Aachen, Techn. Hochsch., Thesis (doctoral), 2000.

Abstract not available. / Thesis (M.Med.Sc.-Pharm.)-University of KwaZulu-Natal, 2006.

Le syndrome de mort subite du nourrisson (SMSN), les malaises graves du nourrisson (ALTE) et les apnées du prématuré sont des pathologies sévères et/ou fréquentes chez le nouveau-né et peuvent être à l'origine d'expériences dramatiques pour les parents. Les observations cliniques et les données actuelles de la littérature nous portent à croire que la laryngite de reflux pourrait être impliquée via son interaction avec la fonction laryngée, incluant les chémoréflexes laryngés, la déglutition et la coordination respiration-déglutition. Notre objectif était d'étudier l'impact d'une laryngite de reflux induite expérimentalement sur la fréquence des déglutitions non nutritives (DNN) et sur la coordination respiration-déglutition dans notre modèle unique d'agneau nouveau-né. Douze agneaux nouveau-nés à terme ont été randomisés dans un groupe contrôle (n=6) et un groupe laryngite (n=6). Après une instrumentation chirurgicale, 2mL d'une solution de pepsine-HCl à pH 2,0 (laryngite) ou de salin 0,9% (contrôle) étaient instillés au niveau de la muqueuse laryngée trois fois par jour pour huit jours. Au dernier jour, une polysomnographie de quatre heures était faite pour enregistrer les DNN et les paramètres cardio-respiratoires. Deux techniques d'analyse complémentaires (qualitative et quantitative) de la coordination respiration-déglutition ont été utilisées sur les données obtenues. Tous les larynx ont été recueillis pour étude histologique et l'application d'un score d'inflammation. Une laryngite de reflux significative d'intensité légère à modérée a été induite dans le groupe laryngite (p= 0,02). Une diminution significative des épisodes de bouffées de DNN en sommeil agité (REM) (p=0,03), ainsi qu'une diminution significative des fréquences cardiaque et respiratoire de base (p < 0,0001) ont été observées dans le groupe laryngite. Aucune altération de la fréquence des DNN isolées (p = 0,9) ou de la coordination respiraton-déglutition (0,3 < p < 1,0) n'a été retrouvée. Nos résultats suggèrent qu'une laryngite de reflux diminue la fréquence des bouffées de DNN en REM, en plus d'augmenter le tonus parasympathique de base dans notre modèle d'ovin nouveau-né.

TESI DOCTORAL:L'objectiu principal de la tesi va ser estudiar els mecanismes implicats en la resistència a las fluoroquinolones en soques clíniques del gènere "Klebsiella", centrant els estudis en els mecanismes de reflux.Els mecanismes que confereixen resistència als bacteris per un determinat antibiòtic poden ser diversos, des de la inactivació enzimàtica de l'antibiòtic, la modificació de la diana i mecanismes més generals com la disminució de la permeabilitat de la membrana i l'expressió de bombes de reflux. Les bombes de reflux són translocases que es situen a la membrana citoplasmàtica amb capacitat per expulsar fora del bacteri una gran varietat de substàncies mitjançant la força protó-motriu, pel que no requereixen la hidròlisi de l'ATP.Pel que fa les bombes de reflux en bacteris Gram negatius s'ha vist que en Escherichia coli l'operó acrAB codifica per una bomba de reflux però no codifica per cap proteïna de membrana externa (OMP), s'ha descrit que és la proteïna TolC la que actua com a canal de mebrana externa. En el cas de Klebsiella es coneix el sistema de reflux AcrAB com el d'E. coli i en els estudis realitzats en aquest treball s'ha posat de manifest la presència d'aquesta bomba de reflux en les soques clíniques estudiades i la seva implicació en la resistència a les fluoroquinolones mitjançant mesures d'acumulació de ciprofloxacina, efectes de l'antibiòtic sobre el creixement i corbes de mort.No es coneix quina és la proteïna formadora de canal de membranqa externa que està associada a la bomba de reflux AcrAB en Klebsiella. La cerca d'aquesta proteïna associada a la bomba de reflux va ser l'objectiu prinicipal d'aquesta tesi doctoral. Es va posar de manifest la presència de la proteïna TolC en una soca clínica de Klebsiella oxytoca, de la qual es va determinar la seva seqüència i es va comparar amb la d'altres enterobacteris obetenint un elevat percentatge d'identitat, especialment amb la proteïna TolC de Enterobacter aerogenes.Una vegada coneguda la seqüència de la proteïna TolC de K. oxytoca es va realitzar una aproximació al model estructural de la proteïna obtenint una estructura molt similar a la descrita en E. coli. La diferència més destacable s'observà en les cadenes que s'estenen cap a l'exterior del bacteri, aquestes estructures tenen com a funció ser receptores de bacteriocines i fags, on TolC de K. oxytoca presentava una menor longitud. En l'estudi de sensibilitat a colicines s'observà la resistècnia a colicina E1 de la soca clínica de K. oxytoca, pel que la menor longitud de les cadenes exteriors de la proteïna TolC modifica la seva funció com a receptor de colicines. Estudis fisiològics realitzats en la proteïna TolC de K. oxytoca van demostrar que aquesta proteïna forma canals transmembrana en bicapes lipídiques artificials amb una conductància aproximada de 80 pS en KCl 1M i que presenta una forta selectivitat catiònica.

