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"Efeitos da infusão de Luffa operculata sobre o epitélio e a atividade mucociliar do palato isolado de rã" / Effects of Luffa operculata infusion on the epithelium and the mucociliary activity of the isolated frog palateMiyake, Mônica Aidar Menon 24 March 2004 (has links)
Luffa operculata é uma planta medicinal popularmente usada para tratamento de rinites e rinossinusites. A infusão de seu fruto seco é usada no nariz, liberando secreção mucosa profusa, mas pode causar irritação, epistaxe ou anosmia. Avaliamos os efeitos de diferentes concentrações da infusão do fruto seco da Luffa operculata na velocidade de transporte mucociliar (VTM), freqüência de batimento ciliar (FBC), diferença de potencial transepitelial (DPT) e morfologia do epitélio (microscopia de luz e eletrônica de transmissão), no modelo do palato isolado de rã. Os resultados apontam para dano epitelial dose-dependente no epitélio mucociliar, sugerindo que ela seja potencialmente nociva à mucosa nasal humana / Luffa operculata is a medicinal plant popularly used for treatment of rhinitis and rhinosinusitis. Its dry fruit infusion is used into the nose, delivering profuse mucous secretion, but may cause nasal mucosa irritation, epistaxis or anosmia. We evaluated the effects of different concentrations of Luffa operculata dry fruit infusion on mucociliary transport velocity (MTV), ciliary beat frequency (CBF), transepithelial potential difference (TPD) and epithelial morphology (light and electron transmission microscopy) of the isolated frog palate preparation. Results pointed to dose-dependent epithelial damage on mucociliary epithelium, suggesting that it is potentially noxious to the human nasal mucosa
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"Efeitos da infusão de Luffa operculata sobre o epitélio e a atividade mucociliar do palato isolado de rã" / Effects of Luffa operculata infusion on the epithelium and the mucociliary activity of the isolated frog palateMônica Aidar Menon Miyake 24 March 2004 (has links)
Luffa operculata é uma planta medicinal popularmente usada para tratamento de rinites e rinossinusites. A infusão de seu fruto seco é usada no nariz, liberando secreção mucosa profusa, mas pode causar irritação, epistaxe ou anosmia. Avaliamos os efeitos de diferentes concentrações da infusão do fruto seco da Luffa operculata na velocidade de transporte mucociliar (VTM), freqüência de batimento ciliar (FBC), diferença de potencial transepitelial (DPT) e morfologia do epitélio (microscopia de luz e eletrônica de transmissão), no modelo do palato isolado de rã. Os resultados apontam para dano epitelial dose-dependente no epitélio mucociliar, sugerindo que ela seja potencialmente nociva à mucosa nasal humana / Luffa operculata is a medicinal plant popularly used for treatment of rhinitis and rhinosinusitis. Its dry fruit infusion is used into the nose, delivering profuse mucous secretion, but may cause nasal mucosa irritation, epistaxis or anosmia. We evaluated the effects of different concentrations of Luffa operculata dry fruit infusion on mucociliary transport velocity (MTV), ciliary beat frequency (CBF), transepithelial potential difference (TPD) and epithelial morphology (light and electron transmission microscopy) of the isolated frog palate preparation. Results pointed to dose-dependent epithelial damage on mucociliary epithelium, suggesting that it is potentially noxious to the human nasal mucosa
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Faktori rizika značajni za nastanak dehiscencije staplerskih anastomoza kod pacijenata operisanih zbog karcinoma rektuma / Risk factors significant for development of dehiscence of stapler anastomosis in patients with rectal cancer removedLalović Nenad 26 September 2016 (has links)
<p>UVOD: Kolorektalna anastomoza koja se formira u dubini karlice radi uspostavljanja kontinuiteta gastrointestinalnog trakta nakon resekcije dijela crijeva ima svoje specifičnosti u toku formiranja, zarastanja, kao i kada se jave komplikacije. Na sam proces zarastanja kolorektalnih anastomoza utiču sistemski, lokalni i tehnički faktori. Bilo kakav kompromis po pitanju ovih principa nosi povećan rizik od komplikacija! Najteža komplikacija na anastomozi je dehiscencija. „Samo neučinjena anastomoza neće dehiscirati“. Ova stara hirurška poslovica je važeća i danas, a što je anastomoza distalnija, mogućnost dehiscencije je veća, posebno kod niskih subperitonealnih anastomoza sa rektumom ili anusom. Učestalost dehiscencija ovih anastomoza u literaturi varira od 0,5 - 69 %, što može ukazivati na kvalitet hirurškog rada, korišćenje definicije dehiscencije, način dijagnostike, itd. Međunarodna grupa za karcinom rektuma definisala je dehiscenciju anastomoze kao defekt crijevnog zida, uključujući šavnu ili staplersku liniju neorektalnog rezervoara, što dovodi do komunikacije između intra i ekstra luminalnog prostora. CILJEVI: Osnovni cilj ove studije je bio da se utvrde preoperativni i perioperativni faktori rizika značajni za nastanak dehiscencija kolorektalnih anastomoza, kao i značaj prokalcitonina i C-reaktivnog proteina u detekciji dehiscencija kolorektalnih anastomoza u subkliničkoj fazi bolesti. MATERIJAL I METODOLOGIJA: Istraživanjem je obuhvaćeno 100 pacijenata operisanih u elektivnom programu, kod kojih je urađena radikalna operacija karcinoma rektuma uz kreiranje dvostruke staplerske kolorektalne anastomoze. Svi pacijenti uključeni u istraživanje, odabrani metodom slučajnog izbora, bili su podijeljeni u dvije grupe. Grupa A: pacijenti kod kojih je urađena radikalna operacija karcinoma rektuma i kreirana primarna staplerska kolorektalna anastomoza. Grupa B: pacijenti kod kojih je urađena radikalna operacija karcinoma rektuma Hartmanovom procedurom u prvom aktu, a rekonstrukcija kontinuiteta gastrointestinalnog trakta uspostavljena u drugom aktu kreiranjem sekundarne staplerske kolorektalne anastomoze. Primjenom statističkih testova analizirani su preoperativni (pol, godine života, komorbiditeti, ASA skor, indeks tjelesne mase preoperativna primjena hemoradioterapije, laboratorijske analize) i perioperativni (vrijeme trajanja