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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
21

Les récits de voyage en Algérie dans la presse illustrée et les revues du XIXe siècle ou l'invention d'un orient de proximité / Travelogues in Algeria in the illustrated press and reviews of 19th century, or the invention of an ‘Orient in proximity

Ait Sidhoum, Slimane 09 December 2013 (has links)
La première partie dresse dans ses trois chapitres une typologie des voyageurs en Algérie (pour l’essentiel fonctionnaires, militaires, savants et écrivains-journalistes), étudie d’est en ouest et du nord au sud les parcours géographiques préférentiels qu’ils ont suivis, et décrit quelques-uns des traits narratologiques dominants de leurs récits (temporalité, pratique du feuilleton, usage de l’illustration). La seconde partie montre comment ces relations de voyages et ces reportages témoignent à leur façon de la formation graduelle de l’Algérie coloniale. On y découvre comment ils récrivent à leur façon l’histoire contrastée de l’expansion territoriale de la France : histoire du colon agriculteur installé sur les terres des habitants autochtones expropriés ; histoire du paysage et des modes de vies algériens transformés par l’introduction des techniques et de la civilisation occidentale, avec ses apports, ses paradoxes et ses ratages ; histoire enfin de la recherche des vestiges romains et de l’éloge de la latinité dont les colonisateurs français, nourris de culture livresque antique, entendent se dire les héritiers et les imitateurs. La dernière partie, enfin, s’interroge sur la portée ethnologique éventuelle de ces récits viatiques. L’auteur y souligne toute la complexité et l’ambivalence des relations de voyage qui, en appliquant à l’appréhension de l’autre des critères de définition et de hiérarchisation ethniques qui lui sont étrangers, génèrent des mythes orientalisants sans rapport véritable avec le monde observé. / The first part in three chapters presents a typology of travellers in Algeria (particularly officials, soldiers, scholars and writer-journalists), studies from east to west and from north to south, the preferred geographical circuit that they followed, and describes some of the dominant characteristics of narratology in their stories (temporality, series of articles, illustrations). The second part shows how theses travel narrations and accounts witness in their own manner the gradual formation of colonial Algeria. We discover how they rewrite in their own manner the contradictory accounts of territorial expansion of France: history of colonial cultivators established on the lands of expropriated natives; history of landscape and the Algerian ways of living transformed by the introduction of western techniques and civilization, its contributions, paradoxes and failures; at last, history of search for Roman empire remnants and the praises of Latinism, whose, the French colonizers, nurtured by the ancient bookish tradition, intend to be called the heir and the imitators. The last part inquires on the ethnological aspects of these viaticum stories. The writer puts an emphasis on the complexity and the ambivalence of the travel narration that, applying certain criteria of definition and ethnical hierarchies to the apprehension of the other, that are unknown to him, create oriental myths that have no relation with the society being observed.
22

Fluorose dentária e concentração de flúor nas unhas de crianças residentes em diferentes áreas fluoretadas

