bluuebunny/crossref_metadata_2025 huggingface dataset:
Synthesis, Spectral Characterization, and Biochemical Evaluation of Antidiabetic Properties of a New Zinc-Diosmin Complex Studied in High Fat Diet Fed-Low Dose Streptozotocin Induced Experimental Type 2 Diabetes in Rats
Authors: Gopalakrishnan Veerasamy , Iyyam Pillai Subramanian , Subramanian Sorimuthu Pillai
Published: December 2015

In view of the established antidiabetic properties of zinc, the present study was aimed at evaluating the hypoglycemic properties of a new zinc-diosmin complex in high fat diet fed-low dose streptozotocin induced experimental type 2 diabetes in rats. Zinc-diosmin complex was synthesized and characterized by various spectral studies. The complexation between zinc ions and diosmin was further evidenced by pH-potentiometric titrations and Job’s plot. Diabetic rats were orally treated with zinc-diosmin complex at a concentration of 20 mg/kg b.w./rat/day for 30 days. At the end of the experimental period, the rats were subjected to oral glucose tolerance test. In addition, HOMA-IR and various biochemical parameters related to glucose homeostasis were analyzed. Treatment with zinc-diosmin complex significantly improved the glucose homeostasis in diabetic rats. Treatment with zinc-diosmin complex significantly improved insulin sensitivity, at least in part, through enhancing protein metabolism and alteration in the levels of muscle and liver glycogen. The assay of clinical marker enzymes revealed the nontoxic nature of the complex. Determination of renal tissue markers such as blood urea and serum creatinine indicates the renoprotective nature of the complex. These findings suggest that zinc-diosmin complex is nontoxic and has complimentary potential to develop as an antihyperglycemic agent for the treatment of diabetes mellitus.
Adipocyte-Like Differentiation in a Posttreatment Embryonal Rhabdomyosarcoma
Authors: Balitzer Dana , McCalmont Timothy H. , Horvai Andrew E.
Published: December 2015

We describe a 16-year-old boy with rhabdomyosarcoma, consistent with embryonal subtype, of the lower extremity who received systemic neoadjuvant chemotherapy and subsequent excision. Microscopic sections of the postchemotherapy excision demonstrated diffuse, prominent, and immature adipocyte-like differentiation, in addition to skeletal muscle differentiation. Adipocyte-like differentiation was confirmed by a combination of positive Oil Red O and adipophilin immunohistochemical staining. To our knowledge, this represents the first report of an unusual phenomenon of differentiation of a soft tissue rhabdomyosarcoma into adipocyte-like cells after chemotherapy.
Rapid Switch from Intra-Aortic Balloon Pumping to Percutaneous Cardiopulmonary Support Using Perclose ProGlide
Authors: Sakakura Kenichi , Adachi Yusuke , Taniguchi Yousuke , Wada Hiroshi , Momomura Shin-ichi , Fujita Hideo
Published: December 2015

We present a case of a patient who needed rapid switch from intra-aortic balloon pumping (IABP) to percutaneous cardiopulmonary support (PCPS)/venoarterial extracorporeal membrane oxygenation. It is difficult to switch from IABP to PCPS, because 0.035-inch guidewires cannot pass the IABP guidewire lumen (0.025-inch compatible), and the IABP sheath needs to be removed together with the IABP catheter. First, a 0.025-inch guidewire was inserted into the IABP wire lumen, and then the IABP catheter together with the 8 Fr IABP sheath was removed, leaving the 0.025-inch guidewire in place. We used the Perclose ProGlide for safe and rapid exchange of the 0.025-inch guidewire for a 0.035-inch guidewire. This allowed insertion of a PCPS cannula and the prompt initiation of PCPS.
Pyoderma Gangrenosum Simulating Necrotizing Fasciitis
Authors: de Souza Erik Friedrich Alex , da Silva Guilherme Almeida Rosa , dos Santos Gustavo Randow , Motta Heloisa Loureiro de Sá Neves , Cardoso Pedro Afonso Nogueira Moisés , de Azevedo Marcelo Costa Velho Mendes , Pires Karina Lebeis , Motta Rogerio Neves , Silva Walter de Araujo Eyer , Ferry Fernando Raphael de Almeida , Pinto Jorge Francisco da Cunha
Published: December 2015

Pyoderma gangrenosum received this name due to the notion that this disease was related to infections caused by bacteria in the genusStreptococcus. In contrast to this initial assumption, today the disease is thought to have an autoimmune origin. Necrotizing fasciitis was first mentioned around the fifth century AD, being referred to as a complication of erysipelas. It is a disease characterized by severe, rapidly progressing soft tissue infection, which causes necrosis of the subcutaneous tissue and the fascia. On the third day of hospitalization after antecubital venipuncture, a 59-year-old woman presented an erythematous and painful pustular lesion that quickly evolved into extensive ulceration circumvented by an erythematous halo and accompanied by toxemia. One of the proposed etiologies was necrotizing fasciitis. The microbiological results were all negative, while the histopathological analysis showed epidermal necrosis and inflammatory infiltrate composed predominantly of dermal neutrophils. Pyoderma gangrenosum was considered as a diagnosis. After 30 days, the patient was discharged with oral prednisone (60 mg/day), and the patient had complete healing of the initial injury in less than two months. This case was an unexpected event in the course of the hospitalization which was diagnosed as pyoderma gangrenosum associated with myelodysplastic syndrome.
Silencing ofEag1Gene Inhibits Osteosarcoma Proliferation and Migration by Targeting STAT3-VEGF Pathway
Authors: Wu Xinyu , Chen Zhida , Zeng Wengrong , Zhong Yuanfu , Liu Qingjun , Wu Jin
Published: December 2015

