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Alsaif, Aysha S. Y. A. S. "Treatment of dental plaque biofilms using photodynamic therapy." Thesis, University of Leeds, 2017. http://etheses.whiterose.ac.uk/18523/.
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BACKGROUND: Photodynamic therapy (PDT) is a treatment modality involving a dye that is activated by exposure to light of a specific wavelength in the presence of oxygen to form oxygen species causing localised damage to microorganisms. AIM: To determine the most effective bactericidal incubation and irradiation times of erythrosine-based PDT, using a tungsten filament lamp, on in vivo- formed dental plaque biofilms. MATERIALS AND METHODS: The study was a two-phase randomised controlled study consisting of in-vitro and in-situ phases. Phase-1 aimed to determine the most appropriate incubation-time using erythrosine(220μM) based-PDT on lactobacillus species grown in-vitro. Phase-2 was conducted on 18-healthy adult participants wearing intraoral appliances with human enamel slabs to collect dental plaque samples in two separate periods for use in arm-1 and arm-2. For phase-2, accumulated dental plaque samples were tested under different experimental conditions; a) Control-1 (No erythrosine, no light); b) Control-2 (+Erythrosine, no light); c) Treatment-1 (+Erythrosine, +15min continuous light); d) Treatment-2 (+Erythrosine, +30sec light pulses for 5- times separated by 1min dark periods). Incubation-times of 15min and 2min were used in arm-1 and arm-2, respectively; as adapted from the previous pilot study and phase-1. Following treatment, percentage reduction of total bacterial counts were compared between the different groups. Additionally, Confocal Laser Scanning Microscopy(CLSM) was used to investigate the effect of PDT on in vivo-formed plaque biofilms. RESULTS: Significant reductions in the percentage of total bacterial counts (~93-95%) of in vivo-formed biofilms were found when using either 2min or 15min incubation-times and applying 15min continuous light. Whereas, when applying fractionated light, there was more cell death when 15min incubation-time was used (~91%) compared with the 2min incubation-time (~64%). CLSM results supported these findings. CONCLUSION: Improving the clinical usefulness of PDT by reducing its overall treatment time seems to be promising and effective in killing in vivo- formed dental plaque biofilms.
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Gong, Miranda Christina, and Miranda Christina Gong. "Strategies for a Novel Anti-Influenza Therapy." Thesis, The University of Arizona, 2017. http://hdl.handle.net/10150/624996.
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This experiment compares the implications of two methods of measuring viral particles, specifically Influenza particles in human cell lines in vitro. These strategies include plaque assays and xCELLigence screening. Plaque assays, also known as reduction assays, are plates that are overlaid with semi-solid medium that limits the spread of the virus and shows where each particle is located based on the "plaque" or empty space on the plates where cells have died and been removed. xCELLigence screening is a newer program that checks for "impedance", an artificial number that will measure the cells killed by virus as well as cell to cell interaction on a 96 well plate that utilizes gold microelectrodes. Both methods have variables that can make them useful in certain situations, however, the focus is on how reliable the xCELLigence program is in comparison to more traditional methods of quantifying viral particles.
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Skeoch, Sarah. "Investigation of atherosclerosis and the effects of anti-inflammatory therapy on plaque morphology in rheumatoid arthritis." Thesis, University of Manchester, 2015. https://www.research.manchester.ac.uk/portal/en/theses/investigation-of-atherosclerosis-and-the-effects-of-anti-inflammatory-therapy-on-plaque-morphology-in-rheumatoid-arthritis(971c3727-54a8-49ff-aab7-8a6e0aa9d1ba).html.
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Introduction: Rheumatoid arthritis (RA) is a systemic autoimmune condition, characterised by an inflammatory arthritis. It is associated with a 50% increased risk of cardiovascular (CV) mortality. Chronic inflammation is thought to lead to accelerated atherosclerosis in RA. There is some evidence to suggest that patients have a more inflammatory, unstable atherosclerotic plaque phenotype. The impact of advances in RA treatment, on cardiovascular co-morbidity remains unclear. The aims of the current study were to employ non-invasive imaging techniques to test the hypothesis that RA patients have more inflammatory, unstable atherosclerotic plaques compared to unaffected individuals and that treatment of active arthritis would lead to alterations in plaque composition and inflammation. Secondary aims were to evaluate the association of clinical phenotype and potential serological biomarkers of CV risk with plaque presence and phenotype. Methods: A prospective pilot study of patients with active RA and age and sex matched controls was conducted. Subjects underwent clinical and serological evaluation, then carotid artery ultrasound was performed to screen for carotid plaque. Dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) was performed on those with suitable plaque. A subgroup of patients had a carotid artery positron emission tomography (PET) scan. Patients were followed up with repeat clinical, serological and DCE-MRI assessments. The primary outcome evaluated was difference in plaque inflammation measured on DCE-MRI between patients and controls and in patients longitudinally. Secondary outcomes included differences in plaque composition on DCE-MRI, plaque inflammation on PET and the relationship of clinical, serological and imaging findings. Results: 130 patients and 52 controls were recruited and screened for carotid plaque. There was a higher prevalence of plaque on ultrasound in the patient group (53% vs 36%) and plaque was independently associated with high sensitivity c reactive protein (hsCRP). Carotid DCE- MRI data was analysed in 15 patients and 5 controls. There was no significant difference in plaque inflammation on DCE-MRI between the groups. However there was a significantly higher rate of plaque calcification in patients, despite similar plaque burden in both groups (73.3% vs 20%, p=0.038). All 15 patients exhibited features of high-risk plaque. Plaque inflammation was seen in all 13 patients in whom PET imaging was undertaken. No significant improvement in plaque inflammation was detected on DCE-MRI over time, which was in keeping with the lack of clinical improvement found in most cases. ConclusionsIncreased prevalence of atherosclerosis and differences in plaque phenotype were observed in this study and findings would support the hypothesis that patients have a more high-risk plaque phenotype. The high prevalence of calcified lesions in RA is a novel finding which warrants further investigation. The study was underpowered to detect significant changes in plaque inflammation, measured on DCE-MRI, between the groups and in patients over time. However, this study provides valuable data with which to plan a larger study to investigate the effects of anti-inflammatory therapy on atherosclerosis in RA in the future.
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Metzger, Katja Annett. "Diagnostik und Therapie atherosklerotischer Plaques mittels Ultraschallkontrastmittel am Mausmodell." Diss., Ludwig-Maximilians-Universität München, 2015. http://nbn-resolving.de/urn:nbn:de:bvb:19-181773.
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Stein, Ronja Maria Verfasser], and Michael [Akademischer Betreuer] [Hertl. "Photodynamische Therapie und Pathomechanismen des Lichen planus / Ronja Maria Stein ; Betreuer: Michael Hertl." Marburg : Philipps-Universität Marburg, 2017. http://d-nb.info/1136718400/34.
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Scavo, Linda. "Effet de la mélatonine sur le risque d’ostéoporose, le métabolisme énergétique cérébrale et la remyélinisation dans un modèle expérimental de souris EAE Melatonin Therapy Modulates Cerebral Metabolism and Enhances Remyelination by Increasing PDK4 in a Mouse Model of Multiple Sclerosis." Thesis, université Paris-Saclay, 2020. http://www.theses.fr/2020UPASS108.
