bluuebunny/crossref_metadata_2025 huggingface dataset:
A Conversation with Irma Adelman
Authors: Adelman Irma , Zilberman David , Kim Eunice
Published: June 2014

Irma Adelman was born in Czernowitz, Romania, in March of 1930. Her father was a Jewish businessman with socialist leanings, and although her mother was educated to be a lawyer, she never practiced and thus concentrated her energies on her only daughter, Irma. Despite Irma’s Jewish background, she was educated by French Catholic nuns, and her family lived in affluence in her early life. It was not long before her family encountered anti-Semitism and discrimination in the late 1930s, her father foresaw the dark shadow of World War II, and the family immigrated to Palestine in 1939. Irma attended high school in Palestine and also fought in the Israeli war of independence. After the war, she immigrated to the United States, where she enrolled as an undergraduate at the University of California, Berkeley (UC Berkeley), as a business administration major. Soon after her arrival at Berkeley, she met and married her husband, an American physics PhD candidate. They decided to settle in the United States and had one son, Alex.

After her undergraduate studies, Irma enrolled at UC Berkeley as a PhD student in economics. Given her strong quantitative skills, she benefited from training by Robert Dorfman in mathematical models in economics and from courses in econometrics and statistics offered by George Kuznets in the Department of Agricultural Economics. Her classmates in Kuznets's courses included Arnold Zellner, Zvi Griliches, and Yair Mundlak.

After graduating at the top of her class in 1955, Irma faced considerable difficulties in landing a tenure-track academic position, which was typical of the discrimination against professional women at the time. She held various nontenure appointments at UC Berkeley, at Mills College, and at Stanford for several years. During this period, she published her first book ( Adelman & Morris 1973 ), the classic Klein-Goldberger paper ( Adelman & Adelman 1959 ), and the pathbreaking hedonic pricing paper ( Adelman & Griliches 1961 ), as well as many other publications in leading journals. Yet she was still unable to land a tenure-track position in the Bay Area. She and her husband decided to relocate due to her husband’s job offer, and thus she moved to Washington, DC, where she obtained a regular associate professorship at John Hopkins University. There she also met Cynthia Taft Morris, who would later become a lifelong friend and collaborator. While in Washington, DC, she became acquainted with agencies such as USAID and the World Bank. In 1966, she moved to Chicago for a position at Northwestern University, where she stayed until 1971. In 1973, she joined the World Bank along with having a professorship at the University of Maryland. From Maryland, in 1979 she returned to UC Berkeley’s Department of Agricultural Economics, where she stayed until her early retirement in 1995. She has been a professor emeritus of the Graduate School ever since.
Agriculture in African Development: Theories and Strategies
Authors: Dercon Stefan , Gollin Douglas
Published: June 2014

Agriculture is the largest sector in most sub-Saharan economies in terms of employment, and it plays an important role in supplying food and export earnings. Rural poverty rates remain high, and labor productivity is strikingly low. This article asks how these factors shape the role of agriculture in African development strategies. Is agricultural growth a prerequisite for growth in other sectors? Or will urbanization and nonagricultural export markets ultimately be the forces that pull the rural economy into higher productivity? We argue that agricultural development strategies will vary widely because of heterogeneity across and within countries.
Intergenerational Mobility and Inequality: The Latin American Case
Authors: Torche Florencia
Published: June 2014

Prompted by new data and a renewed concern about equality of opportunity, the study of intergenerational mobility has flourished in Latin America in the past decade. Although analysis is still restricted to a handful of countries, one conclusion appears clear: Intergenerational income mobility is weaker in Latin America than in industrial countries and is characterized by “persistence at the top,” a pattern consistent with the high levels of economic concentration in the region. However, social class mobility in Latin America does not differ from that in the industrialized world. This essay reviews two generations of mobility research since the 1960s, takes stock of current findings on economic and class mobility in Latin America, examines the linkages between mobility and macro-level factors, and engages a new literature on equality of opportunity. I suggest that the comparative understanding of mobility in Latin America can inform and inspire research in the industrialized world.
The Sociology of Empires, Colonies, and Postcolonialism
Authors: Steinmetz George
Published: June 2014

