Introdução. Hepatite B oculta é caracterizada pela presença do HBV-DNA em pacientes que não expressam o antígeno B de superfície (HBsAg) e é relatada com maior freqüência em pacientes infectados pelo vírus da hepatite C (HCV). Nesse estudo avaliamos a prevalência de hepatite B oculta em transplantados renais infectados ou não pelo HCV e avaliamos a função hepática nos diferentes grupos. Material e métodos. Amostras de soro de 101 pacientes transplantados renais foram avaliadas para testes de função hepática, marcadores sorológicos e reação de polimerização em cadeia (PCR) para o HBV-DNA. Todos os pacientes eram HBsAg negativos e havia 51 pacientes anti- HCV reagentes e 50 pacientes não reagentes. A pesquisa do HBV-DNA foi feita por técnica de PCR aninhado para os genes S e “core”. Resultados. A pesquisa do gene S do HBV-DNA resultou positiva em 2 pacientes, sendo um do grupo anti-HCV reagente e o outro do grupo não reagente. A pesquisa do gene da região do “core” foi positiva em um paciente do grupo anti-HCV não reagente. A análise demonstrou que os pacientes do grupo anti-HCV reagente apresentam maior tempo de tratamento dialítico (50,8 + 34,6 e 32,02 + 20,87; p<0,001). Da mesma forma o grupo anti-HCV reagente apresentou valores mais elevados de aminotransferases: ALT: 34.5 ± 26.7 x 20.9 ± 10.0; (P < 0.001); AST: 31.7 ± 17.7 x 24.9 ± 14.9; (P < 0.05); gama glutamiltranspeptidase : 66.1 ± 82.4 x 33.4 ± 44.6; (P < 0.02) e fosfatase alcalina : 307.9 ± 397.7 x 186.9 ± 63.4; (P< 0.04). Os níveis de ciclosporina sérica também mais elevados também foram encontrados no grupo anti-HCV reagente 170.9 ± 69.8 and 135.0 ± 48.1 respectivamente (P < 0.02). No modelo de análise multivariada evidenciou-se que apenas a presença de infecção pelo HCV é determinante das alterações nas provas de função hepática. Conclusão. Hepatite B oculta foi um achado infreqüente na nossa população de pacientes transplantados renais, não tendo sido encontrada diferença na sua prevalência em pacientes infectados ou não pelo HCV. Pacientes anti-HCV reagentes apresentam alterações significativas das provas de função hepática e dos níveis sangüíneos de ciclosporina. / Background: Occult hepatitis B (HB) is characterized by the presence of HBV-DNA in patients who do not present HB surface antigen (HBsAg) detectable in sera. This condition is frequently described in patients with hepatitis C virus (HCV) infection and its clinical implications are uncertain. Since transplant patients were at risk for hepatitis B and/or C infection by blood transfusions, dialysis treatment and the transplant procedure itself we aimed to evaluate the prevalence of occult HB either with or without HCV infection. Patients and Methods: One hundred and one HBsAg negative renal transplant patients were evaluated. Fifty-one were anti-HCV reagents (Elisa III). Sera was analyzed for the presence of the S and core genes of the HBV-DNA by a nested PCR technique. Serological markers of HBV infection, liver function testes and ciclosporine through levels were also analysed. Results: The core gene of the HBV-DNA was identified in one HCV infected patient and in one anti-HCV negative who also presented the S gene (prevalence: 2% and 1% for each gene respectivelly). HCV infected patients presented longer pre-transplant dialysis time (50.8 ± 34.6 versus 32.0 ± 20.9; p<0,001). Results of liver function tests were also increased in the HCV infected group: ALT: 34.5 ± 26.7 x 20.9 ± 10.0; (P < 0.001); AST: 31.7 ± 17.7 x 24.9 ± 14.9; (P < 0.05); GGT: 66.1 ± 82.4 x 33.4 ± 44.6; (P < 0.02) and alkaline phosphatase: 307.9 ± 397.7 x 186.9 ± 63.4; (P< 0.04). Ciclosporine through levels were also significantly higher in HCV infected patients 170.9 ± 69.8 and 135.0 ± 48.1 respectivelly (P < 0.02). Multivariate analysis revealed that only HCV infection was determinant of the increased results of the LFTs. Conclusion: We found that occult hepatitis B is infrequent condition in our population of renal transplant patients and that HCV infection seems not to be a risk factor. In accordance with our previous work HCV we showed that infected renal transplant patients present evidence of liver damage and altered metabolism evidenced by the elevated liver function testes a higher ciclosporine through levels.

