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Sample records for eq paliperidone paliperidone

  1. Paliperidone palmitate-induced sialorrhoea

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    Cengiz Cengisiz

    2016-03-01

    Full Text Available Extrapyramidal, metabolic, and cardiac side effects were reported for atypical antipsychotics; although a few resources show paliperidone-induced sialorrhea, there are no resources that show paliperidone palmitate-induced sialorrhea. In this paper, we present the paliperidone palmitate-induced sialorrhea side effects of a patient who applied on our clinic [Cukurova Med J 2016; 41(0.100: 8-13

  2. Paliperidone-associated motor tics.

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    Hsieh, Ming-Han; Chiu, Nan-Ying

    2014-01-01

    Paliperidone-associated motor tics. Case report. We report a 30-year-old man with schizophrenia who developed motor tics (eye blinking) after treatment of paliperidone up to 15 mg daily. Tic-like symptoms, from simple eye blinking to complex Tourette-like syndrome, may occur during paliperidone treatment, especially with high dose. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

  3. Manic Symptoms during a Switch from Paliperidone ER to Paliperidone Palmitate in a Patient with Schizophrenia

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    Kadir Demirci

    2015-01-01

    Full Text Available Some antipsychotic drugs have treatment efficacy for mania and bipolar disorder. However, these drugs may rarely cause manic symptoms in some schizophrenic patients. We hereby report a 22-year-old female patient with schizophrenia who experienced a manic episode during a switch from paliperidone ER to paliperidone palmitate. This case is an important reminder that an abrupt switch from oral paliperidone to paliperidone palmitate may predispose certain patients to hypomanic or manic symptoms.

  4. Mania associated with paliperidone treatment in schizophrenia: A case report

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    Süleyman Demir

    2015-09-01

    Full Text Available Paliperidone is an atypical antipsychotic drug used to treat schizophrenia. Paliperidone can cause some rare side effects during treatment. Despite many publications of mania and hypomania induced by antipsychotics, mania cases induced by paliperidone are few in the literature. In this case a schizophrenia patient showing symptoms of mania during usage of paliperidone with a dose of 9 mg/day in which the symptoms rapidly disappeared after discontinuation of paliperidone and initiation of aripiprazole was reported. Clinicians should be aware of that Paliperidone treatment may trigger mania symptoms. J Clin Exp Invest 2015; 6 (3: 321-323

  5. Paliperidone

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    ... activities and may cause changes in mood and personality) who take antipsychotics (medications for mental illness) such ... to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in ...

  6. Paliperidone for the treatment of schizoaffective disorder.

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    Alphs, Larry; Fu, Dong-Jing; Turkoz, Ibrahim

    2016-01-01

    Schizoaffective disorder (SCA) is a complex mental illness characterized by psychosis and affective symptoms. Treatment usually involves concomitant therapy with antipsychotics, mood stabilizers, and/or antidepressants. Effective treatment must address acute symptoms, maintain long-term stability, promote recovery, and improve patient functioning. Data from 3 pivotal studies evaluating the acute and maintenance treatment of SCA with paliperidone are reviewed. Two formulations of paliperidone have been studied for these indications: an extended-release oral formulation (NCT00397033, NCT00412373) and long-acting injectable once-monthly paliperidone palmitate (NCT01193153). The reported effects of these formulations on psychotic, depressive, and manic symptoms are discussed. Both formulations were found to be safe and effective for the acute and maintenance treatment of SCA. Of critical importance for this treatment population is that rapid improvement was seen in all major symptoms of SCA, including psychosis, depression, and mania. Mediation analyses suggest that the known antipsychotic effects of paliperidone occur independently of its antidepressant effects. Both formulations of the drug are effective when used as monotherapy or adjunctively with antidepressants or mood stabilizers. Beyond symptom control, both formulations improved patient functioning and increased patient satisfaction.

  7. A case of paliperidone-palmitate-induced tardive dyskinesia.

    LENUS (Irish Health Repository)

    Lally, John

    2012-06-13

    OBJECTIVES: This is one of the first cases reported in the literature of paliperidone-palmitate-induced prolonged dyskinesia. METHOD: Case report. RESULTS: We report the case of a 49-year-old woman with paranoid schizophrenia who developed orofacial dyskinesia some 4 months after the commencement of paliperidone long-acting injection. CONCLUSION: This case serves as a clinical reminder that dyskinesia can occur with all antipsychotic medications.

  8. Once-monthly paliperidone injection for the treatment of schizophrenia

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    Delia Bishara

    2010-09-01

    Full Text Available Delia BisharaPharmacy Department, South London and Maudsley NHS Foundation Trust, London, United KingdomAbstract: Paliperidone palmitate is a new long-acting antipsychotic injection for the treatment of acute and maintenance therapy in schizophrenia. Paliperidone (9-hydroxyrisperidone is the major active metabolite of risperidone and acts at dopamine D2 and serotonin 5HT2A receptors. As with other atypical antipsychotics, it exhibits a high 5HT2A:D2 affinity ratio. It also has binding activity as an antagonist at α1- and α2 adrenergic receptors and H1 histaminergic receptors, but has virtually no affinity for cholinergic receptors. Paliperidone palmitate has been shown to be effective in reducing Positive and Negative Syndrome Scale total scores in four short-term trials in acute schizophrenia. It was also effective as maintenance therapy in a long-term trial in which time to recurrence of symptoms was significantly longer in paliperidone-treated patients compared with placebo. In addition, paliperidone was shown to be noninferior to risperidone long-acting injection in one study, but this noninferiority was not established in another longer study comparing the two drugs. Treatment should be initiated with 234 mg on day 1 and 156 mg on day 8, followed by a recommended monthly maintenance dose of 39–234 mg based on efficacy and tolerability. Paliperidone palmitate is generally well tolerated, although it can cause weight gain and a rise in prolactin levels, which is generally greater in women than in men. Overall, paliperidone palmitate may have advantages over other currently available long-acting injections, and therefore may be a useful alternative for the treatment of schizophrenia, although further long-term trials comparing it with active treatments are warranted.Keywords: paliperidone palmitate, injection, schizophrenia, long-acting

  9. Practical guidelines on the use of paliperidone palmitate in schizophrenia.

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    Newton, Richard; Hustig, Harry; Lakshmana, Raju; Lee, Joseph; Motamarri, Balaji; Norrie, Peter; Parker, Robert; Schreiner, Andreas

    2012-04-01

    Paliperidone palmitate is an atypical long-acting injectable (LAI) antipsychotic that has been approved for use in the US, EU, Australia and numerous other countries for acute and maintenance therapy of schizophrenia. LAI antipsychotics are often viewed as a 'last-resort' treatment for difficult-to-treat patients, however this article considers their role more broadly in the management of partial or non-adherence in schizophrenia. A search of MedLine, CTR and PsychInfo was conducted to identify relevant publications and clinical trials (search term 'paliperidone palmitate', up to December 2010). The findings were discussed in a number of teleconferences and the manuscript was finalized with a face-to-face meeting of the authors group. Relapse prevention in schizophrenia requires a comprehensive approach to treatment, which includes antipsychotic medication and psychosocial measures as well as family and/or carer involvement. Good symptom control and the interconnected issue of treatment adherence are arguably the most crucial factors for success. Carer and patient feedback should be carefully considered. Negotiation about commencing LAI therapy done early in course of disease is easier than many clinicians believe, although it is not often attempted in practice. Paliperidone palmitate is useful in both the acute and maintenance phases of treatment. A case-based approach is presented to suggest various opportunities where use of paliperidone palmitate could be considered within the disease course of schizophrenia. Paliperidone palmitate offers some advantages in terms of tolerability, simplicity of treatment initiation and long duration between injections. The consensus of the authors is that rather than reserving paliperidone palmitate for use in difficult-to-treat or refractory patients, it could be used to promote adherence and prevent relapse earlier in the course of the illness.

  10. Direct and indirect effects of paliperidone extended-release tablets on negative symptoms of schizophrenia

    OpenAIRE

    Bossie, Cynthia

    2008-01-01

    Ibrahim Turkoz, Cynthia A Bossie, Bryan Dirks, Carla M CanusoOrtho-McNeil Janssen Scientific Affairs, LLC, Titusville, NJ, USAAbstract: Direct and indirect effects of the new psychotropic paliperidone extended-release (paliperidone ER) tablets on negative symptom improvement in schizophrenia were investigated using path analysis. A post hoc analysis of pooled data from three 6-week, double-blind, placebo-controlled studies of paliperidone ER in patients experiencing acute exacerbation was con...

  11. Paliperidone Palmitate for Schizoaffective Disorder: A Review of the Clinical Evidence.

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    Greenberg, William M; Citrome, Leslie

    2015-12-01

    Despite being frequently diagnosed, there has been very limited study of efficacious treatments for schizoaffective disorder. Paliperidone had been approved for the treatment of schizoaffective disorder, and a recently completed relapse prevention study of the use of a once-monthly injectable paliperidone formulation has also led to an indication for that preparation to treat schizoaffective disorder. To review the efficacy and tolerability of paliperidone for schizoaffective disorder, we conducted a systematic literature search of studies of paliperidone in the treatment of schizoaffective disorder, and briefly reviewed evidence regarding the somewhat controversial nature of that diagnostic entity. We located several studies of the use of paliperidone extended release in the treatment of schizoaffective disorder, but only one completed study of the use of paliperidone palmitate, which demonstrated efficacy in preventing relapse. Three other studies are currently recruiting participants. Efficacy and tolerability were similar to the profile of oral paliperidone in the treatment of individuals with schizophrenia. These results were similar for both individuals treated with paliperidone palmitate alone, and for those treated with paliperidone palmitate with adjunctive mood stabilizers and/or antidepressants. The use of paliperidone palmitate does not require initial co-administration of oral paliperidone, has relatively little risk of drug-drug interactions, and its pharmacokinetics are favorable for once-monthly administration, an important treatment option for individuals with psychotic disorders, who may often be non-adherent to effective medication regimens. Paliperidone palmitate is an approved treatment for schizoaffective disorder, and can be efficacious with or without commonly employed adjunctive treatments.

  12. Bilayer tablets of Paliperidone for Extended release osmotic drug delivery

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    Chowdary, K. Sunil; Napoleon, A. A.

    2017-11-01

    The purpose of this study is to develop and optimize the formulation of paliperidone bilayer tablet core and coating which should meet in vitro performance of trilayered Innovator sample Invega. Optimization of core formulations prepared by different ratio of polyox grades and optimization of coating of (i) sub-coating build-up with hydroxy ethyl cellulose (HEC) and (ii).enteric coating build-up with cellulose acetate (CA). Some important influence factors such as different core tablet compositions and different coating solution ingredients involved in the formulation procedure were investigated. The optimization of formulation and process was conducted by comparing different in vitro release behaviours of Paliperidone. In vitro dissolution studies of Innovator sample (Invega) with formulations of different release rate which ever close release pattern during the whole 24 h test is finalized.

  13. 78 FR 66009 - Determination That INVEGA (Paliperidone) Extended-Release Tablet, 12 Milligrams, Was Not...

    Science.gov (United States)

    2013-11-04

    ...] Determination That INVEGA (Paliperidone) Extended-Release Tablet, 12 Milligrams, Was Not Withdrawn From Sale for... Food and Drug Administration (FDA) has determined that INVEGA (paliperidone) extended-release tablet...-release tablet, 12 mg, if all other legal and regulatory requirements are met. FOR FURTHER INFORMATION...

  14. Paliperidone Palmitate Improves and Maintains Functioning in Asia-Pacific Patients with Schizophrenia.

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    Zhang, Hongyan; Turkoz, Ibrahim; Zhuo, Jianmin; Mathews, Maju; Tan, Wilson; Feng, Yu

    2017-11-01

    Post hoc analyses (two single-arm studies) were conducted to determine the impact of once-monthly injection of paliperidone palmitate on functioning in adult patients with schizophrenia in the Asia-Pacific region. Study 1 enrolled hospitalized patients with acute exacerbation of schizophrenia, and study 2 enrolled patients with recently diagnosed schizophrenia unsatisfactorily treated with oral antipsychotics. Patients received paliperidone palmitate, 150 mg eq. on day 1, 100 mg eq. on day 8, then once monthly (50-150 mg eq.) (study 1, days 36 and 64; study 2, 18 months). Functional status was evaluated by Personal and Social Performance score in both studies and employment only in study 2. In study 1, 54 of 184 patients (29.4%) with an unfavorable level of functioning at the baseline improved to a favorable level (Personal and Social Performance score greater than 70) at day 92. This improvement was significantly greater among patients with recently diagnosed schizophrenia (5 years or less) compared with patients with chronic schizophrenia (more than 5 years): 40% versus 22% (p schizophrenia. Janssen-Cilag Asia-Pacific Medical Affairs.

  15. Safety and Efficacy of Paliperidone Extended-Release in Acute and Maintenance Treatment of Schizophrenia

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    Edoardo Spina

    2011-01-01

    Full Text Available Paliperidone, the major active metabolite of risperidone, is a second-generation antipsychotic that has been developed as an extended-release (ER tablet formulation that minimizes peak-trough fluctuations in plasma concentrations, allowing once-daily administration and constant drug delivery. Paliperidone ER has demonstrated efficacy in the reduction of acute schizophrenia symptoms in 6-week, placebo-controlled, double-blind trials and clinical benefits were maintained in the longer-term according to extension studies of up to 52 weeks in duration. Compared with quetiapine, paliperidone ER was associated with a more rapid symptom improvement. In addition, it was more effective than placebo in the prevention of symptom recurrence. Paliperidone ER is generally well tolerated with a predictable adverse event profile. Like risperidone, it is associated with a dose-dependent risk of extrapyramidal symptoms and prolactin elevation. Short-and longer-term studies have indicated a low liability for paliperidone ER to cause metabolic (ie, weight gain, hyperglycaemia and lipid dysregulation or cardiovascular adverse effects. Available safety data from elderly patients appear to be promising. Due to negligible hepatic biotransformation, paliperidone ER is unlikely to be involved in clinically significant metabolic drug-drug interactions. Additional active comparator trials evaluating efficacy, tolerability and cost-effectiveness are required to better define the role of paliperidone ER in the treatment of schizophrenia in relation to other currently available second-generation antipsychotics, particularly risperidone.

  16. Pharmacokinetic drug evaluation of paliperidone in the treatment of schizoaffective disorder.

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    Macaluso, Matthew; Oliver, Hannah; Sohail, Zohaib

    2017-08-01

    This paper reviews the pharmacokinetics, receptor binding, clinical efficacy and safety of paliperidone in the treatment of patients with schizoaffective disorder. Areas covered: We reviewed the literature using keywords 'paliperidone', 'schizoaffective disorder' and 'clinical trials' with a focus on seminal data papers and information that is clinically relevant to the treatment of schizoaffective disorder. The purpose of this paper is to provide a clinically oriented review of the pharmacokinetic and pharmacodynamic properties of paliperidone including receptor binding, clinical efficacy, safety and tolerability. Expert opinion: Paliperidone is currently the only medication FDA approved specifically for the treatment of schizoaffective disorder. Paliperidone is an active metabolite of risperidone, is minimally metabolized in the liver and is primarily known to be cleared through the kidneys. For this reason, paliperidone could be considered for some patients with schizoaffective disorder who also have hepatic impairment. After correcting for the reduced protein binding that is characteristic of hepatically impaired patients, the Cmax was 12% lower than in healthy subjects while the AUC and CL/F were comparable [14]. In addition, the availability of long acting injectable formulations may be useful for patients who are non-adherent with oral medications. The cost of paliperidone may be a disadvantage.

  17. Long-acting injectable paliperidone palmitate versus oral paliperidone extended release: a comparative analysis from two placebo-controlled relapse prevention studies.

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    Markowitz, Michael; Fu, Dong-Jing; Levitan, Bennett; Gopal, Srihari; Turkoz, Ibrahim; Alphs, Larry

    2013-07-11

    Increasing availability and use of long-acting injectable antipsychotics have generated a need to compare these formulations with their oral equivalents; however, a paucity of relevant data is available. This post hoc comparison of the long-term efficacy, safety and tolerability of maintenance treatment with paliperidone palmitate (PP) versus oral paliperidone extended release (ER) used data from two similarly designed, randomised, double-blind (DB), placebo-controlled schizophrenia relapse prevention trials. Assessments included measures of time to relapse, symptom changes/functioning and treatment-emergent adverse events (TEAEs). Time to relapse between treatment groups was evaluated using a Cox proportional hazards model. Between-group differences for continuous variables for change scores during the DB phase were assessed using analysis of co-variance models. Categorical variables were evaluated using Chi-square and Fisher's exact tests. No adjustment was made for multiplicity. Approximately 45% of enrolled subjects in both trials were stabilised and randomised to the DB relapse prevention phase. Risk of relapse was higher in subjects treated with paliperidone ER than in those treated with PP [paliperidone ER/PP hazard ratio (HR), 2.52; 95% confidence interval (CI), 1.46-4.35; p 70, both approximately 58.5%; p = 1.000] compared with a 10.9% decrease for paliperidone ER (58.5% vs 47.6%, respectively; p = 0.048). The least squares mean change for Positive and Negative Syndrome Scale (PANSS) total score at DB end point in these previously stabilised subjects was 3.5 points in favour of PP (6.0 vs 2.5; p = 0.025). The rates of TEAEs and AEs of interest appeared similar. This analysis supports maintenance of effect with the injectable compared with the oral formulation of paliperidone in patients with schizophrenia. The safety profile of PP was similar to that of paliperidone ER. Future studies are needed to confirm these findings.

  18. Paliperidone for irritability in adolescents and young adults with autistic disorder.

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    Stigler, Kimberly A; Mullett, Jennifer E; Erickson, Craig A; Posey, David J; McDougle, Christopher J

    2012-09-01

    Individuals with autistic disorder (autism) frequently exhibit significant irritability marked by severe tantrums, aggression, and self-injury. Despite advances in the treatment of this symptom domain in autism, there remains an ongoing need for more effective and better tolerated pharmacotherapies. The aim of this study is to determine the effectiveness and tolerability of paliperidone for irritability in autism. This is a prospective, 8-week open-label study of paliperidone in 25 adolescents and young adults with autism. Primary outcome measures included the Clinical Global Impressions-Improvement (CGI-I) Scale and the Irritability subscale of the Aberrant Behavior Checklist (ABC-I). Concomitant medications (except antipsychotics) were permitted if dosages were stable for ≥2 months. Twenty-one (84 %) of 25 subjects ages 12-21 years (mean 15.3 years) responded to paliperidone, based on a CGI-I Scale score of 1 or 2 (very much or much improved) and ≥25 % improvement on the ABC-I. The mean final dosage of paliperidone was 7.1 mg/day (range 3-12 mg/day). Two subjects discontinued paliperidone prior to study completion (moderate sedation, n = 1; nonresponse, n = 1). Mild-to-moderate extrapyramidal symptoms were recorded in four subjects. A mean weight gain of 2.2 ± 2.6 kg (range -3.6 to +7.9 kg) was recorded. Mean age- and sex-normed body mass index increased from 23.6 to 24.2 (p ≤ 0.001). Mean serum prolactin increased from 5.3 to 41.4 ng/mL (p ≤ 0.0001). Paliperidone treatment was associated with significant improvement in irritability and was generally well tolerated. Larger scale, placebo-controlled studies are needed to elucidate the efficacy and tolerability of paliperidone in this population.

  19. Effects of the antipsychotic paliperidone on stress-induced changes in the endocannabinoid system in rat prefrontal cortex.

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    MacDowell, Karina S; Sayd, Aline; García-Bueno, Borja; Caso, Javier R; Madrigal, José L M; Leza, Juan Carlos

    2017-09-01

    Objectives There is a need to explore novel mechanisms of action of existing/new antipsychotics. One potential candidate is the endocannabinoid system (ECS). The present study tried to elucidate the effects of the antipsychotic paliperidone on stress-induced ECS alterations. Methods Wister rats were submitted to acute/chronic restraint stress. Paliperidone (1 mg/kg) was given prior each stress session. Cannabinoid receptors and endocannabinoids (eCBs) synthesis and degradation enzymes were measured in prefrontal cortex (PFC) samples by RT-PCR and Western Blot. Results In the PFC of rats exposed to acute stress, paliperidone increased CB1 receptor (CB1R) expression. Furthermore, paliperidone increased the expression of the eCB synthesis enzymes N-acylphosphatidylethanolamine- hydrolysing phospholipase D and DAGLα, and blocked the stress-induced increased expression of the degrading enzyme fatty acid amide hydrolase. In chronic conditions, paliperidone prevented the chronic stress-induced down-regulation of CB1R, normalised DAGLα expression and reverted stress-induced down-regulation of the 2-AG degrading enzyme monoacylglycerol lipase. ECS was analysed also in periphery. Acute stress decreased DAGLα expression, an effect prevented by paliperidone. Contrarily, chronic stress increased DAGLα and this effect was potentiated by paliperidone. Conclusions The results obtained described a preventive effect of paliperidone on stress-induced alterations in ECS. Considering the diverse alterations on ECS described in psychotic disease, targeting ECS emerges as a new therapeutic possibility.

  20. Critical evaluation of paliperidone in the treatment of schizophrenia in Chinese patients: a systematic literature review

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    Zhang LL

    2016-01-01

    Full Text Available LiLi Zhang,1 JiTao Li,2–4 YanJie Zhao,5 Yun’Ai Su,2–4 Tianmei Si2–4 1Medical Affairs, Xian Janssen Pharmaceutical Co, Ltd, 2National Clinical Research Center for Mental Disorders, 3Peking University Sixth Hospital, Institute of Mental Health, 4The Key Laboratory of Mental Health, Ministry of Health, Peking University, 5National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China Background: Paliperidone (9-hydroxyrisperidone, the major active metabolite of risperidone, has been introduced as a novel atypical antipsychotic agent in many countries. It is available both as an oral extended-release (ER formulation and as a long-acting injection (paliperidone palmitate, PP, which have been approved for treating schizophrenia in the People’s Republic of China since 2009 and 2012, respectively. This systematic review summarizes the efficacy, effectiveness, and safety of paliperidone in the treatment of schizophrenia in the Chinese population. Methods: A systematic literature search was conducted on the databases covering international and Chinese core journals, published from January 1, 2008, to May 22, 2015. Results: A total of 122 publications were retrieved, of which 63 studies were identified for inclusion; most studies were related to paliperidone ER (n=53, nine were related to PP, and one study was related to both agents. Paliperidone ER demonstrated at least comparable efficacy with active comparators, including risperidone, olanzapine, ziprasidone, or aripiprazole, and was found to be superior with respect to the onset of action and improvement in the Personal and Social Performance Scale score. Paliperidone ER appeared to be associated with a lower risk of metabolic syndromes; the most common treatment-emergent adverse events were extrapyramidal symptoms, akathisia, insomnia, and somnolence. Results from interventional and observational studies showed that PP

  1. Thiolated Chitosan Masked Polymeric Microspheres with Incorporated Mesocellular Silica Foam (MCF for Intranasal Delivery of Paliperidone

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    Stavroula Nanaki

    2017-11-01

    Full Text Available In this study, mesocellular silica foam (MCF was used to encapsulate paliperidone, an antipsychotic drug used in patients suffering from bipolar disorder. MCF with the drug adsorbed was further encapsulated into poly(lactic acid (PLA and poly(lactide-co-glycolide (PLGA 75/25 w/w microspheres and these have been coated with thiolated chitosan. As found by TEM analysis, thiolated chitosan formed a thin layer on the polymeric microspheres’ surface and was used in order to enhance their mucoadhesiveness. These microspheres aimed at the intranasal delivery of paliperidone. The DSC and XRD studies showed that paliperidone was encapsulated in amorphous form inside the MCF silica and for this reason its dissolution profile was enhanced compared to the neat drug. In coated microspheres, thiolated chitosan reduced the initial burst effect of the paliperidone dissolution profile and in all cases sustained release formulations have been prepared. The release mechanism was also theoretically studied and three kinetic models were proposed and successfully fitted for a dissolution profile of prepared formulations to be found.

  2. Paliperidone Inducing Concomitantly Syndrome of Inappropriate Antidiuretic Hormone, Neuroleptic Malignant Syndrome, and Rhabdomyolysis

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    Jaspinder Kaur

    2016-01-01

    Full Text Available Paliperidone, an active metabolite of risperidone, is a new atypical antipsychotic agent. Syndrome of inappropriate antidiuretic hormone (SIADH, neuroleptic malignant syndrome (NMS, and rhabdomyolysis are the uncommon side effects of psychotropic drugs. We report a case of 35-year-old male with schizoaffective disorder who was admitted for acute-on-chronic exacerbation of his psychotic disorder for which intramuscular paliperidone 234 mg injection was given. Two days later, the patient developed hyponatremic seizures secondary to SIADH which was treated with hypertonic saline. On the third day, he developed high grade fever and severe muscle rigidity with raised creatine phosphokinase (CPK and liver enzymes levels. He was treated with dantrolene 100 mg, bromocriptine 2.5 mg, and lorazepam 2 mg. Our patient required management of the three rare conditions following treatment with paliperidone. This case highlights the need for health care providers to be aware of the rare, potentially life threatening but preventable hyponatremia, NMS, and rhabdomyolysis as a possible adverse effect of paliperidone.

  3. Paliperidone ER in the Treatment of Borderline Personality Disorder: A Pilot Study of Efficacy and Tolerability

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    Silvio Bellino

    2011-01-01

    Full Text Available Antipsychotics are recommended for the treatment of impulsive dyscontrol and cognitive perceptual symptoms of borderline personality disorder (BPD. Three reports supported the efficacy of oral risperidone on BPD psychopathology. Paliperidone ER is the metabolite of risperidone with a similar mechanism of action, and its osmotic release reduces plasmatic fluctuations and antidopaminergic effects. The aim of this study is to evaluate efficacy and safety of paliperidone ER in BPD patients. 18 outpatients with a DSM-IV-TR diagnosis of BPD were treated for 12 weeks with paliperidone ER (3–6 mg/day. They were assessed at baseline, week 4, and week 12, using the CGI-Severity item, the BPRS, the HDRS, the HARS, the SOFAS, the BPD Severity Index (BPDSI, and the Barratt Impulsiveness Scale (BIS-11. Adverse events were evaluated with the DOTES. Paliperidone ER was shown to be effective and well tolerated in reducing severity of global symptomatology and specific BPD symptoms, such as impulsive dyscontrol, anger, and cognitive-perceptual disturbances. Results need to be replicated in controlled trials.

  4. A critical appraisal of paliperidone long-acting injection in the treatment of schizoaffective disorder.

    Science.gov (United States)

    Chue, Pierre; Chue, James

    2016-01-01

    Schizoaffective disorder (SCA) is a chronic and disabling mental illness that presents with mixed symptoms of schizophrenia and affective disorders. SCA is recognized as a discrete disorder, but with greater heterogeneity and symptom overlap, leading to difficulty and delay in diagnosis. Although the overall prognosis is intermediate between schizophrenia and mood disorders, SCA is associated with higher rates of suicide and hospitalization than schizophrenia. No treatment guidelines exist for SCA, and treatment is frequently complex, involving off-label use and polypharmacy (typically combinations of antipsychotics, mood stabilizers, and antidepressants). Oral paliperidone extended-release was the first agent to be approved for the treatment of SCA. As in schizophrenia and bipolar disorder, adherence to oral medications is poor, further contributing to suboptimal outcomes. The use of an antipsychotic in a long-acting injection (LAI) addresses adherence issues, thus potentially reducing relapse. Paliperidone palmitate represents the LAI formulation of paliperidone. In a long-term, double-blind, randomized, controlled trial of adult patients (n=334; intent-to-treat [ITT]) with SCA, paliperidone long-acting injection (PLAI) significantly delayed risk of relapse compared to placebo (hazard ratio 2.49, 95% confidence interval, 1.55-3.99; P<0.001). This study demonstrated the efficacy and safety of PLAI when used as either monotherapy or adjunctive therapy for the maintenance treatment of SCA. The results are consistent with a similarly designed study conducted in patients with schizophrenia, which suggests a benefit in the long-term control of not only psychotic but also affective symptoms. No new safety signals were observed. When used in monotherapy, PLAI simplifies treatment by reducing complex pharmacotherapy and obviating the necessity for daily oral medications. PLAI is the second agent, and the first LAI, to be approved for the treatment of SCA; as an LAI

  5. A Case of Ileus in a Patient with Schizophrenia Under Paliperidone Palmitate Treatment

    OpenAIRE

    Can, Serdar S?leyman; Kabaday?, Esra

    2016-01-01

    Constipation is a side effect of antipsychotic drugs that have high affinity for muscarinic cholinergic receptors. In addition, ileus is an important side effect of antipsychotic treatment, with potentially morbid and mortal consequences if early detection fails. In this report, a colonic ileus case is described in a patient with schizophrenia under the treatment of paliperidone palmitate. Consequently, complete physical examination and close screening of side effects are recommended when ant...

  6. Evidence based administration of risperidone and paliperidone for the treating conduct disorder

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    Ahmad Ghanizadeh

    2013-01-01

    Full Text Available Background: This study evaluates the evidence-based administration of risperidone and paliperidone for the treating children and adolescents with conduct disorder (CD. Materials and Methods: A review of the current literature from clinical trials that investigated the efficacy of risperidone and paliperidone on CD considering the inclusion criteria and search strategies was performed by a search of PubMed and Google Scholar databases. Results: Out of 53 titles, 31 were irrelevant. The abstract of 22 potentially related articles were studied. Only six articles reported the results of clinical trial. However, one of them reported the effect of risperidone on conduct behaviors in autistic disorders. One study was a re-analysis of two previous studies, one study reported the effects of maintenance versus withdrawal of risperidone treatment and two studies included children with sub-average intelligence. Headache, somnolence and increased appetite are among the most common reported adverse effects. No study examined the effect of paliperidone on CD was found. Conclusion: Current literature suggests that risperidone could be effective for treating some conduct behaviors in children and adolescents. The effect of risperidone on CD is not a well-researched area. There is no well-controlled evidence based reports about the safety and efficacy of risperidone for the treatment of CD. Further trials should examine the efficacy of these medications on CD rather than conduct behaviors or disruptive behavior disorders.

  7. Paliperidone for the treatment of ketamine-induced psychosis: a case report.

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    Zuccoli, M L; Muscella, A; Fucile, C; Carrozzino, R; Mattioli, F; Martelli, A; Orengo, S

    2014-01-01

    Ketamine is an anaesthetic and analgesic drug synthesized in the 1960s from phencyclidine. The recreational use of ketamine increased among the dance culture of techno and house music, in particular in clubs, discotheques, and rave parties. The psychotropic effects of ketamine are now well known and they range from dissociation to positive, negative, and cognitive schizophrenia-like symptoms. We report a case of a chronic oral consumption of ketamine which induced agitation, behavioral abnormalities, and loss of contact with reality in a poly-drug abuser; these symptoms persisted more than two weeks after the drug consumption had stopped. Antipsychotic treatment with paliperidone led to a successful management of the psychosis, getting a complete resolution of the clinical picture. Paliperidone has proven to be very effective in the treatment of ketamine-induced disorders. Moreover, the pharmacological action and metabolism of paliperidone are poorly dependent from the activity of liver enzymes, so that it seems to be one of the best second generation antipsychotics for the treatment of smokers and alcohol abusers.

  8. Paliperidone palmitate once-monthly reduces risk of relapse of psychotic, depressive, and manic symptoms and maintains functioning in a double-blind, randomized study of schizoaffective disorder.

    Science.gov (United States)

    Fu, Dong-Jing; Turkoz, Ibrahim; Simonson, R Bruce; Walling, David P; Schooler, Nina R; Lindenmayer, Jean-Pierre; Canuso, Carla M; Alphs, Larry

    2015-03-01

    Schizoaffective disorder is a complex illness for which optimal treatment is not well established. Results of the first controlled, relapse-prevention study of paliperidone palmitate once-monthly injectable (paliperidone monthly) in schizoaffective disorder are presented. The study was conducted between September 20, 2010, and October 22, 2013. Patients with schizoaffective disorder (confirmed by the Structured Clinical Interview for DSM-IV Axis I Disorders) experiencing acute exacerbation of psychotic and depressive/manic symptoms were stabilized with paliperidone monthly as monotherapy or as adjunctive therapy to mood stabilizers or antidepressants and randomly assigned (1:1) to paliperidone monthly or placebo in a 15-month, double-blind, relapse-prevention phase. Randomization was stratified by administration as monotherapy or adjunctive therapy and by study center. The primary endpoint was time to relapse. 334 patients were evaluated. Paliperidone monthly significantly delayed time to relapse for psychotic, depressive, and manic symptoms compared with placebo (P schizoaffective disorder (5.9%, 3.0%), headache (3.5%, 5.5%), and nasopharyngitis (3.5%, 5.5%). Incidence of any extrapyramidal-related adverse event was 7.1% for placebo and 8.5% for paliperidone monthly. Paliperidone monthly as monotherapy or adjunctive therapy significantly delayed psychotic, depressive, and/or manic relapses; reduced their risk; and better maintained functioning in patients with schizoaffective disorder. Results support the value of maintenance treatment with paliperidone monthly in schizoaffective disorder. ClinicalTrials.gov identifier: NCT01193153. © Copyright 2015 Physicians Postgraduate Press, Inc.

  9. A critical appraisal of paliperidone long-acting injection in the treatment of schizoaffective disorder

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    Chue P

    2016-01-01

    Full Text Available Pierre Chue,1 James Chue2 1Department of Psychiatry, University of Alberta, 2Clinical Trials and Research Program, Edmonton, AB, Canada Abstract: Schizoaffective disorder (SCA is a chronic and disabling mental illness that presents with mixed symptoms of schizophrenia and affective disorders. SCA is recognized as a discrete disorder, but with greater heterogeneity and symptom overlap, leading to difficulty and delay in diagnosis. Although the overall prognosis is intermediate between schizophrenia and mood disorders, SCA is associated with higher rates of suicide and hospitalization than schizophrenia. No treatment guidelines exist for SCA, and treatment is frequently complex, involving off-label use and polypharmacy (typically combinations of antipsychotics, mood stabilizers, and antidepressants. Oral paliperidone extended-release was the first agent to be approved for the treatment of SCA. As in schizophrenia and bipolar disorder, adherence to oral medications is poor, further contributing to suboptimal outcomes. The use of an antipsychotic in a long-acting injection (LAI addresses adherence issues, thus potentially reducing relapse. Paliperidone palmitate represents the LAI formulation of paliperidone. In a long-term, double-blind, randomized, controlled trial of adult patients (n=334; intent-to-treat [ITT] with SCA, paliperidone long-acting injection (PLAI significantly delayed risk of relapse compared to placebo (hazard ratio 2.49, 95% confidence interval, 1.55–3.99; P<0.001. This study demonstrated the efficacy and safety of PLAI when used as either monotherapy or adjunctive therapy for the maintenance treatment of SCA. The results are consistent with a similarly designed study conducted in patients with schizophrenia, which suggests a benefit in the long-term control of not only psychotic but also affective symptoms. No new safety signals were observed. When used in monotherapy, PLAI simplifies treatment by reducing complex

  10. Effects of paliperidone extended release on hostility among Thai patients with schizophrenia

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    Jariyavilas A

    2017-01-01

    Full Text Available Apichat Jariyavilas,1 Nuntika Thavichachart,2 Ronnachai Kongsakon,3 Sunanta Chantakarn,4 Suwanna Arunpongpaisal,5 Vasu Chantarasak,6 Piyadit Jaroensook,7 Khanogwan Kittiwattanagul,8 Osot Nerapusee9 1Srithanya Hospital, Department of Mental Health, Ministry of Public Health, Bangkok, 2Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, 3Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Bangkok, 4Department of Psychiatry, Faculty of Medicine, Siriraj Hospital, Bangkok, 5Department of Psychiatry, Faculty of Medicine, Khon Kaen University, Khon Kaen, 6Somdetchaopraya Institute of Psychiatry, Bangkok, 7Prasrimahabhodhi Hospital, Ubon Ratchathani, 8Khon Kaen Rajanagarindra Psychiatric Hospital, Khon Kaen, 9Medical Affairs, Janssen-Cilag, Bangkok, Thailand Objective: This open-label prospective study investigated the effects of paliperidone extended release (ER on hostility in Thai patients with schizophrenia. Background: Patients diagnosed with schizophrenia may be hostile or exhibit aggressive behavior, which can occasion their admission to psychiatric hospital. Antipsychotic medications are often used to treat hostility and aggression in such patients. Paliperidone ER is effective and well tolerated in the treatment of schizophrenia. However, there are no data available for paliperidone ER with regard to its efficacy on hostility and aggression among Thai patients. This study was a part of the PERFEcT study, a 6-month, open-label, multicenter, multicountry, prospective trial to explore the safety, efficacy, and functionality of paliperidone ER tablets. The current study included only the data obtained from Thai participants. Materials and methods: Flexible dosing of paliperidone ER in a range of 3–12 mg/day was used, allowing investigators to adjust the dosage of each subject individually. The 199 Thai patients had a stable Clinical Global Impression – severity score before enrollment. Demographic

  11. Rats and rabbits as pharmacokinetic screening tools for long acting intramuscular depots: case study with paliperidone palmitate suspension.

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    Patel, Harilal; Patel, Prakash; Modi, Nirav; Patel, Pinakin; Wagh, Yogesh; George, Alex; Desai, Nirmal; Srinivas, Nuggehally R

    2018-05-08

    Development of prodrug of 9-hydroxyrisperidone (paliperidone) long-acting intramuscular injection has enabled delivery over four-week time period with improved compliance. The key aim of this work was to establish a reliable preclinical model which may potentially serve as a screening tool for judging the pharmacokinetics of paliperidone formulation(s) prior to human clinical work. Sparse sampling composite study was used in rats, (Wistar/Sprague-Dawley (SD; n = 10)) and a serial blood sampling study design was used in rabbits (n = 4). Animals received intramuscular injection of paliperidone palmitate in the thigh muscle at dose of 16 (rats) and 4.5 mg/kg (rabbits). Samples were drawn in rats (retro-orbital sinus) and rabbits (central ear artery) and were analysed for paliperidone using liquid chromatography-mass spectrometry/ mass spectrometry (LC-MS/MS) assay. The plasma data was subjected to pharmacokinetic analysis. Following intramuscular injection of depot formulation in Wistar/SD rats and rabbits, absorption of paliperidone was slow and gradual with median value of time to reach maximum concentration (T max ) occurring on day 7. The exposures (i.e. area under the curve (AUC; 0-28) days) were 18,597, 21,865 and 18,120 ng.h/mL, in Wistar, SD and rabbits, respectively. The clearance was slow and supported long half-life (8-10 days). Either one of the two models can serve as a research tool for establishing pharmacokinetics of paliperidone formulation(s).

  12. Role of paliperidone extended-release in treatment of schizoaffective disorder.

    Science.gov (United States)

    Canuso, Carla M; Turkoz, Ibrahim; Fu, Dong Jing; Bossie, Cynthia A

    2010-10-05

    Schizoaffective disorder is characterized by the presence of symptoms of both schizophrenia and a major mood disorder. The coexistence of these symptoms can be difficult to manage, and these patients are generally treated with antipsychotics as well as mood stabilizers and/or antidepressants. Additionally, no established treatment guidelines exist for this disorder. This review describes the combined results of two international, double-blind, placebo-controlled clinical studies of paliperidone extended-release (ER), an atypical antipsychotic recently approved in the US for the treatment of schizoaffective disorder. Subjects in these six-week trials were aged 18-65 years, had a diagnosis of schizoaffective disorder based on the Structural Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition) Disorders, and were experiencing an acute exacerbation. The subjects from these studies had significant symptomatology as evidenced by a mean (standard deviation) baseline Positive and Negative Syndrome Scale total score of 92.8 (13.0). Based on Young Mania Rating Scale and/or a 21-item Hamilton Rating Scale for Depression score of ≥16 at baseline, 79.5% and 66.9% of subjects presented with prominent manic and depressive symptoms, respectively, and 46.4% presented with mixed symptoms. Approximately half (45%) of subjects were taking adjunctive mood stabilizers and/or antidepressants. Paliperidone ER was found to be effective in improving psychotic and mood symptoms in these subjects. Paliperidone ER was also effective as monotherapy or adjunctive to mood stabilizers and/or antidepressants for subjects with prominent manic, depressive, or mixed symptoms at baseline. No new tolerability signals were observed in this population. To the best of our awareness, these pooled data provide the largest data set of patients with schizoaffective disorder, and extend our knowledge of disease characteristics and treatment response.

  13. Recovery outcomes of schizophrenia patients treated with paliperidone palmitate in a community setting: patient and provider perspectives on recovery.

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    Williams, Wesley; McKinney, Christopher; Martinez, Larry; Benson, Carmela

    2016-01-01

    This study evaluated the effect of paliperidone palmitate long-acting injectable (LAI) antipsychotic on recovery-oriented mental health outcomes from the perspective of healthcare providers and patients during the treatment of patients with schizophrenia or schizoaffective disorders. Archival data for patients with a primary diagnosis of schizophrenia or schizoaffective disorder receiving ≥6 months of paliperidone palmitate LAI were retrieved from the electronic medical records system at the Mental Health Center of Denver. Mental health recovery was assessed from both a provider's (Recovery Markers Inventory [RMI]) and patient's (Consumer Recovery Measure [CRM]) perspective. A three-level hierarchical linear model (HLM) was utilized to determine changes in CRM and RMI scores by including independent variables in the models: intercept, months from treatment (slope), treatment time period (pretreatment and treatment), age, gender, primary diagnosis, substance abuse diagnosis, concurrent medications, and adherence to paliperidone palmitate LAI. A total of 219 patients were identified and included in the study. Results of the final three-level HLMs indicated an overall increase in CRM scores (p a retrospective, non-comparative design, and did not adjust for multiplicity Conclusions: The current study demonstrates that changes in recovery-oriented mental health outcomes can be detected following the administration of a specific antipsychotic treatment in persons with schizophrenia or schizoaffective disorders. Furthermore, patients receiving paliperidone palmitate LAI can effectively improve recovery-oriented outcomes, thereby supporting the drug's use as schizophrenia treatment from a recovery-oriented perspective.

  14. Cost Effectiveness of Paliperidone Long-Acting Injectable Versus Other Antipsychotics for the Maintenance Treatment of Schizophrenia in France.

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    Druais, Sylvain; Doutriaux, Agathe; Cognet, Magali; Godet, Annabelle; Lançon, Christophe; Levy, Pierre; Samalin, Ludovic; Guillon, Pascal

    2016-04-01

    French clinical recommendations suggest prescribing long-acting injectable (LAI) antipsychotics to patients with a maintenance treatment indication in schizophrenia. Despite this, and due to their relatively high acquisition and administration costs, LAIs are still underused in clinical practice in France, thus highlighting the need for pharmacoeconomic evaluations. Our objective was to estimate the cost effectiveness of paliperidone LAI (or paliperidone palmitate), a once-monthly second-generation LAI antipsychotic, compared with the most common antipsychotic medications for the maintenance treatment of schizophrenia in France. A Markov model was developed to simulate the progression of a cohort of schizophrenic patients through four health states (stable treated, stable non-treated, relapse and death) and to consider up to three lines of treatment to account for changes in treatment management. Paliperidone LAI was compared with risperidone LAI, aripiprazole LAI, olanzapine LAI, haloperidol LAI (or haloperidol decanoate) and oral olanzapine. Costs, quality-adjusted life-years (QALYs) and number of relapses were assessed over 5 years based on 3-month cycles with a discount rate of 4% and from a French health insurance perspective. Patients were considered to be stabilised after a schizophrenic episode and would enter the model at an initiation phase, followed by a prevention of relapse phase if successful. Data (e.g. relapse or discontinuation rates) for the initiation phase came from randomised clinical trials, whereas relapse rates in the prevention phase were derived from hospitalisation risks based on real-life French data to capture adherence effects. Safety and utility data were derived from international publications. Additionally, costs were retrieved from French health insurance databases and publications. Finally, expert opinion was used for validation purposes or in case of gaps in data. The robustness of results was assessed through deterministic and

  15. [Study of Flexible Doses of Paliperidone ER in Pacients with Schizophrenia who Have Undergone Inefficient Treatment with other Antipsychotics].

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    Córdoba, Rodrigo; Cano, Juan Fernando; Arango-Dávila, César Augusto; Miranda, Carlos; Holguín, Jorge; Fernández, Darío; Márquez, Miguel; Lupo, Christian; Gargoloff, Pedro; Petracca, Gustavo; Lucchetti, César

    2012-06-01

    Extended-release (ER) paliperidone is an innovative atypical antipsychotic that allows minimal peak-to-through fluctuations with once-daily dosing. To evaluate effectiveness, safety and tolerability of flexible, once-daily doses of paliperidone ER (3-12 mg/day) in patients with schizophrenia from Argentina and Colombia who had previously failed treatment with other antipsychotic agents. The authors conducted a 6-month, open-label, prospective and multicentric study. Effectiveness was assessed with Positive and Negative Syndrome Scale (PANSS) and Personal and Social Performance scale (PSP). Other measures of effectiveness, safety and tolerability, were also conducted. Paliperidone ER 3-12 mg/day improved Positive and Negative Syndrome Scale (PANSS) total scores (primary endpoint) from baseline to study end (p < 0,001). In the PANSS total score, the mean change from baseline (83, 9 units) to end point (53,7 units) was significant (p < 0,001). Flexible doses of paliperidone ER demonstrated a ≥20% reduction in the PANSS total score (p<0.001) in almost two-thirds of patients. PSP mean change from baseline (52 units) to end point (85 units) was significant (p < 0,001). Secondary effectiveness assessments, as well as safety and tolerability measures, demonstrated favourable results throughout the study. Flexible doses of paliperidone ER over 6 months were effective, safe and well tolerated in patients with schizophrenia from Argentina and Colombia. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  16. Lithium carbonate as a treatment for paliperidone extended-release-induced leukopenia and neutropenia in a patient with schizoaffective disorder; a case report.

    Science.gov (United States)

    Matsuura, Hiroki; Kimoto, Sohei; Harada, Izumi; Naemura, Satoshi; Yamamuro, Kazuhiko; Kishimoto, Toshifumi

    2016-05-26

    Antipsychotic drug treatment can potentially lead to adverse events such as leukopenia and neutropenia. Although these events are rare, they represent serious and life-threatening hematological side effects. We present a case study of a patient with schizoaffective disorder in a 50-year-old woman. We report a case of paliperidone extended-release (ER)-induced leukopenia and neutropenia in a female patient with schizoaffective disorder. Initiating lithium carbonate treatment and decreasing the dose of valproic acid improved the observed leukopenia and neutropenia. This treatment did not influence psychotic symptoms. The combination of paliperidone ER and valproic acid induces increased paliperidone ER plasma levels. Lithium carbonate was successfully used to treat paliperidone ER-induced leukopenia and neutropenia.

  17. Number needed to treat and number needed to harm with paliperidone palmitate relative to long-acting haloperidol, bromperidol, and fluphenazine decanoate for treatment of patients with schizophrenia

    Directory of Open Access Journals (Sweden)

    Srihari Gopal

    2011-03-01

    Full Text Available Srihari Gopal1, Joris Berwaerts1, Isaac Nuamah1, Kasem Akhras2, Danielle Coppola1, Ella Daly1, David Hough1, Joseph Palumbo11Johnson & Johnson Pharmaceutical Research & Development, LLC, Raritan, NJ, USA; 2Johnson & Johnson Pharmaceutical Services, LLC, Raritan, NJ, USABackground: We analyzed data retrieved through a PubMed search of randomized, placebo-controlled trials of first-generation antipsychotic long-acting injectables (haloperidol decanoate, bromperidol decanoate, and fluphenazine decanoate, and a company database of paliperidone palmitate, to compare the benefit-risk ratio in patients with schizophrenia.Methods: From the eight studies that met our selection criteria, two efficacy and six safety parameters were selected for calculation of number needed to treat (NNT, number needed to harm (NNH, and the likelihood of being helped or harmed (LHH using comparisons of active drug relative to placebo. NNTs for prevention of relapse ranged from 2 to 5 for paliperidone palmitate, haloperidol decanoate, and fluphenazine decanoate, indicating a moderate to large effect size.Results: Among the selected maintenance studies, NNH varied considerably, but indicated a lower likelihood of encountering extrapyramidal side effects, such as akathisia, tremor, and tardive dyskinesia, with paliperidone palmitate versus placebo than with first-generation antipsychotic depot agents versus placebo. This was further supported by an overall higher NNH for paliperidone palmitate versus placebo with respect to anticholinergic use and Abnormal Involuntary Movement Scale positive score. LHH for preventing relapse versus use of anticholinergics was 15 for paliperidone palmitate and 3 for fluphenazine decanoate, favoring paliperidone palmitate.Conclusion: Overall, paliperidone palmitate had a similar NNT and a more favorable NNH compared with the first-generation long-acting injectables assessed.Keywords: long-acting injectables, first-generation antipsychotics

  18. Paliperidone extended-release: does it have a place in antipsychotic therapy?

    Directory of Open Access Journals (Sweden)

    Carlos Schönfeldt-Lecuona

    2011-03-01

    Full Text Available Maximilian Gahr1,*, Markus A Kölle1,*, Carlos Schönfeldt-Lecuona1, Peter Lepping2, Roland W Freudenmann11Department of Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany; 2Department of Psychiatry, Glyndwr University, Wales, UK *Both authors contributed equally and their order was determined by coin toss.Abstract: Paliperidone (9-hydroxy-risperidone, the active metabolite of risperidone, was approved for treating schizophrenia worldwide in 2006 as paliperidone extended-release (PER, and became the first second-generation antipsychotic specifically licensed for treating schizoaffective disorder in 2009. However, at the same time, its comparatively high cost gave rise to concerns about the cost-effectiveness of PER as compared with its precursor, risperidone. This paper reviews the existing knowledge of the pharmacology, kinetics, efficacy, tolerability, and fields of application of PER, and compares PER with risperidone in order to determine whether it has a place in antipsychotic therapy. An independent assessment of all relevant publications on PER published until July 2010 was undertaken. PER has a unique pharmacological profile, including single dosing, predominantly renal excretion, low drug–drug interaction risk, and differs from risperidone in terms of mode of action and pharmacokinetics. High-level evidence suggests that PER is efficacious and safe in schizophrenia, schizoaffective disorder, and acute manic episodes. There is a striking lack of published head-to-head comparisons between PER and risperidone, irrespective of indication. Low-level evidence shows a lower risk for hyperprolactinemia and higher patient satisfaction with PER than with risperidone. PER adds to the still limited arsenal of second-generation antipsychotics. In the absence of direct comparisons with risperidone, it remains difficult to come to a final verdict on the potential additional therapeutic benefits of PER which would justify its substantially

  19. Cost-effectiveness of 3-month paliperidone treatment for chronic schizophrenia in Spain.

    Science.gov (United States)

    Einarson, Thomas R; Bereza, Basil G; Garcia Llinares, Ignacio; González Martín Moro, Beatriz; Tedouri, Fadi; Van Impe, Kristel

    2017-10-01

    A 3-month long treatment of paliperidone palmitate (PP3M) has been introduced as an option for treating schizophrenia. Its cost-effectiveness in Spain has not been established. To compare the costs and effects of PP3M compared with once-monthly paliperidone (PP1M) from the payer perspective in Spain. This study used the recently published trial by Savitz et al. as a core model over 1 year. Additional data were derived from the literature. Costs in 2016 Euros were obtained from official lists and utilities from Osborne et al. The authors conducted both cost-utility and cost-effectiveness analyses. For the former, the incremental cost per quality-adjusted life-year (QALY) gained was calculated. For the latter, the outcomes were relapses and hospitalizations avoided. To assure the robustness of the analyses, a series of 1-way and probability sensitivity analyses were conducted. The expected cost was lower with PP3M (4,780€) compared with PP1M (5,244€). PP3M had the fewest relapses (0.080 vs 0.161), hospitalizations (0.034 v.s 0.065), and emergency room visits (0.045 v.s 0.096) and the most QALYs (0.677 v.s 0.625). In both cost-effectiveness and cost-utility analyses, PP3M dominated PP1M. Sensitivity analyses confirmed base case findings. For the primary analysis (cost-utility), PP3M dominated PP1M in 46.9% of 10,000 simulations and was cost-effective at a threshold of 30,000€/QALY gained. PP3M dominated PP1M in all analyses and was, therefore, cost-effective for treating chronic relapsing schizophrenia in Spain. For patients who require long-acting therapy, PP3M appears to be a good alternative anti-psychotic treatment.

  20. Tolerability and efficacy of paliperidone ER compared to olanzapine in the treatment of schizophrenia: A randomized, double-blind, multicentric trial

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    Sandip Shah

    2011-01-01

    Full Text Available Background: Paliperidone is an active metabolite of risperidone and actss through a combination of central dopamine Type 2 (D2 and serotonin Type 2 (5HT2A receptor antagonism. Aim: The present randomized, double-blind, multicentric trial was designed to determine the safety and efficacy of paliperidone extended release (ER compared to olanzapine in the treatment of acute schizophrenia. Materials and Methods: A total of 214 patients with diagnosis of schizophrenia were randomized to paliperidone ER (n=109 and olanzapine (n=106 treatment groups. Totally 206 patients were evaluated for efficacy parameters using Positive and negative syndrome scale (PANSS score and Clinical Global Impression-severity of illness (CGI-S and Clinical Global Impression-improvement of illness (CGI-I scales. Safety was assessed by treatment-emergent adverse events and movement disorders. Results: All patients showed significant reduction in PANSS scores at the end of treatment. However, the results were comparable and there was no significant difference at the end of the trial between paliperidone ER group and olanzapine group. Both the treatment groups showed decrease in the severity of illness and improvement in symptomatology. The most common adverse events reported in paliperidone ER versus olanzapine group were Extra Pyramidal Syndrome (EPS (13.7% vs. 15.6%, headache (12.7% vs. 8.9%, increased appetite (8.8% vs. 10.0% and drowsiness (4.9% vs. 303%. There was no clinically relevant difference in change from baseline to the end of the trial in abnormal involuntary movement scale (AIMS and barnes akathisia rating scale (BARS total scores between both the groups. Conclusion: Paliperidone ER is effective in controlling schizophrenic symptoms as well as exhibits comparable tolerability profile. Thus, paliperidone ER has the potential to be a useful new treatment option for patients with schizophrenia.

  1. A Flexible-Dose Study of Paliperidone ER in Patients With Nonacute Schizophrenia Previously Treated Unsuccessfully With Oral Olanzapine.

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    Kotler, Moshe; Dilbaz, Nesrin; Rosa, Fernanda; Paterakis, Periklis; Milanova, Vihra; Smulevich, Anatoly B; Lahaye, Marjolein; Schreiner, Andreas

    2016-01-01

    The goal of this study was to explore the tolerability, safety, and treatment response of switching from oral olanzapine to paliperidone extended release (ER). Adult patients with nonacute schizophrenia who had been treated unsuccessfully with oral olanzapine were switched to flexible doses of paliperidone ER (3 to 12 mg/d). The primary efficacy outcome was a ≥ 20% improvement in Positive and Negative Syndrome Scale (PANSS) total scores from baseline to endpoint for patients who switched medications because of lack of efficacy with olanzapine and noninferiority versus previous olanzapine treatment (mean endpoint change in PANSS total scores vs. baseline of ≤ 5 points) for patients who switched for reasons other than lack of efficacy. Safety and tolerability were assessed by monitoring adverse events, extrapyramidal symptoms, and weight change. Of 396 patients, 65.2% were men, mean age was 40.0 ± 12.0 years, and 75.5% had paranoid schizophrenia. Among the patients whose main reason for switching was lack of efficacy, an improvement in the PANSS total score of ≥ 20% occurred in 57.4% of patients. Noninferiority was confirmed for each subgroup of patients whose main reason for switching was something other than lack of efficacy. Paliperidone ER was generally well tolerated. Extrapyramidal symptoms as measured by total Extrapyramidal Symptom Rating Scale scores showed statistically significant and clinically relevant improvements at endpoint, the average weight decreased by 0.8 ± 5.2 kg at endpoint, and a clinically relevant weight gain of ≥ 7% occurred in 8.0% of patients. Paliperidone ER flexibly-dosed over 6 months was well tolerated and associated with a meaningful clinical response in patients with nonacute schizophrenia who had previously been unsuccessfully treated with oral olanzapine.

  2. The Direct and Indirect Effects of Paliperidone Extended-release on Depressive Symptoms in Schizoaffective Disorder: A Path Analysis.

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    Turkoz, Ibrahim; Fu, Dong-Jing; Bossie, Cynthia A; Alphs, Larry

    2015-01-01

    This analysis evaluates improvement in symptoms of depression in patients with schizoaffective disorder administered oral paliperidone extended-release by accounting for the magnitude of direct and indirect (changes in negative and positive symptoms and worsening of extrapyramidal symptoms) treatment effects on depressive symptoms. Data for this post hoc analysis were drawn from two six-week, randomized, placebo-controlled studies of paliperidone extended-release versus placebo in adult subjects with schizoaffective disorder (N=614; NCT00412373, NCT00397033). Subjects with baseline 17-item Hamilton Rating Scale for Depression scores of 16 or greater were included. Structural equation models (path analyses) were used to separate total effects into direct and indirect effects on depressive symptoms. Change from baseline in 17-item Hamilton Rating Scale for Depression score at the Week 6 end point was the dependent variable; changes in Positive and Negative Syndrome Scale positive and negative factors and Simpson-Angus Scale (to evaluate extrapyramidal symptoms) scores were independent variables. At baseline, 332 of 614 (54.1%) subjects had a 17-item Hamilton Rating Scale for Depression score of 16 or greater. Path analysis determined that up to 26.4 percent of the paliperidone extended-release versus placebo effect on depressive symptoms may be attributed to a direct treatment effect, and 45.8 percent and 28.4 percent were mediated indirectly through improvements on positive and negative symptoms, respectively. No effects were identified as mediated through extrapyramidal symptoms changes (-0.7%). RESULTS of this analysis suggest that paliperidone's effect on depressive symptoms in subjects with schizoaffective disorder participating in two six-week, randomized, placebo-controlled studies is mediated through indirect effects (e.g., positive and negative symptom changes) and a direct treatment effect.

  3. Paliperidone Injection

    Science.gov (United States)

    ... Invega Sustenna, Invega Trinza) are used to treat schizophrenia (a mental illness that causes disturbed or unusual ... may help control your symptoms but will not cure your condition. Continue to keep appointments to receive ...

  4. Delirium with anticholinergic symptoms after a combination of paliperidone and olanzapine pamoate in a patient known to smoke cannabis: an unfortunate coincidence.

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    Kokalj, Anja; Rijavec, Nikolina; Tavčar, Rok

    2016-06-22

    We report a case of delirium with anticholinergic symptoms in a 19-year-old female patient with schizophrenia. On the day the symptoms emerged, the patient received olanzapine long-acting injection and a higher dose of paliperidone. We observed symptoms ranging from confusion to delirium as well as some anticholinergic symptoms. The delirium lasted 24 hours and was managed by intravenous fluid substitution and oral benzodiazepines. Olanzapine pamoate, paliperidone and cannabis are central nervous system (CNS) depressants, and their combination can increase the risks of CNS depression. In this case report, we review the symptoms of delirium in a case of antipsychotic overdose and provide general guidelines for managing these symptoms. We also review possible complications in combined use of cannabis, olanzapine and paliperidone. 2016 BMJ Publishing Group Ltd.

  5. Critical appraisal of 3-monthly paliperidone depot injections in the treatment of schizophrenia

    Directory of Open Access Journals (Sweden)

    Carpiniello B

    2016-05-01

    Full Text Available Bernardo Carpiniello, Federica Pinna Department of Public Health, Clinical and Molecular Medicine – Psychiatry Research Unit and Psychiatric Clinic, University Hospital, Cagliari, Italy Aims: Three-monthly injections of paliperidone palmitate (PP-3M represent a new and recently introduced long-acting antipsychotic therapeutic option. This review focuses on available data relating to the efficacy and safety of PP-3M and its position in the current therapeutic scenario.Method: An analysis of PubMed, Scopus, and ISI Web of Knowledge databases was conducted, and all available papers on PP-3M, including poster presentations, were selected and considered for the purpose of the present review. Findings: to date, three full papers have been published, the first, a Phase 1 randomized, open label study investigating the pharmacokinetics, safety, and tolerability of the drug; the second, a Phase 3 double blind study vs placebo focusing on efficacy and tolerability; and the last relating to the practical use of PP-3M. The five posters identified describe data reported in the above-cited papers. Overall, the pharmacokinetic findings obtained in these studies highlight the feasibility of administering PP-3M on a 3-monthly basis, subsequent to the administration of four 1-monthly injections of PP at doses 3.5 times higher than the stabilized dose of 1-monthly injections of PP (ie, 175, 300, 450, and 525 mgs. The published studies highlight a significantly longer time to relapse compared to placebo, and significantly better results compared to placebo for all secondary end-points (Positive and Negative Syndrome Scale, Clinical Global Impression-Severity Scale, Personal and Social Performance Scale scores, in addition to reasonably good safety and tolerability profiles.Conclusion: PP-3M emerges as a potential candidate for use as a first-line long-acting agent in the maintenance treatment of patients with schizophrenia. Further studies should however be

  6. Item Response Theory to Quantify Longitudinal Placebo and Paliperidone Effects on PANSS Scores in Schizophrenia.

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    Krekels, Ehj; Novakovic, A M; Vermeulen, A M; Friberg, L E; Karlsson, M O

    2017-08-01

    As biomarkers are lacking, multi-item questionnaire-based tools like the Positive and Negative Syndrome Scale (PANSS) are used to quantify disease severity in schizophrenia. Analyzing composite PANSS scores as continuous data discards information and violates the numerical nature of the scale. Here a longitudinal analysis based on Item Response Theory is presented using PANSS data from phase III clinical trials. Latent disease severity variables were derived from item-level data on the positive, negative, and general PANSS subscales each. On all subscales, the time course of placebo responses were best described with Weibull models, and dose-independent functions with exponential models to describe the onset of the full effect were used to describe paliperidone's effect. Placebo and drug effect were most pronounced on the positive subscale. The final model successfully describes the time course of treatment effects on the individual PANSS item-levels, on all PANSS subscale levels, and on the total score level. © 2017 The Authors CPT: Pharmacometrics & Systems Pharmacology published by Wiley Periodicals, Inc. on behalf of American Society for Clinical Pharmacology and Therapeutics.

  7. Treatment satisfaction with paliperidone extended-release tablets: open-label study in schizophrenia patients dissatisfied with previous antipsychotic medication

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    Yang FD

    2017-04-01

    Full Text Available Fu De Yang,1 Juan Li,1 Yun Long Tan,1 Wei Ye Liang,1 Rongzhen Zhang,1 Ning Wang,1 Wei Feng,1 Shangli Cai,2 Jian Min Zhuo,2 Li Li Zhang2 1Beijing Hui-Long-Guan Hospital, 2Department of Medical Affairs, Xian Janssen Pharmaceutical Ltd, Beijing, People’s Republic of China Objective: The aim of this study was to evaluate the changes in treatment satisfaction after switching to paliperidone extended-release (ER in Chinese schizophrenia patients dissatisfied with their previous antipsychotic treatment.Methods: In this 8-week, open-label, single-arm, multicenter, prospective study, 1,693 patients dissatisfied with previous antipsychotic medication were enrolled and switched to paliperidone ER tablets (3–12 mg/d based on clinical judgment. The primary efficacy end point was change in Medication Satisfaction Questionnaire (MSQ score from baseline to week 8. The secondary end points included percentage of patients with MSQ score ≥4, as well as changes in Clinical Global Improvement-Severity (CGI-S and Personal and Social Performance (PSP scores.Results: MSQ scores increased significantly from baseline (mean [standard deviation {SD}]: 2.48 [0.55] to week 8 (5.47 [0.89], P<0.0001; primary end point, full analysis set. The percentage of patients with MSQ score ≥4 was 95.9% at week 8, indicating that most of the patients were satisfied with their treatment. Significant (P<0.0001 improvements from baseline to week 8 were noted in CGI-S score (2.37 [1.20] and PSP score (25.5 [15.0]. A total of 174 (10.28% patients experienced adverse events (AEs. The most common (>10 patients events were extrapyramidal disorder (n=84, 4.96%, poor quality sleep (n=18, 1.06% and akathisia (n=13, 0.77%. The majority of AEs were mild to moderate in severity. No deaths occurred.Conclusion: Treatment satisfaction improved after switching to paliperidone ER from the previous antipsychotic in Chinese patients with schizophrenia. Keywords: atypical antipsychotics, open label

  8. Onset of efficacy and tolerability following the initiation dosing of long-acting paliperidone palmitate: post-hoc analyses of a randomized, double-blind clinical trial

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    Fu Dong-Jing

    2011-05-01

    Full Text Available Abstract Background Paliperidone palmitate is a long-acting injectable atypical antipsychotic for the acute and maintenance treatment of adults with schizophrenia. The recommended initiation dosing regimen is 234 mg on Day 1 and 156 mg on Day 8 via intramuscular (deltoid injection; followed by 39 to 234 mg once-monthly thereafter (deltoid or gluteal. These post-hoc analyses addressed two commonly encountered clinical issues regarding the initiation dosing: the time to onset of efficacy and the associated tolerability. Methods In a 13-week double-blind trial, 652 subjects with schizophrenia were randomized to paliperidone palmitate 39, 156, or 234 mg (corresponding to 25, 100, or 150 mg equivalents of paliperidone, respectively or placebo (NCT#00590577. Subjects randomized to paliperidone palmitate received 234 mg on Day 1, followed by their randomized fixed dose on Day 8, and monthly thereafter, with no oral antipsychotic supplementation. The onset of efficacy was defined as the first timepoint where the paliperidone palmitate group showed significant improvement in the Positive and Negative Syndrome Scale (PANSS score compared to placebo (Analysis of Covariance [ANCOVA] models and Last Observation Carried Forward [LOCF] methodology without adjusting for multiplicity using data from the Days 4, 8, 22, and 36 assessments. Adverse event (AE rates and relative risks (RR with 95% confidence intervals (CI versus placebo were determined. Results Paliperidone palmitate 234 mg on Day 1 was associated with greater improvement than placebo on Least Squares (LS mean PANSS total score at Day 8 (p = 0.037. After the Day 8 injection of 156 mg, there was continued PANSS improvement at Day 22 (p ≤ 0.007 vs. placebo and Day 36 (p Conclusions Significantly greater symptom improvement was observed by Day 8 with paliperidone palmitate (234 mg on Day 1 compared to placebo; this effect was maintained after the 156 mg Day 8 injection, with a trend towards a dose

  9. Hospitalizations and economic analysis in psychotic patients with paliperidone palmitate long-acting injection.

    Science.gov (United States)

    Mesones-Peral, Jesús E; Gurillo-Muñoz, Pedro; Sánchez-Sicilia, Mari Paz; Miller, Adam; Griñant-Fernández, Alejandra

    Prevent hospitalizations in psychotic disorders is an important aim, so long-acting antipsychotic is a good option that can control better the correct adherence. Moreover, in the current economic context pharmacoeconomic studies are necessary. We estimate the effect in prevention of paliperidone palmitate long-acting injection (PP-LAI) and calculate the economic cost in the 12 months preceding the start of treatment with PP-LAI and 12 months later. Mirror image study of 71 outpatients diagnosed with psychotic disorders and treated with PP-LAI. In a first analysis, we measured along one year: number of hospitalizations/year, number of hospitalization in days, number of emergency assists/year and if there is antipsychotics associated to long-acting treatment. After this phase, we applied Fees Act of Valencia for economic analysis and estimate of the cost per hospitalization (€ 5,640.41) and hospital emergency (€ 187.61). After one year of treatment with PP-LAI (mean dose=130.65mg/month), we obtained greater numbers in assistance variables: total hospitalizations decrease, 78.8% (P=.009); shortening in hospitalization days, 89.4% (P=.009); abridgement of number of emergency assists, 79.1% (P=.002); decrease of rate of antipsychotics associated to long-acting treatment, 21% (P<.0001); increase in monotherapy, 53.8% (P<.0001). Therefore, after 12 months of treatment with PP-LAI we obtained a reduction in inpatient spending (savings of € 175,766.54) and increased spending on antipsychotics 32% (equivalent to € 151,126.92). PP-LAI can be an effective therapy for the treatment of patients with severe psychotic disorders: improves symptomatic stability and can prevent hospitalizations with cost-effective symptom control. Copyright © 2016 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Costs and effects of paliperidone extended release compared with alternative oral antipsychotic agents in patients with schizophrenia in Greece: a cost effectiveness study.

    Science.gov (United States)

    Geitona, Maria; Kousoulakou, Hara; Ollandezos, Markos; Athanasakis, Kostas; Papanicolaou, Sotiria; Kyriopoulos, Ioannis

    2008-08-28

    To compare the costs and effects of paliperidone extended release (ER), a new pharmaceutical treatment for the management of schizophrenia, with the most frequently prescribed oral treatments in Greece (namely risperidone, olanzapine, quetiapine, aripiprazole and ziprasidone) over a 1-year time period. A decision tree was developed and tailored to the specific circumstances of the Greek healthcare system. Therapeutic effectiveness was defined as the annual number of stable days and the clinical data was collected from international clinical trials and published sources. The study population was patients who suffer from schizophrenia with acute exacerbation. During a consensus panel of 10 psychiatrists and 6 health economists, data were collected on the clinical practice and medical resource utilisation. Unit costs were derived from public sources and official reimbursement tariffs. For the comparators official retail prices were used. Since a price had not yet been granted for paliperidone ER at the time of the study, the conservative assumption of including the average of the highest targeted European prices was used, overestimating the price of paliperidone ER in Greece. The study was conducted from the perspective of the National Healthcare System. The data indicate that paliperidone ER might offer an increased number of stable days (272.5 compared to 272.2 for olanzapine, 265.5 f risperidone, 260.7 for quetiapine, 260.5 for ziprasidone and 258.6 for aripiprazole) with a lower cost compared to the other therapies examined (euro 7,030 compared to euro 7,034 for olanzapine, euro 7,082 for risperidone, euro 8,321 for quetiapine, euro 7,713 for ziprasidone and euro 7,807 for aripiprazole). During the sensitivity analysis, a +/- 10% change in the duration and frequency of relapses and the economic parameters did not lead to significant changes in the results. Treatment with paliperidone ER can lead to lower total cost and higher number of stable days in most of the

  11. Evaluation of sleep profile in schizophrenia patients treated with extended-release paliperidone: an open-label prospective study in Southeast Asia

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    Kongsakon R

    2017-10-01

    Full Text Available Ronnachai Kongsakon,1 Nuntika Thavichachart,2 Ka Fai Chung,3 Leslie Lim,4 Beverly Azucena,5 Elizabeth Rondain,6 Benson Go,7 Fe Costales,8 Osot Nerapusee9 1Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Department of Medicine, Division of Psychiatry, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand; 3Department of Psychiatry, University of Hong Kong, Hong Kong, People’s Republic of China; 4Department of Psychiatry, Singapore General Hospital, Singapore; 5National Center for Mental Health, Mandaluyong, Philippines; 6Makati Medical Center, Makati, Philippines; 7Northern Mindanao Medical Center, Cagayan De Oro, Misamis Oriental, Philippines; 8Perpetual Succour Hospital, Cebu, Philippines; 9Medical Affairs, Janssen‑Cilag, Bangkok, Thailand Objective: To evaluate the effect of 6 months of treatment with paliperidone extended-release (ER tablets on the sleep profile of patients with schizophrenia.Methods: A total of 984 patients meeting the The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV criteria for schizophrenia who switched their antipsychotic to paliperidone ER were recruited from 61 sites in five countries in Southeast Asia. We recorded patient demographics and assessed sleep quality and daytime drowsiness using visual analog scales.Results: Approximately 70% of patients completed the 6-month study. After the use of paliperidone ER, patients reported significantly better sleep quality (76.44 vs 65.48; p<0.001 and less daytime drowsiness compared with their baseline value (23.18 vs 34.22; p<0.001. Factors predicting sleep profile improvement were completion of the study and higher baseline Positive and Negative Syndrome Scale scores.Conclusion: Paliperidone ER can help schizophrenia patients to improve sleep quality and reduce daytime drowsiness; this was seen especially in the patients who completed the 6-month

  12. Efficacy and safety of paliperidone palmitate three-monthly formulation in East Asian patients with schizophrenia: subgroup analysis of a global, randomized, double-blind, Phase III, noninferiority study

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    Savitz AJ

    2017-08-01

    Full Text Available Adam J Savitz,1 Haiyan Xu,2 Srihari Gopal,1 Isaac Nuamah,2 Paulien Ravenstijn,3 David Hough,1 Maju Mathews,4 Yu Feng,5 Lu Yu,6 Masayoshi Takahashi,7 Dennis Liu,8 Gang Wang,9 Jin-Sang Yoon,10 Jiahn-Jyh Chen11 1Department of Central Nervous System, 2Department of Clinical Biostatistics, Janssen Research & Development, LLC, Titusville, NJ, USA; 3Department of Clinical Pharmacology, Janssen Research & Development, Beerse, Belgium; 4Global Medical Affairs, Neurosciences, Janssen Research & Development, NY, USA; 5Medical Affairs, Neurosciences, Janssen Pharmaceutical Companies of Johnson and Johnson, Singapore; 6Department of Clinical Development, Janssen Research & Development, Beijing, China; 7Department of Central Nervous System, Janssen Pharmaceutical KK, Tokyo, Japan; 8Playford Community Team, Northern Adelaide Local Health Network, Adelaide, SA, Australia; 9National Clinical Research Center for Mental Disorders, Beijing Anding Hospital, Affiliated Capital University of Medical Science, Beijing, China; 10Department of Psychiatry, Chonnam National University Hospital, Gwangju, South Korea; 11Department of Geriatric Psychiatry, Taoyuan Mental Hospital, Taoyuan, Taiwan Objective: To demonstrate the efficacy and safety of paliperidone palmitate three-monthly (PP3M formulation in an East Asian population with schizophrenia by subgroup analysis of a double-blind (DB, multicenter, noninferiority study. Patients and methods: Of 1,429 patients who entered the open-label (OL phase, 510 were East Asian (China: 296 [58%], Japan: 175 [34%], South Korea: 19 [4%] and Taiwan: 20 [4%]. In the 17-week OL phase, patients received paliperidone palmitate once-monthly (PP1M formulation on day 1 (150 mg eq., day 8 (100 mg eq. and once-monthly thereafter (50–150 mg eq., flexible. Following the OL phase, patients (n=344 East Asian entered DB phase and were randomized (1:1 to PP1M (n=174 or PP3M (n=170. Primary efficacy endpoint was the percentage of patients who

  13. Intramuscular administration of paliperidone palmitate extended-release injectable microsuspension induces a subclinical inflammatory reaction modulating the pharmacokinetics in rats.

    Science.gov (United States)

    Darville, Nicolas; van Heerden, Marjolein; Vynckier, An; De Meulder, Marc; Sterkens, Patrick; Annaert, Pieter; Van den Mooter, Guy

    2014-07-01

    The present study aims at elucidating the intricate nature of the drug release and absorption following intramuscular (i.m.) injection of sustained-release prodrug nanocrystals/microcrystals. A paliperidone palmitate (PPP) long-acting suspension was characterized with regard to particle size (Dv,50 = 1.09 μm) and morphology prior to i.m. injection in rats. The local disposition was rigorously investigated by means of (immuno)histochemistry and transmission electron microscopy while the concurrent multiphasic pharmacokinetics was linked to the microanatomy. A transient (24 h) trauma-induced inflammation promptly evolved into a subclinical but chronic granulomatous inflammatory reaction initiated by the presence of solid material. The dense inflammatory envelope (CD68(+) macrophages) led to particle agglomeration with subsequent drop in dissolution rate beyond 24 h postinjection. This was associated with a decrease in apparent paliperidone (PP) absorption (near-zero order) until 96 h and a delayed time of occurrence of observed maximum drug plasma concentration (168 h). The infiltrating macrophages phagocytosed large fractions of the depot, thereby influencing the (pro)drug release. Radial angiogenesis (CD31(+)) was observed throughout the inflammatory rim from 72 h onwards and presumably contributed to the sustained systemic PP concentrations by maintaining a sufficient absorptive capacity. No solid-state transitions of the retrieved formulation were recorded with X-ray diffraction analysis. In summary, the initial formulation-driven prodrug (PPP) dissolution and drug (PP) absorption were followed by a complex phase determined by the relative contribution of formulation factors and dynamic physiological variables. © 2014 Wiley Periodicals, Inc. and the American Pharmacists Association.

  14. Methodological challenges in indirect treatment comparisons: spotlight on a recent comparison of long-acting injectable aripiprazole versus paliperidone palmitate in the treatment of schizophrenia.

    Science.gov (United States)

    Singh, Arun; Gopal, Srihari; Kim, Edward; Mathews, Maju; Kern-Sliwa, Jennifer; Turkoz, Ibrahim; Wooller, Annette; Berlin, Jesse

    2018-03-01

    In a recent study, an indirect treatment comparison was performed to examine the relative efficacy and tolerability of aripiprazole once monthly and paliperidone palmitate once monthly. The authors concluded that the results may suggest relative advantages for aripiprazole once monthly over paliperidone palmitate once monthly in the short-term treatment of schizophrenia. However, the validity of the study is compromised as an indirect treatment comparison using extant data may violate important assumptions. Other methodological issues identified further highlight the challenges of performing indirect treatment comparisons.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/.

  15. Different effects of paliperidone and risperidone therapy on blood lipid and Hcy metabolism as well as endocrine hormones in patients with schizophrenia

    OpenAIRE

    Bei-Fang Fan; Ze-Hui Li; Shuo Yang; Cai-Hong Gao

    2017-01-01

    Objective: To explore the different effects of paliperidone and risperidone therapy on blood lipid and Hcy metabolism as well as endocrine hormones in patients with schizophrenia. Methods: A total of 118 patients with schizophrenia who were treated in the hospital between December 2014 and February 2017 were collected as the research subjects and divided into control group and study group by random number table, each group with 59 cases. Control group received risperidone thera...

  16. Estimated medical cost reductions for paliperidone palmitate vs placebo in a randomized, double-blind relapse-prevention trial of patients with schizoaffective disorder.

    Science.gov (United States)

    Joshi, K; Lin, J; Lingohr-Smith, M; Fu, D J

    2015-01-01

    The objective of this economic model was to estimate the difference in medical costs among patients treated with paliperidone palmitate once-monthly injectable antipsychotic (PP1M) vs placebo, based on clinical event rates reported in the 15-month randomized, double-blind, placebo-controlled, parallel-group study of paliperidone palmitate evaluating time to relapse in subjects with schizoaffective disorder. Rates of psychotic, depressive, and/or manic relapses and serious and non-serious treatment-emergent adverse events (TEAEs) were obtained from the long-term paliperidone palmitate vs placebo relapse prevention study. The total annual medical cost for a relapse from a US payer perspective was obtained from published literature and the costs for serious and non-serious TEAEs were based on Common Procedure Terminology codes. Total annual medical cost differences for patients treated with PP1M vs placebo were then estimated. Additionally, one-way and Monte Carlo sensitivity analyses were conducted. Lower rates of relapse (-18.3%) and serious TEAEs (-3.9%) were associated with use of PP1M vs placebo as reported in the long-term paliperidone palmitate vs placebo relapse prevention study. As a result of the reduction in these clinical event rates, the total annual medical cost was reduced by $7140 per patient treated with PP1M vs placebo. One-way sensitivity analysis showed that variations in relapse rates had the greatest impact on the estimated medical cost differences (range: -$9786, -$4670). Of the 10,000 random cycles of Monte Carlo simulations, 100% showed a medical cost difference schizoaffective disorder was associated with a significantly lower rate of relapse and a reduction in medical costs compared to placebo. Further evaluation in the real-world setting is warranted.

  17. In vivo analysis of torsadogenic potential of an antipsychotic drug paliperidone using the acute atrioventricular block rabbit as a proarrhythmia model

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    Mihoko Hagiwara

    2016-09-01

    Full Text Available We assessed electrophysiological effects of an atypical antipsychotic drug paliperidone in acute atrioventricular block rabbits. Intravenous administration of paliperidone at a clinically relevant dose (0.06 mg/kg hardly affected the QT interval or monophasic action potential (MAP duration, and the higher doses (0.6 and 6 mg/kg prolonged the QT interval and MAP duration. Meanwhile, premature ventricular contractions with R on T phenomenon were observed in 3 out of 6 animals at the middle dose, and torsades de pointes (TdP episodes were detected in 2 out of 6 animals at the high dose. Intravenous administration of its chemically related compound risperidone at a clinically relevant dose (0.03 mg/kg hardly affected the electrophysiological parameters, and the higher doses (0.3 and 3 mg/kg prolonged the QT interval and MAP duration. Meanwhile, the premature ventricular contractions with R on T were observed in 2 out of 6 animals at the middle dose, and TdP episodes were detected in 4 out of 6 animals at the high dose. These results suggest that paliperidone showed torsadogenic potential at supra-therapeutic doses, whose potency can be estimated to be equal or slightly subordinate in comparison with that of risperidone.

