bluuebunny/crossref_metadata_2025 huggingface dataset:
Le management néolibéral en Allemagne
Authors: Sack Detlef , Donzelot Jules
Published: October 2012

En quoi les évolutions françaises se distinguent-elles de ce qui se passe dans le reste de l’Europe ? La comparaison avec notre voisin permet de mettre à l’épreuve l’idée que l’Europe fonctionne comme un espace de diffusion de pratiques transposables au-delà des particularités nationales.
L'imaginaire de guerre en Irak, entre traumatisme et réconciliation
Authors: Masson Nicolas
Published: October 2012

Dans la vallée d’Elah de Paul Haggis et Redacted de Brian de Palma sont, parmi d’autres, deux films qui témoignent de la capacité américaine à s’emparer par la fiction de la situation irakienne. Mais ces films montrent aussi, après le traumatisme des photos d’Abou Ghraib, que les images du cinéma ne sont pas isolables de la circulation folle des images dans l’information et à travers les réseaux numériques.
La inversión Matuyama-Brunhes en la secuencia de terrazas del río Jarama entre Velilla de San Antonio y Altos de la Mejorada, al SE de Madrid (España)
Authors: Pérez-González A. , Gallardo-Millán J.L. , Uribelarrea del Val D. , Panera J. , Rubio-Jara S.
Published: October 2012

Al Este de la ciudad de Madrid, en el valle del río Jarama y entre Mejorada del Campo y Velilla de San Antonio se han estudiado las propiedades paleomagnéticas de una secuencia de terrazas comprendidas entre El Rasillo y Altos de la Mejorada, a lo largo de la autopista M-203 de reciente construcción. La cartografía geomorfológica realizada permitió separar además de la llanura aluvial a +4-5 m, terrazas a +20 m, +30-35 m, +60-65 m, +85-90 m, +105-110 m y +125-130 m. De ellas se muestrearon 5 niveles, a excepción de la de +20 m, en taludes frescos de la autovía que permiten situar a las terrazas con altitudes relativas igual o mayores a +60-65 m en el Chron Matuyama, mientras que las terrazas a +20 m y +30-35 m pertenecerían al Chron Brunhes (< 0.780 Ma). Dataciones por ESR en terrazas del valle del río Arlanzón en Burgos (Moreno et al., 2012), sugieren que en el valle del Jarama la inversión Matuyama-Brunhes podría establecerse entre el final de la sedimentación de la terraza a +60-65 m y el encajamiento de la terraza a +50-55 m subsiguiente, representada aguas arriba de Mejorada del Campo, en Marchamalo (Pérez-González, 1994).
L’anglais et les magistrats français, résultats d’une enquête de terrain
Authors: Braud Valérie
Published: October 2012

Les magistrats français constituent une communauté de discours dont la particularité est de ne pas appartenir à une communauté internationale qui partagerait un discours spécialisé commun. Le point de départ de l’étude est une interrogation sur le statut et l’importance que revêt la connaissance de l’anglais pour les magistrats français. Ceux-ci sont en effet tenus de dire le droit dans un cadre strictement national. Cependant cette profession, vouée aux évolutions politiques, sociales et économiques dans le cadre notamment de l’ouverture à l’Europe et à l’international, se voit contrainte de devoir intégrer l’importance grandissante de l’anglais dans les échanges professionnels et para-professionnels. L’auteur présente les résultats d’une analyse des situations et des contextes dans lesquels les magistrats sont amenés à utiliser l’anglais afin d’évaluer leurs besoins langagiers. Les résultats de cette étude, menée auprès de 500 magistrats en juillet 2006, montrent que l’anglais est utilisé à trois niveaux : national, européen et international. Les besoins langagiers peuvent être caractérisés selon des critères de fréquence d’utilisation, de contexte et de compétences.
Blockade of Myeloid-Derived Suppressor Cells after Induction of Lymphopenia Improves Adoptive T Cell Therapy in a Murine Model of Melanoma
Authors: Kodumudi Krithika N. , Weber Amy , Sarnaik Amod A. , Pilon-Thomas Shari
Published: October 2012

Administration of nonmyeloablative chemotherapeutic agents or total body irradiation (TBI) prior to adoptive transfer of tumor-specific T cells may reduce or eliminate immunosuppressive populations such as T regulatory cells (Tregs) and myeloid-derived suppressor cells (MDSC). Little is known about these populations during immune reconstitution. This study was designed to understand the reconstitution rate and function of these populations post TBI in melanoma tumor‑bearing mice. Reconstitution rate and suppressive activity of CD4+CD25+Foxp3+ Tregs and CD11b+Gr1+ MDSC following TBI-induced lymphopenia was measured in B16 melanoma tumor‑bearing mice. To ablate the rapid reconstitution of suppressive populations, we treated mice with docetaxel, a known chemotherapeutic agent that targets MDSC, in combination with adoptive T cell transfer and dendritic cell immunotherapy. Both Treg and MDSC populations exhibited rapid reconstitution after TBI-induced lymphopenia. Although reconstituted Tregs were just as suppressive as Tregs from untreated mice, MDSC demonstrated enhanced suppressive activity of CD8+ T cell proliferation compared with endogenous MDSC from tumor-bearing mice. TBI-induced lymphopenia followed by docetaxel treatment improved the efficacy of adoptive T cell transfer and dendritic cell immunotherapy in melanoma-bearing mice, inducing a significant reduction in tumor growth and enhancing survival. Tumor regression correlated with increased CTL activity and persistence of adoptively transferred T cells. Overall, these findings suggest that TBI-induced MDSC are highly immunosuppressive and blocking their rapid reconstitution may improve the efficacy of vaccination strategies and adoptive immunotherapy.
Dynamics of CD4+ T Cell Responses against Listeria monocytogenes
Authors: Graw Frederik , Weber K. Scott , Allen Paul M. , Perelson Alan S.
Published: October 2012

