bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of 30-day unplanned readmissions after degenerative spinal disease surgery
Authors: Adam D. , Iftimie D. , Burduşa Gina , Moisescu Cristiana
Published: March 2017

Background: Degenerative spinal disease surgery is frequently performed in most neurosurgical departments. Unplanned 30-day readmissions represent a significant economic burden and have been used in several studies as a tool to evaluate quality of patient care.

Objective: To review 30-day unplanned readmission rates after degenerative spinal disease surgery in our department, in order to identify their causes and determine strategies aimed at decreasing their frequency.

Methods: A retrospective analysis was performed on all patients operated in our department for spinal stenosis or disc herniation over a 3 year period (January 2014 – December 2016), evaluating the rate and causes of unplanned readmission in the first month after discharge. Complications were divided in medical and surgical.

Results: Out of the 1106 patients included, 33 (2,98%) presented a 30-day unplanned readmission. The percentage was higher after disc herniation surgery (3,40%), compared to spinal stenosis (1,92%). Pain management was the most common medical cause for readmission (45,45%), while in the surgical group, CSF leaks were the most frequent complication (18,18%).

Conclusions: The rate of 30-day readmissions was low in our series but, even so, they associate significant costs. They could be avoided by applying correct and aseptic surgical technique, proper availability of dural sealing agents and superior patient medical education.
Trends in Folklore Studies Development in the Research and Education Space at Ukrainian and Foreign Universities
Authors: Vovk Myroslava
Published: March 2017

Trends in development of folklore studies in the research and education space at Ukrainian and foreign universities have been analyzed. They are fundamentalization, synthesis of academic science and educational practice, professionalization, institutionalization, humanitarization, anthropoligization, interdisciplinarity. It has been defined that in Ukrainian and foreign folkloristic discourse of the 20th – the beginning of the 21th centuries, folklore is studied through the prism of functional, communicative, anthropological, context-based approaches that is partially realized in the official definition of folklore according to the 1989 UNESCO Recommendation on the Safeguarding of Traditional Culture and Folklore. It has been found out that while structuring the content of folkloristic disciplines as well as directing future specialists’ researches the multivectoring of folklore studies allows instructors to use the achievements of folkloristic directions that were formed in historical retrospective and actively developed at the modern stage: linguofolkloristics, ethnomusicology, folk therapy (folk music therapy, fairytale therapy, folk dance therapy), etc. It has been justified that folklore studies in Ukrainian and foreign research and education space is being developed as an interdisciplinary science based on the historical and pedagogical experience and taking into account modern integration processes that define the problematics of the content of folkloristic, culturological training of future pedagogue-researcher who is to be educated as a man of culture, nationally aware and, at the same time, multicultural personality.
Comparative Analysis of Future Cooks’ Training in Vocational Institutions in Ukraine and Abroad
Authors: Kankovsky Ihor , Krasylnykova Hanna , Drozich Iryna
Published: March 2017

The article deals with comparative analysis of conceptual approaches and content of cooks’ training in Ukraine, European countries, the USA and Eastern Partnership countries. It has been found out that national vocational education is grounded on education standards and activity-based approach to forming the training content, subject-based structure of curricula and, surely, needs to become competency-based. It has been revealed that in Eastern Partnership countries there is a normative base of cooks’ vocational training and it is accorded with the competency-based approach. However, such states as the Russian Federation, the Republic of Belarus, the Republic of Kazakhstan implement study programs for training cooks in traditional institutions of formal vocational training of Post-Soviet type. At the same time, the training of future cooks in European countries is mainly oriented toward the concept of continuing education and is variable, multilevel, wide-profile, at most approximated to the needs of catering trade. The level-based curricula and dual system of cooks’ training in vocational schools of France, Austria and Italy have been characterized. In addition, the authors have defined the common feature of professional practical training of cooks in culinary schools in the USA, that is its organization under the conditions of real production that ensures a wide professional competency of future cooks, their acquiring knowledge and skills needed for professional activity. It has been concluded that positive aspects of foreign experience may assist in defining prognostic directions for the development of cooks’ vocational training in Ukraine.
The Organization of Future Translators’ Self-Directed Learning at US Universities
Authors: Nakonechna Alyona
Published: March 2017

The article deals with studying the peculiarities in the organization of future translators’ self-directed learning at US universities. It has been stated that various researches on the problem prove the underestimation of self-directed learning that leads to insufficient professional competency of future translators. It has been found out that to create an environment favourable for self-directed learning educators should consider four factors, namely, autonomy and responsibility, complexity, duration, “voice and choice”. It has been indicated that the system of independent learning and teaching consists of three components – teacher, learner and communication method. The traits of autonomous learners have been listed. The functions of self-directed learning in US higher education institution have been presented. Six ways of supporting autonomy, namely, classroom-based, curriculum-based, teacher-based, learner-based, resource-based, technology-based, have been singled out and analyzed. The experience of the Kent State University in training future Masters of Arts in Translation has been analyzed. Based on the research performed, the positive aspects of the experience have been justified and relevant recommendations to improve the organization of future translators’ self-directed learning in Ukrainian higher education institutions have been outlined.
Foreign Experience in Training Future Engineering Educators for Modeling Technological Processes
Authors: Bokhonko Yevhen
Published: March 2017

