Thesis (M.S.)--University of Wisconsin-Madison, 1994. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 62-65).

Thesis (M. Phil.)--University of Hong Kong, 1996. / Includes bibliographical references (leaf 121-133).

Thesis (doctoral)--Lund, 1982.

Thesis (doctoral)--Lund University, 1997. / Added t.p. with thesis statement inserted.

Thesis (M. Phil.)--University of Hong Kong, 200. / Also available online.

Proefschrift Maastricht. / Met lit. opg. - Met samenvatting in het Nederlands.

Made available in DSpace on 2014-06-11T19:32:56Z (GMT). No. of bitstreams: 0 Previous issue date: 2006-12-07Bitstream added on 2014-06-13T20:24:25Z : No. of bitstreams: 1 nascimento_gvr_dr_botfm.pdf: 431185 bytes, checksum: 6bbeed7f487bb4cbad5e3143bf450b76 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Evidências apontam que o momento de início da diálise pode influenciar diretamente a evolução de pacientes portadores de Insuficiência Renal Aguda (IRA). Assim, a diálise precoce surge como meio adicional para reduzir a mortalidade nestes pacientes. Porém, os parâmetros utilizados para o início da terapia substitutiva renal (TSR) nestes casos ainda não estão estabelecidos. Objetivo: avaliar se pacientes com IRA por Necrose Tubular Aguda (NTA) submetidos a diálise com níveis baixos de uréia (inferior aos atualmente preconizados) apresentam menor mortalidade e maior recuperação renal comparados aqueles submetidos a TSR com uréia elevada. Métodos: corte retrospectiva de pacientes com IRA por NTA submetidos a diálise no período de marco de 2001 a maio de 2006 no HCUNESP. Os pacientes foram alocados em 2 grupos de acordo com os valores de uréia no momento da indicação da diálise: GI: 150 e GII:>150 mg/dl. IRA foi definida como um aumento de creatinina sérica > 30% do valor basal, excluídas causas pré-renais e pós-renais. Foram avaliados pacientes >18 anos, em diálise por mais de 48 h e com ATN-ISS < 0,9 e acompanhados até óbito, recuperação da função renal ou tempo em diálise > 30 dias. Estatística: Teste T e Mann-Whitney (comparação entre grupos) e Qui-quadrado, Exato de Fisher e Goodman (proporções). Nível de significância de 5%. Resultados: Foram analisados 1561 pacientes, sendo excluídos 861 por não apresentarem IRA por NTA. Dos 700 restantes, 333 (47,5%) foram submetidos a diálise, sendo excluídos 247. Os 86 pacientes restantes foram alocados em 2 grupos, sendo 23 em GI e 63 em GII. / There is evidence that the timing of dialysis initiation can influence the evolution of patients with acute renal failure (ARF). Also early dialysis seems to reduce mortality in these patients. However the parameters used at the start of renal replacement therapy (RRT) still are not established in these cases. Objective: to evaluate whether patients with ARF due to acute tubular necrosis (ATN), starting dialysis with low urea levels (lower than current recommendations) present less mortality and higher renal recuperation than those submitted to RRT with elevated urea. Patients and Methods: a retrospective cohort of patients with ARF due to ATN submitted to dialysis, from March 2001 to May 2006 at HC-UNESP. Patients were allocated into two groups according to urea values at time of RRT indication: GI.150 and GII>150 mg/dl. ARF was defined as serum creatinine >30% above basal value; pre and post renal causes were excluded. Patients were >18 years old, in dialysis for >48h, and with ATN-ISS <0.9; they were accompanied until death, renal function recovery, or RRT>30 days. Statistics: T and Mann-Whitney tests (comparison between groups) and Chi squared; Exact Fisher, and Goodman tests (proportions); significance level 5%. Results: From 1561 patients analyzed, 861 were excluded for not presenting ARF due to ATN. From the remaining 700, 333 (47.5%) were submitted to RRT, of these, 247 were excluded, leaving 86 patients (23 in GI and 63 in GII). Groups had similar median ages (GI: 61 and GII: 63 years); prognosis index: ATN-ISS (0.61and 0.67) and APACHE II (21 and 28); percentage of patients with prior end-stage renal disease (21.7% and 46%); in clinical wards (43.5% and 66.7%), and ICU (69.6% and 77.8%); number of RRT sessions (9 and 8); type of dialysis (hemodialysis: 43,5% and 20,7%) and dialysis dose received (Kt/V: 0.62}0.16 and 0.54}0.11). GI patients presented higher renal function recuperation (GI: 43.5%, GII 11.1%; p=0.