The generation of CD4+ T cell memory cells is poorly understood. Recently, two different murine CD4+ TCR transgenic T cell lines, LLO118 and LLO56, both specific for the same epitope but differing in their expression level of the cell surface protein CD5, were generated. Notably, these cell lines showed different behavior upon primary and secondary exposure to Listeria monocytogenes. Whereas LLO118 showed a stronger primary response and generated more robust CD8+ T cell help upon secondary exposure, LLO56 CD4+ T cells had a dramatically better recall response. Using different mathematical models, we analyzed the dynamics of the two CD4+ T cell lines in mice during infection with L. monocytogenes. Our models allowed the quantitative comparison of the two T cell lines and provided predictions for the conversion of naive T cells into memory cells. LLO118 CD4+ T cells are estimated to have a higher proliferation rate than LLO56 CD4+ T cells upon primary exposure. This difference can be explained by the lower expression level of CD5 on LLO118 CD4+ T cells. Furthermore, LLO56 memory cells are predicted to have a 3-fold longer half-life than LLO118 memory cells (t1/2LLO118 ≈ 4.3 to 5 d and t1/2LLO56 ≈ 11.5 to 13.9 d). Although both cell lines differ in their memory capabilities, our analysis indicates no difference in the rate at which memory cells are generated. Our results show that different CD5 expression levels influence the proliferation dynamics of activated naive CD4+ T cells while leaving the conversion rate of those cells into memory cells unaffected.
HIV-1 gp120 Impairs the Induction of B Cell Responses by TLR9-Activated Plasmacytoid Dendritic Cells
Authors: Chung Nancy P. Y. , Matthews Katie , Klasse Per Johan , Sanders Rogier W. , Moore John P.
Published: October 2012

Plasmacytoid dendritic cells (pDCs) play a central role in innate and adaptive immune responses to viral infections, including HIV type 1 (HIV-1). pDCs produce substantial quantities of type I IFN and proinflammatory cytokines upon stimulation via TLRs, specifically TLR7 or TLR9. The HIV-1 envelope glycoproteins, exemplified by the gp120 monomer, are the focus of vaccines aimed at inducing B cell responses. We have studied how the interactions of gp120 with various receptors on human pDCs affect the activation of these cells via TLR9 and their subsequent ability to stimulate B cells. We observed that IFN-α production by pDCs in response to TLR9, but not TLR7, stimulation was reduced by exposure to gp120. Specifically, gp120 inhibited the CpG-induced maturation of pDCs and their expression of TNF-α, IL-6, TLR9, IFN regulatory factor 7, and BAFF. Receptor-blocking and cross-linking studies showed that these inhibitory effects of gp120 were mediated by interactions with CD4 and mannose-binding C-type lectin receptors, but not with the chemokine receptors CCR5 and CXCR4. Of note is that gp120 inhibited the activation of B cells by TLR9-stimulated pDCs. Taken together, our data show that HIV-1 gp120 impairs pDC functions, including activation of B cell responses, and imply that TLR9 ligands may not be good adjuvants to use in combination with envelope glycoprotein vaccines.
Towards the fulfilment of three generations of rights: A theological contribution by Koos Vorster
Authors: Koopman Nico N.
Published: October 2012

In this article the theological contribution of Koos Vorster to human rights discourses was discussed. It was shown how he focused upon all three generations rights, namely the first generation civil and political rights, second generation social, economic and cultural rights, and third generation developmental and ecological rights. He appreciates the importance of nurturing citizens and leaders of public and civic virtue and character for the implementation of rights and the creation of a human rights culture. He also gives special attention to the implementation  of  ecological  rights  and  therefore  discussed  various  forms  of  ecocide. Ultimately, Vorster stimulates systematic theological discourses on ecological rights by viewing the implementation of ecological rights as a theological matter. It had to do with the heart of Christian faith.Aangaande die vervulling van drie generasies van regte: ‘n Teologiese bydrae deur Koos Vorster. In hierdie artikel was die teologiese bydrae van Koos Vorster tot menseregte-diskoerse bespreek. Dit dui aan dat hy op al drie generasies van menseregte gefokus het, naamlik eerste generasie burgerlike en politieke regte, tweede generasie sosiale, ekonomiese en kulturele regte en derde generasie ontwikkelings- en ekologiese regte. Hy waardeer die belangrikheid van die vorming van burgers en leiers van burgerlike en openbare deug en karakter vir die implementering van regte en die bou van ‘n menseregtekultuur. Hy het spesiale aandag gegee aan die implementering van ekologiese regte en hy het  derhalwe die verskillende vorme van die vernietiging van die natuurlike omgewing bespreek. Hy stimuleer sistematies-teologiese denke oor ekologiese regte. Hy het die implementering van ekologiese beskou as ‘n  teologiese saak. Dit het met die hart van die Christelike geloof te make gehad.
Vascular Effects of Bisphosphonates–-A Systematic Review
Authors: Santos Leyna L. , Cavalcanti Taciana B. , Bandeira Francisco A.
Published: October 2012

Background

Osteoporosis and cardiovascular disease are interconnected entities with pathophysiological similarities. Bisphosphonates are therapeutic options available for resorptive bone diseases; however, experimental evidence has demonstrated a role for bisphosphonates in the inhibition of atherogenesis.

