículo e programa de estágio docente); 9) manutenção de índices elevados de produção dos docentes; 10) preparação de novos docentes para orientação através de participação como co-orientação e envolvimento no programa para se adequar às necessidades. O Programa de Pós-Graduação em Cirurgia Translacional passou por momentos difíceis e que através de uma série de medidas, ajustes e a colaboração e compreensão do seu corpo docente pode sair da nota 3 e quase fechamento, para um nível de excelência mantendo nota 6 em três triênios seguidos.

Determinants of tobacco use by students.

PubMed

Vargas, Lorena Silva; Lucchese, Roselma; Silva, Andrécia Cósmem da; Guimarães, Rafael Alves; Vera, Ivânia; Castro, Paulo Alexandre de

2017-05-04

questionário estruturado, cujas variáveis preditoras foram: dados sociodemográficos, núcleo familiar, religião, prática de atividade física, funcionalidade familiar e pai ou mãe fumante. Foram implementados dois modelos multivariáveis, o primeiro para uso de tabaco na vida e o segundo para uso regular, obtendo-se como medida de efeito razão de prevalência (RP) e seus respectivos IC95%. Variáveis com p < 0,10 foram incluídas em modelos de regressão de Poisson com variância robusta, para obtenção da RP ajustada (RPaj) e IC95%. O teste Qui-quadrado de Wald foi utilizado para testar as diferenças entre as proporções, e valores com p < 0,05 foram considerados estatisticamente significantes. As prevalências de consumo de tabaco na vida e regular foram de 33,4% (IC95% 29,8-36,9) e 6,7% (IC95% 5,0-8,8), respectivamente. Os fatores associados ao consumo de tabaco na vida foram: idade de 15 a 17 anos (RPaj = 1,98) e superior a 18 anos (RPaj = 3,87), sexo masculino (RPaj = 1,23), moderada disfuncionalidade familiar (RPaj = 1,30), elevada disfuncionalidade familiar (RPaj = 1,97) e pai ou mãe fumante (RPaj = 1,60). Em relação ao consumo regular de tabaco, permaneceram associados a idade superior a 18 anos (RPaj = 4,63), não possuir religião (RPaj = 2,08), elevada disfuncionalidade familiar (RPaj = 2,35) e pai ou mãe fumante (RPaj = 2,89). Estudantes apresentam elevada prevalência de consumo de tabaco na vida e regular. Esse consumo associa-se com variáveis sociodemográficas e disfuncionalidade familiar.

Compatibility and competitiveness of a laboratory strain of Anastrepha Fraterculus (Diptera: Tephritidae) after irradiation treatment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Allinghi, A.; Calcagno, G.; Gomez Cendra, P.

poblacion salvaje (TUC) de Anastrepha fraterculus (Wiedemann). La linea de laboratorio se produce en condiciones de cria semi-masiva en las instalaciones de la Estacion Experimental Agroindustrial Obispo Colombres (Tucuman, Argentina). Las moscas salvajes se obtuvieron de frutas infestadas de guayabos en Horco Molle (Tucuman, Argentina). Las pupas de laboratorio fueron irradiadas ({sup 60}Co) 48 horas antes de la emergencia del adulto. Las dosis utilizadas fueron 0 (control), 40, 70, y 100 Gy. Se liberaron 25 machos y 25 hembras de TUC y LAB dentro de las jaulas y se recolectaron las parejas formadas. Solo se considero 1 dosis de irradiacion por vez. Las hembras apareadas fueron separadas y se les permitio poner huevos en frutas artificiales para estimar la esterilidad inducida a traves del porcentaje de eclosion. La hora de inicio de la copula no difirio significativamente entre poblaciones ni entre los tratamientos de irradiacion. La duracion de la copula mostro grandes diferencias entre dosis de irradiacion pero no entre cepas. Los indices ISI (aislamiento) y el RSI (esterilidad relativa) indican que LAB y TUC son totalmente compatibles, los machos de TUC y LAB no difieren en su competitividad y la irradiacion dentro del rango de dosis utilizadas tampoco afecto este indice. Las hembras LAB no irradiadas muestran una mayor propension para el apareamiento que las hembras de TUC. Sin embargo se observo una reduccion significativa del indice FRPI (actuacion relativa de hembras) a medida que se aumenta la dosis de irradiacion. El analisis de la esterilidad inducida indica que con dosis de 40 Gy la fertilidad disminuye del 80% al 0.75%, y con dosis mayores la esterilidad fue total. Las hembras irradiadas con dosis de 40 Gy tienen una fertilidad de aproximadamente 2% y con dosis mayores no ponen huevos. (author)« less

The conceptualization model problem—surprise

NASA Astrophysics Data System (ADS)

Bredehoeft, John

2005-03-01

que le modèle conceptuel peut bien changer lorsque des nouvelles informations apparaissent. Dans l'analyse finale le hydrogéologue prend une décision subjective sur le modèle conceptuel approprié. Le problème du le modèle conceptuel ne doit pas rendre le modèle inutilisable. Ce problème introduit une incertitude qui n'est pas toujours reconnue. Les incertitudes du modèle conceptuel deviennent plus importantes dans les cases de prévisions à long terme dans l'analyse de performance. La base para hacer un análisis de un modelo es el modelo conceptual. Se define aquí la sorpresa como los datos nuevos que convierten en incoherente al modelo conceptual previamente aceptado; tal como se define aquí esto representa un cambio de paradigma. Los datos empíricos limitados indican que estas sorpresas suceden entre un 20 a un 30% de los análisis de modelos. Esto sugiere que los analistas de modelos de agua subterránea tienen dificultades al seleccionar el modelo conceptual apropiado. No hayotra solución disponible a este problema del modelo conceptual diferente de: (1) Recolectar tanta información como sea posible, mediante la utilización de todos los métodos aplicables, lo cual puede resultar en que esta nueva información ayude a cambiar el modelo conceptual vigente, y (2) Que el analista de modelos se mantenga siempre abierto al hecho de que un modelo conceptual puede cambiar de manera total, en la medida en que se colecte mas información. En el análisis final el hidrogeólogo toma una decisión subjetiva en cuanto al modelo conceptual apropiado. El problema de la conceptualización no produce modelos inútiles. El problema presenta una incertidumbre, la cual a menudo no es tenida en cuentade manera adecuada. Esta incertidumbre en los modelos conceptuales se aumenta, cuando se hacen predicciones a largo plazo del comportamiento de un sistema dado.

