The aim of this study is to examine the knowledge and experience of the bad breath among high school students in Kristianstad. A further objective was to measure the amount of VSC (Volatile Sulfur Compounds) among those who perceive themselves to have a bad breath. A questionnaire with 21 closed questions was distributed to 120 high school students from Kristianstad municipality who were between the ages of 17-20. The results of this study revealed that most of the students had good knowledge of halitosis. The majority of all participants thought it was important to smell fresh in the mouth and also experienced most of their breath as very good or good. Only a few felt that they had bad breath. However, these persons did think their breath affect their everyday life. Furthermore, they have never felt embarrassed or caught in embarrassing situations due to their breath. The results from the clinical examination was carried out on 8 of the 120 students and was designed to measure the amount of sulphurous gases in the oral cavity which revealed that the average values that emerged in the examination below is the limited values for having a poor breath. / Syftet med denna studie var att undersöka kunskapen och upplevelsen av dålig andedräkt hos gymnasieelever i Kristianstad, ytterligare ett syfte var att mäta mängden VSC (reaktiva svavelföreningar)  hos dem som upplever sig ha dålig andedräkt. En enkät med 21 slutna frågor delades ut till 120 gymnasieelever som var mellan 17-20 år och studerade i Kristanstads kommun. Av resultatet i denna studie framkom att de flesta av gymnasieeleverna hade goda kunskaper om halitosis. Nästan alla 120 som besvarade enkäten tyckte att det var viktigt att lukta fräsch i munnen och dessutom upplevde de flesta sin andedräkt som mycket bra eller bra. Endast ett fåtal (14% ) kände att de ibland hade dålig andedräkt. Hos dessa  påverkades inte andedräkten deras vardagliga liv och de hade aldrig blivit generade eller hamnat i pinsamma situationer på grund av sin andedräkt. Resultatet från den kliniska undersökningen som gjordes på 8 av de 120 elever som besvarade enkäten där mängden av de svavelhaltiga gaserna i munhålan mättes visade att i genomsnitt ligger värden som framkom i undersökningen under gränsvärden för att man skall ha dålig andedräkt.

Functional magnetic resonance imaging (fMRI) is a widely used, noninvasive technique to map brain activation, and has provided considerable insight into human brain function over the past two decades. Until recently, fMRI studies have focused on gray matter; however, reports of fMRI activation in white matter are mounting. White matter fMRI activation has the potential to greatly expand the breadth of brain connectivity research, as well as improve the assessment and diagnosis of white matter and connectivity disorders. Despite these potential benefits, white matter fMRI activation remains controversial. The controversy is partially due to the existence of incompletely understood facets of fMRI signals in white matter. This thesis describes three experiments that aim to refine what is currently known about white matter fMRI activation. In the first experiment, one of the main concerns about fMRI activation in white matter was addressed; namely, whether white matter has sufficient cerebrovascular reactivity to support hemodynamic changes that can be measured with fMRI. It was demonstrated that white matter has the capacity to support detectable hemodynamic changes in the absence of partial volume effects. In the second experiment, the effect of static magnetic field strength on sensitivity to white matter fMRI activation was explored as a possible cause of the relative paucity of reports of white matter fMRI activation. The results showed greater sensitivity to white matter fMRI activation at 4 T relative to 1.5 T MRI. In the third experiment, the relationship between white matter activation and the activated network of gray matter regions was explored. This was accomplished using fMRI-guided tractography in which structural connections between activated clusters are evaluated. Structural connectivity between white matter fMRI activation and regions of gray matter activation was demonstrated, providing evidence of the functional significance of fMRI activation in white matter. These experiments provide important insights, which will allow for improved investigations of white matter fMRI activation in the future. In addition, it is posited that experimenter bias, via selective reporting of activation clusters, has contributed to the slow acceptance of fMRI activation in white matter.