Sociologists are adding specific disciplinary accents to the burgeoning literature in colonial, imperial, and postcolonial studies. They have been especially keen to add explanatory accounts to the historical literature on empires. Starting in the 1950s, sociologists pioneered the study of colonies as historical formations. Against traditional anthropological approaches, sociologists insisted on studying colonizer and colonized in their dynamic interactions, asking how both groups were being transformed. Like contemporary postcolonial scholars, sociologists began asking in the 1950s how metropoles were being remade by overseas colonialism and colonial immigration. Echoing discussions in the 1950s among sociologists working in the colonies, current discussions of postcolonial sociology question the applicability of Western social scientific concepts and theories to the global South and ask how sociology itself has been shaped by empire. Current sociological research on empires focuses on six sets of causal mechanisms: (1) capitalism; (2) geopolitics, war, and violence; (3) cultural representations and subjectivity; (4) resistance and collaboration by the colonized; (5) institutional dimensions of empires and colonies; and (6) conflict and compromise among colonizers at the heart of colonial states.
Endogenous Selection Bias: The Problem of Conditioning on a Collider Variable
Authors: Elwert Felix , Winship Christopher
Published: June 2014

Endogenous selection bias is a central problem for causal inference. Recognizing the problem, however, can be difficult in practice. This article introduces a purely graphical way of characterizing endogenous selection bias and of understanding its consequences ( Hernán et al. 2004 ). We use causal graphs (direct acyclic graphs, or DAGs) to highlight that endogenous selection bias stems from conditioning (e.g., controlling, stratifying, or selecting) on a so-called collider variable, i.e., a variable that is itself caused by two other variables, one that is (or is associated with) the treatment and another that is (or is associated with) the outcome. Endogenous selection bias can result from direct conditioning on the outcome variable, a post-outcome variable, a post-treatment variable, and even a pre-treatment variable. We highlight the difference between endogenous selection bias, common-cause confounding, and overcontrol bias and discuss numerous examples from social stratification, cultural sociology, social network analysis, political sociology, social demography, and the sociology of education.
Biotin uptake by mouse and human pancreatic beta cells/islets: a regulated, lipopolysaccharide-sensitive carrier-mediated process
Authors: Ghosal Abhisek , Sekar Thillai V. , Said Hamid M.
Published: June 2014

Biotin is essential for the normal function of pancreatic beta cells. These cells obtain biotin from their surroundings via transport across their cell membrane. Little is known about the uptake mechanism involved, how it is regulated, and how it is affected by internal and external factors. We addressed these issues using the mouse-derived pancreatic beta-TC-6 cells and freshly isolated mouse and human primary pancreatic beta cells as models. The results showed biotin uptake by pancreatic beta-TC-6 cells occurs via a Na+-dependent, carrier-mediated process, that is sensitive to desthiobiotin, as well as to pantothenic acid and lipoate; the process is also saturable as a function of concentration (apparent Km = 22.24 ± 5.5 μM). These cells express the sodium-dependent multivitamin transporter (SMVT), whose knockdown (with doxycycline-inducible shRNA) led to a sever inhibition in biotin uptake. Similarly, uptake of biotin by mouse and human primary pancreatic islets is Na+-dependent and carrier-mediated, and both cell types express SMVT. Biotin uptake by pancreatic beta-TC-6 cells is also adaptively regulated (via transcriptional mechanism) by extracellular substrate level. Chronic treatment of pancreatic beta-TC-6 cells with bacterial lipopolysaccharides (LPS) leads to inhibition in biotin uptake. This inhibition is mediated via a Toll-Like receptor 4-mediated process and involves a decrease in membrane expression of SMVT. These findings show, for the first time, that pancreatic beta cells/islets take up biotin via a specific and regulated carrier-mediated process, and that the process is sensitive to the effect of LPS.
Argininosuccinate lyase in enterocytes protects from development of necrotizing enterocolitis
Authors: Premkumar M. H. , Sule G. , Nagamani S. C. , Chakkalakal S. , Nordin A. , Jain M. , Ruan M. Z. , Bertin T. , Dawson B. , Zhang J. , Schady D. , Bryan N. S. , Campeau P. M. , Erez A. , Lee B.
Published: June 2014

