Viešasis administravimas Lietuvos visuomenės sveikatos politikos įgyvendinimas: Pasvalio rajono mokyklų (1 – 12 klasių) vaikų sveikatos būklės ypatumai. Renata Nevulytė Mokslinis vadovas Prof. habil. dr. Kęstutis Kriščiūnas Šiaulių universitetas, Socialinių mokslų fakultetas, Viešojo administarvimo katedra. Šiauliai, 2011, Psl.sk. 100. Darbo tikslas: išanalizuoti Lietuvos visuomenės sveikatos politikos įgyvendinimo teorinius aspektus, išsiaiškinti Pasvalio rajono mokyklų vaikų sveikatos būklės ypatumus ir edukacines galimybes. Uždaviniai: 1. Išnagrinėti Lietuvos visuomenės sveikatos politikos įgyvendinimo esminius aspektus; 2. Nustatyti vaikų sveikatos ypatumus; 3. Atlikti vaikų sveikatos būklės analizę Pasvalio rajono mokyklose pagal vaiko sveikatos pažymėjimus; 4. Atskleisti vaikų sveikatos stiprinimo edukacines galimybes; Tyrimo hipotezė: tikėtina, kad jaunesnio mokyklinio amžiaus vaikų (1 – 6 kl.) sveikatos įvertinimo rodikliai yra geresni, ir tai sudaro geras prielaidas jų sveikatai išlaikyti ir pasiekti, kad ji neblogėtų, naudojant edukacines priemones, nei vyresnio mokyklinio amžiaus vaikų (7 – 12 kl.). Metodika: 1. Lyginamoji mokslinės literatūros analizė. 2. Mokinių sveikatos vertinimas, remiantis profilaktiniais sveikatos patikrinimų pažymėjimais. 3. Statistinė analizė (Exel programa skaičiuojamas mokinių sergamumas 1000 profilaktiškai pasitikrinusių sveikatą). Buvo skaičiuojami sveikatos pažymėjimų, kuriuos užpildo gydytojai profilaktinių patikrinimų metu... [toliau žr. visą tekstą] / Public Administration The realization of health policy in Lithuania’s society: the peculiarities of children health conditions in the schools of Pasvalys Region (Forms 1-12) Renata Nevulytė Research Adviser: Prof. habil. dr. Kęstutis Kriščiūnas Šiauliai University, Faculty of Social Sciences, Department of Public Administration, 2011, P. 100. The aim of the research: to analyze the theoretical aspects of the realization of health policy in Lithuanian’s society, to pay attention to the peculiarities of children health conditions and educational possibilities in the schools of Pasvalys Region. To achieve the aim the following objectives have been set: 1. To analyze the main aspects of the realization of health policy in Lithuania’s society. 2. To determine the peculiarities of children health. 3. To analyze health condition of children in the schools of Pasvalys Region according to the medical certificate of child. 4. To reveal the educational possibilities of strengthening of children health. The hypothesis of the research: it is believed that the index of health evaluation of younger school-age children (Forms1-6) is higher and it impacts the good assumptions of maintaining their health and to ensure that it does not get worse while using educational tools in comparison with older school-age children (Forms 7-12). Methods of the investigation applied in the work are as follows: 1. The descriptive – theoretical literary analysis. 2. The evaluation of children health was... [to full text]

Transition zone biopsies have been found to increase the detection rates of cancer of the prostate in patients with negative digital rectal examination. There are however no data available whether the higher biopsy rate is associated with greater morbidity. The present study was therefore designed to evaluate the complication rate of extended sextant biopsy. In this prospective study, 162 consecutive patients who presented for prostatic evaluation were included. After starting prophylactic antibiotic treatment 48 h prior to the procedure, transrectal ultrasound-guided core biopsies were obtained from each lobe: three each from the peripheral zone (apex, mid-zone and base) and two from the transition zone of each prostatic lobe. In all patients a questionnaire was obtained 10–12 days after the procedure. Major complications occurred in 3 patients. In 2 of the 3 cases major macroscopic hematuria was treated by an indwelling catheter for 1 or 2 days and 1 patient developed fever >38.5°C for 1 day. Minor macroscopic hematuria was present in 68.5% of the patients. In 17.9% of these cases, the hematuria lasted for more than 3 days. Hematospermia was observed in 19.8% and minor rectal bleeding occurred in 4.9%. Ten-core biopsies did not lead to an increase in adverse effects or complications when compared to the results of sextant biopsies reported in the literature. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Introduction : l’analyse histopathologique des pièces d’annexectomie prophylactique(pBSO) pour risque génétique (mutations BRCA) a pu révéler des anomalies cytologiques etarchitecturales interprétées comme potentiellement pré-cancéreuses et dénommées « dysplasieovarienne et tubaire ». Nous proposons d’étudier les aspects morphologiques,immunohistochimiques et moléculaires des dysplasies tubo-ovariennes.Matériels & Méthodes : l’analyse morphologique a été réalisée dans un premier grouped’annexectomies après stimulation de l’ovulation (protocole de Fécondation in vitro).L’évaluation morphologique et immunohistochimique (expression de Ki67, p53, Bcl2, PAX2et ALDH1) a par la suite concerné 111pBSO, 42 annexectomies exposées au Tamoxifène et116 témoins non cancéreux et spontanément fertiles (nBSO). Les analyses ont été réaliséespar deux pathologistes en aveugle. Les cellules épithéliales d’intérêt ovariennes et tubairesprovenant du groupe pBSO ont été microdisséquées par laser ; l’ADN extrait a été étudié parhybridation génomique comparative (CGH array). La longueur des télomères a été évaluéepar PCR quantitative en temps réel.Résultats : les scores moyens de dysplasie ovarienne et tubaire étaient significativement plusélevés dans les groupes stimulation de l’ovulation et génétique par rapport aux témoins. Seulle score de dysplasie tubaire était supérieur aux témoins pour le groupe Tamoxifène. Onretrouvait une surexpression de ALDH1 dans les groupes pBSO et tBSO alors que Ki67, p53,bcl2 et PAX2 étaient faiblement exprimés dans les groupes pBSO et tBSO. D’ailleurs,l’expression d’ALDH1 était faible dans l’épithélium non dysplasique, forte dans la dysplasieet constamment faible dans les carcinomes occultes. De subtiles altérations génomiques et desraccourcissements télomériques ont été mis en évidence au niveau des dysplasies génétiques.Conclusions : les scores élevés de dysplasie, la forte expression d’ALDH1 et les altérationsmoléculaires provenant du groupe à risque génétique pourraient supporter le conceptd’instabilité génétique. La dysplasie tubo-ovarienne pourrait être une étape importante etprécoce de la carcinogenèse ovarienne. Nos résultats suggèrent également qu’un certainnombre de cancers de l’ovaire pourrait avoir pour origine la trompe de Fallope. Le marqueurde cellules souches ALDH1 pourrait constituer une cible dans la prévention et le diagnosticprécoce des cancers de l’ovaire. / Background: Histopathological examination of material from prophylactic salpingooophorectomies(pBSO) performed in patients at genetic risk has revealed frequentabnormalities interpreted as possible pre-cancerous “ovarian and tubal dysplasia” lesions. Wesought to study the morphologic, immunohistochemical and molecular features in ovarian andtubal dysplasiaMaterials and methods : Morphologic analysis was evaluated in 37 oophorectomies afterovulation induction (iBSO). Morphologic features and immunohistochemical expressionpatterns of Ki-67, p53, Bcl2, PAX2 and ALDH1 (an enzyme significantly associated withearly-stage ovarian cancer) were evaluated in 111 pBSO, 42 salpingo-oophorectomiesexposed with Tamosifen (tBSO) and 116 normal salpingo-oophorectomies (nBSO).Representative slides from formalin-fixed, paraffin-embedded tissue blocks were read blindlyby two gynaecological pathologists. Tubal and ovarian epitheliums from normal anddysplastic tissues (from pBSO) were laser microdissected and studied by comparativegenomic hybridization (array CGH). Telomere length was performed using quantitative realtimePCR.Results: Mean ovarian and tubal dysplasia score were significantly higher in the ovulationinduction group and in the genetic risk group than in controls. Only tubal dysplasia score wassignificantly higher in the Tamoxifen group. Increased ALDH1 expression was observed inpBSO and tBSO compared with nBSO whereas expression patterns of Ki67, p53, bcl2 andPAX2 were low at moderate in pBSO and tBSO group. Interestingly, ALDH1 expression waslow in non dysplastic epithelium, high in dysplasia and constantly low in the carcinoma foundincidentally on pBSO. Subtle genomic alterations were found in the dysplastic ovarian andtubal epitheliums. Shortened telomeres were found in dysplastic tissues from pBSO.Conclusion: The increased dysplasia scores, the strong ALDH1 expression and the geneticalterations in ovaries and tubes from BRCA 1/2 carriers could support the genetic instabilityof dysplasia and might be consistent with progression towards neoplastic transformation andcould justify the use of the term “dysplasia”. Ovarian and tubal dysplasia may be a premalignant,non-invasive histopathological abnormalitie that could be an important step in11early ovarian neoplasia. Our results suggest that a greater percentage of ovarian cancers thanoriginally thought may actually have a fallopian origin with metastasis to the ovary. The stemcell marker ALDH1 activation in pBSO could be considered as a target for early diagnosisand prevention of ovarian cancers.