Barbosa, Tatiana de Freitas [UNESP] 12 August 2010 (has links) (PDF)
Made available in DSpace on 2014-06-11T19:27:45Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-08-12Bitstream added on 2014-06-13T20:56:49Z : No. of bitstreams: 1 barbosa_tf_me_araca.pdf: 715889 bytes, checksum: f9c4cf0b3fff1513c875f5ce77fdf964 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A fluoretação das águas de abastecimento público tem ocasionado significante redução na prevalência da cárie em diferentes populações, entretanto, a exposição ao flúor pelo uso de diferentes métodos tem trazido preocupações quanto ao aumento na prevalência de fluorose dentária. Por isso, estudos sobre os fatores de risco associados à fluorose são necessários, além do acompanhamento contínuo e efetivo da exposição ao flúor, por diferentes meios, incluindo mais recentemente os marcadores biológicos para esse íon, como a unha, que também reflete o nível de exposição crônica, desde que um indivíduo tenha uma ingestão de flúor relativamente constante. Assim, objetivou-se analisar o teor de fluoreto das águas de abastecimento público em diferentes áreas de um município, uma abastecida por poços profundos e outra pela estação de tratamento de água (ETA), e verificar se os teores de fluoretos encontrados refletem diferenças nas concentrações de flúor observadas nas unhas das crianças de 12 anos e na prevalência de fluorose dentária. Para isso, foram selecionados 43 pontos para coleta de amostras de água, abrangendo as 17 fontes de abastecimento existente no município. A população de estudo foi constituída por 60 crianças, de 12 anos de idade, nascidas e moradoras permanentes nas duas áreas de estudo, seguindo os critérios de inclusão, sendo uma com excesso e outra sem excesso de flúor nas águas de abastecimento público. As amostras de água, coletadas mensalmente nos pontos previamente estabelecidos, foram analisadas em duplicata no período de janeiro a dezembro de 2009, utilizando-se um analisador de íons acoplado a um eletrodo específico para flúor. Coletas e análise do flúor nas unhas das crianças foram realizadas, utilizando-se a técnica da microdifusão facilitada por HMDS. Para verificação da fluorose... / The fluoridation of public water supply has caused a significant reduction in the prevalence of caries in different populations, however, exposure to fluoride by using different methods has brought concerns about the increasing prevalence of dental fluorosis. Therefore, studies on the risk factors associated with fluorosis are needed, besides the efficient and continuous monitoring of fluoride exposure by various means, including most recently the biological markers for this ion, such as fingernail, that also reflects the level of chronic exposure, as long as an individual has a relatively constant intake of fluoride. The objective was to analyze the fluoride content of public water supply in different areas of a district, one served by deep wells and one by the water treatment station (WTS), and check if the levels of fluoride found reflect differences in the concentrations of fluoride observed in nails of 12 years old children and the prevalence of dental fluorosis. For this, 43 points were selected to collect water samples, covering the 17 existing sources of supply in the municipality. The study population consisted of 60 children, 12 years old, born and permanent residents in both areas of study, following the inclusion criteria, one with and one without too much fluoride excess in public water supply. Water samples collected monthly in points previously established, were analyzed in duplicate in the period from January to December of 2009, using an ion analyzer coupled to a specific electrode for fluoride. Sampling and analysis of fluoride in children nails were done, using the technique of facilitated microdiffusion HMDS. For verification of dental fluorosis we used the modified DEAN index .Of the total samples studied (n=512), 44% (n=224) had adequate levels and 56% (n =288) inadequate levels, and 10% (n=49) lower levels and 46% (n=239) higher... (Complete abstract click electronic access below)
23

Unhas humanas como marcadores biológicos de exposição ao flúor: correlação com a saliva da parótida e influência da idade / Human nails as biological markers of fluoride exposure: correlation to parotid ductal saliva and influence of age