Orientador: Egberto Ribeiro Turato / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-14T16:32:41Z (GMT). No. of bitstreams: 1 Packer_MilenePescatori_M.pdf: 419054 bytes, checksum: 4c762c969689734886832bbc0d1ec1ea (MD5) Previous issue date: 2009 / Resumo: Discutir as vivências relatadas por moradores de rua, com história de uso abusivo de álcool, que passaram a morar em instituição confessional do Município de Campinas, dentro de um programa de acolhimento e de cuidados gerais. Sujeitos e Métodos: Foi empregado o método de pesquisa clínico-qualitativo com entrevista semi-dirigida com questões abertas. A coleta dos dados foi na Fraternidade Toca de Assis. A pesquisa contou com nove sujeitos ex-moradores de rua, sendo usado o critério da saturação para o fechamento da amostra. Foi utilizada a técnica de análise do conteúdo temático para a formação das categorias aprovadas pelos pares. Resultados: Foram extraídos três artigos: "Facilitações e barreiras em pesquisa de campo a propósito do emprego de métodos qualitativos em instituição informal de saúde"; "Pra suprir um vazio no estômago": o uso do álcool segundo relatos de ex-moradores de rua"; "Virei um mendigo": relatos de exmoradores de rua acolhidos em uma Instituição Confessional no Brasil". Discussão: A escolha de um campo que escapa ao habitual dos profissionais institucionalizados na saúde permitiu uma discussão acerca dos desafios da entrada em campo, assim como da coleta dos dados. Consideramos que o relato desta experiência acrescentaria os elementos teóricos à metodologia escolhida. No relato da experiência de vida dos sujeitos da pesquisa foi enfática a relação pessoal desses sujeitos com o fenômeno do uso abusivo do álcool e o processo de desconstrução psicológica da identidade. Conclusões: É possível ser construída uma nova vida, principalmente pelos próprios ex-moradores de rua. Depreende-se que parecem querer sair das ruas, mesmo que isso lhes pareça algo distante. / Abstract: Discuss the experiences of homeless with abuse of alcohol in an institution Confessional. Subjects and Methods: Clinical-qualitative research with semi-structured Interview to open question. Data collection was in the Fraternity Toca de Assis. The research subjects had nine homeless, and used the criterion of saturation for the closing of the sample. Used the technique of analysis of thematic content for the formation of the categories approved by peers. Results: Extracted three papers: "Facilities and barriers in field research by the way of the use of qualitative methods in health informal institution"; "to fill an empty stomach.": the use of alcohol according to reports from ex-homeless"; "turned a beggar": reports of ex-homeless sheltered in a Confessional Institution in Brazil". Discussion: The choice of a field beyond the usual of institutionalized health professionals led a discussion about the challenges of entering the field, as well as data collection. We believe that reporting this experience add elements to the methodology chosen theorists. In reporting the experience of life of research subjects was emphatically a personal relationship with the subject the phenomenon of abuse of alcohol and the process of psychological deconstruction of identity. Conclusions: It can be built a new life mainly by the homeless. It seems that they want to leave the streets, even if this seems distant. / Mestrado / Ciencias Biomedicas / Mestre em Ciências Médicas

Introdução. A infecção causada pelo vírus da hepatite B (HBV) é um dos agravos de maior prevalência no mundial. Segundo a Organização Mundial da Saúde (OMS) existem mais de 350 milhões de portadores crônicos da doença. A infecção pelo HBV é rotineiramente identificada quando há a presença do HBsAg circulante. Entretanto, em alguns casos o HBV-DNA tem sido detectado em indivíduos HBsAg negativos, positivos ou negativos para anti-HBc e anti-HBs. Essa apresentação sorológica e molecular é denominada infecção oculta pelo HBV (OBI). Geralmente a concentração do HBV-DNA no soro será abaixo de 200 UI/mL. Objetivo: Determinar a prevalência da OBI, em doadores de sangue do Estado do Amapá no ano de 2014. Material e Métodos. Foram analisadas um total de 62 amostras de doadores de sangue do estado do Amapá, no ano de 2014, que apresentavam o perfil sorológico: HBsAg negativo, anti-HBc positivo e com anti-HBs negativo ou positivo. Os