Necrotizing enterocolitis (NEC), the most common neonatal gastrointestinal emergency, results in significant mortality and morbidity, yet its pathogenesis remains unclear. Argininosuccinate lyase (ASL) is the only enzyme in mammals that is capable of synthesizing arginine. Arginine has several homeostatic roles in the gut and its deficiency has been associated with NEC. Because enterocytes are the primary sites of arginine synthesis in neonatal mammals, we evaluated the consequences of disruption of arginine synthesis in the enterocytes on the pathogenesis of NEC. We devised a novel approach to study the role of enterocyte-derived ASL in NEC by generating and characterizing a mouse model with enterocyte-specific deletion of Asl ( Asl flox/flox; VillinCre tg/+, or CKO). We hypothesized that the presence of ASL in a cell-specific manner in the enterocytes is protective in the pathogenesis of NEC. Loss of ASL in enterocytes resulted in an increased incidence of NEC that was associated with a proinflammatory state and increased enterocyte apoptosis. Knockdown of ASL in intestinal epithelial cell lines resulted in decreased migration in response to lipopolysaccharide. Our results show that enterocyte-derived ASL has a protective role in NEC.
Pulmonary ventilation defects in older never-smokers
Authors: Sheikh Khadija , Paulin Gregory A. , Svenningsen Sarah , Kirby Miranda , Paterson Nigel A. M. , McCormack David G. , Parraga Grace
Published: June 2014

Hyperpolarized 3He MRI previously revealed spatially persistent ventilation defects in healthy, older compared with healthy, younger never-smokers. To understand better the physiological consequences and potential relevance of 3He MRI ventilation defects, we evaluated 3He-MRI ventilation-defect percent (VDP) and the effect of deep inspiration (DI) and salbutamol on VDP in older never-smokers. To identify the potential determinants of ventilation defects in these subjects, we evaluated dyspnea, pulmonary function, and cardiopulmonary exercise test (CPET) measurements, as well as occupational and second-hand smoke exposure. Fifty-two never-smokers (71 ± 6 yr) with no history of chronic respiratory disease were evaluated. During a single visit, pulmonary function tests, CPET, and 3He MRI were performed and the Burden of Obstructive Lung Disease questionnaire administered. For eight of 52 subjects, there was spirometry evidence of airflow limitation (Global Initiative for Chronic Obstructive Lung Disease-Unclassified, I, and II), and occupational exposure was reported in 13 of 52 subjects. In 13 of 52 (25%) subjects, there were no ventilation defects and in 39 of 52 (75%) subjects, ventilation defects were observed. For those subjects with ventilation defects, six of 39 showed a VDP response to DI/salbutamol. Ventilation heterogeneity and VDP were significantly greater, and forced expiratory volume in 1 s (FEV1)/forced vital capacity was significantly lower ( P < 0.05) for subjects with ventilation defects with a response to DI/salbutamol than subjects with ventilation defects without a response to DI/salbutamol and subjects without ventilation defects. In a step-wise, forward multivariate model, FEV1, inspiratory capacity, and airway resistance significantly predicted VDP ( R2 = 0.45, P < 0.001). In conclusion, most never-smokers had normal spirometry and peripheral ventilation defects not reversed by DI/salbutamol; such ventilation defects were likely related to irreversible airway narrowing/collapse but not to dyspnea and decreased exercise capacity.
New approach to measure cutaneous microvascular function: an improved test of NO-mediated vasodilation by thermal hyperemia
Authors: Choi Patricia J. , Brunt Vienna E. , Fujii Naoto , Minson Christopher T.
Published: June 2014