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La Sclérose en plaques (SEP) est une maladie auto-immune chronique démyélinisante et neurodégénérative du SNC. Elle représente la première cause de handicap non traumatique chez l’adulte jeune et surtout les femmes. Malgré tous les efforts des chercheurs, la cause exacte de la SEP reste inconnue à ce jour. Selon eux, la SEP est considérée une maladie qui survient en présence des facteurs environnementaux combinés à des facteurs génétiques. La thérapie actuelle utilise des médicaments qui suppriment les attaques immunologiques sans supprimer tout le système immunitaire. La mélatonine s’est révélée d’être un candidat neuroprotecteur puissant pour réduire la perte de la myéline.Le but de ce travail est d’examiner la corrélation clinique entre la mélatonine sérique et la proCT chez les patients atteints de SEP et d’évaluer l’effet de la mélatonine sur l’ostéoporose, les voies métaboliques et la remyélinisation au niveau du cerveau in vivo. Pour ce faire, différentes techniques de biologie moléculaire et cellulaire ont été utilisées dans le modèle expérimental d'encéphalomyélite auto-immune (EAE).Les résultats obtenus se divisent en trois parties. Dans la première partie, Les données ont montré une augmentation significative des taux sériques de proCT chez les patients atteints de SEP, inversement corrélée aux niveaux de mélatonine et celui de l’ostéocalcine OCN par rapport aux sujets sains. Dans la seconde partie, nous avons démontré que la mélatonine a diminué les scores cliniques moyens, a réduit significativement les taux sériques de proCT et a augmenté le niveau de 25-hydroxyvitamine D, du calcium et de l’OCN chez les souris EAE par rapport au souris EAE témoins. Dans la troisième partie, les résultats ont montré que la mélatonine a augmenté le niveau des cytokines anti-inflammatoires (l’interleukine-10 (IL-10) et l’interleukine-4 (IL-4)) et a diminué le taux des cytokines pro-inflammatoires (le facteur de nécrose tumorale–alpha (TNF-α) et l’interleukine 1-bêta (IL-1β)) chez les souris EAE par rapport aux souris EAE témoins. Nous avons aussi démontré que le taux de la glycoprotéine oligodendrocytaire de la myéline (MOG), le taux de la protéine basique de la myéline (MBP) et le taux de la protéine basique oligodendrocytaire associée à la myéline (MOBP) ont étéaugmentés par celle-ci. De plus, elle a entraîné une augmentation significative des concentrations cérébrales d’acétate, de N-acétylaspartate (NAA) et de 3-hydroxy-3-méthylglutaryl-Coenzyme-A réductase (HMGCR). Les niveaux d’expression de l’ARNm et des protéines de pyruvate déshydrogénase kinase-4 (PDK-4) ont également augmenté chez les souris traitées à la mélatonine par rapport aux souris EAE non traitées. Le traitement à la mélatonine a entraîné une augmentation des taux de lactate dans le cerveau, alors que l'activité du complexe de pyruvate déshydrogénase (PDC) actif et total, enzyme sous le contrôle de PDK-4, a été supprimée.En conclusion, cette étude suggère que ProCT pourrait être un biomarqueur chez les patients atteints de SEP. Les résultats obtenus sur les souris EAE traitées à la mélatonine démontrent son importance sur l’atténuation de la gravité de la maladie et de l’inflammation intracérébrale ainsi que sur l’amélioration du métabolisme osseux qui a pour conséquent une réduction de l’ostéoporose. De même, ce traitement porte une importance sur la réduction des médiateurs inflammatoires tout en stimulant l’oligodendrogénèse. Ainsi, la mélatonine exerce un effet modulatoire sur les voies métaboliques impliquées dans le métabolisme cérébral et améliore le dysfonctionnement mitochondrial<br>Multiple Sclerosis (MS) is a chronic auto-immune demyelinating and neurodegenerative disease of the CNS. It represents the leading cause of non-traumatic disability in young adults and especially women. Despite all the efforts of researchers, the exact cause of MS remains unknown to this day. According to them, MS is considered a disease that occurs in the presence of environmental factors combined with genetic factors. Current therapy uses drugs that suppress immunological attacks without suppressing the entire immune system. Melatonin has been shown to be a potent neuroprotective candidate to reduce the loss of myelin.The aim of this work is to examine the clinical correlation between serum melatonin and proCT in MS patients and to assess the effect of melatonin on osteoporosis, metabolic pathways and remyelination in the brain. in vivo. To do this, different molecular and cellular biology techniques were used in the experimental model of autoimmune encephalomyelitis (EAE).The results obtained are divided into three parts. In the first part, the data showed a significant increase in serum proCT levels in MS patients, inversely correlated with melatonin and osteocalcin OCN levels compared to healthy subjects. In the second part, we demonstrated that melatonin decreased the average clinical scores, significantly reduced serum proCT levels and increased the level of 25-hydroxyvitamin D, calcium and OCN in EAE mice compared to control EAE mice. In the third part, the results showed that melatonin increased the level of anti-inflammatory cytokines (interleukin-10 (IL-10) and interleukin-4 (IL-4)) and decreased the rate of pro-inflammatory cytokines (tumor necrosis factor – alpha (TNF-α) and interleukin 1-beta (IL-1β)) in EAE mice compared to control EAE mice. We also demonstrated that the level of myelin oligodendrocyte glycoprotein (MOG), the level of myelin basic protein (MBP) and the level of myelin oligodendrocytic basic protein (MOBP) wereincreased by it. In addition, it has led to a significant increase in brain concentrations of acetate, N-acetylaspartate (NAA) and 3-hydroxy-3-methylglutaryl-Coenzyme-A reductase (HMGCR). Expression levels of mRNA and pyruvate dehydrogenase kinase-4 (PDK-4) proteins also increased in melatonin-treated mice compared to untreated EAE mice. Treatment with melatonin resulted in increased lactate levels in the brain, while the activity of the active and total pyruvate dehydrogenase (PDC) complex, an enzyme under the control of PDK-4, was suppressed.In conclusion, this study suggests that ProCT may be a biomarker in patients with MS. The results obtained on melatonin-treated EAE mice demonstrate its importance in reducing the severity of the disease and intracerebral inflammation, as well as improving bone metabolism, which consequently reduces osteoporosis. Likewise, this treatment is important for the reduction of inflammatory mediators while stimulating oligodendrogenesis. Thus, melatonin exerts a modulatory effect on the metabolic pathways involved in brain metabolism and improves mitochondrial dysfunction
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Metzger, Katja Annett [Verfasser], and Sven [Akademischer Betreuer] Reese. "Diagnostik und Therapie atherosklerotischer Plaques mittels Ultraschallkontrastmittel am Mausmodell / Katja Annett Metzger. Betreuer: Sven Reese." München : Universitätsbibliothek der Ludwig-Maximilians-Universität, 2015. http://d-nb.info/1070762946/34.
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Carty, Nikisha Christine. "Recombinant AAV Gene Therapy and Delivery." Scholar Commons, 2009. https://scholarcommons.usf.edu/etd/1890.
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Alzheimer's disease (AD), first characterized in the early 20th century, is a common form of dementia which can occur as a result of genetic mutations in the genes encoding presenilin 1, presenilin 2, or amyloid precursor protein (APP). These genetic alterations can accelerate the pathological characteristics of AD, including the formation of extracellular neuritic plaques composed of amyloid beta peptides and the formation of intracellular neurofibrillary tangles consisting of hyperphosphorylated tau protein. Ultimately, AD results in gross neuron loss in the brain which is evidenced clinically as a progressive decline in mental capacity. A strong body of scientific evidence has previously demonstrated that the driving factor in the pathogenesis of AD is potentially the accumulation of Aß peptides in the brain. Thus, reduction of Aß deposition is a major therapeutic strategy in the treatment of AD. Recently it has been suggested that Aß accumulation in the brain is modulated, not only by Aß production, but also by its degradation. Several important studies have demonstrated that Aß degradation is modulated by several endogenous zinc metalloproteases shown to have amyloid degrading capabilities. These endogenous proteases include neprilysin (NEP), endothelin converting enzyme (ECE), insulin degrading enzyme (IDE) and matrix metalloprotease 9 (MMP9). In this investigation we study the effects of upregulating expression of several of these proteases through administration of recombinant adeno-associated viral vector (rAAV) containing both endogenous and synthetic genes for ECE and NEP on amyloid deposition in amyloid precursor protein (APP) plus presenilin-1 (PS1) transgenic mice. rAAV administration directly into the brain resulted in increased expression of ECE and NEP and a substantial decrease in amyloid pathology. We were able to significantly increase the area of viral distribution by using novel delivery methods resulting in increased gene expression and distribution.
These data support great potential of gene therapy as a method of treatment for neurological diseases. Optimization of gene transfer methods aimed at a particular cell type and brain region in the CNS can be accomplished using AAV serotype specificity and novel delivery techniques leading to successful gene transduction thus providing a promising therapeutic avenue through which to treat AD.
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Sarlon-Bartoli, Gabrielle. "Outils diagnostique et thérapeutique innovants de la dysfonction vasculaire au cours des maladies artérielles périphériques." Thesis, Aix-Marseille, 2012. http://www.theses.fr/2012AIXM5510/document.
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Les maladies artérielles périphériques athéromateuses sont graves : l'atteinte des troncs supra-aortiques est à risque d'accident vasculaire cérébral et l'atteinte des artères des membres inférieurs est à risque d'amputation et de décès cardiovasculaire. Le développement de stratégies innovantes capables d'optimiser le diagnostic précoce et le traitement de ces maladies est un enjeu considérable.Nous montrons une corrélation entre deux biomarqueurs inflammatoires, les microparticules leucocytaires (MPL) et la lipoprotéine phospholipase A2, et l'instabilité de la plaque carotidienne définie histologiquement, dans une population de patients porteurs d'une sténose carotidienne serrée. Les MPL sont élevées de façon significative et indépendante y compris chez les patients asymptomatiques porteurs d'une sténose carotidienne serrée instable. Ainsi, le taux circulant de MPL aider à sélectionner les meilleurs candidats à une chirurgie carotidienne préventive parmi les patients ayant une sténose carotidienne serrée asymptomatique. Deuxièmement, nous montrons que l'administration ex vivo d'érythropoïétine (EPO) améliore les capacités proangiogéniques des progéniteurs endothéliaux circulants tardifs in vitro et in vivo sur un modèle d'ischémie de patte de souris nude. Ces effets semblent médiés par la sous-unité CD131 du récepteur à l'EPO. Si ces résultats se confirment chez l'homme, l'EPO pourrait être utilisée pour améliorer les capacités de revascularisation des progéniteurs endothéliaux circulants tardifs circulants humains avant réinjection autologue comme produit de thérapie cellulaire chez des patients atteints d'ischémie critique des membres inférieurs<br>Atherosclerotic peripheral arterial diseases are frequent and severe. They undertake the functional and vital prognosis of patients: lesions of supra-aortic trunks are at risk of stroke and lesions of lower limb arteries are at risk of amputation and cardiovascular death. The development of innovative strategies that optimize early diagnosis and therapeutic management of these diseases is thus a considerable challenge.In this work, we show a correlation between inflammatory biomarkers, leukocyte microparticles and lipoprotein phospholipase A2, and carotid plaque instability defined histologically, in a population of patients with tight carotid stenosis with or without neurological symptoms. Leukocyte microparticles are elevated significantly and independently including asymptomatic patients with tight unstable carotid stenosis. Thus, the circulating levels of leukocyte microparticles could be a tool in the future to select the best candidates for carotid surgery among patients with asymptomatic carotid stenosis tight.Second, we show that ex vivo administration of erythropoietin improves the proangiogenic capacity of late circulating endothelial progenitor in vitro and in vivo in a mouse model of hindlimb ischemia. These effects appear mediated by CD131 subunit of the receptor for erythropoietin. If these results are confirmed in humans, erythropoietin could be used to improve the revascularization capacity of late circulating endothelial progenitor before reinjection as autologous cell therapy product in patients with critical ischemia of the lower limbs
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Gamper, Coralie. "Nanoparticules dérivées de virus de plante pour le traitement et l'imagerie du cancer." Thesis, Strasbourg, 2019. http://www.theses.fr/2019STRAJ038/document.
