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1.
Nature ; 546(7658): 406-410, 2017 06 15.
Artículo en Inglés | MEDLINE | ID: mdl-28538727

RESUMEN

Transmission of Zika virus (ZIKV) in the Americas was first confirmed in May 2015 in northeast Brazil. Brazil has had the highest number of reported ZIKV cases worldwide (more than 200,000 by 24 December 2016) and the most cases associated with microcephaly and other birth defects (2,366 confirmed by 31 December 2016). Since the initial detection of ZIKV in Brazil, more than 45 countries in the Americas have reported local ZIKV transmission, with 24 of these reporting severe ZIKV-associated disease. However, the origin and epidemic history of ZIKV in Brazil and the Americas remain poorly understood, despite the value of this information for interpreting observed trends in reported microcephaly. Here we address this issue by generating 54 complete or partial ZIKV genomes, mostly from Brazil, and reporting data generated by a mobile genomics laboratory that travelled across northeast Brazil in 2016. One sequence represents the earliest confirmed ZIKV infection in Brazil. Analyses of viral genomes with ecological and epidemiological data yield an estimate that ZIKV was present in northeast Brazil by February 2014 and is likely to have disseminated from there, nationally and internationally, before the first detection of ZIKV in the Americas. Estimated dates for the international spread of ZIKV from Brazil indicate the duration of pre-detection cryptic transmission in recipient regions. The role of northeast Brazil in the establishment of ZIKV in the Americas is further supported by geographic analysis of ZIKV transmission potential and by estimates of the basic reproduction number of the virus.


Asunto(s)
Infección por el Virus Zika/transmisión , Infección por el Virus Zika/virología , Virus Zika/aislamiento & purificación , Américas/epidemiología , Número Básico de Reproducción , Brasil/epidemiología , Variación Genética , Genoma Viral/genética , Humanos , Microcefalia/epidemiología , Microcefalia/virología , Epidemiología Molecular , Filogeografía , Análisis Espacio-Temporal , Virus Zika/genética , Infección por el Virus Zika/epidemiología
2.
Socioecon Plann Sci ; 84: 101387, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-35937707

RESUMEN

This paper uses Value-Based Data Envelopment Analysis (VBDEA), to assess the impact of the COVID-19 pandemic on the efficiency of 37 state-owned enterprises (SOE) hospitals by employing data publicly available from the Portuguese Health Service database between January and November 2019 and 2020, respectively. Furthermore, a productivity index (specifically adjusted to the VBDEA approach) is also used that allows identifying which factors are behind the relative efficiency changes of these hospitals. The factors considered to perform the efficiency assessment of the Portuguese SOE hospitals include labour, capacity, and activity-related indicators. Out of the 37 SOE hospitals, 21 and 17 were efficient in 2019 and 2020, respectively. Irrespective of the value functions considered, the hospitals more often viewed as a reference for best practices were Santa Maria Maior, Tâmega e Sousa and Entre Douro e Vouga. Santa Maria Maior and Algarve were the only hospitals found to be robustly efficient for both years. Overall, the majority of SOE hospitals showed negative productivity (except for Évora and Santa Maria Maior) and all of them presented negative technological change, thus highlighting the massive impact that the COVID-19 outbreak has had on the performance of these hospitals. An additional conclusion is that inefficient hospitals substantially increased all their resources in 2020 as compared to inefficient hospitals in 2019, suggesting that the inefficiency of these hospitals was not due to the lack of resources. Finally, irrespective of the model employed, the hospitals located in the Portuguese northern region were more resilient to the COVID-19 crisis. All in all, to become more resilient (even for future COVID-19 outbreaks), hospitals should undertake changes that are advantageous irrespective of the obstacles they face and that are even beneficial during normal times. A culture of cooperation within and across hospitals should also be cultivated, which allows exchanging resources where they can be used more efficiently.

