Nos países ocidentais industrializados, aproximadamente 0,2 a 4,0% das gestações são complicadas por cardiopatias, e o número de pacientes que desenvolvem problemas cardíacos durante a gravidez vem aumentando. Os objetivos do trabalho foram verificar as cardiopatias em gestantes em uma maternidade pública do estado do Tocantins e descrever o perfil de morbidade das cardiopatias em gestantes. Optou-se por um estudo descritivo, exploratório e documental. O estudo foi realizado em uma maternidade pública, localizada no município de Palmas-TO, sendo referência no Estado em obstetrícia. Trata-se de uma população composta por gestantes portadoras de cardiopatias. A coleta foi realizada na avaliação dos prontuários das gestantes com cardiopatias que foram atendidas na referida instituição hospitalar nos meses de janeiro de 2014 a dezembro de 2014com a utilização de um formulário de pesquisa elaborado pela pesquisadora. Após o período de coleta de dados de dois meses, foi possível chegar ao quantitativo de 23 gestantes portadoras de cardiopatia. Nas características sociodemográficas, as mulheres tinham em média 23,95±4,47 anos de idade;21 (91,3%) gestantes foram declaradas como pardas;14 (60,9%) das gestantes eram residentes no interior do Estado do Tocantins;14 (60,9%) gestantes possuíam nível médio completo;12 (57,1%) gestantes eram do lar. No perfil de morbidade, 15 (71,4%) pacientes não apresentaram hipertensão; 01 (4,8%) gestante era diabética. No perfil obstétrico, 10 (43,5%) pacientes eram secundigestas;11 (47,8%) já haviam apresentado um parto;21 (91,3%) não tiveram aborto;12 (54,6%) realizaram entre quatro e nove consultas;16 (72,7%) se submeteram ao parto cesáreo. Dentre as cardiopatias identificadas, 5 (21,73%)gestantes apresentaram Arritmia e 5 (21,73%)Taquicardia; 4 (17,39%) gestantes apresentaram Insuficiência Mitral, todavia entre as gestantes estudadas encontramos 13 patologias. Diante da variedade de patologias encontradas e dos casos em que ha mais de uma patologia, reforça-se a necessidade de profissionais capacitados e com competência técnica para o manejo adequado dessas cardiopatias. / In western industrialized countries, about 0.2 to 4.0% of pregnancies are complicated by heart disease, and the number of patients developing heart problems during pregnancy has increased. The objectives of the study were to verify the cardiopathies in pregnant women in a public maternity hospital in the State of Tocantins and To describe the profile of morbidity of heart diseases in pregnant women. We chose a descriptive, exploratory and documentary. The study was conducted in a public hospital, located in the city of Palmas-TO, with reference in the state in obstetrics. This is a population composed of pregnant women with heart disease. Data collection was performed in the evaluation of medical records of pregnant women with heart disease who were seen at that hospital from January 2014 to December 2014 using a survey form developed by the researcher. After the data collection period of two months, it was possible to reach the quantity of 23 pregnant women with heart disease. In socio-demographic characteristics, women had an average of 23.95 ± 4.47 years old; 21 (91.3%) patients were declared as mixed; 14 (60.9%) of pregnant women were residents within the State of Tocantins; 14 (60.9%) women had completed secondary level; 12 (57.1%) women were housewives. In morbidity profile, 15 (71.4%) did not have hypertension; 01 (4.8%) was p regnant diabetic. In obstetrical profile, 10 (43.5%) patients had more than one pregnancy; 11 (47.8%) had presented a birth; 21 (91.3%) had no abortion; 12 (54.6%) were between four and nine consultations; 16 (72.7%) underwent cesarean section. Among the identified heart disease, 5 (21.73%) patients presented Arrhythmia and 5 (21.73%) Tachycardia; 4 (17.39%) patients presented Mitral Regurgitation, however among pregnant women studied found 13 diseases. Given the variety of pathologies found and where there is more than one condition, it reinforces the need for qualified professionals with expertise for the proper management of these diseases.