The article deals with the study of foreign experience in training engineering educators for modeling technological processes. It has been stated that engineering education is a field that is being dramatically developed taking into account the occurring changes in educational paradigms, global higher education space, national higher education systems, economics, society, etc. It has been indicated that the abundance of the latest information and communication technologies alter the approaches to training various specialists, and, in particular, engineering educators. It has been mentioned that engineering teacher education is undergoing significant development. The activities of the International Society for Engineering Education – IGIP have been justified. It has been found out that there is the vital need for those specialists able to combine the techniques of traditional teaching and innovative scientific achievements, design technical structures, be leader and facilitator of the education process. It has been defined that the activity of the society is aimed at providing engineering educators with relevant training that involves their obtaining the qualification that is accorded with European education standards. US experience in training engineering educators for professional activity has been analyzed. It has been specified that engineering education has become more integrated into the curricula of elementary, middle and high school because of the increasing focus on STEM subjects; the demand for engineering educators is dramatically growing at all the levels of the education system. The peculiarities of engineering educators’ training have been demonstrated on the example of the Purdue Polytechnic Institute. It has been concluded that Bachelor of Science in Engineering Technology Teacher Education is a rather interdisciplinary degree program and trains future engineering educators for a wide range of fields. The organization of the program is considerate and well-planned. It has been stated that in Great Britain future engineering educators should be able to apply innovative and less conventional teaching methodology, namely, via problem-based learning, virtual learning environment, etc. According to the mentioned above, the author has outlined the recommendations to improve engineering teacher education in Ukraine.
Supply Chain Management and Customer Satisfaction in Small to Medium Enterprises
Authors: Omoruyi Osayuwamen , Mafini Chengedzai
Published: March 2017

To circumvent the possibility of business failure, small to medium enterprises in emerging economies face mounting pressure to increase the satisfaction of their customers. The adoption of supply chain management practices is critical to the provision of quality products and services as well as the satisfaction of customers by small to medium enterprises. This paper investigated the relationship between customer satisfaction, supply chain management practices and three input factors; namely, product quality, flexibility and product variety in small to medium enterprises. The study adopted a quantitative approach in which a four section questionnaire was distributed to 131 managers in small to medium enterprises based in Gauteng Province, South Africa. Hypotheses were tested using regression analysis. The results of the study revealed that product quality and flexibility predicted supply chain management practices. Supply chain management practices were also statistically significant, and mediated the relationship between customer satisfaction and product quality and flexibility. Based on these results, conclusions were drawn and appropriate recommendations were made.
Gibt es bei der Genossenschaft eine schädliche Gesellschafter-Fremdfinanzierung nach der Zinsschranke?
Authors: Kollruss Thomas
Published: March 2017

Is borrowing from members for cooperatives (not part of a concern) within the scope of the interest barrier and can in this respect establish a harmful borrowing from shareholders within the meaning of § 8a subsection 2 KStG? This is a question of great scientific and practical relevance. This paper concludes that cooperatives (not part of a concern) are not within the scope of a harmful shareholder borrowing within the meaning of § 8a subsection 2 KStG.
Silent Crooke’s cell corticotroph adenoma of the pituitary gland presenting as delayed puberty
Authors: Giri Dinesh , Roncaroli Federico , Sinha Ajay , Didi Mohammed , Senniappan Senthil
Published: March 2017

Corticotroph adenomas are extremely rare in children and adolescents. We present a 15-year-old boy who was investigated for delayed puberty (A1P2G1, bilateral testicular volumes of 3 mL each). There was no clinical or laboratory evidence suggestive of chronic illness, and the initial clinical impression was constitutional delay in puberty. Subsequently, MRI scan of the brain revealed the presence of a mixed cystic and solid pituitary lesion slightly displacing the optic chiasma. The lesion was removed by transphenoidal surgery and the biopsy confirmed the lesion to be pituitary adenoma. Furthermore, the adenoma cells also had Crooke’s hyaline changes and were intensely positive for ACTH. However there was no clinical/biochemical evidence of ACTH excess. There was a spontaneous pubertal progression twelve months after the surgery (A2P4G4, with bilateral testicular volume of 8 mL). Crooke’s cell adenoma is an extremely rare and aggressive variant of corticotroph adenoma that can uncommonly present as a silent corticotroph adenoma in adults. We report for the first time Crooke’s cell adenoma in an adolescent boy presenting with delayed puberty.

Learning points:

Constitutional delay of growth and puberty (CDGP) is a diagnosis of exclusion; hence a systematic and careful review should be undertaken while assessing boys with delayed puberty.

Crooke’s cell adenomas are a group of corticotroph adenomas that can rarely present in childhood and adolescence with delayed puberty.