operacije, udaljenost anastomoze od anokutane linije, veličina tumora u cm, intraoperativna primjena krvi) faktori rizika za nastanak dehiscencije anastomoze kod obje grupe. Kod svih pacijenata drugog i četvrtog postoperativnog dana kontrolisane su vrijednosti C reaktivnog proteina i prokalcitonina u serumu, bez obzira da li su postojali ili ne klinički manifestni znaci dehiscencije anastomoze. Takođe, primjenom ROC krive analizirana je senzitivnost, specifičnost i dijagnostička tačnost C reaktivnog proteina i prokalcitonina drugog i četvrtog postoperativnog dana u detekciji dehiscencije kolorektalne anastomoze. REZULTATI: Nema statistički značajne razlike u pojavi dehiscencije anastomoze između primarnih i sekundarnih dvostrukih staplerskih anastomoza. Incidencija dehiscencija anastomoza je bila 11% u ukupnom uzorku. Osam pacijenata je reoperisano, dok su tri pacijenta tretirana konzervativno. Kod tri pacijenta, kod kojih je nastala dehiscencija i koji su reoperisani, zbog posljedice sepse i septičnog šoka nastupio je smrtni ishod. Pol, godine života, komorbiditeti, stadijum bolesti, dužina trajanja operacije, intraoperativna primjena krvi, nisu statistički značajni faktori rizika (p>0,05) za nastanak dehiscencije primarnih i sekundarnih dvostrukih staplerskih kolorektalnih anastomoza. Udaljenost anastomoze od anokutane linije (<7cm), veličina tumora preko 5 cm su statistički značajni faktori rizika za nastanak dehiscencije anastomoze. Postoji visoko statistički značajna razlika (p<0,001) vrijednosti CRP-a i PCT-a četvrtog postoperativnog dana kod bolesnika sa i bez prisutne dehiscenecije kolorektalne anastomoze. Na osnovu ROC analize CRP–a za četvrti postoperativni dan, za graničnu vrijednost od 130 mg/l senzitivnost iznosi 82%, specifičnost 96% i dijagnostička tačnost 94%. Za graničnu vrijednost PCT-a od 0,78 ng/ml za četvrti postoperativni dan primjenom ROC krive utvrđena je sezitivnost 91%, specifičnost 92%, dok je dijagnostička tačnost bila 86%. Četvrti postoperativni dan CRP ima veću dijagnostičku tačnost i specifičnost u detekciji dehiscencije kolorektalne anastomoze u odnosu na PCT. ZAKLJUČAK: I pored velikog tehnološkog napretka, usavršavanja hirurških tehnika, boljeg razumijevanja prirode maligne bolesti, unapređivanja intraoperativnog i postoperativnog kontinuiranog praćenja bolesnika, uvođenja novih antimikrobnih lijekova, problem u liječenju i pojava dehiscencija kolorektalnih anastomoza su i dalje značajno prisutni. Otkrivanjem dehiscencija kolorektalnih anastomoza u subkliničkoj fazi, identifikovanje preoperativnih i perioperativnih faktora rizika značajnih za nastanak dehiscencija, omogućilo bi da se dehiscencija ranije uoči i efikasnije riješi.</p> / <p>INTRODUCTION: Colorectal anastomosis, which is formed deep in the pelvis because of establishment of continuity of gastrointestinal tract after resection of the part of intestines, has got its specifities during forming and healing process and when complications occur. Systemic, local and technical factors influence the healing process of anastomosis itself. Any kind of compromise in terms of these principles causes higher risk of complications! The most serious complication of anastomosis is dehiscence. “Only anastomosis which is not carried out will not dehisce.” This old surgical saying is still true, and the more distal anastomosis is, the possibility of development of dehiscence is higher, especially in lower subperitoneal anastomosis with rectum and anus. Incidence of dehiscence of these anastomosis in literature varies from 0,5 to 69 %, which may indicate the quality of surgical work, use of definition of dehiscence, kind of diagnostics etc. International group for rectal cancer defined dehiscence of anastomosis as a defect of intestinal wall, including suturing or stapler line of neorectal reservoir, which leads to communication between intra and extra luminal space. AIMS: Basic aim of this study was to determine preoperative and postoperative risk factors significant for the development of dehiscence of colorectal anastomosis, as well as significance of procalcitonin and C-reactive protein in detection of dehiscence of colorectal anastomosis at the subclinical stage of the disease. MATERIAL AND METHODOLOGY: The study included 100 patients operated on in the elective programme, on which radical operation of the rectal cancer was carried out with creation of double stapler colorectal anastomosis. All patients included in the study were randomly chosen and divided into two groups. Group A: the patients on which radical operation of the rectal cancer was carried out and primary stapler colorectal anastomosis created. Group B: the patients on which radical operation of the rectal cancer was carried out using Hartman's procedure in the first act, and reconstruction of the continuity of gastrointestinal tract was established in the second act by creation of secondary stapler colorectal anastomosis. By application of statistical tests preoperative (sex, age, comorbidities, ASA score, body mass index, preoperative application of haemoradiotherapy, laboratory analyses) and perioperative (duration of operation, distance of anastomosis from anocutaneous line, size of tumor in cm, intraoperative application of blood) risk factors for development of dehiscence of anastomosis in both groups were analysed. In all patients on the second and fourth postoperative day values of C-reactive protein and procalcitonin in the serum were analysed, regardless of the existence of clinically or non-clinically manifested signs of dehiscence of anastomosis. Also, sensitivity, specifity and diagnostically accurate C-reactive protein and procalcitonin on the second and fourth postoperative day in detection of dehiscence of colorectal anastomosis were analysed by application of ROC curve. RESULTS: There is no statistically significant difference in the development of dehiscence of anastomosis between primary and secondary double stapler anastomosis. Incidence of dehiscence of anastomosis was 11% in all samples. Eight patients were reoperated on, whereas three patients were treated conservatively. In three patients who developed dehiscence and were