Fluorescence energy transfer from poly(9,9-dioctylfluorene) to polymeric energy acceptors that include head-to-tail regioregular poly(3-hexylthiophene or P3HT) and poly(2-methoxy-5(2 -ethylhexyloxy)-1,4-phenylenevinylene) or MEH-PPV and monomeric acceptor meso-tetraphenylporphyrin or TPP was studied and correlated with the underlying morphology when the donor-acceptor blends were prepared as drop-coated films or breath-figure structures. It was found that the phase-separate morphology in films and breath figures was influenced by a number of factors, including material transport dynamics, solubility of the blend components in a solvent, interaction of the solvent with the substrate, and the diffusion rate of the blend components.

Introdução: As doenças cardíacas ou do aparelho circulatório são as principais causas de morte na população brasileira, sendo responsável por um terço dos óbitos. Embora o tratamento conservador seja amplamente adotado, grande parte das doenças cardiovasculares necessita e tem como tratamento a cirurgia cardíaca, da qual as mais comuns são a cirurgia de revascularização do miocárdio (CRVM) e de troca valvar. Atualmente existem diversos estudos avaliando a função pulmonar ou a capacidade funcional para o acompanhamento do tratamento conservador ou em situação pré-operatória, porém estudos avaliando e correlacionando essas variáveis no pré-cirúrgico são escassos na literatura científica não sendo possível averiguar a existência da relação entre os níveis de nitrito e nitrato e o desempenho nos testes de capacidade funcional. Objetivo: Avaliar a correlação nitrito/nitrato (NOx) do condensado do exalado pulmonar (CEP) e a distância caminhada nos testes de caminhada de 6 minutos (TC6) e shuttle walk test (SWT), além de verificar se a utilização de medicações contendo betabloqueadores, nitrato ou enzima conversora de angiotensina (IECA) podem influenciar nas concentrações de nitrito/nitrato no CEP e nas distâncias caminhadas no TC6 e no SWT e comparar seu comportamento entre valvopatas e coronariopatas no pré operatório de cirurgia cardíaca. Metodologia: Foram selecionados 73 pacientes, dos quais 28 eram coronariopatas e 45 valvopatas, de ambos os sexos, com idade entre 20 e 80 anos, feita coleta do CEP para análise do NOx e submetidos ao TC6 e ao SWT para avaliação da distância caminhada. Resultados: Na análise das concentrações de NOx do CEP não foi encontrada diferença estatisticamente significativa entre as medicações utilizadas via oral contendo nitrato (dinitrato de isossorbida), IECA (captopril ou enalapril) e/ou betabloqueador ou entre os pacientes do grupo coronariopata e grupo valvopata (p>0,05). Houve diferença estatisticamente significativa no TC6 nos valores de frequência cardíaca (FC) inicial, final e repouso e no valor referente à dispnéia final, e no SWT nos valores de FC inicial, final e repouso, na pressão arterial sistólica (PAS) inicial e no valor referente à dispnéia final entre os grupos coronariopata e valvopata. No entanto, foram interrompidos 4 TC6 e 7 SWT do grupo coronariopata devido ao desencadeamento de dor precordial, fato não ocorrido no grupo valvopata, apresentando nível de significância. A FC inicial e de repouso no TC6 e a FC final no SWT dos pacientes que não ingeriram nenhum medicamento antes do teste é diferente em relação à dos pacientes que fizeram uso de quaisquer medicamentos descritos antes do teste sugerindo a ação de medicamentos que modulam a FC como os betabloqueadores. Foi constatado correlação positiva moderada entre o NOx do CEP e os valores de PAS inicial e final de coronariopatas e correlação negativa fraca a moderada entre o NOx do CEP e os