Thesis (Ph.D.)--University of Adelaide, Dept. of Paediatrics, 1999. / Bibliography: leaves 231-266.

München, Techn. Univ., Diss., 2004.

Thesis (M.S.)--University of Missouri-Columbia, 2006. / The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file (viewed Aug. 29, 2007). Includes bibliographical references.

Orientador: Elizete Aparecida Lomazi da Costa Pinto / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-09T12:58:44Z (GMT). No. of bitstreams: 1 Vicente_AlessandraMariaBorges_M.pdf: 1347949 bytes, checksum: 33220d2f782629ad1ffff9ceeb2a979a (MD5) Previous issue date: 2007 / Resumo: Doença do refluxo gastroesofágico, em crianças, pode causar prejuízos nutricionais, doença respiratória, alterações neurocomportamentais e inflamação esofágica. O tratamento desta doença requer medidas posturais, orientação alimentar e terapia medicamentosa. O tratamento cirúrgico está indicado para pacientes com doença do refluxo gastroesofágico crônica, associada ou não a complicações. A fundoplicatura é indicada, em substituição ao uso contínuo dos inibidores de bomba de prótons, para pacientes que não respondem ou respondem apenas parcialmente ao tratamento medicamentoso e quando há recorrência dos sintomas com a descontinuação das medicações. No pós-operatório pode ocorrer desmanche da válvula e recorrência da doença de refluxo, sugerindo a necessidade de monitorização da condição cirúrgica. A avaliação do funcionamento da válvula, baseada apenas nos sintomas dos pacientes, tem se mostrado insuficiente para essa monitorização. O objetivo desse estudo foi identificar a freqüência de anormalidades na válvula anti-refluxo e a freqüência de complicações pépticas do esôfago no pós-operatório tardio de fundoplicatura em crianças. Em estudo transversal e descritivo, foram selecionados 45 pacientes que realizaram fundoplicatura de Nissen num período de 12 a 30 meses prévios à avaliação. O estudo foi conduzido de maio de 2004 a fevereiro de 2007, no Hospital de Clínicas da Universidade Estadual de Campinas, onde todas as cirurgias foram realizadas. A faixa etária dos pacientes avaliados variou de 16 meses a 16,9 anos. Endoscopia digestiva alta foi o instrumento utilizado para verificar o aspecto da fundoplicatura e o do esôfago, além de permitir a coleta de amostra para estudo histológico. Dos 45 pacientes avaliados, 26 (57,8%) eram encefalopatas crônicos. Válvula anti-refluxo bem posicionada e configurada foi encontrada em 41 (91,1%) pacientes. A fundoplicatura foi efetiva no tratamento do processo inflamatório esofágico, mesmo quando havia subestenose ou estenose de esôfago associadas no pré-operatório. Contudo, complicações foram identificadas: esofagite péptica em 6 dos 45 pacientes e necessidade de nova fundoplicatura em dois pacientes. Esofagite péptica associou-se, com significância estatística, à presença de anormalidades na válvula anti-refluxo (p=0,005, teste exato de Fisher). Durante o estudo foram diagnosticados dois pacientes com diagnóstico de esôfago de Barrett. Os resultados permitem concluir que a endoscopia digestiva alta realizada no período pós-operatório tardio de fundoplicatura para doença do refluxo gastroesofágico em crianças permite avaliar a condição da válvula anti-refluxo e diagnosticar a presença de complicações / Abstract: Gastroesophageal reflux disease in childhood may cause nutritional impairment, esophagus inflammation, respiratory disorders and neurobehavioral alterations. In most cases, treatment includes postural, dietary and medical therapy. Anti-reflux surgery is recommended to patients who do not present improvement with proton pump inhibitors treatment, or present recurrence of symptoms when medical therapy is discontinued. Fundoplication surgery failed has been detected and it has been showed that wrap condition needs monitoring and that clinical symptoms are not sensitive enough to indicate fundoplication efficacy. The objective of this study was to identify the frequency of defective wrap in the late postoperative period and evaluate esophageal complications related with gastroesophageal reflux recurrence in children. The study was cross sectional and descriptive, by selecting 45 patients who had undergone Nissen fundoplication, 12 to 30 months before. All procedures were done at the Hospital de Clínicas da Universidade Estadual de Campinas, in the period from May 2004 to February 2007. The age range at post-surgery examination varied from 16 months up to 16.9 years. Upper gastrointestinal endoscopy was used to determine esophageal endoscopic and histopathologic appearance and fundoplication condition. In the evaluated sample, 26 patients (57.8%) were neurologically disabled. Intact wrap was identified in 41 patients (91.1%). The fundoplication was effective for treating esophagitis, even in patients with esophagus stenosis. However, some complications were identified: peptic esophagitis in 6 of 45 patients and a second fundoplication was necessary in 2 patients. Peptic esophagitis in the endoscopic evaluation was associated with defective wrap (p=0.005, Fisher¿s exact test). Two patients with Barrett esophagus were identified, during study. We conclude that endoscopic follow up may be useful for patients who underwent anti-reflux surgery. Endoscopy allows the diagnosis of possible complications / Mestrado / Pediatria / Mestre em Saude da Criança e do Adolescente