Cutaneous hyperemia in response to rapid skin local heating to 42°C has been used extensively to assess microvascular function. However, the response is dependent on both nitric oxide (NO) and endothelial-derived hyperpolarizing factors (EDHFs), and increases cutaneous vascular conductance (CVC) to ∼90–95% maximum in healthy subjects, preventing the study of potential means to improve cutaneous function. We sought to identify an improved protocol for isolating NO-dependent dilation. We compared nine heating protocols (combinations of three target temperatures: 36°C, 39°C, and 42°C, and three rates of heating: 0.1°C/s, 0.1°C/10 s, 0.1°C/min) in order to select two protocols to study in more depth ( protocol 1; N = 6). Then, CVC was measured at four microdialysis sites receiving: 1) lactated Ringer solution (Control), 2) 50-mM tetraethylammonium (TEA) to inhibit EDHFs, 3) 20-mM nitro-L-arginine methyl ester (L-NAME) to inhibit NO synthase, and 4) TEA+L-NAME, in response to local heating either to 39°C at 0.1°C/s ( protocol 2; N = 10) or 42°C at 0.1°C/min ( protocol 3; N = 8). Rapid heating to 39°C increased CVC to 43.1 ± 5.2%CVCmax (Control), which was attenuated by L-NAME (11.4 ± 2.8%CVCmax; P < 0.001) such that 82.8 ± 4.2% of the plateau was attributable to NO. During gradual heating, 81.5 ± 3.3% of vasodilation was attributable to NO at 40°C, but at 42°C only 32.7 ± 7.8% of vasodilation was attributable to NO. TEA+L-NAME attenuated CVC beyond L-NAME at temperatures >40°C (43.4 ± 4.5%CVCmax at 42°C, P < 0.001 vs. L-NAME), suggesting a role of EDHFs at higher temperatures. Our findings suggest local heating to 39°C offers an improved approach for isolating NO-dependent dilation and/or assessing perturbations that may improve microvascular function.
Fine-Mapping IGF1 and Prostate Cancer Risk in African Americans: The Multiethnic Cohort Study
Authors: Giorgi Elena E. , Stram Daniel O. , Taverna Darin , Turner Stephen D. , Schumacher Fredrick , Haiman Christopher A. , Lum-Jones Annette , Tirikainen Maarit , Caberto Christian , Duggan David , Henderson Brian E. , Le Marchand Loic , Cheng Iona
Published: June 2014

Genetic variation at insulin-like growth factor 1 (IGF1) has been linked to prostate cancer risk. However, the specific predisposing variants have not been identified. In this study, we fine-mapped the IGF1 locus for prostate cancer risk in African Americans. We conducted targeted Roche GS-Junior 454 resequencing of a 156-kb region of IGF1 in 80 African American aggressive prostate cancer cases. Three hundred and thirty-four IGF1 SNPs were examined for their association with prostate cancer risk in 1,000 African American prostate cancer cases and 991 controls. The top associated SNP in African Americans, rs148371593, was examined in an additional 3,465 prostate cancer cases and 3,425 controls of non-African American ancestry—European Americans, Japanese Americans, Latinos, and Native Hawaiians. The overall association of 334 IGF1 SNPs and prostate cancer risk was assessed using logistic kernel-machine methods. The association between each SNP and prostate cancer risk was evaluated through unconditional logistic regression. A false discovery rate threshold of q < 0.1 was used to determine statistical significance of associations. We identified 8 novel IGF1 SNPs. The cumulative effect of the 334 IGF1 SNPs was not associated with prostate cancer risk (P = 0.13) in African Americans. Twenty SNPs were nominally associated with prostate cancer at P < 0.05. The top associated SNP among African Americans, rs148371593 [minor allele frequency (MAF) = 0.03; P = 0.0014; q > 0.1], did not reach our criterion of statistical significance. This polymorphism was rare in non-African Americans (MAF < 0.003) and was not associated with prostate cancer risk (P = 0.98). Our findings do not support the role of IGF1 variants and prostate cancer risk among African Americans. Cancer Epidemiol Biomarkers Prev; 23(9); 1928–32. ©2014 AACR.
Problems of in vitro SPF Measurements Brought about by Viscous Fingering Generated during Sunscreen Applications
Authors: Fujikake K. , Tago S. , Plasson R. , Nakazawa R. , Okano K. , Maezawa D. , Mukawa T. , Kuroda A. , Asakura K.
Published: June 2014