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Les possibilités de combinaison thérapeutiques offertes par les nanoparticules ont ouvert un nouveau champ d’investigation pour la recherche sur le cancer. Dans ce projet de recherche, des nanoparticules dérivées de la protéine de capside du virus de la mosaïque du tabac (TMV) ont été utilisées afin de transporter différents peptides thérapeutiques ciblant le récepteur neuropiline-1. Cette stratégie a permis de solubiliser un peptide fortement hydrophobe ayant préalablement démontré son efficacité anticancéreuse sur des lignées de cancer du sein humain et de glioblastome. Les résultats obtenus ont également permis de démontrer la possibilité de combiner différents peptides thérapeutiques via l’auto-assemblage de la protéine de capside du TMV<br>Nanoparticles play an ever increase role in carrying therapeutic compounds in the cancer field. In this research project, the coat protein of Tobacco mosaic virus (TMV) was used as nanocarrier to solubilize a hydrophobic peptide interfering with the transmembrane domain of neuropilin-1. The nanoparticles created have conserved the antiangiogenic and antimigratory effect of the therapeutic peptide. This strategy was also used to create nanoparticles carrying a peptide targeting the ectodomain of neuropilin-1. The two types of nanoparticles were then assembled through auto-assembling ability of the coat protein. These nanoparticles also exhibit antiangiogenic ability thus, confirming the validity of this approach to combine therapeutic peptides
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Almeida, Ana Lúcia de Jesus [UNESP]. "O lugar Social do fisioterapeuta." Universidade Estadual Paulista (UNESP), 2008. http://hdl.handle.net/11449/105047.
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almeida_alj_dr_prud.pdf: 1955312 bytes, checksum: cfcc325f336a0e681fecc65766a59dde (MD5)<br>Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)<br>O presente trabalho visa compreender a produção do lugar social por meio das práticas dos fisioterapeutas em seu espaço de trabalho. As práticas tradicionais dos fisioterapeutas têm demonstrado que o exercício profissional está caracterizado por ações fragmentadas e descontextualizadas. Assim, na perspectiva de buscar um entendimento teórico sobre essas questões, a Geografia contribuiu com o entendimento das relações construídas no espaço das práticas. O material empírico utilizado foi 89 entrevistas com fisioterapeutas, dados do I Censo de Fisioterapeutas do Estado de São Paulo e dados do Ministério da Educação sobre a trajetória dos cursos de graduação em Fisioterapia. As análises dessas informações mostraram que o lugar social do fisioterapeuta está fortemente ligado à reabilitação, identificado com o ideário liberal privatista, com as instituições formadoras, predominantemente vinculadas ao ensino privado e concentradas na região sudeste, principalmente no Estado de São Paulo. As entrevistas e os dados analisados sustentam as evidências de uma prática profissional fragmentada e reducionista, resultando em um processo de alienação dos fisioterapeutas...<br>This thesis aims to understand the production of social place through the practice of physical therapists at their work place. The traditional work of physical therapy as exercised by professional tends to be characterized by actions both fragmented and decontextualized. In an effort to explain this situation, geography offers theoretical perspectives useful for understanding how workplaces are constructed. This empirical research used includes 89 interviews with physical therapists, data from the “First São Paulo State Physical Therapists Census” and Brazil’s Ministry of Education studies on the trajectory of undergraduate physical therapy programs. Most of these programs are located in private colleges, that are regionally concentrated in southeast of Brazil, especially the state of São Paulo. The analysis of this information demonstrated that the workplace of the physical therapist is built around rehabilitation services that are tightly linked to the individualist, own private and liberal ideal. On the one hand, the interviews and data sustain the argument that traditional professional practice is fragmented and reductionist, resulting in a process that alienates physical therapists... (Complete abstract click electronic access below)
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Almeida, Ana Lúcia de Jesus. "O lugar Social do fisioterapeuta /." Presidente Prudente : [s.n.], 2008. http://hdl.handle.net/11449/105047.
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Orientador: Raul Borges Guimarães<br>Banca: Amélia Pasqual Marques<br>Banca: Eliane Ferrari Chagas<br>Banca: Maria Aparecida de Moraes Silva<br>Banca: Samuel do Carmo Lima<br>Resumo: O presente trabalho visa compreender a produção do lugar social por meio das práticas dos fisioterapeutas em seu espaço de trabalho. As práticas tradicionais dos fisioterapeutas têm demonstrado que o exercício profissional está caracterizado por ações fragmentadas e descontextualizadas. Assim, na perspectiva de buscar um entendimento teórico sobre essas questões, a Geografia contribuiu com o entendimento das relações construídas no espaço das práticas. O material empírico utilizado foi 89 entrevistas com fisioterapeutas, dados do I Censo de Fisioterapeutas do Estado de São Paulo e dados do Ministério da Educação sobre a trajetória dos cursos de graduação em Fisioterapia. As análises dessas informações mostraram que o lugar social do fisioterapeuta está fortemente ligado à reabilitação, identificado com o ideário liberal privatista, com as instituições formadoras, predominantemente vinculadas ao ensino privado e concentradas na região sudeste, principalmente no Estado de São Paulo. As entrevistas e os dados analisados sustentam as evidências de uma prática profissional fragmentada e reducionista, resultando em um processo de alienação dos fisioterapeutas... (Resumo completo, clicar acesso eletrônico abaixo)<br>Abstract: This thesis aims to understand the production of social place through the practice of physical therapists at their work place. The traditional work of physical therapy as exercised by professional tends to be characterized by actions both fragmented and decontextualized. In an effort to explain this situation, geography offers theoretical perspectives useful for understanding how workplaces are constructed. This empirical research used includes 89 interviews with physical therapists, data from the "First São Paulo State Physical Therapists Census" and Brazil's Ministry of Education studies on the trajectory of undergraduate physical therapy programs. Most of these programs are located in private colleges, that are regionally concentrated in southeast of Brazil, especially the state of São Paulo. The analysis of this information demonstrated that the workplace of the physical therapist is built around rehabilitation services that are tightly linked to the individualist, own private and liberal ideal. On the one hand, the interviews and data sustain the argument that traditional professional practice is fragmented and reductionist, resulting in a process that alienates physical therapists... (Complete abstract click electronic access below)<br>Doutor
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Gentz, Irina [Verfasser], Thomas [Akademischer Betreuer] Mücke, and Herbert [Akademischer Betreuer] Deppe. "Der Einfluss der CO2-Laser-Therapie auf den Krankheitsverlauf bei Patienten mit oralem Lichen planus - eine Vergleichsstudie / Irina Gentz. Betreuer: Thomas Mücke. Gutachter: Thomas Mücke ; Herbert Deppe." München : Universitätsbibliothek der TU München, 2015. http://d-nb.info/1079001603/34.
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Persson, Nickolas. "Applikation för mobila trygghetslarm som stöd för äldre personers aktivitet utanför bostaden." Thesis, Hälsohögskolan, Högskolan i Jönköping, HHJ, Avd. för rehabilitering, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-39077.
