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Role of Thoracic Vagal Branches in Regulation of Neurogenic Plasma Leakage in Rat Lower AirwayLee, Yi-Chung 22 June 2001 (has links)
Vagal sensory afferent innervation corresponds to regulation of neurogenic inflammation in the airways. Capsaicin is mostly used for stimulation of sensory nerves that induce pain and inflammatory responses. It can specifically stimulate sensory afferent nerves, inducing neurogenic inflammation in the airways. According the past studies, we have found the right thoracic vagus nerve (RTVN) and right recurrent laryngeal nerve (RRLN); branches of right thoracic vagus trunk (RTVT) mediate different degree of neurogenic inflammation by intraenous injection of capsaicin (300 nmol/ml/kg). In order to investigate the innervation from the RTVN and RRLN of rat tracheobronchi and their involvement in plasma exudation, we injected 3 £gl of capsaicin (10 mg/ml) into RTVT and denervated the RRLN or RTVN and used India ink as tracer dye to label the leaky microvessels. Our observation indicated that injection of capsaicin into the RTVT coud induce obvious plasma exudation in trachea (area density of leaky blood vessels was about 22%), but plasma exudation was significantly decreased after denervation of RRLN. The left upper side of trachea was decreased by 77.6% and the right upper side decreased by 84.5%. This phenomenon was not caused by denervation of RTVN. The results suggest that vagal nerve innervation of upper trachea mostly came from the RLN.
Otherwise, capsaicin injection into the RTVT also induced neurogenic inflammation in the larynx. Experimental denervation of both superior and recurrent laryngeal nerves resulted in a decrease of plasma extravasation by 84.98%. Denervation of either RTVN or RRLN also decreased the plasma extravasation in the larynx. The evidence suggest that sensory fibers in the superior laryngeal nerve, recurrent laryngeal nerve, and thoracic vagus nerve might come from the same population of vagal ganglion sensory neurons.
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Mechanisms underlying changes in microvascular blood flow in a diabetic rat model: relevance to tissue repairBassirat, Maryam Unknown Date (has links) (PDF)
Diabetes mellitus is a chronic syndrome affecting carbohydrate, protein, and fat metabolism. It is characterized primarily by relative or absolute insufficiency of insulin secretion (type I diabetes or IDDM) or concomitant insensitivity / resistance to the metabolic action of insulin on target tissues (Type II diabetes or NIDDM), both resulting in hyperglycaemia. Diabetes mellitus is known to induce microvascular changes and alterations to neuronal functions. The neurovascular system comprising of unmyelinated primary afferent sensory neurones and the microvasculature innervated by these nerves play a major role in modulating inflammatory and tissue repair processes. Sensory nerve terminals respond to injury via the release of sensory neuropeptides which mediate inflammation and tissue repair. These processes are known to be altered in diabetes. This thesis is concerned with the role of diabetes in modulating microvascular blood flow directly and indirectly via modulating sensory nerve activity and the effect of these changes on repair processes in skin of 4 weeks streptozotocin (STZ)-induced diabetic rats. The following hypotheses were examined: 1. That factors implicated in long-term diabetic vascular damage play a role in altering skin microvascular function in early diabetes. 2. That preventing the deleterious effects of these factors could improve skin microvascular blood flow and skin repair processes in early diabetes. (For complete abstract open document)
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Reservatório ileal continente : uma opção viável para ampliação vesical e derivação urináriaTavares, Patric Machado January 2018 (has links)
OBJETIVO: Apresentar os resultados da técnica de derivação urinária continente descrita por Macedo, em relação à continência, achados operatórios e complicações cirúrgicas. MÉTODOS: De janeiro de 2006 a novembro de 2016, 29 pacientes foram submetidos à técnica de Macedo. Dados demográficos, tempo de hospitalização, tempo cirúrgico, tempo de seguimento, taxa de continência, capacidade do reservatório e complicações pós-operatórias foram avaliados. RESULTADOS: Sessenta e nove por cento eram masculinos e a mediana de idade foi de 16,9 anos. A etiologia principal foi meningomielocele (69,1%). A média do tempo cirúrgico foi 4,2 h (DP 0,9 2,9-6,3). A mediana do tempo de internação foi 10 dias (IIQ: 11,3; 5-51). A média de seguimento foi 3,3 anos (DP 2,2 0,3 – 