So far, the role of Ether à go-go 1 (Eag1) potassium channels in migration and invasion progression of cancers remains elusive. In the present study, the effects ofEag1knockdown on osteosarcoma cell proliferation, growth, and apoptosis were examined. Then, we evaluated the effects ofEag1silencing on osteosarcoma cell migration and invasion. In addition, we detected the expression of vascular endothelial growth factor (VEGF) and signal transducer and activator of transcription 3 (STAT3) in osteosarcoma cell treated with Eag1 small interfering RNAs (siRNAs). Finally, STAT3 siRNA was employed to determine the influence of downregulation of STAT3 on cell proliferation and migration. The results showed that knockdown ofEag1significantly suppressed osteosarcoma cell proliferation and osteosarcoma xenografts growth. However,Eag1silencing had little effect on cell apoptosis. Additionally, osteosarcoma cell adhesion, migration, and invasion were also potently attenuated. Notably, the expression levels of VEGF decreased evidently upon Eag1 siRNAs treatment, paralleled with reductions in the expression levels of STAT3. Moreover, a similar pattern was observed in osteosarcoma cell proliferation and migration suppression between STAT3 siRNA and Eag1 siRNAs groups. Our data indicated that Eag1 promotes osteosarcoma proliferation and migration, at least in part, by targeting STAT3-VEGF pathway.
Effect of Atlas Vertebrae Realignment in Subjects with Migraine: An Observational Pilot Study
Authors: Woodfield H. Charles , Hasick D. Gordon , Becker Werner J. , Rose Marianne S. , Scott James N.
Published: December 2015

Introduction. In a migraine case study, headache symptoms significantly decreased with an accompanying increase in intracranial compliance index following atlas vertebrae realignment. This observational pilot study followed eleven neurologist diagnosed migraine subjects to determine if the case findings were repeatable at baseline, week four, and week eight, following a National Upper Cervical Chiropractic Association intervention. Secondary outcomes consisted of migraine-specific quality of life measures.Methods. After examination by a neurologist, volunteers signed consent forms and completed baseline migraine-specific outcomes. Presence of atlas misalignment allowed study inclusion, permitting baseline MRI data collection. Chiropractic care continued for eight weeks. Postintervention reimaging occurred at week four and week eight concomitant with migraine-specific outcomes measurement.Results. Five of eleven subjects exhibited an increase in the primary outcome, intracranial compliance; however, mean overall change showed no statistical significance. End of study mean changes in migraine-specific outcome assessments, the secondary outcome, revealed clinically significant improvement in symptoms with a decrease in headache days.Discussion. The lack of robust increase in compliance may be understood by the logarithmic and dynamic nature of intracranial hemodynamic and hydrodynamic flow, allowing individual components comprising compliance to change while overall it did not. Study results suggest that the atlas realignment intervention may be associated with a reduction in migraine frequency and marked improvement in quality of life yielding significant reduction in headache-related disability as observed in this cohort. Future study with controls is necessary, however, to confirm these findings. Clinicaltrials.gov registration number isNCT01980927.
Molecular Integrity of Mitochondria Alters by Potassium Chloride
Authors: Mishra Suman , Mishra Rajnikant
Published: December 2015

Potassium chloride (KCl) has been commonly used in homogenization buffer and procedures of protein extraction. It is known to facilitate release of membrane-associated molecules but the higher concentration of KCl may affect the integrity of mitochondria by breaching the electrostatic force between the lipids and proteins. Therefore, it has been intended to explore the effect of KCl on mitochondrial proteome. The mitochondria were isolated from the mice liver and sub-fractionated into mitochondrial matrix and outer mitochondrial membrane fraction. The fractions were analysed by denaturing polyacrylamide gel electrophoresis (PAGE) and 2D-PAGE. The analysis of ultrastructure and protein profiles by MALDI-MS and data-mining reveals KCl-associated alterations in the integrity of mitochondria and its proteome. The mitochondrial membrane, cristae, and the matrix proteins appear altered under the influence of KCl.
Study of Cysteine-Rich Protein 61 Genetic Polymorphism in Predisposition to Fracture Nonunion: A Case Control
Authors: Ali Sabir , Hussain Syed Rizwan , Singh Ajai , Kumar Vineet , Walliullah Shah , Rizvi Nazia , Yadav Manish , Ahmad Mohammad Kaleem , Mahdi Abbas Ali
Published: December 2015

Background. Many factors are responsible for this impaired healing, especially in long bones, but a possible genetic predisposition for the development of this complication remains unknown till now. In the present study, we aim to examine the CYR61 gene polymorphism in fracture nonunion patients and the correlation with clinical findings. Materials and Methods. We performed SNP analysis of the CYR61 gene in 250 fracture nonunion patients and 250 healthy subjects were genotyped in this hospital-based case control study, and 56 cases were further evaluated for mRNA expression of CYR61 by real-time quantitative reverse-transcription PCR. Results. CYR61 gene TT, TG, and GG genotype frequencies of total fracture nonunion cases were 41.6%, 49.2%, and 9.20% and 54.4%, 39.2%, and 6.40% in healthy controls. Heterozygous TG genotype was found statistically significant in fracture nonunion cases compared with that in controls, whereas homozygous mutant GG genotype was not found significant. Moreover, we found that TG + GG genotypes were significantly different in serum expression of CYR61 mRNA when compared with cases (TT genotypes). Conclusions. Our result signifies that genotype of CYR61 affects the mRNA expression and acts as a risk factor that could synergistically increase the susceptibility of a patient to develop fracture nonunion.
Deep Response in Multiple Myeloma: A Critical Review
Authors: Fulciniti Mariateresa , Munshi Nikhil C. , Martinez-Lopez Joaquin
Published: December 2015