Rejane Fukushima 07 December 2007 (has links)
Avaliou-se a influência da exposição ao flúor (F) através da água de beber, da velocidade de crescimento das unhas, da idade e do gênero na concentração deste elemento nas unhas das mãos e dos pés. Em adição, verificou-se a correlação entre as concentrações de F na saliva total, saliva do ducto da parótida e unhas das mãos e dos pés. Participaram do estudo 300 indivíduos, das faixas etárias de 3-7,14-20, 30-40 e 50-60 anos, residentes de cinco comunidades brasileiras, sendo duas no Estado de São Paulo (Pirajuí e Bauru, com água não fluoretada e 0,7 mgF/L na água de abastecimento, respectivamente) e três no Estado da Paraíba (Cajazeirinhas, Brejo dos Santos e Brejo das Freiras, com 0,2, 0,7 e 1,7 mgF/L na água de consumo, respectivamente). Foram coletadas duas ou três (apenas em Bauru) amostras de água de beber, além de duas amostras de: unhas dos pés, unhas das mãos, saliva total e saliva do ducto da parótida de cada indivíduo. O F nas amostras foi analisado com eletrodo íon-específico. Os dados obtidos foram analisados estatisticamente através de análise de variância e regressão linear (p<0,05). A exposição ao F através da água de beber, a velocidade de crescimento das unhas, a idade e o gênero influenciaram a concentração de F nas unhas das mãos e dos pés, sendo que o fator de exposição ao F através da água foi o que exerceu maior influência pelo modelo de regressão linear adotado. As unhas dos pés (R2=0,46) se mostraram melhores indicadoras de exposição ao F do que as das mãos (R2=0,24). Foi encontrada uma correlação negativa significativa entre velocidade de crescimento das unhas e concentração de F nas mesmas. Houve correlação positiva significativa entre concentração de F nas unhas das mãos e dos pés com: saliva total (r=0,36 e r=0,41) e saliva do ducto da parótida (r=0,25 e r=0,53), respectivamente. Também se observou correlação positiva entre saliva total e do ducto da parótida (r=0,24), bem como entre concentração de F na água e saliva total (r=0,41) e saliva do ducto (r=0,65). Todos os fatores testados influenciaram os níveis de F nas unhas e, portanto, devem ser levados em consideração quando se utiliza este marcador biológico. / The influence of fluoride (F) concentration in the drinking water, nails growth rate, age and gender upon the F content in fingernail and toenail were evaluated. In addition, the correlations among the F concentrations in whole saliva, parotid ductal saliva and finger/toenails were verified. Three hundred volunteers of 3-7, 14-20, 30-40, 50-60 years participated. They were residents of five Brazilian communities, two in Sao Paulo State (Pirajuí and Bauru, non-fluoridated and 0.7 mgF/L artificially fluoridated drinking water, respectively) and three in Paraiba State (Cajazeirinhas, Brejo dos Santos and Brejo das Freiras, 0.2, 0.7 and 1.73 mgF/L naturally fluoridated drinking water, respectively). Two or three samples of drinking water, and two samples of fingernails, toenails, whole saliva and ductal saliva were collected from each volunteer, with one-week interval period between the collections. F in water, whole saliva, ductal saliva and nails was determined using the ion-sensitive electrode. Data were analyzed by ANOVA and linear regression (p<0.05). The F exposure from the drinking water, nails growth rate, age and gender influenced the levels of F in fingernails and toenails. Considering the model of multivariate linear regression adopted, F exposure from the water influenced the most. Toenails (R2=0.46) seemed to be better indicators of F than fingernails (R2=0.24). It was found a significant negative correlation between nails growth rate and their content of F. Positive correlations were found between F concentration in fingernails and toenails and: F concentration in whole saliva (r=0.36 and r=0.41) and in parotid ductal saliva (r=0.25 and r=0.53), respectively. Moreover, it was observed a positive correlation between whole and parotid saliva (r=0.24), as well as between F concentration in the drinking water and whole (r=0.41) and parotid saliva (r=0.65). All factors that influenced nails F concentration must be taken into account when using them as biological markers.
24

Onicomicose em pacientes dialíticos e transplantados renais: prevalência, etiologia e perfil de suscetibilidade a antifúngicos em pacientes atendidos no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo / Onychomycosis in dialysis patients and kidney transplant recipient: prevalence, etiology and antifungal susceptibility profile in patients treated at the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

