bluuebunny/crossref_metadata_2025 huggingface dataset:
Uptake and Effects of the e-Vita Personal Health Record with Self-Management Support and Coaching, for Type 2 Diabetes Patients Treated in Primary Care
Authors: van Vugt M. , de Wit M. , Sieverink F. , Roelofsen Y. , Hendriks S. H. , Bilo H. J. G. , Snoek F. J.
Published: February 2016

We studied the use, uptake, and effects of e-Vita, a personal health record, with self-management support and personalized asynchronized coaching, for type 2 diabetes patients treated in primary care. Patients were invited by their practice nurse to join the study aimed at testing use and effects of a personal health record. Patients were followed up for 6 months. Uptake and usage were monitored using log data. Outcomes were self-reported diabetes self-care, diabetes-related distress, and emotional wellbeing. Patients’ health status was collected from their medical chart. 132 patients agreed to participate in the study of which less than half (46.1%) did not return to the personal health record after 1st login. Only 5 patients used the self-management support program within the personal health record, 3 of whom asked a coach for feedback. Low use of the personal health record was registered. No statistical significant differences on any of the outcome measures were found between baseline and 6 month follow-up. This study showed minimal impact of implementing a personal health record including self-management support in primary diabetes care. Successful adoption of web-based platforms, as ongoing patient centered care, is hard to achieve without additional strategies aimed at enhancing patient motivation and engaging professionals.
Relationship between Daytime Sleepiness and Intrinsically Photosensitive Retinal Ganglion Cells in Glaucomatous Disease
Authors: Gracitelli Carolina P. B. , Duque-Chica Gloria Liliana , Moura Ana Laura de Araújo , Roizenblatt Marina , Nagy Balazs V. , de Melo Geraldine Ragot , Borba Paula Delegrego , Teixeira Sérgio H. , Tufik Sergio , Ventura Dora Fix , Paranhos Augusto
Published: February 2016

Patients with glaucoma showed to have higher daytime sleepiness measured by Epworth sleepiness scale. In addition, this symptom was associated with pupillary reflex and polysomnography parameters. These ipRGC functions might be impaired in patients with glaucoma, leading to worse quality of life.
Using Fresh Frozen Plasma for Acute Airway Angioedema to Prevent Intubation in the Emergency Department: A Retrospective Cohort Study
Authors: Saeb Aya , Hagglund Karen H. , Cigolle Christine T.
Published: February 2016

Background. Angioedema (AE) is a common condition which can be complicated by laryngeal edema, having up to 40% mortality. Although sporadic case reports attest to the benefits of fresh frozen plasma (FFP) in treating severe acute bouts of AE, little evidence-based support for this practice is available at present.Study Objectives. To compare the frequency, duration of intubation, and length of intensive care unit (ICU) stay in patients with acute airway AE, with and without the use of FFP.Methods. A retrospective cohort study was conducted, investigating adults admitted to large community hospital ICU with a diagnosis of AE during the years of 2007–2012. Altogether, 128 charts were reviewed for demographics, comorbidities, hospital courses, and outcomes. A total of 20 patients received FFP (108 did not).Results. Demographics and comorbidities did not differ by treatment group. However, nontreated controls did worse in terms of intubation frequency (60% versus 35%;p=0.05) and ICU stay (3.5 days versus 1.5 days;p<0.001). Group outcomes were otherwise similar.Conclusion. In an emergency department setting, the use of FFP should be considered in managing acute airway nonhereditary AE (refractory to steroid, antihistamine, and epinephrine). Larger prospective, better controlled studies are needed to devise appropriate treatment guidelines.
Weight Fluctuation and Postmenopausal Breast Cancer in the National Health and Nutrition Examination Survey I Epidemiologic Follow-Up Study
Authors: Komaroff Marina
Published: February 2016

Objective. The aim of this study is to investigate if weight fluctuation is an independent risk factor for postmenopausal breast cancer (PBC) among women who gained weight in adult years.Methods. NHANES I Epidemiologic Follow-Up Study (NHEFS) database was used in the study. Women that were cancers-free at enrollment and diagnosed for the first time with breast cancer at age 50 or greater were considered cases. Controls were chosen from the subset of cancers-free women and matched to cases by years of follow-up and status of body mass index (BMI) at 25 years of age. Weight fluctuation was measured by the root-mean-square-error (RMSE) from a simple linear regression model for each woman with their body mass index (BMI) regressed on age (started at 25 years) while women with the positive slope from this regression were defined as weight gainers. Data were analyzed using conditional logistic regression models.Results. A total of 158 women were included into the study. The conditional logistic regression adjusted for weight gain demonstrated positive association between weight fluctuation in adult years and postmenopausal breast cancers (odds ratio/OR = 1.67; 95% confidence interval/CI: 1.06–2.66).Conclusions. The data suggested that long-term weight fluctuation was significant risk factor for PBC among women who gained weight in adult years. This finding underscores the importance of maintaining lost weight and avoiding weight fluctuation.
Dicycle Cover of Hamiltonian Oriented Graphs
Authors: Alsatami Khalid A. , Lai Hong-Jian , Zhang Xindong
Published: February 2016

A dicycle cover of a digraph D is a family F of dicycles of D such that each arc of D lies in at least one dicycle in F. We investigate the problem of determining the upper bounds for the minimum number of dicycles which cover all arcs in a strong digraph. Best possible upper bounds of dicycle covers are obtained in a number of classes of digraphs including strong tournaments, Hamiltonian oriented graphs, Hamiltonian oriented complete bipartite graphs, and families of possibly non-Hamiltonian digraphs obtained from these digraphs via a sequence of 2-sum operations.
HCV and Oxidative Stress: Implications for HCV Life Cycle and HCV‐Associated Pathogenesis
Authors: Medvedev Regina , Ploen Daniela , Hildt Eberhard
Published: February 2016