Indicators to assess the quality of programs to prevent occupational risk for tuberculosis: are they feasible?

PubMed

Santos, Talita Raquel Dos; Padoveze, Maria Clara; Nichiata, Lúcia Yasuko Izumi; Takahashi, Renata Ferreira; Ciosak, Suely Itsuko; Gryschek, Anna Luiza de Fátima Pinho Lins

2016-06-07

testado em cinco situações devido à falta de uso do teste tuberculínico nessas instituições. O tempo necessário para aplicar indicadores em relação aos resultados de tuberculose ocupacional depende em grande parte do nível da organização da estrutura administrativa para a coleta de dados. os indicadores de avaliação da estrutura de prevenção de tuberculose ocupacional são altamente viáveis. No entanto, a viabilidade de aplicação dos indicadores de processo e de resultado é limitada devido a variações relevantes em questões administrativas nas instituições de saúde. analizar la viabilidad de los indicadores de calidad de la evaluación de los programas hospitalarios para la prevención de la tuberculosis en el trabajo. estudio descriptivo transversal. Se probaron los indicadores dirigidos a evaluar los programas para la prevención de la tuberculosis laboral en seis hospitales. El criterio para definir la viabilidad fue el tiempo para aplicar los indicadores. el tiempo empleado para la evaluación de los los indicadores varió desde 02'52 '' hasta 15h11'24 ''. El indicador para la evaluación de la estructura requiere menos tiempo; se invirtió más tiempo en los indicadores de proceso, lo que incluye la observación de las prácticas de los empleados del cuidado de salud en relación con el uso de máscaras N95. No se pudo probar uno de los indicadores de resultados de tuberculosis en cinco situaciones debido a la falta de uso de la prueba de la tuberculina en estas centros. El tiempo necesario para aplicar los indicadores en relación con los resultados por tuberculosis laboral depende en gran medida del nivel de organización de la estructura administrativa para la recopilación de datos. los indicadores para evaluar la estructura para la prevención de la tuberculosis laboral son altamente factibles. Sin embargo, la viabilidad de aplicación de los indicadores de proceso y el resultado es limitada debido a las variaciones relevantes en

Inequalities in healthy life expectancy by Federated States.

PubMed

Szwarcwald, Célia Landmann; Montilla, Dália Elena Romero; Marques, Aline Pinto; Damacena, Giseli Nogueira; Almeida, Wanessa da Silva de; Malta, Deborah Carvalho

2017-06-01

ça de vida saudável foi estimada pelo método de Sullivan, com base nas informações da Pesquisa Nacional de Saúde, 2013. Foram adotados três critérios para definição de estado "não saudável": autoavaliação de saúde ruim, funcionalidade para realização das atividades da vida diária, e presença de doença crônica não transmissível com grau intenso de limitação. O indicador de nível socioeconômico foi construído com base no número de bens no domicílio e grau de escolaridade do responsável. Para analisar as desigualdades geográficas e por nível socioeconômico, foram calculadas medidas de desigualdade, como a razão, a diferença e o coeficiente angular. A esperança de vida saudável entre os homens variou de 13,8 (Alagoas) a 20,9 (Espírito Santo) para o critério de autoavaliação de saúde ruim. Entre as mulheres, as estimativas correspondentes foram sempre mais altas e variaram de 14,9 (Maranhão) a 22,2 (São Paulo). Quanto à razão de desigualdades por Unidade da Federação, as medianas foram sempre maiores para a esperança de vida saudável do que para a esperança de vida, independentemente da definição adotada para estado saudável. Quanto às diferenças por Unidade da Federação, a esperança de vida saudável chegou a ser sete anos maior em um estado do que em outro. Por nível socioeconômico, foram encontradas diferenças de três e quatro anos, aproximadamente, entre os últimos e primeiro quintos, para homens e mulheres, respectivamente. Além de os indicadores de mortalidade estarem associados às condições de vida, as desigualdades são ainda mais pronunciadas quando o bem-estar e as limitações nas atividades habituais são levados em consideração, mostrando a necessidade de promover ações e programas para diminuir o gradiente socioespacial.

Assessing ecological correlates of marine bird declines to inform marine conservation

PubMed Central

Vilchis, L Ignacio; Johnson, Christine K; Evenson, Joseph R; Pearson, Scott F; Barry, Karen L; Davidson, Peter; Raphael, Martin G; Gaydos, Joseph K

2015-01-01

ólo proporciona percepciones únicas de este tipo de especies que están en riesgo de ser extirpadas y el por qué de esto, sino también puede informar a las medidas de conservación proactivas para contrarrestar amenazas – información que es primordial para la conservación específica de especies y del ecosistema en su totalidad. PMID:25195954

Caracterización espectroscópica de hielos de interés atmosférico y astrofísico

NASA Astrophysics Data System (ADS)

Escribano, R.