Antonio Marques dos Santos Filho 30 August 2016 (has links)
Onicomicose é uma infecção crônica das unhas provocadas por fungos. É a doença mais comum das unhas em todo o mundo e constitui cerca de metade de todas as alterações ungueais em indivíduos imunocompetentes e imunossuprimidos. Nos últimos anos, vários estudos tem demonstrado aumento na prevalência de onicomicose. Esse aumento pode ser atribuído a diversos fatores, incluindo o aumento da expectativa de vida, e propagação do vírus da imunodeficiência humana (HIV). Nesse sentido, o número de pacientes renais crônicos vem aumentando em todo mundo. No entanto, a literatura relata poucos estudos sobre a prevalência e as características das onicomicoses nestes pacientes. Diante disso, nossos objetivos foram determinar a prevalência, etiologia e perfil de suscetibilidade das onicomicoses provenientes de pododáctilos de pacientes dialíticos (DL), receptores de transplante renal (RTR) e pacientes grupo controle. Foram examinados 510 pacientes, sendo 336 provenientes da Unidade de Transplante Renal (149 DL e 187 RTR), e 174 pacientes do Ambulatório de Clínica Geral, sem histórico de doença associada à imunossupressão (Grupo controle). Os isolados foram identificados por testes fenotípicos e moleculares. O perfil de suscetibilidade foi realizado pelo método de microdiluição em caldo frente aos fármacos fluconazol, itraconazol, voriconazol e terbinafina. A prevalência de onicomicose foi de 23,4% nos pacientes DL e 23,0% nos RTR, significativamente maior que no grupo controle (13,2%). Nos pacientes DL, onicomicose foi associada com diabetes, mas não com o tempo de diálise e sexo. Nos pacientes RTR, onicomicose foi mais prevalente em homens, mas não houve associação com duração do transplante, diabetes e protocolo de tratamento imunossupressor. Trichophyton rubrum foi a agente mais prevalente (45,9%), seguido por T. mentagrophytes (24,5%) e Candida parapsilosis (18%). Todos antifúngicos foram eficazes frente aos isolados de dermatófitos, sendo terbinafina o mais eficiente. Os isolados de C. parapsilosis foram todos sensíveis aos quatro antifúngicos de acordo com os atuais \"end-points\". Nossos achados permitiram concluir que pacientes renais (DL e RTR) tem risco aumentado de desenvolver onicomicose. Nossos dados também revelaram que a etiologia e a suscetibilidade das espécies isoladas são comparáveis aos encontrados em outros grupos de pacientes não renais descritos na literatura. / Onychomycosis is a chronic fungal infection of the nail. It is the most common disorder of nails worldwide and constitutes about 50% of all nail changes of the immunosuppressed and healthy patients. In recent years, several reports have shown increased prevalence of onychomycosis. This increase can be attributed to several factors, including increased life expectancy, and to the human immunodeficiency virus (HIV) epidemics. In this regard, the number of chronic renal patients is also increasing worldwide. However, the literature reports few studies on onychomycosis in these patients. Therefore, our objectives were to determine the prevalence, etiology and susceptibility profile of onychomycosis of the toenail of patients undergoing hemodialysis treatment (HD), kidney transplant recipients (KTR) and control patients. Were examined 510 patients, 336 attending the Renal Transplantation Unit (187 KTR e 149 HD) and 174 patients attending an internal medicine outpatient service with diseases other than renal disease (control group). The isolates were identified by phenotypic and molecular tests. Antifungal susceptibility tests were performed using a broth microdilution method against the antifungal drugs voriconazole, itraconazole, fluconazole and terbinafine. The prevalence of onychomycosis in HD patients (23.4%) and KTR (23.0%) was significantly higher than control group (13.2%). In HD patients, onychomycosis was associated with diabetes but not duration of dialysis and gender. In KTR, onychomycosis was more prevalent in males, but not associated with duration of transplantation, diabetes or immunosuppressive protocols. Trichophyton rubrum was the most prevalent species (45.9%) followed by T. mentagrophytes (24.5%) and Candida parapsilosis (18%). While all antifungals were efficient against the dermatophyte isolates, terbinafine was the most effective. All C. parapsilosis isolates were sensitive to the antifungals according to the current end-points. In conclusion, this study shows that HD patients and KTR are at high risk of contracting onychomycosis. Our data also show that the etiology and susceptibility of the species are comparable with those found in other groups of non-renal patients described in the literature.
25

