Introduction: Several factors have been observed to influence the value of newborn screening analytes (NBS) and should be adjusted for in the interpretation of blood spot samples. The thesis aimed to examine the association of NBS with 1) mode of delivery among term infants and 2) clinical subtypes (i.e., spontaneous onset of labour) of birth among preterm infants. Methods: A retrospective population-based cross-sectional study design was employed. A multivariable logistic regression model was used to examine associations between NBS and mode of delivery among term infants and subtypes among preterm infants. Results: 1) Metabolic profiles of infants born by planned cesarean delivery differ from those born by vaginal delivery following spontaneous onset of labour and 2) Metabolic profiles of preterm infants did not differ by clinical subtype. Conclusions: Our findings conclude that mode of delivery is an important covariate to consider in future modelling studies, but the inclusion of preterm birth subtypes is less compelling.

The interpretation of medical images is one of the most difficult tasks in computer vision, largely because of the high degree of variability associated with normal and abnormal appearances. This thesis introduces a systematic method for the detection of microcalcifications as one of the most important signs of early breast cancer. It involves a four step procedure. The first step is blob detection to detect regions of microcalcification size range. The second step involves a specially designed directional region growing method to find the best fitting boundaries for each blob region. A newly developed combination of classifiers is then applied to label each region as a microcalcification or background. The final processing step involves a search for the existence of clusters of microcalcifications using a hierarchical nearest mean clustering method. The contributions of the work to the field of image processing are; a new blob detection system; a novel region growing method and a theoretical framework for combining classifiers which use a combination of shared and distinct representations. Here specifically, we present a blob detection method with the capability of detecting any suspected blob of specific size range. Then a new region growing method is developed based on a unique directional growing process providing predictable behaviour for the method. The application of two discontinuity measures is considered for the extraction of two fitting boundaries representing information about the region and its local background. The information conveyed by the boundaries and their associated regions is used to compute reliable representations for labelling each blob region. The robustness of the region growing method to the choice of a starting point and to Gaussian noise is examined on real images. We demonstrate that commonly used classifiers provide reliable results in labelling the suspected regions. In spite of achieving an acceptable performance using different individual classifiers, a decision fusion rule involving a weighted combination of classifiers is developed and its performance on the problem is investigated. The combination rule is applicable when mixed mode representations (some shared and some individual features) are used. A comparative study of the individtial classifiers and also of conventional classifier combination techniques with the weighted combiner is performed on independent test sets. The results achieved with the presented algorithm are very promising and approaching a level where a clinical pilot evaluation for screening purposes would be warranted.

Screening acute stroke patients for dysphagia (difficulty swallowing) is recommended within 24 hours due to risks of morbidity and mortality. A review of the international literature identified no universal consensus for a valid method of screening. This thesis describes a multi-method Action Research (AR) programme of study focused on the design, development and evaluation of a reliable and valid dysphagia screening tool (the ‘Head Dysphagia Screen for Stroke’ or HeDSS) for use by Registered General Nurses (RGNs). As a component of the assessment phase of the AR programme, a survey of dysphagia screening practices in England and Wales highlighted widely varied screening practices. Many of these practices were based on limited research evidence, reflecting the lack of consensus for valid dysphagia screening criteria reported in the literature. The design phase of the AR programme involved the development of the HeDSS tool, which centred on the use of research-based screening criteria. Focus group activity determined nurses’ perceptions of the design and subsequent refinement of the HeDSS tool. The intervention and evaluation phases of the AR programme followed three empirical stages. Stage one established the inter-rater reliability of the Speech and Language Therapist Researcher’s (SLTR’s) clinical dysphagia assessment, which acted as a reference standard against which the validity of the HeDSS tool was to be measured. Clinical judgements for the presence and absence of dysphagia in the same 30 referred patients were compared between the SLTR and a Speech and Language Therapist (SLT) of equivalent experience. Inter-rater reliability was substantial (k = .71). The second empirical stage established inter-rater reliability of the HeDSS measurement outcomes (indicative signs of dysphagia and appropriateness of referral for SLT clinical dysphagia assessment) when employed by two RGNs compared against the SLTR when screening two samples of 20 acute stroke patients. Rater agreement was substantial (k = .71 and k = .79, for detection of signs of dysphagia and k = .79 and k = .87 for appropriateness of referral). The final empirical stage evaluated the concurrent validity of the HeDSS tool measurement outcomes when employed by a second sample of two RGNs compared with the SLTR’s clinical dysphagia assessment outcomes in a sample of 100 acute stroke patients. The HeDSS tool measurement outcomes correlated highly with the clinical dysphagia assessment outcomes (sensitivity .88 - .96 and specificity .85 - .88 for detection of dysphagia; sensitivity .90 - .96 and specificity .84 - .88 for determining patients appropriate for assessment). Correlation coefficient measures confirmed high concurrent validity for the HeDSS tool (Phi ranged between .76 - .82). This study is the first in the UK to establish a reliable and valid dysphagia screening tool for use with acute stroke patients and has significantly advanced the professional knowledge base within this domain of practice. It is recommended that a multi-centred programme of research be undertaken to replicate this study with a larger nurse and patient sample.