3.
Lupus ; 28(5): 607-612, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30895904

RESUMEN

OBJECTIVE: The objective of this paper is to evaluate the performance of the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI-2K) in detecting clinically meaningful changes in SLE disease activity. METHODS: A longitudinal cohort study was conducted of 334 SLE patients during a 36-month follow-up. At each outpatient visit, disease activity was scored using the Physician Global Assessment (PGA) and SLEDAI-2K. Correlations between PGA and SLEDAI-2K were assessed. A clinically meaningful change in SLE disease activity was defined as a ΔPGA ≥ 0.3 points from baseline. Performance of SLEDAI-2K in detecting a clinically meaningful worsening or improvement was tested using receiver operating characteristic (ROC) analysis. RESULTS: Adjusted mean PGA and SLEDAI-2K scores presented a high correlation (rho = 0.824, p < 0.0005). In ROC analysis, a SLEDAI-2K variation presented an area under the curve (AUC) of 0.697 (95% confidence interval (CI) (0.628-0.766), p < 0.0005) to detect a clinically meaningful improvement, with a sensitivity of 28.8% for a SLEDAI-2K ≥ 4 reduction. The AUC to detect a clinically meaningful worsening was 0.877 (95% CI (0.822-0.932), p < 0.0005), with a sensitivity of 35.3%. CONCLUSIONS: SLEDAI-2K has a limited ability to detect clinically meaningful changes in SLE disease activity, failing to identify almost two-thirds of cases judged as having a clinically meaningful improvement or worsening. There is a need for more sensitive SLE disease activity measures in clinical practice and research.


Asunto(s)
Progresión de la Enfermedad , Lupus Eritematoso Sistémico/diagnóstico , Índice de Severidad de la Enfermedad , Adulto , Femenino , Humanos , Inmunosupresores/uso terapéutico , Estudios Longitudinales , Lupus Eritematoso Sistémico/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Portugal , Estudios Prospectivos , Curva ROC , Reproducibilidad de los Resultados
4.
Phys Rev Lett ; 120(13): 132504, 2018 Mar 30.
Artículo en Inglés | MEDLINE | ID: mdl-29694208

RESUMEN

A new method to tag the barium daughter in the double-beta decay of ^{136}Xe is reported. Using the technique of single molecule fluorescent imaging (SMFI), individual barium dication (Ba^{++}) resolution at a transparent scanning surface is demonstrated. A single-step photobleach confirms the single ion interpretation. Individual ions are localized with superresolution (∼2 nm), and detected with a statistical significance of 12.9σ over backgrounds. This lays the foundation for a new and potentially background-free neutrinoless double-beta decay technology, based on SMFI coupled to high pressure xenon gas time projection chambers.

5.
Clin Exp Immunol ; 179(2): 354-61, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25267249

RESUMEN

A number of molecules have been shown recently to be involved in the pathogenesis and progression of immunoglobulin (Ig)A nephropathy (IgAN). Among these, we have selected C4d (complement lectin pathway involvement), CD3 (T cell marker, traducing interstitial inflammation), transglutaminase 2 (TGase-2, involved in tissue fibrosis development) and p-extracelluar-regulated kinase (ERK)1/2 (protein kinase intracellular signaling molecule) to perform a panel of immunohistological biomarkers and assess its predictive value for disease progression. Immunohistochemical staining of these biomarkers was performed in paraffin sections from 74 renal biopsy cases with the clinical diagnosis of IgAN. Association between score analysis of these parameters and disease course was assessed through univariate and multivariate analysis, including baseline clinical and histological data. Univariate analysis showed that glomerular C4d, tubulointerstitial TGase2 and CD3 scores were associated with baseline proteinuria and disease progression. Multivariate analysis showed that only baseline estimated glomerular filtration rate (eGFR), C4d and CD3 were associated independently with progressive kidney disease (decline of at least 50% in the eGFR or progression to end-stage renal disease (ESRD) during the follow-up period). Establishing an accurate prediction model for IgAN progression is still a matter of research in clinical nephrology. The complement system, particularly lectin pathway activation, and T cell activation, have been shown previously to be potential modifiers of the disease course. Here we show that the combination of two histological biomarkers (C4d and CD3) can be a powerful predictor of IgAN progression and a potential useful tool for the clinical approach of this disease.


Asunto(s)
Complejo CD3/inmunología , Complemento C4/inmunología , Progresión de la Enfermedad , Glomerulonefritis por IGA/inmunología , Modelos Biológicos , Adolescente , Adulto , Anciano , Complejo CD3/metabolismo , Complemento C4/metabolismo , Femenino , Estudios de Seguimiento , Tasa de Filtración Glomerular/inmunología , Glomerulonefritis por IGA/metabolismo , Glomerulonefritis por IGA/patología , Humanos , Inmunohistoquímica , Fallo Renal Crónico/inmunología , Fallo Renal Crónico/metabolismo , Fallo Renal Crónico/patología , Activación de Linfocitos , Sistema de Señalización de MAP Quinasas/inmunología , Masculino , Persona de Mediana Edad , Proteína Quinasa 1 Activada por Mitógenos/inmunología , Proteína Quinasa 1 Activada por Mitógenos/metabolismo , Proteína Quinasa 3 Activada por Mitógenos/inmunología , Proteína Quinasa 3 Activada por Mitógenos/metabolismo , Estudios Retrospectivos , Linfocitos T/inmunología , Linfocitos T/metabolismo , Linfocitos T/patología
6.
Eur J Paediatr Dent ; 15(3): 281-7, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-25306145