9,8). Procedimento no colo vesical foi realizado em 12 pacientes (41,3%). A taxa de continência do conduto cateterizável foi de 82,8%. A capacidade do reservatório aumentou de 134,4 para 364,4 ml (p <0.0001). A taxa de continência melhorou significativamente (20 vs. 74%, p <0.0001). Não houve mudança na taxa de filtração glomerular a longo prazo (143.1 vs. 147 ml/min, p = 0.45). Taxa de morbidade foi 58% (25 complicações em 17 pacientes), 72% ocorreram nos primeiros 60 dias e 60% foram classificadas Clavien-Dindo I ou II. CONCLUSÃO: Nossos resultados em relação a taxas de continência, tempo cirúrgico e complicações demonstram que a enterocistoplastia de Macedo é viável, reprodutível e com bons resultados. / OBJECTIVE: To present the results of technique of continent urinary diversion, described by Macedo, in relation to continence, operative findings and postoperative complications. METHODS: From January 2006 to November 2016, 29 patients were underwent to urinary diversion by Macedo’s technique. Patients demographics, hospitalization time, surgical time, follow up, continence rate, reservoir capacity and postoperative complications were evaluated. RESULTS: Sixty nine percent were male and the median age was 16.9 years. The main etiology was meningomyelocele (69.1%). The mean surgical time was 4.2 hours (SD 0.9 range 2.9-6.3). The median length of hospital stay was 10 days (IQR: 11.3 range 5-51). The mean follow up was 3.3 years (SD 2.2 range 0.3 - 9.8). Procedure in the bladder neck was performed in 12 patients (41.3%). The continence rate of the catheterizable conduit was 82.8%. The reservoir capacity increased from 134.4 to 364.4 ml (p <0.0001). The continence rate improved significantly (20 vs. 74%, p <0.0001). There was no change in glomerular filtration rates in the long term (143.1 vs. 147 ml/min, p = 0.45). Morbidity rate was 58% (25 complications in 17 patients), 72% occurred within the first 60 days and 60% were classified as Clavien-Dindo I or II. CONCLUSION: Our results regarding continence rates, surgical time and complications demonstrated that Macedo’s enterocystoplasty is feasible, reproducible and with good result.
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La neurogénèse hypothalamique adulte : sensibilité à la photopériode, devenir des neuroblastes et rôle dans la fonction de reproduction / Adult hypothalamic neurogenesis : sensitivity to photoperiod, the fate of neuroblasts and role in the reproductive functionButruille, Lucile 02 June 2017 (has links)
De nombreuse études ont mis en évidence la présence de processus neurogéniques dans l'hypothalamus adulte, une structure du diencéphale impliquée dans la régulation de nombreuses fonctions physiologiques. L’objectif de ma thèse a consisté à étudier les mécanismes de plasticité, tels que la neurogenèse adulte, et leur implication dans le contrôle neuroendocrinien de la fonction de la reproduction. Chez le mouton, une espèce saisonnée, la reproduction est contrôlée par la photopériode. Les variations saisonnières de la durée du jour entrainent des variations saisonnières du taux de prolifération et du nombre de nouveaux neurones. Après avoir identifié les composants cellulaires de la niche neurogénique hypothalamique dans cette espèce, nous avons démontré leur sensibilité à la photopériode. Une analyse longitudinale en neuroimagerie nous permettra de déterminer le devenir des nouveaux neurones hypothalamiques. Une étude fonctionnelle réalisée chez la souris a démontré que les cellules hypothalamiques en division qui expriment la GFAP possèdent un potentiel neurogénique et que leur ablation conduit à la perte de la fonction de reproduction chez le mâle. / Numerous studies have demonstrated the presence of neurogenic processes in the adult hypothalamus, a diencephalon structure involved in the regulation of many physiological functions. The objective of my thesis was to study the mechanisms of plasticity, such as adult neurogenesis, and their involvement in the neuroendocrine control of the reproductive function. In sheep, a seasonal species, reproduction is controlled by the photoperiod. Seasonal variations in the duration of the day lead to seasonal variations in the proliferation rate and in the number of new neurons. After identifying the cellular components of the hypothalamic neurogenic niche in this species, we demonstrated their sensitivity to photoperiod. A longitudinal analysis in neuroimaging will aimed to determine the fate of new hypothalamic neurons. A functional study in mice showed that dividing hypothalamic GFAP positive cells have a neurogenic potential and their ablation leads to severe impairment of the reproductive function in the male.
