bluuebunny/crossref_metadata_2025 huggingface dataset:
The significance of defining the levels of medical evidence in medicolegal practice
Authors: Markos AR
Published: March 2010

The practice of presenting a medical expert testimony to judges, juries and laymen could be improved by adopting the concept of ‘Levels of Medical Evidence’. Clinicians exchange the levels of evidence, between themselves, for valuing the significance of such evidence in matters of medical research, practice and guidelines. The expert witness has a duty to refer to both supportive and contradictive publications. S/he should provide an objective weighting of the publication, by referring to ‘the level of evidence’. Measuring the levels of medical evidence against a grid provide medical experts with an objective way of communication, for clarifying the relevance and quantifying its significance to a non-medical audience. The scarcity of some medical conditions, the rarity of their reporting in literature, and the conflict of medical consensus make the expert opinion of level four. The failure of a medical expert witness to explain where his/her opinion falls in the scale is a potential for misunderstanding, misrepresentation and misquotation.
Clinical negligence lawyers: specialists versus non-specialists – the evidence
Authors: Brigstocke Julian R , Shields David A , Scurr John H
Published: March 2010

During a Parliamentary debate on the NHS Redress Act, questions were raised about the supposed better success rates of specialist lawyers versus non-specialists in clinical negligence cases. As a result we decided to look at the statistical evidence, based on the case files of a large medico-legal practice of a consultant general surgeon.
Pre-hospital risks of the reconfiguration of obstetric services
Authors: Argent VP
Published: March 2010

The increasing centralization and reconfiguration of obstetric services demands insight into the pre-hospital (and inter-hospital) risks of emergency obstetric care. This applies to emergency admissions from home, to transfer of women who encounter problems during home delivery and also to inter-facility transfers from stand-alone midwifery-led units, without the facilities for obstetric emergency intervention, to place of safety consultant obstetric units, as well as transfers from obstetric units to network tertiary centres with neonatal intensive care facilities and for definitive treatment of the critically-ill woman. This article discusses the risks of reconfiguration including the balance between safety and accessibility. The planned reconfiguration of obstetric services must always take into account the need for high quality pre-hospital and inter-hospital care of obstetric emergencies. This requires well-trained and experienced paramedics as full members of the obstetric team. The Pre-Hospital Obstetric Trauma course of the Advanced Life Support Group will become the standard for high quality care.
Gamete donor secrecy and human rights
Authors: Power Eloise
Published: March 2010

This article discusses the legal routes by which donor-conceived children can gain access to information about their biological parents, and ways in which they could challenge the refusal to provide this information.
Effects of Inhaled Corticosteroids in Monotherapy or Combined with Long-Acting β2-Agonists on Mortality among Patients with Chronic Obstructive Pulmonary Disease
Authors: Cyr Marie-Christyne , Beauchesne Marie-France , Lemière Catherine , Aaron Shawn D , Blais Lucie
Published: March 2010

Background

The benefits of inhaled corticosteroids (ICS) in reducing the mortality related to chronic obstructive pulmonary disease (COPD) are controversial.

Objective

To estimate whether ICS in monotherapy or in combination with long-acting β2-agonists (LABA) reduces the mortality rate among COPD patients compared to those treated with LABA monotherapy.

Methods

Using data from the Canadian province of Quebec's health administrative databases, a nested case-control study was conducted. A cohort of COPD patients aged 50 years and over between 1996 and 2000 was initially formed. Patients were included if they filled at least 6 prescriptions of an inhaled branchodilator, received at least 1 medical service for COPD, and did not receive any diagnosis of asthma over a 12-month period. For each case of death identified in the cohort, up to 37 controls were time matched. For cases and controls, the exposure to ICS and LABA was assessed within the 3 months prior to the date of death for cases and date of selection for controls. Adjusted mortality rate ratios were estimated by conditional logistic regression comparing patients using ICS monotherapy or ICS/LABA combination therapy with patients using LABA monotherapy.

Results

This study included 5996 cases of death and 54,750 controls. The mortality rates were found to be lower among users of ICS monotherapy than users of LABA monotherapy (OR 0.69; 95% CI 0.53 to 0.88) and lower among users of an ICS/LABA combination than users of LABA monotherapy (OR 0.73; 95% Cl 0.56 to 0.96). No significant differences were observed between users of ICS/LABA combination therapy and users of ICS monotherapy (OR 1.07; 95% Cl 0.93 to 1.23).

Conclusions

ICS were found to be associated with a reduction in mortality rate when compared to LABA among patients with COPD, However, the ICS/LABA combination therapy did not provide any additional benefit on mortality when compared to ICS monotherapy.
Efficacy of Metformin and Topiramate in Prevention and Treatment of Second-Generation Antipsychotic–Induced Weight Gain
Authors: Ellinger Lara K , Ipema Heather J , Stachnik Joan M
Published: March 2010

Objective

To review the literature describing the efficacy of metformin and topiramate for the treatment of second-generation antipsychotio–induced weight gain.

Data sources

Articles were identified by searching the MEDLINE database (from 1949 through January 2010) using the key words metformin, topiramate, antipsychotic, weight, weight gain, and obesity.

Study selection and data extraction

All randomized, place bo-controlled trials of metformin and topiramate were selected for review.