Isolamento de Sporothrix schenckii de garras de felinos domésticos (domiciliados e querenciados) e daqueles mantidos em cativeiro, em São Paulo (Brasil) / Isolation of S. schenckii from the nails of domestic cats (indoor and outdoor) and in captivity, in São Paulo (Brazil)

Tatiana Saleme Borges 30 July 2007 (has links)
Esporotricose se constitui em micose intermediária, resultante do adentrar do fungo Sporothrix schenkii na pele ou no panículo. Trata-se de uma micose com características zoonóticas (sapro e antropozoonose). Objetivou-se: determinar a ocorrência de esporotricose-infecção ou esporotricose-doença, em felinos domésticos (domiciliados e querenciados), em animais de gatis de benemerência e daqueles felinos selvagens ou exóticos, mantidos em cativeiro, a partir do isolamento do fungo Sporothrix schenckii de decalques de garras em meio de cultivo. A amostragem foi composta por 132 felinos domésticos, selvagens ou exóticos. Da totalidade dos animais, 120 (91,0%) eram felinos domésticos, 11 (8,3%) selvagens e um exótico (0,7%). Segundo o sexo, 89 (67,4%) eram machos e os 43 (32,6%) restantes eram fêmeas. A maioria dos animais (80,3%) não apresentavam precisa definição racial, sendo que a média de idade foi de, aproximadamente, 71,8 meses. Vinte e um (17,5%) felinos eram querenciados. Da totalidade dos animais, 89 (67,4%) mantinham contato com outros animais da mesma espécie. Foi possível isolar o Sporothrix schenckii, das garras de um dos felinos investigados, com quadro generalizado de esporotricose. Os agentes, patógenos em potencial, Microsporum canis e Malassezia pachydermatis foram isolados, respectivamente, em 12,1% e 5,3% dos animais. Isolaram-se fungos anemófilos, reputados como contaminantes: Penicillium sp 28 (52,9%), Aspergillus sp 13 (24,5%), Rhodotorula sp cinco (9,4%), Candida sp cinco (9,4%), Trichoderma sp um (1,9%) e Acremonium sp um (1,9%). Pela magnitude de ocorrência (0,7%) de S. schenckii nas garras de felinos, o pressuposto potencial dos gatos, ora investigados, como possível fonte de infecção, na cidade de São Paulo, se mostrou bastante baixo. / Sporotrichosis is a subcutaneous mycosis, acquired through the skin and panniculus by the insertion of the Sporothrix schenckii fungus. It\'s a zoonotic mycosis (sapro and anthropozoonozis). The goals of this study were: to determine the occurrence of sporotrichosis infection or sporotrichosis disease in domestic felines (indoor and outdoor) cattery and wild or exotic in captivity, through the S. schenckii isolation from nail imprinting in culture media. The sample comprised 132 domestic, wild or exotic felines. From the total, 120 (91.0%) were domestic cats, 11(8.3%) wild and one exotic (0.7%). They were 89 (67.4%) males and 43 (32.6%) females. Most of animals (80.3%) were non-breed and the average age was 71.8 months. Twenty one (17,5%) felines lived outdoor. From the total 89 (67.4%) animals have had regular contact with other of the same species. It was possible to isolate the Sporothrix schenckii from the nails of an investigated one, with generalized sporotrichosis condition. The potencial pathogen, Microsporum canis and Malassezia pachydermatis agents, were isolated in 12.1% and 5.3% respectively. Air fungus, considered as contaminants, were isolated: Penicillium sp 28 (52,9%), Aspergillus sp 13 (24,5%), Rhodotorula sp five (9,4%), Candida sp five (9,4%), Trichoderma sp one (1,9%) e Acremonium sp one (1,9%). The low occurrence of S. schenckii (0.7%) in the feline nails, in this investigation, shows it with a small probability as a source of infection in the city of São Paulo.
26