Up to date, no worldwide standard in vitro method has been established for the determination of the sun protection factor (SPF), since there are many problems in terms of its repeatability and reliability. Here, we have studied the problems on the in vitro SPF measurements brought about by the phenomenon called viscous fingering. A spatially periodic stripe pattern is usually formed spontaneously when a viscous fluid is applied onto a solid substrate. For the in vitro SPF measurements, the recommended amount of sunscreen is applied onto a substrate, and the intensity of the transmitted UV light through the sunscreen layer is evaluated. Our theoretical analysis indicated that the nonuniformity of the thickness of the sunscreen layer varied the net UV absorbance. Pseudo-sunscreen composites having no phase separation structures were prepared and applied on a quartz plate for the measurements of the UV absorbance. Two types of applicators, a block applicator and a 4-sided applicator were used. The flat surface was always obtained when the 4-sided applicator was used, while the spatially periodic stripe pattern was always generated spontaneously when the block applicator was used. The net UV absorbance of the layer on which the stripe pattern was formed was found to be lower than that of the flat layer having the same average thickness. Theoretical simulations quantitatively reproduced the variation of the net UV absorbance led by the change of the geometry of the layer. The results of this study propose the definite necessity of strict regulations on the coating method of sunscreens for the establishment of the in vitro SPF test method.
Multi-Organ Sarcoidosis Treatment with Fumaric Acid Esters: A Case Report and Review of the Literature
Authors: Zouboulis Christos C. , Lippert Undine , Karagiannidis Ioannis
Published: June 2014

Sarcoidosis is a rare, systemic disease that is characterized by the formation of granulomas in various organs, including the skin. As the etiology remains unknown, the treatment of sarcoidosis is challenging. We present a 47-year-old female patient with progressive, multi-organ sarcoidosis who had a complete clinical improvement of the skin lesions, a moderate reduction in pulmonary opacities on chest X-ray, a marked subjective improvement in general status and pulmonary efficiency and a marked reduction in serum angiotensin-converting enzyme and soluble interleukin-2 receptor after 6 months of therapy with fumaric acid esters. The present case and similar reports in the literature highlight the probable efficacy of fumaric acid esters in the treatment of sarcoidosis and other non-infectious, granulomatous diseases.
Birth Weight and Neonatal Adiposity Prediction Using Fractional Limb Volume Obtained with 3D Ultrasound
Authors: O'Connor Clare , O'Higgins Amy , Doolan Anne , Segurado Ricardo , Stuart Bernard , Turner Michael J. , Kennelly Máireád M.
Published: June 2014

Introduction: The objective of this investigation was to study fetal thigh volume throughout gestation and explore its correlation with birth weight and neonatal body composition. This novel technique may improve birth weight prediction and lead to improved detection rates for fetal growth restriction. Materials and Methods: Fractional thigh volume (TVol) using 3D ultrasound, fetal biometry and soft tissue thickness were studied longitudinally in 42 mother-infant pairs. The percentages of neonatal body fat, fat mass and fat-free mass were determined using air displacement plethysmography. Correlation and linear regression analyses were performed. Results: Linear regression analysis showed an association between TVol and birth weight. TVol at 33 weeks was also associated with neonatal fat-free mass. There was no correlation between TVol and neonatal fat mass. Abdominal circumference, estimated fetal weight (EFW) and EFW centile showed consistent correlations with birth weight. Thigh volume demonstrated an additional independent contribution to birth weight prediction when added to the EFW centile from the 38-week scan (p = 0.03). Conclusion: Fractional TVol performed at 33 weeks gestation is correlated with birth weight and neonatal lean body mass. This screening test may highlight those at risk of fetal growth restriction or macrosomia.
Endothelium-Derived Hyperpolarizing Factor Mediates Bradykinin-Stimulated Tissue Plasminogen Activator Release in Humans
Authors: Rahman Ayaz M. , Murrow Jonathan R. , Ozkor Muhiddin A. , Kavtaradze Nino , Lin Ji , De Staercke Christine , Hooper W. Craig , Manatunga Amita , Hayek Salim , Quyyumi Arshed A.
Published: June 2014