marcadores sorológicos HBsAg e anti-HBc foram determinados através do imunoensaio quimioluminescente. As amostras selecionadas para a detecção do HBV-DNA foram testadas utilizando as metodologias de Real-Time PCR Kit NAT HIV/HCV/HBV (Bio-Manguinhos®) e PCR \"in house\". Resultados. Do total de 13.261 doadores triados para infecções transmissíveis pelo sangue, 283 apresentaram resultados reagentes para os marcadores da hepatite B, nos quais: 35 (0,3%) foram HBsAg e 248 (1,9%) para anti-HBc reagentes. Um total de 62 amostras foram testadas pelos métodos moleculares. Todas as amostras apresentaram resultado HBV-DNA não-detectável. Conclusão: O índice de inaptidão sorológica no ano de 2014 no HEMOAP foi de 1,9% para anti-HBc e 0,3% para HBsAg. A população estudada foi constituída predominantemente por adultos com idade entre 29-65 anos, do sexo masculino, casados e naturais de municípios do estado do Amapá / Introduction. The infection caused by the hepatitis B virus (HBV) is one of the most prevalent diseases in the world. According to the World Health Organization (WHO) there are more than 350 million chronic carriers of the disease. HBV infection is routinely identified when there is presence of circulating HBsAg. However, in some cases HBV-DNA has been detected in HBsAg negative individuals, positive or negative for anti-HBc and anti-HBs. This serological and molecular presentation is termed HBV-occult infection (OBI). Usually the concentration of HBV-DNA in serum will be below 200 IU / mL.Objective: To determine the prevalence of OBI in blood donors, in the State of Amapá, in the 2014. Material and methods. A total of 62 samples of blood donors from the State of Amapá in the year 2014 were analyzed, presenting the serological profile: HBsAg negative, anti-HBc positive and with negative or positive anti-HBs. Serum markers HBsAg and anti-HBc were determined by the chemiluminescent immunoassay. Samples selected for HBV-DNA detection were tested using the Real-Time PCR Kit Kit HIV / HCV / HBV (Bio-Manguinhos®) and in-house PCR. Results. Of the total of 13,261 donors screened for blood-borne infections, 283 presented reactive results for hepatitis B markers, in which: 35 (0.3%) were HBsAg and 248 (1.9%) for anti-HBc reagents. All samples showed nondetectable HBV-DNA result. Conclusion: The serological disability index in the year 2014 in HEMOAP was 1.9% for anti-HBc and 0.3% for HBsAg. The studied population consisted predominantly of adults aged 29-65 years, males, married and natural of cities of the state of Amapá

Orientador: Maria Isabel Pedreira de Freitas Ceribelli / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-21T01:00:38Z (GMT). No. of bitstreams: 1 NegrideSousa_AnaClaudia_M.pdf: 10758939 bytes, checksum: 1e275b80f25f5c6d9e3ab12d3eee6c94 (MD5) Previous issue date: 2012 / Resumo: Lâminas e cabos de laringoscópios têm sido analisados evidenciando presença de sangue, fluídos corpóreos e microrganismos, podendo apresentar-se potencialmente contaminados durante seu uso clínico. A forma de utilização destes equipamentos na prática diária pode estar colocando o paciente e a equipe de saúde em risco devido à maneira como vem sendo feita sua limpeza e desinfecção. Neste estudo estabeleceu-se a hipótese de que a lâmina e o cabo de laringoscópio, prontos para serem usados no paciente, sejam potenciais fontes de contaminação. O objetivo geral foi determinar a presença de sangue e de microrganismos neste equipamento. Foram analisados cabos e lâminas de laringoscópios, prontos para uso, em dois hospitais universitários públicos do interior de São Paulo. A amostra foi definida considerandose os equipamentos prontos para uso nas seções selecionadas em cada hospital, totalizando para análise microbiológica na Instituição I, 42 lâminas e na Instituição II 41 lâminas. Para a fase de presença de sangue, respectivamente, foram avaliadas 48 e 50 amostras, sendo estes distribuidos entre lâminas e cabos de laringoscópios. As análises microbiológicas foram realizadas no Laboratório de Microbiologia da Divisão de Patologia Clínica da Instituição II, utilizando-se técnicas laboratoriais quantitativas e qualitativas. Para a identificação de sangue oculto foi utilizado o teste para o monitoramento de sua presença em superfícies com metodologia em conformidade com a norma EM ISO 15883, com nome comercial de HemoCheck-S®. Os