Orientador: Antonio Carlos Cicogna / Banca: Camila Renata Corrêa Camacho / Banca: Alessandra Medeiros / Resumo: A obesidade é um problema atual que ocorre em países desenvolvidos e subdesenvolvidos, em diferentes faixas etárias e classes sociais. Considerada uma doença metabólica crônica, caracterizada pelo acumulo excessivo de gordura em relação à massa magra tecidual, está associada com o aumento de risco de mortalidade, redução na expectativa de vida e numerosas comorbidades como, diabetes mellitus tipo II, resistência à insulina, dislipidemia e doenças cardiovasculares. Diversas modificações, moleculares, estruturais, hemodinâmicas e funcionais, do coração, em humanos e animais, têm sido frequentemente associadas com a obesidade. Embora a elevação do tecido adiposo possa provocar mudanças no desempenho cardíaco, os mecanismos responsáveis por estas alterações não estão esclarecidos. Diferentes fatores têm sido sugeridos como responsáveis pelas possíveis anormalidades funcionais cardíacas em modelos de obesidade, entre eles, as proteínas reguladoras do trânsito de cálcio miocárdico. É bem difundida na literatura a associação de ácidos graxos saturados e aumento do risco de doenças cardiovasculares como, doença arterial coronariana. Alguns autores observaram alterações como, apoptose e hipertrofia cardíaca. Pesquisadores verificaram em ratos Wistar obesos por dieta hiperlipídica, 70% de ácidos graxos insaturados e 30% de saturados, que o aumento na área e volume nuclear do miócito se correlacionou significantemente com os ácidos graxos saturados, embora os seus níveis fossem menores que os insaturados. Na literatura consta que a obesidade por dieta hiperlipídica insaturada não promove alteração na expressão das proteínas relacionadas ao trânsito de cálcio miocárdico; entretanto, não há estudos que avaliaram esta relação na obesidade induzida por dieta hiperlipídica saturada. O objetivo desse estudo foi testar a hipótese que a obesidade por dieta hiperlipídica saturada acarreta... / Abstract: Obesity is a current problem that occurs in developed and developing countries, in different age groups and social classes. It is considered a chronic metabolic disease characterized by excessive fat accumulation in relation to lean tissue, is associated with increased mortality risk, reduced life expectancy and numerous comorbidities as type II diabetes mellitus, insulin resistance, dyslipidemia and cardiovascular diseases. Several molecular, structural, hemodynamic and functional modifications of the heart in humans and animals have been frequently associated with obesity. Although the increase in adipose tissue may cause changes in cardiac performance, the mechanisms responsible for these changes are unclear. Different factors have been suggested as responsible for possible cardiac functional abnormalities in obesity models, including the regulatory proteins of myocardial calcium handling. It is well established in the literature the association of saturated fatty acids and increased risk of cardiovascular diseases such as coronary artery disease. Some authors observed changes as apoptosis and cardiac hypertrophy. Researchers found in obese Wistar rats by high fat diet, 70% unsaturated fatty acids and 30% saturated, that the increase in the nuclear area and volume myocyte were correlated significantly with saturated fatty acids, although the levels were lower than unsaturated. The literature states that obesity by fat unsaturated diet does not promote changes in the expression of proteins related to myocardial calcium handling; however, there are no studies that evaluated this relationship in obesity models induced by saturated high-fat diet. The aim of this study was to test the hypothesis that obesity by saturated high-fat diet leads to changes in the expression and / or phosphorylation of proteins related to myocardial calcium handling. Wistar rats were divided into two groups: control (C, n=18; saturated normolipidic diet) and ... / Mestre