Data synthesis

Weight gain due to second-generation antipsychotic use is a concern due to the risk of long-term metabolic and cardiovascular effects with these agents. These effects include obesity, hyperglycemia, and insulin resistance, all of which may contribute to diabetes and cardiovascular disease. Second-generation antipsychotics vary in the degree to which they cause weight gain, and dietary and lifestyle changes may not be feasible or sufficient in counteracting this weight gain. Although other pharmacologic agents may be beneficial to prevent and treat antipsychotic-induced weight gain, metformin and topiramate have been the most extensively studied in this setting. Metformin acts peripherally to cause weight loss, while topiramate acts centrally. Review of 11 randomized, controlled trials demonstrates beneficial effects of metformin and topiramate in prevention and treatment of weight gain. Metformin is generally well tolerated and has been studied in pediatric patients, while topiramate is associated with more drug interactions and may possibly interfere with control of schizophrenia.

Conclusions

Data for the use of metformin and topiramate in the treatment and prevention of second-generation antipsychotio–induced weight gain are limited. Both may be effective in helping patients lose weight via mechanisms that have yet to be clearly defined. The use of metformin results in greater weight loss than topiramate, and topiramate is associated with more risks and may compromise the treatment of schizophrenia. Treatment of antipsychotic-induced weight gain with metformin may be an option after lifestyle and dietary changes have failed.
Toxicities of Gemcitabine in Patients with Severe Hepatic Dysfunction
Authors: Teusink Ashley C , Hall Philip D
Published: March 2010

Objective

To determine the relationship between doses of gemcitabine and absolute neutrophil count and thrombocytopenia in patients with severe hepatic dysfunction (total bilirubin ≥4.5 mg/dL), and the relationship between doses of gemcitabine in patients with severe hepatic dysfunction and nonhematologic toxicity.

Case summary

A retrospective chart review was conducted for patients receiving gemcitabine at the Medical University of South Carolina from October 2006 through October 2008. Seven patients were identified who had an elevated total bilirubin level (≥4.5 mg/dL) at the time they were receiving gemcitabine. All 7 patients received gemcitabine 1000 mg/m2 throughout their treatment, regardless of liver function. Six patients did not experience significant hematologic toxicity warranting a dose reduction or a dose being held. One patient developed thrombocytopenia, warranting a dose being held.

Discussion

Gemcitabine is a chemotherapy agent frequently used for the treatment of pancreatic cancer as well as metastatic breast, lung, and ovarian cancer. To date there is limited information on dosing of gemcitabine in patients with an elevated total bilirubin. A previous study looking at lower grades of liver dysfunction suggested empiric dose reductions be made in these patients because of increased incidence of toxicity.

Conclusions

These results indicate the possibility that no initial dose reduction is necessary for patients with liver dysfunction receiving gemcitabine; however, close monitoring of these patients is required.
Intervention to Reduce Unnecessary Dispensing of Short-Acting β-Agonists in Patients with Asthma
Authors: Wong Mark D , Manley R Thomas , Stettin Glen , Chen William , Salmun Luis M
Published: March 2010

Background

Several clinical studies have suggested that the overuse of short-acting β-agonists (SABAs) and the underuse of inhaled corticosteroids are prevalent and may compromise patient health and increase the use of scarce health-care resources.

Objective

To examine the impact of an intervention designed to reduce SABA metered-dose inhaler (MDI) overdispensing on asthma-related drug and healthcare utilization endpoints in a mail order pharmacy benefit population.

Methods

Retrospective pre- and postintervention analysis was conducted on all new SABA prescriptions indicating a quantity more than 1 SABA MDI per month and on asthma patients who were continuously enrolled in the Medco Health Solutions prescription benefit program from July 1, 2006, to June, 30, 2007 (pre-intervention), and July 1, 2007, to June 30, 2008 (postintervention). The intervention involved a written or verbal request to the prescriber to reduce the quantity of SABA MDIs dispensed to less than 1 SABA MDI per month if determined appropriate by the prescriber. Effectiveness of the intervention on asthma-related drug and health-care utilization outcomes were measured in the overall Medco pharmacy population and in asthma patients receiving more than 1 SABA MDI per month.

Results

The percentage of new SABA prescriptions dispensed for more than 1 SABA MDI per month was significantly reduced during year 2 (22.9% vs 9.7%, p < 0.01). Of the 1835 asthma patients who received more than 1 SABA MDI per month in year t, 1230 (67%) received fewer than 1 SABA MDI per month during year 2. The incidence of asthma-related hospitalizations, emergency department visits, and oral corticosteroid use did not significantly change from year 1 to year 2.

Conclusions

This analysis shows that an intervention can succeed in reducing the overdispensing of quick-relief medication without compromising asthma control. Further investigation is warranted to better understand the interplay between reduction in excessive SABA use and improved clinical outcomes.
Membrane progestin receptors: beyond the controversy, can we move forward?
Authors: Salhi Amel , Lemale Julie , Paris Nicolas , Bloch-Faure May , Crambert Gilles
Published: March 2010

Steroids are well-known mediators of many different physiological functions. Their best characterized mechanism of action involves interaction with well-defined nuclear receptors and regulation of gene transcription. However, rapid effects of steroids have been reported which are incompatible with their classical long-term/slow effects. Although the concept of membrane-bound receptors for steroids which can transduce their rapid effects has been proposed many years ago, it is only recently that such proteins have been identified and characterized. In this review, we will discuss recent data regarding the rapid action of progesterone mediated by newly characterized membrane-bound receptors belonging to the progestin and adiponectin receptor family.
Advances in research on the accumulation, redox behavior, and function of vanadium in ascidians
Authors: Michibata Hitoshi , Ueki Tatsuya
Published: March 2010