dados foram analisados descritivamente. Os resultados para o teste de sangue oculto nas lâminas e cabos dos laringoscópios foram de 14,3% e 46,0% positivos na Intituição I e II, respectivamente. Para o crescimento de microrganismos na Instituição I o resultado foi positivo para 76,2% das amostras, na Instituição II, um total de 92,7%. Na contagem de UFC mais de 101 UFC foram encontradas em 31,3% amostras na Instiutição I e na Instituição II em 44,7%. O estudo concluiu que a lâminas e o cabos dos laringoscópios nestas duas intituições pesquisadas oferecem riscos aos pacientes, apresentando crescimento de microrganismos e presença de sangue oculto. Urge providências para que seja possível sua utilização, garantindo-se a segurança dos pacientes e dos profissionais que tem contato direto com este equipamento / Abstract: Laryngoscope blades and handles have been analyzed showing the presence of blood, body fluids and microorganisms, which may present as potentially contaminated during its clinical use. The daily practical utilization of devices can be exposing patients and health professionals to risk, due to ineffective cleaning and disinfecting methods. This study established the hypothesis that the laryngoscope blade and handle, when ready to use, are potential sources of contamination. Thus, the overall objective is to determine the presence of microorganisms and blood in the equipment. Laryngoscope handles and blades was analyzed, when ready to use, in two public school hospital in the country side of São Paulo. The sample size was defined considering the equipment readiness in specific areas of each hospital, summarizing 42 blades at institution I and 41 blades at institution II for microbiological analysis. For the presence of blood testing phase, 48 and 50 samples were evaluated respectively, considering laryngoscope blades and handles. Microbiological analysis was performed at the Laboratory of Microbiology, Division of Clinical Pathology, Institution II, using qualitative and quantitative laboratory techniques. For occult blood finding, the surface test methodology in accordance with standard EN ISO 15883 was used, commercial name HemoCheck-S ® and data was analyzed descriptively. The results for occult blood test in the blades and handles of laryngoscopes were positive for 14.3% and 46.0%, for institutions I and II, respectively. For microorganisms' growth test, institution I indicated positive to 76.2% of the samples and institution II showed positive for a total of 92.7% of the samples. For UFC counting, UFC higher than 101 UFC was found in 31.3% of samples for institution I and 44.7% for institution II. This study revealed that the laryngoscope blades and handles of two evaluated institutions shows risks to patients, indicating a growth of microorganisms and the presence of occult blood. Urgent steps should be taken to allow their utilization, guaranteeing the safety of patients and health professionals who have direct contact with this equipment / Mestrado / Enfermagem e Trabalho / Mestre em Ciências da Saúde

This thesis seeks to examine the relationship between occult religion and the global circulation of texts. For some time now, scholars have rejected the secularism thesis or the idea that there has been a decline of religion in the post-Enlightenment period. Today, we largely accept that religion did not actually decline or disappear but, rather, it has changed form. Religion shifted from traditional religious institutions to become an aspect of aesthetic culture, available through the commercial economy. My work explores how the relationship between the book and commercial religion emerged and evolved during the long nineteenth century. Occultism has long been viewed as an aspect of the rise of secular society following the Enlightenment. This thesis proposes a new lens through which we can view the evolution of occultism, seeing it as a response to growth in global networks of empire and the commercialization of religion through the printed word. It explores how the nature of the transmission of occultism shifted, particularly during the final decades of the nineteenth century. Antoine Faivre’s foundational text Access to Western Esotericism (1994) put forward the concept of the transmission of occultism as something that occurs between a disciple and an initiate. My thesis, however, argues that