Diss. (sammanfattning) Linköping : Univ., 2006. / Härtill 5 uppsatser.

Thesis (Ph. D.)--University of Alabama at Birmingham, 2008. / Title from first page of PDF file (viewed Feb. 19, 2009). Includes bibliographical references.

A obesidade grau III ou também chamada obesidade mórbida é uma condição clínica freqüente e que vem apresentado crescimento progressivo, estando associada a elevadas taxas de morbi-mortalidade. Trata-se de uma doença de origem multifatorial, freqüentemente associada a comorbidezes, necessitando uma abordagem terapêutica que propicie redução de peso, melhora das doenças associadas e conseqüente melhora da qualidade de vida. O tratamento convencional deve ser sempre a primeira escolha, principalmente nos casos de inicio recente e sem antecedentes de tratamentos adequados prévios. A taxa de insucesso, contudo, é extremamente elevada, ocorrendo falha em mais de 90% dos casos. O tratamento cirúrgico atualmente é a alternativa com melhores resultados, porém com riscos de complicações a curto, médio e longo prazo, caso não seja realizado um rigoroso acompanhamento clinico, nutricional e psicológico em equipe multidisciplinar experiente. Esta revisão tem por objetivo discorrer sobre as morbidades associadas à obesidade grave, as opções de tratamento convencional e cirúrgico bem como riscos relacionados à persistência de um grande excesso de peso versus risco cirúrgico. / Morbid obesity is a frequent disease with a progressive increase in incidence and associated with high morbid and mortality rates. It is a multifactorial disease, and is usually associated with comorbidities. It is necessary specific treatment to reduce weight, to improve the comorbidities and obtain a better quality of life. The classic treatment, diet and exercise, should be the first choice, especially in cases of recent onset of severe obesity and poor quality previous treatments. Unfortunately, in more than 90% of the patients this kind of treatment will fail. Bariatric surgery is, nowadays, the best option of treatment, but has several risks of complications in the short, medium or long time followup, mostly in patients not followed by a specialized multidisciplinary team. This is a review about morbid obesity, comorbidities, options of treatment and the risks of stay severely obese versus surgical procedures.

sustained multiple concussions may be at risk of cumulative impairment. The role of neuropsychological testing in the management of sports-related concussion is a contentious and challenging issue which has gained credibility given the lack of clear and well-established guidelines pertaining to the diagnosis, assessment and return-to-play decisions following concussion. Despite various traditional paper and pencil tests being shown to be effective indicators of postconcussive neuropsychological dysfunction, testing has not been widely implemented, due to time- and labour-demands. ImPACT, a computer-based neuropsychological assessment instrument, has been recognised as a valid and reliable tool in the monitoring of athletes' symptoms and neurocognitive functioning preseason and postconcussion. As a part of larger-scale concussion research conducted on top-team university rugby players, this is an in-depth case study conducted on a 20-year old participant with a history of multiple concussions, who was referred following a concussion sustained during the season. The objectives of the study were: (i) to determine the sensitivity of ImPACT versus WAIS-III Digit Span and Trail Making Test during the acute postconcussive phase; and (ii) to examine the sensitivity of ImPACT versus a comprehensive battery of neuropsychological tests to possible residual deficits as a result of the multiple concussions. ImPACT was determined to be more sensitive to acute postconcussive impairment following concussion than Digit Span and Trail Making Test. Furthermore, the ImPACT preseason baseline scores appear to be sensitive to neurocognitive dysfunction, possibly due to cumulative concussive injuries.