Methods

A systematic review of the vascular effects of bisphosphonates on atherosclerosis was performed. Vascular effects were evaluated by the thickening of the intima-media of carotid arteries and calcification of the coronary and aorta arteries. Electronic databases PubMed, The Cochrane Library, and Embase from January 1980 to May 2011 were searched.

Results

Of 169 potentially relevant articles, 9 clinical trials were selected. Two articles showed the benefit of the use of etidronate (–0.038 mm, P <0.005) and alendronate (–0.025 mm, P <0.05) on carotid artery intima-media thickening (CIMT) after one year. One article found no changes associated with the use of alendronate. The use of risedronate was associated with a reduction of plaque score on the carotid arteries (decrease of 1% at 1 year, P = 0.015). Of those studies that evaluated the effect on coronary artery calcification (CAC), the results are conflicting: one study showed no changes with use of etidronate and in another, etidronate resulted in inhibition of the process of CAC after 1 year of follow-up (–372 mm3in CAC score, P <0.01). Three studies showed positive effects of etidronate on the aortic calcificaton (AC) score, showing no effect with use of ibandronate, and another showed a inhibition in the progression of the abdominal AC score with use of risendronate ( P = 0.043).

Conclusion

Bisphosphonates seem to have an inhibitory effect on the atherosclerotic process; however, larger placebo-controlled studies are needed to better clarify this issue.
HadISD: a quality-controlled global synoptic report database for selected variables at long-term stations from 1973–2011
Authors: Dunn R. J. H. , Willett K. M. , Thorne P. W. , Woolley E. V. , Durre I. , Dai A. , Parker D. E. , Vose R. S.
Published: October 2012

Abstract. This paper describes the creation of HadISD: an automatically quality-controlled synoptic resolution dataset of temperature, dewpoint temperature, sea-level pressure, wind speed, wind direction and cloud cover from global weather stations for 1973–2011. The full dataset consists of over 6000 stations, with 3427 long-term stations deemed to have sufficient sampling and quality for climate applications requiring sub-daily resolution. As with other surface datasets, coverage is heavily skewed towards Northern Hemisphere mid-latitudes. The dataset is constructed from a large pre-existing ASCII flatfile data bank that represents over a decade of substantial effort at data retrieval, reformatting and provision. These raw data have had varying levels of quality control applied to them by individual data providers. The work proceeded in several steps: merging stations with multiple reporting identifiers; reformatting to netCDF; quality control; and then filtering to form a final dataset. Particular attention has been paid to maintaining true extreme values where possible within an automated, objective process. Detailed validation has been performed on a subset of global stations and also on UK data using known extreme events to help finalise the QC tests. Further validation was performed on a selection of extreme events world-wide (Hurricane Katrina in 2005, the cold snap in Alaska in 1989 and heat waves in SE Australia in 2009). Some very initial analyses are performed to illustrate some of the types of problems to which the final data could be applied. Although the filtering has removed the poorest station records, no attempt has been made to homogenise the data thus far, due to the complexity of retaining the true distribution of high-resolution data when applying adjustments. Hence non-climatic, time-varying errors may still exist in many of the individual station records and care is needed in inferring long-term trends from these data. This dataset will allow the study of high frequency variations of temperature, pressure and humidity on a global basis over the last four decades. Both individual extremes and the overall population of extreme events could be investigated in detail to allow for comparison with past and projected climate. A version-control system has been constructed for this dataset to allow for the clear documentation of any updates and corrections in the future.
Current distribution of Pilularia globulifera L. in Poland – changes of geographical range and habitat preferences
Authors: Szczęśniak Ewa , Rosadziński Stanisław , Spałek Krzysztof , Szymanowski Mariusz , Kreitschitz Agnieszka , Kruk Jerzy , Śliwiński Michał , Kamiński Ryszard
Published: October 2012

Pilularia globulifera is a subatlantic European fern threatened with extinction. In Poland, it reaches the eastern border of its continuous range. Up to the end of the 20th century, it was observed here in 21 stands; only 2 of them existed by the second half of the century, so the species was categorized as critically endangered. Five new locations have been found in western and northwestern Poland during the last 10 years. Abundant and permanent populations grow in 3 locations, while 2 stands were ephemeral. All the current stands are situated in anthropogenic habitats with spontaneous vegetation, in oligotrophic to eutrophic waters. One of the new localities is about 280 km distant from the eastern range of the limit known previously. Pilularia forms its own plant community Pilularietum globuliferae, enters plots of Ranunculo-Juncetum bulbosi and occurs in mesotrophic to eutrophic rushes of Eleocharis palustris, Phragmites australis, Typha angustifolia and Equisetum fluviatile. Specimens are vigorous and regularly produce sporocarps.
Dexterity Analysis of a 4-UPS-RPS Parallel Mechanism
Authors: Chen Xiulong , Sun Xianyang
Published: October 2012

A novel 4-UPS-RPS spatial 5 degrees of freedom parallel mechanism is introduced and its dexterity measures are analysed. The stationary platform of the parallel mechanism is connected with the moving platform by the same four UPS (universal joints-prismatic pairs-spherical joints) driving links and a RPS (revolute joints-prismatic pairs-spherical joints) link. The velocity Jacobian matrix and the force Jacobian matrix of the parallel mechanism are derived, and the dimensionless velocity Jacobian matrix is established. On this basis, the three dexterity measures, including average conditional number, the smallest singular value and operation, are obtained. According to these, the square mean dexterity coefficient, which is used to comprehensively evaluate the dexterity of various configurations, is proposed. In addition, the distribution of different dexterity measures above in the workspace is analysed respectively. This research can provide an important theoretical base for the dimensional synthesis and trajectory planning for a parallel mechanism.
Considerations when devising a protocol for pre-eclampsia
Authors: O’Sullivan Geraldine
Published: October 2012