  18. Safety and efficacy of paliperidone palmitate 1-month formulation in Chinese patients with schizophrenia: a 25-week, open-label, multicenter, Phase IV study

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    Zhao JP

    2017-08-01

    Full Text Available Jingping Zhao,1,* Lehua Li,1,* Jianguo Shi,2 Yi Li,3 Xiufeng Xu,4 Keqing Li,5 Lili Zhang,6 Shangli Cai,6 Yu Feng,6 Jianmin Zhuo,6 Weihong Liu,6 Huafei Lu6 1Department of Psychiatry, The Mental Health Institute, The Second Xiangya Hospital of Central South University, 2Department of Psychiatry, Mental Health Center of Xi’an City, 3Department of Psychiatry, Mental Health Center of Wuhan City, 4Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, 5Department of Psychiatry, The Sixth People’s Hospital of Hebei Province, 6Department of Medical Affairs, Xi’an Janssen Pharmaceutical Ltd., Beijing, People’s Republic of China *These authors contributed equally to this work Rationale: Long-acting injectable (LAI paliperidone palmitate 1-month formulation (PP1M has demonstrated acceptable tolerability and favorable clinical outcomes in Western and Asian patients with schizophrenia. Hence, analysis of the outcomes of long-term PP1M treatment specifically in Chinese patients is of interest.Objective: The aim of this study is to evaluate the long-term safety and efficacy of PP1M treatment in Chinese patients with schizophrenia.Methods: In this 25-week, open-label, Phase IV study, patients (18–65 years diagnosed with schizophrenia and having a baseline Positive and Negative Syndrome Scale (PANSS total score of 60–120 (inclusive were enrolled. All patients received injections of PP1M 150 mg eq. (day 1 and 100 mg eq. (day 8, followed by a flexible once-monthly maintenance dosing (75, 100, or 150 mg eq..Results: Of the 353 patients, 234 (66.3% completed the study treatment (mean age, 31.1 years; 52.7% men. The PANSS total score (primary end point improved significantly over the 6-month treatment period (mean [standard deviation] change from baseline to end of treatment, -27.2 [18.30]; P<0.0001. The Clinical Global Impressions-Severity and Personal and Social Performance scores (secondary end points also improved

  19. Costs and effects of paliperidone extended release compared with alternative oral antipsychotic agents in patients with schizophrenia in Greece: A cost effectiveness study

    Directory of Open Access Journals (Sweden)

    Papanicolaou Sotiria

    2008-08-01

    Full Text Available Abstract Background To compare the costs and effects of paliperidone extended release (ER, a new pharmaceutical treatment for the management of schizophrenia, with the most frequently prescribed oral treatments in Greece (namely risperidone, olanzapine, quetiapine, aripiprazole and ziprasidone over a 1-year time period. Methods A decision tree was developed and tailored to the specific circumstances of the Greek healthcare system. Therapeutic effectiveness was defined as the annual number of stable days and the clinical data was collected from international clinical trials and published sources. The study population was patients who suffer from schizophrenia with acute exacerbation. During a consensus panel of 10 psychiatrists and 6 health economists, data were collected on the clinical practice and medical resource utilisation. Unit costs were derived from public sources and official reimbursement tariffs. For the comparators official retail prices were used. Since a price had not yet been granted for paliperidone ER at the time of the study, the conservative assumption of including the average of the highest targeted European prices was used, overestimating the price of paliperidone ER in Greece. The study was conducted from the perspective of the National Healthcare System. Results The data indicate that paliperidone ER might offer an increased number of stable days (272.5 compared to 272.2 for olanzapine, 265.5 f risperidone, 260.7 for quetiapine, 260.5 for ziprasidone and 258.6 for aripiprazole with a lower cost compared to the other therapies examined (€7,030 compared to €7,034 for olanzapine, €7,082 for risperidone, €8,321 for quetiapine, €7,713 for ziprasidone and €7,807 for aripiprazole. During the sensitivity analysis, a ± 10% change in the duration and frequency of relapses and the economic parameters did not lead to significant changes in the results. Conclusion Treatment with paliperidone ER can lead to lower total cost

  20. The social functional outcome of being naturalistically treated with paliperidone extended-release in patients with schizophrenia

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    Nakagawa R

    2015-06-01

    Full Text Available Ryoko Nakagawa,1 Takashi Ohnishi,1 Hisanori Kobayashi,1 Akihide Wakamatsu,2 Ai Tanimura,3 Kazuo Morita,3 Toshio Yamaoka,3 Hideo Usui,3 Yoshimasa Ogawa,3 Akiko Fujino,3 Kazutake Yoshizawa11Evidence Generation Department, Medical Affairs Division, 2Medical Affairs Strategy Department, Medical Affairs Division, 3Drug Safety Surveillance Department, Japan Safety and Surveillance Division, Janssen Pharmaceutical K.K., Tokyo, JapanBackground: Social functioning is an important outcome for patients with schizophrenia. To evaluate the effects of paliperidone extended-release (PAL-ER on social function, symptomatology, and safety in the routine clinical practice, we conducted a 1-year post-marketing surveillance study of PAL-ER. We also explored relationships between symptomatic improvement and socially functional outcome in patients with schizophrenia.Patients and methods: Patients with an established diagnosis of schizophrenia were allowed flexible 3–12 mg/day dosing during the surveillance. Patients were assessed on social functioning using the Social and Occupational Functioning Assessment Scale (SOFAS and on symptomatology using the Clinical Global Impression–Schizophrenia scale. All adverse events (AEs were also collected.Results: A total of 1,429 patients were enrolled in the surveillance study, of whom 1,405 were evaluable for safety and 1,142 were evaluable for efficacy. The treatment discontinuation rate for any reason during the observation period was 34.66%. Significant improvements were observed on both Social and Occupational Functioning Assessment Scale and Clinical Global Impression–Schizophrenia scale during the observation period. The percentage of patients with socially functional remission (SOFAS ≥61 also increased significantly. A significant association between early improvements in positive symptoms, sex, severity of negative symptoms at baseline, and socially functional remission was observed. A total of 33.52% of patients

  1. Risk assessment and experimental design in the development of a prolonged release drug delivery system with paliperidone.

    Science.gov (United States)

    Iurian, Sonia; Turdean, Luana; Tomuta, Ioan

    2017-01-01

    This study focuses on the development of a drug product based on a risk assessment-based approach, within the quality by design paradigm. A prolonged release system was proposed for paliperidone (Pal) delivery, containing Kollidon ® SR as an insoluble matrix agent and hydroxypropyl cellulose, hydroxypropyl methylcellulose (HPMC), or sodium carboxymethyl cellulose as a hydrophilic polymer. The experimental part was preceded by the identification of potential sources of variability through Ishikawa diagrams, and failure mode and effects analysis was used to deliver the critical process parameters that were further optimized by design of experiments. A D-optimal design was used to investigate the effects of Kollidon SR ratio ( X 1 ), the type of hydrophilic polymer ( X 2 ), and the percentage of hydrophilic polymer ( X 3 ) on the percentages of dissolved Pal over 24 h ( Y 1 - Y 9 ). Effects expressed as regression coefficients and response surfaces were generated, along with a design space for the preparation of a target formulation in an experimental area with low error risk. The optimal formulation contained 27.62% Kollidon SR and 8.73% HPMC and achieved the prolonged release of Pal, with low burst effect, at ratios that were very close to the ones predicted by the model. Thus, the parameters with the highest impact on the final product quality were studied, and safe ranges were established for their variations. Finally, a risk mitigation and control strategy was proposed to assure the quality of the system, by constant process monitoring.

  2. Risk assessment and experimental design in the development of a prolonged release drug delivery system with paliperidone

    Directory of Open Access Journals (Sweden)

    Iurian S

    2017-03-01

    Full Text Available Sonia Iurian, Luana Turdean, Ioan Tomuta Department of Pharmaceutical Technology and Biopharmacy, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania Abstract: This study focuses on the development of a drug product based on a risk assessment-based approach, within the quality by design paradigm. A prolonged release system was proposed for paliperidone (Pal delivery, containing Kollidon® SR as an insoluble matrix agent and hydroxypropyl cellulose, hydroxypropyl methylcellulose (HPMC, or sodium carboxymethyl cellulose as a hydrophilic polymer. The experimental part was preceded by the identification of potential sources of variability through Ishikawa diagrams, and failure mode and effects analysis was used to deliver the critical process parameters that were further optimized by design of experiments. A D-optimal design was used to investigate the effects of Kollidon SR ratio (X1, the type of hydrophilic polymer (X2, and the percentage of hydrophilic polymer (X3 on the percentages of dissolved Pal over 24 h (Y1–Y9. Effects expressed as regression coefficients and response surfaces were generated, along with a design space for the preparation of a target formulation in an experimental area with low error risk. The optimal formulation contained 27.62% Kollidon SR and 8.73% HPMC and achieved the prolonged release of Pal, with low burst effect, at ratios that were very close to the ones predicted by the model. Thus, the parameters with the highest impact on the final product quality were studied, and safe ranges were established for their variations. Finally, a risk mitigation and control strategy was proposed to assure the quality of the system, by constant process monitoring. Keywords: pharmaceutical development, quality by design, failure mode effects analysis, Ishikawa diagram, fish-bone diagram, hydrophilic matrix

  3. Comparison of Medicaid spending in schizoaffective patients treated with once monthly paliperidone palmitate or oral atypical antipsychotics.

    Science.gov (United States)

    Xiao, Yongling; Muser, Erik; Fu, Dong-Jing; Lafeuille, Marie-Hélène; Pilon, Dominic; Emond, Bruno; Wu, Allen; Duh, Mei Sheng; Lefebvre, Patrick

    2016-01-01

    Compared to oral atypical antipsychotics (OAAs), long-acting injectable antipsychotics require less frequent administration, and thus may improve adherence and reduce risk of relapse in schizoaffective disorder (SAD) patients. To evaluate the impact of once monthly paliperidone palmitate (PP) versus OAAs on healthcare resource utilization, Medicaid spending, and hospital readmission among SAD patients. Using FL, IA, KS, MS, MO, and NJ Medicaid data (January 2009-December 2013), adults with ≥2 SAD diagnoses initiated on PP or OAA (index date) were identified. Baseline characteristics and outcomes were assessed during the 12month pre- and post-index periods, respectively. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were used to reduce confounding and compare the estimated treatment effect for PP versus OAA. A total of 10,778 OAA-treated patients and 876 PP-treated patients were selected. Compared to OAAs, PP was associated with significantly lower medical costs (PSM: mean monthly cost difference [MMCD] = -$383, p < 0.001; IPTW: MMCD = -$403, p = 0.016), which offset the higher pharmacy costs associated with PP (PSM: MMCD = $270, p < 0.001; IPTW: MMCD = $350, p < 0.001) and resulted in similar total healthcare cost (PSM: MMCD = -$113, p = 0.414; IPTW: MMCD = -$53, p = 0.697) for PP versus OAA. Reduced risk of hospitalization (PSM: incidence rate ratio [IRR] = 0.85, p = 0.128; IPTW: IRR = 0.96, p = 0.004) and fewer hospitalization days (PSM: IRR = 0.74, p = 0.008; IPTW: IRR = 0.85, p < 0.001) were observed in PP versus OAA patients. Among hospitalized patients, PP was associated with a lower risk of 30 day hospital readmission compared to OAA (IPTW: odds ratio = 0.89, p = 0.041). Limitations The Medicaid data may not be representative of the nation or other states, and includes pre-rebate pharmacy costs (potentially over-estimated). Also

  4. Impact of time of initiation of once-monthly paliperidone palmitate in hospitalized Asian patients with acute exacerbation of schizophrenia: a post hoc analysis from the PREVAIL study.

    Science.gov (United States)

    Li, Huafang; Li, Yan; Feng, Yu; Zhuo, Jianmin; Turkoz, Ibrahim; Mathews, Maju; Tan, Wilson

    2018-01-01

    To evaluate the differences in efficacy and safety outcomes in acute exacerbating schizophrenia patients between 2 subgroups (≤1 week and >1 week), differing in time interval from hospitalization to time of initiation of once-monthly paliperidone palmitate. PREVAIL was a multicenter, single-arm, open-label, prospective Phase IV study in hospitalized Asian patients (either sex, aged 18-65 years) diagnosed with schizophrenia ( Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition). Change from baseline to week 13 in primary (Positive and Negative Syndrome Scale [PANSS] total score), secondary endpoints (PANSS responder rate, PANSS subscale, PANSS Marder factor, Clinical Global Impression-Severity, and Personal and Social Performance scale scores, readiness for hospital discharge questionnaire) and safety were assessed in this post hoc analysis. Significant mean reduction from baseline to week 13 in the PANSS total score, 30% PANSS responder rates ( P ≤0.01), PANSS subscales (positive and general psychopathology; all P ≤0.01), PANSS Marder factor (positive symptoms, uncontrolled hostility, and excitement and anxiety/depression; all P ≤0.01), Personal and Social Performance scale scores ( P ≤0.05) and Clinical Global Impression-Severity categorical summary ( P ≤0.05) were significantly greater in the ≤1 week subgroup versus >1 week subgroup ( P ≤0.05). The readiness for hospital discharge questionnaire improved over time for the overall study population, but remained similar between subgroups at all-time points. Treatment-emergent adverse events were similar between the subgroups. Early initiation of once-monthly paliperidone palmitate in hospitalized patients with acute exacerbation of schizophrenia led to greater improvements in psychotic symptoms with comparable safety than treatment initiation following 1 week of hospitalization.

  5. 帕利哌酮与氟哌啶醇治疗儿童抽动障碍对照研究%A Control Study of Paliperidone Versus Haloperidol in the Treatment of Tic Disorders in Children

    Institute of Scientific and Technical Information of China (English)

    陆志新; 石磊; 李志佳

    2015-01-01

    Objective To compare the efficacy and adverse reactions between Paliperidone and Haloperidol in the treatment of children with tic disorders(TD). Methods Sixty children of 8-16 years old with tic disorders admitted in our clinic from January 2012 to March 2014 were randomly assigned to Paliperidone group (n=30) and Haloperidol group (n=30), treated by Paliperidone and Haloperidol, respectively, for 8 weeks. The treatment efficacy and adverse reactions were measured by the Yale Global Tic Severity Scale (YGTSS) and the Treatment Emergent Symptom Scale (TESS) at the baseline, week 2, 4 and 8, respectively. Results After 2 weeks of treatment, the total tic scores measured by the YGTSS decreased in both groups, and the rate of YGTSS decreased in Paliperidone group was significantly higher than that in Haloperidol group. The overall rate of effectiveness after 8 weeks’ treatment was 90.0% and 66.7% in Paliperidone group and Haloperidol group, respectively(P<0.05). The incidence of adverse reactions after 8 weeks’treatment was 20.0% and 76.7% in Paliperidone group and Haloperidol group, respectively(P<0.01). Conclusion Both Paliperidone and Haloperidol can be used for children with tic disorders. However, Paliperidone may be a promising drug in the treatment of children with tic disorders because of its higher efficacy and less adverse reactions and better tolerance.%目的:比较利帕利哌酮与氟哌啶醇治疗儿童抽动障碍(tic disorders, TD)的疗效及不良反应。方法对该院2012年1月—2014年3月门诊收治的60例儿童抽动障碍患者(年龄8~16岁)随机分成两组,分别给予利帕利哌酮与氟哌啶醇,其中帕利哌酮组30例,氟哌啶醇组30例,疗程8周。分别采用耶鲁抽动症状严重程度量表(Yale Global Tic Severity Scale, YGTSS)和不良反应量表(treatment emergent symptom scale, TESS)对治疗前、治疗后第2、4、8周的治疗效果和不良反应进行评估。结果帕利哌

  6. One patient with schizophrenia showed reduced drug-induced extrapyramidal symptoms as a result of an alternative regimen of treatment with paliperidone 3 and 6 mg every other day.

    Science.gov (United States)

    Suzuki, Hidenobu; Hibino, Hiroyuki; Inoue, Yuichi; Matsumoto, Hideo; Mikami, Katsunaka

    2017-01-01

    Schizophrenia is a chronic disease that requires long-term management with antipsychotics. Antipsychotic drugs are given by tapering their dose, extending the dosing interval, and so on, as part of a treatment strategy to minimize the adverse effects while at the same time maintaining efficacy. We report the case of one patient with schizophrenia in whom the clinical symptoms were alleviated after treatment with 6 mg paliperidone. However, the patient developed extrapyramidal syndrome, for which 3 and 6 mg paliperidone were administered alternately every other day. Extrapyramidal syndrome was assessed using the Drug-Induced Extrapyramidal Symptoms Scale, Abnormal Involuntary Movement Scale, or Barnes Akathisia Scale. There was improvement in Drug-Induced Extrapyramidal Symptoms Scale score and Abnormal Involuntary Movement Scale score. However, there was almost no change in the Positive and Negative Syndrome Scale total score, positive score, negative score, or general score. The results indicate the possibility of lessened adverse effects as a result of an alternative regimen of treatment with paliperidone 3 and 6 mg every other day in the maintenance phase.

  7. Impact of time of initiation of once-monthly paliperidone palmitate in hospitalized Asian patients with acute exacerbation of schizophrenia: a post hoc analysis from the PREVAIL study

    Directory of Open Access Journals (Sweden)

    Li H

    2018-04-01

    Full Text Available Huafang Li,1,2 Yan Li,1,2 Yu Feng,3 Jianmin Zhuo,4 Ibrahim Turkoz,5 Maju Mathews,5 Wilson Tan3 1Shanghai Mental Health Centre, Shanghai Jiao Tong University School of Medicine, Shanghai, China; 2Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China; 3Janssen Pharmaceutical Companies of Johnson and Johnson, Singapore; 4Janssen China Research and Development, Shanghai, China; 5Janssen Research & Development LLC, Titusville, NJ, USA Purpose: To evaluate the differences in efficacy and safety outcomes in acute exacerbating schizophrenia patients between 2 subgroups (≤1 week and >1 week, differing in time interval from hospitalization to time of initiation of once-monthly paliperidone palmitate. Patients and methods: PREVAIL was a multicenter, single-arm, open-label, prospective Phase IV study in hospitalized Asian patients (either sex, aged 18–65 years diagnosed with schizophrenia (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Change from baseline to week 13 in primary (Positive and Negative Syndrome Scale [PANSS] total score, secondary endpoints (PANSS responder rate, PANSS subscale, PANSS Marder factor, Clinical Global Impression-Severity, and Personal and Social Performance scale scores, readiness for hospital discharge questionnaire and safety were assessed in this post hoc analysis. Results: Significant mean reduction from baseline to week 13 in the PANSS total score, 30% PANSS responder rates (P≤0.01, PANSS subscales (positive and general psychopathology; all P≤0.01, PANSS Marder factor (positive symptoms, uncontrolled hostility, and excitement and anxiety/depression; all P≤0.01, Personal and Social Performance scale scores (P≤0.05 and Clinical Global Impression-Severity categorical summary (P≤0.05 were significantly greater in the ≤1 week subgroup versus >1 week subgroup (P≤0.05. The readiness for hospital discharge questionnaire improved over time for the overall study population, but

  8. An open-label, flexible-dose study of paliperidone extended-release in Chinese patients with first-onset psychosis

    Directory of Open Access Journals (Sweden)

    Si TM

    2015-01-01

    Full Text Available TianMei Si,1 QingRong Tan,2 KeRang Zhang,3 Yang Wang,4 Qing Rui4 1Peking University Institute of Mental health, Key Laboratory of Mental Health, Ministry of Health (Peking University, Beijing, 2Fourth Military Medical University, First Hospital, Xi’an, 3Shanxi Medical University, First Hospital, Shanxi, 4Janssen Research and Development, Beijing, People’s Republic of China Background: Antipsychotic medications facilitate the improvement of psychotic symptoms in patients with first-episode psychosis. Paliperidone extended-release (pali-ER, an atypical anti­psychotic, was assessed for efficacy and safety in Chinese patients with first-episode psychosis. Methods: In this 8-week, open-label, single-arm, multicenter study, patients with first-episode psychosis (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria and a Positive and Negative Syndrome Scale (PANSS total score ≥70 were treated with flexible-dose pali-ER tablets (3–12 mg/day. The primary efficacy endpoint was the percentage of patients with an increase of ≥8 points in Personal and Social Performance (PSP score from baseline to day 56 (8 weeks. Secondary endpoints included reduction in PANSS total score, improvement in Clinical Global Impression-Severity score, PSP score, Subjective Well-being under Neuroleptics Scale score, and relationship between duration of untreated psychosis and PANSS or PSP. Incidences of treatment-emergent adverse events were used to evaluate safety.Results: Overall, 283 of 294 patients (96% achieved a ≥8-point increase in PSP (primary endpoint, analysis set. For the secondary efficacy endpoints, 284/306 patients (93% had a ≥30% reduction in PANSS total score; 266/306 patients (87% achieved a ≤3 Clinical Global Impression-Severity scale score, and 218/294 patients (74% had a PSP score ≥71. The Subjective Well-being under Neuroleptics Scale score was improved from a baseline mean of 72.7 to 94.7 at endpoint. There was a

  9. Once-monthly injection of paliperidone palmitate in patients with recently diagnosed and chronic schizophrenia: a post-hoc comparison of efficacy and safety.

    Science.gov (United States)

    Si, Tianmei; Zhuo, Jianmin; Turkoz, Ibrahim; Mathews, Maju; Tan, Wilson; Feng, Yu

    2017-12-01

    The use of long-acting injectable antipsychotics in recently diagnosed schizophrenia remains less explored. We evaluated the efficacy and safety of paliperidone palmitate once-monthly (PP1M) treatment in adult patients with recently diagnosed vs. chronic schizophrenia. These post-hoc analyses included two multicenter studies. Study 1 (NCT01527305) enrolled recently diagnosed (≤5 years) and chronic (>5 years) patients; Study 2 (NCT01051531) enrolled recently diagnosed patients only. Recently diagnosed patients were further sub-grouped into ≤2 years or 2-5 years. The primary efficacy endpoint was the change from baseline in Positive and Negative Syndrome Scale (PANSS) total score. In Study 1, 41.5% patients had recent diagnosis (≤2 years: 56.8%; 2-5 years: 43.2%); 58.5% had chronic schizophrenia. In Study 2, 52.8% and 47.2% patients were grouped into ≤2 years and 2-5 years, respectively. PANSS total score showed significantly greater improvement in patients with recently diagnosed vs. chronic schizophrenia. Similar results were obtained for PANSS responder rate, improvements in PANSS, and CGI-S scores. PP1M was efficacious in both recently diagnosed and chronic schizophrenia, with the benefits being more pronounced in patients with recently diagnosed schizophrenia. This adds to growing evidence recommending long-acting antipsychotic interventions at early stages of schizophrenia.

  10. Predictive factors of overall functioning improvement in patients with chronic schizophrenia and schizoaffective disorder treated with paliperidone palmitate and aripiprazole monohydrate.

    Science.gov (United States)

    Girardi, Paolo; Del Casale, Antonio; Rapinesi, Chiara; Kotzalidis, Georgios D; Splendori, Francesca; Verzura, Claudio; Trovini, Giada; Sorice, Serena; Carrus, Dario; Mancinelli, Iginia; Comparelli, Anna; De Filippis, Sergio; Francomano, Antonio; Ballerini, Andrea; Marcellusi, Andrea; Mennini, Francesco S; Ducci, Giuseppe; Sani, Gabriele; Pompili, Maurizio; Brugnoli, Roberto

    2018-05-01

    Long-acting injectable (LAI) antipsychotics can improve medication adherence and reduce hospitalisation rates compared with oral treatments. Paliperidone palmitate (PAL) and aripiprazole monohydrate (ARI) LAI treatments were associated with improvements in global functioning in patients with schizophrenia. The objective of this study was to assess the predictive factors of better overall functioning in patients with chronic schizophrenia and schizoaffective disorder treated with PAL and ARI. Enrolled were 143 (97 males, 46 females, mean age 38.24 years, SD = 12.65) patients with a diagnosis of schizophrenia or schizoaffective disorder, whom we allocated in two groups (PAL and ARI treatments). We assessed global functioning, amount of oral medications, adherence to oral treatment, and number of hospitalisations before LAI introduction and at assessment time point. Longer treatment time with LAIs (p schizoaffective disorder. Better improvement in functioning could be achieved with ARI in young individuals with recent illness onset and PAL in patients at risk for recurrent hospitalisations. Copyright © 2018 John Wiley & Sons, Ltd.

  11. Impact of Paliperidone Palmitate Versus Oral Atypical Antipsychotics on Health Care Resource Use and Costs in Veterans With Schizophrenia and Comorbid Substance Abuse.

    Science.gov (United States)

    Lefebvre, Patrick; Muser, Erik; Joshi, Kruti; DerSarkissian, Maral; Bhak, Rachel H; Duh, Mei Sheng; Shiner, Brian; Young-Xu, Yinong

    2017-07-01

    Almost half of all patients diagnosed with schizophrenia have a history of substance abuse (SA). However, data on treatment of schizophrenia with paliperidone palmitate (PP) among patients with comorbid SA are limited. The objective of this study was to compare all-cause and SA-related health care resource utilization and costs in veterans with schizophrenia and co-occurring SA who were treated with PP versus oral atypical antipsychotics (OAAs). Veterans Health Administration electronic health record data were used to conduct a retrospective longitudinal study in veterans with schizophrenia who initiated PP or OAA between January 1, 2010 and June 30, 2016, had ≥12 months of enrollment before treatment initiation (baseline), were diagnosed with SA, and had ≥1 Global Assessment of Functioning score during baseline. Differences in baseline characteristics were adjusted for using inverse probability of treatment weighting. Adjusted cost differences and incidence rate ratios (IRR) for the association between PP versus OAA and all-cause and SA-related health care costs and health care resource utilization in the 12 months after treatment initiation were estimated with corresponding 95% CIs using weighted linear and Poisson regression models, respectively. Of 6872 veterans in the study, 1684 (25%) and 5188 (75%) were treated with PP and OAA, respectively. After adjustment, PP was associated with fewer all-cause inpatient (IRR = 0.88; 95% CI, 0.85 to 0.90), mental health-related inpatient (IRR = 0.88; 95% CI, 0.85 to 0.91), and long-term care stays (IRR = 0.53; 95% CI, 0.44 to 0.64), but more frequent mental health intensive case management visits (IRR = 1.51; 95% CI, 1.49 to 1.53) compared with OAA (all P schizophrenia and comorbid SA. Thus, PP appears to be a valuable treatment option for patients in this subpopulation. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  12. Relationship between response to aripiprazole once-monthly and paliperidone palmitate on work readiness and functioning in schizophrenia: A post-hoc analysis of the QUALIFY study.

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    Steven G Potkin

    Full Text Available Schizophrenia is a chronic disease with negative impact on patients' employment status and quality of life. This post-hoc analysis uses data from the QUALIFY study to elucidate the relationship between work readiness and health-related quality of life and functioning. QUALIFY was a 28-week, randomized study (NCT01795547 comparing the treatment effectiveness of aripiprazole once-monthly 400 mg and paliperidone palmitate once-monthly using the Heinrichs-Carpenter Quality-of-Life Scale as the primary endpoint. Also, patients' capacity to work and work readiness (Yes/No was assessed with the Work Readiness Questionnaire. We categorized patients, irrespective of treatment, by work readiness at baseline and week 28: No to Yes (n = 41, Yes to Yes (n = 49, or No at week 28 (n = 118. Quality-of-Life Scale total, domains, and item scores were assessed with a mixed model of repeated measures. Patients who shifted from No to Yes in work readiness showed robust improvements on Quality-of-Life Scale total scores, significantly greater than patients not ready to work at week 28 (least squares mean difference: 11.6±2.6, p<0.0001. Scores on Quality-of-Life Scale instrumental role domain and items therein-occupational role, work functioning, work levels, work satisfaction-significantly improved in patients shifting from No to Yes in work readiness (vs patients No at Week 28. Quality-of-Life Scale total scores also significantly predicted work readiness at week 28. Overall, these results highlight a strong association between improvements in health-related quality of life and work readiness, and suggest that increasing patients' capacity to work is an achievable and meaningful goal in the treatment of impaired functioning in schizophrenia.

  13. Rapid onset of treatment effects on psychosis, depression, and mania in patients with acute exacerbation of schizoaffective disorder following treatment with oral extended-release paliperidone.

    Science.gov (United States)

    Fu, Dong-Jing; Turkoz, Ibrahim; Bossie, Cynthia A; Patel, Hiren; Alphs, Larry

    2016-03-15

    Patients with schizoaffective disorder (SCA) experience complicated interplays of psychotic, depressive, and manic symptoms. Paliperidone extended-release (pali ER) tablets have been shown to be efficacious in these patients, but treatment response has not been studied relative to the onset of effects for these symptom domains. In a pooled analysis of data from two 6-week, randomized, placebo-controlled studies, the onset of treatment effects with oral pali ER was evaluated by symptom domain (psychosis, depression, mania) in patients with an acute SCA exacerbation. Subjects were categorized as having prominent psychotic (Positive and Negative Syndrome Scale score >70), depressive (Hamilton Rating Scale for Depression-21 score ≥16), or manic (Young Mania Rating Scale score ≥16) symptoms at baseline. Of the 614 patients in these analyses, 597 (97.2%), 411 (66.9%), and 488 (79.5%) had prominent psychotic, depressive, and manic symptoms at baseline, respectively. Pali ER treatment was associated with rapid and significant improvement of all three symptom domains versus placebo within 1 week of initiation, regardless of whether treatment was given as monotherapy or in combination with mood stabilizers and/or antidepressants. Adverse events were similar to those reported in the original published studies. This post hoc analysis of two phase 3 trials requires confirmation in prospective studies. This pooled analysis suggests that treatment with pali ER is associated with rapid control of psychotic, depressive, and manic symptoms in patients with SCA. Its findings support the benefit of pali ER as a primary treatment for the management of SCA. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

  14. Paliperidone palmitate once-monthly maintains improvement in functioning domains of the Personal and Social Performance scale compared with placebo in subjects with schizoaffective disorder.

    Science.gov (United States)

    Fu, Dong-Jing; Turkoz, Ibrahim; Walling, David; Lindenmayer, Jean-Pierre; Schooler, Nina R; Alphs, Larry

    2018-02-01

    Evaluate the effect of paliperidone palmitate once-monthly (PP1M) injectable on the specific functioning domains of the Personal and Social Performance (PSP) scale in patients with schizoaffective disorder (SCA) participating in a long-term study. This study (NCT01193153) included both in- and outpatient subjects with SCA experiencing an acute exacerbation of psychotic and mood symptoms. Subjects were treated with PP1M either as monotherapy or in combination with antidepressants or mood stabilizers during a 25-week open-label (OL) phase. Stabilized subjects were randomly assigned 1:1 (PP1M or placebo) into a 15-month double-blind (DB) relapse-prevention period. Functioning of the randomized subjects during OL and DB phases was evaluated using the PSP scale (four domains: socially useful activities, personal/social relationships, self-care, and disturbing/aggressive behaviors). Three statistical approaches were utilized to analyze PSP scores to assess robustness and consistency of findings. No adjustments were made for multiplicity. 334 of 667 enrolled subjects were stabilized with PP1M, randomly assigned to PP1M (n=164) or placebo (n=170) in the DB phase, and included in this analysis. Improvements in all PSP domain scores were observed during the OL phase and were maintained during the DB phase with PP1M, but decreased with placebo. Differences compared to placebo were significant in all four PSP domains during the DB phase (P≤0.008). The analysis in this study showed that PP1M improves functioning, as measured by the four PSP domain scores, in symptomatic subjects with SCA. Functioning was maintained compared with placebo. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  15. Sensitivity analysis of EQ3

    International Nuclear Information System (INIS)

    Horwedel, J.E.; Wright, R.Q.; Maerker, R.E.

    1990-01-01

    A sensitivity analysis of EQ3, a computer code which has been proposed to be used as one link in the overall performance assessment of a national high-level waste repository, has been performed. EQ3 is a geochemical modeling code used to calculate the speciation of a water and its saturation state with respect to mineral phases. The model chosen for the sensitivity analysis is one which is used as a test problem in the documentation of the EQ3 code. Sensitivities are calculated using both the CHAIN and ADGEN options of the GRESS code compiled under G-float FORTRAN on the VAX/VMS and verified by perturbation runs. The analyses were performed with a preliminary Version 1.0 of GRESS which contains several new algorithms that significantly improve the application of ADGEN. Use of ADGEN automates the implementation of the well-known adjoint technique for the efficient calculation of sensitivities of a given response to all the input data. Application of ADGEN to EQ3 results in the calculation of sensitivities of a particular response to 31,000 input parameters in a run time of only 27 times that of the original model. Moreover, calculation of the sensitivities for each additional response increases this factor by only 2.5 percent. This compares very favorably with a running-time factor of 31,000 if direct perturbation runs were used instead. 6 refs., 8 tabs

  16. Predictive performance of two PK-PD models of D2 receptor occupancy of the antipsychotics risperidone and paliperidone in rats

    NARCIS (Netherlands)

    Kozielska, Magdalena; Johnson, Martin; Pilla Reddy, Venkatesh; Vermeulen, An; de Greef, Rik; Li, Cheryl; Grimwood, Sarah; Liu, Jing; Groothuis, Genoveva; Danhof, Meindert; Proost, Johannes

    2010-01-01

    Objectives: The level of dopamine D2 receptor occupancy is predictive of efficacy and safety in schizophrenia. Population PK-PD modelling has been used to link observed plasma and brain concentrations to receptor occupancy. The objective of this study was to compare the predictive performance of two

  17. Evaluation of sleep profile in schizophrenia patients treated with extended-release paliperidone: an open-label prospective study in Southeast Asia

    OpenAIRE

    Kongsakon,Ronnachai; Thavichachart,Nuntika; Chung,Ka Fai; Lim,Leslie; Azucena,Beverly; Rondain,Elizabeth; Go,Benson; Costales,Fe; Nerapusee,Osot

    2017-01-01

    Ronnachai Kongsakon,1 Nuntika Thavichachart,2 Ka Fai Chung,3 Leslie Lim,4 Beverly Azucena,5 Elizabeth Rondain,6 Benson Go,7 Fe Costales,8 Osot Nerapusee9 1Department of Psychiatry, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Department of Medicine, Division of Psychiatry, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand; 3Department of Psychiatry, University of Hong Kong, Hong Kong, People’s Republic of China; ...

  18. EQ-5D Portuguese population norms.

    Science.gov (United States)

    Ferreira, Lara Noronha; Ferreira, Pedro L; Pereira, Luis N; Oppe, Mark

    2014-03-01

    The EQ-5D is a widely used preference-based measure. Normative data can be used as references to analyze the effects of healthcare, determine the burden of disease and enable regional or country comparisons. Population norms for the EQ-5D exist for other countries but have not been previously published for Portugal. The purpose of this study was to derive EQ-5D Portuguese population norms. The EQ-5D was applied by phone interview to a random sample of the Portuguese general population (n = 1,500) stratified by age, gender and region. The Portuguese value set was used to derive the EQ-5D index. Mean values were computed by gender and age groups, marital status, educational attainment, region and other variables to obtain the EQ-5D Portuguese norms. Health status declines with advancing age, and women reported worse health status than men. These results are similar to other EQ-5D population health studies. This study provides Portuguese population health-related quality of life data measured by the EQ-5D that can be used as population norms. These norms can be used to inform Portuguese policy makers, health care professionals and researchers in issues related to health care policy and planning and quantification of treatment effects on health status.

  19. EQ DAN AQ DALAM PENGEMBANGAN PROFESIONALISME PUSTAKAWAN

    Directory of Open Access Journals (Sweden)

    Aris Nurohman

    2016-05-01

    EQ and AQ in developing of librarian profession will aid to self control and emotion management. By EQ and AQ will aid librarians able to manage self complexity, so it will bear intellectual, skill, behavior, leadership, good personality, smart, creative, progressive and broad horizon.

  20. EQ3/6: status and applications

    Energy Technology Data Exchange (ETDEWEB)

    Wolery, T.J.; Isherwood, D.J.; Jackson, K.J.; Delany, J.M.; Puigdomenech, I.

    1984-12-01

    EQ3/6 is a set of related computer codes and data files for use in geochemical modeling of aqueous systems. The EQ3/6 package centers around two large computer codes, EQ3NR and EQ6, which are supported by a common thermodynamic data base. EQ3NR is a speciation-solubility code, whose function is to compute a model of the state of an aqueous solution. This code is very flexible in terms of the input that it will accept. EQ6 is a reaction-path code, which calculates models of changes in aqueous systems as they proceed toward a state of overall chemical equilibrium. EQ3/6 prior to FY83 had no capability for modeling brines, because the approximations for calculating the thermodynamic activity of water and the activity coefficients of the solute species were restricted to low ionic strengths ({le} 1.0 molal). An option has been added to use Pitzer`s equations for such calculations. At present, EQ3/6 contains two alternate Pitzer coefficient data bases. Several improvements have been made to the EQ6 code. Prior to FY83, the code could run models of mineral dissolution kinetics, but could not calculate models of precipitation kinetics. This problem has been overcome by additional code development. The speed of non-kinetic EQ6 calculations has recently been enhanced by the creation of two new calculational modes, economy mode and super economy mode. A calculational mode to simulate systems open to large gas reservoirs has also been developed. 34 references.

  1. Uniform topology on EQ-algebras

    Directory of Open Access Journals (Sweden)

    Yang Jiang

    2017-04-01

    Full Text Available In this paper, we use filters of an EQ-algebra E to induce a uniform structure (E, , and then the part induce a uniform topology in E. We prove that the pair (E, is a topological EQ-algebra, and some properties of (E, are investigated. In particular, we show that (E, is a first-countable, zero-dimensional, disconnected and completely regular space. Finally, by using convergence of nets, the convergence of topological EQ-algebras is obtained.

  2. Correspondence between EQ-5D health state classifications and EQ VAS scores

    Directory of Open Access Journals (Sweden)

    Whynes David K

    2008-11-01

    Full Text Available Abstract Background The EQ-5D health-related quality of life instrument comprises a health state classification followed by a health evaluation using a visual analogue scale (VAS. The EQ-5D has been employed frequently in economic evaluations, yet the relationship between the two parts of the instrument remains ill-understood. In this paper, we examine the correspondence between VAS scores and health state classifications for a large sample, and identify variables which contribute to determining the VAS scores independently of the health states as classified. Methods A UK trial of management of low-grade abnormalities detected on screening for cervical pre-cancer (TOMBOLA provided EQ-5D data for over 3,000 women. Information on distress and multi-dimensional health locus of control had been collected using other instruments. A linear regression model was fitted, with VAS score as the dependent variable. Independent variables comprised EQ-5D health state classifications, distress, locus of control, and socio-demographic characteristics. Equivalent EQ-5D and distress data, collected at twelve months, were available for over 2,000 of the women, enabling us to predict changes in VAS score over time from changes in EQ-5D classification and distress. Results In addition to EQ-5D health state classification, VAS score was influenced by the subject's perceived locus of control, and by her age, educational attainment, ethnic origin and smoking behaviour. Although the EQ-5D classification includes a distress dimension, the independent measure of distress was an additional determinant of VAS score. Changes in VAS score over time were explained by changes in both EQ-5D severities and distress. Women allocated to the experimental management arm of the trial reported an increase in VAS score, independently of any changes in health state and distress. Conclusion In this sample, EQ VAS scores were predictable from the EQ-5D health state classification, although

  3. Preserving EQ as per CSA N290.13: EQ of equipment for CANDU NPP

    International Nuclear Information System (INIS)

    Bordeleau, H.

    2006-01-01

    EQ is basically a Quality Assurance process that ensures that required safety related equipment will performed their safety functions during accident generating harsh environmental condition. As any good Quality Assurance Program, EQ activities have to be imbedded in the normal tasks of the people at the plant in such a way that it is not an extra concern but part of the things to be assessed and done on a regular basis so that the EQ Status of the equipment will not be compromised. The experience shows us that even with brand new plants there are discrepancies between equipment designed to be installed and that installed (wrong model or wrong instrument). Improper installation was also found. To eliminate these mistakes it is recommended to have a thorough initial inspection during construction or commissioning and later at regular intervals during operation. To avoid new mistakes during maintenance, crews have to be properly qualified and trained on completed procedure with appropriate work report that will required to be scrutinized for possible common cause failure and OPEX report. Procurement and handling of equipment and spare parts require a thorough revision of procurement and storage practices to guarantee proper storage, availability and identification of equipment for EQ replacement. A shelf life program for degradable material shall be implemented. Condition monitoring program could be use to extend life of equipment or as a qualification methods, caution should be use to look very precisely to the critical parameters that need to be monitored and to carefully tailor the monitoring program. EQ program should also consider barriers, they are not EQ equipment; it is usually made out of non-ageing material like metal or concrete. But there could be sealing material used in conjunction with the barriers and these may need special care. The impact of EQ parameters changes related to services conditions, new technical data or condition monitoring has to be

  4. Performance of the EQ-5D and the EQ-5D+C in elderly patients with cognitive impairments

    Directory of Open Access Journals (Sweden)

    Verhey Frans RJ

    2007-06-01

    Full Text Available Abstract Background The EQ-5D is a reliable tool for measuring Health-Related Quality of Life (HRQoL. However, concern has been expressed that it may ignore elements of HRQoL, particularly cognition. In response to this concern, the EQ-5D has been extended with a cognitive dimension (EQ-5D+C. The aim of this study was to compare the performance of the EQ-5D and the EQ-5D+C in elderly patients with cognitive impairments by assessing their construct validity and responsiveness. Methods Data from the MEDICIE study (n = 196 were used, in which all questionnaires were rated by proxies. Results Regarding construct validity, we found similar correlations between the EQ-5D and the Mini Mental State Examination (MMSE and between the EQ-5D+C and the MMSE. Furthermore, both the EQ-5D and the EQ-5D+C were responsive to changes in the MMSE, with the EQ-5D performing slightly better. Conclusion We conclude that the EQ-5D performs well for evaluating HRQoL in a population with cognitive impairments. Based on the results of this explorative study, it does not seem necessary to adjust the current classification system by adding a cognitive dimension. However, in order to compare both instruments regarding utility values, it is necessary to develop a new scoring algorithm for the EQ-5D+C by conducting a general population study. Considering the explorative nature of this study, it is recommended that more aspects of the validity of both the EQ-5D and the EQ-5D+C are explored in patients with cognitive impairments using a more tailored study design.

  5. Correction to: Comparing the UK EQ-5D-3L and English EQ-5D-5L Value Sets

    NARCIS (Netherlands)

    B. Mulhern (Brendan); Feng, Y. (Yan); K.K. Shah (Koonal); M.F. Janssen (Bas); M. Herdman (Michael); van Hout, B. (Ben); N. Devlin (Nancy)

    2018-01-01

    textabstractThe article Comparing the UK EQ-5D-3L and English EQ-5D-5L Value Sets, written by Brendan Mulhern, Yan Feng, Koonal Shah, Mathieu F. Janssen, Michael Herdman, Ben van Hout, Nancy Devlin was originally published electronically on the publisher’s internet portal (currently SpringerLink) on

  6. Comparing the UK EQ-5D-3L and English EQ-5D-5L Value Sets.

    Science.gov (United States)

    Mulhern, Brendan; Feng, Yan; Shah, Koonal; Janssen, Mathieu F; Herdman, Michael; van Hout, Ben; Devlin, Nancy

    2018-06-01

    Three EQ-5D value sets (EQ-5D-3L, crosswalk, and EQ-5D-5L) are now available for cost-utility analysis in the UK and/or England. The value sets' characteristics differ, and it is important to assess the implications of these differences. The aim of this paper is to compare the three value sets. We carried out analysis comparing the predicted values from each value set, and investigated how differences in health on the descriptive system is reflected in the utility score by assessing the value of adjacent states. We also assessed differences in values using data from patients who completed both EQ-5D-3L and EQ-5D-5L. The distribution of the value sets systematically differed. EQ-5D-5L values were higher than EQ-5D-3L/crosswalk values. The overall range and difference between adjacent states was smaller. In the patient data, the EQ-5D-5L produced higher values across all conditions and there was some evidence that the value sets rank different health conditions in a similar severity order. There are important differences between the value sets. Due to the smaller range of EQ-5D-5L values, the possible change in quality-adjusted life years (QALYs) might be reduced, but they will apply to both control and intervention groups, and will depend on whether the gain is in quality of life, survival, or both. The increased sensitivity of EQ-5D-5L may also favour QALY gains even if the changes in utility are smaller. Further work should assess the impact of the different value sets on cost effectiveness by repeating the analysis on clinical trial data.

  7. Structural equation modeling with EQS basic concepts, applications, and programming

    CERN Document Server

    Byrne, Barbara M

    2013-01-01

    Readers who want a less mathematical alternative to the EQS manual will find exactly what they're looking for in this practical text. Written specifically for those with little to no knowledge of structural equation modeling (SEM) or EQS, the author's goal is to provide a non-mathematical introduction to the basic concepts of SEM by applying these principles to EQS, Version 6.1. The book clearly demonstrates a wide variety of SEM/EQS applications that include confirmatory factor analytic and full latent variable models. Written in a "user-friendly" style, the author "walks" the reader through the varied steps involved in the process of testing SEM models: model specification and estimation, assessment of model fit, EQS output, and interpretation of findings. Each of the book's applications is accompanied by: a statement of the hypothesis being tested, a schematic representation of the model, explanations of the EQS input and output files, tips on how to use the pull-down menus, and the data file upon which ...

  8. Measurement properties of the EQ-5D-5L compared to the EQ-5D-3L in psoriasis patients.

    Science.gov (United States)

    Poór, Adrienn Katalin; Rencz, Fanni; Brodszky, Valentin; Gulácsi, László; Beretzky, Zsuzsanna; Hidvégi, Bernadett; Holló, Péter; Kárpáti, Sarolta; Péntek, Márta

    2017-12-01

    The purpose of this study is to assess the measurement properties of EQ-5D-5L compared to EQ-5D-3L in psoriasis patients. A cross-sectional survey was carried out at an academic dermatology clinic in Hungary. Psoriasis patients completed the EQ-5D-3L, EQ-5D-5L and Dermatology Life Quality Index (DLQI) questionnaires, and Psoriasis Area and Severity Index (PASI) was assessed. The UK value sets were used to calculate the 3L and 5L index scores. We tested the feasibility, ceiling effect, redistribution properties, the level of inconsistency and informativity (Shannon and Shannon Evenness indices). Spearman's rank-order correlations were performed between EQ-5D, EQ VAS, DLQI and PASI scores. Known-groups validity was evaluated by comparing age groups, clinical subtypes and treatment groups. Mean age of the 238 patients was 47 years, and 36.6% of them received biological therapy. Mean EQ-5D index score was 0.77 (SD: 0.26) with the 3L and 0.84 (SD: 0.19) with the 5L. The overall ceiling effect decreased from 37.1 (3L) to 32.9% (5L). Shannon index improved significantly for most dimensions, but Shannon Evenness index improved only in three dimensions. Compared to the 3L, the 5L version confirmed a better convergent validity with PASI, but not with the DLQI. Known-groups validity was equally demonstrated both for the 5L and 3L. The EQ-5D-5L seems to improve measurement properties by reducing ceiling effects, strengthening correlations with PASI and improving informativity. Follow-up studies are needed to test responsiveness and reliability in psoriasis.

  9. Mapping onto Eq-5 D for patients in poor health

    Directory of Open Access Journals (Sweden)

    Brazier John E

    2010-11-01

    Full Text Available Abstract Background An increasing amount of studies report mapping algorithms which predict EQ-5 D utility values using disease specific non-preference-based measures. Yet many mapping algorithms have been found to systematically overpredict EQ-5 D utility values for patients in poor health. Currently there are no guidelines on how to deal with this problem. This paper is concerned with the question of why overestimation of EQ-5 D utility values occurs for patients in poor health, and explores possible solutions. Method Three existing datasets are used to estimate mapping algorithms and assess existing mapping algorithms from the literature mapping the cancer-specific EORTC-QLQ C-30 and the arthritis-specific Health Assessment Questionnaire (HAQ onto the EQ-5 D. Separate mapping algorithms are estimated for poor health states. Poor health states are defined using a cut-off point for QLQ-C30 and HAQ, which is determined using association with EQ-5 D values. Results All mapping algorithms suffer from overprediction of utility values for patients in poor health. The large decrement of reporting 'extreme problems' in the EQ-5 D tariff, few observations with the most severe level in any EQ-5 D dimension and many observations at the least severe level in any EQ-5 D dimension led to a bimodal distribution of EQ-5 D index values, which is related to the overprediction of utility values for patients in poor health. Separate algorithms are here proposed to predict utility values for patients in poor health, where these are selected using cut-off points for HAQ-DI (> 2.0 and QLQ C-30 ( Conclusion Mapping algorithms overpredict utility values for patients in poor health but are used in cost-effectiveness analyses nonetheless. Guidelines can be developed on when the use of a mapping algorithms is inappropriate, for instance through the identification of cut-off points. Cut-off points on a disease specific questionnaire can be identified through association

  10. German Value Set for the EQ-5D-5L.

    Science.gov (United States)

    Ludwig, Kristina; Graf von der Schulenburg, J-Matthias; Greiner, Wolfgang

    2018-06-01

    The objective of this study was to develop a value set for EQ-5D-5L based on the societal preferences of the German population. As the first country to do so, the study design used the improved EQ-5D-5L valuation protocol 2.0 developed by the EuroQol Group, including a feedback module as internal validation and a quality control process that was missing in the first wave of EQ-5D-5L valuation studies. A representative sample of the general German population (n = 1158) was interviewed using a composite time trade-off and a discrete choice experiment under close quality control. Econometric modeling was used to estimate values for all 3125 possible health states described by EQ-5D-5L. The value set was based on a hybrid model including all available information from the composite time trade-off and discrete choice experiment valuations without any exclusions due to data issues. The final German value set was constructed from a combination of a conditional logit model for the discrete choice experiment data and a censored at -1 Tobit model for the composite time trade-off data, correcting for heteroskedasticity. The value set had logically consistent parameter estimates (p German version of EQ-5D-5L representing the preferences of the German population. The study successfully employed for the first time worldwide the improved protocol 2.0. The value set enables the use of the EQ-5D-5L instrument in economic evaluations and in clinical studies.

  11. Interim report on modeling sorption with EQ3/6

    International Nuclear Information System (INIS)

    Viani, B.

    1988-01-01

    Reversible, equilibrium models of sorption to be incorporated into the EQ3/6 geochemical modeling package are summarized. Empirical sorption models as formulated in linear, Langmuir, and Freundlich isotherms will be developed as options to EQ3/6. This work will be done at LLNL. Options for modeling sorption using surface- complexation constructs (diffuse, constant capacitance, and triple-layer models) will also be developed. Development of the surface-complexation options will require part of the work be done under contract. 27 refs., 1 fig

  12. Cross-cultural measurement equivalence of the 5-level EQ-5D (EQ-5D-5L) in patients with type 2 diabetes mellitus in Singapore.

    Science.gov (United States)

    Wang, Ye; Tan, Ngiap-Chuan; Tay, Ee-Guan; Thumboo, Julian; Luo, Nan

    2015-07-16

    This study aimed to assess the measurement equivalence of the 5-level EQ-5D (EQ-5D-5L) among the English, Chinese, and Malay versions. A convenience sample of patients with type 2 diabetes mellitus were enrolled from a public primary health care institution in Singapore. The survey questionnaire comprised the EQ-5D-5L and questions assessing participants' socio-demographic and clinical characteristics. Multiple linear regression models were used to assess the difference in EQ-5D-5L index (calculated using an interim algorithm) and EQ-visual analog scale (EQ-VAS) scores across survey language (Chinese vs. English, Malay vs. English, and Malay vs. Chinese). Measurement equivalence was examined by comparing the 90% confidence interval of difference in the EQ-5D-5L index and EQ-VAS scores with a pre-determined equivalence margin. Multiple logistic regression models were used to assess the response patterns of the 5 Likert-type items of the EQ-5D-5L across survey language. Equivalence was demonstrated between the Chinese and English versions and between the Malay and English versions of the EQ-5D-5L index scores. Equivalence was also demonstrated between the Chinese and English versions and between the Malay and Chinese versions of the EQ-VAS scores. Equivalence could not be determined between the Malay and Chinese versions of the EQ-5D-5L index score and between the Malay and English versions of the EQ-VAS score. No significant difference was found in responses to EQ-5D-5L items between any languages, except that patients who chose to complete the Chinese version were more likely to report "no problems" in mobility compared to those who completed the Malay version of the questionnaire. This study provided evidence for the measurement equivalence of the different language versions of EQ-5D-5L in Singapore.

  13. Americium thermodynamic data for the EQ3/6 database

    International Nuclear Information System (INIS)

    Kerrisk, J.F.

    1984-07-01

    Existing thermodynamic data for aqueous and solid species of americium have been reviewed and collected in a form that can be used with the EQ3/6 database. Data that are important in solubility calculations for americium at a proposed Yucca Mountain nuclear waste repository were emphasized. Conflicting data exist for americium complexes with carbonates. Essentially no data are available for americium solids or complexes at temperatures greater than 25 0 C. 17 references, 4 figures

  14. Disturbed mouse circadian rhythm before the Kobe EQ in 1995

    Science.gov (United States)

    Yokoi, Sayoko

    2013-04-01

    Legends of macro-anomalies before large earthquakes have been passed down for generations in Asia. Most of the statements on earthquake precursors are considered unreliable afterthoughts by traditional scientists. However, disturbed biological rhythms in mice were observed before the Kobe EQ in 1995 (Yokoi et al, 2003). The records of unusual mouse behavior before the earthquake were obtained to study biological clock at Institute for Protein Research, Osaka University. It is clarified that the disturbance was very rare phenomena statistically. Similar phenomenon was observed before the Wenchuan earthquake in 2008, too (Li et al, 2009). In the presentation, I will discuss the phenomena as one example of preseismic unusual animal behaviors.

  15. Download this PDF file

    African Journals Online (AJOL)

    A simple and sensitive stability indicating HPLC method is developed for the quantification of paliperidone in bulk and tablet dosage form. ... using the calibration curve or from the regression ... System suitability: System suitability test was.

  16. The EQ3/6 software package for geochemical modeling: Current status

    International Nuclear Information System (INIS)

    Worlery, T.J.; Jackson, K.J.; Bourcier, W.L.; Bruton, C.J.; Viani, B.E.; Knauss, K.G.; Delany, J.M.

    1988-07-01

    EQ3/6 is a software package for modeling chemical and mineralogic interactions in aqueous geochemical systems. The major components of the package are EQ3NR (a speciation-solubility code), EQ6 (a reaction path code), EQLIB (a supporting library), and a supporting thermodynamic data base. EQ3NR calculates aqueous speciation and saturation indices from analytical data. It can also be used to calculate compositions of buffer solutions for use in laboratory experiments. EQ6 computes reaction path models of both equilibrium step processes and kinetic reaction processes. These models can be computed for closed systems and relatively simple open systems. EQ3/6 is useful in making purely theoretical calculations, in designing, interpreting, and extrapolating laboratory experiments, and in testing and developing submodels and supporting data used in these codes. The thermodynamic data base supports calculations over the range 0-300 degree C. 60 refs., 2 figs

  17. The EQ3/6 software package for geochemical modeling: Current status

    Energy Technology Data Exchange (ETDEWEB)

    Wolery, T.J.; Jackson, K.J.; Bourcier, W.L.; Bruton, C.J.; Viani, B.E.; Knauss, K.G.; Delany, J.M.

    1988-07-01

    EQ3/6 is a software package for modeling chemical and mineralogic interactions in aqueous geochemical systems. The major components of the package are EQ3NR (a speciation-solubility code), EQ6 (a reaction path code), EQLIB (a supporting library), and a supporting thermodynamic data base. EQ3NR calculates aqueous speciation and saturation indices from analytical data. It can also be used to calculate compositions of buffer solutions for use in laboratory experiments. EQ6 computes reaction path models of both equilibrium step processes and kinetic reaction processes. These models can be computed for closed systems and relatively simple open systems. EQ3/6 is useful in making purely theoretical calculations, in designing, interpreting, and extrapolating laboratory experiments, and in testing and developing submodels and supporting data used in these codes. The thermodynamic data base supports calculations over the range 0-300{degree}C. 60 refs., 2 figs.

  18. Solução concentrada de albumina eqüina na fluidoterapia em eqüinos com desidratação leve a moderada

    OpenAIRE

    Belli,C.B.; Michima,L.E.S.; Latorre,S.M.; Fernandes,W.R.

    2008-01-01

    Avaliou-se o efeito da solução concentrada de albumina eqüina diluída a 5% em solução fisiológica (SF) durante fluidoterapia em eqüinos, após indução de desidratação leve a moderada, utilizando-se cinco eqüinos adultos, sem alterações clínicas. Cada animal passou por dois protocolos de fluidoterapia: apenas com SF (metade sob pressão e metade em fluxo contínuo - grupo-controle); com solução de albumina eqüina e SF (apenas em fluxo contínuo - grupo experimental). Avaliaram-se peso, exame físic...

  19. Validation of the EQ-5D in a general population sample in urban China.

    Science.gov (United States)

    Wang, Hong-Mei; Patrick, Donald L; Edwards, Todd C; Skalicky, Anne M; Zeng, Hai-Yan; Gu, Wen-Wen

    2012-02-01

    To evaluate the reliability and validity of the EQ-5D in a general population sample in urban China. Thousand and eight hundred respondents in 18 communities of Hangzhou, China were recruited by multi-stage stratified random sampling. Respondents self-administered a questionnaire including the EQ-5D, the SF-36, and demographic questions. Test-retest reliability at 2-week intervals was evaluated using Kappa coefficient, the intraclass correlation coefficient. The standard error of measurement (SEM) was used to indicate the absolute measurement error. Construct validity was established using convergent, discriminant, and known groups analyses. Complete data for all EQ-5D dimensions were available for 1,747 respondents (97%). Kappa values were from 0.35 to 1.0. The ICCs of test-retest reliability were 0.53 for the EQ-5D index score and 0.87 for the EQ VAS score. The SEM values were 0.13 (9.22% range) and 4.20 (4.20% range) for the EQ-5D index and EQ VAS scores, respectively. The Pearson's correlation coefficients between the EQ-5D and the SF-36 were stronger between comparable dimensions than those between less comparable dimensions, demonstrating convergent and discriminant evidence of construct validity. The Chinese EQ-5D distinguished well between known groups: respondents who reported poor general health and chronic diseases had worse HRQoL than those without. Older people, females, people widowed or divorced, and those with a lower socioeconomic status reported poorer HRQoL. Respondents reporting no problems on any EQ-5D dimension had better scores on the SF-36 summary scores than those reporting problems. The Chinese version of the EQ-5D demonstrated acceptable construct validity and fair to moderate levels of test-retest reliability in an urban general population in China.

  20. EQ3/6 software test and verification report 9/94

    International Nuclear Information System (INIS)

    Kishi, T.

    1996-02-01

    This document is the Software Test and Verification Report (STVR) for the EQ3/6 suite of codes as stipulated in the Individual Software Plan for Initial Qualification of EQ3/6 (ISP-NF-07, Revision 1, 11/25/92). The software codes, EQPT, EQ3NR, EQ6, and the software library EQLIB constitute the EQ3/6 software package. This software test and verification project for EQ3/6 was started under the requirements of the LLNL Yucca Mountain Project Software Quality Assurance Plan (SQAP), Revision 0, December 14, 1989, but QP 3.2, Revision 2, June 21, 1994 is now the operative controlling procedure. This is a ''V and V'' report in the language of QP 3.2, Revision 2. Because the author of this report does not have a background in geochemistry, other technical sources were consulted in order to acquire some familiarity with geochemisty, the terminology minology involved, and to review comparable computational methods especially, geochemical aqueous speciation-solubility calculations. The software for the EQ3/6 package consists of approximately 47,000 lines of FORTRAN77 source code and nine on platforms ranging from workstations to supercomputers. The physical control of EQ3/6 software package and documentation is on a SUN SPARC station. Walkthroughs of each principal software packages, EQPT, EQ3NR, and EQ6 were conducted in order to understand the computational procedures involved, to determine any commonality in procedures, and then to establish a plan for the test and verification of EQ3/6. It became evident that all three phases depended upon solving an n x n matrix by the Newton-Raphson Method. Thus, a great deal of emphasis on the test and verification of this procedure was carried out on the first code in the software package EQPT

  1. EQ3/6 software test and verification report 9/94

    Energy Technology Data Exchange (ETDEWEB)

    Kishi, T.

    1996-02-01

    This document is the Software Test and Verification Report (STVR) for the EQ3/6 suite of codes as stipulated in the Individual Software Plan for Initial Qualification of EQ3/6 (ISP-NF-07, Revision 1, 11/25/92). The software codes, EQPT, EQ3NR, EQ6, and the software library EQLIB constitute the EQ3/6 software package. This software test and verification project for EQ3/6 was started under the requirements of the LLNL Yucca Mountain Project Software Quality Assurance Plan (SQAP), Revision 0, December 14, 1989, but QP 3.2, Revision 2, June 21, 1994 is now the operative controlling procedure. This is a ``V and V`` report in the language of QP 3.2, Revision 2. Because the author of this report does not have a background in geochemistry, other technical sources were consulted in order to acquire some familiarity with geochemisty, the terminology minology involved, and to review comparable computational methods especially, geochemical aqueous speciation-solubility calculations. The software for the EQ3/6 package consists of approximately 47,000 lines of FORTRAN77 source code and nine on platforms ranging from workstations to supercomputers. The physical control of EQ3/6 software package and documentation is on a SUN SPARC station. Walkthroughs of each principal software packages, EQPT, EQ3NR, and EQ6 were conducted in order to understand the computational procedures involved, to determine any commonality in procedures, and then to establish a plan for the test and verification of EQ3/6. It became evident that all three phases depended upon solving an n x n matrix by the Newton-Raphson Method. Thus, a great deal of emphasis on the test and verification of this procedure was carried out on the first code in the software package EQPT.

  2. Letter report: status on code maintenance (EQ3/6)

    International Nuclear Information System (INIS)

    Wolery, T.J.

    1995-01-01

    EQ3/6 is a software package for geochemical modeling of aqueous systems, such as water/rock or waste/water rock. It is being developed for a variety of applications in geochemical studies for the Yucca Mountain Site Characterization Project. Version 7.2a was the first version of this software to be certified for use in quality- affecting work (originally issued for use in non-quality-affecting work only on 12/28/93; certified on S/17/94). In the past year, the Version 7 line software has been maintained while the new Version 8 line has been developed. In this period, sixteen defect reports have been logged and resolved. Corrected software is being released as Version 7.2b. Defect reporting and resolution for the Version 7 line will continue until all released versions in this line are retired, perhaps six months to a year after Version 8.0 is released later this year. The Version 7 software is written in Fortran 77, technically speaking, but incorporates many aspects of older Fortran. The Version 8 software is written in a much more modern Fortran, technically somewhere between Fortran 77 and Fortran 90. Future code maintenance activities will include a more complete move to Fortran 90, as well as continued maintaining of defect reporting and resolution

  3. Development and validation of the alcohol Expectancy Questionnaire Short Form (EQ-SF).

    Science.gov (United States)

    Mezquita, Laura; Camacho, Laura; Suso-Ribera, Carlos; Ortet, Generós; Ibáñez, Manuel I

    2018-01-15

    Alcohol expectancies are proximal variables to alcohol use and misuse. In recent decades, different measures have been developed to assess this construct. One of the most frequently used and recommended instruments is the Expectancy Questionnaire (EQ; Leigh y Stacy, 1993). Our aim is to develop a short version of the EQ (EQ-SF) for suitable use in time-limited administrations. Two samples, adolescents (N = 514, 57.20% females) and adults (N = 548, 61.50% females), completed the EQ together with alcohol-use measures. Different item selection strategies were applied to select the 24 items. The EQ-SF structure was explored using confirmatory factor analysis, and measurement invariance was tested running a multi-group analysis comparing groups by sex and age. Reliability was tested using Cronbach's alpha and omega coefficients. Concurrent validity was investigated with regression analyses. The EQ-SF showed acceptable between-groups measurement invariance. Alphas and omegas ranged from .77 to .93. Positive expectancies predicted both alcohol use and alcohol-related problems. Negative expectancies predicted alcohol-related problems. Sex and age moderated these associations. Males with high positive alcohol expectancies showed higher alcohol consumption than females, while adults with high negative alcohol expectancies showed greater alcohol-related problems than adolescents. Different evidence on the validity and reliability of the EQ-SF suggest that it is a suitable instrument to assess alcohol expectancies in the Spanish population.

  4. [Validity and reliability of the spanish EQ-5D-Y proxy version].

    Science.gov (United States)

    Gusi, N; Perez-Sousa, M A; Gozalo-Delgado, M; Olivares, P R

    2014-10-01

    A proxy version of the EQ-5D-Y, a questionnaire to evaluate the Health Related Quality of Life (HRQoL) in children and adolescents, has recently been developed. There are currently no data on the validity and reliability of this tool. The objective of this study was to analyze the validity and reliability of the EQ-5D-Y proxy version. A core set of self-report tools, including the Spanish version of the EQ-5D-Y were administered to a group of Spanish children and adolescents drawn from the general population. A similar core set of internationally standardized proxy tools, including the EQ-5D-Y proxy version were administered to their parents. Test-retest reliability was determined, and correlations with other generic measurements of HRQoL were calculated. Additionally, known group validity was examined by comparing groups with a priori expected differences in HRQoL. The agreement between the self-report and proxy version responses was also calculated. A total of 477 children and adolescents and their parents participated in the study. One week later, 158 participants completed the EQ-5D-Y/EQ-5D-Y proxy to facilitate reliability analysis. Agreement between the test-retest scores was higher than 88% for EQ-5D-Y self-report, and proxy version. Correlations with other health measurements showed similar convergent validity to that observed in the international EQ-5D-Y. Agreement between the self-report and proxy versions ranged from 72.9% to 97.1%. The results provide preliminary evidence of the reliability and validity of the EQ-5D-Y proxy version. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  5. Comparing and transforming PROMIS utility values to the EQ-5D.

    Science.gov (United States)

    Hartman, John D; Craig, Benjamin M

    2018-03-01

    Summarizing patient-reported outcomes (PROs) on a quality-adjusted life year (QALY) scale is an essential component to any economic evaluation comparing alternative medical treatments. While multiple studies have compared PRO items and instruments based on their psychometric properties, no study has compared the preference-based summary of the EQ-5D-3L and Patient Reported Outcomes Measurement Information System (PROMIS-29) instruments. As part of this comparison, a major aim of this manuscript is to transform PROMIS-29 utility values to an EQ-5D-3L scale. A nationally representative survey of 2623 US adults completed the 29-item PROMIS health profile instrument (PROMIS-29) and the 3-level version of the EQ-5D instrument (EQ-5D-3L). Their responses were summarized on a health utility scale using published estimates. Using regression analysis, PROMIS-29 and EQ-5D-3L utility weights were compared with each other as well as with self-reported general health. PROMIS-29 utility weights were much lower than the EQ-5D-3L weights. However, a correlation coefficient of 0.769 between the utility values of the two instruments suggests that the main discordance is simply a difference in scale between the measures. It is also possible to map PROMIS-29 utility weights onto an EQ-5D-3L scale. EQ-5D-3L losses equal .1784 × (PROMIS-29 Losses) .7286 . The published estimates of the PROMIS-29 produce lower utility values than many other health instruments. Mapping the PROMIS-29 estimates to an EQ-5D-3L scale alleviates this issue and allows for a more straightforward comparison between the PROMIS-29 and other common health instruments.

  6. Measurement properties of the EQ-5D-5L compared to the EQ-5D-3L across eight patient groups

    DEFF Research Database (Denmark)

    Janssen, M F; Pickard, A Simon; Golicki, Dominik

    2012-01-01

    PURPOSE: The aim of this study was to assess the measurement properties of the 5-level classification system of the EQ-5D (5L), in comparison with the 3-level EQ-5D (3L). METHODS: Participants (n = 3,919) from six countries, including eight patient groups with chronic conditions (cardiovascular...... of the 3-level system which improves upon the measurement properties, reducing the ceiling while improving discriminatory power and establishing convergent and known-groups validity.......), redistribution properties, ceiling, discriminatory power, convergent validity, and known-groups validity. RESULTS: Missing values were on average 0.8 % for 5L and 1.3 % for 3L. In total, 2.9 % of responses were inconsistent between 5L and 3L. Redistribution from 3L to 5L using EQ dimension-specific rating scales...

  7. Testes genéticos na eqüideocultura

    Directory of Open Access Journals (Sweden)

    Eduardo Geraldo Alves Coelho

    2008-07-01

    Full Text Available Nos últimos anos a equideocultura deu um salto qualitativo, havendo hoje, no mercado, animais de alto valor e geneticamente superiores. Isso é possível, em grande parte, devido aos avanços na área da genética animal, os quais permitem identificar, não apenas anomalias, mas também diversos genes de interesse econômico. Com o auxílio da citogenética pode-se identificar indivíduos com alterações no número ou na estrutura dos cromossomos, o que em muitos casos afeta principalmente a reprodução. Também a confirmação de genealogia, anteriormente feita por tipagem sangüínea e atualmente por testes de DNA, tem papel extremamente importante, não apenas por garantir a ascendência dos animais, mas também porque um pedigree confiável pode permitir ao criador identificar a origem de problemas genéticos em seu rebanho e reduzi-los ou mesmo, eliminá-los. Ainda com as ferramentas da biologia molecular, podemos hoje, identificar indivíduos que apresentam genes desejáveis ou indesejáveis, o que nos permite selecioná-los precocemente, reduzindo assim, os custos do produtor e aumentando o valor agregado dos animais. Entre tais genes podemos destacar os que identificam portadores ou afetados por mutações genéticas indesejáveis como: SCID (Síndrome da Imunodeficiência Combinada, HYPP (Parilisa Hipercalêmica, HERDA (Astenia Dérmica Regional Hereditária Eqüina, etc. Também a identificação dos genes que determinam a cor ou padrão da pelagem já pode ser feita direta ou indiretamente (por meio de marcadores genéticos, como é o caso dos genes para as pelagens Overo, Tobiano, etc. Com os avanços no estudo do genoma eqüino muito mais estará disponível em breve, o que certamente só trará maiores contribuições à equideocultura mundial.In the last few years the horse breeding industry is achieving significant progresses producing animals of high commercial value and genetically superior. It was possible, mainly due to

  8. Estimating an exchange rate between the EQ-5D-3L and ASCOT.

    Science.gov (United States)

    Stevens, Katherine; Brazier, John; Rowen, Donna

    2018-06-01

    The aim was to estimate an exchange rate between EQ-5D-3L and the Adult Social Care Outcome Tool (ASCOT) using preference-based mapping via common time trade-off (TTO) valuations. EQ-5D and ASCOT are useful for examining cost-effectiveness within the health and social care sectors, respectively, but there is a policy need to understand overall benefits and compare across sectors to assess relative value for money. Standard statistical mapping is unsuitable since it relies on conceptual overlap of the measures but EQ-5D and ASCOT have different conceptualisations of quality of life. We use a preference-based mapping approach to estimate the exchange rate using common TTO valuations for both measures. A sample of health states from each measure was valued using TTO by 200 members of the UK adult general population. Regression analyses are used to generate separate equations between EQ-5D-3L and ASCOT values using their original value set and TTO values elicited here. These are solved as simultaneous equations to estimate the relationship between EQ-5D-3L and ASCOT. The relationship for moving from ASCOT to EQ-5D-3L is a linear transformation with an intercept of -0.0488 and gradient of 0.978. This enables QALY gains generated by ASCOT and EQ-5D to be compared across different interventions. This paper estimated an exchange rate between ASCOT and EQ-5D-3L using a preference-based mapping approach that does not compromise the descriptive systems of the two measures. This contributes to the development of preference-based mapping through the use of TTO as the common metric used to estimate the exchange rate between measures.

  9. The Predictability of Iranian EFL Teachers’ Emotional Quotient (EQ with Their Job Satisfaction

    Directory of Open Access Journals (Sweden)

    Pantea Khoshnoodfar

    2018-03-01

    Full Text Available As teacher education and teacher related issues are under the attention in the past decade in second language (L2 teaching /learning; this research investigated the predictability of Iranian EFL teachers’ emotional quotient (EQ with their job satisfaction. To this end, 90 EFL teachers at English language institutes in Tehran province were selected as the participants. The needed data was gathered by the use of two standardized questionnaires (filled by the participants: EQ and teacher job satisfaction questionnaires. First of all, the normality of the gathered data was checked through using SPSS version 23. Then, the Spearman coefficient of correlation was used to find whether there is any relationship between the participants’ EQ and job satisfaction.  The results proved the two variables had a statistically significant and positive correlation with each other. In the next step, the researchers opted for the multiple regression analysis to achieve the research objective. The present study was a quasi-Experimental including a cause and effect design. The predictor was the independent variable (EQ and the predicted one was the dependent variable (job satisfaction. The findings illustrated a statistically significant and positive predictability of Iranian EFL teachers’ EQ with their job satisfaction. The results of the present research would be useful for second language teacher education courses. It was proven that, since teachers’ EQ can control their job satisfaction, the findings of the present paper could be beneficial in teacher training issues and teacher education.

  10. Validity and responsiveness of the EQ-5D in assessing and valuing health status in patients with anxiety disorders

    Directory of Open Access Journals (Sweden)

    Heinrich Sven

    2010-05-01

    Full Text Available Abstract Background The EQ-5D is a generic questionnaire which generates a health profile as well as index scores for health-related quality of life that may be used in cost-utility analysis. Aims of the study To examine validity and responsiveness of the EQ-5D in patients with anxiety disorders. Methods 389 patients with anxiety disorders completed the EQ-5D at baseline and 6-month follow-up. Subjective measures of quality of life (WHOQOL-BREF and psychopathology (BAI, BDI-II, BSQ, ACQ, MI were used for comparison. Validity was analyzed by assessing associations between EQ-5D scores and related other scores. Responsiveness was analyzed by calculating effect sizes of differences in scores between baseline and follow-up for 3 groups indicating more, constant or less anxiety. Meaningful difference scores for shifting to less or more anxiety were derived by means of regression analysis. Results 88.4% of respondents reported problems in at least one of the EQ-5D dimension at baseline; the mean EQ VAS score was 63.8. The EQ-5D dimension most consistently associated with the measures used for comparison was 'anxiety/depression'. EQ VAS and EQ-5D index scores were highly correlated (|r|>0.5 with scores of the WHOQOL-BREF dimensions 'physical', 'mental' and 'overall' as well as BAI and BDI-II. The EQ-5D index tended to be the most responsive score. Standardized meaningful difference scores were not significantly different between EQ VAS, EQ-5D index and measures used for comparison. Conclusions The EQ-5D seems to be reasonably valid and moderately responsive in patients with anxiety disorders. The EQ-5D index may be suitable for calculating QALYs in economic evaluation of health care interventions for patients with anxiety disorders. Trial registration Current Controlled Trials ISRCTN15716049

  11. Anchoring Vignettes in EQ-5D-5L Questionnaire: Validation of a New Instrument.

    Science.gov (United States)

    Azzolina, Danila; Minto, Clara; Boschetto, Stefania; Martinato, Matteo; Bauce, Barbara; Iliceto, Sabino; Gregori, Dario

    2017-01-01

    Health Related Quality of Life (HRQoL) is an indicator of patient's physical, psychological and social life. HRQoL is influenced by experience, beliefs, perceptions and expectations, and measures subjective perspective of the patient himself. EQ-5D-5L and SF-12 questionnaires are validated instruments useful to measure HRQoL, increasingly administered in electronic formats. The main purpose is to evaluate the feasibility of anchoring vignettes for the EQ-5D-5L questionnaire, with the aim to improve intergroup comparability of responses among different subjects. A comparison with SF-12 questionnaire is carried out. This is a cross-sectional study conducted at the ambulatories of cardiology of the University Hospital of Padova, in Italy. Thirty-eight subjects with a diagnosis of cardiovascular disease or at risk of cardiovascular disease were enrolled. A factorial analysis has been performed to assess the convergent validity of EQ-5D-5L questionnaire compared to Sf-12. Moreover, a compound Hierarchical Ordered Probit (Chopit) model has been estimated to evaluate if the questionnaire form affects the subjective evaluation process in order to compare EQ-5D-5L with and without vignettes. Correlation and factor analysis demonstrate that EQ_5D questionnaire is coherent with SF-12 in paper format. Chopit model estimation shows that questionnaire format does not affect the subjective question interpretation. Moreover, in a parametric model including vignettes, education attainment, disease severity, and gender are predictors of HRQoL status. The EQ-5D including vignettes in electronic format seems to be a valid tool to measure HRQoL as compared to EQ-5D without vignettes in paper format and to SF-12 questionnaire.

  12. Calculation of chemical equilibrium between aqueous solution and minerals: the EQ3/6 software package

    International Nuclear Information System (INIS)

    Wolery, T.J.

    1979-01-01

    The newly developed EQ/36 software package computes equilibrium models of aqueous geochemical systems. The package contains two principal programs: EQ3 performs distribution-of-species calculations for natural water compositions; EQ6 uses the results of EQ3 to predict the consequences of heating and cooling aqueous solutions and of irreversible reaction in rock--water systems. The programs are valuable for studying such phenomena as the formation of ore bodies, scaling and plugging in geothermal development, and the long-term disposal of nuclear waste. EQ3 and EQ6 are compared with such well-known geochemical codes as SOLMNEQ, WATEQ, REDEQL, MINEQL, and PATHI. The data base allows calculations in the temperature interval 0 to 350 0 C, at either 1 atm-steam saturation pressures or a constant 500 bars. The activity coefficient approximations for aqueous solutes limit modeling to solutions of ionic strength less than about one molal. The mathematical derivations and numerical techniques used in EQ6 are presented in detail. The program uses the Newton--Raphson method to solve the governing equations of chemical equilibrium for a system of specified elemental composition at fixed temperature and pressure. Convergence is aided by optimizing starting estimates and by under-relaxation techniques. The minerals present in the stable phase assemblage are found by several empirical methods. Reaction path models may be generated by using this approach in conjunction with finite differences. This method is analogous to applying high-order predictor--corrector methods to integrate a corresponding set of ordinary differential equations, but avoids propagation of error (drift). 8 figures, 9 tables

  13. Preliminary findings of an investigation into the relationship between national culture and EQ-5D value sets.

    Science.gov (United States)

    Bailey, Henry; Kind, Paul

    2010-10-01

    Despite the growing importance of the EQ-5D descriptive system as a basis for the valuation of QALYs in cost-utility analysis, for most countries, there are no EQ-5D value sets. Researchers and policy makers wishing to use the EQ-5D descriptive system in a country for which there is no value set are advised to use one from a nearby or 'similar' population. Factors other than geographic proximity can affect the relative values of EQ-5D states. This study explores the links between national culture and EQ-5D value sets. Rank correlation analysis is used to explore relationships between the relative values of a set of EQ-5D states and dimensions of national culture. The latter are taken from Hofstede's framework which operationalizes national culture in five dimensions. For the data currently available (countries for which EQ-5D value sets and scores on dimensions of culture both exist), moderate and strong correlations were found between the culture dimension of power distance and individualism and the EQ-5D dimensions of pain/discomfort and anxiety/depression. Moderate correlations were also observed between the cultural dimension of masculinity and the EQ-5D dimensions of self care, usual activities and pain/discomfort. Uncertainty avoidance correlates with the EQ-5D dimension of anxiety/depression. The correlation patterns observed are generally consistent with a priori expectations based on the nature of the dimensions of culture and the EQ-5D model. This analysis demonstrates the potential of national culture in providing insight into the drivers of the relative values of EQ-5D dimensions for different countries and in informing decisions about which EQ-5D value sets to use in situations where one does not exist.

  14. CO{sub 2}-EQ emissions of forest chip production in Finland in 2020

    Energy Technology Data Exchange (ETDEWEB)

    Kariniemi, Arto; Kaerhae, Kalle (Metsaeteho Oy, Helsinki (Finland)), e-mail: arto.kariniemi@metsateho.fi

    2010-07-15

    The research carried out by Metsaeteho Oy calculated what would be the total fuel consumption and CO{sub 2}-eq emissions of forest chip production if the use of forest chips is 24 TWh in 2020 in Finland in accordance with the target set of Long-term Climate and Energy Strategy. CO{sub 2}-eq emissions were determined with Metsaeteho Oy's updated Emissions Calculation Model. If the production and consumption of forest chips in Finland are 24 TWh in 2020, then the total CO{sub 2}-eq emissions would be around 230,000 tonnes. The volume of diesel consumption was 73 million litres and petrol 1.7 million litres. Electric rail transportation and chipping at the mill site consumed 17 GWh of electricity. The supply chain with the lowest CO{sub 2}-eq emissions was logging residues comminuted at plant. Conversely, the highest CO{sub 2}-eq emissions came from stump wood when operating with terminal comminuting. Less than 3% of the energy content was consumed during the forest chip production. Energy input/output ratio in the total volume was 0.026 MWh/MWh which varied from 0.019 to 0.038 between the supply systems researched. Hence, forest chip production gave a net of some 97% of the energy content delivered at the plant

  15. Is there a link between the volume of physical exercise and emotional intelligence (EQ?

    Directory of Open Access Journals (Sweden)

    Gáspár Zoltán

    2017-03-01

    Full Text Available Emotional intelligence (EQ was linked to sport participation. We report two studies in which we tested the link between exercise volume, defined as weekly hours of exercise, and EQ. Volunteers (n = 64 and n = 84 completed the Wong and Law Emotional Intelligence Scale. In Study I, significant correlations between exercise volume and use- and regulation-of-emotions prompted us to use a posteriori grouping into high- and low exercise-volume groups. The former exhibited better use-of-emotions than the latter (p = .007, d = .87. In Study II, using a priori grouping, we replicated the finding from Study I (p = .001, d = .78, and the groups also differed in “self-emotions appraisal” (p = .05, d = .44 and total EQ (p = .017, d = .54. Since the items measuring the use-of-emotions involve motivational aspects of the EQ, we posit that this dimension is “naturally” linked to exercise volume. Our findings also suggest that self-emotions appraisal and the overall EQ are linked to greater volumes of exercise. These results should provide an incentive for longitudinal studies in this area.