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Bakgrund: Välfärdstekniska hjälpmedel kan möjliggöra sköra äldre personers kvarboende i den egna bostaden och är därför viktiga att utveckla. Applikationer (appar) för mobilt trygghetslarm är ett exempel, för att skapa trygghet i aktiviteter i och framförallt utanför den egna bostaden, vilket bidrar med delaktighet i samhället för användaren. Det är dock oklart hur äldre personer ser på dessa hjälpmedel. Syfte: Syftet med studien var att beskriva sköra äldre personers aktiviteter utanför den egna bostaden samt deras attityder relaterat till framtida användning av mobilt trygghetslarm vid dessa aktiviteter. Metod: En enkätundersökning genomfördes på en geriatrisk slutenvårdsavdelning (n=47). Analyser, bland annat gruppjämförelser genomfördes via Chi2-test (χ2) och Mann Whitney U-test. Resultat: Antalet aktiviteter utanför bostaden en vanlig vecka var lågt ( =3) och respondenterna avstod dessa aktiviteter då de ofta var otrygga (n=21), ensamma då de gick ut (n=30) eller kände oro (n=27). Ensamboende och kvinnor avstod i högre utsträckning aktiviteter utanför bostaden jämfört med sammanboende och män. Slutsats: Flera deltagare ansåg att appen skulle öka deras aktiviteter utanför den egna bostaden och respondenterna hade generellt en positiv attityd relaterat till framtida användning av app för mobilt trygghetslarm.<br>Background: Welfare technology aids can enable frail elderly people to age in place and are therefore important to develop. Applications for mobile security alarms are an example to create security in activities, especially outside the home, which contributes to engagement in the society. However, it is unclear how frail elderly people look at these aids. Objective: The purpose of the study was to describe activities of frail elderly people outside their own homes and their attitudes related to the potential future use of mobile security alarms in these activities. Method: A survey was conducted in a geriatric department (n=47). Analyses, including group comparisons, were conducted by Chi-Test (χ2) and Mann Whitney U-Test. Result: The number of activities outside the home a regular week was low ( = 3) and the participants abstained from these activities because they were insecure (n=21), alone when they went out (n=30) or felt unease (n=27). Lonely living and women engaged significant lower in activities outside their home compared with cohabitants’ and men. Conclusion: Several participants considered that the application would increase their activities outside their own home and the participants generally had a positive attitude related to the future use of mobile security alarm applications.
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Axelsson, Bertil. "The incurable cancer patient at the end of life : Medical care utilization, quality of life and the additive analgesic effect of paracetamol in concurrent morphine therapy." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2001. http://publications.uu.se/theses/91-554-4968-9/.
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Riddle, Brad A. "Exploring the effect of a lifestyle enrichment program to reduce perfectionism and increase spiritual, individual, and interpersonal satisfaction in Christians, using a cognitive behavioral intervention." Theological Research Exchange Network (TREN) Access this title online Theological Research Exchange Network (TREN), 2006. http://www.tren.com.
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Le, Cleach Laurence. "Apport des revues systématiques et méta-analyses en réseau en Dermatologie Interventions for chronic palmoplantar pustulosis Oral antiviral therapy for prevention of genital herpes outbreaks in immunocompetent and nonpregnant patients Workflow for Searching Databases to Reduce Evidence Selection Bias in Systematic Reviews Systemic pharmacological treatments for chronic plaque psoriasis: a network meta-analysis." Thesis, Paris Est, 2019. http://www.theses.fr/2019PESC0045.
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La décision médicale nécessite d’avoir à disposition une synthèse rigoureuse et actualisée des données de la recherche. Les revues systématiques (RS) et méta-analyses (MA) sont la méthode la plus rigoureuse pour produire ces synthèses. Nous avons réalisé des RS et MA Cochrane sur trois maladies chroniques en dermatologie. Notre objectif était de produire une synthèse des données, de proposer des pistes d’amélioration pour la recherche à venir et d’ouvrir sur des projets de méta-recherche.La première revue avait pour objectif d’évaluer l’efficacité et la tolérance des traitements de la pustulosepalmoplantaire. Nous avons inclus 36 essais contrôlés randomisés (ECR) comprenant un total de 1504 patients. Le comparateur était le placebo ou aucun traitement dans 31 ECR. Au total, nous avons trouvé un faible degré de certitude que l’analogue topique de la vitamine D (maxacalcitrol) était plus efficace que le placebo à court terme ; que l'alitrétinoïne et trois traitements biologiques n'étaient pas plus efficaces que le placebo ; enfin un degré de certitude modéré que le secukinumab (anti IL17) était supérieur au placebo. Dans cette revue, aucune donnée probante n’a été retrouvée pour les principaux traitements utilisés en pratique courante (corticoïdes locaux, photothérapie, acitrétine, méthotrexate, ciclosporine).La méta-analyse en réseau est une méthode statistique permettant de déterminer l’efficacité relative de l’ensemble des traitements y compris pour les comparaisons qui n’ont pas été évaluées dans un ECR. Cette méthode a été appliquée dans les deux revues suivantes.La deuxième revue avait pour objectif d’évaluer l’efficacité et la tolérance relative d’un traitement suppressif par aciclovir, valaciclovir ou famciclovir dans l’herpès génital du sujet immunocompétent. Nous avons inclus 26 ECR portant sur un total de 6950 patients. Les résultats montraient que l'aciclovir, le famciclovir et le valaciclovir diminuaient le risque d’avoir au moins une récidive d'herpès génital sous traitement comparativement au placebo. La méta-analyse en réseau n'a révélé aucune différence statistiquement significative entre les traitements. Dans cette revue, le manque de comparaisons directes, l’absence des critères de jugement pertinents pour les patients, le risque de biais élevé et non clair pour une majorité d’essais et une hétérogénéité importante limitent la pertinence et le niveau de confiance dans les résultats.La troisième revue avait pour objectif d’évaluer l’efficacité et la tolérance relative des traitements systémiques du psoriasis modéré à sévère chez l’adulte. Nous avons identifié 109 essais pertinents pour un total de 39,882 patients. Soixante-quatorze essais ont été inclus dans la méta-analyse en réseau. Cette étude a montré que l’ixekizumab était le meilleur traitementversus placebo (RR 32.45, 95% IC 23.61 à 44.60; (haut degré de certitude)), suivi par le secukinumab (haut degré de certitude), puis le brodalumab (degré de certitude modéré), puis guselkumab (degré de certitude modéré), le certolizumab (degré de certitude modéré), et l’ustekinumab (haut degré de certitude). Dans cette revue, malgré un nombre conséquent d’essais, un certain nombre de points limites diminuaient le degré de confiance dans les résultats : peu d’essais face-face, peu d’essais évaluant et rapportant la qualité de vie, l’absence d’évaluation au long court et l’inclusion d’une population sélectionnée.Ces trois revues ont permis de mettre en évidence des biais récurrents pouvant s’appliquer au traitement de maladies chroniques en dermatologie notamment le manque d’essai face-face, l’évaluation le plus souvent à court terme et le peu d’essais rapportant un critère de qualité de vie. Ce travail permet également de guider les essais à venir dans ces trois domaines afin d’améliorer l’agenda de la recherche, la diffusion des résultats et la rédaction de recommandations<br>Medical decision-making requires a rigorous and up-to-date synthesis of research data. Systematic reviews (SR) and meta-analyses (MA) are the most rigorous method for producing these syntheses. Cochrane is an independent international organization whose mission is to produce and disseminate systematic reviews. We have performed RS and MA Cochrane on three chronic diseases in dermatology. Our objective was threefold: to produce a rigorous synthesis of the data, to propose ways of improving future research in these fields and finally to open up to meta-research projects. The first review aimed to evaluate the efficacy and tolerance of treatments for palmoplantarpustulosis, a chronic inflammatory disease characterized by the presence of pustules on palms and plants. We included 36 randomized controlled trials (RCTs) that encompassed a total of 1,504 patients. Overall, we found that the topical analogue of vitamin D (maxacalcitrol) was more effective than placebo in the short term; alitretinoin and three biological treatments (etanercept (anti TNF), ustekinumab (anti IL17-IL23) and guselkumab (anti IL23)) were no more effective than placebo (low degree of certainty); and secukinumab (anti IL17) was superior to placebo (moderate degree of certainty). In this first review, we observed a situation where no evidence was found for the main treatments (local corticosteroids, phototherapy, acitretin, methotrexate, and cyclosporine) used. Network meta-analysis is a statistical method for determining the relative effectiveness of all treatments, including comparisons that have not been evaluated in an RCT. This method was applied in the following two reviews.The objective of the second review was to evaluate the efficacy and relative safety of suppressive treatment with acyclovir, valaciclovir or famciclovir in genital herpes in the immunocompetent subject. We included 26 RCTs with a total of 6,950 patients. The results showed that acyclovir, famciclovir and valaciclovir reduced the risk of having at least one recurrence of genital herpes under treatment compared to placebo. The network meta-analysis revealed no statistically significant differences between treatments. No conclusions on adverse reactions could be drawn due to the poor quality of their description. The lack of direct comparison, the absence of the most relevant judgment criteria for patients, the risk of high and unclear bias in a majority of trials and a heterogeneity whose causes could not be explored alter the relevance and level of confidence in the results.The objective of the third review was to evaluate the efficacy and relative tolerance of systemic treatments for moderate to severe psoriasis in adults. We included 109 trials for a total of 39,882 patients. Seventy-four of these trials were included in the network meta-analysis. This study showed that ixekizumab was the best treatment. (versus placebo: RR 32.45, 95% CI 23.61 to 44.60; (high certainty), followed by secukinumab (high certainty), then brodalumab (moderate certainty), then guselkumab (moderate certainty), certolizumab (moderate certainty), and ustekinumab (high certainty). In this third review, the number of trials allowed us to conduct a network meta-analysis and classify the treatments. However, a number of points decreased the degree of confidence in the results: the few face-to-face trials, few trials evaluating and reporting on quality of life, the absence of long-term short evaluation and the inclusion of a selected population.These three reviews highlighted recurrent biases that could be applied to other chronic dermatological diseases, including the lack of face-to-face testing, primarily short term evaluations, and the lack of reports including a quality of life criterion. This work also provides guidance for future trials in these three areas in terms of comparisons to be made and bias to be avoided
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Becker, Michelle Caitlin. "The Combination of Carboxylesterase-Expressing Oncolytic Vaccinia Virus and Irinotecan." Thèse, Université d'Ottawa / University of Ottawa, 2013. http://hdl.handle.net/10393/23653.