valores de FC final e de dispnéia final nos valvopatas no TC6, além da correlação positiva moderada entre o NOx do CEP e os valores de PAS inicial de indivíduos coronariopatas e correlação negativa fraca a moderada entre o NOx do CEP e os valores de FC inicial nos valvopatas no SWT. Foi identificado correlação negativa moderada na distância caminhada no TC6 e no SWT apenas nos indivíduos coronariopatas. Conclusões: Não foram identificadas influências do uso de medicações betabloqueadoras, nitrato ou IECA sobre a dosagem de NOx ou a distância caminhada em nenhum dos testes e em nenhum dos grupos, no entanto coronariopatas com níveis mais elevados de NOx apresentaram uma distância deambulada menor. / Introduction: Heart disease or circulatory system diseases are the leading causes of death in our population, accounting for one third of deaths. Although conservative treatment is widely adopted, part of cardiovascular disease treatment demands heart surgery, of which the most common are coronary artery bypass grafting (CABG) and valve replacement. Currently there are many studies evaluating lung function or functional capacity for monitoring of conservative treatment or preoperative situation, but studies assessing and correlating these variables in pre surgical are rare in the literature is not possible to ascertain the existence of the relationship between levels of nitrite and nitrate (NOx) in exhaled breath condensate (EBC) and performance in functional ability tests. Methods: were selected 73 patients, 28 with coronary artery diseas and 45 with heart valve disease of both genders, aged 20 to 80 years old. The EBC was collected for analysis of NOx and performed the six minutes walking test (6MWT) and shuttle walk test (SWT) to evaluate the distance walked. Results: the analysis of the concentrations of NOx in EBC has no statistically significant difference found between the medications used, such as oral nitrate (isosorbide dinitrate), ace inhibitors (captopril or enalapril) and/or beta-blockers in both coronary artery disease and heart valve disease (p> 0.05). There was a statistically significant difference in 6MWT for HR initial, final and rest and final dyspnea, and in SWT for HR initial, final and rest, the initial SBP and the final dyspnea between the coronary artery disease e heart valve disease. However, were interrupted 4 6MWT and 7 SWT from coronary artery disease related to chest pain, this fact was not related in patients with valve disease, presenting a significance level. The initial and resting HR during the 6MWT and in SWT final HRr patients not ingesting any medication before the test is different from patients who used any medications before the test, suggesting the action of drugs that modulate the HR, such as beta blockers. Moderate positive correlation was found between the NOx in EBC and SBP initial and final in coronary disease and weak to moderate correlation between the NOx in EBC and final HR and final dyspnea in 6MWT from heart valve disease. Besides the positive moderate correlation between NOx in the EBC and the SBP initial in coronary disease during 6MWT and weak to moderate negative correlation between NOx in the EBC and the HR initial in valve disease during SWT. Moderate negative correlation was identified in the distance walked during the 6MWT and SWT only between individuals with coronary artery disease. Conclusions: the use of beta-blocker drugs, ace inhibitors or nitrate evidenciates no influence on the NOx or on the distance walked in any tests, and none of the groups, however, individuals with coronary artery disease showed higher NOx levels and performed lower distance walked.