Studies on bisphosphonate elution from orthopaedic implants

Roberts, Jacintha. January 2008 (has links)
No description available.
27

A Geotechnical Evaluation of the Launched Soil-Nailing Method of Landslide Stabilization in Summit County, Ohio

Wendlandt, Nichole Jean 15 April 2009 (has links)
No description available.
28

Single shear vs. double shear for nails in lateral loading

Stoneburner, Paul W. January 1952 (has links)
Tests were conducted on three-member southern pine joints to determine (1) the relationship of the lateral load-carrying capacity of nails in single and double shear, and (2) to develop a basis for structural design data for laterally loaded nails in double shear applicable whenever deformation is a governing factor, such as in joints of trussed rafters. The test loads at or near proportional limit show that low-carbon-steel plain-shank and helically threaded Screwtite nails loaded in double shear carry twice the single-shear loads; while hardened high-carbon-steel plain-shank and Screwtite nails loaded in double shear carry considerably less than twice the single-shear loads. If these relationships between single-shear and double-shear loads are to be valid, the nail must be optimum diameter tor the joint. Structural design data as based on test loads at or near proportional limit for laterally loaded low-carbon-steel plain-shank nails in single and double shear are applicable to low-carbon-steel Screwtite nails and to same-length, smaller-diameter, hardened high-carbon-steel plain-shank and Screwtite nails. This finding, however, is not valid if consideration is to be given to the load-carrying capacity beyond proportional limit and at ultimate, to the influence or exposure on nail-holding power, and to certain advantage resulting from the use of threaded-shank as well as hardened nails. Design data as advanced in the National Design Specification for low-carbon-steel plain-shank nails in single shear are verified within their scope. Additional information is presented on the performance or plain-shank nails, Screwtite nails, and Stronghold Screwnails under given conditions, on the effects or pre-boring and clinching, and on the efficiency or toothed-ring Burrlock fasteners as reinforcement for nailed lumber joints. / M.S.
29

Le mélanome acro-lentigineux : étude rétrospective épidémiologique, clinique et anatomopathologique, et recherche de facteurs pronostiques d’un sous-type rare de mélanome / Acral Lentiginous Melanoma : a retrospective, epidemiological, clinical and histological study of a rare subtype of melanoma, with identification of prognostic factors