Introdução: As doenças cardíacas (DC) representam a principal causa de morte da população brasileira. Evidências epidemiológicas mostram que a alimentação é fator de risco para o desenvolvimento dessas doenças. Objetivo: Verificar a associação da alimentação, com incidência de DC referida, segundo variáveis demográficas e biopsicossociais. Métodos: Foram utilizados dados do Estudo SABE (Saúde, Bem-estar e Envelhecimento), longitudinal, epidemiológico, de base domiciliar, realizado em 2000 (2.143 idosos) e, em 2006 (1.115 idosos), no município de São Paulo Brasil. A população de estudo foi constituída por idosos ( 66 anos), de ambos os sexos, que não referiram DC, em 2000, e que apresentavam todos os dados necessários para este estudo. As variáveis analisadas foram: DC referida, em 2006; alimentação, referida em 2000, incluindo - número de refeições (Nref - < 3 e 3/dia), frequência de ingestão de líquidos (Lq - 5 e > 5 copos/dia), de laticínios (Lat - 1x/dia), de ovos e leguminosas (Leg - 1x/semana), de carnes (Car - 3x/semana), de frutas, legumes e verduras (Flv - 2x/dia); sexo, grupo etário, autopercepção da saúde, escolaridade, companhia no domicílio, tabagismo e hipertensão arterial. Para verificar a associação, utilizou-se teste de Rao & Scott (p<0,05), para amostra complexa, e regressão logística múltipla, calculados pelo programa estatístico STATA 10.1. Resultados: Foram analisados 900 idosos, dos quais, 132 referiram DC (novos casos), em 2006, correspondendo ao coeficiente de incidência (CI) de 14,5/1.000 pessoas-ano (IC95 por cento = 12,12 17,61). Considerando as variáveis demográficas e biopsicossociais, constatou-se que a referência da saúde como rui, segundo a autopercepção e tabagismo para as mulheres, e HAS para os homens constituíram fator de risco. As demais (escolaridade, companhia no domicílio, sexo e grupo etário) não apresentaram diferença estatística em relação à referência de DC. Quanto às variáveis alimentares, verificou que, somente, a referência de não ingerir Lat e Leg, em 2000, apresentou-se associada à DC (Lat - OR: 1,97 IC 95 por cento : 1,11 - 3,47) e (Leg - OR: 2,26 IC95 por cento : 1,11 - 4,60). O CI, em relação a estes alimentos, também apresentou diferença estatística. Conclusão: Constatou-se que a alimentação dos idosos esteve associada à referência de DC. A referência de não ingerir Lat e Leg, constituiu fator de risco para DC em 2006 / Introduction: Heart diseases (HD) are the main cause of death in Brazilian population. Epidemiological evidence shows that diet can be a risk factor for the development of HD. Objective: To investigate the association of food dietary intake, with reported HD incidence, according to demographic and biopsychosocial variables. Methods: The study used data from SABE (Health, Well-being and Ageing): longitudinal, epidemiological, household survey, conducted in 2000 (2,143 elderly individuals) and in 2006 (1,115 elderly individuals), in the city of Sao Paulo - Brazil. The study population was formed by elderly individuals ( 66 y), both sexes, who did not report HD in 2000 and all the necessary data for this study existed. The variables analyzed were referred HD, in 2006; information about dietary intake in 2000, including - number of meals (<3 and 3/day), frequency of fluids intake ( 5 and > 5 cups/day ), dairy (1/day), eggs and legumes (1/week), meat (3/week), fruits and vegetables (2/day), sex, age groups, self-perceived health status, education level, home company, smoking and systemic arterial hypertension. To verify the association Rao & Scott (p <0.05) test was used for complex sample, and multiple logistic regression, calculated by STATA 10.1 statistical program. Results: 900 elderly individuals were analyzed, 132 of them reported HD (new cases) in 2006, corresponding to an incidence rate of 14.5/1,000 person-years (95 per cent CI = 12.12 to 17.61). Considering the demographic and biopsychosocial variables, the association between poor self-perceived health status and smoking for women, and reported hypertension for men, were considered risk factor for HD. The others (educational level, home company, gender and age) showed no statistical difference considering the HD reference. For dietary intake variables, it was found that only the reference of not eating Lat and Leg in 2000, showed to be associated with HD - (Lat - OR: 1.97 - 95 per cent CI: 1.1 1-3, 47) and (Leg - OR: 2.26 - 95 per cent : 1,11 - 4,60). The incidence rate, for these foods also have statistical difference. Conclusion: The elderly dietary intake influences the HD reference. The reference of not eating dairy and legume was a risk factor for HD