the widening of print activity and literacy expanded the opportunities for initiation into magic to occur more broadly, changing the nature of who could become an initiate. As such, secrecy around magic became redefined. It shifted from being a pursuit of the literate elite to something that was widely available. This analysis is delivered in four chapters. The introduction examines the relationship between literature and nineteenth-century occultism. It also discusses the influence of globalization. Chapter one discusses the occult in post-revolutionary France and the influence of Egyptian orientalism on French occultism. Chapter two addresses Victorian occultism and discusses the context of a growing Victorian literary industry. Chapter three addresses the Theosophical Society as an agent of globalized and commercialized religion. It also addresses the importance of British imperialism in India. Finally, chapter four discusses the Hermetic Order of the Golden Dawn and the resurgence of Egyptian orientalism and elitism in British occultism.

Orientador: Maria Aparecida Mesquita / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-24T07:52:26Z (GMT). No. of bitstreams: 1 Freitas_BiancaRosaViana_M.pdf: 1586958 bytes, checksum: d79cc5666f8ce8e1281b43dad83b32ba (MD5) Previous issue date: 2013 / Resumo: O câncer colorretal (CCR) tem uma alta mortalidade, que pode ser diminuída com o rastreamento da população de risco médio a partir dos 50 anos de idade. Além da detecção precoce do CCR, é importante que os métodos de rastreamento identifiquem a presença de adenomas avançados. Um dos procedimentos recomendados para o rastreamento populacional é a pesquisa de sangue oculto nas fezes, realizada anualmente. O método tradicional para essa pesquisa é o teste do guáiaco. Entretanto, esse método tem uma sensibilidade relativamente baixa para detectar o CCR, e muito baixa para detectar os adenomas avançados. Além disso, exige dos pacientes várias restrições dietéticas e medicamentosas. Mais recentemente, os dados da literatura têm sugerido que o método imunoquímico de pesquisa do sangue oculto fecal é uma alternativa mais eficaz que o teste do guáiaco, com a vantagem de não demandar restrições dietéticas para a sua realização. Entretanto, existem ainda discordâncias entre os autores quanto à acurácia do método. Além disso, na maior parte dos estudos os pacientes com resultados negativos para a pesquisa do sangue oculto fecal não foram submetidos à colonoscopia, o que impede a determinação da sensibilidade e especificidade do teste. No Brasil ainda não existem estudos com grandes casuísticas para avaliar o desempenho desse método na detecção do CCR e de adenomas avançados. Portanto, o objetivo desse estudo foi avaliar a sensibilidade e a especificidade da pesquisa do sangue oculto nas fezes pelo método imunoquímico na detecção do CCR e de adenomas avançados em comparação com os achados da colonoscopia. A população de estudo foi constituída pelos pacientes com agendamento para o exame de colonoscopia no Gastrocentro entre julho de 2009 e julho de 2010. Foi solicitado que trouxessem uma amostra de fezes no dia da reunião de orientação sobre o exame de colonoscopia, realizada sete dias antes da realização do exame. Ao final, 302 pacientes realizaram os dois exames, sendo 64,2% do sexo feminino e 35,8% do sexo masculino, com idade de 56 ± 14 anos. As principais indicações para a colonoscopia foram: seguimento pós-cirúrgico de pacientes com CCR, alteração do hábito intestinal e seguimento de pólipos. Quanto aos resultados da colonoscopia, o exame não demonstrou nenhuma anormalidade em 52% dos pacientes, enquanto que o principal achado foi a presença de pólipos em 24,5% dos pacientes. Nove (3%) pacientes apresentaram CCR e 11 (15%) apresentaram adenomas avançados. A comparação com os dados da colonoscopia mostrou que a pesquisa do sangue oculto nas fezes pelo método imunoquímico apresentou sensibilidade de 88,9% para detectar o CCR e de 63,6% para os adenomas avançados. A especificidade do teste tanto para CCR quanto para adenomas avançados foi de 87,6 %. Em conclusão, a pesquisa de sangue oculto nas fezes pelo método imunoquímico apresentou uma boa sensibilidade e especificidade para a detecção das neoplasias avançadas na população estudada, indicando que esse método pode ser um instrumento útil para os futuros programas de rastreamento