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1.
Vet Parasitol ; 277: 109018, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31896020

RESUMO

Control of sheep gastrointestinal nematode (GIN) infections mostly relies on the use of anthelmintics. Refugia-based control strategies as targeted selective treatments (TST) can delay anthelmintic resistance development, but the optimal decision criteria for selecting individuals to be treated in subclinical infection scenarios remain unclear. The present study aimed to evaluate the suitability of body condition score (BCS) and faecal egg counts (FEC) as treatment indicators and to determine their optimized threshold values for treatment in TST by determining the relationships of BCS, FEC and anthelmintic treatment with several productive parameters in pre-mating and pre-partum periods at an individual level. Deworming in pre-mating period increased BCS gain, but its magnitude was directly associated with strongyle FEC before treatment. Deworming also increased fertility in ewes with BCS < 2.75 and the proportion of lambing ewes that got pregnant during the first ovulation cycle. Nevertheless, treatment did not yield productive benefits in ewes with higher BCS values. On the other hand, deworming in the pre-partum lowered lamb peri-partum mortality and increased lamb weight at birth and the growth of lambs during lactation, especially in lambs born from ewes with strongyle FEC > 400 epg before treatment. These results showed that FEC and especially BCS can be potential decision criteria for the implementation of TST in these types of scenarios. The TST scheme derived from the present results on the control of GIN infections should include anthelmintic treatment of ewes with BCS lower than ≈ 3 approximately five weeks before mating and lambing. In the pre-lambing period, treatment may be unnecessary if flock mean strongyle FEC is lower than ≈ 200 epg, as the proportion of ewes with individual FEC > 400 epg would be very low. The results suggest that implementation of this TST scheme would provide benefits, such as the improvement of productivity, a rational management of parasites in refugia, and preservation of future efficacy of anthelmintics, in comparison to traditional deworming schemes.


Assuntos
Gastroenteropatias/veterinária , Infecções por Nematoides/veterinária , Doenças dos Ovinos/tratamento farmacológico , Doenças dos Ovinos/prevenção & controle , Animais , Infecções Assintomáticas , Feminino , Gastroenteropatias/tratamento farmacológico , Gastroenteropatias/prevenção & controle , Infecções por Nematoides/tratamento farmacológico , Infecções por Nematoides/prevenção & controle , Gravidez , Ovinos
2.
Lung Cancer ; 136: 74-79, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31446228

RESUMO

OBJECTIVES: GSK3052230 (FP-1039) is a soluble fusion protein that acts as ligand trap sequestering fibroblast growth factors (FGFs) involved in tumor growth and angiogenesis, while sparing the hormonal FGFs. Because of this selectivity, the molecule is predicted to avoid toxicities associated with small molecule inhibitors of FGFR, including hyperphosphatemia and retinal, nail, and skin toxicities. Herein we report the results of a phase 1b study where GSK3052330 was administered with standard of care chemotherapy in FGFR1-amplified squamous non-small cell lung cancer (sqNSCLC) patients. METHODS AND METHODS: Eligible patients with stage IV or recurrent metastatic sqNSCLC harboring FGFR1 gene amplification received escalating doses of GSK3052230 in combination with paclitaxel and carboplatin at the starting doses 200 mg/m2 and AUC of 6, respectively, in the first line setting (Arm A) or docetaxel 75 mg/m2 in second line (Arm B). The primary endpoints of the study were safety and tolerability, to identify a maximum tolerated dose (MTD), and to assess overall response rate (ORR) based on investigator assessment. RESULTS: Twenty-nine patients were enrolled into the study, including 20 patients on Arm A and 9 patients on Arm B. There were no dose limiting toxicities in either Arm and the MTD was not reached. The most common adverse events (AEs) were compatible with the chemotherapy backbone used in each Arm, including neutropenia, alopecia, nausea, arthralgia, asthenia, diarrhea and peripheral neuropathy. The overall response rate and median progression-free survival were 47% and 5.5 months, respectively, for Arm A and 0% and 4.6 months, respectively, for Arm B. CONCLUSION: GSK3052230 is a novel FGFR pathway inhibitor, which is well tolerated in combination with chemotherapy. Importantly, AEs associated with small molecule inhibitors of FGFR were not observed, as predicted by the unique mechanism of action of this drug.