Introdução: A má digestão de lactose detectada por testes respiratórios é bastante comum em pacientes com síndrome do intestino irritável (SII), e alguns pacientes com SII referem exacerbar seus sintomas após a ingestão de leite e produtos lácteos. A fim de uma melhor percepção sobre este tema, este trabalho investigou os efeitos da dieta isenta de lactose em pacientes com SII e teste respiratório de hidrogênio para avaliação da digestão de lactose normal ou anormal. Objetivo: Avaliar os efeitos de uma dieta isenta de lactose em pacientes de SII com ou sem teste positivo para má digestão de lactose (teste respiratório). Métodos: 80 pacientes atendidos no Ambulatório de Doenças Funcionais Intestinais do Serviço de Gastroenterologia Clínica do HCFMUSP foram recrutados para o estudo prospectivo. Os pacientes preencheram os critérios de Roma III para SII. Durante o ensaio do teste respiratório de hidrogênio todos os sintomas desencadeados pela ingestão de lactose foram anotados. Ambos os grupos de pacientes com e sem má digestão de lactose, foram submetidos a uma dieta isenta de lactose durante 4 semanas. A história prévia de intolerância ao leite e derivados também foi documentada. No final de cada semana, os pacientes foram solicitados a informar a respeito dos seus sintomas, e os resultados, foram devidamente marcados de acordo com a sua intensidade (Escore Global). Além disso, foi também obtida a Avaliação Global do Paciente no final do tratamento (AFG). Resultados: 33/80 (41,25%) pacientes com SII tiveram um teste respiratório anormal para a má digestão de lactose, e 47/80 dos pacientes (58,75%) com SII tiveram um teste respiratório normal (ns). Não houve diferença significativa na freqüência de queixas de intolerância prévia ao leite e derivados em ambos os grupos. No entanto, mais pacientes no grupo com má digestão de lactose referiram sintomas durante o teste respiratório com 25 g de lactose do que o grupo com digestão normal a lactose (p <0,001). Ambos os grupos igualmente melhoraram após uma dieta isenta de lactose, quando avaliados pelo escore geral e pelo AFG. Conclusões: Ambos os grupos de pacientes com SII, com e sem má digestão de lactose, melhoraram após 4 semanas de dieta isenta de lactose. Os nossos resultados sugerem que outros mecanismos, além da intolerância à lactose, devem ser levados em conta para explicar a melhora com uma dieta isenta de lactose em pacientes com SII / Introduction: Lactose intolerance detected by respiratory tests is rather common in patients with irritable bowel syndrome(IBS); also, some IBS patients refer their symptoms exacerbate after ingestion of milk and dairy products. In order to gain some insight into this topic we investigated the effects of a lactose-free diet in IBS patients with and without lactose intolerance diagnosed by means of the hydrogen respiratory test. Objective: To evaluate the effects of a lactose-free diet in IBS patients with and without lactose intolerance. Methodos: 80 patients who attended the outpatient clinic at the University of São Paulo School of Medicine Hospital, Brazil, were recruited for this prospective study. Patient met the Rome III criteria for IBS. During the hydrogen respiratory test all the symptoms triggered by lactose ingestion were taken down. Both groups of patients, with and without lactose intolerance, were submitted to a lactose-free diet for 4 weeks. Previous history of milk/dairy products intolerance was documented. At the end of each week, patients were asked to inform about their symptoms and the results were duly scored according to their intensity (Global Score). Also, the Patient Final Global Evaluation of the Treatment (PFGET) was obtained as well. Results: 33/80 (41.25%) IBS patients had an abnormal respiratory test for lactose intolerance; 47/80 (58.75%) IBS patients had a normal respiratory test (n.s.). There was no significant difference in the frequency of previous complaints after milk/dairy products ingestion in both groups. However, more patients in the lactose intolerant group referred symptoms during the respiratory test with 25 g of lactose than the lactose tolerant group (p<0,001). Both groups similarly improved after a lactose-free diet when evaluated by both the Global Score and the PFGET. Conclusions: Both groups of IBS patients, with and without lactose intolerance, improved after a 4-week lactose-free diet. Our results suggest that other mechanisms, in addition to lactose intolerance, should be taken into account to explain why IBS patients improve with a lactose-free diet

Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2015-05-25T13:09:16Z No. of bitstreams: 2 Tese - Felix André Sanches Penhavel - 2014.pdf: 2537517 bytes, checksum: 2edff02f8a1f3fa50c180c2222a53b17 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2015-05-25T13:34:49Z (GMT) No. of bitstreams: 2 Tese - Felix André Sanches Penhavel - 2014.pdf: 2537517 bytes, checksum: 2edff02f8a1f3fa50c180c2222a53b17 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2015-05-25T13:34:49Z (GMT). No. of bitstreams: 2 Tese - Felix André Sanches Penhavel - 2014.pdf: 2537517 bytes, checksum: 2edff02f8a1f3fa50c180c2222a53b17 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2014-12-15 / American Tripanosomiasis is one of the most prevalente tropical disease in Latin America. One third of brazilian territory is considered endemic for Chagas disease. Vectorial transmission is not complitely interrupted. In Central Brazil, specially Goiás State, digestive forms with megasyndormes have a high frequence. The involvement of small bowel has been discribed with functional disturbances. Patients with acquired megacolon may have normal bowel movements or long lasting constipation. Until now the influence of small bowel on the frequence of bowel movements is not clear. This prospective study addressed the small bowel motility measuring the orocecal transit time (OCTT) and the occurence of small bowel intestinal bacterial overgrowth (SIBO) by hydrogen breath test. 45 patients with positive serology for Chagas disease were divided into four groups: A – without megacolon and no constipation (17); B – with megacolon and no constipation (8); C – with megacolon and constipation (10) and D – without megacolon and constipation (10). Constipation was defined by at least 7 days without bowel movements. 15 healthy volunteers were taken as a control group (CG). Non hydrogen producers: 10/45 patients and 1/15 controls. The OCTT (medium time in minutes) was longer in patients than in controls: A=108.18, B=108.0, C=112.5, D=130.0 and CG=68.46. Patients together showed difference compared to controls (P=0.001). No difference was found among groups (P>0.05). The prevalence of SIBO was: 66.7% in constipated patients (C and D), 25% in non constipated patients (A and B) and 8.3% in controls. Significant statistical difference was found only comparing constipated patients and controls (P=0.017). The presence of megacolon did not show influence the frequence of SIBO (P=0.181). Lactose and D-xylose malabsorption was higher in controls. The number of patients with symptoms during the test was the same for chagasic and controls independently of the test result. Patients with Chagas disease have a prolonged OCTT and those with constipation showed a higher prevalence of SIBO and both factors are not related to megacolon. Chagasic patients showed a less frequency of lactose and D- xylose malabsorption. / A Tripanossomíase Americana é uma das doenças tropicais mais prevalentes na América Latina. Mais de um terço do território brasileiro é área endêmica, e a transmissão vetorial ainda não se interrompeu em todos os estados. Em Goiás, as megassíndromes do tubo digestivo são muito frequentes. O comprometimento do tubo digestivo não se restringe à víscera dilatada e alterações funcionais têm sido descritas no intestino delgado. O objetivo geral deste estudo foi investigar alterações de motilidade e de absorção de carboidratos no intestino delgado de pacientes chagásicos com e sem constipação e megacólon. Avaliou-se 45 pacientes com sorologia positiva para doença de Chagas, divididos em quatro grupos: A - sem constipação, sem megacólon (17); B - sem constipação, com megacólon (8); C - com constipação, com megacólon (10) e D - com constipação, sem megacólon (10). Quinze voluntários sadios foram usados como controles (GC). Todos os pacientes e controles realizaram três testes respiratórios com os substratos: lactulose, lactose e D-xilose. Identificou-se não produção de hidrogênio em 10 pacientes e um controle. O tempo de trânsito orocecal (TTOC) (média em minutos) foi maior nos pacientes do que nos controles: A=108,18; B=108,0; C=112,5; D=130,0 e GC=68,46 (P=0,001). Não houve diferença no TTOC entre os grupos de pacientes (P<0,05). A prevalência de supercrescimento bacteriano no intestino delgado (SBID) foi de 66,7% nos pacientes constipados (C e D), 25% nos não constipados (A e B) e de 8,3% nos controles (P=0,017). A presença de megacólon não influenciou a frequência de SBID (P=0,181). A má absorção de lactose foi maior entre os controles. O número de pacientes que apresentava sintomas ou não durante o teste da lactose foi igual para pacientes e controles, independentemente do resultado do teste. A má absorção de D-xilose foi mais frequente no grupo controle. Concluiu-se que os pacientes chagásicos têm o tempo de trânsito orocecal prolongado e que aqueles com constipação apresentam uma maior prevalência de SBID, ambos os fatores não sofrem influência da presença do megacólon. A má absorção de lactose e D-xilose foi maior entre controles.