RESUMEN

AIM: To evaluate the association between dental health status and levels of cariogenic bacteria in teenagers and the influence of behaviours and socio-demographic background on levels of bacteria. MATERIALS AND METHODS: Study design: A cross-sectional population-based sample of 13-year-old adolescents (112 females and 78 males, total 190) was examined. The number of decayed, missing and filled surfaces (DMFS), plaque and hygiene index were recorded according to the WHO criteria. The saliva samples were collected in a sterile container and then analysed by culture on Mitis Salivarius Bacitracin (MSB) agar for mutans Streptococci and on Man Rogosa Sharp (MRS) agar for Lactobacilli. The levels of bacteria were expressed as the number of colonies forming units per millilitre of saliva (CFU/ml). Associations between levels of mutans Streptococci and Lactobacilli and dental health were estimated by odds ratio (OR) and 95% confidence interval (95% CI) using unconditional logistic regression. RESULTS: No mutans Streptococci were detected in 53.2% of the adolescents but 22.6% presented ≥ 10³ CFU/ml. For Lactobacilli, these values were, respectively 43.7% and 34.7%. After adjustment for gender and social class, the OR (95% CI) for DMFS >5 was 8.66 (3.57-21.02) if mutans Streptococci ≥ 10³ CFU and 2.11 (0.96-4.64) if Lactobacilli ≥ 10³ CFU. CONCLUSION: This data allow us to conclude that hygiene habits and dental visits are not associated with high levels of cariogenic bacteria, but high scores of DMFS were found in adolescents with high levels of mutans Streptococci and lower parents' education.


Asunto(s)
Caries Dental/microbiología , Conductas Relacionadas con la Salud , Estado de Salud , Lactobacillus/aislamiento & purificación , Salud Bucal , Streptococcus mutans/aislamiento & purificación , Adolescente , Carga Bacteriana , Estudios de Cohortes , Estudios Transversales , Índice CPO , Atención Odontológica/estadística & datos numéricos , Índice de Placa Dental , Escolaridad , Femenino , Humanos , Masculino , Índice de Higiene Oral , Padres/educación , Vigilancia de la Población , Portugal , Saliva/microbiología , Factores Sexuales , Clase Social , Cepillado Dental/estadística & datos numéricos
7.
Ultrasound Obstet Gynecol ; 38(2): 145-51, 2011 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-20878670

RESUMEN

OBJECTIVES: The primary aim of this study was to assess pregnant women's knowledge of first-trimester combined Down syndrome screening in a setting of required informed consent. As the secondary aim, we wanted to identify relevant differences in knowledge level among subgroups of pregnant women, including those informed in different ways about prenatal examinations. METHODS: Data stem from a population-based cross-sectional questionnaire study including 15 multiple-choice questions assessing knowledge of different aspects of screening. Included were 6427 first-trimester pregnant women from three Danish obstetric departments offering prenatal screening free of charge. Both participants and non-participants in the screening program were included. The results are based on 4095 responders (64%). Differences between subgroups were examined using chi-squared tests and logistic regression analysis. Estimates are stated with 95% CI. RESULTS: The majority of the participants (87.6 (86.6-88.6)% to 92.6 (91.7-93.3)%) correctly identified the test concept and the main condition being screened for. Fewer participants (16.4 (15.3-17.6)% to 43.3 (41.8-44.8)%) correctly recognized test accuracy and the potential risk of adverse findings other than Down syndrome. Knowledge level was positively associated with length of education (adjusted ORs 1.0 (0.8-1.4) to 3.9 (2.4-6.4)) and participation in the screening program (adjusted OR 0.9 (0.6-1.3) to 5.9 (3.9-8.8)). Participation in an individual information session was weakly associated with more knowledge. CONCLUSION: The majority of the pregnant women correctly identified the test concept and the main condition being screened for. The pregnant women were found less knowledgeable on test accuracy and drawbacks.