O objetivo desse trabalho foi investigar a atividade sexual dos pacientes submetidos à cirurgia de valvopatia e compreender as repercussões emocionais desses dois eventos. Para sua realização foram convidados funcionários e pacientes dos hospitais Instituto do Coração, localizado na cidade de São Paulo e Cirurgia em Aracaju no Estado de Sergipe. A amostra da pesquisa foi composta por 35 sujeitos portadores de valvopatia de ambos os sexos, entre 20 e 45 anos, que tinham sido submetidos apenas a uma cirurgia de correção dessa enfermidade, alfabetizados e que não tinham apresentado disfunção sexual antes da cirurgia. Foi também realizado um grupo controle com 35 funcionários pertencentes aos hospitais citados e que até o momento da realização da pesquisa não eram portadores de doenças crônicas. Os participantes responderam perguntas sobre atividade sexual e também criaram quatro histórias, a partir da apresentação das imagens contidas nas Pranchas (4, 10, 13HF, 16) do Teste de Apercepção Temática (TAT). Os resultados da pesquisa apontaram, na comparação entre os grupos, para uma presença estatisticamente significante (p<0,05), no grupo de pacientes, da ansiedade como interferência negativa para o desempenho sexual e de medos como não ser aceito e não ter excitação pelo parceiro, além de não satisfazer sexualmente o parceiro. Este grupo também afirmou que houve mudanças nos seus relacionamentos familiares, sociais e amorosos após a cirurgia. O TAT apontou para uma maior intensidade das necessidades emocionais de planejar e manter uma atividade sexual, apoio e afiliação no grupo de pacientes. Sugere-se que, em estudos posteriores, inclua-se o parceiro na amostra a ser pesquisada, uma vez que suas respostas podem complementar os achados do estudo e também se inclua as entrevistas em outros momentos como o pré-cirúrgico, o que contribuirá para uma melhor interpretação na análise da situação-problema. / The objective of this study was to investigate the sexual activity of patients submitted to the surgery of valvopathy and understand the emotional repercussions of these two events. For its realization were invited hospital staff and patients from the hospitals Instituto do Coração do Hospital das Clínicas da Universidade de São Paulo, and Hospital Cirurgia in Aracaju, both located in Brazil. The research sample consisted of 35 citizens of both gender who are affected by a valvopathy, between 20 and 45 years, that had been submitted only to a one surgery of correction of this disease, literate and that they have not presented some sexual dysfunction before the surgery. It also held a control group with 35 employees belonging to the hospitals cited and that until the completion of the research were not carriers of chronic diseases. The participants had answered questions about sexual activity and also created four stories from the presentation of the images contained in plates 4, 10, 13HF and 16 of the Thematic Apperception Test (TAT). The research results had pointed, in the comparison between groups, a statistically significant (p < 0.05) presence, in the group of patients, of the anxiety as a negative interference for the sexual performance, and the presence of sexual fears such as not be accepted by the partner, not be excited about the partner, and not sexually satisfy your partner. This group also affirmed that it had changes in its familiar, social and love relationships after the surgery. The TAT pointed a greater intensity of emotional needs to plan and maintain a sexual activity, support and membership in the group of patients. It is suggested that in further studies the partner should be included in the sample to be investigated, since their responses can complement the findings of the study and also includes interviews at other times as the pre-surgical, which must contribute to a better interpretation and analysis of the situation-problem