Hypertension is the most frequent medical complication of pregnancy. Pre-eclampsia is one of the main causes of maternal and fetal morbidity and mortality. Hypertension is the most common first sign of preeclampsia. Pre-eclampsia is also associated with fetal growth restriction, low birth weight, preterm delivery, small for gestational age infants and respiratory distress syndrome.
Regional anaesthesia for postoperative pain management after liver resection
Authors: Trepenaitis Darius , Česnaitis Tadas , Macas Andrius
Published: October 2012

Background. Pain is the most common complication in the postoperative period. If adequate treatment is not taken, it can transform to chronic pain. Postoperative pain brings a lot of social, psychological and financial problems for patients and their families. Materials and methods. This prospective study included 30 patients after laparatomic liver resection operation. Patients were randomly assign­ ed to Infiltrated or Control groups. An infiltration of 40 ml levobupivacaine 0.25% solution to the operation cut edges was performed to the Infiltrated group. The pain was evaluated using the numerical rating scale after 2, 5, 12, 24, 48 hours and 1 month after the operation. Our aim was to determine the effect of local anesthesia in the operation wound. The total usage of morphine and any side effects were registered. Results. A statistically significant reduction in pain was observed in the Infiltrated group in all evaluation periods. Opioids usage was higher in the Control group almost by 4 times and adverse effects were 9 to 1 compared to the Infiltrated group. Conclusions. Surgical wound infiltration with local anesthetic for postoperative pain management after liver resection operations has a positive effect on postoperative pain reduction and leads to lesser usage of opioid analgetics. As a result, there is a less chance of opioids induced adverse effects.
Pediatric sepsis and septic shock: definitions and treatment algorithms
Authors: Krastins Jekabs
Published: October 2012

Sepsis remains one of the leading causes of morbidity and mortality in children despite improved understanding of the pathophysiology leading to better clinical management and survival. Recent studies have identified several areas that must be addressed by the clinician in order to continue to impact the morbidity and mortality associated with sepsis. In this review, we discuss the evidence in several of these areas including recognition of shock, initial resuscitation and fluid therapy, use of inotropes and vasopressors, identification and control of the source of infection, maintenance of oxygen delivery and ventilation. The overall goal is to provide the bedside clinician with an updated systematic approach to treat sepsis in children.
Sepsis in orthopaedic surgery: epidemiology, microbiology, treatment, consequences
Authors: Golubovska Iveta , Solovjova Elena , Vigante Dace , Miscuks Aleksejs , Jurkevics Vitolds
Published: October 2012

Background. Musculoskeletal sepsis is a region of orthopaedic surgery focused on the diagnosis and treatment of infections involving the bones, joints, muscles, and skin. The objective of our study was to point out things that should be taken into account by physicians faced with probable musculoskeletal sepsis. Materials and methods. A retrospective study was carried out and included all of the orthopaedic patients with positive blood culture between January 1, 2009 and March 31, 2012 who were admitted to the Hospital of Traumatology and Orthopaedics. Results. In total, thirty five patients were hospitalized. Thirty one patients met the criteria for admission to the ICU. The median time spent in the ICU was 8 days with a range from 1 to 70. The source of infection was recognized in twenty five patients, it was not obvious for six patients. Moderate or severe septic shock developed in nineteen (61.3%) patients, twenty four (77.4%) required invasive monitoring, five PICCO monitoring, three of them required continuous haemodialysis. Overall mortality was 19.4% (six patients). 58.1% were artificially ventilated from 1 to 46 days. The main microbial culture was Staphylococcus aureus (45.2%), the second one was Clebsiella pneumoniae (12.9%), the third microbial cultures were Escherichia coli and Enterobacter cloacae (6.5%). More prevalent risk factors were diabetes mellitus, oncologic disease, ischemic heart disease and adipositas. Conclusions. Patients with a history of pain, swollen and tender joints, extremities or back with restriction of movement should be regarded as having septic inflammation until proven otherwise. We should always take into account orthopaedic sepsis if any other source is not obvious.
Good medical practice for regional block’s procedures
Authors: Švedienė Saulė , Ivaškevičius Juozas
Published: October 2012

Scientific and technological advances, changes in the social environment of doctor’s activities have caused a lot of changes in medicine during recent years. The perioperative period is emotionally stressful for patients because of their fears about anesthesia. The anesthesist‘s duty is to guide the patient through this period by managing his fears, establishing the confidence. The patient also has to be aware of the possible risks related to anesthesia. According to the consent process, the patient should be supplied with comprehensive information before the invasive procedures: risks and benefits, all possible alternatives. This enables the patient to make a conscious choice and increases the participation in his own care. Information about postoperative pain treatment would be helpful as the pain relief is influenced by patient’s knowledge and beliefs. In this regard, regional anesthesia can provide a safer alternative to general anesthesia and prolonged postoperative analgesia. Continuous infusion, which is the actual clinical standard, allows to adjust the rate of infusion and concentration of drugs according to patient’s response and to maintain a constant drug level over time. New techniques of the needle tip guidance under ultrasound imaging reduce the fears about the nerve damage as a smaller volume of local anesthetic can be placed at very precise points of the targeted nerve. Continuing professional education is obligatory for good medical practice and professional standards. It includes the development of theoretical knowledge and practical skills in the techniques, communication, teaching, management and clinical responsibilities.
Fluid therapy in burns
Authors: Sjöberg Folke
Published: October 2012

