28 research outputs found

    Human papillomavirus genotypes in cervical cancers in Mozambique.

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    The distribution of human papillomavirus (HPV) types in cervical cancers is essential for design and evaluation of HPV type-specific vaccines. To follow up on a previous report that HPV types 35 and 58 were the dominant HPV types in cervical neoplasia in Mozambique, the HPV types in a consecutive case series of 74 invasive cervical cancers in Mozambique were determined. The most common worldwide major oncogenic HPV types 16 and 18 were present in 69 % of cervical cancers, suggesting that a vaccine targeting HPV-16 and -18 would have a substantial impact on cervical cancer also in Mozambique

    A method description and feasibility study

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    A detailed transabdominal and transvaginal ultrasound examination, performed by an expert examiner, could render a similar diagnostic performance to computed tomography for assessing pelvic/abdominal tumor spread disease in women with epithelial ovarian cancer (EOC). This study aimed to describe and assess the feasibility of lung and intercostal upper abdomen ultrasonography as pretreatment imaging of EOC metastases of supradiaphragmatic and subdiaphragmatic areas. A preoperative ultrasound examination of consecutive patients suspected of having EOC was prospectively performed using transvaginal, transabdominal, and intercostal lung and upper abdomen ultrasonography. A surgical-pathological examination was the reference standard to ultrasonography. Among 77 patients with histologically proven EOC, supradiaphragmatic disease was detected in 13 cases: pleural effusions on the right (n = 12) and left (n = 8) sides, nodular lesions on diaphragmatic pleura (n = 9), focal lesion in lung parenchyma (n = 1), and enlarged cardiophrenic lymph nodes (n = 1). Performance (described with area under the curve) of combined transabdominal and intercostal upper abdomen ultrasonography for subdiaphragmatic areas (n = 77) included the right and left diaphragm peritoneum (0.754 and 0.575 respectively), spleen hilum (0.924), hepatic hilum (0.701), and liver and spleen parenchyma (0.993 and 1.0 respectively). It was not possible to evaluate the performance of lung ultrasonography for supradiaphragmatic disease because only some patients had this region surgically explored. Preoperative lung and intercostal upper abdomen ultrasonography performed in patients with EOC can add valuable information for supradiaphragmatic and subdiaphragmatic regions. A reliable reference standard to test method performance is an area of future research. A multidisciplinary approach to ovarian cancer utilizing lung ultrasonography may assist in clinical decision-making.publishersversionpublishe

    a comprehensive review

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    The role of endobronchial ultrasound (EBUS) and trans-esophageal endobronchial ultrasound (EUS-B) in lung cancer is well established and scientifically validated. There is increasing data that endosonography is a crucial tool for the diagnosis of central lung lesions, and mediastinal staging and restaging of non-small cell lung cancer patients. The present article reviews the technical aspects of EBUS and EUS-B and focus on the last published research regarding its value in lung cancer.publishersversionpublishe

    A Survey of the European Association of Bronchology and Interventional Pulmonology (EABIP)

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    Publisher Copyright: © Copyright 2017 S. Karger AG, Basel. All rights reserved.Background: Airway stenting (AS) commenced in Europe circa 1987 with the first placement of a dedicated silicone airway stent. Subsequently, over the last 3 decades, AS was spread throughout Europe, using different insertion techniques and different types of stents. Objectives: This study is an international survey conducted by the European Association of Bronchology and Interventional Pulmonology (EABIP) focusing on AS practice within 26 European countries. Methods: A questionnaire was sent to all EABIP National Delegates in February 2015. National delegates were responsible for obtaining precise and objective data regarding the current AS practice in their country. The deadline for data collection was February 2016. Results: France, Germany, and the UK are the 3 leading countries in terms of number of centres performing AS. These 3 nations represent the highest ranked nations within Europe in terms of gross national income. Overall, pulmonologists perform AS exclusively in 5 countries and predominately in 12. AS is performed almost exclusively in public hospitals. AS performed under general anaesthesia is the rule for the majority of institutions, and local anaesthesia is an alternative in 9 countries. Rigid bronchoscopy techniques are predominant in 20 countries. Amongst commercially available stents, both Dumon and Ultraflex are by far the most commonly deployed. Finally, 11 countries reported that AS is an economically viable activity, while 10 claimed that it is not. Conclusion: This EABIP survey demonstrates that there is significant heterogeneity in AS practice within Europe. Therapeutic bronchoscopy training and economic issues/reimbursement for procedures are likely to be the primary reasons explaining these findings.publishersversionpublishe