3.
J Vasc Access ; 20(2): 140-145, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29984611

RESUMO

BACKGROUND:: Diagnostic and Interventional Nephrology has been a rising field in recent years worldwide. Catheter insertion, renal biopsy, renal ultrasound, and peritoneal dialysis catheter or permanent dialysis catheter insertion are vital to our specialty. At present, many of these procedures are delegated to other specialties, generating long waiting lists and limiting diagnosis and treatment. METHODS:: An online survey was emailed to all Nephrology departments in Spain. One survey response was allowed per center. RESULTS:: Of 195 Nephrology departments, 70 responded (35.8%). Of them, 72.3% (52) had ultrasound equipment, 77.1% insert temporary jugular catheters, and 92.8% femoral. Up to 75.7% (53 centers) perform native renal biopsies, of which 35.8% (19) are real-time ultrasound guided by nephrologists. Transplant kidney biopsies are done in 26 centers, of which 46.1% (12) by nephrologists. Tunneled hemodialysis catheters are inserted in 27 centers (38.5%), peritoneal catheter insertion in 18 (31.6%), and only 2 centers (2.8%) perform arteriovenous fistulae angioplasty. In terms of ultrasound imaging, 20 centers (28.5%) do native renal ultrasound and 16 (22.8%) transplanted kidneys. Of all units 71.4% offer carotid ultrasound to evaluate cardiovascular risk, only in 15 centers (21%) by nephrologists. AVF ultrasound scanning is done in 55.7% (39). CONCLUSION:: Diagnostic and Interventional Nephrology is slowly spreading in Spain. It includes basic techniques to our specialty, allowing nephrologists to be more independent, efficient, and reducing waiting times and costs, overall improving patient care. Nowadays, more nephrologists aim to perform them. Therefore, appropriate training on different techniques should be warranted, implementing an official certification and teaching programs.


Assuntos
Nefrologistas/tendências , Nefrologia/tendências , Diálise Peritoneal/tendências , Padrões de Prática Médica/tendências , Ultrassonografia de Intervenção/tendências , Derivação Arteriovenosa Cirúrgica/tendências , Cateterismo Venoso Central/tendências , Pesquisas sobre Serviços de Saúde , Humanos , Biópsia Guiada por Imagem/tendências , Diálise Renal/tendências , Espanha
4.
PLoS One ; 13(12): e0208589, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30586415

RESUMO

INTRODUCTION: The safety of using GBCAs to enhance the visibility of body structures is currently discussed due to possible gadolinium retention in brain structures. The aim of the study was to evaluate the effect of multiple exposures to macrocyclic GBCAs in children. MATERIALS AND METHODS: This retrospective, single-center study included data from 43 patients who had received ≥4 injections of macrocyclic GBCAs during MRI examinations over performed over 8 to 84 months. Signal intensity was measured on unenhanced T1-weighted MRI, and globus pallidus to thalamus (GP/Th) and dentate nucleus to pons (DN/P) ratios were calculated. The differences in ratios were tested with the Student's t-test or the Wilcoxon rank sum test. For categorical data, Pearson's chi-squared test was used. Relationships were analyzed with the Spearman's rank correlation coefficient. RESULTS: Patients with the mean age of 7.5 years (SD = 4.2) received 8.19 (SD = 3.63) injections of GBCAs on average. Differences in GP/Th and DN/P ratios between the first and the last measurement were insignificant. Children before the end of myelination process (≤2 years of age) had the first GP/Th ratio values significantly lower than those >2 years of age (p = 0.0284), which than increased at the final scan and reached the level similar to values obtained in the group of >2 years of age. CONCLUSIONS: Maturation of the brain may affect both signal intensity of brain structures and susceptibility to GBCAs; thus, assessment of signal intensity of the brain structures should be conducted taking into account the age of a child.


Assuntos
Núcleos Cerebelares/diagnóstico por imagem , Meios de Contraste/química , Gadolínio/química , Globo Pálido/diagnóstico por imagem , Imagem por Ressonância Magnética , Astrocitoma/diagnóstico por imagem , Astrocitoma/patologia , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/patologia , Núcleos Cerebelares/química , Criança , Pré-Escolar , Meios de Contraste/metabolismo , Feminino , Gadolínio/metabolismo , Globo Pálido/química , Humanos , Lactente , Masculino , Estudos Retrospectivos
7.
Neuroimage Clin ; 19: 892-900, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30013928

