Neste trabalho determinamos relações entre a obstrução de Euler de uma função analítica com singularidade isolada f e o número de Milnor de f definido por Bruce e Roberts para funções definidas em espaços singulares. Apresentamos também uma generalização da obstrução de Euler de uma função analítica com singularidade isolada para o caso de uma aplicação \'f : (V, 0) seta (\'C POT. k\', 0) onde (V, 0) é o germe de uma variedade analítica complexa, equidimensional de dimensão \' n > OU = k\' , e uma fórmula para calcular a obstrução de Euler de k-referenciais, em termos da obstrução de Euler de f / In this work we determine relations between the local Euler obstruction of an analytic function singular at the origin to the case of a analytic map \'f : (V, 0) seta (\'C POT. k, 0\'), where (V, 0) is the germ of a complex analytic variety, equidimensional of dimension \' n > OU = k\', and a formula which computes the local Euler obstruction, defined for k-frames, in the local Euler obstruction of f

INTRODUÇÃO E OBJETIVOS: Há controvérsias em relação à indicação e ao momento ideal de realização de derivação urinária em pacientes com obstrução ureteral secundária a neoplasias malignas avançadas. O objetivo do presente estudo foi identificar fatores relacionados ao mau prognóstico de pacientes com nefropatia obstrutiva maligna e criar um modelo de estratificação de risco desses pacientes, a fim de fornecer evidências para uma melhor decisão terapêutica. MÉTODO: Realizou-se estudo prospectivo com pacientes portadores de insuficiência renal obstrutiva por neoplasias pélvicas, acompanhados por um tempo mínimo de seis meses, tratados entre janeiro de 2009 à novembro de 2011. De um total de 340 pacientes submetidos à procedimentos de descompressão ureteral por catéter ureteral (CUR) ou nefrostomia percutânea (NPC), 208 foram incluídos no estudo por serem maiores de 18 anos, apresentarem obstrução ureteral secundária à neoplasias malignas, confirmada por tomografia computadorizada (TC) ou ultrassom (USG) e por terem realizado derivação urinária por catéter ureteral ou nefrostomia percutânea em nossa Instituição. RESULTADOS: A sobrevida média global foi de 144 dias, com mortalidade ao final do estudo de 164 pacientes (78.8%), sendo 44 (21.2%) durante a internação hospitalar. Não houve diferença significativa na sobrevida global entre os dois tipos de derivação urinária realizada (p = 0.216). Após análise univariada, a presença de qualquer sintoma (p = 0.014), derrame pleural (p = 0.015), grau de hidronefrose 1 e 2 (p = 0.001), Índice de Charlson >= 6 (p = 0.003), linfonodos retroperitoneais metastáticos (p = 0.002), linfonodos pélvicos metastáticos (p = 0.024), número de sítios relacionados à disseminação da doença >= 4 (p < 0.001), niveis séricos iniciais de uréia >= 80mg/dl (p = 0.01), sódio <= 138 mEq/L (p = 0.018) e albumina < 3.0 mg/dl (p = 0.035), diálise peri-operatória (p = 0.05) e índice de ECOG PS (Eastern Cooperative Oncology Group Performance Status) >= 2 (p < 0.001), foram associados a menor sobrevida média. A análise multivariada de Cox revelou que apenas o número de sítios relacionados à disseminação maligna (quatro ou mais) e o índice de ECOG PS >= 2 foram significativamente associados à menor sobrevida. A fim de criar um modelo de estratificação de risco, os pacientes foram, posteriormente, divididos em três grupos: nenhum fator de risco - grupo I, um fator de risco - II e dois fatores de risco - III. As taxas de sobrevida mediana de 1,6 e 12 meses nesses grupos foram, respectivamente de 94.4%, 57.3% e 44.9% no grupo I, de 78.0%, 36.3% e 15.5% no grupo II e de 46.4%, 14.3% e 7.1% no grupo III, com diferenças significativas nos perfis de sobrevivência dos três grupos de risco (p < 0.001). CONCLUSÕES: Nosso modelo de estratificação de risco poderá representar uma ferramenta útil na decisão de se instituir procedimentos de desobstrução ureteral em pacientes com neoplasias abdominopélvicas malignas avançadas. Pacientes com mais de quatro sítios de metástases e com índice de performance (ECOG) igual ou superior a 2 apresentam pobre evolução após derivações urinárias realizadas para tratar nefropatia obstrutiva maligna. De acordo com o método de estratificação de risco de óbito por nós descrito, pacientes com um ou mais fatores de risco evoluem com sobrevida mais precária que os casos sem fatores de risco presentes / INTRODUCTION AND OBJECTIVES: There is a controversy regarding the decision to perform diversion