A dissertação se situa no campo de pesquisa de métodos não invasivos de análise clínica, mais especificamente, de prognóstico da gravidade de insuficiência cardíaca, IC, com base em bioindicador presente no ar exalado por pacientes, em estudo no IncorHCFMUSP. O bioindicador mais relevante encontrado por GC-MS foi a acetona (propanona). Para a coleta do ar exalado desenvolveu-se dispositivo que compreende frasco borbulhador (impinger) com difusor, contendo 5 mL de água, imerso em banho de gelo e acoplado a saco plástico para definição de volume amostrado (7,6 L). A preservação de amostras deu-se por congelamento a -80ºC. Para a determinação do analito, escolheu-se método espectrofotométrico (474 nm) baseado na reação da acetona com salicilaldeído em meio básico, apresentando limite de detecção de 0,3 mg/L em fase líquida e 0,3 &#181;g/L em ar exalado. Foram realizados estudos de eficiência de coleta por geração de atmosfera controlada. Resultados iniciais obtidos com amostras coletadas de pacientes portadores de IC pelos colaboradores do Incor indicam a potencialidade do bioindicador e dos equipamentos e métodos desenvolvidos para acetona nesta dissertação. / The dissertation fits in the research field of noninvasive clinical analysis, more specifically, the prognosis of the severity of heart failure, HF, based on a biomarker found in the air exhaled by patients, in a study at InCor-HCFMUSP. The most relevant biomarker found by GC-MS was acetone (propanone). For the breath collection a device was developed which comprises a scrubber flask (impinger) with diffuser, containing 5 mL of water, immersed in an ice bath and attached to a plastic bag for delimitation of the sample volume (7,6 L). For the determination of acetone a spectrometric method (474 nm) was chosen based on a reaction of acetone with salicylaldehyde in alkaline medium, with detection limits of 0,3 mg/L in liquid phase and 0,3 &#181;g/L in breath. Preliminary studies made with samples collected from HF patients by the co-workers from InCor indicate the potential of the identified biomarker and the suitability of the equipment and methods developed in this dissertation for its analysis.

La forme suit l’esprit. Tout projet d’architecture doit se doter d’esprit. Cela fait sens, de faire démarrer le projet par ce souffle conceptuel, cet esprit qui va créer la forme. Une architectonique instaurée par le spirituel et en lien avec l’habiter, pour en faire une architecture qui a une âme, animée par une pensée ! Ceci permet de fonder une méthode à l’établissement du projet architectural. Des projets conçus à partir d’une pensée singulière forte sont étudiés afin de dégager l’essence et le sens du spirituel en architecture. Quatre types d’apports théoriques sont observés : le premier sert à l’histoire et à la théorie de l’architecture. Le deuxième sert le projet d’architecture en relatant les démarches spirituelles de six architectes modernes et contemporains. Le troisième prouve l’immuabilité des démarches spirituelles. Le quatrième dégage le facteur spirituel, commun à toutes les démarches, servant à engendrer l’œuvre architecturale singulière. / Form follows spirit. Every architecture project should get hold of a spirit. It is meaningful hence to start the project with a conceptual inspiration, the spirit who will create the form. Architectonic is derived from the spiritual and related to the dwelling to attain a soulful architecture yet moved by one though.This enables the elaboration of a methodology for the architectural project.Projects that were conceived out of one and only powerful though are surveyed so as to reveal the essence and meaning of the spiritual in architecture. Four types of theoretical approaches are observed. The first caters for the history & theory of architecture. The second attends to the architectural project by narrating the respective spiritual processes of six contemporary and modernist architects. The third asserts the immutability of the spiritual processes. The fourth reveals the spiritual dimension that is common to all processes and that helps in begetting the unique architectural opus.