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This project combines oncolytic Vaccinia virus (VV) with irinotecan (CPT-11) for the treatment of cancer. VV can infect, replicate in and destroy cancer cells, yet leave healthy cells relatively unaffected. CPT-11 is a chemotherapeutic of which ~5% is converted to the more active chemotherapeutic SN-38 by endogenous carboxylesterase (CE) enzymes. SN-38 is a topoisomerase I inhibitor that induces DNA double strand breaks, leading to growth arrest and apoptosis. Consequently, VV has been engineered to express a more effective isoform of the CE enzyme. The virus’ tumour tropism should restrict enhanced conversion of CPT-11 to the tumour.
Neither CPT-11 nor SN-38 interfered with VV replication or spread. Engineered recombinants expressed CE enzyme which, when combined with CPT-11, produced DNA double strand breaks and cancer cell death. In vitro, the combination of CE-virus and CPT-11 killed more K-562 cancer cells than its non-CE counterpart and CPT-11.
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Karlsson, Fredrik. "The acquisition of contrast : a longitudinal investigation of initial s+plosive cluster development in Swedish children." Doctoral thesis, Umeå : Department of philosophy and linguistics, Umeå university, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-829.
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Bertrand, Baptiste. "Traitement des altérations de la peau par la fraction vasculaire stromale et les produits autologues dérivés du tissu adipeux." Thesis, Aix-Marseille, 2019. http://theses.univ-amu.fr.lama.univ-amu.fr/190417_BERTRAND_242uf54uog131hnsdbu686cwseau_TH.pdf.
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Certaines altérations de la cicatrisation ou du volume sous cutané sont difficiles à traiter. L’objectif de notre travail de thèse était d’évaluer l’efficacité et la tolérance de produits autologues innovants de thérapie cellulaire dérivés du tissu adipeux. Nous avons étudié l’action de la fraction vasculaire stromale (FVS), obtenue par digestion enzymatique du tissu adipeux, de la Nanofat ou « graisse émulsifiée » et du plasma riche en plaquette (PRP), dans des modèles murins de radiodermite chronique, de plaie diabétique ou chez l’homme pour les ridules péribuccales. L’injection locale de FVS a permis d’améliorer la cicatrisation des plaies diabétiques ou de radiodermite. Les cellules de la FVS se sont intégrées dans le bourgeon de granulation au septième jour, et semblent stimuler les cellules régénératrices du tissu receveur. L’utilisation du PRP en adjuvant au tissu adipeux a montré une action pro-cicatrisante pour l’ulcère de radiodermite, mais n’a pas permis d’améliorer la survie du greffon de tissu adipeux. L’injection locale de Nanofat a montré des résultats intéressants dans le comblement des rides péribuccales. Sa composition cellulaire est proche de la FVS, avec une persistance des cellules « régénératrices » du tissu adipeux malgré une importante diminution de la viabilité cellulaire et la présence dans le produit obtenu de débris cellulaires<br>Some alterations in wound healing or subcutaneous fat volume are difficult to treat. The objective of our thesis work was to evaluate the efficacy and tolerance of innovative autologous products of cell therapy derived from adipose tissue. We evaluated the action of the stromal vascular fraction (FVS), obtained by enzymatic digestion of adipose tissue, Nanofat or "emulsified fat" and platelet-rich plasma (PRP), in murine models of chronic radiodermatitis, diabetic wound or in human for perioral wrinkles. Local injection of FVS has improved the healing of diabetic wounds or radiodermatitis wounds. Human FVS cells were integrated into the murine wound on day 7, and appear to stimulate the regenerative cells of the recipient tissue. The use of PRP in association with adipose tissue has shown a pro-healing action for radiodermatitis ulcer, but failed to improve adipose tissue graft survival. The local injection of Nanofat has shown interesting results in the filling of perioral wrinkles. Its cellular composition is close to the FVS, with persistence of "regenerative" cells of adipose tissue despite a significant decrease in cell viability and the presence in the product of cell debris
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Shand, Meagan. "Understanding and building resilience with art: A socio-ecological approach." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2014. https://ro.ecu.edu.au/theses/1402.
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Resilience is a widely researched phenomenon, it means different things to different people and is perceived and measured according to the theoretical lens being applied. The following thesis reviews the theoretical development of resilience that has led to contemporary understandings, to establish a platform for the research topic - understanding and building resilience with Art. Narrative research methods are combined with art processes to illuminate the stories of eight culturally diverse women participating in a community based mental health art program, in Western Australia. Fifteen resilience themes emerged from the collective experience, and are presented in a socio-ecological framework to understand the complex interplay between the individual and their environment. Six key learnings that illustrate the unique contribution art has to make to building individual, social and community resilience in the Australian policy context are explored and discussed.
The discussion revisits a strengths approach to resilience, and through metaphor and symbol it reminds us that resilience in its most basic form is strength during difficult time. Social, cultural and spiritual aspects of strength and resilience are highlighted; and the concept of resilient places is introduced and the crucial role they have to play in social inclusion and social support is discussed. It brings to light evidence that not all people in Australia have equal access to social networks and the need to bridge the gap to community for people who live with complex needs and are separated from family, friends and other natural support systems. By presenting resilience within a socio-ecological framework, the social and community aspects of resilience cannot be ignored.
The strength of this research is the creative use of art and narrative to illuminate the lived experience and communicate findings to a wider audience. The use of a public exhibition and the publication of a colourful resource book and its wide dissemination via the World Wide Web; projected the science in the lime light, inviting a broader and more diverse audience to engage with the stories of resilience, enhancing the potential of the findings to influence community attitudes as well as policy and practice. This research demonstrates that art is much more than ‘a means to an end’, it is valuable research tool that can be used to explore, embody and express complex and challenging social phenomenon, such as resilience.
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Järpeskog, Timo M. "Hyperrealitet, perceptionsfenomenologi och relationsinramning : Prövandet av en teoretisk förklaringsmodell med utgångspunkt från en kritisk undersökning av forskning om naturens läkande egenskaper." Thesis, Högskolan i Gävle, Religionsvetenskap, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-27284.
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Denna masteruppsats diskuterar naturens läkande effekt på människan genom att analysera nuvarande forskningsläge i både svenskt och internationellt perspektiv. Analysen förstås genom en teoretisk modell som baserar sig på ekologisk perceptionsfenomenologi, hyperrealitet och relationsinramning. Uppsatsens slutsats är att naturens läkande effekt kan förklaras med en perceptiv relation mellan människan och den mer-än-mänskliga världen, men också, att mer forskning behövs.<br>This master thesis discusses the healing properties of nature on the human being through an analysis of current Swedish and international research. The analysis is made by using a theoretical model based on ecological perception phenomenology, hyperreality and relational frame theory. The conclusion of the thesis is that the healing properties of nature may be explained by the perceptive relation between the human being and the more-than-human world, but also that more research is needed.
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Chan, Bo-Ine, and 陳柏穎. "Plaque control in therapy of gastric ulcer." Thesis, 2005. http://ndltd.ncl.edu.tw/handle/98190894252309956726.
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碩士<br>高雄醫學大學<br>牙醫學研究所碩士班<br>93<br>Background: Helicobacter pylori is one of the most common pathogens worldwide,and approximately 50% of the world population is infected with it . Many investigators had reported strong correlation between H. pylori and duodenal ulcer, gastric ulcer, gastritis, and even gastric cancer, but most of all have no clinical symptom . Microaerophilic acidic environment of dental plaque can be an ideal environment for growth of H pylori. However, whether dental plaque is a potential reservoir for gastric H. pylori reinfection remains controversial.
Objective : The aim of this study is to investigate the relationship of H. pylori in the stomach and dental plaque, and plaque control would benefit therapy of gastric ulcer by full mouth scaling.
Material & Methods: forty-two patients who first received gastric endoscopic biopsy in Kaohsiung Medical University Hospital were enrolled in our study. Patients were excluded if they were edentulous or had received gastrointestinal tract surgery and medical therapy that may alter the results (include proton pump inhibitors, antibiotics and compounds containing bismuth) within one month. Gastric specimens were obtained from gastric antrum and body, and were assessed by rapid urease test, culture, histology and 13-C urea breath test. Gastric H. pylori infection was confirmed when the culture was positive or a concordance of two of the other three tests was positive. At the same day of endoscopy ,dental plaque specimens were collected after recording the plaque index、 gingival index and probing depth of patients, and then assessed by rapid urease test (RUT) and polymerase chain reaction (PCR) (cagA gene). According to patients’mind to receive full mouth scaling and oral hygiene instruction, or not. Four months after H. pylori eradication therapy for 4 months, above assessments were repeated to confirm the outcome of therapy.