RESUMO

Purpose: To characterise brain lesions in dyskinetic cerebral palsy (DCP) using the semi-quantitative scale for structural MRI (sqMRI) and to investigate their relationship with motor, communication and cognitive function. Materials and methods: Thirty-nine participants (19 females, median age 21y) with DCP were assessed in terms of motor function, communication and a variety of cognitive domains. Whole-head magnetic resonance imaging (MRI) was performed including T1-MPRAGE, T2 turbo spin echo (axial plane), and fluid attenuated inversion recovery images (FLAIR). A child neurologist visually assessed images for brain lesions and scored these using the sqMRI. Ordinal, Poisson and binomial negative regression models identified which brain lesions accounted for clinical outcomes. Results: Brain lesions were most frequently located in the ventral posterior lateral thalamus and the frontal lobe. Gross (B = 0.180, p < .001; B = 0.658, p < .001) and fine (B = 0.136, p = .003; B = 0.540, p < .001) motor function were associated with global sqMRI score and parietal involvement. Communication functioning was associated with putamen involvement (B = 0.747, p < .028). Intellectual functioning was associated with global sqMRI score and posterior thalamus involvement (B = -0.018, p < .001; B = -0.192, p < .001). Selective attention was associated with global sqMRI score (B = -0.035, p < .001), parietal (B = -0.063, p = .023), and corpus callosum involvement (B = -0.448, p < .001). Visuospatial and visuoperceptive abilities were associated with global sqMRI score (B = -0.078, p = .007) and medial dorsal thalamus involvement (B = -0.139, p < .012), respectively. Conclusions: Key clinical outcomes in DCP are associated with specific observable brain lesions as indexed by a simple lesion scoring system that relies only on standard clinical MRI.


Assuntos
Encéfalo/diagnóstico por imagem , Paralisia Cerebral/diagnóstico por imagem , Cognição/fisiologia , Comunicação , Atividade Motora/fisiologia , Adolescente , Adulto , Encéfalo/fisiopatologia , Paralisia Cerebral/fisiopatologia , Criança , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Adulto Jovem
8.
J Appl Ecol ; 55(2): 852-862, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29540935

RESUMO

Grassland diversity can support sustainable intensification of grassland production through increased yields, reduced inputs and limited weed invasion. We report the effects of diversity on weed suppression from 3 years of a 31-site continental-scale field experiment.At each site, 15 grassland communities comprising four monocultures and 11 four-species mixtures based on a wide range of species' proportions were sown at two densities and managed by cutting. Forage species were selected according to two crossed functional traits, "method of nitrogen acquisition" and "pattern of temporal development".Across sites, years and sown densities, annual weed biomass in mixtures and monocultures was 0.5 and 2.0 t  DM ha-1 (7% and 33% of total biomass respectively). Over 95% of mixtures had weed biomass lower than the average of monocultures, and in two-thirds of cases, lower than in the most suppressive monoculture (transgressive suppression). Suppression was significantly transgressive for 58% of site-years. Transgressive suppression by mixtures was maintained across years, independent of site productivity.Based on models, average weed biomass in mixture over the whole experiment was 52% less (95% confidence interval: 30%-75%) than in the most suppressive monoculture. Transgressive suppression of weed biomass was significant at each year across all mixtures and for each mixture.Weed biomass was consistently low across all mixtures and years and was in some cases significantly but not largely different from that in the equiproportional mixture. The average variability (standard deviation) of annual weed biomass within a site was much lower for mixtures (0.42) than for monocultures (1.77). Synthesis and applications. Weed invasion can be diminished through a combination of forage species selected for complementarity and persistence traits in systems designed to reduce reliance on fertiliser nitrogen. In this study, effects of diversity on weed suppression were consistently strong across mixtures varying widely in species' proportions and over time. The level of weed biomass did not vary greatly across mixtures varying widely in proportions of sown species. These diversity benefits in intensively managed grasslands are relevant for the sustainable intensification of agriculture and, importantly, are achievable through practical farm-scale actions.

