Teses / dissertações sobre o tema "Fibrosis Assessment"
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Meloff, Liann Rachel. "Assessment of eating disorder symptomatology in patients with cystic fibrosis". Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2001. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp05/NQ64876.pdf.
Texto completo da fonteBradley, Judith. "The assessment of disability and handicap in adult cystic fibrosis". Thesis, University of Ulster, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.311617.
Texto completo da fonteJaffe, Adam. "Assessment and feasibility of gene therapy for cystic fibrosis in children". Thesis, Imperial College London, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.589769.
Texto completo da fonteAdam, Ryan John. "Quantitative morphologic assessment of the newborn cystic fibrosis pig tracheal lobe". Thesis, University of Iowa, 2012. https://ir.uiowa.edu/etd/2807.
Texto completo da fonteAdam, Ryan J. "Radiographic assessment of lung anatomy, physiology, and disease in a porcine model of cystic fibrosis and people with cystic fibrosis". Diss., University of Iowa, 2017. https://ir.uiowa.edu/etd/5692.
Texto completo da fonteGuha, Indra Neil. "Exploring the diagnostic tools for the assessment of liver fibrosis using biofluids". Thesis, University of Southampton, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.443044.
Texto completo da fonteOlveda, David Brian Uy. "Assessment of Schistosomiasis Induced Morbidity in the Philippines". Thesis, Griffith University, 2017. http://hdl.handle.net/10072/368011.
Texto completo da fonteThesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Medical Science
Griffith Health
Full Text
Gangell, Catherine Louise. "Evaluation of the forced oscillation technique for clinical assessment of young children with cystic fibrosis". University of Western Australia. School of Paediatrics and Child Health, 2008. http://theses.library.uwa.edu.au/adt-WU2008.0213.
Texto completo da fonteGray, Robert Donald. "Non-invasive biomarkers of inflammation in the assessment of cystic fibrosis lung disease". Thesis, University of Edinburgh, 2010. http://hdl.handle.net/1842/24641.
Texto completo da fonteKarlas, Thomas, e Johannes Wiegand. "Non-Invasive Assessment of Hepatic Steatosis in Patients with NAFLD Using Controlled Attenuation Parameter and 1H-MR Spectroscopy". Universitätsbibliothek Leipzig, 2014. http://nbn-resolving.de/urn:nbn:de:bsz:15-qucosa-142654.
Texto completo da fonteSaynor, Zoe Louise. "Assessment and interpretation of aerobic exercise (dys)function in paediatric patients with cystic fibrosis". Thesis, University of Exeter, 2016. http://hdl.handle.net/10871/21875.
Texto completo da fonteDaniels, Thomas William Vaisey. "Longitudinal assessment of cystic fibrosis pulmonary disease using clinical, biochemical and emerging microbiological techniques". Thesis, University of Southampton, 2010. https://eprints.soton.ac.uk/196559/.
Texto completo da fonteSrivastava, Shelley. "Association of breath glucose with pulmonary disease in cystic fibrosis : assessment of a potential new biomarker". Thesis, St George's, University of London, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.568718.
Texto completo da fonteMitchelmore, Philip. "Assessment of Pseudomonas aeruginosa epidemiology and the wider microbial diversity within the bronchiectatic lung". Thesis, University of Exeter, 2018. http://hdl.handle.net/10871/33665.
Texto completo da fonteChin, Calvin Woon Loong. "Assessment and risk prediction in patients with aortic stenosis : insights from cardiovascular magnetic resonance". Thesis, University of Edinburgh, 2015. http://hdl.handle.net/1842/15841.
Texto completo da fonteHorsley, Alex. "Non-invasive assessment of ventilation maldistribution in lung disease using multiple breath inert gas washouts". Thesis, University of Edinburgh, 2009. http://hdl.handle.net/1842/4512.
Texto completo da fonteNorén, Bengt. "Non-Invasive Assessment of Liver Fibrosis with 31P-Magnetic Resonance Spectroscopy and Dynamic Contrast Enhanced Magnetic Resonance Imaging". Doctoral thesis, Linköpings universitet, Medicinsk radiologi, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-90154.
Texto completo da fonteSingh, Harnoor. "YKL-40 as a non-invasive serum marker in assessment of rapid fibrosis progression post-orthotopic liver transplantation". Thesis, Boston University, 2012. https://hdl.handle.net/2144/12629.
Texto completo da fonteLiver biopsy has been considered the gold standard method to assess the progression of fibrosis in chronic hepatitis C viral infection. Despite its prevalent use, significant complications along with patient discomfort are often reported. A reliable, non-invasive method to assess rapid fibrosis progression in patients with HCV infection must be determined. This study involved 57 subjects that underwent liver transplantation due to end stage liver disease as a result of chronic HCV infection. Serum samples were collected from all subjects at time of biopsy. Measurement of YKL-40 was performed using ELISA assays. Serum samples collected for all subjects at time of biopsy had a total YKL-40 concentration range from 38-1442 ng/mL with a mean of 228.74 ng/mL and a standard deviation of 271.26 ng/mL. The median YKL-40 concentration was 128 ng/mL. Serum YKL-40 is a reliable marker of rapid fibrosis progression and can be used in combination with other markers to accurately predict rapid fibrosis progression in HCV infected patients post orthotopic liver transplantation.
Patel, Keyur. "Development of Serum Markers for the Non-Invasive Assessment of Longitudinal Change and Adjacent Stage Differentiation in Hepatic Fibrosis". Thesis, The University of Sydney, 2016. http://hdl.handle.net/2123/16619.
Texto completo da fonteBarbosa, Claudia Regina 1974. "Perfil de micronutrientes em pacientes com fibrose cística acompanhados no HC da Unicamp". [s.n.], 2012. http://repositorio.unicamp.br/jspui/handle/REPOSIP/308360.