En años recientes se ha incrementado el estudio de procesos físicos y químicos que tienen lugar en la superficie o el interior de hielos, tanto en medios astrofísicos como en la atmósfera terrestre y en otros cuerpos del sistema solar. Se ha comprobado que las partículas heladas actúan como catalizadores de reacciones químicas, que no ocurrirían en su ausencia. En la atmósfera terrestre, es bien conocida la importancia de partículas de hidratos de ácido nítrico, formando las llamadas nubes estratosféricas polares, en los procesos de destrucción de ozono estratosférico. En hielos astrofísicos, átomos como H, C, N y O pueden adherirse o introducirse en la estructura cristalina o amorfa del hielo, y dar lugar a reacciones de formación de moléculas evitando su barrera de activación. Existen partículas heladas en el medio interestelar formando parte de las llamadas nubes moleculares densas y frías, con valores del orden de 106 átomos de H por cm3 y temperaturas entre 3 y 90 K. Alrededor de protoestrellas, pueden formarse hielos de distinta composición, polares o apolares, en las zonas de alejamiento y temperatura decreciente a partir del núcleo caliente. Por su parte, los cometas están formados por un núcleo de hielo y rocas, sobre el que se encuentran adheridas moléculas gaseosas, y una cola, formada por los gases liberados por efecto del calentamiento debido a la radiación solar incidente. En nuestro sistema solar, los polos de La Tierra y de Marte están cubiertos de hielo, así como la mayoría de los cuerpos externos. Los satélites de Júpiter han sido estudiados detalladamente, y se han encontrado en ellos, y en Tritón (satélite de Neptuno), hielos de moléculas como SON2, CO2, N2, CH4 y otros. Para la caracterización espectroscópica de estos hielos se precisan medidas en el laboratorio, aún conociendo la imposibilidad intrínseca de reproducir exactamente las condiciones en que se formaron y se encuentran en los medios astrof

Apparent Motion of the Sun, Shadows of Objects and Measurement of Time in the View of Seventh Grade Students of Middle School. (Breton Title: Movimento Aparente do Sol, Sombras dos Objetos e Medição do Tempo na Visão de Alunos do Sétimo Ano do Ensino Fundamental.) Movimiento Aparente del Sol, Sombras de los Objetos y Medición del Tiempo en la Visión de Estudiantes del Séptimo Grado del Ciclo Pirmario

NASA Astrophysics Data System (ADS)

Iria Machado, Daniel

2013-07-01

analemático, conduzida por um monitor. Uma proporção significativa de estudantes desconhecia inicialmente a maioria dos fenômenos tratados. A intervenção realizada colaborou para uma parte dos alunos assimilar novos conceitos, propiciando o contato com novos fenômenos e, em menor grau, a elaboração de explicações a respeito destes, indicando um potencial educativo dessa ação. Porém, a contribuição para o entendimento de algumas das ideias exploradas foi pequena, apontando para a necessidade de se fazer observações, estudos e discussões complementares. El movimiento aparente del Sol en la esfera celeste y el comportamiento de las sombras de los objetos a lo largo del tiempo son fenómenos observables en la vida cotidiana. Sin embargo, los estudiantes a menudo no tienen una adecuada comprensión de dichos problemas, e incluso pueden mostrar conceptos erróneos acerca de ellos. Por lo tanto, se realizó una investigación a fin de conocer las nociones de los estudiantes acerca de estas cuestiones y evaluar la contribución a su comprensión proporcionada por una actividad realizada con un reloj de Sol interactivo, en un entorno informal de aprendizaje. Se investigaron las ideas de 43 estudiantes del séptimo grado del ciclo primario mediante la aplicación de un test con preguntas abiertas antes y después de una actividad con un reloj de Sol analemático, dirigida por un monitor. Una proporción significativa de los estudiantes inicialmente desconocía la mayoría de los fenómenos tratados. La intervención realizada contribuyó para que los estudiantes asimilasen nuevos conceptos, proporcionando el contacto con nuevos fenómenos y, en menor medida, desarrollasen explicaciones acerca de estos, lo que indica un potencial educativo de esta acción. Sin embargo, la contribución a la comprensión de algunas de las ideas exploradas fue pequeña, lo que apunta a la necesidad de hacer observaciones, estudios y debates adicionales.

LINEA ALBA COLLAGEN ASSESSMENT IN MORBIDLY OBESE PATIENTS.

PubMed

Grossi, João Vicente Machado; Nicola, Felipe Fernandes; Zepeda, Ivan Alberto; Becker, Martina; Trindade, Eduardo Neubarth; Diemen, Vinicius Von; Cavazzola, Leandro Totti; Trindade, Manoel Roberto Maciel

ão-obesos (grupo controle). As amostras foram retiradas da linha alba abdominal no período de 2013 a 2014 e inicialmente foram separadas conforme faixas etárias (18-30, 31-45 e 46-60), gênero, medidas de IMC, circunferência abdominal e cervical e espessura do subcutâneo do indivíduo. Foi coletado material para biópsia da linha alba supraumbilical para análise imunoistoquímica, diferenciando o colágeno tipo I e III e sua relação de tipo I/III. Utilizou-se o programa de contagem de pixels Image-Pro Plus(r), que mensurou a quantidade do colágeno. O grupo obesidade teve idade 44,11±9,90 anos, Na faixa etária de 18-30 anos foram incluídos três (6,8%) obesos; na de 31-45 anos 22 (50%) e na de 46-60 anos 19 (43,1%). O gênero feminino apresentou predomínio, com 36 (81,8%) pacientes. O IMC (kg/m²) foi de 48,81±6,5; a circunferência abdominal (cm) foi de 136,761±13,55; a espessura do subcutâneo (cm) foi de 4,873±0,916. A quantidade de colágeno tipo I foi de 134.683,3±206.657,4; a de colágeno tipo III foi de 413.137,2±283.656,1; a razão do colágeno tipo I/III foi 0,419±0,636. Considerando-se faixas de idade, gênero e IMC, foram constatadas diferenças estatísticas em todas as análises quando comparadas com às dos cadáveres. Os obesos mórbidos apresentaram quantidade de colágeno na linha alba supraumbilical menor que a do grupo controle de cadáveres não-obesos na mesma faixa etária.

Migration of recharge waters downgradient from the Santa Catalina Mountains into the Tucson basin aquifer, Arizona, USA

NASA Astrophysics Data System (ADS)

Cunningham, Erin E. B.; Long, Austin; Eastoe, Chris; Bassett, R. L.