9.
Neuroimage Clin ; 15: 789-800, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28702354

RESUMO

BACKGROUND: Dyskinetic cerebral palsy (CP) is one of the most disabling motor types of CP and has been classically associated with injury to the basal ganglia and thalamus. Although cognitive dysfunction is common in CP, there is a paucity of published quantitative analyses investigating the relationship between white matter (WM) microstructure and cognition in this CP type. AIMS: This study aims (1) to compare brain WM microstructure between people with dyskinetic CP and healthy controls, (2) to identify brain regions where WM microstructure is related to intelligence and (3) to identify brain regions where WM microstructure is related to executive function in people with dyskinetic CP and (4) to identify brain regions where the correlations are different between controls and people with CP in IQ and executive functions. PATIENTS AND METHODS: Thirty-three participants with dyskinetic CP (mean ± SD age: 24.42 ± 12.61, 15 female) were age and sex matched with 33 controls. Participants underwent a comprehensive neuropsychological battery to assess intelligence quotient (IQ) and four executive function domains (attentional control, cognitive flexibility, goal setting and information processing). Diffusion weighted MRI scans were acquired at 3T. Voxel-based whole brain groupwise analyses were used to compare fractional anisotropy (FA) and of the CP group to the matched controls using a general lineal model. Further general linear models were used to identify regions where white matter FA correlated with IQ and each of the executive function domains. RESULTS: White matter FA was significantly reduced in the CP group in all cerebral lobes, predominantly in regions connected with the parietal and to a lesser extent the temporal lobes. There was no significant correlation between IQ or any of the four executive function domains and WM microstructure in the control group. In participants with CP, lower IQ was associated with lower FA in all cerebral lobes, predominantly in locations that also showed reduced FA compared to controls. Attentional control, goal setting and information processing did not correlate with WM microstructure in the CP group. Cognitive flexibility was associated with FA in regions known to contain connections with the frontal lobe (such as the superior longitudinal fasciculus and cingulum) as well as regions not known to contain tracts directly connected with the frontal lobe (such as the posterior corona radiata, posterior thalamic radiation, retrolenticular part of internal capsule, tapetum, body and splenium of corpus callosum). CONCLUSION: The widespread loss in the integrity of WM tissue is mainly located in the parietal lobe and related to IQ in dyskinetic CP. Unexpectedly, executive functions are only related with WM microstructure in regions containing fronto-cortical and posterior cortico-subcortical pathways, and not being specifically related to the state of fronto-striatal pathways which might be due to brain reorganization. Further studies of this nature may improve our understanding of the neurobiological bases of cognitive impairments after early brain insult.


Assuntos
Encéfalo/patologia , Paralisia Cerebral/patologia , Função Executiva/fisiologia , Inteligência/fisiologia , Substância Branca/patologia , Adulto , Imagem de Difusão por Ressonância Magnética , Feminino , Humanos , Testes de Inteligência , Masculino , Adulto Jovem
10.
Hum Brain Mapp ; 38(9): 4594-4612, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28608616

RESUMO

Dyskinetic cerebral palsy (CP) has long been associated with basal ganglia and thalamus lesions. Recent evidence further points at white matter (WM) damage. This study aims to identify altered WM pathways in dyskinetic CP from a standardized, connectome-based approach, and to assess structure-function relationship in WM pathways for clinical outcomes. Individual connectome maps of 25 subjects with dyskinetic CP and 24 healthy controls were obtained combining a structural parcellation scheme with whole-brain deterministic tractography. Graph theoretical metrics and the network-based statistic were applied to compare groups and to correlate WM state with motor and cognitive performance. Results showed a widespread reduction of WM volume in CP subjects compared to controls and a more localized decrease in degree (number of links per node) and fractional anisotropy (FA), comprising parieto-occipital regions and the hippocampus. However, supramarginal gyrus showed a significantly higher degree. At the network level, CP subjects showed a bilateral pathway with reduced FA, comprising sensorimotor, intraparietal and fronto-parietal connections. Gross and fine motor functions correlated with FA in a pathway comprising the sensorimotor system, but gross motor also correlated with prefrontal, temporal and occipital connections. Intelligence correlated with FA in a network with fronto-striatal and parieto-frontal connections, and visuoperception was related to right occipital connections. These findings demonstrate a disruption in structural brain connectivity in dyskinetic CP, revealing general involvement of posterior brain regions with relative preservation of prefrontal areas. We identified pathways in which WM integrity is related to clinical features, including but not limited to the sensorimotor system. Hum Brain Mapp 38:4594-4612, 2017. © 2017 Wiley Periodicals, Inc.