procedures in patients with ureteral obstruction secondary to advanced malignancies. The goal of this study was to identify poor prognosis factors and to create a model to stratify patients with malignant obstructive nephropathy in order to provide evidence-based information for better treatment decisions. METHODS: A prospective study was performed from January 2009 to November 2011, with patients followed at least for 6 months. From 340 patients initially submitted to ureteral decompression procedures by ureteral stents or percutaneous nephrostomy, 208 were elected for the study because they were 18 years old or more and presented ureteric obstruction secondary to any type of malignancy, confirmed by computadorized tomography (CT) or ultrasound (US) and were submitted to urinary diversion by ureteral stents or percutaneous nephrostomy at our institution.RESULTS: The median survival for all patients was 144 days, with mortality at the end of study seen in 164 patients (78.8%) including 44 (21.2%) during hospitalization. There was no significant difference in overall survival between the two types of urinary diversion (p = 0.216). After univariated analysis the presence of any symptoms (p = 0.014), pleural effusion (p = 0.015), degree of hydronephrosis 1 and 2 (p = 0.001), Charlson Index >= 6 (p = 0.003), metastatic retroperitoneal lymph nodes (p = 0.002), metastatic pelvic lymph nodes (p = 0.024), number of sites related to dissemination >= 4 (p < 0.001), preoperative serum level urea >= 80mg/dl (p = 0.01), sodium <= 138mEq/L (p = 0.018), albumin < 3.0 mg/dl (p = 0.035), perioperative dyalisis (p = 0.05) and ECOG PS index >= 2 (p < 0.001) were associated to shorter mean survival. The multivariate Cox proportional hazards regression model revelead that only the number of sites related to malignant dissemination (4 or more) and the index of performance status of Eastern Cooperative Oncology Group (ECOG PS >= 2) were significantly associated with short survival. To creat a risk stratification model, the patients were further divided into three risk groups: no risk factor - favorable group, one risk factor - intermediate and two risk factors - unfavorable, to creat a risk stratification model. The median survival rates at 1,6 and 12 months were respectively, 94.4%, 57.3% and 44.9% in the favorable group; 78.0%, 36.3% and 15.5% in the intermediate group and 46.4%, 14.3% and 7.1% in the unfavorable group. There were significant differences in the survival profiles of the three risk groups (p < 0.001). CONCLUSION: Our model of stratification may be a useful tool before deciding on ureteral desobstruction procedures in patients with advanced abdominopelvic malignancies. Patients with more than four sites of metastases and performance index (ECOG) equal to or greater than 2 have a poorer outcome after urinary diversion. According to the method of risk stratification for death from we described, patients with one or more risk factors have significant poorer outcome than cases with no risk factors

Neste trabalho, definimos a obstrução local de Euler de um espaço analítico complexo singular (X, \'x IND.0\'), denotada por Eu(X, \'x IND.0\'), e a obstrução local de Euler de uma função holomorfa f definida neste espaço, com uma singularidade isolada em \'x IND. 0\', denotada por \'Eu IND. f\' (X, \'x IND.0\'); e apresentamos duas fórmulas para seus respectivos cálculos. Em seguida, através de uma abordagem geométrica, determinamos as relações entre \'Eu IND. f\' (X,\'x IND.0\') e algumas generalizações do número de Milnor para funções em espaços singulares / In this work we define the local Euler obstruction of a complex analytic singularity (X, \'x IND.0\'), denoted Eu(X, \'x IND.0\'), and the local Euler obstruction of a holomorphic function f defined on this space, with an isolated singularity at \'x IND. 0\', denoted \'Eu IND. f\' (X, \'x IND.0\'); and we present two formulas for their respective calculations. Next, using a geometric approach, we determine the relations between \'Eu IND.f\' (X, \'x IND.0\') and several generalizations of the Milnor number for functions on singular spaces