Crooke’s cell adenomas can be clinically silent but are potentially aggressive tumours that require careful monitoring.
Defining Pediatric Chronic Critical Illness for Clinical Care, Research, and Policy
Authors: Shapiro Miriam C. , Henderson Carrie M. , Hutton Nancy , Boss Renee D.
Published: March 2017

Chronically critically ill pediatric patients represent an emerging population in NICUs and PICUs. Chronic critical illness has been recognized and defined in the adult population, but the same attention has not been systematically applied to pediatrics. This article reviews what is currently known about pediatric chronic critical illness, highlighting the unique aspects of chronic critical illness in infants and children, including specific considerations of prognosis, outcomes, and decision-making. We propose a definition that incorporates NICU versus PICU stays, recurrent ICU admissions, dependence on life-sustaining technology, multiorgan dysfunction, underlying medical complexity, and the developmental implications of congenital versus acquired conditions. We propose a research agenda, highlighting existing knowledge gaps and targeting areas of improvement in clinical care, research, and policy.
Unique Characteristics of the X Chromosome and Related Disorders
Authors: Shah Kshama , DeRemigis Alison , Hageman Joseph R. , Sriram Sudhir , Waggoner Darrel
Published: March 2017

X-linked disorders include chromosomal aberrations as well as deleterious variants in the specific genes encoded on the X chromosome. In comparison to autosomal chromosomes, the X chromosome has unique features that impact disease expression. The primary features that alter the transmission and expression of X-linked disorders are X inactivation and the unequal distribution of X chromosomes between male and female infants. This article reviews these unique characteristics and applies their guiding principles in a broad overview to Klinefelter syndrome, ornithine transcarbamylase (OTC) deficiency, hemophilia, and fragile X syndrome.
Neonatal Lactic Acidosis: A Diagnostic and Therapeutic Approach
Authors: Ganetzky Rebecca D. , Cuddapah Sanmati R.
Published: March 2017

Neonatal lactate elevation is a relatively common finding with heterogeneous causes. Understanding the reason for the lactate elevation is critical to determining the prognosis and treatment options. Lactate can be elevated spuriously, secondary to a number of common neonatal conditions or intermediary inborn errors of metabolism, or as a primary finding in mitochondrial diseases. The extent of the lactate elevation, clinical context, and simple metabolic tests can help differentiate among these causes.
Trends in Patent Ductus Arteriosus Diagnosis and Management for Very Low Birth Weight Infants
Authors: Ngo Samantha , Profit Jochen , Gould Jeffrey B. , Lee Henry C.
Published: March 2017

OBJECTIVE:

To examine yearly trends of patent ductus arteriosus (PDA) diagnosis and treatment in very low birth weight infants.

METHODS:

In this retrospective cohort study of very low birth weight infants (<1500 g) between 2008 and 2014 across 134 California hospitals, we evaluated PDA diagnosis and treatment by year of birth. Infants were either inborn or transferred in within 2 days after delivery and had no congenital abnormalities. Intervention levels for treatment administered to achieve ductal closure were categorized as none, pharmacologic (indomethacin or ibuprofen), both pharmacologic intervention and surgical ligation, or ligation only. Multivariable logistic regression was used to assess risk factors for PDA diagnosis and treatment.

RESULTS:

PDA was diagnosed in 42.8% (12 002/28 025) of infants, with a decrease in incidence from 49.2% of 4205 infants born in 2008 to 38.5% of 4001 infants born in 2014. Pharmacologic and/or surgical treatment was given to 30.5% of patients. Between 2008 and 2014, the annual rate of infants who received pharmacologic intervention (30.5% vs 15.7%) or both pharmacologic intervention and surgical ligation (6.9% vs 2.9%) decreased whereas infants who were not treated (60.5% vs 78.3%) or received primary ligation (2.2% vs 3.0%) increased.

CONCLUSIONS:

There is an increasing trend toward not treating patients diagnosed with PDA compared with more intensive treatments: pharmacologic intervention or both pharmacologic intervention and surgical ligation. Possible directions for future study include the impact of these trends on hospital-based and long-term outcomes.
Influence of testosterone on mean arterial pressure: A physiological study in male and female normotensive WKY and hypertensive SHR rats
Authors: Loh SY , Salleh N
Published: March 2017

Introduction

Testosterone plays an important role in the blood pressure regulation. However, information with regard to the effect of this hormone on blood pressure in normotensive and hypertensive conditions is limited. Therefore, in this study, the relationship between plasma testosterone level and mean arterial pressure (MAP) was investigated under these conditions.

Methods

Normotensive Wistar-Kyoto (WKY) and hypertensive Spontaneous Hypertensive (SHR) male and female rats were gonadectomized with female rats treated with testosterone. Estrous cycle stages of intact female rats of both strains were identified by vaginal smear. Pressure in the carotid artery of anesthetized rats was measured via direct cannulation technique. The blood was withdrawn for plasma testosterone level measurement by enzyme-linked immunosorbent assay.

Results

Treatment of ovariectomized female WKY and SHR rats with testosterone for 6-week duration has resulted in MAP to increase (P < 0.05). In male WKY and SHR rats, MAP and plasma testosterone levels decreased by orchidectomy (P < 0.05). No significant differences in MAP and plasma testosterone levels were observed in intact female WKY and SHR rats between stages of the estrous cycle.