A obesidade grau III ou também chamada obesidade mórbida é uma condição clínica freqüente e que vem apresentado crescimento progressivo, estando associada a elevadas taxas de morbi-mortalidade. Trata-se de uma doença de origem multifatorial, freqüentemente associada a comorbidezes, necessitando uma abordagem terapêutica que propicie redução de peso, melhora das doenças associadas e conseqüente melhora da qualidade de vida. O tratamento convencional deve ser sempre a primeira escolha, principalmente nos casos de inicio recente e sem antecedentes de tratamentos adequados prévios. A taxa de insucesso, contudo, é extremamente elevada, ocorrendo falha em mais de 90% dos casos. O tratamento cirúrgico atualmente é a alternativa com melhores resultados, porém com riscos de complicações a curto, médio e longo prazo, caso não seja realizado um rigoroso acompanhamento clinico, nutricional e psicológico em equipe multidisciplinar experiente. Esta revisão tem por objetivo discorrer sobre as morbidades associadas à obesidade grave, as opções de tratamento convencional e cirúrgico bem como riscos relacionados à persistência de um grande excesso de peso versus risco cirúrgico. / Morbid obesity is a frequent disease with a progressive increase in incidence and associated with high morbid and mortality rates. It is a multifactorial disease, and is usually associated with comorbidities. It is necessary specific treatment to reduce weight, to improve the comorbidities and obtain a better quality of life. The classic treatment, diet and exercise, should be the first choice, especially in cases of recent onset of severe obesity and poor quality previous treatments. Unfortunately, in more than 90% of the patients this kind of treatment will fail. Bariatric surgery is, nowadays, the best option of treatment, but has several risks of complications in the short, medium or long time followup, mostly in patients not followed by a specialized multidisciplinary team. This is a review about morbid obesity, comorbidities, options of treatment and the risks of stay severely obese versus surgical procedures.

La précarité est une dimension plus vaste que la pauvreté atteignant presque 15 % de la population française. Les personnes précaires ont plus de risques de développer certaines pathologies, dont des pathologies liées à l’alimentation, le diabète. Une étude d’intervention randomisée a été réalisée auprès d’une population de personnes précaires sur une durée de 12 mois. Les volontaires recevaient des conseils diététiques et/ou des chèques afin de favoriser la consommation de fruits et légumes. D’une consommation initiale d’environ 2,5 portions par jour, avec 30 % de sujets consommant en moyenne moins d’un fruit et légume par jour, l’augmentation moyenne est de 0,7 portions de fruits et légumes par jour, identique dans les deux groupes. Les chèques ont permis une diminution significative du pourcentage de très petits consommateurs. L’impact de la précarité a également été évalué chez des patients diabétiques au cours de trois études transversales. La précarité s’associe à un risque de déséquilibre glycémique et secondairement de rétinopathie, mais sans lien démontré entre la précarité et le stade d’une rétinopathie diabétique. L’une de ces études suggère un lien entre la précarité et le risque de néphropathie diabétique, et démontre une moins bonne qualité de vie des patients. Ces travaux soulèvent des questions sur les multiples freins à une alimentation saine ou à une prise en charge de la maladie pour des personnes précaires et orientent vers des perspectives : cibler les populations, envisager des éducations répétées et il doit être aussi possible de faire mieux avec les mêmes moyens. / Insecurity is a broader dimension of poverty reaching almost 15% of the French population. Insecure people are most at risk of developing various diseases, including diseases related to diet, and diabetes. A randomized intervention study was conducted among deprived volunteers on a period of 12 months. The volunteers were given dietary advice and/or vouchers exchangeable for fresh fruit and vegetables in order to promote their consumption. The baseline consumption was about 2.5 servings of fruit and vegetables per day, with 30% of non daily consumers. The average increase was 0.7 servings of fruits and vegetables per day, in both groups. Vouchers led to a significant decrease in very small consumers. The impact of deprivation has also been evaluated in diabetic patients in three cross-sectional studies. Insecurity was associated with a risk of poor glycemic control and secondarily with retinopathy, but no proven link between deprivation and the stage of diabetic retinopathy. One of these studies suggested a link between insecurity and the risk of diabetic nephropathy. Moreover, deprived patients with diabetes suffer lower quality of life.These studies raise questions about the multiple barriers to a healthy diet or a treatment of chronic disease for deprived people. This is part of the wider reflexion on how to treat these populations, by considering intensified repeated educational programs, and by improving existing approaches.