  16. Intoxicação experimental por monensina em eqüinos

    Directory of Open Access Journals (Sweden)

    Bezerra Jr Pedro Soares

    2000-01-01

    Full Text Available Sete eqüinos foram tratados experimentalmente com monensina sódica. Dois desses animais receberem 3-4 kg/eqüino/dia de uma ração comercial sabidamente implicada em surtos naturais da intoxicação por monensina em eqüinos e que continha 180 ppm±20 da droga. Um eqüino recebeu uma única dose de 5 mg/kg e um outro recebeu 4 doses diárias de 1 mg/kg de monensina sódica originária de um premix. Esses quatro eqüinos morreram ou foram sacrificados in extremis, 3-8 dias após o início da administração da droga. Um quinto eqüino recebeu dose única de 5 mg/kg de monensina, ficou levemente doente e se recuperou. Dois eqüinos não desenvolveram sinais da intoxicação. Um desses eqüinos tinha recebido 40 doses diárias de 0,5 mg/kg de monensina e o outro recebeu 3 kg/dia de uma ração da mesma marca que a usada nas fazendas onde surtos de intoxicação por monensina foram detectados (mas de uma outra partida, mais tarde determinada como contendo menos de 5 ppm de monensina. O aparecimento dos sinais clínicos ocorreu de 2 a 5 dias após a administração da droga e a duração do quadro clínico variou de 24 a 76 horas. Os sinais clínicos incluíam taquicardia, arritmia, gemidos, incoordenação, sudorese, decúbito esternal, decúbito lateral, pedaleios e morte. Em cinco dos eqüinos intoxicados observaram-se marcadas elevações da atividade plasmática de creatina fosfoquinase e, em um eqüino, houve leve aumento da atividade plasmática de aspartato aminotransferase. Os principais achados de necropsia consistiram em áreas brancas ou amarelas, focais ou focalmente extensas e bilateralmente simétricas nos músculos esqueléticos. Essas lesões eram associadas a edema gelatinoso e translúcido das fáscias intermusculares. Quadríceps femoral, adutor, pectíneo, grácil, semi-membranáceo, supra-espinhal, subescapular, braquicefálico e quadríceps femoral estavam entre os músculos esqueléticos mais afetados. Os exames histol

  17. EQ-5D-3L as a health measure of Brazilian adult population.

    Science.gov (United States)

    Menezes, Renata de Miranda; Andrade, Mônica Viegas; Noronha, Kenya Valéria Micaela de Souza; Kind, Paul

    2015-11-01

    This study explores the use of EQ-5D-3L as a measure of population health status in a Brazilian region with significant socioeconomic, demographic, and epidemiological heterogeneity. Data came from a study of 3363 literate individuals aged between 18 and 64 years living in urban areas of the state of Minas Gerais. Descriptive analysis and logistic and OLS regression models were performed to analyze the relationship between EQ-5D-3L (descriptive system and EQ VAS) and other health (self-assessed health status and 8 self-reported diagnosed chronic diseases), socioeconomic (educational level and economic class), and demographic (gender and age) measures. Additionally, a grade of membership (GoM) analysis was performed to identify multidimensional health profiles. A total of 76 health statuses were identified in the Brazilian population. The most prevalent one is full health (44 % of the sample). Elderly people, women, and individuals with poor health and lower socioeconomic conditions generally report more health problems in the EQ-5D-3L dimensions. The GoM analysis demonstrated that health status of older individuals is associated with the socioeconomic condition. Arthritis exhibited the strongest association with the EQ-5D-3L instrument. The results indicate that EQ-5D-3L is a good measure of health status for the Brazilian population. The instrument has a good discriminatory capacity in terms of demographic, socioeconomic, and health measures. The high prevalence of individuals with full health may indicate the presence of ceiling effect. However, this prevalence is smaller than that in other countries.

  18. Validity, responsiveness, and minimal clinically important difference of EQ-5D-5L in stroke patients undergoing rehabilitation.

    Science.gov (United States)

    Chen, Poyu; Lin, Keh-Chung; Liing, Rong-Jiuan; Wu, Ching-Yi; Chen, Chia-Ling; Chang, Ku-Chou

    2016-06-01

    To examine the criterion validity, responsiveness, and minimal clinically important difference (MCID) of the EuroQoL 5-Dimensions Questionnaire (EQ-5D-5L) and visual analog scale (EQ-VAS) in people receiving rehabilitation after stroke. The EQ-5D-5L, along with four criterion measures-the Medical Research Council scales for muscle strength, the Fugl-Meyer assessment, the functional independence measure, and the Stroke Impact Scale-was administered to 65 patients with stroke before and after 3- to 4-week therapy. Criterion validity was estimated using the Spearman correlation coefficient. Responsiveness was analyzed by the effect size, standardized response mean (SRM), and criterion responsiveness. The MCID was determined by anchor-based and distribution-based approaches. The percentage of patients exceeding the MCID was also reported. Concurrent validity of the EQ-Index was better compared with the EQ-VAS. The EQ-Index has better power for predicting the rehabilitation outcome in the activities of daily living than other motor-related outcome measures. The EQ-Index was moderately responsive to change (SRM = 0.63), whereas the EQ-VAS was only mildly responsive to change. The MCID estimation of the EQ-Index (the percentage of patients exceeding the MCID) was 0.10 (33.8 %) and 0.10 (33.8 %) based on the anchor-based and distribution-based approaches, respectively, and the estimation of EQ-VAS was 8.61 (41.5 %) and 10.82 (32.3 %). The EQ-Index has shown reasonable concurrent validity, limited predictive validity, and acceptable responsiveness for detecting the health-related quality of life in stroke patients undergoing rehabilitation, but not for EQ-VAS. Future research considering different recovery stages after stroke is warranted to validate these estimations.

  19. PP: A graphics post-processor for the EQ6 reaction path code

    International Nuclear Information System (INIS)

    Stockman, H.W.

    1994-09-01

    The PP code is a graphics post-processor and plotting program for EQ6, a popular reaction-path code. PP runs on personal computers, allocates memory dynamically, and can handle very large reaction path runs. Plots of simple variable groups, such as fluid and solid phase composition, can be obtained with as few as two keystrokes. Navigation through the list of reaction path variables is simple and efficient. Graphics files can be exported for inclusion in word processing documents and spreadsheets, and experimental data may be imported and superposed on the reaction path runs. The EQ6 thermodynamic database can be searched from within PP, to simplify interpretation of complex plots

  20. Cardiotoxicity of tricyclic antidepressant treated by 2650 mEq sodium bicarbonate: A case report.

    Science.gov (United States)

    Amiri, Hassan; Zamani, Nasim; Hassanian-Moghaddam, Hossein; Shadnia, Shahin

    2016-01-01

    Poisoning with tricyclic antidepressants is an important cause of drug-related self-poisoning in the developed world and a very common cause of poisoning and mortality in developing countries. Electrocardiographic manifestations of most tricyclic antidepressant-poisoned patients resolve by the administration of 1-2 mEq/kg of sodium bicarbonate. Some rare cases have been reported who have been resistant to the long-term or high doses of bicarbonate administration. We present a case of acute tricyclic antidepressant toxicity referring with status epilepticus, hypotension, and refractory QRS complex widening that resolved after the intravenous administration of 2650 mEq sodium bicarbonate.

  1. Cardiotoxicity of tricyclic antidepressant treated by 2650 mEq sodium bicarbonate: A case report

    Directory of Open Access Journals (Sweden)

    Hassan Amiri

    2016-12-01

    Full Text Available Poisoning with tricyclic antidepressants is an important cause of drug-related self-poisoning in the developed world and a very common cause of poisoning and mortality in developing countries. Electrocardiographic manifestations of most tricyclic antidepressant-poisoned patients resolve by the administration of 1–2 mEq/kg of sodium bicarbonate. Some rare cases have been reported who have been resistant to the long-term or high doses of bicarbonate administration. We present a case of acute tricyclic antidepressant toxicity referring with status epilepticus, hypotension, and refractory QRS complex widening that resolved after the intravenous administration of 2650 mEq sodium bicarbonate.

  2. Emotional Intelligence and Job Satisfaction: The EQ Relationship for Deans of U.S. Business Schools

    Science.gov (United States)

    Coco, Charles M.

    2009-01-01

    The main purpose of this study was to determine if a positive relationship existed between Emotional Intelligence and Job Satisfaction for deans of business schools. A secondary purpose was to determine which Emotional Quotient (EQ) competencies were most important for satisfied deans and how these competencies assisted processes related to…

  3. Extension of the EQ3/6 computer codes to geochemical modeling of brines

    Energy Technology Data Exchange (ETDEWEB)

    Jackson, K.J.; Wolery, T.J.

    1984-10-23

    Recent modifications to the EQ3/6 geochemical modeling software package provide for the use of Pitzer's equations to calculate the activity coefficients of aqueous species and the activity of water. These changes extend the range of solute concentrations over which the codes can be used to dependably calculate equilibria in geochemical systems, and permit the inclusion of ion pairs, complexes, and undissociated acids and bases as explicit component species in the Pitzer model. Comparisons of calculations made by the EQ3NR and EQ6 compuer codes with experimental data confirm that the modifications not only allow the codes to accurately evaluate activity coefficients in concentrated solutions, but also permit prediction of solubility limits of evaporite minerals in brines at 25/sup 0/C and elevated temperatures. Calculations for a few salts can be made at temperatures up to approx. 300/sup 0/C, but the temperature range for most electrolytes is constrained by the availability of requisite data to values less than or equal to 100/sup 0/C. The implementation of Pitzer's equations in EQ3/6 allows application of these codes to problems involving calculation of geochemical equilibria in brines; such as evaluation of the chemical environment which might be anticipated for nuclear waste canisters located in a salt repository. 26 references, 3 figures, 1 table.

  4. Validez convergente y discriminante del Inventario de Cociente Emocional (EQ-i

    Directory of Open Access Journals (Sweden)

    Evangelina Regner

    2008-01-01

    Full Text Available Desde la aparición del constructo de inteligencia emocional (Salovey & Mayer, 1990 el campo de las habilidades emocionales se ha ido ampliando notablemente, debido a la apa rición de diferentes conceptualizaciones, teorías e instrumentos de medición. Los desarrollos actuales se han centrado en el estudio de la validez de las pruebas utilizadas para medir la inteligencia emocional. El objetivo de la investigación que se informa fue estudiar la validez convergente y discriminante del Inventario de Cociente Emocional (EQ-i de Bar-On (1997a, 1997b en una muestra argentina de 100 personas adultas. Los instrumentos aplicados fueron: el EQ-i, el Inventario Re visado de Personalidad NEO (NEO PI-R de Costa y Mc Crae (1992 y la Prueba de Inteligencia o de Razonamiento Ver bal (RV de Bennett, Seashore y Wesman (1992. Para analizar los datos se realizaron correlaciones entre el EQ-i, el NEO PI-R y RV y regresiones múltiples por pasos sucesivos entre los factores de personalidad del NEO PI-R y las escalas de inteligencia emocional del EQ-i...

  5. Comparing the standard EQ-5D three-level system with a five-level version

    NARCIS (Netherlands)

    Janssen, Mathieu F.; Birnie, Erwin; Haagsma, Juanita A.; Bonsel, Gouke J.

    2008-01-01

    OBJECTIVES: The aim of this study is a head-to-head comparison of the performance of the three-level EQ-5D (3L) and a newly developed five-level version (5L). METHODS: Eighty-two respondents valued 15 standardized disease descriptions and their own health on three response scales (3L, 5L, and visual

  6. Societal Preferences for EQ-5D Health States from a Brazilian Population Survey.

    Science.gov (United States)

    Viegas Andrade, Mônica; Noronha, Kenya; Kind, Paul; Maia, Ana Carolina; Miranda de Menezes, Renata; De Barros Reis, Carla; Nepomuceno Souza, Michelle; Martins, Diego; Gomes, Lucas; Nichele, Daniel; Calazans, Julia; Mascarenhas, Tamires; Carvalho, Lucas; Lins, Camila

    2013-12-01

    To elicit preference weights for a subset of EuroQol five-dimensional (EQ-5D) questionnaire health states from a representative sample for the state of Minas Gerais, Brazil, using a time trade-off (TTO) method and to analyze these data so as to estimate social preference weights for the complete set of 243 states. Data came from a valuation study with 3362 literate individuals aged between 18 and 64 years living in urban areas. The present study was based on quota sampling by age and sex. Face-to-face interviews were conducted in participants' own homes. A total of 99 EQ-5D questionnaire health states were selected, presorted into 26 blocks of six unique health states. Each participant valued one block together with the full health, worst health, and dead states. Each health state was evaluated by more than 100 individuals. TTO data were modeled at both individual and aggregate levels by using ordinary least squares and random effects methods. Values estimated by different models yielded very similar results with satisfactory goodness-of-fit statistics: the mean absolute error was around 0.03 and fewer than 25% of the states had a mean absolute error greater than 0.05. Dummies coefficients for each level within the EQ-5D questionnaire dimensions of health displayed an internally consistent ordering, with the mobility dimension demonstrating the largest value decrement. The values of mean observed transformed TTO values range from 0.869 to-0.235. The study demonstrates the feasibility of conducting face-to-face interviews using TTO in a Brazilian population setting. The estimated values for EQ-5D questionnaire health states based on this Minas Gerais survey represent an important first step in establishing national Brazilian social preference weights for the EQ-5D questionnaire. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  7. Mapping EORTC QLQ-C30 onto EQ-5D for the assessment of cancer patients

    Directory of Open Access Journals (Sweden)

    Kim Seon Ha

    2012-12-01

    Full Text Available Abstract Background The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30 is the instrument most frequently used to measure quality of life in cancer patients, whereas the EQ-5D is widely used to measure and evaluate general health status. Although the EORTC QLQ-C30 has been mapped to EQ-5D utilities, those studies were limited to patients with a single type of cancer. The present study aimed to develop a mapping relationship between the EORTC QLQ-C30 and EQ-5D-based utility values at the individual level. Methods The model was derived using patients with different types of cancer who were receiving chemotherapy. The external validation set comprised outpatients with colon cancer. Ordinary least squares regression was used to estimate the EQ-5D index from the EORTC QLQ-C30 results. The predictability, goodness of fit, and signs of the estimated coefficients of the model were assessed. Predictive ability was determined by calculating the mean absolute error, the estimated proportions with absolute errors > 0.05 and > 0.1, and the root-mean-squared error (RMSE. Results A model that included global health, physical, role, emotional functions, and pain was optimal, with a mean absolute error of 0.069 and an RMSE of 0.095 (normalized RMSE, 8.1%. The explanatory power of this model was 51.6%. The mean absolute error was higher for modeled patients in poor health. Conclusions This mapping algorithm enabled the EORTC QLQ-C30 to be converted to the EQ-5D utility index to assess cancer patients in Korea.

  8. Mapping of the DLQI scores to EQ-5D utility values using ordinal logistic regression.

    Science.gov (United States)

    Ali, Faraz Mahmood; Kay, Richard; Finlay, Andrew Y; Piguet, Vincent; Kupfer, Joerg; Dalgard, Florence; Salek, M Sam

    2017-11-01

    The Dermatology Life Quality Index (DLQI) and the European Quality of Life-5 Dimension (EQ-5D) are separate measures that may be used to gather health-related quality of life (HRQoL) information from patients. The EQ-5D is a generic measure from which health utility estimates can be derived, whereas the DLQI is a specialty-specific measure to assess HRQoL. To reduce the burden of multiple measures being administered and to enable a more disease-specific calculation of health utility estimates, we explored an established mathematical technique known as ordinal logistic regression (OLR) to develop an appropriate model to map DLQI data to EQ-5D-based health utility estimates. Retrospective data from 4010 patients were randomly divided five times into two groups for the derivation and testing of the mapping model. Split-half cross-validation was utilized resulting in a total of ten ordinal logistic regression models for each of the five EQ-5D dimensions against age, sex, and all ten items of the DLQI. Using Monte Carlo simulation, predicted health utility estimates were derived and compared against those observed. This method was repeated for both OLR and a previously tested mapping methodology based on linear regression. The model was shown to be highly predictive and its repeated fitting demonstrated a stable model using OLR as well as linear regression. The mean differences between OLR-predicted health utility estimates and observed health utility estimates ranged from 0.0024 to 0.0239 across the ten modeling exercises, with an average overall difference of 0.0120 (a 1.6% underestimate, not of clinical importance). This modeling framework developed in this study will enable researchers to calculate EQ-5D health utility estimates from a specialty-specific study population, reducing patient and economic burden.

  9. The BarOn Emotional Quotient Inventory (EQ-i): Development and psychometric adaptation in Bahasa Indonesia

    NARCIS (Netherlands)

    Dewi, Z.L.; Halim, M.S.; Derksen, J.J.L.

    2015-01-01

    The BarOn Emotional Quotient Inventory (EQ-i ; BarOn, 2004) was created to assess emotional intelligence (EI). In our research project we produced the Indonesian version. The EQ-i was translated from English into Bahasa Indonesia and back-translated into English. Test-retest reliabilities and

  10. Testing mapping algorithms of the cancer-specific EORTC QLQ-C30 onto EQ-5D in malignant mesothelioma

    NARCIS (Netherlands)

    D.T. Arnold (David); D. Rowen (Donna); M.M. Versteegh (Matthijs); A. Morley (Anna); C.E. Hooper (Clare); N.A. Maskell (Nicholas)

    2015-01-01

    markdownabstract__Background:__ In order to estimate utilities for cancer studies where the EQ-5D was not used, the EORTC QLQ-C30 can be used to estimate EQ-5D using existing mapping algorithms. Several mapping algorithms exist for this transformation, however, algorithms tend to lose accuracy in

  11. Validity of the EQ-5D as a generic health outcome instrument in a heroin-dependent population

    NARCIS (Netherlands)

    van der Zanden, Bart P.; Dijkgraaf, Marcel G. W.; Blanken, Peter; de Borgie, Corianne A. J. M.; van Ree, Jan M.; van den Brink, Wim

    2006-01-01

    OBJECTIVE: To evaluate the validity of the EuroQol (EQ-5D) in a population of chronic, treatment-resistant heroin-dependent patients. METHODS: The EQ-5D is studied relative to the Maudsley Addiction Profile (MAP), the Symptom Checklist (SCL-90) and the European Addiction Severity Index (EuropASI)

  12. Quality of life profile of general Vietnamese population using EQ-5D-5L.

    Science.gov (United States)

    Nguyen, Long Hoang; Tran, Bach Xuan; Hoang Le, Quynh Ngoc; Tran, Tung Thanh; Latkin, Carl A

    2017-10-11

    Health-related quality of life (HRQOL) is a vital benchmark to assess the effects of health interventions and policies. Measuring HRQOL of the general population is essential to establish a reference for health outcomes evaluations. However, evidence on HRQOL of general populations in low and middle income countries is very limited. This study aimed to measure HRQOL of the Vietnamese population by using the EuroQol-5 dimensions-5 levels (EQ-5D-5L) instrument and determine its associated factors. A cross-sectional study was performed in Hanoi with 1571 residences in Hanoi, the capital city of Vietnam. EQ-5D-5L and EQ- visual analogue scale (EQ-VAS) were used to assess HRQOL. Potential covariates included socio-demographic characteristics, having acute symptoms in the last four weeks, chronic diseases in the last three months, having multiple health issues, and health service utilisation in the last twelve months. A generalized linear model was employed to identify the association between HRQOL and covariates. Overall, the mean EQ-5D utility index was 0.91 (SD = 0.15), and the mean EQ-VAS score was 87.4 (SD = 14.3). The highest proportion of respondents reporting any problems was in Usual activities (24.3%), followed by Anxiety/Depression (15.2%) and Pain/Discomfort (10.0%), while the lowest percentage was in Self-care (2.5%). Lower HRQOL composite scores were related to unemployment, lower income, higher education, living in urban areas, having chronic diseases, having multiple health issues and using health service. For any health problem self-reported by respondents, the health utility reduced by 0.02 (respiratory diseases) to 0.15 (musculoskeletal diseases). Health utility of the general population and reductions for self-reported health problems in this study are useful for future population health evaluations and comparisons. It also informs the development of interventions to reduce health problems of the general population.

  13. Reliability and validity of the EQ-5D-3L for Kashin-Beck disease in China.

    Science.gov (United States)

    Fang, Hua; Farooq, Umer; Wang, Dimiao; Yu, Fangfang; Younus, Mohammad Imran; Guo, Xiong

    2016-01-01

    Kashin-Beck Disease (KBD) is an endemic osteoarthropathy in areas which extend from the North-East to the South-West of China. Most of the patients with KBD suffer multiple dysfunctions in major joints causing decreased health status. However because of their low education level and unique living habits, it is hard to find tools to measure the health-related quality of life (HRQOL). European quality of life (EQ-5D-3L) patient-reported instrument is widely used to measure HRQOL. This study aimed to establish the validity and reliability of the Chinese version of the EQ-5D-3L for evaluating HRQOL of KBD individuals in rural area. 368 individuals who were suffering from KBD were recruited through stratified multistage random sampling from Shaanxi province, China. The EQ-5D-3L and the WHOQOL-BREF were administrated in each individual by face to face interview. Test-retest reliability was assessed at 10-14 days intervals. The test-retest reliability was measured by calculating the Kappa coefficients for EQ-5D-3L five dimensions. For the EQ VAS, the intraclass correlation coefficient (ICC) was computed. Convergent and divergent analysis, construct validity was established using Spearman's rank correlation between the EQ-5D-3L and the WHOQOL-BREF. Known groups' validity was examined by comparing groups with a priori expected differences in health-related quality of life (HRQOL). For 362 individuals (98%), comprehensive data of all the EQ-5D-3L dimensions were available. Kappa values of the EQ-5D-3L five items ranged from 0.324 to 0.554. ICC of the EQ VAS was 0.497. For convergent validity, the three items (self-care, usual activity, and mobility) of EQ-5D-3L, index scores, and VAS showed moderate correlations with the physical health domain of the WHOQOL-BREF (r absolute value ranged from 0.339 to 0.475). For divergent validity, the 5 items of EQ-5D-3L showed weak or no correlations with environment and social relationship domains of WHOQOL-BREF. The Chinese EQ-5D-3L

  14. Does the EQ-5D measure quality of life in schizophrenia?

    DEFF Research Database (Denmark)

    Halling Hastrup, Lene; Nordentoft, Merete; Hjorthoej, Carsten

    2011-01-01

    Most health economic evaluations in mental care include outcome measures aimed at specific aspects of health, like symptom improvement, functional improvement and quality of life instead of generic preference based outcome measures. The health economic guidelines (NICE) recommend to include...... a generic preference based outcome measure, like EQ-5D, in health economic evaluations in order to allow for comparisons of health related quality of life of patient groups across different diseases, providing information particular useful to support health policy decisions and cost-effectiveness analysis...... in mental health, but only few studies have addressed the correlation between the EQ-5D and a condition-specific quality of life measure in mental health....

  15. Modeling ion exchange in clinoptilolite using the EQ3/6 geochemical modeling code

    International Nuclear Information System (INIS)

    Viani, B.E.; Bruton, C.J.

    1992-06-01

    Assessing the suitability of Yucca Mtn., NV as a potential repository for high-level nuclear waste requires the means to simulate ion-exchange behavior of zeolites. Vanselow and Gapon convention cation-exchange models have been added to geochemical modeling codes EQ3NR/EQ6, allowing exchange to be modeled for up to three exchangers or a single exchanger with three independent sites. Solid-solution models that are numerically equivalent to the ion-exchange models were derived and also implemented in the code. The Gapon model is inconsistent with experimental adsorption isotherms of trace components in clinoptilolite. A one-site Vanselow model can describe adsorption of Cs or Sr on clinoptilolite, but a two-site Vanselow exchange model is necessary to describe K contents of natural clinoptilolites

  16. Mieloencefalite protozoária eqüina (Relato de caso.

    Directory of Open Access Journals (Sweden)

    R. C. Gonçalves

    2005-03-01

    Full Text Available RESUMO :O objetivo deste trabalho foi relatar um caso de mieloencefalite protozoária eqüina no Estado de São Paulo, Brasil. O diagnóstico se baseou nos sinais clínicos, no resultado positivo para anticorpos contra Sarcocystis neurona no soro e no líquor pela técnica de Western blot. Palavras chave: Mieloencefalite, Sarcocystis neurona, eqüinos. SUMMARY: The purpose of this work was to present a case of equine protozoal myeloencephalitis (EPM in the State of São Paulo, Brazil. The diagnosis was based on the clinical sings, the positive results of the serum and cerebrospinal fluid analysis (Western blot for antibodies against Sarcocystis neurona. Keywords: Myeloencephalitis, Sarcocystis neurona,

  17. Tamuarawai (EQS) : an early lapita site on Emirau, New Ireland, PNG

    International Nuclear Information System (INIS)

    Summerhayes, G.R.; Matisoo-Smith, E.; Mandui, H.; Allen, J.; Specht, J.; Hogg, N.; McPherson, S.

    2010-01-01

    In 2007 a new Early Lapita site called Tamuarawai (EQS) was located on Emirau Island, Papua New Guinea. Two seasons of excavation (2007, 2008) have been undertaken. This paper describes the site and some of the preliminary analyses undertaken. Some unusual results suggest that Tamuarawai will make an important contribution to modelling the Early Lapita occupation of the Bismarck Archipelago. (author). 29 refs., 11 figs., 11 tabs.

  18. EQ3/6 data base - Ongoing development at Lawrence Livermore National Laboratory

    International Nuclear Information System (INIS)

    Delany, J.M.

    1986-01-01

    The EQ/6 Data Base has been revised and enhanced to meet the maintenance needs of a large continuously evolving data base. Within the last year a new data-base structure has been developed to manage the manipulation, basic data entry, import/export, retrieval and display features. The data management approach includes visual simplicity, on-line documentation, information management and controls to limit user error, ensure data protection and proper documentation of thermodynamic values and their sources

  19. An EQ-5D-5L value set based on Uruguayan population preferences.

    Science.gov (United States)

    Augustovski, Federico; Rey-Ares, Lucila; Irazola, Vilma; Garay, Osvaldo Ulises; Gianneo, Oscar; Fernández, Graciela; Morales, Marcelo; Gibbons, Luz; Ramos-Goñi, Juan Manuel

    2016-02-01

    To derive a value set from Uruguayan general population using the EQ-5D-5L questionnaire and report population norms. General population individuals were randomly assigned to value 10 health states using composite time trade off and 7 pairs of health states through discrete choice experiments. A stratified sampling with quotas by location, gender, age and socio-economic status was used to respect the Uruguayan population structure. Trained interviewers conducted face-to-face interviews. The EuroQol valuation technology was used to administer the protocol as well as to collect the data. OLS and maximum likelihood robust regression models with or without interactions were tested. We included 794 respondents between 20 and 83 years. Their characteristics were broadly similar to the Uruguayan population. The main effects robust model was chosen to derive social values. Values ranged from -0.264 to 1. States with a misery index = 6 had a mean predicted value of 0.965. When comparing the Uruguayan population with the Argentinian EQ-5D-5L crosswalk value set, the prediction for states which differed from full health only in having one of the dimensions at level 2 were about 0.05 higher in Uruguay. The mean index value, using the selected Uruguayan EQ-5D-5L value set, for the general population in Uruguay was 0.895. In general, older people had worse values and males had slightly better values than females. We derived the EQ-5D-5L Uruguayan value set, the first in Latin America. These results will help inform decision-making using economic evaluations for resource allocation decisions.

  20. Psychometric properties of the Serbian version of the Empathy Quotient (S-EQ

    Directory of Open Access Journals (Sweden)

    Dimitrijević Aleksandar

    2012-01-01

    Full Text Available In the present study we examined psychometric properties of the Serbian translation of the Empathy Quotient scale (S-EQ. The translated version of the EQ was applied on a sample of 694 high-school students. A sub-sample consisting of 375 high-school students also completed the Interpersonal Reactivity Index (IRI, another widely used empathy measure. The following statistical analyses were applied: internal consistency analysis, explanatory (EFA and confirmatory (CFA factor analyses, and factor congruence analysis. Correlation with IRI and gender differences were calculated to demonstrate validity of the instrument. Results show that the Serbian 40-item version of EQ has lower reliability (Cronbach’s alpha = .782 than the original. The originally proposed one factor structure of the instrument was not confirmed. The short version with 28 items showed better reliablity (alpha= .807. The three-factor solution (cognitive empathy, emotional reactivity, and social skills showed good cross-sample stability (Tucker congruence coefficient over .8 but the results of CFA confirmed the solution proposed in the reviewed literature only partially. The mean scores are similar to those obtained in the other studies, and, as expected, women have significantly higher scores than men. Correlations with all subscales of IRI are statistically significant for the first two subscales of EQ, but not for the „social skills.” We concluded that the Serbian version of the „Empathy Quotient” is a useful research tool which can contribute to cross-cultural studies of empathy, although its psychometric characteristics are not as good as those obtained in the original study. We also suggest that a 28-item should be used preferably to the original 40-item version. [Projekat Ministarstva nauke Republike Srbije, br. 179018: Identification, measurement and development of cognitive and emotional competences important for a society oriented to European integrations

  1. Supplement to nuclear EQ sourcebook: A compilation of documents for nuclear equipment qualification

    International Nuclear Information System (INIS)

    Anon.

    1993-01-01

    In the nuclear power industry, environmental and seismic qualification of safety-related electrical and instrumentation equipment is collectively known as Equipment Qualification (EQ). Related technology, as well as regulatory requirements, have evolved rapidly during the last 15 years. For environmental qualification, what began in 1971 with one trial-use guide (IEEE Std 323-1971), now stands as a full complement of Nuclear Regulatory Commission (NRC) rules, guides, and industry standards. As the original 1992 version of the Nuclear EQ Sourcebook was compiled to serve the user-community need for a complete and exhaustive single source of nuclear EQ documentation, this Supplement is published to provide the user community with nuclear EQ documentation revisions and updates that have been published since the publication of the original volume in May of 1992. The first volume of this publication included documents issued before December, 1991. That first volume was well received and also prompted positive response from industry on its usefulness and on recommendations to improve the completeness and enhance the ease of use. This Supplement, therefore, includes new documents, revisions, and updates issued and published since December 1991 and up to and including March 1993. It incorporates various enhancements in order to better serve the user community. One such enhancement included in this Supplement is the new Equipment Classification Index that is described in the User Guide section of this publication. 37 papers, including Bulletins, Federal rules, Generic Letters, Notices, Regulatory Guides, IEEE Standards, IEEE Recommended Practices, and IEEE Guides, have been processed separately for inclusion on the data base

  2. Intoxicação em eqüino por Ricinus communis: relato de caso.

    Directory of Open Access Journals (Sweden)

    R. Y. A. Baccarin

    2005-03-01

    Full Text Available RESUMO: A intoxicação por Ricinus communis (Euphorbiaceae geralmente ocorre após a ingestão acidental de suas folhas ou sementes, podendo causar distúrbios neuromusculares e gastrintestinais. Um eqüino da raça Mangalarga Marchador de 4 anos de idade foi atendido no setor de Clínica de Eqüinos do Hospital Veterinário (HOVET da Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo (FMVZ-USP após ter ingerido e aspirado um filtrado preparado à base de frutos de mamona. O animal apresentava pleuropneumonia, alterações de comportamento, comprometimentos hepático e renal, peritonite e desidratação. PALAVRAS-CHAVE: Eqüino, Ricinus communis, pleuropneumonia. SUMMARY: The Ricinus communis (Euphorbiaceae intoxication generally occurs after accidental ingestion of its leaves or seeds, and may cause neuromuscular and gastrintestinal disturbance. An equine, Mangalarga Marchador breed, 4-year old, was attended at the section of Clínica de Eqüinos from the Hospital Veterinário (HOVET of Faculdade de Medicina Veterinária e Zootecnia of Universidade de São Paulo (FMVZ-USP after ingestion and aspiration of a R. communis fruits filtrate. The animal presented pleuropneumonia, behavioural alterations, hepatic and renal disturbances, peritonitis and dehydration. KEYWORDS: Equine, Ricinus communis, pleuropneumonia.

  3. Examining the incremental impact of long-standing health conditions on subjective well-being alongside the EQ-5D.

    Science.gov (United States)

    Wu, Mengjun; Brazier, John; Relton, Clare; Cooper, Cindy; Smith, Christine; Blackburn, Joanna

    2014-04-29

    Generic preference-based measures such as the EQ-5D and SF-6D have been criticised for being narrowly focused on a sub-set of dimensions of health. Our study aims to explore whether long-standing health conditions have an incremental impact on subjective well-being alongside the EQ-5D. Using data from the South Yorkshire Cohort study (N = 13,591) collected between 2010 and 2012 on the EQ-5D, long-standing health conditions (self-reported), and subjective well-being measure--life satisfaction using a response scale from 0 (completely dissatisfied) to 10 (completely satisfied), we employed generalised logit regression models. We assessed the impact of EQ-5D and long-standing health conditions together on life satisfaction by examining the size and significance of their estimated odds ratios. The EQ-5D had a significant association with life satisfaction, in which anxiety/depression and then self-care had the largest weights. Some long-standing health conditions were significant in some models, but most did not have an independent impact on life satisfaction. Overall, none of the health conditions had a consistent impact on life satisfaction alongside the EQ-5D. Out study suggests that the impact of long-standing health conditions on life satisfaction is adequately captured by the EQ-5D, although the findings are limited by reliance on self-reported conditions and a single item life satisfaction measure.

  4. Validation of Ulchin Units 1, 2 CONTEMPT Model Prior to the Production of EQ Envelope Curve

    International Nuclear Information System (INIS)

    Hwang, Su Hyun; Kim, Min Ki; Hong, Soon Joon; Lee, Byung Chul; Suh, Jeong Kwan; Lee, Jae Yong; Song, Dong Soo

    2010-01-01

    The Ulchin Units 1, 2 will be refurbished with RSG (Replacement of Steam Generator) and PU (Power Uprate). The current EQ (Environmental Qualification) envelope curve should be modified according to RSG and PU. The containment P/T (Pressure/Temperature) analysis in Ulchin Units 1, 2 FSAR was done using EDF computer program PAREO6. PAREO6 uses the same assumptions as the US NRC CONTEMPT program, and the results given by both programs are in good agreement. It is utilized to determine pressure and temperature variations in a PWR containment subsequent to a reactor coolant or secondary system pipe break. But PAREO6 cannot be available to the production of EQ envelope curve, so CONTEMPT code should be used instead of PAREO6. It is essential to validate the CONTEMPT OSG (Original Steam Generator) model prior to the production of EQ envelope curve considering RSG and PU. This study has been performed to validate the CONTEMPT model of Ulchin Units 1, 2 by comparing the CONTEMPT results with the PAERO6 results in Ulchin Units 1, 2 FSAR

  5. Validation of Ulchin Units 1, 2 CONTEMPT Model Prior to the Production of EQ Envelope Curve

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Su Hyun; Kim, Min Ki; Hong, Soon Joon; Lee, Byung Chul [FNC Technology Co., SNU, Seoul (Korea, Republic of); Suh, Jeong Kwan; Lee, Jae Yong; Song, Dong Soo [KEPCO Research Institute, Daejeon (Korea, Republic of)

    2010-10-15

    The Ulchin Units 1, 2 will be refurbished with RSG (Replacement of Steam Generator) and PU (Power Uprate). The current EQ (Environmental Qualification) envelope curve should be modified according to RSG and PU. The containment P/T (Pressure/Temperature) analysis in Ulchin Units 1, 2 FSAR was done using EDF computer program PAREO6. PAREO6 uses the same assumptions as the US NRC CONTEMPT program, and the results given by both programs are in good agreement. It is utilized to determine pressure and temperature variations in a PWR containment subsequent to a reactor coolant or secondary system pipe break. But PAREO6 cannot be available to the production of EQ envelope curve, so CONTEMPT code should be used instead of PAREO6. It is essential to validate the CONTEMPT OSG (Original Steam Generator) model prior to the production of EQ envelope curve considering RSG and PU. This study has been performed to validate the CONTEMPT model of Ulchin Units 1, 2 by comparing the CONTEMPT results with the PAERO6 results in Ulchin Units 1, 2 FSAR

  6. Testing mapping algorithms of the cancer-specific EORTC QLQ-C30 onto EQ-5D in malignant mesothelioma.

    Science.gov (United States)

    Arnold, David T; Rowen, Donna; Versteegh, Matthijs M; Morley, Anna; Hooper, Clare E; Maskell, Nicholas A

    2015-01-23

    In order to estimate utilities for cancer studies where the EQ-5D was not used, the EORTC QLQ-C30 can be used to estimate EQ-5D using existing mapping algorithms. Several mapping algorithms exist for this transformation, however, algorithms tend to lose accuracy in patients in poor health states. The aim of this study was to test all existing mapping algorithms of QLQ-C30 onto EQ-5D, in a dataset of patients with malignant pleural mesothelioma, an invariably fatal malignancy where no previous mapping estimation has been published. Health related quality of life (HRQoL) data where both the EQ-5D and QLQ-C30 were used simultaneously was obtained from the UK-based prospective observational SWAMP (South West Area Mesothelioma and Pemetrexed) trial. In the original trial 73 patients with pleural mesothelioma were offered palliative chemotherapy and their HRQoL was assessed across five time points. This data was used to test the nine available mapping algorithms found in the literature, comparing predicted against observed EQ-5D values. The ability of algorithms to predict the mean, minimise error and detect clinically significant differences was assessed. The dataset had a total of 250 observations across 5 timepoints. The linear regression mapping algorithms tested generally performed poorly, over-estimating the predicted compared to observed EQ-5D values, especially when observed EQ-5D was below 0.5. The best performing algorithm used a response mapping method and predicted the mean EQ-5D with accuracy with an average root mean squared error of 0.17 (Standard Deviation; 0.22). This algorithm reliably discriminated between clinically distinct subgroups seen in the primary dataset. This study tested mapping algorithms in a population with poor health states, where they have been previously shown to perform poorly. Further research into EQ-5D estimation should be directed at response mapping methods given its superior performance in this study.

  7. Estimating EQ-5D values from the Oswestry Disability Index and numeric rating scales for back and leg pain.

    Science.gov (United States)

    Carreon, Leah Y; Bratcher, Kelly R; Das, Nandita; Nienhuis, Jacob B; Glassman, Steven D

    2014-04-15

    Cross-sectional cohort. The purpose of this study is to determine whether the EuroQOL-5D (EQ-5D) can be derived from commonly available low back disease-specific health-related quality of life measures. The Oswestry Disability Index (ODI) and numeric rating scales (0-10) for back pain (BP) and leg pain (LP) are widely used disease-specific measures in patients with lumbar degenerative disorders. Increasingly, the EQ-5D is being used as a measure of utility due to ease of administration and scoring. The EQ-5D, ODI, BP, and LP were prospectively collected in 14,544 patients seen in clinic for lumbar degenerative disorders. Pearson correlation coefficients for paired observations from multiple time points between ODI, BP, LP, and EQ-5D were determined. Regression modeling was done to compute the EQ-5D score from the ODI, BP, and LP. The mean age was 53.3 ± 16.4 years and 41% were male. Correlations between the EQ-5D and the ODI, BP, and LP were statistically significant (P < 0.0001) with correlation coefficients of -0.77, -0.50, and -0.57, respectively. The regression equation: [0.97711 + (-0.00687 × ODI) + (-0.01488 × LP) + (-0.01008 × BP)] to predict EQ-5D, had an R2 of 0.61 and a root mean square error of 0.149. The model using ODI alone had an R2 of 0.57 and a root mean square error of 0.156. The model using the individual ODI items had an R2 of 0.64 and a root mean square error of 0.143. The correlation coefficient between the observed and estimated EQ-5D score was 0.78. There was no statistically significant difference between the actual EQ-5D (0.553 ± 0.238) and the estimated EQ-5D score (0.553 ± 0.186) using the ODI, BP, and LP regression model. However, rounding off the coefficients to less than 5 decimal places produced less accurate results. Unlike previous studies showing a robust relationship between low back-specific measures and the Short Form-6D, a similar relationship was not seen between the ODI, BP, LP, and the EQ-5D. Thus, the EQ-5D cannot be

  8. Health-related quality of life measured using the EQ-5D-5L: South Australian population norms.

    Science.gov (United States)

    McCaffrey, Nikki; Kaambwa, Billingsley; Currow, David C; Ratcliffe, Julie

    2016-09-20

    Although a five level version of the widely-used EuroQol 5 dimensions (EQ-5D) instrument has been developed, population norms are not yet available for Australia to inform the future valuation of health in economic evaluations. The aim of this study was to estimate HrQOL normative values for the EQ-5D-5L preference-based measure in a large, randomly selected, community sample in South Australia. The EQ-5D-5L instrument was included in the 2013 South Australian Health Omnibus Survey, an interviewer-administered, face-to-face, cross-sectional survey. Respondents rated their level of impairment across dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) and global health rating on a visual analogue scale (EQ-VAS). Utility scores were derived using the newly-developed UK general population-based algorithm and relationships between utility and EQ-VAS scores and socio-demographic factors were also explored using multivariate regression analyses. Ultimately, 2,908 adults participated in the survey (63.4 % participation rate). The mean utility and EQ-VAS scores were 0.91 (95 CI 0.90, 0.91) and 78.55 (95 % CI 77.95, 79.15), respectively. Almost half of respondents reported no problems across all dimensions (42.8 %), whereas only 7.2 % rated their health >90 on the EQ-VAS (100 = the best health you can imagine). Younger age, male gender, longer duration of education, higher annual household income, employment and marriage/de facto relationships were all independent, statistically significant predictors of better health status (p measured with the EQ-VAS. Only age and employment status were associated with higher utility scores, indicating fundamental differences between these measures of health status. This is the first Australian study to apply the EQ-5D-5L in a large, community sample. Overall, findings are consistent with EQ-5D-5L utility and VAS scores reported for other countries and indicate that the majority of South

  9. Avaliação de solução concentrada de albumina eqüina na fluidoterapia em eqüinos com desidratação leve a moderada

    OpenAIRE

    Carla Bargi Belli

    2005-01-01

    A utilização de colóides é indicada em várias situações, mas nem sempre aplicável na clínica de eqüinos. O objetivo desse trabalho foi avaliar o uso de solução concentrada de albumina eqüina (diluída a 5%) durante fluidoterapia em eqüinos com desidratação leve a moderada, comparando-a com fluidoterapia apenas com solução fisiológica. Foram utilizados dois grupos de cinco eqüinos adultos, sem alterações clínicas. Cada animal passou pelo protocolo dos dois grupos experimentais (fluidoterapia ap...

  10. Inequalities in health status among rural residents: EQ-5D findings from household survey China.

    Science.gov (United States)

    Li, Haitao; Wei, Xiaolin; Ma, Aixia; Chung, Roger Y

    2014-05-19

    This study analyzed inequalities in health status among different socioeconomic and demographic rural residents covered by the New Rural Cooperative Medical System in China. A cross-sectional study was conducted in Lian Yungang City, China. A total of 337 respondents, who were selected by using a multistage stratified systematic random sampling method, completed the surveys. A questionnaire consisting of EQ-5D and demographic and socioeconomic information was adopted for data collection, and was administered by face-to-face interviews. Multiple regression models were employed to examine the differences in the Visual Analogue Scale (VAS) score and the EQ-5D dimensions. Compared with those with lower education attainment, the respondents with higher education levels tended to report a higher VAS score (β = 2.666, 95% CI: 0.978 to 6.310), and were less likely to suffer from pain/discomfort (OR = 3.968; 95% CI: 1.447 to 10.880). The singles were more likely than the married to report moderate or extreme problems in usual activities (OR = 4.583; 95% CI: 1.188 to 17.676) and mobility (OR = 10.666; 95% CI: 2.464 to 6.171). However, no statistically significant differences were identified between the respondents with different income levels in the VAS score and EQ-5D dimensions. This study suggests that the singles and the people with lower education levels are high-risk groups for poorer health status in the Chinese rural population. The findings from this study warrant further investigation.

  11. Guide to data preparation for EQ3/6 (Wolery) modified for the IBM 3033

    International Nuclear Information System (INIS)

    Noy, D.J.

    1981-11-01

    The ability to predict mineral-fluid equilibria is an important aspect of geochemical research into radioactive waste disposal. The interaction of ground waters and waste leachates with the host rock of a disposal site, either at elevated or ambient temperatures, will influence the performance of the disposal system. The EQ3/6 package (Wolery, 1979) provides a technique for the prediction of such interactions using available thermodynamic data, and for extrapolating laboratory experimental data on rock-fluid equilibria. This report describes the modifications performed on this package to allow operation on an IBM machine, and is intended as a guide to data preparation for the programmes. (author)

  12. EQ3/6 geochemical modeling task plan for Nevada Nuclear Waste Storage Investigations (NNWSI)

    Energy Technology Data Exchange (ETDEWEB)

    Isherwood, D.; Wolery, T.

    1984-04-10

    This task plan outlines work needed to upgrade the EQ3/6 geochemical code and expand the supporting data bases to allow the Nevada Nuclear Waste Storage Investigations (NNWSI) to model chemical processes important to the storage of nuclear waste in a tuff repository in the unsaturated zone. The plan covers the fiscal years 1984 to 1988. The scope of work includes the development of sub-models in the EQ3/6 code package for studying the effects of sorption, precipitation kinetics, redox disequilibrium, and radiolysis on radionuclide speciation and solubility. The work also includes a glass/water interactions model and a geochemical flow model which will allow us to study waste form leaching and reactions involving the waste package. A special emphasis is placed on verification of new capabilities as they are developed and code documentation to meet NRC requirements. Data base expansion includes the addition of elements and associated aqueous species and solid phases that are specific to nuclear waste (e.g., actinides and fission products) and the upgrading and documentation of the thermodynamic data for other species of interest.

  13. A social preference valuations set for EQ-5D health states in Flanders, Belgium.

    Science.gov (United States)

    Cleemput, Irina

    2010-04-01

    This study aimed at deriving a preference valuation set for EQ-5D health states from the general Flemish public in Belgium. A EuroQol valuation instrument with 16 health states to be valued on a visual analogue scale was sent to a random sample of 2,754 adults. The initial response rate was 35%. Eventually, 548 (20%) respondents provided useable valuations for modeling. Valuations for 245 health states were modeled using a random effects model. The selection of the model was based on two criteria: health state valuations must be consistent, and the difference with the directly observed valuations must be small. A model including a value decrement if any health dimension of the EQ-5D is on the worst level was selected to construct the social health state valuation set. A comparison with health state valuations from other countries showed similarities, especially with those from New Zealand. The use of a single preference valuation set across different health economic evaluations within a country is highly preferable to increase their usability for policy makers. This study contributes to the standardization of outcome measurement in economic evaluations in Belgium.

  14. An Australian discrete choice experiment to value eq-5d health states.

    Science.gov (United States)

    Viney, Rosalie; Norman, Richard; Brazier, John; Cronin, Paula; King, Madeleine T; Ratcliffe, Julie; Street, Deborah

    2014-06-01

    Conventionally, generic quality-of-life health states, defined within multi-attribute utility instruments, have been valued using a Standard Gamble or a Time Trade-Off. Both are grounded in expected utility theory but impose strong assumptions about the form of the utility function. Preference elicitation tasks for both are complicated, limiting the number of health states that each respondent can value and, therefore, that can be valued overall. The usual approach has been to value a set of the possible health states and impute values for the remainder. Discrete Choice Experiments (DCEs) offer an attractive alternative, allowing investigation of more flexible specifications of the utility function and greater coverage of the response surface. We designed a DCE to obtain values for EQ-5D health states and implemented it in an Australia-representative online panel (n = 1,031). A range of specifications investigating non-linear preferences with respect to time and interactions between EQ-5D levels were estimated using a random-effects probit model. The results provide empirical support for a flexible utility function, including at least some two-factor interactions. We then constructed a preference index such that full health and death were valued at 1 and 0, respectively, to provide a DCE-based algorithm for Australian cost-utility analyses. Copyright © 2013 John Wiley & Sons, Ltd.

  15. Mormo em eqüídeos nos Estados de Pernambuco e Alagoas

    Directory of Open Access Journals (Sweden)

    Mota Rinaldo A.

    2000-01-01

    Full Text Available Com base em aspectos clínico-patológicos, epidemiológicos e sorológicos, bem como pelo isolamento de Burkholderia mallei, diagnosticaram-se focos de mormo em eqüídeos na Zona da Mata dos Estados de Pernambuco e Alagoas. Clinicamente observaram-se hipertermia, respiração ruidosa, inapetência, emagrecimento progressivo até caquexia, congestão nasal e descarga mucopurulenta, erosões, úlceras e cicatrizes na mucosa nasal. Os linfonodos mandibulares e cervicais superficiais apresentavam-se aumentados de volume, com abscessos e fístulas exsudando material purulento. Na pele, ao longo dos vasos linfáticos, havia formação de nódulos firmes e abscessos que, nos casos crônicos, fistulavam e ulceravam deixando cicatrizes estrelares. A histopatologia dos nódulos de diversos sítios, tanto dos eqüídeos como dos cobaios utilizados na prova de Straus, revelou lesões granulomatosas e piogranulomas. Os dados deste estudo evidenciam a emergência da doença nesta área e permitem recomendar inquéritos soro-epidemiológicos nos Estados de ocorrência dos surtos e nos Estados limítrofes.

  16. A qualitative examination of the content validity of the EQ-5D-5L in patients with type 2 diabetes.

    Science.gov (United States)

    Matza, Louis S; Boye, Kristina S; Stewart, Katie D; Curtis, Bradley H; Reaney, Matthew; Landrian, Amanda S

    2015-12-01

    The EQ-5D is frequently used to derive utilities for patients with type 2 diabetes (T2D). Despite widely available quantitative psychometric data on the EQ-5D, little is known about content validity in this population. Thus, the purpose of this qualitative study was to examine content validity of the EQ-5D in patients with T2D. Patients with T2D in the UK completed concept elicitation interviews, followed by administration of the EQ-5D-5L and cognitive interviewing focused on the instrument's relevance, clarity, and comprehensiveness. A total of 25 participants completed interviews (52.0 % male; mean age = 53.5 years). Approximately half (52 %) reported that the EQ-5D-5L was relevant to their experience with T2D. When asked if each individual item was relevant to their experience with T2D, responses varied widely (24.0 % said the self-care item was relevant; 68.0 % said the anxiety/depression item was relevant). Participants frequently said items were not relevant to themselves, but could be relevant to patients with more severe diabetes. Most participants (92.0 %) reported that T2D and/or its treatment/monitoring requirements had an impact on their quality of life that was not captured by the EQ-5D-5L. Common missing concepts included food awareness/restriction (n = 13, 52.0 %); activities (n = 11, 44.0 %); emotional functioning other than depression/anxiety (n = 8, 32.0 %); and social/relationship functioning (n = 8, 32.0 %). The results highlight strengths and potential limitations of the EQ-5D-5L, including missing content that could be important for some patients with T2D. Suggestions for addressing limitations are provided.

  17. Cross-cultural measurement equivalence of the EQ-5D-5L items for English-speaking Asians in Singapore.

    Science.gov (United States)

    Luo, N; Wang, Y; How, C H; Wong, K Y; Shen, L; Tay, E G; Thumboo, J; Herdman, M

    2015-06-01

    To investigate how the response labels of the 5-level EQ-5D (EQ-5D-5L) items are interpreted and used by English-speaking Chinese and non-Chinese Singaporeans, as a means to assessing whether those items are cross-culturally equivalent health-status measures in this Asian population. In face-to-face interviews, Chinese, Malay and Indian visitors to a primary care institution in Singapore were asked to rate the relative severity conveyed by EQ-5D-5L response labels, each containing the keyword of 'no(t),' 'slight(ly),' 'moderate(ly),' 'severe(ly),' or 'unable'/'extreme(ly),' using a 0-100 numerical rating scale. Participants were also asked to describe 25 hypothetical health states using the EQ-5D-5L response labels. Differences between Chinese and Malay/Indian participants in label interpretation and selection were examined using multivariate regression analysis to adjust for participant characteristics. The differences in adjusted mean severity scores for individual EQ-5D-5L labels between Chinese (n = 148) and non-Chinese (Malay: n = 53; Indian: n = 56) participants ranged from 0.0 to 9.0. The relative severity of the labels to the participants supported the ordinality of the EQ-5D-5L response labels and was similar across ethnic groups. Chinese and non-Chinese participants selected similar response labels to describe each hypothetical health state, with the adjusted odds ratios of selecting any type of the five response labels for non-Chinese versus Chinese participants ranging from 0.92 to 1.15 (p > 0.05 for all). The EQ-5D-5L items are likely to generate equivalent health outcomes between English-speaking Chinese and non-Chinese Singaporeans.

  18. Econometric modelling of multiple self-reports of health states: The switch from EQ-5D-3L to EQ-5D-5L in evaluating drug therapies for rheumatoid arthritis.

    Science.gov (United States)

    Hernández-Alava, Mónica; Pudney, Stephen

    2017-09-01

    EQ-5D is used in cost-effectiveness studies underlying many important health policy decisions. It comprises a survey instrument describing health states across five domains, and a system of utility values for each state. The original 3-level version of EQ-5D is being replaced with a more sensitive 5-level version but the consequences of this change are uncertain. We develop a multi-equation ordinal response model incorporating a copula specification with normal mixture marginals to analyse joint responses to EQ-5D-3L and EQ-5D-5L in a survey of people with rheumatic disease, and use it to generate mappings between the alternative descriptive systems. We revisit a major cost-effectiveness study of drug therapies for rheumatoid arthritis, mapping the original EQ-5D-3L measure onto a 5L valuation basis. Working within a comprehensive, flexible econometric framework, we find that use of simpler restricted specifications can make very large changes to cost-effectiveness estimates with serious implications for decision-making. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  19. Understanding the relationship between the EQ-5D, SF-6D, HAQ and disease activity in inflammatory arthritis.

    LENUS (Irish Health Repository)

    Adams, Roisin

    2012-02-01

    BACKGROUND: The growth of economic analyses and in particular cost-utility analyses (CUA), which use the QALY as a measure of outcome, has heightened the interest in the methodologies used to calculate the QALY. The EQ-5D has produced quite different utility values from that of the SF-6D. This article seeks to understand these differences using a cohort of patients with inflammatory arthritis. OBJECTIVE: To examine the relationship between the disease-specific measure, Health Assessment Questionnaire (HAQ) disability index (DI) and the preference-based measures, SF-6D, EQ-5D and European League Against Arthritis (EULAR) Disease Activity Score (DAS) in patients with rheumatoid arthritis (RA) and psoriatic arthritis (PsA). METHODS: Patients with RA and PsA (n = 504) attending a tertiary rheumatology referral centre completed the HAQ, SF-6D and the EQ-5D before starting biological therapy and again 12 months later. The SF-36 was converted into a utility using the preference-based SF-6D. Clinical outcomes such as the DAS, joint counts and laboratory measures were also recorded. We calculated single index utility scores from the preference-based instruments using UK population norms. We used regression analysis to derive a mapping function and calculated utility scores from the HAQDI and the DAS 28. RESULTS: The mean utility observed at baseline for RA was 0.43 for the EQ-5D and 0.54 for the SF-6D and for PsA was 0.49 for the EQ-5D and 0.57 for the SF-6D. The utility gain demonstrated by the EQ-5D was over twice that of the SF-6D. The EQ-5D scored 17% of the RA group as less than 0 (state defined as worse than death); 7% of this group remained less than 0 at follow-up. The distribution of the utility estimates was similar for both RA and PsA. CONCLUSIONS: Our findings draw attention to the impact of states worse than death on the overall distribution for the EQ-5D derived utilities and how these impact on its use in practice. EQ-5D-derived QALY changes are over twice

  20. Energy efficiency and CO{sub 2} -eq emissions of forest chip supply chains in Finland 2020

    Energy Technology Data Exchange (ETDEWEB)

    Kariniemi, A.; Kaerhae, K. (Metsaeteho Oy, Helsinki (Finland)), Email: arto.kariniemi@metsateho.fi, Email: kalle.karha@metsateho.fi

    2009-07-01

    The research carried out by Metsaeteho Oy calculated what would be the total fuel consumption and CO{sub 2}-eq emissions of forest chip production if the use of forest chips is 24 TWhin 2020 in Finland in accordance with the target set of Long-term Climate and Energy Strategy. CO{sub 2}-eq emissions were determined with Metsaeteho OY's updated Emissions Calculation Model. If the production and consumption of forest chips in Finland are 24 TWh in 2020, then the total CO{sub 2}-eq emissions would be around 245000 tonnes. The volume of diesel consumption was 79 million litres and petrol 1,5 millions litres. Electric rail transportation and chipping at the mill site consumed 15 GWh of electricity. The supply chain with the lowest CO{sub 2}-eq emissions was logging residues comminuted at plant. Conversely, the highest CO{sub 2}-eq emissions came from stump wood when operating with terminal comminuting. Some 3% of the energy content was consumed during the forest chip production. Energy input/output ratio in the total volume was 0.030 MWh/MWh which varied from 0.022 to 0.044 between the supply systems researched. Hence, forest chip production gave a net of some 97% of the energy content delivered at the plant. (orig.)

  1. Quality of Life Evaluation of Cervical Cancer Inpatients Before and After Chemotherapy by Using the EQ-5D Questionnaire

    Directory of Open Access Journals (Sweden)

    Suwendar

    2017-03-01

    Full Text Available The quality of life is one of success parameters of the treatment effort including chemotherapy in cancer patients. Cancer patients undergoing chemotherapy may experience changes in their quality of life. This study aimed to assess the quality of life of patients with cervical cancer in Indonesia using the EQ‑5D questionnaire pre and post-chemotherapy. The research was an analitycal non-experimental study according to the patient’s perspective using prospective data collection techniques. The research subjects were the patients who suffered from cervical cancer who were hospitalized in class 3 and fullfilled the inclusive requirement. The research was conducted in Dr. Hasan Sadikin Bandung general hospital, from June until December 2015. The study was conducted by the EQ-5D questionnaire. Futhermore, the percentage of the patients’ problems, EQ-5D index (utility and EQ-5D VAS were calculated. Utility and EQ-5D values was analysed statistically using Wilcoxon test (α=5% to determine if there were significant condition changes before and after chemotherapy. The results showed that after the first cycle of chemotherapy, the percentage of patients reporting problem is related to ability to walk/move and the usual activities problem increased, pain/discomfort and anxiety/depression problem decreased, while the self‑care problem did not change. After the first cycle of chemotherapy, the utility and EQ-5D values increased and showed significant improvement (T count value=2.0 and 4.5 respectively in patients with stage I.

  2. Improvements in the EQ-10 electrodeless Z-pinch EUV source for metrology applications

    Science.gov (United States)

    Horne, Stephen F.; Gustafson, Deborah; Partlow, Matthew J.; Besen, Matthew M.; Smith, Donald K.; Blackborow, Paul A.

    2011-04-01

    Now that EUV lithography systems are beginning to ship into the fabs for next generation chips it is more critical that the EUV infrastructure developments are keeping pace. Energetiq Technology has been shipping the EQ-10 Electrodeless Z-pinch™ light source since 2005. The source is currently being used for metrology, mask inspection, and resist development. These applications require especially stable performance in both power and source size. Over the last 5 years Energetiq has made many source modifications which have included better thermal management as well as high pulse rate operation6. Recently we have further increased the system power handling and electrical pulse reproducibility. The impact of these modifications on source performance will be reported.

  3. Intoxicações em eqüinos no Brasil Intoxications in horses in Brazil

    Directory of Open Access Journals (Sweden)

    Franklin Riet-Correa

    1998-12-01

    Full Text Available Relatam-se algumas intoxicações descritas em eqüídeos no Brasil. Dentre as intoxicações por plantas, incluem-se: Senecio spp., Ateleia glazioviana, Crotalaria juncea, Equisetum spp., Pteridium aquilinum, Baccharis coridifolia, Senna occidentalis e Brachiaria spp.. Mencionam-se, também, as micotoxicoses causadas por Fusarium moniliforme, Claviceps purpurea e aflatoxinas, e as intoxicações por uréia, iodo, chumbo e inseticidas clorados.Toxic disease reported in horses in Brazil are reviewed. Intoxications by plants including: Senecio spp, Ateleia glazioviana, Crotalaria juncea, Equisetum spp., Pteridium aquilinum, Baccharis coridifolia, Senna occidentalis e Brachiaria spp. are described. Mycotoxicosis caused by Fusarium moniliforme, Claviceps purpurea and aflatoxins, and intoxications by urea, iodine, lead, chlorinated insecticides are also mentioned.

  4. Energy and CO{sub 2eq} analysis of the agricultural phase in the sunflower biodiesel chain

    Energy Technology Data Exchange (ETDEWEB)

    Spugnoli, C.P.; Dainelli, R.; D' avino, L.; Mazzoncini, M.; Lazzeri, L. [DEISTAF Univ. degli Studi di Firenze, Firenze (Italy)

    2010-07-01

    The suitability of the sunflower for biodiesel production was discussed in terms of the reference values on carbon dioxide equivalents (CO{sub 2eq}) emissions for every phase of the biofuels chain as indicated in the European Union (EU) Directive on renewable energies. A life cycle analysis performed on the agricultural phase of the sunflower showed that CO{sub 2eq} emissions from the cultivation phase exceeded the EU reference value. This paper highlighted the relevance of allocation methods to spread out energy consumption and CO{sub 2eq} emissions among sunflower biodiesel and oilcake. Allocation was made according to the principles of mass content, energy content and the economic value of co-products. The CO{sub 2eq} reductions obtained with the 3 methods were approximately 60, 50 and 25 per cent, respectively when compared to a case without allocation. Since these methods did not distinguish the different functionality of co-products in relation to their real use, this study also considered the method of system expansion and allocation by substitution. The considered equivalent functions of oilcake were animal feed, coal fuel and fertilizer. The results showed that while the substitution with coal gives rise to an emission credit, the others allow only minor improvements. A sensitivity analysis emphasized the significance of fossil fuels and fertilizers on energy depletion and CO{sub 2eq} emissions. It was concluded that only a major revision of farm practices aimed at reducing the use of N-fertilizer, can allow the sunflower to be suitable for biodiesel production in central Italy, given the EU constrains for CO{sub 2eq} emissions.

  5. Comparing UK, USA and Australian values for EQ-5D as a health utility measure of oral health.

    Science.gov (United States)

    Brennan, D S; Teusner, D N

    2015-09-01

    Using generic measures to examine outcomes of oral disorders can add additional information relating to health utility. However, different algorithms are available to generate health states. The aim was to assess UK-, US- and Australian-based algorithms for the EuroQol (EQ-5D) in relation to their discriminative and convergent validity. Methods: Data were collected from adults in Australia aged 30-61 years by mailed survey in 2009-10, including the EQ-5D and a range of self-reported oral health variables, and self-rated oral and general health. Responses were collected from n=1,093 persons (response rate 39.1%). UK-based EQ-5D estimates were lower (0.85) than the USA and Australian estimates (0.91). EQ-5D was associated (pUSA, and from 0.05 to 0.08 for the Australian-based estimates. The effect sizes (ESs) of the associations with all seven oral health variables were similar for the UK (ES=0.26 to 0.49), USA (ES=0.31 to 0.48) and Australian-based (ES=0.31 to 0.46) estimates. EQ-5D was correlated with global dental health for the UK (rho=0.29), USA (rho=0.30) and Australian-based estimates (rho=0.30), and correlations with global general health were the same (rho=0.42) for the UK, USA and Australian-based estimates. EQ-5D exhibited equivalent discriminative validity and convergent validity in relation to oral health variables for the UK, USA and Australian-based estimates.

  6. Quality of life profile and psychometric properties of the EQ-5D-5L in HIV/AIDS patients

    Directory of Open Access Journals (Sweden)

    Tran Bach

    2012-11-01

    Full Text Available Abstract Objectives We assessed health-related quality of life (HRQOL, its associated factors, and examined measurement properties of the EuroQol - 5 Dimensions - 5 Levels (EQ-5D-5L in HIV/AIDS patients. Methods A cross-sectional multi-site survey was conducted in 1016 patients (age: 35.4 ± 7.0 years; 63.8% male in three epicenters of Vietnam. Internal consistency reliability, convergent validity, and discriminative validity of the EQ-5D-5L and a visual analogue scale (VAS were evaluated. Tobit censored regression models were used to identify predictors of HRQOL in HIV/AIDS patients. Results The mean EQ-5D-5L single index and VAS were 0.65 (95% Confidence Interval (CI = 0.63; 0.67 and 70.3 (95% CI = 69.2; 71.5. Cronbach’s alpha of five dimensions was 0.85. EQ-5D-5L has a good convergent validity with VAS (0.73. It discriminated patients at different HIV/AIDS stages, duration of ART, and CD4 cell count. Predictors of poorer HRQOL included being female, lower education level, unemployment, alcohol and drug use, CD4 Conclusion The EQ-5D-5L has good measurement properties in HIV/AIDS patients and holds potentials for monitoring ART outcomes. Integration of HRQOL measurement using EQ-5D-5L in HIV/AIDS clinical practice could be helpful for economic evaluation of HIV/AIDS interventions.

  7. Canadian valuation of EQ-5D health states: preliminary value set and considerations for future valuation studies.

    Directory of Open Access Journals (Sweden)

    Nick Bansback

    Full Text Available The EQ-5D is a preference based instrument which provides a description of a respondent's health status, and an empirically derived value for that health state often from a representative sample of the general population. It is commonly used to derive Quality Adjusted Life Year calculations (QALY in economic evaluations. However, values for health states have been found to differ between countries. The objective of this study was to develop a set of values for the EQ-5D health states for use in Canada.Values for 48 different EQ-5D health states were elicited using the Time Trade Off (TTO via a web survey in English. A random effect model was fitted to the data to estimate values for all 243 health states of the EQ-5D. Various model specifications were explored. Comparisons with EQ-5D values from the UK and US were made. Sensitivity analysis explored different transformations of values worse than dead, and exclusion criteria of subjects.The final model was estimated from the values of 1145 subjects with socio-demographics broadly representative of Canadian general population with the exception of Quebec. This yielded a good fit with observed TTO values, with an overall R2 of 0.403 and a mean absolute error of 0.044.A preference-weight algorithm for Canadian studies that include the EQ-5D is developed. The primary limitations regarded the representativeness of the final sample, given the language used (English only, the method of recruitment, and the difficulty in the task. Insights into potential issues for conducting valuation studies in countries as large and diverse as Canada are gained.

  8. The EQ-5D (Euroqol is a valid generic instrument for measuring quality of life in patients with dyspepsia

    Directory of Open Access Journals (Sweden)

    Goh Khean-Lee

    2009-03-01

    Full Text Available Abstract Background There is little information of the validity of generic instruments in measuring health-related quality of life (HRQOL in patients with dyspepsia. We aimed to assess the reliability and validity of the EQ-5D, a brief and simple instrument, in measuring HRQOL in adult patients with dyspepsia. Methods Consecutive adults with dyspepsia attending the Gastroenterology clinic in a tertiary referral center were interviewed with the EQ-5D (both English and Malay versions, the short-form Nepean Dyspepsia Index (SF-NDI, the SF-36 and Leeds Dyspepsia Questionnaire (LDQ. Known-groups and convergent construct validity were investigated by testing hypotheses at attribute and overall levels. A repeat telephone interview was conducted 2 weeks later to assess test-retest reliability. Results A total of 113 patients (mean (SD age: 53.7 (14 years; 49.5% male; 24.8% Malays, 37.2% Chinese; 70.8% functional dyspepsia were recruited. Response rate was 100% with nil missing data. Known-groups validation revealed 20/26 hypotheses fulfillment. Patients with more severe dyspepsia reported more problems with their usual activity (p = 0.07 and pain (p = 0.06 and demonstrated lower median VAS scores (60 vs 70, p = 0.002 and EQ-5D utility scores (0.72 vs 0.78, p = 0.002. Those reporting problems in various EQ-5D dimensions had significantly lower scores in relevant SF-36 and SF-NDI dimensions. The overall EQ-5D utility score also demonstrated good correlation with the SF-36 summary physical and mental scores and the SF-NDI total score. Intraclass correlation coefficient for test-retest reliability was 0.66 (95% CI = 0.55 – 0.76. Conclusion The EQ-5D is an acceptable, valid and reliable generic instrument for measuring HRQOL in adult patients with dyspepsia.

  9. A Head-to-Head Comparison of UK SF-6D and Thai and UK EQ-5D-5L Value Sets in Thai Patients with Chronic Diseases.

    Science.gov (United States)

    Sakthong, Phantipa; Munpan, Wipaporn

    2017-10-01

    Little was known about the head-to-head comparison of psychometric properties between SF-6D and EQ-5D-5L or the different value sets of EQ-5D-5L. Therefore, this study set out to compare the psychometric properties including agreement, convergent, and known-group validity between the SF-6D and the EQ-5D-5L using the real value sets from Thailand and the UK in patients with chronic diseases. 356 adults taking a medication for at least 3 months were identified from a university hospital in Bangkok, Thailand, between July 2014 and March 2015. Agreement was assessed by intraclass correlation coefficients (ICCs) and Bland-Altman plots. Convergent validity was evaluated using Spearman's rank correlation coefficients between SF-6D and EQ-5D-5L and EQ-VAS and SF-12v2. For known-groups validity, the Mann-Whitney U test and Kruskal-Wallis test were used to examine the associations between SF-6D and EQ-5D-5L and patient characteristics. Agreements between the SF-6D and the EQ-5D-5L using Thai and UK value sets were fair, with ICCs of 0.45 and 0.49, respectively. Bland-Altman plots showed that the majority of the SF-6D index scores were lower than the EQ-5D-5L index scores. Both the EQ-5D-5L value sets were more related to the EQ-VAS and physical health, while the SF-6D was more associated with mental health. Both EQ-5D-5L value sets were more sensitive than the SF-6D in discriminating patients with different levels of more known groups except for adverse drug reactions. The SF-6D and both EQ-5D-5L value sets appeared to be valid but sensitive to different outcomes in Thai patients with chronic diseases.

  10. An analysis of Euroqol EQ-5D and Manchester Oxford Foot Questionnaire scores six months following podiatric surgery.

    Science.gov (United States)

    Maher, Anthony J; Kilmartin, Timothy E

    2012-07-09

    In the United Kingdom patient-reported outcome measures (PROMS) have been adopted as a key measure of foot surgery outcomes. The intention of this study was to evaluate the responsiveness of a regional outcome measure; the Manchester Oxford Foot Questionnaire (MOXFQ) and a generic measure; the EuroQol EQ-5D, in the context of day care Podiatric Surgery. A prospective audit of 375 consecutive day care surgical admissions was undertaken. All patients attending for surgery, who agreed to participate, were included. Pre operation patients completed the MOXFQ and the EQ-5D. Both questionnaires were completed again at 6 months post operation. Additional data was collected on patient demographics, surgical procedures and complications. Few complications were encountered and most patients (84%) returned for a final review 6 months post operation. Mean MOXFQ scores improved for each domain: pain; 51.7 pre-operation, reduced to 16.5 post-operation, walking; 50.2 reduced to 14.1 and social interaction; 45.7 reduced to 10.6. The minimal clinically important differences (MCID) estimates for the pain domain were exceeded by 82.6% of patients, while 74.8% exceeded the MCID for walking and 68.5% exceeded the MCID for social interaction. A small number of patients (2.9%) deteriorated across all three MOXFQ domains.The EQ-5D Index, summary of health related quality of life, improved from 0.66 pre-operation to 0.86 post operation. The EQ-5D index MCID was exceeded by 79.2% of patients. Index scores deteriorated for 1.8% of patients following surgery. Effect sizes measured following surgery were largest for the MOXFQ domains: Walking; 1.39, Pain; 1.52 and Social Interaction: 1.39. The EQ-5D index effect size was 0.83. The EQ-5D visual analogue scale (VAS) was not influenced by surgery. Both the MOXFQ and EQ-5D index (but not the VAS) appear sensitive to changes in health status at 6 months following elective foot surgery. Both instruments were particularly responsive to changes

  11. Development and validation of stability indicating studies of ...

    African Journals Online (AJOL)

    Development and validation of stability indicating studies of paliperidone ... A simple and sensitive stability indicating HPLC method is developed for the ... The developed method was proved adequate for quantitative determination of ... Browse By Country · List All Titles · Free To Read Titles This Journal is Open Access.

  12. Corrected QT changes during antipsychotic treatment of children and adolescents

    DEFF Research Database (Denmark)

    Jensen, Karsten Gjessing; Juul, Klaus; Fink-Jensen, Anders

    2015-01-01

    covering 9 antipsychotics and including 5,423 patients with QTc data (mean age = 12.8 ± 3.6 years, female = 32.1%). Treatments included aripiprazole: studies = 14; n = 814; haloperidol: studies = 1; n = 15; molindone: studies = 3; n = 125; olanzapine: studies = 5; n = 212; paliperidone: studies = 3; n...

  13. Change in Prolactin Levels in Pediatric Patients Given Antipsychotics for Schizophrenia and Schizophrenia Spectrum Disorders: A Network Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Chakrapani Balijepalli

    2018-01-01

    Full Text Available Background. Treatment of schizophrenia with first- and second-generation antipsychotics has been associated with elevated prolactin levels, which may increase the risk for prolactin-related adverse events. Methods. Randomized controlled trials (RCTs included in a recent systematic review were considered for this analysis. A Bayesian network meta-analysis was used to compare changes in prolactin levels in pediatric patients diagnosed with schizophrenia or schizophrenia spectrum disorders treated with second-generation antipsychotics (SGAs. Results. Five RCTs, including 989 patients combined, have evaluated the changes in prolactin for pediatric patients after 6 weeks of treatment with risperidone, quetiapine, aripiprazole, olanzapine, and paliperidone. In the overall study population, treatment with risperidone was associated with the highest increase in mean prolactin levels compared to other SGAs. Patients treated with risperidone 4–6 mg/day were found to experience the greatest increases (55.06 ng/ml [95% CrI: 40.53–69.58] in prolactin levels, followed by risperidone 1–3 mg/day, paliperidone 3–6 mg/day, and paliperidone 6–12 mg/day. Conclusions. This study shows that there are differences in SGAs ability to cause hyperprolactinemia. Further, there is clear evidence of safety concerns with risperidone and paliperidone treatment in adolescent schizophrenia patients. Registration. PROSPERO CRD42014009506.

  14. What matters most?: evidence-based findings of health dimensions affecting the societal preferences for EQ-5D health states

    Directory of Open Access Journals (Sweden)

    Monica Viegas Andrade

    2013-01-01

    Full Text Available This study analyzes how different health dimensions defined by the EQ-5D-3L instrument affect average individual preferences for health states. This analysis is an important benchmark for the incorporation of health technologies as it takes into consideration Brazilian population preferences in health resource allocation decisions. The EQ-5D instrument defines health in terms of five dimensions (mobility, daily activities, self-care activities, pain/discomfort, and anxiety/depression each divided into three levels of severity. Data came from a valuation study with 3,362 literate individuals aged between 18 and 64 living in urban areas of Minas Gerais State, Brazil. The main results reveal that health utility decreases as the level of severity increases. With regard to health issues, mobility stands out as the most important EQ-5D dimension. Independently of severity levels of the other EQ-5D-3L dimensions, the highest decrements in utilities are associated with severe mobility problems.

  15. Patient Characteristics Impacting Health State Index Scores, Measured by the EQ-5D of Females with Stress Urinary Incontinence Symptoms

    NARCIS (Netherlands)

    Tincello, Douglas; Sculpher, Mark; Tunn, Ralf; Quail, Deborah; van der Vaart, Huub; Falconer, Christian; Manning, Martina; Timlin, Louise

    2010-01-01

    Objective: To describe the characteristics of women seeking treatment for symptoms of stress urinary incontinence (SUI) and to investigate the association of SUI symptoms with generic health-related quality of life (HRQoL) as measured by the EuroQol (EQ-5D) instrument. Methods: The Stress Urinary

  16. Mapping EQ-5D utilities to GBD 2010 and GBD 2013 disability weights: Results of two pilot studies in Belgium

    NARCIS (Netherlands)

    C. Maertens De Noordhout (Charline); B. Devleesschauwer (Brecht); Gielens, L.; Plasmans, M.H.D.; J.A. Haagsma (Juanita); N. Speybroeck (Niko)

    2017-01-01

    textabstractBackground: Utilities and disability weights (DWs) are metrics used for calculating Quality-Adjusted Life Years and Disability-Adjusted Life Years (DALYs), respectively. Utilities can be obtained with multi-attribute instruments such as the EuroQol 5 dimensions questionnaire (EQ-5D). In

  17. Multinational consistency of a discrete choice model in quantifying health states for the extended 5-level EQ-5D

    NARCIS (Netherlands)

    Krabbe, P.F.M.; Devlin, N.J.; Stolk, E.A.; Shah, K.K.; Oppe, M.; Van Hout, B.; Quik, E.H.; Pickard, A.S.; Xie, F.

    2013-01-01

    Objectives: To investigate the feasibility of choice experiments for EQ-5D-5L states using computer-based data collection, and to examine the consistency of the estimated parameters values derived after modeling the stated preference data across countries in a multinational study. Methods: Similar

  18. PENGEMBANGAN BAHAN AJAR MATEMATIKA DENGAN PENDEKATAN KONTEKSTUAL DAN METODE PENEMUAN TERBIMBING UNTUK MENINGKATKAN EQ DAN SQ SISWA SMP AKSELERASI

    Directory of Open Access Journals (Sweden)

    Yhasinta Agustyarini

    2015-05-01

    DEVELOPING MATHEMATICS INSTRUCTIONAL MATERIAL USINGCONTEXTUAL APPROACH AND GUIDED INQUIRY METHOD TO INCREASE EQ AND SQ OF ACCELERATION STUDENTS IN JUNIOR HIGH SCHOOL Abstract This research is aimed to describe steps of developing mathematics instructional material using contextual approach and guided inquiry method and describe the quality of the developed product. This research is a developmental research with the main steps cover (1 preliminary investigation, (2 design, (3 realization/construction, (4 test, evaluation, and revision, and (5 implementation. The result of validation by expert jugdement shows that the instructional material that is developed is of valid criteria of very good category. The aspects of practicality was of practice criteria of very good category as seen from the implementation of the learning, evaluation by the teachers, and evaluation by the students. The aspect of effectiveness could be reached from the students’ achievement and EQ and SQ questionnaire. The result of the test shows that more than 80% of the student achieve the minimum score and percentage many of students who are at a high minimum and very high minimum category increase on EQ and SQ questionnaire. The research produced mathematics instructional material and supporting components, consisting of valid, practical, and effective syllabuses, lesson plans, mathematics module, and the valid, practical, and reliable of test. Keywords: development, instructional material, contextual approach, guided inquiry, EQ, SQ, acceleration

  19. An exploration of differences between Japan and two European countries in the self-reporting and valuation of pain and discomfort on the EQ-5D.

    Science.gov (United States)

    Feng, Yan; Herdman, Mike; van Nooten, Floortje; Cleeland, Charles; Parkin, David; Ikeda, Shunya; Igarashi, Ataru; Devlin, Nancy J

    2017-08-01

    To investigate the systematic differences in the self-reporting and valuation of overall health and, in particular, pain/discomfort between three countries (England/UK, Japan, and Spain) on the EQ-5D. Existing datasets were used to explore differences in responses on the EQ-5D descriptive system between Japan (3L and 5L), the UK (3L), England (5L), and Spain (5L), particularly on the dimension of pain/discomfort. The role of different EQ dimensions in determining self-reported overall health scores for the EuroQol visual analog scale (EQ-VAS) was investigated using ordinary least squares regression. Time trade-off (TTO) results from Japanese and UK respondents for the EQ-5D-3L as well as Japanese and English respondents for the EQ-5D-5L were compared using t tests. For the EQ-5D-3L, a higher percentage of respondents in Japan than in the UK reported 'no pain/discomfort' (81.6 vs 67.0%, respectively); for the EQ-5D-5L, the proportions were 79.2% in Spain, 73.2% in Japan, and 63-64% in England, after adjusting for age differences in samples. The 'pain/discomfort' dimension had the largest impact on respondents' self-reported EQ-VAS only for EQ-5D-3L in Japan. Using the EQ-5D-3L, Japanese respondents were considerably less willing to trade off time to avoid pain/discomfort than the UK respondents; for example, moving from health state, 11121 (some problems with pain/discomfort) to 11131 (extreme pain/discomfort) represented a decrement of 0.65 on the observed TTO value in the UK compared with 0.15 in Japan. Using the EQ-5D-5L, Japanese respondents were also less willing to trade off time to avoid pain/discomfort than respondents in England; however, the difference in values was much smaller than that observed using EQ-5D-3L data. This study provides evidence of between-country differences in the self-reporting and valuation of health, including pain/discomfort, when using EQ-5D in general population samples. The results suggest a need for caution when comparing or

  20. Mapping MOS-HIV to HUI3 and EQ-5D-3L in Patients With HIV

    Directory of Open Access Journals (Sweden)

    Vilija R. Joyce MS

    2017-07-01

    Full Text Available Objectives: The Medical Outcomes Study HIV Health Survey (MOS-HIV is frequently used in HIV clinical trials; however, scores generated from the MOS-HIV are not suited for cost-effectiveness analyses as they do not assign utility values to health states. Our objective was to estimate and externally validate several mapping algorithms to predict Health Utilities Index Mark 3 (HUI3 and EQ-5D-3L utility values from the MOS-HIV. Methods: We developed and validated mapping algorithms using data from two HIV clinical trials. Data from the first trial (n = 367 formed the estimation data set for the HUI3 (4,610 observations and EQ-5D-3L (4,662 observations mapping algorithms; data from the second trial (n = 168 formed the HUI3 (1,135 observations and EQ-5D-3L (1,152 observations external validation data set. We compared ordinary least squares (OLS models of increasing complexity with the more flexible two-part, beta regression, and finite mixture models. We assessed model performance using mean absolute error (MAE and mean squared error (MSE. Results: The OLS model that used MOS-HIV dimension scores along with squared terms gave the best HUI3 predictions (mean observed 0.84; mean predicted 0.80; MAE 0.0961; the finite mixture model gave the best EQ-5D-3L predictions (mean observed 0.90; mean predicted 0.88; MAE 0.0567. All models produced higher prediction errors at the lower end of the HUI3 and EQ-5D-3L score ranges (<0.40. Conclusions: The proposed mapping algorithms can be used to predict HUI3 and EQ-5D-3L utility values from the MOS-HIV, although greater error may pose a problem in samples where a substantial proportion of patients are in poor health. These algorithms may be useful for estimating utility values from the MOS-HIV for cost-effectiveness studies when HUI3 or EQ-5D-3L data are not available.

  1. Level of agreement between patient and proxy responses to the EQ-5D health questionnaire 12 months after injury.

    Science.gov (United States)

    Gabbe, Belinda J; Lyons, Ronan A; Sutherland, Ann M; Hart, Melissa J; Cameron, Peter A

    2012-04-01

    Health-related quality of life represents a patient's experiences and expectations and should be collected from the patient. In trauma, collection of information from the patient can be challenging, particularly for subgroups where cognitive impairment is prevalent, increasing reliance on proxy reporting. This study assessed the agreement between patient and proxy reporting of health-related quality of life 12 months after injury. The Victorian State Trauma Registry and Victorian Orthopaedic Trauma Outcomes Registry collect EQ-5D data at 12 months after injury. Cases where data were collected from the patient and proxy were extracted. Agreement between patient and proxy responses was compared using kappa (K) coefficients for the individual EQ-5D items, and Bland-Altman plots and Wilcoxon signed-rank tests for the EQ-5D summary score and visual analog scale (VAS). Agreement between patient and proxy respondents was substantial for the mobility (K = 0.61) and personal care items (K = 0.67) and moderate for the usual activities (K = 0.50), pain/discomfort (K = 0.42), and anxiety/depression items (K = 0.47). The mean difference between proxy and patient-reported scores for the VAS (0.74, 95% confidence interval: -2.73, 4.21) and the EQ-5D summary score (-0.02, 95% confidence interval: -0.07, 0.03) was small, but the limits of agreement were wide (-34.22 to 35.71 for VAS and -0.55 to 0.51 for summary score), suggesting no systematic bias. Although proxy and patient responses for the EQ-5D VAS may differ, the differences show random variability rather than systematic bias. Group comparisons using proxy responses are unlikely to be biased, but proxy responses should be used with caution when assessing individual patient recovery.