Novel and more effective treatment strategies against multiple myeloma (MM) have significantly prolonged patients’ survival and raised interest in the depth of response and its association with clinical outcome. Minimal residual disease (MRD) has emerged as one of the most relevant prognostic factors in MM and should be included in a new definition of complete response (CR). Although further standardization is still required, MRD monitoring should be applied in prospective clinical trials as a sensitive tool to compare and evaluate the efficacy of different treatment strategies, particularly in the consolidation and maintenance settings, and implement individualized therapy-monitoring approaches. Here, we review current definition of deep response in MM, advantages and limitations of current MRD assessment assays, clinical evidences for MRD monitoring as a prognostic tool for therapeutic decisions in MM, and challenges to develop uniform criteria for MRD monitoring.
4 × 4 MIMO Multiband Antenna System for Mobile Handsets
Authors: Trinh Le Huy , Ferrero Fabien , Lizzi Leonardo , Ribero Jean-Marc , Staraj Robert
Published: December 2015

A 4 × 4 MIMO multiband antenna system for mobile handsets is proposed in this paper. The placement of the elements on the terminal chassis as well as the single structure has been optimized in order to reduce the Envelope Correlation Coefficient (ECC). Simulated and measured results, including also the integration with a a real 7-inch commercial tablet, aimed at validating the proposed solution are presented.
Effect of Priming and Seed Size on Germination and Emergence of Six Food-Type Soybean Varieties
Authors: Kering Maru K. , Zhang Bo
Published: December 2015

Soybean (Glycine max(L.) Merr.), a good source of protein and oil, is used to produce nutritious isoflavone-rich soybean-based foods. The objectives of this study were (i) to determine the germination difference among soybean seeds in various seed sizes and (ii) to evaluate effects of seed pretreatment on germination and seedling emergence. Six varieties of different seed size class were used: (i) small size (MFS-561 and V08-4773), (ii) medium size (Glen and V03-47050), and (iii) large size (MFL-159 and V07-1897). Pregermination treatments include 0, 5, or 10 hours soaking and germinating/planting with or without nitrogen fertilizer. Large seed size varieties showed low germination rate and N addition caused the least reduction in germination in these seeds during the first 24 hours. While N had no effect on seed germination after 72 hours, growth in N treated seed was low. Seedling emergence was comparable across varieties in 2013 and water priming and N application had no effect. However, while varieties did not differ in final emergence for nonprimed seeds in 2014, water priming led to a high reduction in seedling emergence of large seed varieties in this study. Application of N fertilizer had no effect on seedling emergence in field experiments.
Renal Damage Frequency in Patients with Solitary Kidney and Factors That Affect Progression
Authors: Basturk T. , Koc Y. , Ucar Z. , Sakaci T. , Ahbap E. , Kara E. , Bayraktar F. , Sevinc M. , Sahutoglu T. , Kayalar A. , Sinangil A. , Akgol C. , Unsal A.
Published: December 2015

Background. The aim of this study is to assess renal damage incidence in patients with solitary kidney and to detect factors associated with progression.Methods. Medical records of 75 patients with solitary kidney were investigated retrospectively and divided into two groups: unilateral nephrectomy (group 1) and unilateral renal agenesis/dysplasia (group 2). According to the presence of kidney damage, each group was divided into two subgroups: group 1a/b and group 2a/b.Results. Patients in group 1 were older than those in group 2 (p=0.001). 34 patients who comprise group 1a had smaller kidney size (p=0.002) and higher uric acid levels (p=0.028) than those in group 1b at presentation. Uric acid levels at first and last visit were associated with renal damage progression (p=0.004, 0.019). 18 patients who comprise group 2a were compared with those in group 2b in terms of presence of DM (p=0.038), HT (p=0.003), baseline proteinuria (p=0.014), and uric acid (p=0.032) levels and group 2a showed higher rates for each. Progression was more common in patients with DM (p=0.039), HT (p=0.003), higher initial and final visit proteinuria (p=0.014, for both), and higher baseline uric acid levels (p=0.047).Conclusions. The majority of patients with solitary kidney showed renal damage at presentation. Increased uric acid level is a risk factor for renal damage and progression. For early diagnosis of renal damage and reducing the risk of progression, patients should be referred to a nephrologist as early as possible.
Transportation Mode Detection Based on Permutation Entropy and Extreme Learning Machine
Authors: Zhang Lei , Liu LeiJun , Bao SuNing , Qiang MengTing , Zou XiaoMei
Published: December 2015

With the increasing prevalence of GPS devices and mobile phones, transportation mode detection based on GPS data has been a hot topic in GPS trajectory data analysis. Transportation modes such as walking, driving, bus, and taxi denote an important characteristic of the mobile user. Longitude, latitude, speed, acceleration, and direction are usually used as features in transportation mode detection. In this paper, first, we explore the possibility of using Permutation Entropy (PE) of speed, a measure of complexity and uncertainty of GPS trajectory segment, as a feature for transportation mode detection. Second, we employ Extreme Learning Machine (ELM) to distinguish GPS trajectory segments of different transportation. Finally, to evaluate the performance of the proposed method, we make experiments on GeoLife dataset. Experiments results show that we can get more than 50% accuracy when only using PE as a feature to characterize trajectory sequence. PE can indeed be effectively used to detect transportation mode from GPS trajectory. The proposed method has much better accuracy and faster running time than the methods based on the other features and SVM classifier.
Effects of 12‐Week Endurance Training at Natural Low Altitude on the Blood Redox Homeostasis of Professional Adolescent Athletes: A Quasi‐Experimental Field Trial
Authors: Tong Tomas K. , Kong Zhaowei , Lin Hua , He Yeheng , Lippi Giuseppe , Shi Qingde , Zhang Haifeng , Nie Jinlei
Published: December 2015

