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Rastreamento da doença renal crônica: validação do questionário “Scored" nomograma para estimativa da taxa de filtração glomerular e avaliação dos marcadores funcional e de lesão do parênquima renalMagacho, Edson José de Carvalho 24 April 2014 (has links)
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Previous issue date: 2014-04-24 / FAPEMIG - Fundação de Amparo à Pesquisa do Estado de Minas Gerais / Fatores desencadeantes da Doença Renal Crônica (DRC), como hipertensão e diabetes principalmente, apresentam aumento de prevalência à medida que a população envelhece. Como desconhecemos a prevalência da DRC na pré-diálise na população brasileira e Bang e cols. propuseram um método para rastrear a DRC denominado Tabela Screening For Ocult Renal Disease (Scored), o objetivo do
estudo foi validar a tabela Scored no Brasil. Trata-se de um estudo transversal cuja amostra foi de 600 servidores da Universidade Federal de Juiz de Fora (UFJF) preferencialmente. Foram coletados dados sociodemográficos, realizados exames físicos, exames de urina e sangue e os entrevistados responderam à Tabela Scored. Para determinação da presença da DRC, foram considerados os critérios de filtração glomerular (FG) < 60mL/min/1,73m2 e/ou presença de proteinúria/microalbuminúria
como marcador de lesão renal identificados em um intervalo mínimo de 90 dias, como proposto pelo grupo de trabalho Kidney Disease Outcomes Quality Iniciative (K/DOQI), apoiado pela National Kidney Foundation (NKF) americana. Para validação do questionário original, foi calculada a sensibilidade, a especificidade, a acurácia, valores preditivos positivo (VPP) e negativo (VPN). O questionário Scored
apresentou sensibilidade de 80%, especificidade de 65%, VPP de 14%, VPN de 97% e acurácia de 66%. A DRC foi diagnosticada pelo critério de filtração glomerular estimada < 60mL/min/1,73m2 (8,8%), por relação albumina creatinina alterada (5%) e por presença de hematúria glomerular (16,3%) no primeiro exame, tendo se confirmado no segundo exame por filtração glomerular estimada < 60mL/min/1,73m2
(3,5%), por relação albumina creatinina alterada (3%) e por presença de hematúria glomerular (9,5%). As etapas cumpridas no processo de adaptação transcultural permitiram desenvolver a versão brasileira do questionário Scored, de fácil compreensão, aceitação e de baixíssimo custo, e poderá constituir importante instrumento de rastreio de pessoas com chance de apresentar DRC. Na avaliação
laboratorial da DRC, a repetição dos exames para estimativa da FG, pesquisa de proteinúria/microalbuminúria e hematúria glomerular se mostrou fundamental para conclusão diagnóstica, principalmente este último que apresentou percentuais importantes de confirmação. / Triggering factors of Chronic Kidney Disease (CKD), such as hypertension and diabetes mostly, present an increase in the prevalence as the population ages. We are unaware of the prevalence of CKD in the pre-dialysis of the Brazilian population and Bang and Cols proposed a method to track the DRC called SCORED system (Screening For Occult Renal Disease). The aim of the study was to validate the
Scored table in Brazil. This is a cross-sectional study which sampled 600 employees of the Universidade Federal de Juiz de Fora (UFJF), preferably. Socio-demographic data were collected, physical examinations, urine and blood were performed and those interviewed answered the Scored Table. To determine the presence of CKD were considered the Glomerular Filtration Rates (GFR) 60mL/min/1,73m2 and also the presence of proteinuria / microalbuminuria as a marker of kidney damage identified at a interval of at least 90 days, as proposed by the working group Kidney Disease Outcomes Quality Initiative (K / DOQI), supported by the american National Kidney Foundation (NKF). For the validation of the original questionnaire, the sensitivity, specificity, and accuracy were calculated, as well as the positive predictive values (PPV) and negative predictive values (NPV). The Scored questionnaire showed a sensitivity of 80%, specificity of 65%, PPV 14%, NPV 97% and an accuracy of 66%. CKD was diagnosed according to the criteria of estimate glomerular filtration rate < 60mL/min/1,73m2 (8,8%), by the relation of amended
albumin creatinine (5%) and by the presence of glomerular hematuria (16.3%) at the first examination, being confirmed in the second examination by estimate glomerular filtration rate of 60mL/min/1,73m2 (3,5%), by the relation of amended albumin creatinine (3%) and by the presence of glomerular hematuria. The steps taken in the cross-cultural adaptation process allowed the development of the Brazilian version of the Scored questionnaire, easy to understand, with good acceptance and very low cost, this may constitute an important screening tool for people with chance of having CKD. As for the laboratory evaluation of CKD, repeating the exams to estimate the GF, the search for proteinuria / microalbuminuria and glomerular hematuria proved fundamental to the diagnostic conclusion, especially this latter, which showed significant percentage of confirmation.