The discovery of high levels of vanadium-containing compounds in ascidian blood cells goes back to 1911. Ascidians, which are also known as tunicates or sea squirts, belong to a subphylum of the Chordata, between the vertebrates and invertebrates. This discovery attracted the attention of an interdisciplinary group of chemists, physiologists, and biochemists, in part because of interest in the possible role of vanadium in oxygen transport as a prosthetic group in respiratory pigments, which was later shown not to be such a role, and in part because of the fact that high levels of vanadium were unknown in other organisms. The intracellular concentration of vanadium in some ascidian species can be as high as 350 mm, which is 107times that in seawater. Vanadium ions, which are thought to be present in the +5 oxidation state in seawater, are reduced to the +3 oxidation state via the +4 oxidation state and are stored in the vacuoles of vanadium-containing cells called vanadocytes, where high levels of protons and sulfate ions are also found. Recently, many proteins and genes that might be involved in the accumulation and reduction of vanadium have been isolated. In this review, we not only trace the history of vanadium research but also describe recent advances in our understanding of the field from several viewpoints: (i) vanadium-accumulating blood cells, (ii) the energetics of vanadium accumulation, (iii) the redox mechanism of vanadium, (iv) the possible role of sulfate, and (v) the physiological roles of vanadium.
Metabolic Autocrine Regulation of Neurons Involves Cooperation among Pannexin Hemichannels, Adenosine Receptors, and KATPChannels
Authors: Kawamura Masahito , Ruskin David N. , Masino Susan A.
Published: March 2010

Metabolic perturbations that decrease or limit blood glucose—such as fasting or adhering to a ketogenic diet—reduce epileptic seizures significantly. To date, the critical links between altered metabolism and decreased neuronal activity remain unknown. More generally, metabolic changes accompany numerous CNS disorders, and the purines ATP and its core molecule adenosine are poised to translate cell energy into altered neuronal activity. Here we show that nonpathological changes in metabolism induce a purinergic autoregulation of hippocampal CA3 pyramidal neuron excitability. During conditions of sufficient intracellular ATP, reducing extracellular glucose induces pannexin-1 hemichannel-mediated ATP release directly from CA3 neurons. This extracellular ATP is dephosphorylated to adenosine, activates neuronal adenosine A1receptors, and, unexpectedly, hyperpolarizes neuronal membrane potential via ATP-sensitive K+channels. Together, these data delineate an autocrine regulation of neuronal excitability via ATP and adenosine in a seizure-prone subregion of the hippocampus and offer new mechanistic insight into the relationship between decreased glucose and increased seizure threshold. By establishing neuronal ATP release via pannexin hemichannels, and hippocampal adenosine A1receptors coupled to ATP-sensitive K+channels, we reveal detailed information regarding the relationship between metabolism and neuronal activity and new strategies for adenosine-based therapies in the CNS.
Repression of Fgf Signaling by Sprouty1-2 Regulates Cortical Patterning in Two Distinct Regions and Times
Authors: Faedo Andrea , Borello Ugo , Rubenstein John L. R.
Published: March 2010

A fundamental question in developmental biology is how signaling pathways establish a transcription factor code that controls cell proliferation, regional fate and cell fate. Morphogenesis of the rostral telencephalon is controlled in part by Fgf signaling from the rostral patterning center. How Fgf signaling is regulated in the telencephalon is critical for understanding cerebral cortex formation. Here we show that mouseSprouty1andSprouty2(Spry1-2), which encode negative feedback regulators of Fgf signaling, are affecting cortical proliferation, differentiation, and the expression of genes regulating progenitor identity in the ventricular zone. In addition,Spry2has a later function in regulating the MAPK pathway, proliferation, and gene expression in the cortex at mid-neurogenesis. Finally, we provide evidence thatCoup-TFI, a transcription factor that promotes caudal fate, does so through repressing Fgf signaling, in part by promotingSpryexpression.
Group II Metabotropic Glutamate Receptor Stimulation Triggers Production and Release of Alzheimer's Amyloid β42from Isolated Intact Nerve Terminals
Authors: Kim Soong Ho , Fraser Paul E. , Westaway David , St. George-Hyslop Peter H. , Ehrlich Michelle E. , Gandy Sam
Published: March 2010

Aberrant accumulation of amyloid β (Aβ) oligomers may underlie the cognitive failure of Alzheimer's disease (AD). All species of Aβ peptides are produced physiologically during normal brain activity. Therefore, elucidation of mechanisms that interconnect excitatory glutamatergic neurotransmission, synaptic amyloid precursor protein (APP) processing and production of its metabolite, Aβ, may reveal synapse-specific strategies for suppressing the pathological accumulation of Aβ oligomers and fibrils that characterize AD. To study synaptic APP processing, we used isolated intact nerve terminals (cortical synaptoneurosomes) from TgCRND8 mice, which express a human APP with familial AD mutations. Potassium chloride depolarization caused sustained release from synaptoneurosomes of Aβ42as well as Aβ40, and appeared to coactivate α-, β- and γ-secretases, which are known to generate a family of released peptides, including Aβ40and Aβ42. Stimulation of postsynaptic group I metabotropic glutamate receptor (mGluRs) with DHPG (3,5-dihydroxyphenylglycine) induced a rapid accumulation of APP C-terminal fragments (CTFs) in the synaptoneurosomes, a family of membrane-bound intermediates generated from APP metabolized by α- and β-secretases. Following stimulation with the group II mGluR agonist DCG-IV, levels of APP CTFs in the synaptoneurosomes initially increased but then returned to baseline by 10 min after stimulation. This APP CTF degradation phase was accompanied by sustained accumulation of Aβ42in the releasate, which was blocked by the group II mGluR antagonist LY341495. These data suggest that group II mGluR may trigger synaptic activation of all three secretases and that suppression of group II mGluR signaling may be a therapeutic strategy for selectively reducing synaptic generation of Aβ42.
β-Adrenergic Blockade during Memory Retrieval in Humans Evokes a Sustained Reduction of Declarative Emotional Memory Enhancement
Authors: Kroes Marijn C. W. , Strange Bryan A. , Dolan Raymond J.
Published: March 2010