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Reservatório ileal continente : uma opção viável para ampliação vesical e derivação urináriaTavares, Patric Machado January 2018 (has links)
OBJETIVO: Apresentar os resultados da técnica de derivação urinária continente descrita por Macedo, em relação à continência, achados operatórios e complicações cirúrgicas. MÉTODOS: De janeiro de 2006 a novembro de 2016, 29 pacientes foram submetidos à técnica de Macedo. Dados demográficos, tempo de hospitalização, tempo cirúrgico, tempo de seguimento, taxa de continência, capacidade do reservatório e complicações pós-operatórias foram avaliados. RESULTADOS: Sessenta e nove por cento eram masculinos e a mediana de idade foi de 16,9 anos. A etiologia principal foi meningomielocele (69,1%). A média do tempo cirúrgico foi 4,2 h (DP 0,9 2,9-6,3). A mediana do tempo de internação foi 10 dias (IIQ: 11,3; 5-51). A média de seguimento foi 3,3 anos (DP 2,2 0,3 – 9,8). Procedimento no colo vesical foi realizado em 12 pacientes (41,3%). A taxa de continência do conduto cateterizável foi de 82,8%. A capacidade do reservatório aumentou de 134,4 para 364,4 ml (p <0.0001). A taxa de continência melhorou significativamente (20 vs. 74%, p <0.0001). Não houve mudança na taxa de filtração glomerular a longo prazo (143.1 vs. 147 ml/min, p = 0.45). Taxa de morbidade foi 58% (25 complicações em 17 pacientes), 72% ocorreram nos primeiros 60 dias e 60% foram classificadas Clavien-Dindo I ou II. CONCLUSÃO: Nossos resultados em relação a taxas de continência, tempo cirúrgico e complicações demonstram que a enterocistoplastia de Macedo é viável, reprodutível e com bons resultados. / OBJECTIVE: To present the results of technique of continent urinary diversion, described by Macedo, in relation to continence, operative findings and postoperative complications. METHODS: From January 2006 to November 2016, 29 patients were underwent to urinary diversion by Macedo’s technique. Patients demographics, hospitalization time, surgical time, follow up, continence rate, reservoir capacity and postoperative complications were evaluated. RESULTS: Sixty nine percent were male and the median age was 16.9 years. The main etiology was meningomyelocele (69.1%). The mean surgical time was 4.2 hours (SD 0.9 range 2.9-6.3). The median length of hospital stay was 10 days (IQR: 11.3 range 5-51). The mean follow up was 3.3 years (SD 2.2 range 0.3 - 9.8). Procedure in the bladder neck was performed in 12 patients (41.3%). The continence rate of the catheterizable conduit was 82.8%. The reservoir capacity increased from 134.4 to 364.4 ml (p <0.0001). The continence rate improved significantly (20 vs. 74%, p <0.0001). There was no change in glomerular filtration rates in the long term (143.1 vs. 147 ml/min, p = 0.45). Morbidity rate was 58% (25 complications in 17 patients), 72% occurred within the first 60 days and 60% were classified as Clavien-Dindo I or II. CONCLUSION: Our results regarding continence rates, surgical time and complications demonstrated that Macedo’s enterocystoplasty is feasible, reproducible and with good result.
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Alterações da função vesical devido ao envelhecimento em mulheres avaliadas através do estudo urodinâmicoALBUQUERQUE NETO, Moacir Cavalcante de 22 January 2016 (has links)
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Previous issue date: 2016-01-22 / Objetivos: O declínio da função vesical com a idade pode levar a comprometimento da
qualidade de vida além de sérios problemas de saúde aos idosos. Assim, avaliaremos as
alterações da função vesical com o envelhecimento em mulheres através do estudo urodinâmico
e tentaremos desenvolver fórmulas que possam estimar os valores esperados dos parâmetros
urodinâmicos avaliados de acordo com a idade.
