Patients’ Satisfaction with Prosthetic Devices

The purpose of the paper was to ascertain the factors which affect the satisfaction of patients with the prosthetic therapy. The purpose of the paper was also to ascertain if there are common factors characteristic for patients dissatisfied with the prosthetic therapy although the specialist appraises it as objectively successful. 52 patients of the Clinical Institute for Rehabilitation and Orthopedic Devices were participating in the research, to which, after unsuccessful surgical-prosthetic rehabilitation, reamputation and prosthetic provision was carried out, which was appraised successful by the doctor. It was endeavored to appraise to what extent the appraisal by the doctor corresponds to patient’s satisfaction. On the basis of the questionnaire elaborated specifically for this research and the statistical processing, it was concluded that where the doctor appraised the prosthetic therapy as successful, the same opinion was shared by the majority of the patients (92.3%). Patients are similarly satisfied with the function and the esthetic quality of the prosthesis (73%). The reason why 7.7% of patients are dissatisfied in cases when the doctor considers that there are no objective reasons for that should be sought in non-medical factors. The age, the education, the marital status, the income state, the size of the residence and the regional affiliation do not have a significant influence on the satisfaction of patients with the prosthesis (p>0.05). Patients with a minor handicap achieve satisfaction with the prosthetic therapy faster, as well as the right-handed persons if the prosthesis on the right-hand extremity is in question (p<0.05). This investigation showed that the responsibility of not wearing prosthetic aids, both orthopedic, and dental prostheses, couldn’t be only neuroticism by prosthetic patients, because that connection is not statistically significant (p<0.09)

O Comportamento Cíclico do Capital dos Bancos Brasileiros

No contexto de transição regulamentar para os padrões do acordo de Basiléia II, este artigo analisa o comportamento cíclico do capital bancário brasileiro sob a regulação atual. Utilizamos um painel não-balanceado de dados dos bancos operando no Brasil entre 2003 e 2008 para estimar, através de técnicas de painel dinâmico, uma equação do capital econômico dos bancos. Nossos resultados mostram que esta variável move-se com o ciclo de negócios.Bancos, Basiléia II, Ciclos Econômicos, Capital dos Bancos

Istraživanje prisustva različitih serovarova Leptospirae Interrogans u lovačkih pasa u Bosni i Hercegovini

Leptospirosis is an acute, subacute and chronical contagious disease of animals and humans. Causative agents of this disease belong to the genus Leptospira, family Leptospiraca. As a disease of wild animals, leptospirosis is widespread through Europe. Certain wild animals (rodents, fox and wild boars) are important reservoirs and highly probable vectors for the spread of infection into domestic animals and humans. During the hunting season, hunting dogs are often in direct or indirect contact with wild animals that could be carriers of this disease, and the possibility of appearance and spreading within this cohort of dogs is very high. The main reasons for this study on the prevalence of Leptospirosis in Bosnia and Herzegovina are the regular contact between hunting dogs and wild animals (carriers), and the lack of data about Leptospirosis in hunting dogs. In total, 175 serum samples from 15 towns of Bosnia and Herzegovina were tested. Twelve serovars of L. interrogans were used in the microscopic agglutination test. Presence of antibodies of four serovars was confirmed. Prevalence of seropositive dogs was 15.4% (27/175). Most positive dogs had a reaction to the Pomona serovar 51.8% (n=14), while the prevalence of the Sejroe serovar was 33.3%, Icterohaemorrhagiae serovar 11.1% and Bratislava serovar 3.7%. The highest number of positive reactions 55.5% (n=15) was with serum dilution of 1:200. This study showed that most infections in dogs were caused by serovars that are currently not included in commercial vaccines. One of the most efficient preventive measure could be vaccination with the serovars most often found in wild animals, as they appear to be the most common source of the infection.Leptospiroza je akutna, subakutna i kronična zarazna bolest životinja i ljudi. Uzročnici ove bolesti pripadaju rodu Leptospira, porodici Leptospiraca. Leptospiroza kao bolest divljih životinja široko je rasprostranjena u Europi. Određene divlje životinje (glodavci, lisice i divlje svinje) kao važan rezervoar i vrlo vjerojatan vektor zaraze proširile su bolest na domaće životinje i ljude. Lovački psi tijekom sezone lova često su u direktnom ili indirektnom kontaktu s divljim životinjama koje bi mogle biti nositelji ove bolesti, a mogućnost pojave i širenja unutar kategorije takvih pasa vrlo je velika. Glavni razlozi ove studije o učestalosti leptospiroze na području Bosne i Hercegovine su redoviti kontakti lovačkih pasa i divljih životinja (nositelji) i nedovoljni podatci o prisutnosti leptospiroze u kategoriji lovačkih pasa. Ukupno je istraženo 175 uzoraka seruma iz 15 gradova Bosne i Hercegovine. U mikroskopskom testu aglutinacije korišteno je dvanaest serovara L. Interrogans. Potvrđena je prisutnost antitijela na četiri serovara. Prevalencija seropozitivnih pasa bila je 15,4 % (27/175). Većina pozitivnih pasa imala je reakciju na serovar Pomona 51,8 % (n=14), dok je u serovaru Sejroe prevalencija 33,3 %, serovar Icterohaemorrhagiae 11,1 % i serovar Bratislava 3,7 %. Najveći broj pozitivnih reakcija bio je s razrjeđivanjem seruma od 1:200 ili 55,5 % (n=15). Studije pokazuju da su većinu infekcija u pasa prouzročili serovari koji nisu uključeni u komercijalna cjepiva. Jedna od najučinkovitijih preventivnih mjera mogla bi biti cijepljenje sa serovarovima koji se najčešće nalaze u divljih životinja jer su one najčešći izvor zaraze