LIMA, Eveline Nogueira. Análise fisiológica, bioquímica e proteômica de respostas ao estresse hidrico em genótipos de feijão-caupi [Vigna unguiculata (L.) Walp. ]. 2017. 118 f. Tese (Doutorado em Agronomia/Fitotecnia)- Universidade Federal do Ceará, Fortaleza, 2017. / Submitted by Deocleciano Xavier (dixavier.ufc@gmail.com) on 2017-05-31T18:47:56Z No. of bitstreams: 1 Tese Eveline final.pdf: 2295282 bytes, checksum: 9670bf45fb153919f6d8ecb2718bd846 (MD5) / Approved for entry into archive by Jairo Viana (jairo@ufc.br) on 2017-06-08T17:38:18Z (GMT) No. of bitstreams: 1 Tese Eveline final.pdf: 2295282 bytes, checksum: 9670bf45fb153919f6d8ecb2718bd846 (MD5) / Made available in DSpace on 2017-06-08T17:38:18Z (GMT). No. of bitstreams: 1 Tese Eveline final.pdf: 2295282 bytes, checksum: 9670bf45fb153919f6d8ecb2718bd846 (MD5) Previous issue date: 2017 / A physiological, biochemistry and proteomic studies were conducted on cowpea [Vigna unguiculata (L.) Walp.)], aiming to identify mechanisms involved in drought tolerance or susceptibility by using three different approaches. The importance of these studies is based on the fact that cowpea is a nutritional and economically crop cultivated mainly in the water deficient semiarid region of the Northeast of Brazil. Three experiments were conducted, two in a greenhouse and one in the laboratory. The objective of the first trial was to identify genotypes that were tolerant or susceptible to water deficit by using two approaches: (a) water deficit simulated by the use of PEG6000 (Polyethylene glycol) and (b) by Screening Box. The results of these trials revealed that the two methodologies were efficient to allowed the selection of cowpea “Pingo de Ouro 1,2” genotype as being tolerant to water deficit, while the “Santo Inácio Vermelho” genotype was found to be susceptible. The second trail aimed to look for understanding the mechanism underlying plants tolerant to drought by means of physiological and biochemistry characterization of drought tolerance in the contrasting genotypes susceptible. A completely randomized design (CRD) was used in a 4x2 factorial arrangement. The physiological responses, as measured by gas exchange, chlorophyll at the flowering stage, photosynthetic pigments, membrane damage by lipid peroxidation (DPL), and determination of organic solutes (Proline, Soluble Carbohydrates and N-amino acids) were characterized. Some mechanisms were effectives in identifying the “Pingo de Ouro 1,2” genotype tolerance to stomata conductance to water (gs). This observation showed the efficiency in the stomata control, the ratio of liquid assimilation rate and stomata conductance to stream (A/gs), water use efficiency (A/E), providing greater efficiency of water use in the tolerant genotype. The carboxylation efficiency and the total chlorophyll that had their values recovered when the genotype was irrigated again after the four days of severe water deficit, which indicated that the mentioned genotype can tolerant a longer period of drought. The goals of the third trial were to identify the differentially expressed proteins and proteins responses to the water deficits in the experimental genotypes of the trial number 2. Proteins were extracted from leaves, while the control treatments irrigated show moderate water deficit (-1,0 MPa) and severe deficit (-1,5 MPa) of each tolerant and sensitive water deficit genotype were evaluated by 2D-SDS PAGE, using mass spectrometry for identification of proteins. Within all the comparisons, 108 differentially expressed proteins were identified that were involved in several cellular pathways that affected the two genotypes. Proteins were identified both in the tolerant “Pingo de Ouro 1,2” genotype as well as in the susceptible to water deficit “Santo Inácio Vermelho” genotype. The conclusion is that these genotypes could be used as markers. The proteins that were most expressed among the mentioned genotypes, was the