A obstrução intestinal mecânica representa uma condição de urgência, necessitando diagnóstico precoce e terapêutica adequada, em virtude do seu elevado grau de morbidade e de mortalidade. Desta forma, o objetivo deste estudo foi avaliar o efeito da N-acetilcisteína associada ao Ringer lactato ou à solução salina hipertônica na resposta inflamatória, histologia e translocação bacteriana em modelo experimental de obstrução e isquemia intestinal. Para tanto, Foram constituídos quatro grupos experimentais, com 10 ratos Wistar em cada, além do grupo de referência: OI - Submetidos a obstrução e isquemia intestinal e enterectomia com anastomose intestinal, sem reanimação volêmica; RL - Submetidos a obstrução e isquemia intestinal, reanimação volêmica com Ringer lactato (32ml/kg, i.v., em 10 minutos) e enterectomia com anastomose intestinal; RLNAC - Submetidos a obstrução e isquemia intestinal, reanimação volêmica com Ringer lactato associado a NAC (32ml/kg + 150 mg/kg i.v. em 10 minutos) e enterectomia com anastomose intestinal; SHNAC - Submetidos a obstrução e isquemia intestinal, reanimação volêmica com solução salina hipertônica a 7,5% associado com NAC (4ml/kg + 150 mg/kg i.v., em 10 minutos) e enterectomia com anastomose intestinal. Grupo Referência (n=5): Animais anestesiados, submetidos a coleta de materiais para cultura e histologia e sacrificados por exsanguinação. Os animais receberam uma associação anestésica de cetamina e xilazina intramuscular em membro posterior direito, na dose de 60mg/kg e 10mg/kg, respectivamente. Decorridas 24 h do tratamento, a eutanásia foi realizada por exanguinação, sob anestesia, após a coleta dos tecidos / Mechanical intestinal obstruction represents a condition of urgency, necessary early diagnosis and appropriate therapy, due to their high degree of morbidity and mortality. In this way, the objective of this study was to evaluate the effect of N-acetylcysteine associated with lactated Ringer\'s or hypertonic saline solution in the inflammatory response, histology and translocation in an experimental model of intestinal obstruction and ischemia. For Four experimental groups were constituted with 10 Wistar rats each, in addition to the reference group: OI - submitted to obstruction and ischemia intestinal and enterectomy with intestinal anastomosis, without volume resuscitation; RL - Undergoing intestinal obstruction and ischemia, volume resuscitation with Ringer\'s lactate (32ml / kg, i.v., within 10 minutes) and anastomosis enterectomy intestinal; RLNAC - Undergoing obstruction and intestinal ischemia, resuscitation with lactated Ringer\'s lactating NAC (32 ml / kg + 150 mg / kg i.v. in 10 minutes) and enterectomy with intestinal anastomosis; SHNAC - Submitted to obstruction and intestinal ischemia, volume resuscitation with saline solution hypertension at 7.5% associated with CAP (4 ml / kg + 150 mg / kg i.v., in 10 minutes) and enterectomy with intestinal anastomosis. Reference Group (n = 5): Anesthetized animals, submitted to collection of materials for culture and histology and sacrificed by exsanguination. The animals received a anesthetic association of ketamine and intramuscular xylazine in limb posterior right, at the dose of 60mg / kg and 10mg / kg, respectively. After 24 h of treatment, euthanasia was performed by exsanguination, under anesthesia, after collection of tissues

Para que o sistema de irrigação localizada opere com uma boa uniformidade de aplicação, é necessário que sejam adotas boas práticas de instalação e manejo, como também, que a fonte de água atenda aos requisitos de qualidade exigida e que o sistema de filtragem contribua para reduzir os riscos de obstrução. Entretanto, há condições em que o risco de obstrução pode ocorrer após o sistema de filtragem. Procedimentos inadequados de montagem e manutenção da linha podem levar a entrada de partículas sólidas que oferecem risco de obstrução. A característica da partícula associada a posição da linha pode favorecer ou reduzir os riscos de obstrução. O trabalho teve como objetivo avaliar o efeito do pulso de partículas em diferentes posições de linha. O experimento foi realizado no Instituto Nacional Ciência e Tecnologia em Engenharia de Irrigação, INCT-EI, vinculado ao Laboratório de Irrigação do Departamento de Engenharia de Biossistemas, da Escola Superior de Agricultura \"Luiz de Queiroz\"- (ESALQ/USP). Foram avaliados dois modelos de tubos gotejadores com emissores convencionais (não compensantes), integrados, de formato plano (tipo pastilha), submetidos a pulso por partículas sólidas combinando três fatores: posição da linha (para cima, para baixo e para o lado), diâmetro da partícula (0,05-0,1mm; 0,1-0,25mm; 0,25-0,5mm), concentração de partículas (5g, 10g e 20g), em sete posições de gotejadores na linha espaçados a cada 0,5 