Istraživanje klamidioze u populaciji pasa lutalica u Bosni i Hercegovini

Our research describe epidemiological presence of Chlamydiosis in different categories of dogs in Bosnia and Herzegovina. Problem of stray dogs, inordinately examined and not vaccinated dogs is one of the most complex problems among citizens, nongovernment organisations and institutions in Bosnia and Herzegovina. Chlamydiosis is zoonotic disease caused by Gram-negative, intracellulare bacteria, which include strains: Chlamydophila felis, Chlamydophila abortus, Chlamydophila psittaci and Chlamydophila caviae. Disease have endemic characteristics and there is little information about natural infections in dogs, which were mostly related to conjuctivitis, encephalitis and symptoms characteristic for pneumonia. In Europe, research of clamidiosis in dogs has been conducted in a small number of countries which include Germany, Slovakia, Sweden and Lithuania. This was a first of its kind study of Clamidiosis in dog population, carried out in Bosnia and Herzegovina. The study was conducted in twelve cities in Bosnia and Herzegovina with cooperation between two departments for contagious disease in Veterinary faculty of Sarajevo and Veterinary faculty of Ljubljana. The aim of the research was to determine presence of Chlamydial infections in different categories of dogs, using modern serological and molecular diagnostic methods. Blood serum samples were taken during 2012/2013. In total, 294 samples were assessed for presence of specific Chlamydial antibodies using method of indirect immunofluorescence, while method of RT- PCR was used for determination of antigen. After assessing 294 blood serum samples, 2.04% (6 samples) were positive for Cp. psittaci. Most of the positive samples originated from stray dogs. From serology positive animals, nose swabs were taken and assessed using RT-PCR. The presence of nucleic acid from Cp. psittaci was not confirmed in any of them.Naše istraživanje opisuje epidemiološko prisuće klamidioze u različitim kategorijama pasa u Bosni i Hercegovini. Problem pasa lu- talica koji nisu redovito pregledavani i necije- pljenih jedan je od najkompleksnijih proble- ma među građanima, problema nevladinih organizacija i institucija u Bosni i Hercegovi- ni. Klamidioza je zoonotska bolest koju izazi- va Gram-negativna, intracelularna bakterija, a koja uključuje sojeve: Chlamydophilia felis, Chlamydophilia abortus, Chlamydophilia psittaci i Chlamydophilia caviae. Bolest je endemičnog karaktera i malo je dostupnih informacija o prirodnim infekcijama u pasa, koje su obič- no bile povezivane s konjuktivitisom, ence- falitisom i simptomima karakterističnim za pneumoniju. Mali je broj europskih zemalja istraživao klamidiozu u pasa. Istraživali su ju: Njemačka, Slovačka, Švedska i Litva. Ovo je prvo istraživanje ovog tipa, provedeno na psima u Bosni i Hercegovini. Istraživanje je provedeno u dvanaest gradova Bosne i Her- cegovine u suradnji odjela za zarazne bolesti Veterinarskog fakulteta u Sarajevu i Veteri- narskog fakulteta u Ljubljani, Slovenija. Cilj je istraživanja bio uporabom metoda serolo- gije i molekularne dijagnostike odrediti pri- suće klamidijalnih infekcija među različitim kategorija pasa. Krvni serumi su uzorkovani tijekom 2012./2013. godine. Ukupno je pre- gledavano 294 uzoraka na prisuće specifičnih klamidijalnih protutijela metodom indirektne fluoroscence, dok je RT-PCR metoda korište- na za određivanje antigena. Nakon pregleda 294 uzoraka seruma, 2,04 % (6 uzorka) su bila pozitivna na Cp. psittaci. Većina pozitivnih uzoraka je imala podrijetlo od uličnih pasa. Od serološki pozitivnih životinja, uzimani su brisevi nosne sluznice i pregledani upo- rabom RT-PCR metode. Prisuće nukleinske kiseline od Cp. psittaci nije potvrđena niti u jednoj od životinja

Concepts of municipal health managers of Pernambuco about the allocation and management of health spending

