As doenças perimplantares (DPi) vêm sendo consideradas umas das maiores causas de perdas tardias de implantes dentários e nenhum dos tratamentos já propostos na literatura mostrou ser eficiente a ponto de se tornar a primeira escolha terapêutica. Considerando que a definição correta do tratamento depende invariavelmente do entendimento da etiopatogenia, ocorrências e diagnóstico das DPi, o objetivo da presente tese foi abordar as DPi através de uma ampla revisão dos seus conceitos e da apresentação de dados clínicos preliminares de três meses de um ensaio clínico controlado randomizado comparando os resultados dos tratamentos cirúrgico (C) e não cirúrgico (NC) da perimplantite. Foram incluídos implantes apresentando um ou mais sítios com profundidade de sondagem perimplantar (PSi) ≥ 5mm, com presença de sangramento submucoso (SSi) e/ou supuração e apresentando perda óssea radiográfica (PO) ≥ 3mm. O tratamento não cirúrgico incluiu debridamento mecânico com curetas de teflon e irrigação com solução salina, assim como o tratamento cirúrgico, com acesso por retalho mucoperiostal. Não foram utilizadas técnicas ressectivas e nem implantoplastia. A amostra foi randomizada de maneira estratificada para o hábito de fumar e a presente análise, de 3 meses de acompanhamento após o tratamento, se refere à amostra de 22 indivíduos (29 implantes), sendo 12 (17 implantes) no grupo C e 10 (12 implantes) no NC. No início do estudo não foram observadas diferenças significativas entre os grupos para variáveis demográficas e clínicas, exceto nas condições periodontais de índice de placa visível (IPV) (NC 22,3±14,08 / C 40,2±19,9) e sangramento a sondagem (NC 15,9±10,2 / C 31,8±15,9). Após três meses de tratamento, não houve desistências e, considerando o pior sítio do implante, os dois tratamentos reduziram significativamente as medidas de PSi (NC 5,8±0,27 para 4,3±0,55mm / C 5,9±0,29 para 5,0±0,28mm), os dois grupos apresentaram redução de SSi mas apenas no grupo C foi significativa, diminuindo de 100% para 53%. Não houve diferenças entre os níveis de perda de inserção clínica (PIi). Em uma análise multivariada para identificar os preditores de sucesso dos tratamentos, implantes com PSi basal > 6 mm apresentaram piores reduções de PSi, SSi e PIi, o histórico de periodontite dificultou a redução de PSi enquanto indivíduos com 5 ou mais implantes e reabilitados com próteses cimentadas apresentaram piores reduções de SSi. A taxa de sucesso dos tratamentos foi de 33% no grupo NC e 17% para o grupo C sem diferenças estatísticas. Conclui-se que ambos os tratamentos diminuíram sinais inflamatórios embora sem a demonstração de diferenças entre eles, e que preditores de risco ao sucesso do tratamento devem ser investigados. / Peri-implant diseases (PiD) have been considered the major causes of late loss of dental implants, and none of the proposed treatments in the literature demonstrated to be efficient to become the first therapeutic choice. Considering that the correct definition of treatment depends invariably on the understanding of the etiopathogenesis, occurrence and diagnosis of PiD, the aim of the present theses was to approach PiD through a 9oné99ono f its concepts and presenting preliminary clinical data of 3 months from a randomized controlled 9oné9 comparing surgical (ST) and non-surgical (NST) treatments of peri-implantitis. Implants presenting pocket depth (PD) ≥5mm and bleeding on probing (Bosshardt et al.) with radiographic bone loss ≥3 mm were included in the study. NST included mechanical debridement of the implant with Teflon curets and irrigation with saline solution, whereas ST included the debridement with mucoperiostal flap. Ressective surgery and implantoplasty were not applied. The sample was randomized by stratification according to smoking habit, and the present 3-months analysis after treatment referes to 22 individuals (29 implants), 12 (17 implants) in ST and 10 (12 implants) in the NST group. At basliene, no significant differences were observed between groups for demographic and clinical variables, except for periodontal conditions of teeth in regards to visible plaque (NST 22.3±14.08% and ST 40.2±19.9%) and BOP (NST 15.9±10.2% and ST 31.8±15.9%). After 3 months, there were no drop-outs and, considering the worst site of each implant, the two treatments reduced significantly mean PD (NST 5.8±0.27mm to 4.3±0.55mm and ST 5.9±0.29mm to 5.0±0.28mm. Both groups presented reduction in BOP, but only in the ST the reduction was significant, decreasing from 100% to 53%. There were no significant differences in clinical attachment loss after 3 months in the two groups. In a multivariable analysis to identify predictors of treatment success, implants with baseline PD >6mm presented lower reduction in PD over 3 months, as well as BOP and CAL. Previous history of periodontitis lead to higher PD and individuals with more then 5 implants and rehabilitated with bonded prosthesis had higher BOP over time. It can be concluded that both treatments reduced signs of inflammation although without significant differences between them, and baseline PD, number of implants, history of periodontitis and type of prosthetic fixation may be used as predictors of clinical outcomes of peri-implantitis treatment.