reoperated on, the death occurred due to sepsis and septic shock. Sex, age, comorbidities, stage of the disease, duration of operation, intraoperative application of blood were not statistically significant risk factors (p>0,05) for the development of dehiscence of primary and secondary double stapler colorectal anastomosis. Distance of anastomosis from anocutaneous line (<7cm), size of tumor over 5 cm were statistically significant risk factors for the development of dehiscence of anastomosis. There is highly statistically significant difference (p<0,001) values of CRP and PCT on the fourth postoperative day in patients with and without dehiscence of colorectal anastomosis. On the basis of ROC analysis of CRP for the fourth postoperative day, for the bordering value of 130 mg/l sensitivity is 82%, specificity 96% and diagnostic accuracy 94%. For bordering value of PCT of 0,78 ng/ml for the fourth postoperative day, by application of ROC curve, the following values were determined: sensitivity 91%, specificity 92% and diagnostic accuracy 86%. CRP for the fourth postoperative day has got higher diagnostic accuracy and specificity in detection of dehiscence of colorectal anastomosis in relation to PCT. CONCLUSION: In spite of huge technological advance, improvement of surgical techniques, better understanding of the nature of malignant diseases, improvement of intraoperative and postoperative continuous follow up of the patient, introduction of new antimicrobial medicines, the problem in treating and development of dehiscence of colorectal anastomosis is still significantly present. Detection of dehiscence of colorectal anastomosis at the subclinical stage, identification of preoperative and perioperative risk factors significant for the development of dehiscence would help in early detection of dehiscence and contribute to more effective operations.</p>
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Groddjur i Solna - Inventering, spridningsvägar och förbättringsförslagSalomonsson, Johan January 2016 (has links)
The number of amphibians has decreased worldwide. Causes include landscape fragmentation and habitat loss. In Sweden all amphibian species are protected and according to the EU Habitats Directive, both the great crested newt (Triturus cristatus) and its habitat are protected. Inventory of amphibians is important because it shows if the environment has a good ecological status since other groups of organisms thrive in the same conditions as the amphibians. Amphibians themselves are also important in the ecosystem. In Solna, Stockholm County, an inventory of amphibians was made in seven ponds and migrating routes between them were investigated. Smooth newt (Lissotriton vulgaris) was found in five of the ponds which indicates good conditions in breeding ponds, and great crested newts were found in two ponds. The common frog (Rana temporaria) and the common toad (Bufo bufo) were found in one of the ponds. Several major barriers exist in the study area, such as the railway, the motorway E4 and Bergshamravägen, which effectively cut off the natural areas and make it difficult for fauna to migrate. There need to be more and better migrating routes. Therefore measures are proposed for Solna municipality to get a functioning network of breeding ponds. Minor measures, such as clearing an overgrown pond where the great crested newt is present, can be helpful. Another suggestion is to create fauna lanes in tunnels for cars and pedestrians, which allows amphibians and other fauna to get past a barrier like roads. According to the ”Program för Nya Ulriksdal” a pond will be removed when a green area is to be exploited. A suggestion is that the pond should be preserved or compensatory measures shoud be performed by constructing a new pond. More costly measures, such as broad ecoducts or tunnels for passing the railway and the motorway, are also proposed. More migrating corridors should be created and fauna passages projected in urban planning. Preserving existent migrating corridors is also of importance. / Groddjuren har minskat i antal i hela världen. Orsaker till det är bland annat fragmentering av landskapet och habitatförlust. I Sverige är alla groddjursarter fridlysta och enligt EU:s Art- och habitatdirektiv ska både arten större vattensalamander (Triturus cristatus) och dess livsmiljö skyddas. Inventering av groddjur är viktig för att det visar om landskapet över lag har en bra ekologisk status, i och med att även andra organismgrupper trivs med samma förutsättningar som groddjuren. Inventering visar också vilka åtgärder som behövs för att få en god status. Groddjuren i sig har också en viktig funktion i ekosystemet. I Solna, i Stockholms län, har sju vattensamlingar inventerats med avseende på groddjur och spridningsvägarna mellan dem har undersökts. Mindre vattensalamander (Lissotriton vulgaris) förekom i fem av dammarna, vilket tyder på bra förhållanden i lekvattnen, större vattensalamander hittades i två dammar. Även vanlig groda (Rana temporaria) och vanlig padda (Bufo bufo) sågs i en damm. I undersökningsområdet finns flera kraftiga barriärer i form av till exempel järnvägen, E4:an och Bergshamravägen, som effektivt skär av naturområden och gör det svårt för groddjur och annan fauna att sprida sig. Spridningsvägarna behöver bli fler och bättre. Därför föreslås åtgärder för Solna stad för att få ett fungerande nätverk av leklokaler. Åtgärder kan vara av mindre omfattning, som att röja en övervuxen damm där större vattensalamander förekommer. Ett annat förslag är att skapa viltfiler i bil-, gång- och cykeltunnlar, som ger möjlighet för groddjur och annat vilt att ta sig förbi en barriär i form av en väg. Enligt Program för Nya Ulriksdal kommer en damm att tas bort när ett grönområde ska bebyggas. Här föreslås att dammen ska bevaras eller att en kompensationsåtgärd utförs genom att anlägga en ny damm. Mer kostsamma åtgärder som breda ekodukter eller tunnlar för att kunna passera järnvägen och motorvägen föreslås också. Över lag bör fler spridningskorridorer skapas och faunapassager planeras in vid stadsplanering. Det är också viktigt att bevara befintliga spridningskorridorer.