Results: Those patients to receive full mouth scaling and oral hygiene instruction H. pylori before eradication therapy is positive and after is negative in dental plaque and stomach is 44% and 48 % individually. It shows that plaque control has a tendency towards eradication therapy of H. pylori . The existence of H. pylori in the dental plaque after the eradication therapy indicated that the antibiotics might not be as effective in such a biofilm as in the stomach and oral cavity . It shows that the presence of H. pylori in dental plaque is one of the risk factors of gastric infection. The fact that the plaque index、 gingival index and probing depth of gastric H. pylori (+) patients were significantly higher than gastric H. pylori (-) patients suggested that oral hygiene is important to gastric H. pylori infection status.
Conclusions: 1.Oral cavity is a reservoir of H. pylori,2. plaque control has a tendency towards eradication therapy of H. pylori , 3. oral hygiene is important to gastric H. pylori infection status .The existence of H. pylori in the dental plaque after the eradication therapy infers that the recolonization of H. pylori from dental plaque may be a source of the transmission and recrudescence of gastsric infection.
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Chin, Jamie A. "Examining morphological differences in Heschl's gyrus between neurotypical and dyslexic brains." Thesis, 2020. https://hdl.handle.net/2144/41502.
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Current methods of diagnosis for developmental dyslexia rely on family history report and cognitive and language behavioral testing. However, relying on these measures alone to predict dyslexia in at-risk children can result in low sensitivity and specificity, with dyslexic individuals either being missed or over-identified. Prediction accuracy could be increased by considering structural differences in the dyslexic brain along with behavioral measures. Reduplication of Heschl’s gyrus, where the primary auditory cortex resides, has been suggested as a risk factor for developing dyslexia. The current investigation explored if differences in interhemispheric duplication patterns and gray matter volume of Heschl’s gyrus could distinguish between dyslexic and neurotypical (control) brains. A detailed labeling protocol based on macroanatomical landmarks and explicitly defined reduplication morphotypes: single Heschl’s gyrus (SH), common stem duplication (CSD), complete posterior duplication (CPD), and multiple duplication (MD) was developed. Overall, there was no significant difference in the incidence of morphotypes between control and dyslexic brains. Duplication of Heschl’s gyrus was a common occurrence in both groups. However, results suggest that the MD morphotype may occur more often in dyslexic brains. Gray matter volume of anterior Heschl’s gyrus was larger in the left hemisphere in both groups but tended to be larger overall in dyslexic brain. Results of this investigation confirmed the presence of high morphological variability between and within brains and suggest that reduplications in Heschl’s gyrus alone are not enough to designate between neurotypical and dyslexic brains. It is likely that developmental dyslexia has heterogeneous origins, and it is possible that increased gyrification combined with other structural differences is one possible origin.
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Cartwright, Gaynor Dorothy. "The relative effectiveness of combined spinal manipulative therapy and occlusional splint therapy in the treatment of chronic tension-type headaches." Thesis, 2002. http://hdl.handle.net/10321/2756.
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A dissertation submitted in partial compliance with the requirements for a Master's Degree in Technology in Chiropractic at Technikon Natal, 2002.<br>The purpose of this study, was to investigate and determine what role the treatment of nocturnal bruxism, in conjunction with spinal manipulative therapy, would play in the management of tension-type headaches.<br>M
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Radke, Peter W. "Therapie der In-Stent-Restenose durch die Rotations-Atherektomie : Mechanismen und Ergebnisse eines Plaque-abladierenden Verfahrens /." 2003. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=014639850&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.
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Hilker, Lutz. "Untersuchung des Einflusses einer lipidsenkenden Therapie auf die Progression atherosklerotischer Plaques unter Verwendung der dreidimensionalen Sonographie /." 2003. http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&doc_number=015409702&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA.
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Manning, Kieth Earl. "Condylar position changes coincident with occlusal splint therapy a thesis : ... submitted in partial fulfillment ... restorative dentistry /." 1989. http://catalog.hathitrust.org/api/volumes/oclc/68789638.html.
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Mihailidis, Alex. "The Development of Intelligent Systems to Support Older Adults and Aging-in-Place." 2009. http://hdl.handle.net/2429/7451.
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Fonseca, Mariana Soares Ventura Lopes. "Relatórios de Estágio e Monografia intitulada “Psoríase: Perspetivas futuras com um olhar no passado”." Master's thesis, 2020. http://hdl.handle.net/10316/93089.
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Relatório de Estágio do Mestrado Integrado em Ciências Farmacêuticas apresentado à Faculdade de Farmácia<br>Psoriasis is a chronic, benign and immune-mediated skin inflammation. Among the several forms of Psoriasis, the most common and the one focused on this monograph is the so-called Plaque Psoriasis (PP), characterized by the appearance of well-defined red plaques with raised white surfaces, called crusts. The pathogenesis of the disease, not yet fully understood, is a complex phenomenon that involves not only keratinocytes, but also inflammatory cells and cells belonging to adaptive and innate immunity. Currently, studies indicate the existence of a genetic predisposition related to the onset of PP. However, the absence of disease in subsequent generations suggests that other factors, such as the exposure to sunlight, are implicated in the development of this pathology. Despite being a benign pathology, PP has several associated diseases and complications, which contribute to the decrease in patient's quality of life and lead to the need to establish an effective therapeutic regimen. The Psoriasis Severity Index by Area and the Dermatology Quality of Life Index are tools used to assess the degree of Psoriasis and select the most appropriate therapy for each case. The so far available therapies for Psoriasis are only suppressive therapies, as there is still no cure for this disease. These therapies include topical drugs, phototherapy, systemic oral agents and biological drugs (BD). However, current and most widely used treatments present some drawbacks. Considering these disadvantages and combining the fact that more is known about the pathogenesis of the disease, many studies have been developed on the therapeutics to be instituted as well as research into new drugs. In the context of innovations in the treatment of Psoriasis we highlight the BD that have recently entered the market and those that are in the final phase of development, the biosimilars and changes in topical formulations in order to improve therapeutic efficacy.<br>A Psoríase é uma doença inflamatória cutânea, crónica, benigna e imunomediada. Existem várias formas de Psoríase, sendo a mais comum e a focada nesta monografia a chamada Psoríase Tipo Placa (PTP). Caraterizada pelo aparecimento de placas vermelhas bem demarcadas e com superfícies elevadas brancas, apelidadas de crostas. A patogénese da doença, ainda não totalmente compreendida, é um fenómeno complexo que envolve não só os queratinócitos, mas também células inflamatórias e células pertencentes à imunidade adaptativa e inata. Na atualidade, estudos indicam a existência de uma predisposição genética relacionada com o aparecimento da PTP. Contudo, a ausência de doença nas gerações seguintes sugere que outros fatores, como exposição à luz solar, estejam implicados no desenvolvimento desta patologia A PTP é uma patologia benigna, mas com várias doenças associadas e complicações, que contribuem para a diminuição da qualidade de vida do doente e para a necessidade de instituição de um esquema terapêutico eficaz. Para avaliar o grau de Psoríase e selecionar a terapêutica mais adequada para cada caso, calcula-se o Índice da Gravidade da Psoríase por Área e o Índice de Qualidade de Vida em Dermatologia.As terapêuticas existentes até ao momento para a Psoríase são apenas terapias supressoras, na medida em que ainda não existe uma cura para a doença. Nestas terapêuticas encontram-se fármacos tópicos, fototerapia, agentes orais sistémicos e medicamentos biológicos (MB). Contudo, os tratamentos atuais e mais utilizados apresentam alguns inconvenientes. Considerando-se essas desvantagens e aliando-se o facto de se saber cada vez mais sobre a patogénese da doença, têm sido desenvolvidos mais estudos sobre a terapêutica a instituir e novos fármacos a utilizar. No âmbito das inovações no tratamento da Psoríase destaca-se os MB que recentemente entraram no mercado e os que se encontram na fase final de desenvolvimento, os biossimilares e alterações nas formulações tópicas com o intuito de melhorar a eficácia terapêutica.A presente monografia pretende realizar uma caraterização da Psoríase, colocando em confronto as abordagens terapêuticas tradicionais e as inovações farmacológicas desenvolvidas nos últimos anos.
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Baumann, Dorothee [Verfasser]. "Einfluss einer lipidsenkenden Therapie auf kalzifizierte und nicht-kalzifizierte koronare Plaques : Ergebnisse der Mehrschicht-Spiral-CT / vorgelegt von Dorothee Baumann." 2009. http://d-nb.info/99986369X/34.
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Meyer, M. Eleanor. "Power of place: understanding and advocating for occupational therapy's role in home modification." Thesis, 2020. https://hdl.handle.net/2144/41428.