Koon Chi Man. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2000. / Includes bibliographical references (leaves 158-174). / Abstracts in English and Chinese. / Acknowledgment --- p.i / Abbreviations --- p.ii / Abstract --- p.v / Chinese Abstract --- p.viii / Table of Content --- p.x / Chapter Chapter one: --- Introduction --- p.1 / Chapter 1.1 --- Introduction --- p.1 / Chapter 1.2 --- Classification of Plant Polysaccharides --- p.2 / Chapter 1.2.1 --- Definition of Dietary Fiber --- p.3 / Chapter 1.2.2 --- Types of Soluble Dietary Fiber --- p.3 / Chapter 1.3 --- Physiological Effect of Fiber --- p.6 / Chapter 1.3.1 --- Reduction in Absorption by Viscous Polysaccharides --- p.7 / Chapter 1.3.2 --- Gastric Emptying --- p.7 / Chapter 1.3.3 --- Effect of Viscous Polysaccharides on Intraluminal Mixing --- p.8 / Chapter 1.3.4 --- Effect of Luminal Secretions on Viscosity --- p.9 / Chapter 1.4 --- Physicochemical Qualities and Hypocholesterolemic Effects --- p.9 / Chapter 1.5 --- Gastrointestinal Events and Hypocholesterolemic Effects --- p.11 / Chapter 1.5.1 --- Mouth --- p.11 / Chapter 1.5.2 --- Stomach --- p.12 / Chapter 1.5.3 --- Small intestine --- p.12 / Chapter 1.5.4 --- Large intestine --- p.13 / Chapter 1.6 --- Proposed Mechanisms for Hypocholesterolemic Effects --- p.13 / Chapter 1.6.1 --- Altered Bile Acid Absorption and Metabolism --- p.14 / Chapter 1.6.2 --- Modified Lipid Absorption and Metabolism --- p.15 / Chapter 1.6.3 --- Effects of SCFA on Lipid Metabolism --- p.15 / Chapter 1.6.4 --- Changed Hormone Concentrations --- p.16 / Chapter Chapter Two: --- Materials and Methods --- p.17 / Chapter 2.1 --- Materials --- p.17 / Chapter 2.1.1 --- Fungus --- p.17 / Chapter 2.1.2 --- Animals --- p.17 / Chapter 2.1.2.1 --- Golden Syrian Hamster --- p.17 / Chapter 2.1.2.2 --- Rabbit --- p.18 / Chapter 2.1.3 --- Characterization of Auricularia Polytricha --- p.18 / Chapter 2.1.4 --- Chromatographic materials --- p.22 / Chapter 2.1.5 --- "Determination of Plasma TC，HDL-C, LDL-C，TG，AST and ALT" --- p.24 / Chapter 2.1.6 --- HMG-CoA Reductase Activity Assay --- p.26 / Chapter 2.1.7 --- "Quantitative Determination of Liver Cholesterol, Acidic and Neutral Sterol" --- p.27 / Chapter 2.1.8 --- Animal Diets --- p.29 / Chapter 2.1.8.1 --- Hamster Diets --- p.29 / Chapter 2.1.8.2 --- Rabbit Diets --- p.29 / Chapter 2.2 --- Methods --- p.33 / Chapter 2.2.1. --- Extraction of Water-Soluble AP Polysaccharide (APP) --- p.33 / Chapter 2.2.2. --- Characterization of Auricularia Polytricha --- p.34 / Chapter 2.2.2.1 --- Determination of carbohydrate content of AP Polysaccharide --- p.34 / Chapter 2.2.2.2 --- Determination of uronic acid content of AP Polysaccharide --- p.34 / Chapter 2.2.2.3 --- Determination of protein content of AP Polysaccharide by BCA protein assay --- p.35 / Chapter 2.2.2.4 --- Determination of component sugar units of AP Polysaccharide --- p.35 / Chapter 2.2.2.5 --- Fractionation of AP Polysaccharide --- p.36 / Chapter 2.2.2.6 --- Determination of monosaccharides of AP Polysaccharide by HPLC --- p.37 / Chapter 2.2.3 --- "Determination of plasma TC, HDL-C, LDL-C,TG,AST and ALT" --- p.39 / Chapter 2.2.3.1 --- Plasma Total Cholesterol --- p.39 / Chapter 2.2.3.2 --- Plasma HDL-Cholesterol --- p.40 / Chapter 2.2.3.3 --- Plasma LDL-Cholesterol --- p.40 / Chapter 2.2.3.4 --- Plasma Triglyceride --- p.41 / Chapter 2.2.3.5 --- Plasma Aspartate Aminotransferase --- p.41 / Chapter 2.2.3.6 --- Plasma Alanine Aminotransferase --- p.42 / Chapter 2.2.4 --- HMG-CoA Reductase Activity Assay --- p.42 / Chapter 2.2.4.1 --- Preparation of Hepatic Microsome --- p.42 / Chapter 2.2.4.2 --- HMG-CoA Activity Assay --- p.43 / Chapter 2.2.5 --- Quantitative Determination of Liver Cholesterol --- p.44 / Chapter 2.2.5.1 --- Cholesterol Extraction and its Silylation --- p.44 / Chapter 2.2.5.2 --- GLC Analysis of TMS-Ether Derivative of Cholesterol --- p.45 / Chapter 2.2.6 --- Quantitative Determination of Neutral and Acidic Sterols --- p.45 / Chapter 2.2.6.1 --- Separation of Neutral and Acidic Sterols --- p.45 / Chapter 2.2.6.2 --- Conversion of Neutral Sterols to its