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Povezanost vremena nastanka multiple skleroze sa karakteristikama kliničke slike, toka bolesti, nalazima nuklearne magnetne rezonance i likvora / The correlation of time beginning Multiple sclerosis with clinical features, disease course, magnetic resonance imaging features,and presence oligoclonal band in cerebrospinal fluidSuknjaja Vesna 21 September 2016 (has links)
<p>UVOD: Početak multiple skleroze (MS) u dečijem uzrastu je dijagnostički i terapijski izazov. I ako rani početak MS-a uglavnom ukazuje na dobru kratkoročnu prognozu, neka deca razviju tešku onesposobljenost, fizičku ili kognitivnu, a više od 50% obolelih uđe u sekundarno progresivnu formu bolesti pre 30. godine života. Rana dijagnoza je neophodna za uvođenje imunomodulatorne terapije, kojom se obezbeđuje dobra dugoročna prognoza. CILJ: Analiza parametara koji bi omogućili ranu dijagnozu multiple skleroza sa ranim početkom u odnosu na simptome, sprovedene dijagnostičke procedure i tok bolesti. Sagledavanje inicijalnih kliničkih manifestacija multiple skleroze, prisustva ologoklonaliteta, nalaza MRI endokranijuma i njihovih osobenosti u dečijoj populaciji uz komparaciju sa inicijalnim kliničkim manifestacijama kod pacijenata obolelih od multiple skleroze u odraslom dobu. MATERIJALI METODE: Ova retrospektivno/ prospektivna studija obuhvata pacijente lečene na Klinici za neurologiju KCV u Novom Sadu u periodu od dvanaest godina, od januara 2003. godine do januara 2015. godine sa znacima i simptomima inicijalne demijelinacione bolesti CNS. Od ove kohorte izdvojeno je dve grupe pacijenata; prva grupa pacijenata kod kojih je bolest nastala pre 18. godine života, i druga grupa uzrasta od 20-55 godina. Pacijenti su epidemiološki obrađeni prema godinama početka bolesti, polu, porodičnoj istoriji, simptomima na početku bolesti (inicijalni simptom), toku bolesti- pojavi drugog relapsa i vremena do pojave drugog relapsa, nalazu MRI, nalazu evociranih potencijala i prisustvo oligoklonalnih traka u likvoru. Tokom praćenja beleži se vreme do drugog relapsa i tip relapsa. Tražila se korelacija između kliničkih i dijagnostičkih rezultata sa brzinom pojave drugog relapsa. Za testiranje razlika između grupa korišćen je Pirsonov hi-kvadrat test, a za testiranje jačine povezanosti korišćeno je Kramerovo V. Neparametrijski podaci su obrađivani Men-Vitni U testom. REZULTATI: Od ukupnog broja ispitanika, u grupi pacijenata sa ranim početkom MS-a odnos ženskog i muškog pola je bio 1,3:1, a u grupi pacijenata sa uobičajenim početkom MS-a 2,2:1. Iz dobijenih rezultata vidimo da ima manje nego što je očekivano pacijenata rođenih u mesecima decembru 4,6% i januaru (5,9%), a više nego što je očekivanu u mesecima martu (11,3%) i julu (10,6%), što nije statistički značajno (p=0,726). Prema manifestaciji bolesti kod dece 17,6% ima polisimptomatski početak, a kod odraslih 37,6% ima polisimptomatski početak.Polisimptomatski početak statistički je značajno više zastupljen kod odraslih pacijenata (p=0,020).Poremećaj piramidnog sistema (P=0,010) i senzorne smetnje (P=0,006) su zastupljeniji kao inicijalni stimptom u grupi odraslih.Nisu nađene statistički značajne razlike u zastupljenosti optičkog neuritisa (p=0,366 ili p>0,05) i ataksije /stablarne simptomatologije (p= 0,791) u ove dve grupe. Najčešći inicijalni simptom kod dece, gotovo u istoj razmeri su optički neuritis (35,3%) i ataksija (35,3%). U grupi odraslih pacijenata senzorne smetnje (41,6%) su najčešći inicijalni simptom, odmah za njim sledi piramidna simptomatologija (37,6%). Prema nalazu broja lezija na MRI pregledu, u grupi ispitanika sa ranim početkom MS-a više su zastupljeni oni sa manje od 4 lezije, nego što je to slučaj u grupi odraslih. Odnos broja pacijenata sa 4-10 i preko 10 lezija simetričan je u obe grupe. Korelacija između doba početka MS-a i broja lezija viđenih na MRI je statistički značajna i neznatna (P=0,06). Nije nađena statistička značajnost u prisustvu lezija u korpusu kalozumu između ove dve grupe pacijenata ( P=0,920). Primenom Fišerovog dvostranog egzaktnog testa koji je u ovom slučaju statistički značajan (p=0,034), možemo reći da se grupa sa ranim početkom MS-a i ona sa uobičajenim početkom statistički značajno razlikuju, tumefaktivne lezije su prisutnije kod ispitanika sa ranim početkom MS-a. Pozitivni oligoklonali su zastupljeniji u grupi odraslih pacijenata ( P= 0,018). U našoj grupi ispitanika kada smo pratili vreme pojave drugog pogoršanja, najkraće godinu dana, u grupi dece 11 pacijenata (21,6%) nije imalo pogoršanje , dok je 40 pacijenata imalo pogoršanje (78,4%),. Medijana kod grupe dece za pojavu drugog šuba bolesti je 12 meseci. U grupi odraslih 22 pacijenta ( 21,8%) nije imalo drugi relaps tokom perioda praćenja, dok je njih 79 (78,2%) imalo drugi relaps. Prosečno vreme u grupi odraslih pacijenata do drugog relapsa je 9 meseci. U grupi dece ne postoje značajne razlike u odnosu broja lezija viđenih na inicijalnom MRI pregledu i vremenu pojave drugog relapsa ( p=0,884) Kod odraslih postoji značajna razlika u vremenu relapsa između grupe sa manje od 4 lezije i grupe sa 4-10 lezija (p=0,09).Korelirali smo pacijente sa pozitivnim i negativnim ologoklonalnim trakama u likvoru u obe grupe sa vremenom nastanka prvog pogoršanja, pri toj korelaciji nije dobijena statistički značajna razlika ni u grupi dece ( P= 0,598) ni u grupi odraslih (P=0,133). Kod ispitanika sa ranim početkom češća je pozitivna porodična anamneza, u vidu prisustva MS i drugih imunoloških bolesti( P =0,042). ZAKLJUČAK: Polisimptomatski početak je češći kod odraslih, pozitivne oliogoklonalne trake su ređe pozitivne kod dece, kod dece je najčešći inicijalni simptom optički neuritis a kod odraslih senzitivne i motorne smetnje. Manje od 4 lezije se češće javljaju kod dece na inicijalnom MRI pregledu, što je najverovatnije povezano sa vremenom stvarnog početka bolesti i njenom kliničkom manifestacijom. Kod pacijenta sa ranim početkom MS-a duži je period do drugog pogoršanja. U grupi dece ne postoje statistički značajne razlike u odnosu broja lezija viđenih na inicijalnom MRI pregledu i vremenu pojave drugog relapsa. Kod odraslih postoji značajna razlika u vremenu relapsa između grupe sa manje od 4 lezije i grupe sa 4-10 lezija. Inicijalne manifestacije MS-a u dečijem uzrastu ne razlikuje se u mnogome od MS-a kod odraslih po karakteristikama i toku bolesti.