HCV (hepatitis C virus) is a member of the Flaviviridae family that contains a single‐stranded positive‐sense RNA genome of approximately 9600 bases. HCV is a major causative agent for chronic liver diseases such as steatosis, fibrosis, cirrhosis, and hepatocellular carcinoma which are caused by multifactorial processes. Elevated levels of reactive oxygen species (ROS) are considered as a major factor contributing to HCV‐associated pathogenesis. This review summarizes the mechanisms involved in formation of ROS in HCV replicating cells and describes the interference of HCV with ROS detoxifying systems. The relevance of ROS for HCV‐associated pathogenesis is reviewed with a focus on the interference of elevated ROS levels with processes controlling liver regeneration. The overview about the impact of ROS for the viral life cycle is focused on the relevance of autophagy for the HCV life cycle and the crosstalk between HCV, elevated ROS levels, and the induction of autophagy.
Hypoxia-Induced Epithelial-to-Mesenchymal Transition in Hepatocellular Carcinoma Induces an Immunosuppressive Tumor Microenvironment to Promote Metastasis
Authors: Ye Long-Yun , Chen Wei , Bai Xue-Li , Xu Xing-Yuan , Zhang Qi , Xia Xue-Feng , Sun Xu , Li Guo-Gang , Hu Qi-Da , Fu Qi-Han , Liang Ting-Bo
Published: February 2016

Portal vein tumor thrombosis (PVTT) is a significant risk factor for metastasis in hepatocellular carcinoma (HCC) patients and is therefore associated with poor prognosis. The presence of PVTT frequently accompanies substantial hypoxia within the tumor microenvironment, which is suggested to accelerate tumor metastasis, but it is unclear how this occurs. Recent evidence has shown that the hypoxia-inducible factor HIF-1α induces epithelial-to-mesenchymal transition (EMT) in tumor cells to facilitate metastasis. In this study, we investigated whether hypoxia-induced EMT in cancer cells also affects immune cells in the tumor microenvironment to promote immunosuppression. We found that hypoxia-induced EMT increased the expression of the CCL20 cytokine in hepatoma cells. Furthermore, coculture of monocyte-derived macrophages with hypoxic hepatoma cells revealed that the expression of indoleamine 2, 3-dioxygenase (IDO) was induced in monocyte-derived macrophages in a CCL20-dependent manner. In turn, these IDO-expressing monocyte-derived macrophages suppressed T-cell proliferation and promoted the expansion of immunosuppressive regulatory T cells. Moreover, high CCL20 expression in HCC specimens was associated with PVTT and poor patient survival. Collectively, our findings suggest that the HIF-1α/CCL20/IDO axis in hepatocellular carcinoma is important for accelerating tumor metastasis through both the induction of EMT and the establishment of an immunosuppressive tumor microenvironment, warranting further investigation into the therapeutic effects of blocking specific nodes of this signaling network. Cancer Res; 76(4); 818–30. ©2016 AACR.
Phytoestrogen Suppresses Efflux of the Diagnostic Marker Protoporphyrin IX in Lung Carcinoma
Authors: Fujita Hirofumi , Nagakawa Keisuke , Kobuchi Hirotsugu , Ogino Tetsuya , Kondo Yoichi , Inoue Keiji , Shuin Taro , Utsumi Toshihiko , Utsumi Kozo , Sasaki Junzo , Ohuchi Hideyo
Published: February 2016

One promising method to visualize cancer cells is based on the detection of the fluorescent photosensitizer protoporphyrin IX (PpIX) synthesized from 5-aminolevulinic acid (ALA), but this method cannot be used in cancers that exhibit poor PpIX accumulation. PpIX appears to be pumped out of cancer cells by the ABC transporter G2 (ABCG2), which is associated with multidrug resistance. Genistein is a phytoestrogen that appears to competitively inhibit ABCG2 activity. Therefore, we investigated whether genistein can promote PpIX accumulation in human lung carcinoma cells. Here we report that treatment of A549 lung carcinoma cells with genistein or a specific ABCG2 inhibitor promoted ALA-mediated accumulation of PpIX by approximately 2-fold. ABCG2 depletion and overexpression studies further revealed that genistein promoted PpIX accumulation via functional repression of ABCG2. After an extended period of genistein treatment, a significant increase in PpIX accumulation was observed in A549 cells (3.7-fold) and in other cell lines. Systemic preconditioning with genistein in a mouse xenograft model of lung carcinoma resulted in a 1.8-fold increase in accumulated PpIX. Long-term genistein treatment stimulated the expression of genes encoding enzymes involved in PpIX synthesis, such as porphobilinogen deaminase, uroporphyrinogen decarboxylase, and protoporphyrinogen oxidase. Accordingly, the rate of PpIX synthesis was also accelerated by genistein pretreatment. Thus, our results suggest that genistein treatment effectively enhances ALA-induced PpIX accumulation by preventing the ABCG2-mediated efflux of PpIX from lung cancer cells and may represent a promising strategy to improve ALA-based diagnostic approaches in a broader set of malignancies. Cancer Res; 76(7); 1837–46. ©2016 AACR.
Galectin-3 Cleavage Alters Bone Remodeling: Different Outcomes in Breast and Prostate Cancer Skeletal Metastasis
Authors: Nakajima Kosei , Kho Dhong Hyo , Yanagawa Takashi , Harazono Yosuke , Hogan Victor , Chen Wei , Ali-Fehmi Rouba , Mehra Rohit , Raz Avraham
Published: February 2016