This field study investigated the influences of exposure to natural low altitude on endurance training‐induced alterations of redox homeostasis in professional adolescent runners undergoing 12‐week off‐season conditioning program at an altitude of 1700 m (Alt), by comparison with that of their counterparts completing the program at sea‐level (SL). For age‐, gender‐, and Tanner‐stage‐matched comparison, 26 runners (n = 13 in each group) were selected and studied. Following the conditioning program, unaltered serum levels of thiobarbituric acid reactive substances (TBARS), total antioxidant capacity (T‐AOC), and superoxide dismutase accompanied with an increase in oxidized glutathione (GSSG) and decreases of xanthine oxidase, reduced glutathione (GSH), and GSH/GSSG ratio were observed in both Alt and SL groups. Serum glutathione peroxidase and catalase did not change in SL, whereas these enzymes, respectively, decreased and increased in Alt. Uric acid (UA) decreased in SL and increased in Alt. Moreover, the decreases in GSH and GSH/GSSG ratio in Alt were relatively lower compared to those in SL. Further, significant interindividual correlations were found between changes in catalase and TBARS, as well as between UA and T‐AOC. These findings suggest that long‐term training at natural low altitude is unlikely to cause retained oxidative stress in professional adolescent runners.
The Influence of Alcohol Consumption, Cigarette Smoking, and Physical Activity on Leukocyte Telomere Length
Authors: Latifovic Lidija , Peacock Sarah D. , Massey Thomas E. , King Will D.
Published: December 2015

Background: Telomeres protect from DNA degradation and maintain chromosomal stability. Short telomeres have been associated with an increased risk of cancer at several sites. However, there is limited knowledge about the lifestyle determinants of telomere length. We aimed to determine the effect of three factors, known to be important in cancer etiology, on relative leukocyte telomere length (rLTL): alcohol consumption, smoking, and physical activity.

Methods: This cross-sectional study included 477 healthy volunteers ages 20 to 50 years who completed a questionnaire and provided a fasting blood sample. Multiplex quantitative real-time PCR (qPCR) was used to measure rLTL. Regression coefficients were calculated using multiple linear regression while controlling for important covariates.

Results: There was no association between alcohol consumption and rLTL. Daily smokers and those in the middle and lower tertile of pack-years smoking had shorter rLTL than never daily smokers (P = 0.02). Data were suggestive of a linear trend with total physical activity (P = 0.06). Compared with the lowest quartile, the highest quartile of vigorous physical activity was associated with longer rLTL. A significant linear trend of increasing rLTL with increasing vigorous physical activity was observed (P = 0.02).

Conclusions: Cigarette smoking and vigorous physical activity have an impact on telomere length. Smoking was related to shorter telomere length while vigorous physical activity was related to longer telomeres.

Impact: The findings from this study suggest that lifestyle may play an important role in telomere dynamics and also suggest that engaging in healthy behaviors may mitigate the effect of harmful behaviors on telomere length. Cancer Epidemiol Biomarkers Prev; 25(2); 374–80. ©2015 AACR.
The Antitumor Efficacy of IL2/IL21-Cultured Polyfunctional Neu-Specific T Cells Is TNFα/IL17 Dependent
Authors: Phan-Lai Vy , Dang Yushe , Gad Ekram , Childs Jennifer , Disis Mary L.
Published: December 2015

Purpose: Infusion of HER2-specific T cells, derived from vaccine-primed patients and expanded with IL2/IL12, has induced tumor regression in a minority of patients with metastatic treatment-refractory HER2+ breast cancer. We questioned whether alteration of cytokine growth factors used to culture vaccine–primed T cells could improve antitumor activity.

Experimental Design: Using the TgMMTV-neu murine mammary tumor model, we cultured T cells derived from mice immunized with a previously defined neu class II peptide, p98-114 (neu p98), and evaluated different cytokine combinations for expansion.

Results: Infusion of neu p98-specific T-cell lines derived from all cytokine conditions evaluated resulted in significant antitumor activity compared with infused naïve splenocytes (P < 0.05). T cells cultured with IL2/IL21 could uniquely mediate complete regression of spontaneous mammary tumors. IL2/IL21 cultured neu-specific T cells demonstrated a different cytokine secretion pattern as compared with other cultured T cells; secreting high levels of TNFα and IL17 (P < 0.05). Moreover, tumor-infiltrating CD8+ cells were significantly increased after the infusion of IL2/IL21 cultured T cells as compared with tumors treated with T cells expanded under other cytokine conditions (P < 0.001). The antitumor effect of the infusion of IL2/IL21 cultured cells was mediated by CD8 T cells. Depletion of TNFα or IL17, but not IFNγ, abrogated the tumor growth inhibition induced by the IL2/IL21 T cells and markedly decreased the influx of CD8 into tumors. Finally, IL2/IL21-cultured human antigen specific T cells also displayed a similar polyfunctional Th1/Th17 phenotype.

