No description available.

Objective: To evaluate pressor sensitivity to catecholamines in dogs after induction of iatrogenic hyperadrenocorticism (I-HAC) by serial arterial blood pressure measurements during infusions of increasing dose rates of norepinephrine. Animals: Eight dogs with I-HAC induced by administration of oral hydrocortisone at a mean dose of 3.3 mg/kg PO TID for 42-49 days and 8 control dogs which received empty gelatin capsules PO TID for 42-49 days. Procedure: Systolic, diastolic, mean blood pressure and heart rate measurements were recorded after sequential administration of increasing dose rates of norepinephrine (0.1, 0.125, 0.2, 0.3, 0.4, 0.6 and 0.8 mg/kg/min) for 10 minutes. The changes in systolic, diastolic, mean blood pressure and heart rate were compared between control dogs and dogs with I-HAC. Results: Dogs in the I-HAC group had a more pronounced pressor response to norepinephrine infusions than control dogs. The infusions were not completed in 7 of the 8 dogs in the I-HAC group versus 3 dogs in the control group due to severe elevations in systolic blood pressure. The mean change in systolic blood pressure was consistently higher in dogs in the I-HAC group. The difference was statistically significant at the 0.2 mg/kg/min norepinephrine dose rate. The mean change in heart rate was consistently lower in the I-HAC group, a difference that was significant at the 0.2 mg/kg/min norepinephrine dose rate. Conclusions and clinical relevance: Increased pressor sensitivity or decreased baroreceptor response to norepinephrine was seen in dogs with I-HAC suggesting that this mechanism is involved in the development of hypertension in canine hyperadrenocorticism. / Master of Science

No description available.

Thesis (M.A.)--University of Toronto, 2006. / Source: Masters Abstracts International, Volume: 44-06, page: 2506.

Magister Scientiae Dentium - MSc(Dent) / Aim To analyze the demographic profile, clinical data and radiographs of patients who had third molar surgery under general anaesthesia at the Faculty of Dentistry at the University of the Western Cape over a 10 year period. Introduction Minor oral surgical procedures are carried out by Maxillofacial and Oral Surgeons daily. The surgical removal of third molars is a large part of Minor Oral Surgery which is common throughout the world. The general impression of third molar surgery performed by experienced professionals is the ease of the operation, however no-matter how experienced one may be, a simple procedure should never be underestimated (Carvalho and Do Egito Vasconselos, 2011). New surgical techniques, as well as extensive training, skill and experience have led to the evolution of oral surgery and allowed this procedure to be carried out in a less traumatic manner. Certain factors precipitate third molar surgery to be performed in theatre as opposed to the dental clinic setting. These factors will be discussed in this research report.

Despite intensive research, the cellular and molecular mechanisms involved in human cellular susceptibility to prion infection remain poorly defined, in part due to the continuing lack of cultured human cells that are susceptible to infection with human prions. Such culture models would present distinct advantages including speed and expense compared with animal models, and would provide systems in which to investigate the interaction between PrPC and PrPSc, the basis of cellular susceptibility, the nature of the species barrier and the mechanism of prion propagation in situ. This study sought to examine whether non-neuronal cells might provide opportunities to establish human cell lines replicating human prions. A human follicular dendritic cell-like cell line (termed HK) was obtained, further characterised and then tested for its ability to support human prion replication. The mechanisms of internalisation, intracellular trafficking and the eventual fate of exogenous PrPSc taken up by these cells were also examined. This thesis similarly examined the cellular response of human embryonic stem cells (hESC) to acute exposure to human and animal prions. PrPC was found to be abundantly expressed by HK cells and HK cell extracts were found to support conversion to PrPSc in a cell-free conversion assay. However, HK cells exposed to infectious brain homogenates failed to accumulate PrPSc or become infected in vitro. Exposed HK and hESC did display a readily detectable, time dependent uptake of PrPSc from medium spiked with prion-infected brain homogenates that was independent of the species, disease phenotype and PRNP codon 129 genotype of the human source and the recipient cells. The exposed cells showed intensely labelled intracellular accumulations of PrPSc with coarse granular morphology, largely in the juxtanuclear region of cytoplasm. However, when the brain-spiked medium was withdrawn and cells were given control medium, the intensity and extent of PrPSc immunostaining rapidly diminished. Co-localisation studies implicated caveolae-mediated endocytic uptake of exogenous PrPSc, apparently preceding uptake via clathrin coated pits in HK cells. Evidence suggesting that the endosomal recycling compartment and lysosomes are involved in intracellular trafficking and degradation of exogenous PrPSc was also found. Understanding the cell biology of these processes may help to explain why the majority of cultured cells are refractory to prion infection in vitro. Internalization of misfolded PrP and its subsequent degradation in the lysosomal compartment might function as a self-protective cellular mechanism, serving to eliminate non-native, presumably dysfunctional and potentially dangerous PrP conformers, whether generated endogenously or acquired through exposure to exogenous prion infectivity.