Submitted by Etelvina Domingos (etelvina.domingos@ufpe.br) on 2015-03-06T19:11:13Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissertação_Clessius_Versão Final_Biblioteca.pdf: 652084 bytes, checksum: 87d6b1c2770f0d28cb3554f4a1ff3d88 (MD5) / Made available in DSpace on 2015-03-06T19:11:13Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissertação_Clessius_Versão Final_Biblioteca.pdf: 652084 bytes, checksum: 87d6b1c2770f0d28cb3554f4a1ff3d88 (MD5) Previous issue date: 2012 / CNPq / Neste trabalho n os obtemos condi c~oes para a exist^encia e unicidade de solu c~oes brandas assintoticamente quase peri odicas para equa c~oes diferenciais abstratas de primeira ordem com a parte linear dominada por um operador de Hille-Yosida com dom nio n~ao necessariamente denso. Para alcan car nosso objetivo, usamos a teoria de extrapola c~ao e a teoria de ponto xo. Como aplica c~ao, examinamos condi c~oes su cientes para exist^encia de solu c~oes assintoticamente quase peri odicas de equa c~oes da teoria de condu c~ao de calor.

Introdução: Acretismo placentário é condição pouco frequente na qual há aderência anormal do tecido trofoblástico à parede uterina. É uma causa importante de hemorragia puerperal, associada a altas taxas de morbimortalidade maternofetal, grande necessidade de transfusão de hemoconcentrados. Os tratamentos propostos variam desde conduta conservadora até a histerectomia pós-parto, associada ou não a procedimentos endovasculares. Objetivo: O presente estudo visa descrever a técnica endovascular de balonamento temporário e embolização das artérias ilíacas internas durante o parto cesáreo, avaliar sua eficácia em reduzir o sangramento materno relacionado ao acretismo placentário, bem como relatar a segurança e o índice de complicações relacionadas ao tratamento endovascular. Materiais e métodos: Coorte retrospectiva de pacientes com diagnóstico pré-natal de acretismo placentário submetidas a tratamento endovascular de balonamento temporário e embolização das artérias ilíacas internas, seguido de histerectomia puerperal no nosso serviço, no período de janeiro de 2012 até novembro de 2016. Foram analisados dados relativos aos antecedentes gestacionais e cirúrgicos, achados de exames de imagem, achados histológicos, níveis de hemoglobina prévios, durante e após o parto, bem como volumes de hemoconcentrados administrados e taxa de complicações relacionadas ao procedimento endovascular. Resultados: Trinta e Siqueira FM 7 cinco pacientes foram submetidas ao manejo proposto durante o período estudado. Foi observado um volume médio de transfusão relacionado ao procedimento e perda sanguínea estimada de 540 ml e 1229 ml, respectivamente. Ocorreram complicações relacionadas ao procedimento endovascular em quatro pacientes, sendo um caso de necrose muscular glútea, um de lesão isquêmica cutânea superficial e dois casos de trombose arterial aguda de membros inferiores. Conclusão: O presente estudo demonstrou que o balonamento temporário e embolização das artérias ilíacas internas reduziu significativamente as necessidades transfusionais relacionadas ao parto nas pacientes com acretismo placentário, quando comparado com casos da literatura nos quais não foram realizadas intervenções endovasculares, com baixo índice de complicações relacionadas ao procedimento. / Introduction: Placenta accreta (PA) is the infrequent condition in which there is abnormal adherence of the trophoblastic tissue to the uterine wall. It\'s considered a major cause of puerperal bleeding, associated with high maternal morbimortality and need for blood products transfusion. Proposed treatments range from conservative to postpartum hysterectomy, combined or not to endovascular techniques. Objectives: to describe the detailed endovascular technique of temporary balloon occlusion followed by embolization of the internal iliac arteries (IIA) during cesarean section, evaluate the ability in reducing birth-related blood loss in patients with diagnosed PA and to assess safety and complications related to the endovascular procedure. Materials and methods: retrospective cohort of patients diagnosed with PA submitted to temporary balloting and embolization of the IAA followed by puerperal hysterectomy in our institution from January 2012 to November 2016. We recorded patient data such as gestational and surgical history, pre-natal radiological image findings, histopathological description, pre e postoperative hemoglobin levels and volume of blood products transfused in all patients. Follow up accounted for possible complications related to the procedure. Results: thirty-five patients were submitted to the approach during the study period. The median volume of packed red blood cells (RBC) and estimated blood loss were 540 ml and 1229 ml respectively. A total of 4 patients had complications attributed to the endovascular procedure - one case of Siqueira FM 9 deep glute tissue necrosis, one of superficial tissue necrosis and two cases of acute arterial thrombosis of the inferior limbs. Conclusion: the present study demonstrated that temporary ballooning and embolization of the IAA was able to significantly reduce birth-related blood loss and transfusion needs in patients with PA when compared to other literature series where no endovascular procedures were performed, with a low rate of procedure-related complications.