Made available in DSpace on 2014-12-17T14:13:40Z (GMT). No. of bitstreams: 1 ArianoJFO_TESE.pdf: 4702952 bytes, checksum: 4c768ba0623fffd6e9b8beb9419b70d5 (MD5) Previous issue date: 2011-09-05 / Diversion colitis is a chronic inflammatory process affecting the dysfunctional colon, after a colostomy. It is postulated that nutritional deficiency of the colonic epithelium by the absence of short-chain fatty acids (SCFA) is one of the factors responsible for the appearance of DC and that their employment could reverse the morphological changes of the mucosa. The treatment of choice for fecal diversion colitis (DC) is the reconstruction of the intestinal tract, although they suggested therapeutic options using enemas. This study evaluates the effect of SCFA in atrophy and inflammation in excluded colonic segments before and after the installation DC. Forty Wistar rats were divided into four groups (n = 10 for each group), submitted colostomy with distal colon exclusion. Two control groups (A1 and B1) received rectally administered physiological saline, whereas two experimental groups (A2 and B2) received rectally administered short-chain fatty-acids. The A groups were prophylactically treated (5th to 40th days postoperatively), whereas the B groups were therapeutically treated (after postoperative day 40), for 07 days. Histological sections stained with HE were used for histological analysis of the thickness of the colonic mucosa excluded (t- Student p ≤0.05). Inflammatory reaction of the lamina propria and mucosa were measured with scores previously established (Mann Whitney p ≤ 0.05). There was a significant thickness recovery of the colonic mucosa in group B2 animals (p = 0.0001), which also exhibited a significant reduction in the number of eosinophilic polymorphonuclear cells in the lamina propria (p = 0.0126) and in the intestinal lumen (p = 0.0256). Group A2 did not prevent the mucosal atrophy and significant increases in the numbers of lymphocytes (p=0.0006) and 50 eosinophilic polymorphonuclear cells in the lamina propria of the mucosa (p = 0.0022). Therapeutic use of short-chain fatty-acids significantly reduced eosinophilic polymorphonuclear cell numbers in the intestinal wall and in the colonic lumen; it also reversed the atrophy of the colonic mucosa. Prophylactic use did not impede the development of mucosal atrophy / Colite de deriva??o fecal (CD) ? um processo inflamat?rio cr?nico que acomete o segmento intestinal desfuncionalizado, ap?s a confec??o de colostomia. Postula-se que a defici?ncia nutricional do epit?lio col?nico pela aus?ncia de ?cidos graxos de cadeia curta (AGCC) seja um dos fatores respons?veis pelo surgimento da CD e que o emprego deles poderia reverter as altera??es morfol?gicas da mucosa. O tratamento de elei??o para a colite por deriva??o fecal (CD) ? a reconstru??o do tr?nsito intestinal, embora sejam sugeridas terap?uticas opcionais empregando enemas. O presente estudo visou estudar o efeito dos AGCC na atrofia e inflama??o de segmentos col?nicos exclu?dos, antes e depois da instala??o da CD. Quarenta ratos Wistar foram divididos em quatro grupos (n=10 para cada grupo), todos submetidos a colostomia com exclus?o do c?lon distal. Nos dois grupos controle instilou-se solu??o salina 0,9% por via retal (grupos A1 e B1) e nos dois grupos teste (grupos A2 e B2) AGCC foram instilados por via retal. O grupo A foi submetido a interven??o profil?tica, entre o 5? e o 40? dia de p?s-operat?rio (DPO), enquanto o grupo B foi submetido a interven??o terap?utica a partir o 40? DPO, durante 07 dias. Sec??es histol?gicas coradas com HE foram usadas para an?lise histol?gica da espessura da mucosa do c?lon exclu?do (t de Student com p≤0,05). Rea??o inflamat?ria da l?mina pr?pria e mucosa foi quantificada com escores previamente estabelecidos (teste de Mann Whitney p≤0,05). Houve significante recupera??o da espessura da mucosa col?nica dos animais do grupo B2 (p=0,0001), que, tamb?m, apresentou significativa redu??o da presen?a de xii polimorfonucleares eosin?filos (PNE) na l?mina pr?pria (p=0,0126) e na luz intestinal (p=0,0256). O Grupo A2 n?o preveniu a atrofia da mucosa e mostrou significativo aumento do n?mero de linf?citos (p = 0.0006) e da quantidade de PNE na l?mina pr?pria da mucosa (p = 0.0022). Concluiu-se que o emprego terap?utico de AGCC reduz significativamente o n?mero de polimorfonucleares eosin?filos na parede intestinal e na luz do c?lon, e tamb?m reverte a atrofia da mucosa col?nica. Entretanto, o emprego profil?tico dos AGCC n?o impede o desenvolvimento da atrofia da mucosa