Aims: Bradykinin (BK) stimulates tissue plasminogen activator (t-PA) release from human endothelium. Although BK stimulates both nitric oxide and endothelium-derived hyperpolarizing factor (EDHF) release, the role of EDHF in t-PA release remains unexplored. This study sought to determine the mechanisms of BK-stimulated t-PA release in the forearm vasculature of healthy human subjects. Methods: In 33 healthy subjects (age 40.3 ± 1.9 years), forearm blood flow (FBF) and t-PA release were measured at rest and after intra-arterial infusions of BK (400 ng/min) and sodium nitroprusside (3.2 mg/min). Measurements were repeated after intra-arterial infusion of tetraethylammonium chloride (TEA; 1 µmol/min), fluconazole (0.4 µmol·min-1·l-1), and NG-monomethyl-L-arginine (L-NMMA, 8 µmol/min) to block nitric oxide, and their combination in separate studies. Results: BK significantly increased net t-PA release across the forearm (p < 0.0001). Fluconazole attenuated both BK-mediated vasodilation (-23.3 ± 2.7% FBF, p < 0.0001) and t-PA release (from 50.9 ± 9.0 to 21.3 ± 8.9 ng/min/100 ml, p = 0.02). TEA attenuated FBF (-14.7 ± 3.2%, p = 0.002) and abolished BK-stimulated t-PA release (from 22.9 ± 5.7 to -0.8 ± 3.6 ng/min/100 ml, p = 0.0002). L-NMMA attenuated FBF (p < 0.0001), but did not inhibit BK-induced t-PA release (nonsignificant). Conclusion: BK-stimulated t-PA release is partly due to cytochrome P450-derived epoxides and is inhibited by K+Ca channel blockade. Thus, BK stimulates both EDHF-dependent vasodilation and t-PA release.
The Regulation of Coenzyme Q Biosynthesis in Eukaryotic Cells: All That Yeast Can Tell Us
Authors: González-Mariscal Isabel , García-Testón Elena , Padilla Sergio , Martín-Montalvo Alejandro , Pomares Viciana Teresa , Vazquez-Fonseca Luis , Gandolfo Domínguez Pablo , Santos-Ocaña Carlos
Published: June 2014

Coenzyme Q (CoQ) is a mitochondrial lipid, which functions mainly as an electron carrier from complex I or II to complex III at the mitochondrial inner membrane, and also as antioxidant in cell membranes. CoQ is needed as electron acceptor in β-oxidation of fatty acids and pyridine nucleotide biosynthesis, and it is responsible for opening the mitochondrial permeability transition pore. The yeast model has been very useful to analyze the synthesis of CoQ, and therefore, most of the knowledge about its regulation was obtained from the Saccharomyces cerevisiae model. CoQ biosynthesis is regulated to support 2 processes: the bioenergetic metabolism and the antioxidant defense. Alterations of the carbon source in yeast, or in nutrient availability in yeasts or mammalian cells, upregulate genes encoding proteins involved in CoQ synthesis. Oxidative stress, generated by chemical or physical agents or by serum deprivation, modifies specifically the expression of some COQ genes by means of stress transcription factors such as Msn2/4p, Yap1p or Hsf1p. In general, the induction of COQ gene expression produced by metabolic changes or stress is modulated downstream by other regulatory mechanisms such as the protein import to mitochondria, the assembly of a multi-enzymatic complex composed by Coq proteins and also the existence of a phosphorylation cycle that regulates the last steps of CoQ biosynthesis. The CoQ biosynthetic complex assembly starts with the production of a nucleating lipid such as HHB by the action of the Coq2 protein. Then, the Coq4 protein recognizes the precursor HHB acting as the nucleus of the complex. The activity of Coq8p, probably as kinase, allows the formation of an initial pre-complex containing all Coq proteins with the exception of Coq7p. This pre-complex leads to the synthesis of 5-demethoxy-Q6 (DMQ6), the Coq7p substrate. When de novo CoQ biosynthesis is required, Coq7p becomes dephosphorylated by the action of Ptc7p increasing the synthesis rate of CoQ6. This critical model is needed for a better understanding of CoQ biosynthesis. Taking into account that patients with CoQ10 deficiency maintain to some extent the machinery to synthesize CoQ, new promising strategies for the treatment of CoQ10 deficiency will require a better understanding of the regulation of CoQ biosynthesis in the future.
Evaluation of the Implementation of a Rapid Response Treatment Protocol for Patients with Acute Onset Stroke: Can We Increase the Number of Patients Treated and Shorten the Time Needed
Authors: Advani Rajiv , Naess Halvor , Kurz Martin W.
Published: June 2014