    Current Practice of Airway Stenting in the Adult Population in Europe: A Survey of the European Association of Bronchology and Interventional Pulmonology (EABIP)

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    Background: Airway stenting (AS) commenced in Europe circa 1987 with the first placement of a dedicated silicone airway stent. Subsequently, over the last 3 decades, AS was spread throughout Europe, using different insertion techniques and different types of stents. Objectives: This study is an international survey conducted by the European Association of Bronchology and Interventional Pulmonology (EABIP) focusing on AS practice within 26 European countries. Methods: A questionnaire was sent to all EABIP National Delegates in February 2015. National delegates were responsible for obtaining precise and objective data regarding the current AS practice in their country. The deadline for data collection was February 2016. Results: France, Germany, and the UK are the 3 leading countries in terms of number of centres performing AS. These 3 nations represent the highest ranked nations within Europe in terms of gross national income. Overall, pulmonologists perform AS exclusively in 5 countries and predominately in 12. AS is performed almost exclusively in public hospitals. AS performed under general anaesthesia is the rule for the majority of institutions, and local anaesthesia is an alternative in 9 countries. Rigid bronchoscopy techniques are predominant in 20 countries. Amongst commercially available stents, both Dumon and Ultraflex are by far the most commonly deployed. Finally, 11 countries reported that AS is an economically viable activity, while 10 claimed that it is not. Conclusion: This EABIP survey demonstrates that there is significant heterogeneity in AS practice within Europe. Therapeutic bronchoscopy training and economic issues/reimbursement for procedures are likely to be the primary reasons explaining these findings. (C) 2017 S. Karger AG, Base

    Perfil epidemiologico, complic√ß√Ķes e custo do aborto clandestino, compara√ß√£o com aborto hospitalar e parto, em Maputo, Mo√ßambique