no Brasil / Abstract: Colorectal cancer (CRC) has a high mortality, which can be reduced through the screening of average-risk population beginning at age 50 years. In addition to the early detection of CRC, it is important that screening methods to identify the presence of advanced adenomas. One of the recommended procedures for population screening is the fecal occult blood test held annually. The traditional method for this research is the guaiac test. However, this method has a relatively low sensitivity for detecting CRC and very low to detect advanced adenomas. In addition, the test requires dietary and medication restrictions. More recently, data from the literature have suggested that the immunochemical fecal occult blood test is a more effective alternative to the guaiac test, with the advantage that it does not require dietary restrictions. However, there are still disagreements among authors regarding the accuracy of the method. Furthermore, in most studies the patients with negative results for the fecal occult blood test did not undergo colonoscopy, and therefore sensitivity and specificity could not be calculated. In Brazil there are no studies with large samples to assess the accuracy of this method. Therefore the aim of this study was to evaluate the sensitivity and specificity of the immunochemical fecal occult blood test for the detection of CRC and advanced adenomas compared with the findings of colonoscopy. The study population was composed of patients scheduled for colonoscopy at Gastrocentro-Unicamp between July 2009 and July 2010. Patients were asked to bring a stool sample on the day of the educational session about colonoscopy, which takes place one week before the exam. At the end, 302 patients underwent both examinations, 64.2% were female and 35.8% male, with mean age 56 ± 14 years. The main indications for colonoscopy were: postoperative follow-up of patients with RCC, changes in bowel habits and follow-up of polyps. Regarding the results of the colonoscopy examination, no abnormality was found in 52% of patients, whereas the main finding was the precence of polyps in 24.% of patients. Nine (3%) of our patients had RCC, while 11 (15%) had advanced adenomas. The comparison with the data of colonoscopy showed that the immunochemical fecal occult blood test had a sensitivity of 88.9% to detect CCR and 63.6% for advanced adenomas. The specificity of the test for both CCR and advanced adenomas was 87.6%. In conclusion, the immunochemical fecal occult blood test showed good sensitivity and specificity for the detection of advanced neoplasia in our study population, indicating that this method can be a useful tool for future screening programs in Brazil / Mestrado / Clinica Medica / Mestra em Clínica Médica

A Cochrane review conducted a meta-analysis looking only at FOBT for colorectal cancer screening. This review, based on published and unpublished data from 5 controlled trials, demonstrated that 3-card home FOBT conferred a reduction in colorectal cancer mortality of 16% (relative risk [RR]=0.84; 95% confidence interval [CI], 0.77-0.92) and a number needed to screen of 1173 (95% CI, 741-2807) to prevent 1 death from colon cancer over a 10-year period. If adjusted for adherence to screening, the reduction in mortality increased to 23% (RR=0.77; 95% CI, 0.57-0.89). In addition, long-term follow up of one of the RCTs in the review showed a continued reduction in colorectal cancer mortality of 34% (RR=0.66; 95% CI, 0.54-0.81) in subjects adhering to the FOBT screening protocol over a 13-year interval. Overall mortality did not differ between the screened and unscreened groups. A systematic review performed for the US Preventive Services Task Force (USPSTF) incorporated more recent data on colorectal cancer screening including colonoscopy. This review reached similar conclusions as above. This review also looked at office FOBT performed after digital rectal exam. It is important to note that a single office FOBT has a lower sensitivity than 3-card home FOBT and its effectiveness for reducing colorectal cancer mortality was unknown at the time of the systematic review. A subsequent 2005 Veterans Affairs prospective cohort study found that the sensitivity for detecting advanced neoplasia was only 4.9% for digital FOBT, and negative results did not decrease the likelihood of advanced