Asunto(s)
Síndrome de Down/diagnóstico , Conocimientos, Actitudes y Práctica en Salud , Madres/estadística & datos numéricos , Aceptación de la Atención de Salud/estadística & datos numéricos , Adolescente , Adulto , Distribución de Chi-Cuadrado , Estudios Transversales , Toma de Decisiones , Dinamarca/epidemiología , Síndrome de Down/epidemiología , Síndrome de Down/psicología , Escolaridad , Femenino , Humanos , Consentimiento Informado/estadística & datos numéricos , Modelos Logísticos , Madres/psicología , Medida de Translucencia Nucal , Oportunidad Relativa , Aceptación de la Atención de Salud/psicología , Embarazo , Primer Trimestre del Embarazo , Diagnóstico Prenatal , Encuestas y Cuestionarios , Adulto Joven
8.
Sci Rep ; 11(1): 929, 2021 01 13.
Artículo en Inglés | MEDLINE | ID: mdl-33441710

RESUMEN

The present study used 16S rRNA gene amplicon sequencing to assess the impact on salivary microbiome of different grades of dental and periodontal disease and the combination of both (hereinafter referred to as oral disease), in terms of bacterial diversity, co-occurrence network patterns and predictive models. Our scale of overall oral health was used to produce a convenience sample of 81 patients from 270 who were initially recruited. Saliva samples were collected from each participant. Sequencing was performed in Illumina MiSeq with 2 × 300 bp reads, while the raw reads were processed according to the Mothur pipeline. The statistical analysis of the 16S rDNA sequencing data at the species level was conducted using the phyloseq, DESeq2, Microbiome, SpiecEasi, igraph, MixOmics packages. The simultaneous presence of dental and periodontal pathology has a potentiating effect on the richness and diversity of the salivary microbiota. The structure of the bacterial community in oral health differs from that present in dental, periodontal or oral disease, especially in high grades. Supragingival dental parameters influence the microbiota's abundance more than subgingival periodontal parameters, with the former making a greater contribution to the impact that oral health has on the salivary microbiome. The possible keystone OTUs are different in the oral health and disease, and even these vary between dental and periodontal disease: half of them belongs to the core microbiome and are independent of the abundance parameters. The salivary microbiome, involving a considerable number of OTUs, shows an excellent discriminatory potential for distinguishing different grades of dental, periodontal or oral disease; considering the number of predictive OTUs, the best model is that which predicts the combined dental and periodontal status.


Asunto(s)
Enfermedades de la Boca/microbiología , Enfermedades Periodontales/microbiología , Saliva/microbiología , Adulto , Bacterias/genética , ADN Bacteriano/genética , ADN Ribosómico/genética , Servicios de Salud Dental , Femenino , Estado de Salud , Secuenciación de Nucleótidos de Alto Rendimiento , Humanos , Masculino , Microbiota , Persona de Mediana Edad , Salud Bucal/estadística & datos numéricos , ARN Ribosómico 16S/genética
9.
J Nanosci Nanotechnol ; 9(6): 3535-45, 2009 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-19504879

RESUMEN

We assembled a new electrospinning apparatus and used poly(ethylene oxide) as a model polymer to perform a systematic study on the influence of solution and processing parameters on the morphology of electrospun nanofibers. Solution parameters studied were polymer concentration and molecular mass. The solvent used, 60 wt% water, 40 wt% ethanol, was the same throughout the study. Processing parameters analyzed were: solution feed rate, needle tip-collector distance and electrostatic potential difference between the needle and collector. Solution viscosity increased both with polymer concentration and molecular mass. Polymer concentration plays a decisive role on the outcome of the electrospinning process: a low concentration led to the formation of beaded fibers; an intermediate concentration yielded good quality fibers; a high concentration resulted in a bimodal size distribution and at even higher concentration a distributed deposition. Fiber diameter increased with polymer molecular mass and higher molecular masses are associated with a higher frequency of splaying events. Fiber diameter increased linearly with solution feed rate. While an increase in needle-collector distance represents a weaker electric field, a greater distance to be covered by the fibers and a longer flight time, presumably favoring the formation of thinner fibers, as solvent evaporation leads to a local increase of concentration and viscosity, viscoelastic forces opposing stretching caused an increase of fiber diameter with needle-collector distance. A higher voltage applied at the needle is associated with a higher charging of the polymer and a higher electrical current through it ultimately leading to incomplete solvent evaporation and merged fibers being produced. Controlling the charging of the polymer independently of the electric field strength was achieved by applying a voltage to the collector while distance and potential difference were kept constant. The increased electrostatic repulsion associated with an increase of the high voltage applied to the needle led to the disappearance of merged fibers.