Assuntos
Encéfalo/diagnóstico por imagem , Encéfalo/fisiopatologia , Paralisia Cerebral/diagnóstico por imagem , Paralisia Cerebral/fisiopatologia , Cognição , Atividade Motora , Adolescente , Adulto , Paralisia Cerebral/psicologia , Criança , Cognição/fisiologia , Conectoma/métodos , Avaliação da Deficiência , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Atividade Motora/fisiologia , Vias Neurais/diagnóstico por imagem , Vias Neurais/fisiopatologia , Testes Neuropsicológicos , Tamanho do Órgão , Substância Branca/diagnóstico por imagem , Substância Branca/fisiopatologia , Adulto Jovem
12.
Brain Dev ; 39(1): 62-66, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27567161

RESUMO

Mutations in the ACTA2 gene lead to a multisystemic smooth muscle dysfunction syndrome that causes vascular disease, congenital mydriasis, and variable presentation of urinary and gastrointestinal problems. The heterozygous Arg179 mutation is associated with a distinctive cerebrovascular phenotype. We report the cases of two newborn siblings with heterozygous ACTA2 Arg179Cys substitution and provide neuroimaging exams that demonstrate the distinctive cerebrovascular phenotype, also associated with variable degree of hypoplasia of the vertebro-basilar circulation as well as hypoxic-ischemic lesions.


Assuntos
Actinas/genética , Encéfalo/diagnóstico por imagem , Transtornos Cerebrovasculares/diagnóstico por imagem , Transtornos Cerebrovasculares/genética , Mutação , Angiografia Cerebral , Transtornos Cerebrovasculares/complicações , Transtornos Cerebrovasculares/terapia , Infecção Hospitalar/complicações , Evolução Fatal , Feminino , Humanos , Imagem Tridimensional , Recém-Nascido , Imagem por Ressonância Magnética , Masculino , Irmãos
13.
Saúde debate ; 40(111): 279-291, dez. 2016. graf
Artigo em Português | LILACS-Express | ID: biblio-846135

RESUMO

RESUMO Ao refletir seu caráter sistêmico, as Parcerias para o Desenvolvimento Produtivo (PDP) representam uma inflexão na política de saúde e constituem o principal instrumento de ação pública da comunidade de política desenvolvimentista de saúde. Considerando a relevância da saúde para uma trajetória de desenvolvimento nacional que alia competitividade econômica e inclusão social, este artigo visa analisar os elementos político-institucionais que condicionam o desenvolvimento nacional na política de saúde, com destaque para as PDP. Para tanto, utiliza o arcabouço teórico da análise cognitiva das políticas públicas visando identificar como as instituições orientam suas estratégias e as preferências dos atores, e como influenciam os resultados da ação pública.


ABSTRACT By reflecting their systemic nature, the Production Development Partnerships (PDP) in Healthcare represent a shift in healthcare policy and constitute the main instrument of public action on the part of the healthcare development policy community. Considering the importance of healthcare to a national development trajectory that combines economic competitiveness and social inclusion, this article aims to analyze the political and institutional factors that affect national development in healthcare policy, by highlighting the PDP. In order to do so, it uses the theoretical framework of cognitive analysis of public policies to identify how institutions manage their strategies and the preferences of the actors involved, and how they influence the results of public action.

14.
An. pediatr. (2003. Ed. impr.) ; 85(6): 312-317, dic. 2016. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-158239

RESUMO

Introducción. La hipotermia es el tratamiento estándar en la encefalopatía hipóxico isquémica (EHI) a pesar de que todavía no se conocen todos sus efectos y complicaciones. La bradicardia sinusal está ampliamente descrita en la literatura como consecuencia de dicho enfriamiento pero se ha estudiado poco la actividad eléctrica cardiaca en este grupo de pacientes. Objetivo. Determinar si existe un alargamiento del intervalo QT corregido (QTc) durante la hipotermia en neonatos con EHI moderada-grave y su evolución durante el tratamiento. Material y métodos. Se reclutó a pacientes con EHI tratados con hipotermia entre noviembre del 2012 y octubre del 2013. Se realizaron electrocardiogramas (ECG) durante la hipotermia (uno cada 24 h durante el tratamiento) y durante el recalentamiento (a 34,5, 35,5 y 36,5°C). Se realizó un séptimo ECG a la semana de vida. Resultados. Se incluyó a un total de 19 pacientes. Se observó un alargamiento del QTc en todos los pacientes durante la hipotermia. En 84% de los pacientes (n=16), el alargamiento se apreció en todos los ECG durante la hipotermia. Tras el recalentamiento, todos los pacientes presentaron una normalización del mismo. No se encontraron diferencias estadísticamente significativas al evaluar la prolongación del QTc según el grado de EHI (p=0,192) y según el uso de soporte inotrópico o no (p=0,669). Ningún paciente presentó arritmias potencialmente graves. Conclusiones. La hipotermia moderada aplicada a los recién nacidos con EHI moderada-grave parece inducir una prolongación en el intervalo QTc temporal que se resuelve con el recalentamiento del paciente hasta temperatura fisiológica (AU)