Phan, Alice 04 May 2011 (has links)
Le mélanome acro-lentigineux (ALM) est le 4ème sous-type histologique de mélanome et représente moins de 10% des mélanomes. Beaucoup de controverses entourent ce sous-type rare, comme un plus mauvais pronostic. L’objectif de notre travail était de mieux caractériser l’ALM sur le plan épidémiologique, clinique, histologique, et évolutif et d’identifier d’éventuels facteurs pronostiques. Entre 1996 et 2004, 126 cas d’ALMs (6% des mélanomes) ont été répertoriés et suivis dans le service de dermatologie de l’Hôpital de l’Hôtel-Dieu, Lyon. Toutes les lames histologiques ont été récupérées et systématiquement relues. Les analyses statistiques ont été réalisées par comparaison de sous-groupes, calculs et comparaison des courbes de survie par la méthode de Kaplan-Meier et le test de Log-Rank, et recherche de facteurs pronostiques indépendants en utilisant le modèle de régression logistique de Cox. La survie médiane sans récidive et spécifique étaient respectivement de 10,1 et 13,5 ans. Le taux de survie à 5 ans était de 76%. Dans la première partie de notre travail, nous avons étudié toutes les caractéristiques épidémiologiques et cliniques de l’ALM, afin de mieux comprendre l’histoire clinique. Les hommes avaient un plus mauvais pronostic ainsi que les formes achromiques. La seconde partie est une étude détaillée des particularités anatomo-pathologiques des ces tumeurs, avec une évaluation de leur signification pronostique. L’analyse multivariée des facteurs pronostiques a permis de souligner l’impact de l’index mitotique et de la présence de microsatellites en histologie. Enfin, la troisième partie de notre travail avait pour but de préciser les critères dermoscopiques d’aide au diagnostic de l’ALM, dont le retard diagnostique est fréquent. A partir d’une des plus grandes séries de cas d’ALM, notre travail souligne le caractère distinct de ce sous-type de mélanome, dont le mauvais pronostic est vraisemblablement lié à un stade avancé au diagnostic, la dermoscopie constituant une aide précieuse pour un diagnostic plus précoce. / Acral Lentiginous Melanoma (ALM) is the fourth main histological subtype of melanoma and accounts for less than 10% of all melanomas. Many controversies surround this rare subtype, as a poorer prognosis. The aim of our study was to investigate the distinctive epidemiological, clinical and histological characteristics and outcome of ALM, and to evaluate their prognostic values in order to identify independent prognostic factors. Between 1996 and 2004, 126 patients with ALMs (6% of all melanomas) were retrieved and followed up at the Department of Dermatology, Hôtel-Dieu University Hospital, Lyon, France. All histological material were systematically reexamined. Statistical analysis was performed by comparing the baseline characteristics of subgroups with appropriate tests. ALM-specific and disease-free survivals were estimated using the Kaplan-Meier method and compared using the Log-Rank test. A Cox proportional hazards model was used to identify independent prognostic factors. The median disease-free and ALM-specific survivals were 10.1 and 13.5 years, respectively. The 5-year survival rate was 76%. In the first part of this study, we reviewed patient demographics, the initial presentation of the lesion, and clinical outcome. Male gender and amelanosis were significantly associated with a poorer prognosis. The second part is a detailed analysis of histopathological features, with evaluation of their prognostic value. The presence of microsatellites and a high mitotic rate appeared to be of particular importance in predicting the outcome of ALM. Then, the third part emphasized all dermoscopic features of ALM, in order to improve recognition of suspicious cases and to permit an earlier diagnosis. This large register-based review of ALM shows that ALM is an unusual subtype of melanoma that exhibits distinctive epidemiological, clinical and pathological features. The classical poorer prognosis is mainly due to a more advanced stage at the time of diagnosis. Dermoscopy could be helpful to improve the diagnostic accuracy in such locations.
30

Estudo sobre determinação de elementos químicos em unhas humanas pelo método de análise por ativação com nêutrons / A study on chemical element determinations in human nails by neutron activation analysis