Texto completo da fonteTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: A Fibrose Cística (FC) é a doença de maior prevalência dentre as doenças hereditárias incidentes nos indivíduos caucasóides. A doença é progressiva e apresenta como manifestação clínica à obstrução respiratória crônica, infertilidade masculina e deficiência de ganho de peso pelo dano ao pâncreas exócrino. A maioria dos pacientes tem níveis elevados de eletrólitos no suor. O objetivo do presente trabalho consistiu na importância do diagnóstico precoce das repercussões nutricionais sobre a evolução e prognóstico da doença, pois avaliou o perfil nutricional dos micronutrientes (vitaminas lipossolúveis e oligoelementos) em pacientes com Fibrose Cística atendidos no ambulatório de Fibrose Cística do Hospital das Clínicas da UNICAMP. Foram estudados 86 pacientes, além de 34 voluntários saudáveis para o grupo controle. Amostras de sangue foram coletadas para quantificação dos parâmetros bioquímicos séricos, por métodos enzimáticos colorimétricos. As vitaminas lipossolúveis foram determinadas após seu isolamento por cromatografia líquida rápida de proteínas (High Protein Liquid Chromatograpy-HPLC).Observamos que para a análise dos níveis séricos das vitaminas lipossolúveis e dos oligoelementos na população estudada mostrou valores adequados, exceto para a vitamina A e E, mesmo com uma dieta insuficiente para elementos
Abstract: The Cystic Fibrosis (FC) is the illness of bigger prevalence amongst the incident hereditary illnesses in the caucasian subjects. The illness is gradual and presents as clinical manifestation to the chronic respiratory blockage, masculine infertility and deficiency of profit of weight for the damage to the exocrine pancreas. The majority of the patients has high electrolyte levels in the sweat The present work consisted of the importance of the precocious diagnosis of the nutrition repercussions on the evolution and prognostic of the illness, therefore it evaluated the nutritional profile of the micronutrients (fat-soluble vitamins and oligoelements) in patients with Cystic Fibrosis taken care of in the clinic of Cystic Fibrosis of the Hospital of the Clinics of the UNICAMP. We studied 86 patients and 34 healthy volunteers in the control group. Blood samples were collected for measurement of serum biochemical parameters for enzymatic colorimetric methods. Soluble vitamins were determined after their isolation by fast protein liquid chromatography (High Protein Liquid Chromatograpy-HPLC).We observe that for the analysis of the serum levels of fat-soluble vitamins and the oligoelements in the studied population it showed adjusted values, except for the vitamin A and the E, exactly with a insufficient diet for elements
Doutorado
Saude da Criança e do Adolescente
Doutora em Saúde da Criança e do Adolescente
McDonald, Catherine M. "Nutrition Education for Parents of Children with Cystic Fibrosis : Assessment of Needs and Strategies for Improved Knowledge and Confidence in Self Care". DigitalCommons@USU, 2005. https://digitalcommons.usu.edu/etd/5524.
Texto completo da fonteAquino, Carlos Valentim Magalhães Nascimento Guarilha de. "Associação do estado nutricional com perfil inflamatório e a prática do exercício físico de crianças e adolescentes com fibrose cística". Instituto Fernandes Figueira, 2013. https://www.arca.fiocruz.br/handle/icict/8264.
Texto completo da fonteFundação Oswaldo Cruz. Instituto Fernandes Figueira. Departamento de Ensino. Programa de Pós-Graduação em Saúde da Criança e da Mulher. Rio de Janeiro, RJ, Brasil.
O estado nutricional (EN) é marcador de prognóstico para pacientes com Fibrose Cística (FC) . O objetivo deste trabalho foi avaliar a associação do EN com o perfil inflamatório, prática de atividade física e ingestão alimentar de crianças e adolescentes com FC. O estudo foi observacional do tipo transversal com indivíduos acompanhados no Instituto Fernandes Figueira, da Fundação Osvald o Cruz. Foram selecionados 46 crianças de oito a 18 anos com diagnóstico con firmado de FC. A avaliação do estado nutricional foi feita pelos indicadores altura/idade, pelo índice de massa corporal/ Idade (IMC/I) e pelo IMC em kg/m2 (OMS 2006). Para compos ição corporal utilizou - se a Equação de Slaughter (1988), Circunferência e área muscular do braço e dobra cutânea tricipital. A ingestão dietética foi avaliada pelo recordatório alimentar de 24horas. As citocinas (IL - 1, IL6 e IL 8) por método Elisa e a prot eína C reativa ( PCR ) por nefelometria Avaliou - se a associação entre estado nutricional e as variáveis estudadas por modelos bivariados e multivariados de regressão linear com significância p<0,05. A média de idade encontrada foi de 11,9±2,83 anos, sendo 6 0,9% do gênero feminino, 57,8% apresentou comprometimento do estado nutricional pelo IMC/I, 37,8% e 52,2% pela CMB e AMB respect ivamente e 15,6% baixa estatura . A DCT apresentou - se r eduzida em 17,8% dos pacientes , 26,1% das crianças estavam com percentual de gordura baixo segundo a equação de Slaughter, . A med ia da razão DCSe/DCT apresentou risco e/ou elevação da distribuição de gordura na região abdominal em 55,6% dos pacientes , 22,9% praticou de atividade física, 76,1% atingiu a recomendação de ingest ão energética, sendo significativamente maior no grupo de pacientes em risco ou desnutridos. A razão de ingestão de n6/n3 foi adequada mas os l ipídeos foram consumidos a baixo do percentual recomendado em 54,3% dos casos e os carboidratos ac ima em 32,6% . Os valores de PCR foram inferiores a 0,5mg/dL (prova inflamatória negativa) em 71,1% dos casos. A maioria , 52,2% e 62,5% dos pacientes desnutridos segundo a AMB e CMB respectivamente, possuía esta medida maior que 0,5mg/dL. O TNF - α e a Il 8 foram as únicas citocinas que se associaram de mod o significativo com o IMC. N a análise de regressão linear múltipla as variáveis estatisticamente significativas foram: IL - 8 , Atividade física e VET. Os desfechos estudados foram, percentual de g ordura, adequação do IMC , CMB e AMB. A análise dos compartimentos corporais foi o método mais sensível de avaliação do estado nutricional, o tecido gorduroso foi preservado e a ingestão calórica adequada não foi capaz de preservar a MCM o que sugere um mec anismo semelhante ao da caquexia. O consumo total de lipídeos ainda foi baixo apesar da sua importância para FC, com adequação da razão n6/n3. A dosagem sérica de citocinas não parecem demonstrar a inflamação sistêmica. A única citocina que se associou p ositivamente com o percentual de gordura corporal foi a IL - 8 e parece mais relacionada ao tecido adiposo visceral do que a inflamação presente na FC. Desta forma na FC também deve ser dada maior atenção aos fatores como a pratica da atividade física e ingestão alimentar principalmente de lipídeo, assim como a medida da adiposidade abdominal na avaliação nutricional para prevenção de doenças cardiovasculares.