subunit of major partial ribulose-1,5 bisphosphate carboxylase/oxigenase, (chloroplast), and a difference was found between these proteins. Considering the described situation, it can be assumed that the tolerance has more efficient mechanisms of dry escape than the sensitive one. The results indicated information for understanding the molecular bases of tolerance and sensible cowpea genotypes under water deficit. / No presente trabalho foi realizado um estudo englobando fisiologia, bioquímica e proteômica no feijão-caupi, uma cultura de grande importância nutricional e econômica, principalmente para a região Nordeste. O objetivo geral do estudo foi de identificar mecanismos envolvidos na tolerância à seca no feijão-caupi utilizando as três abordagens. Para tanto, foram conduzidos três experimentos, dois em casa de vegetação e um em laboratório. No primeiro experimento o objetivo foi identificar genótipos de feijão-caupi tolerantes e suscetíveis ao déficit hídrico a nível de plântulas, utilizando-se de duas metodologias, estresse hídrico simulado com o uso de PEG6000 (Polietilenoglicol) e Screening Box. Os resultados demostraram que as duas metodologias se mostraram eficientes na seleção de genótipos de feijão-caupi, sendo o genótipo Pingo de Ouro 1,2 tolerante ao déficit hídrico e o genótipo Santo Inácio Vermelho sensível. No segundo experimento o objetivo foi compreender os mecanismos de tolerância por meio da caracterização fisiológica e bioquímica para tolerância à seca em genótipos de feijão-caupi contrastantes para essa característica. Utilizou-se o delineamento inteiramente casualizado (DIC), num arranjo fatorial 4x2. Foram caracterizadas as respostas fisiológicas, como trocas gasosas, florescência da clorofila a, pigmentos fotossintéticos, danos de membrana pela peroxidação de lipídeos (MDA) e determinação de solutos orgânicos (Prolina, Carboidratos Solúveis e N-aminoácidos). Alguns mecanismos foram eficientes em evidenciar a tolerância do genótipo Pingo de Ouro 1,2, como a condutância estomática ao vapor d’água (gs), demostrando eficiência no controle estomático; a razão da taxa de assimilação liquida e condutância estomática ao vapor d’agua (A/gs); a eficiência do uso da água (A/E), provando maior eficiência do uso desta no genótipo tolerante; a eficiência de carboxilação e a clorofila total que tiveram os seus valores recuperados quando o genótipo foi irrigado novamente após os quatros dias de déficit severo, demostrando que este genótipo pode tolerar por mais tempo o período de seca. No terceiro experimento o objetivo foi identificar as proteínas diferencialmente expressas e as proteínas responsivas aos déficits hídricos nos genótipos contrastantes do experimento 2. As proteínas foram extraídas de folhas de feijão-caupi, dos tratamentos controle (irrigado), déficit moderado (-1,0 MPa) e déficit severo (-1,5 MPa), de cada genótipo tolerante e sensível ao déficit hídrico e foram analisadas pela 2D-SDS PAGE, usando espectrometria de massa na identificação das proteínas. Dentro de todas as comparações foram identificadas 108 proteínas diferencialmente expressas, dessas foram encontradas proteínas envolvidas em várias vias celulares que afetou os dois genótipos. Foram identificadas proteínas tanto no genótipo Pingo de Ouro 1,2 (tolerante) quanto no genótipo Santo Inácio Vermelho (sensível), podendo estas ser utilizadas como marcadores. Das proteínas que foram mais expressas entre os genótipos tem-se a subunidade maior ribulose-1,5-bisfosfato carboxilase/oxigenase, parcial (cloroplasto). Uma diferença encontrada entre os dois genótipos está relacionada a essa proteína. O genótipo sensível teve maior repressão dessa proteína, com isso pode-se sugerir que o genótipo tolerante possua mecanismo mais eficiente de escape à seca que o sensível. Os resultados mostram informações para compreensão das bases moleculares em relação à tolerância e sensibilidade do feijão-caupi sob déficit hídrico.