Management of bone metastasis remains clinically challenging and requires the identification of new molecular target(s) that can be therapeutically exploited to improve patient outcome. Galectin-3 (Gal-3) has been implicated as a secreted factor that alters the bone microenvironment. Proteolytic cleavage of Gal-3 may also contribute to malignant cellular behaviors, but has not been addressed in cancer metastasis. Here, we report that Gal-3 modulates the osteolytic bone tumor microenvironment in the presence of RANKL. Gal-3 was localized on the osteoclast cell surface, and its suppression by RNAi or a specific antagonist markedly inhibited osteoclast differentiation markers, including tartrate-resistant acid phosphatase, and reduced the number of mature osteoclasts. Structurally, the 158–175 amino acid sequence in the carbohydrate recognition domain (CRD) of Gal-3 was responsible for augmented osteoclastogenesis. During osteoclast maturation, Gal-3 interacted and colocalized with myosin-2A along the surface of cell–cell fusion. Pathologically, bone metastatic cancers expressed and released an intact form of Gal-3, mainly detected in breast cancer bone metastases, as well as a cleaved form, more abundant in prostate cancer bone metastases. Secreted intact Gal-3 interacted with myosin-2A, leading to osteoclastogenesis, whereas a shift to cleaved Gal-3 attenuated the enhancement in osteoclast differentiation. Thus, our studies demonstrate that Gal-3 shapes the bone tumor microenvironment through distinct roles contingent on its cleavage status, and highlight Gal-3 targeting through the CRD as a potential therapeutic strategy for mitigating osteolytic bone remodeling in the metastatic niche. Cancer Res; 76(6); 1391–402. ©2016 AACR.
Activated KRAS Cooperates with MLL-AF4 to Promote Extramedullary Engraftment and Migration of Cord Blood CD34+ HSPC But Is Insufficient to Initiate Leukemia
Authors: Prieto Cristina , Stam Ronald W. , Agraz-Doblas Antonio , Ballerini Paola , Camos Mireia , Castaño Julio , Marschalek Rolf , Bursen Aldeheid , Varela Ignacio , Bueno Clara , Menendez Pablo
Published: February 2016

The MLL–AF4 (MA4) fusion gene is the genetic hallmark of an aggressive infant pro–B-acute lymphoblastic leukemia (B-ALL). Our understanding of MA4-mediated transformation is very limited. Whole-genome sequencing studies revealed a silent mutational landscape, which contradicts the aggressive clinical outcome of this hematologic malignancy. Only RAS mutations were recurrently detected in patients and found to be associated with poorer outcome. The absence of MA4-driven B-ALL models further questions whether MA4 acts as a single oncogenic driver or requires cooperating mutations to manifest a malignant phenotype. We explored whether KRAS activation cooperates with MA4 to initiate leukemia in cord blood–derived CD34+ hematopoietic stem/progenitor cells (HSPC). Clonogenic and differentiation/proliferation assays demonstrated that KRAS activation does not cooperate with MA4 to immortalize CD34+ HSPCs. Intrabone marrow transplantation into immunodeficient mice further showed that MA4 and KRASG12V alone or in combination enhanced hematopoietic repopulation without impairing myeloid–lymphoid differentiation, and that mutated KRAS did not cooperate with MA4 to initiate leukemia. However, KRAS activation enhanced extramedullary hematopoiesis of MA4-expressing cell lines and CD34+ HSPCs that was associated with leukocytosis and central nervous system infiltration, both hallmarks of infant t(4;11)+ B-ALL. Transcriptional profiling of MA4-expressing patients supported a cell migration gene signature underlying the mutant KRAS-mediated phenotype. Collectively, our findings demonstrate that KRAS affects the homeostasis of MA4-expressing HSPCs, suggesting that KRAS activation in MA4+ B-ALL is important for tumor maintenance rather than initiation. Cancer Res; 76(8); 2478–89. ©2016 AACR.
Stomach-Specific Activation of Oncogenic KRAS and STAT3-Dependent Inflammation Cooperatively Promote Gastric Tumorigenesis in a Preclinical Model
Authors: Thiem Stefan , Eissmann Moritz F. , Elzer Joachim , Jonas Anna , Putoczki Tracy L. , Poh Ashleigh , Nguyen Paul , Preaudet Adele , Flanagan Dustin , Vincan Elizabeth , Waring Paul , Buchert Michael , Jarnicki Andrew , Ernst Matthias
Published: February 2016

About 5% to 10% of human gastric tumors harbor oncogenic mutations in the KRAS pathway, but their presence alone is often insufficient for inducing gastric tumorigenesis, suggesting a requirement for additional mutagenic events or microenvironmental stimuli, including inflammation. Assessing the contribution of such events in preclinical mouse models requires Cre recombinase–mediated conditional gene expression in stem or progenitor cells of normal and transformed gastric epithelium. We therefore constructed a bacterial artificial chromosome containing transgene (Tg), comprising the regulatory elements of the trefoil factor 1 (Tff1) gene and the tamoxifen-inducible Cre recombinase (CreERT2)–coding sequence. The resulting Tg(Tff1-CreERT2) mice were crossed with mice harboring conditional oncogenic mutations in Kras or Braf. The administration of tamoxifen to the resulting adult Tg(Tff1-CreERT2);KrasLSL-G12D/+ and Tg(Tff1-CreERT2);BrafLSL-V600E/+ mice resulted in gastric metaplasia, inflammation, and adenoma development, characterized by excessive STAT3 activity. To assess the contribution of STAT3 to the spontaneously developing gastric adenomas in gp130F/F mice, which carry a knockin mutation in the Il6 signal transducer (Il6st), we generated Tg(Tff1-CreERT2);Stat3fl/fl;gp130F/F mice that also harbor a conditional Stat3 knockout allele and found that tamoxifen administration conferred a significant reduction in their tumor burden. Conversely, excessive Kras activity in Tg(Tff1-CreERT2);KrasLSL-G12D/+;gp130F/F mice promoted more extensive gastric inflammation, metaplastic transformation, and tumorigenesis than observed in Tg(Tff1-CreERT2);KrasLSL-G12D/+ mice. Collectively, our findings demonstrate that advanced gastric tumorigenesis requires oncogenic KRAS or BRAF in concert with aberrant STAT3 activation in epithelial precursor cells of the glandular stomach, providing a new conditional model of gastric cancer in which to investigate candidate therapeutic targets and treatment strategies. Cancer Res; 76(8); 2277–87. ©2016 AACR.
Intermittent High-Dose Scheduling of AZD8835, a Novel Selective Inhibitor of PI3Kα and PI3Kδ, Demonstrates Treatment Strategies forPIK3CA-Dependent Breast Cancers
Authors: Hudson Kevin , Hancox Urs J. , Trigwell Cath , McEwen Robert , Polanska Urszula M. , Nikolaou Myria , Morentin Gutierrez Pablo , Avivar-Valderas Alvaro , Delpuech Oona , Dudley Phillippa , Hanson Lyndsey , Ellston Rebecca , Jones Alys , Cumberbatch Marie , Cosulich Sabina C. , Ward Lara , Cruzalegui Francisco , Green Stephen
Published: February 2016