Nutritional status is a prognostic marker in patients with Cystic Fibrosis. The aim of this study was to evaluate the association of the inflammatry status, physical activity and food intake of children and adolescents with CF. The stud y was observational, cross - sectional subjects followed by the Fernandes Figueira Institute, Oswaldo Cruz Foundation. We selected 46 patients from 8 to 18 years old with a confirmed diagnosis of CF. The nutritional status was made by anthropometric height/a ge and body mass index (BMI) in kg/m2 (WHO 2006). For body composition the equation of Slaughter (1988) was used, mid - upper arm circumference and upper arm muscle area and triceps skinfold thickness. Dietary intake was assessed by a 24 - hour dietary recall. Cytokines by ELISA and CRP for nefelometria evaluated the association between nutritional status and the variables studied by bivariate models and multivariate linear regression with significance p <0.05. The average age was 11.9 ± 2.83 years, 60.9% femal e, 57.8% had poor nutritional status by BMI/ I, 37.8% and 52.2% for the MUAC and UAM respectively an d 15.6% short stature. The TSF was presented reduced in 17.8% of patients and 26.1% according to the equation of Slaughte r. The average of the ratio SST / TSF showed a distribution of abdominal fat, 22.9% practiced physical activity, 76.1% reached the recommended energy intake, was significantly higher in patients at risk or malnourished. The ratio n6/n3 intake was adequate but lipids were consumed below the rec ommended percentage in 54.3% of cases and 32.6% up on carbohydrates. CRP values in 71.1% o f cases were less than 0.5 mg/ dL. Most malnourish ed patients according to the UMA and this measur e had CRP greater than 0.5 mg/dL. TNF - α and Il 8 were the only cyto kines that were associated significantly with BMI. After multiple linear regression analysis the variables were statistically significant: IL - 8 , Physical activity and VET. The body composition analysis was the most sensitive method for assessing the nutri tional status, the fat tissue was preserved and adequate caloric int ake was not able to preserve FFM suggesting a mechanism similar to cachexy . The total lipid was still low despite its im portance for CF , with adequacy ratio n6/n3. Serum cytokines do not a ppear to systemic inflammation. The only cytokine that was positively associated with body fat percentage was the IL - 8 and seems more related to visceral adipose tissue than inflammation present in CF. CRP may be a marker of malnutrition. Thus CF should also be given greater attention to environmental factors such as the practice of physical activity and food intake mainly lipid ,as the measurement of waist circumference in the nutritional assessment for cardiovascular disease prevention.
Pham, Hoang Minh [Verfasser]. "Cardiovascular Magnetic Resonance Imaging in the Assessment of Myocardial Blood Flow, Viability, and Diffuse Fibrosis in Congenital and Acquired Heart Disease / Hoang Minh Pham". Kiel : Universitätsbibliothek Kiel, 2014. http://d-nb.info/1052893724/34.
Texto completo da fonteAxelsson, Therese. "An assessment of patients followed for Hepatitis B at the Department of Infectious Diseases at Örebro University Hospital : - Factors associated with significant liver fibrosis evaluated by transient elastography". Thesis, Örebro universitet, Institutionen för medicinska vetenskaper, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-76215.
Texto completo da fonteStark-Kent, Dorothea [Verfasser]. "Evaluation of 13C Mixed Triglyceride Breath Testing and Fecal Elastase 1 assays for the assessment of pancreatic function in babies with cystic fibrosis : Including an assessment of healthy babies to establish the range of normal for the 13C Breath test / Dorothea Stark-Kent". Bonn : Universitäts- und Landesbibliothek Bonn, 2019. http://d-nb.info/1182042996/34.
Texto completo da fonteWilliams, J. E. "A longitudinal study of the body composition of children with cystic fibrosis compared to healthy children using the four-component model with an assessment of clinical tools available for body composition measurements". Thesis, University College London (University of London), 2013. http://discovery.ucl.ac.uk/1402787/.
Texto completo da fonteSharma, Sanjay. "On the improvement of permeability assessment of fibrous materials". Diss., Wichita State University, 2010. http://hdl.handle.net/10057/3288.
Texto completo da fonteThesis (Ph.D.)--Wichita State University, College of Engineering, Dept. of Mechanical Engineering
Castro, Rejane Agnelo Silva de. "Validade e reprodutibilidade do COPD assessment test (CAT) em pacientes com bronquiectasia não-fibrose cística". Universidade Nove de Julho, 2015. http://bibliotecatede.uninove.br/handle/tede/1817.
Texto completo da fonteMade available in DSpace on 2018-06-19T18:12:45Z (GMT). No. of bitstreams: 1 Rejane Agnelo Silva de Castro.pdf: 1052641 bytes, checksum: 1f8691a5b4f1dcb3d43ec9c6aa9e4345 (MD5) Previous issue date: 2015-11-27
Introduction: Instruments to objectively assess the perception of symptoms in patients with BCQ are scarce. Patients with COPD and bronchiectasis (BCQ) share similar symptoms. Therefore, COPD Assesment Test (CAT), originally developed for COPD may be suitable for use in these patients. Objective: To validate and test the reproducibility of the CAT for non-cystic fibrosis (non–CF) bronchiectasis patients. Methods: Hundred patients (FEV1 52 ± 25%; FVC 67 ± 22%; 48 ± 14 years; 42 males) underwent spirometry, cardiopulmonary exercise testing (peak workload and VO2), and shuttle walk test (ST). They answered the Saint George Respiratory Questionnaire (SGRQ) and the Medical Research Council (MRC) scale, and the CAT in two different days (CAT-1 and CAT-2). A pedometer recorded the No. of steps/day (NSD). Results: CAT showed a positive correlation with SGRQ domains (r = 0.74, p< 0.001) and MRC (r = 0.49, p< 0.001). A negative correlation was observed among CAT and lung function (FVC%: r= -0.33, p= 0.001; FEV1%: -0.28, p = 0.004), peak workload (r = -0.31, p = 0.001), VO2 (r = -0.44 p< 0.001), distance walked on ST (%, r= -0.46, p< 0.001), and NSD (r = -0.74, p< 0.001). There was an excellent reliability in the scores from CAT-1 and CAT-2 (21 13.25 – 26.75 and (19 13 – 26.75, respectively) with high intraclass correlation coefficient (ICC: 0.92 [95% CI: 0.83 – 0.96], p< 0.001). Conclusion: CAT is a valid instrument for measuring the impact of bronchiectasis in well-being and daily life of patients with BCT, and is a reproducible questionnaire.
Introdução: Instrumentos que avaliam objetivamente a percepção dos sintomas em pacientes com BCQ são escassos. Pacientes com DPOC e bronquiectasia (BCQ) compartilham sintomas semelhantes. Portanto, o COPD Assesment Test (CAT), originalmente desenvolvido para DPOC, pode ser adequado para uso nesses pacientes. Objetivo: Validar e testar a reprodutibilidade do CAT para BCQ. Métodos: 100 pacientes (42 homens, 48 ± 14 anos, VEF1 52 ± 25% prev, CVF 67 ± 22% prev) foram submetidos à espirometria, shuttle walk test incremental (SWTI) e teste de exercício cardiopulmonar exercício (TECP, carga e VO2 pico). Eles responderam ao Saint George’s Respiratory Questionnaire (SGRQ), à escala de dispneia Medical Research Council (MRC) e ao CAT (este em dois dias diferentes CAT-1 e CAT-2). O número de passos por dia (NP) foi registrado por pedômetro. Resultados: Os escores do CAT correlacionaram-se positivamente com os escores dos domínios SGRQ (r de 0,74, a p< 0,001) e MRC (r= 0,49, p= 0,001). Foi observada correlação negativa entre o CAT e a função pulmonar (CVF%: r= -0,33, p= 0,001; VEF1%: -0,28, p= 0,004), carga (r= -0,31, p= 0,001), VO2 (r= -0,44 p< 0,001), distância no SWTI (r= -0,46, p< 0,001), e NP (r= -0,42, p< 0,001). Houve excelente reprodutibilidade entre os escores de CAT-1 e CAT-2 (21 13,25 – 26 e (19 13 – 26,75, respectivamente), com elevados coeficiente de correlação intraclasse (ICC: 0,91 [95% CI: 0,87-0,94], p<0,001). Conclusão: CAT é um instrumento válido para medir o impacto da BCQ no bem-estar na vida diária dos pacientes com BCQ, e é um questionário reprodutível.