The evolution of counseling is due in no small part to the leadership that has directed and fostered the development of the profession. That development is an ongoing process and though it may take many forms, counselor educators are called upon to act as the leaders that effect change in the field. According to the 2009 standards of the Council for Accreditation of Counseling and Related Educational Programs (CACREP), one of the primary obligations for doctoral programs is to prepare students to serve as leaders of the profession. It is not surprising then that the CACREP (2009) standards state that in addition to entry-level considerations, doctoral program admission criteria should include consideration of each applicant's professional leadership potential. Nevertheless, no guidelines exist that clarify the way in which faculty members are expected to go about determining an applicant's professional leadership potential. The purpose of this exploratory study was to gain insight into how faculty members at CACREP accredited doctoral programs assess leadership potential when screening new applicants. Specifically, this study focused on how leadership attributes (e.g., charisma) versus leadership processes (e.g., future-thinking orientation) factor into the way faculty members assess leadership potential. Participants were randomly assigned one of four study-created vignettes that described a hypothetical doctoral program applicant with varying levels of leadership attributes and processes. They were then asked to rate their "applicant's" leadership potential. A two-way ANOVA revealed that there was a significant interaction between leadership attributes and processes in that the applicant with high leadership attributes was given a higher leadership potential score than the applicant with both high leadership attributes as well as leadership processed. The results support the idea that faculty members at CACREP accredited doctoral programs tended to favor leadership attributes (e.g., charisma, sociability) in a potential leader over leadership processes (e.g., future-thinking orientation, knowledge). These findings also seem to suggest that participants somewhat penalized the applicant that also exhibited characteristics associated with leadership processes. Possible explanations for these findings as well as suggestions for future research are provided.

Much emphasis has been placed on early detection of developmental delays and disabilities due to increased knowledge regarding the important role early intervention can play in a young child's development. The American Academy of Pediatrics (AAP) published policy statements in 2001 and 2006 describing the role of pediatricians in the process of developmental surveillance and screenings. This study seeks to determine the current developmental surveillance and screening practices of pediatricians and family physicians in the southern nine counties of Illinois. Specifically the study aims at looking at to what extent pediatricians/family physicians use standardized developmental screening tools to screen infants and toddlers as described in the AAP recommendations. What methods are pediatricians currently utilizing to screen infants and toddlers (standardized instruments, self made checklists, clinical judgment) In addition, this study looks at to what extent do pediatricians/family physicians follow the AAP's recommendation process for referrals of infants and toddlers identified as at-risk for developmental delays?

No description available.