Conclusions

The effects seen in testosterone-treated ovariectomized female rats and in orchidectomized male rats suggested that testosterone could play an important role in causing the blood pressure to increase.
Effects of time-of-day on oxidative stress, cardiovascular parameters, biochemical markers, and hormonal response following level-1 Yo-Yo intermittent recovery test
Authors: Aloui K , Abedelmalek S , Chtourou H , Wong DP , Boussetta N , Souissi N
Published: March 2017

The aim of this study was to investigate the effect of time-of-day on oxidative stress, cardiovascular parameters, muscle damage parameters, and hormonal responses following the level-1 Yo-Yo intermittent recovery test (YYIRT). A total of 11 healthy subjects performed an intermittent test (YYIRT) at two times-of-day (i.e., 07:00 h and 17:00 h), with a recovery period of ≥36 h in-between, in a randomized order. Blood samples were taken at the rest (baseline) and immediately (post-YYIRT) after the YYIRT for measuring oxidative stress, biochemical markers, and hormonal response. Data were statistically analyzed using one-way and two-way repeated measures ANOVA and Bonferroni test at p < 0.05. Observed power (α = 0.05) and partial eta-squared were used. Our results showed that oxygen uptake (VO2max), maximal aerobic speed, and the total distance covered tended to be higher in the evening (17:00 h). There was also a main effect of time-of-day for cortisol and testosterone concentration, which were higher after the YYIRT in the morning (p < 0.05). The heart rate peak and the rating of perceived exertion scales were lower in the morning (p < 0.05). However, the plasma glucose (p < 0.01), malondialdehyde, creatine kinase (p < 0.01), lactate dehydrogenase (p < 0.05), high-density lipoprotein (p < 0.01), total cholesterol (p < 0.01), and triglycerides (p < 0.05) were higher after the YYIRT in the evening. Low-density lipoprotein, systolic blood pressure, diastolic blood pressure, and lactate levels (p > 0.05) were similar for the morning and evening test. In conclusion, our findings suggest that aerobic performance presents diurnal variation with great result observed in the evening accompanied by an improvement of hormonal, metabolic, and oxidative responses. These data may help to guide athletes and coaches and contribute to public health recommendations on exercise and muscle damage particularly in the competitive periods.
Overjet problems at the growing child, case report using the twin block appliance
Authors: Achmad Muhammad H.
Published: March 2017

Objective : Overjet is a horizontal relationship between maxillary and mandibular incisors. Normal range from overjet is 2-4 mm. Increased overjet is marked by maxillary incisor’s protrusion. A 6 mm overjet will have impact on psychological and social relationship of children due to the aesthetics of the face profile. Increased overjet has relationship with Class II Angle malocclusion, Class II skeletal sagittal relationship, and mandibular retrognathia. Clinical problem caused by increased overjet in children are maxillary permanent incisors trauma in growing age, damaged periodontal tissue, lip incompetency, social impact such as lack of confidence in children, and also increased overjet has a close relationship with Temporomandibular Disorder (TMD) sign and symptoms.Methods : Increased overjet case can be managed by maxillary retraction of labial segment and increasing mandibular labial segment. Case management are based on skeletal and soft tissue pattern and patient’s age. Reducing overjet can be based on using several appliances, such as functional removable appliance to modify dental and skeletal relationship, fixed orthodontic appliances with tipping and bodily movement or using jaw reposition by orthognathic surgery.Results : One of the effective appliance to reduce overjet, especially Class II malocclusion treatment is Twin Block Functional Appliances developed by Clark. Twin Block appliances is used for developing age children in certain time period to support mandibular growth. This appliance is easy to use, so the patient cooperativity can be maintained. Maximum treatment depends on children’s cooperativity.  By using Twin Block functional appliance, we can observe that early treatment can be effective to reduce overjet, to change skeletal pattern, and to increase children psychology such as self-confidence by making aesthetic changes to their faces significantly.[B1] Conclusion : This appliances is made with 70o angle to occlusal plane. Maxillary arch lateral expansion can be achieved with expansion screw. Patient will be instructed to use the appliance for 24 hours a day.[B2]
Surgical management of necrotizing fasciitis due to odontogenic infection with sepsis: a case report
Authors: Nugroho Saka S. , Syamsudin Endang , Hardianto Andri , Riawan Lucky
Published: March 2017

Objective:To perform surgical operation on necrotizing fasciitis due to odontegenic infection with sepsis.Methods: In this case an odontogenic infection was accompanied by a large open wound on the face and sepsis. Patient was hospitalized in the Dr.HasanSadikin General Hospital. Management of this patient in the emergency room were administration of appropriate broad-spectrum empiric antibiotic, incision and pus drainage, and extraction of the infected tooth, followed by fluid resuscitation with strict observation. Surgical debridement was then performed.Results:After being treated for 12 days the patient’s condition improved. We planned closure of defects of the facial area, but the patient refused.Conclusion: Necrotizing fasciitis is an uncommon but potentially lethal condition associated with high rates of morbidity and mortality. Early diagnosis coupled with emergent surgical debridement, appropriate broad-spectrum empiric antibiotic treatment, and a multidisciplinary team approach is essential for successful treatment.
The Prevalence of xerostomia occurrence after doing radiation therapy in patients with head and neck cancer
Authors: Yunus Barunawaty
Published: March 2017