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    Orientadores: Ellen Hardy, Anibal FaundesTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias MedicasResumo: O objetivo geral do estudo foi identificar as caractersiticas das mulheres que se internam, por complica√ß√Ķes de aborto clandestino no Hospital Central de Maputo, Mo√ßambique, e avaliar o custo econ√īmico e para a sa√ļde dessa pr√°tica. A longo prazo o prop√≥sito √© de estimular medidas para prevenir gravidezes indesejadas, bem como a morbi-mortalidade materna resultante. Este foi um estudo caso-controle, em que a forma de t√©rmino da √ļltima gravidez foi a vari√°vel dependente para estudar as caracteristicas s√≥ciodemogr√°ficas e de sa√ļde das mulheres. Ao mesmo tempo foi um estudo anal√≠tico, prospectivo em que a forma de t√©rmino da gesta√ß√£o foi a vari√°vel independente para avaliar complica√ß√Ķes e custos hospitalares. O tamanho amostral foi calculado em 400 mulheres para cada um dos grupos de mulheres com aborto clandestino, hospitalar ou parto. Para as entrevistas foi usado um question√°rio estruturado e pr√©-testado, e para avaliar os custos hospitalares um formul√°rio de custos do IPAS. Os dados foram digitados e analisados atrav√©s do SPSS, utilizando-se os testes de qui-quadrado, teste exato de Fisher e o teste "t" de Student. As mulheres cm aborto clandestino eram mais jovens e uma maior porcentagem era primigesta e teve menos abortos do que aquelas nos outros grupos. O n√ļmero de filhos vivos dos dois grupos com aborto foi semelhante. As mulheres com aborto clandestino tiveram escolaridade menor que as do grupo com aborto hospitalar, mas maior que as do grupo com parto. Uma propor√ß√£o menor de mulheres do grupo com aborto clandestino vivia com um parceiro quando comparadas com os outros grupos, sendo tamb√©m mais frequentemente rec√©m-chegadas √† cidade de Maputo. Uma propor√ß√£o maior de mulheres do grupo com aborto clandestino n√£o tinha religi√£o. No grupo com aborto clandestino a qualidade da habita√ß√£o foi semelhante √† do grupo com parto, mas muito inferior em rela√ß√£o ao grupo com aborto hospitalar. Os parceiros das mulheres com aborto clandestino estavam mais frequentemente desempregados quando comparados ao grupo com abbrto hospitalar. Todos os grupos tiveram conhecimentos elevados acerca de contraceptivos, mas a frequ√™ncia de uso foi maior no grupo com aborto hospitalar. As complica√ß√Ķes, transfus√Ķes de sangue, m√©dia de dias de interna√ß√£o, consumo de antibi√≥ticos de terceira gera√ß√£o e de infus√Ķes foram maiores no grupo com aborto clandestino, tendo ocorrido mortes apenas neste grupo. O custo m√©dio por paciente do grupo com aborto clandestino foi de US100comparadocomUS 100 comparado com US 12 por mulher com aborto hospitalar e 18 d√≥lares do grupo com parto. O autor conclui que o aborto clandestino teve consequ√™ncias mais graves para sa√ļde das mulheres do que outras formas de t√©rmino de gesta√ß√£o estudadas. As mulheres internadas por complica√ß√Ķes de aborto representaram um custo nove e cinco vezes superior √†s mulheres internadas por aborto hospitalar e parto, respectivamenteAbstract: The general objective of the study was to identify characteristics of women who were hospitalized with complications of clandestine abortion in the Central Hospital of Maputo, Mozambique, and to evaluate the health and economic cost of that practice. In the long run is to prevent unwanted pregnancies and lowering maternal morbidity and mortality. This was a case-control study in which the way the last pregnancy ended was the dependent variable when studying socio-demographic characteristics. At the same time it was an analytic, prospective study, in which the way pregnancy ended was the independent variable to study complications and hospital costs. The sample size was 400 women for each of the following three groups of pregnancy termination: clandestine abortion, hospital based abortion and delivery. A structured pretested questionnaire was used for the interviews. The information was entered into a database and the analysis was carried out with SPSS. A form developed by IPAS to evaluate hospital costs was used. Statistical analysis was done using chi-square, Fisher's exact test and Student's t-test. Women in the clandestine abortion group were younger, a larger percentage was primigravida and they had fewer abortions than those in the other groups. Their number of living children was similar to that of women with hospital based abortions. In the clandestine abortion group, schooling was lower than in the hospital based abortion group, but higher than in the delivery group. A smaller proportion of women in the clandestine abortion group lived with a partner when compared with the two other groups, and they were more frequently newcomes to the city of Maputo than the hospital abortion group. A significant proportion of women in the clandestine group had no religious affiliation when compared with the other groups. The housing conditions of women in the clandestine group were the same as those of the delivery group, but much worse than those of with hospital abortion. More of the partners of women in, the clandestine abortion group were unemployed when compared to the partners of the group of hospital based abortions. Knowledge about contraceptive methods was very high in all groups but use was lower in the clandestine abortion group than in the group with hospital abortions. Complications, blood transfusions, consumption of third generation antibiotics and of infusion solutions (IV) and mean length of hospital stay were very high in the clandestine abortion group and negligible in the other two groups. Deaths were observed only in the first group. The mean cost per patient in the clandestine abortion group was US100comparedtoUS 100 compared to US 12 in the hospital based abortion group and US$ 18 in the delivery group. The author concludes that clandestine abortion had more negative effects on women's health than hospital abortions or delivery. Women hospitalized for clandestine abortion complications represented a cost nine and five times greater than that of women who had a hospital based abortion as a delivery, respectivelyDoutoradoTocoginecologiaDoutor em Medicin

    Coordination and control in emerging international construction firms

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    Decisions pertaining to the coordination and control of subsidiaries made by emerging international construction firms are crucial for the success of their internationalization process. The case study approach, based on four emerging international construction firms with headquarters in Portugal, is used to analyse the coordination and control processes adopted by these construction firms at an early internationalization stage. The proposition of the study was that these types of firms learn more from their experiences than from the existing theory in the literature. The results show a clear pattern of replication of home norms and practices, suggesting that at an early stage they neglect the theory of international business, the host countries' specificities and the consequent adaptation needs. The case studies show that all the headquarters initiated the control of their international activities through home-based bureaucratic systems, but have realized that they need more cultural and social control, as recommended by Bartlett and Ghoshal (1989, 1992).Multinational firms, international business, management control,
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