Transition zone biopsies have been found to increase the detection rates of cancer of the prostate in patients with negative digital rectal examination. There are however no data available whether the higher biopsy rate is associated with greater morbidity. The present study was therefore designed to evaluate the complication rate of extended sextant biopsy. In this prospective study, 162 consecutive patients who presented for prostatic evaluation were included. After starting prophylactic antibiotic treatment 48 h prior to the procedure, transrectal ultrasound-guided core biopsies were obtained from each lobe: three each from the peripheral zone (apex, mid-zone and base) and two from the transition zone of each prostatic lobe. In all patients a questionnaire was obtained 10–12 days after the procedure. Major complications occurred in 3 patients. In 2 of the 3 cases major macroscopic hematuria was treated by an indwelling catheter for 1 or 2 days and 1 patient developed fever >38.5°C for 1 day. Minor macroscopic hematuria was present in 68.5% of the patients. In 17.9% of these cases, the hematuria lasted for more than 3 days. Hematospermia was observed in 19.8% and minor rectal bleeding occurred in 4.9%. Ten-core biopsies did not lead to an increase in adverse effects or complications when compared to the results of sextant biopsies reported in the literature. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Aufgrund der verfügbaren Literatur und Daten ist nicht erwiesen, dass eine prophylaktische Thrombozytentransfusion nach myeloablativer Chemotherapie notwendig oder für den Patienten vorteilhaft ist. Die im Verlauf der Jahre immer weiter gesenkten Schwellenwerte zur prophylaktischen Thrombozytentransfusion legten nahe, die Möglichkeit zu überprüfen, auf eine prophylaktische Substitution ganz zu verzichten und nur im Falle relevanter Blutungen zu transfundieren. Mit der hier ausgewerteten Studie liegen erstmals Daten aus einer multizentrischen, prospektiv randomisierten Studie zum Vergleich einer prophylaktischen mit einer therapeutischen Transfusionsstrategie für Thrombozyten nach autologer Stammzelltransplantation vor: es wurde eine prophylaktische Thrombozytentransfusion bei Thrombozytenwerten ≤ 10/nl mit einer neuen Transfusionsstrategie (Substitution nur bei relevanter Blutung oder definierten Risikosituationen) verglichen. Mit der experimentellen, therapeutischen Transfusionsstrategie für Thrombozyten kann eine Reduktion der Thrombozytentransfusionen um ca. 50% im Vergleich zu dem etablierten prophylaktischen Transfusionsregime erreicht werden: bei den hier untersuchten 92 Patienten wurden im experimentellen Arm für 47 Patienten nur 37 Thrombozytenkonzentrate benötigt, für die 45 prophylaktisch behandelten Patienten wurden insgesamt 71 Thrombozytenkonzentrate verbraucht. Die experimentelle therapeutische Transfusionsstrategie für Thrombozyten führte zu keiner statistisch signifikanten Zunahme von Blutungskomplikationen; auch bei der Anzahl der benötigten Erythrozytentransfusionen gab es keine signifikanten Unterschiede; Nebenwirkungen der Transfusionen, Dauer der Thrombopenie und Anzahl der Tage im Krankenhaus waren ebenso nicht signifikant unterschiedlich. Das Risiko, während der Beobachtungszeit (Chemotherapie und autologe Stammzelltransplantation bis zur Regeneration der Thrombozytenwerte), eine Blutung zu erleiden, lag insgesamt bei 14.1%; im experimentellen Arm lag das Risiko bei 19.2%, bei den prophylaktisch substituierten Patienten bei 8.9%; dieser Unterschied war statistisch nicht signifikant, ohnehin traten bei den beobachteten Patienten nur milde, klinisch wenig bedeutsame Blutungen des WHO – Schweregrades < 3 auf, es kam zu keinen blutungsassoziierten Todesfällen Bei klinisch stabilen Patienten und sorgfältiger Überwachung ist ein therapeutisches Transfusionsregime für Thrombozyten nach autologer Stammzelltransplantation praktikabel und sicher anwendbar, die Sicherheit dieses Vorgehens bei Patienten nach autologer Stammzelltransplantation wird mit der vorliegenden randomisierten Studie belegt. Eine therapeutische Thrombozytentransfusionsstrategie ist vermutlich bei einer Vielzahl weiterer hämato-onkologischer Patienten bzw. Krankheitsbilder ausreichend und kann unter signifikanter Einsparung kostbarer Thrombozytenkonzentrate bedrohliche Blutungen ebenso aufhalten oder verhindern wie ein prophylaktisches Regime.