TMS-Ether Derivative --- p.46 / Chapter 2.2.6.3 --- Conversion of Acidic Sterols to its TMS-Ether Derivatives --- p.46 / Chapter 2.2.6.4 --- GLC Analysis of Neutral and Acidic Sterols --- p.47 / Chapter 2.2.7 --- Study of Atherosclerosis of Rabbit --- p.48 / Chapter 2.2.7.1 --- Sudan III staining of the thoracic aorta --- p.48 / Chapter 2.2.7.2 --- Measurement of atheroma formation in the aorta --- p.49 / Chapter 2.2.8 --- Animal Experiments --- p.51 / Chapter 2.2.8.1 --- Protective Effect of APP in Hyperlipidemic Study (Exp. 1) --- p.51 / Chapter 2.2.8.2 --- Therapeutic Effect of APP in Hyperlipidemic Study (Exp. 2) --- p.52 / Chapter 2.2.8.3 --- Dose Response of APP in Hyperlipidemic Study (Exp. 3) --- p.52 / Chapter 2.2.8.4 --- Hypolipidemic Effect of Short Chain Fatty Acid (Exp. 4) --- p.53 / Chapter 2.2.8.5 --- Effect of APP and SCFA on HMG-CoA Reductase Activity (Exp5） --- p.53 / Chapter 2.2.8.6 --- Hypolipidemic and Anti-atherosclerotic Effect of APP (Exp. 6) ´Ø… --- p.54 / Chapter 2.3 --- Statistical analysis --- p.54 / Chapter Chapter Three: --- Fractionation and Characterization of Auricularia Polytricha Polysaccharide --- p.55 / Chapter 3.1 --- Introduction --- p.55 / Chapter 3.2 --- Fungal polysaccharides from Auricularia Polytricha --- p.55 / Chapter 3.3 --- Results --- p.57 / Chapter 3.3.1 --- Extraction and Fractionation of Auricularia Polytricha --- p.57 / Chapter 3.3.2 --- Determination of Carbohydrates Content --- p.58 / Chapter 3.3.3 --- Determination of Protein Content --- p.61 / Chapter 3.3.4 --- Determination of Uronic Acid Content --- p.61 / Chapter 3.3.5 --- Determination of component sugars of AP Polysaccharide --- p.65 / Chapter 3.3.6 --- Fractionation of AP Polysaccharide --- p.67 / Chapter 3.3.7 --- Determination of monosaccharide components of AP Polysaccharide by HPLC --- p.72 / Chapter 3.4 --- Discussion --- p.79 / Chapter Chapter Four: --- "Protective, Therapeutic and Dose Effect of Auricularia Polytricha Polysaccharide (APP) on Hyperlipidemia" --- p.83 / Chapter 4.1 --- Introduction --- p.83 / Chapter 4.2 --- Results (Exp. 1) --- p.86 / Chapter 4.2.1 --- Body Weight and Food Intake --- p.86 / Chapter 4.2.2 --- Effect of APP Supplementation on Hepatic Cholesterol --- p.86 / Chapter 4.2.3 --- "Effect of APP Supplementation on Plasma TC, HDL-C and TG" --- p.87 / Chapter 4.2.4 --- Effect of APP Supplementation on Fecal Output of Neutral Sterols --- p.94 / Chapter 4.2.5 --- Effect of APP Supplementation on Fecal Output of Acidic Sterols --- p.94 / Chapter 4.3 --- Discussion (Exp. 1) --- p.99 / Chapter 4.4 --- Results (Exp. 2) --- p.102 / Chapter 4.4.1 --- Body Weight and Food Intake --- p.102 / Chapter 4.4.2 --- Effect of APP Supplementation on Hepatic Cholesterol --- p.102 / Chapter 4.4.3 --- Effect of APP Supplementation on Plasma TC and TG --- p.103 / Chapter 4.4.4 --- Effect of APP Supplementation on Plasma HDL-C and LDL-C --- p.104 / Chapter 4.5 --- Discussion (Exp. 2) --- p.109 / Chapter 4.6 --- Results (Exp. 3) --- p.111 / Chapter 4.6.1 --- Body Weight and Food Intake --- p.111 / Chapter 4.6.2 --- Dose Response of APP Supplementation on Hepatic Cholesterol --- p.111 / Chapter 4.6.3 --- Dose Response of APP Supplementation on Plasma TG --- p.112 / Chapter 4.6.4 --- Dose Response of APP Supplementation on Plasma HDL-C and LDL-C --- p.112 / Chapter 4.6.5 --- Dose Response of APP Supplementation on ALT and AST Activity --- p.113 / Chapter 4.6.6 --- Dose Response of APP Supplementation on Fecal Output of Neutral and Acidic Sterols --- p.113 / Chapter 4.7 --- Discussion --- p.121 / Chapter Chapter Five: --- Hypolipidemic Effect of Short Chain Fatty Acids --- p.123 / Chapter 5.1 --- "Introduction (Exp. 4,5)" --- p.123 / Chapter 5.2 --- "Results (Exp. 4,5)" --- p.125 / Chapter 5.2.1 --- Body Weight and Food Intake --- p.125 / Chapter 5.2.2 --- Effect of SCFA Supplementation on Hepatic Cholesterol --- p.125 / Chapter 5.2.3 --- "Effect of SCFA Supplementation on Plasma TG, HDL-C and LDL-C" --- p.128 / Chapter 5.2.4 --- Effect of SCFA Supplementation on AST and ALT Activity --- p.128 / Chapter 5.2.5 --- Effect of SCFA supplementation on HMG-CoA Reductase Activity --- p.133 / Chapter 