Xerostomia is one side effect of radiation therapy that most commonly affects head and neck. This situation is a symptom and not a disease which is generally associated with reduced saliva. For patients this situation is not pleasant and for dentist, this symptom is considered as a challenging case. This research intended to know the prevalence of xerostomia after radiation therapy in cancer patients with head and neck area. The subjects of this study were patients with head and neck area cancer who underwent radiotherapy treatment at Hasanuddin University teaching hospital, subjects were then taken saliva before and after given a total dose of 20 Gy and a total dose of 40 Gy. The analysis of the data processed by the computer program and the Wilcoxon test significance level is accepted when p<0.05. The mean bulk saliva before radiotherapy was higher than average rainfall saliva after radiotherapy total dose of 20 Gy and 40 Gy. Radiotherapy of the head and neck area total dose of 20 Gy and 40 Gy may affect rainfall saliva so that patients feel the symptoms of xerostomia.
Management pain and anxiety in endodontic treatment
Authors: Sumidarti Andi , Dwiandhany Wahyuni S.
Published: March 2017

Objective : Dental pain is a common symptom that most often causes patient to seek dentist. A survey conducted by the American Association of Endodontics revealed that more than half patients who come to dentist have experienced pain, which originate from the teeth or of the surrounding tissue, can causes difficulties in handling, also the anxiety of the patient. Understanding the pain experienced by patient will help dentist to determine when to make an action. Most patient being fear with pain, so they delay to get treatment from dentist, and lead to the development of further infection and inflammation. The aim of this paper is to improve the understanding of pharmacology and procedures for pain and anxiety management in endodontic treatment. So, it is important to determine accurate diagnosis, management and drug administration.
Konservasi Kearifan Budaya Lokal dalam Proses Interaksi Sosial Etnis Melayu di Kabupaten Batu Bara
Authors: Nur Ramli
Published: March 2017

The article examines the local wisdoms of ethnic Malay in the district of Batu Bara as a reference for their individual and social interactions with special focus on interethnic relationships, particularly within socio-religious realm. The study finds that ethnic diversity in the district of Batu Bara is not an obstacle to create a harmonious relation in social, economic, political, and religious activities among the people. It means that the Malays in Batu Bara have virtuous interaction with other ethnicities in the region. They, for an instance, are able to build mutual trust with other ethnicities in economic activities. In addition, they are able to work hand-in-hand with other people in many areas of social aspects. It is also found that the Malays of Batu Bara treat other ethnicities as equal in terms of providing an individual his/her social stratum to be, for an example, a prominent figure of society. They also give other people from other ethnicities chance of being political elites or leaders of mass organizations. The study finds that, however, the Malays of Batu Bara tend to choose the local (indigenous) person as their leader.
Truth Claim dan Implikasinya terhadap Usaha Penciptaan Kohesi Damai Antarumat Beragama
Authors: Wakhid Udin Nur Hidayat
Published: March 2017

One of the sacred missions carried out by every religion is spreading harmony and peace. However, the facts show us that religious sentiment often creates disharmony among religious adherents and it also often leads to conflict and violence. This problem is caused by, among others, truth claim which sees other religions as false. The truth claim has been in fact one of the main terms promulgated by every religion towards its followers. Using qualitative approach, this article attempts to explain that every single religion in the world possesses its own distinctive doctrine about truth. The doctrine about truth has in fact led to two implications, namely the positive implication and the negative one. The truth claim would result in positive effect when it is viewed prudently and not understood blindly. It means that every religious adherent should realize the existence of “other” truth out of his/her belief. On the contrary, the truth claim would bring about negative impact when it is seen sightlessly and understood through one-sided view. This negative attitude would be an obstacle for every effort to create peaceful relation among interfaith adherents.
Peningkatan Mutu Pendidikan SMA Muhammadiyah 2 Sidoarjo sebagai Sekolah Berkategori The Outstanding School of Muhammadiyah
Authors: Hidayatulloh Hidayatulloh
Published: March 2017

This article examines about improving the education quality of SMA Muhammadiyah 2 Sidoarjo as the Outstanding School of Muhammadiyah. This article reveals that the quality improvement of SMA Muhammadiyah 2 Sidoarjo was conducted through: the arrangement of school program and self evaluation, the reinforcement of vision, mission and education objective, the reinforcement of leadership and teamwork, the improvement of teachers and educators competence, the improvement learners quality input, the development of curriculum and learning, the development of school culture, the development of facilities and infrastructure, the development of community service, the cooperation of education and student exchange, the mobilization of education funding resources, the develop-ment of SIM, monitoring and evaluation, and education quality system. The management quality of SMA Muhammadiyah 2 Sidoarjo was run through input-process-output formula. The process of quality containes the process of quality planning, main process, supporting process, dan quality improvement process. Factors supporting the quality improvement are: Muhammadiyah’s popular name, the doctrine of education quality improvement, the leadership of TORSIE paradigm, the school academicians’ spirit of gaining achievement, the synergy of school academicians, the appropriate facilities, and the supports of all stakeholders.
Living Law dan ‘Urf sebagai Sumber Hukum Positif di Indonesia
Authors: Mubarok Nafi'
Published: March 2017