Branley, Howard Matthew. "Non-invasive assessment of macrophage behaviour and pulmonary inflammation in fibrosing alveolitis due to systemic sclerosis". Thesis, Imperial College London, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.501207.
Texto completo da fonteSilva, Adikarige Ayona Therese Nilmini. "Assessment and control of conditions in the rumen to increase utilization of fibrous roughages in ruminants". Thesis, University of Aberdeen, 1985. http://digitool.abdn.ac.uk/R?func=search-advanced-go&find_code1=WSN&request1=AAIU363238.
Texto completo da fontePott, Julian [Verfasser]. "Etablierung des „COPD Assessment Test“ zur Erfassung der Lebensqualität bei Patienten mit Cystischer Fibrose : Ein Vergleich zwischen Fragebögen und klinischen Parametern / Julian Pott". Saarbrücken : Saarländische Universitäts- und Landesbibliothek, 2020. http://d-nb.info/122833367X/34.
Texto completo da fonteIkonen, Linus, e Daniel Nilsson. "Quality assessment of mineral wool insulation plates : Using ultrasonic non-destructive testing". Thesis, Blekinge Tekniska Högskola, Institutionen för maskinteknik, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:bth-18223.
Texto completo da fonteI tillverkningsprocessen av isolerskivor i stenull uppstår inneboende defekter i isolerskivorna, dessa defekter består av osmälta basmineraler och ohärdat bindemedel. För att kunna sortera bort dessa skadade skivor från tillverkningslinjen behövs en pålitlig metod för kvalitetsbedömning. Avsikten med det här arbetet är att hitta en oförstörande provningsmetod baserad på ultraljud som kan identifiera de inneboende defekterna. Detta genomfördes genom experiment på defekta isolerskivor med tre olika oförstörande provningsmetoder baserade på ultraljud. Dessa metoderna var, higher harmonics, pitch-echo och through transmission. Through transmission visade lovande resultat i att identifiera de båda typerna av skador. Metoden är baserad på att en sändare sänder ut ultraljud till en mottagare placerad i linje med sändaren. När ett defekt område passerar ultraljudsvågen mellan sändaren och mottagaren försvagas intensiteten av signalen. Försvagningen av signalen beror mestadels på att densiteten är högre hos defekterna än hos basmaterialet i isolerskivan. Denna försvagning indikerar att en defekt befinner sig i mätområdet. Metoden är väl implementerbar i en tillverkningslinje, då det är en snabb metod vilket den behöver vara då objektet är i rörelse. Mer mätningar behövs för att fastställa ett pålitligt referensvärde för att konsekvent kunna sortera ut de defekta isolerskivorna. Metoden är endast utvärderad i en småskalig laborationsmiljö och det behövs fler tester i en större skala undersöka pålitligheten i det verkliga scenariot med tillverkningslinjen.
Lee, Lin Hu, e 胡李琳. "Quantitative Assessment for Skeletal Muscle Fibrosis". Thesis, 2010. http://ndltd.ncl.edu.tw/handle/63986662763214629094.
Texto completo da fonte臺灣大學
應用力學研究所
98
Congenital muscular torticollis ( CMT ) caused by the fibrotic change of the sternocleidomastoid muscle ( SCM ) can be detected by ultrasonography. The incidence of CMT varies from 0.3% to 2% in literature and is the third skeletal muscular diseases in infants. This study aimed to combine the advantages of ultrasound and the accuracy of histopathology to construct objective diagnostic reference by animal model. We proposed a K value based on the ultrasound image’s difference of mean echo intensity in injured and normal side, and K value has positive correlation with the fibrosis ratio of histopathology, Pearson correlation r=0.75 (p<0.01). In five follow-up cases of infants ( 3.1 1.8 months ), K value decrease by time because the degeneration of the fibrotic tissue.
Chuang, Sheng-Hsiang, e 莊勝翔. "Liver Fibrosis Assessment Using Ultrasound Backscattering Dynamics Statistical Parametric Imaging Index". Thesis, 2011. http://ndltd.ncl.edu.tw/handle/41503826089982389602.
Texto completo da fonte國立臺灣大學
應用力學研究所
99
This study is dedicated to the application of liver fibrosis assessment using ultrasound imaging, focusing on the envelope signal converted from RF signal to investigate the differences of the statistical distributions between healthy and disease livers. Liver cirrhosis is considered as an irreversible process that there is almost no effective course of treatment to recover the fibrosis liver. Fibrosis is marked by the gradual replacement of hepatocytes by extracellular collagen, which is a chronic and long-term degeneration of the liver function. Invasive assessment like liver biopsy often accompanied with sequela and is prone to sampling error when small biopsy samples are analyzed. Therefore, there is a clinical need to establish an effective and reliable method for the noninvasive assessment, espesically the prediction of early stage liver fibrosis. Ultrasound speckle in B-mode images, which is the result of a wave interference phenomenon of backscattering signal, has been used for clinical liver fibrosis and steatosis diagnosis. The characteristic of speckle is associated with the density of scatterers in tissue, indicating different patterns among various tissue properties. To analyze the RF signal derived from liver ultrasound, three methods were implemented: Nakagami-m parameter method, Yamaguchi method and ACRA (adaptive criteria-referenced assessment) method. Nakagami-m parameter method uses m-value to describe the distribution within the ROI (region of interest), proved to be a valid approach characterizing breast tumors and cataract lens. Yamaguchi method determines whether the ROI is a fiber area or not based on the assumptive parameters derived from the phantom experiment. ACRA is a method, which was originally developed by our lab and could be adapted to various system conditions; it reflects the degree of fibrosis liver via the unassessed tissues in comparison with a criteria-reference constructed by healthy tissues. Results showed that Nakagami-m and ACRA method were able to discriminate the degree of fibrosis from livers in vitro rat experiment. Area under receiver operating characteristic curve (AUC) was used to judge the performence. In the in vivo linear array experiment, three methods performed well in the early stage F≥1 fibrosis (Nakagami-m: 0.86, Yamaguchi: 0.98, ACRA: 0.95). In the in vivo convex array experiment, three methods performed well in the stage F≥1 and F≥2 fibrosis (Nakagami-m: 0.96, 0.82, Yamaguchi: 0.93, 0.92, ACRA: 0.99, 0.93). In the in vitro operation linear array experiment, only ACRA successfully identified stage F≥2 and F=4. It is concluded that the concept of ACRA could exend to other domains, observing the degree of the difference between tissues to indicate the abnormity. This method possesses clinical potential and application value.
Hsu, Hsuan-Che, e 徐宣哲. "The efficacy assessment of oral adsorbent ameliorated liver fibrosis-induced abnormalities in rats". Thesis, 2014. http://ndltd.ncl.edu.tw/handle/67152216885273820082.