Memory enhancement for emotional events is dependent on amygdala activation and noradrenergic modulation during learning. A potential role for noradrenaline (NE) during retrieval of emotional memory is less well understood. Here, we report that administration of the β-adrenergic receptor antagonist propranolol at retrieval abolishes a declarative memory enhancement for emotional items. Critically, this effect persists at a subsequent 24 h memory test, in the absence of propranolol. Thus, these findings extend our current understanding of the role of NE in emotional memory to encompass effects at retrieval, and provide face validity to clinical interventions using β-adrenergic antagonists in conjunction with reactivation of unwanted memories in anxiety-related disorders.
Neural Cell Adhesion Molecule-Associated Polysialic Acid Regulates Synaptic Plasticity and Learning by Restraining the Signaling through GluN2B-Containing NMDA Receptors
Authors: Kochlamazashvili Gaga , Senkov Oleg , Grebenyuk Sergei , Robinson Catrina , Xiao Mei-Fang , Stummeyer Katharina , Gerardy-Schahn Rita , Engel Andreas K. , Feig Larry , Semyanov Alexey , Suppiramaniam Vishnu , Schachner Melitta , Dityatev Alexander
Published: March 2010

The neural cell adhesion molecule (NCAM) is the predominant carrier of α2,8 polysialic acid (PSA) in the mammalian brain. Abnormalities in PSA and NCAM expression are associated with schizophrenia in humans and cause deficits in hippocampal synaptic plasticity and contextual fear conditioning in mice. Here, we show that PSA inhibits opening of recombinant NMDA receptors composed of GluN1/2B (NR1/NR2B) or GluN1/2A/2B (NR1/NR2A/NR2B) but not of GluN1/2A (NR1/NR2A) subunits. Deficits in NCAM/PSA increase GluN2B-mediated transmission and Ca2+transients in the CA1 region of the hippocampus. In line with elevation of GluN2B-mediated transmission, defects in long-term potentiation in the CA1 region and contextual fear memory in NCAM/PSA-deficient mice are abrogated by application of a GluN2B-selective antagonist. Furthermore, treatment with the glutamate scavenger glutamic-pyruvic transaminase, ablation ofRas-GRF1(a mediator of GluN2B signaling to p38 MAPK), or direct inhibition of hyperactive p38 MAPK can restore impaired synaptic plasticity in brain slices lacking PSA/NCAM. Thus, PSA carried by NCAM regulates plasticity and learning by inhibition of the GluN2B-Ras-GRF1-p38 MAPK signaling pathway. These findings implicate carbohydrates carried by adhesion molecules in modulating NMDA receptor signaling in the brain and demonstrate reversibility of cognitive deficits associated with ablation of a schizophrenia-related adhesion molecule.
Glia Contribute to the Purinergic Modulation of Inspiratory Rhythm-Generating Networks
Authors: Huxtable Adrianne G. , Zwicker Jennifer D. , Alvares Tucaauê S. , Ruangkittisakul Araya , Fang Xin , Hahn Leanne B. , Posse de Chaves Elena , Baker Glen B. , Ballanyi Klaus , Funk Gregory D.
Published: March 2010

Glia modulate neuronal activity by releasing transmitters in a process called gliotransmission. The role of this process in controlling the activity of neuronal networks underlying motor behavior is unknown. ATP features prominently in gliotransmission; it also contributes to the homeostatic ventilatory response evoked by low oxygen through mechanisms that likely include excitation of preBötzinger complex (preBötC) neural networks, brainstem centers critical for breathing. We therefore inhibited glial function in rhythmically active inspiratory networksin vitroto determine whether glia contribute to preBötC ATP sensitivity. Glial toxins markedly reduced preBötC responses to ATP, but not other modulators. Furthermore, since preBötC glia responded to ATP with increased intracellular Ca2+and glutamate release, we conclude that glia contribute to the ATP sensitivity of preBötC networks, and possibly the hypoxic ventilatory response. Data reveal a role for glia in signal processing within brainstem motor networks that may be relevant to similar networks throughout the neuraxis.
Sertad1 Plays an Essential Role in Developmentaland Pathological Neuron Death
Authors: Biswas Subhas C. , Zhang Yi , Iyirhiaro Grace , Willett Ryan T. , Rodriguez Gonzalez Yasmilde , Cregan Sean P. , Slack Ruth S. , Park David S. , Greene Lloyd A.
Published: March 2010

Developmental and pathological death of neurons requires activation of a defined pathway of cell cycle proteins. However, it is unclear how this pathway is regulated and whether it is relevantin vivo. A screen for transcripts robustly induced in cultured neurons by DNA damage identified Sertad1, a Cdk4 (cyclin-dependent kinase 4) activator. Sertad1 is also induced in neurons by nerve growth factor (NGF) deprivation and Aβ (β-amyloid). RNA interference-mediated downregulation of Sertad1 protects neurons in all three death models. Studies of NGF withdrawal indicate that Sertad1 is required to initiate the apoptotic cell cycle pathway since its knockdown blocks subsequent pathway events. Finally, we find that Sertad1 expression is required for developmental neuronal death in the cerebral cortex. Sertad1 thus appears to be essential for neuron death in trophic support deprivationin vitroandin vivoand in models of DNA damage and Alzheimer's disease. It may therefore be a suitable target for therapeutic intervention.
Neonatal administration of tamoxifen causes disruption of myometrial development but not adenomyosis in the C57/BL6J mouse
Authors: Mehasseb Mohamed K , Bell S C , Habiba M A
Published: March 2010