Este trabalho aborda o tema do potencial iatrogênico da psicanálise. Desde a Grécia Antiga, com Hipócrates, estabeleceu-se como princípio basilar das práticas de cura a necessidade de que, antes de tudo, não se deve causar mal ao paciente. Sabe-se que qualquer tratamento com potencial para curar um paciente tem também potencial de produzir efeitos iatrogênicos. Contudo, no campo da saúde mental, a pesquisa sobre o tema ainda pouco avançou, enfrentando resistência por parte dos profissionais e também obstáculos metodológicos, em particular, a falta de terminologia adequada para identificar, classificar e analisar os efeitos iatrogênicos. Pesquisas sobre o tema mostram que tratamentos em saúde mental provocam piora do quadro clínico do paciente em até 10% dos casos. Indicam também a importância da relação entre paciente e terapeuta, enquanto fonte de eficácia do tratamento, mas também fonte de produção de efeitos iatrogênicos. O presente trabalho é uma pesquisa teórica, que por meio de uma revisão sistemática da literatura sobre o tema do potencial iatrogênico da Psicanálise, visa investigar em que condições o psicanalista e/ou o tratamento psicanalítico podem produzir efeitos iatrogênicos e de que modo a formação psicanalítica pode contribuir para redução desses efeitos. Espera-se que a pesquisa sirva de base para o desenvolvimento de um esquema teórico conceitual que amplie a discussão sobre o tema do potencial iatrogênico da psicanálise. Até o momento foi possível elaborar a proposta de terminologia aplicável ao campo das iatrogenias, a partir da diferenciação entre iatrogenias dolosas e culposas, e com uso das categorias como: imperícia, negligencia e imprudência. Abordamos também a questão dos diversos usos feitos do poder no curso do tratamento, articulado ao tema da responsabilidade do psicanalista, a partir da proposta de formalização da práxis psicanalítica à semelhança de um jogo composto por três elementos - o sujeito, o saber e o sexo, tal como proposto por Jacques 11 Lacan no Seminário XII. Concluímos que nas tentativas de simplificação, redução, recortes ou amputações da prática e da teoria psicanalítica é que residem os maiores riscos de aumento no potencial iatrogênico do tratamento. Espera-se que a presente pesquisa contribua de modo relevante para a construção de um esquema teórico conceitual que amplie a discussão sobre o tema da iatrogenia dos tratamentos em saúde mental, visando, em última instancia, compreender as possibilidades de redução de danos decorrentes do tratamento psicanalítico / This paper discusses the iatrogenic potential of psychoanalysis. Since ancient Greece, with Hippocrates, it was established as a basic principle of healing practices that, first of all, the doctor shall not cause harm to the patient. Today, it is known that any potential treatment for curing a patient also has the potential of producing iatrogenic effects. However, in the field of mental health, research on the subject has made little progress, facing resistance from professionals and methodological obstacles, particularly the lack of a proper terminology to identify, classify and analyze the iatrogenic effects. Research on the subject shows that mental health treatments may cause worsening of the clinical condition of the patient in up to 10% of cases. Researches also indicate the importance of the relationship between patient and therapist, as a source of treatment efficacy, but also as the source of iatrogenic effects. This work is a theoretical research that through a systematic review of the literature on the iatrogenic potential of psychoanalysis, aims to investigate under what conditions the analyst and/or psychoanalytic treatment may produce iatrogenic effects and how psychoanalytic training can help reduce these effects. It is hoped that this research will serve as a basis for the development of a conceptual theoretical framework to broaden the discussion on the subject of the iatrogenic potential of psychoanalysis. So far it was possible to develop a proposal of terminology applicable to the field of iatrogenic effects in mental health, based on the distinction between intentional and culpable iatrogenic, and use of categories such as malpractice, negligence and recklessness. This research also addressed the issue of the different uses made of power in the course of treatment, linked to the psychoanalysts responsibility when conducting a treatment, based on the proposed formalization of psychoanalytic practice like a game, revolving around three elements - the subject, knowledge and sex - as proposed by Jacques Lacan, in Seminar XII. We conclude to argue that in the attempts of simplification, reduction, cuts or amputations of psychoanalytical practice and theory resides the greatest increases in iatrogenic potential of psychoanalysis. It is hoped that this research will 13 contribute in a relevant way for the construction of a conceptual theoretical framework to broaden the discussion on the subject of iatrogenic treatments in mental health, aimed at ultimately, understand the harm reduction opportunities arising from psychoanalytical treatment