Os implantes de titânio estabeleceram-se, ao longo do tempo, como uma opção de tratamento com grande índice de sucesso. Entretanto, falhas são passíveis de ocorrer, devido à exposição de suas superfícies ao meio bucal, imediatamente ou até muito tempo passado de sua implantação. Estas superfícies de titânio podem se infectar por bactérias e seus produtos, de forma semelhante à que ocorre na superfície de raízes dentais. Tais contaminantes intensificam a resposta inflamatória, além de alterar a estrutura superficial do implante podendo dar origem às doenças peri-implantares, como a mucosite peri-implantar e a peri-implantite. Para o tratamento destas doenças, diversos métodos de descontaminação de superfícies de implantes têm sido propostos, incluindo o uso substâncias anti-sépticas, jatos abrasivos, ácidos, antibióticos e lasers. O objetivo foi avaliar comparativamente a capacidade de descontaminação do peróxido de hidrogênio a 1,5 % (H2O2), do gluconato de clorexidina a 0,12% (CLX) e do soro fisiológico (SF) já que, até o momento, nenhuma metodologia está estabelecida como padrão ouro para a limpeza superficial. Placa bacteriana foi colhida de sítios de doença periodontal crônica para contaminação de discos de titânio de superfícies lisas e rugosas. Posteriormente, os discos foram submersos em 10 mL das substâncias estudadas por 1 minuto, friccionados com swab e enxaguados em solução fisiológica. Discos controle (C) foram somente enxaguados em soro fisiológico. Desta forma resultaram os seguintes grupos de estudo, constituídos de 5 discos de cada tipo de superfície lisa (L) e rugosa (R): H2O2 R , CLXR, SFR, CR, H2O2L, CLXL , SFL e CL. A avaliação do potencial descontaminante das substâncias foi realizada através da quantificação do crescimento bacteriano pela contagem das unidades formadoras de colônia (UFCs) após semeadura em Agar-brucella e incubação em jarra de CO2 a 37oC por 24 horas. Os resultados após descontaminação foram comparados através da análise de variância a dois critérios (ANOVA) e o nível de significância adotado para todos os testes foi de 5%. Os resultados obtidos permitiram concluir que: as bactérias da periodontite crônica têm capacidade de contaminar e aderir aos discos de titânio nos dois tipos de superfícies estudados; as superfícies lisas e rugosas não diferem entre si quanto aos procedimentos de contaminação e de descontaminação propostos; a clorexidina, o peróxido de hidrogênio e o soro fisiológico apresentaram-se eficientes na descontaminação das superfícies de titânio contaminadas in vitro; houve ligeira superioridade na descontaminação pelo tratamento com a clorexidina de ambas as superfícies de titânio avaliadas. / Actually, the titanium implants are a successful option of treatment in Dentistry. However, failures are possible to occur due to surface exposition to oral environment immediately or lately after its implantation. The titanium implants surfaces can be infected by bacteria and its products similarly to dental roots surfaces. The contaminants turn the inflammatory response tissues more intensive and them alter the surface structure of the implant and cause periimplant diseases like mucositis and peri-implantitis. Several methods of treatment for those diseases have been proposed in the literature, including antiseptics rinses, abrasives air powder, acids, antibiotics and lasers. The aim of this work was to comparatively evaluate the potential for decontamination of the hydrogen peroxide at 1,5% (H2O2), the 0,12% chlorhexidine gluconate (CLX) and the saline solution (SF) as cleaning methods, once until this moment there is not a gold standard method established for this purpose. Bacterial plaque harvested from sites of chronic periodontal disease was used to contaminate smooth and rough surfaces of titanium. Subsequently, decontamination procedures were realized by submerging the discs in 10 ml of the studied substances for 1 minute, cleaned by rubbing with swab and washed on saline solution. Control discs (C) were only washed in saline solution. The following test groups composed by 5 discs of each surface, smooth (L) and rough (R):, were then originated: H2O2 R , CLXR, SFR, CR, H2O2L, CLXL , SFL and CL. The decontaminant potential of studied substances was realized by counting the colony forming units after seeding in Agar-brucella, under anaerobiosis condition for 24 hours under 37oC. The data analysis was made by Variance Analysis (ANOVA) at 5% of significance level. The results lead to the following conclusions: the chronic periodontal biofilm adhesion was possible on smooth and rough titanium surfaces; the surface characteristic had no significant influence on contamination and decontamination method, independently of the substance used; clorhexidine, hydrogen peroxide and saline solution were efficient on decontaminating both types of titanium surfaces in vitro with slightly superiority to clorhexidine.