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The number of older Americans as a percentage of the United States population is growing. A majority express a strong desire to remain in their homes as they age; however, the physical and cognitive declines associated with the aging process often limit their ability to safely age in place. Social isolation and loneliness brought on by stay-at-home orders in response to the coronavirus pandemic of 2020 further limit this population’s quality of life. Evidence-based occupational therapy research has demonstrated that home modifications can be an effective and cost-efficient intervention for reducing falls and maximizing participation in community-dwelling older adults wishing to age in place. Still, varying levels of education and training in home modifications is needed for occupational therapy practitioners to help meet the needs of the aging-in-place population.
Power of Place: Understanding and Advocating for Occupational Therapy’s Role in Home Modification is a web-based program in home modification for entry-level occupational therapy and occupational therapy assistant students that includes training to become an AARP HomeFit® volunteer. Designed to be embedded in an existing course, the supplemental curriculum includes both synchronous and asynchronous learning grounded in theoretical frameworks of person-environment-occupation, adult learning theory, design thinking and social learning theory. Training to become an AARP HomeFit® volunteer provides the foundation for experiential learning in home modification. Measured improvements in home modification competency and student self-efficacy through participation in Power of Place will drive further student learning, spark interest in becoming a HomeFit® volunteer within their local communities and promote greater recognition of the profession in the public arena.
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Bethke, Gösta [Verfasser]. "Die topische Therapie des oralen Lichen planus mit Methylprednisolonaceponat versus Triamcinolonacetonid : eine prospektive, randomisierte, doppelblinde, placebokontrollierte klinische, immunhistologische und mikrobiologische Studie / von Gösta Bethke." 2009. http://d-nb.info/101212424X/34.
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Heaslip, Robyn. "From Xwelítem ways towards practices of ethical being in Stó:lō Téméxw: a narrative approach to transforming intergenerational white settler subjectivities." Thesis, 2017. https://dspace.library.uvic.ca//handle/1828/8930.
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What must we transform in ourselves as white settlers to become open to the possibility of ethical, respectful, authentic relationships with Indigenous peoples and Indigenous lands? Situating this research in Stó:lō Téméxw (Stó:lō lands/world) and in relationships with Stó:lō people, this question has become an effort to understand what it means to be xwelítem and how white settlers might transform xwelítem ways of being towards more ethical ways of being. Xwelítem is a Halq’eméylem concept used by Stó:lō people which translates as the hungry, starving ones, and is often used to refer to ways of being many Stó:lō associate with white settler colonial society, past and present. Drawing on insights and wisdom of Stó:lō and settler mentors I consider three aspects of xwelítem ways of being. First, to be xwelítem is to erase Stó:lō presence, culture and nationhood, colonial history and contemporary colonial realities of Indigenous oppression and dispossession, and settler privilege. Second, being xwelítem means attempting to dominate, control, and repress those who are painted as “inferior” in dominant cultural narratives, it means plugging into racist colonial narratives and stereotypes. Third, being xwelítem is to be hungry and greedy, driven by consumption and lacking respect, reverence and reciprocity for the land. Guided by Indigenous and decolonizing methodologies, critical place inquiry, narrative therapy, and autoethnography, I shape three narratives that speak to each aspect of being xwelítem, looking back towards its roots and forward towards pathways of transformation. I draw on interviews and experiences with Stó:lō and settler mentors, personal narratives, family history, and literature from critical Indigenous studies, anti-colonial theory, settler colonial studies, analytic psychology, and critical race theory.
I aim to share what I have learned from rather than about Stó:lō culture, stories, teachings, and practices as these have been shared in relationships and as they have pushed me towards seeing anew myself and my family, communities, histories, and cultures. I have also walked this path as I have become a mom, and the co-alignment of these journeys has meant a focus on my role as a parent in recognizing and intervening with becoming/being xwelítem as it influences my daughter. I specifically center the space of intergenerational parent-child relationships and intimate family experiences as a deep influence on developing white settler subjectivities, and therefore also a relational space of profound transformative potential. I end with a call for settlers to offer our gifts towards the wellbeing of the land and Indigenous peoples through cycles of reciprocity as a basis for ethical relationships. Transforming white settler subjectivities is situated within the broader vision of participating in co-resistance, reparations and restitution, of bringing about justice and harmony, which inherently involves supporting the self-determination and resurgence of Indigenous peoples.<br>Graduate
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Kamus, Louis. "Etude pilote sur l'innocuité et la faisabilité de l'emploi d'un système portable de thérapie par pression négative réalisée sur un modèle expérimental de plaies ouvertes chez le cheval." Thèse, 2017. http://hdl.handle.net/1866/19881.
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Oiknine, Natalie. "Comparaisons des exigences d’équilibre dynamique lors de la négociation de l’escalier et d’un plan incliné chez les personnes en santé." Thèse, 2016. http://hdl.handle.net/1866/18924.
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Inclined planes and stairs are current in the environment and represent a barrier for seniors and people with mobility problems. Slower progression, alteration in gait pattern likely explains the high rate of fall on these surfaces, but their effect on balance is not well known. Our objective was thus to compare the difficulty in maintaining dynamic stability during the ascent and descent of an inclined plane and stairs at natural and slow walking speed in healthy individuals. Ten young healthy participants ascended and descended an inclined plane and stairs, instrumented with force- platforms to record ground reaction forces. Whole-body kinematics was also recorded to determine balance difficulty using the stabilizing and destabilizing forces, center of mass velocity and step length. Analyses of variance were used to compare the effect of surface (inclined plane vs. stairs), direction (ascent vs. descent) and speed (natural vs. slow). The stabilizing force was higher on the inclined plane than on the stairs, with a higher velocity of the center of mass. Stabilizing force was higher and destabilizing force was lower during descent than ascent only in the inclined plane but destabilizing force was lower during ascent than descent on the stairs. Slower gait speed reduced balance difficulty on both surfaces. Step length was shorter in the stairs than on the inclined plane, and particularly during descent, and at slow gait speed. Balance difficulty was higher on the inclined plane than on the stairs and at natural speed than at slow speed. The effect of direction was opposite between surfaces with higher difficulty during descent of the inclined plane, but during ascent of the stairs. Further studies are necessary in older adults or individuals with balance deficits.<br>La présence d’un escalier ou d’un plan incliné constitue souvent un obstacle sérieux à la réalisation des habitudes de vie des personnes ayant des incapacités physiques et même chez les personnes âgées. L’objectif général de cette étude était de quantifier l’équilibre dynamique lors de la négociation (montée et descente) d’un escalier et d’un plan incliné chez des sujets en santé. Dix sujets en santé ont été recrutés pour participer à l’évaluation. Les participants ont effectué la montée et la descente du plan incliné et de l’escalier à vitesse naturelle puis à vitesse lente. L’évaluation a compris un enregistrement de la cinématique de l’ensemble du corps. L’ensemble des données ont servi à analyser la force déstabilisante, la force stabilisante, la vitesse du centre de masse et la longueur de pas. Des ANOVAs et des tests t de Student ont permis de comparer l’effet de la surface (plan incliné vs. Escalier), de la direction (montée vs. Descente) et de la vitesse (naturelle vs. lente). La force stabilisante était plus élevée sur le plan incliné qu’à l’escalier, avec une vitesse de centre de masse plus élevée. La force stabilisante était plus élevée et la force déstabilisante était plus basse durant la descente en comparaison avec la montée sur le plan incliné. Par contre, à l’escalier, la force déstabilisante était plus basse lors de la montée en comparaison avec la descente. La vitesse de marche lente a réduit la difficulté en termes d’équilibre sur les deux surfaces. Les pas étaient plus courts sur l’escalier en comparaison avec le plan incliné, particulièrement lors de la descente à vitesse naturelle. L’effet de direction était opposé entre les surfaces, avec une difficulté plus élevée durant la descente du plan incliné et durant la montée de l’escalier. Des études approfondies seront nécessaires chez les personnes âgées et les personnes ayant des déficits de la balance.
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Grenon, Ghislaine. "Le vêtement, outil d’inclusion sociale pour femmes baby-boomers en situation de handicap, potentiellement en situation de handicap et en processus de vieillissement : le manteau d’hiver." Thèse, 2017. http://hdl.handle.net/1866/18392.
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Gour-Provencal, Gabrielle. "Optimisation de la récupération fonctionnelle lors de l’hospitalisation aigüe suite à une lésion traumatique de la moelle épinière." Thèse, 2019. http://hdl.handle.net/1866/23663.
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Introduction et objectifs: La survenue d’une lésion traumatique de la moelle épinière (LTME) entraine des conséquences dévastatrices. Afin de pallier les déficits encourus, les patients entreprennent un processus de réadaptation qui se déroule en quatre phases : l’hospitalisation aigüe, la réadaptation fonctionnelle intensive, la réintégration communautaire et le maintien des acquis. L’hospitalisation aigüe représente une partie cruciale du cheminement clinique puisqu’elle représente une période unique afin de minimiser les complications médicales et d’optimiser la récupération fonctionnelle tôt dans le processus de réadaptation. Ainsi, l’évolution clinique lors de la phase de réadaptation aigüe ne doit pas être négligée puisqu’il a été démontré que celle-ci influence l’issue à moyen et long terme. Notamment, la prévention des plaies de pression (PP) est primordiale puisque l’hospitalisation aigue représente la période ayant le risque le plus élevé de développer une PP et la survenue de celle-ci influence négativement la récupération fonctionnelle à long terme. Or, l’impact de multiples facteurs sur la survenue de plaies de pression (PP) lors de la phase aigüe spécifiquement ainsi que les objectifs qui doivent être priorisés par l’équipe de réadaptation aigüe afin d’optimiser l’issue fonctionnelle au congé de l’hospitalisation aigüe demeurent imprécis. Ainsi l’objectif principal de ce travail est d’identifier comment l’équipe de réadaptation aigüe peut optimiser la récupération fonctionnelle lors de l’hospitalisation aigüe et diminuer la survenue de PP suite à une LTME.