Outcome after burn injury, as also paralleled by other trauma, has been improving steadily over the years. In this aspect a significant improvement was seen especially in the 1970-ties when the 50% survival chance from a burn injury increased from 45% total body surface area burned (TBSA%) in a 21 year old patient up to almost 80% (TBSA%). Although this improvement may be claimed to have many reasons, a significant one that needs to be stressed is the introduction of more thorough use of protocolized fluid treatment strategies
Peripartum cardiomyopathy: case report
Authors: Macas Andrius , Rimaitis Kęstutis , Bakšytė Giedrė , Šilinskytė Laura
Published: October 2012

Peripartum cardiomyopathy is an unusual and uncommon form of dilat­ ed cardiomyopathy that is often fatal to young women, the cause of which is unknown. Diagnostics is difficult and requires vigilance. The treatment does not differ from other forms of heart failure. Fetal outcome, however, is quite good. Maternal outcomes depend on 2–6 months recovery of the left ventricular function. We describe a previously asymptomatic patient who presented with pulmonary edema one day after caesarean section. In this case the solution was favorable to the patient. Complete recovery of the left ventricular function happened earlier than indicated in litera­ ture.
Incidence and outcome of acute kidney injury after open heart surgery in children
Authors: Krastins Jekabs , Straume Zane , Auzins Janis , Petersons Aigars , Petersons Aivars
Published: October 2012

Introduction. Cardiac surgery with cardiopulmonary bypass (CPB) is commonly perceived as a risk factor for decline in renal function. Hypothermia, hypoxia, hypotension, non-pulsatile blood flow during CPB, use of ACE inhibitors, inotropic and (or) vasoactive support affect kidney and contribute to the acute kidney injury (AKI). Objective. To evaluate incidence and outcome of AKI in children undergoing open heart surgery. Methods. We conducted a prospective, non-randomized observational study at the tertiary care of the University Children’s Hospital Pediatric ICU. We enrolled 30 patients, 12 boys and 18 girls with CHD. Their median body weight was 6.8 kg (IQR 5.2
Impact of anesthesia method on cortisol and interleukin-6 concentration changes during and after laparoscopic colorectal surgery
Authors: Gasiūnaitė Diana , Šipylaitė Jūratė , Kontrimavičiūtė Eglė , Poškus Eligijus
Published: October 2012

Results and discussion. There were statistically significant differences be­ tween the groups in pain score after surgery (p
A medida do possível: saúde, risco e tecnobiociências
Authors: Castiel Luis David
Published: October 2012

Discute os aspectos cruciais dos estudos sobre a saúde em nosso país, com um refinado tratamento não só dos aspectos científicos, filosóficos, éticos e políticos envolvidos nas práticas médicas. Também das teorias e pesquisas deste domínio sob a ótica de diferentes campos de saber, dentre os quais a antropologia do conhecimento científico, a filosofia da mente e as tecnobiociências. Adotando uma perspectiva transdisciplinar, o autor nos faz encarar o fato de os insofismáveis progressos tecnológicos dos diagnósticos e das terapêuticas - de que muitas vezes nos orgulhamos - se fazerem acompanhar de sérios indícios de crise, tanto ética, como política e filosófica, que não podemos desdenhar e que dizem respeito aos modelos teóricos e epistemológicos das ciências biomédicas e epidemiológicas.
Postoperative Course After Emergency Colorectal Surgery for Secondary Peritonitis in the Elderly Is Often Complicated by Delirium
Authors: Engelberger Stephan , Zürcher Manuel , Schuld Jochen , Viehl Carsten Thomas , Kettelhack Christoph
Published: October 2012

Postoperative delirium, morbidity, and mortality in our elderly patients with secondary perionitis of colorectal origin is described. This is a chart-based retrospective analysis of 63 patients who were operated on at the University Hospital Basel from April 2001 to May 2004. Postoperative delirium occurred in 33%. Overall morbidity was 71.4%. Surgery-related morbidity was 43.4%. Mortality was 14.4%. There was no statistical significance between delirium, morbidity and mortality (P  =  0.279 and P  =  0.364). There was no statistically significant correlation between the analyzed scores (American Society of Anesthesiologists classification, Mannheimer Peritonitis Index, Acute Physiology and Chronic Health Evaluation score II, physiological and operative surgical severity and enumeration of morbidity and mortality score‚ or short ‚cr-POSSUM’) and postoperative delirium, morbidity or mortality. Postoperative delirium occurred in one-third of the patients, who seem to have a trend to higher morbidity. Even if the different scores already had proven to be predictive in terms of morbidity and mortality, they do not help the risk stratification of postoperative delirium, morbidity, or mortality in our collective population.
Could the eZ-SCOPE AN Gamma Camera Replace Intraoperative Measurement of iPTH for PHPT?
Authors: Fujii Takaaki , Yajima Reina , Yamaguchi Satoru , Tsutsumi Soichi , Asao Takayuki , Kuwano Hiroyuki
Published: October 2012