We previously demonstrated that in the CD-1 mouse, which exhibits a high incidence of age-related adenomyosis, neonatal exposure to tamoxifen induced premature uterine adenomyosis and was associated with abnormal development particularly of the inner myometrium. In the present study, we examined the effect of neonatal tamoxifen administration upon uterine development in the C57/BL6J mouse strain that is not known to develop uterine adenomyosis. Female C57/BL6J pups (n=20) were treated with oral tamoxifen (1 mg/kg) from age 1 to 5 days. Uteri from control and treated mice were obtained on days 5, 10, 15 and 42 of age. We examined sections histologically using image analysis and immunohistochemistry for α-smooth muscle actin (ACTA2, α-SMA), desmin, vimentin, laminin, fibronectin and oestrogen receptor-α (ESR1). Following tamoxifen exposure, all uteri showed inner myometrium thinning, lack of continuity, disorganisation and bundling. However, adenomyosis was not seen in any uterus. ACTA2 immunostaining was less in the circular muscle layer of treated mice. The temporal pattern of desmin immunostaining found in control mice was absent in tamoxifen-treated mice. There was no difference in the localisation of laminin or fibronectin between control and tamoxifen-treated groups. However, laminin immunostaining was reduced in the circular muscle layer of treated mice. Vimentin could not be detected in either group. In conclusion, our results demonstrate that the development of the inner myometrium is particularly sensitive to oestrogen antagonism, and is affected by steroid receptor modulation. Although tamoxifen induces inner myometrial changes including that of ACTA2, desmin, ESR1 and laminin expression in C57/BL6J neonatal mice similar to those induced in CD-1 mice, C57/BL6J mice did not develop premature adenomyosis. Thus, disruption of the development and differentiation of the inner myometrium cannot alone explain the development of tamoxifen-associated adenomyosis, and this must be dependent upon its interaction with strain-dependent factors.
Human toxocariasis: a seroepidemiological survey in the Amazonian city of Yurimaguas, Peru
Authors: Roldán William H. , Cavero Yuri A. , Espinoza Yrma A. , Jiménez Susana , Gutiérrez César A.
Published: March 2010

The aim of this study was to determine the seroprevalence of the infection by Toxocara in the general population of the Amazonian city of Yurimaguas, Peru. From March to August 2008, a total of 300 subjects were sampled and tested by means of a Toxocara ELISA-IgG test. A clinical and epidemiological questionnaire was used to assess the symptomatology and risk factors associated with human toxocariasis. The overall rate of seropositivity was 35.66%, with a significant high proportion in children (p < 0.001). The clinical evaluation revealed that 95.33% of the seropositive group had some type of symptomatology: headache (66.36%), respiratory compromise (63.55%), abdominal pain (54.21%), cutaneous signs (40.19%) and ocular manifestations (36.45%), and almost all of them were statistically significant (p < 0.001). Furthermore, 56.07% of the seropositive subjects presented at least one intestinal pathogen parasite with predominance of helminthes, but without significant association (p = 0.334). The analysis of risk factors showed only that the use of public places and geophagia exhibited a significant association with the seropositivity (p < 0.001). Clinical, serological and epidemiological findings associated to infection with Toxocara were observed in the present study and future studies should be done to assess this serious health problem.
Modulatory activity of antioxidants against the toxicity of Rifampicin in vivo
Authors: Awodele Olufunsho , Akintonwa Alade , Osunkalu Vincent O. , Coker Herbert A.B.
Published: March 2010

The World Health Organization (WHO) has shown concern about the burden of tuberculosis in the developing countries. Even though rifampicin is an effective drug in the management of tuberculosis, it has been documented to have some toxic effects in humans. Therefore, this study intends to investigate the modulatory effect of vitamins C and E on the hepatotoxicity, sperm quality and brain toxicity of Rifampicin. Forty Wistar albino rats were used, 10 animals per group. Group 1 animals received 0.3 mL of distilled water, the Group 2 animals received the therapeutic dose of rifampicin, Group 3 animals received therapeutic doses of rifampicin plus vitamin E, while Group 4 received therapeutic doses of rifampicin and vitamin C. The administration was performed orally during three months; the animals were sacrificed by cervical dislocation at the end of that period. Blood samples were collected and liver function and lipid profile was analyzed using fully automated clinical chemistry device. The liver, brain and reproductive organs underwent histopathological examination. Sperm samples were collected from the epididymis to achieve count and motility and morphological analysis. Results showed rifampicin alone to raise (p < 0.05) liver function enzymes (Aspartate amino transferase [AST], Serum alanine amino transferase [ALT] and Total Bilirubin) when compared with controls. While the vitamin E treated group showed remarkable protection, the vitamin C treated group showed questionable protection against the rifampicin induced liver damage. Sperm count results showed an important (p < 0.05) increase in the sperm quality in vitamin E and C treated groups. However, the vitamin E plus Rifampicin treated group showed increased lipid peroxidation. The histopathological findings revealed structural damages by rifampicin in liver, brain and epididymis while some remarkable architectural integrity was observed in the antioxidant-treated groups. It can be concluded that vitamin E or C improved sperm quality and protected against the brain damage caused by rifampicin. Moreover, vitamin E demonstrated remarkable hepatoprotection against rifampicin induced damage while vitamin C shows a questionable hepatoprotection.
Comparative biology of the two sister species of Triatominae (Hemiptera: Reduviidae)
Authors: Carbajal de la Fuente Ana Laura , Cunha Vanda , Rocha Nathanielly , Lopes Catarina Macedo , Noireau François
Published: March 2010