The PIK3CA gene, encoding the p110α catalytic unit of PI3Kα, is one of the most frequently mutated oncogenes in human cancer. Hence, PI3Kα is a target subject to intensive efforts in identifying inhibitors and evaluating their therapeutic potential. Here, we report studies with a novel PI3K inhibitor, AZD8835, currently in phase I clinical evaluation. AZD8835 is a potent inhibitor of PI3Kα and PI3Kδ with selectivity versus PI3Kβ, PI3Kγ, and other kinases that preferentially inhibited growth in cells with mutant PIK3CA status, such as in estrogen receptor–positive (ER+) breast cancer cell lines BT474, MCF7, and T47D (sub-μmol/L GI50s). Consistent with this, AZD8835 demonstrated antitumor efficacy in corresponding breast cancer xenograft models when dosed continuously. In addition, an alternative approach of intermittent high-dose scheduling (IHDS) was explored given our observations that higher exposures achieved greater pathway inhibition and induced apoptosis. Indeed, using IHDS, monotherapy AZD8835 was able to induce tumor xenograft regression. Furthermore, AZD8835 IHDS in combination with other targeted therapeutic agents further enhanced antitumor activity (up to 92% regression). Combination partners were prioritized on the basis of our mechanistic insights demonstrating signaling pathway cross-talk, with a focus on targeting interdependent ER and/or CDK4/6 pathways or alternatively a node (mTOR) in the PI3K-pathway, approaches with demonstrated clinical benefit in ER+ breast cancer patients. In summary, AZD8835 IHDS delivers strong antitumor efficacy in a range of combination settings and provides a promising alternative to continuous dosing to optimize the therapeutic index in patients. Such schedules merit clinical evaluation. Mol Cancer Ther; 15(5); 877–89. ©2016 AACR.
The Usefulness of Intraoperative Cerebral C-Arm CT Angiogram for Implantation of Intracranial Depth Electrodes in Stereotactic Electroencephalography Procedure
Authors: Mirzayan M. Javad , von Roden Martin , Bulacio Juan , von Podewils Felix , Gonzalez-Martinez Jorge
Published: February 2016

Background: Stereotactic electroencephalography (SEEG) is an invasive diagnostic tool for localizing the epileptic zone in patients with medically refractory focal epilepsy. Despite technical and imaging advances in guiding the electrode placement, vascular injury is still one of its most serious complications. Object: To investigate the usefulness of intraoperative cerebral C-arm CT angiogram (CCTA) in avoiding intracranial hemorrhagic complications during SEEG electrode implantation. Methods: Trajectory data from 12 patients who underwent SEEG electrode implantation were studied in detail. This included an analysis of the implantation of 146 SEEG electrodes, which were guided by intraoperative CCTA, as well as the standard planning based on preoperative contrast-enhanced MRI. In addition, a prospective analysis of SEEG hemorrhagic complications using the studied methodology was performed in a total of 87 patients receiving 1,310 electrodes. Results: There was no complication related to the CCTA itself. Intraoperative CCTA entailed modification of the original trajectory based on the preoperative MRI in 27 of 146 electrode implantations (18.5%). In 10 of them, a severe vascular complication was adverted by intraoperative CCTA. The safety of this new approach was also confirmed by the analysis of postinterventional CT, which revealed a symptomatic hematoma caused by 1 single electrode out of the 1,310 implanted. Conclusions: This study showed that intraoperative CCTA in addition to preoperative MRI is useful in guiding a safer SEEG electrode implantation. The combination of both imaging modalities essentially minimizes the risk of serious hemorrhagic complications.
L-Carnitine for Treatment of Pegasparaginase-Induced Hepatotoxicity
Authors: Alshiekh-Nasany Ruham , Douer Dan
Published: February 2016

Introduction: Similar to pediatric regimens, multiple doses of L-asparaginase (PEG-Asp) are being increasingly used in adults with newly diagnosed acute lymphoblastic leukemia (ALL) with promising results. One of the most common side effects of the drug in adults is high-grade hyperbilirubinemia and transaminitis. Despite being almost always reversible and may not recur, clinicians may still be reluctant to continue with PEG-Asp in patients with liver toxicity, losing the benefit from multiple doses of the drug. Case Report: We describe a case of adult ALL who developed PEG-Asp-related high grade liver toxicity. The rising hyperbilirubinemia and transaminitis rapidly and permanently reversed using the amino-acid derivative L-carnitine. This case goes in line with similar observations in animal models and humans. Conclusion:L-Carnitine may show therapeutic benefit in PEG-Asp-related hepatotoxicity and should be considered in clinical trials of the drug.
First Report of Pyoderma Gangrenosum after Surgery of Breast Cancer-Related Lymphedema with Transfer of Vascularized Free Lymph Nodes of the Groin and Simultaneous DIEP Flap
Authors: García-Ruano Angela A. , Deleyto Esther , Lasso Jose Maria
Published: February 2016