Méthodes et résultats: Une étude de cohorte prospective de soixante et un patients et la revue d’une banque de données prospective de 301 patients avec une LTME aigüe admis dans un centre tertiaire de traumatologie spécialisé ont été complétées. Le pointage SCIM total moyen au congé des soins aigus était de 42.1 + 25.2 après une durée de séjour moyenne de 22.7 ±14.4 jours. Les analyses de régression linéaire multivariée hiérarchique ont démontré que lorsqu’ajustée pour la sévérité de la LTME, une durée de séjour plus longue en soins aigus était associée à des résultats fonctionnels plus faibles au congé de ceux-ci. Les analyses de régression logistique multivariées hiérarchiques ont démontré que lorsqu’ajustées pour le niveau et la sévérité de la LTME, la survenue d'une pneumonie (OR = 2.1, IC = 1.1 à 4.1) était significativement associée à la survenue de PP. Un délai d’admission plus long dans notre centre tertiaire de traumatologie spécialisé, la survenue de complications médicales (PP, pneumonie et infection urinaires) et un temps de thérapie (physiothérapie et ergothérapie) moyen inférieur étaient associés à un plus long séjour en soins aigus lorsqu’ajustés pour les possibles facteurs confondants non modifiables.
Conclusions: Afin d’optimiser l’issue fonctionnelle au congé des soins aigus, l’équipe de réadaptation aigüe doit adresser les facteurs ayant un impact sur la durée de l’hospitalisation aigüe, notamment le transfert rapide des patients vers un centre spécialisé en LTME, la prévention des complications médicales (PP, pneumonie, infection urinaire) et l’optimisation du temps de thérapie, afin de diminuer la durée de séjour en soins aigus et ainsi d’optimiser l’évolution clinique du patient. Puisque les patients avec des LTME ayant des niveaux neurologiques plus hauts et plus sévères, ainsi que ceux développant une pneumonie sont à plus haut risque de développer une PP, nous croyons que ceux-ci devraient être priorisés afin de recevoir un volume de thérapie plus important et faire l’objet de protocoles de prévention plus agressifs. Enfin, le SCIM pourrait sous-estimer les gains fonctionnels rencontrés lors de l'hospitalisation aigüe, puisque les objectifs de cette phase visent plutôt de s’assurer que le patient dispose de bases solides (ex. : équilibre du tronc) lui permettant d’entreprendre une RFI efficace.<br>Introduction and objectives: Traumatic Spinal cord injuries (TSCI) have devastating consequences. To minimise the deficits incurred, patients undertake a rehabilitation process consisting of four phases: acute care hospitalization, intensive functional rehabilitation, community reintegration and maintenance of gains. The acute care hospitalization represents an important part of the clinical pathway as many important decisions about the subsequent rehabilitation plan are taken. It also represents a unique period to minimize medical complications and optimize functional recovery early in the rehabilitation process. Thus, the clinical evolution during the acute care shouldn’t be neglected as it has been shown to influence medium to long term outcome. In particular, pressure injuries (PI) prevention is essential as the acute hospitalization represents the period with the highest PI risk and its occurrence adversely affects long-term functional recovery.Yet, the impact of multiple factors on the occurrence of PI during acute care specifically as well as the goals that must be prioritized by the acute rehabilitation team to optimize the functional outcome at discharge from acute care remain imprecise. Thus, the main objective of this work is to identify how the acute rehabilitation team may optimize functional recovery during acute care and decrease the occurrence of PI following a TSCI.
Methods and results: A prospective cohort study of sixty-one patients and the review of a prospective database of 301 patients with acute TSCI admitted to a SCI-specialized level-1 trauma center were completed. The mean total spinal cord independence measure (SCIM) score at discharge was 42.1 ±25.2 after a mean acute care length of stay (LOS) of 22.7 ±14.4 days. Hierarchical multivariate linear regression analyses showed that when controlled for the severity of the TSCI, longer LOS was significantly associated with poorer functional outcome at discharge from acute care. Hierarchical multivariate logistic regression analyses showed that when controlling for the level and severity of the TSCI, the occurrence of pneumonia (OR=2.1, CI= 1.1-4.1) was significantly associated with the occurrence of PI. Greater admission delay to our SCI-specialised level-1 trauma center, the occurrence of medical complications (PI, pneumonia and urinary tract infection) and lesser total daily therapy (physiotherapy and occupational therapy) resulted in significantly longer acute care LOS when controlled for possible non-modifiable cofounding factors.
Conclusions: In order to optimize functional outcome at discharge from acute care, the rehabilitation team must address factors that influence acute care LOS, particularly early transfer to SCI-specialized trauma centers, medical complications prevention (PI, pneumonia, urinary tract infection) and the optimization of therapy time, in order to decrease acute care length of stay and thus optimize the patient’s clinical evolution. As patients with higher and more severe TSCI, as well as those developing a pneumonia during acute care are at higher risk of developing PI, we believe they should be prioritized to receive a larger volume of therapy and more aggressive prevention protocols. Finally, functional gains during the acute care hospitalisation may be underestimated by the SCIM, which do not measure interventions during acute rehabilitation that are aimed towards ensuring strong foundations (e.g. trunk balance) to undertake efficient IFR.
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Lapierre, Nolwenn. "Implantation d’un système de vidéosurveillance intelligente pour détecter les chutes en milieu de vie." Thèse, 2018. http://hdl.handle.net/1866/21842.
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Boulos, Colette. "Analyse occlusale informatisée, sur une période de six mois post-traitement, comparant des cas traités par orthodontie fixe et par aligneurs amovibles." Thesis, 2020. http://hdl.handle.net/1866/24437.
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Objectif: Suite aux traitements avec aligneurs, une insuffisance de contacts postérieurs est souvent notée cliniquement: existe-t-elle réellement, se corrige-t-elle spontanément? Cette étude vise à comparer la qualité de l’occlusion statique chez des patients ayant été traités avec boitiers conventionnels ou par aligneurs, dès la dépose des appareils orthodontiques et après six mois de mise en place fonctionnelle.
Matériel and Méthodes: La mise en place fonctionnelle de l’occlusion chez des sujets traités par boitiers conventionnels (GB, n=25) ou par aligneurs (GA, n=14) et par a été évaluée par un système d’analyse occlusale informatisée (T-scan 9), au moment de la dépose (T0), puis à 3 et 6 mois de contention (T3 et T6). Les sujets (41% de filles, âge moyenne de 19,38 ± 5,98 ans), étaient traités sans extractions, ni chirurgie, avec pour contention des fils collés ou appareils sans recouvrement occlusal. La symétrie et la simultanéité des contacts ainsi que la position antéro-postérieure du centre de forces (CF) étaient évalués.
Résultats : À tout moment (T0, T3, T6), aucune différence statistiquement significative n’a été observée quant à la position antéro-postérieure du CF (p=0,854), la répartition ou la simultanéité des contacts, quelle que soit la modalité de traitement. Le CF était situé antérieurement chez les patients de sexe féminin à tout temps (p=0,002). La mise en place fonctionnelle semblait être terminée dès trois mois pour les deux groupes.
Conclusion:
La qualité de l’occlusion était comparable dans les deux groupes six mois après la dépose des appareils orthodontiques, signifiant l’absence d’influence du type de traitement à court terme. Le sexe féminin pourrait être associé à un CF plus antérieur même après six mois de mise en place fonctionnelle.<br>Objective: Following aligner therapy, a lack of posterior contacts is common and is expected to resolve with settling. The aim of the study was to compare the quality of occlusion and settling, immediately after treatment and during a retention period of six months, in patients treated with fixed appliance therapy or clear aligners.
Materials and Methods: 25 patients treated with fixed appliances and 14 patients treated with aligners were evaluated by a digital occlusal analysis (T-Scan 9) at time of debonding (T0) and 3 and 6 months later (T3 and T6). Subjects (41% female, average age 19.38 ± 5.98) were treated without extraction or maxillofacial surgery using either bonded wires or removable appliances without occlusal coverage as retainers. Contact symmetry, simultaneity and the antero-posterior position of the Center of Force (COF) were assessed at the time of debonding, and after 3 and 6 months of retention.
Results: At all times of evaluation, the COF position was not statistically different for both treatment modalities (p=0.854), but was located more anteriorly in female patients when compared to male patients (p= 0.002). Settling appeared to be completed by 3 months in both groups.
Conclusion: The quality of the occlusion was comparable after 6 months of settling when treated with either treatment modality indicating no short-term effect of treatment type. Females maintained a more anterior COF after six months of retention.