Sanches, Thalita Pinheiro 17 August 2012 (has links)
As análises de unhas têm sido objeto de estudo para avaliar os níveis de elementos acumulados no organismo humano e com aplicações deste tecido na monitoração da exposição ocupacional ou ambiental, na avaliação do estado nutricional, na identificação da intoxicação por metais tóxicos e na diagnose ou prevenção de doenças. As análises de unhas apresentam vantagens devido à facilidade na coleta, estocagem e transporte das amostras bem como fornecem os níveis de elementos acumulados ao longo de um período de aproximadamente 6 meses ao contrário dos fluídos como sangue e urina. Entretanto há controvérsias sobre a aplicação dos dados de suas análises devido às dificuldades em estabelecer valores confiáveis de referência ou faixas de concentrações para uso como dados de controle. O objetivo deste trabalho foi avaliar os fatores que podem afetar nas concentrações de elementos nas unhas para posterior análise de amostras de um grupo de indivíduos aplicando o método de análise por ativação com nêutrons (NAA). As amostras de unhas das mãos e dos pés coletadas de indivíduos adultos de ambos os sexos, com idades de 18 a 71 anos e residentes na região metropolitana de São Paulo foram cortadas em pequenos fragmentos, lavadas e secas para as análises. O procedimento experimental consistiu em irradiar amostras juntamente com os padrões sintéticos de elementos por 16 h sob fluxo de nêutrons térmicos de cerca de 4,5 x 1012 n cm-2 s-1 do reator nuclear de pesquisa IEA-R1, seguido de espectrometria de raios gama para a determinação dos elementos As, Br, Ca, Co, Cr, Cs, Fe, K, La, Na, Rb, Sb, Sc, Se e Zn. No controle da qualidade analítica foram analisados os materiais de referência certificados cujos os resultados obtidos indicaram boa exatidão e precisão com erros relativos e desvios padrão relativos inferiores a 5,1 % e 11,6 % respectivamente. Os ensaios preliminares indicaram que as contribuições devido às impurezas presentes nos invólucros de plástico utilizados na irradiação assim como aquelas decorrentes da adsorção dos esmaltes nas unhas são muito baixas, podendo ser desprezadas. Nos testes de limpeza das unhas para análise foi verificado que a solução diluída de HNO3 pode provocar a dissolução das amostras. A homogeneidade da amostra preparada foi verificada pelas analises em réplicas. A comparação entre as concentrações de elementos obtidos nas unhas das mãos e dos pés indicou diferenças significativas para os elementos Br, Co e Zn (teste t, p = 0,05). As concentrações de elementos nas unhas quando comparadas em relação ao gênero, faixa etária e Índice de massa corpórea (IMC) dos indivíduos não apresentaram diferenças significativas para a maioria dos elementos determinados. A diferença significativa das concentrações de Zn das unhas das mãos foi verificada entre o gênero dos indivíduos e das concentrações de Cs entre às faixas etárias distintas. As concentrações de elementos obtidas nas unhas dos pés e das mãos apresentaram uma ampla variabilidade e para a maioria dos elementos os dados obtidos são da mesma ordem de grandeza ou dentro das faixas dos valores da literatura. / Nail analyses have been the object of study in order to assess the levels of elements accumulated in the human organism and to use this tissue to monitor environmental and occupational exposure, to evaluate the nutritional status, to verify intoxication by toxic metals and to diagnose or to prevent diseases. Nail analyses present advantages due to easy sample collection, storage, transportation and this tissue provides element level accumulation over time. However, there is controversy regarding the application of nail analysis data due to difficulties to establish reliable reference values or element concentration ranges as control values. The objective of this study was to evaluate the factors that can affect nail element concentrations for further sample analyses of a group of individuals by applying neutron activation analysis (NAA). Fingernails and toenails collected from adult individuals of both genders, aged 18 to 71 years, living in the São Paulo Metropolitan Region were cut in small fragments, cleaned and dried for analyses. Samples and element standards were irradiated for 16 h under a thermal neutron flux of about 4.5 x 1012 n cm-2 s-1 at the IEA-R1 nuclear research reactor followed by gamma ray spectrometry. Element concentrations for As, Br, Ca, Co, Cr, Cs, Fe, K, La, Na, Rb, Sb, Sc, Se and Zn were determined. For quality control of the analytical results, certified reference materials were analysed and the results showed good accuracy and precision with relative errors and relative standard deviations lower than 5.1 % and 11.6 %, respectively. Preliminary assays indicated that the contribution due to impurities from plastic involucres used in the irradiation as well as those from nail polishes is very low and could be considered negligible. Results from the nail sample cleaning process using distinct procedures indicated that HNO3 solution may cause sample dissolution. Sample homogeneity was verified by analysis of a sample in replicate. A comparison of finger and toenail results indicated significant differences (p= 0.05) for the elements Br, Co and Zn. Element concentration comparisons were also made with gender, age and body mass index (BMI) parameters and for the most part showed no significant differences. The differences were found for Zn concentrations when compared between genders in fingernail, for Cs when compared between ages in fingernail. Elements concentrations obtained for both finger and toenail samples presented wide variability and they were of the same order of magnitude or within ranges as those reported in published literature.

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