m. Foi utilizado o delineamento de blocos não casualizados, e para a comparação das médias de vazões relativas, foi adotado o teste de Tukey com significância de 5% e 10% na análise de variância. A análise fatorial revelou que o modelo de gotejador 1 apresenta maior susceptibilidade a obstrução nos quatro primeiros gotejadores, com diferença significativa para fatores isolados quanto em interação. O modelo 2 não apresentou diferença estatística para o fator concentração. Para os demais fatores e interações, foi observado que gotejadores mais distantes também podem apresentar redução de vazão quando submetidos ao pulso. Em ambos modelos, observou-se que o diâmetro da partícula é um fator que influencia a obstrução de gotejadores. Os gotejadores iniciais estão mais propensos a obstrução quando submetidos a pulsos de partículas. A posição da linha voltada para o lado contribui para redução dos riscos de obstrução. / For an irrigation system located operate with good uniformity of application, it is necessary to adopt good installation and management practices, as well as the water source meets the required quality requirements and the filtering system contributes to reduction of obstruction\'s risks. However, there are conditions where the risk of obstruction may occur after the filtering system. Inadequate line assembly and maintenance procedures can lead to the entry of solid particles that allow the clogging emitters. The particle characteristic associated with lineage may favor or reduce the risk of obstruction. The objective of this work was to evaluate the effect of the pulse of particles in different positions of the line. The experiment was carried out at the National Institute of Science and Technology in Irrigation Engineering, INCT-EI, linked to the Irrigation Laboratory of the Department of Biosystems Engineering, School of Agriculture \"Luiz de Queiroz\" - (ESALQ / USP). Two tube models of conventional drippers (non-compensating) were submitted to pulses by solid particles combining three factors: line position (up, down and to the side), particle diameter (0.05-0.1 mm, 0.1-0.25mm, 0.25- 0.5mm), particle concentration (5g, 10g and 20g) in seven positions of drippers in the line spaced every 0.5 m. The design of non-randomized blocks was used, and the Tukey test with significance of 5% and 10% as analysis of variance for comparison of means. The factorial analysis revealed that the model drip tube 1 presented greater susceptibility to obstruction in the first four drippers, with a significant difference for factors isolated and in interaction. The model 2 did not present statistical difference for the concentration factor, however, for the other factors and interactions, it was observed that more distant drippers can also present reduction of flow when submitted to the pulse. In both models, it was observed that the particle diameter is a factor that influences the drip obstruction. It has been observed that the diameter of the particle is a factor that influences the obstruction of drippers. The initial drippers are more prone to obstruction when subjected to pulses of particles. The position of the line facing the side of the contributed to reduces the risk of obstruction.

Objetivo: Estimar a prevalência de sintomas de apneia obstrutiva do sono (AOS), obstrução nasal (ON) e enurese em crianças com fissura labiopalatina unilateral, não sindrômicas. Local de execução: Unidade de Estudos do Sono do Laboratório de Fisiologia - HRAC/USP. Método: Estudo prospectivo transversal com a participação de 174 sujeitos que atenderam aos critérios de inclusão, de 6 a 12 anos de idade (média de 10,0 ± 1,8 anos, 58,62% do sexo masculino). A prevalência de sintomas de AOS e de ON foi estimada pela análise dos escores obtidos pelos instrumentos: Escala de Distúrbios do Sono em Crianças (EDSC); Índice de Congestão Nasal (CQ-5) e Escala Visual Analógica (EVA). A enurese foi considerada como presente quando relatada incontinência urinária intermitente durante o sono (no mínimo 1 episódio/mês, nos últimos 3 meses). Para caracterizar a enurese como monossintomática ou polissintomática, sintomas de disfunção do trato urinário inferior (DTUI) foram investigados pelo instrumento Dysfunctional Voiding Scoring System (DVSS), em Português. Foram colhidos dados sociodemográficos, antecedentes e comorbidades, índice de massa corpórea (IMC) e razão circunferência abdominal/altura (CA/A). Foram analisadas medidas de posição e