10.
Eur J Trauma Emerg Surg ; 43(1): 79-83, 2017 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-26696088

RESUMEN

PURPOSE: Acute cholecystitis and pancreatitis are acute forms of cholecystolithiasis. The presence of acute cholecystitis can lead to important changes in therapy in the early course of acute pancreatitis. The aim of this study was to identify the accuracy of ultrasonography in diagnosing acute cholecystitis with coexistent acute pancreatitis. METHODS: Subjects were all those patients admitted to our hospital with a diagnosis of acute pancreatitis between 1998 and 2015 who underwent cholecystectomy within 15 days of the ultrasonography performed on admittance. Patient data were analyzed retrospectively to compare the ultrasound findings with the pathological findings of the resected gallbladders. Patients were allocated to two groups according to the signs of acute cholecystitis on ultrasonography: group 1 negative and group 2 positive. RESULTS: One hundred and twenty patients were enrolled in the study: 77 in group 1 and 43 in group 2. Similar results were found for the two groups with respect to the pathological diagnosis of acute cholecystitis, i.e., 31.2 % for group 1 and 27.9 % for group 2. Analysis indicated that there was no correlation between the ultrasonography data and pathological findings (p = 0.708). CONCLUSIONS: On the basis of our study, ultrasound findings alone cannot be used to accurately diagnose acute cholecystitis in the setting of acute pancreatitis.


Asunto(s)
Colecistitis Aguda/complicaciones , Colecistitis Aguda/diagnóstico por imagen , Pancreatitis/complicaciones , Pancreatitis/diagnóstico por imagen , Ultrasonografía/métodos , Enfermedad Aguda , Adulto , Anciano , Anciano de 80 o más Años , Colecistectomía/métodos , Colecistitis Aguda/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pancreatitis/cirugía , Estudios Retrospectivos , Sensibilidad y Especificidad , Resultado del Tratamiento
11.
Acta Reumatol Port ; 41(3): 194-212, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27770754

RESUMEN

OBJECTIVE: To provide evidence-based guidance for the rational and safe prescription of biological therapies in children and adolescents with juvenile idiopathic arthritis (JIAs) considering the latest available evidence and the new licensed biologics. METHODS: Rheumatologists and Pediatricians with expertise in Pediatric Rheumatology updated the recommendations endorsed by the Portuguese Society of Rheumatology and the Portuguese Society of Pediatrics based on published evidence and expert opinion. The level of agreement with final propositions was voted using an online survey. RESULTS: In total, 20 recommendations to guide the use of biological therapy in children and adolescents with JIAs are issued, comprising 4 general principles and 16 specific recommendations. A consensus was achieved regarding the eligibility and response criteria, maintenance of biological therapy, and procedures in case of non-response, for each JIA category. Specific recommendations concerning safety procedures were also updated. CONCLUSIONS: These recommendations take into account the specificities of each JIA category and are intended to continuously improve the management of JIA patients.


Asunto(s)
Artritis Juvenil/tratamiento farmacológico , Productos Biológicos/uso terapéutico , Adolescente , Niño , Árboles de Decisión , Humanos , Portugal , Guías de Práctica Clínica como Asunto , Inhibidores del Factor de Necrosis Tumoral
12.
Gynecol Obstet Fertil ; 33(3): 129-39, 2005 Mar.
Artículo en Francés | MEDLINE | ID: mdl-15848085

RESUMEN

OBJECTIVE: The aim of the study was to investigate patients' perceptions after stereotactic breast biopsy instrumentation, after both procedure and results. PATIENTS AND METHOD: From 1 March 2002 to 31 March 2003, a questionnaire (Likert response type) on stress was given to 73 patients who had breast biopsies procedures, the first time at the end of the procedure (T1) and then after the histological diagnosis (T2). RESULTS: The questionnaire was validated through analysis of principal component with Varimax rotation. Three factors were identified: procedure, quality of life, information and perception after biopsy. Responses were analysed with Chi-square. Two groups of women were identified, the first group (G1) corresponding to patients with a benign diagnosis (N=32) and the second group (G2) to patients with malignant diagnosis (N=32). Only the "procedure" factor was different at T1 and T2 (P=0.022). Compression was found to be painful: 11% at T1 versus 21% at T2. Women were disturbed by local anesthesia: 26% at T1 versus 21% at T2. Biopsy was painful: 6% at T1 versus 13% at T2. Examination was too long: 24% at T1 versus 35% at T2. The procedure was discomfortable: 52% at T1 versus 54% at T2. Information satisfied patients in 90% cases. There was no statistically significant difference according to procedures and histological disease (P=0.357). DISCUSSION AND CONCLUSION: Information and medical empathy conditioned patients' perceptions. Patients tolerated the procedures well.