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A Comprehensive Neuropsychological Screening Device for Adults: Reliability of Parallel FormsGanci, Maria 12 1900 (has links)
The purpose of the present study was to evaluate the reliability of parallel-forms of the Comprehensive Neuropsychological Screening Device (CNS). Forty-five subjects ranging in age from 16 to 69 were administered Form A and Form B of the CNS at two week intervals. Results indicated that the CNS has adequate test-retest reliability. The results suggest the applicability of using the CNS as a screening device for brain dysfunction.
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Approches et outils pour l’évaluation de l’Exposome : du dosage de contaminants vers le screening non ciblé pour la caractérisation des expositions humaines environnementales / Approaches and tools for assessing the Exposome : from dosage of contaminants to screening for characterization of human environmental exposureCortejade, Aurélie 20 November 2015 (has links)
Ces travaux mettent en avant le développement de méthodes analytiques afin d'évaluer l'Exposome selon différentes stratégies. Une méthode multirésidus sélective permettant l'analyse d'additifs plastiques et de leurs produits de dégradation pouvant être relargués par des emballages plastiques dans les boissons et les aliments, et ainsi être ingérés par l'Homme, a tout d'abord été mise au point. Cette méthode consiste en une extraction de type Stir Bar Sorptive Extraction sur des barreaux à base de dérivés de polydiméthylsiloxane des additifs plastiques ciblés, suivie d'une analyse par chromatographie liquide ultra-haute performance couplée à un spectromètre de masse en tandem de type triple quadripôle. Afin de détecter et quantifier une plus large gamme de contaminants entrant en contact avec l'Homme, une méthode de screening a été développée par chromatographie liquide couplée à la spectrométrie de masse haute résolution avec un instrument de type QqToF, à partir d'une matrice urinaire. La méthode de screening ciblé, validée selon les recommandations FDA, a permis de quantifier des contaminants appartenant à diverses familles dans l'urine, sans préparation préalable de l'échantillon, à des concentrations de l'ordre du ng/mL. Appliquée à des urines de volontaires, la méthode de screening non ciblé a permis d'émettre de nombreuses hypothèses d'identification de composés après fragmentation MS/MS. La mise en place de tels outils pour caractériser l'Exposome, associée à des études statistiques et bio-informatiques, contribueront grandement à la compréhension des relations de causalité entre les maladies humaines et les facteurs environnementaux / These research works highlight the development of analytical methods, based on mass spectrometry, to assess the Exposome according to different strategies. A selective multiresidue method for the analysis of plastic additives and their degradation products that may be released by plastic packaging in food and beverages and thus ingested by man was developed. This method consists of a Stir Bar Sorptive Extraction with bars covered by polydimethylsiloxane derivatives, followed by an analysis by liquid chromatography coupled to tandem mass spectrometry with a triple quadrupole instrument. To detect and quantify a wide range of contaminants in contact with man in daily routine, a screening method was developed by liquid chromatography coupled to high resolution mass spectrometry with a quadrupole-time-of-flight instrument from urinary matrix. The targeted screening method validated according to FDA guidelines allows the quantification of contaminants classified according to different families, in urine without sample preparation, at concentrations of the order of ng.mL-1. This method was applied to volunteers’ urine samples. The non-targeted screening method allows issuing numerous assumptions of compound identification after MS/MS fragmentation. The implementation of this tool to measure the Exposome associated with statistical studies, contribute greatly to the understanding of the causal relationships between diseases and environmental factors
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Biological and phytochemical screening of major compounds in Cephalanthus natalensisNgwenya, Nomcebo Marcia 02 May 2012 (has links)