Texto completo da fonteBo-YenHuang e 黃柏諺. "In vivo Quantitative Assessment of Hepatic Fibrosis by Ultrasonic Backscattering and Statistical Model". Thesis, 2017. http://ndltd.ncl.edu.tw/handle/4gzb8b.
Texto completo da fonte國立成功大學
資訊工程學系
105
In general, the liver biopsy is the most accurate method to assess liver fibrosis. The liver biopsy is a procedure to remove a small piece from liver tissue and it is invasive that can cause many complications. Besides, rats are widely used in liver fibrosis experiments and a lot of rats are sacrificed to verify, assess the liver fibrosis level and reduced the sampling errors. Therefore, ultrasound and statistical parameters were used to assess the liver fibrosis as a non-invasive method in this study. Sprague Dawley rats were induced liver fibrosis by CCl4. A 7.5MHz single element transducer was used in ultrasound system. Nakagami parameter and IB were used to quantitatively assess the liver fibrosis as a non-invasive method. B-mode images of mild and severe groups were significantly brighter than control group, but the difference of brightness between mild and severe groups were not significant. IB of control group was –131.9±3.3dB, mild group was –117.3±0.8dB, and severe group was –114.0±2.5dB. The p-value of IB between control group and mild group was small than 0.01 when the p-value of IB between mild group and severe group was small than 0.05. IB was the strength of backscattering signals, which was easily affected by ultrasound system and the angle of incident signals. Nakagami statistical parameter could indicate the scatterer properties by ultrasonic backscattering signals. Nakagami parameter of control group was 0.58±0.03, mild group was 0.78±0.02, and severe group was 0.83±0.02. The scatterer distribution of control group, mild group, and severe group were pre-Rayleigh distribution. The p-value of Nakagami parameter between control group and mild group was small than 0.01 when the p-value of Nakagami parameter was small than 0.05. Nakagami images could show the local scatterer properties which B-mode images could not. In the end, B-mode images are still widely used in medical field, so the Nakagami images can provide the local information to B-mode images and make the more accurate assessment of liver fibrosis stages.
Vinco, Giulia. "Assessment of Myocardial Fibrosis Using Advanced Echocardiography in Patients With Systemic Lupus Erythematosus: a Pilot Study". Doctoral thesis, 2021. http://hdl.handle.net/11562/1049393.
Texto completo da fonteChang, Chin-Chen, e 張晉誠. "Functional Imaging of the Liver: Gd-EOB-DTPA-enhanced MRI for Assessment of Hepatic Function and Fibrosis". Thesis, 2018. http://ndltd.ncl.edu.tw/handle/9n9x3n.
Texto completo da fonte國立陽明大學
生物醫學影像暨放射科學系
107
Abstract Chronic liver disease usually accompanies parenchymal fibrosis and hepatic dysfunction. The consequences also affect prognosis and treatment outcome. Tissue proof is considered as gold standard to monitor the disease progression; however, repeated procedure is not practicable due to its invasiveness and possible complications. Non-invasive methods for assessing liver function and parenchymal fibrosis have been developed. Gd-EOB-DTPA is a liver-specific MR contrast agent, which can provide anatomical and functional information for imaging diagnosis of liver disease. The clearance of intravenous indocyanine green (ICG) is regarded as liver function and widely used reference before hepatectomy. Liver parenchymal cell volume (PCV) is a way of estimation of residual hepatocytes from surgical specimen. We used Gd-EOB-DTPA-enhanced MRI to assess liver function and validate with ICG tests and PCV. Nineteen patients scheduled for operation were enrolled. Functional liver volume (FLV) was computed from 20 min post-contrast MR images. FLV showed significantly correlated with ICG-R15 (ICG retention measured in serum 15 min after injection) (r = −0.47, p = .042) and PCV (r = 0.814, p <.001). This MR-derived index was proven to be clinically feasible for quantifying liver function in patients with chronic liver disease. Acoustic radiation force impulse (ARFI) is an ultrasound technique for measurement of liver parenchymal stiffness. ARFI has been reported to be a reliable method to assess fibrosis severity in a variety of liver parenchymal diseases. We aimed to compare the diagnostic abilities of Gd-EOB-DTPA-enhanced MRI and ARFI with the METAVIR system for staging parenchymal fibrosis in patients with chronic liver disease. Twenty-three consecutive patients with histopathologically proven hepatic fibrosis were prospectively recruited. Shear wave velocity (SWV) measurements were used to determine liver stiffness by ARFI. During the MR study, T1-weighted images were acquired before and 20 min after injection of Gd-EOB-DTPA and the liver-enhancement ratio (LER) was calculated. The diagnostic abilities of ARFI and MRI were compared using receiver operating characteristic analysis. Among the patients, 43.5%, 17.4%, 21.7%, and 17.4% had METAVIR F4, F3, F2, and F1, respectively. The area under ROC curve for F2-F3-F4 vs. F1, F3-F4 vs. F1-F2, and F4 vs. F1-F2-F3 was 0.842, 0.794, and 0.792 for SWV, and 0.855, 0.778, and 0.669 for LER, respectively. The correlation coefficient was 0.573 (p = 0.004) between the SWV and METAVIR score, -0.451 (p = 0.031) between LER and the METAVIR score, and -0.474 (p = 0.022) between the SWV and LER. Liver parenchymal enhancement of Gd-EOB-DTPA-enhanced MRI could be another noninvasive method for assessing the stiffness and fibrosis of liver parenchyma via comparison with the ARFI and METAVIR scoring systems. In the last part of the thesis, various advanced MR techniques to evaluate liver parenchyma are discussed, including MR elastography, diffusion-weighted MRI, multi-parametric MRI, and artificial intelligence. In conclusion, Gd-EOB-DTPA-enhanced MRI is clinically feasible for quantifying liver function and reflecting the severity of liver parenchymal fibrosis.
Theng, Si Min, e 鄧思敏. "Assessment of the Therapeutic Efficacy of Oncostatin M-preconditioned MSCs in the Bleomycin-induced Pulmonary Fibrosis Mouse Model". Thesis, 2012. http://ndltd.ncl.edu.tw/handle/40288781243802172489.