Asunto(s)
Neoplasias de la Mama/patología , Neoplasias de la Mama/psicología , Mama/patología , Estrés Psicológico/etiología , Adulto , Anciano , Anciano de 80 o más Años , Biopsia con Aguja/métodos , Biopsia con Aguja/psicología , Neoplasias de la Mama/diagnóstico , Diagnóstico Diferencial , Femenino , Humanos , Persona de Mediana Edad , Dolor/epidemiología , Dolor/etiología , Técnicas Estereotáxicas/efectos adversos , Encuestas y Cuestionarios
13.
Sci Total Environ ; 512-513: 381-396, 2015 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-25638653

RESUMEN

Society gets numerous benefits from the water environment. It is crucial to ensure that water management practices deliver these benefits over the long-term in a sustainable and cost-effective way. Currently, hydromorphological alterations and nutrient enrichment pose the greatest challenges in European water bodies. The rapidly changing climatic and socio-economic boundary conditions pose further challenges to water management decisions and the achievement of policy goals. Scenarios are a strategic tool useful in conducting systematic investigations of future uncertainties pertaining to water management. In this study, the use of scenarios revealed water management challenges for England and Wales to 2050. A set of existing scenarios relevant to river basin management were elaborated through stakeholder workshops and interviews, relying on expert knowledge to identify drivers of change, their interdependencies, and influence on system dynamics. In a set of four plausible alternative futures, the causal chain from driving forces through pressures to states, impacts and responses (DPSIR framework) was explored. The findings suggest that scenarios driven by short-term economic growth and competitiveness undermine current environmental legislative requirements and exacerbate the negative impacts of climate change, producing a general deterioration of water quality and physical habitats, as well as reduced water availability with adverse implications for the environment, society and economy. Conversely, there are substantial environmental improvements under the scenarios characterised by long-term sustainability, though achieving currently desired environmental outcomes still poses challenges. The impacts vary across contrasting generic catchment types that exhibit distinct future water management challenges. The findings suggest the need to address hydromorphological alterations, nutrient enrichment and nitrates in drinking water, which are all likely to be exacerbated in the future. Future-proofing river basin management measures that deal with these challenges is crucial moving forward. The use of scenarios to future-proof strategy, policy and delivery mechanisms is discussed to inform next steps.


Asunto(s)
Conservación de los Recursos Naturales/métodos , Recursos Hídricos/estadística & datos numéricos , Abastecimiento de Agua/estadística & datos numéricos , Cambio Climático , Inglaterra , Ambiente , Monitoreo del Ambiente , Gales
14.
Mater Sci Eng C Mater Biol Appl ; 46: 348-58, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-25491997

RESUMEN

Many polymers have been investigated with respect to their use in skin tissue engineering. However, directly comparable data on the role played by different polymers in assisting skin wound healing requires their in vitro and in vivo evaluation under the same conditions. Therefore, we performed a study in order to compare the performance of electrospun nanofiber mats from three different polymers concerning cell-scaffold interaction and wound healing promotion. A polyester (polycaprolactone, PCL), a protein (gelatin from cold water fish skin, GEL) and a polysaccharide (chitosan, CS) were the polymers chosen. Gelatin nanofibers were crosslinked with glutaraldehyde vapor. The scaffolds were characterized physico-chemically, in vitro by seeding with human fetal fibroblasts, HFFF2, and used in vivo as skin substitutes in a rat wound model with total skin removal. In vitro tests revealed that cells adhered and proliferated in all scaffolds. However, cells deep into the scaffold were only observed in the PCL and CS scaffolds. In in vivo tests CS scaffolds had the highest impact on the healing process by decreasing the extent of wound contraction and enhancing the production of a neodermis and re-epithelialization of the wound.