dispersão, frequências percentuais e absolutas e razão de prevalências. Diferenças entre subgrupos foram analisadas a um nível de significância de 5%. Resultados: Escore EDSC positivo para AOS foi observado em 60 (34,48%) crianças da amostra; escore CQ-5 positivo para ON em 45 (25,86%), escore DVSS positivo para DTUI em 30 (17,24%) e 29 (16,67%) crianças apresentaram enurese. Ronco habitual foi observado em 75,00% no subgrupo AOS e sensação de nariz obstruído habitual em 75,56% no subgrupo ON. Não foram constatadas diferenças significativas quanto a sexo, raça, IMC e razão CA/A. A ocorrência de enurese foi maior aos 6 e 7 anos, com queda gradativa aos 8 anos e ausência aos 12 anos. Houve predomínio de enurese primária (65,52%), infrequente (68,96%) e polissintomática (72,41%). Comparativamente aos dados da literatura, as razões de prevalências de AOS, do sintoma nariz obstruído e de enurese foram até 6,75 vezes (IC 95% 5,3 - 8,7), 2,14 vezes (IC 95% 1,8 - 2,5) e 3,33 vezes (IC 95% 2,3 - 4,7) maiores, respectivamente. Foi identificada associação entre sintomas de AOS e ON (p=0,0001), com correlação positiva e moderada entre os escores médios do EDSC e do CQ-5 (0,545). Não se verificou maior prevalência de enurese nas crianças com sintomas de AOS. Conclusão: As crianças com FLPUNS tem alta prevalência de obstrução nasal e enurese e estão sob risco para apneia obstrutiva do sono / Objectives: To estimate the prevalence ratios of nasal obstruction (NO) symptoms, OSA-related symptoms and enuresis in Brazilian nonsyndromic children with repaired unilateral cleft lip and palate (UCLP/NS). Setting: Sleep Studies Unit, Laboratory of Physiology, HRAC/USP. Methods: 174 children with repaired UCLP/NS, meeting inclusion criteria, participated in this prospective, cross-sectional study (aged 6-12 y, 58.62% boys). Validated questionnaires were used to predict OSA and subjective NO, Sleep Disturbance Scale for Children (SDSC), Congestion Quantifier Five Item (CQ-5) and Visual Analog Scale (VAS), respectively. Enuresis was defined as intermittent incontinence of urine during sleeping (with a minimum of one episode per month and at least for 3 months). In order to identify non-monosymptomatic enuresis, lower urinary tract dysfunction was assessed by a validated questionnaire, the Dysfunctional Voiding Scoring System (DVSS). Sociodemographic data, medical history, comorbidities, body mass index (BMI) and waist-to-height ratio (WHR) were analyzed. Measures of central tendency and dispersion, absolute and relative frequencies and prevalence ratios were analyzed. Subgroups were compared at 5% significance level. Results: Positive screening for OSAS-related symptoms was seen in 60 (34.48%) children and subjective NO in 45 (25.86%). Enuresis was seen in 29 (16.67%) children and positive DVSS score in 30 (17.24%). Habitual snoring was seen in 75.00% of the children with OSA-related symptoms and sensation of nasal obstruction in 75.56% of the children with positive CQ-5 score. No differences were observed for gender, race, BMI and WHR. The occurrence of enuresis was higher at 6/7 y of age, with a gradual decline at 8 years and absence at 12 y. There was a predominance of primary (65.52%), infrequent (68.96%) and non-monosymptomatic (72.41%) enuresis. Compared to literature data, prevalence ratios of OSA-related symptoms, NO and enuresis were, respectively, 6.75 (95% CI 5.3 - 8.7), 2.14 (95% CI 1.8 - 2.5) and 3.33 (95% CI 2.3 - 4.7) times higher. Association was identified between symptoms of OSA and ON (p=0.0001), with a positive and moderate correlation between the average scores of the EDSC and CQ-5 (0.545). Prevalence of enuresis was not higher in children with symptoms of OSA. Conclusion: Nonsyndromic children with cleft lip and palate have a high prevalence of symptoms of nasal obstruction and enuresis, and are at risk for obstructive sleep apnea