'origine thermonucléaire permettent de caractériser qualitativement les cheminements de l'eau et leurs vitesses. Les isotopes stables ne mettent pas en évidence un effet d'altitude. Les teneurs en tritium indiquent que quelques sources et certains puits fournissent une eau ancienne, alors que l'eau de la plupart des sources date des années soixante ou est plus récente. Resumen Los acuíferos en las cuencas aluviales áridas del sudoeste de los Estados Unidos de América se recargan principalmente por la infiltración procedentes de los arroyos y playas de las propias cuencas y por entradas a lo largo de los límites de las mismas. La cuenca de Tucson, en el sudeste de Arizona es una de ellas. Las Montañas de Santa Catalina forman el contorno septentrional de esta cuenca y reciben una precipitación de más del doble (700mm/año) que la media de la propia cuenca (unos 300mm/año). En este estudio, se utilizaron isótopos ambientales para investigar la infiltración a través de fracturas y juntas superficiales. Se obtuvieron muestras de manantiales y de la escorrentía en las Montañas de Santa Catalina, así como de pozos ubicados al pie de las mismas. Los isótopos estables (Deuterio y Oxígeno-18) y el Tritio procedente de las bombas termonucleares permitieron la caracterización cualitativa de las líneas de flujo y de las velocidades. Los datos procedentes de la medida de isótopos estables no parecen presentar un efecto de altitud. Los valores de Tritio indican que aunque algunos pozos y manantiales descargan agua previa a los ensayos termonucleares, la mayoría descargan aguas de fecha posterior a 1960.

Evaluation in health: participatory methodology and involvement of municipal managers.

PubMed

Almeida, Cristiane Andrea Locatelli de; Tanaka, Oswaldo Yoshimi

2016-08-04

, its involvement with the evaluations at the federal level can also be stimulated. Analisar alcances e limites do uso de metodologia participativa de avaliação junto a gestores e gerentes municipais de saúde. Pesquisa qualitativa com gestores e gerentes de saúde da Comissão Intergestores Regional de uma região de saúde do estado de São Paulo. Representantes de sete municípios membros participaram de sete oficinas facilitadas pelos pesquisadores, com o objetivo de avaliar um problema específico da linha de cuidados sob a perspectiva da integralidade. A análise do material empírico coletado baseou-se na metodologia hermenêutica-dialética e visou a avaliação da metodologia participativa aplicada, segundo sua capacidade de promover um processo de avaliação passível de ser utilizado como suporte à gestão municipal. Com a abordagem participativa de avaliação, foi possível promover debates em profundidade com o grupo, principalmente relacionados à construção da integralidade da atenção e à inclusão da perspectiva do usuário na tomada de decisão, de forma vinculada à busca de solução para problemas concretos dos gestores. Mediante a exploração conjunta, foi aberta a possibilidade de utilização de dados advindos dos sistemas eletrônicos de informação, bem como de informações advindas diretamente dos usuários dos serviços, para enriquecer debates e negociações entre parceiros. Os participantes se mostraram descrentes do potencial de replicação deste tipo de avaliação sem o acompanhamento direto da academia, dada a dificuldade de organização do processo no cotidiano, já tomado por questões emergenciais e políticas. Avaliações de programas e serviços realizadas no âmbito da Comissão Intergestores Regional, partindo do interesse local e facilitando o envolvimento de seus membros pelo uso de metodologias participativas, podem contribuir para a construção da integralidade do cuidado. Na medida em que o ato de avaliar

BREAST CANCER METASTASIS IN THE STOMACH: WHEN THE GASTRECTOMY IS INDICATED ?

PubMed

Rodrigues, Marcus Vinicius Rozo; Tercioti-Junior, Valdir; Lopes, Luiz Roberto; Coelho-Neto, João de Souza; Andreollo, Nelson Adami

2016-01-01

the absence of other secondary involvement and control of the primary lesion. A neoplasia de mama é o tumor maligno mais comum na população feminina tendo o trato gastrointestinal, e mais especificamente o estômago, como local incomum para metástases. Analisar uma série de casos com esse tumor e propor medidas que possam diagnosticá-lo com maior precocidade. Foram analisados retrospectivamente 12 pacientes com diagnóstico de neoplasia gástrica secundária a câncer de mama, confirmado por biópsia e imunoistoquímica. Foram analisados idade do diagnóstico, tipo histológico do tumor primário, intervalo de tempo entre o diagnóstico do tumor e a metástase, tratamento e sobrevida. A idade média foi de 71,3 anos (40-86 anos). Em média, o diagnóstico da metástase gástrica foi de sete anos após o diagnóstico da lesão primaria (0-13 anos). Nove casos tiveram metástases em outros órgãos, sendo os ossos os locais mais acometidos. Evidenciou-se positividade de anticorpo CK7 em 90,9% casos, receptor de estrógeno em 91,67%, receptor de progesterona em 66,67% e BRST2 em 41,67%. A ausência de CK20 foi de 88,89%. Oito casos foram tratados com quimioterapia associada ou não ao bloqueio hormonal e em quatro foi indicada ressecção cirúrgica sendo em três gastrectomia total e em um caso gastrectomia subtotal. A sobrevida média foi de 14,58 meses. Em doentes com história prévia de câncer de mama apresentando diagnóstico endoscópico de neoplasia gástrica, é necessário considerar a possibilidade de metástase. A confirmação é feita por estudo imunoistoquímico e a gastrectomia deve ser orientada diante da ausência de outros locais de acometimento secundário e controle da lesão primária.

Atrial Function in Patients with Breast Cancer After Treatment with Anthracyclines.