Aims: This study aims to evaluate the implementation of a rapid response treatment protocol for patients presenting with acute onset ischemic stroke. Improvements of routines surrounding the admission and treatment of patients with intravenous thrombolysis (IVT), such as door-to-needle (DTN) times, and increasing the numbers of patients treated are discussed. Methods: We conducted a retrospective analysis of all patients (n = 320) treated with IVT for acute onset ischemic stroke at the Stavanger University Hospital, Norway, between 2003 and 2012. In 2009, a succession of changes to pre- and intra-hospital routines were made as well as an improvement in the education of primary health care physicians, nurses and paramedics involved in the treatment of acute onset stroke patients (rapid response treatment protocol). Analyses of DTN times, onset-to-needle times and the number of patients treated per year were carried out to ascertain the effect of the changes made. The primary aim was to analyze DTN times to look for any changes, and the secondary aim was to analyze changes in the number of patients treated per year. Results: In the years after the implementation of the rapid treatment protocol, we saw an improvement in the median DTN time with a decrease from 73 to 50 min in the first year (p = 0.03), a decrease of 45 min in the second year (p = 0.01) and a decrease of 31 min in the third year (p < 0.001). Similarly, an improvement in the number of patients treated per year was seen after enhancements in the treatment chain were made. A significant, 27-fold increase was shown when the number of patients treated in 2012 was compared with all patients treated in all years prior to the implementation of the rapid treatment protocol. Conclusions: The implementation of the rapid treatment protocol for acute onset ischemic stroke patients led to a significant decrease in the DTN time at our center. These improvements also produced an increase in the number of patients treated per year. The extension of the therapeutic window from 3 to 4.5 h for the use of intravenous recombinant tissue plasminogen activator also played a role in the increased treatment numbers.
Couragierte Pionierinnen - Botanikerinnen im 18. Jahrhundert
Authors: Pfister Thomas
Published: June 2014

Botanik als Wissenschaft war bis in das 18. Jahrhundert ein Teilgebiet der Medizin und den Männern vorbehalten. Trotzdem wagten sich einige mutige Pionierinnen in diese Domäne. Als Pflanzensammlerinnen oder -zeichnerinnen und als «Forscherinnen» leisteten sie wichtige Erkenntnisse zur Entwicklung der Botanik. Als Beispiel einer Pionierin der Botanik wird die Geschichte der Jeanne Baret erzählt, die als erste Frau die Welt umrundete und dabei unglaubliche Leistungen zur Entdeckung noch unbekannter Pflanzen erbrachte. Während alle Welt den Botaniker Carl Linné kennt, sind die frühen Botanikerinnen der Nachwelt oft kaum (mehr) bekannt. Der Essay vergleicht die speziellen Merkmale dieser Frauen, die es ihnen ermöglichten, trotz widriger Umstände einen Beitrag zur Botanik zu leisten. Neben einer starken Persönlichkeit waren dies bei allen Botanikerinnen viel Enthusiasmus für ihr Fachgebiet sowie die Unterstützung durch männliche Förderer in ihrer nächsten Umgebung.
Porphyromonas gingivalis Fimbriae Dampen P2X7-Dependent Interleukin-1β Secretion
Authors: Morandini Ana Carolina , Ramos-Junior Erivan S. , Potempa Jan , Nguyen Ky-Anh , Oliveira Ana Carolina , Bellio Maria , Ojcius David M. , Scharfstein Julio , Coutinho-Silva Robson
Published: June 2014