O artigo trata da questão do financiamento da saúde e da forma como os secretários municipais lidam com as regulamentações sobre os gastos no setor. O estudo objetivou ouvir os gestores a respeito de sua concepção sobre gasto em saúde, conhecimento acerca dos instrumentos legais que direcionam o financiamento e sua participação nas definições para alocação dos recursos. Foram selecionados 10 (dez) municípios do Estado de Pernambuco para abordagem através de entrevistas semiestruturadas aos seus respectivos secretários de saúde. A seleção foi aleatória, sorteando-se 05 (cinco) municípios dentre os de melhor desempenho do Estado - quanto à regularidade da alimentação do Sistema de Informação sobre Orçamentos Públicos em Saúde (Siops) e quanto ao cumprimento da Emenda Constitucional nº 29 - e os 05 (cinco) piores com relação aos mesmos critérios. As respostas foram analisadas através da técnica de análise de conteúdo. Nos resultados identificou-se que, para esses gestores, apenas despesas em ações e serviços próprios da saúde devem ser consideradas gastos para fins de pagamento com recursos destinados ao setor. Alguns secretários conhecem e especificam a regulamentação sobre gastos em saúde, participam na definição do orçamento municipal e gerem os recursos do Fundo Municipal de Saúde. Apesar da não uniformidade das respostas, observou-se que os secretários estavam motivados para participar da discussão sobre financiamento e de atuarem ativamente, junto aos demais órgãos da Administração Pública Municipal e do Prefeito, da alocação dos recursos, de acordo com as necessidades de saúde da população.This article discusses the issue of health financing and the way district secretaries deal with municipal regulations on spending in the sector. We heard managers regarding their idea of spending in health, their knowledge of legal instruments that direct financing and their participation in resources' allocation. The health secretaries of 10 (ten) municipalities in the State of Pernambuco were approached through semi-structured interviews. The criteria for inclusion in the study referred to regularity of data feeding into SIOPS (Information System in Public Health Budgets) and the fulfillment of Constitutional Amendment nº. 29: five municipalities were chosen among those with the best records within the State, and 05 (five) among those with the worst records. Content analysis was used for treating interviews' data. Results showed that these administrators admit payments using health resources only for expenses in actions and services specific of the health field. Some secretaries know and are capable of specifying legal parameters for health expenses. They take part in the district's budget decision making process and also manage resources from the Municipal Fund for Health. Despite the differences while responding, it was noticed that the secretaries were willing to discuss financing and took an active role in resources allocation with other Municipal Public Administration bodies, in order to attend to population's health needs

Prospective Relationship between Hemispheric Lateralisation and CD4+ T Cells in Human Immunodeficiency Virus Type 1

Objectives: Neuromodulation of the immune system has been proposed to be influenced by hemispheric lateralisation (HL). The present study tested whether HL predicted CD4+ levels, statistically controlling for confounders. Methods: Employing two assessments of HL, 68 human immunodeficiency virus (HIV)-1+ patients were followed prospectively. Numerous exclusion criteria and confounder assessments were employed (e.g. age/medication). Results: Left HL significantly positively predicted CD4+ levels at follow-up, and this was qualified by medication (HAART) status: only in HAART-naïve patients did HL predict CD4 levels. Furthermore, HL significantly predicted whether patients had clinically significantly high/low CD4+ counts. Conclusions: Using a more rigorous methodology than a previous study, the present work partly corroborated the theory of HL influences on immunity, extended it to HIV immunity and identified a possible moderator: HAART medication. Implications for future research and treatments are provided

The Molecular Profile of Synovial Fluid Changes upon Joint Distraction and is Associated with Clinical Response in Knee Osteoarthritis

Objective: Surgical knee joint distraction (KJD) leads to clinical improvement in knee osteoarthritis (OA) and also apparent cartilage regeneration by magnetic resonance imaging. We investigated if alteration of the joint’s mechanical environment during the 6 week period of KJD was associated with a molecular response in synovial fluid, and if any change was associated with clinical response.Method: 20 individuals undergoing KJD for symptomatic radiographic knee OA had SF sampled at baseline, midpoint and endpoint of distraction (6 weeks). SF supernatants were measured by immunoassay for 10 predefined mechanosensitive molecules identified in our previous pre-clinical studies. The composite Knee injury and OA Outcome Score-4 (KOOS4) was collected at baseline, 3, 6 and 12 months.Results: 13/20 (65%) were male with mean age 54±5yrs. All had Kellgren-Lawrence grade≥2 knee OA. 6/10 analytes showed statistically significant change in SF over the 6 weeks distraction (activin A;TGFβ-1;MCP-1;IL-6;FGF-2;LTBP2), P&lt;0.05. Of these, all but activin A increased. Those achieving the minimum clinically important difference of 10 points for KOOS4 over 6 months showed greater increases in FGF-2 and TGFβ-1 than non-responders. An increase in IL-8 during the 6 weeks of KJD was associated with significantly greater improvement in KOOS4 over 12 months.Conclusion: Detectable, significant molecular changes are observed in SF following KJD, that are remarkably consistent between individuals. Preliminary findings appear to suggest that increases in some molecules are associated with clinically meaningful responses. Joint distraction may provide a potential opportunity in the future to define regenerative biomarker(s) and identify pathways that drive intrinsic cartilage repair