This article deals with the issue of living law and ‘urf as the sources of positive law in Indonesia. The existence of living law and ‘urf (habits which are normally and consistently conducted by members of society) are acknow-ledged in Indonesian legal system. In fact, the theory of living law and ‘urf have been adopted as legal reasoning for many laws or bills, such as the law number 23/2014 on local government and the law number 21/2008 on Shariah banking. It can bee seen that many legal decisions by courts judges also have their sources from living laws, such as what deals with criminal sanction, female reciepient of inheritance, the validaty of a merriage. Many legal decisions by court judges also adopt the ‘urf, such as the amount of money for ‘iddah (waiting time before marriage after divorce), the validity of eloping (kawin lari), shared property in marriage.
Hiperinsulinismo endógeno: revisão e seguimento de 24 casos
Authors: Felício João S. , Martins Carlliane P. , Semer Mauro , Kalinin Larissa , Nery Marcia , Machado Marcel C. C. , Liberman Bernardo
Published: March 2017

Em decorrência do hiperinsulinismo endógeno (HHE), a hipoglicemia é diagnosticada em um indivíduo sintomático com níveis baixos de glicose plasmática, concomitante a valores elevados de insulina plasmática e peptídeo-C. Entre as causas de HHE, estão as doenças das células-b das ilhotas pancreáticas, o uso de secretagogos e a hipoglicemia autoimune. Neste artigo de revisão, estudamos 24 pacientes com hipoglicemia decorrente de hiperinsulinismo endógeno com a finalidade de descrever os aspectos de diagnóstico e tratamento. Nosso estudo mostrou que, após a realização do teste de jejum de 12h (minijejum) em três dias diferentes, todos os pacientes preencheram os critérios diagnósticos de HHE. Adicionalmente, encontramos que 11 dos 12 pacientes (91,7%) que realizaram o teste do glucagon apresentaram níveis de glicose no tempo 120 minutos menores que 50 mg/dL e inferiores ao valor basal. O teste do minijejum (3 amostras) e o teste do glucagon poderiam ser úteis para evitar a realização do jejum prolongado no diagnóstico do hiperinsulinismo endógeno.
Does undetectable basal Tg measured with a highly sensitive assay in the absence of antibodies and combined with normal ultrasonography ensure the absence of disease in patients treated for thyroid carcinoma?
Authors: Rosário Pedro Weslley , Mineiro Filho Augusto Flávio Campos
Published: March 2017

It has been proposed that, in patients treated for well-differentiated thyroid carcinoma, undetectable basal thyroglobulin (Tg) levels measured with a highly sensitive assay in the absence of anti-thyroglobulin antibodies (TgAb) and combined with negative neck ultrasonography (US) ensured the absence of disease. We report a series of five patients with well-differentiated (papillary) carcinoma submitted to total thyroidectomy with apparently complete tumor resection, followed by remnant ablation with 131I (100-150 mCi), who had no distant metastases upon initial post-therapy whole-body scanning. When tumor recurrence or persistence was detected, these patients presented undetectable basal Tg (0.1 ng/mL) in the absence of TgAb, and US showed no anomalies. Two patients had lymph node metastases, one had mediastinal metastases, bone involvement was observed in one patient, and local recurrence in one. We conclude that further studies are needed to define in which patients undetectable basal Tg (negative TgAb) combined with negative US is sufficient, and no additional tests are required.
Methionine- and choline-deficient diet induces hepatic changes characteristic of non-alcoholic steatohepatitis
Authors: Marcolin Éder , Forgiarini Luiz Felipe , Tieppo Juliana , Dias Alexandre Simões , Freitas Luiz Antonio Rodrigues de , Marroni Norma Possa
Published: March 2017

CONTEXT: Non-alcoholic steatohepatitis is a disease with a high incidence, difficult diagnosis, and as yet no effective treatment. So, the use of experimental models for non-alcoholic steatohepatitis induction and the study of its routes of development have been studied. OBJECTIVES: This study was designed to develop an experimental model of non-alcoholic steatohepatitis based on a methionine- and choline-deficient diet that is manufactured in Brazil so as to evaluate the liver alterations resulting from the disorder. METHODS: Thirty male C57BL6 mice divided in two groups (n = 15) were used: the experimental group fed a methionine- and choline-deficient diet manufactured by Brazilian company PragSoluções®, and the control group fed a normal diet, for a period of 2 weeks. The animals were then killed by exsanguination to sample blood for systemic biochemical analyses, and subsequently submitted to laparotomy with total hepatectomy and preparation of the material for histological analysis. The statistical analysis was done using the Student's t-test for independent samples, with significance level of 5%. RESULTS: The mice that received the methionine- and choline-deficient diet showed weight loss and significant increase in hepatic damage enzymes, as well as decreased systemic levels of glycemia, triglycerides, total cholesterol, HDL and VLDL. The diagnosis of non-alcoholic steatohepatitis was performed in 100% of the mice that were fed the methionine- and choline-deficient diet. All non-alcoholic steatohepatitis animals showed some degree of macrovesicular steatosis, ballooning, and inflammatory process. None of the animals which were fed the control diet presented histological alterations. All non-alcoholic steatohepatitis animals showed significantly increased lipoperoxidation and antioxidant enzyme GSH activity. CONCLUSION: The low cost and easily accessible methionine- and choline-deficient diet explored in this study is highly effective in inducing steatosis and steatohepatitis in animal model, alterations that are similar to those observed in human livers.
The aerobic capacity and muscle strength are correlated in candidates for liver transplantation
Authors: Galant Lucas Homercher , Forgiarini Jr. Luiz Alberto , Dias Alexandre Simões
Published: March 2017