Orientador: Maria Luiza Moretti / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-18T15:05:39Z (GMT). No. of bitstreams: 1 Passos_AnaIsabelaMorsch_M.pdf: 2317515 bytes, checksum: 2a34cbc644c6ec0279e1f66cf58ccf4a (MD5) Previous issue date: 2011 / Resumo: A função pulmonar, em pacientes infectados pelo vírus da imunodeficiência humana (HIV), tem sido associada com a redução nos parâmetros de ventilação pulmonar. Métodos: Foi realizado estudo do tipo corte transversal para avaliar a função pulmonar de pacientes com aids atendidos em ambulatórios de doenças infecciosas. Foram avaliados dados de espirometria, pressão inspiratória máxima (PImáx) e pressão expiratória máxima (PEmáx). Também foram coletados, através de prontuários médicos, dados clínicos, demográficos e laboratoriais. Resultados: Os dados de PImáx e PEmáx foram avaliados em 73 pacientes, o exame de espirometria foi avaliado em 54 pacientes. O tempo médio de infecção pelo HIV (em anos) foi semelhante para os homens (8,5 ± 5,1) e mulheres (10,4 ± 4,2, p = 0,13) e o tempo médio de utilização da terapia antiretroviral foi de 8,5 ± 4,1 anos para as mulheres e 7,7 ± 4,1 anos para os homens (p = 0,46). Os valores de PImáx e PEmáx foram abaixo do previsto em 38 (52%) e 25 (34%) pacientes, respectivamente. O uso do tenofovir e a presença de tosse, no momento em que o teste foi realizado, foram independentemente associados com PEmáx abaixo do valor previsto. Valores elevados de creatinoquinase foram associados com o uso prolongado de terapia antiretroviral (9,6 ± 4,1 anos versus 7,4 ± 3,9 anos, p = 0,05). Os valores de capacidade vital forçada (CVF) se apresentaram reduzidos em 14 (26,4%) pacientes e foi independentemente associado com risco cardiovascular intermediário ou alto (p = 0,002) e com murmúrio vesicular reduzido à ausculta pulmonar (p = 0,047). Os valores de volume expiratório forçado no primeiro segundo (VEF1) foram significativamente menores nos pacientes com tempo prolongado de tabagismo (p = 0,019) e risco cardiovascular intermediário ou alto (p = 0,003). A redução da relação VEF1/CVF foi associada com o tabagismo (p = 0,041). Conclusão: Nas medidas de PImáx e PEmáx, 38 (52,1%) e 25 (34,2%) pacientes apresentaram resultados abaixo do previsto. O exame de Espirometria foi considerado normal em 45 pacientes. Houve diagnóstico de distúrbio obstrutivo e restritivo em um (1,9%) e 8 (14,8%) pacientes. O uso de Tenofovir e a presença de tosse foram independentemente associadas à PEmáx abaixo do previsto. Pacientes com menores valores de CVF foram os com maior risco cardiovascular e murmúrio vesicular diminuído à ausculta pulmonar. Pacientes com menores valores de VEF1 foram aqueles com maior tempo de tabagismo e maior risco cardiovascular. A variável independentemente associada a valores reduzidos de VEF1/CVF foi tabagismo / Abstract: Background: Pulmonary function, in HIV infected patients, has been associated with reduction in pulmonary ventilation parameters Methods: We conducted a sectional study to evaluate the pulmonary function of AIDS patients cared for in the infectious diseases ambulatories. Maximal inspiratory (MIP) and expiratory (MEP) pressures and spirometry were assessed. Clinical, demographic and laboratorial data were also evaluated. Results: MIP and MEP were assessed in 73 and spirometry in 54 patients. The mean time of HIV infection (in years) was similar for men (8.5+5.1) and women (10.4±4.2; p= .13) and the mean time of use of antiretroviral therapy (ART) was 8.5±4.1 years for women and 7.7±4.1 years for men (p= .46). MIP and MEP values were not normal in 38 (52%) and 25 (34%) patients, respectively. The use of tenofovir (TVF) and presence of cough, by the time the test was