A hérnia perineal é uma enfermidade que ocorre comumente em cães machos, principalmente não castrados com faixa etária entre cinco e 14 anos. A etiologia é desconhecida, sendo que vários fatores já foram associados tais como alterações hormonais, neurogênicas ou características anatômicas. Sabe-se que a atrofia muscular, principalmente do músculo elevador do ânus, está relacionada diretamente com o desenvolvimento da hérnia perineal e, de acordo com os músculos envolvidos, é classificada em caudal, dorsal, ventral ou ciática. Várias técnicas cirúrgicas foram descritas para sua correção, porém as taxas de complicações e recidivas são elevadas, sem que tenha havido avaliações comparativas das técnicas e determinação de qual é mais adequada para cada caso. Portanto, objetivou-se com o presente estudo a avaliação crítica das técnicas de herniorrafia perineal realizadas em cães machos, por meio da colimação dos resultados coligidos em trabalhos científicos observados na literatura. Para tanto foi realizada uma busca nas bases de dados referenciais eletrônicas Embase, Google Acadêmico, PubMed, SciELO, Science Direct e Web of Science. Os processos de reparação de hérnia perineal tais como a técnica de sutura padrão, transposição do músculo obturador interno; transposição do músculo glúteo superficial; transposição do músculo semitendinoso; reparação com uso de membranas sintéticas ou biológicas; e colopexia associada ou não a cistopexia foram avaliados quanto à presença de complicações e recidivas. Com a busca por meio das bases de dados referenciais eletrônicas obteve-se 5311 resultados em português e inglês. A busca manual resultou na obtenção de outros 41 artigos. Após avaliação do título e resumo, exclusão dos resultados repetidos, e leitura do texto completo, foram selecionados 30 artigos de acordo com os critérios de inclusão e exclusão. Baseando-se na comparação e avaliação dos resultados é possível concluir que existe falta de dados clínicos padronizados bem como informações sobre o tempo de acompanhamento pós-operatório e taxas de recidiva extremamente variáveis, dificultando estabelecer paralelo entre o nível de gravidade da enfermidade com as complicações advindas após realização das diferentes técnicas cirúrgicas preconizadas, dificultando a avaliação da eficácia de tais técnicas / Perineal hernia is a disease that occurs commonly in male dogs, especially uncastrated aged between five and 14 years. The etiology is unknown, and several factors have been associated such as hormonal, neurogenic or anatomical features changes. It is known that muscle atrophy, mainly of the levator ani muscle, is directly related to the development of perineal hernia and, according to the involved muscles, it is classified into caudal, dorsal, ventral or sciatica. Several surgical techniques have been described for its repair, but the complications and recurrences rates are high, without there have been comparative evaluation techniques and determination of which is more appropriate for each case. Therefore, the present study had the objective of critically evaluate the perineal hernia repair techniques performed in male dogs through collimation of the results collected in scientific studies reported in the literature. Therefore it was carried out a search in the electronic reference databases Embase, Google Scholar, PubMed, SciELO, Science Direct and Web of Science. The perineal hernia repair procedures such as standard suture technique, transposition of the internal obturator muscle; transposition of superficial gluteal muscle; transposition of semitendinosus muscle; repair with the use of synthetic or biological membranes; and colopexy with or without cistopexia were evaluated for the presence of complications and recurrences. With the search through the electronic reference databases, it was obtained 5311 results in Portuguese and English. The manual search resulted in obtaining another 41 articles. After evaluation of the title and abstract, excluding the repeated result and reading the full text, it was selected 30 articles according to the inclusion and exclusion criteria. Based on the comparison and evaluation of the results it is possible to conclude that there is a lack of standardized clinical data as well as information about the time of postoperative follow-up and extremely variable recurrences rates, making it difficult to establish a parallel between the level of the disease severity with complications arising after implementation of the various preconized surgical techniques, making it difficult to evaluate the effectiveness of such techniques