Texto completo da fonte長庚大學
醫學生物技術暨檢驗學系
100
Idiopathic pulmonary fibrosis (IPF) is characterized by an intricate cytokine network and abnormal deposition of mesenchymal cells. Recent studies indicated that Oncostatin M (OSM), a member of IL-6 family cytokine, was up-regulated in the bronchoalveolar lavage fluid (BALF) of patients with interstitial lung disease. Furthermore, exogenous administration of OSM into the lungs of mice resulted in a significant recruitment of inflammatory cells, as well as a dose-dependent increase of collagen deposition in the lungs. These results suggested that OSM is a potent mediator of lung inflammation and lung fibrosis. To date, there are no effective treatments for IPF. Recent studies indicated that mesenchymal stem cells (MSCs) significantly reduced damage in the alveoli and were engrafted at injury sites. Interestingly, OSM induced proliferation, differentiation of MSCs, and also induced Oncostatin M receptor (OSMR) expression in the cells. Moreover, OSM also activated HGF expression in fibroblast and might participate in repair after lung injury. Taken together, to improve the protective effect of the transplanted MSCs, we proposed to enrich OSMR overexpressed cell population of MSCs by OSM pretreatment, upon transplantation, OSM binding to the OSM receptor lead to activate signaling pathway from MSC and further induced cytoprotective genes for pulmonary fibrosis treatment. Our data showed that OSM-pretreatment induced OSMR, gp130 and HGF mRNA and protein expression in MSCs. When cocultured with OSM-pretreated MSCs and TGF-β1 treated MRC-5s, the fibrotic marker, the fibronectin mRNA expression was significantly down-regulated. Furthermore, intratracheal instillation of OSM-pretreated MSCs into BPF mouse model at day 3, eighteen days after treatment, the pulmonary respiratory function have shown significant improvement, the mRNA expression of inflammatory factors IL-1β, IL-6 and fibrotic factor collagen III, MMP-9 were significantly decreased in the lung tissues when compared to MSCs group. Our data indicated that anti-inflammation and anti-fibrotic ability were better than MSCs. In conclusion, we demonstrated that OSM-pretreated MSCs significant improves the therapeutic effect of the pulmonary fibrosis.
Maglione, Marco. "Towards a global assessment of pediatric non-cystic fibrosis chronic pulmonary disorders: new insights in disease diagnosis and monitoring". Tesi di dottorato, 2017. http://www.fedoa.unina.it/11470/7/maglione_marco_29.pdf.
Texto completo da fonteZhuang, Shu-Ru, e 莊淑如. "Studies on the life style, diet behavior, nutrition assessment and immune function of patients with oral submucous fibrosis or oral cancer". Thesis, 2000. http://ndltd.ncl.edu.tw/handle/56093316956965963394.
Texto completo da fonte中山醫學院
營養科學研究所
88
Abstract Oral submucous fibrosis (OSF), an obscure oral pathosis, is characterized by an abnormal accumulation of oral submucous collagen fibers, epithelium atrophy, and the resultant limitation of mouth opening. Studies indicated that OSF was one of precarcinogenic lesions and mortality of oral cancer is the fifth cause of cancer-related death among men. The reasons for the occurrence of OSF and oral cancer were still unknown. Some studies showed that it is closely related to nutritional deficiency, but it is limited to the related evidence. The purpose of this study is to understand the life style, diet behavior, nutritional assessment and immune function of patients with OSF and oral cancer, and the data colleted could be served as a reference on clinical therapy. Subjects were recruited from Taichung and Changhua. To understand the life style, diet behavior and daily intake of patients with OSF and oral cancer. The subjects got to complete a life a style questionnaire, 24-h diet recall, and the blood samples were collected to examine the nutritional status and immune function. The results show that 96.4% of OSF and oral cancer patients had the habit of chewing betel quid. And, 92.8% of them favored smoking and 65% of them favored drinking. The intake of energy, vitamin E, B2, B6, C, niacin, calcium, and iron for all patients were all lower than daily recommended nutrient allowance (RDNA). The nutritional status showed that the content of vitamin E, B1, selenium and zinc were lower in all patients and vitamin B6 was decreased with the severity of disease. The evaluation of the immune showed that, the relative percentage of T-lymphocyte and the ratio of CD4 and CD8 were also gradually decreased with the severity of disease. In conclusion, patients with OSF and oral cancer had poor diet intake, malnutrition and depressed immune-response sensitivity, etc. Correct diet advice and nutrition supplement could be greatly helpful to prevention and clinical therapy of OSF and oral cancer. Key words: OSF, oral cancer, nutrition, immune, diet behavior
Fakuade, Funsho Emmanuel. "An integrative and translational assessment of altered atrial electrophysiology, calcium handling and contractility in patients with atrial fibrillation". Doctoral thesis, 2020. http://hdl.handle.net/21.11130/00-1735-0000-0005-14F1-4.
Texto completo da fonteSAFFIOTI, FRANCESCA. "Non-invasive assessment of liver fibrosis and portal hypertension in primary sclerosing cholangitis and primary biliary cholangitis: transient elastography, point share wave elastography and biomarkers". Doctoral thesis, 2018. http://hdl.handle.net/11570/3146302.
Texto completo da fonteSilva, Joana Sílvia Delgado. "Safety and efficacy of catheter-based renal denervation for the management of resistant hypertension: clinical, imaging and immunological assessment". Doctoral thesis, 2022. http://hdl.handle.net/10316/98609.
Texto completo da fonteHypertension (HT) is the most common modifiable cardiovascular risk factor and is responsible for significant mortality and morbidity. It is estimated that 30-45% of the adult population has HT, with its prevalence increasing with advancing age. The employment of lifestyle changes and drug therapy reduces the risk of major cardiovascular events such as acute myocardial infarction, stroke and heart failure and increases life-expectancy. However, despite the availability of safe and efficacious anti-hypertensive drugs, the prevalence of uncontrolled HT continues to rise, with non-adherence to therapy being the most important contributor of poor blood pressure control. HT is considered true resistant when a documented failure to achieve blood pressure guideline-recommended targets is observed and, secondary HT, non-adherence and pseudo-hypertension have been excluded. The pathophysiology of resistant HT is complex and not clear. The vasoconstrictor effects of the sympathetic nervous system and its implication on the pathogenesis of refractory hypertension have long been known, turning it into an attractive therapeutic target. Renal denervation (RDN) is a minimally invasive percutaneous technique which consists on the delivery of radiofrequency energy on the renal artery wall in order to achieve a selective disruption of sympathetic nerve endings. First generation randomized trials were rather controversial, specifically HTN-3, given the results were not the expected and renal denervation did not achieve a higher blood pressure reduction than the control arm. Several questions have been raised by this ‘negative’ study and prompted investigation around the technique. Up to the current date, RDN has been employed to treat patients with resistant HT and second generation trials have included a wider cohort of patients, in order to assess safety and efficacy of the procedure, based on the development of more advanced devices and the recent knowledge regarding renal nerve distribution. In the current study, we used RDN to treat patients with true resistant HT, in order to assess i) the safety of the technique, through the performance of intra-arterial optical coherence tomography (OCT) in a porcine