</p> / <p>INTRODUCTION: Тhe onset of multiple sclerosis (MS) in childhood poses diagnostic and therapeutic challenges. Althougth the onset of MS in childhood typically predicts a fevoruable short/term prognosis, some children are severy disabled. Etiher physically or cognitively, and more then 50% are predicted to enter the secondary-progressive phase of the disease by the age of 30 years. Immunomodulatory therapies for MS and their safe application in children can improve long-therm prognosis. AIM: We saught to identifay clinical and diagnostic features in children wich inplicate to early diagnosis of MS in children. We aimd to determine the clinical features, cerebro spinal fluid, magnetic resonance imagin (MRI) features of children and their comparation with adult MS patients. METHODS: In this retrospective/prospective study we present data from 152 patients with clinical isolated syndrom (CIS) for the first time, which are obtained throught Clinic of Neurology , Clinical Centre of Vojvodina, Novi Sad from January 2003 to January 2015g. Patients were divided into two grups - in first group patients 51 with early onset of disease before 18 years, and second group patients with adult onset desease (20-55 year). Patients wer observed for a minimum one year. The common presenting symptoms, gender, MRI finding, oligoclonal band (OCB) and Visual evoked potential findings, corse of disease, family history were compared between the two groups and with thime of second relaps. To test the difference between groups was used Chi-square Pearson product moment test, and to test the strength of connection used is a Kramer V. Population data are processed Men-Whitney U test. RESULTS: Of the total number of respondents, in the Group of patients with early beginning MS the ratio of women and men was 1.3:1, and in the group of adult MS patients 2, 2:1. From the results we can see that fewer than expected has patients born in the months December ( 4.6%) and January (5.9%), and higher than expected in a March (11.3%) and July (10.6%), which is not statistically significant (p = 0,726). According to the manifestation of disease in children 17.6% has a polifocal onset, and in adults 37.6% has a polifocal onset. Polifocal beginning is significantly over represented in adult MS patients (p = 0,020). Motor disorder (P = 0,010) and sensory disabilities (P = 0.006) are more present as the initial manifestation illness in the adult. They not found statistically significant differences in the representation of optic neuritis (p = 0,366 or p > 0.05) and ataxia (p = 0.791) in these two groups. The most common initial symptom in children, almost in the same scale are the optical neuritis (35.3%) and ataxia 6 (35.3%). In a group of adult patients sensory disturbances (41.6%) are the most common initial symptom, right behind him follows a motor disturbens (37.6%). According to the number of lesions on the MRI exam, in a group of subjects with early MS more are they less than four lesions, than is the case in the group adults. The ratio of the number of patients with 4-10 and over 10 symmetrical lesions in both groups. Correlation between the time of the beginning of the MS and the number of lesions seen on MRI is statistically significant and insignificant (P = 0.06). There was no statistical significance in the presence of lesions in the corpus callosum indicates between these two groups of patients (P = 0,920). Application of Fisher the exact test case that is in this case a statistically significant (p = 0.034). We can say that the group with the early start of MS and the one with the usual beginning of significantly different, tumefactiv lesions are present in patients with early onset MS, Positive oligoclonal bands are more present in a group with adult MS patients (P = 0.018). In our group of respondents when we track time appear another relapse, minimum one year, 11 children (21,6%) had no deterioration, while the 40 children had worsening (78,4%). The median at groups of children for the appearance of second relapse is 12 months. In the adult these 22 (21,8%) had another relapse for tracking period, while 79 (78.2%) had another relapse. The average amount of time in the adult patients relapse to another is 9 months. In a group of children there are no statistically significant differences in the relative number of lesions seen on the initial MRI examination and time show up another relapse (p = 0,884). In adults there is a significant difference in relapse time between groups with fewer than four lesions and groups with 4-10 lesions (p = 0.09). Pressures are patients with positive and negative ologoclonal bands in the cerebrospinal fluid in both groups with the time of occurrence of the first downturn, when the correlation is not get statistically significant difference in the children (P = 0.598) or in a group of adults (P = 0,133). In patients with early starting stacks is a negative family history, and often the presence of MS and other immunological diseases (P = 0,042). CONCULSIONS: Polisifocal beginning is more common in adults, positive oliogoklonalne bands are less positive in children, with children being the most common initial symptom is optic neuritis, in adult sensitive and motor disturbances. Tumefactiv lesions are present in patients with early onset MS. Less than four lesions are more common in children on the initial MRI examination, which is probably connected with the time of the real onset of the disease and its clinical manifestation n the group of children there are no statistically significant differences in relation to the number of lesions seen on MRI at the initial examination and the timing of another relapse. For adults there is a significant difference in time of relapse between the groups with less than 4 lesions and groups with 4-10 lesions. Children onset MS does not significantly differ from that it has been typically seen in adults in terms of major clinical manifestations and course of disease.</p>
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Ultradiluição homeopática de triiodotironina altera a apoptose celular da cauda de girinos de Rana catesbeiana: in vitro / Ultra high dilution of triiodothyronine modifies the cellular apoptosis of Rana catesbeiana tadpole tail: in vitroGuedes, José Roberto Pereira 11 March 2010 (has links)