Conclusions: Expansion of HER2 vaccine–primed T cells with IL2/IL21 may have the potential to effectively mediate tumor regression when used in adoptive transfer. Clin Cancer Res; 22(9); 2207–16. ©2015 AACR.
Statistical Challenges in the Design of Late-Stage Cancer Immunotherapy Studies
Authors: Mick Rosemarie , Chen Tai-Tsang
Published: December 2015

The past several years have witnessed a revival of interest in cancer immunology and immunotherapy owing to striking immunologic and clinical responses to immune-directed anticancer therapies and leading to the selection of “Cancer Immunotherapy” as the 2013 Breakthrough of the Year by Science. But statistical challenges exist at all phases of clinical development. In phase III trials of immunotherapies, survival curves have been shown to demonstrate delayed clinical effects, as well as long-term survival. These unique survival kinetics could lead to loss of statistical power and prolongation of study duration. Statistical assumptions that form the foundations for conventional statistical inference in the design and analysis of phase III trials, such as exponential survival and proportional hazards, require careful considerations. In this article, we describe how the unique characteristics of patient response to cancer immunotherapies will impact our strategies on statistical design and analysis in late-stage drug development. Cancer Immunol Res; 3(12); 1292–8. ©2015 AACR.
Learning Curve for Intrapulmonary Artery Doppler in Fetuses with Congenital Diaphragmatic Hernia
Authors: Cruz-Martínez Rogelio , Cruz-Lemini Monica , Mendez Antonio , Illa Miriam , García-Baeza Víctor , Martinez Josep Maria , Gratacós Eduard
Published: December 2015

Objective: To assess the learning curve for intrapulmonary artery Doppler in fetuses with congenital diaphragmatic hernia (CDH). Methods: Three fetal medicine fellows with the theoretic knowledge, but without prior experience, in the evaluation of intrapulmonary artery Doppler in CDH fetuses were selected. Each trainee and 1 experienced explorer assessed the intrapulmonary artery in the contralateral lung to the side of the hernia for calculation of 2 Doppler parameters - pulsatility index (PI) and peak early diastolic reversed flow (PEDRF) - in a cohort of 90 consecutive CDH fetuses. The average difference between the 3 trainees and the expert was calculated. A difference below 15% was considered as accurate measurement. The average learning curve was delineated using the cumulative sum analysis (CUSUM). Results: Among the total 270 intrapulmonary artery Doppler measurements performed by the 3 trainees, the number of failed examinations was 14 (15.6%) and 16 (17.8%) for PI and PEDRF, respectively. The CUSUM plots demonstrate that the learning curve was achieved by 53 and 63 tests performed for calculations of the intrapulmonary artery PI and PEDRF, respectively. Conclusion: Competence in Doppler evaluation of the intrapulmonary artery in CDH fetuses is achieved only after intensive continuous training.
The Effect of Aging and the High-Frequency Auditory Threshold on Speech-Evoked Mismatch Negativity in a Noisy Background
Authors: Chen Junming , Chen Suijun , Zheng Yiqing , Ou Yongkang
Published: December 2015

Mismatch negativity (MMN) has been widely used to study the function of central auditory processing in the elderly. However, current research has not yet considered the effect of noise and high-frequency hearing threshold on MMN in the elderly. The aim of this study was to evaluate the effect of aging and high-frequency hearing loss on speech-related MMN in noisy backgrounds. Additionally, the possible mechanisms of central auditory processing dysfunction in the elderly were investigated. Fifty people aged 61-80 (70 ± 5.8) years were recruited for this study. They were divided into a 61- to 70-year-old group and a 71- to 80-year-old group. Fifty younger adults aged 21-40 (31 ± 5.3) years were recruited as healthy controls. Pure-tone hearing thresholds were recorded. A speech discrimination score (SDS) and a speech-evoked MMN under white noise with a bandwidth from 125 to 8,000 Hz background condition were recorded. The relationships between SDS and MMN latency and amplitude were analyzed. The effects of age and binaural 2,000-, 4,000- and 8,000-Hz pure-tone hearing thresholds on MMN latency and amplitude were analyzed. We found that the hearing thresholds of 2,000, 4,000 and 8,000 Hz in the 61- to 70-year-old and 71- to 80-year-old groups were higher than those in the control group. The SDS in a noisy background in the 61- to 70-year-old and 71- to 80-year-old groups were lower than those in the control group. Speech-evoked MMN latency was longer in the 61- to 70-year-old and in the 71- to 80-year-old groups than in the control group (215.8 ± 14.2 ms). SDS and speech-evoked MMN latency were negatively correlated. Age and speech-evoked MMN latency were positively correlated, as were the binaural 4,000- to 8,000-Hz pure-tone hearing thresholds and speech-evoked MMN. This study suggests that in elderly subjects, the function of preattentive central auditory processing changes. Additionally, increasing age and high-frequency hearing thresholds create a synergy in neurons that is weakened in the MMN time window, which may be a cause of central auditory processing disorders in elderly subjects in noisy background conditions.
Primary Adrenocortical Insufficiency Case Series: Genetic Etiologies More Common than Expected
Authors: Tsai Sarah L. , Green Jane , Metherell Lou A. , Curtis Fiona , Fernandez Bridget , Healey Ara , Curtis Joseph
Published: December 2015

Background/Aims: Primary adrenal insufficiency (AI) is an important cause of morbidity in children. Our objectives were: (1) to describe the clinical presentation of children with new-onset primary AI, and (2) to identify monogenic causes of primary AI in children. Methods: Chart review and mutation detection in candidate genes were conducted for 11 patients with primary AI. Results: The likely cause of AI was determined in 9 patients. One had a homozygous MC2R mutation associated with familial glucocorticoid deficiency. Two had the same homozygous mutation in the AIRE gene which is associated with type 1 autoimmune polyglandular syndrome. One patient had a heterozygous change in this gene of undetermined significance. Five were homozygous for the previously reported p.R188C STAR mutation causing nonclassic lipoid congenital adrenal hyperplasia, representing the largest cohort of such patients from a single geographic area. In the remaining 2 patients, no clear etiology was identified. Conclusions: We recommend genetic testing for patients who have negative anti-adrenal antibodies or suggestive family history. Diagnosing a genetic etiology can provide information about prognosis and treatment, and is therefore beneficial for patients. Our high proportion of patients with nonclassic lipoid congenital adrenal hyperplasia likely represents a founder effect.
Donepezil Adherence, Persistence and Time to First Discontinuation in a Three-Year Follow-Up of Older People
Authors: Ndukwe Henry C. , Nishtala Prasad S.
Published: December 2015