Materiais e métodos: Foi realizada uma análise retrospectiva dos estudos urodinâmicos
realizados no Serviço de Urologia do Departamento de Cirurgia do Hospital das Clínicas da
UFPE, cadastrados no prontuário eletrônico www.infomed.net.br entre maio de 2011 e
novembro de 2015, a fim de obter e calcular os parâmetros necessários para avaliar a função
vesical em diferentes faixas etárias (18-30, 31-40, 41-50, 51-60, 61-70, 71-80 e maior que 80
anos). Além disso, excluímos pacientes com qualquer fator conhecido que tenha o potencial de
afetar a função vesical que não a idade.
Resultados: De um total de 3103 exames analisados, foram selecionadas 719 pacientes do sexo
feminino para serem incluídas no estudo. A média de idade das pacientes foi de 49,3 anos e em
todos os parâmetros avaliados (fluxo máximo, volume urinado, complacência vesical,
capacidade cistométrica máxima, pressão detrusora no fluxo máximo, resíduo pós-miccional,
índice de contratilidade vesical e índice de eficiência vesical) obtivemos correlação
estatisticamente significante entre o declínio da função vesical e a idade. Ainda, conseguimos
expressar por equações matemáticas a relação de causa-efeito por regressão linear.
Conclusão: O presente estudo observou que há uma diminuição da função vesical tanto de
armazenamento (diminuição da capacidade cistométrica máxima e complacência vesical)
quanto de esvaziamento (diminuição do fluxo máximo, da pressão detrusora no fluxo máximo,
do volume urinado, do índice de contratilidade vesical e do índice de eficiência vesical, assim
como o aumento do resíduo pós-miccional) com o envelhecimento. Paralelamente, estamos
propondo fórmulas que podem estimar os valores esperados dos parâmetros urodinâmicos
avaliados de acordo com a idade, na população estudada. / Purposes: The bladder function declines with age and can lead to impaired quality of life and
serious health problems in the elderly. The aim of the study is to evaluate changes in bladder
function with aging in women by urodynamic study and try to develop equations that can
estimate the expected values of the urodynamic parameters evaluated according to the age.
Methods: A retrospective analysis of urodynamic studies in the Urology Service of the
Department of Surgery - Hospital das Clínicas, Federal University of Pernambuco, recorded in
the electronic medical database www.infomed.net.br among May 2011 and November 2015
was performed in order to obtain and calculate the parameters necessary to evaluate bladder
function in different age groups (18-30, 31-40, 41-50, 51-60, 61-70, 71-80 and above 80 years).
Patients with any factor that had the potential to affect bladder function were excluded.
Results: 3103 urodynamics studies were analyzed and 719 female patients were selected. The
average age of patients was 49.3 years and in all evaluated parameters (maximum flow, volume
of urination, bladder compliance, maximum cystometric capacity, detrusor pressure at
maximum flow, post-void residual urine volume, bladder contractility index and bladder
voiding efficiency) statistically significant correlation between the decline of bladder function
and age were obtained. Also we presented mathematical equations with cause-effect
relationship by linear regression.
Conclusion: The present study showed that there is a decrease in the bladder storage function
(reduction in maximum cystometric capacity and bladder compliance) and in the bladder
emptying function (reduction of the maximum flow, detrusor pressure at maximum flow,
volume of the urination, contractility index urinary bladder and bladder voiding efficiency , as
well increased post-void residual urine volume) with aging. Analyzing data let us to propose
equations that can estimate the expected values of the urodynamic parameters evaluated
according to the age in the studied population.