INTRODUCTION: Triatoma pseudomaculata and T. wygodzinskyi (Hemiptera: Reduviidae: Triatominae) are two Brazilian vectors of Chagas disease. The first is an arboricolous species in sylvatic environment and considered a vector of T. cruzi in peridomestic structures; the second, a rupicolous species in the wild environment of no epidemiological importance. In order to test the assumption that sister species share biological traits, comparative studies of their development cycle and blood ingestion were conducted. METHODS: Eggs laid by five field females of each species were randomly selected. The nymphs were observed daily and fed on mice weekly. The time required to pass through the different stages to adulthood was recorded in days. The triatomines were weighed individually before and after feeding. The mortality rate according to each nymphal stage was calculated. RESULTS AND CONCLUSIONS: Analysis of the results shows that they display only minor biological differences even though they exhibit a distinct ecology. This suggests that the biological traits are important criteria to determine the relationship between species.
Características clínico-evolutivas de 134 pacientes com histoplasmose disseminada associada a SIDA no Estado do Ceará
Authors: Pontes Lícia Borges , Leitão Terezinha do Menino Jesus Silva , Lima Gabrielle Gurgel , Gerhard Emília Santiago , Fernandes Thyago Araújo
Published: March 2010

INTRODUÇÃO: Desde o início da epidemia de HIV no Ceará, histoplasmose disseminada tem sido detectada com frequência em pacientes com aids. MÉTODOS: De modo a conhecer características clínico-laboratoriais, evolução e sobrevida da co-infecção HD/AIDS, analisou-se retrospectivamente 134 prontuários casos de HD internados de 1999 a 2005 no hospital referência para HIV no Ceará. RESULTADOS: Pacientes com HD apresentaram maior frequência de febre diária, tosse, perda de peso, hepatoesplenomegalia e insuficiência renal aguda. Diagnóstico foi dado por pesquisa e/ou cultura. À admissão, foram fatores de risco relacionados ao óbito de pacientes com HD: vômitos, dispnéia, insuficiência respiratória e IRA, hemoglobina<8g/L, uréia>40mg/dL e creatinina >1,5mg/dL. CONCLUSÕES: pacientes com HD apresentaram caracteristicamente febre mais elevada, internamentos anteriores por infecção respiratória, mais complicações clínicas e como fatores independentes para óbito, anemia importante e elevação de uréia.
Reflexões sobre a docência de enfermagem em uma universidade pública
Authors: Merighi Miriam Aparecida Barbosa
Published: March 2010

É discutido o papel do docente de enfermagem que trabalha em Escola de Enfermagem vinculada Universidade Pública, numa tentativa de propor estratégias de integração entre ensino-pesquisa e assistência e, consequentemente benefícios para os próprios docentes, para a escola de enfermagem e para a profissão.
Organização do trabalho na unidade centro de material
Authors: Silva Arlete
Published: March 2010

Este trabalho aborda a Unidade Centro de Material no contexto hospitalar, e os seus aspectos organizacionais, relacionados ao dimensionamento, zoneamento, recursos materiais e humanos.
Informação/educação em DST/AIDS/sexualidade humana - um relato de experiência de 14 anos
Authors: Gir Elucir , Moriya Tokico Murakawa , Oliveira Maria Helena Pessini de , Pelá Nilza Teresa Rotter
Published: March 2010

As autoras relatam suas experiências de 14 anos sobre informação/educação em Doenças Sexualmente Transmissíveis/Aids e Sexualidade Humana. Descrevem as ações implementadas, destacando os resultados positivos, bem como os negativos. Quanto aos resultados positivos destacam evidentemente a divulgação de informações sobre medidas preventivas acerca da infecção pelo HIV/AIDS, DST e aspectos da sexualidade humana a diversos segmentos da comunidade leiga e científica, bem como, o repasse do aprendizado adquirido nessas vivencias para o ensino de graduação, pós-graduação e desenvolvimento da pesquisa. Quanto aos negativos, perceberam a dificuldade em avaliar as ações de informações, ou seja palestras, por constituírem-se uma estratégia de comunicação praticamente unilateral. Nessa trajetória apontam alguns fatos que historicamente marcaram a implementação de ações oficiais.
Equipe de enfermagem: experiência do cuidar de criança com cancer nos plantões noturnos
Authors: Melo Luciana de Lione , Valle Elizabeth Ranier Martins do
Published: March 2010

Este trabalho se propõe a desvelar algumas facetas da experiência de uma equipe de enfermagem que cuida de crianças com câncer nos plantões noturnos. Para tanto, recorri a uma metodologia qualitativa - método fenomenológico - que me possibilita uma análise compreensiva dos depoimentos da equipe de enfermagem que vivencia esta experiência. As convergências dessas falas são analisadas e possibilitam a identificação de algumas unidades de significado que podem contribuir com subsídios para garantir institucionalmente as condições mínimas de trabalho para equipe de enfermagem, bem como prepará-la para lidar com tais circunstâncias.
Transtorno do pânico
Authors: Salum Giovanni Abrahão , Blaya Carolina , Manfro Gisele Gus
Published: March 2010