5.3 --- "Discussion (Exp. 4,5)" --- p.135 / Chapter Chapter Six: --- Hypolipidemic and Antiatherosclerotic Effect of APP --- p.137 / Chapter 6.1 --- Introduction (Exp. 6) --- p.137 / Chapter 6.2 --- Results (Exp. 6) --- p.139 / Chapter 6.2.1 --- Body Weight and Food Intake --- p.139 / Chapter 6.2.2 --- Effect of APP Supplementation on Hepatic Cholesterol --- p.139 / Chapter 6.2.3 --- "Effect of APP Supplementation on Plasma TG, HDL- and LDL-C" --- p.141 / Chapter 6.2.3 --- Effect of APP Supplementation on AST and ALT Activity --- p.142 / Chapter 6.2.5 --- Effect of APP supplementation on HMG-CoA Reductase Activity --- p.146 / Chapter 6.2.6 --- Effect of APP supplementation on the Formation of Atheroma --- p.146 / Chapter 6.3 --- Discussion (Exp. 6) --- p.151 / Chapter Chapter Seven: --- General Discussion and Future Perspectives --- p.153 / References --- p.158

The United States health-care system is considered to be unsustainable due to its unbearably high cost. Many of the resources are spent on acute conditions rather than aiming at preventing them. Preventive medicine methods, therefore, are viewed as a potential remedy since they can help reduce the occurrence of acute health episodes. The work in this dissertation tackles two distinct problems related to the prevention of acute disease. Specifically, we consider: (1) early detection of incorrect or abnormal postures of the human body and (2) the prediction of hospitalization due to heart related diseases. The solution to the former problem could be used to prevent people from unexpected injuries or alert caregivers in the event of a fall. The latter study could possibly help improve health outcomes and save considerable costs due to preventable hospitalizations. For body posture detection, we place wireless sensor nodes on different parts of the human body and use the pairwise measurements of signal strength corresponding to all sensor transmitter/receiver pairs to estimate body posture. We develop a composite hypothesis testing approach which uses a Generalized Likelihood Test (GLT) as the decision rule. The GLT distinguishes between a set of probability density function (pdf) families constructed using a custom pdf interpolation technique. The GLT is compared with the simple Likelihood Test and Multiple Support Vector Machines. The measurements from the wireless sensor nodes are highly variable and these methods have different degrees of adaptability to this variability. Besides, these methods also handle multiple observations differently. Our analysis and experimental results suggest that GLT is more accurate and suitable for the problem. For hospitalization prediction, our objective is to explore the possibility of effectively predicting heart-related hospitalizations based on the available medical history of the patients. We extensively explored the ways of extracting information from patients' Electronic Health Records (EHRs) and organizing the information in a uniform way across all patients. We applied various machine learning algorithms including Support Vector Machines, AdaBoost with Trees, and Logistic Regression adapted to the problem at hand. We also developed a new classifier based on a variant of the likelihood ratio test. The new classifier has a classification performance competitive with those more complex alternatives, but has the additional advantage of producing results that are more interpretable. Following this direction of increasing interpretability, which is important in the medical setting, we designed a new method that discovers hidden clusters and, at the same time, makes decisions. This new method introduces an alternating clustering and classification approach with guaranteed convergence and explicit performance bounds. Experimental results with actual EHRs from the Boston Medical Center demonstrate prediction rate of 82% under 30% false alarm rate, which could lead to considerable savings when used in practice.

Thesis. 1977. B.S.--Massachusetts Institute of Technology. Dept. of Electrical Engineering and Computer Science. / MICROFICHE COPY AVAILABLE IN ARCHIVES AND ENGINEERING. / Bibliography: leaf 50. / B.S.