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Avaliação da disfagia na doença de Parkinson: um estudo utilizando eletromiografia de superfícieBELO, Luciana Rodrigues 14 March 2016 (has links)
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Previous issue date: 2016-03-14 / REUNI / A Eletromiografia de Superfície (EMGs) vem sendo bastante utilizada em pesquisas para o
estudo da deglutição. Desta forma, o objetivo desta tese foi avaliar e comparar parâmetros da
EMGs dos músculos supra-hióideos na deglutição de volumes fixos e consumo contínuo de
água entre sujeitos com doença de Parkinson (DP) disfágicos e sujeitos com deglutição
normal composto por sujeitos com DP e sujeitos sem sequelas neurológicas, considerados
normais (grupo controle). Tratou-se de um estudo analítico descritivo do tipo transversal com
amostra de conveniência. Foi desenvolvido no laboratório de Eletroneuromiografia em
parceria com o Programa Pró-Parkinson e Real Hospital Português entre Setembro de 2014 à
Abril de 2015. O projeto foi aprovado pelo Comitê de Ética em Pesquisa com Seres Humanos
do Centro de Ciências da Saúde da Universidade Federal de Pernambuco, sob ofício nº
842/2011. Os sujeitos assinaram o termo de consentimento livre e esclarecido, responderam a
ficha de registro de dados e foram submetidos à EMGs dos músculos supra-hióideos na
deglutição dos volumes fixos de 10 e 20 ml e no consumo contínuo de 100 ml de água.
Apenas o grupo DP realizou o estadiamento pela escala de HY, foi avaliado a partir do mini
exame do estado mental, para identificar dificuldades cognitivas que impeçam a realização da
EMGs e submetido à Videoendoscopia da deglutição com a aplicação da escala de severidade
da disfagia ao protocolo de avaliação específico deste exame. Apenas o grupo controle
respondeu ao questionário de qualidade de vida em disfagia. O período total de coleta foi de
sete meses. Os dados foram processados pelo BioanalyzerBR versão 2 e a análise estatística foi
realizada pelo programa STATISTICA por meio da análise de variância (ANOVA), teste
Exato de Fisher e o KAPPA, considerando nível de significância menor que 0,05. No grupo
DP disfágico foi observado uma frequência maior de deglutição em partes no volume de 20
ml de água. Esta variável, em ambos os volumes testados, apresenta alta especificidade (97%
- 10 ml e 94% - 20 ml), alto valor preditivo positivo (91% - 10 ml e 87%), odds ratio com boa
razão (19.4 – 10 ml e 15.0 - 20ml) e houve significância estatística para ambos. A duração no
grupo DP disfágico é mais prolongada em ambos os volumes fixos testados (Efeito principal
para grupos - ANOVA: p= 0.0028*). O volume fixo de 10 ml apresenta especificidade de
91%, valor preditivo positivo 80% e odds ratio de 12.9 podendo ser considerado um bom
teste para identificar a disfagia. Na prova do consumo contínuo de 100 ml de água, o número
de deglutições foi maior, duração total mais prolongada e volume médio por gole menor no
grupo DP disfágico, com significância estatística. O número de deglutições e o volume médio
por gole apresentaram especificidade alta (88%), valor preditivo positivo alto (78%) e odds
ratio de 8.2 com significância estatística para ambos. O registro eletromiográfico da
deglutição em partes nos volumes fixos, duração da deglutição de 10 ml de água, número de
deglutições, volume médio por gole, obtidos na prova do consumo contínuo de 100 ml de
água, podem ser úteis para a indicação da disfagia neurogênica nos pacientes com DP. Sendo
importante associar seus resultados às informações colhidas na avaliação clínica inicial. / Surface Electromyography (sEMG) has been widely used in research for the study of
swallowing. Thus, the aim of this thesis was to evaluate and compare SEMG parameters of
suprahyoid muscles swallowing fixed volumes and continuous consumption of water between
subjects with Parkinson's disease (PD) dysphagia and subjects with normal swallowing
composed of subjects with PD and subjects without neurological involvement, considered
normal (control group). This was a descriptive analytical cross-sectional study with a
convenience sample. It was developed in the laboratory of Electroneuromyography in
partnership with Pro-Parkinson Program and the Royal Portuguese Hospital from September
2014 to April 2015. The project was approved by the Ethics Committee on Human Research
of the Health Sciences Center of the Federal University Pernambuco, under Official letter No.