Asunto(s)
Quitosano/química , Gelatina/química , Nanofibras , Poliésteres/química , Humanos , Técnicas In Vitro , Microscopía Electrónica de Rastreo , Andamios del Tejido
15.
Obstet Gynecol ; 82(6): 960-4, 1993 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-7694215

RESUMEN

OBJECTIVE: To determine a reference level for alpha-fetoprotein (AFP) in the amniotic fluid (AF) in pregnant women with insulin-dependent diabetes mellitus in order to suggest an explanation for the observed decrease in maternal serum AFP. METHODS: Alpha-fetoprotein was measured in AF, maternal serum, or both in the second trimester in 287 pregnant women with insulin-dependent diabetes mellitus. Retrospectively, these AFP values were correlated with glycosylated hemoglobin (HbA1C) levels, early fetal growth delay, and congenital malformations. RESULTS: The median concentration of AFAFP was 0.89 multiples of the normative median (MoM) (n = 280; 95% confidence interval [CI] 0.88-0.93 MoM); the maternal serum AFP (MSAFP) value was 0.78 MoM (n = 155; 95% CI 0.77-0.84 MoM). A statistically significant but weak positive correlation was found between HbA1C and MSAFP (r2 = 0.033, P = .03), but the correlation with AFAFP was not statistically significant. The levels of AFP did not correlate with early fetal growth delay. One neural tube defect, but none of the 11 other major malformations, was detected by AFP screening. CONCLUSIONS: A physiologic basis for the decreased AFAFP and MSAFP levels is still obscure. Screening for congenital malformations in diabetic pregnancies should include both a mid-gestation ultrasound scan and MSAFP measurement. However, routine amniocentesis does not seem to be indicated. Concentrations of AFAFP may be corrected for the observed decrease.


Asunto(s)
Líquido Amniótico/química , Diabetes Mellitus Tipo 1/metabolismo , Embarazo en Diabéticas/metabolismo , alfa-Fetoproteínas/análisis , Anomalías Congénitas/diagnóstico , Diabetes Mellitus Tipo 1/sangre , Femenino , Humanos , Embarazo , Embarazo en Diabéticas/sangre , Diagnóstico Prenatal/métodos , Valores de Referencia , Estudios Retrospectivos
16.
Braz J Med Biol Res ; 29(12): 1583-91, 1996 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-9222416

RESUMEN

The purpose of the present study was to determine biochemical parameters of folate uptake, and the putative contribution of the membrane-anchored folate receptor in microvillous membrane vesicles obtained from the syncytiotrophoblast of human term placenta. Uptake of [3H]-pteroylglutamic acid (PGA) by microvillous membrane vesicles was pH dependent with a maximum at pH 6.0, and attained equilibrium at 60 min of incubation. Uptake was higher in the presence on an inward pH gradient (pHout = 6.0; pHin = 7.5) than in the absence of the gradient (pHout = pHin = 6.0). The effect of changes in medium osmolality showed that both binding to the vesicular membrane and internalization contributed to the measured [3H]-PGA uptake. Equilibrium uptake experiments using [3H]-PGA concentrations within the physiological range of folate in blood serum showed that saturation was achieved at 30 nM and revealed a single class of binding sites with a Kd of 1.8 nM for [3H]-PGA. Cleavage of the glycosyl-phosphatidylinositol moiety of the folate receptor, which anchors the receptor to the membrane, with phosphatidylinositol-specific phospholipase C resulted in a reduction of about 80% in [3H]-PGA uptake. In conclusion, our results showed that the folate uptake in the maternally facing membrane of the human placenta presents a saturable component and is mediated by the folate receptor to ensure an adequate maternal-fetal folate transfer.


Asunto(s)
Ácido Fólico/farmacocinética , Placenta/metabolismo , Placenta/ultraestructura , Proteínas Portadoras/fisiología , Femenino , Receptores de Folato Anclados a GPI , Humanos , Microvellosidades/metabolismo , Embarazo , Receptores de Superficie Celular/fisiología
17.
Bull Cancer ; 84(11): 1073-8, 1997 Nov.
Artículo en Francés | MEDLINE | ID: mdl-9536989

RESUMEN

The purpose was to evaluate the interest of stereotaxic fine-needle aspiration for round opacities when the ultrasound and echoguided punctures are inefficient; especially when women are under menopausal hormonal replacement therapy. Sixty stereotactic guided fine-needle aspirations detected by mammography have been performed between january 1990 and august 1996. The stereotaxic procedure is performed with a DMR unit (GE with Stereotix II). Stereotaxic views are done to verify needle position. After aspiration, cytologic examination is realised. Cystic fluid was always obtained and cytologic examination proved benign cysts in all cases. In 50 cases, cysts completely disappeared. There were 2 relapses that received after a second. This method is reliable for evaluation of non palpable mammographically detected opacities. The use of this technique spares the patient a surgical biopsy. This procedure enables women under menopausal hormone replacement therapy to continue the treatment.