  2. Assessment of the Swedish EQ-5D experience-based value sets in a total hip replacement population.

    Science.gov (United States)

    Nemes, Szilárd; Burström, Kristina; Zethraeus, Niklas; Eneqvist, Ted; Garellick, Göran; Rolfson, Ola

    2015-12-01

    All patients undergoing elective total hip replacement (THR) in Sweden are asked to complete a survey, including the EQ-5D. Thus far, EQ-5D values have been presented using the UK TTO value set based on hypothetical values. Shift to the use of the recently introduced Swedish experience-based value set, derived from a representative Swedish population, is an appealing alternative. To investigate how accurate the Swedish experience-based VAS value set predicts observed EQ VAS values and to compare correlations between Swedish and UK value sets including two provisional value sets derived from the THR population. Pre- and one-year postoperative data from 56,062 THR patients from the Swedish Hip Arthroplasty Register were used. Agreement between the observed and the predicted EQ VAS values was assessed with correlation. Based on pre- and postoperative data, we constructed two provisional VAS value sets. Correlations between observed and calculated values using the Swedish VAS value set were moderate (r = 0.46) in preoperative data and high (r = 0.72) in postoperative data. Correlations between UK and register-based value sets were constantly lower compared to Swedish value sets. Register-based values and Swedish values were highly correlated. The Swedish value sets are more accurate in terms of representation of the Swedish THR patients than the currently used UK TTO value set. We find it feasible to use the experience-based Swedish value sets for further presentation of EQ-5D values in the Swedish THR population.

  3. Evaluating the discriminatory power of EQ-5D, HUI2 and HUI3 in a US general population survey using Shannon's indices

    NARCIS (Netherlands)

    Janssen, Mathieu F. Bas; Birnie, Erwin; Bonsel, Gouke J.

    2007-01-01

    OBJECTIVES: To compare quantitatively the discriminatory power of the EQ-5D, HUI2 and HUI3 in terms of absolute and relative informativity, using Shannon's indices. METHODS: EQ-5D and HUI2/3 data completed by a sample of the general adult US population (N = 3,691) were used. Five dimensions allowed

  4. EQ-10 electrodeless Z-pinch EUV source for metrology applications

    Science.gov (United States)

    Gustafson, Deborah; Horne, Stephen F.; Partlow, Matthew J.; Besen, Matthew M.; Smith, Donald K.; Blackborow, Paul A.

    2011-11-01

    With EUV Lithography systems shipping, the requirements for highly reliable EUV sources for mask inspection and resist outgassing are becoming better defined, and more urgent. The sources needed for metrology applications are very different than that needed for lithography; brightness (not power) is the key requirement. Suppliers for HVM EUV sources have all resources working on high power and have not entered the smaller market for metrology. Energetiq Technology has been shipping the EQ-10 Electrodeless Z-pinchTM light source since 19951. The source is currently being used for metrology, mask inspection, and resist development2-4. These applications require especially stable performance in both output power and plasma size and position. Over the last 6 years Energetiq has made many source modifications which have included better thermal management to increase the brightness and power of the source. We now have introduced a new source that will meet requirements of some of the mask metrology first generation tools; this source will be reviewed.

  5. Transforming EQ-5D utilities for use in cost–value analysis of health programs.

    Science.gov (United States)

    Nord, Erik; Johansen, Rune

    2015-04-01

    In a number of jurisdictions there is increasing interest in incorporating concerns for fairness in models for economic evaluation of health interventions. Cost–value analysis is a name for evaluations with such a broader aim. The most widely held concern for fairness is a concern for the worse off, i.e. the idea that severity of illness should count in determining priorities. In economic evaluations of improvements in health-related quality of life this concern may be taken into account by replacing conventional health state utilities with societal values for health states that are characterised by strong upper end compression and decreasing marginal value of utility gains. We review evidence on the strength of concerns for the worse off--measured at the cardinal level--in 15 articles published in peer-reviewed journals in the time period 1978–2010, with reports from altogether 20 individual studies in nine different countries. We report 116 individual observations of paired comparisons of utility improvements with different start levels. Concerns for severity show up quite strongly across countries, sample types and question framings. By means of regression analyses we fit a societal value function to the data that has the property of decreasing marginal value of utility gains. Using the central tendency in the data we present two plausible transformations of EQ-5D utilities into societal values that reflect concerns for the worse off.

  6. Nuclear EQ sourcebook: A compilation of documents for nuclear equipment qualification

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    In the nuclear power industry, environmental and seismic qualification of safety-related electrical and instrumentation equipment is collectively known as Equipment Qualification (EQ). Related technology, as well as regulatory requirements, have evolved rapidly during the last 15 years. For environmental qualification, what began in 1971 with one trial-use guide (IEEE Std 323-1971), now stands as a full complement of Nuclear Regulatory Commission (NRC) rules, guides and industry standards. In addition to the Institute of Electrical and Electronics Engineers (IEEE), the American Society of Mechanical Engineers (ASME) has also undertaken development of its own set of standards for use in qualifying safety-related mechanical equipment. To ensure that the original design and qualification is preserved, engineers need to select and use the correct set of NRC regulations, regulatory guides, industry standards, and generic correspondence. Given that the total number of these documents exceed 200, this task becomes resource intensive. This compilation is the first known publication available to serve the user-community need for a complete and exhaustive single source. Approximately 180 items (Bulletins, Federal Rules, Generic Letters, Notices, Regulatory Guides, IEEE Standards, IEEE Recommended Practices, and IEEE Guides) have been processed separately for inclusion on the data base

  7. Estenose de piloro em eqüino adulto Pyloric stenosis in a mature horse

    Directory of Open Access Journals (Sweden)

    Ana Lúcia Miluzzi Yamada

    2009-02-01

    Full Text Available Neste trabalho, é descrito um caso de estenose hipertrófica de piloro diagnosticado por gastroscopia em um eqüino Quarto de Milha, de quatro anos de idade, que apresentava inapetência, emagrecimento progressivo, cólica, bruxismo e sialorréia. A gastroduodenite ulcerativa crônica e os espasmos prolongados foram as supostas causas da hipertrofia da musculatura circular do piloro, causando a estenose. O tratamento com substâncias antiulcerativas é paliativo e o acesso cirúrgico ao piloro no animal adulto é complexo, sendo o prognóstico duvidoso.A case of hypertrophic pyloric stenosis diagnosed by gastroscopy was reported in a 4-years-old Quarter Horse gelding, with signs of inappetence, chronic weight loss, colic, bruxism and sialorrhea. Gastroduodenal ulceration and spasms were supposed as causes of pyloric muscular hypertrophy and stenosis. Antiulcerative medications are merely palliative and the complex surgical approach to the site of stenosis makes the prognostic to be doubtful.

  8. Criptococose pulmonar granulomatosa em um eqüino Granulomatous cryptococcal pneumonia in a horse

    Directory of Open Access Journals (Sweden)

    Glaucia Denise Kommers

    2005-08-01

    Full Text Available Descreve-se um caso de pneumonia granulomatosa por Cryptococcus neoformans em um eqüino, macho, Quarto de Milha, de 8 anos de idade com história de laminite crônica por 2 anos. Na necropsia, havia múltiplos nódulos macios e gelatinosos distribuídos aleatoriamente nos pulmões. Histologicamente, observaram-se cavidades císticas preenchidas por numerosas estruturas leveduriformes circundadas por um espesso halo claro e por reação inflamatória granulomatosa leve. Em seções coradas por azul alciano e PAS, observou-se densa cápsula mucinosa circundando estruturas leveduriformes com morfologia típica de C. neoformans.A case of cryptococcal granulomatous pneumonia is described in an 8-year-old, male, Quarter Horse with chronic laminitis of 2 years duration. Multiple soft gelatinous nodules were randomly distributed in the lungs. Microscopically, there were cavities filled with numerous yeast-like organisms surrounded by a clear halo and evoking a mild granulomatous reaction. An Alcian blue- and PAS-positive mucinous capsule surrounded the yeast-like structures morphologically typical of Cryptococcus neoformans.

  9. Implementation of equilibrium aqueous speciation and solubility (EQ3 type) calculations into Cantera for electrolyte solutions.

    Energy Technology Data Exchange (ETDEWEB)

    Moffat, Harry K.; Jove-Colon, Carlos F.

    2009-06-01

    In this report, we summarize our work on developing a production level capability for modeling brine thermodynamic properties using the open-source code Cantera. This implementation into Cantera allows for the application of chemical thermodynamics to describe the interactions between a solid and an electrolyte solution at chemical equilibrium. The formulations to evaluate the thermodynamic properties of electrolytes are based on Pitzer's model to calculate molality-based activity coefficients using a real equation-of-state (EoS) for water. In addition, the thermodynamic properties of solutes at elevated temperature and pressures are computed using the revised Helgeson-Kirkham-Flowers (HKF) EoS for ionic and neutral aqueous species. The thermodynamic data parameters for the Pitzer formulation and HKF EoS are from the thermodynamic database compilation developed for the Yucca Mountain Project (YMP) used with the computer code EQ3/6. We describe the adopted equations and their implementation within Cantera and also provide several validated examples relevant to the calculations of extensive properties of electrolyte solutions.

  10. Comparison of howRU and EQ-5D measures of health-related quality of life in an outpatient clinic

    Directory of Open Access Journals (Sweden)

    Tim Benson

    2013-11-01

    Full Text Available This paper reports on a head-to-head study of howRU and EQ-5D on patients with cardiovascular disease. howRU is a short generic measure of health-related quality of life comprising 39 words, designed for routine use, which we compare with EQ-5D (230 words. Patients attending a clinic completed both instruments. Completed data were available for 116 patients, 51% female, mean age 56 and SD 20. howRU is shorter, has better readability statistics, a higher completion rate, a wider range of states used and a smaller ceiling effect than EQ-5D. The correlations of howRU with EQ-5D are similar to those of EQ-5D with other validated instruments.

  11. Evaluating the sensitivity of EQ-5D in a sample of patients with type 2 diabetes mellitus in two tertiary health care facilities in Nigeria.

    Science.gov (United States)

    Ekwunife, Obinna Ikechukwu; Ezenduka, Charles C; Uzoma, Bede Emeka

    2016-01-12

    The EQ-5D instrument is arguably the most well-known and commonly used generic measure of health status internationally. Although the instrument has been employed in outcomes studies of diabetes mellitus in many countries, it has not yet been used in Nigeria. This study was carried out to assess the sensitivity of the EQ-5D instrument in a sample of Nigerian patients with type 2 diabetes mellitus (T2DM). A cross-sectional study was conducted using the EQ-5D instrument to assess the self-reported quality of life of patients with T2DM attending two tertiary healthcare facilities in south eastern Nigeria consenting patients completed the questionnaire while waiting to see a doctor. A priori hypotheses were examined using multiple regression analysis to model the relationship between the dependent variables (EQ VAS and EQ-5D Index) and hypothesized independent variables. A total of 226 patients with T2DM participated in the study. The average age of participants was 57 years (standard deviation 10 years) and 61.1% were male. The EQ VAS score and EQ-5D index averaged 66.19 (standard deviation 15.42) and 0.78 (standard deviation 0.21) respectively. Number of diabetic complications, number of co-morbidities, patient's age and being educated predicted EQ VAS score by -6.76, -6.15, -0.22, and 4.51 respectively. Also, number of diabetic complications, number of co-morbidities, patient's age and being educated predicted EQ-5D index by -0.12, -0.07, -0.003, and 0.06 respectively.. Our findings indicate that the EQ-5D could adequately capture the burden of type 2 diabetes and related complications among Nigerian patients.

  12. The impact of a revised EQ-5D population scoring on preference-based utility scores in an inflammatory arthritis cohort.

    LENUS (Irish Health Repository)

    Adams, Roisin

    2012-02-01

    BACKGROUND AND OBJECTIVE: It is well established that there are problems with the EQ-5D. This is due to the original scoring methods used and how negative time trade-off (TTO) values were treated. A revised scoring method has been published. This article applies this to an inflammatory arthritis cohort. The objective is to examine the impact of a revised scoring system for the EQ-5D (UK) TTO on the utility estimates and in the case of rheumatoid arthritis, to explore the impact of using different utility metrics on the incremental cost-effectiveness ratio (ICER) results of an economic model. METHODS: A total of 504 patients with inflammatory arthritis were rescored using revised EQ-5D scoring, which uses an episodic random utility model to deal with negative TTO values. Differences in utility scores were compared and the new mapping coefficients were obtained. These were then used in an economic model to examine the impact on the ICER. RESULTS: In rheumatoid arthritis, the overall change is less for the revised EQ-5D scoring than with the original EQ-5D (TTO) but greater than the SF-6D: EQ-5D UK -0.22 (95% confidence interval [CI] -0.30 to -0.15), revised EQ-5D UK -0.16 (95% CI -0.21 to -0.10) and SF-6D -0.08 (95% CI -0.11 to -0.05). A similar trend is seen in the psoriatic arthritis group. The economic model produced different ICERs, when different utility measures were used; EQ-5D (TTO) euro42,402, SF-6D euro111,788, and revised EQ-5D (TTO) euro57,747. CONCLUSION: In the context of inflammatory arthritis, this article demonstrates that a revised scoring for EQ-5D may have a significant impact on utility estimates and on the output of the economic model.

  13. Effects of Lowering Dialysate Calcium Concentration on Mineral and Bone Disorders in Chronic Hemodialysis Patients: Conversion from 3.0 mEq/L to 2.75 mEq/L.

    Science.gov (United States)

    Yamada, Shunsuke; Ueki, Kenji; Tokumoto, Masanori; Suehiro, Takaichi; Kimura, Hiroshi; Taniguchi, Masatomo; Fujimi, Satoru; Kitazono, Takanari; Tsuruya, Kazuhiko

    2016-02-01

    Selection of a lower dialysate calcium concentration (DCa) can reduce calcium burden and prevent vascular calcification in hemodialysis patients. However, decreased DCa can worsen mineral and bone disorders. This 1-year retrospective observational study evaluated 121 hemodialysis patients at Fukuoka Renal Clinic who underwent conversion of DCa from 3.0 mEq/L to 2.75 mEq/L. The primary outcomes were changes in serum levels of calcium, phosphate, and parathyroid hormone (PTH). The effects of baseline serum calcium and PTH levels on changes in biochemical parameters were also determined. One year after DCa conversion, mean serum calcium level decreased, while serum phosphate, alkaline phosphatase, and PTH concentrations increased. The rate of achievement of target PTH was higher in patients with lower serum PTH level at baseline, while patients with higher baseline serum PTH level tended to exceed the upper limit of the PTH target range. Patients with higher baseline serum calcium concentration showed a greater decrease in serum calcium level and a greater increase in serum PTH level at 1 year. Patients with a lower baseline serum PTH level can benefit from optimal PTH control following conversion of DCa from 3.0 mEq/L to 2.75 mEq/L. However, secondary hyperparathyroidism may be exacerbated in some patients with higher baseline serum calcium (Ca) and PTH levels. These results indicate that an individualized approach can maximize the benefits of Ca unloading after conversion to lower DCa. © 2015 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.

  14. Geochemical modeling (EQ3/6) plan: Office of Civilian Radioactive Waste Management Program

    International Nuclear Information System (INIS)

    McKenzie, W.F.; Wolery, T.J.; Delany, J.M.; Silva, R.J.; Jackson, K.J.; Bourcier, W.L.; Emerson, D.O.

    1986-01-01

    This plan replaces an earlier plan for the Nevada Nuclear Waste Storage Investigations (NNWSI) Project. It includes activities for all repository projects in the Office of Geologic Repositories: NNWSI, the Basalt Waste Isolation Project, the Salt Repository Project, and the Crystalline Project. Each of these projects is part of the Office of Civilian Radioactive Waste Management (OCRWM) Program. The scope of work for fiscal years 1986 to 1992 includes the work required to upgrade the geochemical codes and supporting data bases, to permit modeling of chemical processes associated with nuclear waste repositories in four geological environments: tuff, salt, basalt, and crystalline rock. Planned tasks include theoretical studies and code development to take account of the effects of precipitation kinetics, sorption, solid solutions, glass/water interactions, variable gas fugacities, and simple mass transport. Recent progress has been made in the ability of the codes to account for precipitation kinetics, highly-saline solutions, and solid solutions. Transition state theory was re-examined resulting in new insights that will provide the foundation for further improvements necessary to model chemical kinetics. Currently there is an increased effort that is concentrated on the supporting data base. For aqueous species and solid phases, specific to nuclear waste, requisite thermodynamic values reported in the literature are being evaluated and for cases where essential data is lacking, laboratory measurements will be carried out. Significant modifications and expansions have been made to the data base. During FY86, the total number of species in the data base has almost doubled and many improvements have been made with regard to consistency, organization, user applications, and documentation. Two Ridge computers using a RISC implementation of UNIX were installed; they are completely dedicated EQ3/6 machines

  15. Geochemical modeling (EQ3/6) plan: Office of Civilian Radioactive Waste Management Program

    Energy Technology Data Exchange (ETDEWEB)

    McKenzie, W.F.; Wolery, T.J.; Delany, J.M.; Silva, R.J.; Jackson, K.J.; Bourcier, W.L.; Emerson, D.O.

    1986-08-28

    This plan replaces an earlier plan for the Nevada Nuclear Waste Storage Investigations (NNWSI) Project. It includes activities for all repository projects in the Office of Geologic Repositories: NNWSI, the Basalt Waste Isolation Project, the Salt Repository Project, and the Crystalline Project. Each of these projects is part of the Office of Civilian Radioactive Waste Management (OCRWM) Program. The scope of work for fiscal years 1986 to 1992 includes the work required to upgrade the geochemical codes and supporting data bases, to permit modeling of chemical processes associated with nuclear waste repositories in four geological environments: tuff, salt, basalt, and crystalline rock. Planned tasks include theoretical studies and code development to take account of the effects of precipitation kinetics, sorption, solid solutions, glass/water interactions, variable gas fugacities, and simple mass transport. Recent progress has been made in the ability of the codes to account for precipitation kinetics, highly-saline solutions, and solid solutions. Transition state theory was re-examined resulting in new insights that will provide the foundation for further improvements necessary to model chemical kinetics. Currently there is an increased effort that is concentrated on the supporting data base. For aqueous species and solid phases, specific to nuclear waste, requisite thermodynamic values reported in the literature are being evaluated and for cases where essential data is lacking, laboratory measurements will be carried out. Significant modifications and expansions have been made to the data base. During FY86, the total number of species in the data base has almost doubled and many improvements have been made with regard to consistency, organization, user applications, and documentation. Two Ridge computers using a RISC implementation of UNIX were installed; they are completely dedicated EQ3/6 machines.

  16. EQ-5D™-derived utility values for different levels of migraine severity from a UK sample of migraineurs

    Directory of Open Access Journals (Sweden)

    Stafford Megan R

    2012-06-01

    Full Text Available Abstract Background To estimate utility values for different levels of migraine pain severity from a United Kingdom (UK sample of migraineurs. Methods One hundred and six migraineurs completed the EQ-5D to evaluate their health status for mild, moderate and severe levels of migraine pain severity for a recent migraine attack, and for current health defined as health status within seven days post-migraine attack. Statistical tests were used to evaluate differences in mean utility scores by migraine severity. Results Utility scores for each health state were significantly different from 1.0 (no problems on any EQ-5D dimension (p  Conclusions Results indicate that all levels of migraine pain are associated with significantly reduced utility values. As severity worsened, utility decreased and severe migraine pain was considered a health state worse than death. Results can be used in cost-utility models examining the relative economic value of therapeutic strategies for migraine in the UK.

  17. Adverse Selection in Community Based Health Insurance among Informal Workers in Bangladesh: An EQ-5D Assessment

    Directory of Open Access Journals (Sweden)

    Sayem Ahmed

    2018-01-01

    Full Text Available Community-based Health Insurance (CBHI schemes are recommended for providing financial risk protection to low-income informal workers in Bangladesh. We assessed the problem of adverse selection in a pilot CBHI scheme in this context. In total, 1292 (646 insured and 646 uninsured respondents were surveyed using the Bengali version of the EuroQuol-5 dimensions (EQ-5D questionnaire for assessing their health status. The EQ-5D scores were estimated using available regional tariffs. Multiple logistic regression was applied for predicting the association between health status and CBHI scheme enrolment. A higher number of insured reported problems in mobility (7.3%; p = 0.002; self-care (7.1%; p = 0.000 and pain and discomfort (7.7%; p = 0.005 than uninsured. The average EQ-5D score was significantly lower among the insured (0.704 compared to the uninsured (0.749. The regression analysis showed that those who had a problem in mobility (m 1.25–2.17; self-care (OR = 2.29; 95% CI: 1.62–3.25 and pain and discomfort (OR = 1.43; 95% CI: 1.13–1.81 were more likely to join the scheme. Individuals with higher EQ-5D scores (OR = 0.46; 95% CI: 0.31–0.69 were less likely to enroll in the scheme. Given that adverse selection was evident in the pilot CBHI scheme, there should be consideration of this problem when planning scale-up of these kind of schemes.

  18. Usefulness of EQ-5D in Assessing Health Status in Primary Care Patients with Major Depressive Disorder

    Directory of Open Access Journals (Sweden)

    Nowicki Marie-Laure

    2004-05-01

    Full Text Available Abstract Objectives Major depressive disorder (MDD is a prevalent psychiatric disorder associated with impaired patient functioning and reductions in health-related quality of life (HRQL. The present study describes the impact of MDD on patients' HRQL and examines preference-based health state differences by patient features and clinical characteristics. Methods 95 French primary care practitioners recruited 250 patients with a DSM-IV diagnosis of MDD for inclusion in an eight-week follow-up cohort. Patient assessments included the Montgomery Asberg Depression Rating Scale (MADRS, the Clinical Global Impression of Severity (CGI, the Short Form-36 Item scale (SF-36, the Quality of Life Depression Scale (QLDS and the EuroQoL (EQ-5D. Results The mean EQ-5D utility at baseline was 0.33, and 8% of patients rated their health state as worse than death. There were no statistically significant differences in utilities by demographic features. Significant differences were found in mean utilities by level of disease severity assessed by CGI. The different clinical response profiles, assessed by MADRS, were also revealed by EQ-5D at endpoint: 0.85 for responders remitters, 0.72 for responders non-remitter, and 0.58 for non-responders. Even if HRQL and EQ-5D were moderately correlated, they shared only 40% of variance between baseline and endpoint. Conclusions Self-reported patient valuations for depression are important patient-reported outcomes for cost-effectiveness evaluations of new antidepressant compounds and help in further understanding patient compliance with antidepressant treatment.

  19. Experience-based VAS values for EQ-5D-3L health states in a national general population health survey in China.

    Science.gov (United States)

    Sun, Sun; Chen, Jiaying; Kind, Paul; Xu, Ling; Zhang, Yaoguang; Burström, Kristina

    2015-03-01

    To investigate the feasibility of deriving experience-based visual analogue scale (VAS) values for EQ-5D-3L health states using national general population health survey data in China. The EQ-5D-3L was included in the National Health Services Survey (n = 120,709, aged 15-103 years) to measure health-related quality of life. The respondents reported their current health status on a VAS and completed the EQ-5D-3L questionnaire, enabling modelling of the association between the experience-based VAS values and self-reported problems on EQ-5D dimensions and severity levels. VAS values were generally negatively associated with problems reported on the EQ-5D dimensions, and the anxiety/depression dimension had the greatest impact on VAS values. A previously obtained value for dead allowed the values for all 243 EQ-5D-3L health states to be transformed to the 0-1 scale (0 = dead, 1 = full health). This study presents the feasibility of deriving an experience-based VAS values for EQ-5D-3L health states in China. The analysis of these VAS data raises more fundamental issues concerning the universal nature of the classification system and the extent to which Chinese respondents utilise the same concepts of health as defined by this classification system.

  20. Quality of Life Assessment Using EuroQOL EQ-5D Questionnaire in Patients with Deep Infiltrating Endometriosis: The Relation with Symptoms and Locations

    Science.gov (United States)

    Touboul, C.; Amate, P.; Ballester, M.; Bazot, M.; Fauconnier, A.; Daraï, E.

    2013-01-01

    The objective of this study was to evaluate the quality of life (QOL) of patients with deep infiltrating endometriosis (DIE) using EuroQOL (EQ-5D) and its correlation with symptoms and locations of endometriotic lesions. One hundred and fifty-nine patients referred for DIE from January 2011 to April 2011 were prospectively invited to complete questionnaires evaluating symptoms associated with endometriosis as well as the EQ-5D questionnaire and health state. Patients also had locations of DIE evaluated by clinical examination and magnetic resonance imaging (MRI). All 159 patients completed the questionnaires. Item response rate was 91.1%. The most intense symptoms were dysmenorrhea (7.1/10), painful defecation (6.3/10), and fatigue (6.0/10). Mean (SD) scores were 77 (14) for the EQ-5D questionnaire and 63.4 (21) for the health state. A relation was observed between the EQ-5D questionnaire and the presence of dysmenorrhea, dyspareunia, cyclic pelvic pain, painful defecation, and diarrhea or constipation. Vaginal and rectal infiltrations were significantly associated with altered EQ-5D and health state scores. The EQ-5D questionnaire is easy to complete and well related to symptoms of DIE. Rectal and vaginal infiltrations were found to be determinant factors of altered QOL by the EQ-5D questionnaire and health state. PMID:26464845

  1. Interpretation and use of the 5-level EQ-5D response labels varied with survey language among Asians in Singapore.

    Science.gov (United States)

    Luo, Nan; Wang, Ye; How, Choon How; Tay, Ee Guan; Thumboo, Julian; Herdman, Michael

    2015-10-01

    This study aimed to investigate the comparability of the English, Chinese, and Malay versions of the 5-level EQ-5D (EQ-5D-5L) response labels in Singapore. Visitors to a primary care institution in Singapore (n = 743) were asked to complete two exercises: (1) rating the severity of the EQ-5D-5L response labels presented in English, Chinese, or Malay using a 0-100 numeric rating scale and (2) using the labels to describe various hypothetical health problems. Label ratings and choices between language versions were compared using regression analysis. Perceived severity of the English and Chinese labels was similar. Compared with their English counterparts, the Malay label "slight(ly)" was rated as more severe (adjusted mean difference: 10.5 to 14.5) and "unable"/"extreme(ly)" as less severe (adjusted mean difference: -13.3 to -11.0) (P language versions of the instrument. Future studies need to investigate ways to reduce the variations and increase the cross-cultural measurement equivalence of the instrument. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Membrana amniótica preservada em glicerina no reparo de feridas cutâneas de membros locomotores de eqüinos

    OpenAIRE

    Oliveira,Valdemir Alves de; Alvarenga,José de

    1998-01-01

    Neste estudo experimental, avaliou-se o uso de membrana amniótica eqüina preservada em glicerina 98%, à temperatura ambiente, em feridas com cura por segunda intenção, nos membros locomotores de eqüinos. Foram provocadas cirurgicamente feridas de 9,6cm² na face lateral da articulação metacarpo-falangeana, face medial do terço proximal do metacarpo e face lateral do terço médio do metatarso de ambos os membros locomotores de cinco eqüinos adultos, perfazendo total de trinta feridas. Foram cons...

  3. HUBUNGAN EQ, PENGETAHUAN KEWIRAUSAHAAN, DAN HASRAT MARGINAL MENABUNG, DENGAN MOTIVASI BERWIRAUSAHA MAHASISWA PENDIDIKAN EKONOMI

    Directory of Open Access Journals (Sweden)

    Tri Handayani

    2016-12-01

    Full Text Available Penelitian ini bertujuan untuk mendeskripsikan korelasi kecerdasan emosional, pengetahuan kewirausahaan, dan hasrat marginal menabung dengan motivasi berwirausaha mahasiswa Pendidikan Ekonomi FKIP Universitas Negeri Jambi. Penelitian ini merupakan penelitian korelasional. Dengan populasi mahasiswa Pendidikan Ekonomi FKIP Universitas Negeri Jambi dan sampel penelitian ini adalah mahsiswa angkatan 2012 sebanyak 79 orang yang dipilih dengan teknik nonprobability purpose  sampling. Teknik pengumpulan data yang digunakan yaitu angket untuk kecerdasan emosional, hasrat  marginal menabung dan motivasi berwirausaha dan tes untuk pengetahuan kewirausahaan. Teknik analisis yang digunakan adalah correlasi product moment dengan taraf signiikansi 0,05. Hasil penelitian menunjukkan bahwa: (1 Terdapat hubungan positif dan signifikan antara kecerdasan emosional dan motivasi berwirausaha dengan determinasi korelasi 0,456, pada taraf signifikan 0,05 (2 Terdapat hubungan positif dan signifikan antara pengetahuan kewirausahaan dan motivasi berwirausaha dengan determinasi korelasi 0.459, pada taraf signifikan 0,05. (3 Terdapat hubungan positif dan signifikan antara hasrat marginal menabung dan motivasi berwirausaha dengan determinasi korelasi 0,517, pada taraf signifikan 0,05 (4 Terdapat hubungan positif dan signifikan secara bersamaan antara kecerdasan emosional, pengetahuan kewirausahaan, dan hasrat marginal menabung dengan motivasi berwirausaha dengan determinasi korelasi 0,625, pada taraf signifikan 0,05   KORRELATION EQ, ENTREPRENEUR KNOWLEDGE, AND MARGINAL PROPENSITY TO SAVE WITH ENTREPRENEUR MOTIVATION OF STUDENT ECONOMIC EDUCATION Abstract This research aims to describe the relationship between emotional inteligency, entrepreneur knowledge,  marginal propensity to save, and entrepreneurship motivation of students majoring in Economic Education Science, in Teacher Education Faculty, Jambi University. This is correlation research. The population of this

  4. Letter Report: Progress in developing EQ3/6 for modeling boiling processes

    Energy Technology Data Exchange (ETDEWEB)

    Wolery, T. J., LLNL

    1995-08-28

    EQ3/6 is a software package for geochemical modeling of aqueous systems, such as water/rock or waste/water rock. It is being developed for a variety of applications in geochemical studies for the Yucca Mountain Site Characterization Project. The present focus is on development of capabilities to be used in studies of geochemical processes which will take place in the near-field environment and the altered zone of the potential repository. We have completed the first year of a planned two-year effort to develop capabilities for modeling boiling processes. These capabilities will interface with other existing and future modeling capabilities to provide a means of integrating the effects of various kinds of geochemical processes in complex systems. This year, the software has been modified to allow the formation of a generalized gas phase in a closed system for which the temperature and pressure are known (but not necessarily constant). The gas phase forms when its formation is thermodynamically favored; that is, when the system pressure is equal to the sum of the partial pressures of the gas species as computed from their equilibrium fugacities. It disappears when this sum falls below that pressure. `Boiling` is the special case in which the gas phase which forms consists mostly of water vapor. The reverse process is then `condensation.` To support calculations of boiling and condensation, we have added a capability to calculate the fugacity coefficients of gas species in the system H{sub 2}O-CO{sub 2}-CH{sub 4}-H{sub 2},-Awe{sub 2}-N{sub 2},-H{sub 2}S-NH3. This capability at present is accurate only at relatively low pressures, but is adequate for all likely repository boiling conditions. We have also modified the software to calculate changes in enthalpy (heat) and volume functions. Next year we will be extending the boiling capability to calculate the pressure or the temperature at known enthalpy. We will also add an option for open system boiling.

  5. Equilíbrio ácido-base e hidroeletrolítico em eqüinos com cólica

    OpenAIRE

    Di Filippo,Paula Alessandra; Santana,Aureo Evangelista; Pereira,Gener Tadeu

    2008-01-01

    Foram utilizados setenta eqüinos distribuídos em três grupos experimentais, G1 (vinte eqüinos hígidos), G2 (vinte e cinco eqüinos com cólica, os quais passaram por tratamento clínico ou cirúrgico e sobreviveram) e G3 (vinte e cinco eqüinos com cólica, os quais passaram por tratamento clínico ou cirúrgico e foram a óbito ou foram sacrificados). Amostras de sangue foram obtidas em dez diferentes momentos, mediante punção da jugular, para estudo do equilíbrio ácido-base e hidroeletrolítico. Os e...

  6. A systematic literature review to compare quality of life in psoriasis with other chronic diseases using EQ-5D-derived utility values

    Directory of Open Access Journals (Sweden)

    Møller AH

    2015-07-01

    Full Text Available Anders Holmen Møller,1 Sandra Erntoft,1 Gabrielle R Vinding,2 Gregor BE Jemec21LEO Pharma A/S, Ballerup, Denmark; 2Department of Dermatology, Roskilde Hospital, Health Sciences Faculty, University of Copenhagen, Copenhagen, DenmarkBackground: Psoriasis is a chronic, immune-mediated dermatological disease associated with substantial economic, clinical, and humanistic burden.Objective: The aim of this study was to understand the disutility of patients with psoriasis vulgaris, using mean baseline EuroQoL five dimensions (EQ-5D index scores reported in the published literature, and to compare this to patients with other chronic diseases.Methods: Two systematic literature searches were conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA guidelines. Searches were conducted in ten databases including Embase, MEDLINE, and the Cochrane Central Register of Controlled Trials (CENTRAL. The first search (December 2013 used search terms psoria* AND (EQ5D OR EQ OR EUROQoL. Only publications of original research, which reported baseline EQ-5D scores for mild/moderate/severe psoriasis, were included. The second search (March 2014 used the terms (systematic review AND (EQ5D OR EQ 5D OR EuroQoL. Titles were screened by two independent reviewers. Four independent reviewers reviewed titles and full-length papers. EQ-5D scores for psoriasis patients were qualitatively compared with scores from patients with other chronic diseases identified through the literature search.Results: Of 133 publications on psoriasis, 12 met the inclusion criteria. The mean EQ-5D index scores for psoriasis (all severities ranged from 0.52 (standard deviation: 0.39 to 0.9 (standard deviation: 0.1. Of the 48 results from the second search, six met the inclusion criteria. The reported EQ-5D lower limit for other diseases ranged from 0.20 (Type 2 diabetes mellitus to 0.66 (liver diseases. The highest EQ-5D estimates for other diseases ranged

  7. EQPT, a data file preprocessor for the EQ3/6 software package: User's guide and related documentation (Version 7.0)

    International Nuclear Information System (INIS)

    Daveler, S.A.; Wolery, T.J.

    1992-01-01

    EQPT is a data file preprocessor for the EQ3/6 software package. EQ3/6 currently contains five primary data files, called datao files. These files comprise alternative data sets. These data files contain both standard state and activity coefficient-related data. Three (com, sup, and nea) support the use of the Davies or B equations for the activity coefficients; the other two (hmw and pit) support the use of Pitzer's (1973, 1975) equations. The temperature range of the thermodynamic data on these data files varies from 25 degrees C only to 0-300 degrees C. The principal modeling codes in EQ3/6, EQ3NR and EQ6, do not read a data0 file, however. Instead, these codes read an unformatted equivalent called a data1 file. EQPT writes a datal file, using the corresponding data0 file as input. In processing a data0 file, EQPT checks the data for common errors, such as unbalanced reactions. It also conducts two kinds of data transformation. Interpolating polynomials are fit to data which are input on temperature adds. The coefficients of these polynomials are then written on the datal file in place of the original temperature grids. A second transformation pertains only to data files tied to Pitzer's equations. The commonly reported observable Pitzer coefficient parameters are mapped into a set of primitive parameters by means of a set of conventional relations. These primitive form parameters are then written onto the datal file in place of their observable counterparts. Usage of the primitive form parameters makes it easier to evaluate Pitzer's equations in EQ3NR and EQ6. EQPT and the other codes in the EQ3/6 package are written in FORTRAN 77 and have been developed to run under the UNIX operating system on computers ranging from workstations to supercomputers

  8. EQPT, a data file preprocessor for the EQ3/6 software package: User`s guide and related documentation (Version 7.0); Part 2

    Energy Technology Data Exchange (ETDEWEB)

    Daveler, S.A.; Wolery, T.J.

    1992-12-17

    EQPT is a data file preprocessor for the EQ3/6 software package. EQ3/6 currently contains five primary data files, called datao files. These files comprise alternative data sets. These data files contain both standard state and activity coefficient-related data. Three (com, sup, and nea) support the use of the Davies or B-dot equations for the activity coefficients; the other two (hmw and pit) support the use of Pitzer`s (1973, 1975) equations. The temperature range of the thermodynamic data on these data files varies from 25{degrees}C only to 0-300{degrees}C. The principal modeling codes in EQ3/6, EQ3NR and EQ6, do not read a data0 file, however. Instead, these codes read an unformatted equivalent called a data1 file. EQPT writes a datal file, using the corresponding data0 file as input. In processing a data0 file, EQPT checks the data for common errors, such as unbalanced reactions. It also conducts two kinds of data transformation. Interpolating polynomials are fit to data which are input on temperature adds. The coefficients of these polynomials are then written on the datal file in place of the original temperature grids. A second transformation pertains only to data files tied to Pitzer`s equations. The commonly reported observable Pitzer coefficient parameters are mapped into a set of primitive parameters by means of a set of conventional relations. These primitive form parameters are then written onto the datal file in place of their observable counterparts. Usage of the primitive form parameters makes it easier to evaluate Pitzer`s equations in EQ3NR and EQ6. EQPT and the other codes in the EQ3/6 package are written in FORTRAN 77 and have been developed to run under the UNIX operating system on computers ranging from workstations to supercomputers.

  9. The time to trade-off method versus the EQ-5D index to determine health utility in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Dmitriy Vladimirovich Goryachev

    2010-01-01

    The values of the utility index calculated by TTO failed to correlate with those of HAQ and EQ-5D. The disease duration was unrelated to the values of the utility index calculated by any of the methods used. The association of TTO index was found only for VAS-GH "thermometer". Conclusion. EQ-5D index and VAS-GH are the methods of choice in determining health utility for a clinicoeconomic analysis in patients with RA.

  10. Preliminary validation and principal components analysis of the Control of Eating Questionnaire (CoEQ) for the experience of food craving.

    Science.gov (United States)

    Dalton, M; Finlayson, G; Hill, A; Blundell, J

    2015-12-01

    The Control of Eating Questionnaire (CoEQ) comprises 21-items that are designed to assess the severity and type of food cravings an individual experiences over the previous 7 days. The CoEQ has been used in clinical trials as a multi-dimensional measure of appetite, craving and mood regulation however its underlying component structure has yet to be determined. The current paper has two aims; (1) to examine the psychometric properties, and internal consistency of the CoEQ; and (2) to provide a preliminary examination of the underlying components by exploring their construct and predictive validity. Data were pooled from four studies in which a total 215 adults (80% women; Age=29.7 ± 10.3; BMI=26.5 ± 5.2) had completed the CoEQ alongside measures of psychometric eating behaviour traits, ad libitum food intake, and body composition. A principal components analysis (PCA) and parallel analysis was conducted to examine the underlying structure of the questionnaire. The resulting subscales were tested for internal consistency (Cronbach's α=0.66-0.88). PCA revealed four components that explained 54.5% of the variance. The components were identified as: Craving Control, Positive Mood, Craving for Sweet, and Craving for Savoury. Associations between the underlying CoEQ subscales and measures of body composition and eating behaviour traits confirmed construct validity of the subscales. The associations between the subscales and snack food selection and intake of palatable snack foods supported the CoEQ's predictive validity. The CoEQ has good psychometric properties with a clear component structure and acceptable internal consistency. This preliminary validation supports the CoEQ as a measure of the experience of food cravings.

  11. Validation and comparison of EuroQoL-5 dimension (EQ-5D) and Short Form-6 dimension (SF-6D) among stable angina patients

    OpenAIRE

    Wu, Jing; Han, Yuerong; Zhao, Fei-Li; Zhou, Jin; Chen, Zhijun; Sun, He

    2014-01-01

    Objectives Several preference-based health-related quality of life (HRQoL) instruments have been published and widely used in different populations. However no consensus has emerged regarding the most appropriate instrument in therapeutic area of stable angina. This study compared and validated the psychometric properties of two generic preference-based instruments, the EQ-5D and SF-6D, among Chinese stable angina patients. Methods Convergent validity of the EQ-5D and SF-6D was examined with ...

  12. EQ3/6, a software package for geochemical modeling of aqueous systems: Package overview and installation guide (Version 7.0)

    International Nuclear Information System (INIS)

    Wolery, T.J.

    1992-01-01

    EQ3/6 is a software package for geochemical modeling of aqueous systems. This report describes version 7.0. The major components of the package include: EQ3NR, a speciation-solubility code; EQ6, a reaction path code which models water/rock interaction or fluid mixing in either a pure reaction progress mode or a time mode; EQPT, a data file preprocessor, EQLIB, a supporting software library; and five supporting thermodynamic data files. The software deals with the concepts of thermodynamic equilibrium, thermodynamic disequilibrium, and reaction kinetics. The five supporting data files contain both standard state and activity coefficient-related data. Three support the use of the Davies or B equations for the activity coefficients; the other two support the use of Pitzer's equations. The temperature range of the thermodynamic data on the data files varies from 25 degree C only to 0--300 degree C. EQPT takes a formatted data file (a data0 file) and writes an unformatted near-equivalent called a datal file, which is actually the form read by EQ3NR and EQ6. EQ3NR is useful for analyzing groundwater chemistry data, calculating solubility limits, and determining whether certain reactions are in states of partial equilibrium or disequilibrium. It is also required to initialize an EQ6 calculation. EQ6 models the consequences of reacting an aqueous solution with a set of reactants which react irreversibly. It can also model fluid mixing and the consequences of changes in temperature. This code operates both in a pure reaction progress frame and in a time frame

  13. EQ3/6, a software package for geochemical modeling of aqueous systems: Package overview and installation guide (Version 7.0)

    Energy Technology Data Exchange (ETDEWEB)

    Wolery, T.J.

    1992-09-14

    EQ3/6 is a software package for geochemical modeling of aqueous systems. This report describes version 7.0. The major components of the package include: EQ3NR, a speciation-solubility code; EQ6, a reaction path code which models water/rock interaction or fluid mixing in either a pure reaction progress mode or a time mode; EQPT, a data file preprocessor, EQLIB, a supporting software library; and five supporting thermodynamic data files. The software deals with the concepts of thermodynamic equilibrium, thermodynamic disequilibrium, and reaction kinetics. The five supporting data files contain both standard state and activity coefficient-related data. Three support the use of the Davies or B-dot equations for the activity coefficients; the other two support the use of Pitzer`s equations. The temperature range of the thermodynamic data on the data files varies from 25{degree}C only to 0--300{degree}C. EQPT takes a formatted data file (a data0 file) and writes an unformatted near-equivalent called a datal file, which is actually the form read by EQ3NR and EQ6. EQ3NR is useful for analyzing groundwater chemistry data, calculating solubility limits, and determining whether certain reactions are in states of partial equilibrium or disequilibrium. It is also required to initialize an EQ6 calculation. EQ6 models the consequences of reacting an aqueous solution with a set of reactants which react irreversibly. It can also model fluid mixing and the consequences of changes in temperature. This code operates both in a pure reaction progress frame and in a time frame.

  14. Reaction of Topopah Spring tuff with J-13 water: a geochemical modeling approach using the EQ3/6 reaction path code

    Energy Technology Data Exchange (ETDEWEB)

    Delany, J.M.

    1985-11-25

    EQ3/6 geochemical modeling code package was used to investigate the interaction of the Topopah Spring Tuff and J-13 water at high temperatures. EQ3/6 input parameters were obtained from the results of laboratory experiments using USW G-1 core and J-13 water. Laboratory experiments were run at 150 and 250{sup 0}C for 66 days using both wafer-size and crushed tuff. EQ3/6 modeling reproduced results of the 150{sup 0}C experiments except for a small increase in the concentration of potassium that occurs in the first few days of the experiments. At 250{sup 0}C, the EQ3/6 modeling reproduced the major water/rock reactions except for a small increase in potassium, similar to that noted above, and an overall increase in aluminum. The increase in potassium concentration cannot be explained at this time, but the increase in A1 concentration is believed to be caused by the lack of thermodynamic data in the EQ3/6 data base for dachiardite, a zeolite observed as a run product at 250{sup 0}C. The ability to reproduce the majority of the experimental rock/water interactions at 150{sup 0}C validates the use of EQ3/6 as a geochemical modeling tool that can be used to theoretically investigate physical/chemical environments in support of the Waste Package Task of NNWSI.

  15. Reaction of Topopah Spring tuff with J-13 water: a geochemical modeling approach using the EQ3/6 reaction path code

    International Nuclear Information System (INIS)

    Delany, J.M.

    1985-01-01

    EQ3/6 geochemical modeling code package was used to investigate the interaction of the Topopah Spring Tuff and J-13 water at high temperatures. EQ3/6 input parameters were obtained from the results of laboratory experiments using USW G-1 core and J-13 water. Laboratory experiments were run at 150 and 250 0 C for 66 days using both wafer-size and crushed tuff. EQ3/6 modeling reproduced results of the 150 0 C experiments except for a small increase in the concentration of potassium that occurs in the first few days of the experiments. At 250 0 C, the EQ3/6 modeling reproduced the major water/rock reactions except for a small increase in potassium, similar to that noted above, and an overall increase in aluminum. The increase in potassium concentration cannot be explained at this time, but the increase in A1 concentration is believed to be caused by the lack of thermodynamic data in the EQ3/6 data base for dachiardite, a zeolite observed as a run product at 250 0 C. The ability to reproduce the majority of the experimental rock/water interactions at 150 0 C validates the use of EQ3/6 as a geochemical modeling tool that can be used to theoretically investigate physical/chemical environments in support of the Waste Package Task of NNWSI

  16. Solubility of unirradiated UO2 fuel in aqueous solutions. Comparison between experimental and calculated (EQ3/6) data

    International Nuclear Information System (INIS)

    Ollila, K.

    1995-11-01

    The solubility behaviour of unirradiated UO 2 pellets was studied under oxic (air-saturated) and anoxic (N 2 ) conditions in deionized water, in sodium bicarbonate solutions with varying bicarbonate content (60 - 600 ppm), in Allard groundwater simulating granitic fresh groundwater conditions, and in bentonite water simulating the effects of bentonite on granitic fresh groundwater (25 deg C). The release of uranium was measured during static batch dissolution experiments of long duration (2-6 years). A comparison was made with the theoretical solubility data calculated with the geochemical code EQ3/6 in order to evaluate solubility (steady state) limiting factors. (orig.) (26 refs., 32 figs., 13 tabs.)

  17. Freqüência de anemia infecciosa em eqüinos no Acre, 1986 a 1996

    Directory of Open Access Journals (Sweden)

    Santos R.M.L.

    2001-01-01

    Full Text Available Foram analisadas as fichas de 9.963 eqüídeos do Acre, submetidos ao teste de imunodifusão em gel de ágar (IDGA para anemia infecciosa eqüina (AIE, no período de 1986 a 1996. As regiões sócio-ecológicas da Bacia do Alto Juruá, Alto Acre e Alta Bacia do Purus apresentaram os maiores índices da doença, o que caracteriza a associação entre região e positividade. Essas áreas são fronteiriças com o Peru, Bolívia e o Estado do Amazonas, são distantes de Rio Branco, capital do Estado, onde muitas vezes é difícil o acesso pelas estradas, revelando serem áreas de risco. As regiões Oriental e Rio Branco apresentaram baixos índices de positividade. Não se observou diferença estatística entre animais positivos e negativos quanto à espécie, sexo, raça e idade.

  18. Plan for integrated testing for NNWSI [Nevada Nuclear Waste Storage Investigations] non EQ3/6 data base portion

    International Nuclear Information System (INIS)

    Oversby, V.M.

    1987-01-01

    The purposes of the Integrated Testing Task are to develop laboratory data on thermodynamic properties for actinide and fission product elements for use in the EQ3/6 geochemical modelling code; to determine the transport properties of radionuclides in the near-field environment; and develop and validate a model to describe the rate of release of radionuclides from the near-field environment. Activities to achieve the firs item have been described in the Scientific Investigation Plan for EQ3/6, where quality assurance levels were assigned to the acitivities. This Scientific Investigation Plan describes activities to achieve the second and third purposes. The information gathered in these activities will be used to assess compliance with the performance objective for the Engineered Barrier System (EBS) to control the rate of release of radionuclides if the repository license application includes part of the host rock; to provide a source term for release of radionuclides from the waste package near-field environment to the system performance assessment task for use in showing compliance with the Environmental Protection Agency requirements; and to provide a source term for release of radionculides from the waste package near-field environment to the system performance assessment task for use in doing calculations of cumulative releases of radionuclides from the repository over 100,000 years as required by the site evaluation process. 5 refs

  19. ANALISIS PENGARUH EMOTIONAL QUOTIENT (EQ DAN STRES KERJA TERHADAP PERFORMA KERJA KARYAWAN PADA PT. BANK MESTIKA DHARMA MEDAN

    Directory of Open Access Journals (Sweden)

    Bambang Bambang

    2013-02-01

    Full Text Available Human Resources are a generator of available resources in the activities and routine of an organization or company that the good and the bad performance of an organization are determined by the performance of human resources. Professional employee  is a reliable employee with balanced quality between academic and emotional capability. Academic intelligence is frequently given a higher position than emotional intelligence is an individual evaluation. Emotional intelligence is the factor  determining the effectiveness of someone is working that with high emotional intelligence, the human resources can be easily directed and guided to work in accordance with the goals of organization. The prupose of this quantitative descriptive explanatory study was to look at the influence of Emotional Quotient (EQ and Work Stress on the performance of the employees of PT. Bank Mestika Dharma Medan using the theory of human resources management related to Emotional Quotient (EQ, work stress and work performance. The population of this study was 585 employees and 238 of them were selected to be the samples for this study. The data obtained were analyzed through multiple linear regression tests using F test to simultaneously test the hypothesis and using t test to do a partial test. The result of the hypothesis test showed that simultaneously the variable of Emotional Quotient and work stress had a significant influence on the improvemnet of the performance  of the employees of PT. Bank Mestika Dharma Medan

  20. Modelling uranium solubilities in aqueous solutions: Validation of a thermodynamic data base for the EQ3/6 geochemical codes

    International Nuclear Information System (INIS)

    Puigdomenech, I.; Bruno, J.

    1988-01-01

    Experimental solubilities of U 4+ and UO 2 2+ that are reported in the literature have been collected. Data on oxides, hydroxides and carbonates have been selected for this work. They include results both at 25 degrees C and at higher temperatures. The literature data have been compared with calculated uranium solubilities obtained with the EQ3/6 geochemical modelling programs and an uranium thermodynamic data base selected for the Swedish nuclear waste management program. This verification/validiation exercise has shown that more experimental data is needed to determine the chemical composition of anionic uranyl hydroxo complexes as well as their equilibrium constants of formation. There is also a need for more solubility data on well characterised alkaline or alkaline-earth uranates. For the uranyl carbonate system, the calculated results agree reasonably well with the experimental literature values, which span over a wide range of pH, (CO 3 2- ) T , CO 2 (g)-pressure, and T. The experimental solubility of UO 2 (s) agrees also well with the EQ3/6 calculations for pH greater than 6. However, in more acidic solutions the experimental solubilities are higher than the calculated values. This is due to the formation of polynuclear hydroxo complexes of uranium, which are not well characterised, and are not included in the thermodynamic data base used in this study. (authors)

  1. Questioning the differences between general public vs. patient based preferences towards EQ-5D-5L defined hypothetical health states.

    Science.gov (United States)

    Ogorevc, Marko; Murovec, Nika; Fernandez, Natacha Bolanos; Rupel, Valentina Prevolnik

    2017-03-28

    The purpose of this article is to explore whether any differences exist between the general population and patient based preferences towards EQ-5D-5L defined hypothetical health states. The article discusses the role of adaptation and self-interest in valuing health states and it also contributes rigorous empirical evidence to the scientific debate on the differences between the patient and general population preferences towards hypothetical health states. Patient preferences were elicited in 2015 with the EQ-5D-5L questionnaire using time trade-off and discrete choice experiment design and compared to the Spanish general population preferences, which were elicited using identical methods. Patients were chosen on a voluntary basis according to their willingness to participate in the survey. They were recruited from patient organisations and a hospital in Madrid, Spain. 282 metastatic breast cancer patients and 333 rheumatoid arthritis patients were included in the sample. The analysis revealed differences in preferences between the general population and patient groups. Based on the results of our analysis, it is suggested that the differences in preferences stem from patients being more able to accurately imagine "non-tangible" dimensions of health states (anxiety or depression, and pain or discomfort) than the general population with less experience in various health states. However, this does not mean that general public values should not be reflected in utilities derived for coverage decision making. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. [Antipsychotic Treatment of the Adult Patient in the Acute Phase of Schizophrenia].

    Science.gov (United States)

    Bohórquez Peñaranda, Adriana; Gómez Restrepo, Carlos; García Valencia, Jenny; Jaramillo González, Luis Eduardo; de la Hoz, Ana María; Arenas, Álvaro; Tamayo Martínez, Nathalie

    2014-01-01

    To determine the efficacy and safety of different antipsychotic drugs in the management of patients diagnosed with schizophrenia in the acute phase. To formulate evidence-based recommendations on the antipsychotic (AP) drug management strategies for the treatment of the adult diagnosed with schizophrenia in the acute phase. Clinical practice guidelines were prepared, using the guidelines of the Methodology Guide of the Ministry of Health and Social Protection, in order to identify, synthesise, and evaluate the evidence and formulate recommendations as regards the management and follow-up of adult patients diagnosed with schizophrenia. The evidence of the NICE 82 guideline was adopted and updated, which answered the question on the management of the acute phase of adults with a diagnosis of schizophrenia. The evidence and its level were presented to the Guideline Development Group (GDG) in order to formulate recommendations following the methodology proposed by the GRADE approach. Clozapine, olanzapine, risperidone, ziprasidone, amisulpride, paliperidone, haloperidol, quetiapine, and aripiprazole were more effective than placebo for the majority of psychotic symptoms and the abandonment of treatment, but asenapine was not. Paliperidone, risperidone, quetiapine, clozapine, and olanzapine showed significant increases in weight compared to placebo. Haloperidol, risperidone, ziprasidone, and paliperidone had a higher risk of extrapyramidal symptoms than placebo. There was a significant risk of sedation or drowsiness with, risperidone, haloperidol, ziprasidone, quetiapine, olanzapine, and clozapine in the comparisons with placebo. Of the results of the comparisons between AP, it was shown that clozapine and paliperidone had a clinically significant effect compared to haloperidol and quetiapine, respectively. Olanzapine and risperidone had a lower risk of abandoning the treatment in general, and due to adverse reactions in two comparisons of each one, haloperidol was the

  3. Inequalities in Health Status from EQ-5D Findings: A Cross-Sectional Study in Low-Income Communities of Bangladesh

    Science.gov (United States)

    Sultana, Marufa; Sarker, Abdur Razzaque; Mahumud, Rashidul Alam; Ahmed, Sayem; Ahmed, Wahid; Chakrovorty, Sanchita; Rahman, Hafizur; Islam, Ziaul; Khan, Jahangir A. M.

    2016-01-01

    Background: Measuring health status by using standardized and validated instrument has become a growing concern over the past few decades throughout the developed and developing countries. The aim of the study was to investigate the overall self-reported health status along with potential inequalities by using EuroQol 5 dimensions (EQ-5D) instrument among low-income people of Bangladesh. Methods: A cross-sectional household survey was conducted in Chandpur district of Bangladesh. Bangla version of the EQ-5D questionnaire was employed along with socio-demographic information. EQ-5D questionnaire composed of 2-part measurements: EQ-5D descriptive system and the visual analogue scale (VAS). For measuring health status, UK-based preference weights were applied while higher score indicated better health status. For facilitating the consistency with EQ-5D score, VASs were converted to a scale with scores ranging from 0 to 1. Multiple logistic regression models were also employed to examine differences among EQ-5D dimensions. Results: A total of 1433 respondents participated in the study. The mean EQ-5D and VAS score was 0.76 and 0.77, respectively. The females were more likely to report any problem than the males (P economic and demographic inequalities in health status was observed in the study. Study suggests to do further investigation with country representative sample to measure the inequalities of overall health status. It would be helpful for policy-maker to find a new way aiming to reduce such inequalities. PMID:27239879

  4. Health-related quality of life in pregnant women living with HIV: a comparison of EQ-5D and SF-12.

    Science.gov (United States)

    Wang, Xiaowen; Guo, Guangping; Zhou, Ling; Zheng, Jiarui; Liang, Xiumin; Li, Zhanqin; Luo, Hongzhuan; Yang, Yuyan; Yang, Liyuan; Tan, Ting; Yu, Jun; Lu, Lin

    2017-08-30

    This paper investigates the properties and performance of the two generic measures, EQ-5D and SF-12, for Health-Related Quality of Life (HRQoL) assessments of pregnant women living with HIV in Kunming City, Yiliang County, Daguan County, Longchuan County, Tengchong County, Longling County and Fengqing County in Yunnan Province, China. As part of a screening programme for the prevention of mother-to-child transmission of HIV (PMTCT), a retrospective cross-sectional survey was conducted in the seven Maternal and Infant Health Care centers in Yunnan Province, China, between April and June of 2016. The demographic and HIV infection-related information used in the study was collected through questionnaires designed by the study's staff. HRQoL information was collected using two generic scales: EQ-5D and SF-12. A total sample of one hundred and one pregnant women with a mean age of 30.4 ± 5.1 years was investigated. Average time elapsed since infection diagnoses was 5.8 ± 3.4 years. Only one infant (1.0%) was HIV positive, and 56 (55.4%) infants were HIV negative. The HIV status of 44 (43.6%) infants was unknown. The relationship between the EQ-5D functional dimensions and the PCS-12 and the relationship between the EQ-5D anxiety/depression dimension and the MCS-12 were stronger. Those whose PCS-12 and MCS-12 scores were at the median or lower were classified as being in worse health, while those over the median were classified as being in better health. Respondents who reported no problem on each of the EQ-5D dimensions was divided according to the median SF-12 component scores. Those who scored at the median or lower than the median were classified as being in worse health, while those higher than the median were classified as being in better health. The VAS scores were also significantly different than the median split of the SF-12 scores for these subjects. EQ-5D and SF-12 showed a discrimination ability in measuring the HRQoL of pregnant women living with

  5. Revisão de 26 casos clínicos de duodeno-jejunite proximal em eqüinos (1996-2000

    Directory of Open Access Journals (Sweden)

    Fernandes Wilson Roberto

    2003-01-01

    Full Text Available Os dados de 26 eqüinos com duodeno-jejunite proximal (DJP, examinados no HOVET-FMVZ-USP entre dezembro de 1996 e novembro de 2000, foram revisados. Durante esse período, foram atendidos 1555 animais, dos quais 205 apresentavam distúrbios gastrintestinais (13,2%. Os casos de DJP representaram 1,7% do total de eqüinos atendidos. A idade, os achados clínico-laboratoriais e a evolução clínica foram comparados entre eqüinos sobreviventes (grupo 1 e eqüinos não sobreviventes (grupo 2. Vinte eqüinos (76,9% sobreviveram. Todos os animais foram submetidos exclusivamente a tratamento médico. A análise dos resultados foi feita através de comparação entre médias pelo teste t de Student com significância de 5%. Houve diferença significativa entre os dois grupos em relação aos seguintes parâmetros analisados: contagem total de leucócitos no sangue, creatinina sérica e freqüência cardíaca. A principal complicação nos animais recuperados foi laminite (30,8%.

  6. ENIGMATIC RECURRENT PULSATIONAL VARIABILITY OF THE ACCRETING WHITE DWARF EQ LYN (SDSS J074531.92+453829.6)

    Energy Technology Data Exchange (ETDEWEB)

    Mukadam, Anjum S.; Szkody, Paula [Department of Astronomy, University of Washington, Seattle, WA 98195-1580 (United States); Townsley, D. M.; Brockett, T. [Department of Physics and Astronomy, University of Alabama, Tuscaloosa, AL 35487 (United States); Gaensicke, B. T.; Parsons, S. [Department of Physics, University of Warwick, Coventry CV4 7AL (United Kingdom); Southworth, J. [Astrophysics Group, Keele University, Staffordshire ST5 5BG (United Kingdom); Hermes, J. J.; Montgomery, M. H.; Winget, D. E.; Harrold, S. [Department of Astronomy, University of Texas at Austin, Austin, TX 78759 (United States); Tovmassian, G.; Zharikov, S. [Observatorio Astronomico Nacional SPM, Instituto de Astronomia, Universidad Nacional Autonoma de Mexico, Ensenada, BC (Mexico); Drake, A. J. [Department of Astronomy and the Center for Advanced Computing Research, California Institute of Technology, Pasadena, CA 91225 (United States); Henden, A. [American Association of Variable Star Observers, 25 Birch Street, Cambridge, MA 02138 (United States); Rodriguez-Gil, P. [Departamento de Astrofisica, Universidad de La Laguna, La Laguna, E-38204 Santa Cruz de Tenerife (Spain); Sion, E. M. [Department of Astronomy and Astrophysics, Villanova University, Villanova, PA 19085 (United States); Zola, S.; Szymanski, T. [Astronomical Observatory, Jagiellonian University, ul. Orla 171, PL-30-244 Krakow (Poland); Pavlenko, E. [Crimean Astrophysical Observatory, Crimea 98409 (Ukraine); and others

    2013-09-15

    Photometric observations of the cataclysmic variable EQ Lyn (SDSS J074531.92+453829.6), acquired from 2005 October to 2006 January, revealed high-amplitude variability in the range 1166-1290 s. This accreting white dwarf underwent an outburst in 2006 October, during which its brightness increased by at least five magnitudes, and it started exhibiting superhumps in its light curve. Upon cooling to quiescence, the superhumps disappeared and it displayed the same periods in 2010 February as prior to the outburst within the uncertainties of a couple of seconds. This behavior suggests that the observed variability is likely due to nonradial pulsations in the white dwarf star, whose core structure has not been significantly affected by the outburst. The enigmatic observations begin with an absence of pulsational variability during a multi-site campaign conducted in 2011 January-February without any evidence of a new outburst; the light curve is instead dominated by superhumps with periods in the range of 83-87 minutes. Ultraviolet Hubble Space Telescope time-series spectroscopy acquired in 2011 March reveals an effective temperature of 15,400 K, placing EQ Lyn within the broad instability strip of 10,500-16,000 K for accreting pulsators. The ultraviolet light curve with 90% flux from the white dwarf shows no evidence of any pulsations. Optical photometry acquired during 2011 and Spring 2012 continues to reflect the presence of superhumps and an absence of pulsations. Subsequent observations acquired in 2012 December and 2013 January finally indicate the disappearance of superhumps and the return of pulsational variability with similar periods as previous data. However, our most recent data from 2013 March to May reveal superhumps yet again with no sign of pulsations. We speculate that this enigmatic post-outburst behavior of the frequent disappearance of pulsational variability in EQ Lyn is caused either by heating the white dwarf beyond the instability strip due to an

  7. Pitiose cutânea em eqüinos: 14 casos Cutaneous pythiosis in horses: 14 cases

    Directory of Open Access Journals (Sweden)

    Eliza Simone Viegas Sallis

    2003-10-01

    Full Text Available A pitiose cutânea é uma doença crônica que afeta preferencialmente eqüinos e, raramente, bovinos, caninos, felinos e seres humanos. É causada por Pythium insidiosum, um fungo aquático. São relatados quatorze casos de pitiose cutânea em eqüinos do município de Uruguaiana, Rio Grande do Sul. As lesões se localizam, principalmente na região distal dos membros pélvicos e caracterizam-se macroscopicamente por granulomas subcutâneos, ulcerados com exsudação sero-sanguinolenta. Microscopicamente há áreas irregulares de necrose circundadas por infiltrado inflamatório constituído por eosinófilos, neutrófilos, macrófagos e abundante tecido fibrovascular. São descritos e discutidos os métodos de diagnóstico, sinais clínicos, achados de necropsia, histopatologia, diagnóstico diferencial e tratamentoCutaneous pythiosis is a chronic condition that may be fatal if early therapy is not implemented. It affects mainly horses and rarely cattle, dogs, cats and human beings. It is caused by Pythium insidiosum, which infects wounds on the skin of ventral abdomen, distal limbs and head of animals which pasture and drink water in swamped land. This report includes fourteen cases of pythiosis in horses from Uruguaiana, in the state of Rio Grande do Sul, Brazil. Methods of diagnosis and treatment are described and discussed.

  8. Disponibilidade biológica do fósforo de diferentes fontes para eqüinos em crescimento

    Directory of Open Access Journals (Sweden)

    FURTADO CARLOS EDUARDO

    2000-01-01

    Full Text Available Objetivou-se neste estudo, determinar a disponibilidade biológica do P de diferentes fontes, para eqüinos em fase de crescimento. Utilizaram-se dezesseis eqüinos machos em fase de crescimento, submetidos à aplicação de quatro fontes fosfatadas -- fosfato de rocha de Tapira (TAP, fosfato de rocha de Patos de Minas (PAT, fosfato bicálcico (BIC e farinha de osso (FOS --, adicionadas à dieta basal em quantidades suficientes para fornecer 22 g de P/animal/dia. No 16º dia, foram-lhes injetados 30 MBq de 32P/animal, e coletaram-se amostras de sangue, fezes e urina, durante sete dias. Foram determinadas as atividades específicas no plasma, fezes e urina e calculou-se a perda endógena fecal e a absorção real de P. Os valores obtidos quanto ao P consumido, P excretado, P no plasma e P retido não apresentaram diferenças estatísticas (P>0,05. Os valores de absorção real do P do TAP, PAT, BIC e da FOS foram, respectivamente, 25,23%, 33,97%, 31,71% e 29,36%. Não houve diferenças estatísticas (P>0,05 entre as fontes estudadas. Em relação ao BIC, as rochas fosfáticas apresentaram altos valores de disponibilidade biológica.

  9. Application of the ruthenium and technetium thermodynamic data bases used in the EQ3/6 geochemical codes

    International Nuclear Information System (INIS)

    Isherwood, D.

    1985-04-01

    Based on a critical review of the available thermodynamic data, computerized data bases for technetium and ruthenium were created for use with the EQ3/6 geochemical computer codes. The technetium data base contains thermodynamic data for 8 aqueous species and 15 solids; 26 aqueous species and 9 solids were included in the ruthenium data base. The EQ3NR code was used to calculate solubility limits for ruthenium (8 x 10 -16 M) in ground water from Yucca Mountain, a potential nuclear waste repository site near the Nevada Test Site (NTS). The code confirmed the essentially unlimited solubility of technetium in oxidizing conditions, such as those that are believed to exist in the unsaturated zone at Yucca Mountain and the Cambric Nuclear event site at the NTS. Ruthenium migration observed from the Cambric site was evaluated. The solubility limit for ruthenium (as the aqueous species RuO 4 - ) when constrained by RuO 2 is approximately equal to the concentration of ruthenium found in the cavity ground water (i.e., 2.1 x 10 -11 vs 4.5 x 10 -11 M). Differences in ruthenium solubility limits between Yucca Mountain and Cambric are primarily due to differences in ground-water pH. Technetium solubility (3 x 10 -8 M) for moderately reducing conditions (Eh = -0.1 V) using the metastable oxide, TcO 2 .2H 2 O, as the solubility constraint is within the range of experimental values recently published in a study of technetium sorption on basalt. Previously published technetium solubilities of 10 -12 to 10 -16 M were apparently based on a technetium data base that did not include aqueous species other than TcO 4 - . When TcO(OH) 2 0 is included in the data base, the calculated values are much closer to the experimental results. Eh-pH diagrams were also generated for a variety of conditions using the SOLUPLOT code

  10. Validation and comparison of EuroQoL-5 dimension (EQ-5D) and Short Form-6 dimension (SF-6D) among stable angina patients.

    Science.gov (United States)

    Wu, Jing; Han, Yuerong; Zhao, Fei-Li; Zhou, Jin; Chen, Zhijun; Sun, He

    2014-10-25

    Several preference-based health-related quality of life (HRQoL) instruments have been published and widely used in different populations. However no consensus has emerged regarding the most appropriate instrument in therapeutic area of stable angina. This study compared and validated the psychometric properties of two generic preference-based instruments, the EQ-5D and SF-6D, among Chinese stable angina patients. Convergent validity of the EQ-5D and SF-6D was examined with eight a priori hypotheses from stable angina patients in conjunction with Seattle Angina Questionnaire (SAQ). Responsiveness was compared using the effect size (ES), relative efficiency (RE) and receiver operating characteristic (ROC) curves. Agreement between the EQ-5D and SF-6D was tested using intra-class correlation coefficient (ICC) and Bland-Altman plot. Factors affecting utility difference were explored with multiple linear regression analysis. In 411 patients (mean age 68.08 ± 11.35), mean utility scores (SD) were 0.78 (0.15) for the EQ-5D and 0.68 (0.12) for the SF-6D. Validity was demonstrated by the moderate to strong correlation coefficients (Range: 0.368-0.594, Pstable-angina-specific health status than the EQ-5D (ES: 0.426 to 1.126). RE suggested that the SF-6D (RE: 44.8 to 177.8%) was more efficient than the EQ-5D except for physical function. Poor agreement between them was observed with ICC (0.448, Pstable angina patients. The SF-6D may be a more effective tool with lower ceiling effect and greater sensitivity. Further study is needed to compare other properties, such as reliability and longitudinal response.

  11. Estimation of minimal clinically important change of the Japanese version of EQ-5D in patients with chronic noncancer pain: a retrospective research using real-world data.

    Science.gov (United States)

    Yoshizawa, Kazutake; Kobayashi, Hisanori; Fujie, Motoko; Ogawa, Yoshimasa; Yajima, Tsutomu; Kawai, Koji

    2016-03-01

    Quality of life (QoL) is routinely assessed and evaluated in medical research. However, in Japan, there is a lack of solid cutoff criteria for evaluating QoL improvement in chronic noncancer pain management. The present study was conducted to identify the minimal clinically important change (MCIC) of the Japanese version of EuroQol-5D 3L(EQ-5D) utility score and numeric rating scale (NRS) with an emphasis on chronic noncancer pain. The data source for this post hoc research was the post-marketing surveillance (PMS) data for a tramadol/acetaminophen combination tablet, which was previously conducted in real-world settings. The parameters extracted from the PMS data were sociodemographic characteristics, NRS, EQ-5D, and dichotomous physician's global impression of treatment effectiveness (PGI). The optimal cutoff points of MCIC for EQ-5D utility and NRS scores were evaluated using receiver operating characteristics (ROC) analysis. An anchor-based approach using PGI was applied. Data of 710 patients with chronic noncancer pain were extracted from the PMS database. The NRS score decreased by 2.7 (standard deviation, 2.3) points, whereas the EQ-5D score increased by 0.16 (0.20) points at 4 weeks from baseline. The changes from baseline in NRS and EQ-5D were significantly correlated (r = 0.53, p 0.80 in both analyses. These results demonstrated novel cutoff criteria for the Japanese version of EQ-5D, focusing on patients with chronic noncancer pain. The obtained criteria were fairly consistent and can be confidently utilized as an evaluation tool in medical research on chronic noncancer pain in Japan, with additional functionality and usability for QoL assessment in pain management practice. The data source of this post hoc research was a PMS study with the identifier number UMIN000015901 at umin.ac.jp, UMIN clinical trial registry (UMIN-CTR).

  12. Application and measurement properties of EQ-5D to measure quality of life in patients with upper extremity orthopaedic disorders: a systematic literature review.

    Science.gov (United States)

    Grobet, Cécile; Marks, Miriam; Tecklenburg, Linda; Audigé, Laurent

    2018-04-13

    The EuroQol-5 Dimension (EQ-5D) is the most widely used generic instrument to measure quality of life (QoL), yet its application in upper extremity orthopaedics as well as its measurement properties remain largely undefined. We implemented a systematic literature review to provide an overview of the application of EQ-5D in patients with upper extremity disorders and analyse its measurement properties. We searched Medline, EMBASE, Cochrane and Scopus databases for clinical studies including orthopaedic patients with surgical interventions of the upper extremity who completed the EQ-5D. For all included studies, the use of EQ-5D and quantitative QoL data were described. Validation studies of EQ-5D were assessed according to COSMIN guidelines and standard measurement properties were examined. Twenty-three studies were included in the review, 19 of which investigated patients with an intervention carried out at the shoulder region. In 15 studies, EQ-5D assessed QoL as the primary outcome. Utility index scores in non-trauma patients generally improved postoperatively, whereas trauma patients did not regain their recalled pre-injury QoL levels. EQ-5D measurement properties were reported in three articles on proximal humerus fractures and carpal tunnel syndrome. Positive ratings were seen for construct validity (Spearman correlation coefficient ≥ 0.70 with the Short Form (SF)-12 or SF-6D health surveys) and reliability (intraclass correlation coefficient ≥ 0.77) with intermediate responsiveness (standardised response means: 0.5-0.9). However, ceiling effects were identified with 16-48% of the patients scoring the maximum QoL. The methodological quality of the three articles varied from fair to good. For surgical interventions of the upper extremity, EQ-5D was mostly applied to assess QoL as a primary outcome in patients with shoulder disorders. Investigations of the measurement properties were rare, but indicate good reliability and validity as well as

  13. Tratamento de compactação do cólon maior em eqüídeos com fluidoterapia enteral

    OpenAIRE

    Lopes,Marco Aurélio Ferreira; Moura,Gabriela Soares de; Junqueira,Luiz Arthur Camargo; Lima,Leonardo Rodrigues de; Pinto,José de Oliveira; Dantas Filho,José; Assis,Carlos Batista de

    1998-01-01

    A eficiência da fluidoterapia por via enteral foi avaliada em 14 eqüídeos (12 eqüinos e dois muares) que apresentavam compactação do cólon maior. Os animais tinham entre um ano e meio e 20 anos de idade e todos eram alimentados com capim elefante (Pennisetum purpureum Schumach) triturado. O início dos sinais de cólica foi observado no dia do internamento em seis casos, um dia antes em cinco casos, três dias antes em um caso, quatro dias antes em um caso e seis dias antes em um caso. Um cavalo...

  14. Influência da heparina sódica na ocorrência de laminite eqüina induzida por sobrecarga de carboidratos

    OpenAIRE

    Martins Filho,L.P.; Fagliari,J.J.; Moraes,J.R.E.; Sampaio,R.C.; Oliveira,J.A.; Lacerda Neto,J.C.

    2008-01-01

    Avaliou-se a eficiência da infusão intravenosa de heparina sódica (100UI/kg/8h, a partir de 24h após o fornecimento de carboidrato, até completar 48h) no controle da laminite eqüina experimentalmente induzida por sobrecarga de carboidrato (17,6g de amido de milho/kg de peso corpóreo). Foram utilizados 15 eqüinos adultos, distribuídos em três grupos experimentais: GI (grupo-controle); GII (grupo laminite) e GIII (grupo laminite+heparina). Posteriormente ao fornecimento de carboidrato, os anima...

  15. Responsiveness of the anxiety/depression dimension of the 3- and 5-level versions of the EQ-5D in assessing mental health.

    Science.gov (United States)

    Crick, Katelynn; Al Sayah, Fatima; Ohinmaa, Arto; Johnson, Jeffrey A

    2018-06-01

    Anxiety and depression disorders are associated with significantly lower health-related quality of life (HRQL). The EQ-5D is a commonly used generic measure of HRQL; it captures mental health through a single domain-the anxiety/depression dimension. Evidence on the responsiveness of this measure in assessing changes in mental health changes is limited. To examine the performance of the anxiety/depression dimension (A/D) of the 3- and 5-level (3L and 5L) versions of the EQ-5D in assessing changes in mental health. Data from two patient populations were used: 495 adults post-discharge from general internal medicine ward (EQ-5D-3L), and 225 type 2 diabetes patients who screened positive for depressive symptoms (EQ-5D-5L). Anchor-based approach along with effect sizes (ES) and ROC analysis was used. Anchors included patient health questionnaire 9-items "PHQ9" and generalized anxiety disorder 2-item questionnaire "GAD2" for EQ-5D-3L, and PHQ9 and SF-12 mental composite summary scores (MCS) for EQ-5D-5L. A/D change was quantified as the difference between follow-up and baseline levels. The A/D dimension of the EQ-5D-3L showed limited responsiveness to changes in depressive symptoms measured by PHQ9 and for anxiety symptoms measured by GAD2, whereby in those who improved or deteriorated in either symptom, more than half of the patients did not have an A/D change. In the ROC analysis, the A/D dimension of the EQ-5D-3L showed weak performance with C-indices ranging from 0.58 to 0.63 and probability of detection of depressive or anxiety symptoms ranging between 20 and 40%, which are all well below acceptable ranges. Similar results were observed for the A/D dimension of the EQ-5D-5L; although the performance was slightly better, it was still below acceptable range. In patients who improved or deteriorated based on the PHQ9 or MCS, around a third had no changes on the A/D dimension. The performance of the A/D dimension of the EQ-5D-5L was also very limited with C

  16. Quantification of the level descriptors for the standard EQ-5D three-level system and a five-level version according to two methods

    NARCIS (Netherlands)

    Janssen, M. F.; Birnie, E.; Bonsel, G. J.

    2008-01-01

    OBJECTIVES: Our aim was to compare the quantitative position of the level descriptors of the standard EQ-5D three-level system (3L) and a newly developed, experimental five-level version (5L) using a direct and a vignette-based indirect method. METHODS: Eighty-two respondents took part in the study.

  17. Quantification of the level descriptors for the standard EQ-5D three-level system and a five-level version according to two methods

    NARCIS (Netherlands)

    M.F. Janssen (Bas); E. Birnie (Erwin); G.J. Bonsel (Gouke)

    2008-01-01

    textabstractObjectives: Our aim was to compare the quantitative position of the level descriptors of the standard EQ-5D three-level system (3L) and a newly developed, experimental five-level version (5L) using a direct and a vignette-based indirect method. Methods: Eighty-two respondents took part

  18. The Relationship between EQ & Constructive and Non-Constructive Problem Solving Styles among Payame Noor University's Students of Abadan in the Year 2014

    Science.gov (United States)

    Rajaeipoor, Saeed; Siadat, Ali; Hoveida, Reza; Mohammadi, Nazanin; Keshavarz, Akbar; Salimi, Mohammad Hossein; Abbasian, Mohammad Reza; Shamsi, Ali

    2015-01-01

    The objective of the present study is considering the relationship between EQ & constructive and non-constructive problem solving styles among students. The applied methodology is cross-correlation method. The statistical population in this study is all the educational sciences' students of Payame Noor university of Abadan in the year 2014 and…

  19. Edentulism and dental prostheses in the elderly: impact on quality of life measured with EuroQol--visual analog scale (EQ-VAS).

    Science.gov (United States)

    Cano-Gutiérrez, Carlos; Borda, Miguel G; Arciniegas, Antonio J; Borda, Claudia X

    2015-01-01

    The objective of this study was to measure the impact of edentulism and dental prostheses on quality of life (QOL) in older adults in Bogota, Colombia. Edentulism is a frequent condition in older adults and has great impact on their QOL. No epidemiological data are currently available on edentulism among older adults in Colombia. Data were obtained from the SABE-Bogota study, a cross-sectional study conducted in 2012, and used to analyze the EQ-VAS (Visual Analog Scale) from the EuroQol instrument to measure the perception of quality of life (QOL) in relation to edentulism. The study included 2,000 individuals over 60 years old. The Spearman-Rho correlation was used to analyze the correlation between EQ-VAS and edentulism. Chi-Square, ANOVA and t-test were used to study the differences in EQ-VAS scores between edentulous and healthy subjects. Statistical significance was set at peducation were related to edentulism. Individuals with fewer teeth and dental prostheses had lower EQ-VAS scores (pmeasuring the perception of QOL in dental health scenarios. Edentulism significantly affects QOL in older adults and the use of dental prosthesis does not improve the perception of QOL.

  20. EQ6, a computer program for reaction path modeling of aqueous geochemical systems: Theoretical manual, user`s guide, and related documentation (Version 7.0); Part 4

    Energy Technology Data Exchange (ETDEWEB)

    Wolery, T.J.; Daveler, S.A.

    1992-10-09

    EQ6 is a FORTRAN computer program in the EQ3/6 software package (Wolery, 1979). It calculates reaction paths (chemical evolution) in reacting water-rock and water-rock-waste systems. Speciation in aqueous solution is an integral part of these calculations. EQ6 computes models of titration processes (including fluid mixing), irreversible reaction in closed systems, irreversible reaction in some simple kinds of open systems, and heating or cooling processes, as well as solve ``single-point`` thermodynamic equilibrium problems. A reaction path calculation normally involves a sequence of thermodynamic equilibrium calculations. Chemical evolution is driven by a set of irreversible reactions (i.e., reactions out of equilibrium) and/or changes in temperature and/or pressure. These irreversible reactions usually represent the dissolution or precipitation of minerals or other solids. The code computes the appearance and disappearance of phases in solubility equilibrium with the water. It finds the identities of these phases automatically. The user may specify which potential phases are allowed to form and which are not. There is an option to fix the fugacities of specified gas species, simulating contact with a large external reservoir. Rate laws for irreversible reactions may be either relative rates or actual rates. If any actual rates are used, the calculation has a time frame. Several forms for actual rate laws are programmed into the code. EQ6 is presently able to model both mineral dissolution and growth kinetics.

  1. EQ6, a computer program for reaction path modeling of aqueous geochemical systems: Theoretical manual, user's guide, and related documentation (Version 7.0)

    International Nuclear Information System (INIS)

    Wolery, T.J.; Daveler, S.A.

    1992-01-01

    EQ6 is a FORTRAN computer program in the EQ3/6 software package (Wolery, 1979). It calculates reaction paths (chemical evolution) in reacting water-rock and water-rock-waste systems. Speciation in aqueous solution is an integral part of these calculations. EQ6 computes models of titration processes (including fluid mixing), irreversible reaction in closed systems, irreversible reaction in some simple kinds of open systems, and heating or cooling processes, as well as solve ''single-point'' thermodynamic equilibrium problems. A reaction path calculation normally involves a sequence of thermodynamic equilibrium calculations. Chemical evolution is driven by a set of irreversible reactions (i.e., reactions out of equilibrium) and/or changes in temperature and/or pressure. These irreversible reactions usually represent the dissolution or precipitation of minerals or other solids. The code computes the appearance and disappearance of phases in solubility equilibrium with the water. It finds the identities of these phases automatically. The user may specify which potential phases are allowed to form and which are not. There is an option to fix the fugacities of specified gas species, simulating contact with a large external reservoir. Rate laws for irreversible reactions may be either relative rates or actual rates. If any actual rates are used, the calculation has a time frame. Several forms for actual rate laws are programmed into the code. EQ6 is presently able to model both mineral dissolution and growth kinetics

  2. Integration of the metal ion charge neutralization model for humic acid complexation into the geochemical speciation code EQ3/6

    International Nuclear Information System (INIS)

    Brendler, V.