842/2011. The subjects signed informed consent and informed, answered the data tab and
underwent EMGs of suprahyoid muscles swallowing of fixed volumes of 10 and 20 ml and
continuous consumption of 100 ml of water. Only the DP group performed staging the HY
scale, it was evaluated from the Mini-Mental State Examination to identify cognitive
difficulties that impede the realization of sEMG and submitted to swallowing video
endoscopy with the implementation of dysphagia severity scale protocol specific evaluation of
this examination. Only the control group responded to the questionnaire of quality of life in
dysphagia. The total collection period was seven months. The data were processed by
BioanalyzerBR version 2 and the statistical analysis was performed by STATISTICA
program through the analysis of variance (ANOVA), Fisher's exact test and the KAPPA
considering a significance level of 0.05. In dysphagia group DP greater frequency of
swallowing was observed in the portions to 20 ml of water. This variable in both volumes
tested, has high specificity (97% - 10 ml 94% - 20 ml), a high positive predictive value (91% -
10 ml 87%), odds ratios with good reason (19.4 - 10 ml and 15.0 - 20 ml) and was statistically
significant for both. The duration in dysphagia DP group is longer in both tested fixed
volumes (main effect for group - ANOVA: p = 0.0028 *). The fixed volume of 10 ml
provides specificity 91%, positive predictive value 80% and an odds ratio of 12.9 and can be
considered a good test to identify dysphagia. In proof of continuous consumption of 100 ml of
water, the number of swallows was higher, total duration and longer average volume lower
sip DP dysphagia group, with statistical significance. The number of swallowing and the
average volume per swallow showed high specificity (88%), high positive predictive value
(78%) and odds ratio of 8.2 with statistical significance for both. Electromyography record
swallowing parts in fixed volumes, duration of swallowing 10 ml of water, number of
swallows, average volume per swallow, obtained in the proof of continuous consumption of
100 ml of water, may be useful for the indication of neurogenic dysphagia in patients with
PD. It is important to associate their results to the information gathered in the initial clinical
evaluation.
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Investigação farmacológica de mecanismos neurogênicos e oxidativos no modelo experimental de gastrosquise em ratos. / Oxidative and neurogenic mechanisms of bowel inflammation in experimental model of gastroschisis.Lívia Terezinha Pimentel Branco 31 October 2008 (has links)
A gastrosquise (G) é o defeito congênito de fechamento da parede abdominal, que causa inflamação intestinal. Avaliou-se aqui a expressão protéica e gênica de marcadores neurogênicos e oxidativos no intestino de fetos de ratas tratadas ou não com dexametasona - DMT. Estes foram divididos em grupos: não manipulado (controle; C), falso operado (sham; S) e operado (G). A atividade da mieloperoxidase (MPO) aumentou no grupo G vs. C, não sendo afetada pela DMT. A expressão RNAm do receptor NK2, mas não NK1, VPAC e TRPV1, foi reduzida nos grupos G e S vs. C, sendo esta revertida pela DMT. A iNOS, mas não nNOS e eNOS, foi maior no grupo G. A DMT não inibiu a iNOS mas aumentou a eNOS. COX-2 aumentou na G e não foi afetada pela DMT. A expressão protéica da SOD-1 ou 3-NT não diferiu entre grupos G e controle. O grupo G tratado com DMT exibiu maior nitração protéica. A IL-6 aumentou no grupo G versus C. Conclui-se que a inflamação no intestino de fetos com G origina-se de uma possível combinação entre mecanismos oxidativos, geração de prostanóides e fatores neurovasculares. / Gastroschisis (G) is a congenital defect of the abdominal wall closure resulting in perivisceritis. The role of neurovascular and oxidative mechanisms in this condition was investigated by analyzing the gene and proteic expressions of these markers in the gut of foetus from female rats treated or not with dexamethasone (DMT). Increased MPO activity was found in G vs. control (C) but not sham (S) group. Reduced mRNA expression of NK2 receptor was found in G and S groups. Neither NK1 nor both VIP and TRPV1 receptors expression changed among groups. Increased expression of iNOS and COX-2, but not nNOS, eNOS and COX-1, was seen in G group. DMT reversed the expression of NK2R and increased that of NK1R without affecting iNOS and COX-2 expression. Increased levels of IL-6 but neither SOD-1 nor 3-NT was found in G group. In conclusion, the inflammatory process observed in the gut of foetus with G arises through a combination of neurogenic mechanisms that act in concert with reactive oxygen species and generation of prostanoids to produce gut dysfunction.