Introduction. Therapeutic hypothermia is the standard treatment for hypoxic ischaemic encephalopathy (HIE), despite not knowing all its effects and complications. Sinus bradycardia is one of the consequences of cooling that has been previously documented in the literature, but little is known about the cardiac electrical activity in these patients. Objective. To determine the corrected QT (QTc) interval in newborns treated with therapeutic hypothermia for HIE. Material and methods. A prospective observational study was conducted in all patients treated with hypothermia for HIE that were admitted to our Unit between November 2012 and October 2013. ECGs were performed during hypothermia (every 24h), during the re-warming period (at 34.5°C, 35.5°C, 36.5°C), and on the 7th day of life. Results. A total of 19 patients were included. A prolonged QTc was observed in all patients during hypothermia, and 84% (n=16) had prolonged QTc in all the ECGs during treatment. In 3 patients, one of the ECGs did not have a prolonged QTc. After re-warming, the QTc interval returned to normal in all patients. No statistically significant differences were seen when the degree of HIE (P=.192) or the use of inotropic support (P=.669) were considered. Conclusions. Therapeutic hypothermia applied to asphyxiated newborns with HIE seems to induce a QTc prolongation that resolves when the patient regains physiological temperature (AU)


Assuntos
Humanos , Masculino , Feminino , Síndrome de Romano-Ward , Hipotermia/terapia , Hipóxia-Isquemia Encefálica/complicações , Hipóxia-Isquemia Encefálica , Hipotermia Induzida/métodos , Hipotermia Induzida/estatística & dados numéricos , Hipotermia Induzida/normas , Eletrocardiografia/métodos , Eletrocardiografia , Estudos Prospectivos , Bradicardia/epidemiologia
15.
Cad Saude Publica ; 32Suppl 2(Suppl 2): e00037415, 2016 Nov 03.
Artigo em Inglês, Português | MEDLINE | ID: mdl-27828672

RESUMO

This article discusses the relations between healthcare systems and the pharmaceutical industry, focusing on state support for pharmaceutical innovation. The study highlights the experiences of the United States, United Kingdom, and Germany, developed countries and paradigms of modern health systems (liberal, universal, and corporatist), in addition to Japan, a case of successful catching up. The study also emphasizes the experiences of China, India, and Brazil, large developing countries that have tried different catching up strategies, with diverse histories and profiles in their healthcare systems and pharmaceutical industries. Finally, with a focus on state forms of support for health research, the article addresses the mechanisms for linkage between health systems and the pharmaceutical industry, evaluating the possibilities of Brazil strengthening a virtuous interaction, favoring the expansion and consolidation of the Brazilian health system - universal but segmented ‒ and the affirmation of the innovative national pharmaceutical industry. Resumo: O artigo discute as relações entre os sistemas de saúde e a indústria farmacêutica, concentrando-se no apoio do Estado à inovação farmacêutica. Salienta as trajetórias dos Estados Unidos, Reino Unido e Alemanha, países desenvolvidos, paradigmáticos dos modernos sistemas de saúde (liberais, universais e corporativos), além do Japão, um caso de emparelhamento bem-sucedido. Também enfatiza as trajetórias de China, Índia e Brasil, países em desenvolvimento, extensos, que experimentaram diferentes estratégias de emparelhamento, dispondo de sistemas de saúde e indústrias farmacêuticas com trajetórias e perfis diversos. Finalmente, com foco nas formas estatais de apoio à pesquisa em saúde, considera os mecanismos de conexão entre os sistemas de saúde e a indústria farmacêutica, avaliando as possibilidades, no Brasil, de fortalecer uma interação virtuosa que favoreça a expansão e consolidação do sistema de saúde brasileiro - universal, conquanto segmentado ‒ e a afirmação da indústria farmacêutica nacional inovadora.