A obesidade grau III ou também chamada obesidade mórbida é uma condição clínica freqüente e que vem apresentado crescimento progressivo, estando associada a elevadas taxas de morbi-mortalidade. Trata-se de uma doença de origem multifatorial, freqüentemente associada a comorbidezes, necessitando uma abordagem terapêutica que propicie redução de peso, melhora das doenças associadas e conseqüente melhora da qualidade de vida. O tratamento convencional deve ser sempre a primeira escolha, principalmente nos casos de inicio recente e sem antecedentes de tratamentos adequados prévios. A taxa de insucesso, contudo, é extremamente elevada, ocorrendo falha em mais de 90% dos casos. O tratamento cirúrgico atualmente é a alternativa com melhores resultados, porém com riscos de complicações a curto, médio e longo prazo, caso não seja realizado um rigoroso acompanhamento clinico, nutricional e psicológico em equipe multidisciplinar experiente. Esta revisão tem por objetivo discorrer sobre as morbidades associadas à obesidade grave, as opções de tratamento convencional e cirúrgico bem como riscos relacionados à persistência de um grande excesso de peso versus risco cirúrgico. / Morbid obesity is a frequent disease with a progressive increase in incidence and associated with high morbid and mortality rates. It is a multifactorial disease, and is usually associated with comorbidities. It is necessary specific treatment to reduce weight, to improve the comorbidities and obtain a better quality of life. The classic treatment, diet and exercise, should be the first choice, especially in cases of recent onset of severe obesity and poor quality previous treatments. Unfortunately, in more than 90% of the patients this kind of treatment will fail. Bariatric surgery is, nowadays, the best option of treatment, but has several risks of complications in the short, medium or long time followup, mostly in patients not followed by a specialized multidisciplinary team. This is a review about morbid obesity, comorbidities, options of treatment and the risks of stay severely obese versus surgical procedures.

M.Tech. (Radiography) / This was a prospective, quantitative comparative study. The aim of the study was to evaluate acute toxicity of radical combination therapy, in the form of radiotherapy and chemotherapy, in HIV +ve patients on HAART and HIV -ve patients for cervical cancer at CDH, Lusaka, Zambia. The specific objectives were to compare acute toxicity in HIV +ve on HAART and HIV -ve patients and to assess the level of severity in the levels of toxicity. The study was conducted from January 2010 to December 2010. A hundred and twenty stage IB₂-IIIB cervical cancer patients were serially recruited and assigned study numbers for identification and confidentiality. Participants received Cisplatin based radical chemoradiation for five to six weeks during which time they were assessed for acute reactions and data was prospectively collected. Four systems namely Genitourinary, Haematopoietic, Skin, and Gastrointestinal were used for the assessment of toxicity in the study. Toxicity was scored using the NCI CTC v2.0. The results of this study showed that, major acute reactions in the CDH study participants were grade 3 leucopoenia (five in each study arm) and one grade 3 acute skin toxicity in the HIV +ve arm. Results also revealed that there were three HIV +ve study participants with grade 3 vomiting and one HIV –ve. There was one grade 3 anaemia in the HIV +ve arm, one grade 3 anaemia in the HIV –ve arm and one grade 4 anaemia in the HIV +ve arm. However, only the incidence of grade 3 leucopoenia in both study arms and vomiting in the HIV +ve study participants was significantly higher. This study demonstrated that radical chemoradiation is well tolerated by HIV +ve patients with intact immunity. Toxicity was usually mild and reversible and no exaggerated toxicities beyond those generally associated with single-agent Cisplatin were observed in the HIV +ve study participants. Therefore, radical chemoradiation in conventional doses can safely be given to cervical cancer HIV +ve patients who are on HAART.