INTRODUCTION Internal abdominal hernias are infrequent but an increasing cause of bowel obstruction still often underdiagnosed. Among adults its usual causes are congenital anomalies of intestinal rotation, postsurgical iatrogenic, trauma or infection diseases. PRESENTATION OF CASE We report the case of a 63-year-old woman with history of chronic constipation. The patient was hospitalized for two days with acute abdominal pain, abdominal distension and inability to eliminate flatus. The X-ray and abdominal computerized tomography scan (CT scan) showed signs of intestinal obstruction. Exploratory laparotomy performed revealed a trans-mesenteric hernia containing part of the transverse colon. The intestine was viable and resection was not necessary. Only the hernia was repaired. DISCUSSION Internal trans-mesenteric hernia constitutes a rare type of internal abdominal hernia, corresponding from 0.2 to 0.9% of bowel obstructions. This type carries a high risk of strangulation and even small hernias can be fatal. This complication is specially related to trans-mesenteric hernias as it tends to volvulize. Unfortunately, the clinical diagnosis is rather difficult. CONCLUSION Trans-mesenteric internal abdominal hernia may be asymptomatic for many years because of its nonspecific symptoms. The role of imaging test is relevant but still does not avoid the necessity of exploratory surgery when clinical features are uncertain. / Revisión por pares

In healthy airways, mucus forms part of the innate immune response protecting the respiratory epithelium from damage by pathogens and environmental debris (Rose and Voynow, 2006). Conversely, in many respiratory diseases, mucus becomes part of the airway disease pathology. Mucus hypersecretion along with reduced clearance can cause blockage of the small airways, impairing gas exchange, promoting inflammation and becoming a culture medium for bacterial colonisation (Thornton et al., 2008). Recurrent airway obstruction (RAO) is a common yet poorly understood equine chronic respiratory disease where such altered mucus properties and clearance have been identified as major factors in the disease pathology (Davis and Rush, 2002; Gerber et al., 2000; Kaup et al., 1990; Robinson, 2001). The gel-forming mucins are largely responsible for the transport properties of mucus. The major equine airway gel-forming mucin in health is Muc5b and to a lesser extent Muc5ac; produced in specialised respiratory epithelial goblet cells and sub-mucosal glands (Rousseau et al., 2011b). Changes in mucin relative and net amounts and their macromolecular properties and interactions have been attributed to the altered physical properties of airway mucus in airways disease (Groneberg et al., 2002a; Jefcoat et al., 2001; Kirkham et al., 2002; Robinson et al., 2003; Sheehan et al., 1995).The project investigates the biochemical properties of mucins present in mucus from healthy horses and horses with RAO. This project identifies the anatomical presence of mucin-producing goblet cells and glands in fixed tissues from the respiratory tracts of healthy horses and subsequently examines mucin-production sites in respiratory tracts from horses with RAO. Finally the project investigates a methodology for the study of mucin production in airway cells harvested from live horses suffering from RAO.Our investigations confirmed that horses with RAO have more endotracheal mucus than healthy controls, and that Muc5b is the predominant mucin with Muc5ac also present in RAO horse mucus, both during symptomatic disease and when horses are asymptomatic. Mucins are produced in epithelial goblet cells and sub-mucosal glands dispersed throughout the length and circumference of the equine trachea and bronchi. Goblet cell hyperplasia occurs in symptomatic exposed RAO horse airways, although goblet cells are smaller than in asymptomatic RAO horse airways. Exposure to a dusty stable environment is associated with more goblet cells per length of bronchial compared to tracheal epithelium in all horses. RAO horses have larger sub-mucosal glands containing more mucin than control horses. Primary epithelial cell cultures grown at an air liquid interface are an alternative approach to study equine airway mucus, although the use of this culture system is in its early stages. We have developed novel ways to harvest equine airway epithelial cells (tracheal brushing) and shown it is possible to freeze cells collected via tracheal epithelial brushing in 20 % FBS and then culture to ALI at a later date.