Bakgrund: Sexualitet spelar en betydande roll i kvinnors liv genom alla dess faser. Mastektomi är en operation som anses vara den vanligaste behandling vid bröstcancer, där bröstvävnad som innehåller tumören tas bort. Att leva utan bröst eller med ett bröst kan påverka sexlivet. Sjuksköterskans roll vid postmastektomi till kvinnor som lider av sexuell ohälsa är att erbjuda stödsamtal där kvinnorna uppmuntras och vägledas till att lära sig olika strategier för att anpassa sig. På så vis kan fortsatt sexuellt välbefinnande uppnås. Syfte: ​​Att beskriva kvinnors upplevelse av sexuell hälsa efter genomgången mastektomi till följd av bröstcancer.​ Metod: Vår litteraturöversikt inkluderades både kvalitativa och blandad metodforskning men stor fokus låg på kvalitativa forskning. Originalartiklarna granskades och resultaten analyserades sedan. Databaserna som används för att söka fram artiklar är CINAHl Complete och Pubmed. Resultat: Resultatet är indelad i fyra huvudteman: Olika upplevelser av intimitet med sin partner, förändringar i kroppsuppfattning, förlust av kvinnlighet och betydelsen av stöd. Kvinnor som förlorar bröstet efter mastektomi kämpar med sin kroppsuppfattning och känner sig mindre attraktiva och feminina. De upplever en rad av känslor som rädsla, skam och brist på självförtroende. Detta har en betydandepåverkan på deras intima och sexuella liv. Kvinnorna som genomgick bröstrekonstruktion upplever en förbättring på av sin sexuella funktion. Stöd från partner och sjukvården är avgörande för att förbättra kvinnors sexuella hälsa, dock upplever många kvinnor en bristande kommunikation och information från sjukvården. Slutsats: ​​​Det har kommit fram att kvinnorna som genomgick transition från sexuell hälsa till sexuell ohälsa efter mastektomi upplevde utmaningar och svårigheter som påverkade deras intima liv och självbild. Författarna understryker vikten av att erbjuda stöd och mer omfattande information till kvinnor angående deras sexualitet. Det har även kommit fram behovet av ytterligare forskning för att förstå olika åldersgruppers upplevelser, samt de olika kulturella faktorer som kan påverkar sexuell hälsa hos kvinnor. Kvinnors självförtroende och kroppsuppfattning har betydligt påverkats av både självstigmatisering och stigmatisering från deras omgivning. / Background: Sexuality plays a significant role in women's lives through all its phases. Mastectomy is an operation that is considered the most common treatment for breast cancer, where breast tissue containing the tumor is removed. Living without breasts or with one breast can affect sexual life. The nurse's role in postmastectomy for women suffering from sexual dysfunction is to offer support conversations where the women are encouraged and guided to learn different strategies to adapt. In this way, continued sexual well-being can be achieved. Aim: To describe women's experience of sexual health after undergoing mastectomy due to breast cancer. Method: Our literature review included both qualitative and mixed method research, but a large focus was on qualitative research. The original articles were reviewed and the results were then analyzed. The databases used to search for articles are CINAHl Complete and Pubmed. Results: ​​The results are divided into four main themes: Different experiences of intimacy with one's partner, changes in body image, loss of femininity and the importance of support. W​omen who lose their breasts after mastectomy struggle with their body image and feel less attractive and feminine. They experience a range of emotions such as fear, shame and lack of self-confidence. This has a significant impact on their intimate and sexual life. The women who underwent breast reconstruction experience an improvement in their sexual function. Support from partners and the healthcare system is crucial to improving women's sexual health, however, many women experience a lack of communication and information from the healthcare system.​​ Conclusions: ​​​It has emerged that the women who underwent a transition from sexual health to sexual ill health after mastectomy experienced challenges and difficulties that affected their intimate life and self-image. The authors emphasize the importance of offering support and more comprehensive information to women regarding their sexuality. It has also come to light the need for further research to understand the experiences of different age groups, as well as the different cultural factors that can affect sexual health in women. Women's self-confidence and body image have been significantly affected by both self-stigmatization and stigmatization from those around them.​