    2002-01-01

    Geochemical modeling often requires the consideration of humics as major complexing agent and colloid. The metal ion charge neutralization model can handle respective interactions and has therefore been integrated into the speciation software EQ3/6. An application showing the influence of the pH-dependence of the loading capacity on actinide speciation is given. (orig.)

  3. Comparison of the SF6D, the EQ5D, and the oswestry disability index in patients with chronic low back pain and degenerative disc disease.

    Science.gov (United States)

    Johnsen, Lars G; Hellum, Christian; Nygaard, Oystein P; Storheim, Kjersti; Brox, Jens I; Rossvoll, Ivar; Leivseth, Gunnar; Grotle, Margreth

    2013-04-26

    The need for cost effectiveness analyses in randomized controlled trials that compare treatment options is increasing. The selection of the optimal utility measure is important, and a central question is whether the two most commonly used indexes - the EuroQuol 5D (EQ5D) and the Short Form 6D (SF6D) - can be used interchangeably. The aim of the present study was to compare change scores of the EQ5D and SF6D utility indexes in terms of some important measurement properties. The psychometric properties of the two utility indexes were compared to a disease-specific instrument, the Oswestry Disability Index (ODI), in the setting of a randomized controlled trial for degenerative disc disease. In a randomized controlled multicentre trial, 172 patients who had experienced low back pain for an average of 6 years were randomized to either treatment with an intensive back rehabilitation program or surgery to insert disc prostheses. Patients filled out the ODI, EQ5D, and SF-36 at baseline and two-year follow up. The utility indexes was compared with respect to measurement error, structural validity, criterion validity, responsiveness, and interpretability according to the COSMIN taxonomy. At follow up, 113 patients had change score values for all three instruments. The SF6D had better similarity with the disease-specific instrument (ODI) regarding sensitivity, specificity, and responsiveness. Measurement error was lower for the SF6D (0.056) compared to the EQ5D (0.155). The minimal important change score value was 0.031 for SF6D and 0.173 for EQ5D. The minimal detectable change score value at a 95% confidence level were 0.157 for SF6D and 0.429 for EQ5D, and the difference in mean change score values (SD) between them was 0.23 (0.29) and so exceeded the clinical significant change score value for both instruments. Analysis of psychometric properties indicated that the indexes are unidimensional when considered separately, but that they do not exactly measure the same

  4. Health utility scores from EQ-5D and health-related quality of life in patients with esophageal cancer: a real-world cross-sectional study.

    Science.gov (United States)

    Doherty, M K; Leung, Y; Su, J; Naik, H; Patel, D; Eng, L; Kong, Q Q; Mohsin, F; Brown, M C; Espin-Garcia, O; Vennettilli, A; Renouf, D J; Faluyi, O O; Knox, J J; MacKay, H; Wong, R; Howell, D; Mittmann, N; Darling, G E; Cella, D; Xu, W; Liu, G

    2018-06-14

    Esophageal cancer and its treatment can cause serious morbidity/toxicity. These effects on health-related quality of life (HRQOL) can be measured using disease-specific scales such as FACT-E, generic scales such as EQ-5D-3L, or through symptoms. In a two-year cross-sectional study, we compared HRQOL across esophageal cancer patients treated in an ambulatory clinic and across multiple disease states, among patients with all stages of esophageal cancer. Consenting patients completed FACT-E, EQ-5D, a visual analog scale, and patient reported (PR)-ECOG. Symptom complexes were constructed from FACT-E domains. Responses were categorized by disease state: pre-, during, and post-treatment, surveillance, progression, and palliative chemotherapy. Spearman correlation and multivariable linear regression characterized these associations. In total, 199 patients completed 317 questionnaires. Mean FACT-E and subscale scores dropped from baseline through treatment and recovered during post-treatment surveillance (P < 0.001); EQ-5D health utility scores (HUS) displayed a similar pattern but with smaller differences (P = 0.07), and with evidence of ceiling effect. Among patients with stage II/III esophageal cancer, mean EQ-5D HUS varied across disease states (P < 0.001), along with FACT-E and subscales (P < 0.001). Among patients with advanced disease, there was no significant difference between baseline and on-treatment total scores, but improved esophageal cancer-specific scales were noted (P = 0.003). Strong correlation was observed between EQ-5D and FACT-E (R = 0.73), along with physical and functional subscales. In addition, the association between FACT-E and EQ-5D HUS was maintained in a multivariable model (P < 0.001). We interpret these results to suggest that in a real-world clinic setting, FACT-E, EQ-5D HUS, and symptoms were strongly correlated. Most HRQOL and symptom parameters suggested that patients had worse HRQOL and symptoms during curative therapy

  5. Longitudinal predictive ability of mapping models: examining post-intervention EQ-5D utilities derived from baseline MHAQ data in rheumatoid arthritis patients.

    Science.gov (United States)

    Kontodimopoulos, Nick; Bozios, Panagiotis; Yfantopoulos, John; Niakas, Dimitris

    2013-04-01

    The purpose of this methodological study was to to provide insight into the under-addressed issue of the longitudinal predictive ability of mapping models. Post-intervention predicted and reported utilities were compared, and the effect of disease severity on the observed differences was examined. A cohort of 120 rheumatoid arthritis (RA) patients (60.0% female, mean age 59.0) embarking on therapy with biological agents completed the Modified Health Assessment Questionnaire (MHAQ) and the EQ-5D at baseline, and at 3, 6 and 12 months post-intervention. OLS regression produced a mapping equation to estimate post-intervention EQ-5D utilities from baseline MHAQ data. Predicted and reported utilities were compared with t test, and the prediction error was modeled, using fixed effects, in terms of covariates such as age, gender, time, disease duration, treatment, RF, DAS28 score, predicted and reported EQ-5D. The OLS model (RMSE = 0.207, R(2) = 45.2%) consistently underestimated future utilities, with a mean prediction error of 6.5%. Mean absolute differences between reported and predicted EQ-5D utilities at 3, 6 and 12 months exceeded the typically reported MID of the EQ-5D (0.03). According to the fixed-effects model, time, lower predicted EQ-5D and higher DAS28 scores had a significant impact on prediction errors, which appeared increasingly negative for lower reported EQ-5D scores, i.e., predicted utilities tended to be lower than reported ones in more severe health states. This study builds upon existing research having demonstrated the potential usefulness of mapping disease-specific instruments onto utility measures. The specific issue of longitudinal validity is addressed, as mapping models derived from baseline patients need to be validated on post-therapy samples. The underestimation of post-treatment utilities in the present study, at least in more severe patients, warrants further research before it is prudent to conduct cost-utility analyses in the context

  6. Placentite fúngica em eqüino: relato de caso / Fungi placentitis in equines: a case report

    Directory of Open Access Journals (Sweden)

    Jayme Augusto Peres

    2008-05-01

    Full Text Available O fungo Aspergillus fumigatus é saprófi ta e oportunista e é o de maior ocorrência em infecções fúngicas nos animais, com capacidade de produzir endotoxinas. Possui hifas septadas e pode ser encontrado no solo, na vegetação, nos alimentos e também em material fermentado de origem vegetal, como silagem, feno e adubo químico. A transmissão ocorre mais comumente pela inalação ou ingestão. Nos eqüinos, a infecção da bolsa gutural resulta numa síndrome clínica caracterizada por sangramento nasal recorrente, associada a alterações visuais e locomotoras, podendo disseminar-se da cavidade nasal e via nervos óticos para o quiasma ótico e o cérebro. Abortos micóticos são esporádicos em eqüinos, ocorrendo geralmente no terço fi nal da gestação, causando placentite necrótica e lesões dermatológicas no feto. O presente relato descreve a ocorrência de morte fetal e materna de uma égua da raça crioula com seis anos e oito meses de idade. O óbito aconteceu quarenta e oito horas após o desenvolvimento dos sinais clínicos de prostração, febre e insufi ciência cardio-respiratória, acompanhada de icterícia das mucosas aparentes. Durante o exame necroscópico, realizado no laboratório de Anatomia Patológica Veterinária da UNICENTRO, foram observadas alterações circulatórias viscerais generalizadas e dermatite difusa no feto. O exame do Imprint das lesões, em microscopia óptica, corado pelo método Panótico demonstrou a presença de hifas fúngicas septadas, caracterizando placentite fúngica por aspergilose.

  7. Application of the ruthenium and technetium thermodynamic data bases used in the EQ3/6 geochemical codes

    Energy Technology Data Exchange (ETDEWEB)

    Isherwood, D.

    1985-04-01

    Based on a critical review of the available thermodynamic data, computerized data bases for technetium and ruthenium were created for use with the EQ3/6 geochemical computer codes. The technetium data base contains thermodynamic data for 8 aqueous species and 15 solids; 26 aqueous species and 9 solids were included in the ruthenium data base. The EQ3NR code was used to calculate solubility limits for ruthenium (8 x 10{sup -16} M) in ground water from Yucca Mountain, a potential nuclear waste repository site near the Nevada Test Site (NTS). The code confirmed the essentially unlimited solubility of technetium in oxidizing conditions, such as those that are believed to exist in the unsaturated zone at Yucca Mountain and the Cambric Nuclear event site at the NTS. Ruthenium migration observed from the Cambric site was evaluated. The solubility limit for ruthenium (as the aqueous species RuO{sub 4}{sup -}) when constrained by RuO{sub 2} is approximately equal to the concentration of ruthenium found in the cavity ground water (i.e., 2.1 x 10{sup -11} vs 4.5 x 10{sup -11} M). Differences in ruthenium solubility limits between Yucca Mountain and Cambric are primarily due to differences in ground-water pH. Technetium solubility (3 x 10{sup -8} M) for moderately reducing conditions (Eh = -0.1 V) using the metastable oxide, TcO{sub 2}.2H{sub 2}O, as the solubility constraint is within the range of experimental values recently published in a study of technetium sorption on basalt. Previously published technetium solubilities of 10{sup -12} to 10{sup -16} M were apparently based on a technetium data base that did not include aqueous species other than TcO{sub 4}{sup -}. When TcO(OH){sub 2}{sup 0} is included in the data base, the calculated values are much closer to the experimental results. Eh-pH diagrams were also generated for a variety of conditions using the SOLUPLOT code.

  8. Piodermite profunda por Staphylococcus intermedius em eqüino Deep pyoderma by Staphylococcus intermedius in equine

    Directory of Open Access Journals (Sweden)

    Fábio Cordeiro Oliveira Santos

    2008-12-01

    Full Text Available Neste trabalho descreve-se um caso de piodermite, com tempo de evolução de um mês, de um eqüino de oito anos de idade, sem raça definida, com áreas alopécicas, crostas na pálpebra superior, nos membros torácicos e pélvicos, na região do prepúcio e, principalmente, na região do pescoço e escápula. O prurido era discreto. O exame histopatológico revelou dermatite piogranulomatosa perivascular e perianexial associada à hiperplasia epidérmica, além de orto e paraceratose e crostas. O epitélio folicular exibiu focos de espongiose e exocitose de neutrófilos, predominando aspectos de inflamação crônica. A cultura bacteriana identificou o Staphylococcus intermedius a partir das suas características morfo-tintoriais e bioquímicas, com resultados positivos aos testes de catalase, coagulase, glicose e produção ácida aeróbica a partir do manitol. O eqüino foi tratado diariamente com dimetilsulfóxido, gentamicina e dexametasona por via tópica. Mesmo que algumas das lesões apresentaram rápida regressão (sete dias, as localizadas na região do pescoço e escápula demoraram 13 meses para a completa cicatrização.A case of one month of evolution, of an 8-year-old equine of undefined breed, presenting alopecic areas, crusts on the upper eyelid, forelimbs, hindlimbs, preputial region and mainly, on the neck and scapula is reported. Pruritus was discrete. The histological analysis revealed pyogranulomatous dermatitis round blood vessels and adnexa, associated with epidermal hyperplasia, as well as orthokeratosis, parakeratosis and crusts. The follicular epithelium exhibited foci of spongiosis and exocytosis of neutrophils, with predominant chronic inflammation changes. Bacterial culture identified Staphylococcus intermedius, based on morphology, staining and biochemical tests positive for catalase, coagulase, glucose and aerobic acid production from mannitol. The equine was treated with dimethylsulfoxide, gentamicine and

  9. Biogeochemical linkage between atmosphere and ocean in the eastern equatorial Pacific Ocean: Results from the EqPOS research cruise

    Science.gov (United States)

    Furutani, H.; Inai, Y.; Aoki, S.; Honda, H.; Omori, Y.; Tanimoto, H.; Iwata, T.; Ueda, S.; Miura, K.; Uematsu, M.

    2012-12-01

    Eastern equatorial Pacific Ocean is a unique oceanic region from several biogeochemical points of view. It is a remote open ocean with relatively high marine biological activity, which would result in limited influence of human activity but enhanced effect of marine natural processes on atmospheric composition. It is also characterized as high nutrient low chlorophyll (HNLC) ocean, in which availability of trace metals such as iron and zinc limits marine primary production and thus atmospheric deposition of these trace elements to the ocean surface is expected to play an important role in regulating marine primary production and defining unique microbial community. High sea surface temperature in the region generates strong vertical air convection which efficiently brings tropospheric atmospheric composition into stratosphere. In this unique eastern equatorial Pacific Ocean, EqPOS (Equatorial Pacific Ocean and Stratospheric/Tropospheric Atmospheric Study) research cruise was organized as a part of SOLAS Japan activity to understand biogeochemical ocean-atmospheric interaction in the region. Coordinated atmospheric, oceanic, and marine biological observations including sampling/characterization of thin air-sea interfacial layer (sea surface microlayer: SML) and launching large stratospheric air sampling balloons were carried out on-board R/V Hakuho Maru starting from 29 January for 39 days. Biogeochemically important trace/long-lived gases such as CO2, dimethyl sulfide (DMS), and some volatile organic carbons (VOCs) both in the atmosphere and seawater were continuously monitored and their air-sea fluxes were also observed using gradient and eddy-covariance techniques. Atmospheric gas measurement of CO2, CH4, N2O, SF6, CO, H2, Ar and isotopic composition of selected gases were further extended to stratospheric air by balloon-born sampling in addition to a vertical profiling of O3, CO2, and H2O with sounding sondes. Physical and chemical properties of marine

  10. The impact of differences between patient and general population EQ-5D-3L values on the mean tariff scores of different patient groups.

    Science.gov (United States)

    Little, Matthew H R; Reitmeir, Peter; Peters, Annette; Leidl, Reiner

    2014-06-01

    Health states can be valued by those who currently experience a health state (experienced health states [EHS]) or by the general public, who value a set of given health states (GHS) described to them. There has been debate over which method is more appropriate when making resource allocation decisions. This article informs this debate by assessing whether differences between these methods have an effect on the mean EQ-5D-3L tariff scores of different patient groups. The European tariff based on GHS valuations was compared with a German EHS tariff. Comparison was made in the context of EQ-5D-3L health states describing a number of diagnosed chronic diseases (stroke, diabetes, myocardial infarction, and cancer) taken from the Cooperative Health Research in the Augsburg Region population surveys. Comparison was made of both the difference in weighting of the dimensions of the EQ-5D-3L and differences in mean tariff scores for patient groups. Weighting of the dimensions of the EQ-5D-3L were found to be systematically different. The EHS tariff gave significantly lower mean scores for most, but not all, patient groups despite tariff scores being lower for 213 of 243 EQ-5D-3L health states using the GHS tariff. Differences were found to vary between groups, with the largest change in difference being 5.45 in the multiple stoke group. The two tariffs have systematic differences that in certain patient groups could drive the results of an economic evaluation. Therefore, the choice as to which is used may be critical when making resource allocation decisions. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  11. Characterization of a Full-Length Endogenous Beta-Retrovirus, EqERV-Beta1, in the Genome of the Horse (Equus caballus

    Directory of Open Access Journals (Sweden)

    Antoinette C. van der Kuyl

    2011-06-01

    Full Text Available Information on endogenous retroviruses fixed in the horse (Equus caballus genome is scarce. The recent availability of a draft sequence of the horse genome enables the detection of such integrated viruses by similarity search. Using translated nucleotide fragments from gamma-, beta-, and delta-retroviral genera for initial searches, a full-length beta-retrovirus genome was retrieved from a horse chromosome 5 contig. The provirus, tentatively named EqERV-beta1 (for the first equine endogenous beta-retrovirus, was 10434 nucleotide (nt in length with the usual retroviral genome structure of 5’LTR-gag-pro-pol-env-3’LTR. The LTRs were 1361 nt long, and differed approximately 1% from each other, suggestive of a relatively recent integration. Coding sequences for gag, pro and pol were present in three different reading-frames, as common for beta-retroviruses, and the reading frames were completely open, except that the env gene was interrupted by a single stopcodon. No reading frame was apparent downstream of the env gene, suggesting that EqERV-beta1 does not encode a superantigen like mouse mammary tumor virus (MMTV. A second proviral genome of EqERV-beta1, with no stopcodon in env, is additionally integrated on chromosome 5 downstream of the first virus. Single EqERV-beta1 LTRs were abundantly present on all chromosomes except chromosome 24. Phylogenetically, EqERV-beta1 most closely resembles an unclassified retroviral sequence from cattle (Bos taurus, and the murine beta-retrovirus MMTV.

  12. The aqueous solubility and speciation analysis for uranium, neptunium and selenium by the geochemical code(EQ3/6)

    International Nuclear Information System (INIS)

    Takeda, Seiji; Shima, Shigeki; Kimura, Hideo; Matsuzuru, Hideo

    1995-11-01

    The geochemical condition of a geologic disposal system of HLW controls the solubility and physicochemical forms of dominant aqueous species for elements, which are one of essential information required for safety assessment. Based on the measured compositions of groundwater, the compositions of groundwater in the disposal system were calculated. The solubility and speciation analyses for the polyvalent elements, uranium, neptunium, and selenium, were performed by the geochemical code EQ3/6. The results obtained were compared with the data appeared in the literatures on the solubilities and speciations. The geochemical behaviors of the elements with respect to the solubility and speciation could quantitatively be elucidated for the compositions of the interstitial waters in an engineered barrier and ground water in a natural barrier. In the pH range of neutral to alkali, the solubilities of U and Np tend to increase with an increase of the carbonate concentration in groundwater. This carbonate concentration dependence of the solubility was also estimated. In the engineered barrier the predominant aqueous species were specified, and in the natural barrier the change of aqueous species was also predicted while the chemical compositions changed from the reducing to oxidizing conditions. The dominant aqueous species for the elements, which migrate in and through the disposal system, were determined by the speciation analysis. (author)

  13. LLNL Yucca Mountain project - near-field environment characterization technical area: Letter report: EQ3/6 version 8: differences from version 7

    Energy Technology Data Exchange (ETDEWEB)

    Wolery, T.J.

    1994-09-29

    EQ3/6 is a software package for geochemical modeling of aqueous systems, such as water/rock or waste/water rock. It is being developed for a variety of applications in geochemical studies for the Yucca Mountain Site Characterization Project. The software has been extensively rewritten for Version 8. The source code has been extensively modernized. The software is now written in Fortran 77 with the most common extensions that are part of the new Fortran 90 standard. The architecture of the software has been improved for better performance and to allow the incorporation of new functional capabilities in Version 8 and planned subsequent versions. In particular, the structure of the major data arrays has been significantly altered and extended. Three new major functional capabilities have been incorporated in Version 8. The first of these allows the treatment of redox disequilibrium in reaction-path modeling. This is a natural extension of the long-running capability of providing for such disequilibrium in static speciation-solubility calculations. Such a capability is important, for example, when dealing with systems containing organic species and certain dissolved gas species. The user defines (and sets the controls for) the components in disequilibrium. Such corrections can now be made if the requisite data are present on a supporting data file. At present, this capability is supported only by the SHV data file, which is based on SUPCRT92. Equilibrium constants and other thermodynamic quantities are correct1961ed for pressures which lie off a standard curve, which is defined on the supporting data file and ordinarily corresponds to 1.013 bar up to IOOC, and the steam/liquid water equilibrium pressure up to 300C. The third new major capability is generic ion exchange option previously developed in prototype in a branch Version 7 level version of EQ3/6 by Brian Viani, Bill Bourcier, and Carol Bruton. This option has been modified to fit into the Version 8 data

  14. Assessing quality of life in children and adolescents: development and validation of the Italian version of the EQ-5D-Y

    Directory of Open Access Journals (Sweden)

    Luciana Scalone

    2011-12-01

    Full Text Available

    Background: Although assessment of Health Related Quality of Life (HRQoL in paediatric populations is gaining interest, it is not sufficiently assessed. While a number of specific paediatric instruments have been developed, some users appear to prefer generic tools such as the EQ-5D, which is a widely used and recommended tool to describe and value health across many different adult populations. We adapted the EQ-5D generic instrument into the EQ-5D-Y(youth for the assessment of HRQoL in children and adolescents, and investigated the feasibility, acceptability, validity and reliability of this new version of the tool.

    Methods: The Italian version of the EQ-5D-Y was administered to 415 children and adolescents from a general population aged between 8 and 15, and to 25 paediatric patients diagnosed with Acute Lymphoblastic Leukaemia (ALL.

    Results: The Italian version of the EQ-5D-Y was found to be feasible and acceptable for self-completion in the target age-group, with less than 1% refusing to complete it and no invalid answers given. Convergent and divergent validity tested with a child specific standard instrument was satisfactory overall. The test-retest reliability was moderate to good in all the domains of the descriptive system, and the Visual Analogue Scale (VAS showed optimal levels of reliability (Intraclass Correlation Coefficient = 0.82. As regards known-group validity, compared with the youths from general population, the ALL patients reported more difficulties in four of the five domains of the descriptive system and, on average, had a lower VAS score.

    Conclusions:The Italian version of the EQ-5D-Y shows to be a promising tool for assessing HRQoL in children and adolescents from 8 to 15 years of age. Future studies should further investigate and optimize its applicability to clinical research and carry out economic evaluations within the health

  15. Whats Your Acquisition EQ

    Science.gov (United States)

    2016-08-01

    Assertiveness Independence Interpersonal Relationships Empathy Social Responsibility Problem Solving Reality Testing Impulse Control Flexibility Stress ...Expression Interpersonal Skills Decision Making Stress Management Self-Regard Self-Actualization Emotional Self-Awareness Emotional Expression...Optimizing - Results Orientation Other Competencies: - Managerial Orientation - Long-term Perspective - Focus on Excellence - Innovativeness

  16. '76 EQ Index

    Science.gov (United States)

    National Wildlife, 1976

    1976-01-01

    This report evaluates the environmental quality of the United States. The analysis reveals that wildlife, soil, water, minerals, and living space indices have slid downward from 1969 to 1975. Only air quality slightly improved and timber remained steady. Despite this pessimistic picture, public support for environmental goals is still high. (MR)

  17. Valores de digestibilidade de alimentos volumosos para eqüinos Values of digestibility of forage feeds for equines

    Directory of Open Access Journals (Sweden)

    Danilo Mariano Figueiredo

    1999-08-01

    Full Text Available Quatro ensaios de metabolismo foram realizados para obter informações sobre os valores de digestibilidade dos nutrientes na alimentação de eqüinos. Cavalos castrados, sem raça definida, com idade média de seis anos de idade foram usados. Nos experimentos foram testados: (1 cana-de-açúcar, (2 combinação de 59,0% de cana-de-açúcar e 41,0% de milho grão inteiro, (3 capim-elefante e (4 cana-de-açúcar com 1,5 % de uréia. O consumo médio de MS foi de 0,89; 1,11; 2,02; e 1,03% PV para cana-de-açúcar, cana-de-açúcar mais milho grão inteiro, capim-elefante e cana-de-açúcar mais uréia, respectivamente. Os valores de energia digestível para cana-de-açúcar, cana-de-açúcar mais milho grão inteiro, cana-de-açúcar mais uréia e capim-elefante foram 2361, 3382, 2060 e 1182 kcal/kg MS, respectivamente. Cana-de-açúcar e cana-de-açúcar mais milho grão inteiro são boas fontes alternativas de alimentos para os eqüinos. O capim-elefante e a adição de 1,5% de uréia a cana-de-açúcar apresentaram menor potencial nutricional como volumoso na alimentação de cavalos adultos.Four metabolism assays were carried out to btain information on the nutrient digestibility of horses feeding. Geldings without definite breed, with average of six years of age, were used. In the experiments were tested: (1 sugar cane; (2 a combination of 59.0% of sugar cane and 41.0% of whole corn grain; (3 elephant grass; (4 and sugar cane with 1.5% of urea. The average DM intake was .89, 1.11, 2.02 and 1.03% LW for sugar cane, sugar cane plus whole corn grain, elephant grass, and sugar cane plus urea, respectively. The values of the digestible energy for sugar cane, sugar cane plus whole corn grain, sugar cane plus urea and elephant grass were 2361, 3382, 2060 and 1182 kcal/kg DM, respectively. The sugar cane and sugar cane plus whole corn grain are good alternative sources of feed for equines. The elephant grass and addition of 1.5% of urea in sugar

  18. Avaliação da eqüidade da Previdência no meio rural do Brasil

    Directory of Open Access Journals (Sweden)

    Ana Cecília Kreter

    2006-09-01

    Full Text Available Este trabalho avalia a eqüidade do sistema brasileiro de aposentadorias pagas no meio rural, dando ênfase à década de 1990. Entende-se como eqüidade a distribuição de aposentadorias sem viés de cor (ou raça, sexo e nível de educação. Motivado pela Constituição Federal de 1988, as Leis nº 8.212 e nº 8.213, de 1991 permitiram que homens (com 60 anos de idade ou mais e mulheres (com 55 anos de idade ou mais que tivessem comprovado exercício da atividade rural pudessem obter aposentadoria de um salário mínimo, mesmo não tendo contribuído com o sistema previdenciário. Tais mudanças foram significativas, pois igualaram os direitos de mulheres e homens e fixaram um valor mínimo das aposentadorias. Usando a análise tabular de microdados da PNAD (para os anos de 1992, 1996 e 1999 o trabalho comprova que essa nova sistemática previdenciária permitiu o aumento da renda per capita dos aposentados no meio rural, sem causar aumento da desigualdade da distribuição de renda. A mesma análise tabular dos dados sugere a presença de vieses na concessão das aposentadorias em favor de homens (em relação às mulheres, dos brancos (em relação aos negros e dos mais instruídos (em relação aos menos instruídos, o que foi estatisticamente comprovado através da estimativa do modelo próbite. O trabalho se encerra sugerindo algumas medidas que possam minimizar essa ineqüidade na distribuição das aposentadorias pagas no meio rural.This paper evaluates the equality of the Brazilian system of pensions paid in rural areas during the 1990s. The equality implies equal access to the social security benefits, regardless ethnic, sex and education differences among retired persons. Basing on 1988 Federal Constitution, Laws 8,212 and 8,213, both from 1991, have instituted the old age pension equal to one minimum wage for men (60 years or older and for women (55 years or older if they can prove they were rural workers. These old citizens can

  19. The impact of influenza on the health related quality of life in China: an EQ-5D survey.

    Science.gov (United States)

    Yang, Juan; Jit, Mark; Zheng, Yaming; Feng, Luzhao; Liu, Xinxin; Wu, Joseph T; Yu, Hongjie

    2017-10-16

    Influenza causes considerable morbidity and mortality in China, but its impact on the health-related quality of life (HRQoL) has not been previously measured. We conducted a retrospective telephone survey to assess the impact of influenza on the HRQoL among outpatients and inpatients using the EuroQoL EQ-5D-3 L instrument. Participants were individuals with laboratory-confirmed influenza infection registered by the National Influenza-like-illness Surveillance Network in 2013. We interviewed 839 of 11,098 eligible influenza patients. After excluding those who were unable to complete the HRQoL for the registered influenza episode, 778 patients were included in the analysis. Both outpatients (n = 529) and inpatients (n = 249) most commonly reported problems with pain/discomfort (71.8% of outpatients and 71.9% of inpatients) and anxiety/depression (62.0% of outpatients and 75.1% of inpatients). For individual influenza outpatients, the mean health utility was 0.6142 (SD 0.2006), and the average quality adjusted life days (QALD) loss was 1.62 (SD 1.84) days. The HRQoL of influenza inpatients was worse (mean health utility 0.5851, SD 0.2197; mean QALD loss 3.51 days, SD 4.25) than that of outpatients (p < 0.05). The presence of underlying medical conditions lowered the HRQoL for both outpatients and inpatients (p < 0.05). Influenza illness had a substantial impact on HRQoL. QALD loss due to an acute influenza episode in younger children was comparable to that due to enterovirus A71-associated hand, foot and mouth disease. Our findings are key inputs into disease burden estimates and cost-effectiveness evaluations of influenza-related interventions in China.

  20. Constraining Stellar Coronal Mass Ejections through Multi-wavelength Analysis of the Active M Dwarf EQ Peg

    Science.gov (United States)

    Crosley, M. K.; Osten, R. A.

    2018-03-01

    Stellar coronal mass ejections remain experimentally unconstrained, unlike their stellar flare counterparts, which are observed ubiquitously across the electromagnetic spectrum. Low-frequency radio bursts in the form of a type II burst offer the best means of identifying and constraining the rate and properties of stellar CMEs. CME properties can be further improved through the use of proposed solar-stellar scaling relations and multi-wavelength observations of CMEs through the use of type II bursts and the associated flares expected to occur alongside them. We report on 20 hr of observation of the nearby, magnetically active, and well-characterized M dwarf star EQ Peg. The observations are simultaneously observed with the Jansky Very Large Array at their P-band (230–470 MHz) and at the Apache Point observatory in the SDSS u‧ filter (λ = 3557 Å). Dynamic spectra of the P-band data, constructed to search for signals in the frequency-time domains, did not reveal evidence of drifting radio bursts that could be ascribed to type II bursts. Given the sensitivity of our observations, we are able to place limits on the brightness temperature and source size of any bursts that may have occurred. Using solar scaling rations on four observed stellar flares, we predict CME parameters. Given the constraints on coronal density and photospheric field strength, our models suggest that the observed flares would have been insufficient to produce detectable type II bursts at our observed frequencies. We consider the implications of these results, and other recent findings, on stellar mass loss.

  1. Data Qualification Report For: Thermodynamic Data File, DATA0.YMP.R0 For Geochemical Code, EQ3/6?

    International Nuclear Information System (INIS)

    P.L. Cloke

    2000-09-01

    The objective of this work is to evaluate the adequacy of chemical thermodynamic data provided by Lawrence Livermore National Laboratory (LLNL) as DataO.ymp.ROA in response to an input request submitted under AP-3.14Q. This request specified that chemical thermodynamic data available in the file, Data0.com.R2, be updated, improved, and augmented for use in geochemical modeling used in Process Model Reports (PMRs) for Engineered Barrier Systems, Waste Form, Waste Package, Unsaturated Zone, and Near Field Environment, as well as for Performance Assessment. The data are qualified in the temperature range 0 to 100 C. Several Data Tracking Numbers (DTNs) associated with Analysis/Model Reports (AMR) addressing various aspects of the post-closure chemical behavior of the waste package and the Engineered Barrier System that rely on EQ316 outputs to which these data are used as input, are Principal Factor affecting. This qualification activity was accomplished in accordance with the AP-SIII.2Q using the Technical Assessment method. A development plan, TDP-EBS-MD-000044, was prepared in accordance with AP-2.13Q and approved by the Responsible Manager. In addition, a Process Control Evaluation was performed in accordance with AP-SV.1Q. The qualification method, selected in accordance with AP-SIII.2Q, was Technical Assessment. The rationale for this approach is that the data in File Data0.com.R2 are considered Handbook data and therefore do not themselves require qualification. Only changes to Data0.com.R2 required qualification. A new file has been produced which contains the database Data0.ymp.R0, which is recommended for qualification as a result of this action. Data0.ymp.R0 will supersede Data0.com.R2 for all Yucca Mountain Project (YMP) activities

  2. A cross-sectional assessment of health-related quality of life in Chinese patients with chronic hepatitis c virus infection with EQ-5D.

    Science.gov (United States)

    Huang, Rui; Rao, Huiying; Shang, Jia; Chen, Hong; Li, Jun; Xie, Qing; Gao, Zhiliang; Wang, Lei; Wei, Jia; Jiang, Jianning; Sun, Jian; Jiang, Jiaji; Wei, Lai

    2018-06-15

    Hepatitis C virus (HCV) infection is one of the most common liver infections, with a decrement in HRQoL of HCV patients. This study aims to assess Health-related quality of life (HRQoL) in Chinese patients with chronic HCV infection, and to identify significant predictors of the HRQoL in these patients of China. In this cross-sectional observational study, treatment-naïve Han ethnic adults with chronic HCV infection were enrolled. Adopting European Quality of Life scale (EQ-5D) and EuroQOL visual analogue scale (EQ-VAS) were used to qualify HRQoL. Results were reported in descriptive analyses to describe sociodemographic and clinical characteristics. Multiple linear regression analysis was applied to investigate the associations of these variables with HRQoL. Binary logistic regression analysis was performed to identify associations of these variables with HRQoL by dimensions of EQ-5D. Nine hundred ninety-seven patients were enrolled in the study [median age 46.0 (37.0, 56.0) years; male 54.8%]. Mean EQ-5D index and EQ-VAS score were 0.780 ± 0.083 and 77.2 ± 14.8. Multiple Linear regression analysis showed that income (< 2000 RMB, β = - 0.134; 2000-4999 RMB, β = - 0.085), moderate or severe symptoms of discomfort (more than one symptoms, β = - 0.090), disease profile (cirrhosis, β = - 0.114), hyperlipidemia (β = - 0.065) and depression (β = - 0.065) were independently associated with EQ-5D index. Residence (the west, β = 0.087), income (< 2000 RMB, β = - 0.129; 2000-4999 RMB, β = - 0.052), moderate or severe symptoms of discomfort (more than one symptoms, β = - 0.091), disease profile and depression (β = - 0.316) were the influencing factors on EQ-VAS. Binary logistic regression indicated that disease profile and clinical depression were the major influencing factors on all five dimensions of EQ-5D. In this cross-sectional assessment of HCV patients in China, we indicated HRQo

  3. Hemogasometria em eqüinos com compactação experimental do cólon maior tratados com sene, fluidoterapia enteral e parenteral

    OpenAIRE

    Ribeiro Filho,José Dantas; Abreu,José Mário Girão; Alves,Geraldo Eleno Silveira; Dantas,Waleska de Melo Ferreira

    2007-01-01

    O equilíbrio ácido-base foi estudado em eqüinos com compactação experimental do cólon maior após o uso de solução isotônica poliônica enteral, sene mais hidratação intravenosa e hidratação intravenosa. As amostras sangüíneas foram colhidas de 20 animais, quatro grupos (E8, RL, SE e C) de cinco animais cada. Os animais dos grupos tratados eram portadores de compactação no cólon maior induzida experimentalmente. Eqüinos no grupo E8 receberam solução isotônica poliônica enteral (8mL kg-1 h-1 48h...

  4. Controle biológico de ciatostomíneos de eqüinos resistentes a ivermectina e pamoato de pirantel com o fungo Monacrosporium thaumasium

    OpenAIRE

    Tavela, Alexandre de Oliveira

    2010-01-01

    A viabilidade de uma formulação do fungo predador de nematóides Monacrosporium thaumasium foi avaliada no controle biológico de ciatostomíneos de eqüinos. Dois grupos (tratado com o fungo e controle) constituídos por seis éguas em cada grupo, mestiças, com idade entre 2,5 a 3,5 anos, foram colocados em pastagens de Cynodon sp. naturalmente infectadas com larvas de ciatostomíneos de eqüinos. No grupo tratado, cada animal recebeu 1g/10 kg de peso corporal (0,2g/10kg de peso vivo de fungo) de pé...

  5. Judicialização da política pública de assistência farmacêutica e eqüidade

    OpenAIRE

    Chieffi,Ana Luiza; Barata,Rita Barradas

    2009-01-01

    O fornecimento de medicamentos por ação judicial, pela Secretaria de Estado da Saúde de São Paulo (SES-SP), tornou-se uma prática rotineira e cada vez mais freqüente. A judicialização do sistema de saúde entra em confronto com princípios básicos do SUS, como o da eqüidade. Este trabalho caracterizou as demandas judiciais para obtenção de medicamentos sob a ótica da judicialização da política pública e da quebra do princípio da eqüidade na dimensão coletiva. O estudo é um trabalho descritivo d...

  6. Spanish Adaptation and Validation of the Transplant Effects Questionnaire (TxEQ-Spanish in Liver Transplant Recipients and Its Relationship to Posttraumatic Growth and Quality of Life

    Directory of Open Access Journals (Sweden)

    María Á. Pérez-San-Gregorio

    2018-04-01

    Full Text Available The valid assessment of the impact of transplantation on psychological well-being is highly relevant to optimize treatment. However, to date there is no standardized instrument available in Spain. The Transplant Effects Questionnaire (TxEQ evaluates the specific problems associated with organ transplantation, such as worry about transplant, guilt regarding the donor, disclosure of having undergone transplantation, adherence to medical treatment and responsibility toward the donor, family, friends, or medical staff. Against this backdrop the English original version of the TxEQ was translated into Spanish and validated in a sample of 240 liver transplant recipients. Participants also filled in the Posttraumatic Growth Inventory (PTGI, and the 12-Item Short Form Health Survey (SF-12v.2. Confirmatory factor analysis of the TxEQ-Spanish revealed a five-factor structure equivalent to the English original version, and satisfactory internal consistency (Cronbach's alpha: worry α = 0.82, guilt α = 0.77, disclosure α = 0.91, adherence α = 0.82, responsibility α = 0.83. Results showed that better mental quality of life was associated with higher adherence and disclosure, as well as less worry and guilt. Higher posttraumatic growth was significantly associated with worry, guilt, and responsibility. Interestingly, the most powerful predictor of posttraumatic growth was worry. Analysis of variance showed an interaction effect of PTG and mental quality of life on adherence, with medium PTG being associated with significantly stronger adherence in participants with better mental quality of life. In conclusion our study could successfully adapt and validate the Spanish version of the TxEQ in a large sample of liver transplant recipients. Our findings show a complex relationship between emotional reactions to transplantation, mental quality of life, and posttraumatic growth, which give further insight into inner processes supporting psychological well

  7. WebEQ: a web-GIS System to collect, display and query data for the management of the earthquake emergency in Central Italy

    Science.gov (United States)

    Carbone, Gianluca; Cosentino, Giuseppe; Pennica, Francesco; Moscatelli, Massimiliano; Stigliano, Francesco

    2017-04-01

    After the strong earthquakes that hit central Italy in recent months, the Center for Seismic Microzonation and its applications (CentroMS) was commissioned by the Italian Department of Civil Protection to conduct the study of seismic microzonation of the territories affected by the earthquake of August 24, 2016. As part of the activities of microzonation, IGAG CNR has created WebEQ, a management tool of the data that have been acquired by all participants (i.e., more than twenty research institutes and university departments). The data collection was organized and divided into sub-areas, assigned to working groups with multidisciplinary expertise in geology, geophysics and engineering. WebEQ is a web-GIS System that helps all the subjects involved in the data collection activities, through tools aimed at data uploading and validation, and with a simple GIS interface to display, query and download geographic data. WebEQ is contributing to the creation of a large database containing geographical data, both vector and raster, from various sources and types: - Regional Technical Map em Geological and geomorphological maps em Data location maps em Maps of microzones homogeneous in seismic perspective and seismic microzonation maps em National strong motion network location. Data loading is done through simple input masks that ensure consistency with the database structure, avoiding possible errors and helping users to interact with the map through user-friendly tools. All the data are thematized through standardized symbologies and colors (Gruppo di lavoro MS 2008), in order to allow the easy interpretation by all users. The data download tools allow data exchange between working groups and the scientific community to benefit from the activities. The seismic microzonation activities are still ongoing. WebEQ is enabling easy management of large amounts of data and will form a basis for the development of tools for the management of the upcoming seismic emergencies.

  8. Associations between community-based physiotherapy for musculoskeletal injury and health related quality of life (EQ-5D): a multi-centre retrospective analysis.

    Science.gov (United States)

    Caplan, Nick; Robson, H; Robson, A; Barry, G; Wilkes, G

    2017-10-25

    Community-based musculoskeletal physiotherapy is used to improve function and health related quality of life (HRQoL). The purpose of this retrospective, multi-centre observational study was to determine the association between community-based physiotherapy management for musculoskeletal disorders and changes in HRQoL. Four thousand one hundred twelve patients' data were included in the study. Patients were included if they received a single period of treatment for a musculoskeletal injury or disorder. Patients were only included if they were being treated for a single morbidity. Patients received standard physiotherapy appropriate to their specific disorder, which could include health education/advice, exercise therapy, manual therapy, taping, soft tissue techniques, electrotherapy and/or acupuncture. Health related quality of life was assessed using the EQ-5D index. EQ-5D improved by 0.203 across all patients (d = 1.10). When grouped by anatomical site of symptom, the largest increases in EQ-5D was in foot pain (0.233; d = 1.29) and lumbar pain (0.231; d = 1.13). Improvements in EQ-5D greater than the minimum clinically important difference (MCID) were seen in 68.4% of all patients. The highest proportion of patients with positive responses to treatment were in ankle pain (74.2%) and thoracic pain (73.4%). The hand (40.5%), elbow (34.7%), and hip (33.9%) showed the greatest proportion of patients that did not respond to treatment. Community-based musculoskeletal physiotherapy is associated with improved health related quality of life. A randomised controlled trial is needed to determine any causal relationship between community-based physiotherapy and health related quality of life improvements.

  9. Does the EQ-5D capture the effects of physical and mental health status on life satisfaction among older people? A path analysis approach.

    Science.gov (United States)

    Sexton, Eithne; Bennett, Kathleen; Fahey, Tom; Cahir, Caitriona

    2017-05-01

    To examine the extent to which EQ-5D utility scores capture the effect of mental and physical health status on life satisfaction (LS) in older adults. Retrospective cohort study of 884 patients aged ≥70 years from 15 general practices in Ireland, including medical records, pharmacy claims, and self-completion questionnaire. Path analysis was used to evaluate the direct and indirect effects of: (1) chronic disease burden (based on medications data); (2) activity limitation (basic and instrumental activities of daily living); (3) anxiety symptoms and; (4) depressive symptoms (Hospital Anxiety and Depression Scale) on LS (Life Satisfaction Index Z), via a utility score based on responses to the EQ-5D scale. Utility scores were calculated using UK time trade-off utility weights. Covariates included age and socioeconomic status. The final path model fitted the data well (goodness of fit χ 2  = 7.5, df (7), p = 0.37). The direct effects of chronic disease burden and disability on LS were not statistically significant and were excluded from the final model, indicating that EQ-5D score mediated 100% of the total effect on LS. The direct and indirect effects of anxiety and depression on LS were statistically significant, but the size of the indirect effect was small (4% of the total effect for anxiety and 6% of the total effect for depression). The EQ-5D does not adequately capture the effects of anxiety and depression on LS among older adults, suggesting that it may lead to inaccurate assessments of the effectiveness of interventions in this cohort.

  10. Multi-Objective Optimization of Building Energy Design to Reconcile Collective and Private Perspectives: CO2-eq vs. Discounted Payback Time

    Directory of Open Access Journals (Sweden)

    Mohamed Hamdy

    2017-07-01

    Full Text Available Building energy design is a multi-objective optimization problem where collective and private perspectives conflict each other. For instance, whereas the collectivity pursues the minimization of environmental impact, the private pursues the maximization of financial viability. Solving such trade-off design problems usually involves a big computational cost for exploring a huge solution domain including a large number of design options. To reduce that computational cost, a bi-objective simulation-based optimization algorithm, developed in a previous study, is applied in the present investigation. The algorithm is implemented for minimizing the CO2-eq emissions and the discounted payback time (DPB of a single-family house in cold climate, where 13,456 design solutions including building envelope and heating system options are explored and compared to a predefined reference case. The whole building life is considered by assuming a calculation period of 30 years. The results show that the type of heating system significantly affects energy performance; notably, the ground source heat pump leads to the highest reduction in CO2-eq emissions, around 1300 kgCO2-eq/m2, with 17 year DPB; the oil fire boiler can provide the lowest DPB, equal to 8.5 years, with 850 kgCO2-eq/m2 reduction. In addition, it is shown that using too high levels of thermal insulation is not an effective solution as it causes unacceptable levels of summertime overheating. Finally a multi-objective decision making approach is proposed in order to enable the stakeholders to choice among the optimal solutions according to the weight given to each objective, and thus to each perspective.

  11. Health-related quality of life (EQ-5D) among homeless persons compared to a general population sample in Stockholm County, 2006.

    Science.gov (United States)

    Sun, Sun; Irestig, Robert; Burström, Bo; Beijer, Ulla; Burström, Kristina

    2012-03-01

    To describe and compare health-related quality of life (HRQoL) among homeless persons with a general population sample in Stockholm County, 2006, and to analyse the importance of certain social determinants of health among the homeless. Face-to-face interviews with 155 homeless persons and a postal survey to a general population sample, mainly based on the same questionnaire, including questions on social determinants of health and HRQoL measured with the EQ-5D. Chronic illness was three times more common among the homeless. HRQoL was worse among homeless persons than in the general population sample: the homeless reported more problems, especially more severe problems, in all the EQ-5D dimensions and had considerably lower EQ-5D(index) and EQ(VAS) score than the general population. Most problems were reported in the dimension anxiety/depression. Among the homeless, longer duration and more severe degree of homelessness lowered HRQoL, but few determinants were statistically significantly related to HRQoL. Having mental disease significantly lowered HRQoL. This study was an attempt to include hard-to-reach groups in an assessment of population health. Homeless persons had considerably worse HRQoL than the general population and reported most problems in the dimension anxiety/depression. Some diseases may contribute to causing homelessness; others may be seen as consequences. Homeless persons are a vulnerable group in society. Further interview studies are needed based on larger sample of homeless persons to explore health determinants such as sex, age, socioeconomic factors, duration and degree of homelessness, and health-related behaviours among the homeless persons.

  12. Household income, income inequality, and health-related quality of life measured by the EQ-5D in Shaanxi, China: a cross-sectional study.

    Science.gov (United States)

    Tan, Zhijun; Shi, Fuyan; Zhang, Haiyue; Li, Ning; Xu, Yongyong; Liang, Ying

    2018-03-14

    In advanced economies, economic factors have been found to be associated with many health outcomes, including health-related quality of life (HRQL), and people's health is affected more by income inequality than by absolute income. However, few studies have examined the association of income inequality and absolute income with HRQL in transitional economies using individual data. This paper focuses on the effects of county or district income inequality and absolute income on the HRQL measured by EQ-5D and the differences between rural and urban regions in Shaanxi province, China. Data were collected from the 2008 National Health Service Survey conducted in Shaanxi, China. The EQ-5D index based on Japanese weights was employed as a health indicator. The income inequality was calculated on the basis of self-reported income. The special requirements for complex survey data analysis were considered in the bivariate analysis and linear regression models. The mean of the EQ-5D index was 94.6. The EQ-5D index of people with low income was lower than that in the high-income group (for people in the rural region: 93.2 v 96.1, P gender, education, marital status, employment, medical insurance, and chronic disease, all the coefficients of the low-income group and high income inequality were significantly negative. After stratifying by income group, all the effects of high income inequality remained negative in both income groups. However, the coefficients of the models in the high income group were not statistically significant. Income inequality has damaging effects on HRQL in Shaanxi, China, especially for people with low income. In addition, people living in rural regions were more vulnerable to economic factors.

  13. Mapping the EORTC QLQ-C30 onto the EQ-5D-3L: assessing the external validity of existing mapping algorithms.

    Science.gov (United States)

    Doble, Brett; Lorgelly, Paula

    2016-04-01

    To determine the external validity of existing mapping algorithms for predicting EQ-5D-3L utility values from EORTC QLQ-C30 responses and to establish their generalizability in different types of cancer. A main analysis (pooled) sample of 3560 observations (1727 patients) and two disease severity patient samples (496 and 93 patients) with repeated observations over time from Cancer 2015 were used to validate the existing algorithms. Errors were calculated between observed and predicted EQ-5D-3L utility values using a single pooled sample and ten pooled tumour type-specific samples. Predictive accuracy was assessed using mean absolute error (MAE) and standardized root-mean-squared error (RMSE). The association between observed and predicted EQ-5D utility values and other covariates across the distribution was tested using quantile regression. Quality-adjusted life years (QALYs) were calculated using observed and predicted values to test responsiveness. Ten 'preferred' mapping algorithms were identified. Two algorithms estimated via response mapping and ordinary least-squares regression using dummy variables performed well on number of validation criteria, including accurate prediction of the best and worst QLQ-C30 health states, predicted values within the EQ-5D tariff range, relatively small MAEs and RMSEs, and minimal differences between estimated QALYs. Comparison of predictive accuracy across ten tumour type-specific samples highlighted that algorithms are relatively insensitive to grouping by tumour type and affected more by differences in disease severity. Two of the 'preferred' mapping algorithms suggest more accurate predictions, but limitations exist. We recommend extensive scenario analyses if mapped utilities are used in cost-utility analyses.

  14. The level of physical exercise is associated with self-reported health status (EQ-5D) in adults with congenital heart disease.

    Science.gov (United States)

    Sandberg, Camilla; Engström, Karl Gunnar; Dellborg, Mikael; Thilén, Ulf; Wadell, Karin; Johansson, Bengt

    2015-02-01

    The prognosis in adults with congenital aortic valve disease is usually favourable; nevertheless, a number of medical and social factors might hamper long-term prognosis and quality of life. With a focus on physical exercise level, data from the Swedish National Registry on Congenital Heart Disease (SWEDCON) were analysed and variables associated with health-related quality of life in adults with congenital aortic valve disease were identified. In this registry study, SWEDCON was searched for adult patients with isolated congenital aortic valve disease and valid EuroQol-5Dimensions health questionnaire (EQ-5D) data. This study identified 315 patients. The majority (n = 202, 64%) reported best possible health status (EQ-5D(index) = 1) whereas 113 (35%) reported some impairment (EQ-5D(index)  3 h/week was independently associated with best possible health status (EQ-5D(index) = 1; p = 0.013). Moreover presence of cardiovascular symptoms (p 3 h/week was, as a single variable, associated with best possible health status in adults with congenital aortic valve disease. In contrast, a number of medical and social factors are associated with worse self-reported health status. Among these, symptoms, smoking, and educational level are potential targets for modification and intervention. There is a need for studies investigating the effect of increased level of physical exercise in patients with congenital aortic valve disease. © The European Society of Cardiology 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  15. Investigating Differences in Health-Related Quality of Life of Greeks and Albanian Immigrants with the Generic EQ-5D Questionnaire

    Directory of Open Access Journals (Sweden)

    Eleni Lahana

    2013-01-01

    Full Text Available Background. Low socioeconomic status (SES has been related by previous studies to low self-perceived HRQoL. Health is a major determinant of the society’s welfare, and few studies have determined the relevant elements that contribute to health and quality of life in Greece. Aim. The aim of the study was to evaluate and test for differences in HRQoL of Greek and Albanian immigrant population according to ethnicity and their demographic and SES characteristics. Methods. The study was conducted in a sample of 660 age-matched and gender-matched Greeks and Albanian immigrants. Moderate or severe decrease in HRQoL was assessed with the generic tool EQ-5D. Differences were statistically analyzed by t-test and ANOVA. Also, logistic and linear regression analyses were conducted for the dependent variables of the EQ-5D dimensions and VAS scores, respectively. Results. The Albanian immigrants reported better self-perceived health than their Greek counterparts. Health problems increase moderately with age and lower SES and are slightly higher for women than for men. Urbanity and superior education in both Greeks and Albaniansareassociated with worse HRQoL. Conclusion. There are some structural and compositional differences in the self-perceived quality of life between the two ethnicities, as estimated by EQ-5D. The combined information presentstopublic health providers the relevant data to assess health policies according to health needs.

  16. Absence of diarrhoea in equidae treated with oxytetracycline/ Ausência de diarréia em eqüídeos medicados com oxitetraciclina

    Directory of Open Access Journals (Sweden)

    Júlio Augusto Naylor Lisbôa

    2004-05-01

    Full Text Available Evaluation and observation was carried out with 24 equidae put on oxytetracycline hydrochloride medication, a drug incriminated as potential cause of severe colitis with diarrhea manifestations for this species. The animals of this study were natural carriers of affections that required antimicrobial use. During 4 to 19 uninterrupted days intravenous doses of 7, 15 or 20mg/kg were administered, every 24 hours. No side effects were observed during the period of treatment or after it. Thus, at the doses and intervals described above, oxytetracycline showed to be safe for equidae.Foram avaliados e acompanhados 24 eqüídeos medicados com cloridrato de oxitetraciclina, fármaco incriminado como potencial causador de colite severa com manifestação de diarréia nesta espécie. Os eqüídeos estudados eram portadores naturais de afecções que requeriam o emprego de antimicrobianos. Administraram-se doses de 7, 15 ou 20mg/kg, a cada 24 horas, por via intravenosa, durante 4 a até 19 dias seguidos. Não se observou qualquer efeito colateral aparente durante o período de tratamento e após o seu término. A oxitetraciclina mostrou-se, portanto, segura para os eqüídeos, nas doses e intervalo entre doses utilizados.

  17. Comparing the self-perceived quality of life of multimorbid patients and the general population using the EQ-5D-3L.

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    Alexandra A N'Goran

    Full Text Available To assess and compare the self-perceived Health Related Quality of Life (HRQoL of multimorbid patients and the general population using health utilities (HU and visual analogue scale (VAS methods.We analyzed data (n = 888 from a national, cross-sectional Swiss study of multimorbid patients recruited in primary care settings. Self-perceived HRQoL was assessed using the EQ-5D-3L instrument, composed of 1 a questionnaire on the five dimensions of mobility, self-care, usual activities, pain/discomfort, and anxiety/depression (EQ-5D dimensions, and 2 a 0-100 (0 = worst- and 100 = best-imaginable health status VAS. We described the EQ-5D dimensions and VAS and computed HU using a standard pan-European value set. HU and VAS are the two components of the overall HRQoL assessment. We examined the proportions of multimorbid patients reporting problems (moderate/severe in each EQ-5D dimension, corresponding proportions without problems, and mean HU and VAS values across patient characteristics. To test differences between subgroups, we used chi-square tests for dichotomous outcomes and T-tests (ANOVA if more than two groups for continuous outcomes. Finally, we compared observed and predicted HU and VAS values.All 888 participants answered every EQ-5D item. Mean (SD HU and VAS values were 0.70 (0.18 and 63.2 (19.2, respectively. HU and VAS were considerably and significantly lower in multimorbid patients than in the general population and were also lower in multimorbid patients below 60 years old and in women. Differences between observed and predicted means (SD were -0.07 (0.18 for HU and -11.8 (20.3 for VAS.Self-perceived HRQoL is considerably and significantly affected by multimorbidity. More attention should be given to developing interventions that improve the HRQoL of multimorbid patients, particularly women and those aged below 60 years old.

  18. INFLUENCIA DE LOS PROBLEMAS CRÓNICOS DE SALUD EN LAS DIMENSIONES DEL CUESTIONARIO EQ-5D: ESTUDIO EN PERSONAS MAYORES INSTITUCIONALIZADAS Y NO INSTITUCIONALIZADAS

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    María Concepción Delgado-Sanz

    2011-01-01

    Full Text Available Fundamento: Las enfermedades crónicas representan factores de riesgo para la calidad de vida relacionada con la salud (CVRS. El objetivo de estudio es analizar la influencia de problemas crónicos de salud autodeclarados en la CVRS, medida a través de las dimensiones del EQ-5D, en personas mayores institucionalizada y no institucionalizada. Métodos: Los datos proceden de dos estudios sobre calidad de vida en personas con 60 o más años de edad, en España, con una muestra de 1.106 personas mayores viviendo en la comunidad, y 234 en centros residenciales. Para analizar la influencia de los problemas crónicos más prevalentes en la CVRS se ajustaron modelos de regresión logística tomando como variable dependiente cada dimensión del EQ-5D y controlando por variables sociodemográficas. Resultados: Los problemas crónicos de salud que influyeron negativamente en la CVRS de los dos grupos de población estudiados, fueron la depresión (rango de OR en las distintas dimensiones del EQ-5D:1,97-6,48, seguida de artrosis/artritis (OR:2,81-6,00, insomnio (OR:2,81-4,61, diabetes (OR:1,68-3,44 e hipertensión arterial (OR:1,42-2,45. Estos problemas afectaron de forma distinta a las dimensiones del EQ-5D y a los dos grupos considerados. Las dimensiones del EQ-5D en las que se observaron más dificultades fueron dolor/malestar y movilidad. Conclusiones: Los resultados de este trabajo indican que el carácter debilitante de las enfermedades crónicas sobre la CVRS es distinto en personas mayores institucionalizadas y no institucionalizadas. Además, destacan la importancia de la promoción de un envejecimiento saludable para atenuar el impacto negativo de los problemas crónicos de la salud sobre la población mayor.

  19. Cerebral equine hydatidosis in Southern Brazil Hidatidose cerebral em eqüino no Sul do Brasil

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    Jerônimo Lopes Ruas

    1997-06-01

    Full Text Available Equine cerebral hydatid disease is described in a 7-year-old, crossbred, female horse. Clinical signs were characterized by circling gait, pressing of head against fences or objects and motor incoordination. On gross examination of the brain the hemispheres were swollen, mainly the left one. On transversal sections, a 5cm X 7cm fluid-filled cyst was observed within the lateral ventricle of the left hemisphere. The cyst extended from the parietal to the occipital lobe, and compressed the third ventricle. There was also marked mid line deviation. Histologically, the brain lesion adjacent to the cyst, was characterized by a piogranulomatous process and vacuolization of neuropil. A diagnosis of equine hydatidosis caused by Echinococcus granulosus was made on the basis of the morphometric features of protoscolices hooks.Descreve-se um caso de hidatidose cerebral em um eqüino, cruza, fêmea, de 7 anos de idade, que apresentou sinais clínicos nervosos de torneio, pressão da cabeça contra cercas e objetos e incoordenação motora. Na abertura da caixa craniana observou-se aumento de volume do cérebro, mais acentuado no hemisfério esquerdo. Ao corte observou-se, no interior do ventrículo lateral esquerdo, um cisto de aproximadamente 5cm x 7cm, de parede branca opaca, com conteúdo líquido translúcido, que se estendia desde o lobo parietal até o lobo ocipital, comprimindo o tecido nervoso. No exame histológico do cérebro observou-se, na área contígua à parede do cisto a presença de um processo inflamatório piogranulomatoso e vacuolização da neurópila. Os dados morfométricos do cisto, dos protoescóleces e dos ganchos permitiram concluir que o cisto era de Echinococcus granulosus.

  20. Comparación de las escalas EQ-5D y FACT-G en la evaluación de la calidad de vida en pacientes colombianos con cáncer

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    Juliet Valdelamar Jiménez

    2015-08-01

    Full Text Available Objective: To evaluate patterns of correlations between the different dimensions of a scale measuring quality of life (FACT-G and one that measures perceived health and quality of life (EQ-5D in cancer patients. Methods: A descriptive study that evaluated 114 patients with confirmed cancer of breast (40=35.09%, gastric (26=22.8%, prostate (22=19.3%, colon-rectal (17=14.91%. Diagnosis was made at the National Cancer Institute of Colombia, to whom applied the FACT-G and EQ-5D scale. Descriptive analyses were used to summarize the variables, methods of multivariate analysis, factor analysis and multidimensional scaling were used to assess patterns of correlation between the variables of each of the two scales used. Results: The dimensions that showed acceptable correlation values were physical well-being and emotional well-being of the FACT- G with anxiety and depression of the EQ- 5D scale. Factor analysis yielded two factors: (a anxiety / depression or the EQ-5D is better grouped with the components of the FACT- G, and (b physical symptoms of FACT-G with the components of the EQ-5D. Multidimensional scaling analysis suggested that each scale measured different dimensions of the construct quality of life. Conclusion: The FACT-G is oriented to emotional and social interaction, while the EQ-5D is oriented to aspects of physical and functionality.

  1. Digestão dos carboidratos de alimentos volumosos em eqüinos Digestion of carbohydrates of forages in horses

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    Eliane da Silva Morgado

    2009-01-01

    Full Text Available Neste estudo, foram realizados dois ensaios com os objetivos de avaliar o fracionamento dos carboidratos de alimentos volumosos e estimar a digestibilidade desses nutrientes em dois ensaios de digestão com eqüinos. No ensaio 1, foram utilizados cinco eqüinos em delineamento de blocos casualizados, com sete tratamentos - fenos de alfafa (Medicago sativa; amendoim forrageiro (Arachis pintoi; desmódio (Desmodium ovalifolium; guandu (Cajanus cajan; macrotiloma (Macrotyloma axillare; estilosantes (Stylosanthes guianensis; ou coastcross (Cynodon dactylon - avaliados pela técnica de sacos de náilon móveis. No ensaio 2, foram utilizados quatro eqüinos em delineamento quadrado latino 4 × 4, alimentados com feno de coastcross em quatro tipos de moagem com o objetivo de avaliar se a redução do tamanho de partícula interfere na digestibilidade dos carboidratos. Os resultados comprovaram que os eqüinos possuem alta eficiência na digestão dos carboidratos não-fibrosos e de suas frações hidrolisáveis e rapidamente fermentáveis. Os fenos de amendoim forrageiro, estilosantess e macrotiloma apresentaram elevada digestibilidade dos carboidratos fibrosos e não-fibrosos, enquanto a digestibilidade de todos os nutrientes do amendoim forrageiro foi superior a 70%, o que indica potencial para uso desta leguminosa em dietas para eqüinos. O processamento do feno de coastcross não influenciou a digestibilidade das frações dos carboidratos fibrosos e não-fibrosos. A análise dos carboidratos fibrosos e não-fibrosos é um bom indicativo do valor nutricional dos alimentos e pode ser incluída na avaliação da qualidade de alimentos para eqüinos.This work was carried out to evaluate the fractions of carbohydrates and estimate the apparent digestibility of these nutrients in two digestion assays with horses. In assay 1, five horses were allotted to a complete randomized blocks design and treatments were seven forages hays, alfalfa (Medicago sativa

  2. Reference bias: presentation of extreme health states prior to eq-vas improves health-related quality of life scores. a randomised cross-over trial

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    McPhail Steven

    2010-12-01

    Full Text Available Abstract Background Clinical practice and clinical research has made a concerted effort to move beyond the use of clinical indicators alone and embrace patient focused care through the use of patient reported outcomes such as health-related quality of life. However, unless patients give consistent consideration to the health states that give meaning to measurement scales used to evaluate these constructs, longitudinal comparison of these measures may be invalid. This study aimed to investigate whether patients give consideration to a standard health state rating scale (EQ-VAS and whether consideration of good and poor health state descriptors immediately changes their self-report. Methods A randomised crossover trial was implemented amongst hospitalised older adults (n = 151. Patients were asked to consider descriptions of extremely good (Description-A and poor (Description-B health states. The EQ-VAS was administered as a self-report at baseline, after the first descriptors (A or B, then again after the remaining descriptors (B or A respectively. At baseline patients were also asked if they had considered either EQ-VAS anchors. Results Overall 106/151 (70% participants changed their self-evaluation by ≥5 points on the 100 point VAS, with a mean (SD change of +4.5 (12 points (p Conclusions Health state self-reports may not be well considered. An immediate significant shift in response can be elicited by exposure to a mere description of an extreme health state despite no actual change in underlying health state occurring. Caution should be exercised in research and clinical settings when interpreting subjective patient reported outcomes that are dependent on brief anchors for meaning. Trial Registration Australian and New Zealand Clinical Trials Registry (#ACTRN12607000606482 http://www.anzctr.org.au

  3. Eficácia de pamoato de pirantel, isolado ou associado ao triclorfon, no controle de ciatostomíneos de eqüinos

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    Marcelo de Campos Pereira

    1994-12-01

    Full Text Available Através de estudo comparativo, objetivou-se avaliar a eficiência anti-helmíntica de pamoato de pirantel, isolado ou associado ao triclorfon, no controle de estrongilídeos de eqüinos da raça Puro Sangue Inglês. As coproculturas realizadas antes e após os tratamentos levaram consistentemente ao encontro de populações puras de ciatostomíneos com oito células intestinais. As reduções de ovos por grama de fezes foram avaliadas do 7º. ao 45º. dias pós-tratamento. Comparando os valores médios de OPG dos eqüinos tratados com pamoato de pirantel (13,2 mg/kg associado ao triclorfon (30 mg/kg e com pamoato de pirantel isolado (13,2 mg/kg, observou-se diferença não significante (P≤0,05 ao longo do experimento, verificando-se, 7 dias após o tratamento, reduções médias de OPG de quase 100% e, do 7º. ao 20º. dias, reduções ainda superiores a 90%. Os resultados indicam que os dois produtos são eficazes na redução de ovos por grama de fezes de ciatostomíneos de eqüinos mantidos sob condições a campo.

  4. Pesquisa em saúde, política de saúde e eqüidade na América Latina

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    Alberto Pellegrini Filho

    2004-06-01

    Full Text Available O autor analisa as relações entre pesquisa de saúde, políticas de saúde e eqüidade na América Latina. Descreve novas tendências no modo de produção do conhecimento, que permitem maior integração entre as necessidades sociais e a pesquisa, facilitando o vínculo entre esta e o processo de definição de políticas. Analisa as manifestações das novas tendências na América Latina e finaliza com a descrição de algumas iniciativas promovidas pela OPAS no sentido de aproveitar as oportunidades abertas pelas novas tendências para a melhoria das condições de saúde na região. Busca defender a tese de que a informação e o conhecimento são bens públicos essenciais e que as iniqüidades de acesso a esses bens são importantes determinantes das iniqüidades em saúde. Para que as políticas de saúde e as políticas de pesquisa em saúde se integrem e se consolidem como políticas públicas voltadas a atender ao interesse público e à promoção da eqüidade, é necessário o fortalecimento do processo democrático de definição das mesmas, multiplicando os atores envolvidos, os espaços e oportunidades de interação entre eles e instrumentando sua participação com o acesso eqüitativo a informações e conhecimentos científicos pertinentes que permitam a defesa fundamentada de seus interesses.

  5. Eqüidade em saúde: uma análise crítica de conceitos Health equity: a critical analysis of concepts

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    Ligia Maria Vieira-da-Silva

    2009-01-01

    Full Text Available A eqüidade em saúde tem sido estudada principalmente a partir de uma perspectiva epidemiológica e pouca atenção tem sido dada às questões conceituais. Em grande parte dos estudos revisados, a eqüidade tem sido utilizada como sinônimo de igualdade, e seu oposto, a iniqüidade, como sinônimo de desigualdade. As tentativas de melhor precisar seus significados têm sido, em boa parte, descritivas, com lacunas no que diz respeito à discussão das relações entre eqüidade em saúde, justiça e o processo de determinação social da saúde-doença. Neste ensaio, pretendemos analisar criticamente a série significante diversidade, diferença, desigualdade, iniqüidade, distinção no que concerne à produção da saúde-doença-cuidado em grupos sociais e suas possibilidades de articulação a uma teoria social da saúde. Nesse percurso, estaremos apoiados, por um lado, no conceito de Perelman de eqüidade e em alguns dos argumentos de Heller sobre a justiça e, por outro lado, na sociologia das práticas de Bourdieu, com o objetivo de melhor desenvolver esses conceitos, procurando discutir implicações para a formulação de políticas públicas no campo da saúde.Health inequalities have been studied mainly from an epidemiological perspective, with limited attention to conceptual issues. The terms "equity" and "equality" have often been used as synonyms, as have their opposites, "inequity" and "inequality". The few attempts to establish their meanings have been either purely descriptive or have failed to add to an understanding of the underlying dynamics in health-disease-related phenomena. The present essay explores the semantic series that includes difference, diversity, distinction, inequality, and inequity and its relationship to health phenomena in light of Perelman's concept of equity, Bourdieu's sociology, and some arguments in Heller's theory of justice, with the aim of contributing to the development of these concepts, while

  6. Carcinoma de células escamosas em bovinos, ovinos e eqüinos: estudo de 50 casos no sul do Rio Grande do Sul

    OpenAIRE

    Adriano Tony Ramos; Diego Mollerke Norte; Fabiana Elias; Cristina Gevehr Fernandes

    2007-01-01

    O carcinoma de células escamosas (CCE) é um tumor maligno dos queratinócitos. O desenvolvimento desse tipo de tumor está associado a muitos fatores, incluindo a exposição prolongada à luz ultravioleta, falta de pigmento na epiderme, perda de pêlos ou cobertura de pêlos muito esparsa nos locais afetados. Realizou-se um estudo retrospectivo dos casos de carcinoma de células escamosas em animais de produção (bovinos, ovinos e eqüinos) de 1978 a 2002. O material foi obtido nos arquivos do Laborat...

  7. Estimation of minimal clinically important change of the Japanese version of EQ-5D in patients with chronic noncancer pain: a retrospective research using real-world data

    OpenAIRE

    Yoshizawa, Kazutake; Kobayashi, Hisanori; Fujie, Motoko; Ogawa, Yoshimasa; Yajima, Tsutomu; Kawai, Koji

    2016-01-01

    Background Quality of life (QoL) is routinely assessed and evaluated in medical research. However, in Japan, there is a lack of solid cutoff criteria for evaluating QoL improvement in chronic noncancer pain management. The present study was conducted to identify the minimal clinically important change (MCIC) of the Japanese version of EuroQol-5D 3L(EQ-5D) utility score and numeric rating scale (NRS) with an emphasis on chronic noncancer pain. Methods The data source for this post hoc research...

  8. Factors Associated with Health-Related Quality of Life in Korean Patients with Chronic Hepatitis C Infection Using the SF-36 and EQ-5D.

    Science.gov (United States)

    Jang, Eun Sun; Kim, Young Seok; Kim, Kyung-Ah; Lee, Youn Jae; Chung, Woo Jin; Kim, In Hee; Lee, Byung Seok; Jeong, Sook-Hyang

    2018-03-29

    This study aimed to describe the Health-related quality of life (HRQoL) outcomes for Korean chronic hepatitis C patients and to investigate the impact of patient and virus-related factors on HRQoL. HRQoL was assessed in 235 HCV-infected patients from 7 nationwide tertiary hospital, including those with liver cirrhosis and hepatocellular carcinoma (HCC), using the Shor-Form 36 (SF-36) version 2 and the European quality of life questionnaire-5 dimensions (EQ-5D-3L). The SF-36 physical (48.8±8.3) and mental (46.2±11.7) component summary scores of the HCV-infected patients were below normal limits. Of the eight domains, general health, vitality, and mental health tended to show low scores. Patients with decompensated cirrhosis had the lowest HRQoL, while HCC and chronic hepatitis patients had similar HRQoL results. The EQ-5D index was low (0.848±0.145) in the HCV infected patients. Multivariable analysis showed age ≤65 years, high monthly family income (>$2,641), low comorbidity score, and sustained virologic response (SVR) were independently associated with favorable HRQoL. HRQoL in Korean patients with chronic HCV infection was low and was affected by cirrhosis severity, SVR, and comorbidity as well as income, which had the strongest effect. Therefore, HRQoL may be improved by antiviral therapy with reasonable costs to prevent cirrhosis progression.

  9. EQ3NR, a computer program for geochemical aqueous speciation-solubility calculations: Theoretical manual, user`s guide, and related documentation (Version 7.0); Part 3

    Energy Technology Data Exchange (ETDEWEB)

    Wolery, T.J.

    1992-09-14

    EQ3NR is an aqueous solution speciation-solubility modeling code. It is part of the EQ3/6 software package for geochemical modeling. It computes the thermodynamic state of an aqueous solution by determining the distribution of chemical species, including simple ions, ion pairs, and complexes, using standard state thermodynamic data and various equations which describe the thermodynamic activity coefficients of these species. The input to the code describes the aqueous solution in terms of analytical data, including total (analytical) concentrations of dissolved components and such other parameters as the pH, pHCl, Eh, pe, and oxygen fugacity. The input may also include a desired electrical balancing adjustment and various constraints which impose equilibrium with special pure minerals, solid solution end-member components (of specified mole fractions), and gases (of specified fugacities). The code evaluates the degree of disequilibrium in terms of the saturation index (SI = 1og Q/K) and the thermodynamic affinity (A = {minus}2.303 RT log Q/K) for various reactions, such as mineral dissolution or oxidation-reduction in the aqueous solution itself. Individual values of Eh, pe, oxygen fugacity, and Ah (redox affinity) are computed for aqueous redox couples. Equilibrium fugacities are computed for gas species. The code is highly flexible in dealing with various parameters as either model inputs or outputs. The user can specify modification or substitution of equilibrium constants at run time by using options on the input file.

  10. EQ3NR, a computer program for geochemical aqueous speciation-solubility calculations: Theoretical manual, user's guide, and related documentation (Version 7.0)

    International Nuclear Information System (INIS)

    Wolery, T.J.

    1992-01-01

    EQ3NR is an aqueous solution speciation-solubility modeling code. It is part of the EQ3/6 software package for geochemical modeling. It computes the thermodynamic state of an aqueous solution by determining the distribution of chemical species, including simple ions, ion pairs, and complexes, using standard state thermodynamic data and various equations which describe the thermodynamic activity coefficients of these species. The input to the code describes the aqueous solution in terms of analytical data, including total (analytical) concentrations of dissolved components and such other parameters as the pH, pHCl, Eh, pe, and oxygen fugacity. The input may also include a desired electrical balancing adjustment and various constraints which impose equilibrium with special pure minerals, solid solution end-member components (of specified mole fractions), and gases (of specified fugacities). The code evaluates the degree of disequilibrium in terms of the saturation index (SI = 1og Q/K) and the thermodynamic affinity (A = -2.303 RT log Q/K) for various reactions, such as mineral dissolution or oxidation-reduction in the aqueous solution itself. Individual values of Eh, pe, oxygen fugacity, and Ah (redox affinity) are computed for aqueous redox couples. Equilibrium fugacities are computed for gas species. The code is highly flexible in dealing with various parameters as either model inputs or outputs. The user can specify modification or substitution of equilibrium constants at run time by using options on the input file

  11. Carcinoma de células escamosas em bovinos, ovinos e eqüinos: estudo de 50 casos no sul do Rio Grande do Sul

    Directory of Open Access Journals (Sweden)

    Adriano Tony Ramos

    2007-12-01

    Full Text Available O carcinoma de células escamosas (CCE é um tumor maligno dos queratinócitos. O desenvolvimento desse tipo de tumor está associado a muitos fatores, incluindo a exposição prolongada à luz ultravioleta, falta de pigmento na epiderme, perda de pêlos ou cobertura de pêlos muito esparsa nos locais afetados. Realizou-se um estudo retrospectivo dos casos de carcinoma de células escamosas em animais de produção (bovinos, ovinos e eqüinos de 1978 a 2002. O material foi obtido nos arquivos do Laboratório Regional de Diagnóstico da Faculdade de Veterinária da Universidade Federal de Pelotas. Os 50 tumores do tipo carcinoma de células escamosas estavam distribuídos nas diferentes espécies (bovina: 30; ovina: sete e eqüina: 13. Dados como raça, sexo, idade e localização corpórea, dentro de cada espécie, foram tabulados. Classificaram-se os tumores segundo seu grau de malignidade em bem diferenciados a pobremente diferenciados, através de avaliação histológica. A etiologia multifatorial dos cce em animais de produção requer mais estudos retrospectivos e prospectivos, para determinar o papel de cada fator na patogênese desse neoplasma.

  12. Estimativa da digestibilidade aparente de nutrientes em dietas para eqüinos, com o uso de óxido crômico e indicadores internos

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    Oliveira Chiara Albano de Araújo

    2003-01-01

    Full Text Available Foram realizados dois ensaios com o objetivo de avaliar a digestibilidade aparente de nutrientes em dietas para eqüinos, utilizando o método da coleta total de fezes e os indicadores óxido crômico, fibra em detergente ácido indigestível (FDAi, fibra em detergente neutro indigestível (FDNi, celulose indigestível (CELi, lignina (LIG e cinzas insolúveis em detergente ácido (CIDA. No primeiro ensaio, foram utilizados cinco potros mestiços, alimentados com cinco dietas contendo níveis diferenciados de proteína bruta, mantendo a relação concentrado e volumoso em 50:50. O óxido crômico foi utilizado como indicador externo. No segundo ensaio, foram utilizados quatro potros mestiços, alimentados com dietas compostas por feno de coastcross como volumoso e concentrado nas proporções de 40:60, 60:40, 80:20 e 100:00. Nos dois ensaios, os teores de fibra em detergente ácido indigestível, fibra em detergente neutro indigestível, celulose indigestível, lignina e cinzas insolúveis em detergente ácido foram obtidos após incubação in vitro. No primeiro ensaio, a FDAi mostrou-se adequada como indicador interno para estimar a digestibilidade; a CELi, em ambos os ensaios, foi adequada como indicador interno para a estimativa da digestibilidade aparente de nutrientes em dietas para eqüinos. O óxido crômico apresentou baixa recuperação fecal no primeiro ensaio e a LIG, baixa recuperação fecal nos dois ensaios, subestimando os coeficientes de digestibilidade dos nutrientes, sendo inadequada sua utilização para estimativa da digestibilidade. A CIDA, em função da metodologia de coleta fecal, também mostrou-se inadequada para as estimativas de digestibilidade em eqüinos.

  13. Sorovares de Salmonella em carne de eqüídeos abatidos no nordeste do Brasil Salmonella serovars in meat of horses slaughtered in northeastern Brazil

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    Ernesto Hofer

    2000-06-01

    Full Text Available Nas décadas de 60 e 70, houve um extraordinário incremento da exportação de produtos cárneos de eqüídeos dos países da América do Sul para a Europa e Japão. Este acontecimento favoreceu o aumento de risco da veiculação de Salmonella através desses produtos, para as populações humana e animal, consumidoras. Assim, num estabelecimento industrial e exportador de carne de eqüídeos localizado no nordeste do Brasil (Pernambuco, foram analisados bacteriologicamente, 19.238 fragmentos de músculos mais externos, que revelaram 666 exames positivos referentes a 433 animais (eqüinos e asininos e resultando no isolamento de 745 cepas de Salmonella. Na amostragem foram caracterizados do ponto de vista antigênico 98 sorovares, predominantemente classificados na subespécie I (98,9% e tendo como os mais freqüentes S. Anatum, S. Carrau, S. Saintpaul, S. Agona e S. Typhimurium. Pelas análises efetuadas admite-se que as causas primordiais da presença de Salmonella nas carnes, provavelmente decorreu do contato com os excretas dos animais abatidos, bem como pela possível contaminação ambiental resultante, tendo em vista a ausência de portadores humanos, pesquisados numa parcela do pessoal.In the sixties and seventies there was an extraordinary increase in export of horse meat products to Europe and Japan. This favored an increase in risk of Salmonella outspread through those products to human and animal consumer populations. Thus, from an exporting company dealing with horse meat located in northeastern Brazil (state of Pernambuco, 19,238 fragments of more external muscles, Salmonella was isolated from 666 samples colleted from 433 animals (horses and donkeys. The serotyping of 745 isolates showed 98 serovars pertaining to 14 serogroups, predominantly classified into subspecies I (98.9%. S. Anatum, S. Carrau, S. Saintpaul, S. Agona, and S. Typhimurium were the most frequent serovars isolated. Preliminary data indicate that the primary

  14. Prevalência de anticorpos antivírus da arterite dos eqüinos em cavalos criados no Estado de São Paulo

    OpenAIRE

    Lara, M.C.C.S.H.; Fernandes, W.R.; Timoney, P.J.; Birgel, E.H.

    2002-01-01

    Utilizou-se a prova de soroneutralização em microplacas para detecção de anticorpos antivírus da arterite dos eqüinos em 659 amostras de soro sangüíneo de animais criados no Estado de São Paulo. A prevalência de anticorpos na população estudada foi igual a 18,2%. A raça Mangalarga foi a que apresentou maior taxa de prevalência, 33,3%. Animais na faixa etária de 6 a 24 meses de idade apresentaram a maior taxa de prevalência, 30,4%, e as fêmeas apresentaram prevalência de 22, 9%, mais alta do q...

  15. Health-related quality of life: validity, reliability, and responsiveness of SF-36, 15D, EQ-5D RAQoL, and HAQ in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Linde, L.; Sørensen, J.; Østergaard, Morten

    2008-01-01

    OBJECTIVE: To compare validity, reliability, and responsiveness of generic and disease specific health-related quality of life (HRQOL) instruments in rheumatoid arthritis (RA). METHODS: Two samples of patients completed the Medical Outcomes Study Short Form-36 Health Survey (SF-36), EuroQol (EQ)-5D...... and VAS pain were responsive to both improvement and deterioration. CONCLUSION: All instruments were valid measures for HRQOL in RA. The RAQoL and HAQ displayed the best reliability, while the SF-36 bodily pain scale and VAS pain were the most responsive. The choice of instrument should depend......, 15D, Rheumatoid Arthritis Quality of Life Scale (RAQoL), Health Assessment Questionnaire (HAQ), and visual analog scales (VAS) for pain, fatigue, and global RA. Validity (convergent, discriminant, and known-groups) was evaluated in a cross-section of 200 patients. Reliability was evaluated...

  16. Anestesia por isofluorano em eqüinos submetidos à infusão contínua de medetomidina ou xilazina

    OpenAIRE

    Dória,Renata Gebara Sampaio; Valadão,Carlos Augusto Araújo; Canola,Paulo Aléscio; Guirro,Érica Cristina Bueno do Prado; Mendes,Marina Ceccato; Escobar,André; Ribeiro,Gesiane; Natalini,Cláudio Côrrea

    2009-01-01

    Avaliaram-se oito eqüinos sob anestesia geral inalatória com isofluorano (1CAM) e infusão contínua de xilazina (0,35mg kg-1h-1) ou medetomidina (3,5µg kg-1h-1), em relação à freqüência cardíaca, ritmo cardíaco, freqüência respiratória, pressão arterial, hemogasometria arterial e temperatura, nos tempos T0 (imediatamente antes do início da infusão contínua) e T10 ao T60 (intervalos de 10 minutos, após início da infusão contínua). Houve redução da freqüência cardíaca e da temperatura e el...