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Hodnocení designu terapie neurogenních poruch komunikace v oblasti klinické logopedie / Evaluation design therapy of neurogenic disorders of language in clinical speech therapyFridrichová, Petra January 2017 (has links)
The thesis titled Evaluation design therapy of neurogenic disorders of language in clinical speech therapy aims to find out what effect the speech reeducation to improve communication skills in people with acquired neurogenic communication disorders speech. Next, determine whether therapy plays a role during client environment, if the success rate of therapy affected patient's condition and the extent to which the clients are motivated to therapy. The theoretical part summarizes the findings from the literature on neurogenic communication disorders, aphasia and dysarthria. Each chapter is devoted to the terminological definition and definition, etiology, symptoms (for aphasia), classification, diagnostics and therapy. The practical part deals with the research survey. There are set targets mentioned methodology, research sample characteristics and place of the investigation. Following processing of four case studies. Which describes the therapy sessions and individual work with clients. KEYWORDS Neurogenic speech disorders, aphasia, dysarthria, logopedic therapy
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Reservatório ileal continente : uma opção viável para ampliação vesical e derivação urináriaTavares, Patric Machado January 2018 (has links)
OBJETIVO: Apresentar os resultados da técnica de derivação urinária continente descrita por Macedo, em relação à continência, achados operatórios e complicações cirúrgicas. MÉTODOS: De janeiro de 2006 a novembro de 2016, 29 pacientes foram submetidos à técnica de Macedo. Dados demográficos, tempo de hospitalização, tempo cirúrgico, tempo de seguimento, taxa de continência, capacidade do reservatório e complicações pós-operatórias foram avaliados. RESULTADOS: Sessenta e nove por cento eram masculinos e a mediana de idade foi de 16,9 anos. A etiologia principal foi meningomielocele (69,1%). A média do tempo cirúrgico foi 4,2 h (DP 0,9 2,9-6,3). A mediana do tempo de internação foi 10 dias (IIQ: 11,3; 5-51). A média de seguimento foi 3,3 anos (DP 2,2 0,3 – 9,8). Procedimento no colo vesical foi realizado em 12 pacientes (41,3%). A taxa de continência do conduto cateterizável foi de 82,8%. A capacidade do reservatório aumentou de 134,4 para 364,4 ml (p <0.0001). A taxa de continência melhorou significativamente (20 vs. 74%, p <0.0001). Não houve mudança na taxa de filtração glomerular a longo prazo (143.1 vs. 147 ml/min, p = 0.45). Taxa de morbidade foi 58% (25 complicações em 17 pacientes), 72% ocorreram nos primeiros 60 dias e 60% foram classificadas Clavien-Dindo I ou II. CONCLUSÃO: Nossos resultados em relação a taxas de continência, tempo cirúrgico e complicações demonstram que a enterocistoplastia de Macedo é viável, reprodutível e com bons resultados. / OBJECTIVE: To present the results of technique of continent urinary diversion, described by Macedo, in relation to continence, operative findings and postoperative complications. METHODS: From January 2006 to November 2016, 29 patients were underwent to urinary diversion by Macedo’s technique. Patients demographics, hospitalization time, surgical time, follow up, continence rate, reservoir capacity and postoperative complications were evaluated. RESULTS: Sixty nine percent were male and the median age was 16.9 years. The main etiology was meningomyelocele (69.1%). The mean surgical time was 4.2 hours (SD 0.9 range 2.9-6.3). The median length of hospital stay was 10 days (IQR: 11.3 range 5-51). The mean follow up was 3.3 years (SD 2.2 range 0.3 - 9.8). Procedure in the bladder neck was performed in 12 patients (41.3%). The continence rate of the catheterizable conduit was 82.8%. The reservoir capacity increased from 134.4 to 364.4 ml (p <0.0001). The continence rate improved significantly (20 vs. 74%, p <0.0001). There was no change in glomerular filtration rates in the long term (143.1 vs. 147 ml/min, p = 0.45). Morbidity rate was 58% (25 complications in 17 patients), 72% occurred within the first 60 days and 60% were classified as Clavien-Dindo I or II. CONCLUSION: Our results regarding continence rates, surgical time and complications demonstrated that Macedo’s enterocystoplasty is feasible, reproducible and with good result.
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