Background: Pyoderma gangrenosum (PG) is a rare cutaneous ulcerative disease that does not respond to antibiotics and worsens with surgical manipulation. This is the first report in the literature revealing that this disease complicates total microsurgical breast reconstruction associated with the transfer of free lymph nodes. Case Report: We report the case of a female patient who underwent left-breast microsurgical reconstruction with a deep inferior epigastric perforator (DIEP) flap and simultaneous transfer of vascularized free lymph nodes for the surgical treatment of secondary left upper-limb lymphedema, and who developed a severe PG of both the skin of the flap and the donor zone on postoperative day 7. After exclusion of other etiologies, treatment with high-dose corticosteroids and topical zinc sulfate was initiated. The flap was salvaged and breast cancer-related lymphedema (BCRL) surgery was definitively effective despite the PG. Conclusions: PG should be considered in the differential diagnosis of progressive cutaneous ulcers following surgical interventions, once infectious and ischemic etiologies have been excluded. Early initiation of immunosuppressive treatment can lead to preservation of the initial flap and function of the transferred lymph nodes in the case of microsurgical breast reconstruction with associated lymph node transfer.
Risk Factors Associated with Left-Sided Cardiac Valve Calcification: A Case Control Study
Authors: Jiang Minyong , Wang Lan , Xuan Qinkao , Shao Yongfeng , Kong Xiangqing , Sun Wei
Published: February 2016

Objectives: To identify risk factors associated with cardiac valve calcification that is easily detectable through routine blood tests in patients who received valve replacement therapy. Methods: Four hundred patients with valvular heart disease who underwent valve replacement surgery between December 2009 and January 2013 were enrolled in this study. Of these, 77 had valve calcification; the other 323 did not. Multivariate logistic regression analysis was used to assess for risk factors associated with valve calcification. Results: In our study population, rheumatic valve lesions were the most common reason for valve replacement. Degenerative nonstenotic valve lesion was a protective factor and degenerative stenotic valve lesion was a strong risk factor for valve calcification. Serum levels of gamma-glutamyl transferase (GGT) of between 30 and 46 IU/l and >90 IU/l and total bilirubin (TBIL) of between 15 and 20 μmol/l were positively correlated with valve calcification. Meanwhile, serum calcium (Ca2+) levels of between 2.3 and 2.4 mmol/l were negatively correlated with rheumatic valve calcification. Conclusions: Degenerative stenotic lesion is a risk factor and degenerative nonstenotic lesion a protective factor for cardiac valve calcification. Serum GGT and TBIL levels are positively correlated and serum Ca2+ levels negatively correlated with rheumatic cardiac valve calcification.
Congenital Bimelic Hypertrophy of the Hands
Authors: Kalay Tugba , Gilhuis H. Jacobus , Kraan Gerald , van Alfen Nens
Published: February 2016

Congenital hypertrophy of the hand is a rare phenomenon. The condition is characterized by hypertrophy of muscles, varies in severity and has been reported under different names. Some patients also have aberrant muscles. Electromyography is unremarkable, and the signal intensity on MRI and ultrasound is normal. The etiology is unknown and does not seem to be confined to a peripheral nerve, part of the plexus or nerve root. The condition is assumed to be congenital. We report a 28-year-old male with asymmetric hypertrophy of both hands and give a review of the 4 other cases known so far.
Partial 1q Duplications and Associated Phenotype
Authors: Morris Marcos L.M. , Baroneza José E. , Teixeira Patricia , Medina Cristina T.N. , Cordoba Mara S. , Versiani Beatriz R. , Roese Liege L. , Freitas Erika L. , Fonseca Ana C.S. , dos Santos Maria C.G. , Pic-Taylor Aline , Rosenberg Carla , Oliveira Silviene F. , Ferrari Iris , Mazzeu Juliana F.
Published: February 2016

Duplications of the long arm of chromosome 1 are rare. Distal duplications are the most common and have been reported as either pure trisomy or unbalanced translocations. The paucity of cases with pure distal 1q duplications has made it difficult to delineate a partial distal trisomy 1q syndrome. Here, we report 2 patients with overlapping 1q duplications detected by G-banding. Array CGH and FISH were performed to characterize the duplicated segments, exclude the involvement of other chromosomes and determine the orientation of the duplication. Patient 1 presents with a mild phenotype and carries a 22.5-Mb 1q41q43 duplication. Patient 2 presents with a pure 1q42.13qter inverted duplication of 21.5 Mb, one of the smallest distal 1q duplications ever described and one of the few cases characterized by array CGH, thus contributing to a better characterization of distal 1q duplication syndrome.
Risk Factors for New-Onset Cardiac Valve Calcification in Patients on Maintenance Peritoneal Dialysis
Authors: Tian Yunhuan , Feng Sheng , Zhan Zhoubing , Lu Ying , Wang Yancai , Jiang Shan , Song Kai , Shen Huaying
Published: February 2016

Objective: Patients with end-stage renal disease are susceptible to cardiac valve calcification (CVC) due to mineral metabolism disorders and other factors. The purpose of this study was to investigate the risk factors for new-onset CVC in patients on maintenance peritoneal dialysis (PD). Methods: This study included patients who underwent PD catheter insertion from January 2006 to June 2013 in our Peritoneal Dialysis Center. Clinical data were collected on CVC status during echocardiography evaluations (twice) at an interval of >6 months. The data collected included intact parathyroid hormone, C-reactive protein (CRP), serum phosphorus (P), serum calcium (Ca), albumin (Alb), prealbumin and the use of five types of antihypertensive drugs, statins, active vitamin D3 and Ca tablets. Results: In total, 194 patients - 105 (54.1%) men, average age 60.5 ± 13.0 years - were included. CVC was present in 50 (25.8%) patients during PD catheter placement. After an average PD duration of 20.9 ± 10.4 months, CVC was detected in 97 patients (50.0%). New-onset CVC was found in 62 patients (32.0%). Multivariate logistic regression analysis revealed that only serum P levels (p = 0.01, OR = 2.569), Alb levels (p = 0.04, OR = 0.935), dialysis duration (p = 0.03, OR = 1.039) and CRP levels (p = 0.02, OR = 1.031) were associated with CVC. Conclusion: Serum P, Alb and CRP levels as well as dialysis duration are independent risk factors for CVC.
Anterior Uveitis Caused by Ocular Side Effects of Afatinib: A Case Report
Authors: Todokoro Daisuke , Itakura Hirotaka , Ibe Takashi , Kishi Shoji
Published: February 2016