Liver diseases are responsible for metabolic and cardiorespiratory alterations. The objective of this paper is to correlate the maximal oxygen uptake (VO2max) and respiratory muscle strength and evaluating the quality of life in liver transplant candidates. Cross-sectional study consisted of 26 patients with cirrhosis who underwent maximal exercise testing, respiratory muscle strength and SF-36. There was a correlation of VO2max with MIP (r = 0.61) and low scores of quality of life. A correlation of VO2max to muscle strength and decreased quality of life in patients with liver disease.
Upper endoscopy versus endosonography in differential diagnosis of gastrointestinal bulging
Authors: Ardengh José Celso , Vaiciunas Spencer , Kemp Rafael , Venco Filadelfo , Lima-Filho Éder Rios , Santos José Sebastião dos
Published: March 2017

CONTEXT: The identification of a bulging covered by normal epithelium is a common finding during an upper gastrointestinal endoscopy. OBJECTIVE: To compare the endoscopic and endosonography findings in the differential diagnosis of the gastrointestinal bulging (subepithelial tumor or extrinsic compression). METHOD: Patients referred by endosonography with bulging of upper gastrointestinal tract were studied retrospectively. The size, location, consistency and presumptive diagnosis were recorded at time of endoscopy and endosonography. Endosonography-guided fine-needle aspiration was proposed in case of uncertain diagnose to increase diagnostic sensitivity. RESULTS: One hundred seventy-six patients (93 women) and mean age 62.5 years (10-87). One hundred fifty-three had subepithelial tumor and 23 had extrinsic compression as a final diagnosis. Endosonography had sensitivity, specificity and accuracy higher than those found by endoscopy for both diagnosis subepithelial tumor and extrinsic compression. Endoscopy and endosonography showed poor concordance (K = 0.13) for subepithelial tumor diagnosis and unsuitable agreement for diagnosis in extrinsic compression (K = 0.01). The endosonography-guided fine-needle aspiration had sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 75%, 72.4%, 80.5%, 65.6% and 74%, respectively. CONCLUSION: Endoscopy has high sensitivity and low specificity for subepithelial tumor and both are low for the extrinsic compression. Endoscopy is a good tool for diagnosis of the subepithelial tumors, but not to determine the cause of an extrinsic compression. The endosonography identifies the layer from which subepithelial tumor comes, obtain histological samples, and increasing the diagnostic accuracy.
Surgical treatment of gastroesophageal reflux disease: total or partial fundoplication? Systematic review and meta-analysis
Authors: Ramos Rodrigo F , Lustosa Suzana Angélica S , Almeida Carlos Augusto P. de , Silva Carolina P. da , Matos Delcio
Published: March 2017

CONTEXT: Although the high incidence of gastroesophageal reflux disease (GERD) in the population, there is much controversy in this topic, especially in the surgical treatment. The decision to use of a total or partial fundoplication in the treatment of GERD is still a challenge to many surgeons because the few evidence found in the literature. OBJECTIVE: To bring more clear evidence in the comparison between total and partial fundoplication. DATA SOURCES: A systematic review of the literature and metaanalysis with randomized controlled trials accessed from MEDLINE, LILACS, Cochrane Controlled Trials Database was done. The outcomes remarked were: dysphagia, inability to belch, bloating, recurrence of acid reflux, heartburn and esophagitis. For data analysis the odds ratio was used with corresponding 95% confidence interval. Statistical heterogeneity in the results of the metaanalysis was assessed by calculating a test of heterogeneity. The software Review Manager 5 (Cochrane Collaboration) was utilized for the data gathered and the statistical analysis. Sensitive analysis was applied using only trials that included follow-up over 2 years. RESULTS: Ten trials were included with 1003 patients: 502 to total fundoplication group and 501 to partial fundoplication group. The outcomes dysphagia and inability to belch had statistical significant difference (P = 0.00001) in favor of partial fundoplication. There was not statistical difference in outcomes related with treatment failure. There were no heterogeneity in the outcomes dysphagia and recurrence of the acid reflux. CONCLUSION: The partial fundoplication has lower incidence of obstructive side effects.
Evaluation of antiulcerogenic activity of aqueous extract of Brassica oleracea var. capitata (cabbage) on Wistar rat gastric ulceration
Authors: Carvalho Camilo Amaro de , Fernandes Kenner Moraes , Matta Sérgio Luiz Pinto , Silva Marcelo Barreto da , Oliveira Leandro Licursi de , Fonseca Cláudio César
Published: March 2017

CONTEXT: The cabbage (Brassica oleraceae var. capitata) is an herbaceous and leafy plant which belongs to the Brassicaceae family, native to coastal southern and Western Europe. Used in cooking for its nutritional value also has known anti-inflammatory activity. OBJECTIVE We studied the antiulcerogenic activity of aqueous extract of Brassica oleracea var. capitata (AEB) in order to validate ethnobotanical claims regarding the plant use in the gastric disorders. METHOD: Acute gastric ulcers were induced in rats by the oral administration of acetylsalicylic acid. The gastroprotective potential of the AEB (0.250, 0.500 and 1.000 mg.kg-1/body weight) was compared with omeprazole (20 mg.kg-1/body weight). RESULTS: The stomach analysis indicated that treatment with AEB inhibited the gastric damage. The gastroprotective activity as evidenced by its significant inhibition in the formation of ulcers induced by chemical agent with a maximum of 99.44% curation (250 mg.kg-1 body weight) in acetylsalicylic acid-induced ulcers. CONCLUSIONS: The AEB demonstrated good antiulcerogenic activities which justify the inclusion of this plant in the management of gastric disorders. Further experiments are underway to determine which antiulcer mechanisms involved in gastroprotection.
Investigation of nutritional risk factors using anthropometric indicators in hospitalized surgery patients
Authors: Leandro-Merhi Vânia Aparecida , Aquino José Luiz Braga de
Published: March 2017