OBJETIVOS: Revisar o transtorno do pânico (TP), considerando seus aspectos clínicos, epidemiológicos, diagnósticos e etiológicos, bem como os avanços no tratamento, uma vez que o TP é uma entidade nosológica acompanhada de importante prejuízo psíquico e funcional. MÉTODO: Foi realizada uma revisão narrativa da literatura nas principais bases de dados existentes (MEDLINE, PsychINFO e SciELO) e em livros-textos atualizados. RESULTADOS: Devido à sintomatologia predominantemente física desse transtorno, os pacientes geralmente procuram vários atendimentos clínicos até que o diagnóstico seja feito. Em função desses aspectos e da sua cronicidade, o TP está associado a elevados custos econômicos. O tratamento do TP pode ser feito com psicoterapia e/ou psicofármacos. As diversas abordagens terapêuticas são apresentadas com o nível de evidência de cada recomendação. Em virtude da cronicidade e morbidade do TP, pesquisas têm se voltado para o estudo de estratégias de prevenção já na infância. CONCLUSÕES: O TP é um transtorno crônico e com baixas taxas de remissão dos sintomas em longo prazo. Sendo assim, sugere-se que sejam delineados novos estudos para tratamento precoce dos transtornos de ansiedade ou mesmo para prevenção em crianças de risco.
Tradução para o português e validação de conteúdo da Social Rhythm Metric-17 (SRM-17)
Authors: Schimitt Regina Lopes , Hidalgo Maria Paz Loayza
Published: March 2010

OBJETIVOS: Traduzir para o português a Social Rhythm Metric-17 (SRM-17), escala que afere ritmo social, e realizar validação de conteúdo da versão produzida. MÉTODO: Foi utilizada uma adaptação do método para validação de instrumentos que compreendeu as seguintes etapas: preparação, tradução, conciliação, retrotradução, revisão da retrotradução, avaliação de clareza, revisão de resultados da avaliação de clareza e finalização, prova de leitura e relatório final. RESULTADOS: A versão final brasileira manteve uma equivalência de itens com relação à primeira versão em inglês do instrumento original, incorporando melhorias. A transposição do instrumento alternativo criado pelo grupo de Cronobiologia Humana do Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre (RS), para a SRM-17 não mostrou discrepâncias significativas e revelou que, embora essa escala seja um instrumento genérico, é sensível às diferenças individuais quanto à aferição de ritmo social. A versão avaliada demonstrou um grau satisfatório de clareza e equivalência semântica. CONCLUSÃO: Este trabalho apresenta uma versão adaptada à realidade brasileira de um instrumento específico para aferir ritmo social. O processo de adaptação transcultural deve efetivar-se com estudos de validação do instrumento final em uma amostra maior da população, nos quais também poderão ser avaliadas as equivalências operacional, de medida e funcional.
Processos atencionais e dependência-independência de campo: estudo com crianças e adolescentes portugueses
Authors: Guisande M. Adelina , Almeida Leandro S. , Ponte Filomena Ermida da , Tinajero Carolina , Páramo M. Fernanda
Published: March 2010

Este artigo relaciona o estilo cognitivo "dependência-independência de campo" com o desempenho em tarefas envolvendo vários processos e recursos de atenção. Com uma amostra de 98 crianças e 95 adolescentes portugueses, foram aplicadas quatro tarefas de atenção: capacidade de armazenamento (Dígitos em ordem direta); memória de trabalho verbal (Dígitos em ordem inversa); capacidade para dirigir, mudar e manter a atenção (Código); e capacidade de atenção sustentada (Teste de Atenção e Rastreio Visual, VSAT). Recorreu-se, ainda, à aplicação de uma prova de fator g, tendo em vista o controle da inteligência. Os resultados revelam diferenças entre dependentes e independentes de campo, especialmente relevantes no grupo de crianças na prova de VSAT. Esses resultados abrem novas linhas de investigação para explicar a pior execução acadêmica dos indivíduos dependentes de campo.
Diferenças na detecção de frequências espaciais e radiais em crianças
Authors: Santos Natanael Antonio dos , França Valtenice de Cássia Rodrigues de Matos , Alves Príscilla Anny de Araújo
Published: March 2010

O objetivo deste estudo foi comparar curvas de sensibilidade ao contraste para estímulos radiais (FSCr) e grades senoidais (FSC) de 0,25, 0,5, 1 e 2 cpg em crianças de 6 a 13 anos. Foram mensurados limiares de contraste para 40 crianças, utilizando o método psicofísico da escolha forçada e níveis baixos de luminância. Todas estavam livres de doenças oculares e tinham acuidade visual normal. Os resultados mostraram que a sensibilidade das crianças foi maior para grades senoidais (FSC) do que para estímulos radiais (FSCr). Esses resultados sugerem que esses estímulos podem ser processados por áreas visuais distintas.
Personalidade e câncer de mama: produção científica em Psico-Oncologia
Authors: Peres Rodrigo Sanches , Santos Manoel Antônio dos
Published: March 2010

O presente estudo se insere no campo da Psico-Oncologia. Objetivou-se empreender uma revisão sistemática da literatura científica dedicada especificamente ao papel da personalidade na evolução da condição clínica e emocional de mulheres acometidas por câncer de mama. Foram consultadas as bases de dados MedLine, PsycINFO, LILACS, SciELO-Brasil e PePSIC. De modo geral, os achados das referências selecionadas apontam que o otimismo enseja uma evolução mais favorável da condição emocional. Além disso, sustentam que pacientes com espírito de luta e manejo apropriado da ansiedade desencadeada por estímulos agressivos tendem a uma melhor condição clínica. Todavia, sugere-se a utilização, em futuras investigações, de escolhas teórico-metodológicas inovadoras para o avanço do conhecimento que atualmente se tem a respeito do assunto em pauta.
Professor@s e Eros
Authors: Britzman Deborah P.
Published: March 2010