Orientador: Marcio de Moraes / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-04T00:42:43Z (GMT). No. of bitstreams: 1 MauretteO¿Brien_PaulEdward_M.pdf: 2138527 bytes, checksum: 184b6be2a89636c5de2b0ea675777d7a (MD5) Previous issue date: 2004 / Resumo: O propósito deste estudo foi avaliar retrospectivamente os casos de queratocistos odontogênicos (QO) tratados pela Área de Cirurgia Buco-Maxilo-Facial da Faculdade de Odontologia de Piracicaba da Universidade Estadual de Campinas (FOP-Unicamp), entre os anos 1995 e 2004. Foram avaliadas as características clínicas, histológicas e a eficácia do protocolo de tratamento em 28 pacientes com diagnóstico histológico de queratocisto odontogênico. Observou-se maior prevalência em mulheres (67,9%) de cor branca (57,1%), com idade média de 30 anos. A maioria das lesões estavam localizadas na região de ângulo e ramo mandibular (53,3%) e tinham padrão histológico paraqueratinizado (70%). Do total dos 28 pacientes, 13 (46,4%) apresentavam dente incluso envolvido na lesão. Inicialmente todos os pacientes foram submetidos a biópsia e tratados principalmente por descompressão e posterior curetagem da lesão remanescente (67,85%). O tempo médio de descompressão foi de 9,27 meses. Houve recorrência em 4 pacientes (14,3%), os quais tinham sido tratados com descompressão e curetagem (2 casos) ou unicamente com descompressão (2 casos). Todos os casos de recorrência foram tratados por meio de enucleação e curetagem associado a ostectomia periférica da cavidade óssea remanescente. O tempo médio de proservação de todos os pacientes da amostra foi de 24 meses, (mais ou menos 9,74). De acordo com os resultados podemos concluir que, dentro das características da amostra atendida, os pacientes são em sua maioria, mulheres adultas de cor branca, tratadas principalmente por meio de descompressão da lesão e apresentando taxas de recorrência similares à relatadas na literatura, demonstrando que o tratamento conservador do queratocisto odontogênico por meio do protocolo utilizado mostrou-se eficaz, de baixa morbidade e com índices de recorrências dentro da média relatada na literatura. No entanto, é necessário a contínua proservação buscando os resultados em longo prazo / Abstract: The aim of our study was to retrospectively evaluate all odontogenic keratocysts (OKC) cases treated in the Oral and Maxillofacial Surgery Department of Piracicaba Dental School at Campinas State University in Sao Paulo, Brazil between 1995 and 2004. This study evaluated clinical and histological characteristics of 28 patients all diagnosed with OKC by histopathology analysis and compared the data with that published in the literature. OKC was more prevalent in white (57.1%) and young (average age 30 years) females (67.9%). Most of the lesions (53.3%) occurred in the angle of the mandible and mandibular ramus. The most common histological pattern of OKC was parakeratinazed (70%) and 13 (46.4%) out of 28 patients presented impacted teeth associated with the lesion. Initial biopsy was performed in all patients and all cases were treated according to the Department of Oral and Maxillofacial Surgery Protocol, which consists mainly of decompression followed by curettage of the remaining lesion. The mean time for decompression was 9.27 months. Recurrence occurred in 4 patients (14.3%), who were initially treated with decompression and curettage (2 cases), or with decompression only (2 cases). All recurrent cases were submitted to enucleation and curettage of the remaining bone cavity. The average follow-up time for the 28 cases was 24 months (more or less 9,74). According to these results, we can conclude that adult white females treated for OKC with decompression, present similar recurrence rates to those reported in the literature. This Department of Oral and Maxillofacial Surgery¿s treatment protocol for OKC offers a conservative and effective option with low morbidity and similar recurrence rates to those reported in the literature. However, a long term follow-up is necessary to confirm these conclusions / Mestrado / Cirurgia e Traumatologia Buco-Maxilo-Faciais / Mestre em Clínica Odontológica

Background - Current guidelines suggest that all cancer patients with venous thrombosis be treated with long-term low molecular weight heparin. Whether treatment strategies should vary according to clinical characteristics remains unknown. // Systematic review - A systematic review was performed to determine current understanding of the association between malignancy characteristics in patients with cancer-associated VTE and the risk of VTE recurrence. Four retrospective and 6 prospective studies were included. They suggest that lung cancer, metastases, and adenocarcinomas confer an increased the risk of recurrence and breast cancer a low risk. // Survey - I performed survey to evaluate thrombosis experts’ opinion about the low risk of VTE recurrence they would consider acceptable for patients with cancer- associated thrombosis 103 specialists participated. 80% of respondents agreed that a risk of recurrent VTE during anticoagulation below 7% is low enough. 92% agreed that a CPR that categorizes risk of recurrence is relevant. // Retrospective Study - I performed a single retrospective cohort study to assess the feasibility of derivation of a CPR that stratifies VTE recurrence risk in patients with cancer–associated thrombosis. The study included 543 patients. A multivariate analysis selected female, lung cancer and prior history of VTE as high risk predictors and breast cancer and stage I disease as low risk. // Conclusion - Patients with cancer-associated thrombosis do have varying risks of recurrent VTE depending on clinical characteristics.