Assuntos
Assistência à Saúde , Descoberta de Drogas , Indústria Farmacêutica/organização & administração , Política de Saúde , Inovação Organizacional , Tecnologia Farmacêutica/organização & administração , Humanos
16.
Res Dev Disabil ; 56: 83-98, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27262445

RESUMO

Standard intelligence scales require both verbal and manipulative responses, making it difficult to use in cerebral palsy and leading to underestimate their actual performance. This study aims to compare three intelligence tests suitable for the heterogeneity of cerebral palsy in order to identify which one(s) could be more appropriate to use. Forty-four subjects with bilateral dyskinetic cerebral palsy (26 male, mean age 23 years) conducted the Raven's Coloured Progressive Matrices (RCPM), the Peabody Picture Vocabulary Test-3rd (PPVT-III) and the Wechsler Nonverbal Scale of Ability (WNV). Furthermore, a comprehensive neuropsychological battery and magnetic resonance imaging were assessed. The results show that PPVT-III gives limited information on cognitive performance and brain correlates, getting lower intelligence quotient scores. The WNV provides similar outcomes as RCPM, but cases with severe motor impairment were unable to perform it. Finally, the RCPM gives more comprehensive information on cognitive performance, comprising not only visual but also verbal functions. It is also sensitive to the structural state of the brain, being related to basal ganglia, thalamus and white matter areas such as superior longitudinal fasciculus. So, the RCPM may be considered a standardized easy-to-administer tool with great potential in both clinical and research fields of bilateral cerebral palsy.


Assuntos
Encéfalo/diagnóstico por imagem , Paralisia Cerebral/psicologia , Deficiência Intelectual/psicologia , Adolescente , Adulto , Gânglios da Base/diagnóstico por imagem , Paralisia Cerebral/diagnóstico por imagem , Criança , Feminino , Humanos , Deficiência Intelectual/diagnóstico por imagem , Testes de Inteligência , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neuroimagem , Testes Neuropsicológicos , Tálamo/diagnóstico por imagem , Escalas de Wechsler , Substância Branca/diagnóstico por imagem , Adulto Jovem
17.
An Pediatr (Barc) ; 85(6): 312-317, 2016 Dec.
Artigo em Espanhol | MEDLINE | ID: mdl-26896912

RESUMO

INTRODUCTION: Therapeutic hypothermia is the standard treatment for hypoxic ischaemic encephalopathy (HIE), despite not knowing all its effects and complications. Sinus bradycardia is one of the consequences of cooling that has been previously documented in the literature, but little is known about the cardiac electrical activity in these patients. OBJECTIVE: To determine the corrected QT (QTc) interval in newborns treated with therapeutic hypothermia for HIE. MATERIAL AND METHODS: A prospective observational study was conducted in all patients treated with hypothermia for HIE that were admitted to our Unit between November 2012 and October 2013. ECGs were performed during hypothermia (every 24h), during the re-warming period (at 34.5°C, 35.5°C, 36.5°C), and on the 7th day of life. RESULTS: A total of 19 patients were included. A prolonged QTc was observed in all patients during hypothermia, and 84% (n=16) had prolonged QTc in all the ECGs during treatment. In 3 patients, one of the ECGs did not have a prolonged QTc. After re-warming, the QTc interval returned to normal in all patients. No statistically significant differences were seen when the degree of HIE (P=.192) or the use of inotropic support (P=.669) were considered. CONCLUSIONS: Therapeutic hypothermia applied to asphyxiated newborns with HIE seems to induce a QTc prolongation that resolves when the patient regains physiological temperature.


Assuntos
Arritmias Cardíacas/etiologia , Hipotermia Induzida/efeitos adversos , Hipóxia-Isquemia Encefálica/complicações , Hipóxia-Isquemia Encefálica/terapia , Eletrocardiografia , Feminino , Humanos , Hipóxia-Isquemia Encefálica/fisiopatologia , Recém-Nascido , Masculino , Estudos Prospectivos
18.
Muscle Nerve ; 53(5): 789-96, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26425938

RESUMO

INTRODUCTION: A long-term peripheral neural interface is an area of intense research. The use of electrode interfaces is limited by the biological response to the electrode material. METHODS: We created an electrode construct to harbor the rat sciatic nerve with interposition of autogenous adipose tissue between the nerve and the electrode. The construct was implanted for 10 weeks. RESULTS: Immunohistochemistry showed a unique laminar pattern of axonal growth layered between fibro-collagenous tissue, forming a physical interface with the tungsten micro-electrode. Action potentials transmitted across the intrerface showed mean conduction velocities varying between 6.99 ± 2.46 and 20.14 ± 4 m/s. CONCLUSIONS: We have demonstrated the feasibility of a novel peripheral nerve interface through modulation of normal biologic phenomena. It has potential applications as a chronic implantable neural interface.