Made available in DSpace on 2016-08-16T18:18:43Z (GMT). No. of bitstreams: 1 Tese Rubenice Amaral da Silva.pdf: 3698265 bytes, checksum: d8b1cb53cd343090f7b5607ad5d40e90 (MD5) Previous issue date: 2012-04-26 / Anacardium occidentale, family Anacardiaceae, is popularly known as cashew tree and it is widely used as food and medicine. This study aimed to review data on antimicrobial properties of Anacardium occidentale, to evaluate the antioxidant and antimicrobial action and to investigate the chemical composition of the extracts of flowers (EBFL), leaves (EBFO) and stem bark (EBC) of A. occidentale, to evaluate the antimicrobial activity of the byproduct obtained in order to use it in the prophylaxis and adjunctive treatment of caries. This review considered publications by Medline, Lilacs, Scielo, Chemical Abstracts, PubMed, Biological Abstract, Web of Sciences and Highwire, between 1980 and 2011, using the descriptors: Anacardium occidentale, antimicrobial, antibacterial, antifungal and pharmacological activity and cashew. The antioxidant activity was determined by DPPH assay and the antimicrobial activity by agar diffusion, broth dilution, determination of the minimum bactericidal concentration (MBC) or minimum fungicide concentration (MFC), using standard strains of Streptococcus mutans, Lactobacillus acidophilus, Staphylococcus aureus, MRSA, Enterococcus faecalis, Streptococcus pyogenes, Pseudomonas aeruginosa, Proteus mirabilis, Escherichia coli, Klebsiella pneumoniae, Helicobacter pylori and Candida albicans and clinical samples of Salmonella choleraesuis, Candida albicans and Candida tropicalis. The chemical composition was determined by colorimetry, chromatography and spectroscopy. The EBFL, more active, was fractionated and the fractions were also evaluated for antibacterial action. Regarding the literature review, 44 articles and 3 dissertations about antimicrobial properties of cashew tree were found. Bark extracts were the mostly used in those researches (30%). Staphylococcus aureus, including MRSA strains were the most studied microorganisms (68%). All extracts have showed antioxidant activity compared to quercetin. On the other hand, the result of experimental protocols showed that the EBFL was presented as the one with the most active antimicrobial action against all microorganisms evaluated either in planktonic cultures or the biofilm. The fraction F1 and bioproduct-based EBFL have also showed potent antimicrobial activity. In EBFL there were identified organic acids, alkaloids, phenolics, hydrolysable tannins, flavones, flavonols, xanthines, steroids and triterpenes. This is the first research on the antioxidant and antimicrobial properties of the flowers of A. occidentale on the prophylactic and therapeutic use in oral diseases, particularly caries and candidiasis, activities that may be related to the presence of flavonoids, tannins, organic acids, alkaloids and phenolic compounds such as anacardic acid, cardol and cardanol. / Anacardium occidentale L. (Anacardiaceae), espécie nativa do Brasil, é conhecida popularmente como cajueiro e muito utilizada como alimento e medicamento. O presente estudo teve como objetivos: organizar os dados publicados sobre as propriedades antimicrobianas de Anacardium occidentale, avaliar a ação antioxidante e antimicrobiana e investigar a composição química dos extratos das flores (EBFL), folhas (EBFO) e da casca do caule (EBC) de A. occidentale e avaliar a atividade antimicrobiana de um bioproduto obtido, visando sua utilização na profilaxia e tratamento auxiliar da cárie. A revisão considerou publicações de: Medline, Lilacs, Scielo, Chemical abstracts, PubMed, Biological Abstract, Web of Sciences e Highwire, entre 1980 e 2011, usando como descritores: Anacardium occidentale e as atividades