Made available in DSpace on 2014-06-11T19:22:21Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-02-22Bitstream added on 2014-06-13T20:09:23Z : No. of bitstreams: 1 lopes_mcs_me_jabo.pdf: 1425980 bytes, checksum: ec77cfbfaaacc7792256be3564bbc255 (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Avaliaram-se os efeitos clínico e comportamental da injeção intravenosa do tramadol no controle da dor induzida experimentalmente, por obstrução intestinal extraluminal, com dreno de Pen Rose. Foram utilizados 24 cavalos distribuídos em quatro grupos: controle (GC, n=6); obstrução duodenal (GD, n=6); obstrução de íleo (GI, n=6) e obstrução de flexura pélvica (GFP, n=6). Após medicação pré-anestésica com a associação de acepromazina (0,025 mg.kg-1 IV), xilazina (0,5 mg.kg-1 IV) e meperidina (4 mg.kg-1 IM), o tramadol foi administrado nas doses de 1,0 mg.kg-1 e 1,5 mg.kg-1, por via intravenosa (IV), imediatamente após a obstrução intestinal, em três cavalos de cada grupo. Avaliaram-se as freqüências cardíaca (FC) e respiratória (f), temperatura retal (TºC), tempo de preenchimento capilar (TPC), motilidade intestinal, comportamento relacionado à dor (olhar para o flanco, cavar, deitar e rolar) hemograma e hemogasometria venosa, nos intervalos: M0 (basal) a cada 0,5 hora de M1 a M6 , na fase de obstrução, e até três horas após a reversão do processo obstrutivo (M7 a M12). Os resultados demonstraram que não houve diferença significativa entres as doses utilizadas dentro de cada grupo, assim como entre os grupos. Houve aumento da FC em M11 no GD e em M12 no GFP. Os sinais de dor abdominal e atonia intestinal iniciaram-se em M5 no GFP e em M6 no GI. Nos animais do GD, os sinais de desconforto não progrediram. No leucograma foi observado um quadro característico de estresse e na hemogasometria os animais do GD tendenciaram à alcalose metabólica com compensação respiratória. Clinicamente, observou-se que a dose de 1,5 mg.kg-1 de tramadol proporcionou melhor conforto para os animais, porem sem significado estatístico, quando comparado coma dose de 1,0 mg.kg-1... / The clinical and behavioral effects of the intravenous injection of tramadol were evaluated during the control of pain induced experimentally due to intestinal extraluminal obstruction using “Pen Rose” drain. A total of 24 horses were used and distributed in four groups: control (GC, n=6); duodenal obstruction (GD, n=6); ileum obstruction (GI, n=6) and pelvic flexure obstruction (GFP, n=6). After administration of pre-anesthetic medications using association of acepromazine (0.025 mg.kg-1 IV), xylazine (0.5 mg.kg-1 IV) and meperidine (4 mg.kg-1 IM), tramadol was administered at doses of 1.0 mg.kg-1 and 1.5 mg.kg-1 intravenously (IV), immediately after the intestinal obstruction in three horses of each group. Evaluations were performed, including heart rate (HR), respiratory rate (RR), rectal temperature (RT), capillary refill time (CRT), gut motility, pain-related behaviour (look for the sidewall, dig down and roll) and blood gases from venous blood at the time: M0 (baseline) and every 0.5 hours from M1 to M6, during obstruction process and also until three hours after the obstructive process be reverted (M7 to M12). The results showed no significant difference among the doses used in the same group as among groups. There was an increase in HR in the GD M11 and M12 of GFP. Signs of abdominal pain and intestinal atony began at M5 in GFP and at M6 in GI. In animals from GD, the discomfort signs did not showed progress. On the leucogram was observed a typical stress and on the blood gas analysis the animals from GD showed a tendency to metabolic alkalosis with respiratory compensation. Clinically, was observed that the dose of 1.5 mg.kg-1 of tramadol provided better comfort to the animals, but there was not statistical significance, compared with the dose 1.0 mg.kg-1... (Complete abstract click electronic access below)

by Martin Li. / Year shown on spine: 1997. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1996. / Includes bibliographical references (leaves 150-157). / DECLARATION --- p.II / ABSTRACT --- p.III / ACKNOWLEDGEMENTS --- p.VII / CONTENTS --- p.VIII / LIST OF ABBREVIATIONS --- p.XIV / LIST OF TABLES --- p.XVI / LIST OF CHART --- p.XXIII / LIST OF FIGURES --- p.XXIV / Chapter CHAPTER 1 --- OBSTRUCTIVE AIRWAY DISEASE: PUBLIC HEALTH AND CLINICAL ASPECTS --- p.1 / Chapter 1.1. --- Background --- p.1 / Chapter 1.2. --- Magnitude of the problem --- p.2 / Chapter 1.2.1. --- Asthma --- p.2 / Chapter 1.2.2. --- Chronic obstructive pulmonary disease --- p.3 / Chapter 1.2.3. --- Prevalence of osteoporosis in Hong Kong --- p.4 / Chapter 1.2.4. --- History of asthma care --- p.5 / Chapter 1.2.5. --- Treatment of OAD --- p.5 / Chapter 1.3. --- Side effects of Glucocorticoid in OAD patients --- p.6 / Chapter 1.4. --- Side effccts of inhaled corticosteroids in OAD patients --- p.7 / Chapter 1.5. --- Trend of asthma therapy in Hong Kong --- p.8 / Chapter CHAPTER 2: --- OSTEOPOROSIS: PUBLIC HEALTH AND CLINICAL ASPECTS --- p.11 / Chapter 2.1. --- Bone Biology --- p.11 / Chapter 2.2. --- Skeletal Organisation --- p.11 / Chapter 2.3. --- Bone remodelling --- p.12 / Chapter 2.4. --- Effect of corticosteroids on bone remodelling --- p.13 / Chapter 2.5. --- Corticosteroids induccs osteoporosis --- p.13 / Chapter 2.6. --- Factors affecting BMD --- p.14 / Chapter 2.6.1. --- Peak bone mass --- p.14 / Chapter 2.6.2. --- Ethnic factors --- p.14 / Chapter 2.6.3. --- Aging --- p.15 / Chapter 2.6.4. --- Calcium intake --- p.15 / Chapter 2.6.5. --- Oestrogen --- p.16 / Chapter 2.6.6. --- Alcohol consumption --- p.17 / Chapter 2.6.7. --- Cigarette smoking --- p.17 / Chapter 2.7. --- Physical activity and BMD --- p.17 / Chapter 2.8. --- Body composition in Chinese subjects --- p.18 / Chapter CHAPTER 3 --- "PHASE I: BODY COMPOSITION AND BONE MINERAL DENSITY IN OBSTRUCTIVE AIRWAY DISEASE PATIENT AND NORMAL CONTROL SUBJECTS: OBJECTIVES, SUBJECTS AND METHODS" --- p.20 / Chapter 3.1. --- Objectives --- p.20 / Chapter 3.2. --- Subjects and methods --- p.21 / Chapter 3.2.1 --- OAD patients --- p.21 / Chapter 3.2.1.1 --- Disease definition and selection criteria --- p.21 / Chapter 3.2.1.2. --- Normal Control subjects --- p.21 / Chapter 3.3. --- Power of estimation --- p.22 / Chapter 3.4. --- Survey methods --- p.22 / Chapter 3.5. --- Questionnaire --- p.23 / Chapter 3.6. --- Body composition and bone mineral density measurement --- p.23 / Chapter 3.6.1. --- Body composition analysis --- p.24 / Chapter 3.6.2. --- Lumbar spine and proximal hip bone mineral density analysis --- p.24 / Chapter 3.6.3. --- Routine quality control of measurements --- p.24 / Chapter 3.6.4. --- Precision on patient repositioning --- p.25 / Chapter 3.7. --- Statistical methods --- p.25 / Chapter 3.8. --- Bone mineral density of normal control subjects --- p.25 / Chapter CHAPTER 4 --- PHASE II: FLUORIDE IN THE TREATMENT OF OSTEOPOROSIS --- p.27 / Chapter 4.1. --- Introduction --- p.27 / Chapter 4.2. --- Mechanisms of action --- p.28 / Chapter 4.2.1. --- Antiresorptive effect of fluoride --- p.28 / Chapter 4.2.2. --- Force-oriented osteogenic effect of fluoride --- p.28 / Chapter 4.2.3. --- Biochemical osteogenic effect --- p.29 / Chapter 4.3. --- Effect of fluoride salts on BMD: results of clinical trials --- p.29 / Chapter 4.4. --- Effcct of fluoride on bone histomorphology --- p.30 / Chapter 4.5. --- Compliance with sodium fluoride therapy --- p.31 / Chapter 4.6. --- Contradiction of fluoride treatment --- p.31 / Chapter 4.7. --- Sodium monofluorophosphate preparation --- p.32 / Chapter CHAPTER 5 --- PHASE II: THE EFFECTS OF FLUORIDE ON BONE MINERAL DENSITY OF OAD PATIENTS ON STEROID TREATMENT --- p.37 / Chapter 5.1. --- Objectives --- p.37 / Chapter 5.2. --- Subjects and methods --- p.37 / Chapter 5.2.1. --- Power of the study --- p.37 / Chapter 5.2.2. --- Subjects --- p.37 / Chapter 5.2.3. --- Method of randomisation --- p.38 / Chapter 5.2.4. --- Treatment modalities --- p.39 / Chapter 5.2.4.1. --- Treatment group --- p.39 / Chapter 5.2.4.2. --- Control group --- p.39 / Chapter 5.2.5. --- Bone mineral density measurements --- p.39 / Chapter 5.2.6. --- Routine quality control of measurement and precision on patient repositioning --- p.40 / Chapter 5.2.7. --- Methods of monitoring drug compliance --- p.40 / Chapter 5.2.8 --- Statistical methods --- p.40 / Chapter CHAPTER 6 --- RESULTS FOR PHASE I --- p.42 / Chapter 6.1. --- Statistical power of this phase of the study --- p.42 / Chapter 6.2. --- Clinical features of OAD subjects on inhaled steroid --- p.42 / Chapter 6.3. --- Anthropometric measurements and bone mineral density --- p.45 / Chapter 6.4. --- Analysis of covariance for BMDs differences --- p.48 / Chapter 6.5. --- Multiple regression --- p.50 / Chapter 6.6 --- Correlation --- p.51 / Chapter CHAPTER 7 --- RESULTS FOR PHASE II: FLUORIDE AND CALCIUM TRIAL --- p.81 / Chapter 7.1. --- Factors affects the power of studies --- p.81 / Chapter 7.2. --- Clinical findings --- p.82 / Chapter 7.3. --- Body measurements and bone mineral densitometry --- p.85 / Chapter CHAPTER 8: --- DISCUSSION FOR PHASE I --- p.117 / Chapter CHAPTER 9: --- DISCUSSION FOR PHASE II: TRIDIN AND CALCIUM TRIAL --- p.124 / APPENDIX 1: QUESTIONNAIRE FOR OAD BONE MINERAL DENSITY STUDY --- p.132 / APPENDIX 2: BONE SCANS FROM HOLOGIC QDR2000 --- p.137 / APPENDIX 3. TABLES AND REFERENCE CURVES FOR NORMAL HONG KONG CHINESE FEMALE OR MALE BMD --- p.142 / REFERENCE --- p.150