CONTEXT: The investigation of risk factors associated with nutritional status could contribute for better knowledge of the malnutrition. OBJECTIVE: To investigate the incidence of malnutrition and its possible association with many parameters that assess nutritional status and to identify the associated risk factors. METHODS: The nutritional status was assessed in 235 hospitalized patients. Malnutrition was defined as present when the patient presented at least two anthropometric criteria below the normal range and habitual energy intake below 75% of the energy requirement (HEI/ER<75%). Gender, age, type of disease, recent weight change and dental problems were investigated as possible associated risk factors. The chi-square and Mann-Whitney tests were used to compare the data and univariate and multiple logistic regressions were used to identify the factors associated with malnutrition. The odds ratio (OR) and confidence interval (CI) of 95% were calculated with the significance level set at 5% (P<0.05). RESULTS: One-fifth (20%) of the patients were malnourished on admission to the hospital and 27.5% reported recent weight loss. Malnutrition (P<0.0001) was greater in patients with malignant diseases. The only variables significantly associated with malnutrition according to univariate logistic regression were recent weight loss (P = 0.0058; OR = 2.909; IC95% = 1.362; 6.212) and malignant disease (P = 0.0001; OR = 3.847; IC95% = 1.948; 7.597). When multiple regression was used in the model which included type of disease, malignant disease was shown to increase the chance of malnutrition fourfold (P = 0.0002; OR = 3.855; IC95% = 1.914; 7.766). When disease was excluded, recent weight loss also increased malnutrition fourfold (P = 0.0012; OR = 3.716; IC95% = 1.677; 8.236). CONCLUSION: Patients with a history of recent weight loss and those with malignant diseases are more susceptible to malnutrition.
Immunohistochemical evaluation of p53 and Ki-67 proteins in colorectal adenomas
Authors: Sousa Walysson Alves Tocantins de , Rodrigues Lusmar Veras , Silva Jr. Raimundo Gerônimo da , Vieira Fernando Lopes
Published: March 2017

CONTEXT: The appearance of adenomas and their progression to adenocarcinomas is the result of an accumulation of genetic changes in cells of the intestinal mucosa inherited or acquired during life. Several proteins have been studied in relation to the development and progression of colorectal cancer, including tumor protein p53 (p53) and antigen identified by monoclonal antibody Ki-67 (Ki-67). OBJECTIVE: To evaluate the expression of p53 and Ki-67 in colorectal adenomas and correlate the observed levels with clinical and pathologic findings. METHOD: The sample consisted of 50 adenomatous polyps from patients undergoing colonoscopy. After performing polypectomy, polyps were preserved in a formalin solution with 10% (vol./vol.) phosphate buffer, submitted for routine preparation of sections and slides and stained with hematoxylin and eosin. For each adenoma we then performed immunohistochemistry to detect specific p53 and Ki-67 proteins using a streptavidin-biotin-peroxidase enzyme immunoassay. RESULTS: p53 was detected in 18% of the adenomas. The average Ki-67 protein index (i.Ki-67) was 0.49. A statistically significant difference was observed in p53 (P = 0.0003) and Ki-67 (P = 0.02) expression between adenomas with low- and high-grade dysplasia, particularly for p53. The expression of Ki-67 was greater in rectal adenomas than in colic adenomas (P = 0.02). No relationship was found between the expression of the two proteins in the sample. CONCLUSION: The p53 protein is expressed in a proportion of adenomas, while the Ki-67 protein was expressed in all adenomas. The expression of p53 was higher in adenomas with high-grade dysplasia. The expression of Ki-67 was higher in rectal adenomas and in adenomas with high-grade dysplasia.
Kinetografia: interpretação dos kinetogramas em um caso de atetose unilateral
Authors: Moreira Milton B.
Published: March 2017

O autor define e explica o que é kinetograma e a técnica de sua realização. Mostra que a movimentação exigida resulta do funcionamento de quase todo o sistema nervoso central através de um mecanismo interno complexo do qual participam vários circuitos nervosos. Adverte que as lesões localizadas nestes últimos acarretam deformações e desorganizações kinetográficas peculiares. Informa que a observação vem demonstrando que desde o início de algumas enfermidades sistematizadas do sistema nervoso central existem variações características nos traçados. Em um caso de atetose unilateral, por lesão do striatum contralateral, o autor procura explicar a ação vicariante do hemisfério cerebral homolateral íntegro, por ocasião dos movimentos simultâneos e sinérgicos das duas mãos. Responsabiliza a comissura de Meynert pela condução interpalidal da suplência verificada mediante os kinetogramas e expõe o circuito reverberante aberrante (extrapiramidal) que entra em funcionamento nestas condições excepcionais.