Afatinib is a second-generation epidermal growth factor receptor (EGFR) inhibitor that has been shown to be effective against EGFR-mutated non-small cell lung cancer (NSCLC) resistant to conventional EGFR inhibitors such as gefitinib and erlotinib. Although ocular side effects of gefitinib and erlotinib have been reported, those for afatinib have yet to be definitively established. This report presents details on the first case of unilateral iridocyclitis associated with the side effects of afatinib therapy. A 75-year-old Japanese male ex-smoker with EGFR-mutated NSCLC underwent afatinib therapy for multiple metastases. At 2 weeks, bilateral conjunctivitis developed. Topical medication and a 1-week afatinib washout period resulted in the improvement of the conjunctivitis. However, 3 days after the resumption of afatinib, the patient developed unilateral granulomatous anterior uveitis in his right eye. Best-corrected visual acuity (BCVA) measurement indicated a decimal visual acuity of 0.2, while the slit-lamp findings were characterized by granulomatous inflammation, keratic precipitates, Koeppe nodules and posterior synechiae. There was no evidence suggesting other intraocular inflammatory disease or metastatic tumor. The left eye was intact. The use of topical medication including steroids and a washout of afatinib resulted in a gradual subsiding of the anterior uveitis. After resolution of the anterior uveitis, oral afatinib was resumed. BCVA of the right eye finally recovered to a decimal acuity of 1.0. Ophthalmologists should be aware of the possibility that side effects associated with afatinib could cause granulomatous anterior uveitis.
Minimally Invasive Pterygium Surgery: Sutureless Excision with Amniotic Membrane and Hydrogel Sealant
Authors: Bondalapati Sailaja , Ambati Balamurali
Published: February 2016

Purpose: To describe a novel technique for sutureless pterygium surgery using ReSure® tissue sealant. Methods: In this retrospective observational case series, we describe a modified procedure for pterygium excision followed by amniotic membrane transplant (AMT) adhered to the corneal and conjunctival defects using ReSure tissue sealant. Results: Nine eyes of seven patients (age range: 28-80 years, 4 females and 3 males) underwent pterygium removal with AMT followed by adherence of tissue to the conjunctival edges with ReSure. No issues with transplant dislocation or failure and no intra- or postoperative complications were noted. No recurrences were noted during the follow-up period. Conclusion: ReSure may be considered as a potential sealant to adhere AMT to defective corneal and conjunctival tissues in sutureless pterygium surgery.
Monetary Policy and Reserve Requirement in a DSGE Model with Financial Frictions
Authors: Divino José Angelo , Kornelius Alexandre
Published: February 2016

Este artigo modifica o modelo DSGE de Gertler & Karadi (2011), que inclui fricção sobre o balanço dos intermediários financeiros, para introduzir a exigência de recolhimentos compulsórios pela Autoridade Monetária e um choque de confiança dos depositantes no sistema financeiro. Os impactos dessas mudanças sobre os canais de transmissão da política monetária são analisados. Os resultados indicam que a presença de compulsório amplifica a transmissão da política monetária pelo canal do crédito, aumentando a alavancagem dos bancos quando há uma queda nos juros e diminuindo caso contrário. A diminuição do crédito quando os juros aumentam pode ser contrabalanceada por uma política macroprudencial de ajuste do nível de compulsório baseada em uma regra que depende de desvios do crédito no estado estacionário. O compulsório não deve, porém, substituir a taxa de juros como o instrumento de política monetária mais adequada para estabilizar a inflação.
Supply Behavior of Hydrous Ethanol in Brazil
Authors: Costa Cinthia Cabral da , Burnquist Heloisa Lee , Valdes Constanza , Souza Maurício Jorge Pinto de
Published: February 2016

Este estudo construiu um modelo econômico para a oferta de etanol hidratado e de cana-de-açúcar no Brasil. Um modelo econométrico de dados em painel foi usado para estimar os modelos econômicos, utilizando as informações dos principais estados produtores, no período 2000/01— 2011/12. Os resultados indicaram a elasticidade-preço da oferta de etanol hidratado de 0,75 e que o preço do etanol anidro teve uma influência relevante sobre o preço do etanol hidratado no período. Para a oferta de cana-de-açúcar, a área plantada e o número de usinas recém instaladas foram importantes para explicar a área plantada corrente
Identificação humana através da sobreposição de imagens
Authors: Paiva Luiz Airton Saavedra de , Melani Rodolfo Francisco Haltenhoff , Oliveira Silvia Virginia Tedeschi
Published: February 2016

A identificação humana como atividade pericial pode ser realizada através de diferentes técnicas. Muitas vezes a escassez de registros em vida (
ante-mortem) inviabiliza a aplicação de técnicas mais seguras. O presente trabalho relata um caso onde a técnica de superposição de imagens restou como única possibilidade de identificação de um indivíduo. Foram utilizadas fotografias do crânio de um esqueleto submetido a exame antropológico-forense, e fotografias da pessoa desaparecida. A sobreposição das imagens conseguida através do Programa Adobe ® Photoshop ® cs 6.0 versão para Windows, pela facilidade de execução e baixo custo, revelou-se fundamental, junto a outras evidências, na identificação deste caso.
A função da confidencialidade: bioética e incesto
Authors: Gobetti Gisele G.
Published: February 2016