Objetivos: Principalmente nas regiÃes com maior carga de TB no mundo, ainda existe grande demora no recebimento dos exames diagnÃsticos de TB pelos pacientes. Pesquisadores da Rede Brasileira de Tuberculose desenvolveram e avaliaram o desempenho de um teste diagnÃstico para TB pulmonar: escore clÃnico Neural TB. O objetivo desse trabalho foi avaliar a efetividade do escore clÃnico Neural TB no diagnÃstico rÃpido de tuberculose pulmonar em unidade de referÃncia. MÃtodos: Foi realizado um ensaio clÃnico pragmÃtico, que recebeu intervenÃÃo diagnÃstica na segunda metade do projeto. Foram recrutados 351 pacientes com 18 anos de idade ou mais, com suspeita de TB pulmonar e aplicado o escore clÃnico Neural TB. Na primeira fase do estudo, os pacientes seguiram a rotina do Hospital. Na segunda fase, os pacientes tinham a coleta do escarro para baciloscopia antecipada de acordo com a classificaÃÃo pelo escore clÃnico. Para comparaÃÃo entre duas subpopulaÃÃes independentes foram utilizados o teste T-Student e o teste de Mann Whitney. Os resultados foram considerados significantes para um valor de p < 0,05. Foi calculada RazÃo de prevalÃncia e intervalo de confianÃa de 95%. A concordÃncia entre Escore e diagnÃstico de TB pulmonar foi realizada pelo Ãndice de Kappa. Resultados: Quando comparado ao diagnÃstico realizado atravÃs da baciloscopia do escarro, cultura do escarro ou diagnÃstico clÃnico-radiolÃgico em conjunto, o escore clÃnico Neural TB apresentou sensibilidade de 75,9%, especificidade de 48,8% e acurÃcia de 55%. O uso do escore clÃnico Neural TB foi capaz de diminuir o tempo entre a triagem e a leitura da lÃmina por baciloscopia em 1 dia (de 3,2 para 2,6 dias; p < 0,001). Apesar de diminuir o tempo para inÃcio do tratamento em mÃdia 4 dias com relaÃÃo ao grupo baseline (de 8,2 para 4 dias), essa diferenÃa nÃo foi estatisticamente significante (p = 0,166). ConclusÃes: O escore clÃnico pode ser uma ferramenta Ãtil na detecÃÃo de casos de TB pulmonar. Por sua simplicidade, nÃo necessita de equipamentos caros e complexos para sua execuÃÃo. Ao ser utilizado por um profissional treinado, o questionÃrio poderà gerar informaÃÃes sobre encaminhamentos ou pedidos de exames na abordagem do paciente sintomÃtico respiratÃrio, ou ainda ajudar na decisÃo sobre inÃcio do tratamento. / Objectives: Mainly in regions with the greatest TB burden in the world, there is still a delay for patients to receive the results of the diagnostic exams. Researchers from Rede Brasileira de Tuberculose developed and evaluated the performance of a diagnostic test for pulmonary TB: Neural TB clinical score. The objective of the present work is to evaluate the effectiveness of the Neural TB clinical score in the rapid diagnose of pulmonary tuberculosis in a reference unit. Methods: A pragmatic clinical essay with diagnostic intervention in the second half of the project was conducted. We recruited 351 patients aged 18 years or older, suspected of having pulmonary TB, and we applied the Neural TB clinical score to them. In the first phase of the essay, patients followed the routine of the Hospital. In the second phase, patients had collection of sputum samples for baciloscopy anticipated according to their classification by the score. T-Student test and Mann Whitney test were used to compare two independent subpopulations. Results were considered significant if p value < 0,05. Prevalence ratio and 95% confidence interval were calculated. Kappa index was used to measure conformity between the clinical score and pulmorary TB diagnostic. Results: Neural TB clinical score showed sensitivity of 75,9%, specificity of 48,8% and accuracy of 55% when compared to the diagnostic realised through sputum baciloscopy, sputum culture or clinical-radiological diagnostic altogether. The use of Neural TB clinical score was able to reduce time between patient screening and detection of organisms in a sputum sample slide in 1 day (from 3.2 to 2.6 days; p < 0.001). Although time until beginning the treatment was reduced 4 days in average when compared to the baseline group (from 8.2 to 4 days), this difference was not statistically significant (p = 0.166). Conclusion: The clinical score may be a useful tool for the detection of pulmonary tuberculosis cases. Because it is simple, it does not require expensive or complex equipment for its execution. As it is used by a trained professional, the questionnaire may produce information about referrals or test requests for the respiratory symptomatic patient, or even help in the decision of starting treatment.