Magister Scientiae Dentium - MSc(Dent) / Diabetes is often associated with a number of medical complications as a result of the metabolic changes taking place systemically. There is considerable evidence it is associated with oral complications including among others, gingivitis, periodontal disease, xerostomia, oral candidiasis, dental caries, periapical abscesses, lichen planus,burning mouth syndrome and an altered taste sensation (Lamster et al. 2008; Skamagas et al. 2008; Vernillo, 2003). The aim of the present study was to compare the oral health status in diabetic and non-diabetic patients with regards to their oral health problems, oral pathology and self perceived quality of life.A comparative cross-sectional study to determine the common oral complications prevalent in diabetics and non-diabetics was carried out in KwaZulu-Natal, at Prince Mshiyeni Memorial, EThekwini District, Umlazi. The study sample consisted of 150 diabetic patients and 150 non-diabetic patients attending the hospital. The oral health status was assessed clinically for each patient and recorded prior to the interview. The DMFT, plaque index and appearance of marginal gingiva were used to assess oral health status. An intra-oral examination was carried out to identify oral pathology lesions and other oral problems. Patients were then interviewed on the self perceived quality of life and the impact that diabetes has had on their lives. Plaque Index and DMFT were significantly higher among the diabetic group as opposed to the non-diabetic group. Periodontal disease was observed in more than half of the diabetic group as opposed to only 14.7% of the non-diabetic group. Except for tooth decay, the diabetic patients had more oral health problems compared to the non-diabetic group. More than half of the diabetic group reported having xerostomia compared to only 7.3% of the non-diabetic group. Altered taste sensation was also more prevalent in the diabetic group. In general, the diabetic group demonstrated a higher prevalence of oral pathology lesions and medical diabetes complications compared to the non-diabetic group.The self perceived quality of life was said to have deteriorated in 92% of diabetic subjects due to concomitant diabetic complications and 75% of this group indicated that they were not satisfied with their current quality of life.Diabetic patients were significantly less likely to perceive their quality of life as very satisfied after having adjusted for age and gender variables (OR=0.0188; CI: 0.0059-0.0594). Furthermore, diabetic patients were almost 6 times more likely to perceive themselves as “not satisfied” with their quality of life (QOL) as compared to non-diabetic patients.Individuals with diabetes exhibited poorer oral health when compared to non-diabetics.They exhibited a higher DMFT and had a significantly higher average number of missing teeth compared to the non-diabetic group. Special care needs to be given to diabetic patients because of the associated complications to improve their quality of life. A more detailed and in-depth study that utilises a diabetes-specific quality of life instrument may provide a more accurate way of determining the quality of life as well as periodontal disease in patients.

The present study comprises part of an ongoing research study investigating the effects 0 f cumulative mild head injuries 0 n Rugby Union p layers. The aim 0 f t he study was to ascertain whether there are neuropsychological effects of cumulative mild head injuries sustained during the rugby-playing careers of senior schoolboy rugby players. Participants were top-level rugby players from high schools in Grahamstown and Cape Town (n = 79) and non-contact sport controls of top-level field hockey players from the same schools (n = 58). Group mean comparisons across a battery of neuropsychological tests were carried out between the Total Rugby versus the Total Field Hockey group, and the Rugby Forwards versus the Rugby Backs group. Comparisons between Total Rugby versus Total Field Hockey revealed impaired performance by the rugby players on two tests of visuoperceptual tracking, namely Digit Symbol Substitution and Trail Making Test (Part A). For Rugby Forwards versus Rugby Backs, there were no consistent differences to support the expectation that forwards would perform worse than backs. Forwards performed more poorly than backs on WMS Associate Learning Subtest - Hard (Delayed Recall), whereas backs performed more poorly than forwards on Digits Backwards. This suggests that some individuals in the cohort were starting to exhibit verbal memory deficit, albeit not clearly in association with forward positional play. Overall, results of the present study provide tentative support for the hypothesis that school level rugby players are more susceptible to the effects of cumulative concussive and sub-concussive head injuries than are non-contact sport controls. / KMBT_363 / Adobe Acrobat 9.54 Paper Capture Plug-in