Made available in DSpace on 2015-04-09T12:28:02Z (GMT). No. of bitstreams: 0 Previous issue date: 2014-02-17Bitstream added on 2015-04-09T12:48:27Z : No. of bitstreams: 1 000814326.pdf: 359070 bytes, checksum: 6c4f05f013b9c86649717ad6dd9be440 (MD5) / As proteínas de fase aguda são glicoproteínas sintetizadas pelos hepatócitos e surgem precocemente na circulação sanguínea durante processos inflamatórios. Assim, o estudo objetivou identificar, diferenciar, quantificar, avaliar e comparar as proteínas séricas de fase aguda em equinos com cólica de ocorrência natural e naqueles submetidos à obstrução intestinal experimental e correlacioná-las com o leucograma destes animais. Utilizaram-se 27 equinos adultos, 12 animais atendidos junto ao Hospital Veterinário Governador Laudo Natel (FCAV/Unesp) no período de julho de 2010 à julho de 2013 para tratamento de abdômen agudo, sobreviventes ou não, e 15 animais submetidos a obstrução intestinal experimental de intestino delgado ou grosso. Foram colhidas amostras de sangue total com anticoagulante, para realização do leucograma, e sem anticoagulante para realização do eletroforetograma em SDS-PAGE imediatamente antes da laparotomia (M0), após o procedimento cirúrgico (M1) e, diariamente, até o sétimo dia pós-operatório, com exceção do sexto dia (M2, M3, M4, M5, M6 e M7). Para análise dos dados utilizou-se o método estatístico multivariado com análise de fatores. Os equinos com cólica natural apresentaram padrão de resposta inflamatória mais intensa que os equinos submetidos à obstrução experimental. Os equinos submetidos à obstrução experimental apresentaram, ainda, resposta inflamatória ao modelo de obstrução instituído. As proteínas de fase aguda tiveram maior participação na variabilidade da resposta inflamatória que o leucograma e, somente quando avaliou-se a influência do tempo em cada grupo, observou-se correlação entre as proteínas de fase aguda e o leucograma. As proteínas de fase aguda alfa-1 glicoproteína ácida, haptoglobina e ceruloplasmina mostraram-se eficientes marcadores da resposta inflamatória e suas alterações podem ser utilizadas como indicadores prognósticos e do ... / The acute phase proteins are glycoproteins synthesized by hepatocytes and appear early in the bloodstream during inflammatory processes. The study aimed to identify, differentiate, measure, evaluate and compare the acute phase serum proteins in horses with naturally occurring colics and those undergoing experimental intestinal obstruction and correlate them with the leukon count in these animals. From the 27 adult horses studied 12 were treated in the Veterinary Hospital Governor Laudo Natel (FCAV / UNESP) from July 2010 to July 2013 for acute abdomen, survivors or not, and 15 animals were subjected to experimental small or large intestinal obstruction. Samples were obtained from whole blood with anticoagulant, to perform the WBC, and without anticoagulant to perform the SDS-PAGE electrophoretogram immediately before laparotomy (MO), after surgery (M1), and daily until the seventh day after surgery, except the sixth day (M2, M3, M4, M5, M6 and M7). For data analysis the multivariate statistical method with exploratory factor analysis was used. The horses with naturally occurringg colic showed intense inflammatory patterns that horses undergoing experimental intestinal obstruction. The horses undergoing experimental intestinal obstruction had also inflammatory obstruction established the model. The acute phase proteins had greater participation in the variability of the inflammatory response than the WBC and only when the influence of time in each group was evaluated there was a correlation between acute phase proteins and WBC. The acute phase protein alpha 1-acid glycoprotein, haptoglobin and ceruloplasmin were effective markers of the inflammatory response and its changes can be used as prognostic and time course indicators of acute abdomen in horses