Abstract This thesis describes part of the work that has been done in the Chemical Process Engineering Laboratory of the University of Oulu to systematize conceptual process design. The aim has been to develop a design methodology, i.e. how process design is done, based on a carefully elaborated concept analysis. The starting point has been that all the knowledge related to process design, i.e. not only the procedural knowledge related to the design activity itself, but also the declarative knowledge related to the design target (process) and the environment (project) in which the design is done, should be systematized. The process design methodology can be represented within a single formalism by treating the activity, target and resources as structural parts of the project object. In that case, each design decision becomes properly constrained by the goal and the resources available, and is also stored together with the domain knowledge on which the decision was based. This holistic approach was adopted when the phenomenon driven process design methodology was built to systematize chemical process development while simultaneously supporting creativity. This thesis concentrates on knowledge generation activity as part of the phenomenon driven process design methodology. A brief description of the generic chemical process object model is presented, after which the focus is on the design activity and the strategy of design. The phenomenon driven process design of an MTBE production process is described as an illustration of the methodology. It is shown how combinations of reaction and separation, such as reactive distillation, evolve naturally during a design project. For the evaluation of attainable state distributions, which is an important design task implied by the methodology, a robust method was developed to solve the modified MESH equations of reactive distillation. The method was also applied when developing a rigorous calculation method for the determination of minimum energy demand of multicomponent distillation.

Laryngopharyngeal reflux (LPR) is a prevalent disorder which can lead to voice disorders, but its diagnosis is difficult. Consequently, various tools and methods have been explored for the diagnosis of LPR. A link may exist between vocal characteristics and reflux symptoms which may improve the diagnosis of LPR. This study’s objective was to investigate the associations between reflux symptoms, acoustic-, perceptual-, and physical vocal characteristics, the glottal function index (GFI) and the voice handicap index (VHI), in adults with non-organic voice disorders. A retrospective cohort explorative research design was employed by investigating, analysing and describing the existing database of an ear, nose and throat specialist (ENT) in the form of administrative data sets, case histories, questionnaires, and patient and stroboscopy reports. Data collection took place at an ENT practice at a private hospital in Gauteng, South Africa. The data of 51 individuals with non-organic voice disorder, aged 18 and older, were included in this study. Comparisons were made between the reflux symptom index (RSI), acoustic characteristics (jitter, shimmer and fundamental frequency (fo), maximum phonation time (MPT), perceptual characteristics (grade of hoarseness, roughness, breathiness, asthenia, strain and instability), physical vocal characteristics, GFI and VHI. Fair correlations were found between RSI and phase closure (rs=0.424; p=0.035), RSI and GFI (rs=0.366; p=0.008), RSI and VHIP (rs=0.302; p=0.035) and between RSI and caffeine intake (rs=0.322); p=0.043). Results indicated that underlying associations exist between reflux symptoms, vocal characteristics, the GFI and the VHI. Used in conjunction, these measurement tools could improve the clinical diagnosis of LPR. The implications of these findings are promising but further research is recommended. / Dissertation (MA)--University of Pretoria, 2020. / 2022/12/31 / Speech-Language Pathology and Audiology / MA (Speech-Language Pathology) / Unrestricted