  17. Eficácia de pamoato de pirantel, isolado ou associado ao triclorfon, no controle de ciatostomíneos de eqüinos

    OpenAIRE

    Marcelo de Campos Pereira; Maurício Del Bigio; Reinaldo de Campos

    1994-01-01

    Através de estudo comparativo, objetivou-se avaliar a eficiência anti-helmíntica de pamoato de pirantel, isolado ou associado ao triclorfon, no controle de estrongilídeos de eqüinos da raça Puro Sangue Inglês. As coproculturas realizadas antes e após os tratamentos levaram consistentemente ao encontro de populações puras de ciatostomíneos com oito células intestinais. As reduções de ovos por grama de fezes foram avaliadas do 7º. ao 45º. dias pós-tratamento. Comparando os valores médios de OPG...

  18. Health-related quality of life as measured with EQ-5D among populations with and without specific chronic conditions: a population-based survey in Shaanxi Province, China.

    Science.gov (United States)

    Tan, Zhijun; Liang, Ying; Liu, Siming; Cao, Wenjun; Tu, Haibo; Guo, Lingxia; Xu, Yongyong

    2013-01-01

    The aim of this study was to examine health-related quality of life (HRQoL) as measured by EQ-5D and to investigate the influence of chronic conditions and other risk factors on HRQoL based on a distributed sample located in Shaanxi Province, China. A multi-stage stratified cluster sampling method was performed to select subjects. EQ-5D was employed to measure the HRQoL. The likelihood that individuals with selected chronic diseases would report any problem in the EQ-5D dimensions was calculated and tested relative to that of each of the two reference groups. Multivariable linear regression models were used to investigate factors associated with EQ VAS. The most frequently reported problems involved pain/discomfort (8.8%) and anxiety/depression (7.6%). Nearly half of the respondents who reported problems in any of the five dimensions were chronic patients. Higher EQ VAS scores were associated with the male gender, higher level of education, employment, younger age, an urban area of residence, access to free medical service and higher levels of physical activity. Except for anemia, all the selected chronic diseases were indicative of a negative EQ VAS score. The three leading risk factors were cerebrovascular disease, cancer and mental disease. Increases in age, number of chronic conditions and frequency of physical activity were found to have a gradient effect. The results of the present work add to the volume of knowledge regarding population health status in this area, apart from the known health status using mortality and morbidity data. Medical, policy, social and individual attention should be given to the management of chronic diseases and improvement of HRQoL. Longitudinal studies must be performed to monitor changes in HRQoL and to permit evaluation of the outcomes of chronic disease intervention programs.

  19. Health-related quality of life effects of enzalutamide in patients with metastatic castration-resistant prostate cancer: an in-depth post hoc analysis of EQ-5D data from the PREVAIL trial.

    Science.gov (United States)

    Devlin, Nancy; Herdman, Michael; Pavesi, Marco; Phung, De; Naidoo, Shevani; Beer, Tomasz M; Tombal, Bertrand; Loriot, Yohann; Ivanescu, Cristina; Parli, Teresa; Balk, Mark; Holmstrom, Stefan

    2017-06-23

    The effect of enzalutamide on health-related quality of life (HRQoL) in the PREVAIL trial in chemotherapy-naïve men with metastatic castration-resistant prostate cancer was analyzed using the generic EQ-5D instrument. Patients received oral enzalutamide 160 mg/day (n = 872) or placebo (n = 845). EQ-5D index and EQ-5D visual analogue scale (EQ-5D VAS) scores were evaluated at baseline, week 13, and every 12 weeks until week 61 due to sample size reduction thereafter. Changes on individual dimensions were assessed, and Paretian Classification of Health Change (PCHC) and time-to-event analyses were conducted. With enzalutamide, EQ-5D index and EQ-5D VAS scores declined more slowly versus placebo and time to diverge from full health was prolonged. Average decline in EQ-5D index (-0.042 vs. -0.070; P < .0001) and EQ-5D VAS (-1.3 vs. -4.4; P < .0001) was significantly smaller with enzalutamide. There were significant (P < .05) between-group differences favoring enzalutamide in Pain/Discomfort to week 37, Anxiety/Depression at week 13, and Usual Activities at week 25, but no significant differences for Mobility and Self-care. The PCHC analysis showed more enzalutamide patients reporting improvement than placebo patients at weeks 13, 25, and 49 (all P < .05) and week 37 (P = .0512). Enzalutamide was superior (P ≤ .0003) to placebo for time to diverge from full health and time to first deterioration on Pain/Discomfort and Anxiety/Depression dimensions. This in-depth post hoc analysis showed that enzalutamide delayed HRQoL deterioration and had beneficial effects on several HRQoL domains, including Pain/Discomfort and the proportion of patients in full health, compared with placebo, and may help to support future analyses of this type. NCT01212991.

  20. Aderências peritoneais em eqüinos: tratamento profilático com carboximetilcelulose Peritoneal adhesions in horses: prophylactic treatment with carboxymethylcelullose

    Directory of Open Access Journals (Sweden)

    Marco Aurélio Ferreira Lopes

    1998-09-01

    Full Text Available As aderências peritoneais formam-se freqüentemente nos eqüinos submetidos a laparotomia. As aderências podem ser assintomáticas ou podem causar complicações como cólica e osbstrução intestinal, às vezes com estrangulamento vascular. Com o objetivo de avaliar a eficiência do uso intraperitoneal de carboximetilcelulose (CMC na prevenção de aderências peritoneais em eqüinos, fez-se o seguinte experimento: dezoito eqüinos clinicamente normais, sem raça definida (SRD, foram anestesiados e submetidos a laparotomia na linha mediana ventral, quando se produziu lesões no jejuno distal para induzir a formação de aderências peritoneais. Em quatro animais (bloco I foram criadas seis lesões: um segmento com aproximadamente 45cm de comprimento foi submetido à isquemia, através da ligadura da circulação mural e dos vasos mesentéricos por duas horas; em cinco pequenas áreas, com cerca de três por cinco centímetros, foi feita abrasão da serosa pela fricção 100 vezes de uma gaze seca e um ponto simples seromuscular de categute cromado foi aplicado no seu centro. Nos outros 14 animais (bloco II. o modelo adotado foi semelhante com pequenas modificações: ao invés de um segmento de isquemia foram criados quatro segmentos com 25cm de comprimento; a abrasão das cinco pequenas áreas foi feita com uma pinça Rochester aberta e não com uma gaze seca; a sutura seromuscular com categute aplicada no centro das áreas de abrasão foi uma linha contínua simples, com aproximadamente 2,5cm de comprimento e não um ponto simples. Os animais foram aleatoriamente divididos em dois grupos. Em dois animais do bloco I e sete animais do bloco II (grupo tratamento, antes da síntese da parede abdominal, foi instilada, na cavidade peritoneal, uma solução decmC a 7% na dose de 7 ml/kg. Nos outros nove animais (grupo controle a parede foi suturada da mesma forma, mas nenhum medicamento foi aplicado na cavidade peritoneal. Os eqüinos foram

  1. Exploration of the association between quality of life, assessed by the EQ-5D and ICECAP-O, and falls risk, cognitive function and daily function, in older adults with mobility impairments

    Directory of Open Access Journals (Sweden)

    Davis Jennifer C

    2012-10-01

    Full Text Available Abstract Background Our research sought to understand how falls risk, cognitive function, and daily function are associated with health related quality of life (using the EuroQol-5D and quality of life (using the ICECAP-O among older adults with mobility impairments. Methods The EQ-5D and ICECAP-O were administered at 12 months post first clinic attendance at the Vancouver Falls Prevention Clinic. We report descriptive statistics for all baseline characteristics collected at first clinic visit and primary outcomes of interest. Using multivariate stepwise linear regression, we assessed the construct validity of the EQ-5D and ICECAP-O using three dependent measures that are recognized indicators of “impaired mobility” – physiological falls risk, general balance and mobility, and cognitive status among older adults. Results We report data on 215 seniors who attended the Vancouver Falls Prevention Clinic and received their first clinic assessment. Patients had a mean age of 79.3 (6.2 years. After accounting for known covariates (i.e., age and sex, the ICECAP-O domains explained a greater amount of variation in each of the three dependent measures compared with the EQ-5D domains. Conclusion Both the EQ-5D and ICECAP-O demonstrate associations with falls risk and general balance and mobility; however, only the ICECAP-O was associated with cognitive status among older adults with mobility impairments. Trial registration ClinicalTrials.gov Identifier: NCT01022866

  2. Comparison of the Multiattribute Utility Instruments EQ-5D and SF-6D in a Europe-Wide Population-Based Cohort of Patients with Inflammatory Bowel Disease 10 Years after Diagnosis.

    Science.gov (United States)

    Huppertz-Hauss, Gert; Aas, Eline; Lie Høivik, Marte; Langholz, Ebbe; Odes, Selwyn; Småstuen, Milada; Stockbrugger, Reinhold; Hoff, Geir; Moum, Bjørn; Bernklev, Tomm

    2016-01-01

    Background. The treatment of chronic inflammatory bowel disease (IBD) is costly, and limited resources call for analyses of the cost effectiveness of therapeutic interventions. The present study evaluated the equivalency of the Short Form 6D (SF-6D) and the Euro QoL (EQ-5D), two preference-based HRQoL instruments that are broadly used in cost-effectiveness analyses, in an unselected IBD patient population. Methods. IBD patients from seven European countries were invited to a follow-up visit ten years after their initial diagnosis. Clinical and demographic data were assessed, and the Short Form 36 (SF-36) was employed. Utility scores were obtained by calculating the SF-6D index values from the SF-36 data for comparison with the scores obtained with the EQ-5D questionnaire. Results. The SF-6D and EQ-5D provided good sensitivities for detecting disease activity-dependent utility differences. However, the single-measure intraclass correlation coefficient was 0.58, and the Bland-Altman plot indicated numerous values beyond the limits of agreement. Conclusions. There was poor agreement between the measures retrieved from the EQ-5D and the SF-6D utility instruments. Although both instruments may provide good sensitivity for the detection of disease activity-dependent utility differences, the instruments cannot be used interchangeably. Cost-utility analyses performed with only one utility instrument must be interpreted with caution.

  3. Comparison of the Multiattribute Utility Instruments EQ-5D and SF-6D in a Europe-Wide Population-Based Cohort of Patients with Inflammatory Bowel Disease 10 Years after Diagnosis

    Directory of Open Access Journals (Sweden)

    Gert Huppertz-Hauss

    2016-01-01

    Full Text Available Background. The treatment of chronic inflammatory bowel disease (IBD is costly, and limited resources call for analyses of the cost effectiveness of therapeutic interventions. The present study evaluated the equivalency of the Short Form 6D (SF-6D and the Euro QoL (EQ-5D, two preference-based HRQoL instruments that are broadly used in cost-effectiveness analyses, in an unselected IBD patient population. Methods. IBD patients from seven European countries were invited to a follow-up visit ten years after their initial diagnosis. Clinical and demographic data were assessed, and the Short Form 36 (SF-36 was employed. Utility scores were obtained by calculating the SF-6D index values from the SF-36 data for comparison with the scores obtained with the EQ-5D questionnaire. Results. The SF-6D and EQ-5D provided good sensitivities for detecting disease activity-dependent utility differences. However, the single-measure intraclass correlation coefficient was 0.58, and the Bland-Altman plot indicated numerous values beyond the limits of agreement. Conclusions. There was poor agreement between the measures retrieved from the EQ-5D and the SF-6D utility instruments. Although both instruments may provide good sensitivity for the detection of disease activity-dependent utility differences, the instruments cannot be used interchangeably. Cost-utility analyses performed with only one utility instrument must be interpreted with caution.

  4. Experimental peritonitis in horses: peritoneal fluid composition Peritonite experimental em eqüinos: composição do líquido peritoneal

    Directory of Open Access Journals (Sweden)

    L.C.N. Mendes

    1999-06-01

    Full Text Available Sixteen adult horses were randomly divided into four equal groups of four animals and each group was injected intraperitoneally with one of the following suspension: Group I, 100×10(7 colony-forming units (CFU of E. coli diluted in 500ml of 0.9% saline; Group II, 100×10(7 CFU of Bacteroides fragilis in 500ml of 0.9% saline; Group III, 100×10(7 CFU of E. coli in combination with 100×10(7 CFU of B. fragilis in 500ml of 0.9% saline; Group IV, 500ml of 0.9% saline. A significant increase in leukocyte number was observed in the peritoneal fluid by four hours after the inoculations in animals of Group I and II, and by eight hours in animals of Group III. The highest cell count observed was 516×10³ leukocytes/mm³. Significant increases in peritoneal fluid fibrinogen (1g/dl and total protein (9.1% concentrations were also observed. Horses inoculated with pure cultures of either E. coli or B. fragilis demonstrated mild and self-limiting peritonitis, while those inoculated with a combination of both bacteria demonstrated laboratory findings of higher intensity and duration.Dezesseis eqüinos adultos foram aleatoriamente divididos em quatro grupos de quatro animais que receberam inoculação intraperitoneal das seguintes suspenções: grupo I, 100×10(7 unidades formadoras de colônias (CFU de E. coli diluídas em 500ml de solução salina a 0,9%; grupo II, 100×10(7 CFU de Bacteroides fragilis em 500ml de solução salina a 0,9%; grupo III, 100×10(7 CFU de E. coli combinados com 100×10(7 CFU de B. fragilis em 500ml de solução salina a 0,9%; grupo IV, 500ml de solução salina a 0,9%. Observou-se aumento significativo do número de leucócitos no líquido peritoneal quatro horas após as inoculações dos animais dos grupos I e II, e oito horas após as inoculações dos animais do grupo III. A contagem mais elevada foi de 516×10³ leucócitos/mm³. Aumentos significativos nas concentrações de fibrinogênio (1g/dl e proteína total (9

  5. O tubo de silicone como dreno torácico em eqüinos The silicon tube when used as a thoracic drain in horses

    Directory of Open Access Journals (Sweden)

    Raquel Yvonne Arantes Baccarin

    2002-10-01

    Full Text Available O tórax agudo possui ocorrência comum em eqüinos, e é responsável por alta mortalidade. Diante disso, o aprimoramento dos meios de tratamento certamente contribuirá para o maior índice de sobrevivência desses animais. Para tanto, este estudo teve a finalidade de avaliar: a complacência, capacidade de drenagem e a radiopacidade de tubo de silicone quando utilizado como dreno torácico em eqüinos e, as possíveis alterações causadas nas variáveis fisiológicas, no hemograma e no líquido pleural. O tubo de silicone foi introduzido na cavidade pleural de 10 eqüinos hígidos através de trocarte, mediante sedação dos animais e anestesia local. Após introdução e posicionamento, o tubo foi conectado a equipo de infusão e tampado por torneira de três vias. Avalioaram-se as variáveis fisiológicas dos animais, analisaram-se o hemograma, o fibrinogênio plasmático e o líquido pleural durante 15 dias. Os dados obtidos foram confrontados estatisticamente pela análise de variância. Concluiu-se que o tubo de silicone permite drenagem satisfatória; mantém sua consistência inalterada na presença do líquido pleural; é radiopaco ao exame radiográfico e é passível de alterar sua complacência na presença de vácuo.The acute thorax syndrome is common in horses and has a high mortality rate. The development of more efficient treatment regimens will certainly account for an increased number of successful outcomes. The purpose of this research was to evaluate the silicon tube’s complacency, draining ability and radiopacity when used as a thoracic drain in horses. Changes in physiologic parameters, blood cell count and pleural fluid were also investigated. Ten horses of different breeds, body weight and age were used and the silicon tube was placed in the pleural cavity by means of a trocar, with the horse under sedation and local anesthesia. Following introduction and placement in the ventral portion of the cavity, the tube was

  6. Development of the web-based Spanish and Catalan versions of the Euroqol 5D-Y (EQ-5D-Y) and comparison of results with the paper version.

    Science.gov (United States)

    Robles, Noemí; Rajmil, Luis; Rodriguez-Arjona, Dolors; Azuara, Marta; Codina, Francisco; Raat, Hein; Ravens-Sieberer, Ulrike; Herdman, Michael

    2015-06-03

    The objectives of the study were to develop web-based Spanish and Catalan versions of the EQ-5D-Y, and to compare scores and psychometric properties with the paper version. Web-based and paper versions of EQ-5D-Y were included in a cross-sectional study in Palafolls (Barcelona), Spain and administered to students (n = 923) aged 8 to 18 years from 2 primary and 1 secondary school and their parents. All students completed both the web-based and paper versions during school time with an interval of at least 2 h between administrations. The order of administration was randomized. Participants completed EQ-5D-Y, a measure of mental health status (the Strengths and Difficulties Questionnaire), and sociodemographic variables using a self-administered questionnaire. Parents questionnaire included parental level of education and presence of chronic conditions in children. Missing values, and floor and ceiling effects were compared between versions. Mean score differences were computed for the visual analogue scale (VAS). Percentage of agreement, kappa index (k) and intraclass correlation coefficient (ICC) were computed to analyze the level of agreement between web-based and paper versions on EQ-5D-Y dimensions and VAS. Known groups validity was analyzed and compared between the two formats. Participation rate was 77 % (n = 715). Both formats of EQ-5D-Y showed low percentages of missing values (n = 2, and 4 to 9 for web and paper versions respectively), and a high ceiling effect by dimension (range from 79 % to 96 %). Percent agreement for EQ-5D-Y dimensions on the web and paper versions was acceptable (range 89 % to 97 %), and k ranged from 0.55 (0.48-0.61, usual activities dimension) to 0.75 (0.68-0.82, mobility dimension). Mean score difference on the VAS was 0.07, and the ICC for VAS scores on the two formats was 0.84 (0.82-0.86). Both formats showed acceptable ability to discriminate according to self-perceived health, reporting chronic conditions, and

  7. Técnica de biópsia hepática em eqüino por laparoscopia Hepatic biopsy in horses by laparoscopy

    Directory of Open Access Journals (Sweden)

    Luis Cláudio Lopes Correia da Silva

    2002-06-01

    Full Text Available Este trabalho experimental objetivou a avaliação do uso da laparoscopia para biópsia hepática em eqüino e o estudo das possíveis alterações clínicas e laboratoriais decorrentes de tal procedimento. Foram utilizados 10 animais, os quais foram submetidos a procedimento cirúrgico em posição quadrupedal, por abordagem pelo flanco direito, no 17º espaço intercostal, após jejum alimentar e hídrico de 36 e 18 horas respectivamente. A avaliação pós-operatória constou de exame físico diário e colheita de amostras de sangue seriadas. O procedimento possibilitou inspeção dos órgãos e estruturas anatômicas localizados dorsalmente à direita da cavidade abdominal, favorecendo a escolha do local de biópsia hepática. Não foram observadas alterações no exame físico dos animais. Os exames hematológicos e de função hepática não apresentaram alterações significativas. Concluiu-se que o emprego da laparoscopia para realização de biópsia hepática em eqüino é simples, eficaz e seguro.The purpose of this research was to evaluate the use of laparoscopy in obtaining hepatic biopsy in horses and to determine a possible clinical and laboratorial changes related to the procedure. Ten animals were submitted to 36 hours of fastening and 18 hours of water deprivation and then operated in the standing position, through a right flank approach at the level of the 17th intercostal space. Post-operative evaluation consisted of daily physical examination and seriated blood sampling. The procedure allowed for wide visualization of the viscera and anatomical structures located on the right side of the abdominal cavity, favouring the choice of the spot for hepatic biopsy collection. No changes were noted in the physical state of the animals and alterations in hemogram and hepatic function tests were not statistically significant. It was concluded that laparoscopy is a simple, effective and safe technique for obtaining hepatic biopsy

  8. Do country-specific preference weights matter in the choice of mapping algorithms? The case of mapping the Diabetes-39 onto eight country-specific EQ-5D-5L value sets.

    Science.gov (United States)

    Lamu, Admassu N; Chen, Gang; Gamst-Klaussen, Thor; Olsen, Jan Abel

    2018-03-22

    To develop mapping algorithms that transform Diabetes-39 (D-39) scores onto EQ-5D-5L utility values for each of eight recently published country-specific EQ-5D-5L value sets, and to compare mapping functions across the EQ-5D-5L value sets. Data include 924 individuals with self-reported diabetes from six countries. The D-39 dimensions, age and gender were used as potential predictors for EQ-5D-5L utilities, which were scored using value sets from eight countries (England, Netherland, Spain, Canada, Uruguay, China, Japan and Korea). Ordinary least squares, generalised linear model, beta binomial regression, fractional regression, MM estimation and censored least absolute deviation were used to estimate the mapping algorithms. The optimal algorithm for each country-specific value set was primarily selected based on normalised root mean square error (NRMSE), normalised mean absolute error (NMAE) and adjusted-r 2 . Cross-validation with fivefold approach was conducted to test the generalizability of each model. The fractional regression model with loglog as a link function consistently performed best in all country-specific value sets. For instance, the NRMSE (0.1282) and NMAE (0.0914) were the lowest, while adjusted-r 2 was the highest (52.5%) when the English value set was considered. Among D-39 dimensions, the energy and mobility was the only one that was consistently significant for all models. The D-39 can be mapped onto the EQ-5D-5L utilities with good predictive accuracy. The fractional regression model, which is appropriate for handling bounded outcomes, outperformed other candidate methods in all country-specific value sets. However, the regression coefficients differed reflecting preference heterogeneity across countries.

  9. Equilíbrio ácido-base e hidroeletrolítico em eqüinos com cólica Acid-base and hidroelectrolytic balance in colic horses

    Directory of Open Access Journals (Sweden)

    Paula Alessandra Di Filippo

    2008-08-01

    Full Text Available Foram utilizados setenta eqüinos distribuídos em três grupos experimentais, G1 (vinte eqüinos hígidos, G2 (vinte e cinco eqüinos com cólica, os quais passaram por tratamento clínico ou cirúrgico e sobreviveram e G3 (vinte e cinco eqüinos com cólica, os quais passaram por tratamento clínico ou cirúrgico e foram a óbito ou foram sacrificados. Amostras de sangue foram obtidas em dez diferentes momentos, mediante punção da jugular, para estudo do equilíbrio ácido-base e hidroeletrolítico. Os eqüinos com cólica apresentaram diminuição (PSeventy horses were distributed into three experimental groups ad follows: G1, twenty healthy animals; G2, twenty-five colic horses that survived after clinical or surgical treatment; and G3, twenty-five colic horses that were sacrificed or died after clinical or surgical treatment. Blood samples were taken from the jugular vein to assess acid-base balance and water-electrolyte balance. Colic horses had lower pH(v (P<0.05, mainly G3 animals. Acidosis was confirmed by the lower pH(v associated with decreased pCO2(v, cBase(v and cHCO-3(vP, which was probably due to an increased production of lactate during anaerobic glycolysis as a result from hypovolemia. Furthermore, hyponatremia, hypokalemia and hyperchloremia were detected. The presence and the extent of the imbalances contributed substantially to the prognosis of colic horses.

  10. Establishing utility values for the 22-item Sino-Nasal Outcome Test (SNOT-22) using a crosswalk to the EuroQol-five-dimensional questionnaire-three-level version (EQ-5D-3L).

    Science.gov (United States)

    Crump, R Trafford; Lai, Ernest; Liu, Guiping; Janjua, Arif; Sutherland, Jason M

    2017-05-01

    Chronic rhinosinusitis (CRS) is a common condition for which there are numerous medical and surgical treatments. The 22-item Sino-Nasal Outcome Test (SNOT-22) is a patient-reported outcome measure often used with patients diagnosed with CRS. However, there are no utility values associated with the SNOT-22, limiting its use in comparative effectiveness research. The purpose of this study was to establish utilities for the SNOT-22 by mapping responses to utility values associated with the EuroQol-5-dimensional questionnaire-3-level version (EQ-5D-3L). This study used data collected from patients diagnosed with CRS awaiting bilateral endoscopic sinus surgery in Vancouver, Canada. Study participants completed both the SNOT-22 and the EQ-5D-3L. Ordinary least squares was used for 3 models that estimated the EQ-5D-3L utility values as a function of the SNOT-22 items. A total of 232 participants completed both the SNOT-22 and the EQ-5D-3L. As expected, there was a negative relationship between the SNOT-22 global scores and EQ-5D-3L utility values. Adjusted R 2 for the 3 models ranged from 0.28 to 0.33, and root mean squared errors between 0.23 and 0.24. A nonparametric bootstrap analysis demonstrated robustness of the findings. This study successfully developed a mapping model to associate utility values with responses to the SNOT-22. This model could be used to conduct comparative effectiveness research in CRS to evaluate the various interventions available for treating this condition. © 2017 ARS-AAOA, LLC.

  11. Probabilistic mapping of descriptive health status responses onto health state utilities using Bayesian networks: an empirical analysis converting SF-12 into EQ-5D utility index in a national US sample.

    Science.gov (United States)

    Le, Quang A; Doctor, Jason N

    2011-05-01

    As quality-adjusted life years have become the standard metric in health economic evaluations, mapping health-profile or disease-specific measures onto preference-based measures to obtain quality-adjusted life years has become a solution when health utilities are not directly available. However, current mapping methods are limited due to their predictive validity, reliability, and/or other methodological issues. We employ probability theory together with a graphical model, called a Bayesian network, to convert health-profile measures into preference-based measures and to compare the results to those estimated with current mapping methods. A sample of 19,678 adults who completed both the 12-item Short Form Health Survey (SF-12v2) and EuroQoL 5D (EQ-5D) questionnaires from the 2003 Medical Expenditure Panel Survey was split into training and validation sets. Bayesian networks were constructed to explore the probabilistic relationships between each EQ-5D domain and 12 items of the SF-12v2. The EQ-5D utility scores were estimated on the basis of the predicted probability of each response level of the 5 EQ-5D domains obtained from the Bayesian inference process using the following methods: Monte Carlo simulation, expected utility, and most-likely probability. Results were then compared with current mapping methods including multinomial logistic regression, ordinary least squares, and censored least absolute deviations. The Bayesian networks consistently outperformed other mapping models in the overall sample (mean absolute error=0.077, mean square error=0.013, and R overall=0.802), in different age groups, number of chronic conditions, and ranges of the EQ-5D index. Bayesian networks provide a new robust and natural approach to map health status responses into health utility measures for health economic evaluations.

  12. Health-Related Quality of Life of the General German Population in 2015: Results from the EQ-5D-5L.

    Science.gov (United States)

    Huber, Manuel B; Felix, Julia; Vogelmann, Martin; Leidl, Reiner

    2017-04-16

    The EQ-5D-5L is a widely used generic instrument to measure health-related quality of life. This study evaluates health perception in a representative sample of the general German population from 2015. To compare results over time, a component analysis technique was used that separates changes in the description and valuation of health states. The whole sample and also subgroups, stratified by sociodemographic parameters as well as disease affliction, were analyzed. In total, 2040 questionnaires (48.4% male, mean age 47.3 year) were included. The dimension with the lowest number of reported problems was self-care (93.0% without problems), and the dimension with the highest proportion of impairment was pain/discomfort (71.2% without problems). Some 64.3% of the study population were identified as problem-free. The visual analog scale (VAS) mean for all participants was 85.1. Low education was connected with significantly lower VAS scores, but the effect was small. Depression, heart disease, and diabetes had a strong significant negative effect on reported VAS means. Results were slightly better than those in a similar 2012 survey; the most important driver was the increase in the share of the study population that reported to be problem-free. In international comparisons, health perception of the general German population is relatively high and, compared with previous German studies, fairly stable over recent years. Elderly and sick people continue to report significant reductions in perceived health states.

  13. Measuring health-related quality of life in women with endometriosis: comparing the clinimetric properties of the Endometriosis Health Profile-5 (EHP-5) and the EuroQol-5D (EQ-5D).

    Science.gov (United States)

    Aubry, G; Panel, P; Thiollier, G; Huchon, C; Fauconnier, A

    2017-06-01

    Which of the Endometriosis Health Profile-5 (EHP-5) and the EuroQol-5D (EQ-5D) is the most efficient to assess quality of life in women suffering from endometriosis? Although EHP-5 and EQ-5D instruments had an excellent responsiveness, EHP-5 has a better discriminative ability than EQ-5 to measure health-related quality of life (HrQoL). Proper measurement of HrQoL is important in endometriosis. While many quality of life instruments are available, few have been completely validated in endometriosis. The EHP-5 and the EQ-5D are short and practical scales, which may be useful. Literature is lacking to determine which one is the most suitable in clinical practice or in clinical research. This prospective and observational study conducted between 1 January 2012 and 31 December 2013 included a total of 253 consecutive women with proven endometriosis, undergoing medical or surgical treatment, in 2 French tertiary care centers. Women over 18 years consulting for painful symptoms of at least 3 months' duration or for infertility, with endometriosis proven histologically or radiologically, were requested to fill in the 2 scales before (T0) and 12 months after treatment (T1). Construct validity consisted in testing presupposed relationships between the scales and the characteristics of the patients or the endometriosis. Responsiveness to change was calculated for all patients and in each treatment group. Effect sizes were used according to Cohen's d method. A total of 216 women filled in completely all the questionnaires at T0 and 133 (61.6%) at T1. EHP-5 and EQ-5D had good discriminative abilities regarding the patients' symptoms, with significant superiority of EHP-5 concerning three of the nine hypotheses. The largest difference was that calculated for the 'intensity of dysmenorrhea' using the Visual Analogic Scale, with respectively effect size from Cohen's d (ES) = 0.86 95% CI (0.54-1.17) for EHP-5 versus 0.48 95% CI (0.16-0.79) for EQ-5D. There were no differences in

  14. The use of the EQ-5D-Y health related quality of life outcome measure in children in the Western Cape, South Africa: psychometric properties, feasibility and usefulness - a longitudinal, analytical study.

    Science.gov (United States)

    Scott, Des; Ferguson, Gillian D; Jelsma, Jennifer

    2017-01-19

    The EQ-5D-Y, an outcome measure of Health Related Quality of Life (HRQoL) in children, was developed by an international task team in 2010. The multinational feasibility, reliability and validity study which followed was undertaken with mainly healthy children. The aim of this study was to investigate the psychometric properties of the EQ-5D-Y when used to assess the HRQoL of children with different health states. A sample of 224 children between eight and twelve years were grouped according to their health state. The groups included 52 acutely ill children, 67 children with either a chronic health condition or disability and 105 mostly healthy, mainstream school children as a comparator. They were assessed at baseline, at three months and at six months. An analysis of the psychometric properties was performed to assess the reliability, validity and responsiveness of the EQ-5D-Y in the different groups of children. Cohen's kappa, the intraclass correlation coefficient, Pearson Chi-square, Kruskal-Wallis ANOVA and effect size of Wilcoxon Signed-rank test were used to determine the reliability, validity and responsiveness of the instrument. The EQ-5D-Y dimensions were found to be reliable on test-retest (kappa varying from 0.365 to 0.653), except for the Usual Activities dimension (kappa 0.199). The Visual Analogue Scale (VAS) was also reliable (ICC = 0.77). Post-hoc analysis indicated that dimensions were able to discriminate between acutely ill and healthy children (all differences p Wilcoxon Signed-rank test for VAS was 0.43). Six of the nine therapists who took part in the study, found the measure quick and easy to apply, used the information in the management of the child and would continue to use it in future. The EQ-5D-Y could be used with confidence as an outcome measure for acutely-ill children, but demonstrated poorer psychometric properties in children with no health condition or chronic conditions. It appears to be feasible and useful to include the

  15. An Empirical Comparison of the EQ-5D-5L, DEMQOL-U and DEMQOL-Proxy-U in a Post-Hospitalisation Population of Frail Older People Living in Residential Aged Care.

    Science.gov (United States)

    Ratcliffe, Julie; Flint, Thomas; Easton, Tiffany; Killington, Maggie; Cameron, Ian; Davies, Owen; Whitehead, Craig; Kurrle, Susan; Miller, Michelle; Liu, Enwu; Crotty, Maria

    2017-06-01

    To empirically compare the measurement properties of the DEMQOL-U and DEMQOL-Proxy-U instruments to the EQ-5D-5L and its proxy version (CEQ-5D-5L) in a population of frail older people living in residential aged care in the post-hospitalisation period following a hip fracture. A battery of instruments to measure health-related quality of life (HRQoL), cognition, and clinical indicators of depression, pain and functioning were administered at baseline and repeated at 4 weeks' follow-up. Descriptive summary statistics were produced and psychometric analyses were conducted to assess the levels of agreement, convergent validity and known group validity between clinical indicators and HRQoL measures. There was a large divergence in mean (SD) utility scores at baseline for the EQ-5D-5L and DEMQOL-U [EQ-5D-5L mean 0.21 (0.19); DEMQOL-U mean 0.79 (0.14)]. At 4 weeks' follow-up, there was a marked improvement in EQ-5D-5L scores whereas DEMQOL-U scores had deteriorated. [EQ-5D-5L mean 0.45 (0.38); DEMQOL-U mean 0.58 (0.38)]. The EQ-5D and CEQ-5D-5L were more responsive to the physical recovery trajectory experienced by frail older people following surgery to repair a fractured hip, whereas the DEMQOL-U and DEMQOL-Proxy-U appeared more responsive to the changes in delirium and dementia symptoms often experienced by frail older people in this period. This study presents important insights into the HRQoL of a relatively under-researched population of post-hospitalisation frail older people in residential care. Further research should investigate the implications for economic evaluation of self-complete versus proxy assessment of HRQoL and the choice of preference-based instrument for the measurement and valuation of HRQoL in older people exhibiting cognitive decline, dementia and other co-morbidities.

  16. A Non-Interventional Naturalistic Study of the Prescription Patterns of Antipsychotics in Patients with Schizophrenia from the Spanish Province of Tarragona.

    Directory of Open Access Journals (Sweden)

    Ana M Gaviria

    Full Text Available The analysis of prescribing patterns in entire catchment areas contributes to global mapping of the use of antipsychotics and may improve treatment outcomes.To determine the pattern of long-term antipsychotic prescription in outpatients with schizophrenia in the province of Tarragona (Catalonia-Spain.A naturalistic, observational, retrospective, non-interventional study based on the analysis of registries of computerized medical records from an anonymized database of 1,765 patients with schizophrenia treated between 2011 and 2013.The most used antipsychotic was risperidone, identified in 463 (26.3% patients, followed by olanzapine in 249 (14.1%, paliperidone in 225 (12.7%, zuclopenthixol in 201 (11.4%, quetiapine in 141 (8%, aripiprazole in 100 (5.7%, and clozapine in 100 (5.7%. Almost 8 out of 10 patients (79.3% were treated with atypical or second-generation antipsychotics. Long-acting injectable (LAI formulations were used in 44.8% of patients. Antipsychotics were generally prescribed in their recommended doses, with clozapine, ziprasidone, LAI paliperidone, and LAI risperidone being prescribed at the higher end of their therapeutic ranges. Almost 7 out of 10 patients (69.6% were on antipsychotic polypharmacy, and 81.4% were on psychiatric medications aside from antipsychotics. Being prescribed quetiapine (OR 14.24, 95% CI 4.94-40.97, LAI (OR 9.99, 95% CI 6.45-15.45, psychiatric co-medications (OR 4.25, 95% CI 2.72-6.64, and paliperidone (OR 3.13, 95% CI 1.23-7.92 were all associated with an increased likelihood of polypharmacy. Being prescribed risperidone (OR 0.54, 95% CI 0.35-0.83 and older age (OR 0.98, 95% CI 0.97-0.99 were related to a low polypharmacy probability.Polypharmacy is the most common pattern of antipsychotic use in this region of Spain. Use of atypical antipsychotics is extensive. Most patients receive psychiatric co-medications such as anxiolytics or antidepressants. Polypharmacy is associated with the use of quetiapine or

  17. Níveis de fibra em detergente neutro em dietas para eqüinos Neutral detergent fiber levels in diet of equines

    Directory of Open Access Journals (Sweden)

    Auro César Braga

    2008-11-01

    Full Text Available Objetivou-se nesta pesquisa avaliar os efeitos de dois níveis de fibra em detergente neutro (FDN da dieta (25 e 35%, provenientes de duas proporções de volumoso/concentrado (50:50 e 60:40, sobre a digestibilidade dos nutrientes, o pH fecal e os parâmetros sangüíneos de lactato, glicose, uréia, creatinina e fosfatase alcalina, visando estabelecer os níveis mínimos e seguros de fibra em dietas para eqüinos. Utilizaram-se cinco eqüinos sem raça definida, com 6 a 8 anos de idade e peso médio de 300 kg, alojados em gaiolas próprias para estudos de metabolismo. Os animais foram distribuídos em delineamento de quadrado latino 5 × 5, composto de cinco tratamentos (dois níveis de FDN, 25 e 35%, duas relações volumoso:concentrado, 50:50 e 60:40, e uma dieta controle, com relação 50:50 volumoso:concentrado e cinco períodos. Cada período experimental teve duração de 15 dias (10 de adaptação e 5 de coleta de fezes e sangue e determinação do pH fecal. Os níveis de FDN utilizados neste experimento (25 e 35% reduziram a digestibilidade dos componentes fibrosos (fração parede celular da dieta, entretanto, não influenciaram os níveis sangüíneos de lactato, glicose, uréia, creatinina e fosfatase alcalina e o pH fecal. A dieta com 25% de FDN promoveu alteração no teor plasmático de fibrinogênio, portanto, pode aumentar a predisposição dos animais a quadros de laminite e cólica.The objective of this research was to evaluate the effects of two levels of neutral detergent fiber (NDF of the diet (25 and 35% from two forage to concentrate (50:50 and 60:40 ratio on nutrient digestibility, fecal pH and blood parameters as lactate, glucose, urea, creatinine, fibrinogen and alkaline phosphatase, to establish minimum and safe levels of fiber in equines diets. Five horses without defined race, with 6 to 8 years old and average 300 kg BW, were housing in metabolism cages. The animals were distributed to 5 × 5 Latin square design

  18. Halicephalobus gingivalis (H.deletrix in the brain of a horse Halicephalobus gingivalis (H.deletrix no cérebro de um eqüino

    Directory of Open Access Journals (Sweden)

    Rosemeri de Oliveira Vasconcelos

    2007-08-01

    Full Text Available A 10-year-old Mangalarga gelding with rhabditiform nematode infection in the brain is described. Clinical signs were limited to circling and right side paralysis. Histological examination of the brain revealed marked gliosis and discreet edema. The perivascular mononuclear inflammatory infiltrate was composed of few layers of lymphocytes, plasmocytes and macrophages and rare eosinophils. The presence of rhabditiform nematodes was associated with the infiltrate. Areas of malacia associated with the parasites and parasite tracks with axonal spheroids were also seen close to the vessels and to the etiological agent and were more evident in the white matter. In the meninges there was moderate inflammatory infiltrate associated with perivascular parasites. The identification of the nematode was based on the histological examination of the cerebral fragments.Um eqüino macho, com 10 anos, Mangalarga, apresentou uma infecção por um nematódeo rabditiforme no cérebro. Os sinais clínicos limitaram-se ao fato de o animal andar em círculos e apresentar paralisia do lado direito. O exame histológico do cérebro revelou acentuada gliose e discreto edema intersticial. O infiltrado inflamatório mononuclear perivascular era composto por poucas camadas de linfócitos, plasmócitos, macrófagos e raros eosinófilos, associados aos nematódeos rabditiformes. Áreas de malácia e trajetos com esferóides axonais são vistos ao redor de vasos e do agente etiológico, sendo mais evidentes na substância branca. Nas meninges, o infiltrado inflamatório foi moderado e associado a parasitas perivasculares. A identificação do nematódeo foi baseada no exame histológico do cérebro do cavalo.

  19. Data Qualification Report For: Thermodynamic Data File, DATA0.YMP.R0 For Geochemical Code, EQ3/6 

    Energy Technology Data Exchange (ETDEWEB)

    P.L. Cloke

    2001-10-16

    The objective of this work is to evaluate the adequacy of chemical thermodynamic data provided by Lawrence Livermore National Laboratory (LLNL) as DataO.ymp.ROA in response to an input request submitted under AP-3.14Q. This request specified that chemical thermodynamic data available in the file, Data0.com.R2, be updated, improved, and augmented for use in geochemical modeling used in Process Model Reports (PMRs) for Engineered Barrier Systems, Waste Form, Waste Package, Unsaturated Zone, and Near Field Environment, as well as for Performance Assessment. The data are qualified in the temperature range 0 to 100 C. Several Data Tracking Numbers (DTNs) associated with Analysis/Model Reports (AMR) addressing various aspects of the post-closure chemical behavior of the waste package and the Engineered Barrier System that rely on EQ316 outputs to which these data are used as input, are Principal Factor affecting. This qualification activity was accomplished in accordance with the AP-SIII.2Q using the Technical Assessment method. A development plan, TDP-EBS-MD-000044, was prepared in accordance with AP-2.13Q and approved by the Responsible Manager. In addition, a Process Control Evaluation was performed in accordance with AP-SV.1Q. The qualification method, selected in accordance with AP-SIII.2Q, was Technical Assessment. The rationale for this approach is that the data in File Data0.com.R2 are considered Handbook data and therefore do not themselves require qualification. Only changes to Data0.com.R2 required qualification. A new file has been produced which contains the database Data0.ymp.R0, which is recommended for qualification as a result of this action. Data0.ymp.R0 will supersede Data0.com.R2 for all Yucca Mountain Project (YMP) activities.

  20. Laminite experimental: aspectos morfológicos, morfométricos e ultra-estruturais das lâminas dérmicas e epidérmicas do casco de eqüinos tratados com a trinitroglicerina

    OpenAIRE

    Sampaio, Rita de Cássia de Lima [UNESP

    2007-01-01

    As alterações ultra-estruturais ocorridas nas lâminas epidérmicas e dérmicas de eqüinos com laminite são responsáveis pela rotação ou afundamento da falange distal dentro do casco. Com o objetivo de prevenir esta ocorrência foram estudados os efeitos da sobrecarga de carboidratos (SCHO), assim como da utilização de trinitroglicerina na fase prodrômica da laminite, nas lâminas epidérmicas do casco de quinze eqüinos. A indução da laminite por meio da sobrecarga de carboidratos alterou siginific...

  1. Effect-based trigger values for in vitro and in vivo bioassays performed on surface water extracts supporting the environmental quality standards (EQS) of the European Water Framework Directive.

    Science.gov (United States)

    Escher, Beate I; Aїt-Aїssa, Selim; Behnisch, Peter A; Brack, Werner; Brion, François; Brouwer, Abraham; Buchinger, Sebastian; Crawford, Sarah E; Du Pasquier, David; Hamers, Timo; Hettwer, Karina; Hilscherová, Klára; Hollert, Henner; Kase, Robert; Kienle, Cornelia; Tindall, Andrew J; Tuerk, Jochen; van der Oost, Ron; Vermeirssen, Etienne; Neale, Peta A

    2018-07-01

    Effect-based methods including cell-based bioassays, reporter gene assays and whole-organism assays have been applied for decades in water quality monitoring and testing of enriched solid-phase extracts. There is no common EU-wide agreement on what level of bioassay response in water extracts is acceptable. At present, bioassay results are only benchmarked against each other but not against a consented measure of chemical water quality. The EU environmental quality standards (EQS) differentiate between acceptable and unacceptable surface water concentrations for individual chemicals but cannot capture the thousands of chemicals in water and their biological action as mixtures. We developed a method that reads across from existing EQS and includes additional mixture considerations with the goal that the derived effect-based trigger values (EBT) indicate acceptable risk for complex mixtures as they occur in surface water. Advantages and limitations of various approaches to read across from EQS are discussed and distilled to an algorithm that translates EQS into their corresponding bioanalytical equivalent concentrations (BEQ). The proposed EBT derivation method was applied to 48 in vitro bioassays with 32 of them having sufficient information to yield preliminary EBTs. To assess the practicability and robustness of the proposed approach, we compared the tentative EBTs with observed environmental effects. The proposed method only gives guidance on how to derive EBTs but does not propose final EBTs for implementation. The EBTs for some bioassays such as those for estrogenicity are already mature and could be implemented into regulation in the near future, while for others it will still take a few iterations until we can be confident of the power of the proposed EBTs to differentiate good from poor water quality with respect to chemical contamination. Copyright © 2018 Elsevier B.V. All rights reserved.

  2. A comparison of the sensitivity of EQ-5D, SF-6D and TTO utility values to changes in vision and perceived visual function in patients with primary open-angle glaucoma

    Directory of Open Access Journals (Sweden)

    Bozzani Fiammetta Maria

    2012-08-01

    Full Text Available Abstract Background Economic viability of treatments for primary open-angle glaucoma (POAG should be assessed objectively to prioritise health care interventions. This study aims to identify the methods for eliciting utility values (UVs most sensitive to differences in visual field and visual functioning in patients with POAG. As a secondary objective, the dimensions of generic health-related and vision-related quality of life most affected by progressive vision loss will be identified. Methods A total of 132 POAG patients were recruited. Three sets of utility values (EuroQoL EQ-5D, Short Form SF-6D, Time Trade Off and a measure of perceived visual functioning from the National Eye Institute Visual Function Questionnaire (VFQ-25 were elicited during face-to-face interviews. The sensitivity of UVs to differences in the binocular visual field, visual acuity and visual functioning measures was analysed using non-parametric statistical methods. Results Median utilities were similar across Integrated Visual Field score quartiles for EQ-5D (P = 0.08 whereas SF-6D and Time-Trade-Off UVs significantly decreased (p = 0.01 and p = 0.001, respectively. The VFQ-25 score varied across Integrated Visual Field and binocular visual acuity groups and was associated with all three UVs (P ≤ 0.001; most of its vision-specific sub-scales were associated with the vision markers. The most affected dimension was driving. A relationship with vision markers was found for the physical component of SF-36 and not for any dimension of EQ-5D. Conclusions The Time-Trade-Off was more sensitive than EQ-5D and SF-6D to changes in vision and visual functioning associated with glaucoma progression but could not measure quality of life changes in the mildest disease stages.

  3. Contribuição ao estudo do funículo espermático em eqüinos sem raça definida (Equus caballus, L.

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    André Luiz Quagliatto Santos

    1992-06-01

    Full Text Available Utilizando 35 pares de funículos esperméticos de eqüinos sem raça definida, estudaram-se os aspectos histológicos dos envoltórios funiculares, dos vasos arteriais e venosos e dos tecidos intervasculares, assim como o seu arranjo vascular e o comprimento do segmento da artéria testicular nele contido.

  4. Ativação de plaquetas de eqüinos com laminite induzida e tratados com ketoprofeno, fenilbutazona e flunixin meglumina Platelets activation in equine with induced laminitis and treated with ketoprophen, phenylbutazone and flunixin meglumin

    Directory of Open Access Journals (Sweden)

    F.O. Paes Leme

    2006-04-01

    Full Text Available Avaliou-se a ativação de plaquetas em 20 eqüinos com laminite induzida, tratados com ketoprofeno, fenilbutazona e flunixin meglumina. As alterações de plaquetas incluíram mudança de forma, alteração da relação entre os eixos maior e menor, aumento de perímetro, emissão de pseudópodes, aumento no número dealfa-grânulos e de grânulos de glicogênio e redução no número degama-grânulos. As plaquetas de eqüinos, quando ativadas, apresentaram perfil de organela diferente de plaquetas normais, e as drogas antiinflamatórias, não-esteroidais, demonstraram atividade na ativação plaquetária de eqüinos in vivo. O flunixin meglumina apresentou melhor atividade em modular a ativação plaquetária de eqüinos in vivo do que a fenilbutazona e o ketoprofeno.The platelets activation from 20 equines submitted to laminitis induction and treated with ketoprophen, phenylbutazone and flunixin meglumin, was evaluated. The platelets changes included shape change, altered relations between axis, increased perimeter, pseudopodia, increased alpha-granules and glycogen-granules, and decreased in gamma-granules. Platelets when activated present a different organelle profile than normal ones. Equine activated platelets had different organelles profile than normal ones, and anti-inflammatory drugs can modulate the platelet activation, being the flunixin meglumin better than phenylbutazone and ketoprophen.

  5. Does the choice of tariff matter?: A comparison of EQ-5D-5L utility scores using Chinese, UK, and Japanese tariffs on patients with psoriasis vulgaris in Central South China.

    Science.gov (United States)

    Zhao, Yue; Li, Shun-Ping; Liu, Liu; Zhang, Jiang-Lin; Chen, Gang

    2017-08-01

    There is an increasing trend globally to develop country-specific tariffs that can theoretically better reflect population's preferences on health states for preference-based health-related quality-of-life instruments, also known as multiattribute utility instruments. This study focused on the most recently developed 5-level version of EuroQol-5 Dimension (EQ-5D) questionnaire, 1 of the world's most well-known multiattribute utility instruments, and aimed to empirically explore the agreements and known-group validities of applying the country-specific tariff versus tariffs developed from other countries using a sample of psoriasis vulgaris patients in Mainland China.A convenience sampling framework was adopted to recruit patients diagnosed with psoriasis vulgaris from Xiangya Hospital, Central South University, China, between May 2014 and February 2015. The 5-level EuroQol-5 dimensions (EQ-5D-5L) utilities were scored by using the Chinese, Japanese, and UK tariffs. Health state utilities were compared using a range of nonparametric test. The intraclass correlation coefficients and Bland-Altman plots were used to examine the agreements among the 3 EQ-5D-5L scores. Health state utility decrements between known groups were investigated using both effect size and a regression analysis.In all, 350 patients (aged 16 years or older) were recruited. There were significant differences among the 3 national tariff sets. Overall, 3 tariffs showed excellent agreements (intraclass correlation coefficient >0.90); however, the wide limits of agreement from the Bland-Altman plots suggest that these tariffs cannot be used interchangeably. The EQ-5D-5L scores using the Chinese-specific tariff showed the best known-group validity than the other 2 tariffs in this Chinese patient sample. The evidence from this study supports the choice of the country-specific tariff to be used in Mainland China.

  6. Controle público e eqüidade no acesso a hospitais sob gestão pública não estatal Public control and equity of access to hospitals under non-State public administration

    Directory of Open Access Journals (Sweden)

    Nivaldo Carneiro Junior

    2006-10-01

    Full Text Available OBJETIVO: Analisar as organizações sociais de saúde à luz do controle público e da garantia da eqüidade no acesso aos serviços de saúde. MÉTODOS: Utilizou-se a técnica de estudo de caso e foram selecionadas duas organizações sociais de saúde na região metropolitana de São Paulo. As categorias analíticas foram eqüidade no acesso e controle público, baseando-se em entrevistas com informantes-chave e relatórios técnico-administrativos. RESULTADOS: Observou-se que financiamento global e o controle administrativo das organizações sociais de saúde são atribuições do gestor estadual. A presença do gestor local é importante para a garantia da eqüidade no acesso, sendo que o controle público se expressa por ações fiscalizadoras mediante procedimentos contábil-financeiros. CONCLUSÕES: A eqüidade no acesso e o controle público não são contemplados na gestão dessas organizações. A questão central encontra-se na capacidade do poder público se fazer presente na implementação dessa modalidade no âmbito local, garantido a eqüidade no acesso e contemplando o controle público.OBJECTIVE: To analyze social health organizations in the light of public control and the guarantee of equity of access to health services. METHODS: Utilizing the case study technique, two social health organizations in the metropolitan region of São Paulo were selected. The analytical categories were equity of access and public control, and these were based on interviews with key informants and technical-administrative reports. RESULTS: It was observed that the overall funding and administrative control of the social health organizations are functions of the state administrator. The presence of a local administrator is important for ensuring equity of access. Public control is expressed through supervisory actions, by means of accounting and financial procedures. CONCLUSIONS: Equity of access and public control are not taken into consideration

  7. Humoral immune response of horses experimentally infected with Trypanosoma evansi/ Resposta imune humoral de eqüinos infectados experimentalmente com Trypanosoma evansi

    Directory of Open Access Journals (Sweden)

    Lúcia Padilha Cury Thomaz de Aquino

    2001-05-01

    Full Text Available Six adult horses were experimentally infected with Trypanosoma evansi (106 parasites. Three other adult horses served as negative control. Serum samples of the experimentally infected horses with T. evansi and non-infected controls horses were obtained before inoculation, and daily thereafter until 14 days post infection (DPI. After that time the serum samples were obtained weekly. Sera of the infected and non-infected control horses was tested by indirect fluorescent antibody test (IFAT and enzyme-linked immunosorbent assay (ELISA for the detection of antibodies against T. evansi. Both ELISA and IFAT detected trypanosomal antibodies shortly after infection and showed progressive increases in antibodies levels during early stages of infection. The responses started on the eighth and eleventh DPI. Maximum IFAT and ELISA values were reached after four weeks of infection and were maintained at this level until the end of the period of study.Seis eqüinos foram inoculados com 106 tripomastigota sangüícolas de Trypanosoma evansi. Três outros animais foram mantidos como testemunhas. Amostras de soro sangüíneo foram obtidas de todos os animais, antes da inoculação, e diariamente até o 14º dia pós inoculação (DPI; após este período uma vez por semana. Pesquisa de anticorpos anti- T. evansi, foram realizadas através da reação de imunofluorescência indireta (RIFI e do ensaio de imunoabsorção enzimática (ELISA. A resposta imune humoral, detectada através da RIFI e do ELISA, iniciou-se, em média, a partir do oitavo DPI, alcançando títulos máximos após quatro semanas de evolução, e os titulos de anticorpos anti- T. evansi mantiveram-se elevadas até o término das observações.

  8. Descentralização, universalidade e eqüidade nas reformas da saúde Decentralization, universal access, and equity in health reforms

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    Hésio Cordeiro

    2001-01-01

    Full Text Available Este artigo contextualiza as políticas aplicadas ao campo da saúde na década de 1990 a partir de dois eixos contraditórios: o mandato da Constituição Federal de 1988 e da Lei Orgânica da Saúde (LOAS de 1990; e a onda neoliberal que influenciou as reformas de Estado em toda a América Latina. O texto detalha os percursos e os percalços do setor saúde na implantação de uma agenda de descentralização fundamentada nos princípios constitucionais de universalização, eqüidade e participação cidadã. E conclui que a reforma da saúde, tal como prevista na LOAS, está se realizando com oscilações, avanços e recuos que traduzem ambigüidades, conflitos e contradições em relação às mudanças no papel do Estado brasileiro a partir da década de 1990. Ele perdeu sua capacidade de formular e implementar políticas nacionais de desenvolvimento, centrou-se no ajuste fiscal e está permeado pelas pressões da globalização do capital.This article analyzes Brazilian policies applied to the field of health in the 1990s from two contradictory angles: the mandate of the 1988 Federal Constitution and the 1990 National Health Act (LOAS on the one hand and the neoliberal wave that influenced public sector reforms throughout Latin America on the other. The paper discusses pathways and obstacles in the health sector during the implementation of a decentralization agenda based on the constitutional principles of universal access, equity, and citizens' participation. It concludes that the health reform provided for under the National Health Act is being achieved with ups and downs that express contradictions related to changes in the role of the Brazilian public sector beginning in the 1990s. The state lost its capacity to formulate and implement national development policies, focused on fiscal adjustment, and is permeated by pressure from globalization of capital.

  9. Distribuição da força de trabalho: eqüidade e negociação Workforce distribution: equity and negotiation

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    Vera Regina da Silva Miguelote

    2008-01-01

    Full Text Available A enorme desproporção na densidade de recursos humanos - existente entre os países da África e o resto do mundo - coloca a questão da eqüidade na distribuição da força de trabalho como destaque estratégico para a resolução dos problemas de saúde. Daí a relevância do tema recursos humanos na agenda política global e nas prioridades para o setor saúde. A política de captação e recrutamento por parte dos países desenvolvidos, associada à ausência de políticas claras, nos países em desenvolvimento, contribui para o aumento da migração. Algumas agências internacionais, sob a liderança da Organização Mundial da Saúde (OMS, têm-se destacado na definição ou desenvolvimento de políticas de recursos humanos em saúde (RHS. No entanto, a existência de um paradoxo entre a interdependência e a soberania dos países requer um posicionamento ético estratégico, no sentido de fortalecer as nações em suas transações comerciais. Assim, um dos desafios para a saúde global está em aproveitar o potencial de articulação oferecido pelo General Agreement on Trade in Services (GATS, para as negociações internacionais de RHS.The significant existing disproportion in the density of human resources makes the equity of human resources distribution a strategic issue for possible solutions of health problems. This can explain the importance of the human resources issue in the global health agenda and its priority for the health sector. The policy of recruitment of health workers by developed countries as well as a lack of clear policies to prevent brain drain by developing countries are contributing migration factors. Under the leadership of WHO, some international agencies have been developing and subsidizing human health resources policies. However the existing paradox between the interdependency and sovereignty of countries requires an ethical and strategic standpoint in order to strengthen nations in their commercial

  10. Avaliação comparativa entre acepromazina, detomidina e romifidina em eqüinos Comparative evaluation of acepromazine, detomidine and romifidine in horses

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    Denise Tabacchi Fantoni

    1999-03-01

    Full Text Available Os efeitos da acepromazina, detomidina e romifidina em eqüinos foram comparados, objetivando-se determinar qual o agente mais seguro e efetivo para a referida espécie animal. Foram utilizados 15 eqüinos hígidos, de ambos os sexos, idades e raças variadas e encaminhados ao setor de Cirurgia do Hospital Veterinário da FMVZ - USP. Os animais foram distribuídos em três grupos: grupo I, recebeu 0,1mg/kg de acepromazina; grupo II recebeu 20mcg/kg de detomidina e grupo III, o qual recebeu 80mcg/kg de romifidina, sendo todos os agentes administrados através da via intravenosa. Previamente à administração dos fármacos e aos 15, 30, 60 e 90 minutos, após sua aplicação, foram avaliadas a freqüência e ritmo cardíacos, freqüência respiratória, pressão arterial sistólica e diastólica, assim como foram coletadas amostras de sangue arterial para verificação do pH, pressão parcial de oxigênio e pressão parcial de dióxido de carbono. Os resultados foram submetidos à análise estatística através do teste de análise de variância (ANOVA, seguido do teste de Tukey. Não foi observada nenhuma alteração da freqüência respiratória nos grupos estudados. Verificou-se diminuição significativa dos valores da FC nos animais tratados com os agentes alfa-2 agonistas quando comparados com os valores obtidos no grupo I. Após a administração da acepromazina, observou-se diminuição significativa das pressões sistólica e diastólica em relação aos valores controle. Os animais do grupo I apresentaram valores pressóricos estatisticamente inferiores em relação aos valores obtidos nos grupos II e III. Os animais do grupo II demonstraram incremento da pressão arterial sistólica após 15 minutos da aplicação do agente, com subseqüente redução destes valores. O mesmo ocorreu no grupo III, porém, sem valor estatístico significativo. Com estes resultados, pode-se concluir que a romifidina e a detomidina promoveram altera

  11. Uso de óleo na dieta de eqüinos submetidos ao exercício Use of oil in diet of equine under exercise

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    Fernando Mattos

    2006-08-01

    Full Text Available Objetivou-se com esta pesquisa avaliar, por meio de parâmetros hematofisiológicos, o desempenho atlético de cavalos submetidos a exercícios de média intensidade alimentados com dietas suplementadas com dois níveis de óleo vegetal (250 e 500 g/dia. Foram utilizados 18 eqüinos machos, castrados, sem raça definida, com faixa etária entre 4 e 8 anos de idade e peso corporal de 456±2,90 kg. Os animais foram distribuídos em um delineamento inteiramente aleatório, em um esquema de parcela subdividida no tempo, em que os tempos de coleta constituíram a subparcela e os níveis de óleo de soja (0, 250 e 500 g/cavalo/dia, a parcela. Os cavalos receberam, durante 30 dias, 8,40; 7,95 e 7,30 kg/dia das rações contendo 0, 250 e 500 g de óleo, respectivamente, divididas em três refeições diárias. Ao final dos 30 dias, foi realizado o exercício-teste com todos os cavalos, durante 2 horas, ao trote alongado. Foram avaliados, no início e final do exercício, os teores de glicose e lactato sangüíneos, o hematócrito e a temperatura corporal. As freqüências cardíaca e respiratória foram tomadas no início, 1 e 2 horas de exercício e 15 minutos após o exercício. Verificou-se efeito da interação tempos de coleta ´ níveis de óleo na dieta sobre os teores de glicose e lactato e valores de hematócrito, temperatura corporal, freqüência cardíaca e respiratória. A adição de 250 e 500 g de óleo na dieta de eqüinos submetidos ao exercício de média intensidade proporcionou melhora no desempenho hematofisiológico e, portanto, pode resultar em melhor desempenho atlético dos cavalos. Os cavalos que consumiram óleo na proporção de 500 g/dia apresentaram melhor recuperação pós-prova, confirmada pela freqüência cardíaca e pelo hematócrito.The objective of this research was to estimate, by haematophysiological parameters, the physical performance of horses under exercise of mid intensity and fed diets with two levels of

  12. Development and implementation of a set of numerical quadratures SQ{sub N} and EQ{sub N} type in the transport code AZTRAN; Desarrollo e implementacion de un conjunto de cuadraturas numericas de tipo SQ{sub N} y EQ{sub N} en el codigo de transporte AZTRAN

    Energy Technology Data Exchange (ETDEWEB)

    Chepe P, M. [Universidad Autonoma Metropolitana, Unidad Iztapalapa, San Rafael Atlixco 186, Col. Vicentina, 09340 Ciudad de Mexico (Mexico); Xolocostli M, J. V.; Gomez T, A. M. [ININ, Carretera Mexico-Toluca s/n, 52750 Ocoyoacac, Estado de Mexico (Mexico); Del Valle G, E., E-mail: liaison.web@gmail.com [IPN, Escuela Superior de Fisica y Matematicas, Av. IPN s/n, Col. Lindavista, 07738 Ciudad de Mexico (Mexico)

    2015-09-15

    The deterministic transport codes for analysis of nuclear reactors have been used for several years already, these codes have evolved in terms of the methodology used and the degree of accuracy, because at the present time has more computer power. In this paper, the transport code used considers the classical technique of multi-group for discretization energy, for space discretization uses the nodal methods, while for the angular discretization the discrete ordinates method is used; so that presents the development and implementation of a set of numerical quadratures of SQ{sub N} type symmetrical with the same weight for each angular direction and these are compared with the quadratures of EQ{sub N} type. The two sets of numerical quadratures were implemented in the program AZTRAN to a problem with isotropic medium in XYZ geometry, in steady state using the nodal method RTN-0 (Raviart-Thomas-Nedelec). The analyzed results correspond to the effective multiplication factor k{sub eff} and neutron angular flux with approximations from S{sub 4} to S{sub 16}. (Author)

  13. Análise da eqüidade e da eficiência dos estados no contexto do federalismo fiscal brasileiro

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    Celso Vila Nova de Souza Júnior

    2006-12-01

    Full Text Available O artigo avalia em que medida o Fundo de Participação dos Estados (FPE atende aos objetivos redistributivos traçados pela Constituição Federal bem como o seu impacto sobre a eficiência da gestão pública. Emprega-se a Análise de Componentes Principais (ACP e a Análise de Envoltória de Dados (DEA para estimar a eficiência relativa dos 27 Estados brasileiros em três etapas. Na primeira, constrói-se uma fronteira de melhor disponibilidade de serviços para avaliar a eqüidade distributiva entre os Estados. Em seguida, uma função custo é usada para se obter um índice de eficiência dos gastos públicos. Na terceira etapa estima-se uma fronteira que descreve a eficiência arrecadatória. Mediante a integração dessas três análises obtém-se o nível ótimo de transferências do FPE. Os resultados mostram que a região Sul apresentou a melhor disponibilidade de serviços e a maior eficiência no uso dos recursos. No extremo oposto encontra-se o Nordeste, onde há fortes carências e também grande desperdício. Quanto ao esforço de arrecadação, não se evidenciaram perdas tributárias acentuadas. O estudo conclui que todos os Estados necessitam de complementação de verbas, mas constata distorções presentes no atual critério.This article evaluates whether the State Participation Fund (FPE achieves the redistributive goals established by the Federal Constitution, as well as its impact on public administration efficiency. We use Principal Component Analysis (PCA and Data Envelopment Analysis (DEA in order to estimate the relative efficiency of the 27 Brazilian states in three steps. First, we build an optimal public service supply frontier in order to evaluate the distributive equity among states. Then, we use a cost function to obtain a public expenditure efficiency index. Third, we estimate a frontier that describes tax revenue efficiency. Integrating these three analyses, we obtain the optimal level of transfers from the

  14. Performance of PROMIS Physical Function Compared with KOOS, SF-36, Eq5d And Marx Activity Scale in Patients Who Undergo ACL Reconstruction

    Science.gov (United States)

    Scott, Elizabeth; Glass, Natalie; Wolf, Brian R.; Hettrich, Carolyn M.; Bollier, Matthew

    2018-01-01

    Objectives: Anterior cruciate ligament reconstruction is a commonly performed orthopaedic procedure. PROMIS (Patient-Reported Outcome Measurement Information System) was developed by the National Institutes of Health in an effort to advance patient-reported outcome (PRO) instruments by developing question banks for major health domains. Our goal was to compare the responsiveness and construct validity of the PROMIS physical function (PF) computer adaptive test (CAT) with current PRO instruments utilized in patients who undergo anterior cruciate ligament reconstruction. Methods: A total of 174 patients ages 14-53 scheduled to undergo anterior cruciate ligament reconstruction were asked to complete PROMIS PF-CAT, Short Form-36 Health Survey (SF36-PF and -GH), Marx activity rating scale (Marx), Knee Injury and Osteoarthritis Score (KOOS-ADL, -Sport, -QOL), and the EuroQol five dimensions questionnaire (EQ5D) at their preoperative visit. These surveys were repeated at six weeks and six months after surgery. Correlations between PRO instruments was defined as excellent (>0.7), excellent-good (0.61-0.7), good (0.4-0.6), and poor (0.2-0.3) using Spearman Correlation Coefficients. The effect size (Cohen d) and standardized response mean (SRM) were used to describe the responsiveness of each PRO at the 6 week and 6 month follow-up visits and were defined as small (0.2), medium (0.5) and large (0.8). Ceiling and floor effects were defined as present if ≥15% of participants scored the highest or lowest score on a PRO, respectively. Subgroup analyses were performed comparing change in PRO scores at follow-up between participants with and without additional arthroscopic procedures (meniscal debridement and/or repair, microfracture, or OATS vs ACL reconstruction only) using linear mixed models. Results: There were excellent and excellent-good correlations between the PROMIS PF-CAT and physical function PROs including the SF36-PF (r=0.75-0.80, p0.05) to poor correlation with

  15. Formação e estrutura populacional do eqüino Brasileiro de Hipismo Formation and population structure of the Brasileiro de Hipismo horse breed

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    I.M.G. Dias

    2000-12-01

    Full Text Available Analisaram-se dados do Stud Book Brasileiro do Cavalo de Hipismo, da Associação Brasileira de Criadores do Cavalo de Hipismo (ABCCH, correspondentes a julho de 1977 a setembro de 1998. O arquivo final continha 19.303 eqüinos, 11.508 da raça Brasileira de Hipismo (BH e 7.795 de raças formadoras. Distribuição de freqüência, medidas de tendência central e de dispersão por criador, proprietário, sexo, tipo de registro, estado do nascimento, raça formadora, cruzamento utilizado na formação e coeficiente de endogamia foram estabelecidas para os efetivos da raça BH. Foram também calculados número da geração de cada animal, intervalo de gerações (anos e tamanho efetivo da população (Ne. Vinte raças foram utilizadas na formação do BH, sendo as principais: BH (22,5%, animais sem genealogia conhecida (21,9%, PSI (15,0%, Hanoverana (8,1%, Westfalen (5,2%, Holsteiner (4,8% e Trakehner (4,1%. Registros foram feitos em 14 estados da Federação, 76% deles em São Paulo. Número máximo de gerações encontrado foi de 3,12 (um animal, 59,7% dos animais na geração base e 24,1% na geração 1,5. O intervalo médio de gerações foi de 9,9 anos, 10,4 para garanhões e 9,3 para éguas. O Ne foi de 253 animais e os coeficientes de endogamia observado e esperado foram próximos de zero.Data from Brasileiro de Hipismo Stud Book, collected by the breed Association (ABCCH, from July 1977 to September 1998 were analyzed. Final data set included 19,303 animals, 11,508 Brasileiro de Hipismo (BH and 7,795 of other foundation breeds. Data were analyzed for frequency, central tendency and range of variation according to owner, breeder, sex, type of registration, county and state of birth and foundation breeds. The frequency of crosses using foundation breeds and inbreeding coefficient according to year of birth and sex were estimated. Generation number for each animal, generation interval and effective population size (Ne were calculated. Among

  16. Analyzing Health-Related Quality of Life Data to Estimate Parameters for Cost-Effectiveness Models: An Example Using Longitudinal EQ-5D Data from the SHIFT Randomized Controlled Trial.

    Science.gov (United States)

    Griffiths, Alison; Paracha, Noman; Davies, Andrew; Branscombe, Neil; Cowie, Martin R; Sculpher, Mark

    2017-03-01

    The aim of this article is to discuss methods used to analyze health-related quality of life (HRQoL) data from randomized controlled trials (RCTs) for decision analytic models. The analysis presented in this paper was used to provide HRQoL data for the ivabradine health technology assessment (HTA) submission in chronic heart failure. We have used a large, longitudinal EuroQol five-dimension questionnaire (EQ-5D) dataset from the Systolic Heart Failure Treatment with the I f Inhibitor Ivabradine Trial (SHIFT) (clinicaltrials.gov: NCT02441218) to illustrate issues and methods. HRQoL weights (utility values) were estimated from a mixed regression model developed using SHIFT EQ-5D data (n = 5313 patients). The regression model was used to predict HRQoL outcomes according to treatment, patient characteristics, and key clinical outcomes for patients with a heart rate ≥75 bpm. Ivabradine was associated with an HRQoL weight gain of 0.01. HRQoL weights differed according to New York Heart Association (NYHA) class (NYHA I-IV, no hospitalization: standard care 0.82-0.46; ivabradine 0.84-0.47). A reduction in HRQoL weight was associated with hospitalizations within 30 days of an HRQoL assessment visit, with this reduction varying by NYHA class [-0.07 (NYHA I) to -0.21 (NYHA IV)]. The mixed model explained variation in EQ-5D data according to key clinical outcomes and patient characteristics, providing essential information for long-term predictions of patient HRQoL in the cost-effectiveness model. This model was also used to estimate the loss in HRQoL associated with hospitalizations. In SHIFT many hospitalizations did not occur close to EQ-5D visits; hence, any temporary changes in HRQoL associated with such events would not be captured fully in observed RCT evidence, but could be predicted in our cost-effectiveness analysis using the mixed model. Given the large reduction in hospitalizations associated with ivabradine this was an important feature of the analysis. The

  17. Eqüidade na legislação: um princípio do sistema de saúde brasileiro? Equity in law: a Brazilian health system's principle?

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    Cristina Maria Rabelais Duarte

    2000-01-01

    Full Text Available Este artigo procura delinear a concepção inerente à legislação brasileira e apontar possíveis conseqüências da reforma do setor proposta pelo atual governo. Após uma abordagem conceitual do termo eqüidade, os textos da Constituição Federal e Leis Complementares são avaliados. Em seguida, assumindo que os mecanismos de repasse de verbas do governo federal para os municípios funcionam como instrumentos de redistribuição - ou não - de recursos, são analisados aqueles implementados pelas Normas Operacionais Básicas, considerando sua capacidade de promoção de eqüidade. Uma visão panorâmica das propostas de reforma do sistema de saúde atualmente em debate e do papel desempenhado pelo setor privado de assistência é proporcionada, procurando-se enfatizar suas implicações sobre a eqüidade. À guisa de conclusão, resgata-se que as profundas desigualdades sociais existentes no Brasil exigem políticas pautadas em princípios de solidariedade e eqüidade. Neste sentido, a Constituição e Leis Orgânicas são avançadas e a normatização atual, embora ainda distante de concretizar os ditames constitucionais, apresenta progressos nesta direção.This article intends to delineate the definition accept in Brazilian legislation and put in question possible results of the setorial reform suggest by actual government. After a conceptual approach, the Magna Charta and Complementary Laws are analyzed. Following, assuming that the budget repass from federal to municipality government are instruments - or not - of redistribution, those mechanisms implemented by "Normas Operacionais Básicas" are analyzed, considering their capacity of promote equity. A panoramic view about reform health system reform proposes and the role of health private sector emphasizes the implications on equity. In conclusions, it's indicated that the extent of social inequalities in Brazil demand politics engaged with solidarity and equity. The Magna Charta and

  18. Development of a Web-Based Clinical Decision Support System for Drug Prescription: Non-Interventional Naturalistic Description of the Antipsychotic Prescription Patterns in 4345 Outpatients and Future Applications.

    Science.gov (United States)

    Berrouiguet, Sofian; Barrigón, Maria Luisa; Brandt, Sara A; Ovejero-García, Santiago; Álvarez-García, Raquel; Carballo, Juan Jose; Lenca, Philippe; Courtet, Philippe; Baca-García, Enrique

    2016-01-01

    The emergence of electronic prescribing devices with clinical decision support systems (CDSS) is able to significantly improve management pharmacological treatments. We developed a web application available on smartphones in order to help clinicians monitor prescription and further propose CDSS. A web application (www.MEmind.net) was developed to assess patients and collect data regarding gender, age, diagnosis and treatment. We analyzed antipsychotic prescriptions in 4345 patients attended in five Psychiatric Community Mental Health Centers from June 2014 to October 2014. The web-application reported average daily dose prescribed for antipsychotics, prescribed daily dose (PDD), and the PDD to defined daily dose (DDD) ratio. The MEmind web-application reported that antipsychotics were used in 1116 patients out of the total sample, mostly in 486 (44%) patients with schizophrenia related disorders but also in other diagnoses. Second generation antipsychotics (quetiapine, aripiprazole and long-acting paliperidone) were preferably employed. Low doses were more frequently used than high doses. Long acting paliperidone and ziprasidone however, were the only two antipsychotics used at excessive dosing. Antipsychotic polypharmacy was used in 287 (26%) patients with classic depot drugs, clotiapine, amisulpride and clozapine. In this study we describe the first step of the development of a web application that is able to make polypharmacy, high dose usage and off label usage of antipsychotics visible to clinicians. Current development of the MEmind web application may help to improve prescription security via momentary feedback of prescription and clinical decision support system.

  19. Design of a long-term antipsychotic in situ forming implant and its release control method and mechanism.

    Science.gov (United States)

    Wang, Lexi; Wang, Aiping; Zhao, Xiaolei; Liu, Ximing; Wang, Dan; Sun, Fengying; Li, Youxin

    2012-05-10

    Two kinds of in situ forming implants (ISFIs) of atypical antipsychotics, risperidone and its 9-hydroxy active metabolite, paliperidone, using poly(lactide-co-glycolide)(PLGA) as carrier, were investigated. Significant difference was observed in the solution-gel transition mechanism of the two systems: homogeneous system of N-methyl-2-pyrrolidone (NMP) ISFI, in which drug was dissolved, and heterogeneous system of dimethyl sulfoxide (DMSO) ISFI, in which drug was dispersed. Fast solvent extractions were found in both systems, but in comparison with the high drug release rate from homogeneous system of drug/polymer/NMP, a fast solvent extraction from the heterogeneous system of drug/polymer/DMSO was not accompanied by a high drug release rate but a rapid solidification of the implant, which resulted in a high drug retention, well-controlled initial burst and slow release of the drug. In vivo study on beagle dogs showed a more than 3-week sustained release with limited initial burst. Pharmacologic evaluation on optimized paliperidone ISFIs presented a sustained-suppressing effect from 1 day to 38 day on the MK-801 induced schizophrenic behavior mice model. A long sustained-release antipsychotic ISFI of 50% drug loading and controlled burst release was achieved, which indicated a good potential in clinic application. Copyright © 2012 Elsevier B.V. All rights reserved.

  20. Development of a Medication Monitoring System for an Integrated Multidisciplinary Program of Assertive Community Treatment (IMPACT Team

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    Nicole B. Washington, DO, Assistant Professor

    2012-01-01

    Full Text Available Purpose: The primary goal was to improve medication management oversight for a severely mentally ill (SMI community-based population by developing a medication monitoring system based on current guidelines to optimize pharmacotherapy and minimize potential medication-related adverse effects. The secondary goal was improvement in coordination of care between healthcare providers. Methods: Guidelines for medication used for psychiatric indications were reviewed. A database of medication for psychiatric indications with monitoring recommendation was developed. Results: Medication regimens for 68 members of the Integrated Multidisciplinary Program of Assertive Community Treatment (IMPACT program qualified for review. Fourteen medications, carbamazepine, chlorpromazine, clozapine, fluphenazine and fluphenazine long-acting injections (LAI, haloperidol and haloperidol LAI, lithium, lurasidone, olanzapine, paliperidone and paliperidone LAI, perphenazine, quetiapine, risperidone and risperidone LAI, valproic acid/divalproex, and ziprasidone, were identified. In total, 111 medications are used on a monthly basis. Each member receives more than one medication qualifying for review. Additional monitoring parameters that were evaluated included changes in laboratory orders for members with insulin-dependent diabetes. Annual lipid panels were changed to every 6 months, if applicable. Conclusions and Future Directions: This medication monitoring program was developed to help ensure IMPACT members receive the most effective care and minimize potential medication-related adverse effects. The secondary goal was to improve coordination of care. Medication monitoring will be added as a continuous quality assurance measure. Lab results will be reviewed at least monthly. The medication monitoring program will be evaluated annually.

  1. Concentrações sangüíneas de lactato em eqüinos durante a prova de fundo do concurso completo de equitação

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    Gomide Lina Maria Wehrle

    2006-01-01

    Full Text Available Colheu-se sangue de 13 eqüinos competindo na prova de Fundo do Concurso Completo de Equitação, categoria internacional três estrelas, e dosou-se lactato sangüíneo na manhã antes da prova, antes e imediatamente depois das fases B e D e 10 minutos após a fase D. Foi observado aumento significativo nas concentrações de lactato apenas após o término da fase D, demonstrando que os animais foram submetidos a um grande esforço físico, com desenvolvimento de acidose metabólica decorrente do acúmulo de lactato. Houve diminuição significativa dos valores dez minutos após o término do cross-country, exceto para o eqüino de número 12, único animal a completar o percurso dentro do tempo estipulado, o qual apresentou sinais clínicos de exaustão.

  2. Health related quality of life and comorbidity. A descriptive analysis comparing EQ-5D dimensions of patients in the German disease management program for type 2 diabetes and patients in routine care.

    Science.gov (United States)

    Ose, Dominik; Miksch, Antje; Urban, Elisabeth; Natanzon, Iris; Szecsenyi, Joachim; Kunz, Cornelia Ursula; Freund, Tobias

    2011-08-02

    The co-occurance of multiple medical conditions has a negative impact on health related quality of life (HRQoL) for patients with type 2 diabetes. These patients demand for intensified care programs. Participation in a disease management program (DMP) for type 2 diabetes has shown to counterbalance this effect. However, it remains unclear which dimensions of HRQoL are influenced by the DMP. The aim of this study was to explore the HRQoL dimensions of patients with type 2 diabetes in the German DMP and patients in routine care (RC). This analysis is part of a comparative evaluation of the German DMP for patients with type 2 diabetes. A questionnaire, including the HRQoL measure EQ-5D, was mailed to a random sample of 3,546 patients with type 2 diabetes (59.3% female). The EQ-5D dimensions were analyzed by grouping patients according to their participation in the German DMP for diabetes into DMP and RC. Compared to patients in DMP, patients in RC reported more problems for the dimensions mobility (P German DMP for type 2 diabetes mellitus show significantly higher ratings of their HRQoL in the dimensions mobility, self care and performing usual activities compared to patients in RC. This difference can also be observed in patients with significant comorbidities. As these dimensions are known to be essential for diabetes care, the German DMP may contribute to improved care even for comorbid diabetes patients.

  3. Fraturas odontomaxilares e mandibulares em eqüídeos tratados por diferentes técnicas de osteossíntese Odontomaxillares and mandibularies fractures in equides treated with different osteosynthesis techniques

    Directory of Open Access Journals (Sweden)

    G.E.S. Alves

    2008-12-01

    Full Text Available Oito eqüinos e um muar com fraturas odontomaxilares e mandibulares foram tratados com diferentes técnicas de osteossíntese modificadas, consistindo de cerclagens associadas ou não a bandas de tensão, placa de neutralização e pino intraosseo, sendo este aplicado com metodologia não encontrada na literatura consultada. Os procedimentos cirúrgicos nos eqüideos foram realizados com os animais em estação mediante contenção física, em brete, e química, com sedação ou neuroleptoanalgesia associada a bloqueios anestésicos regionais. Os animais apresentaram capacidade de mastigação e ingestão voluntária no pós-operatório imediato e recuperação óssea adequada.Eight equines and one mule with odontomaxillaries and mandibularies fractures were treated with different osteosynthesis modified techniques, consisting of cerclages with or without tension bands, neutralization plates, and intraosseous pin applied by a methodology which was not found in the literature. The surgery procedures in equides were performed with the animals in stand position under physical contention, sedation, or neuroleptoanalgesy and regional nerve block. All animals were able to eat voluntarily in the immediate post-operatory time and had good bone recuperation.

  4. HUBUNGAN ANTARA KECERDASAN EMOSIONAL (EQ DAN MOTIVASI BELAJAR DENGAN PERILAKU BELAJAR SISWA MATA PELAJARAN PENDIDIKAN AGAMA ISLAM (PAI DI SMPN 01 JENANGAN PONOROGO

    Directory of Open Access Journals (Sweden)

    Putri Wahyuningttyas

    2016-03-01

    لإسلامية في المدرسة الثانوية العامة الحكومية  (1 جناعان فونوروغو وعدده 0,823.   Keywords: Kecerdasan Emosional (EQ, motivasi belajar, perilaku belajar

  5. Queilite angular traumática em eqüinos associada à ingestão de Panicum maximum Angular cheilitis in horses associated with ingestion of Panicum maximum

    Directory of Open Access Journals (Sweden)

    José Diomedes Barbosa

    2009-05-01

    Full Text Available Uma condição com aumento da fenda bucal de eqüinos por lesão na comissura labial foi estudada. Este aumento tinha extensão variável e era uni ou bilateral. Na mucosa da bochecha da comissura labial exposta havia pequenas erosões. Durante a mastigação havia perda de pequena quantidade de capim e saliva pela fenda bucal aumentada. Os animais apresentavam bom estado nutricional. O exame histopatológico de tecido retirado da comissura labial revelou epidermite superficial. Nas quatro propriedades onde se verificou o problema, constatou-se que os eqüinos eram mantidos em sistema extensivo de criação em pastagem de Panicum maximum (variedades Tanzânia, Mombaça, Tobiatã e Colonião, com folhas maduras, altas, lignificadas e de bordos cortantes. De acordo com os dados epidemiológicos, com os achados clínicos e histopatológicos, concluí-se que essas lesões foram causadas pela ação cortante das folhas de Panicum maximum, associada à forma de apreensão da pastagem alta e mastigação pelos eqüinos.A condition with enlargement of the oral cleft in horses was studied. The enlargement of varied extension was uni or bilateral. The cheek mucosa of the labial commissure showed slight erosions. During chewing there was loss of small amounts of grass and saliva through the oral cleft. The affected horses were in good nutritional condition. Histopathological studies of tissues obtained by biopsia, revealed a superficial epidermitis. The pastures consisted of Panicum maximum grass (varieties Tanzânia, Mombaça, Tobiatã and Colonião which was mature, tall, lignified, with leaves of cutting edges. Based on epidemiological, clinical and histopathological data, it was concluded that the lesions were caused by the hard grass, favored by the way horses pull the tall grass and chew it.