Ultradiluição (UHD) é o efeito de uma solução, diluída acima do número de Avogrado, que na dependência da sua dinamização (diluição com sucussão) induz um efeito celular supressivo ou estimulante, com conseqüente obtenção de uma curva dose-efeito oscilatória. Por outro lado, a 3,3,5 Triiodo-L-Tironina (T3) é o hormônio mais importante na indução e manutenção das mudanças metamórficas dos girinos, nelas incluídas a absorção da cauda. O presente estudo, cego e randomizado, tem como objetivo comprovar que o T3 5.10-24M (10ª cH) altera a apoptose induzida pelo T3 100 nM na cauda de girinos de Rana catesbeiana, in vitro. Foram distribuídos 60 explantes em três grupos: Grupo A: sem o estímulo do T3 em dose farmacológica e em UHD; Grupo B (teste): sob a ação de T3 100 nM e T3 10ª cH (5.10-24 M); Grupo C (controle): sob a ação do T3 100 nM e etanol 70% sem sucussão. A análise estatística da área dos explantes, no primeiro e ultimo dia do experimento, e do índice apoptótico foi realizado através do teste t Student e foi considerado estatisticamente significante quando p<0,05. Embora sem diferenças significativas na área dos explantes do grupo teste e no grupo controle, um maior e significante índice apoptótico foi identificado nos explantes do grupo teste. Este resultado confirma que o T3 na 10ª cH altera a ação do T3 em dose farmacológica. Futuros experimentos serão realizados, com diferentes dinamizações, com o objetivo da parametrização da curva dose-efeito / Ultra High Dilution (UHD) is the effect of a solution, beyond the Avogadro limits, that in the dependence of the applied dinamization (dilution with succussion) elicits a suppressive or a stimulant effect on a living cell, with a consequent generation of an oscillatory dose-effect curve. The entire process of anuran amphibian metamorphosis is under thyroid hormones control, included the complete resorption of the tadpole tail. A random and blind study was performed, with the intent to prove that T3 5.10-24 M (10ª cH) modifies the apoptosis induction of T3 100 nM in Rana catesbeiana tadpoles tail tips, in vitro. 60 Explants were distributed in three ways: Group A: without T3 action, at pharmacological and UHD dose; Group B (test): under the action of T3 100 nM and treated with T3 10ª cH (UHD); Group C (control): under the action of T3 100 nM and treated with ethanol 70% unsuccussed. In order to identify significant differences in the area of the remainder explants, at the first and final day of the experiment, and in the apoptotic index we used a student t-test. Although we didnt find statistical difference in macroscopic tadpoles tail tips area from test and control groups, a high and significant (p<0,05) index of apoptosis in histology was found in explants of test group. This data confirms that T3 10 cH modifies the effect of T3 at pharmacological dose. More studies will be necessary, using different dinamizations, to the parameterization of the dose-effect curve proceeding from these experiments
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Uticaj preparata koncentrovanih faktora rasta na regeneratorne i reparatorne procese u postekstrakcionim ranama / The effect of concetrated growth factors on regeneration and reparation of extraction woundsTadić Ana 05 April 2019 (has links)
<p>Ekstrakcija zuba je intervencija prilikom koje se zub vadi iz svog ležišta u zubnoj alveoli. Rana koja nastaje kao posledica ove intervncije je takvog oblika da njene ivice nije moguće približiti jednu drugoj , te zarasta per secundam intentionem. Ekstrakcija zuba ima za posledicu mnogobrojne promene na tvrdim i mekim tkivima alveolarnog nastavka u periodu od nekoliko meseci do godinu dana nakon intervencije. Savremena stomatologija se i dalje intenzivno bavi proučavanjem procesa zarastanja ekstrakcione rane iz potrebe da se što bolje razumeju promene u tkivu koje nastaju po gubitku zuba da bi se mogle prevenirati i/ili usmeriti tako da se omogući kasnija lakša protetska rehabilitacija pacijenata. Mnoge studije su pokazale efikasnost faktora rasta u tokom procesa zaceljivanja tkiva.Opisan je veliki broj tehnika za pripremu autolognih krvnih preparata koji sadrže faktore rasta, ali su njihova praktična primena i efikasnost su dalje nejasni zato što svaka od ovih metoda dovodi do izrade različitog produkta sa različitom biologijom i potencijalnim indikacijama za upotrebu. Ekstrakcije mandibularnog trećeg molara spadaju u jednu od najčešćih intervencija sa kojom se u svom radu svakodnevno sreću oralni i maksilofacijalni hirurzi. Ova hirurška procedura je povezana za postoperativnim efektima koji u velikoj meri utiču na kvalitet života pacijenta kao što su bol, trizmus, edem, infekcija i alveolitis. U literaturi postoje dokazi da aplikacija nekog od autolognog krvnog preparata sa visokim sadržajem faktora rasta u određenoj meri može da poboljša proces zarastanja tkiva i da umanji neželjene propratne pojave hirurške intervencije nakon ekstrakcije mandibularnog trećeg molara. Cilj ovog rada je bio da utvrdimo da li primena autolognih krvnih preparata sa koncentrovanim faktorima rasta ubrzava stvaranje koštanog tkiva u ekstrakcionoj rani, kao i da li utiče na učestalost pojave alveolitisa i pojavu aproksimalinih parodontalnih džepova na susednim zubima nakon hirurške ekstrakcije donjeg trećeg molara. Studija je sprovedena kao prospektivna klinička studija split-mouth dizajna. U studiju je bilo uključeno 30 pacijenata kod kojih je indikovana ekstrakcija oba mandibularna treća molara i kod kojih su ovi zubi bilateralno u približno istom položaju u odnosu na drugi donji molar. Nakon hirurške ekstrakcije u jednu alveolu je aplikovan preparat koncentrovanih faktora rasta. Kontrolnu grupu u istraživanju činilo je 30 zubnih alveola u koje nije aplikovan preparat koncentrovanih faktora rasta. U eksperimentalnu grupu spadalo je 30 alveola u koje su aplikovani preparati koncentrovanih faktora rasta nakon ekstrakcije zuba. Pacijentima je prvi obavezan kontrolni pregled zakazivan za 7 dana nakon intervencije, tokom koga su uklanjane suture, a vršen je i klinički pregled rane i parodontološkom sondom je proveravana dubina parodontalnog džepa na distalnoj površini drugog molara. Druga postoperativna kontrola je zakazivana 4 nedelje nakon intervencije, a treća nakon 8 nedelja i na ovim kontrolama je merena dubina parodontalnog džepa na distalnoj površini drugog molara. Ispitanicima su napravljena tri CBCT snimka operisanih regija i to po sledećoj dinamici- prvi snimak neposredno nakon ekstrakcije zuba, drugi 4 nedelje i treći 8 nedelja po intervenciji. Svaki CBCT