Intraoperative intact parathyroid hormone (iPTH) measurements have been proposed as an effective assay in surgery for primary hyperparathyroidism (PHPT). We have demonstrated the efficiency of the use of a hand-held gamma camera, eZ-SCOPE AN, with technetium-99m sestamibi (Tc-MIBI) scintigraphy for navigation surgery for PHPT. The aim of this preliminary study was to assess the possibility that the eZ-SCOPE AN can replace the measurement of intraoperative iPTH in surgery for PHPT. Sixteen consecutive patients with documented primary hyperparathyroidism underwent surgery using this compact camera. iPTH was routinely measured preoperatively and 10 minutes after the complete removal of adenoma. All patients had a well-defined parathyroid lesion identified on preoperative Tc-MIBI. The eZ-SCOPE revealed hyperfunctioning parathyroid glands in all cases. iPTH levels were decreased in all cases after the removal of adenomas. Our results suggest that this gamma camera is useful for confirming complete resection of endocrinologically active tissue in surgery for PHPT. In selective patients with scan-positive cases identified by preoperative Tc-MIBI, the eZ-SCOPE may replace the intraoperative iPTH assay in surgery for PHPT.
Hemobilia Due to Cystic Artery Stump Pseudoaneurysm Following Laparoscopic Cholecystectomy: Case Presentation and Literature Review
Authors: Petrou Athanasios , Brennan Nicholas , Soonawalla Zahir , Silva Michael Anthony
Published: October 2012

Hemobilia is the process of bleeding into the biliary tree and is an unusual cause of upper gastrointestinal hemorrhage. When this event results from a cystic artery pseudoaneurysm, it is a particularly rare phenomenon; fewer than 20 cases are described in the literature. Alongside the literature review, we report a case of a 34-year-old woman presenting 3 months post laparoscopic cholecystectomy with hematemesis. Computed tomography (CT) angiography revealed a cystic artery pseudoaneurysm. Following an ineffective hyperselective arterial embolization, the patient was successfully treated by surgical ligation of the right hepatic artery. Even though this complication is uncommon, all surgeons need to be aware of its presentation and of available therapeutic options.
The Value of Immunohistochemistry in Diagnosing Primary Renal Synovial Sarcoma: A Case Report and Literature Review
Authors: Yang Luo , Wang Kunjie , Hong Li , Wang Yan , Li Xiang
Published: October 2012

Primary synovial sarcoma of the kidney is rare and difficult to diagnose with 100% accuracy without the use of up-to-date histopathologic methods. Immunohistochemical procedures are well established and are continuously expanding and improving. Currently, these methods are successful in up to 90% of tumor identification. The remaining cases will ultimately benefit by combining immunohistochemistry with tumor-specific genetic marker identifiers, the latter of which are increasing in availability for tumor diagnosis. The principal immunohistochemical methods enlisted in establishing a diagnosis of primary renal synovial sarcoma are summarized.
Transesophageal Echocardiography for the Noncardiac Surgical Patient
Authors: Rebel Annette , Klimkina Oksana , Hassan Zaki-Udin
Published: October 2012

Transesophageal echocardiography (TEE) has been established as a very valuable asset for patient monitoring during cardiac surgery. The value of perioperative TEE for patients undergoing noncardiac surgery is less clear. This article reviews the technical aspects of TEE and comments on the potential benefit of using TEE as a monitoring modality apart from cardiac surgery. Based on patient's comorbidities and/or injury pattern, TEE is a fast and minimally invasive approach to obtain important hemodynamic information, especially useful in a hemodynamically unstable patient. However, certain requirements for the use of the technique are necessary, most important the development of sufficient echocardiographic skills by the anesthesiologists. Indications, skill requirements, and possible complications of the technique are reviewed.
Iatrogenic Esophageal Injuries: Evidence-Based Management for Diagnosis and Timing of Contrast Studies After Repair
Authors: Ko Ellen , O-Yurvati AH
Published: October 2012

Leakage from gastroesophageal repair is considered a major complication and is often associated with increased hospital stay, morbidity, and mortality. Management of these patients is variable among surgeons. Cases managed by the thoracic surgical service from March 1, 2010 to March 1, 2011 were retrospectively reviewed. Eight patients met criteria for inclusion: 4 were repaired primarily, 2 by debridement with diversion, and 2 by Ivor-Lewis resection and reconstruction. Esophograms were completed between 1 and 7 days postoperatively. Of the 8 patients treated, there was 1 mortality (12%) due to fungal mediastinitis. Soluble contrast imaging revealed 2 leaks (25%), 1 contained and 1 diffuse, which was the only mortality. Changes in clinical status, even minor, require contrast imaging of the esophagus to assess repair integrity. Timing of contrast study is variable in the literature, averaging 5 to 14 days. A conservative time frame is 7 days, unless any clinical suspicion of an esophageal leak exists.
The Effect of Antifibrinolytic Prophylaxis on Postoperative Outcomes in Patients Undergoing Cardiac Operations
Authors: Koul Abhinav , Ferraris Victor , Davenport Daniel L , Ramaiah Chandrashekhar
Published: October 2012