Background: Donepezil is indicated for the management of mild to moderate dementia, particularly in Alzheimer's disease. Several studies have described low adherence rates with donepezil. Aim: To examine and measure donepezil adherence, persistence and time to first discontinuation in older New Zealanders. Methods: An inception cohort of 1,999 new users of donepezil, aged 65 years or older, were identified from the Pharmaceutical Collections and National Minimum Dataset from 1 November 2010 to 31 December 2013. Kaplan-Meier curves and Cox regression analysis were used to estimate the cumulative probability and risk of time to first discontinuation of donepezil therapy. Results: The mean age of the cohort was 79.5 ± 6.4 years and included 42.7% females. Adherence was high (89.0%), while the proportion of donepezil dispensings (81.0-32.5%) declined between 6 and 36 months. Persistence between the 1st and 6th dispensing visit decreased by 19.0%, and 11.0% of the total cohort had a gap of 31 days or more. The adjusted risk of time to first discontinuation in the non-adherent group was 2.2 times (95% CI 1.9-2.6) that of the adherent group. Conclusions: The non-adherent new donepezil users, on average, discontinued faster than the adherent group. Time to first discontinuation in this study was higher compared to discontinuation rates observed in clinical trials.
China's Tu Youyou, Nobel Laureate in Medicine 2015, and Relationships with the TCM Research Center Graz at the Medical University
Authors: Litscher Daniela , Litscher Gerhard
Published: December 2015

For the first time in history, the Nobel Prize in Medicine 2015 was awarded to a researcher who is specialized in traditional Chinese medicine. The Chinese Tu Youyou received this highest award in medicine for her excellent work in malaria research. Tu Youyou and her team found out that artemisinin, the active ingredient of the medicinal herb ‘sweet wormwood', represents an effective malaria therapy. In the following article, the research that led to this Nobel Prize is introduced. In addition, the insidious tropical disease malaria will be explained briefly. Results of the research on moxibustion using Artemisia are also presented in this article; these studies were carried out at the TCM Research Center Graz, partly in close cooperation with the China Academy of Chinese Medical Sciences, the institution of the Nobel Prize winner.
Early time courses of recurrent thromboembolism and bleeding during apixaban or enoxaparin/warfarin therapy
Authors: Gallus Alex S. , Sanders Paul , Thompson John R. , Agnelli Giancarlo , Buller Harry R. , Cohen Alexander T. , Ramacciotti Eduardo , Weitz Jeffrey I. , Raskob Gary E.
Published: December 2015

Risks of recurrence and bleeding are highest during the first weeks of anticoagulant therapy for venous thromboembolism (VTE). We therefore examined the early time course of recurrence and major bleeding in a pre-specified sub-analysis of the AMPLIFY trial, a randomised, double-blind, six-month comparison of oral apixaban with conventional therapy (enoxaparin followed by warfarin) in 5,395 patients with symptomatic proximal deep-vein thrombosis or pulmonary embolism. Early events were of particular interest because apixaban was given without initial heparin treatment. The primary efficacy and safety outcomes were the incidences of the adjudicated composite of recurrent symptomatic VTE or death related to VTE, and of adjudicated major bleeding, respectively. This analysis reports on recurrence and bleeding after 7, 21, and 90 days of therapy, in addition to the previously reported end-of-study results. These were the times specified before statistical analysis. Recurrent VTE after 7, 21, and 90 days, and six months had occurred in 18 (0.7%), 29 (1.1%), 46 (1.8%), and 59 patients (2.3%), respectively, given apixaban, and in 23 (0.9%), 35 (1.3%), 58 (2.2%), and 71 patients (2.7%), respectively, given conventional therapy. Major bleeding had occurred during these time intervals in 3 (0.1%), 5 (0.2%), 11 (0.4%), and 15 patients (0.6%), respectively, who received apixaban, and in 16 (0.6%), 26 (1.0%), 38 (1.4%), and 49 patients (1.8%), respectively, given conventional therapy. Efficacy of apixaban was non-inferior at each time point, with no excess of early recurrences. The reduced bleeding risk associated with apixaban began early during the course of treatment.
Extensão Médica Acadêmica: uma análise retrospectiva dos seis anos do projeto e seu impacto na humanização do cuidado, treinamento clínico e formação multidisciplinar dos alunos da Faculdade de Medicina da Universidade de São Paulo
Authors: Cavalieri Vinicius Alves , Iuamoto Leandro Ryuchi , Pfann Robert Zawadzki , Uema Rodrigo Hideki , Onotera Miki , Oide Junior Mauro Shigueharu
Published: December 2015