PubMed

Yaylali, Yalin Tolga; Saricopur, Ahmet; Yurtdas, Mustafa; Senol, Hande; Gokoz-Dogu, Gamze

2016-11-01

incluídas neste estudo retrospectivo, além de 42 indivíduos saudáveis (47 ± 9 anos). Medidas ecocardiográficas foram realizadas por aproximadamente 11 ± 7 meses (média de 9 meses) após tratamento com antraciclinas. AEA esquerdo intra-atrial (11,4 ± 6,0 vs. 8,1 ± 4,9, p=0,008) e AEA interarterial (19,7 ± 7,4 vs. 14,7 ± 6,5, p=0,001) foram prolongados; Volume de esvaziamento passivo e fracionamento de AE diminuíram (p=0,0001 e p=0,0001); Volume de esvaziamento ativo e fracionamento de AE (p=0,0001 e p=0,0001); Tempo de aceleração mitral A (0,8 ± 0,2 vs. 0,6 ± 0,2, p=0,0001) e de desaceleração de onda-E mitral (201,2 ± 35,6 vs. 163,7 ± 21,8, p=0,0001) aumentarão; Razão mitral E/A (1,0 ± 0,3 vs. 1,3 ± 0,3, p=0,0001) e mitral Em (0,09 ± 0,03 vs. 0,11 ± 0,03, p=0,001) diminuíram; Razão mitral Am (0,11 ± 0,02 vs. 0,09 ± 0,02, p=0,0001) e mitral E/Em (8,8 ± 3,2 vs. 7,6 ± 2,6, p=0,017) aumentaram nos pacientes. Em pacientes com câncer de mama após terapia com antraciclina: intervalos eletromecânicos intra-atriais esquerdos, intra-atriais foram prolongados. A função diastólica foi prejudicada. O relaxamento ventricular esquerdo foi prejudicado, e a condução elétrica atrial esquerda pode estar contribuindo para o desenvolvimento de arritmias atriais.

Aquifer overexploitation: what does it mean?

NASA Astrophysics Data System (ADS)

Custodio, Emilio

2002-02-01

actividades humanas y por la propia explotación del acuífero. Sin embargo, en la práctica se suele considerar que hay sobreexplotación cuando se observan o se perciben ciertos resultados negativos de la explotación, tales como un descenso continuado del nivel del agua, un deterioro de su calidad, un encarecimiento del agua extraída, o daños ecológicos. Pero estos efectos no están necesariamente relacionados con el hecho de que la extracción sea mayor que la recarga, puesto que pueden ser simplemente el resultado de interferencias o del dilatado período transitorio que sigue a los cambios en los términos del balance de agua, y cuya duración depende del tamaño del acuífero, y de su permeabilidad y coeficiente de almacenamiento. Las extracciones del acuífero suponen una disminución del almacenamiento de agua subterránea durante este periodo transitorio. Para decidir que grado de "sobreexplotación del acuífero" es aconsejable o admisible hace falta la consideración detallada y actualizada de los efectos de la explotación y las medidas de corrección que se adopten. Para esa decisión no basta con reglas generales y el apoyo de algunas observaciones indirectas. Se necesitan observaciones de control, buen conocimiento del acuífero y cálculos o modelación del comportamiento, y todo ello en el marco de un conjunto de objetivos y políticas establecidas por una institución de gestión, con la implicación de aquellos que tienen un interés en el agua subterránea, y teniendo en cuenta los condicionantes ambientales y sociales. La sobreexplotación de acuíferos, que con frecuencia suele asociarse a algo éticamente malo, no tiene por qué ser necesariamente así durante cierto tiempo, sino una etapa en la evolución hacia un desarrollo sustentable. En la realidad la designación de sobreexplotación de acuíferos es principalmente un adjetivo que trata de calificar a una evolución preocupante bajo determinados puntos de vista, sin que tenga una significaci

Building sustainability indicators in the health dimension for solid waste management.

PubMed

Veiga, Tatiane Bonametti; Coutinho, Silvano da Silva; Andre, Silvia Carla Silva; Mendes, Adriana Aparecida; Takayanagui, Angela Maria Magosso

2016-08-08

concordância entre os sujeitos participantes que variou de 82% a 94% em relação a esses indicadores. os indicadores propostos podem auxiliar, tanto na identificação de dados atualizados no setor, quanto na ampliação das discussões das políticas de saúde ambiental, voltadas não apenas para resíduos sólidos urbanos, mas objetivando também o alcance de melhores condições de saúde no contexto da atual realidade brasileira. elaborar una lista de indicadores de sostenibilidad en la dimensión salud para la gestión de residuos sólidos urbanos. estudio descriptivo y exploratorio realizado con 52 especialistas en el área de residuos sólidos, utilizando la técnica Delphi en tres etapas, con uso de escala de medida de grado de importancia para obtención de consenso entre investigadores de esta área. de los sujetos estudiados , 92,3% tenían doctorado con mayor concentración en el grupo etario entre 30 y 40 años (32,7%) y 51% del sexo masculino. Al final de la 3ª. Etapa de aplicación de la técnica Delphi, el promedio y el desvío estándar de todos los indicadores propuestos variaron de 4,22 (±0,79) a 4,72 (±0,64), en una escala de puntos atribuida a cada indicador de 1 a 5 (Respectivamente de "dispensable" a "muy importante"). Los resultados mostraron un nivel de acuerdo entre los sujetos participantes que varió de 82% a 94% en relación a estos indicadores. los indicadores propuestos pueden ayudar tanto en la identificación de datos actualizados en este sector, como también para ampliar las discusiones de las políticas de salud ambiental, dirigidas no solamente para residuos sólidos urbanos pero también para alcanzar mejores condiciones de salud en el contexto de la realidad brasileña actual.

Descriptive attributes used in the characterization of stingless bees (Apidae: Meliponini) in rural populations of the Atlantic forest (Misiones-Argentina)