Antifibrinolytic agents such as aprotinin and epsilon aminocaproic acid limit postoperative bleeding and blood transfusion in patients undergoing cardiac operations using cardiopulmonary bypass (CPB). Recent evidence suggests that these agents have adverse side effects that influence operative mortality and morbidity. We studied postoperative bleeding, transfusion rates, and operative outcomes in our patients in order to assess the efficacy of these agents during cardiac operations requiring CPB. We reviewed records of 520 patients undergoing a variety of cardiac operations between January 2005 and May 2009. We measured multiple variables including pre-operative risk factors, antifibrinolytic agent used, and outcomes of operation, such as measures of bleeding and blood transfusion, as well as serious operative morbidity and mortality. Postoperative bleeding rates varied significantly between patients receiving aprotinin and those receiving aminocaproic acid (P < 0.05). There was an associated 12% decrease in operative site bleeding in aprotinin-treated patients compared with aminocaproic acid. There was no significant difference in the transfusion rates of packed red blood cells between patients receiving aminocaproic acid or aprotinin (P > 0.05), though individuals in the aprotinin group did receive FFP more frequently than patients in the aminocaproic acid group (P < 0.05). There was no significant difference in morbidity and mortality rates between patients in either drug group (P > 0.05). Our study shows that aprotinin is more effective at controlling operative site bleeding than aminocaproic acid. Reduced operative site bleeding did not portend better outcome or differences in transfusion requirements. Aminocaproic acid remains a safe and cost-effective option for antifibrinolytic prophylaxis because of unavailability of aprotinin.
Unusual Location of Hydatid Cysts: A Case Report and Literature Review
Authors: Yagmur Yusuf , Akbulut Sami
Published: October 2012

Hydatid cysts develop most frequently in the liver and lungs, but they are occasionally found in other organs. Hydatid cysts in the axillary space are an extremely rare event in areas where the disease is endemic, and are still common in many countries, including Turkey. A 73-year-old man presented to our clinic with a painful axillary mass. Thoracoabdominal computed tomography revealed multilocular cystic masses localized in the left axillary space, with minimal invasion of the peripheral soft tissue and no pulmonary or hepatic involvement. An echinococcal indirect hemagglutination test was negative. The masses were dissected through their stalks and removed completely. Macroscopic and microscopic examination of the specimens confirmed hydatid cysts. This case report demonstrates that hydatid cysts should be considered as a possible cause for palpable lesions in the axillary region or chest wall, especially in endemic locations.
Successful Combination Therapy of Radical Liver Resection With 5-Fluorouracil/leucovorin, Oxaliplatin, Plus Bevacizumab for Ascending Colon Cancer With Pulmonary and 43 Liver Metastases: Report of a Case
Authors: Ochiai Takanori , Masuda Taiki , Yagi Masayuki , Kasai Reo , Furuyama Takaki , Tsukamoto Kanako , Ito Hiromitsu , Igari Kimihiro , Aihara Arihiro , Kumagai Yoichi , Iida Michio , Odajima Hajime , Tanaka Shinji , Arii Shigeki , Yamazaki Shigeru
Published: October 2012

At the time of diagnosis, 20% to 25% of patients with colorectal cancer already have liver metastases, the presence of which is a most important prognostic factor. A 64-year-old man was admitted to our hospital for investigation of anemia and multiple liver tumors. Examinations revealed ascending colon carcinoma with more than 40 liver metastases and 2 lung metastases. We performed right hemicolectomy with lymph node dissection, which was followed by 5-fluorouracil/leucovorin, oxaliplatin, plus bevacizumab (FOLFOX-BV). After 4 courses of chemotherapy, the lung metastases were in complete remission and the liver metastases had shrunk. We suggested the option of radical liver resection, but the patient declined initially as he had not suffered any severe side effects of FOLFOX-BV. After 23 courses of the chemotherapy, he agreed to undergo hepatectomy. We performed extended right lobectomy with partial left and caudal lobe resection. All of the macroscopic metastatic lesions were resected. Histopathologically, viable cancer cells were recognized in 7 of the 43 liver metastatic lesions. Postoperatively, FOLFOX-BV was restarted and continued for 10 months. At the time of writing, 15 months after the hepatectomy, the patient was well without evidence of recurrence of the cancer.
Ultrasonography-Guided Percutaneous Nephrolithotomy for the Treatment of Urolithiasis in Patients with Scoliosis
Authors: Li Hongyan , Zhang Zhuo , Li Hai , Xing Yuanyuan , Zhang Gang , Kong Xiangbo
Published: October 2012

We examined the surgical outcomes of minimally invasive percutaneous nephrolithotomy (MPCNL) in scoliotic patients with complicating urolithiasis. Two patients with scoliosis were hospitalized for MPNCL due to upper tract urolithiasis. Calyx puncture was performed in the prone position under ultrasonographic guidance. The renal access route was established using a set of 8F to 16F dilators, and a transpyelic ballistic lithotriptor was used to fragment the calculi. The stone burdens in the 2 patients were 410 mm2 and 500 mm2. The entire operative time was 40 to 70 minutes, and the mean time of establishing percutaneous access was 20 minutes. The calculi were completely removed by single-session pneumatic lithotripsy. The 2 patients recovered from MPCNL uneventfully, and the follow-up radiologic examinations identified no stone residual or recurrence. MPCNL is a minimally invasive modality that is effective and safe for the treatment of urolithiasis in patients with scoliosis.
MnO Nanocrystals: A Platform for Integration of MRI and Genuine Autophagy Induction for Chemotherapy
Authors: Lu Yang , Zhang Li , Li Jing , Su Yu‐De , Liu Yun , Xu Yun‐Jun , Dong Liang , Gao Huai‐Ling , Lin Jun , Man Na , Wei Peng‐Fei , Xu Wei‐Ping , Yu Shu‐Hong , Wen Long‐Ping
Published: October 2012