Informe de Seminario para optar al grado de Licenciado en Lengua y Literatura Hispánica mención Literatura

Doctor of Philosophy / Department of Diagnostic Medicine/Pathobiology / Michael W. Sanderson / Shiga-toxin-producing Escherichia coli (STEC), of which enterohemorrhagic E. coli (EHEC) are a pathogenic sub-group, are foodborne pathogens of significant public health importance in the United States. STEC belong to the family Enterobacteriaceae commonly found in the large intestine of humans and other warm-blooded animals. EHEC harbors shiga toxin (stx1 and/or stx2) and eae genes which confers the ability to cause human illnesses. The U.S. Department of Agriculture Food Safety and Inspection Service declared seven STEC (O26, O45, O103, O111, O121, O145, and O157) as adulterants in ground beef and non-intact beef products to reduce/eliminate the burden of the pathogens in the beef production chain. STEC control efforts in the U.S. include the development of quantitative microbial risk assessment (QMRA) to identify mitigation strategies that are effective and economical in reducing exposure and reduce occurrence and public health risk from STEC in the beef chain. Collection of accurate and unbiased data is critical for the development of a QMRA that is valid for decision making. Determining the prevalence and concentration of the seven STEC in the different cattle types and seasons is valuable for the development a valid QMRA for STEC in beef production in the U.S. Our systematic review and meta-analysis study of the prevalence and concentration of E. coli O157 along the beef production chain indicated differences in the fecal prevalence of E. coli O157 among cattle types and seasons, revealed decreasing prevalence and concentration of E. coli O157 on cattle hides and carcass surfaces from pre-evisceration to the final chilled carcass stage, and identified study setting, detection method, hide or carcass swab area, and study design as significant sources of heterogeneity among studies reporting prevalence of E. coli O157 along the beef production chain. Bayesian estimation of the diagnostic performance of three laboratory methods (culture, conventional PCR [cPCR], and multiplex quantitative PCR [mqPCR]) used for the detection of the seven STEC in the feces of cattle is necessary to estimate true prevalence of EHEC in cattle. The analysis revealed highest sensitivity of mqPCR, followed by cPCR, and culture for the detection of E. coli O157; the cPCR and mqPCR had comparable specificity, but specificity of mqPCR method was heavily dependent on prior specification. The mqPCR method was the most sensitive for the detection O26, O45, and O103 serogroups. The cPCR method was more sensitive than the culture method for serogroups O26, and O121, but comparable for serogroups O45, O103, O111, and O145. The cPCR method showed higher specificity than mqPCR within serogroups O45, O121, and O145 but no apparent differences within serogroups O26, O103, and O111. A second order quantitative microbial risk assessment was developed to quantify the prevalence and concentration of the seven STEC on pre-evisceration beef carcasses and evaluate the impact of peri-harvest interventions. Simulation scenarios of current industry peri-harvest intervention practices showed variable effectiveness in reducing STEC contamination on pre-evisceration beef carcass, however, a scenario of increased adoption of peri-harvest interventions was more effective at reducing STEC contamination. Fecal-to-hide transfer and hide-to-carcass transfer had a large effect on prevalence and concentration of STEC on pre-evisceration carcasses.

Master of Music / Department of Music / Frank C. Tracz / The following report is research and analysis from the comprehensive examination question based on the Graduate Conducting Recital of Andrew D. Feyes. The recital, performed by the Kansas State University Symphony Band, was given in McCain Auditorium on the campus of Kansas State University on March 13, 2007 at 7:30pm. The repertoire included Fanfare for La Peri, by Paul Dukas, Concerto for 23 Winds, by Walter S. Hartley, and Incidental Suite, by Claude T. Smith. This examination contains thorough theoretical and historical analyses of the included literature. The report also includes the procedures of planning and performing the graduate conducting recital.