PubMed Central

2012-01-01

identify the spectrum of salient properties relevant from the emic perspective to characterize the stingless bees. In this sense, the analysis proposed here is useful to study folk taxonomy in culturally heterogeneous groups or multicultural regions, where the linguistic elements usually employed cannot be applied. Resumen Antecedentes Los seres humanos, al identificar y clasificar a los organismos emplean una combinación de características morfológicas, sensoriales, utilitarias, culturales y ecológicas. Entre los aportes generados desde la etnotaxonomía, se ha obtenido información sobre los caracteres utilizados para identificar y clasificar una gran diversidad de grupos taxonómicos. Sin embargo, aún faltan trabajos donde se comparen los caracteres utilizados en las descripciones de taxones y se analice en qué medida estos descriptores se encuentran representados. Las abejas sin aguijón conforman un diverso grupo de insectos sociales que han sido estudiadas desde la perspectiva etnobiológica, dada su importancia utilitaria y cultural. Los interrogantes que guían este trabajo son ¿Qué elementos tienen en cuenta los pobladores para caracterizar a las abejas sin aguijón? y ¿Qué importancia revisten los mismos en el estudio de las clasificaciones locales? Métodos Se realizaron entrevistas semiestructuradas y recorridos en áreas rurales con los informantes. Se caracterizan a las etnoespecies conocidas localmente; se identifican los atributos descriptores y los criterios emergentes utilizados para dichas caracterizaciones; y se estima la frecuencia de citas de los atributos descriptores y criterios emergentes. Por otra parte, se comparan los atributos descriptores empleados para cada etnoespecie y se analiza el aporte de las caracterizaciones como estrategia heurística en el estudio de los sistemas de clasificación folclóricos. Resultados Se halló el empleo de 19 descriptores biológicos (que fueron agrupados en 4 criterios emergentes) y de comparaciones

Methodological proposal for validation of the disinfecting efficacy of an automated flexible endoscope reprocessor.

PubMed

Graziano, Kazuko Uchikawa; Pereira, Marta Elisa Auler; Koda, Elaine

2016-08-08

ífico, comercialmente disponível, utilizando desinfetante de alto nível à base de ácido peracético 0,2%. o método de avaliação proposto mostrou-se robusto, à medida que as recomendações das legislações pertinentes ao equipamento avaliado foram incorporadas, com algumas adaptações para sua exequibilidade. A aplicação do método proposto permitiu atestar a eficácia do equipamento utilizado na desinfecção de alto nível de endoscópios. o método pode servir de referência para a avaliação de reprocessadoras de endoscópios flexíveis, subsidiando a aquisição dessa categoria de produtos para a saúde. elaborar y aplicar un método para evaluar la eficacia de reprocesadores automatizados de endoscopios flexibles en un momento en el que no hay un método oficial o laboratorios capacitados para cumplir con los requisitos descritos en las normas específicas para este tipo de producto para la salud en Brasil. el presente estudio metodológico fue desarrollado en base a las siguientes referencias teóricas: Organización Internacional de Normalización (International Organization for Standardization - ISO) norma ISO 15883-4/2008 y Agencia Nacional de Vigilancia de la Salud de Brasil (Agência Nacional de Vigilância Sanitária - ANVISA) Resolución del Directorio Colegiado (Resolução de Diretoria Colegiada - RDC) № 35/2010 y 15/2012. El método propuesto se aplicó a un dispositivo comercialmente disponible usando un desinfectante al 0,2% a base de ácido peracético de alto nivel. el método de evaluación propuesto se evaluó como fuerte después de que las recomendaciones formuladas en la legislación pertinente se incorporaron con algunos ajustes para garantizar su factibilidad. La aplicación del método propuesto proporciona evidencia de la eficacia de los equipos de prueba para la desinfección de alto nivel de endoscopios. el método propuesto puede servir de referencia para la evaluación de reprocesadores de endoscopios flexibles, proporcionando de este

Educational intervention in Primary Care for the prevention of congenital syphilis.

PubMed

Lazarini, Flaviane Mello; Barbosa, Dulce Aparecida

2017-01-30

to evaluate the efficiency of educational interventions related to the knowledge of health care professionals of Primary Care and to verify the impact on the vertical transmission rates of congenital syphilis. a quasi-experimental study conducted in the city of Londrina, Paraná, between 2013 and 2015. An educational intervention on diagnosis, treatment and notification was carried out with 102 professionals with knowledge measurement before and after the intervention. Incidence and mortality data from congenital syphilis were taken from the system for notifiable diseases (SINAN) and the Mortality Information System (SIM). Excel tabulation and statistical analysis was done in the Statistical Package for Social Sciences, version 2.1. A descriptive and inferential analysis was performed. the mean number of correct responses increased from 53% to 74.3% after the intervention (p < 0.01). The adherence to professional training was 92.6%. There was a significant reduction in the vertical transmission rate of syphilis from 75% in 2013 to 40.2% in 2015. In 2014 and 2015 there were no records of infant mortality from this condition. the educational intervention significantly increased the knowledge of health professionals about syphilis and collaborated to reduce the rate of vertical transmission of the disease. avaliar a eficiência da intervenção educacional no conhecimento dos profissionais de saúde da Atenção Básica e verificar o impacto nas taxas de transmissão vertical da sífilis congênita. estudo quase-experimental, conduzido na cidade de Londrina, Paraná, no período entre 2013 e 2015. Foi realizada intervenção educacional sobre diagnóstico, tratamento e notificação com 102 profissionais com medida do conhecimento antes e após a intervenção. Os dados de incidência e mortalidade pela sífilis congênita foram retirados do Sistema de Informação de Agravos de Notificação (SINAN) e do Sistema de Informação sobre Mortalidade (SIM). A tabula

Elemental analyses of goundwater: demonstrated advantage of low-flow sampling and trace-metal clean techniques over standard techniques

NASA Astrophysics Data System (ADS)

Creasey, C. L.; Flegal, A. R.