Herein, a kind of novel monocomponent hydrophilic and paramagnetic manganese(II) oxide nanocrystal is prepared in polar solution by a one‐pot microwave‐assisted synthesis. This kind of nanocrystal can be taken up efficiently to serve as an excellent T1 magnetic resonance imaging (MRI) contrast agent with an enhanced r1 value of 0.81 mM−1 s−1. The key to the success of this method is that no additional capping agents are required for coating onto the surface via ligand exchange, facilitating research of their intrinsic biological activities. Furthermore, multiple lines of convincing evidence are presented to prove that MnO nanocrystals (NCs) elicit p53‐activation‐independent and authentic functional autophagy via inducing autophagosome formation. Notably, there are very few reports so far of the autophagy phenomenon induced by magnetic nanocrystals. Moreover, these results offer an indication for cancer therapy that MnO NCs combined with doxorubicin at a nontoxic concentration can have a definite synergistic effect, which is mediated through the genuine autophagy induction, on killing cancer cells in vitro and in vivo.
Highly Sensitive Chemical‐Vapor Sensor Based on Thin‐Film Organic Field‐Effect Transistors with Benzothiadiazole‐Fused‐Tetrathiafulvalene
Authors: Yang Ge , Di Chong‐an , Zhang Guanxin , Zhang Jing , Xiang Junfeng , Zhang Deqing , Zhu Daoben
Published: October 2012

The synthesis of a new tetrathiafulvalene derivative with an electron‐withdrawing benzothiadiazole moiety and its use in thin‐film organic field‐effect transistors (OFETs) are reported. Compared to reported OFETs with other TTF derivatives, a high hole mobility up to 0.73 cm2 V−1 s−1, low off‐current and high on/off ratio up to 105 are demonstrated. In addition, the developed OFETs show fast responsiveness toward chemical vapors of DECP (diethyl chlorophosphate) or POCl3 which are simulants of phosphate‐based nerve agents. In contrast to previously reported OFET‐based sensors, off‐current is used as the output signal, which increases quickly upon exposure to either DECP or POCl3 vapors. High sensitivity is demonstrated toward DECP and POCl3 vapors, with concentrations as low as 10 ppb being detected. These OFETs are also responsive to TNT vapor. The sensing mechanisms for the new type of OFET are discussed.
A regime map for granule formation by drop impact on powder beds
Authors: Emady Heather N. , Kayrak‐Talay Defne , Litster James D.
Published: October 2012

“Tunneling,” “Spreading,” and “Crater Formation” are the three granule formation mechanisms known to occur when single drops impact static powder beds. To quantify the conditions under which each mechanism will occur, dimensional analysis was performed, and a new regime map was created that plots the powder bed porosity against the modified granular Bond number (Bog*), which is a ratio of the capillary force to the gravitational force acting on a particle. Tunneling occurred for Bog* > 65,000 for all values of bed porosity, whereas Spreading and Crater Formation occurred when Bog* < 65,000 for all values of bed porosity below the minimum fluidization porosity. The granule formation mechanism regime map provides a useful tool to design and predict wet granulation processes by predicting the granule formation mechanism, and thereby general granule shape, from a few key dimensionless groups involving formulation properties and process parameters that can be calculated a priori. © 2012 American Institute of Chemical Engineers AIChE J, 59: 96–107, 2013
Modeling and performance monitoring of multivariate multimodal processes
Authors: Feital Thiago , Kruger Uwe , Dutra Julio , Pinto José Carlos , Lima Enrique Luis
Published: October 2012

A multimodal modeling and monitoring approach based on maximum likelihood principal component analysis and a component‐wise identification of operating modes are presented. Analyzing each principal component individually allows separating components describing the variation within the individual modes from those capturing variation which the modes commonly share. On the basis of the former set, a Gaussian mixture model produces a statistical fingerprint that describes the production modes. The advantage of the component‐wise analysis is a simple identification of the mixture model parameters, which does not rely on the computationally cumbersome expectation maximization. The proposed method diagnoses abnormal process conditions by defining statistics relating to the components describing (1) between‐cluster variation, (2) within cluster variation, and (3) model residuals. The article demonstrates the benefits of this approach over existing work by an application to a continuous stirred tank reactor (CSTR) simulator and the analysis of recorded data from a furnace and a chemical reaction process. © 2012 American Institute of Chemical Engineers AIChE J, 59: 1557–1569, 2013
Flow and heat transfer in serpentine channels
Authors: Karale Chaitanya M. , Bhagwat Sunil S. , Ranade Vivek V.
Published: October 2012

Serpentine channels are often used in microchannel reactors and heat exchangers. These channels offer better mixing, higher heat and mass‐transfer coefficients than straight channels. In the present work, flow and heat transfer experiments were carried out with a serpentine channel plate comprising of 10 units (single unit dimensions: 1 × 1.5 mm2 in cross section, length 46.28 mm, Dh 1.2 mm) in series. Pressure drop and heat‐transfer coefficients were experimentally measured. Flow and heat transfer in the experimental set‐up were simulated using computational fluid dynamics (CFD) models to understand the mechanisms responsible for performance enhancement. The CFD methodology, thus, developed was applied to understand the effect of various geometrical parameters on heat transfer enhancement. A criterion was defined for evaluation of heat transfer performance (heat transfer per unit pumping power), thus, ensuring due considerations to required pumping power. The effect of geometrical parameters and the corresponding mechanisms contributing for enhancement are discussed briefly. Based on the results, a design map comprising different serpentine channels showing heat transfer enhancement with pumping power was developed for Reynolds number of 200 which will be useful for further work on flow and heat transfer in serpentine channels. © 2012 American Institute of Chemical Engineers AIChE J, 59: 1814–1827, 2013