  6. Judicialização da política pública de assistência farmacêutica e eqüidade "Judicialization" of public health policy for distribution of medicines

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    Ana Luiza Chieffi

    2009-08-01

    Full Text Available O fornecimento de medicamentos por ação judicial, pela Secretaria de Estado da Saúde de São Paulo (SES-SP, tornou-se uma prática rotineira e cada vez mais freqüente. A judicialização do sistema de saúde entra em confronto com princípios básicos do SUS, como o da eqüidade. Este trabalho caracterizou as demandas judiciais para obtenção de medicamentos sob a ótica da judicialização da política pública e da quebra do princípio da eqüidade na dimensão coletiva. O estudo é um trabalho descritivo dos processos judiciais de solicitação de medicamentos à SES-SP relacionados no Sistema de Controle Jurídico (SCJ no ano 2006. A maioria das ações analisadas foi ajuizada por advogados particulares; 47% dos pacientes possuíam receitas da rede privada e cerca de 73% dos processos foram provenientes de pacientes residentes nos três estratos de menor vulnerabilidade social do Município de São Paulo, Brasil. Os dados demonstram que essas demandas judiciais não respeitam princípios do SUS como o da eqüidade, privilegiando indivíduos com melhor poder aquisitivo e com acesso à informação.The supply of medicines in response to court orders or injunctions has become a common practice in the State of São Paulo, Brazil. This "judicialization" of the health system clashes with basic principles of the Brazilian Unified National Health System (SUS, such as equal opportunity to access health services. The aim of this paper is to analyze the legal action used to obtain medicines through the São Paulo State Health Department, from two main angles: judicialization of public policies and breach of the equity principle. This is a descriptive study of legal action taken to obtain medicines through the São State Health Department, as listed in the Electronic Court Docket System for the year 2006. Most cases were filed through private attorneys; 47% of the patients had obtained their prescriptions through private care; and 73% of the cases

  7. Eqüidade na gestão descentralizada do SUS: desafios para a redução de desigualdades em saúde Equity in decentralized management of the SUS: reducing health inequalities - the challenges

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    Patrícia T. R. Lucchese

    2003-01-01

    Full Text Available O tema da eqüidade em saúde vem ganhando destaque no debate público setorial como objetivo a se alcançar na gestão descentralizada do Sistema Único de Saúde para a efetiva melhoria das condições de saúde do conjunto da população brasileira em todo o território nacional. Este debate, já bastante difícil pela necessidade de se precisar o conceito de eqüidade, evidencia a complexidade do ambiente em que se processam as tarefas públicas para a redução de desigualdades inter-regionais, no contexto de interação e interdependência entre processos econômicos, sociais e culturais, mundiais e nacionais, que pressionam as agendas governamentais nestes tempos de globalização. Este artigo empreende um esforço de sistematização de alguns dos desafios e indagações colocados para uma gestão pública da saúde orientada à eqüidade na República Federativa do Brasil, a partir de uma interpretação própria para o conceito de eqüidade na gestão descentralizada do SUS, da atualização de algumas proposições para a gestão social em discussão no debate internacional sobre o desenvolvimento, e da revisão da contribuição teórica de alguns autores sobre a ação do Estado neste ambiente heterogêneo e contraditório de grandes mutações.In public debate on the health sector, the subject of health equity has come to prominence as a goal to be achieved in decentralising the Unified Health System (SUS in order to improve health conditions throughout Brazil for the population as a whole. The debate is already considerably complicated by the need for a precise definition of the concept of equity, evidencing the complexity of the environment in which the public task of reducing inter-regional inequalities is to be performed in a context of interaction and interdependence among world and national economic, social and cultural processes, which pressure government agendas in these times of globalisation. On the basis of (1 a specific

  8. Anestesia por isofluorano em eqüinos submetidos à infusão contínua de medetomidina ou xilazina Isoflurane anesthesia in horses during medetomidine or xilazine continuous infusion

    OpenAIRE

    Renata Gebara Sampaio Dória; Carlos Augusto Araújo Valadão; Paulo Aléscio Canola; Érica Cristina Bueno do Prado Guirro; Marina Ceccato Mendes; André Escobar; Gesiane Ribeiro; Cláudio Côrrea Natalini

    2009-01-01

    Avaliaram-se oito eqüinos sob anestesia geral inalatória com isofluorano (1CAM) e infusão contínua de xilazina (0,35mg kg-1h-1) ou medetomidina (3,5µg kg-1h-1), em relação à freqüência cardíaca, ritmo cardíaco, freqüência respiratória, pressão arterial, hemogasometria arterial e temperatura, nos tempos T0 (imediatamente antes do início da infusão contínua) e T10 ao T60 (intervalos de 10 minutos, após início da infusão contínua). Houve redução da freqüência cardíaca e da temperatura e el...

  9. Doença vestibular periférica decorrente de osteoartropatia temporoioídea em um eqüino Peripheral vestibular disease associated with temporohyoid osteoarthropathy in a horse

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    Alexandre Secorun Borges

    2003-06-01

    Full Text Available Um eqüino com 22 anos de idade apresentou síndrome vestibular periférica associada à paralisia de nervo facial esquerdo devido à osteoartropatia temporoioídea. O exame endoscópico das bolsas guturais mostrou alteração de contorno da bula timpânica esquerda e aumento de volume da extremidade proximal do osso estiloióide do mesmo lado.A 22-year-old gelding showed vestibular syndrome associated with left facial nerve paralysis due to temporohyoid osteoarthropathy and the diagnostic was confirmed by guttural pouch endoscopic examination. The exam revealed abnormal contour of the left tympanic bulla and an enlargement of the proximal part of the left stylohyoid bone.

  10. Tratamento da compactação experimental do cólon maior em eqüinos: resultados de laboratório e exames bioquímicos

    OpenAIRE

    Alves,G.E.S.; Ribeiro Filho,J.D.; Oliveira,H.P.; Abreu,J.M.G.

    2005-01-01

    Avaliou-se ação da solução isotônica poliônica enteral da sene mais fluidoterapia intravenosa e da fluidoterapia intravenosa no tratamento da compactação no cólon maior em eqüinos. Foram utilizados 20 animais divididos em quatro grupos. Os animais dos grupos tratados eram portadores de compactação no cólon maior induzida experimentalmente. O grupo C, controle, não foi tratado, o grupo E8 foi tratado com solução isotônica poliônica enteral (8ml/kg/hora/48horas), o grupo SE recebeu sene (20mg/k...

  11. Observações clínicas, anatomopatológicas e tratamento de seis casos de dermovilite exsudativa vegetante crônica (cancro da ranilha de eqüinos

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    Lacerda Neto J.C.

    2001-01-01

    Full Text Available Relataram-se oito casos de dermovilite exsudativa vegetante crônica em seis eqüinos de diferentes raças, com idades entre 14 meses e 19 anos. A lesão iniciava-se pelo aparecimento de um tecido podofiloso infiltrativo na região da ranilha e da sola do casco, caracterizado por crescimento rápido e desordenado, de aspecto papiliforme, de coloração esbranquiçada na raiz e escura nas pontas, com secreção necrótica de odor extremamente fétido. Microscopicamente, observou-se a presença de exuberante tecido epidérmico proliferativo, entremeado por escasso tecido conjuntivo. Bactérias gram negativas, associadas à má higiene e umidade, estão incluídas entre os fatores etiológicos, porém prescindem de confirmação científica. Os eqüinos foram divididos em dois grupos de tratamento. No primeiro grupo, constituído de três éguas jovens e um potro, portando lesões em apenas um membro, realizou-se inicialmente remoção cirúrgica da massa invasiva, seguida de cauterização das bordas restantes e posterior aplicação, diária, local de substâncias anti-sépticas. Em três desses pacientes ocorreram recidivas da lesão inicial, com rápido crescimento de tecido hiperplásico, atingindo quase toda a ranilha e metade da sola. Dois animais desenvolveram deformidades do casco, denominadas encastelamento. O segundo grupo, constituído por um macho e uma fêmea, com lesões em dois membros, após o debridamento cirúrgico do tecido, receberam aplicações diárias de ácido pícrico a 5%, associado ao uso local de oxitetraciclina. Embora um desses casos tenha requerido uma segunda intervenção cirúrgica para remoção da massa, os eqüinos apresentaram após um período de dois a três meses total desaparecimento do tecido infiltrativo. A utilização de ácido pícrico a 5% e oxitetraciclina local associada ao debridamento cirúrgico prévio mostrou-se mais eficiente que a utilização de substâncias anti-sépticas no tratamento da

  12. Hemogasometria de eqüinos submetidos à obstrução experimental do duodeno, íleo e cólon maior Blood gas analysis of horses submitted to experimental obstruction of duodenum, ileum and large colon

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    Paula Alessandra Di Filippo

    2009-02-01

    Full Text Available Visando estudar os parâmetros do equilíbrio ácido-base de eqüinos submetidos a um modelo experimental de obstrução intestinal, 24 animais foram distribuídos em quatro grupos, controle instrumentado (GI, obstrução do duodeno (GII, íleo (GIII e cólon maior (GIV. As amostras de sangue venoso foram coletadas antes das cirurgias (T0, durante as obstruções (T30ob-T180ob e após as desobstruções (T60des-T180des. Os eqüinos do GIV, no T30ob, e os eqüinos do GII, nos T60ob, T90ob e T120ob, apresentaram aumento do pH(v, da cHCO-3(vP e da cBase(v que, acrescidos do aumento da pCO2(v e da ctCO2(v, caracterizou a alcalose metabólica com compensação respiratória. Nos T90ob e T120ob, nos animais do GII, e no T180ob, nos animais do GIII, a pO2(v e a sO2(v tiveram comportamento semelhante. Os valores baixos apresentados pelos animais do GII foram associados à hipercapnia ou à hipoventilação, desencadeadas para a correção da alcalose metabólica. Entretanto, a hipoxemia apresentada pelos animais do GIII foi associada à hipovolemia presente neste período. As alterações ácido-base observadas constituem-se de alterações leves e temporárias, as quais não são capazes de predizer o diagnóstico das obstruções intestinais específicas em eqüinos com cólica. Entretanto, por relacionarem-se diretamente com a precocidade do distúrbio gastrintestinal, elas auxiliam o pesquisador no prognóstico.This study aimed to evaluate parameters of acid-base balance in horses submitted to an experimental model of intestinal obstruction. Twenty-four animals were divided in four groups: instrumented control (GI, duodenum obstruction (GII, ileum obstruction (GIII and large colon obstruction (GIV. Venous blood samples were collected before surgery (T0, during the obstruction (T30ob-T180ob and after unblocking procedures (T60des-T180des. Animals from GIV, at T30ob and animals from GII, at T60ob, T90ob and T120ob, presented higher values for pH(v, c

  13. Ocorrência de Trypanosoma evansi em eqüinos no município de Cruz Alta, RS, Brasil Occurrence of Trypanosoma evansi in equines in Cruz Alta, RS, Brazil

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    Régis Adriel Zanette

    2008-08-01

    Full Text Available O objetivo deste trabalho foi relatar a ocorrência de Trypanosoma evansi em eqüinos no município de Cruz Alta, Estado do Rio Grande do Sul, abordando aspectos epidemiológicos e sinais clínicos da infecção. A tripanosomose ocorreu em uma propriedade rural no município de Cruz Alta. Ao exame clínico, observou-se que quatro dos animais apresentavam marcha oscilante, com incoordenação dos membros posteriores. No entanto, eles estavam em bom estado nutricional, sem febre, bem hidratados e alimentavam-se normalmente. Foram coletadas amostras de sangue das éguas para hemograma, sendo identificado aumento das proteínas plasmáticas, leucocitose, eosinofilia e linfocitose em animais com sinais clínicos. No esfregaço sangüíneo periférico, observou-se a forma flagelada do T. evansi em três dos eqüinos.This study aimed at describing the occurrence of Trypanosoma evansi in equines from the city of Cruz Alta, RS, Brazil, relating epidemiological aspects and clinical signs of the infection. The tripanosomiasis occurred in a rural area of Cruz Alta, RS. Clinical signs presented by four animals were stiff and incoordinated gait of the pelvic members, although they were in good nutritional status, without fever, well-hydrated and eating normally. Blood samples were collected from the mares for hemogram. Increased levels of plasmatic proteins, leukocytosis, eosinophilia, and limphocytosis were observed in animals with clinical signs. Flagellated forms of T. evansi were observed in the blood smear of three animals.

  14. A non-linear beta-binomial regression model for mapping EORTC QLQ- C30 to the EQ-5D-3L in lung cancer patients: a comparison with existing approaches.

    Science.gov (United States)

    Khan, Iftekhar; Morris, Stephen

    2014-11-12

    The performance of the Beta Binomial (BB) model is compared with several existing models for mapping the EORTC QLQ-C30 (QLQ-C30) on to the EQ-5D-3L using data from lung cancer trials. Data from 2 separate non small cell lung cancer clinical trials (TOPICAL and SOCCAR) are used to develop and validate the BB model. Comparisons with Linear, TOBIT, Quantile, Quadratic and CLAD models are carried out. The mean prediction error, R(2), proportion predicted outside the valid range, clinical interpretation of coefficients, model fit and estimation of Quality Adjusted Life Years (QALY) are reported and compared. Monte-Carlo simulation is also used. The Beta-Binomial regression model performed 'best' among all models. For TOPICAL and SOCCAR trials, respectively, residual mean square error (RMSE) was 0.09 and 0.11; R(2) was 0.75 and 0.71; observed vs. predicted means were 0.612 vs. 0.608 and 0.750 vs. 0.749. Mean difference in QALY's (observed vs. predicted) were 0.051 vs. 0.053 and 0.164 vs. 0.162 for TOPICAL and SOCCAR respectively. Models tested on independent data show simulated 95% confidence from the BB model containing the observed mean more often (77% and 59% for TOPICAL and SOCCAR respectively) compared to the other models. All algorithms over-predict at poorer health states but the BB model was relatively better, particularly for the SOCCAR data. The BB model may offer superior predictive properties amongst mapping algorithms considered and may be more useful when predicting EQ-5D-3L at poorer health states. We recommend the algorithm derived from the TOPICAL data due to better predictive properties and less uncertainty.

  15. Anti-Sarcocystis neurona immunostaining associated with equine protozoal myeloencephalitis in Brazil Imunomarcação de Sarcocystis neurona associada com um caso de mieloencefalite protozoária eqüina no Brasil

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    Tatiane Alves da Paixão

    2007-12-01

    Full Text Available A retrospective study (1942 to 2005 of histopathological lesions included samples of central nervous system (SNC from 203 animals in the Equidae family. A total of 42.4% of these samples had significant pathological changes, which were classified as inflammatory (62.8%, degenerative (25.6%, circulatory (10.5%, and neoplasic (1.1% lesions. Immunohistochemistry anti-Sarcocystis neurona antigens was performed in all the cases with inflammatory changes (54, of which one of the case of encephalitis resulted positive to immunostaining. Although evidence of EPM (Equine Protozoal Myeloencephalitis has been previously reported in Brazil, to the best of our knowledge, this is the first report in which characteristic EPM lesion was associated with anti-S. neurona immunostaining in Brazil.Em um estudo retrospectivo (de 1942 a 2005, amostras do sistema nervoso central de 203 eqüídeos foram avaliadas para a presença de alterações histológicas. Dessas amostras, 42,4% apresentaram alguma lesão histopatológica significativa, das quais foram classificadas como alterações inflamatórias (62,8%, degenerativas (25,6%, circulatórias (10,5% e neoplásicas (1,1%. Fragmentos de SNC dos 54 animais com alterações inflamatórias foram avaliados para detecção de antígenos de Sarocystis neurona pela técnica de imunoistoquímica, que foi positiva em um caso de encefalite em eqüino. Embora haja registros de MPE no Brasil, este é o primeiro caso confirmado imunoistoquimicamente.

  16. Surgical Repair of an Olecranon Fracture in a Horse / Reparação Cirúrgica de Fratura de Olécrano em Eqüino

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    Josmari Pirolo

    2010-04-01

    Full Text Available Olecranon fractures are frequently encountered in horses especially in foals. External trauma due to kicks or falls is the most common cause of the fracture. Treatment modalities of olecranon fractures including prolonged stall rest and surgical reconstruction of the different types of fractures have been proposed with different outcomes. This article describes a successful surgical reconstruction of an olecranon fracture in an adult horse repaired with a dynamic compression plate. The horse regained complete soundness and performed his job normally for additional 7 years. Information regarding the history, clinical signs, diagnosis, surgical treatment and long-term prognosis is discussed and compared with the current literature.As fraturas de olécrano ocorrem freqüentemente em eqüinos, especialmente em potros jovens. A causa mais comum da fratura relaciona-se ao trauma externo originado, principalmente, por coices ou quedas. Modalidades distintas de tratamento incluindo o repouso prolongado ou a reparação cirúrgica dos variados tipos de fratura têm sido executadas com diferentes resultados. Este trabalho tem por objetivo a descrição de um caso de fratura de olécrano em um eqüino adulto reparada cirurgicamente por meio de placa e parafusos ortopédicos. O animal apresentou recuperação plena da função locomotora desempenhando normalmente suas funções por mais 7 anos. Informações relativas ao histórico, sinais clínicos, diagnóstico, tratamento cirúrgico e prognóstico são discutidas e comparadas com a literatura.

  17. Pesquisa de anticorpos anti-Rickettsia rickettsii em eqüinos do Centro de Controle de Zoonoses do município de São Paulo (CCZ/SP

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    Jonas Moraes-Filho

    2009-04-01

    Full Text Available A Febre Maculosa Brasileira (FMB é uma zoonose transmitida por pelo menos duas espécies de carrapatos: Amblyomma cajennense e Amblyomma aureolatum. Os eqüinos assumem um importante papel de sentinela da FMB em áreas onde o carrapato vetor é o A. cajennense, por ser considerado hospedeiro primário dessa espécie de carrapato. O A. aureolatum, cujos hospedeiros primários são aves, alguns roedores silvestres e canídeos, é incriminado como vetor da doença na região da Grande São Paulo. Este trabalho objetivou pesquisar a presença de anticorpos contra Rickettsia rickettsii, agente da FMB, em eqüinos encaminhados ao Centro de Controle de Zoonoses do município de São Paulo (CCZ/SP no período de 2003 a 2005. Após coleta de sangue, o soro obtido pela centrifugação foi submetido à reação de imunofluorescência indireta (RIFI e os animais foram considerados positivos quando as amostras de soro apresentaram títulos >; 64. Durante os três anos, foram testados 363 amostras pela RIFI, sendo que 64 se mostraram reagentes: 6 (2003, 16 (2004 e 42 (2005. Os títulos finais variaram de 64 a 1.024. Os resultados obtidos demonstram uma baixa porcentagem de animais reagentes (17,6% quando comparados com dados de literatura de áreas endêmicas para FMB onde o vetor é o A. cajennense, sugerindo não ser essa espécie responsável pela transmissão da doença na área de estudo

  18. Políticas e práticas de saúde rumo à eqüidade Políticas y prácticas de salud hacia la equidad Health policies and practices toward equity

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    Roseni Rosângela de Sena

    2007-12-01

    Full Text Available O texto abordou as desigualdades e a exclusão social em saúde e estabeleceu as suas interrelações e determinações sociais, históricas, culturais e econômicas. Apontou as iniqüidades, como conseqüência das desigualdades na produção e na distribuição das riquezas expressas em serviços e bens materiais. Discutiu as práticas de gestão no campo da saúde, como favorecedoras de eqüidade, indicando a gestão compartilhada, como uma ferramenta que potencializa os valores de cidadania e respeito à diversidade. Abordou a participação e o controle social como práticas que promovem eqüidade nos serviços de saúde. Comentou a experiência da Secretaria Municipal de Políticas Sociais e de Saúde de Belo Horizonte com o trabalho em territórios geopolíticos-sociais com práticas de gestão, assistência e controle social que contribuem para a eqüidade. Concluiu que, além das análises e macrointervenções, é fundamental tomar os espaços micro do trabalho para reflexão e atuação na construção da equidade.Este texto abordó las desigualdades y la exclusión social en salud, estableciendo sus interrelaciones y determinaciones sociales, históricas, culturales y económicas. Se señaló a las iniquidades como consecuencia de las desigualdades en la producción y distribución de las riquezas, expresadas en servicios y bienes materiales. Se discutió las prácticas de la gerencia, en el campo de la salud, como facilitadores de la equidad, indicando a la gerencia compartida como herramienta que potencialaza los valores de ciudadanía y respeto a la diversidad. Se abordó la participación y el control social como prácticas que promueven la equidad en los servicios de salud. Se comentó sobre la experiencia del Departamento Municipal de Políticas Sociales y de Salud de Belo Horizonte sobre el trabajo en territorios geopolíticos y sociales, con prácticas de gerencia, asistencia y control social que contribuyeron para la equidad

  19. Membrana amniótica preservada em glicerina no reparo de feridas cutâneas de membros locomotores de eqüinos Equine amniotic membrane preserved in glycerin in reparing the equine limbs cütaneous wounds

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    Valdemir Alves de Oliveira

    1998-12-01

    Full Text Available Neste estudo experimental, avaliou-se o uso de membrana amniótica eqüina preservada em glicerina 98%, à temperatura ambiente, em feridas com cura por segunda intenção, nos membros locomotores de eqüinos. Foram provocadas cirurgicamente feridas de 9,6cm² na face lateral da articulação metacarpo-falangeana, face medial do terço proximal do metacarpo e face lateral do terço médio do metatarso de ambos os membros locomotores de cinco eqüinos adultos, perfazendo total de trinta feridas. Foram constituídos dois grupos experimentais com quinze feridas cada, sendo um destes grupos tratado com membrana amniótica, e o outro, grupo controle, tendo recebido apenas gaze umidecida em solução fisiológica. Os curativos foram trocados a cada 48horas, tendo sido a membrana amniótica e a gaze umidecida substituídas. Em todas as feridas foram mensurados a área, o grau de secreção, a formação de tecido de granulação exuberante e o tempo para a epitelização se completar. Realizou-se também exame bacteriológico e histopatológico em um grupo de feridas, tratadas e controle. Na membrana amniótica, fez-se determinação bioquímica de proteínas e identificação de fator de crescimento de fibroblasto. Em todas as feridas tratadas, observou-se: menor tempo para cicatrização, menor formação de tecido de granulação exuberante, menor incidência de bactérias patológicas e menor aumento na área total.In the present experimental study, the use of the equine amniotic membrane preserved in glvcerol 98%, at room temperature, in wounds with secound intention healing of equine limbs were evaluated. Surgical wounds of the size of 9.6cm² were made on the fetiock joint, medial aspect of the proximal third of the metacarpus and lateral aspect of the medium third of the metatarsus ofboth limbs offive adult horses, making a total of thirty wounds. Two experimental groups were made with fifteen wounds in each group, where one of these groups was

  20. Caracterização do processo de rigor mortis em músculos de eqüinos e maciez da carne Caracterization of rigor mortis process of muscle horse and meat tenderness

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    Tatiana Pacheco Rodrigues

    2004-08-01

    Full Text Available Esta pesquisa utilizou 12 eqüinos de diferentes idades, abatidos em um matadouro-frigorífico (SIF 1803 em Araguari-MG, e estudou a temperatura, pH, comprimento de sarcômero em diferentes intervalos de tempo após abate (1h, 5h, 8h, 10h, 12h, 15h e 24h e força de cisalhamento (maciez dos músculos Longissimus dorsi e Semitendinosus, com intuito de caracterizar o desenvolvimento do processo de rigor mortis de eqüídeos durante o processamento industrial. A temperatura da câmara fria variou de 10,2°C a 4,0°C e a temperatura média inicial das carcaças foi de 35,32°C e a final de 4,15°C. O pH inicial médio do músculo Longissimus dorsi foi 6,49 e o final 5,63, e para o músculo Semitendinosus o pH inicial médio foi 6,44 e o final 5,70. A menor medida de sarcômero observada em ambos os músculos foi na 15ª hora após abate, ou seja, 1,44µm e 1,41µm, respectivamente. A carne dos eqüídeos adultos foi mais dura (pThis work studied 12 horses at different ages butchered in a slaughterhouse in Minas Gerais State, Brazil (SIF 1803 and evaluated temperature, pH, sarcomere length in different periods after slaughter (1h, 5h, 8h, 10h, 12h, 15h, and 24 hours as well as the shear force (meat tenderness of the Longissimus dorsi and Semitendinosus muscles, aiming at characterizing the rigor mortis onset in the meat during industrial processing. The chilly room temperature varied from 10.2°C to 4.0°C, and the mean initial carcass temperature was 35.32°C and the final one was 4.15°C. The mean initial pH of Longissimus dorsi was 6.49 and the final one was 5.63; the mean initial pH of Semitendinosus was 6.44 and the final one was 5.70. The smallest sarcomere size obtained in both muscles occurred at 15 hours postmortem, and the sarcomere lengths were 1.44 µm and 1.41 µm, respectively. The meat from adult horses was tougher than that from young ones (p<0.05, and the Semitendinosus muscle was tougher than Longissimus dorsi muscle.

  1. Exame do fluido peritoneal e hemograma de eqüinos submetidos à laparotomia e infusão intraperitoneal de carboximetilcelulose Peritoneal fluid exam and hemogram of horses submited to laparotomy and carboxymethylcellulose intraperitoneal infusion

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    Marco Aurélio Ferreira Lopes

    1999-03-01

    Full Text Available A aplicação intraperitoneal de carboximetilcelulose (CMC tem sido utilizada na prevenção de aderências peritoneais em animais e em humanos. Os objetivos deste trabalho foram avaliar a resposta do peritônio ao trauma cirúrgico e à aplicação de CMC e estudar como se processa a metabolização da CMC. Dezenove eqüinos mestiços foram submetidos à laparotomia, quando se produziram lesões no jejuno distal por abrasão da serosa e isquemia. Nos 9 eqüinos do grupo tratamento, antes da síntese da parede abdominal, foi instilada, na cavidade peritoneal, uma solução estéril de CMC, a 1% na dose de 7ml/kg. Nos eqüinos do grupo controle, nenhum medicamento foi aplicado na cavidade peritoneal. Após a cirurgia, colheram-se sangue e fluido peritoneal em 9 momentos: 4 horas após o fim da cirurgia, nos 3 primeiros dias pós-operatórios, pela manhã e a cada 48 horas nos dias subseqüentes (no 5º, 7º, 9º, 11º e 13º dias pós-operatórios. Os exames laboratoriais demonstraram que todos os animais desenvolveram inflamação peritoneal. Entretanto, nos animais do grupo tratamento, esta inflamação foi mais intensa e com um curso mais longo. Observou-se também que a excreção da CMC ocorreu por fagocitose.Intraperitoneal application of carboxymethylcellulose (CMC has been used for peritoneal adhesions prevention in animals and humans. The objectives of this research was to study the peritoneal response to surgical trauma and application of CMC and also to study how CMC excretion occurs. Nineteen healthy mixed breed horses were submited to laparotomy to produce lesions in distal jejunum by serosal abrasion and ischemia. In the nine horses of the treatment group, 7ml/kg of a 1% CMC sterile solution were instilated in peritoneal cavity before abdominal wall syntesis. No medication was instiled in peritoneal cavitiy of the control group horses. After surgery, blood and peritoneal fluid were colected in 9 postoperative moments: 4 hours after

  2. Pesquisa em saúde, política de saúde e eqüidade na América Latina Health research, health policy and equity in Latin America

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    Alberto Pellegrini Filho

    2004-06-01

    Full Text Available O autor analisa as relações entre pesquisa de saúde, políticas de saúde e eqüidade na América Latina. Descreve novas tendências no modo de produção do conhecimento, que permitem maior integração entre as necessidades sociais e a pesquisa, facilitando o vínculo entre esta e o processo de definição de políticas. Analisa as manifestações das novas tendências na América Latina e finaliza com a descrição de algumas iniciativas promovidas pela OPAS no sentido de aproveitar as oportunidades abertas pelas novas tendências para a melhoria das condições de saúde na região. Busca defender a tese de que a informação e o conhecimento são bens públicos essenciais e que as iniqüidades de acesso a esses bens são importantes determinantes das iniqüidades em saúde. Para que as políticas de saúde e as políticas de pesquisa em saúde se integrem e se consolidem como políticas públicas voltadas a atender ao interesse público e à promoção da eqüidade, é necessário o fortalecimento do processo democrático de definição das mesmas, multiplicando os atores envolvidos, os espaços e oportunidades de interação entre eles e instrumentando sua participação com o acesso eqüitativo a informações e conhecimentos científicos pertinentes que permitam a defesa fundamentada de seus interesses.The author analyzes the relationships between health research, health policies and equity in Latin America. He describes new trends in the mode of knowledge production that enhance the integration between social needs and research, facilitating the ties between research and the policy making process. The author also analyzes the manifestations of these new trends in Latin America, and describes some initiatives promoted by the PAHO aimed to take advantage of the opportunities opened by these trends to improve health conditions in the region. Throughout the article the author defends the thesis that information and knowledge are

  3. Injeção epidural preventiva de xilazina ou amitraz em eqüinos: efeitos clínicos e comportamentais Pre-emptive epidural injection of xylazine or amitraz, in horses: clinical and behavioral effects

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    Erica Cristina Bueno do Prado Guirro

    2009-04-01

    Full Text Available A xilazina é o fármaco agonista adrenérgico α2 mais utilizado pela via epidural de eqüinos e sabe-se que o amitraz tem ação sobre esses receptores. Assim, foram avaliados os efeitos clínicos e comportamentais causados pela injeção epidural de 0,17mg kg-1 de xilazina (GX ou de 0,1mg kg-1 de amitraz diluído em emulsão lipídica (GA durante 24 horas, em doze eqüinos. A freqüência cardíaca e a altura de cabeça mantiveram-se inalteradas; a freqüência respiratória aumentou de T105 a T360 no GX; a temperatura retal elevou-se de T120 a T720 em GA e de T360 a T720 em GX. Não houve diferença no tempo de latência para urinar ou defecar em ambos os grupos. Em relação às alterações comportamentais, o amitraz provocou sedação (50%, ptose labial (33,4% e palpebral (16,7%, enquanto que a xilazina promoveu ataxia (50%, sudorese perineal (33,4%, ptose palpebral (16,6% e relaxamento do esfíncter anal (16,6%. Considera-se segura a injeção epidural de xilazina ou amitraz em eqüinos, pois as alterações clínicas e comportamentais promovidas são leves e não limitam seu uso.Xylazine is the α2-adrenergic agonist more employed by epidural route in horses and it is known that amitraz acts on these receptors. So, clinical and behavioral effects caused by epidural injection of 0.17mg kg-1 xylazine (GX or 0.1mg.kg-1 amitraz diluted in lipidic emulsion (GA were evaluated in 12 horses. Heart rate and height of the head didn't change; respiratory rate increased from T105 to T360 in GX; rectal temperature increased from T120 to T720 in GA and from T360 to T720 in GX. There is no difference in latency to urine or defecate in both groups. Concerning behavioral changes, amitraz promoted sedation (50%, lip (33.4% and eye (16.6% dropping, while xylazine caused ataxia (50%, perineal sweating (33.4%, eye dropping (16.6% and anal sphincter relaxation (16.6%. So, epidural injection of xylazine or amitraz was considered safe because the clinical and

  4. Digestibilidade dos nutrientes de alimentos volumosos determinada pela técnica dos sacos móveis em eqüinos Nutrient digestibility of forage feed determined using mobile bag technique in horses

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    Vinícius Pimentel Silva

    2009-01-01

    Full Text Available Objetivou-se estimar a digestibilidade de nutrientes de forrageiras em eqüinos utilizando-se a técnica de sacos de náilon móveis. Foram avaliados alfafa (Medicago sativa, amendoim forrageiro (Arachis pintoi, desmódio (Desmodium ovalifolium, estilosantes (Stylosanthes guianensis, guandu (Cajanus cajan, macrotiloma (Macrotyloma axillare e capim-coastcross (Cynodon dactylon cv. coastcross. O delineamento foi em blocos inteiramente casualizados com sete alimentos e cinco blocos (animais. Foram utilizados cinco eqüinos mestiços com 17 a 27 anos de idade e peso vivo médio de 350 kg. O ensaio teve duração de 12 dias: três para a adaptação às baias, cinco para inserção gástrica dos sacos através de sonda nasogástrica e quatro de coleta dos sacos nas fezes. No período pré-experimental de 30 dias, os animais foram mantidos em piquetes com dieta composta de 80% de feno de coastcross e 20% de concentrado. Na confecção dos sacos, utilizou-se náilon com porosidade de 45 µ e dimensão de 7,5 × 2 cm. Em cada saco, foram inseridos 510 mg de matéria seca de amostra do alimento. Os coeficientes de digestibilidade dos nutrientes das forragens foram calculados considerando o resíduo obtido no saco. A digestibilidade dos nutrientes do amendoim, estilosantes e macrotiloma foram superiores à da demais forrageiras, com destaque para a digestibilidade da proteína bruta, cujos valores foram de 91,4; 94,9 e 97,0%, respectivamente. O amendoim e macrotiloma apresentaram digestibilidade da fibra em detergente neutro de 72,3 e 65,2% e da fibra em detergente ácido de 70,9 e 59,4%, respectivamente. O amendoim forrageiro, macrotiloma e estilosantes apresentam digestibilidade dos nutrientes satisfatória e têm potencial para o uso em dietas para eqüinos.This work was carried out to evaluate the nutrient digestibility of forages using mobile bags technique in horses. The forages were lucerne (Medicago sativa, peanut (Arachis pintoi, desmodio

  5. Estudo retrospectivo dos casos de enterolitíase e corpo estranho em intestino grosso de eqüinos, no período de janeiro de 1993 a janeiro de 2003

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    Rodrigo Romero Corrêa

    2006-04-01

    Full Text Available No período de janeiro de 1993 a janeiro de 2003, foram realizados 195 procedimentos cirúrgicos de abdômen agudo em eqüinos, no Serviço de Cirurgia de Grandes Animais do Hospital Veterinário da Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo. Dentre eles, foram diagnosticados 30 casos de enterolitíase e sete casos de corpo estranho, localizados em intestino grosso. Das 37 laparotomias, 35 foram realizadas em decúbito dorsal com acesso pela linha média e duas em estação com acesso pelo flanco. Os animais apresentaram idade variando de um a dezoito anos com média de oito anos, sendo 25 machos e 13 fêmeas. As formações e corpos estranhos apresentaram a seguinte localização: 13 (35,14% em cólon maior, 19 (51,35% em cólon menor, 03 (8,10% em cólon transverso e 02 (5,41% em cólon transverso e menor. Em relação à evolução, 23 (62,16% receberam alta e 14 (37,84% evoluíram para óbito (6 ou foram submetidos à eutanásia (8. Seis procedimentos de eutanásia foram realizados no período trans-operatório e dois no período pós-operatório. Dentre os animais que apresentaram evolução satisfatória, destacam-se um caso em que foram retirados sete enterólitos e outro em que a ponta de um prego que era o núcleo do enterólito se mantinha proeminente e em contato com a mucosa intestinal. Comparativamente às demais afecções do intestino grosso dos eqüinos e pela análise dos resultados obtidos neste estudo, conclui-se que os processos obstrutivos causados por enterólitos ou corpos estranhos apresentam prognóstico favorável.

  6. Anestesia por isofluorano em eqüinos submetidos à infusão contínua de medetomidina ou xilazina Isoflurane anesthesia in horses during medetomidine or xilazine continuous infusion

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    Renata Gebara Sampaio Dória

    2009-04-01

    Full Text Available Avaliaram-se oito eqüinos sob anestesia geral inalatória com isofluorano (1CAM e infusão contínua de xilazina (0,35mg kg-1h-1 ou medetomidina (3,5µg kg-1h-1, em relação à freqüência cardíaca, ritmo cardíaco, freqüência respiratória, pressão arterial, hemogasometria arterial e temperatura, nos tempos T0 (imediatamente antes do início da infusão contínua e T10 ao T60 (intervalos de 10 minutos, após início da infusão contínua. Houve redução da freqüência cardíaca e da temperatura e elevação da pressão arterial média. A paCO2 (no GM elevou-se e a paO2 mostrou-se maior no GM que no GX. Conclui-se que a infusão contínua de doses equipotentes de xilazina e medetomidina, durante anestesia geral inalatória, com isofluorano, em eqüinos, promove alterações cardiocirculatórias, respiratórias, térmicas e hemogasométricas discretas e equivalentes.Eight horses under inhalant general anesthesia with isoflurane (1MAC and continuous infusion of xylazine (0.35mg kg-1h-1 or medetomidine (3.5µg kg-1h-1 were evaluated for heart rate and rhythm, respiratory rate, arterial blood pressure, arterial blood gas analysis and temperature immediately before the beginning of the continuous infusion (T0 and in intervals of 10 minutes after the beginning of the continuous infusion (T10 to T60. Heart rate and temperature decreased and mean arterial pressure increased. PaCO2 (in GM increased and GM showed a higher paO2 than GX. We conclude that equipotent doses of continuous infusion of medetomidine and xylazine during inhalant general anesthesia with isoflurane in horses promote slight and equivalent cardiocirculatory, respiratory, thermic and arterial blood gases changes.

  7. Democracia e gestão participativa: uma estratégia para a eqüidade em saúde? Democracy and participative management: a strategy for equity on health?

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    Ana Maria Costa

    2006-08-01

    Full Text Available As práticas e mecanismos de participação social no campo da saúde constituem referências para a democracia participativa no Brasil. O presente ensaio parte da análise dos Comitês de Promoção de Eqüidade adotados pelo Ministério da Saúde. A eqüidade na saúde, entendida como o provimento de serviços para necessidades específicas de grupos ou pessoas, requer sujeitos e coletividades com poder e autonomia para enunciar seus desejos e necessidades. Os Comitês permitem aos distintos grupos sociais vocalizarem suas demandas e necessidades, provocando respostas articuladas do Governo, valorizando a integração de diversos órgãos governamentais para dentro e para fora do setor da saúde, com transversalidade e intersetorialidade. A institucionalização desta lógica na formulação e na gestão das políticas em saúde permite enfrentar a complexidade dos processos relacionados à saúde e à doença, às desigualdades e às iniqüidades. Ressalta-se a necessidade de mobilizar e re-politizar o debate sobre o direito à saúde, na perspectiva de ampliação da participação e do poder de intervenção dos grupos sociais em situação de exclusão.The practices and mechanisms of social participation in the field of health in Brazil represent references for participative democracy. This essay analyses the Equity Promotion Committees adopted by Health Ministry. Equity in health, understood as services provision for specific needs of groups or persons, requires individuals and groups with power and autonomy to give voice to their desires and needs, provoking articulated answers from government, valuing the integration of different public institutions within and outside of the health sector, in a cross- sectional and inter-institutional way. The implementation of this logic in the formulation and in the management of health policies helps in dealing with the complexity of processes related to health and disease and to inequalities. There

  8. Implante de tubo de silicone com e sem colágeno na regeneração de nervos em eqüinos Implant of silicone tube with or without collagen in nerve regeneration of horses

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    Nádia Delistoianov

    2008-09-01

    Full Text Available A reconstituição cirúrgica de nervos em humanos, em cães e em diversos animais de laboratório é bastante utilizada e tem indicações clínicas e experimentais importantes. No entanto, em eqüinos há poucas informações sobre esta prática. Há relatos sobre a excessiva proliferação de tecido conjuntivo e a formação de neuromas à neurorrafia experimental, mesmo quando se utilizam tubos de silicone para condução do crescimento axonal. O presente estudo teve o objetivo de acrescentar informações sobre o processo de reparação de nervos periféricos em eqüinos por meio de implante de tubo de silicone preenchido ou não com colágeno. Para tanto, foram utilizados oito eqüinos, alocados em dois grupos: GI-13 semanas e GII-26 semanas de observação. Foi realizada secção dos nervos ulnares (NUs e dos ramos cutâneos laterais dos 17° nervos torácicos (NTs, bilateralmente, seguindo tubulização, realizada em cada animal, alternando-se tubos de silicone vazios (TS, em um dos antímeros, ou preenchidos com solução de colágeno (TSC, no contralateral, deixando-se um espaço de 5mm entre os cotos. Nenhuma alteração foi encontrada ao exame do aparelho locomotor e as primeiras reações positivas ao teste de sensibilidade cutânea nos NUs e NTs com TS e TSC foram observadas a partir da 9ª semana, em ambos os grupos. Ao final do período de observação, verificou-se, macroscopicamente, que os nervos encontravam-se envolvidos por tecido conjuntivo e o interior da câmara estava preenchido por tecido de coloração esbranquiçada, de forma cilíndrica, interligando os cotos proximal e distal. Microscopicamente, constatou-se a presença de axônios mielinizados interligando os cotos, as células de Schwann e o processo de remielinização do coto distal, principalmente no TSC. Em ambos os grupos, não houve formação de neuromas e o processo inflamatório limitou-se às áreas perineurais. Concluiu-se que o implante de tubo de

  9. Antipsychotic Management of Schizoaffective Disorder: A Review.

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    Lindenmayer, Jean-Pierre; Kaur, Amandeep

    2016-04-01

    Schizoaffective disorder (SAD) is an incapacitating illness that presents clinicians with challenges in terms of both its diagnosis and its psychopharmacological management. Most studies conducted on the psychopharmacological treatment of SAD also include patients with schizophrenia or other psychotic illnesses, thereby providing an unspecific view to the clinician as to the best way of treating patients with SAD. The objective of this article is to review studies on evidence-based treatment of patients with SAD. We conducted a systematic literature search in MEDLINE/PubMed for full-text studies in the English language using the terms 'Schizoaffective and treatment' or 'antipsychotic schizoaffective'. Our review found relatively few studies with either an active comparator or placebo that examined the efficacy of antipsychotics for patients with SAD without an admixture of patients with schizophrenia. Only oral paliperidone extended release (ER), paliperidone long-acting injection (LAI), and risperidone have been shown to be effective and safe in reducing psychotic as well as affective components in acutely ill SAD patients in controlled studies. Paliperidone ER and LAI have also been shown to be efficacious in the maintenance treatment phase of SAD patients. While no supportive data exist, it is possible that other atypical antipsychotics may have similar efficacy to the two mentioned above. We conclude with a number of research recommendations for the study of treatment options for patients with SAD. First, there is a need for studies with patients specifically diagnosed with SAD for both the acute and the maintenance phase. The sample size needs to be adequate to allow a primary analysis of efficacy and to allow for analysis of the SAD subtypes: depressed and bipolar. Another recommendation is the need for studies of patients with SAD stratified into patients with and without mood stabilizers or antidepressants to allow the examination of the adjunctive role of

  10. Eqüidade de gênero e saúde das mulheres Equidad de género y salud de las mujeres Gender equality and women's health

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    Rosa Maria Godoy Serpa da Fonseca

    2005-12-01

    Full Text Available Inicialmente são contadas duas histórias: uma ocorrida na Idade Média, em Florença, Itália, e outra na década de 90, do século passado, no Rio de Janeiro, Brasil. Ambas referem-se ao princípio da Justiça, o pilar ético da Eqüidade. A partir daí é feita uma análise de gênero da situação de saúde das mulheres e o quanto ela reflete as iniqüidades advindas das condições de desigualdade social a que estão submetidas. Conclui que adotar a eqüidade de gênero como conceito ético associado aos princípios de justiça social e direitos humanos significa re-olhar o cotidiano de milhares de mulheres, indignar-se com o sofrimento e provocar transformações, sem confundir o direito à assistência digna e respeitável por serem, antes de tudo, cidadãs, com o imperativo de tê-las hígidas e produtivas, por serem geradoras e mantenedoras da força de trabalho presente e futura, de quem a sociedade depende para a geração da riqueza social.IInicialmente se cuentan dos historias: una ocurrida en la Edad Media, en Florencia-Italia, y otra en la década del 90, en Rio de Janeiro, Brasil. Ambas se refieren al principio de Justicia, el pilar ético de la Equidad. A partir de ahí se realiza un análisis de género de la situación de salud de las mujeres y lo que ella refleja en cuanto a las inequidades advenidas de las condiciones de desigualdad social a que están sometidas. Concluye que adoptar la equidad de género como concepto ético asociado a los principios de justicia social y derechos humanos significa volver a mirar el cotidiano de millares de mujeres, indignarse con el sufrimiento y provocar transformaciones, sin confundir el derecho a la asistencia digna y respetable por ser, antes de todo, ciudadanas, con el imperativo de tenerlas productivas, al ser generadoras y manutensoras de la fuerza de trabajo presente y futura, de quien la sociedad depende para la generación de la riqueza social.Two stories are told: one that took

  11. Avaliação de dietas para eqüinos de uso militar em atividade física moderada Evaluation of diets for military horses in moderate activity

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    Patrícia Maia Galvão

    2004-12-01

    Full Text Available Objetivou-se, com o presente trabalho, avaliar dietas de cavalos de uso militar em atividade física moderada. O experimento foi realizado no Regimento Escola de Cavalaria do Exército Brasileiro, onde foram avaliadas as dietas dos eqüinos do Esquadrão de Cerimonial. No ensaio de desempenho, foi utilizado delineamento experimental em blocos casualizados, compostos de três tratamentos, sendo o bloco a idade dos animais e os tratamentos, as dietas experimentais. Na dieta I, quinze animais receberam dietas com ração comercial com feno de alfafa e coastcross incorporados ao pelete; na dieta II, quinze animais receberam ração comercial peletizada e, na dieta III, quatorze animais receberam ração comercial peletizada semelhante à dieta II, acrescida de 3,0 kg de aveia hidropônica. Em todas as dietas, foram adicionados 3,0 kg de feno de coastcross. Em seguida, foi conduzido o ensaio de digestão em delineamento inteiramente casualizado, com os três tratamentos supracitados e quatro repetições, além da coleta total de fezes, para avaliação da digestibilidade dos nutrientes das dietas experimentais. Os valores obtidos foram submetidos à análise de variância e as médias, comparadas pelo teste de Tukey, a 5% de probabilidade. Os animais alimentados com as dietas experimentais tiveram o peso vivo e escore corporal inalterados pelas variações dos conteúdos de nutrientes das mesmas. Os coeficientes de digestibilidade foram afetados pela dietas experimentais e, de acordo com os resultados observados, a dieta contendo ração comercial com feno incorporado ao pelete, mostrou-se mais digestível. O consumo de energia e proteína digestível nas dietas avaliadas foi adequado às atividades militares e o consumo de fibra dietética (expressa em FDN e FDA foi adequado às recomendações mínimas necessárias para os eqüinos.This study aims to evaluate diets for military horses in moderate activity. This experiment was conducted at Cavalry

  12. Enterorrafias em plano aposicional convencionale com adesivo à base de cianoacrilato no cólon descendente de eqüinos Conventional appositional pattern and cyanoacrylate tissue adhesive in descending colon enterorrhaphy in horses

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    Claudia Acosta Duarte

    2002-08-01

    Full Text Available Em eqüinos, as enterotomias no cólon descendente são necessárias para remover enterólitos, corpos estranhos e material alimentar compactado que não podem ser removidos por técnicas conservativas. Este segmento intestinal possui um suprimento sangüíneo pobre, além de predisposição a complicações pós-operatórias relacionadas à contaminação bacteriana. Assim, este estudo foi conduzido com o objetivo de efetuar avaliações clínicas e anatomopatológicas do emprego de adesivo tecidual à base de cianoacrilato no cólon descendente de eqüinos, comparando-o a uma técnica de sutura aposicional convencional. A intervenção cirúrgica foi realizada em 15 animais posicionados em decúbito lateral direito, através de laparotomia pelo flanco esquerdo, sob anestesia geral inalatória. Após a exteriorização do cólon descendente, foram realizadas duas enterotomias de cinco centímetros de extensão cada, distanciadas 20cm uma da outra. Os animais foram aleatoriamente distribuídos em cinco tempos de observação de três animais cada e sacrificados aos três, sete, 14, 35 e 70 dias de pós-operatório. O adesivo butil-2-cianoacrilato e o fio de poliglactina 910 mostraram-se igualmente apropriados para uso em enterorrafias desse órgão, sendo que o fio de poliglactina 910 provocou inflamação inicial mais intensa que o cianoacrilato e, mais tardiamente, ambos causaram inflamação granulomatosa do tipo corpo estranho observada, primeiramente, junto ao fio de poliglactina 910 (7º dia e, a partir do 35º dia, ao redor do cianoacrilato.The descending colon enterotomies in horses are necessary to remove enteroliths, foreign body and impacted material that can not be removed with conservative technique. This intestinal segment has a poor blood supply and the predisposition to post operation complications related to bacterium contamination. This trial was conducted in order to evaluate, clinically and anatomopathologically, the use of

  13. Influência da heparina sódica na ocorrência de laminite eqüina induzida por sobrecarga de carboidratos Influence of heparin in occurrence of carbohydrate overload-induced equine laminitis

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    L.P. Martins Filho

    2008-12-01

    Full Text Available Avaliou-se a eficiência da infusão intravenosa de heparina sódica (100UI/kg/8h, a partir de 24h após o fornecimento de carboidrato, até completar 48h no controle da laminite eqüina experimentalmente induzida por sobrecarga de carboidrato (17,6g de amido de milho/kg de peso corpóreo. Foram utilizados 15 eqüinos adultos, distribuídos em três grupos experimentais: GI (grupo-controle; GII (grupo laminite e GIII (grupo laminite+heparina. Posteriormente ao fornecimento de carboidrato, os animais foram submetidos a exames físicos e laboratoriais durante um período de 48 horas. Ao final do experimento, os animais foram submetidos à eutanásia pela aplicação intravenosa de 5ml de maleato de acepromazina seguida de 1g de tiopental sódico e 1 litro de solução saturada de KCl para a obtenção de amostras de tecidos dos cascos, necessárias ao exame histológico. Os animais de GII e GIII, submetidos à sobrecarga de carboidratos, desenvolveram laminite, exibindo claudicação 12 e 24h após o fornecimento de carboidrato, respectivamente, bem como aumentos da freqüência cardíaca e do tempo de preenchimento capilar. As alterações histológicas, semelhantes em GII e GIII, eram do tipo degenerativo, como adelgaçamento de lâminas epidérmicas, retração, achatamento e deslocamento de lâminas dérmicas, vacuolização epidérmica e desorganização do tecido epidérmico. A infusão da heparina sódica não preveniu ou atenuou a degeneração laminar.The efficacy of intravenous heparin administration (100UI/kg/8h, from 24 to 48h after carbohydrate administration in the control of carbohydrate overload-induced equine laminitis (17.6g of corn starch/kg live weight was evaluated. Fifteen horses were allocated into three experimental groups: GI (control group, GII (laminitis group, and GIII (laminitis+heparin group. These animals were submitted to physical and laboratorial examination during 48h. After that time, they were euthanized with

  14. Análise cinemática tridimensional do movimento de eqüinos em esteira rolante Three-dimensional cinematic analysis of the horse movement in treadmill

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    F.G. Christovão

    2007-08-01

    Full Text Available Adaptou-se uma metodologia utilizada no estudo do movimento humano para analisar o movimento de eqüinos em esteira rolante de alto desempenho, construindo-se um sistema de calibração utilizando-se um teodolito eletrônico de alta precisão e calibradores que demarcavam o espaço ocupado pelo animal. Dessa forma, foram obtidas as coordenadas espaciais dos marcadores presentes nos calibradores, compondo o arquivo de calibração. Duas câmeras de vídeo (60Hz foram posicionadas em vista lateral esquerda, distantes 5m da manta de rolagem da esteira a 1,8m de altura. As imagens foram enquadradas utilizando-se um monitor de vídeo. Para a validação do método, um membro da equipe movimentou, no espaço calibrado, uma haste rígida com marcadores fixados nas suas extremidades, distantes um do outro 43,8cm. Para a análise das imagens, utilizou-se o programa Dvideow, desenvolvido pelo Laboratório de Instrumentação para Biomecânica - UNICAMP. Após a reconstrução tridimensional das imagens utilizou-se um programa matemático para o cálculo do valor médio da distância entre os marcadores. Obteve-se, após a mensuração em 100 quadros, o valor médio de 43,7cm com coeficiente de variação de 0,8%. Estes resultados mostram que a metodologia desenvolvida é precisa e adequada para o estudo da locomoção de eqüinos.A methodology used for the study of human movement was adapted to analyze the movement of equines in a high performance treadmill. An electronic high precision theodolite was used to construct a calibration system to demarcate the volume occupied by the animal. It was taken the three dimensions coordinates of each marker present in the calibrator, composing the calibration archive. Two video cameras (60 Hz were located approximately 5m from the left lateral side of the treadmill at 1.8m height. The images had been fit using a video monitor. For the validation of the method, a member of the team moved into the calibrated space, a

  15. Seasonal abundance of equine strongyles (Nematoda: Strongylidae in the State of Rio de Janeiro, Brazil Abundância sazonal de estrongilídeos de eqüinos (Nematoda: Strongylidae no Estado do Rio de Janeiro

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    I.V.F. Martins

    2005-02-01

    Full Text Available The seasonal abundance of lumenal and larval forms of equine strongyles in the State of Rio de Janeiro, Brazil was evaluated. Thirty horses referred to the Federal Rural University of Rio de Janeiro were necropsied and their gastrointestinal tracts were separated into stomach, small intestine, cecum, ventral colon, dorsal colon and rectum. Two aliquots of 5% of the content were collected and examined for the presence of small strongyles and the rest of the content was examined for the presence of large strongyles. The mesenteric artery, liver, pancreas and peritoneum were examined for the presence of strongyle larvae. The mucosa of intestine segments was cut into parts of equal length, and each one was examined by the mural transillumination technique. Higher abundances of larvae of Strongylus equinus (PEstudou-se a ocorrência sazonal de formas larvares e adultas de estrongilídeos nas mucosas do estômago, intestino delgado, ceco, colon ventral, colon dorsal e reto de 30 eqüídeos no Estado do Rio de Janeiro. Os grandes estrongilídeos foram encontrados em todas as mucosas e duas alíquotas de 5% do conteúdo foram retiradas para a procura de pequenos estrongilídeos. Artéria mesentérica, fígado, pâncreas e peritônio foram também examinados para larvas de estrongilídeos. As mucosas foram examinadas pela técnica de transiluminação. Larvas de Strongylus equinus (P<0,10 e adultos de Strongylus vulgaris (P<0,05 foram mais abundantes na estação seca. Larvas escistadas de ciatostomíneos o foram na estação chuvosa (P<0,02.

  16. Ocorrência de poliúria-polidpsia em eqüinos estabulados - descrição de dois casos de polidipsia psicogênica Incidence of two cases of polyuria-polydipsia in confined horses

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    J.C. Lacerda Neto

    2000-06-01

    Full Text Available Dois eqüinos da raça Brasileira de Hipismo, machos, quatro anos de idade, apresentando sinais de poliúria-polidipsia, foram submetidos a completa avaliação clínica e a exames de sangue e urina. Não foram observadas alterações clínicas, hematológicas ou bioquímicas, a não ser um decréscimo na gravidade específica da urina de ambos os animais (1,009 e 1,008. Realizou-se um teste de privação de água de 24 horas e durante esse período a gravidade especifica da urina subiu gradualmente até atingir a normalidade (1,028 e 1,026, respectivamente. O comportamento anormal ocorreu por confinamento excessivo. Os resultados clínicos e de laboratório e o teste de privação de água indicam o diagnóstico de polidipsia psicogênica.Two four-year-old male Brasileiro de Hipismo breed horses presenting signs of polyuria-polydipsia, were submitted to a complete clinical evaluation as well as having blood and urine samples collected for laboratory analysis. No clinical, hematological or biochemical abnormalities were observed, but a significant decrease in urine specific gravity was detected in both horses. One of the horses presented 1,009 and the other 1,008. A 24-hour water deprivation test was carried out and, during this period, the urine specific gravity gradually increased reaching the normal values of 1,028 and 1,026. The abnormal behavior occured as a consequence of an excessive confinement. The clinical and laboratory results associated to the 24-hour water deprivation test indicated a diagnosis of psychogenic polydipsia.

  17. Características do líquido peritoneal de eqüinos normais após punção cecal percutânea

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    Valadão Carlos Augusto Araújo

    2004-01-01

    Full Text Available Foram avaliados 10 eqüinos da raça Manga Larga, machos, inteiros clinicamente sadios, submetidos à punção cecal percutânea. Analisou-se a resposta clínica, celular, bioquímica e microbiológica do líquido peritoneal por um período de 24 horas após a punção cecal, nos tempos T0, T6, T12 e T24. Foi observada elevação na freqüência respiratória em T6 e na temperatura retal entre T6 e T12. Decorridas 24 horas da punção cecal, ocorreu aumento na concentração de proteínas totais do líquido peritoneal e na atividade da fosfatase alcalina. Tanto a atividade da ALT quanto os níveis de hemoglobina apresentaram diminuição em T6. Não foram registradas alterações na celularidade do plasma ou do líquido peritoneal e obteve-se resultado negativo para a cultura microbiológica do líquido. Considerando a inexistência de efeitos adversos, além das poucas alterações descritas, conclui-se que a punção cecal percutânea é um procedimento seguro e factível, se praticada criteriosamente.

  18. Angiografia in vivo para avaliação da vascularização do casco de eqüinos In vivo angiography for evaluation of equine foot vasculature

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    Carlos Henrique Maciel Brunner

    2008-02-01

    Full Text Available A proposta deste trabalho foi estabelecer a angiografia digital palmar como método de avaliação qualitativa in vivo da vascularização distal laminar em eqüinos em posição quadrupedal. Foram realizadas 15 angiografias de eqüinos mestiços, sendo seis machos castrados e nove fêmeas, com idade variando entre seis e oito anos. As angiografias foram realizadas, após bloqueio anestésico perineural do nervo digital palmar lateral ou medial, por meio da aplicação de 20mL de contraste na veia digital palmar lateral ou medial garroteada por atadura elástica e torniquete. Imediatamente depois, foi realizada a primeira exposição radiológica em incidência dorso-palmar. Após a dispersão do contraste, o mesmo procedimento foi realizado com o casco submetido ao tratamento térmico com água aquecida e com água resfriada. Em quatro animais, obteve-se imagem radiopaca, com bordas maldefinidas, de aspecto sombreado, ao redor de cada lâmina dérmica, que foi creditada à vasodilatação ocasionada pelo calor. Quando da vasoconstrição ocasionada pelo tratamento com frio, observou-se redução da imagem radiopaca laminar. Esse aspecto pôde ser comprovado em quatro radiografias, porém não se repetiu em todas as angiografias realizadas. Em sete radiografias, houve falha de preenchimento de contraste, o que inviabilizou a comparação entre tratamentos térmicos, sendo que as radiografias realizadas sem nenhum tratamento térmico possuíam preenchimento de contraste adequado. A angiografia digital em eqüinos mostrou-se um método sensível para evidenciar vasoconstrição e vasodilatação in vivo dentro do estojo córneo, porém inúmeros fatores podem contribuir para o aparecimento de artefatos de técnica, o que inviabiliza a comparação de alterações da perfusão laminar do casco por esse método.This study was aimed at establishing the palmar digital angiography as an in vivo qualitative method of evaluation the laminar digital

  19. Influência das gonadotrofinas na regulação da maturação nuclear de oócitos eqüinos Influence of gonadotropins on nuclear maturation of equine oocytes

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    Juan Manuel Larre Borges

    1998-06-01

    Full Text Available A maturação in vitro, fecundação e as técnicas de cultivo de embriões na espécie eqüina são extremamente importantes e necessárias para se examinar as causas de repetição de cio, redução de concepção em éguas velhas e também para a preservação da espécie eqüina. Para avaliar o efeito das gonadotrofinas na regulação da maturação nuclear de oócitos eqüinos, folículos com diâmetro entre 5 a 20mm foram aspirados de 551 ovários provenientes de matadouro obtendo-se 408 oócitos aptos para cultivo. Após a aspiração, os oócitos foram avaliados no próprio líquido folicular quanto a sua integridade e distribuídos nos diferentes tratamentos. No Tratamento I (T1 - grupo controle - os oócitos (n=92 foram cultivados em TCM-199 modificado (mod., com 25mM de HEPES, 2,2mg/ml de bicarbonato de sódio, 1 mi g/ml 17-beta estradiol, 250mi M de piruvato de sódio e 0,4% de albumina sérica bovina. No tratamento 2 (T2, os oócitos (n= 108 foram cultivados no mesmo meio TC M-199 mod. acrescido de lug/ml de hormônio luteinizante suíno (LHs. No Tratamento 3 (T3, os oócitos (n=102 também foram cultivados em TCM-199 mod. porém com 0,5mi g/ml de hormônio folículo estimulante suíno (FSHs e no Tratamento 4 (T4 os oócitos (n= 106 foram cultivados com 1mi g/ml de LHs e 0,5mi g/ml, de FSHs. Os oócitos dos quatros tratamentos foram cultivados em estufa a 39°C com 5% de CO2 , e 95% de umidade relativa no ar, durante 24 h. Após este período, as células do Cumulus oophorus foram removidas e os oócitos fixados em solução de ácido acético glacial-metanol (1:3 em placas de Petri 10 x 35mm por 24h sendo posteriormente corados com aceto-orceína. O percentual de oócitos em telófase I / metáfase II foi de 55,6% (59/106 para o T4 (FSHs/LHs e de 53,9% (55/102 para o T3 (FSHs, os quais não diferiram significativamente. No entanto, estes percentuais foram significativamente superiores (pIn vitro maturation, in vitro fertilization

  20. An enzyme-linked immunosorbent assay for the detection of IgG antibodies against Babesia equi in horses Um ensaio imunoenzimático para a detecção de anticorpos IgG contra Babesia equi em eqüinos

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    Cristiane Divan Baldani

    2004-10-01

    Full Text Available A crude antigenic preparation of Babesia equi was used to develop and establish the suitability of an enzyme-linked immunosorbent assay (ELISA for the detection of parasite carriers. Optimal dilutions of the antigen, using positive and negative reference sera, were determined by checkboard titrations. The specificity and sensitivity of the ELISA were 100 %. A total of 90 serum samples were taken from horses from the Northeast region of São Paulo State and examined for diagnosis of equine B. equi infection by ELISA. Approximately 75% (n=67 of all the horses tested were found serologically positive for B. equi. These results suggest that the ELISA described may prove to be an appropriate serological test for epidemiological studies on B. equi infections in the field and that equine piroplasmosis is a cause for serious concern in the State of São Paulo, Brazil.Um ensaio de imunoadsorção enzimática (ELISA baseado em antígeno bruto de Babesia equi foi desenvolvido para a detecção de portadores crônicos de babesiose eqüina. As diluições ótimas do antígeno e dos soros controles positivo e negativo foram determinadas através de titulação em bloco. A sensibilidade e especificidade do teste foram de 100%. O ELISA foi empregado em 90 soros de eqüinos da região Nordeste do Estado de São Paulo, de modo que aproximadamente 75% (n=67 dos eqüinos foram positivos para B. equi. Estes resultados sugerem que o ELISA descrito pode ser utilizado no diagnóstico sorológico de B. equi e que a piroplasmose eqüina é um problema sério no Estado de São Paulo, Brasil.

  1. Mapping health assessment questionnaire disability index (HAQ-DI) score, pain visual analog scale (VAS), and disease activity score in 28 joints (DAS28) onto the EuroQol-5D (EQ-5D) utility score with the KORean Observational study Network for Arthritis (KORONA) registry data.

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    Kim, Hye-Lin; Kim, Dam; Jang, Eun Jin; Lee, Min-Young; Song, Hyun Jin; Park, Sun-Young; Cho, Soo-Kyung; Sung, Yoon-Kyoung; Choi, Chan-Bum; Won, Soyoung; Bang, So-Young; Cha, Hoon-Suk; Choe, Jung-Yoon; Chung, Won Tae; Hong, Seung-Jae; Jun, Jae-Bum; Kim, Jinseok; Kim, Seong-Kyu; Kim, Tae-Hwan; Kim, Tae-Jong; Koh, Eunmi; Lee, Hwajeong; Lee, Hye-Soon; Lee, Jisoo; Lee, Shin-Seok; Lee, Sung Won; Park, Sung-Hoon; Shim, Seung-Cheol; Yoo, Dae-Hyun; Yoon, Bo Young; Bae, Sang-Cheol; Lee, Eui-Kyung

    2016-04-01

    The aim of this study was to estimate the mapping model for EuroQol-5D (EQ-5D) utility values using the health assessment questionnaire disability index (HAQ-DI), pain visual analog scale (VAS), and disease activity score in 28 joints (DAS28) in a large, nationwide cohort of rheumatoid arthritis (RA) patients in Korea. The KORean Observational study Network for Arthritis (KORONA) registry data on 3557 patients with RA were used. Data were randomly divided into a modeling set (80 % of the data) and a validation set (20 % of the data). The ordinary least squares (OLS), Tobit, and two-part model methods were employed to construct a model to map to the EQ-5D index. Using a combination of HAQ-DI, pain VAS, and DAS28, four model versions were examined. To evaluate the predictive accuracy of the models, the root-mean-square error (RMSE) and mean absolute error (MAE) were calculated using the validation dataset. A model that included HAQ-DI, pain VAS, and DAS28 produced the highest adjusted R (2) as well as the lowest Akaike information criterion, RMSE, and MAE, regardless of the statistical methods used in modeling set. The mapping equation of the OLS method is given as EQ-5D = 0.95-0.21 × HAQ-DI-0.24 × pain VAS/100-0.01 × DAS28 (adjusted R (2) = 57.6 %, RMSE = 0.1654 and MAE = 0.1222). Also in the validation set, the RMSE and MAE were shown to be the smallest. The model with HAQ-DI, pain VAS, and DAS28 showed the best performance, and this mapping model enabled the estimation of an EQ-5D value for RA patients in whom utility values have not been measured.

  2. Surtos de tripanossomíase por Trypanosoma evansi em eqüinos no Rio Grande do Sul: aspectos epidemiológicos, clínicos, hematológicos e patológicos Outbreaks of trypanosomiasis in horses by Trypanosoma evansi in the state of Rio Grande do Sul, Brazil: epidemiological, clinical, hematological, and pathological aspects

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    Aline Rodrigues

    2005-12-01

    Full Text Available Casos de tripanossomíase por Trypanosoma evansi foram diagnosticados em eqüinos no Rio Grande do Sul entre 2003 e 2004. Em uma propriedade (Propriedade A com 125 eqüinos, 52 morreram. A Propriedade A recebeu ao redor de 80 éguas de outras propriedades para cobertura. Dessas, 66 adoeceram e 56 morreram após voltarem para suas propriedades de origem. A doença clínica observada em 21 eqüinos caracterizava-se por emagrecimento (apesar de apetite voraz, letargia, incoordenação e instabilidade dos membros pélvicos, atrofia das grandes massas musculares dos membros pélvicos, fraqueza muscular e palidez das mucosas. Exemplares de T. evansi foram observados na corrente sangüínea de 4 eqüinos. Anemia normocítica normo-crômica, com hematócritos que variavam de 15-31%, e leuco-citose por linfocitose associada à presença de linfócitos atípicos foram observadas em vários eqüinos. Altos níveis de anticorpos contra T. evansi foram detectados em 6 eqüinos da Propriedade A. Oito eqüinos desenvolveram um quadro neurológico encefálico caracterizado por andar em círculos, ataxia, cegueira, hiperexcitabilidade, quedas, embotamento, déficits proprioceptivos e desvio da cabeça. Um eqüino desenvolveu "posição de cão sentado". Nas 13 necropsias, havia espleno-megalia, linfadenomegalia, hiperplasia linfóide no baço e linfo-nodo, atrofia das grandes massas musculares dos membros pélvicos, edema e malacia na substância branca e cinzenta do encéfalo. Histologicamente, uma panencefalite devastadora foi observada nos 7 casos e caracterizada por marcado edema, desmielinização, necrose e infiltrado perivascular de 6-10 camadas de células linfoplasmocitárias afetando tanto a substância branca quanto a cinzenta. Muitos plasmócitos do infiltrado inflamatório continham numerosos grânulos eosinofílicos no citoplasma (células de Mott. Lesões semelhantes foram observadas na medula espinhal do eqüino que desenvolveu "posição de c

  3. Resistência parasitária em helmintos de eqüídeos e propostas de manejo Parasite resistance on helminths of equids and management proposal’s

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    Marcelo Beltrão Molento

    2005-12-01

    Full Text Available Os eqüinos apresentam uma grande variedade de parasitas em sua fauna helmíntica, e algumas espécies/gêneros são de relevada importância, como: Parascaris equorum, Anoplocephala perfoliata, Oxyuris equi, Cyathostomum spp. e Strongylus spp. O controle destas infecções depende principalmente da utilização de produtos antiparasitários de forma supressiva ou estratégica e, em menor escala, de forma curativa. O tratamento supressivo é o fator mais importante na promoção da seleção de organismos resistentes, prejudicando a sustentabilidade de qualquer programa sanitário. As formas de detecção da resistência parasitária são onerosas e as mais comuns expressam resultados imprecisos. Entretanto, estas técnicas servem para monitorar a evolução e determinar os organismos envolvidos. A combinação de drogas é uma ferramenta que deve ser utilizada com muita cautela, pois esta alternativa não garante uma redução significativa de organismos resistentes aos compostos envolvidos. O objetivo deste artigo é apresentar formas de planejamento que auxiliem a melhorar a condição sanitária, o bem-estar dos animais e preserve o efeito tóxico dos produtos antiparasitários.Equines harbour a variety of parasitic organisms on their helminth fauna and there are a few species/genus of interest, such as: Parascaris equorum, Anoplocephala perfoliata, Oxyuris equi, Cyathostomum spp. and Strongylus spp. The control of these infections relies mostly on the suppressive or strategic usage of antiparasitic compounds, and to a less extent on curative/salvage treatments. Suppressive treatment is the most important factor regarding the selection of resistant organisms, causing the impairment of sanitary programs. Detection methods of parasite resistance are expensive and the most common ones express variable results. Although, these techniques allow monitoring the evolution and the determination of which organisms are involved. Drug combination is a

  4. Hypoosmotic test to predict viability of equine chilled semen in different extenders Teste hiposmótico para avaliação da viabilidade do sêmen eqüino resfriado com diferentes diluidores

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    M.I.V. Melo

    2005-12-01

    Full Text Available The hypoosmotic test (HO was used to evaluate plasmatic membrane integrity of equine chilled semen and to estimate the correlation between the results of the HO test and those from applied routine exams of semen. The semen of seven stallions was preserved at 5ºC in three different extenders. Each ejaculate was diluted in three extenders, Kenney (K, Baken with 3% of egg yolk (B3 and Baken with 10% of egg yolk (B10, and chilled at 5ºC. The total motility (MT, progressive motility (MP, spermatic vigor (V, normal spermatic morphology (NOR and HO test were used to evaluate semen immediately after collection and at 24 hour-intervals. Spermatic longevity was defined as the time taken to the progressive motility to decline under 10%. Semen diluted in B3 had the best longevity. The results of the HO test suggest that extenders made with egg yolk preserved the membrane plasmatic. Correlation (PUtilizou-se o teste hiposmótico (HO para estudar a capacidade de preservação da membrana plasmática do sêmen eqüino resfriado em diferentes meios. Estimou-se a correlação entre os resultados do teste HO e os exames de rotina aplicados ao sêmen, usando-se sêmen de sete garanhões. Cada ejaculado foi diluído em três meios, Kenney (K, Baken com 3% de gema (B3 e Baken com 10% de gema de ovo (B10, e resfriado a 5ºC. Avaliaram-se a motilidade total (MT, a motilidade progressiva (MP, o vigor espermático (V, a porcentagem de espermatozóides morfologicamente normais (NOR e os resultados do teste HO no sêmen fresco e a cada 24 horas pós-resfriamento. A longevidade espermática foi considerada como o tempo de manutenção da motilidade espermática progressiva superior a 10% do sêmen diluído e resfriado. Maior longevidade espermática foi obtida nas amostras diluídas em meio B3. Os resultados do teste HO sugerem que os diluidores à base de gema de ovo preservaram melhor a membrana plasmática. Foram obtidos valores de correlação (P<0,05 entre o teste

  5. Estudo anatomopatológico e imunoistoquímico da pitiose em eqüinos naturalmente infectados Anatomopathological and immunohistochemical study of pythiosis in naturally infected horses

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    J.L. Reis Jr.

    2002-08-01

    Full Text Available O trabalho teve como objetivo comparar a técnica de Grocott metanamina de prata (GMS com o método imunoistoquímico de streptavidina-biotina marcada (LSAB no diagnóstico da pitiose. Fragmentos de feridas cutâneas suspeitas de pitiose provenientes de 55 eqüinos foram processados pelas técnicas de hematoxilina/eosina, GMS e imunoperoxidase (LSAB. Trinta e quatro casos foram positivos pelo GMS, dos quais 28 apresentaram imunomarcação (LSAB positiva para Pythium insidiosum. Os seis casos restantes apresentaram diagnóstico compatível de zigomicose. Foram diagnosticados como tecido de granulação com infiltração de eosinófilos sem áreas de necrose (nove casos, tecido de granulação com infiltrado de eosinófilos e presença de áreas de necrose (sete, habronemose (quatro e sarcóide (um. Concluiu-se que a imunoperoxidase pelo método LSAB apresenta maior especificidade no diagnóstico de infecção pelo P. insidiosum do que pelo método GMS.The main goals of this study were to perform an anatomopathological evaluation of equine tissue naturally infected with Pythium insidiosus and to compare the reliability of Grocott methenamine silver nitrate (GMS and the labeled streptavidin-biotin (LSAB techniques for the diagnosis of pythiosis. Samples of cutaneous wounds suggestive of pythiosis obtained from 55 horses were histologically studied using hematoxylin-eosin and GMS stains, and LSAB. Twenty eight, out of 34 GMS-positive samples, were LSAB-positive for Pythiuminsidiosum. The six LSAB-negative samples were apparently cases of zygomicosis. The remaining samples were diagnosed as follow: granulation tissue with eosinophilic infiltration without necrotic areas (nine cases; granulation tissue with eosinophilic infiltration and necrotic areas (seven; habronemiasis (four; sarcoid (one. In conclusion, the LSAB method was more specific for the diagnosis of P. insidiosum when compared to GMS.

  6. Perfil e distribuição da síndrome cólica em eqüinos em três unidades militares do Estado do Rio de Janeiro, Brasil Profile and distribution of equine colic syndrome in three military units in Rio de Janeiro, Brazil

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    Paula Vieira Evans Hossell Laranjeira

    2009-07-01

    Full Text Available Este estudo teve como objetivo avaliar o perfil e a distribuição da síndrome cólica em eqüinos de três unidades militares no Estado do Rio de Janeiro, o Regimento Escola de Cavalaria (REsC, a Academia Militar das Agulhas Negras (AMAN e o Esquadrão Escola de Cavalaria (EEC. No período entre 2003 e 2004, 770 eqüinos foram acompanhados para a ocorrência de casos clínicos de cólica. Realizou-se análise descritiva dos dados, e foram calculadas a taxa de incidência de cólica e a proporção de eqüinos acometidos. O teste do χ2 foi utilizado para avaliar a associação entre síndrome cólica e variáveis relativas às características dos eqüinos e do manejo. A incidência variou entre as unidades militares, 0,12 na AMAN, 0,21 no EEC e 0,95 casos/eqüino-ano no REsC, sendo acometidos 15% dos eqüinos da AMAN, 30% do EEC e 69% do REsC. A maior incidência foi de episódios de origem gástrica, 76,5%. Casos de reincidência foram elevados, sendo 62,5% no REsC, 36,7% na AMAN e 29,0% no EEC. A síndrome cólica estava significativamente associada às variáveis unidade militar, sistema de criação, quantidade de grãos ingerido e suplemento mineral-vitamínico. As altas incidências, reincidências e proporção de animais acometidos observadas ocorreram de forma diferenciada nas três unidades, indicando que, apesar de possuírem como característica comum pertencerem a unidades militares, os eqüinos formam um grupo heterogêneo no que diz respeito à ocorrência de síndrome cólica, provavelmente devido às diferentes condições de manejo.This research aimed to verify the profile and distribution of colic syndrome in horses of three military units in Rio de Janeiro, Brazil, which were Regimento Escola de Cavalaria (REsC, Academia Militar das Agulhas Negras (AMAN, and Esquadrão Escola de Cavalaria (EEC. From 2003 to 2004, 770 horses were followed up for the incidence of colic cases. A descriptive analysis of clinical data

  7. Olanzapine-induced neuroleptic malignant syndrome in a patient with bipolar affective disorder: Does quetiapine holds the solution?

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    Praveen Tripathi

    2013-01-01

    Full Text Available Neuroleptic Malignant Syndrome (NMS is a rare, severe and life threatening condition induced by antipsychotic medications. It is commonly encountered with the use of first generation antipsychotics, however cases of NMS have been reported with the use of second generation antipsychotics like Olanzapine, Risperidone, Paliperidone, Aripiprazole, Ziprasidone, Amisulpride, Quetiapine and Clozapine, though the incidence of such reports is rare. Due to decreased use of first generation antipsychotics, NMS is reported less frequently now a days. In this case report- we highlight the management issues of a patient suffering from bipolar affective disorder, who had developed NMS following intramuscular injection of haloperidol, which was withdrawn and olanzapine was given later on. The patient had again developed NMS with olanzapine. Finally the patient was managed with modified electroconvulsive therapy and discharged on Lithium carbonate and Quetiapine.

  8. Glioblastoma chemotherapy adjunct via potent serotonin receptor-7 inhibition using currently marketed high-affinity antipsychotic medicines

    Science.gov (United States)

    Kast, RE

    2010-01-01

    Glioblastoma treatment as now constituted offers increased survival measured in months over untreated patients. Because glioblastomas are active in synthesizing a bewildering variety of growth factors, a systematic approach to inhibiting these is being undertaken as treatment adjunct. The serotonin 7 receptor is commonly overexpressed in glioblastoma. Research documentation showing agonists at serotonin receptor 7 cause increased extracellular regulated kinase 1/2 activation, increased interleukin-6 synthesis, increased signal transducer and activator of transcription-3 activation, increased resistance to apoptosis and other growth enhancing changes in glioblastoma is reviewed in this paper. Because three drugs in wide use to treat thought disorders – paliperidone, pimozide and risperidone – are also potent and well-tolerated inhibitors at serotonin receptor 7, these drugs should be studied for growth factor deprivation in an adjunctive role in glioblastoma treatment. PMID:20880389

  9. The Safety of Second-Generation Antipsychotics During Pregnancy

    DEFF Research Database (Denmark)

    Damkier, Per; Videbech, Poul

    2018-01-01

    The issue of antipsychotic treatment during pregnancy is subject to substantial uncertainty and some controversy among healthcare providers, specifically pertaining to second-generation antipsychotics (SGAs) that are subject to a large gap in safety data during pregnancy compared...... with antidepressants. The amount of safety data for the use of SGAs during pregnancy is rapidly increasing, thus constantly changing the level of evidence. We performed a clinically focused review on the safety of SGA during pregnancy. Twenty-three studies provided various pregnancy outcomes for 14,382 pregnant women...... exposed to an SGA during pregnancy. In utero exposure to aripiprazole, olanzapine, and quetiapine is not associated with increased risks of major congenital malformations, whereas risperidone and paliperidone may be associated with a very minor increased risk of congenital malformations. Safety data...