Bakgrund: Efter akut kranskärlssjukdom är det viktigt att förändra sin livsstil då det har stor betydelse för framtidsutsikten för dessa patienter. Trots detta så förändrar inte alla patienter sina livsstilsvanor, eller klarar av att bibehålla de nyligen förändrade vanorna.   Syfte: Syftet var att studera vad som påverkar genomförandet av livsstilsförändringar hos personer i efterförloppet av akut kranskärlssjukdom.   Metod: Litteraturstudie med ett systematiskt tillvägagångssätt. Datainsamling genomfördes i databaserna CINAHL, PsycINFO, PubMed, Swemed+ och UniSearch. Efter datainsamling och kvalitetsgranskning inkluderades 15 artiklar varav nio kvalitativa artiklar och sex kvantitativa artiklar. För bearbetning av data utfördes en analys där fyra huvudkategorier identifierades.   Resultat: De fyra huvudkategorierna som identifierades var: Den enskilde individen, Kunskap, Inre faktorer och Yttre faktorer. Dessa områden kunde både främja och/eller hämma genomförandet av livsstilsförändring i efterförloppet av akut kranskärlssjukdom.    Konklusion: Sjuksköterskan bör vara medveten om den multifaktoriella process som livsstilsförändring innebär för patienten. Patientens behov kan tillgodoses genom tydlig information om sjukdomen men även andra aspekter såsom livsstilsförändring och hantering av förändring. Patienten behöver stöd från sjukvården, likasinnade och närstående för att kunna förändra sin livsstil.

Traumatic Brain Injury (TBI) accounts for 1,000,000 hospital admissions in the European Union every year and is the leading cause of death in individuals under 45 years of age in both Europe and the United States. This thesis examines the consequences to both the brain and lung following TBI using the lateral fluid percussion injury (FPI) in an in-vivo murine model. In the murine FPI model, alongside cerebral inflammation (associated with neuronal damage and the infiltration of inflammatory cells), there is significant neutrophil accumulation within the pulmonary interstitium 6 and 24 hours after TBI. This was associated with pulmonary haemorrhage and increased vascular permeability. In an attempt to reduce pulmonary injury, 17-DMAG, an HSP90 inhibitor, was applied but proved to be nonprotective. Since patients with TBI show increased susceptibility to bacterial infection, microaspiration and ventilator-induced lung injury, a double-hit model was established whereby mice first received the head injury and then received a lung injury. This demonstrated worse lung injury following intra-tracheal administration of hydrochloric acid after TBI. Depleting neutrophils with an anti-LY-6G depleting antibody improved outcome in this model, indicating increased susceptibility to damage was neutrophil dependent. To test whether neutrophil accumulation within the pulmonary interstitium was specifically related to brain injury, lung tissue following other distant organ injury such as renal ischemia-reperfusion injury (IRI) and renal transplantation were assessed. Significant pulmonary interstitial neutrophil accumulation was seen following both models and was associated with significant pulmonary haemorrhage. Inducing HSP70 activity with an HSP90 inhibitor was shown to be protective by reducing the degree of pulmonary haemorrhage in these models. In an attempt to identify the mechanisms behind neutrophil accumulation in TBI, renal IRI and renal transplantation, ICAM-1 (CD54), a marker of the reverse transmigration of neutrophils was investigated. No differences in ICAM-1 expression were seen following TBI, indicating that another mechanism must be responsible. This mechanism is the focus of on going work within the laboratory. Hypoxia is believed to contribute towards the development of secondary brain injury however little is known regarding its direct contribution. Working alongside chemists at the University of Edinburgh, a number of novel fluorescent hypoxia probes were designed and tested, but none proved to be able to detect hypoxia in-vitro. In conclusion, this thesis has demonstrated that following mild TBI, the lungs are “primed” with a massive interstitial neutrophil influx and that a subsequent micro aspiration of acid induces exaggerated lung injury. The mechanism by which this occurs is the focus of on-going investigation. Pulmonary sequestration of neutrophils is also a predominant feature of other distant organ injuries.