Professores/as são testemunhas do fantástico mundo da sexualidade. Esse artigo explora a centralidade de Eros para a educação e estabelece uma relação entre o desejo do/a professor/a e os acontecimentos emocionais da relação própria relação aluno/professor. Eu proponho que o aprendizado deva envolver nosso "eu" erótico, além das nossas fantasias. Mas esta perspectiva requer que professores/as considerem uma psicologia do amor como um caminho principal para a as situações emocionais de Eros. Na sua conclusão este trabalho sugere uma pedagogia que dê as boas vindas tanto à homossexualidade como a heterossexualidade como expressões humanas do amor.
Emprego do método de análise hierárquica (AHP) na seleção de variedades para o plantio de cana-de-açúcar
Authors: Costa Helder Gomes , Moll Roberto Nunes
Published: March 2010

Este artigo propõe uma abordagem original para o tratamento do processo decisório, no problema de seleção de variedades de cana-de-açúcar para o cultivo por uma usina. Esta proposta está fundamentada no emprego do método de Análise Hierárquica (Analytic Hierarchy Process, AHP) para a resolução deste problema. Apresenta-se, também, uma breve revisão das funções da gerência agrícola na agroindústria.
Comportamento do algodoeiro cultivar delta opal sob estresse hídrico com e sem aplicação de bioestimulante
Authors: Baldo Roberto , Scalon Silvana de Paula Quintão , Rosa Yara Brito Chaim Jardim , Mussury Rosilda Mara , Betoni Roseli , Barreto Willian dos Santos
Published: March 2010

Objetivou-se, com esse trabalho, avaliar o efeito do bioestimulante Stimulate®, aplicado ou não em diferentes fases do desenvolvimento do algodoeiro cv. Delta Opal, (Gossypium hirsutum L.) cultivado em casa de vegetação e submetido ou não ao estresse hídrico. Foram aplicados 25, 60 e 100% do volume total de poros (VTP) preenchidos com água e o Stimulate® aplicado na semente, na semente e na fase de botão floral e sem a aplicação do bioestimulante, aos 69 dias após a semeadura. A duração do estresse hídrico foi de 15, 30 e 45 dias após a aplicação do estresse hídrico. O algodoeiro cv Delta Opal não tolerou deficiência hídrica de 25% VTP iniciado na fase de botão floral, sendo observadas as menores alturas, diâmetros de colo, número de folhas, e comprometendo também a formação de estruturas reprodutivas. O bioestimulante na dose e na forma aplicada não proporcionou melhoras no desenvolvimento das plantas quando submetidas à falta de água, já em plantas submetidas ao excesso de água, houve aumento do diâmetro do colo das plantas.
Condições higiênico-sanitárias de uma indústria de processamento de conservas de polpa de pequi na região norte do Estado de Minas Gerais
Authors: Ferreira Luiz Carlos , Junqueira Roberto Gonçalves
Published: March 2010

Foi realizada uma avaliação das condições higiênico-sanitárias de uma indústria de processamento de conservas de polpa de pequi da região norte do estado de Minas Gerais. Foram avaliadas as microbiotas da polpa do fruto do pequizeiro (Caryocar brasiliense Camb.) in natura, da polpa recém-retirada, da polpa armazenada após o branqueamento, das mãos dos manipuladores, das superfícies de manipulação, do ambiente e da água usada no processamento, considerando-se a quantificação de bactérias mesófilas aeróbias, bolores e leveduras, enterobactérias, coliformes totais e coliformes a 45 ºC, além da pesquisa de bactérias potencialmente patogênicas, tais como Salmonella spp. e Staphylococcus coagulase positiva. Em proporções variáveis, verificou-se a presença de microrganismos deterioradores, patógenos e daqueles indicadores de contaminação de origem fecal. Demonstrou-se ineficiência dos procedimentos de higiene pessoal e de sanitização das superfícies de manipulação. A água usada pela indústria não estava em conformidade com os padrões bacteriológicos de potabilidade estabelecidos pela legislação brasileira. Os resultados obtidos alertam para a necessidade de implementação de um sistema de monitoramento microbiológico na área de processamento das conservas de polpa de pequi, incluindo equipamentos, utensílios, superfícies, ar, água e os manipuladores. A implementação das Boas Práticas de Fabricação é uma ferramenta essencial a ser utilizada pela indústria avaliada para garantir a segurança do produto final.
Diferenças na intensidade e na expansão da pústula da ferrugem do cafeeiro em dois acessos de Hemileia vastatrix
Authors: Salustiano Maria Eloisa , Pozza Edson Ampélio , Ferraz Filho Antonio Carlos
Published: March 2010

Objetivou-se, neste trabalho, estudar, em ambiente controlado, as diferenças na intensidade de doenças e na expansão da pústula de dois acessos de Hemileia vastatrix, coletados em plantas da cultivar Catuai das cidades de Coromandel (COR2), no Alto Paranaíba e de Ijaci (IIJ1), no Sul de Minas Gerais. As plantas inoculadas foram submetidas a três temperaturas (15, 20 e 25ºC) e três períodos de molhamento foliar (24, 48 e 72 horas de molhamento foliar), em esquema fatorial com três repetições. Ambos os acessos apresentaram maior severidade da doença quando submetidos a 24 horas de molhamento foliar, após a inoculação. A maior freqüência de infecção do IIJ1 foi a 15ºC, no entanto, a temperatura não influenciou essa variável para COR2. Houve maior severidade da ferrugem em COR2 a 25ºC. A maior expansão da pústula, em folhas inoculadas com IIJ1, foi a 15ºC com 7,59cm², e a menor a 25 ºC, com 5,37cm², enquanto para COR2 houve aumento à medida que se elevou a temperatura de 15 para 25ºC, de 1,44 para 6,62 cm², respectivamente. Accessos provenientes de Ijaci e de Coromandel apresentaram diferenças na intensidade da ferrugem e na expansão das pústulas em ambiente controlado.