Asunto(s)
Biopsia con Aguja/métodos , Enfermedad Fibroquística de la Mama/diagnóstico , Técnicas Estereotáxicas , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Enfermedad Fibroquística de la Mama/fisiopatología , Humanos , Mamografía , Menopausia , Persona de Mediana Edad , Radiografía Intervencional , Sensibilidad y Especificidad , Ultrasonografía Mamaria
18.
Rev Saude Publica ; 26(4): 295-8, 1992 Aug.
Artículo en Portugués | MEDLINE | ID: mdl-1342515

RESUMEN

PIP: The probabilities of survival of patients carrying the AIDS virus are presented in the city of Santos, Brazil, where it is estimated that 1056 cases were reported in 1988, 1989, and 1990. Records of epidemiological investigations delivered by outpatient services or obtained by means of active search realized routinely in city hospitals were analyzed. Information on deaths were derived from the offices of the civil registry of Santos, Sao Vincente, and Guaruja, and from the notifications received. Losses (deaths registered in offices of other regions) were estimated at less than 2%, the proportion of incidence in the general population according to data of the Foundation SEADE. The patients were grouped by sex and stage of progression of the disease according to classification of cases (IV B, IV C, IV D, and IV E conform to the classification of the Centers for Disease control) [CDC, suspected cases (class IV A of CDC), and asymptomatic seropositive cases (classes I, II, and II of CDC).^ieng


Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/mortalidad , Brasil/epidemiología , Femenino , Humanos , Masculino , Análisis de Supervivencia , Tasa de Supervivencia
19.
Rev Saude Publica ; 24(4): 286-93, 1990 Aug.
Artículo en Portugués | MEDLINE | ID: mdl-2103646

RESUMEN

The epidemiological approach to occupational accidents and diseases adopted in Brazil is inadequate for many reasons, among them being: 1) the fact that only employers may notify work accidents, thus permitting notorious undernotification of these occupational hazards; 2) the available information does not permit a better understanding of the causal relationship between work accidents and diseases; 3) the official policy exists only for purposes of insurance compensation. The official documents for occupational disease and accident registration are the CTA (Work accident report) and FTA (Casualty treatment card). The Worker's Health Program of SUDS-R-6 proposed, in October, 1988 a method for the codification, registration in a micro-computer data bank and analysis of this information, based on the records presently in use (CAT) for public health service planning and accident prevention purposes. The major interest was in identifying the most common types of accidents in the region and the work environments in which they most frequently occur. The target population were the workers who attended the health units lisenced to deal with work accidents and diseases, in the Northern region of S. Paulo City. The data presented below refer to the months of October, November and December, 1988, the first three months of the project. During that period a total of 2,339 accidents were registered. They were classified as: typical work accidents - 87%: commuting accidents which occurred between the home and the work-place--18% and work diseases (only 2 cases). The majority of workers (50%) were between 25 and 45 years of age, approximately 7% were under 18. Male workers represented 83.2% of accident cases.(ABSTRACT TRUNCATED AT 250 WORDS)


Asunto(s)
Accidentes de Trabajo/estadística & datos numéricos , Brasil/epidemiología , Traumatismos de la Mano/epidemiología , Humanos
20.
Gynecol Obstet Fertil ; 31(3): 256-64, 2003 Mar.
Artículo en Francés | MEDLINE | ID: mdl-12770811

RESUMEN

Stereotactically-guided procedures for diagnosis of breast lesions can avoid a lot of surgical biopsies. Stereotactic guidance is used for vacuum-assisted core biopsies and for stereotactic breast biopsies. Technical details of the procedures are described, and the benefits and the limits of these methods are discussed. Indications for breast sampling are proposed according to the Breast Imaging Reporting and Data System (BI-RADS) assessment categories.


Asunto(s)
Biopsia/métodos , Enfermedades de la Mama/patología , Mama/patología , Enfermedades de la Mama/diagnóstico , Diagnóstico Diferencial , Femenino , Humanos , Mamografía , Técnicas Estereotáxicas , Vacio
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