'introduction accidentelle de contaminants au cours de l'échantillonnage, du stockage et de l'analyse. Lorsque ces techniques sont appliquées, les concentrations résultantes en éléments en traces sont nettement plus faibles que les résultats obtenus par les techniques d'échantillonnage classique. Dans une comparaison de données concernant des puits contaminés et des puits de contrôle d'un site de Californie (États-Unis), les concentrations en éléments en traces de cette étude ont été de 2 à 1000 fois plus faibles que celles déterminées par les techniques conventionnelles utilisées pour l'échantillonnage des mêmes puits cinq mois auparavant et un mois après ces prélèvements. En particulier, les concentrations en cadmium et en chrome obtenues par les techniques classiques de prélèvements dépassent les teneurs maximales admises en Californie, alors que les concentrations obtenues pour ces deux éléments dans cette étude sont nettement au-dessous de ces teneurs maximales. Par conséquent, le recours à des techniques à faible débit et sans traces de métal peut faire apparaître que la publication de contamination d'eaux souterraines par des éléments en traces était erronée. Resumen El uso combinado del purgado y muestreo a bajo caudal con las técnicas limpias de metales traza proporcionan medidas de la concentración de elementos traza en las aguas subterráneas que son más representativas que las obtenidas con técnicas tradicionales. El purgado y muestreo a bajo caudal proporciona muestras de agua prácticamente inalteradas, representativas de las condiciones en el terreno. Las técnicas limpias de metales traza limitan la no deseada introducción de contaminantes durante el muestreo, almacenamiento y análisis. Las concentraciones de elementos traza resultantes suelen ser bastante menores que las obtenidas por técnicas tradicionales. En una comparación entre los datos procedentes de pozos en California, las concentraciones obtenidas con el nuevo m

Re-Creating Missing Population Baselines for Pacific Reef Sharks

PubMed Central

Nadon, Marc O; Baum, Julia K; Williams, Ivor D; Mcpherson, Jana M; Zgliczynski, Brian J; Richards, Benjamin L; Schroeder, Robert E; Brainard, Russell E

2012-01-01

that density of reef sharks has declined to 3–10% of baseline levels in these areas. Resumen Los tiburones y otros depredadores mayores son escasos en la mayoría de los arrecifes de coral, pero estudios de su ecología histórica proporcionan evidencia cualitativa de que los depredadores una vez fueron numerosos en estos ecosistemas. Sin embargo, la cuantificación de la densidad de tiburones en ausencia de humanos (línea de base) es obstaculizada por la falta de datos de series de tiempo pertinentes. Recientemente, los investigadores han utilizado muestreos visuales submarinos, de extensión espacial limitada o de diseño no estándar, para inferir asociaciones negativas entre la abundancia de tiburones de arrecife y las poblaciones humanas. Analizamos datos de 1607 muestreos por remolque de buzos (transectos >1ha muestreados por observadores remolcados por una lancha) realizados en 46 arrecifes en el Océano Pacífico centro-occidental, arrecifes que incluyeron algunos de los más prístinos del mundo. Las estimaciones de densidad de tiburones fue sustancialmente menor (<10%) que estimaciones publicadas a partir de muestreos a lo largo de transectos pequeños (<0.02 ha), lo cual no es consistente con las pirámides de biomasa invertidas (la biomasa de depredadores es mayor que la biomasa de presas) reportadas para arrecifes prístinos por otros autores. Examinamos la relación entre la densidad de tiburones de arrecife observados en los muestreos por remolque de buzos y la población humana en modelos y consideramos la influencia de la productividad oceánica primaria, la temperatura de la superficie del mar, la superficie del arrecife y su complejidad física. Utilizamos estos modelos para estimar la densidad de tiburones en ausencia de humanos. Las densidades de Carcharhinus amblyrhynchos, Triaenodon obesus y el grupo de “tiburones estrictamente arrecifales” incrementó sustancialmente a medida que disminuyó la población humana y que incrementó la

Patterns of evolution of research strands in the hydrologic sciences

NASA Astrophysics Data System (ADS)

Schwartz, F. W.; Fang, Y. C.; Parthasarathy, S.

2005-03-01

première contribution dans leur domaine et qui ont beaucoup influencé la recherche sont en général les plus cités. Il semble que la diminution de l'importance d'un domaine de recherche est aussi reflétée par le nombre de citations. Le modèle des citations des quelques articles classiques montre que l'activité dans le domaine ainsi que l'impact sur les articles suivantes déclinent progressivement pendant le temps ce qui présente une analogie avec les idées de Kuhn sur la science normale et révolutionnaire. Le résultat de l'étude renforce une fois de plus l'importance d'être un pionnier dans un domaine, en faisant avancer la recherche dans le domaine respectif, en adoptant des stratégies qui peuvent créer des percées majeures dans la recherche. Este artículo examina los temas de impacto e innovación en la investigación de las aguas subterráneas, mediante el uso de datos bibliométricos y del análisis de las referencias bibliográficas. El análisis se basó en 3120 artículos de la revista Water Resources Research, con el contenido completo y sus datos de referencias bibliográficas obtenidos de la Red de Ciencia ISI. La investigación se diseñó para desarrollar un entendimiento mayor de la forma en que la cantidad de citas bibliográficas puede ser interpretada por los científicos. No es sorprendente que los artículos más citados, parecen ser los pioneros en el campo, siendo artículos que divergen significativamente de lo que se ha hecho anteriormente, los cuales son efectivos creando de manera similar otros artículos "seguidores". Los artículos que son contribuciones iniciales en una línea de investigación nueva, la cual es de alta influencia, serán en promedio citados muy frecuentemente. Sin embargo, la importancia de una línea de investigación, de acuerdo a su medida por las veces que es citada, parece disminuir con el tiempo. Las tendencias en cuanto a hacer citas bibliográficas de algunos artículos clásicos, muestran que la

Fracture hydraulic conductivity in the Mexico City clayey aquitard: Field piezometer rising-head tests

NASA Astrophysics Data System (ADS)

Vargas, Carlos; Ortega-Guerrero, Adrián

entre la conductividad hidráulica medida y la de la matriz a la presencia de fracturas en el tramo superior situado entre 25 y 40 m, cosa que es coherente con estudios previos de migración de solutos en el acuitardo.