M.Sc. / Cephalanthus natalensis of the Rubiaceae family of plants is used in traditional medical systems. Different parts of this shrubby plant are used to treat different ailments. In this study, the use of C. natalensis for medicinal purposes was investigated. Plant materials (leaves, bark and fruits) were collected from different localities in Swaziland. Extraction of phytochemicals in C. natalensis was done by maceration in four solvents of increasing polarities: hexane, dichloromethane, ethyl acetate and methanol. Amino acids and alkaloids were also extracted in boiling water and mild acid, respectively. Phytochemical screening of compounds was done by means of TLC, HPLC and GC-MS. Previously reported TLC screening of C. natalensis indicated the presence of alkaloids. This study also confirmed the presence of alkaloids, although these were not isolated. No other chemical compounds have been reported from this plant in literature. Phenolic compounds and terpenes were extracted and detected by the chromatographic methods employed. GC-MS analysis was also used to identify and quantify amino acids in the extracts. A phytochemical assessment of compounds was done by investigating the leaves, bark and fruits of C. natalensis. A further phytochemical variation study was conducted by comparing these phytochemicals and their relative concentrations in C. natalensis plants collected from five different localities. While the same compounds were present in all the plants sampled, the concentrations of the different compounds seemed to vary irrespective of the geographic location of the plants sampled. In the different plant parts collected, some common compounds were present in the leaves, bark and fruits and other compounds varied between the different parts studied. The traditional usage of C. natalensis as fever and malaria remedy was investigated in vitro. Antibacterial and antimalarial tests of crude extracts were done. The antibacterial test on the extracts against five bacteria: Bacillus cereus, Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli and Pseudomonas aeruginosa showed an average activity in all the plant parts tested. The average MIC values ranged from 0.917 mg/mL to >100 mg/mL. In the antimalarial test the extracts inhibited 50% of Plasmodium falciparum growth at concentrations ranging from 27 μg/mL to >100 μg/mL. Hexane extracts of the bark had notable antimalarial activity with the highest inhibition at the lowest concentration of 27 μg/mL. The fruits were not as active as expected since they are particularly used as malaria remedy in traditional medicine. Two compounds were also isolated from methanol extracts of C. natalensis for the first time. A volatile isoprenoid ketone, (5E,9E)-6,10,14-trimethylpentadeca-5,9,13-trien-2-one, was isolated and characterised. The structure of the second compound could not be completely characterised due to complex data obtained from the NMR experiments.
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Generalizability of Universal Screening Measures for Behavioral and Emotional RiskTanner, Nicholas Andrew, Tanner, Nicholas Andrew January 2017 (has links)
Data derived from universal screening procedures are increasingly utilized by schools to identify and provide additional supports to students at-risk of behavioral and emotional concerns. As screening has the potential to be resource intensive, effort has been placed on the development of efficient screening procedures, namely brief behavior rating scales. This study utilized classical test theory and generalizability theory to examine the extent to which differences among students, raters, occasions, and screening measures affect the meaningfulness of data derived from universal screening procedures. Teacher pairs from three middle school classrooms completed two brief behavior rating scales during fall and spring screening administrations for all students in their respective classrooms. Correlation coefficients examining interrater reliability, test-retest reliability, and concurrent validity were generally strong. Generalizability analyses indicated that the majority of variance in teacher ratings were attributable to student differences across all score comparisons, but differences between teacher ratings for particular students accounted for relatively large percentages of error variance among student behavior ratings. Although decision studies showed that increasing the number of screening occasions resulted in more generalizable data, the impact of increasing the number of raters resulted in more efficient screening procedures.
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Affordable headphones for accessible screening audiometry : an evaluation of the Sennheiser HD202 II Supra-aural headphoneVan der Aerschot, Marc Katty January 2017 (has links)
It is estimated that approximately 360 Million people have a permanent disabling hearing loss (WHO, 2015). The majority of these people live in lower to middle income countries, where screening and follow-up treatment is not always accessible (WHO, 2015). School based hearing screening is one of the procedures that are not always available due to a number of challenges one of which include the high cost of audiometrical headphones. School based hearing screening is performed with an audiometrical headphones and audiometer, it usually can be used to test all school-aged children and adults.