performed, were independently associated MEP below the predictive value. Elevated CK values were associated with prolonged time ARV usage (9.6±4.1 years vs 7.4±3.9 years; p= .05). FVC was reduced in 14 (26.4%) patients and was independently associated with high and/or intermediate cardiovascular risk (p= .002), and those with reduced vesicular murmur in auscultation (p= .047). FEV1 was significantly lower in patients with prolonged time of smoking (p= .019) and high and/or intermediate cardiovascular risk (p= .003). Reduced FEV1/FVC ratio was associated with smoking (p= .041). Conclusions: In measurements of MIP and MEP, 38 (52.1%) and 25 (34.2%) patients had results below forecast. The spirometry test was considered normal in 45 patients. There was a diagnosis of obstructive and restrictive ventilation disorder in one (1.9%) and 8 (14.8%) patients. The use of tenofovir and cough were independently associated with lower than expected MEP. Patients with lower values of FVC had the highest cardiovascular risk and reduced breath sounds on pulmonary auscultation. Patients with lower values of FEV1 were those with longer duration of smoking and increased cardiovascular risk. The variable independently associated with lower values of FEV1/FVC was smoking / Mestrado / Ciencias Basicas / Mestre em Clinica Medica

Ce travail de thèse a permis le développement et la caractérisation d'instruments basés sur la technique "OF-CEAS" dans le moyen infrarouge pour la détection de traces dans différents mélanges en phase gazeuse. Le Laser à Cascades Inter-bandes (ICL) est la dernière innovation des lasers à semi-conducteurs dans cette zone spectrale. La compatibilité des ICL avec l'OF-CEAS ouvre la voie vers de nouvelles applications pour la réalisation d'instruments compacts et robustes avec un temps de réponse rapide tout en présentant une très bonne limite de détection.Une démonstration de la bonne sensibilité et stabilité des instruments OF-CEAS aété réalisé avec la mesure de continua d'absorption (de la vapeur d'eau et de l'azote). Mais également avec la détection d'une raie quadrupolaire de l'azote de très faible intensité (3x10-29 cm-1/(moléc cm-2). L'objectif principale de ces travaux consistait au développement d'un instrument dédié à la détection de monoxyde d'azote pour l'analyse du gaz exhalé. L'analyseur ainsi réalisé présente une sensibilité de 6x10-10 cm-1 en une acquisition de 180 ms. Sa limite de détection sur le NO est à l'état de l'art, avec à court terme (180 ms) un minimum de 50 ppt est atteint. Celui-ci parvient à un niveau sub-ppt (0.9 ppt) en 12 min d'intégration. / This work of these has made it possible to develop and characterize the use of instruments on the "OF-CEAS" technique in the mid-infrared for traces' detection in different mixtures in the gas phase. Inter-band Cascade Laser (ICL) is the latest innovation in semiconductor lasers in this spectral region. Compatibility of ICL with OF-CEAS offers new applications for compact and robust instruments with fast response time and a low detection limit. A demonstration of the good sensitivity and stability of the OF-CEAS instruments was performed with continua absorption measurements (water vapor and nitrogen). But also with the detection of a very low intensity quadrupole line of nitrogen (3x10-29 cm-1/(moléc cm-2). The main objective of this work was to develop an instrument dedicated to nitrogen oxide detection for the analysis of exhaled breath. The analyzer is presented at the sensitivity of 6x10-10 cm-1 in an acquisition of 180 ms. Its limit of detection on NO is at the state of the art, with short term (180 ms) limit of 50 ppt. It reaches the sub-ppt level (0.9 ppt) with 12 min of integration.