Thesis (M.S.)--University of Alabama at Birmingham, 2008. / Title from first page of PDF file (viewed May 30, 2008). Includes bibliographical references.

Thesis (Ph.D.)--University of Alberta, 2009. / A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Epidemiology, Department of Public Health Sciences. Title from pdf file main screen (viewed on October 11, 2009). Includes bibliographical references.

(Thesis: M.S.P.H.) PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / INTRODUCTION: Although serious complications of invasive bedside procedures are rare they can be life threatening. Interest in identifying and preventing complications of bedside procedures has been heightened recently in light of such complications increasingly being linked to hospital reimbursement. In part I of this thesis we present the validation of ICD-9-CM codes for identification of the two most common complications associated with central venous catheterization. In part II we determine the impact of the development of a medical procedure service (MPS) on patient safety surrounding bedside procedures and resident education. METHODS: Part I: Cases of iatrogenic pneumothorax and central line associated blood stream infections (CLABSI) identified by ICD-9-CM codes in discharge data provided by Boston University Medical Center to the University HealthSystem Consortium were compared with those revealed by medical record abstraction of central venous catheters placed between 7/10-12/11. Part II: Retrospective cohort analysis of consecutive adults admitted to the internal medicine service who underwent a bedside medical procedure between 7/10-12/11 comparing characteristics and outcomes of procedures performed by the MPS versus primary services. RESULTS: Part I: The ICD-9-CM code for iatrogenic pneumothorax (512.1) had a sensitivity of 66.7%, specificity of 100%, positive predictive value of 100% and negative predictive value of 99.5%. The ICD-9-CM codes for CLABSI (999.31 and 999.32) had a sensitivity of 41.7%, specificity of 98.0%, positive predictive value of 20.0% and negative predictive value of 99.3%. Part II: We evaluated 1707 bedside procedures (548 by MPS, 1159 by primary services). While the MPS was more likely to successfully complete procedures (95.8% vs. 92.8%, p=0.02) and to use best practice safety process measures (95.4% vs. 51.0%, p<0.0001), the composite rate of major complications was similar (1.6% vs. 1.9%, p=0.71). CONCLUSIONS: Complications associated with invasive beside procedures are rare. The low sensitivity and variable positive predictive value of ICD-9-CM codes for detection of complications of central venous catheterization limits their use for internal quality improvement purposes. While use of a medical procedure service was associated with increased use of evidence based process measures, it did not significant affect the rate of major complications associated with bedside procedures. / 2031-01-01