Hydrogeology of a fractured shale (Opalinus Clay): Implications for deep geological disposal of radioactive wastes

NASA Astrophysics Data System (ADS)

Gautschi, Andreas

2001-01-01

ême lorsque des fractures et des failles existaient dans certains des intervalles d'essais. Ces mesures sont conformes aux données hydrogéologiques tirées du recoupement des argiles à Opalinus par dix tunnels du Jura plissé du nord de la Suisse. Malgré une tectonique intense, peu de manifestations de faibles venues d'eau ont été rencontrées dans plus de 6600 m de tunnel. Toutes les venues d'eau se sont produites dans des sections de tunnel où le recouvrement est inférieur à 200 m. Les données hydrauliques sont en bon accord avec les données hydrochimiques et isotopiques de l'eau porale des argiles. En se basant sur le grand nombre de données hydrogéologiques, qui portent en partie sur les environnements géologiques particulièrement peu propices, on peut avancer que le transport advectif le long des failles et des fractures n'est pas un facteur susceptible de remettre en question le choix de l'argile à Opalinus comme roche hôte pour le stockage de déchets radioactifs en formation géologique profonde. Resúmen. Dentro del programa suizo de eliminación de residuos radiactivos de alta actividad, se está investigando la posibilidad de utilizar unos esquistos Jurásicos (Arcilla Opalina) como depósito geológico. Las observaciones efectuadas en pozos en arcilla y los resultados de un programa de estudio alemán sobre eliminación de residuos peligrosos han demostrado que, a profundidades de entre 10 y 30 m, la permeabilidad de la Arcilla Opalina decrece en varios órdenes de magnitud. Los ensayos hidráulicos realizados en sondeos más profundos (en intervalos situados a más de 300 m) proporcionaron conductividades hidráulicas inferiores a 10-12 m/s, pese a que algunos de los intervalos interceptaban juntas y fallas. Estas medidas son coherentes con los datos hidrogeológicos de las secciones de Arcilla Opalina existentes en 10 túneles del Jurásico Plegado, al norte de Suiza. A pesar de las fallas extensivas, apenas se hallaron indicios de entrada de

Dealing with spatial heterogeneity

NASA Astrophysics Data System (ADS)

Marsily, Gh.; Delay, F.; Gonçalvès, J.; Renard, Ph.; Teles, V.; Violette, S.

2005-03-01

ès fins de barrières de perméabilité, qui ont une influence importante sur les écoulement, et, plus encore, sur le transport. Les modè les génétiques récemment apparus ont la capacité de mieux incorporer dans les modèles de faciès les observations géologiques, chose courante dans l'industrie pétrolière, mais insuffisamment développée en hydrogéologie. On conclut que les travaux de recherche ultérieurs devraient s'attacher à développer les modèles de faciès, à les comparer entre eux, et à mettre au point de nouvelles méthodes d'essais in situ, comprenant les méthodes géophysiques, capables de reconnaître la géométrie et les propriétés des faciès. La constitution d'un catalogue mondial de la géométrie et des propriétés des faciès aquifères, ainsi que des méthodes de reconnaissance utilisées pour arriver à la détermination de ces systèmes, serait d'une grande importance pratique pour les applications. La heterogeneidad se puede manejar por medio de la definición de características homogéneas equivalentes, conocidas como promediar o tratando de describir la variabilidad espacial de las características de las rocas a partir de observaciones geológicas y medidas locales. Las técnicas disponibles para estas descripciones son generalmente modelos geoestadísticos continuos o modelos de facies discontinuos como los modelos Boolean, de Indicador o de umbral de Gaussian y el modelo de cadena de Markow. Estos modelos de facies son mas adecuados para tratar la conectvidad de estratos geológicos (por ejemplo canales de alta permeabilidad enterrados o barreras de baja permeabilidad que tienen efectos importantes sobre el flujo y especialmente sobre el transporte en los acuíferos. Los modelos genéticos ofrecen nuevas formas de incorporar más geología en las descripciones de facies, un enfoque que está bien desarollado en la industria petrolera, pero insuficientemente en la hidrogeología. Se concluye que los trabajos futuros deber

Estimation of the depth to the fresh-water/salt-water interface from vertical head gradients in wells in coastal and island aquifers

NASA Astrophysics Data System (ADS)

Izuka, Scot K.; Gingerich, Stephen B.

gradients verticaux de charge à partir des mesures de niveau piézométrique faites en cours de foration d'un puits incomplet; le gradient est alors utilisé pour estimer la profondeur de l'interface. L'application de cette méthode à un système eau douce - eau salée simulé numériquement montre que la méthode est la plus précise lorsque le gradient est mesuré dans un puits pénétrant profondément dans l'aquifère. Même en utilisant un puits peu profond, la méthode estime la position de l'interface avec plus de précision que ne le fait la relation de Ghyben-Herzberg lorsqu'il existe un gradient vertical de charge bien marqué. L'application de la méthode à des données de terrain montre que la foration, les méthodes de mesure de niveau et les hétérogénéités au sein de l'aquifère peuvent être la cause de difficultés, mais que les effets de ces difficultés peuvent être réduits. Resumen Para la estimación de la productividad de pozos en acuíferos costeros y en islas es necesaria una estimación precisa de la profundidad de la interfaz teórica entre agua dulce y agua salada. La relación de Ghyben-Herzberg, usada habitualmente para estimar la profundidad de la interfaz, puede subestimar o sobrestimar el espesor de agua dulce, al asumir la ausencia de flujos y gradientes verticales. La estimación de la profundidad de la interfaz debe considerar tanto estos gradientes verticales, como la posible anisotropía del acuífero. En este artículo se presenta un método para calcular los gradientes verticales de niveles a partir de las medidas obtenidas durante la perforación de un pozo parcialmente penetrante para, a partir de este gradiente, estimar la profundidad de la interfaz. La aplicación del método a un sistema de agua dulce/agua salada simulado numéricamente muestra que el método es más preciso cuando el gradiente se mide en un pozo profundo. Incluso en el caso de un pozo superficial, el método permite una estimación más precisa de la

Plan for a groundwater monitoring network in Taiwan

NASA Astrophysics Data System (ADS)

Hsu, Shiang-Kueen

ón de 517 estaciones de medida hidrogeológicas y 990 pozos de observación durante un periodo de 17 años. Bajo este programa, los niveles de agua se miden continuamente, mientras que las muestras para análisis de calidad se toman sólo durante la perforación y cuando el pozo está en servicio. En 1996, el DWR y la Comisión de Planificación de los Recursos de Agua se unieron para formar la actual Oficina de Recursos de Agua.5