model and, its efficacy through the histologic evaluation of the treated renal artery; ii) the impact of the technique on the sympathetic cardiac innervation, in a subgroup of patients; iii) the impact of the technique in the immune system and, possibly, identify a biomarker to predict response; iv) the efficacy of the technique through a clinical evaluation and ambulatory blood pressure monitoring v) the impact of renal denervation on several parameters such as left ventricular ejection fraction, diastolic function, arrhythmic profile, renal function, glycemic and lipid profiles, NT pro-BNP and vitamin D. In the first part of our research, we performed unilateral pre-bifurcation RDN, with a multi-electrode (second generation) catheter, in twelve domestic pigs. The contralateral artery was untreated (control). OCT was performed pre and immediately post procedure and follow-up with renal angiogram and OCT was performed after one month. We demonstrated that RDN caused acute vessel wall changes (intimal disruption (edema/spasm) and intraluminal thrombus formation) visible by OCT but, after one month, the vessel was completely healed, with no evidence of renal stenosis in any of the treated subjects. The histological analysis revealed nearly absent tyrosine hydroxylase immunostaining and a statistically significant increase in the amount of collagen fibers in the denervated artery, compatible with a decrease in nerve terminals and an increase in fibrosis, compared to the control, suggesting an efficacious delivery of the radiofrequency energy to the vessel wall. No differences were found in the norepinephrine or epinephrine renal tissue levels between the treated and contralateral kidney. Subsequently, we performed 123I-labelled meta-iodobenzylguanidine (MIBG) cardiac scintigraphy, in a subgroup of patients, before and six months after RDN, to evaluate the impact of the procedure on cardiac sympathetic activity. Early heart to mediastinum ratio (HMR) was significantly lower in responders at baseline but similar after six months follow-up. Late HMR was statistically similar in both groups pre- and post RDN but reduced in comparison to values reported in healthy subjects. Accordingly, there were no statistically significant differences regarding the washout rate but above normal baseline values were detected, a difference more evident in the non-responders (sympathetic overdrive? increased risk of cardiovascular events?), with both group values converging after the RDN. None of the evaluated rates altered significantly at follow-up, translating an absence of deleterious sympathetic nerve disruption. In conclusion, RDN is a safe procedure, in terms of cardiac nerve integrity, but none of the evaluated MIBG parameters were useful to predict response. In the third part our research, we investigated the cellular immune profile in our cohort of 23 patients with resistant HT and treated with RDN. A preliminary assay, which included an extended analysis of T, B and natural killer cells, monocytes and dendritic cells, guided the forthcoming study in order to select T cells (CD4 and CD8, memory and activated subsets) as possible biomarkers of response to RDN. Blood samples were obtained in six timings, pre and post procedure. Response to RDN was evaluated at six-months and one year and was observed in 69.6 and 82.6% of patients, respectively. Absolute values of HLA-DR+ double negative T cells were significantly lower in the group of responders at one year. Additionally, interaction between the timings were found in three T cell subsets (T CD4, T CD8 and naïve T CD8 cells), with the responders tending to present with lower absolute values and little inter-timing variation. Afterwards, our research focused on investigating the behavior of cytokines in 21 RDN patients. We analyzed 45 protein targets which included cytokines, chemokines and growth factors. Response to RDN was evaluated as described previously. Venous blood samples were obtained at four timings, pre and post procedure. 66.7% of the patients were responders at six months and 85.7% were late-responders. Levels of regulated on activation, normal T cell expressed and secreted (RANTES) were significantly lower in responders, both at baseline and at 30 days (p=0.037). As there is evidence that Angiotensin II inhibits RANTES expression and, the renin-angiotensin-aldosterone system is directly linked to the sympathetic nervous system, we could hypothesize that low levels of RANTES are associated with higher levels of angiotensin II and therefore to an over activated sympathetic nervous system, turning these patients more prone to a RDN response. Finally, we assessed serum vitamin D concentration as a predictor of blood pressure response to RDN. Additionally, we evaluated overall long-term safety and efficacy, as well as echocardiographic parameters, in the cohort of 24 patients submitted to RDN. Response at six-months (early-responders) and one year was evaluated. We observed that responders at six-months had significantly higher baseline and six-month follow-up values of vitamin D than non-responders. Responders at one year (including late-responders) continued to present with higher vitamin D levels than non-responders, although it didn’t reach statistical significance, probably due to the low number of the later at this stage. In the long-term follow-up (mean 52 months), 70.8% of the patients maintained a clinical response. Regarding echocardiographic parameters, there was an improvement in diastolic function in non-responders, finding that could reflect benefit from the RDN, even though no effect on blood pressure was observed. No other relevant echocardiographic differences were found. In conclusion, RDN effectively lowered the blood pressure in the majority of the studied patients, with an optimal safety pattern. Our study contributed to better comprehend the clinical, immunological and hemodynamic profiles of patients submitted to this procedure and, to identify potential biomarkers of denervation success. Our findings may allow for a better identification of patients who could really derive benefit from RDN and prompt further investigation around this area.
A hipertensão (HT) é o factor de risco cardiovascular modificável mais comum e é responsável por morbilidade e mortalidade significativas. É estimado que 30-45% da população adulta tenha HT sendo que, a sua prevalência aumenta com o avanço da idade. A implementação de alterações do estido de vida e a terapêutica com fármacos reduz o risco de eventos cardiovasculares major com o enfarte agudo do miocárdio, acidente vascular cerebral e insuficiência cardíaca e, aumenta a expectativa de vida. No entanto, apesar da disponibilidade de medicamentos seguros e eficazes para controlar a HT, a prevalência de HT não controlada continua a aumentar sendo que, o mais importante contribuidor para um mau controle tensional é a não aderência à terapêutica. A HT é considerada verdadeiramente resistente quando não se conseguem atingir os valores de pressão arterial recomendados pelas guidelines e, quando são excluídos HT secundária, não-aderência e pseuso-hipertensão. A patofisiologia da HT resistente é complexa e pouco clara. Os efeitos vasoconstrictores do sistema nervoso simpático e a sua implicação na patogénese da HT resistente é conhecida, tornando-o num alvo terapêutico atrativo. A desnervação renal (RDN) é uma técnica percutânea minimamente invasiva que consiste na aplicação de energia de radiofrequência na parede da artéria renal, com o objectivo de provocar lesão nos terminais nervosos simpáticos. Os ensaios randomizados de primeira geração foram controversos, especificamente o HTN-3, uma vez que os resultados não foram os esperados e a RDN não se associou a uma maior queda na pressão arterial, em relação ao grupo de controlo. Várias questões foram colocadas por este estudo ‘negativo’ e motivou uma maior investigação da técnica. Até ao presente, a