Orientadores: Célia Regina Garlipp, Carlos Emilio Levy / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-21T18:20:39Z (GMT). No. of bitstreams: 1 Martinez_MayaraHidalgoMagri_M.pdf: 2010266 bytes, checksum: 23bb4f89ea7b258a0fd5fe0e20f6cc1f (MD5) Previous issue date: 2012 / Resumo: Infecção do trato urinário (ITU) é muito comum na prática clínica, acometendo pessoas de ambos os sexos em todas as faixas etárias. Para seu diagnóstico é importante definir rapidamente a presença de bacteriúria e piúria bem como a etiologia da doença através da urocultura. A urocultura é o teste microbiológico mais comum na prática laboratorial, embora seja um procedimento demorado e de custo relativamente elevado. Nosso objetivo foi avaliar a aplicação de um sistema automatizado de análise da urina (LabUMat/UriSed) como método de triagem para a investigação de ITU através da comparação de seus resultados com os das uroculturas. Analisamos amostras de urina de pacientes adultos e crianças de ambos os sexos provenientes de ambulatórios e enfermarias do Hospital de Clínicas da UNICAMP encaminhados às Seções de Líquidos Biológicos e Microbiologia da Divisão de Patologia Clínica para análise físicoquímica, sedimento e urocultura. Foram estabelecidos valores de cortes baseados na comparação dos resultados das uroculturas com os parâmetros urinários: leucócito-esterase, nitrito, leucócitos, bactérias e leveduras, sendo que a positividade de pelo menos um destes parâmetros classificava a amostra para uma triagem positiva para ITU. O estudo foi conduzido em três etapas: Na primeira etapa, a análise de 2126 amostras de urinas permitiu adotar um primeiro valor de corte para os parâmetros analisados: contagem de bactérias >11/campo; contagem de leucócitos >5/campo, presença de leveduras além de nitrito e leucócito-esterase positivos. Esses valores foram comparados com os resultados da urocultura em meio CLED e testados na rotina laboratorial. Em uma segunda etapa, com a finalidade de aprimorar o valor de corte dos parâmetros e aumentar o valor preditivo positivo sem comprometer o valor preditivo negativo, estabeleceu-se um novo valor de corte. Para tanto, foram analisadas 2075 amostras de urinas e com os seguintes valores de corte estabelecidos: contagem de bactérias 'maior ou igual'12,5/campo; contagem de leucócitos >5/campo, presença de leveduras e nitrito bem como leucócito-esterase positivo 'maior ou igual'2+. Esses valores foram comparados com os resultados das uroculturas em meio CLED e testados na rotina laboratorial. A fim de refinar e validar o teste de triagem para urocultura foram analisados, em uma terceira etapa, 1379 amostras de urina. Nesta etapa os valores de corte dos parâmetros foram: contagem de bactérias >12,5/campo, contagem de leucócitos >5/campo, presença de leveduras e leucócito - esterase positivos 'maior ou igual'2+. Nesta etapa as amostras cujos parâmetros urinários avaliados estavam abaixo do valor de corte, foram consideradas negativas para ITU e semeadas em meio CLED. As amostras em que pelo menos um dos parâmetros estudados estava acima do valor de corte, foram consideradas positivas, sendo semeadas em meio Chromagar a fim de se identificar presuntivamente os patógenos. O teste mostrou sensibilidade de 97%, valor preditivo negativo de 99%, valor preditivo positivo de 27%, especificidade de 59% e acurácia de 64%. Em todas as etapas observou-se uma potencial redução de 50% nas semeaduras de uroculturas. Os dados sugerem que o sistema automatizado LabUMat / UriSed é uma boa ferramenta para a triagem de ITU, especialmente se considerarmos os dados clínicos dos pacientes / Abstract: Urinary tract infection (UTI) is very common in clinical practice, affecting people of both genders in all age groups. For the laboratory diagnosis of UTI is of great importance the definition of significant bacteriuria and pyuria and a bacterial culture of a urine sample to establish the etiology of the disease. The quantitative urine culture is the commonest microbiology test in Clinical Pathology Laboratory practice, although it is a very time-consuming and expensive procedure. Our aim was to evaluate the performance of the LabUMat with UriSed System as a screening method for the investigation of UTI comparing its results with the outcome of urine culture. We studied urine samples from children and adults of both genders from outpatients and hospitalized patients from Clinical Hospital / UNICAMP referred to Body Fluids and Microbiology Laboratories at Division of Clinical Pathology for physicochemical analysis, sediment observation and urine culture. We established cut-off values based on the comparison of the outcome of urine cultures with urinary parameters: leukocyte esterase, nitrite