In this dissertation, a novel fast modeling technique called peri-ultrasound that can model both linear and nonlinear ultrasonic behavior of materials is developed and implemented. Nonlinear ultrasonic response can detect even very small material non- linearity. Quantification of the material nonlinearity at the early stages of damage is important to avoid catastrophic failure and reduce repair costs. The developed model uses the nonlocal continuum-based peridynamic theory which was found to be a good simulation tool for handling crack propagation modeling, in particular when multiple cracks grow simultaneously. The developed peri-ultrasound modeling tool has been used to model the ultrasonic response at the interface of two materials in presence of an interface crack. Also, the stress wave propagation in a half-space (or half-plane for a 2-dimensional problem) with boundary loading is investigated using peri-ultrasound modeling. In another simulation, well-established two-dimensional Lamb's problem is investigated where the results are verified against available analytical solution. Also, the interaction between the surface wave and a surface breaking crack is studied.

Magister Educationis - MEd / The study explored the comparison of grade 8 to 10 urban and peri-urban learners' contexts preferences in mathematical literacy. There is currently a strong emphasis on the use of contexts for school mathematics. This has been also the case for South Africa when grade 10 learners have to make a choice between mathematics and mathematical literacy as one of their compulsory subjects for grade 10. This study focused more on the use of mathematics in real life situations. Data was collected by using questionnaires developed as part of the Relevance of School Mathematics Education (ROSME) project. The questionnaire dealt with contexts preferred by grade 10 learners from urban and peri-urban areas. The data were analysed using non-parametric statistical techniques. The findings radicate that there were contexts highly preferred by learners from both urban and peri-urban areas; least preferred by learners from both areas, highly preferred by learners from periurban areas but not by learners from urban areas and least preferred by learners from urban areas but not by those from peri-urban areas and vice versa. It is recommended that contexts highly preferred by learners should be incorporated in the learning experiences of learners. / South Africa

Master of Public Health - MPH / Background:cholera outbreaks have almost become a norm in Lusaka district with the onset of rains.The disease forms part of the preventable diarrhea diseases that have greatly contributed to the high morbidity and mortality rates especially in children under five. In an effort to mitigate the recurrence of cholera in the district of Lusaka, various strategies have been employed to resolve the crisis. However none have investigated the skill or capacity of the public health officers involved in health promotion and disease prevention,themselves. Therefore in this study, focus is turned on one of the integral officers in this public health arena who seem directly involved in preventive health, the Environmental Health Officers. The aim is to clarify their role and skills capacity with the hope of initiating a process of developing appropriate skills and therefore positively contribute to the fight to contain cholera outbreaks.Study Design:this is mainly a qualitative descriptive study that seeks to gain insight into the problem EHOs in Lusaka may be facing in averting cholera outbreaks by exploring in-depth, their attitudes, beliefs and values concerning their role and capacity with consideration to the training they receive to prepare them for their role. The sample was drawn from the EHO’s from 26 health centers under the jurisdiction of the Lusaka Urban District Health Management Team (LUDHMT).Data Collection:data was collected from the EHOs through focus group discussions to scrutinize how their knowledge and experience interact in their setting. Consequently, a few follow-up EHO interviews were done for further clarification of recorded data. Face to face, semistructured interviews were conducted with their supervisors as well as EHO trainers from the two local colleges concerned with EHO training. UWC, SOPH, mini-thesis, Hilary Chibiya, 2520505.May 2009 Analysis of Results:a qualitative approach to data analysis was employed which commenced during data collection through member checking to comparing, coding, categorizing and seeking meaningful interpretations of emerging themes.Discussion and Conclusion:while the EHOs’ perceive themselves essentially as promoters of environmental health,this study discovered that they dwell more on control measures in the matter of cholera out breaks. Even though they feel confident to contain an outbreak they expressed a lack in the level of skills they possessed to enable them to monitor, evaluate and consequently get rid of the all the factors that cause the disease to recur. Inevitably with this lack of self-assurance to eradicate cholera they seem resolved to focusing their resources to adequately prepare for the control of cholera than its prevention, instead. Very importantly, it was found that both policy development and training are to lagging behind the demands of the EHOs current role and their work is hindered by lack of funds specific to prevention activities complicated by an unhealthy donor dependency. There also is a need for all the key players in the environmental Health arena to appreciate the shift in the role of an EHO from the former traditional responsibilities because the incidence of cholera could keep recurring unless all these stakeholders could join forces in training and supporting the EHO appropriately.UWC, SOPH, mini-thesis, Hilary Chibiya, 2520505.May 2009