O presente estudo pretende construir uma reflexão sobre a função da confidencialidade para os profissionais de saúde que lidam com pessoas envolvidas em casos de incesto, na tentativa de avaliar os limites éticos destas intervenções. A metodologia utilizada constituiu-se por uma reflexão teórica baseada na experiência de trabalho da autora no CEARAS, referendada pela Bioética e pela Psicanálise e ilustrada por uma pesquisa realizada com os profissionais de saúde, incluindo os médicos, enfermeiras, técnicas e auxiliares de enfermagem e assistentes sociais do Pronto-Atendimento Pediátrico do Hospital Universitário da Faculdade de Medicina da Universidade de São Paulo. Entrevistas livres de exploração sobre a possibilidade de atendimento a crianças e adolescentes com suspeitas de abuso sexual e o modo de lidar com estas questões foram realizadas com os profissionais. As entrevistas foram gravadas e transcritas para serem analisadas através do método de análise de conteúdo. O atendimento de pacientes envolvidos em situações de abuso sexual é considerado pelos profissionais de saúde como um problema de difícil abordagem. A ausência do conflito entre a quebra do segredo profissional e a manutenção do vínculo de confiança entre profissional de Saúde e paciente em situações de incesto demonstra a dificuldade de os profissionais lidarem com tais casos e discriminarem a função de um profissional de saúde, pelo incesto se tratar justamente do tabu estruturante do ser humano.
Ética: origens e distinção da moral
Authors: Figueiredo Antônio Macena
Published: February 2016

Ética e moral são termos freqüentemente utilizados no cotidiano, porém, definir o que significam, não é tarefa fácil. Basta perguntar se existe alguma distinção entre esses vocábulos para constatarmos que as pessoas se vêem em dificuldade ao tentar explicar. Este artigo tem como objetivo apresentar alguns esclarecimentos teórico-filosóficos sobre a origem das divergências conceituais. Parte de uma breve revisão sobre as origens etimológicas dos termos
ethos e mos. São apresentados os diversos sentidos em que esses vocábulos podem ser empregados, conceitos utilizados e finaliza com uma reflexão sobre a compreensão da ética como ciência específica ou como ramo de estudo da filosofia.
 
Exumação em processo de canonização
Authors: Romeu Yara Suely , Morrone André Ribeiro
Published: February 2016

Este artigo trata dos procedimentos exumatórios em casos de “Canonização” preconizados pelo rito da Igreja Católica Apostólica Romana, através da experiência dos autores quando de suas atuações como colaboradores Externos responsáveis pelos atos exumatórios dos restos mortais de dois religiosos em que se-lhes eram postuladas as canonizações.
Pontos positivos e negativos observados em uma experiência prática com pares educativos em prevenção de aids numa escola secundária em São Paulo, Brasil
Authors: Strazza Leila , Massad Eduardo , Carvalho Heráclito Barbosa de
Published: February 2016

Pares educativos são uma importante ferramenta educativa utilizada internacionalmente com boas avaliações na eficácia. O presente estudo tem por objetivo avaliar o processo de implantação de pares educativos como programa de prevenção em uma escola modelo da periferia de São Paulo, com alunos de ensino médio, no período de 2003 a 2004. O trabalho foi aplicado em fases: identificação dos principais problemas frente à epidemia HIV/aids naquela escola, elaboração e aplicação de um questionário em 115 alunos e realização de quatro oficinas de sexo seguro. Na implantação desse processo foram destacados os principais pontos positivos e negativos. Como pontos positivos destacaram-se: elaboração do questionário, aceitação de materiais didáticos utilizados nas oficinas. Como pontos negativos destacaram-se: resistência da escola impondo limites no processo; obstrução na inserção do problema principal desta escola no questionário, indicação dos pares educativos e falta de tempo dos funcionários.
Best parameters for sexual dimorphism in the facial thickness tissue with ultrasonic assessment
Authors: Galdames Iván Claudio Suazo , Alarcón Guillermo Enrique Salgado , Matamala Daniela Alejandra Zavando
Published: February 2016

Knowledge of facial tissue thickness is crucial to facial reconstruction procedures in forensic sculpture. The literature still brings some controversy on the validity of data obtained for different population groups. The purpose of this study was to investigate sexual dimorphism in the thickness of the facial tissues. The study sample consisted of 43 volunteers, between 24 and 48 years of age, and of normal body mass. Ultrasound measurements of facial tissue thickness were obtained at 14 median and paramedian landmarks. A T test was used to compare measurements from males and females, with a significance level of at least 0.05. Discriminant function analysis was used to determine the points that showed most distinction between the sexes. Measurements at paramedian landmarks were greater in males, while those at median landmarks were greater in female subjects, except for Down’s A and B points. We conclude that sexual dimorphism in facial thickness justifies the pre-assignment of sex in reconstruction procedures in forensic sculpture
Fatores de risco associados à satisfação no trabalho em trabalhadores de nutrição hospitalar
Authors: Jorge Adriano Tanus , Glina Débora Raab , Rocha Lys Esther , Isosaki Mitsue
Published: February 2016