INTRODUÇÃO: A necessidade de um ensino baseado em comunidade para a formação de profissionais de saúde mais humanizados é evidente e mandatória. A Extensão Médica Acadêmica surge nesse âmbito buscando estimular a formação de profissionais de saúde mais humanizados desde os primeiros anos de faculdade. Estruturado como um projeto de voluntariado que engloba diversos cursos da saúde (fisioterapia, nutrição, fonoaudiologia e medicina), busca-se promover o contato do aluno com a prática profissional, mantendo-o estimulado a estudar, melhorando suas habilidades técnicas e fornecendo atendimento de saúde multiprofissional de qualidade. OBJETIVOS: Analisar a percepção dos membros de medicina quanto ao aprendizado e humanização. Levantar o número de atendimentos e membros por ano nos últimos 6 anos. Analisar a estrutura organizacional do projeto e verificar se atende aos seus objetivos. MÉTODOS: Foram coletados dados dos atendimentos no período de 2009 a 2014, calculando número de atendimentos, número de voluntários por curso, e número de alunos de medicina por ano de graduação. Dados foram obtidos pelo Projeto de Satisfação com questionário respondido por 68 alunos de medicina contendo 5 questões formuladas na escala de Likert de 5 pontos. Utilizamos o Ranking Médio (RM) das respostas para analisar os dados coletados. RESULTADOS: Houve aumento gradativo dos membros, com predomínio de alunos de medicina e dos primeiros anos da faculdade. No primeiro semestre de 2015 existiam 252 acadêmicos, e 40 profissionais. Dos questionários obteve-se um RM de percepção de aprendizado de 4,162 e percepção de humanização de 3,964, sendo 67,6% dos entrevistados alunos do primeiro ano. O total de consultas foi de 1656 e 597 coletas de exames laboratoriais. CONCLUSÃO: A EMA atinge seus objetivos, com um RM de 3,964 na percepção de humanização e 4,162 na de aprendizado. Além disso, observou-se um aumento de voluntários no projeto, e um grande impacto para as comunidades atendidas.
A privação de sono nos alunos da área de saúde em atendimento nas Unidades Básicas de Saúde e suas consequências
Authors: Castilho Carla Prado , Limas Ludy Mila Dias de , Monteiro Mariane Lago , Silva Pedro Henrique Maia Nogueira da , Bueno Helvécio , Fari Talitha Araújo
Published: December 2015

Introdução: Os estudantes de graduação pertencem a um grupo com altas probabilidades de apresentar sonolência diurna excessiva e má qualidade do sono. Objetivo: O objetivo deste trabalho foi investigar a privação do sono dos estudantes da área de saúde em atendimento nas Unidades Básicas de Saúde (UBS) de Paracatu-MG, a fim de poder retratar essa realidade e elaborar medidas que solucionem o problema. Métodos: o estudo é do tipo transversal e usou-se de questionário, o qual foi montado com base nos questionários de Pittsburgh e Berlim. Foram entrevistados 100 alunos de quatro semestres distintos de forma que cada semestre foi representado por 25 estudantes. Foram utilizados questionários. Resultados: Observou-se sobre o tempo de sono por noite que 34% dos entrevistados dormem em média 7h por noite. Para se manterem acordados durante um longo período de tempo, 4,1% relataram fazer uso de medicamentos, dentre os quais 60% fazem o uso de ritalina. A privação de sono altera o desempenho acadêmico de 88,54% dos entrevistados. Conclusão: A partir do presente artigo, verificou-se que a maioria dos estudantes da área de saúde dos UBS de Paracatu-MG dormem em média 7 horas, o que pode acarretar uma má qualidade do sono provocando um baixo rendimento acadêmico.
Perfil epidemiológico dos idosos chagásicos da Unidade de Saúde da Família do bairro Nossa Senhora de Fátima, USF - Nossa Senhora de Fátima, da cidade de Paracatu – MG
Authors: Ferreira Laura Fernandes , Carneiro Maria Luiza Cunha , Neiva Laura Gonçalves Almeida , Sampaio Bruna Monteiro , Gontijo Francinely Martins , Bueno Helvécio , Faria Talitha Araújo
Published: December 2015

A doença de Chagas é uma afecção parasitária ocasionada pela picada do barbeiro. Uma série de fatores bio ecológicos e político-sociais levam à aproximação entre as populações humanas e o ciclo enzóotico, resultando em grandes áreas de dispersão da endemia chagásica e em fatores socioeconômicos e culturais conformes. Esse trabalho teve como objetivo levantar o número de idosos chagásicos que estão ou não fazendo o tratamento da doença no Bairro Nossa Senhora de Fátima de Paracatu - MG. É um estudo descritivo transversal com aplicação de questionário para um universo de 14 idosos. Em relação ao tratamento da doença, observou-se o conhecimento acerca do sistema de saúde, sendo que 100% possui algum grau de conhecimento e utiliza do mesmo. A maioria dos idosos do referente estudo está sob uso de medicação. Por fim, é notada uma íntima relação entre os portadores da doença, o êxodo rural e as casas de pau-a-pique, além de outros fatores como nível de informação, conhecimento dos serviços de saúde e diagnóstico para acompanhar a evolução da doença.
Avaliação do conhecimento na requisição correta dos exames de imagem dos internos de 5o e 6o ano da Faculdade de Medicina da Universidade de Mogi das Cruzes, SP
Authors: Foltran Caroline , Pizzol Lucianna Rossi , Santana Mayara Lucy Guimarães Castro de , Fernandes Marcio Robortella
Published: December 2015