antimicrobiana, antibacteriana, antifúngica e farmacológica e caju. A ação antioxidante foi determinada pelo ensaio de 2,2-difenil-picrilhidrazila (DPPH) e a antimicrobiana por difusão em agar, diluição em caldo e determinação da concentração bactericida (CBM) ou fungicida (CFM) mínima, utilizando cepas padrão de Streptococcus mutans, Lactobacillus acidophilus, Staphylococcus aureus e MRSA, Enterococcus faecalis, Streptococcus pyogenes, Pseudomonas aeruginosa, Proteus mirabilis, Escherichia coli, Klebsiella pneumoniae, Helicobacter pylori, Candida albicans e amostras clínicas de Salmonella choleraesuis, Candida albicans e Candida tropicalis. A composição química foi determinada por colorimetria, cromatrografia e espectroscopia. Do extrato das flores (EBFL), o mais ativo, foram obtidas frações que foram avaliadas quanto à ação antimicrobiana. Em relação a revisão de literatura foram encontrados 44 artigos e 3 dissertações sobre propriedades antimicrobianas do cajueiro. A maioria dos estudos utilizou extratos da casca (30%) e Staphylococcus aureus, incluindo as cepas MRSA, foram os micro-organismos mais estudados (68%). Nos ensaios para determinar a atividade antioxidante todos os extratos apresentaram valores semelhantes a quercetina, utilizada como controle positivo. Os resultados dos protocolos experimentais mostraram que o EBFL apresentou ação antimicrobiana mais efetiva por inibir o crescimento de todos os micro-organismos testados, tanto em culturas planctônicas como no biofilme. A fração F1 e um bioproduto à base de EBFL também apresentaram potente ação antimicrobiana sendo tão efetivos sobre micro-organismos cariogênicos quanto à clorexidina. No EBFL foram identificados ácidos orgânicos, alcaloides, compostos fenólicos, taninos hidrolisáveis, flavonas, flavonóis, xantinas, esteroides e triterpenos. Concluímos que as propriedades antimicrobianas e antioxidantes das flores podem estar relacionadas à presença de flavonoides e/ou de compostos fenólicos tais como ácidos anacárdicos, cardol e cardanol. Importante ressaltar que este trabalho é o primeiro relato sobre de A. occidentale quanto ao uso profilático e terapêutico em doenças bucais, em especial, a cárie e a candidíase.

Abstract Computed tomography (CT) and interventional procedures cause relatively high patient doses compared with other imaging modalities in radiology. The optimization of the imaging equipment and procedures is important and necessary due to the known risks caused by ionization radiation. The different irradiation geometries and dose units between imaging techniques complicate the comparison of patients’ radiation exposure. Absorbed doses (D) of organs predict the tissue reactions of the procedures, while effective dose (E) is a useful means of comparing the stochastic effects of the different imaging procedures. A and E can be estimated from dosimetric measurements in a phantom. In vivo measurements are used during a radiological examination. In the present thesis, various properties of radiophotoluminescence dosimeters (RPLD) were investigated to verify the applicability of RPL dosimetry in radiology. The absorbed dose was determined in vaginal fornix of seven pregnant women, in the area near the head of the fetus during prophylactic catheterization before uterine artery embolization (UAE). The evaluation of the radiation exposure of digital subtraction angiography (DSA) and computed tomography angiography (CTA) was performed using an anthropomorphic phantom. Absorbed doses of organs and effective dose were determined for a typical four-vessel angiography of the cerebral area, including intracranial vessels, and for the cervicocerebral area, including both cervical and intracranial vessels. RPLD shows excellent dose linearity and minimal fading. The low dose detection threshold was determined to be 20 µGy with a coefficient of variation (CV) of 12.2%. The methodology is independent of photon energy in the energy range used in radiology. For seven patients studied, the mean value of D in vaginal fornix was 11.2 mGy (range 2.2–28.7) being low dose study when pulsed fluoroscopy with an optimized protocol is used without angiography exposures. In the assessment of cerebral vessels, the