snimak je analiziran da bi se prikupili željeni podaci: zapremina šupljine alveole koja je ostala nakon ekstrakcije zuba i gustina novostvorenog koštanog tkiva, što su parametri na osnovu kojih procenjujemo proces zarastanja koštanog tkiva nakon intervencije. Ova metodologija je originalna , obzirom da su do sada korišćene dvodimenzionalne radiografske metode snimanja sa ciljem praćenja koštanog zarastanja nakon ekstrakcije zuba manje precizne i pouzdane. Dobijenu podaci su obrađeni odgovarajućim matematičko-statističkim postupcima. Najznačajniji rezultati istraživanja su zatim tabelarno i grafički prikazani. Na osnovu dobijenih rezultata došli smo do zaključka da iako primena koncentrovanih faktora rasta dovodi do intenziviranja procesa koštanog zarastanja i smanjenja dubine parodontalnog džepa na distalnoj površini susednih zuba, ta razlika nije statistički značajna. Obzirom da ni u jednom slučaju nije došlo do pojave alveolitisa, nismo mogli zaključiti na koji način primena koncentrovanih faktora rasta utiče na učestalost ove komplikacije.</p> / <p>Tooth extraction is an intervention during which a tooth is removed from its socket. A wound that remains after this is of specific size and shape and it heals per secundam intentionem. Where once was a tooth, in following months and years, a large number of changes in composition of hard and soft tissues occure. Haeling of extraction wound in still in focus of contemporary dentistry, since it is imperative to understand all tissue changes in order to prevent and/or gide them and enable prosthodontic rehabilitation of the patient. Many studies confirm a benefitial effect of growth factors douring wound healing. A large number of techniques is developed to prepare autologous blood concentrates containing growth factors, like platelet-rich fibrin (PRF) , but their aplicability and efficancy are still unclear because each of these methods results in product with different biology and physical characteristics, as well as different potential indications. Third mandibular molar extraction is one of the most frequent interventions that oral and maxillofacial surgeon face in their everyday clinical practice. This procedure is usually followed by postoperative effects affecting such as pain, trismus, edema, infection and alveolitis. In contemporary literature there is enough evidence to suport beneficial role of autologous blood preparations in wound healing, and some authors even sugest that they can reduce incidence of postextraction complications afther third molar surgery. The aim of this study was to determin weather concentrated growth factors have beneficial effect on bone healing after tooth extraction, as well as their effect on the incidence of alveolitis and do they reduce pocket depth on distal side of adjacent tooth. This study was conducted as prospective clinical split-mouth designed study. 30 patients with both mandibular third molars indicated for the extraction, in similar position, were included in the study. On the same day surgical removal of both mandibular molars was performed, and in one socket PRF was placed. Patients were scheduled for a check-up and suture removals on the 7th postoperative day. During this visit, as well as after 4 and after 8 weeks, depth of distal pocket of the second molar was measured. CBCT was made on the day of surgery, 4 and 8 weeks afther surgery. On these radiographs volume of the bone defect was measured as well as density of newly formed bone tissue in the socket. This is original methodology, while previous studies used two-dimensional radiography methods in order to evaluate bone healing after tooth extractions, with less precision and liability. We processed and analyzed gained data using appropriate mathematical-statistical methods. According to our data we concluded that application of PRF in the extraction socket improves bone healing and reduces depth of pocket on the adjacent teeth, although this effects are not statistically significant. In our study, alveolitis did not occur neither in control nor in the experimental group, so we could not conclude if the application of PRF has any effect on prevention of this complication.</p>
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Ultradiluição homeopática de triiodotironina altera a apoptose celular da cauda de girinos de Rana catesbeiana: in vitro / Ultra high dilution of triiodothyronine modifies the cellular apoptosis of Rana catesbeiana tadpole tail: in vitroJosé Roberto Pereira Guedes 11 March 2010 (has links)
Ultradiluição (UHD) é o efeito de uma solução, diluída acima do número de Avogrado, que na dependência da sua dinamização (diluição com sucussão) induz um efeito celular supressivo ou estimulante, com conseqüente obtenção de uma curva dose-efeito oscilatória. Por outro lado, a 3,3,5 Triiodo-L-Tironina (T3) é o hormônio mais importante na indução e manutenção das mudanças metamórficas dos girinos, nelas incluídas a absorção da cauda. O presente estudo, cego e randomizado, tem como objetivo comprovar que o T3 5.10-24M (10ª cH) altera a apoptose induzida pelo T3 100 nM na cauda de girinos de Rana catesbeiana, in vitro. Foram distribuídos 60 explantes em três grupos: Grupo A: sem o estímulo do T3 em dose farmacológica e em UHD; Grupo B (teste): sob a ação de T3 100 nM e T3 10ª cH (5.10-24 M); Grupo C (controle): sob a ação do T3 100 nM e etanol 70% sem sucussão. A análise estatística da área dos explantes, no primeiro e ultimo dia do experimento, e do índice apoptótico foi realizado através do teste t Student e foi considerado estatisticamente significante quando p<0,05. Embora sem diferenças significativas na área dos explantes do grupo teste e no grupo controle, um maior e significante índice apoptótico foi identificado nos explantes do grupo teste. Este resultado confirma que o T3 na 10ª cH altera a ação do T3 em dose farmacológica. Futuros experimentos serão realizados, com diferentes dinamizações, com o objetivo da parametrização da curva dose-efeito / Ultra High Dilution (UHD) is the effect of a solution, beyond the Avogadro limits, that in the dependence of the applied dinamization (dilution with succussion) elicits a suppressive or a stimulant effect on a living cell, with a consequent generation of an oscillatory dose-effect curve. The entire process of anuran amphibian metamorphosis is under thyroid hormones control, included the complete resorption of the tadpole tail. A random and blind study was performed, with the intent to prove that T3 5.10-24 M (10ª cH) modifies the apoptosis induction of T3 100 nM in Rana catesbeiana tadpoles tail tips, in vitro. 