In an attempt to reduce the cost of school based hearing screening, this study evaluated the Sennheiser HD 202 II headphone to establish it as a widely available and cost-effective alternative for audiometrical headphones currently used. The headphones were compared to ISO standards (ISO 389-1, ISO 389-5 and ISO 389-9) and IEC standards (IEC 60318-1 and IEC 60645-1). The following characteristics of the headphone were compared: equivalent threshold sound pressure levels, attenuation, maximum permissible ambient noise levels, force of the headband, total harmonic distortion and frequency response.
After evaluation the Sennheiser HD 202 II does not show the same standard as audiometrical headphones for diagnostic testing. The headphone can however be used for screening purposes if a few measures are taken into account. The correct ETSPL values should be used, disruptive background noise should be avoided and only the frequencies from the research (250- 1600 Hz) can be tested. once these measures are taken into account the Sennheiser HD 202 II proves to be a cost-effective alternative headphone for screening purposes. / Dissertation (M Communication Pathology)--University of Pretoria, 2017. / Speech-Language Pathology and Audiology / M Communication Pathology / Unrestricted
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Bio-pharmacological screening on liver-protective and anti-hepatocarcinoma activities of Vietnam natural products / Etude par ciblage pharmacologique des propriétés hépatoprotectrices ou anti-hépatocarcimone de substances naturelles du VietnamPham, Minh Quan 30 May 2016 (has links)
Le carcinome hépatocellulaire (HCC) est le cancer du foie le plus répandu et représente la seconde cause de décès par cancer dans le monde. Un mauvais pronostic et l'absence de traitement efficace en font un problème majeur de santé publique dans les pays en voie de développement, notamment en Asie du Sud-Est, justifiant pleinement la recherche de molécules ou d'approches thérapeutiques nouvelles contre l'HCC. Ce travail porte sur la recherche de molécules isolées de plantes vietnamiennes actives contre l'HCC. La première approche a consisté en un criblage pharmacologique de 33 substances naturelles qui a conduit à l'identification de 7 ent-kaurane diterpénoïdes isolés de Croton kongensis Gagnep. présentant des propriétés antiprolifératives originales. La seconde approche, par criblage in silico d'une banque de 354 substances naturelles, a permis d'identifier la solasonine comme inhibiteur de l'interaction mortalin - p53 induisant l'apoptose dans la lignée cellulaire humaine HepG2. / Human hepatocellular carcinoma (HCC) is the most common type of liver cancer, the second most common cause of death from cancer worldwide. A very poor prognosis and a lack of effective treatments make liver cancer a major public health problem, notably in less developed regions, particularly in Eastern Asia. This fully justifies the search of new molecules and therapeutic strategies against HCC. The present work focused on finding bioactive compounds from Vietnamese plants against HCC. The first approach used classical screening of 33 natural compounds which resulted in the identification of 7 ent-kaurane diterpenoids isolated from Croton kongensis Gagnep. as potential agents. The second approach aimed at identifying molecules that could abrogate the interaction between Mortalin and p53 by in silico screening of a database of 354 natural compounds, which allowed the identification of Solasonine as a potent inhibitor of p53 - mortalin interactions.
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Marketing Strategy of YouTube in the Czech Republic / Marketingová Strategie YouTube v České republiceHurychová, Andrea January 2012 (has links)
The goals of the thesis are to present YouTube in the Czech Republic, to discuss its entire business model, analyze the main local competitors and mostly to suggest marketing strategy that will strengthen the position of YouTube as an online medium. The current trends in the internet society are introduced as well as the role of social media in order to understand how these factors are related to the position of YouTube in marketing. From general YouTube introduction the situation of this platform in the Czech market is analyzed. Based on this deep analysis, the key factors that should be taken into account in the Czech YouTube marketing strategy will be discussed.
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An evaluation of cystic fibrosis screening programmes for implementation in British ColumbiaScriabin, Jannie Martine January 1982 (has links)
Four methods were investigated to determine their suitability for use in a CF screening programme for the province of British Columbia.