effective dose for CTA was approximately one-fifth of the dose compared with DSA. The dose for cervicocerebral vessels CTA was approximately one third higher compared with DSA. Conversion factors from the DAP and the DLP to the effective dose were calculated for the specific angiographic protocols. RPL dosimetry shows sufficient reliability in measuring radiation doses in radiology. / Tiivistelmä Tietokonetomografiakuvauksissa ja toimenpideradiologisissa tutkimuksissa potilaan säteilyaltistus on suhteellisesti korkeampi verrattuna muihin radiologisiin kuvausmenetelmiin. Kuvauslaitteiden erilaiset kuvausgeometriat ja annosyksiköt hankaloittavat potilaan säteilyaltistuksen vertailua eri tutkimusmenetelmien välillä. Kudokseen absorboituneen annoksen (D) avulla arvioidaan ionisoivan säteilyn suoraa haittavaikutusta kudokselle, kun taas efektiivisen annoksen (E) määrittämisellä arvioidaan säteilyn satunnaista haittaa. D ja E voidaan mitata annosmittarilla käyttäen potilasvastinetta. In vivo mittauksella saadaan annostietoa tutkimuksen aikana suoraan potilaasta. Radiofotoluminesenssiannosmittarin (RPLD) soveltuvuus radiologisiin annosmittauksiin varmistettiin tutkimalla mittarin eri fysikaalisia ominaisuuksia. RPLD:a käytettiin intravaginaalisen annoksen mittauksessa seitsemällä raskaana olevalla naisella. Potilaille tehtiin massiivisen verenvuodon ehkäisemiseksi kohdun valtimosuonten katetrointi läpivalaisuohjattuna ennen kohtuvaltimoiden tukkimishoitoa (UAE). Mittaustulokset antavat tietoa kudokseen absorboituneesta annoksesta lähellä syntymätöntä lasta. Tietokonetomografia-angiografia (TTA) ja digitaalinen subtraktioangiografia (DSA) tutkimusten annosmittaukset tehtiin potilasvastineessa käyttäen RPLD:a. Elinannoksista laskettiin efektiivinen annos aivovaltimoiden ja aivokaulavaltimoiden angiografiatutkimuksille. RPL -annosmittausmenetelmän havaittiin olevan lineaarinen ja annoksen häviäminen mittarista on vähäistä. Matalan annoksen mittausraja oli 20 µGy 12.2% toistettavuudella. RPLD on riippumaton säteilyenergiasta radiologiassa käytettävällä energia-alueella. Seitsemän potilaan keskimääräinen absorboitunut annos oli 11.2 mGy (vaihteluväli 2.2–28.7 mGy) emättimen pohjukasta mitattuna. Annostaso osoittaa, että katetrointitoimenpide on matala-annostutkimus, kun toimenpide tehdään läpivalaisuohjauksessa, eikä angiografisia kuvia käytetä. Aivovaltimoiden TTA:n efektiivinen annos oli viidesosa DSA menetelmän annoksesta. Aivokaulavaltimoiden TTA:n efektiivinen annos oli arviolta 35% korkeampi kuin DSA menetelmän annos. Konversiokertoimet DAP ja DLP yksiköistä efektiivisen annoksen laskemiseksi määritettiin tutkimuksessa käytetyille kuvausohjelmille. RPL -menetelmä osoitti riittävää luotettavuutta radiologisten säteilyannosten mittauksessa.

Background: Prophylactic mastectomies in carriers of mutations in BRCA1 or BRCA2 are becoming increasingly more accepted. We investigated the outcome after prophylactic mastectomy, especially regarding satisfaction with the procedure, in a monocenter study. Methods: BRCA1/2 mutation carriers and non-carriers with elevated pedigree-based cancer risk were followed prospectively in a structured surveillance program between 2000 and 2017. A retrospective telephone survey was conducted among all patients with documented prophylactic mastectomy. Complications and satisfaction with the decision for prophylactic mastectomy were recorded. Results: 39 patients who opted for a prophylactic mastectomy (38 BRCA1/2 mutation carriers and 1 noncarrier) were interviewed. Mostly nipple-sparing mastectomy with reconstruction was performed (87%). Half of the patients (22/39; 56.4%) had a history of unilateral breast cancer. The median time since prophylactic mastectomy was 5.6 years. While 61.5% did not report any complications, flap loss was seen in 15% (3/20) and moderate limitations in everyday life were present in 20% (7/35). An improvement in quality of life was noticed by 82% after prophylactic mastectomy and no patient expressed regret with regard to the decision. Conclusions: Prophylactic mastectomy is a procedure with risk for long-term complications in some cases. Our results confirm high satisfaction with the decision and improved quality of life.