Cardiac diseases and conduction disorders are associated with stroke, heart failure and sudden cardiac death and are a major health concern worldwide. In the US alone, more than 14 million people suffer from heart rhythm disorders. Current mapping and characterization techniques in the clinic involve invasive procedures, which are time-consuming, costly, and may involve ionizing radiation. In this dissertation, we introduce Electromechanical Wave Imaging (EWI) as a non-invasive, ultrasound-based treatment planning tool for pre-procedure characterization and assessment of arrhythmia in the clinic. In particular, standard EWI processing methods for mapping the electromechanical wave (EW), i.e. the onset of the mechanical activity following the depolarization of the heart, are described and detailed. Next, validation of EWI is performed with 3D electromechanical mapping and the EW propagation is shown to follow the electrical activation in all four chambers of the heart. Demonstration of the value of EWI for the characterization of cardiac arrhythmia is accomplished in vivo in a large animal model. First, EWI is shown capable of localizing the earliest region of activation in the ventricles during pacing from a standard pacemaker lead, as well as during pacing from a novel biological pacemaker. Repeatability is also demonstrated between consecutive cardiac cycle during normal sinus rhythm and during pacing. Then, in the atria, we demonstrate that EWI is capable of accurately identifying focal sources while pacing from several locations in both the left and right atria. In addition to being capable of localizing the focal source, EWI is also shown capable of differentiating between endocardial and epicardial focal sources. Finally, it is shown that EWI can correctly identify regions of infarction and monitor formation of infarcts over several days, after ligation of the left anterior descending coronary artery of canine hearts. Novel processing techniques aimed at extracting quantitative parameters from EWI estimates are then developed and implemented. Details of the implementation of processing methods for estimating the velocity of the EW propagation are presented, and a study of the EW velocity values in a canine heart before and after infarct formation is conducted. Electromechanical cycle length mapping (ECLM), which is aimed at extracting local rates of electromechanical activation in the heart, is then introduced and its implementation detailed. ECLM is subsequently validated in a paced canine heart in vivo. Finally, initial clinical feasibility is demonstrated. First, in the study of treatment of chaotic arrhythmia such as in the case of atrial fibrillation patients undergoing direct current cardioversion, ECLM is shown to be able to confirm acute treatment success. Then, the clinical value of EWI in the electrophysiology lab as a treatment planning tool for the characterization of focal arrhythmia is shown in ventricular tachycardia and Wolff-Parkinson-White patients. EWI is currently only a step away from real-world clinical application. As a non-invasive, ultrasound-based imaging modality, EWI is capable of providing relevant insights into the origins of an arrhythmia and has the potential to position itself in the clinic as a uniquely valuable pre-procedure planning tool for the non-invasive characterization of focal arrhythmias.

Introdução: Vários são os mecanismos envolvidos no desenvolvimento da resposta local e sistêmico na pancreatite aguda. O sistema cardiovascular pode ser afetado durante todo o curso clínico da pancreatite aguda. O objetivo deste estudo foi avaliar a produção local de citocinas pelo miocárdio, assim como, as alterações funcionais e histológicas do miocárdio na pancreatite aguda grave. Métodos: Os animais foram divididos em três grupos: Grupo 1: controle; Grupo 2: controle operado; Grupo 3: pancreatite aguda grave. Foram medidos os níveis séricos de amilase e de citocinas (TNF-alfa IL-6 e IL-10), expressão de RNAm de TNF-alfa, IL-6 e TGF-beta e ecocardiograma com avaliação da função cardíaca. Alterações do tecido cardíaco foram analisadas pelo exame histológico. Resultados: Os níveis séricos de TNF-alfa e IL-10 foram significativamente maiores no grupo pancreatite aguda 2h. Os níveis de RNAm de IL-6 do grupo pancreatite aguda 2h foram estatisticamente superiores. Os níveis de RNAm do TNF-alfa do grupo controle operado e pancreatite aguda 2h foram estatisticamente menores. Mudanças significativas no diâmetro do ventrículo esquerdo foram encontradas nos grupos pancreatite aguda 2h e 12h. Houve alterações estatísticas para a degeneração vacuolar, picnose e perda de núcleo, e os linfócitos. Conclusão: Encontramos alterações cardíacas e histológicas compatíveis com o processo inflamatório desencadeado por pancreatite aguda grave com o incremento da produção de citocinas pelo miocárdio / Background: Several mechanisms are involved in the development of the local and systemic response in acute pancreatitis. Cardiovascular system may be affected throughout the clinical course of acute pancreatitis. The aim was to evaluate local myocardial cytokine production, as well as, functional and histological myocardial alterations in severe acute pancreatitis. Methods: The animals were divided into three groups: Group 1: control; Group 2: sham; Group 3: severe acute pancreatitis. Echocardiographic assessment of cardiac function, serum levels of amylase and cytokines (TNF-alfa, IL-6 and IL-10), and mRNA expression of TNF-alfa, IL-6 and TGF-beta were measured. Myocardial tissue alterations were analysed by histological examination. Results: The serum TNF-alfa, and IL-10 levels were significant higher in acute pancreatitis 2h group. The mRNA IL-6 levels from acute pancreatitis 2h group were statistically higher. The mRNA TNF-alfa levels from sham group and acute pancreatitis 2h group were statistically lower. Significant changes in the left ventricular diameter were found in acute pancreatitis 2h and 12h groups. There were statistical changes for vacuolar degeneration, picnosis and loss of nucleus, and lymphocytes. Conclusion: We found cardiac and histological changes compatible with the inflammatory process triggered by severe acute pancreatitis with the promotion of local myocardial cytokine production

Wang Mei. / "July 2002." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2002. / Includes bibliographical references (p. 208-233). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.