60 Explants were distributed in three ways: Group A: without T3 action, at pharmacological and UHD dose; Group B (test): under the action of T3 100 nM and treated with T3 10ª cH (UHD); Group C (control): under the action of T3 100 nM and treated with ethanol 70% unsuccussed. In order to identify significant differences in the area of the remainder explants, at the first and final day of the experiment, and in the apoptotic index we used a student t-test. Although we didnt find statistical difference in macroscopic tadpoles tail tips area from test and control groups, a high and significant (p<0,05) index of apoptosis in histology was found in explants of test group. This data confirms that T3 10 cH modifies the effect of T3 at pharmacological dose. More studies will be necessary, using different dinamizations, to the parameterization of the dose-effect curve proceeding from these experiments
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Magnetnorezonantna dijagnostika akutnog pankreatitisa / Magnetoresonant diagnosis of pancreatitis acutaGvozdenović Katarina 25 October 2017 (has links)
<p>Akutni pankreatitis predstavlja zbirni pojam dinamičkih, lokalnih i sistemskih patofizioloških procesa nastalih iznenadnim prodorom aktivnih litičkih pankreasnih enzima u žlezdani parenhim. Cilj istraživanja je da se Utvrditi senzitivnost difuzione sekvence magnetne rezonance (DWI) radi utvrđivanja morfoloških promena parenhima kod akutnog pankreatitisa. Poređenje difuzione mape i difuzionog koeficijenta kod pacijenata sa akutnim pankreatitisom i kod pacijenata sa morfološki urednim parenhimom pankreasa na magnetnoj rezonanci. Utvrditi da li postoje statistički značajne razlike difuzionog koeficijenta kod pacijenata sa akutnim pankreatitisom u odnosu na pol. Utvrditi da li postoje statistički značajne razlike difuzionog koeficijenta kod pacijenata sa akutnim pankreatitisom u odnosu na godine. Odrediti prelomnu tačku difuzionog koeficijenta kod pacijenata sa akutnim pankreatitisom. Studija je bila prospektivnog karaktera i obuhvatilo je 30 ispitanika sa morfološki urednim parenhimom pankreasa i 30 sa dijagnozom akutnog pankreatitisa unutar 72 sata od početka simptoma. Svi pacijenti su pregledani magnetnom rezonancom u Centru za radiologiju, Kliničkog Centra Vojvodine. Rezultati ukazuju da postoje razlike difuzionog koeficijenta kod pacijenata sa akutnim pankreatitisom i kontrolne grupe. Takođe smo dokazali da difuzioni koeficijent zavisi od pola i starosti i utvrdili smo prelomnu tačku difuzije za rano dijagnostikovanje akutnog pankreatitisa.</p> / <p>Acute pancreatitis is defined as cumulative term of dynamic local and general pathophysiological processes caused by sudden penetration of active lithic pancreatic enzymes in the glandular parenchyma. Goal of this research is to note the changes (sensitivity) in values of diffusion weighted images (DWI) in acute pancreatitis and to determine morphological changes in glandular parenchyma of pancreas. Comparation of DWI between patients with acute pancreatitis and patients with normal pancreatic parenchyma based on magnetic resonance (MRI). We also want to determine whether there were statistically significant differences of DWI in patients with acute pancreatitis in relation to sex and age. One of our goals also was to determine breakpoint of DWI as a sure sign of acute pancreatitis. This was prospective study and included 30 patients with morphologically healthy parenchyma of the pancreas (control group) and 30 with the diagnosis of acute pancreatitis – in first 72 hours of the onset of symptoms. All patients were examined on MRI in department of Radiology of Clinical Center of Vojvodina. Our results indicate that was a big difference of DWI between patients with acute pancreatitis and control group. We prove that DWI depends on the sex and age. 1,77x10-6mm/s2 was breakpoint which indicates acute pancreatitis.</p>
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The Presence of Micropterus salmoides (Largemouth Bass) Influences the Populations of Rana draytonii (California Red-Legged Frog) and Pseudacris regilla (Pacific Treefrog) in Two Ponds in Santa Barbara County, CaliforniaGilliland, Kenneth Lee 01 February 2010 (has links) (PDF)
Alien fish have been implicated in the decline of Rana draytonii (California red-legged frog) and Pseudacris regilla (Pacific treefrog) populations. Micropterus salmoides (largemouth bass) is a common sport fish that has been introduced into the sympatric range of these two anuran species; however, no studies have investigated the individual influence that this alien fish has on these two species. I conducted M. salmoides control or eradication experiments during a four year study in two ponds within the Transverse Mountain Range of Santa Barbara County, California. Changes in the densities of all life stages of R. draytonii and P. regilla were assessed through repeated visual encounter surveys. In response to the manipulations of the M. salmoides populations there was an increase in the density of both species. For R. draytonii, this salient increase in density was recorded in the larval and metamorph life stages. For P. regilla, a slight, yet steady increase in the density of adult, metamorph, and larval life stages was recorded. My results suggest that M. salmoides can be controlled or eradicated from lentic waterbodies and provides reasonable evidence that the negative effects of this species on R. draytonii and P. regilla populations can be minimized or reversed. The reversal of these effects may translate into increases in the densities and potential recruitment of these two native anurans. Therefore, my results provide tentative support that the control or eradication of M. salmoides where they cohabitate with these two species may be a viable conservation measure for R. draytonii and P. regilla populations. Since my study was performed at a very local scale and all results are strictly observational and descriptive, additional studies should be performed at a larger spatial scale and buttressed with controlled laboratory and field enclosures experiments to identify the causal factors responsible for the identified patterns.
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