neoplasia. The USPSTF review did not find any screening trials of colonoscopy but analyzed data from the National Polyp Study and a case-control study to draw its conclusions. The review reported an odds ratio for colorectal cancer mortality for patients who had colonoscopy to be 0.43 (95% CI, 0.30-63). The USPSTF review also looked at the sensitivity and adverse effects of FOBT compared to colonoscopy. One-time 3-card home FOBT had a sensitivity of 30% to 40% for detecting cancer. The sensitivity of one-time colonoscopy was difficult to determine since it was the criterion standard examination, but it was estimated to be greater than 90%, with a risk of perforation of 1/2000. The USPSTF review found both screening strategies cost-effective (<$30,000 per additional life-year gained) compared to no screening. FOBT had a cost per life-year saved of $5691 to $17,805 compared with $9038 to $22,012 for colonoscopy performed every 10 years.

Introduction Occult constipation (OC) – a subtype of constipation causing chronic or recurring gastrointestinal symptoms in the absence of classic symptoms of overt constipation – is a differential diagnosis that should be considered in patients with gastrointestinal symptoms of unclear etiology. Previous studies have investigated the symptomatology of OC and compared treatment regimens but to our knowledge there have been no studies comparing symptomatology with treatment outcomes to investigate whether some symptoms could be related to a better prognosis. Aim The aims of this study were to describe the symptoms present in patients with OC as well as investigate possible association between symptoms and treatment outcomes. Method This was a retrospective review of patient records including 88 patients under 18 years old with diagnosed constipation treated by Dr. Magnus Liljedahl at Gävle Hospital between 2017 and 2019. Results Out of the 88 patients included in the study, six (6.8 %) were classed as having suspected OC, 18 (20.5 %) confirmed OC and 44 (50.0 %) overt constipation. The most common symptoms in patients with OC were abdominal pain, fatigue, headache, back pain, and nausea. On follow-up, 16 patients with OC were symptom-free and three had symptoms remaining. When comparing symptomatology of OC with treatment outcomes no statistically significant differences were seen between the groups. Conclusion This study gives an overview of the symptoms seen in OC but limited information on any association between symptomatology and treatment outcomes. It does, however, emphasize that OC is a differential diagnosis in patients with gastrointestinal symptoms of unclear etiology.

No description available.

Spiritualism was a popular cultural movement that flourished in the late-19th century across the United States and eventually Europe. While there were many facets of its philosophy, the primary conviction behind Spiritualism was that spirits of the dead could communicate with the living through human mediums. Although this basic definition of Spiritualism is virtually uncontested in contemporary scholarship, the cultural causes of the movement remain a highly debated topic. Historians have proposed a variety of theories for Spiritualism's inception, but none have yet to explore the economic motivations behind the movement. Spiritualism was, in fact, a vital commercial enterprise that spurred entrepreneurial and consumption opportunities for thousands of nascent capitalists. During the movement's prime, a host of Spiritualist merchandise was mass produced and marketed, including talking boards, spirit photographs, séances, and planchettes. Together, these products were produced and consumed in what became an "economy of the supernatural"--a thriving industry based on the desire to communicate with deceased humans. Through analysis of product advertisements and opinions raised about the issue found in mass media, this thesis will demonstrate that economic motivation was behind every aspect of Spiritualist practice. No part of the movement was left untouched by the desire for financial gain. Furthermore, this thesis argues that while various cultural forces influencing Spiritualism would diminish over time, the movement was able to sustain itself through the development of an economy of supernatural products and services, many of which continue to be produced to this very day. / History