  10. Alteração do teor de cálcio no banho de DP para 2,5 mEq/L é eficaz no reestabelecimento dos valores preconizados por diretrizes atuais em pacientes com PTH < 150 pg/dL Low-calcium peritoneal dialysis solution is effective in bringing PTH levels to the range recommended by current guidelines in patients with PTH levels < 150 pg/dL

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    Thyago Proença de Moraes

    2010-09-01

    Full Text Available INTRODUÇÃO/OBJETIVO: A doença óssea adinâmica (DOA é um achado comum em diálise peritoneal (PD e é considerada fator de risco para desenvolvimento de fraturas e doença cardiovascular. Dados do BRAZPD apontam as soluções de cálcio a 3,5 mEq/L presentes na maioria das prescrições no país, que possui quase 9.000 pacientes em PD. É comum o balanço positivo de cálcio com concentrações a 3,5 mEq/L contribuindo para o desenvolvimento de DOA. Diretrizes atuais recomendam um PTHi na DRC V em diálise entre 2 e 9 vezes (150-500 pg/mL o valor máximo da normalidade. O objetivo deste estudo foi avaliar a resposta em 6 meses do PTH-i após a conversão para solução de cálcio a 2,5 mEq/L de pacientes que usavam soluções com cálcio a 3,5 mEq/L e com PTH-i basal INTRODUCTION/OBJECTIVE: Adinamic bone disease (ABD is a common finding in peritoneal dialysis (PD and is associated with higher risk of developing cardiovascular and bone disease. Data from BRAZPD indicates that 3.5 mEq/L calcium PD solutions represents the majority of PD prescriptions in the country. A positive calcium balance can contribute to ABD development. Currently guidelines suggest that PTH-i levels in end stage renal disease should be kept from 150-300 pg/mL. The purpose of this study is to evaluate 6 month PTH-i response after conversion to 2.5 mEq/L calcium PD solution in patients with baseline PTH-i levels < 150 pg/mL. METHODS: Prospective, observational study of all prevalent patients (at least 90 days on therapy on PD of a single Brazilian center from January 2008 to May 2009. Inclusion criteria (1 be in use of a PD solution with 3.5mEq/L of calcium; (2 baseline PTH leves < 150 pg/ mL. According to clinical practice patients could be switched to PD solutions with 2.5 mEq/L of calcium. RESULTS: 35 patients (age 62 ± 17 years were included. Of these 22 were converted to 2.5 mEq/L calcium solutions. Diabetic nephropathy (36% was the main cause of renal disease

  11. Enterite granulomatosa associada a larvas de ciatostomíneos em eqüinos no Rio Grande do Sul Granulomatous enteritis associated with larval cyathostomiasis in horses in Rio Grande do Sul, Brazil

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    Felipe Pierezan

    2009-05-01

    Full Text Available São descritos cinco casos de enterite granulomatosa associada a larvas de ciatostomíneos em eqüinos provenientes de três propriedades rurais do Rio Grande do Sul. Os casos ocorreram entre janeiro de 1999 e dezembro de 2007. A evolução clínica nos dois casos cujo seguimento clínico foi acompanhado foi de 10 e 14 dias. Os sinais clínicos apresentados por três eqüinos foram semelhantes e consistiam de diarréia (3/3, emagrecimento (2/3, pirexia (1/3, taquicardia (1/3 e taquipnéia (1/3. Os achados macroscópicos incluíram espessamento da parede do cólon maior e ceco por edema e ocorrência de numerosos pontos marrom-escuros com 1-4mm, levemente salientes, disseminados pela mucosa. A incisão desses pontos revelou pequenas larvas de nematódeos marrom-avermelhadas de 1-2mm. Numerosos parasitas, compatíveis morfologicamente com pequenos estrôngilos, foram observados na luz intestinal ou aderidos à mucosa do cólon maior e ceco. Histologicamente, na mucosa e submucosa do cólon maior e ceco, foram observados múltiplos granulomas constituídos por moderado ou acentuado infiltrado inflamatório, composto por macrófagos, macrófagos epitelióides e eosinófilos circundados por linfócitos e plasmócitos. No centro desses granulomas, observaram-se cortes transversais de parasitas com morfologia compatível com ciatostomíneos. Adicionalmente, havia edema e infiltrado inflamatório linfo-histioplasmocitário e eosinofílico, leve ou moderado na submucosa e mucosa do cólon maior e ceco; necrose e proliferação linfo-histiocítária em folículos linfóides na submucosa e hiperplasia de células caliciformes na mucosa. O diagnóstico de enterite granulomatosa associada a ciatostomíneos foi realizado com base nos achados epidemiológicos, clínicos e macroscópicos e confirmado pela histologia.Five cases of granulomatous enteritis associated with cyathostomes are described in horses from three farms in Rio Grande do Sul, Brazil. The cases

  12. Efeitos da isoflavona e dos estrogênios conjugados eqüinos sobre a qualidade de vida na pós-menopausa Effects of isoflavone and conjugated equine estrogen on the postmenopausal quality of life

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    Lúcia Helena Laprano Vieira

    2007-05-01

    Full Text Available OBJETIVO: analisar os efeitos da isoflavona e do estrogênio sobre a qualidade de vida de mulheres na pós-menopausa. MÉTODOS: realizou-se estudo randomizado, duplo-cego, com 79 pacientes, amenorréia de 12 meses, idade superior a 40 anos e índice de massa corporal (IMC superior a 30 kg/m². As mulheres foram aleatoriamente divididas em dois grupos de tratamento: GECP recebeu duas cápsulas, via oral, de 12/12 horas, uma contendo 0,625 mg de estrogênios conjugados eqüinos e, a outra, placebo (n=33; GECS recebeu duas cápsulas de 150 mg de extrato de soja, com 60 mg de isoflavonas cada (n=32, por seis meses. O Questionário de Qualidade de Vida Específico para Menopausa foi empregado antes e após um, três e seis meses de tratamento. Os parâmetros do risco de câncer ginecológico foram avaliados. Para análise dos dados, aplicaram-se os testes de ANOVA e de Tukey. RESULTADOS: quanto aos parâmetros vasomotores, houve redução nos valores após seis meses de tratamento, 1,6±0,8 e 2,4±1,6, em relação aos valores antes da terapia, 4,0±2,2 e 4,2±2,3, respectivamente, nos GECP e GECS. Os aspectos psicossociais mostraram diminuição dos valores após seis meses de terapia, 2,5±1,2 e 2,9±1,4, em relação aos valores antes da terapia, 3,6±1,6 e 4,1±1,9, respectivamente, nos GECP e GECS. De forma semelhante ocorre no aspecto físico e nos sintomas sexuais. CONCLUSÕES: as isoflavonas agem positivamente na qualidade de vida de mulheres na pós-menopausa, semelhantemente aos estrogênios conjugados eqüinos.PURPOSE: to analyze the isoflavone and estrogen effects on the postmenopausal quality of life. METHODS: this is a randomized and double-blind study with 79 postmenopausal patients, 12 months of amenorrhea, 40 years old or more and body mass index (BMI above 30 kg/m². The participants were randomly divided into two treatment groups: GECP received orally two capsules, every 12 hours, one contained 0.625 mg conjugated equine estrogen

  13. Uso do farelo de vagem de algaroba (Prosopis juliflora (Swartz D.C. em dietas para eqüinos Effects of feeding mesquite pod meal (Prosopis juliflora (Swartz D.C. for horses

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    Rosane Barros da Silva Stein

    2005-08-01

    Full Text Available Este trabalho foi conduzido para se avaliar o uso do farelo de vagem de algaroba (FVA em substituição ao milho desintegrado com palha e sabugo (MDPS sobre o consumo de nutrientes em dietas para eqüinos. Foram utilizadas 16 éguas da raça Mangalarga Marchador, com idade variando de 3,5 a 18,4 anos e peso médio de 394,8 kg. No ensaio de digestão, foi utilizado o método da coleta total de fezes e foram estimados os coeficientes de digestibilidade aparente da matéria seca (CDMS, matéria orgânica (CDMO, proteína bruta (CDPB, fibra em detergente neutro (CDFDN, hemicelulose (CDHCEL, fibra em detergente ácido (CDFDA e energia bruta (CDEB. As dietas, isoprotéicas e isocalóricas, foram compostas de feno de coastcross e concentrado na proporção de 60:40. Os níveis de substituição do MDPS pelo FVA foram de 0, 33, 66 e 100%. O delineamento experimental adotado foi em blocos casualizados (idade das éguas, com quatro repetições por tratamento. Não houve efeito dos blocos nas variáveis avaliadas. O consumo de matéria seca não foi afetado pela inclusão do FVA, observando-se valores médios de 1,8% do peso vivo (PV, 7,02 kg MS/dia, 79,84 g MS/kg PV0,75. Os CDMS, CDMO, CDPB e CDHCEL não diferiram entre as dietas experimentais, com valores médios de 49,15, 50,18, 56,89 e 35,43%, respectivamente. Verificou-se efeito linear decrescente no CDFDN e quadrático no CDFDA e CDEB, em função dos níveis crescentes de substituição. De acordo com as equações de regressão, o valor máximo do CDFDA seria obtido com 22,3% de substituição, enquanto os valores do CDFDN e CDEB seriam máximos na dieta sem o FVA. Conclui-se que, apesar da redução no aproveitamento das frações fibrosas das dietas, o FVA pode ser utilizado em dietas para eqüinos.Sixteen mares of Mangalarga Marchador breed, averaging from 3.5 to 18.4 years old and 394.8 kg, were assigned to a randomized blocks (mares age design, with four replicates by treatment, to evaluate

  14. Cost-Utility Analysis of Depot Atypical Antipsychotics for Chronic Schizophrenia in Croatia.

    Science.gov (United States)

    Jukic, Vlado; Jakovljevic, Miro; Filipcic, Igor; Herceg, Miroslav; Silic, Ante; Tomljanovic, Tatjana; Zilbershtein, Roman; Jensen, Rasmus C D; Hemels, Michiel E H; Einarson, Thomas R

    As a nation with a developing economy, Croatia is faced with making choices between pharmaceutical products, including depot injectable antipsychotics. We conducted a pharmacoeconomic analysis to determine the cost-effectiveness of atypical depots in Croatia. A 1-year decision-analytic framework modeled drug use. We determined the average direct cost to the Croatian Institute for Health Insurance of using depot formulations of paliperidone palmitate long-acting injectable (PP-LAI), risperidone LAI (RIS-LAI), or olanzapine LAI (OLZ-LAI). An expert panel plus literature-derived clinical rates populated the core model, along with costs adjusted to 2012 by using the Croatian consumer price index. Clinical outcomes included quality-adjusted life-years, hospitalization rates, emergency room treatment rates, and relapse days. Robustness of results was examined with one-way sensitivity analyses on important inputs; overall, all inputs were varied over 10,000 simulations in a Monte Carlo analysis. Costs (quality-adjusted life-years) per patient were €5061 (0.817) for PP-LAI, €5168 (0.807) for RIS-LAI, and €6410 (0.812) for OLZ-LAI. PP-LAI had the fewest relapse days, emergency room visits, and hospitalizations. Results were sensitive against RIS-LAI with respect to drug costs and adherence rates, but were generally robust overall, dominating OLZ-LAI in 77.3% and RIS-LAI in 56.8% of the simulations. PP-LAI dominated the other drugs because it had the lowest cost and best clinical outcomes. Compared with depots of olanzapine and risperidone and oral olanzapine, PP-LAI was the cost-effective atypical LAI for treating chronic schizophrenia in Croatia. Using depot paliperidone in place of either olanzapine or risperidone would reduce the overall costs of caring for these patients. Copyright © 2013, International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc.

  15. Efficacy, acceptability and tolerability of 8 atypical antipsychotics in Chinese patients with acute schizophrenia: A network meta-analysis.

    Science.gov (United States)

    Bai, Zhihua; Wang, Guoqiang; Cai, Shangli; Ding, Xindi; Liu, Weiwei; Huang, Depei; Shen, Weidi; Zhang, Juncheng; Chen, Kui; Yang, Yuqing; Zhang, Lili; Zhao, Xiaochen; Ouyang, Qiong; Zhao, Jingping; Lu, Huafei; Hao, Wei

    2017-07-01

    We aimed to create hierarchies of the efficacy, acceptability and tolerability of eight atypical antipsychotics in the treatment of Chinese patients with acute schizophrenia. We systematically searched for RCT articles published between January 1st 2005 and December 31st 2014 in electronic databases (Medline, Pubmed, Embase, the Cochrane Library and ClinicalTrial.gov for studies in English and the China National Knowledge Infrastructure, Wan Fang, and VIP Information/Chinese Scientific Journals Database for studies in Chinese). The primary outcome was efficacy, as measured by the change of PANSS total score. Pairwise comparisons were performed using random-effects model by the Dersimonian-Laird method and network meta-analyses were performed in a Bayesian set. Sixty high-quality RCTs with 6418 participants were included. A pattern of superiority from olanzapine, paliperidone and amisulpride was seen in the primary outcome. Only paliperidone was found better than aripiprazole (odds ratio, 0.49 [95% credible intervals, 0.25 to 0.99]), ziprasidone (0.42 [0.21 to 0.85]) and quetiapine (0.36 [0.13 to 0.93]) in terms of all-cause discontinuation. The best and worst drugs in terms of weight gain, EPS and somnolence were aripiprazole and olanzapine, clozapine and amisulpride, aripiprazole and clozapine, respectively. The rank of efficacy did not change substantially in sensitivity analyses or in meta-regressions. Our findings provided the hierarchies of eight antipsychotics in efficacy, acceptability and tolerability. These findings are expected to help Chinese clinicians to select the appropriate antipsychotic drug for their patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Medical school gift restriction policies and physician prescribing of newly marketed psychotropic medications: difference-in-differences analysis.

    Science.gov (United States)

    King, Marissa; Essick, Connor; Bearman, Peter; Ross, Joseph S

    2013-01-30

    To examine the effect of attending a medical school with an active policy on restricting gifts from representatives of pharmaceutical and device industries on subsequent prescribing behavior. Difference-in-differences approach. 14 US medical schools with an active gift restriction policy in place by 2004. Prescribing patterns in 2008 and 2009 of physicians attending one of the schools compared with physicians graduating from the same schools before the implementation of the policy, as well as a set of contemporary matched controls. Probability that a physician would prescribe a newly marketed medication over existing alternatives of three psychotropic classes: lisdexamfetamine among stimulants, paliperidone among antipsychotics, and desvenlafaxine among antidepressants. None of these medications represented radical breakthroughs in their respective classes. For two of the three medications examined, attending a medical school with an active gift restriction policy was associated with reduced prescribing of the newly marketed drug. Physicians who attended a medical school with an active conflict of interest policy were less likely to prescribe lisdexamfetamine over older stimulants (adjusted odds ratio 0.44, 95% confidence interval 0.22 to 0.88; P=0.02) and paliperidone over older antipsychotics (0.25, 0.07 to 0.85; P=0.03). A significant effect was not observed for desvenlafaxine (1.54, 0.79 to 3.03; P=0.20). Among cohorts of students who had a longer exposure to the policy or were exposed to more stringent policies, prescribing rates were further reduced. Exposure to a gift restriction policy during medical school was associated with reduced prescribing of two out of three newly introduced psychotropic medications.

  17. Toracoscopia em eqüinos: técnica e emprego como método de avaliação da cavidade pleural Thoracoscopy in horses: technique and its use as pleural cavity evaluation method

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    André Luis do Valle De Zoppa

    2001-10-01

    Full Text Available Toracoscopia é o método de visibilização da cavidade torácica através de endoscópio rígido ou flexível, indicado como exame auxiliar para diagnóstico das diversas afecções do tórax. Pode ser realizada com o animal sob anestesia geral ou em posição quadrupedal através de anestesia local associada ou não a sedativos. Neste trabalho, foram utilizados seis eqüinos hígidos, que foram submetidos a toracoscopia, em posição quadrupedal, nos dois hemitórax, com intervalo de 15 dias entre cada procedimento. Durante o exame, pôde-se observar as diversas estruturas da cavidade torácica, tais como: músculo diafragma (porção muscular e tendínea, hiato esofágico, mediastino, aorta, troncos dorsal e ventral do nervo vago, ducto torácico, veia ázigos, veias intercostais, músculos intercostais, costelas, tronco nervoso simpático, tronco vascular toracocervical, traquéia, pulmão (lobo cranial e caudal, esôfago, pericárdio, veia cava caudal, nervo frênico e linfonodos aórticos. Discretas alterações foram observadas ao exame físico, laboratorial e ultra-sonográfico no período pós-operatório, sem que trouxessem prejuízos ao desenvolvimento do experimento e recuperação do animal. A toracoscopia mostrou ser exame de auxílio importante, pela facilidade, rapidez de execução, ampla visibilização da cavidade pleural e trauma mínimo ao paciente.Thoracoscopy is the technique based upon the thoracic cavity visualization by means of rigid or flexible endoscope. It is indicated as an additional diagnostic aid to better define thoracic diseases. It can be performed either in an animal subjected to general anesthesia or in a horse standing on stocks with local anesthesia with or without sedative. Six healthy horses were used in this study they were subjected to thoracoscopy in both hemithorax, standing on stocks, with a 15-day interval between each procedure. It was possible to visualize several thoracic structures through

  18. Alterações radiográficas e ultra-sonográficas iniciais em osteoartrite experimental eqüina Early radiographic and ultrasonographic changes in equine experimental osteoarthritis

    Directory of Open Access Journals (Sweden)

    L. Rasera

    2007-06-01

    Full Text Available Avaliaram-se oito articulações metacarpofalangeanas (MCF de eqüinos adultos pelos exames radiográfico e ultra-sonográfico após indução cirúrgica de uma instabilidade articular, para mimetizar as alterações iniciais da osteoartrite (OA naturalmente adquirida. Foram mensurados a circunferência articular, a amplitude do movimento articular e o grau de claudicação dos membros torácicos (avaliação clínica. Dez dias após a intervenção cirúrgica os animais foram exercitados em um andador por um período de 60 dias. Os exames radiográfico e ultra-sonográfico foram realizados antes da intervenção cirúrgica e após 25, 40 e 70 dias, e a avaliação clínica, semanalmente, durante todo o período experimental. Observaram-se alterações ultra-sonográficas aos 25 dias após a instabilidade articular, enquanto as alterações radiográficas somente foram visualizadas aos 40 dias. Houve aumento significativo (PEight metacarpophalangeal joints (MCP of mature horses were evaluated by radiographic and ultrasonographic exams after surgically instability-induced that mimics the early changes of naturally acquired osteoarthritis (OA. Joint circunference, range of motion and lameness score were measured (clinical evaluation. Ten days after surgically joint instability the animals were walked on a horse walker by a 60-day period. Radiography and ultrasonography were taken immediately before desmotomy and 25, 40 and 70 days after surgery. Clinical evaluation was performed at each 7-day intervals. Ultrasonographic changes were observed on day 25 after articular instability while radiographic changes were only visualized on day 40. Joint circunference was significantly higher (P<0.05 in OA joints (25.75cm± 1.1 on day 7 as compared with contralateral joints (24.88cm± 1.0 and a range of motion was significantly less (P<0.05 in OA joints (96.38º± 10.7, on day 25, compared with basal value (109.24º± 10.3 and contralateral joint (108.75º

  19. UTILIZATION OF THE THERAPY PHYSICAL IN HORSES WITH FACIAL PARALYSIS Trabajo del Fisioterapia en Cabalos con parálisis de la cara Emprego da Fisioterapia em Eqüinos com Paralisia Facial

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    Luís Antônio Franco SILVA

    2008-07-01

    Full Text Available Facial paralysis is an injury that assaults horses, not very unusual in veterinary. It occurs mainly because of direct or indirect traumas over the facial nerve, that goes over the masseter muscle, having only skin an tissue to protect it. Paralyses are common in cases of compression because of the contention of the animal head on the ground. This work reports the case of a PSI mare with four years, that was taken care of in the Veterinarian Hospital of the Veterinary School of the Federal University of Goiás, presenting signs of facial nerve injury; and a cart horse that was taken care at Racecourse of the Pond of Jockey Club of Goiás, with 10 years, debilitated and having facial habronemiasis. These animals received therapy physical, using cinesiotherapy and electrical stimulation, for 60 days, obtaining a satisfactory effect like improve of the left facial muscle, return to symmetrical the left nostril, discreet ptosis in the underling lip, normalization of the action to feed and improve of the facial esthetics. Concluding that therapy physical was a efficient method of treatment injuries in the facial nerve, like compression, helping in the return of the disturbs of muscle function and to the welfare of these animals.

     

    Key words: Animal, cinesiotherapy, electrical stimulation, neurology, rehabilitation.

    A paralisia facial, uma afecção que acomete eqüinos, é comum na medicina veterinária e decorre principalmente de traumatismos diretos ou indiretos sobre o nervo facial, que passa sobre o músculo masseter, contando apenas com a pele e o tecido subcutâneo para sua proteção. As paralisias têm origem na compressão causada pela contenção da cabeça do animal em decúbito lateral. Este trabalho relata dois casos de paralisia facial. Um deles é de uma égua PSI de quatro anos de idade, atendida no Hospital Veterinário da Escola

  20. Which Questionnaire Should Be Used to Measure Quality-of-Life Utilities in Patients with Acute Leukemia? An Evaluation of the Validity and Interpretability of the EQ-5D-5L and Preference-Based Questionnaires Derived from the EORTC QLQ-C30.

    Science.gov (United States)

    van Dongen-Leunis, Annemieke; Redekop, W Ken; Uyl-de Groot, Carin A

    The aim of this study was to assess the validity and interpretability of different preference-based questionnaires (generic 5-level EuroQol five-dimensional questionnaire [EQ-5D-5L], cancer-specific Quality of Life Questionnaire Preference-Based Measure, and European Organization of Randomized Controlled Trials 8 Dimension [EORTC-8D]) in patients with acute leukemia. Patients who participated in Hemato-Oncologie voor Volwassenen Nederland (HOVON - the Haemato Oncology Foundation for Adults in the Netherlands) clinical trials between 1999 and 2011 at a single hospital were invited to complete the questionnaires. Interpretability was evaluated by the frequency of incomplete data and highest and lowest possible scores. Content validity was evaluated by exploring the health-related quality-of-life domains included in the questionnaires. Construct validity was assessed using correlations with other quality-of-life scales (EQ-visual analogue scale score and global quality-of-life scale of the EORTC Quality of Life Questionnaire) and ability to distinguish between patients with different health statuses. Questionnaires were returned by 89% (111 of 125) of the patients. Six to seven respondents did not return full questionnaires. Perfect health on the EQ-5D-5L was reported by 32 respondents and many of them (N = 17) did report health problems on other questionnaires. All questionnaires were strongly correlated (range 0.61-0.78) with other quality-of-life scales and yielded substantially different utility values for patients with different health statuses. Nevertheless, the disease-specific preference-based questionnaires showed greater discriminatory power. Although the Quality of Life Questionnaire Preference-Based Measure and the EORTC-8D appear to have better validity, this study does not provide any strong evidence against the use of the EQ-5D-5L for measuring quality-of-life utilities in acute leukemia. However, our findings need to be confirmed in larger longitudinal

  1. A “questão social” e o social-liberalismo brasileiro: contribuição à crítica da noção do desenvolvimento econômico com eqüidade (The “social question” and brazilian social-liberalism: a contribution to the critique of the notion of economic development with equity)

    OpenAIRE

    Rodrigo Castelo Branco

    2008-01-01

    Resumo: O objeto de estudo do artigo é o social-liberalismo brasileiro, suas teses acerca do desenvolvimento econômico com eqüidade e suas propostas políticas de resolução da “questão social”. A nossa hipótese de trabalho é que, na era neoliberal, determinadas correntes do pensamento social brasileiro entram em uma nova fase do longo processo daquilo que Lukács chamou de decadência ideológica do pensamento burguês. Além da apresentação das principais teses do social-liberalismo brasileiro, pr...

  2. Eqüidade e atenção à saúde da gestante em Campinas (SP, Brasil Equity and access to health care for pregnant women in Campinas (SP, Brazil

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    Solange Duarte de Mattos Almeida

    2005-01-01

    intensidade e direção nas variáveis relativas às condições e à atenção à saúde. Os resultados sugerem que a organização dos serviços públicos de saúde em Campinas tem viabilizado em alguns aspectos a promoção da eqüidade na saúde.OBJECTIVE: To compare the health care received during pregnancy, delivery, and the puerperium by women belonging to two different per capita family income strata: less than 1 minimum wage, and 1 or more minimum wages. METHOD: This is a cross-sectional observational study that was carried out with a random sample of 248 female residents of the city of Campinas, in the state of São Paulo, Brasil, who had given birth between April 2001 and March 2002. Socio-demographic data, as well as information concerning maternal morbidity and health care during pregnancy, delivery, and the puerperium, were obtained through home interviews. The Kessner index, the Adequacy of Prenatal Care Utilization index, and an index proposed by the authors based on the recommendations of the Brazilian Department of Health were used to assess the adequacy of prenatal care. The minimum wage in Brazil at the time of the study was 180 reais (approximately 71.4 US dollars. RESULTS: The lower income group included a larger proportion of women with low schooling, as well as adolescents, black women, and single women. Prenatal care was provided by the public Unified Health System to 73.7% of the women in the lower income group, versus 33.3% in the higher income group. The women in the lower income group started attending prenatal care later and had fewer visits in all than higher-income women. However, some health care quality indicators, such as performance of routine laboratory tests and anti-HIV antibody testing, the proportion of cesarean sections, and the frequency of infant rooming-in, showed more favorable figures in the lower income group. Both groups received comparable counseling and had similar rates of clinical testing, post-delivery tubal sterilization

  3. In vitro culture, PCR , and nested PCR for the detection of Theileria equi in horses submitted to exercise Cultivo in vitro, PCR e nested PCR na detecção de Theileria equi em eqüinos submetidos a exercícios

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    C.D. Baldani

    2008-06-01

    Full Text Available This study compared the usefulness of in vitro culture, PCR, and nested PCR for the diagnosis of Theileria equi in horses submitted to stress during exercise. Blood samples from 15 apparently healthy horses, previously conditioned to a high-speed equine treadmill, were taken prior to and after exercise. The animals were divided into two experimental groups: 30-day training schedule (G1 and 90-day training schedule (G2. Statistical analysis was performed using a chi-square test and kappa statistic was used in order to assess agreement. No significant difference was observed between samples collected at resting or after exercise. In G1, merozoites of T. equi were detected in the blood smears of four horses before in vitro culture, whereas 14 samples were positive, confirmed by culture. In G2, five and 11 horses were positive before and after culture, respectively. No PCR amplified product was observed in any of the tested animals although the PCR system based on the 16S rRNA gene of T. equi detected DNA in blood with an equivalent 8x10-5% parasitaemia. The nested PCR based on the T. equi merozoite antigen gene (EMA-1 allowed the visualization of amplified products in all the horses. Therefore, nested PCR should be considered as a means of detection of sub-clinical T. equi infections and in vitro culture could be used as a complement to other methods of diagnosis.Comparou-se a utilização do cultivo in vitro, PCR e nested PCR no diagnóstico de Theileria equi em eqüinos submetidos ao estresse induzido por exercícios. Amostras de sangue foram obtidas de 15 eqüinos submetidos a treinamento em esteira rolante de alto desempenho, sendo as amostras colhidas antes e após os exercícios. Os animais foram divididos em dois grupos experimentais: 30 dias de treinamento (G1 e 90 dias de treinamento (G2. O teste do qui-quadrado foi empregado para as análises estatísticas e o índice kappa utilizado para avaliar a concordância. Não houve diferen

  4. Intoxicações natural e experimental por amitraz em eqüídeos: aspectos clínicos Natural and experimental poisoning by amitraz in horses and donkey: clinical aspects

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    Marcos Dutra Duarte

    2003-09-01

    Full Text Available A administração oral e a aspersão com amitraz reproduziram experimentalmente em 17eqüinos e um asinino um quadro de intoxicação muito similar a outro que vinha ocorrendo em cavalos no Estado do Rio de Janeiro. O início dos sintomas após a administração oral variou entre 15min. e 2h05min., na aplicação por aspersão variou entre 6h28min. e 8h38min. A evolução nos casos de administração oral foi de 4 a 9 dias, nos de aspersão de 5 a 6 dias. Somente morreram animais que receberam a administração oral. Um animal aspergido com o amitraz foi sacrificado. Por via oral foram usadas dosagens de 5,5 mg/kg (uma administração, 5,8 mg/kg (duas administrações e num terceiro animal, doses que variaram entre 7,2 e 36,4 mg/kg (cinco administrações. Nas aplicações por aspersão, a intoxicação foi reproduzida com soluções nas concentrações de 0,1 e 0,2%. Com relação ao sistema nervoso, os principais sinais observados foram apatia, sonolência, ptoses palpebral e auricular, dificuldade de apreensão, mastigação e deglutição do alimento, arrastar das pinças dos cascos no solo, exposição do pênis, sensibilidade cutânea diminuída/ausente, instabilidade em estação, abdução dos membros, cabeça baixa, incoordenação, bocejos, flacidez labial, exposição da língua, cruzamento dos membros ao caminhar, resposta postural diminuída após cruzar e abduzir os membros, reflexos do lábio superior, palatal, lingual, de deglutição e flexor diminuídos/ausentes, reflexos auricular, palpebral e de ameaça diminuídos e resposta ambulatória diminuída ao teste de girar em círculo de pequeno raio. No que se refere ao sistema digestivo, foram evidenciados, principalmente, hipomotilidade/atonia intestinal, edema dos lábios, distensão abdominal, deitar e levantar com freqüência, rolar no solo, olhar para o flanco, gemer e impactação do intestino grosso. Observaram-se ainda taquicardia, aumento do tempo de preenchimento

  5. Inibição e reversão da agregação plaquetária de eqüinos in vitro com o uso de ketoprofeno, fenilbutazona e flunixim meglumine In vitro inibition and reversion of equine platelet aggregation using ketoprophen, phenylbutazone and flunixin meglumin

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    Fabiola O. Paes Leme

    2009-10-01

    Full Text Available Como são várias as enfermidades e os distúrbios que induzem à hipercoagulabilidade e à pré-ativação de plaquetas em eqüinos. A atividade de medicamentos utilizados para controle dessas enfermidades sobre a agregação de plaquetas pode, não apenas servir para avaliar sua evolução, como também a resposta terapêutica. Com o objetivo de avaliar a prevenção e a reversão da agregação plaquetária de eqüinos in vitro foram utilizados os antiinflamatórios não esteroidais (AINES: ketoprofeno, fenilbutazona e flunixim meglumine. A comparação demonstrou que a fenilbutazona e o ketoprofeno previnem a agregação de plaquetas de eqüinos induzida pelo ADP, de forma mais eficaz do que o flunixim-meglumine e, superior ao fragmento monoclonal de anticorpo Reopro, sendo semelhante a dos bloqueadores de receptores de membrana Ro-438857 e RGDS. Quanto a reverão da agregação plaquetária tanto a fenilbutazona quanto o ketoprofeno demonstraram efeitos dose-dependente.Several diseases may lead to platelet pre-activation and hypercoagulability states in horses. The activity of many drugs against platelet aggregation may, not only contribute to the evaluation of a disease but also its response to the therapy. With the aim to study in vitro prevention and reversion of platelet aggregation, the non steroidal anti-inflammatory drug (NSAID: ketoprophen, phenylbutazone and flunixin-meglumin were evaluated. The comparison demonstrated that phenylbutazone and ketoprophen prevented platelet aggregation induced by ADP better than flunixin-meglumin, in a superior manner to the monoclonal antibody Reopro, and in a better way than the membrane receptor blockers Ro-438857 and RGDS. The reversion of platelet aggregation demonstrated that even phenylbutazone or ketoprophen have a dose-dependent effect.

  6. Prevalência de anticorpos antivírus da arterite dos eqüinos em cavalos criados no Estado de São Paulo Prevalence of equine arteritis virus specific antibodies in horses of São Paulo State, Brazil

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    M.C.C.S.H. Lara; W.R. Fernandes; P.J. Timoney; E.H. Birgel

    2002-01-01

    Utilizou-se a prova de soroneutralização em microplacas para detecção de anticorpos antivírus da arterite dos eqüinos em 659 amostras de soro sangüíneo de animais criados no Estado de São Paulo. A prevalência de anticorpos na população estudada foi igual a 18,2%. A raça Mangalarga foi a que apresentou maior taxa de prevalência, 33,3%. Animais na faixa etária de 6 a 24 meses de idade apresentaram a maior taxa de prevalência, 30,4%, e as fêmeas apresentaram prevalência de 22, 9%, mais alta do q...

  7. Prevalência de anticorpos contra os vírus da influenza, da arterite viral e herpesvírus em eqüinos do Estado do Rio Grande do Sul, Brasil Prevalence of antibodies to influenza virus, viral arteritis and herpesvirus in horses of the Rio Grande do Sul state, Brazil

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    Diego Gustavo Diel

    2006-10-01

    Full Text Available O presente estudo teve como objetivo determinar a prevalência de anticorpos contra os vírus da influenza (EIV, da arterite viral (EVAV e herpesvírus (EHV em eqüinos no Estado do Rio Grande do Sul (RS, Brasil. Amostras de soro provenientes de eqüinos de 65 municípios do Estado foram submetidas ao teste de inibição da hemaglutinação (HI para a pesquisa de anticorpos contra o EIV, e à técnica de soroneutralização (SN, para a detecção de anticorpos contra os vírus da EVA e da EHV. Das 1.506 amostras testadas, 986 (65,4% apresentaram anticorpos para o EIV (títulos entre 10 e 1280, 33 (2,2% para o EVAV (2-16 e 67 (4,5% foram positivas para o EHV (2-64. Dentre os 65 municípios amostrados, 55 (84,6% apresentaram pelo menos um animal positivo para o EIV, 15 (23% para o EVAV e 12 (18,5% para o EHV. A prevalência de anticorpos para cada vírus não variou muito entre animais de diferentes propósitos (esporte, exposição e reprodução e entre machos e fêmeas, indicando que os diferentes sistemas de criação apresentam condições epidemiológicas semelhantes em relação a essas infecções. Os resultados obtidos sugerem a circulação desses agentes na população eqüina do RS e alertam para a necessidade de estudos adicionais sobre a importância e o impacto econômico-sanitário dessas viroses para a eqüideocultura do Estado.This study was aimed at investigating the prevalence of antibodies against infections virus of influenza virus (EIV, viral viral arteritis (EVAV, and herpesvirus (EHV among horses in Rio Grande do Sul (RS state, Brazil. Serum samples from horses of Serum samples from horses from 65 counties of northern and northwestern of RS, submitted to serological diagnosis for equine infectious anemia (EIA at the University of Passo Fundo (UPF, were tested by inhibition hemaglutination test (HI for EIV and by virus -neutralization test (VN for EVAV and EHV antibodies. From 1506 samples, 986 (65.4% presented antibodies

  8. Eficácia de vermífugos à base de avermectinas e milbemicinas utilizados há cinco anos em uma criação de eqüinos Efficacy of avermectins and milbemicins anthelmintics derivatives being used for five years in an equine farm

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    Carlos Eduardo Wayne Nogueira

    2002-08-01

    Full Text Available Avaliou-se a eficácia do controle parasitário com anti-helmínticos (AH de largo espectro usados há mais de cinco anos, em um plantel eqüino da raça puro-sangue inglês, sob manejo semi-intensivo. Os animais foram tratados com Ivermectin (Eqvalan® e Moxidectin (Equest®, por via oral. Durante o estudo, o número de ovos por grama de fezes (opg manteve-se zero na maioria dos animais.The efficacy of parasite control with broad spectrum anthelmintics, used for over five years on a Thoroughbred herd was evaluated. The animals were kept on semi-intensive pasture regimen. During this study the horses received Ivermectin (Eqvalan® and Moxidectin (Equest®; both treatments were given orally. The epg number was zero for most animals troughout the trial.

  9. Que direito à saúde para a população GLBT? Considerando direitos humanos, sexuais e reprodutivos em busca da integralidade e da eqüidade What do health rights mean for the GLBT population?Considering human, sexual and reproductive rights in the search for equity and integrality in the health system

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    Tatiana Lionço

    2008-06-01

    Full Text Available Este artigo tem como objetivo problematizar a pertinência de uma política de saúde para a população de Gays, Lésbicas, Bissexuais, Travestis e Transexuais - GLBT. A partir da consideração dos processos de violação de seus direitos humanos, sistematicamente comprometidos devido a estigmas e processos discriminatórios, busca-se evidenciar a necessidade de uma política de saúde específica a esta população, na perspectiva da integralidade da atenção e da eqüidade no sistema de saúde. O desafio da construção de uma política de atenção integral à saúde dessa população, tal como prevista no programa de governo federal Brasil sem Homofobia, implica a complexificação e alargamento do que se compreende por direitos sexuais e reprodutivos para a efetiva promoção da eqüidade e universalidade do acesso aos bens e serviços.This paper discusses whether a specific health policy for Gays, Lesbians, Bisexuals, Transvestites and Transsexuals is a good way to improve their lives and health situation, recognizing that their human rights are systematically violated by prejudice and discrimination processes. A health policy could be a strong political and technical instrument for achieving integrality in health care and equity in the health system. Building a health policy according to the constitutional right of universality and integrality in health care is proposed by the Federal Government's program called No Homophobia in Brazil. For its consolidation, we need to broaden what we understand by sexual and reproductive rights.

  10. Pitiose eqüina no Pantanal brasileiro: aspectos clínico-patológicos de casos típicos e atípicos Equine pythiosis in the Brazilian Pantanal region: clinical and pathological findings of typical and atypical cases

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    Adriana B. Monteiro Leal

    2001-12-01

    Full Text Available A pitiose eqüina é doença endêmica no Pantanal Brasileiro e causa prejuízos significativos a eqüinocultura. Neste trabalho são relatados 16 casos de pitiose subcutânea em eqüinos no Pantanal Sul-Matogrossense, que foram divididos em onze casos típicos e cinco casos atípicos, de acordo com o quadro clínico e o tempo de duração das lesões. O diagnóstico foi confirmado pela detecção de anticorpos específicos pelo teste ELISA, isolamento do agente e histopato-lógico. A duração da doença variou entre 1 e 6 meses nos casos típicos e superior a 12 meses nos casos atípicos. As lesões dos casos típicos caracterizavam-se por granulomas subcutâneos, ulcerados, com abundante secreção serossangui-nolenta e prurido. Nos casos atípicos foram observadas lesões subcutâneas caracterizadas por grandes massas "tumorais" circunscritas, recobertas por pele escura, sem ulcerações e com pouca secreção. Os animais estavam em bom estado nutricional e as lesões apresentavam-se de aspecto organizado, às vezes pedunculadas. Histologicamente, foi observado tecido de granulação com muitos eosinófilos nos casos típicos, enquanto os atípicos, se caracterizaram por hiperplasia pseudo-epiteliomatosa da epiderme e infiltrado eosinofílico. As características clínicas e histopato-lógicas completas das duas formas clínicas e os possíveis fatores responsáveis pelas diferenças entre as duas formas são apresentados e discutidos.Equine pythiosis is an endemic disease of horses and causes significant economic losses to equine breeding in the Brazilian Pantanal. This article describes 16 cases of subcutaneous pythiosis in horses from that region. The clinical cases were divided in typical (11 and atypical (5, according to the clinical features and duration of the disease. The clinical diagnosis was confirmed by detection of specific antibodies by ELISA, isolation of the agent and histopathology. The duration of the disease varied from 1

  11. Efeito do ultra-som terapêutico em tendinite experimental de eqüinos: estudo clínico, ultra-sonográfico e histopatológico de dois protocolos Clinic, ultrasonographic and histopatological studies of two protocols of ultrasonic therapy on experimental tendonitis in horses

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    M.A.L. Fernandes

    2003-02-01

    Full Text Available Avaliaram-se dois protocolos de ultra-som no tratamento de lesões do tendão flexor digital superficial (TFDS. Foram estudados 18 eqüinos, nos quais foi injetada uma solução de colagenase a 0,25% no TFDS esquerdo, à altura do terço médio da região metacarpiana. Os eqüinos foram divididos em: grupo A - tratado por ultra-som (UST na freqüência de 3 MHz e intensidade de 1W/cm², no modo contínuo, por seis minutos; grupo B - tratado na mesma freqüência, intensidade e tempo, no modo pulsado; e grupo C - controle. Os tratamentos foram iniciados 48h após a indução da lesão, totalizando oito sessões. Os eqüinos foram estudados por 40 dias, avaliando-se o quadro clínico e a regressão dos sintomas. Por meio de exames ultra-sonográficos semanais avaliaram-se a área transversal e a ecogenicidade da lesão para estabelecimento do índice de severidade (IS. A lesão resultou em aumento médio de 1,5cm na circunferência da região metacarpiana, resposta à pressão digital de leve a moderada e grau de claudicação de 1 a 3. A regressão dos sintomas ocorreu, em média, nove dias no grupo A, 12 dias no grupo B e 21 dias no grupo C. O percentual de regressão no IS aos 40 dias foi de 42,5, 57,7 e 34,1, respectivamente. A avaliação histológica mostrou neovascularização pronunciada e maior atividade fibroblástica nos grupos tratados (A e B comparados ao grupo-controle. Estes resultados sugerem que o UST é efetivo na redução dos sintomas clínicos da tendinite.In order to evaluate two therapeutic ultrasound protocols for treatment of injuries of the superficial digital flexor tendon (SDFT a study was performed in 18 horses. In each horse, a 0.25% solution of collagenase was injected in the middle of the left SDFT. The horses were randomly and equally divided into three groups. Horses from Group A were treated with therapeutic ultrasound of 3 MHz frequency and 1 W/cm² intensity on continuous mode for six minutes; horses from Group

  12. Hemogasometria em eqüinos com compactação experimental do cólon maior tratados com sene, fluidoterapia enteral e parenteral Blood gas analysis in equine with experimental large colon impaction treated with sene, enteral and parenteral fluid therapy

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    José Dantas Ribeiro Filho

    2007-06-01

    Full Text Available O equilíbrio ácido-base foi estudado em eqüinos com compactação experimental do cólon maior após o uso de solução isotônica poliônica enteral, sene mais hidratação intravenosa e hidratação intravenosa. As amostras sangüíneas foram colhidas de 20 animais, quatro grupos (E8, RL, SE e C de cinco animais cada. Os animais dos grupos tratados eram portadores de compactação no cólon maior induzida experimentalmente. Eqüinos no grupo E8 receberam solução isotônica poliônica enteral (8mL kg-1 h-1 48h-1; no grupo SE, sene foram administrados na dose de 20mg kg-1, duas doses de 24/24h, mais Ringer lactato intravenoso, 10mL kg-1h(-112h-1, durante dois dias; sendo que o grupo RL recebeu Ringer lactato intravenoso (16mL kg-1h(-112h-1 durante dois dias. O grupo C, controle, não foi tratado. Entre os tratamentos testados, a fluidoterapia intravenosa com solução de Ringer lactato (RL foi o tratamento mais eficiente para a correção das variáveis hemogasométricas em eqüinos com compactação do cólon maior. A solução isotônica poliônica enteral (E8 e sene associada com fluidoterapia intravenosa (SE foram eficientes, porém em menor grau.The blood acid-base status was studied in equines when induced large colon impaction was followed by applying an isotonic polionic enteral solution, or sene associated with intravenous fluid therapy, or fluid therapy alone. The blood samples were collected in twenty animals, four groups (E8, RL, SE, and C of five animals each. Animals of the treated groups had experimentally induced colon impactions. Equines in group E8 received isotonic polionic enteral solution (8 mL kg-1 h-1 48 h-1; in group SE, sene was applied at 20mg kg-1, two doses per animal, at 24-hour intervals, along with the Ringer lactate IV, 10mL kg-1 h-1, 12 h-1, both during two days; and in the RL animals received Ringer lactate IV only (16mL kg-1 h-1 12h-1, applied during two days. Group C was the non-treated control. Among the

  13. Astrocytic and microglial response and histopathological changes in the brain of horses with experimental chronic Trypanosoma evansi infection Resposta astrocítica e microglial e alterações histopatológicas no sistema nervoso central de eqüinos infectados cronicamente com Trypanosoma evansi

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    Karen Regina Lemos

    2008-08-01

    Full Text Available This study aimed to characterize astrocytic and microglial response in the central nervous system (CNS of equines experimentally infected with T. evansi. The experimental group comprised males and females with various degrees of crossbreeding, ages between four and seven years. The animals were inoculated intravenously with 10(6 trypomastigotes of T. evansi originally isolated from a naturally infected dog. All equines inoculated with T. evansi were observed until they presented symptoms of CNS disturbance, characterized by motor incoordination of the pelvic limbs, which occurred 67 days after inoculation (DAI and 124 DAI. The animals in the control group did not present any clinical symptom and were observed up to the 125th DAI. For this purpose the HE histochemical stain and the avidin biotin peroxidase method was used. Lesions in the CNS of experimentally infected horses were those of a wide spread non suppurative meningoencephalomyelitis.The severity of lesions varied in different parts of the nervous system, reflecting an irregular distribution of inflammatory vascular changes. The infiltration of mononuclear cells was associated with anisomorphic gliosis and reactive microglia was identified. The intensity of the astrocytic response in the CNS of the equines infected by T. evansi characterizes the importance of the performance of these cells in this trypanosomiasis. The characteristic gliosis observed in the animals in this experiment suggests the ability of these cells as mediators of immune response. The parasite, T. evansi, was not identified in the nervous tissues.Este estudo objetivou caracterizar a participação astrocítica e microglial no sistema nervoso central (SNC de eqüinos experimentalmente infectados com T. evansi. O grupo experimental foi formado por machos e fêmeas com vários graus de cruzamentos e idade variando entre quatro e sete anos. Os animais foram inoculados com 10(6 tripomastigotas de T. evansi, originalmente

  14. Parafusos bioabsorvíveis na reparação de fraturas experimentais de sesamóides proximais em eqüinos Bioabsorbable screws in the healing of experimentally induced fractures of the proximal sesamoid bone in horses

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    Marcelo Damas Pyles

    2007-10-01

    Full Text Available Avaliou-se a eficácia dos implantes bioabsorvíveis de ácido polilático na fixação interna de fraturas induzidas no osso sesamóide proximal de eqüinos. Osteossínteses foram realizadas em oito eqüinos, distribuídos em dois grupos de quatro animais conforme o implante: aqueles que receberam implantes bioabsorvíveis formaram o grupo GI e os que receberam implantes metálicos do grupo GII. O monitoramento radiográfico foi realizado no 30° dia (D30, no 60° dia (D60, no 90° dia (D90 e no 120o dia (D120 pós-operatório. Ao exame radiográfico no D30, observou-se preenchimento do foco de fratura de aspecto radiopaco, porém com densidade reduzida nos animais do grupo GII. Tal preenchimento às análises clínica e radiográfica apresentou qualidade superior no grupo GI, quando comparado com o grupo GII. No D120, observou-se, nos animais de ambos os grupos, ao exame radiográfico, o preenchimento do foco de fratura por tecido radiopaco, indicando a reparação da fratura em sua quase totalidade. Contudo, no GI, observaram-se pontos de esclerose ao redor do implante bioabsorvível e, ao exame físico, ausência de claudicação e, nos animais do GII, diminuição da flexão metacarpo-falangeana e claudicação de grau I. Os implantes bioabsorvíveis de PLLA mostram-se eficazes na fixação interna de fraturas induzidas dos ossos sesamóides proximais de eqüinos; os animais submetidos à redução da fratura com implantes bioabsorvíveis apresentaram ao final do experimento grau de claudicação menor quando comparados com os animais que receberam implantes metálicos. À análise radiográfica, os implantes bioabsorvíveis de PLLA possibilitaram remodelamento ósseo de melhor qualidade, quando comparados com os implantes metálicos.This study evaluated the efficacy of bioabsorbable polylactic acid implants in internal fixation of induced fractures of the proximal sesamoid bone in horses. Eight horses underwent osteosynthesis; four

  15. Ocorrência de doenças oftalmológicas em eqüinos utilizados para tração urbana na cidade de Londrina, PR Occurrence of ophthalmologic diseases in horses used for urban cart hauling in Londrina, PR, Brazil

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    Peter Reichmann

    2008-12-01

    Full Text Available Com o objetivo de verificar a ocorrência de doenças oculares em eqüinos utilizados para serviços de tração urbana na cidade de Londrina, PR, foram revistos os registros clínicos de 805 eqüinos atendidos no Hospital Veterinário da Universidade Estadual de Londrina no período entre 1992 e 2007. Nesses registros clínicos foram verificados 25 casos de doenças oftalmológicas (3,1%, compostas por 12 casos (48% de doenças da córnea, seis casos (24% de catarata, seis casos (24% de doenças da conjuntiva (paralelas a outras enfermidades oculares ou não, dois casos (8% de uveíte recorrente eqüina, um caso de carcinoma de células escamosas da terceira pálpebra, um caso de lesão crônica de pálpebra, com necrose e perda do globo ocular, e um caso de Phthisis bulbi (4% cada. A principal causa das enfermidades oftalmológicas diagnosticadas nesses animais foi traumática (36% dos casos. A maioria das doenças diagnosticadas neste estudo, se não tratadas adequadamente, pode resultar em cegueira e, conseqüentemente, pode inutilizar o animal para uso em tração urbana. Isso reforça a necessidade de conscientização dos carroceiros sobre a importância e a profilaxia dessas enfermidades.The clinical records of 805 horses admitted to the Veterinary Hospital of the State University of Londrina between 1992 and 2007 were reviewed in order to establish the occurrence of ophthalmologic diseases in horses used for hauling carts in Londrina, Paraná, Brazil. Among these records, there were 25 ophthalmologic cases (3.1%, composed of 12 cases (48% of corneal diseases, six cases (24% of cataracts, six cases (24% of conjunctival diseases (associated or not to other lesions, two cases (8% of recurrent equine uveitis, one case of squamous cell carcinoma of the third eyelid, one case of chronic necrotic eyelid lesion with loss of the eye globe and one case of phthisis bulbi (4% each. Trauma was the most important etiology for eye diseases diagnosed

  16. Avaliação de parâmetros clínicos e hematológicos de eqüinos submetidos a um programa de controle estratégico de Amblyomma cajennense (Fabricius, 1787 (Acari: Ixodidae Evaluation of clinical and hematological parameters of equines submitted to a strategic control program of Amblyomma cajennense (Fabricius, 1787 (Acari: Ixodidae

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    A.P. Cunha

    2008-02-01

    Full Text Available Estudaram-se aspectos clínicos e hematológicos em eqüinos submetidos a um programa de controle estratégico de A. cajennense. Os tratamentos carrapaticidas foram realizados a cada sete dias e divididos em dois módulos, o primeiro com início em abril de 2004, e o segundo com início em julho do mesmo ano, utilizando-se a base química piretróide - cipermetrina na concentração de 0,015%. Além do acompanhamento clínico dos animais, foram realizados hemogramas completos antes e após o programa. As dosagens bioquímicas de bilirrubinas, gama-glutamiltransferase (GGT, aspartato aminotransferase (AST, creatina kinase (CK, proteína total, albumina e globulinas, foram realizadas antes, durante e ao final do programa. Os resultados demonstraram que houve uma melhora no quadro hematológico dos animais após o programa de controle. Os tratamentos carrapaticidas, na forma em foram aplicados, não provocaram alterações desfavoráveis nos parâmetros clínicos e hematológicos dos eqüinos. Tais informações podem ser consideradas na busca de alternativas viáveis e seguras para o controle dessa espécie de carrapato.Clinical and hematological parameters were studied in equines submitted to a strategic control program of Amblyomma cajennense. The acaricide treatments were carried to each seven days and divided in two batteries, the first one began in April 2004 and the second in July 2004. A pyrethroid chemical base - 0.015% cypermethrin was used. Clinical examinations of the animals and complete hemograms were carried before and after the control program of the tick. Seric dosages of bilirrubins, gamma-glutamiltransferase (GGT, aspartate aminotransferase (AST, creatin kinase (CK, total protein, albumin, and globulins, were carried before and throughout the experiment. The results showed an improvement in the hematological parameters of the animals after the end of control program. The acaricide treatments did not cause undesirable alterations

  17. Classificação de coeficientes de variação na experimentação com nutrição de eqüinos Classification of the coefficient of variation in experimentation with equine nutrition

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    A.M.Q. Lana

    2006-10-01

    Full Text Available Foi realizada a classificação de coeficientes de variação dos coeficientes de digestibilidade da matéria seca, matéria orgânica, proteína bruta, fibras em detergente neutro e ácido, energia bruta, fibra bruta, celulose, hemicelulose, lignina, extrato etéreo e ganho de peso diário, com base em artigos científicos e teses em eqüinocultura. Os coeficientes de variação foram classificados em: baixo [(m+2DP]. Todas as respostas medidas apresentaram distribuição normal pelo teste Lilliefors. Quanto aos coeficientes de digestibilidade da fibra em detergente neutro e celulose, houve concordância entre a classificação proposta e a sugerida na literatura, sendo os mais discrepantes os coeficientes de digestibilidade da energia bruta e lignina. Desse modo, para cada variável analisada existe distribuição diferenciada dos coeficientes de variação, o que sugere a necessidade de classificação específica para as respostas medidas em nutrição de eqüinos.Coefficients of variation (CV distribution for several variables in equine nutrition were obtained. The data are from theses and published scientific papers in equine nutrition. The CV were classified as low [CV£(m-1sd]; medium [(m-1sd(m+2sd]. The Lilliefors test for all variables showed no discrepancy from normal distribution. The distributions obtained for coefficients of digestibility for cellulose and fibre in neutral and acid detergent, were close enough to the classification suggested in the literature. However, the distributions for coefficient of digestibility for gross energy and lignin, showed high discrepancies from this classification suggesting that trial precision should be evaluated according to the variable considered. There is a different distribution for coefficients of variation for each variable suggesting the need of specific classification for each characteristic in equine studies.

  18. Prevalência de anticorpos antivírus da arterite dos eqüinos em cavalos criados no Estado de São Paulo Prevalence of equine arteritis virus specific antibodies in horses of São Paulo State, Brazil

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    M.C.C.S.H. Lara

    2002-06-01

    Full Text Available Utilizou-se a prova de soroneutralização em microplacas para detecção de anticorpos antivírus da arterite dos eqüinos em 659 amostras de soro sangüíneo de animais criados no Estado de São Paulo. A prevalência de anticorpos na população estudada foi igual a 18,2%. A raça Mangalarga foi a que apresentou maior taxa de prevalência, 33,3%. Animais na faixa etária de 6 a 24 meses de idade apresentaram a maior taxa de prevalência, 30,4%, e as fêmeas apresentaram prevalência de 22, 9%, mais alta do que nos machos.With the purpose of studying the prevalence of equine viral arteritis in horses raised in São Paulo State, Brazil, by the standard microtiter serum neutralization test, 659 serum samples were investigated. The prevalence of antibodies in the horse population was 18.2%, which was significantly higher in Mangalarga horses (33.3% than in any other breed (Thoroughbred, Arab, Quarter Horse, mixed breeds and others. The distribuition of horses by age showed that horses between 6 to 24 months of age (30.4% had a higher prevalence (30.4% rate than others. The female horses prevalence rate of 22.9% was significantly higher than in male horses.

  19. Estudo comparativo de três métodos de diagnóstico para detecção de anticorpos anti-Theileria equi em eqüinos de áreas endêmicas do estado do Rio de Janeiro

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    Tiago Marques dos Santos

    2009-12-01

    Full Text Available Este trabalho teve o objetivo de avaliar a reação de imunofluorescência indireta (RIFI, ensaio imunoenzimático (ELISA e a reação de fixação do complemento (RFC no diagnóstico de Theileria equi em amostras de soro de 79 equinos na Universidade Federal Rural do Rio de Janeiro (UFRRJ, Seropédica, RJ, Brasil. Houve reação positiva para Theileria equi em 74,7, 75,9 e 60,8% das amostras testadas pela RIFI, ELISA e RFC, respectivamente. Observou-se discrepância em 16,45% (n=13 das amostras de soro testadas pelo ELISA indireto e RIFI. Quando comparado a RIFI e a RFC, a discrepância observada entre os soros testados foi de 36,70% (n=29. O teste ELISA indireto e a RFC apresentaram discordância em 37,97% (n=30 das amostras de soros. Os resultados do presente estudo sugerem que a melhor alternativa para o diagnóstico sorológico de T. equi em eqüinos portadores é a associação dos testes de RIFI e ELISA indireto, especialmente para a realização de estudos soroepidemiológicos.

  20. Sorovares de leptospiras predominantes em exames sorológicos de bubalinos, ovinos, caprinos, eqüinos, suínos e cães de diversos estados brasileiros Most frequent serovars of leptospires in serological tests of buffaloes, sheeps, goats, horses, swines and dogs from several brazilian states

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    Andrea Cecília Mercaldi Favero

    2002-08-01

    Full Text Available Em estudo retrospectivo abrangendo os anos de 1984 a 1997, foram realizados 15.558 exames sorológicos para leptospirose (SAM, com coleção de 24 sorovares, que incluíram: 284 ovinos, 879 bubalinos, 983 cães, 1.941 caprinos, 2.903 eqüinos e 8.568 suínos, distribuídos percentualmente por estado da seguinte forma: ovinos - SP (100%; bubalinos - SP (100%; cães - SP (80,7%, RS (0,10%, SC (0,10% e PI (19,0%; caprinos - SP (33,1%, PB (63,7% e CE (3,2%; eqüinos - SP (79,3%, RS (9,98%, SC (0,62%, PR (2,5%, RJ (0,17%, MG (1,96%, MT (3,99%, PB (1,3% e PI (0,03%; suínos - SP (61,91%, RS (0,3%, SC (5,95%, PR (3,67%, RJ (0,88%, MG (24,38%, GO (1,12%, SE (0,2%, PE (0,90%, CE (0,34% e MA (0,1%. A distribuição temporal dos animais examinados incluiu: para a espécie ovina - 54,5% referentes aos anos 1996 e 97, 33,3% referentes a 89 e 90 e 12,2% aos outros anos; espécie bubalina - 21,7% no intervalo de 1984 a 95 e 78,83% entre 96 e 97; espécie canina - 16,91% entre 1984 e 92 e 83,09% entre 1993 e 97; caprinos - 6,97% entre 1984 e 91 e 93,09% entre 1992 e 97, sendo que 49% das amostras foram referentes ao ano de 1992; eqüinos - 18,1% no intervalo de 84 a 90 e 81,9% de1991 a 97; suínos - 61,16% referentes aos anos 90, 91, 95 e 96. As médias de animais reatores e variantes mais freqüentes por espécie foram: ovinos - 0,70% de soropositividade e reações mais freqüentes para a variante icterohaemorrhagiae; bubalinos - 43,7% de positivos e variantes hardjo seguida de pomona; cães - soropositividade de 17,7% e reações para as variantes copenhageni e icterohaemorrhagiae no estado de SP e pyrogenes no PI; caprinos - 4,17% de positividade e variantes icterohaemorrhagiae e grippotyphosa no CE, icterohaemorrhagiae na PB e pyrogenes em SP; eqüinos - 29% de soros positivos e variantes icterohaemorrhagiae no PR, SC, SP, RJ e MG, grippotyphosa no MT, pyrogenes na PB e patoc no RS; suínos - soropositividade de 24,46% e grippotyphosa seguida de

  1. EQ6 Calculations for Chemical Degradation of Navy Waste Packages

    International Nuclear Information System (INIS)

    S. LeStrange

    1999-01-01

    The Monitored Geologic Repository Waste Package Operations of the Civilian Radioactive Waste Management System Management and Operating Contractor (CRWMS M and O) performed calculations to provide input for disposal of spent nuclear fuel (SNF) from the Navy (Refs. 1 and 2). The Navy SNF has been considered for disposal at the potential Yucca Mountain site. For some waste packages, the containment may breach (Ref. 3), allowing the influx of water. Water in the waste package may moderate neutrons, increasing the likelihood of a criticality event within the waste package. The water may gradually leach the fissile components and neutron absorbers out of the waste package. In addition, the accumulation of silica (SiO 2 ) in the waste package over time may further affect the neutronics of the system. This study presents calculations of the long-term geochemical behavior of waste packages containing the Enhanced Design Alternative (EDA) II inner shell, Navy canister, and basket components. The calculations do not include the Navy SNF in the waste package. The specific study objectives were to determine the chemical composition of the water and the quantity of silicon (Si) and other solid corrosion products in the waste package during the first million years after the waste package is breached. The results of this calculation will be used to ensure that the type and amount of criticality control material used in the waste package design will prevent criticality

  2. EQ6 Calculations for Chemical Degradation of Navy Waste Packages

    Energy Technology Data Exchange (ETDEWEB)

    S. LeStrange

    1999-11-15

    The Monitored Geologic Repository Waste Package Operations of the Civilian Radioactive Waste Management System Management & Operating Contractor (CRWMS M&O) performed calculations to provide input for disposal of spent nuclear fuel (SNF) from the Navy (Refs. 1 and 2). The Navy SNF has been considered for disposal at the potential Yucca Mountain site. For some waste packages, the containment may breach (Ref. 3), allowing the influx of water. Water in the waste package may moderate neutrons, increasing the likelihood of a criticality event within the waste package. The water may gradually leach the fissile components and neutron absorbers out of the waste package. In addition, the accumulation of silica (SiO{sub 2}) in the waste package over time may further affect the neutronics of the system. This study presents calculations of the long-term geochemical behavior of waste packages containing the Enhanced Design Alternative (EDA) II inner shell, Navy canister, and basket components. The calculations do not include the Navy SNF in the waste package. The specific study objectives were to determine the chemical composition of the water and the quantity of silicon (Si) and other solid corrosion products in the waste package during the first million years after the waste package is breached. The results of this calculation will be used to ensure that the type and amount of criticality control material used in the waste package design will prevent criticality.

  3. Efeitos do processamento da alfafa e da adição de óleo de soja sobre a digestibilidade total da dieta de eqüinos Effects of alfalfa processing and addition of soybean oil on the total diet digestibility of foals

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    Alexandre Augusto de Oliveira Gobesso

    2009-04-01

    Full Text Available Avaliou-se o efeito do processamento do feno de alfafa (Medicago sativa L. e da adição de óleo de soja em dietas sobre a digestibilidade total de matéria seca, matéria orgânica, proteína bruta, extrato etéreo, fibra em detergente neutro e fibra em detergente ácido em eqüinos. Utilizaram-se quatro potros machos, sem raça definida, com aproximadamente 14 meses de idade e 197,25 kg, em delineamento quadrado latino (4 × 4 e em arranjo fatorial (2 × 2, composto de duas formas de fenação da alfafa (em cubos ou em ramas e da adição ou não de óleo de soja em dietas contendo concentrado comercial na forma de péletes. A digestibilidade dos nutrientes foi determinada pelo método de coleta total de fezes durante três dias. A adição de óleo de soja refinado aumentou a digestibilidade total de matéria seca, matéria orgânica, extrato de etéreo e fibra em detergente neutro. A fenação da alfafa em cubos aumentou a digestibilidade total da proteína bruta, fibra em detergente neutro e da fibra em detergente ácido. A adição de óleo de soja nas dietas avaliadas foi um modo prático e seguro de aumentar a densidade calórica sem reduzir a digestibilidade dos macronutrientes orgânicos. O processamento da alfafa na forma de cubos melhorou a digestibilidade total da proteína bruta, fibra em detergente e fibra em detergente ácido da dieta em eqüinos.The effect of alfalfa hay processing (Medicago sativa L. and the addition of soybean oil in diets on the total dry matter digestibility, organic matter, crude protein, ether extract, neutral detergent fiber and acid detergent in horses was evaluated. Four crossbred male foals with approximately 14 months of age and 197.25 kg were used and assigned in a (4 × 4 Latin square design with a factorial arrangement (2 × 2 composed of two alfalfa haying forms (cubes or branches and the addition or absence of soybean oil in commercial diets containing concentrated in the form of pellets. The

  4. A ortodontia nas políticas públicas de saúde bucal: um exemplo de eqüidade na Universidade Federal de Juiz de Fora Orthodontics in oral public health policies: an example of equity in Juiz de Fora Federal University

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    Sérgio Murta Maciel

    2006-07-01

    Full Text Available Devido à grande prevalência das más-oclusões, à grande transformação epidemiológica por que passa a saúde bucal, com o forte declínio das cáries, e sob a referência dos princípios constitucionais de integralidade e eqüidade, tornou-se necessário viabilizar a incorporação de procedimentos ortodônticos pelo setor público de saúde. Uma das sugestões neste sentido seria a utilização dos serviços prestados nas universidades públicas, que além de formar recursos humanos, podem abrir espaço para uma política social paralela. Este artigo apresenta o exemplo da clínica de ortodontia da Universidade Federal de Juiz de Fora, que, por ser um pólo de referência regional em atenção à saúde bucal, vem participando das ações públicas de saúde bucal, através dos serviços prestados à população. Expõe as diferentes faces das más-oclusões dentárias, que afetam as pessoas nos âmbitos social, psicológico e biológico, e faz uma leitura histórica da saúde bucal no Brasil com um recorte para a assistência ortodôntica, que, por real importância e por direitos constitucionais, deveria figurar entre os procedimentos cobertos pelo SUS. Idealiza-se um sistema de triagem para esses casos, abrangendo critérios econômico, biológico e psiscossocial, que aproxime a assistência à saúde bucal da eqüidade.Due to the great prevalence of malocclusions; to the great epidemic transformation of oral health, with the decreased number of decays, and based on the principles of the Brazilian Constitution of integrality and equity, it became necessary to incorporate orthodontics procedures in public health care. In this sense, one suggestion would be the use of services offered by public universities, which, besides forming human resources, give rise to parallel social policies. This paper shows the example of the Juiz de Fora Federal University's orthodontic clinic, a regional reference pole in oral health, and the role it plays

  5. Fotossensibilização hepatógena em eqüinos pela ingestão de Brachiaria humidicola (Gramineae no Estado do Pará Hepatogenous photosensitization in horses caused by Brachiaria humidicola (Gramineae in the State of Pará

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    José Diomedes Barbosa

    2006-09-01

    Full Text Available São apresentados os aspectos clínico-patológicos e epidemiológicos de doença, caracterizada por fotossensibili-zação, que ocorre em eqüinos no nordeste do Estado do Pará. De um total de 40 animais examinados clinicamente, sete foram necropsiados, e tiveram fragmentos de órgãos examinados microscopicamente. Em virtude das lesões características encontradas, sobretudo nas partes despigmentadas da pele, das le-sões hepáticas macro e microscópicas, e sabendo-se que as brachiárias, de uma maneira geral, encerram saponinas com propriedades tóxicas, que causam alterações hepáticas e fo-tossensibilização em bovinos e ovinos, conclui-se, que essa doença fotossensibilizante foi determinada pelo pastoreio de Brachiaria humidicola, alimentação exclusiva dos animais enfermos.Data on the clinical-pathological aspects and on the epidemioloy of a disease in horses, characterized by phototsensitization, which occurs in northeastern of Pará, Brazil, are presented. Of a total of 40 horses examined clinically, post-mortem examination was performed on seven. Due to the characteristic lesions found on the non-pigmented skin, the macroscopic and histological alterations in the liver, and knowing that Brachiaria grasses contain saponins with toxic properties, which cause liver lesions and photosensitization in cattle and sheep, it is concluded that this disease in horses is caused by grassing exclusively Brachiaria humidicola.

  6. Terapia intensiva neonatal e pediátrica no Rio de Janeiro: distribuição de leitos e análise de eqüidade Neonatal and pediatric intensive care in Rio de Janeiro: distribution of beds and analysis of equity

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    ARNALDO PRATA BARBOSA

    2002-12-01

    Full Text Available OBJETIVOS: Identificar as UTIs pediátricas do Rio de Janeiro, número de leitos, distribuição geográfica, natureza pública ou privada, tipo de atendimento e de hospital, estudar a demanda da população e elaborar propostas de melhoria na eqüidade. MÉTODOS: Foram visitadas todas as UTIs do Estado, de julho de 97 a junho de 98, levantado o número de leitos e tempo médio de permanência. Com essas informações e dados do IBGE, estabeleceu-se a necessidade de leitos e a comparação entre oferta e demanda por regiões, formulando-se propostas de melhoria na eqüidade. RESULTADOS: Foram identificadas 80 UTIs (excluídas seis, totalizando 1.080 leitos; 60% intensivos e 40% semi-intensivos; 57% públicos e 43% privados; 52% em UTIs neonatais exclusivas, 14% em pediátricas e 34% em mistas (65% leitos neonatais, totalizando 791 leitos neonatais (73%. A maioria das UTIs (75% situava-se em hospitais gerais, 20% em maternidades ou hospitais materno-infantis e somente 5% eram centros universitários; a maioria na região metropolitana (89%, com 93% dos leitos para 74% da população infantil, dos quais a maioria na cidade do Rio de Janeiro (76%, com 73% dos leitos para 37% da população, enquanto que no interior existem apenas oito unidades (11% e 79 leitos (7% para 26% da população. CONCLUSÕES: Não há eqüidade na distribuição e no acesso aos leitos disponíveis, com carência no setor público e excesso no privado, grande concentração na região metropolitana e somente 5% das UTIs em hospitais universitários, propondo-se medidas de redistribuição e alocação de novos leitos em regiões mais carentes, associada à criação de uma central de vagas e sistema eficiente de transporte e referência.OBJECTIVES: To identify the pediatric ICUs at Rio de Janeiro, number of beds, geographical distribution, public or private nature, type of hospital and assistance, studying population demand and to propose measures for improving equity

  7. Repair of lamellar scleral lesions in dogs with preserved equine renal capsule: short report Reparação de lesões lamelares esclerais em cães com cápsula renal de eqüino preservada: relato curto

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    Alexandre Lima de Andrade

    2004-02-01

    Full Text Available PURPOSE: To evaluate the u se of equine renal capsule preserved in glycerin to repair lamellar scleral lesions in dogs. METHODS: Twelve healthy mongrel dogs, male and female, weighing 12 kg were used. The study was both clinical and morphological, and performed on the first, third, seventh, 15th, 30th and 60th day after surgery. Temporal canthotomy was performed after standard preoperative and general anesthesia. Conjunctival and scleral square incisions of 0.5x0.5 cm were carried out in a one o'clock position, near the limbus. A fragment of hydrated biological prosthesis, of the same shape, was sutured with 7-0 vicryl® in an interrupted suture. RESULTS: The clinical evaluation showed blepharospasm/photophobia until the 7th day after surgery. Conjunctival edema appeared up to the 5th day after surgery. Mucoid ocular discharge was sustained until the 10th day after surgery. Hyperemia was observed until the end of the evaluation period. There were no signs of graft extrusion in all animals. The anterior and posterior segments did not show clinical signs of inflammation. The optical microscopy morphological evaluation showed an inflammatory exudation with acute aspects in the early and intermediate periods, and inflammatory exudation with chronic aspects in the late periods. There was incorporation of the implant by the recipient's sclera. CONCLUSION: These results suggest that the equine renal preserved capsule could be a useful alternative tissue to repair lamellar corneal lesions in dogs and humans.OBJETIVO: Avaliar o uso da cápsula renal de eqüino preservada em glicerina 98% no reparo de lesões lamelares esclerais em cães. MÉTODOS: Foram utilizados 12 cães, machos e fêmeas, com peso médio de 12kg. Foram realizadas avaliações clínica e morfológica aos 1, 3, 7, 15, 30 e 60 dias de pós-operatório. Após anestesia geral e procedimentos padrões de preparo do campo operatório, foi realizada cantotomia temporal, seguida de incis

  8. Assessement of glycaemia and serum activities of aspartate aminotransferase, creatinekinase, gamma glutamyltransferase and lactate dehydrogenase in thoroughbred horses submitted to exercise of different intensities/ Avaliação da glicemia e da atividade sérica de aspartato aminotransferase, creatinoquinase, gama-glutamiltransferase e lactato desidrogenase em eqüinos puro sangue inglês (PSI submetidos a exercícios de diferentes intensidades

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    Joandes Henrique Fonteque

    2005-06-01

    Full Text Available In order to evaluate the influence of exercise of different intensities on biochemical parameters in Thoroughbred horses blood was collected from 60 animals, 30 males and 30 females.The animals were subdivided in two groups : 30 horses, 15 males and 15 females with 24 to 36 months of age and not in training, and after 12 months of training; 30 horses, 15 males and 15 females with 36 to 48 months of age in training. Blood samples were collected before and after trot and gallop. Plasmatic glucose was analyzed through a colorimetric method, while aspartate aminotransferase (AST, creatine kinase (CK, lactate dehydrogenase (LDH and gammaglutamyltransferase (GGT were analyzed through kinetic methods. Results show a statistically significant increase in plasmatic glucose after trot and gallop independent of gender, while the increases in CK and LDH were different for males and females. Variations for AST and GGT were not statistically significant.O objetivo do presente estudo foi avaliar as alterações na bioquímica sérica em eqüinos PSI submetidos a exercícios de diferentes intensidades. Foram colhidas amostras de sangue de 60 eqüinos PSI, distribuídos nos seguintes grupos: 30 animais sendo 15 machos e 15 fêmeas, com idade de 24 a 36 meses, não submetidos a treinamento e após um período de 12 meses de treinamento e 30 eqüinos de 36 a 48 meses, em fase de treinamento, antes e após o trote . Dos animais de 36 a 48 meses foram selecionados 20 machos e 10 fêmeas e colhido sangue antes e após o galope. Determinou-se, por métodos colorimétricos, os valores da glicose plasmática e, por métodos cinéticos, as enzimas aspartato aminotransferase (AST, creatinoquinase (CK, lactato desidrogenase (LDH e gama-glutamiltransferase (GGT. A análise estatística dos resultados comprovou a ocorrência de aumento significativo (p < 0,05 dos valores da glicose plasmática após o trote e galope para ambos os sexos. Para as enzimas CK e LDH ocorreram

  9. Anestesia em eqüinos com síndrome cólica: análise de 48 casos e revisão de literatura Anesthesia in horses with colic syndrome: analysis of 48 cases and literature review

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    Alonso Gabriel Pereira Guedes

    2002-06-01

    Full Text Available A cólica eqüina é uma síndrome que cursa com dor abdominal, distúrbios hidroeletrolíticos e ácido-base e disfunção de órgãos vitais como pulmões e coração. Os procedimentos anestésicos nesses animais apresentam particularidades que aumentam o risco de complicações. Os animais devem ser avaliados no período pré-anestésico e as terapias de reposição devem ser instituídas quando necessárias. A medicação pré-anestésica deve proporcionar analgesia e sedação do animal. A xilazina e/ou butorfanol podem ser utilizados com esse objetivo. A indução pode ser realizada com éter gliceril guaiacolato e cetamina com ou sem diazepam, ou mesmo com cetamina e diazepam pela via intravenosa. A manutenção anestésica deve ser feita preferencialmente com isofluorano, mas o halotano também pode ser utilizado. Manter ventilação pulmonar mecânica, com o animal recebendo oxigênio a 100% durante todo o período cirúrgico e pós-operatório imediato. A recuperação deve ser feita em ambiente escurecido e calmo, com forração e piso não escorregadio. Analgesia e oxigenoterapia também são importantes nessa fase.The equine colic is a syndrome that leads to abdominal pain, hydroeletrolitic and acid-base disturbances and functional alterations of the vital organs like lungs and heart. Anesthetic procedures in these animals show certain particularities that elevate the complications risk. The animals should be evaluated at the preanesthetic period and the reposition treatments should be done as necessary. The premeds should give analgesia and sedation to the animal. Xylazina and/or butorphanol may be used to this aim. Induction can be done with guaiacol glycerine ether, ketamine with/without diazepam, or even with ketamine and diazepam by the intravenous route. Isoflurane is the anesthetic of choice for the maintenance of the anesthesia, but halothane also can be used. Intermitent positive pressure ventilation should be established

  10. Desempenho e parâmetros sangüíneos de eqüinos em crescimento submetidos a dietas com diferentes níveis de farelo de canola Performance and blood parameters of growing equine fed diets with different levels of canola meal

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    Kátia de Oliveira

    2001-02-01

    Full Text Available Utilizando potros, avaliaram-se dietas em que a proteína do farelo de soja foi substituído em diferentes níveis (0; 35; 65 e 100% pela do farelo de canola. As rações foram isoprotéicas ( 17% PB e isocalóricas (4200 kcal/kg. Foram utilizados 16 eqüinos da raça Mangalarga, sendo oito machos e oito fêmeas, com média de dez meses e 218 kg PV inicial, consumindo um total de 2,5% PV, na matéria seca (MS. A dieta era composta por 40% de volumoso e 60% de concentrado. O delineamento experimental utilizado foi em blocos ao acaso, considerando quatro blocos e quatro tratamentos. Não se verificou efeito dos tratamentos sobre as variáveis de desempenho (ganho diário de peso vivo, altura na cernelha, perímetro torácico e perímetro da canela e parâmetros sangüíneos (glicose e uréia dos potros em crescimento. Nos concentrados para potros dos 9 a 11,5 meses de idade, o farelo de soja pode ser substituído pelo farelo de canola.Diets composed by four different levels (0; 53; 65 and 100% of canola meal replacing soybean meal crude protein (CP were evaluated using foals. The diets were isoproteic (17% CP and isocaloric (4200 kcal/kg. Sixteen Managalarga breed foals, eight males and eight females, averaging 10 months and 218 kg LW, fed a total intake of 2.5% LW on dry matter (DM basis were used. The diet was composed by 60:40 forage to concentrate ratio. A completely block experimental design, with four blocks and four treatments, was used. There were no effect of treatments on the performance variables (average daily gain, wither height, heart girth and cannon bone circumference and blood parameters (glucose and urea of growing foals. In the concentrate for growing foals from 9 to 11.5 months old, the soybean meal can be replaced by canola meal.

  11. Concentrações plasmáticas de triptamina, tiramina e feniletilamina em eqüinos sob efeitos de sobrecarga de carboidratos e antiinflamatórios não esteroidais Plasmatic concentrations of tryptamine, tyramine end phenylethylamine in horses under the effect of carbohydrate overload and non-steroid antinflammatory compounds

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    Paulo Tarso L. Botteon

    2008-06-01

    Full Text Available As concentrações plasmáticas das aminas triptamina (TRP, tyramina (TYR e pheniletilamina (PEA foram determinadas por cromatografia gasosa (CG de 20 eqüinos sob efeito de sobrecarga por carboidratos (SC. Após 36h da SC os animais foram aleatoriamente divididos em quatro grupos (n=5 e receberam a cada 12h por via iv: solução salina 10mL (GC, ketoprofeno 2,2mg/kg (GK, fenilbutazona 4,4mg/kg (GF e flunixin meglumine 1,1mg/kg (GFM. As concentrações das aminas TYR e PEA variaram de 0,18 a 164,2mg/L, com diferenças nos tempos avaliados, mas não entre os tratamentos (pThe concentrations of the bioactives amines tryptamine (TRP, tyramine (TYR and phenylethylamine (PEA were determined by gas chromatography in plasma samples of 20 horses submitted to carbohydrate overload. Thirty hours after the overload, the horses were randomly distributed in four groups (n=5 and were submitted to four IV treatments every 12 hours: 10ml of saline (GC, ketoprofen 2.2mg/kg (GK, phenylbutazone 4.4mg/kg (GF, and flunixin meglumine 1.1mg/kg (GFM. Blood samples were collected at various times after the overload (0-72 h. Plasma TYR and PEA concentrations ranged from 0.18 to 164.2mg/L, and differed significantly with time (p<0.01, but did not differ in the treatments. Plasma concentrations of TRP differed between times and treatments. The GC was significantly major than other treatments at 48h and 60h after the overload, and the plasma concentration of TRP in groups GK and GFM was significantly lower than in groups GF and GC at 72 h (p=0.0012. We concluded that the anti-inflammatory drugs evaluated do not interfere in the plasma concentration of TYP and PEA. For TRP, ketoprofen and flunixin meglumine was effective to reduce de plasmatic concentration of this amine.

  12. Utilização de hidrocortisona em eqüinos submetidos a isquemia e reperfusão no jejuno e suas conseqüências sobre o cório laminar Hydrocortisone in horses submitted to jejunal isquemia and reperfusion and its effects in the laminar corium

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    J.J.M. Rio Tinto

    2004-06-01

    Full Text Available Estudou-se o efeito da administração de succinato sódico de hidrocortisona (SSH no desenvolvimento de lesões no cório laminar de eqüinos. Doze animais foram submetidos à laparotomia sob anestesia geral e à isquemia total em dois segmentos do jejuno, enquanto três foram usados como controle. Após uma hora de isquemia, seis animais receberam 4,0mg/kg de SSH por via intravenosa (grupo T e seis receberam placebo (grupo NT. Após duas horas de isquemia foi restabelecido o fluxo de sangue local e, decorridas duas horas de reperfusão, foi realizada a laparorrafia e permitiu-se a recuperação anestésica. Após 12 horas do início da reperfusão, os animais foram sacrificados e deles colhidas amostras de tecido laminar para avaliação histomorfológica. As alterações avaliadas ao microscópio óptico foram quantificadas por escores que variaram de 0 a 3. Os escores para lesão no tecido laminar foram semelhantes nos animais dos grupos T (0,41 e NT (0,54, permitindo concluir que a hidrocortisona não acentuou as lesões produzidas no tecido laminar após a isquemia e reperfusão no jejuno.To evaluate whether hydrocortisone sodium succinate (HSS aggravates lesions in the laminar tissue secondary to intestinal ischemia and reperfusion (IR, two segments of the jejunum were isolated in 12 halothane-anesthetized horses, and total ischemia was induced on them. Three other horses were used as controls. One hour after the onset of the ischemia, HSS (4.0mg/kg was administered intravenously to six animals (T group and saline to the others (NT group. After two hours of ischemia and two hours of reperfusion the abdomen was closed and the horses were allowed to recover from anesthesia. After 12 hours of reperfusion the horses were euthanatized and biopsy specimens were taken from the laminar tissue and the lesions were evaluated and scored. No significant differences between T (0.41 and NT (0.54 groups for laminar lesion scores were observed. The

  13. Patogênese, sinais clínicos e patologia das doenças causadas por plantas hepatotóxicas em ruminantes e eqüinos no Brasil Pathogenesis, clinical signs and pathology of diseases caused by hepatotoxic plants in ruminants and horses in Brazil

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    Julio Cesar A. Santos

    2008-01-01

    Full Text Available Plantas que causam lesões hepáticas em ruminantes e eqüinos constituem um grupo importante de plantas tóxicas no Brasil. Em geral essas plantas podem ser divididas em três grandes grupos: plantas que causam necrose hepática aguda; plantas que causam fibrose hepática; e plantas que causam fotossensibilização. Em algumas dessas plantas os princípios tóxicos já foram identificados. Das plantas que causam necrose hepática aguda, os carboxiatractilosídeos estão presentes em Cestrum parqui e Xanthium cavanillesi. Os alcalóides pirrolizidínicos estão presentes nas plantas que causam fibrose hepática (Senecio spp., Echium plantagineum, Heliotropum spp. e Crotalaria spp.. Das plantas que causam fotossensibilização hepatógena são conhecidos os furanossesquiterpenos em Myoporum spp., triterpenos em Lantana spp., e saponinas esteroidais em Brachiaria spp. e Panicum spp. O quadro clínicopatológico dessas intoxicações e o mecanismo geral da insuficiência hepática, incluindo meios de diagnóstico, são descritos neste artigo de revisão.Plants causing hepatic lesions in ruminants and horses constitute one important group of poisonous plants in Brazil. These plants can be placed in three major groups: plants causing acute liver necrosis; plants causing liver fibrosis; and plants causing hepatogenous photosensitization. For some of these plants the toxic principles are known. Cestrum parqui and Xanthium cavanillesi that cause acute liver necrosis contain carboxy-atractylosides. Senecio spp., Crotalaria spp., and Echium plantagineum that cause liver fibrosis contain pyrrolizidine alkaloids. As for the group of plants causing hepatogenous photosensibilization, Myoporum spp. contain furanosesquiterpenes, Lantana spp contain triterpenes, and Brachiaria spp. and Panicum spp. contain steroidal saponins. The clinical and pathologic features of the toxicosis caused by these phytotoxins, general mechanisms of production for the production of

  14. Efeitos de diferentes níveis de cálcio dietético na cinética de cálcio e fósforo em eqüinos Effects of different levels of dietary calcium on calcium and phosphorus kinetics in horses

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    Dorinha Miriam Silber Schmidt Vitti

    2008-03-01

    Full Text Available Objetivou-se estudar o metabolismo de cálcio (Ca e fósforo (P nos eqüinos em crescimento que receberam diferentes níveis de suplementação de Ca: 0,15; 0,45 e 0,75% na dieta, utili