Nosocomial infections represent for the health care providers serious economical and also health complications. The aim of this thesis is a comprehensive presentation of nosocomial infections. Second part focuses on a bacteria Clostridium difficile. This thesis analyzes epidemiological situation in a particular medical care facility together with the cost of therapy. The incidence of Clostridium difficile is, despite of the worldwide increasing trend, decreasing in the selected facility. Significant differences exist among individual departments in the amount of samples collected as well as in their rate of positivity for the bacteria presence. Data collected are applied to a German pharmacoeconomic model which compares vancomycin therapy with fidaxomicin therapy. On a group of 100 patients it was proved that more efficient is, despite of its higher price, treatment by fidaxomicin because it leads to a lower percentage of recurrences and morbidity and mortality decrease.

This study attempts to explain why some countries experience multiple civil wars while others who have experienced a civil war build long-term stability from the rubble of conflict. The explanation of why civil war recurs focuses on the collective action problem, centering on the rebel leaders' ability to solve the Rebel's Dilemma. I further argue that once the Rebel's Dilemma has been solved once it is much easier for rebel leaders to solve it again and again. The empirical finds suggest that the political situation resulting from the first war plays a strong role in the solutions to the collective action problem and thus the long-term stability following a civil war. Namely, the level of democracy, partition and third party enforcement of the peace all affect the ability of the rebel leaders to solve the collective action problem and the likelihood of another civil war.

Un cadre statistique bayésien a été créé dans le cadre de cette thèse pour le développement de modèles cliniques basés sur une approche d’apprentissage continu dans laquelle de nouvelles données peuvent être ajoutées. L’objectif des modèles est de prévoir les effets de la radiothérapie à partir de preuves cliniques. Des concepts d’apprentissage machine ont été utilisés pour résoudre le cadre bayésien. Les modèles développés concernent un cancer du cerveau agressif appelé glioblastome. Les données médicales comprennent une base de données d’environ 90 patients souffrant de glioblastome ; la base de données contient des images médicales et des entrées de données telles que l’âge, le sexe, etc. Des modèles de prévision neurologique ont été construits pour illustrer le type de modèles qui sont obtenus avec la méthodologie. Des modèles de récidive du glioblastome, sous la forme de modèles linéaires généralisés (GLM) et de modèles d’arbres de décision, ont été développés pour explorer la possibilité de prédire l’emplacement de la récidive à l’aide de l’imagerie préradiothérapie. Faute d’une prédiction suffisamment forte obtenue par les modèles arborescents, nous avons décidé de développer des outils de représentation visuelle. Ces outils permettent d’observer directement les valeurs d’intensité des images médicales concernant les lieux de récidive et de non-récurrence. Dans l’ensemble, le cadre élaboré pour la modélisation des données cliniques en radiothérapie fournit une base solide pour l’élaboration de modèles plus complexes. / A Bayesian statistics framework was created in this thesis work for developing clinical based models in a continuous learning approach in which new data can be added. The objective of the models is to forecast radiation therapy effects based on clinical evidence. Machine learning concepts were used for solving the Bayesian framework. The models developed concern an aggressive brain cancer called glioblastoma. The medical data comprises a database of about 90 patients suffering glioblastoma; the database contains medical images and data entries such as age, gender, etc. Neurologic grade predictions models were constructed for illustrating the type of models that can be build with the methodology. Glioblastoma recurrence models, in the form of Generalized Linear Models (GLM) and decision tree models, were developed to explore the possibility of predicting the recurrence location using pre-radiation treatment imaging. Following, due to the lack of a sufficiently strong prediction obtained by the tree models, we decided to develop visual representation tools to directly observe the medical image intensity values concerning the recurrence and non-recurrence locations. Overall, the framework developed for modeling of radiation therapy clinical data provides a solid foundation for more complex models to be developed.