INTRODUÇÃO: A radiologia é uma especialidade médica em constante processo de modernização. Além da maior disponibilidade e funcionalidade dos métodos, maior é a demanda dos pacientes por exames. No entanto, nota-se uma inversão de valores na prática médica, no qual é comum o pedido de exames complementares de forma incorreta e indiscriminada a fim de suprir a anamnese falha. O estudo objetivou avaliar o conhecimento dos internos de 5º e 6º ano da Faculdade de Medicina da Universidade de Mogi das Cruzes (FMUMC) acerca da disciplina de Radiologia e Diagnóstico por Imagem. METODOLOGIA: É um estudo de delineamento transversal quantitativo analítico, pautado em questionários aplicados nos acadêmicos do 5º e 6º ano da FMUMC. Os dados foram analisados pelo programa estatístico Minitab e os participantes foram classificados de acordo com o percentual de desempenho: bom (≥ 60%), satisfatório (50-59,9%) e insatisfatório (≤49,9%). RESULTADOS: Após análise criteriosa de 114 questionários, as perguntas com maior índice de reprovação abordaram os seguintes temas com o respectivo percentual de erro: apontar os métodos diagnósticos associados a contraste (100%) e exame de primeira escolha para fratura óssea (97,37%), pneumonia (92.11%) e pneumotórax (90,8%). A média de acerto do questionário foi de 51,6% e o percentual da classificação final: bom desempenho (11,20%), satisfatório (50%) e insatisfatório (38,80%). DISCUSSÃO: Observou-se uma alta taxa de erros, principalmente em perguntas relacionadas a questões básicas de Radiologia. Destaca-se a falta de conhecimento dos acadêmicos acerca dos custos dos exames frente ao enorme gasto público brasileiro com exames solicitados desnecessariamente. As patologias mais frequentes de pronto atendimento foram negligenciadas e com pior desempenho dos participantes. CONCLUSÃO: Enfatiza-se a boa formação acadêmica na disciplina de Radiologia e Diagnóstico por Imagem, por se tratar de uma ferramenta fundamental na prevenção na solicitação indiscriminada e incorreta de exames complementares.
Extensão universitária: aprender fazendo, fazer aprendendo
Authors: Ayres José Ricardo De C. M.
Published: December 2015

Universidades em todo o mundo estão reformando seus currículos em um esforço para envolver processos de aprendizagem em serviços comunitários. Este ensaio conceitual discute o efeito mutuamente fecundante de teoria e prática quando são criadas oportunidades para estudantes de graduação participarem ativamente de projetos de intervenção de cunho pedagógico, com destaque para o curso médico e iniciativas proativas dos alunos. O ensaio analisou o entrelaçamento entre fazer e aprender nesses processos, salientando seus benefícios para comunidades, estudantes e universidade, com um potencial promissor para a renovação de paradigmas teóricos e de estruturas institucionais e interações nas práticas de saúde.
Extensão universitária na atualidade: a IFMSA Brazil como foco
Authors: Lacerda Paulo Narley Matos , Souza Lucas Rodrigues de , Endo Renata Matsuura , Nazima Maira Tiyomi Sacata Tongu
Published: December 2015

A extensão universitária é o processo que possibilita articular o ensino e pesquisa de forma a realizar uma maior integração entre a Universidade e a sociedade. O presente trabalho visa apresentar uma instituição que realiza este tipo de atividade no Brasil, a IFMSA Brazil (International Federation of Medical Students Associations of Brazil), e a forma como ela desenvolve a sua parceria com as universidades, além de mostrar os principais resultados de suas ações. A IFMSA Brazil é uma organização estudantil ligada à Organização das Nações Unidas e faz parte da IFMSA, uma instituição formada por estudantes de medicina de mais de 100 países. As principais atividades desenvolvidas pela IFMSA Brazil estão relacionadas a seus comitês permanentes, os quais abrangem desde intercâmbios médicos clínicos, cirúrgicos e de pesquisa) nacionais e internacionais a projetos, campanhas e eventos voltados a áreas como saúde pública, saúde reprodutiva, direitos humanos e educação médica. Dentro de cada comitê local existe uma estrutura administrativa que estabelece a relação entre a Universidade e a IFMSA Brazil, possibilitando a presença dos intercâmbios, estimulando a capacitação dos estudantes de medicina pelos professores e buscando melhorias na qualidade de ensino da faculdade de medicina. Os comitês permanentes não voltados ao intercâmbio são os que fazem a comunicação da IFMSA Brazil com a sociedade, por meio das campanhas, projetos e eventos. Como resultado da qualidade das ações da IFMSA Brazil, em 2014, esta instituição recebeu o prêmio de segundo lugar no concurso Rex Crossley Awards, com um projeto voltado para a melhoria da comunicação entre o estudante de medicina e pacientes autistas.
MadAlegria: a valorização de estratégias de humanização na formação do profissional de saúde
Authors: Utsunomiya Key Fujisaki , Basile Maria Aparecida , Lopes Thiago Edi Landim , Okajima Leila Tiemi , Ferreira Elizabeth Alves Gonçalves
Published: December 2015

O MadAlegria é um projeto de extensão universitária da Faculdade de Medicina da Universidade de São Paulo, elaborado com a finalidade de aprimorar a habilidade de seus voluntários de criar vínculo profissional com o paciente e melhorar o acolhimento no sistema de saúde. O MadAlegria tem como objetivo amenizar o ambiente hospitalar e outros cenários de prática de saúde, promover o trabalho em equipe multidisciplinar e sensibilizar os estudantes para a importância da humanização na relação entre os profissionais da saúde e o paciente, incentivando assim o exercício da cidadania por meio de recursos lúdicos da figura do Palhaço e do Contador de Histórias em hospital. O projeto foi iniciado em 2010 e desde 2011 foram formados 134 Palhaços em Hospital e 35 Contadores de Histórias. Com cinco anos de existência o projeto evoluiu com a inclusão de alunos de cursos da USP, além dos da área de saúde, professores, outros profissionais da saúde e usuários do sistema. A Missão, Visão e Valores do MadAlegria foram definidos, bem como houve uma readequação de seu Estatuto. Os atendimentos semanais no Instituto do Câncer do Estado de São Paulo (ICESP) foram mantidos, e acrescidos de atendimentos no Instituto Central do Hospital das Clínicas da FMUSP (ICHC), onde o MadAlegria participa da Rede Humaniza FMUSPHC. A manutenção do trabalho voluntário pelos participantes formados no projeto tem sido um grande desafio. A experiência vivida em um projeto de extensão universitária como o MadAlegria é intensa e há relatos de alunos que demonstram que essa vivência influencia o perfil profissional, tornando mais humanizado o cuidado com o outro.