RDN tem sido usada para tratar doentes com HT resistente e os ensaios de segunda geração já incluiram uma população de doentes mais ampla, para avaliação da segurança e eficácia do procedimento, baseando-se no desenvolvimento de um catéter mais avançado, multi-eléctrodo, e no conhecimento recente relativo à distribuição dos nervos renais. Na presente tese, utilizámos a RDN para tratar doentes com HT resistente verdadeira, com o objectivo de avaliar i) a segurança da técnica, através da realização de tomografia de coerência óptica (OCT) intra-arterial num modelo porcino e, a sua eficácia através da avaliação histológica da artéria renal tratada; ii) o impacto da técnica na inervação simpática cardíaca, num subgrupo de doentes; iii) o impacto da técnica no sistema imunitário e, potencialmente, identificar um biomarcador predictor de resposta; iv) a eficácia da técnica através de uma avaliação clínica e de monitorização ambulatória da pressão arterial; v) o impacto da RDN em vários parâmetros como a fração de ejeção do ventrículo esquerdo, função diastólica, perfil disrítmico, função renal, perfis glucídico e lipídico, NT pro-BNP e vitamina D. Na primeira parte da nossa investigação, realizámos, em doze porcos domésticos, RDN unilateral, pré-bifurcação, com um catéter multi-eléctrodo (segunda geração). A artéria contra-lateral não foi tratada (controlo). Foi realizado OCT pré e imediatamente após o procedimento e, após um mês, follow-up com angiografia renal e OCT. Demonstrámos que a RDN causou alterações agudas na parede do vaso (alterações da intíma (edema/espasmo) e formação de trombo intra-luminal) visíveis por OCT mas, após um mês, o vaso estava totalmente recuperado, não se observando estenose da artéria renal em nenhum caso. A análise histológica revelou uma quase ausência de coloração para tirosina hidroxilase e um aumento estatisticamente significativo na quantidade de fibras de colagénio na artéria tratada, alterações compatíveis com uma redução dos terminais nervosos e um aumento da fibrose, comparativamente com o controlo, sugerindo uma entrega eficaz da energia de radiofrequência na parede arterial. Não se encontraram diferenças estatisticamente significativas em relação aos níveis tecidulares renais de norepinefrina e adrenalina, entre o rim tratado e o contra-lateral. Subsequentemente, realizámos cintigrafia cardíaca com 123I meta-iodobenzylguanidina (MIBG), num subgrupo de doentes, antes e seis meses depois da RDN, para avaliação do impacto do procedimento na actividade simpática cardíaca. O ratio coração/mediastino (HMR) precoce foi significativamente mais baixo nos respondedores pré-procedimento, mas semelhante entre os grupos após seis meses de follow-up. O HRM tardio foi estatisticamente semelhante entre os grupos, pré- e pós-RDN, mas apresentando valores mais baixos do que os reportados em indivíduos saudáveis. Por conseguinte, não se verificaram diferenças estatisticamente significativas na taxa de washout, mas valores basais acima do normal foram detectados, sendo esta diferença mais evidente nos não-respondedores (hiperactivação simpática? risco aumentado de eventos cardiovasculares?), verificando-se uma aproximação entre os 2 grupos após a RDN. Nenhum dos parâmetros avaliados se alterou significativamente no follow-up, o que poderá traduzir uma ausência de lesão dos nervos simpáticos. Em conclusão, a RDN é um procedimento seguro, em termos de integridade nervosa cardíaca, mas nenhum dos parâmetros de MIBG avaliados foram úteis para predizer resposta. Na terceira parte da nossa investigação, avaliámos o perfil imunológico celular na nossa população de 23 doentes com HT resistente e tratada com RDN. Um estudo preliminar, que incluiu uma análise exaustiva de células T, B e natural killer, monócitos e células dendríticas, orientou o o estudo posterior e permitiu identificar as células T (CD4 e CD8, memória e activadas) como possíveis biomarcadores de resposta na RDN. Foram obtidas amostras de sangue em seis instantes de tempo, pré e pós-procedimento. A resposta à RDN foi avaliada aos seis meses e um ano e observou-se em 69.6 e 82.6% dos doentes, respectivamente. Os valores absolutos das células T duplas-negativas activadas foram significativamente inferiores no grupo de respondedores ao ano. Verificou-se adicionalmente uma interação entre os diferentes tempos em 3 subgrupos de células T (T CD4, T CD8 e T CD8 naive), com tendência para os respondedores apresentarem valores absolutos inferiores e pouca variação entre os tempos. Seguidamente, a nossa investigação focou-se em avaliar o comportamento das citocinas em 21 doentes tratados com RDN. Foram analizados 45 alvos proteicos que incluiram citocinas, quimiocinas e factores de crescimento. A resposta à RDN foi avaliada de acordo com o descrito previamente. Amostras de sangue venoso foram obtidas em quatro instantes de tempo, pré e pós-procedimento. 66.7% dos doentes foram respondedores aos 6 meses e 85.7% foram respondedores-tardios. Os níveis de RANTES (regulada sob activação, expressada e secretada por células T normais) foram significativamente mais baixos nos respondedores, tanto basalmente como aos 30 dias (p=0.037). Como há evidência que a Angiotensina II inibe a expressão da RANTES e, o sistema renina-angiotensina-aldosterona está directamente conectado ao sistema nervoso simpático, podemos colocar a hipótese de que baixos níveis de RANTES estão associados a valores elevados de angiotensina II e consequentemente, a um sistema nervoso simpático sobreactivado, tornando estes doentes mais susceptíveis de responderem à RDN. Por último, avaliámos a concentração da vitamina D sérica, colocando a hipótese de potencial preditora de resposta à RDN. Adicionalmente, avaliámos a segurança e eficácia a longo-prazo, assim como os parâmetros ecocardiográficos, na população de 24 doentes submetida a RDN. Foi avaliada a resposta aos 6 meses (respondedores precoces) e ao ano. Observámos que os respondedores apresentaram valores basais e aos seis meses significativamente mais elevados de vitamina D que os não-respondedores. Os respondedores ao ano (que inclui os respondedores tardios) continuaram a apresentar valores mais elevados de vitamina D que os não-respondedores, apesar de ausência de significado estatístico, provavelmente pelo baixo número de não-respondedores nesta altura. No follow-up a longo-prazo (média de 52 meses), 70.8% dos doentes mantiveram resposta clínica. Em relação aos parâmetros ecocardiográficos, verificou-se uma melhoria da função diastólica nos não-respondedores, achado que poderá reflectir benefício da RDN, apesar de não se ter observado efeito na pressão arterial. Não foram encontradas outras diferenças de relevo nos parâmetros ecocardiográficos. Em conclusão, a RDN efectivamente reduziu a pressão arterial na maioria dos doentes estudados, apresentando um óptimo padrão de segurança. O nosso estudo contribuiu para uma melhor compreensão do perfil clínico, imagiológico, imunológico e hemodinâmico dos doentes submetidos a este procedimento e, para a identificação de potenciais biomarcadores de sucesso. Os nossos resultados poderão permitir uma melhor seleção de doentes, para que possam realmente beneficiar da RDN, e potenciar investigação nesta área.
Agrawalla, Abhisek, e Namrata Keshri. "Durability Assessment of Multiwalled Carbon-Nanotubes Modified Advanced Fibrous Polymeric Composite in Different Marine Environment". Thesis, 2015. http://ethesis.nitrkl.ac.in/6799/1/DURABILITY_Agrawalla_2015.pdf.
Texto completo da fonteOduneye, Samuel. "MR-Guided Assessment and Management of Ventricular Tachycardia". Thesis, 2013. http://hdl.handle.net/1807/43685.
Texto completo da fonteDalai, Renu Prava. "An Assessment of Mechanical Behavior of Fibrous Polymeric Composites Under Different Loading Speeds at Above- And Sub-Ambient Temperatures". Thesis, 2010. http://ethesis.nitrkl.ac.in/2049/1/thesis_renu.pdf.
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