and quantitative determination of bacteriuria, leukocyturia and presence of yeasts. A positivity of at least one parameter classified the sample as a positive screening of UTI. This study was conducted in three stages: In the first stage, the analysis of 2,126 urine samples allowed to adopt the first cut-off value for the parameters analyzed: quantification of bacteriuria (>11 elements/hpf), quantification of leukocyturia (>5 cells/hpf), presence of yeasts besides nitrite and leukocyte esterase positive. These values were compared with the outcome of uroculture in CLED agar medium culture and tested in the laboratory routine. In the second stage, in order to improve cut-off values of urinary parameters and increase the positive predictive value without compromising the negative predictive value, it was established a new cut-off value. We analyzed 2,075 urine samples with the following established cut-off values: quantification of bacteriuria (> or = 12.5 elements/hpf) and leukocyturia (> 5 cells/hpf), presence of yeasts, nitrite and leukocyte esterase positive (> or = 2+). These values were compared with the outcome of uroculture and tested in the laboratory routine. In order to refine and validate the screening test for uroculture were analyzed, in a third stage, 1,379 urine samples. In this stage the cutoff values of the parameters were: quantification of bacteriuria (>12.5 elements/hpf) and leukocyturia (> 5 cells/hpf), presence of yeasts and leukocyte esterase positive (> or = 2+). In this stage the urinary samples whose evaluated parameters were below the cut-off value were considered negative for UTI and were plated in CLED agar medium culture. Samples which at least one of the parameters evaluated was above the cut-off value, were considered positive, and were plated in Chromagar commercial medium, in order to presumptively identify pathogens. The test showed sensitivity of 97%, negative predictive value of 99%, positive predictive value of 27%, specificity of 59% and accuracy of 64%. In all stages we observed a potential 50% reduction in sowing urocultures. The data suggest that the LabUMat with UriSed System is a good tool for screening for UTI, especially if we consider patients' clinical data / Mestrado / Ciencias Biomedicas / Mestra em Ciências Médicas

Mammographic techniques used for screening programmes need to be of the highest quality; hence, the need of a good phantom to mimic breast response to radiation. The phantom materials must be sensitive to small changes in the mammography system and provide a means of evaluating the absorbed dose to the breast. These materials have to provide the same attenuation properties as the real tissues being simulated, for the radiation modalities being investigated. Cross-linked hydrophilic copolymers have the potential to be good phantom materials for the breast as their elemental compositions are similar to soft tissue. Two types of hydrophilic copolymer materials used in this study were designated as ED1S and ED4C. They were made from a certain proportionate mixture of methyl methacrylate and vinyl pyrrolidone. The physical properties of the materials such as liquid uptake and dimensional changes in hydration and dehydration processes were studied. The equilibrium water content of ED1S and ED4C fully hydrated in water was 55% and 70% respectively. The samples underwent distortion when dehydrated and a volume approximation formula for the dehydrated samples was derived. The linear attenuation coefficient and the mass attenuation coefficient of the hydrophilic copolymer materials at photon energies in the mammographic energy region were determined. Both a single beam transmission method and a photon transmission tomography method were used. The results were compared with XCOM calculated attenuation coefficients of water and average breasts using the elemental composition found in the literature. It was found that the mass attenuation coefficient of dry hydrophilic copolymer samples closely fit the XCOM calculated old-age breast (Breast 3) and samples fully hydrated in water fit the calculated young-age breast (Breast 1). Measurements were also carried out to determine the linear attenuation coefficient of normal and abnormal breast tissues at four photon energies in the mammographic energy region. The values found were in good accord with calculated average breast values. However, more studies need to be done as only three samples were used. The electron density of the hydrophilic copolymer materials was determined by using the Compton scattering technique. The electron density for dry ED1S sample was (3.1 +/- 0.4) x 1023 electrons per cm3 and for dry ED4C was (4.4 +/- 0.4) x 1023 electrons per cm3.