Assuntos
Potenciais de Ação/fisiologia , Axônios/fisiologia , Eletrodos Implantados , Microeletrodos , Tecido Nervoso/fisiologia , Condução Nervosa/fisiologia , Nervo Isquiático/fisiologia , Tecido Adiposo , Animais , Axônios/patologia , Colágeno/fisiologia , Feminino , Imuno-Histoquímica , Metais , Tecido Nervoso/crescimento & desenvolvimento , Tecido Nervoso/patologia , Ratos , Ratos Sprague-Dawley , Nervo Isquiático/crescimento & desenvolvimento , Nervo Isquiático/patologia
19.
Cad. saúde pública ; 32(supl.2): e00037415, 2016. tab
Artigo em Inglês | LILACS | ID: lil-798199

RESUMO

Abstract: This article discusses the relations between healthcare systems and the pharmaceutical industry, focusing on state support for pharmaceutical innovation. The study highlights the experiences of the United States, United Kingdom, and Germany, developed countries and paradigms of modern health systems (liberal, universal, and corporatist), in addition to Japan, a case of successful catching up. The study also emphasizes the experiences of China, India, and Brazil, large developing countries that have tried different catching up strategies, with diverse histories and profiles in their healthcare systems and pharmaceutical industries. Finally, with a focus on state forms of support for health research, the article addresses the mechanisms for linkage between health systems and the pharmaceutical industry, evaluating the possibilities of Brazil strengthening a virtuous interaction, favoring the expansion and consolidation of the Brazilian health system - universal but segmented ‒ and the affirmation of the innovative national pharmaceutical industry.


Resumen: El artículo discute las relaciones entre los sistemas de salud y la industria farmacéutica, concentrándose en el apoyo del Estado a la innovación farmacéutica. Resalta las trayectorias de los Estados Unidos, Reino Unido y Alemania, países desarrollados, paradigmáticos de los modernos sistemas de salud (liberales, universales y corporativos), además de Japón, un caso de emparejamiento exitoso. También enfatiza las trayectorias de China, India y Brasil, países en desarrollo, extensos, que experimentaron diferentes estrategias de emparejamiento en este ámbito, disponiendo de sistemas de salud e industrias farmacéuticas con trayectorias y perfiles diversos. Finalmente, centrándose en las formas estatales de apoyo a la investigación en salud, se consideran los mecanismos de conexión entre los sistemas de salud y la industria farmacéutica, evaluando las posibilidades, en Brasil, de fortalecer una interacción virtuosa que favorezca la expansión y consolidación del sistema de salud brasileño -universal, pese a estar segmentado-, y la consolidación de la industria farmacéutica nacional innovadora.


Resumo: O artigo discute as relações entre os sistemas de saúde e a indústria farmacêutica, concentrando-se no apoio do Estado à inovação farmacêutica. Salienta as trajetórias dos Estados Unidos, Reino Unido e Alemanha, países desenvolvidos, paradigmáticos dos modernos sistemas de saúde (liberais, universais e corporativos), além do Japão, um caso de emparelhamento bem-sucedido. Também enfatiza as trajetórias de China, Índia e Brasil, países em desenvolvimento, extensos, que experimentaram diferentes estratégias de emparelhamento, dispondo de sistemas de saúde e indústrias farmacêuticas com trajetórias e perfis diversos. Finalmente, com foco nas formas estatais de apoio à pesquisa em saúde, considera os mecanismos de conexão entre os sistemas de saúde e a indústria farmacêutica, avaliando as possibilidades, no Brasil, de fortalecer uma interação virtuosa que favoreça a expansão e consolidação do sistema de saúde brasileiro - universal, conquanto segmentado ‒ e a afirmação da indústria farmacêutica nacional inovadora.


Assuntos
Humanos , Assistência à Saúde , Descoberta de Drogas , Indústria Farmacêutica/organização & administração , Política de Saúde , Inovação Organizacional , Tecnologia Farmacêutica/organização & administração
20.
Brasília; IPEA; maio 2015. 67 p. (Texto para Discussão / IPEA).
Monografia em Português | LILACS, ECOS | ID: biblio-992092

RESUMO

Este trabalho analisa os principais tipos de políticas industriais contemporâneas, a saber: busca do futuro, reposicionamento e proteção. Aborda as políticas desenvolvidas para os setores farmacêutico, automotivo e têxtil, tomadas, respectivamente, como expressões de tais tipos de políticas. Focaliza a trajetória, especialmente no século em curso, das políticas apontadas na China, na Índia e no Brasil, em um esforço de análise histórica comparativa


Assuntos
China , Indústria Farmacêutica , Indústria Têxtil , Indústrias , Política Pública , Brasil
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