A fecal trypsin method which measured trypsin activity by incubating dry stool samples on filter paper cards with the substrate p-tosyl-arginine methyl ester (TAME) and a pH sensitive dye was shown to be non-specific and therefore unsatisfactory.
An attempt to combine a fecal albumin screen with a more specific quantitative immunodiffusion technique for albumin and alpha-1 antitrypsin was unsuccessful.
A meconium albumin assay using the Boehringer-Mannheim Corporation (BMC) test-strip and a more specific fecal trypsin assay which uses the substrate benzoyl-arginine-p-nitroanilide (BAPNA) were incorporated into two pilot projects at Children's Hospital in Vancouver.
The BMC test-strip was simple to use, reliable and inexpensive. Of 8,891 infants tested, 3 positives were diagnosed as suffering from cystic fibrosis and 1 CF patient tested negative. False positives were obtained on 1.3% of infants. The incidence of CF as determined by this screen was 1 in 2000. The meconium albumin screen was satisfactory as a local pilot project but the disadvantages of testing the unstable meconium specimens make the screen unsuitable for a province-wide application.
The BAPNA fecal trypsin method devised by Crossley was used to test 4085 dry stool specimens collected in the hospital and at home. Out of a total number of 190 positive results, none was diagnosed as having CF, giving a false positive rate of 5.0% for the hospital collected specimens
and 3.4% for the specimens collected at home. The false positive rate in the hospital collected specimens was due mostly to the large proportion of young infants (under 3 days). The false positive rate of the home collected specimens appeared to be due mostly to the thinner spread of stool sample on the card. Because the quantity of stool sample per test was significantly lower in the home than the hospital collected specimens a new cut-off point for the home collected specimens was considered. Its application/ however did not lower the false positive rate sufficiently. As a result, the high incidence of false positives and the difficulties encountered as a result of this incidence also makes the fecal trypsin screen unsuitable for the province of B.C.
Difficulties encountered during the follow-up of positive results obtained in the two pilot projects are discussed and recommendations are made regarding the efficient and adequate implementation of a follow-up system. / Medicine, Faculty of / Pathology and Laboratory Medicine, Department of / Graduate
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A descriptive study of a screening clinic for 3-year-oldsMyers, Dorothy Rae January 1978 (has links)
A community health unit in a British Columbia suburb established a screening clinic for 3-year-olds modelled on similar programs already operating in nearby localities. The purpose of the study was to describe this new screening clinic: to report on the procedures employed, the personnel involved, the characteristics of the clientele, and the types, incidence, and disposition of problems detected amongst the children brought to the clinic.
The study population consisted of the 47 children and their parents who were the clients of the clinic during its first three months. The research instruments were original questionnaires and forms devised to obtain sociological and health history information. The forms were completed during a home visit and by a telephone interview with each family. The data are arranged in frequency tables and percentages calculated where appropriate. A few variables are cross-tabulated to add descriptive depth to the study.
The families in the study were from the middle and upper-middle class segment of society. They had frequently used other health resources in the community. The mothers' main concerns were about speech and language development and behavior problems of their children. Twenty-four children were referred by the clinic staff for 39 problems requiring retesting, further investigation, or intervention. Twelve of these referrals were for problems of vision, 10 for behavior, 6 for speech and language, 3 each for hearing, nutrition, and dental health, and 2 for physical developmental delay.
The children cooperated enthusiastically in the test procedures and their parents found the clinic to be reassuring and a valuable learning experience. The parents were willing to comply with the referrals, but some delays in the follow-up procedures were noted, due to the newness of the clinic.
The screening clinic for 3-year-olds appears to be filling a previously unmet need in the community. Community health workers involved in planning and promoting new services should find the detailed descriptions of the procedures and of the clientele of the clinic useful to them. The extensive bibliography provides a background of published material on the rationale and result of a variety of methods of screening. Comparison with similar clinics in other areas will be impossible until terminology used, test procedures employed, and methods of reporting results are standardized. Meanwhile, the clinic staff should continue to maintain statistical evidence of the results obtained and to evaluate the procedures used in its program. / Applied Science, Faculty of / Nursing, School of / Graduate
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