Objetivo: O objetivo deste estudo foi avaliar os fatores de risco à satisfação no trabalho entre trabalhadores de um hospital cardiológico de São Paulo. Método: Esse é um estudo epidemiológico transversal com a aplicação de questionário para 115 trabalhadores de um total de 129 funcionários. O questionário incluiu a caracterização sóciodemográfica, situação do trabalho e satisfação no trabalho e é baseado no questionário de Cooper´s (Occupational Stress Indicator-OSI). A análise dos dados incluiu a análise de regressão para verificação dos fatores de risco associados à insatisfação, sendo esta definida quando o total de pontos for menor ou igual a 76. Resultado: A maioria dos trabalhadores eram mulheres (81%), com nível educacional secundário (58%), casados (50%) com filhos (61%) e trabalhavam como atendentes de nutrição (66%). A média de idade era de 37 anos com o tempo de trabalho no hospital de 9 anos. A prevalência de insatisfação no trabalho foi de 59%. Os fatores de risco associados a satisfação no trabalho foram: presença de sintomas osteomusculares (Odds ratio (OR) 5,68, 95 % CI, 1.96-16.44); volume de trabalho excessivo (OR 3.91, 95% CI, 1.36-11.23); trabalho monótono e repetitivo (OR 3.60, 95% CI, 1.35-9.57) e pobre qualidade de instrumentos de trabalho (OR 3.47, 95% CI, 1.26-9.54). Discussão: A associação entre insatisfação no trabalho e presença de sintomas osteomusculares sugere a possibilidade da contribuição da insatisfação na presença da sintomatologia bem como o inverso, considerando tratar-se de estudo transversal. As ações preventivas deveriam incluir mudanças na organização do trabalho e melhora na qualidade dos instrumentos.
Eutanásia e sua relação com casos terminais, doenças incuráveis, estados neurovegetativos, estados sequelares graves ou de sofrimento intenso e irreversível e morte encefálica
Authors: Pittelli Sergio Domingos , Oliveira Reinaldo Ayer de
Published: February 2016

Os autores traçam considerações a respeito dos conceitos de terminalidade, eutanásia e ortotanásia referindo-os aos vários estados clínicos relacionados às situações limítrofes da vida, apontando e dirimindo equívocos manifestados nos meios de comunicações e por formadores de opinião. Discutem a Resolução CFM 1805/2006 e o Código de Ética Médica (Resolução 1931/2009) demonstrando a relação dos respectivos conteú-dos normativos com os conceitos em apreço.
A importância da identificação humana nos desastres de massa naturais, acidentais ou provocados: uma abordagem multidisciplinar
Authors: Funabashi Karina Silva , Monteiro Ana Carolina , Moraes Danilo Alves de , Rocha Murilo Ramos , Moreira Patricia Cristina Fincatti , Iwamura Edna Sadayo Miazato
Published: February 2016

Desastres de massa sempre existiram e agora ocorrem com maior frequência pela ação do homem. Dessa
forma, consideramos importante a inclusão desse tema, tanto pelo caráter multidisciplinar dos trabalhos que se seguem aos desastres, em que profissionais das áreas da saúde, justiça e defesa civil estão envolvidos, bem como por ser do interesse de toda a sociedade. O escopo deste artigo é apresentar alguns dos principais acidentes de massa ocorridos nos últimos anos descritos na literatura enfocando as questões que se colocam aos profissionais nessas situações, bem como os avanços científicos e sua importância na identificação humana. Apresentamos: a) as dificuldades encontradas na identificação das vítimas dos ataques terroristas de 11 de setembro de 2001 no World Trade Center; b) o uso das técnicas para identificação de vítimas de guerras, genocídios; c) o uso das técnicas para identificação de vítimas de catástrofes naturais como o do Tsunami no Sul da Ásia em 26 de dezembro de 2004; d) a identificação do respomsável por um atentado em Jakarta em 2004: e) a Internet como ferramenta na vigilância da saúde na Geórgia em vítimas do furacão Katrina, ocorrido em 29 de agosto de 2005 e suas consequências. Como consideração final, apresentamos algumas recomendações, descritas após experiências vivenciadas em eventos dessa natureza.
Internet como ferramenta de apoio no ensino odontológico: avaliação da aptidão técnica dos estudantes de graduação da Faculdade de Odontologia da Universidade de São Paulo
Authors: Nogi Fábio Massaharu , Melani Rodolfo Francisco Haltenhoff
Published: February 2016

A disseminação da Internet a partir dos anos 90 tem determinado alterações substanciais na dinâmica das interações sociais, contribuindo para a formação de uma cultura globalizada, na qual o trânsito de informações e conhecimentos se processa através de novos paradigmas de comunicação. Diante desse quadro, o impacto
da Internet na formação profissional tem sido amplamente discutido em diversas áreas do conhecimento, com o intuito de se instituir diretrizes e protocolos que possam fornecer o arcabouço necessário para a elaboração de projetos de Educação On-Line eficientes. O escopo deste estudo foi analisar a viabilidade de utilização da Internet como instrumento de apoio a aulas presenciais no processo de ensino-aprendizagem em Odontologia. Com essa finalidade, procedeu-se à aplicação de um questionário versando sobre o manejo do computador e da Internet em 143 alunos da Faculdade de Odontologia da Universidade de São Paulo (FOUSP), que cursavam o 2º e o 8º semestres da graduação no período diurno. Após a análise das respostas, os autores concluíram que os estudantes avaliados demonstraram boa aptidão técnica no manejo de computadores e da Internet, estando aptos para utilizar a Internet como ferramenta de auxílio pedagógico em sua formação profissional.
O aprendizado de criminalística: interações entre as modalidades formal, informal e não-formal de educação
Authors: Garrido Rodrigo Grazinoli
Published: February 2016

O artigo avalia o trânsito do conhecimento criminalístico entre as vertentes do ensino informal, não-formal e
formal. Para tanto, foi realizado estudo descritivo transversal com alunos do Curso de Formação Profissional (CFP) de Peritos Criminais da Academia de Polícia Civil Sylvio Terra (ACADEPOL-PCERJ) e com alunos de Ensino Superior e Médio que buscaram mini-cursos na área de Criminalística. A partir da resposta de 202 questionários foi possível determinar claramente um ciclo informal-formal do ensino de Criminalística. Filmes e seriados de Televisão têm incrementado o interesse pela área, oferecendo um conhecimento prévio e levando à busca por cursos e palestras não formais. Os alunos do ensino formal também adquiriram conhecimentos prévios por meio destas mídias. Esse interesse pode ser aproveitado no Ensino Médio como fator de interdisciplinaridade e contextualização de conteúdos de ciências naturais. Já no Ensino Superior, deve propiciar o estabelecimento de cursos e habilitações em Criminalística. Dessa forma, devem-se formar profissionais com interesse pela área e, sobretudo, cidadãos mais conscientes.