In this dissertation, we provide combinatorial methods to obtain the probabilistic mul-tivariate generating function that counts the occurrences of patterns in a text generated by a Markovian source. The generating function can then be expanded into the Taylor series in which the power of a term gives the size of a text and the coeÿcient provides the proba-bilities of all possible pattern occurrences with the text size. The analysis is on the basis of the inclusion-exclusion principle to pattern counting (Goulden and Jackson, 1979 and 1983) and its application that Bassino et al. (2012) used for obtaining the generating function in the context of the Bernoulli text source. We followed the notations and concepts created by Bassino et al. in the discussion of distinguished patterns and non-reduced pattern sets, with modifications to the Markovian dependence. Our result is derived in the form of a linear matrix equation in which the number of linear equations depends on the size of the alphabet. In addition, we compute the moments of pattern occurrences and discuss the impact of a Markovian text to the moments comparing to the Bernoulli case. The methodology that we use involves the inclusion-exclusion principle, stochastic recurrences, and combinatorics on words including probabilistic multivariate generating functions and moment generating functions.<br>

Many angiosperms have undergone some series of polyploidization events over the course of their evolutionary history. In these genomes, especially those resulting from multiple autopolyploidization, it may be relatively easy to recognize all the sets of n homeologous chromosomes, but it is much harder, if not impossible, to partition these chromosomes into n subgenomes, each representing one distinct genomic component of chromosomes making up the original polyploid. Thus, if we wish to infer the polyploidization history of the genome, we could make use of all the gene trees inferred from the genes in one set of homeologous chromosomes to construct a consensus tree, but there is no evident way of combining the trees from the different sets because we have no labelling of the chromosomes that is known to be consistent across these sets. We suggest here that lacking a consistent leaf-labelling, the topological structure of the trees may display sufficient resemblance so that a higher level consensus could be revealing of evolutionary history. This would be especially true of the peripheral structures of the tree, likely representing events that occurred more recently and have thus been less obscured by subsequent evolutionary processes. Here, we present a statistical test to assess whether the subgenomes in a polyploid genome could have been added one at a time. The null hypothesis is that the accumulation of chromosomes follows a stochastic process in which transition from one generation to the next is through randomly choosing an edge, and then subdividing this edge in order to link the new internal vertex to a new external vertex. We analyze the probability distributions of a number of peripheral tree substructures, namely leaf- or terminal-pairs, triples and quadruples, arising from this stochastic process, in terms of some exact recurrences. We propose some conjectures regarding the asymptotic behaviours of these distributions. Applying our analysis to a sugarcane genome, we demonstrate that it is unlikely that the accumulation of subgenomes has occurred one at a time in this genome.

Eighty-four patients who were endoscopically confirmed to have healed duodenal ulcers were entered into this 1 year, double-blind, placebo-controlled trial of sucralfate, lg twice daily, in the prevention of duodenal ulcer recurrence. Patients remained in the study until recurrence of ulceration was endoscopically confirmed. Sixty-one patients could be evaluated for efficacy of treatment. Within 6 months, 23 of 31 placebo patients (74%) and 6 of 30 sucralfate patients (20%) had ulcer recurrence. At 12 months, 25 of 31 placebo patients (80%) and 8 of 30 receiving sucralfate (27%) had ulcer recurrence. The lower rate of ulcer recurrence in patients receiving sucralfate was significant (p = 0.0001). Survival curves also showed that sucralfate was significantly more effective in preventing relapse (p = 0.0001). Three patients were judged as experiencing drug-related side effects, two of which were in the placebo group. The results indicate that sucralfate is significantly more effective than placebo in the prevention of recurrence of duodenal ulcer disease.

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / We analyzed the association between antibiotic resistance and recurrent urinary tract infection (rUTI) by Escherichia coli. Susceptibility levels to 14 antimicrobial agents and the presence of extended-spectrum β-lactamases (ESBL) were established using MicroScan. Incidences of multidrug resistant (MDR), extensively drug resistant (XDR), and ESBL-producer isolates as well as rUTIs were estimated. The time to recurrence was established adjusted for number of antibiotic-resistant families and MDR as predictors of interest, respectively. Overall, 8,553 urinary tract infection (UTI) cases related to E. coli, including 963 rITU, were analyzed with levels of resistance >30% in all cases, except for amikacin, nitrofurantoin, and carbapenems. The incidence of rUTI was of 11.3%, being 46.5%, 24.3%, and 42.5% for MDR, XDR, and ESBLs, respectively. Bivariate analysis showed that rUTI was associated with age, gender, resistance to specific antimicrobials, MDR, and XDR. The number of antibiotic families tested as resistant, MDR, XDR, gender, and age were associated with time to recurrence when adjusted for number of antibiotic families, and MDR, gender, and age were related when adjusted for MDR. High rates of antibiotic resistance to the usual antibiotics was observed in E. coli causing UTI, with female sex, age, and antibiotic resistance being risk factors for the development of rUTI. / Fondo Nacional de Desarrollo Científico, Tecnológico y de Innovación Tecnológica / Revisión por pares