Porphyromonas gingivalis is a major contributor to the pathogenesis of periodontitis, an infection-driven inflammatory disease that leads to bone destruction. This pathogen stimulates pro-interleukin (IL)-1β synthesis but not mature IL-1β secretion, unless the P2X7 receptor is activated by extracellular ATP (eATP). Here, we investigated the role of P. gingivalis fimbriae in eATP-induced IL-1β release. Bone marrow-derived macrophages (BMDMs) from wild-type (WT) or P2X7-deficient mice were infected with P. gingivalis (381) or isogenic fimbria-deficient (DPG3) strain with or without subsequent eATP stimulation. DPG3 induced higher IL-1β secretion after eATP stimulation compared to 381 in WT BMDMs, but not in P2X7-deficient cells. This mechanism was dependent on K+ efflux and Ca2+-independent phospholipase A2 activity. Accordingly, non-fimbriated P. gingivalis failed to inhibit apoptosis via the eATP/P2X7 pathway. Furthermore, P. gingivalis-driven stimulation of IL-1β was Toll-like receptor 2 and MyD88 dependent, and not associated with fimbria expression. Fimbria-dependent down-modulation of IL-1β was selective, as levels of other cytokines remained unaffected by P2X7 deficiency. Confocal microscopy demonstrated the presence of discrete P2X7 expression in the absence of P. gingivalis stimulation, which was enhanced by 381-stimulated cells. Notably, DPG3-infected macrophages revealed a distinct pattern of P2X7 receptor expression with a marked focus formation. Collectively, these data demonstrate that eATP-induced IL-1β secretion is impaired by P. gingivalis fimbriae in a P2X7-dependent manner.
Transfusion Efficacy of Apheresis Platelet Concentrates Irradiated at the Day of Transfusion Is Significantly Superior Compared to Platelets Irradiated in Advance
Authors: Julmy Friedgard , Ammann Roland A. , Fontana Stefano , Taleghani Behrouz Mansouri , Hirt Andreas , Leibundgut Kurt
Published: June 2014

Background: Gamma irradiation is currently the standard care to avoid transfusion-associated graft-versus-host disease. Guidelines on gamma irradiation of blood components state that platelets (PLTs) can be irradiated at any stage in their 5-day storage and can thereafter be stored up to their normal shelf life of 5 days after collection. In this study, we explored whether the timing of irradiation has an effect on transfusion efficacy of apheresis PLT concentrates (APCs). Methods: Based on the 1-hour percent PLT recovery (PPR1h), transfusion efficacy of 1,000 eligible APCs transfused to 144 children were evaluated retrospectively. PPR1h was compared in transfused APCs irradiated at the day of transfusion and APCs irradiated in advance. Results: In univariate analysis, transfusion efficacy of APCs irradiated in advance was significantly lower than that of APCs irradiated at the day of transfusion (mean PPR1h 27.7 vs. 35.0%; p = 0.007). This was confirmed in multivariate analysis (p = 0.030). Compared to non-irradiated APCs, transfusion efficacy of APCs irradiated at the day of transfusion was not significantly inferior (mean difference -2.8%; 95% CI -6.1 to 0.5%; p = 0.092), but APCs irradiated in advance were clearly less efficient (mean difference -8.1%; 95% CI -12.2 to -4.0%; p < 0.001). Conclusion: Our data strongly support that APCs should not be irradiated in advance, i.e., ≥24 h before transfusion.
A Simple Guideline Reduces the Need for Red Blood Cell Transfusions in Swiss Hospitals: A Prospective, Multicentre, Before-and-After Study in Elective Hip and Knee Replacement
Authors: Fontana Stefano , de la Cuadra Cristina , Müller Urs , Schmid Pirmin , Perler Malgorzata , Luginbühl Martin , Taleghani Behrouz Mansouri
Published: June 2014

Introduction: Optimising the use of blood has become a core task of transfusion medicine. Because no general guidelines are available in Switzerland, we analysed the effects of the introduction of a guideline on red blood cell (RBC) transfusion for elective orthopaedic surgery. Methods: Prospective, multicentre, before-and-after study comparing the use of RBCs in adult elective hip or knee replacement before and after the implementation of a guideline in 10 Swiss hospitals, developed together with all participants. Results: We included 2,134 patients, 1,238 in 7 months before, 896 in 6 months after intervention. 57 (34 or 2.7% before, 23 or 2.6% after) were lost before follow-up visit. The mean number of transfused RBC units decreased from 0.5 to 0.4 per patient (0.1, 95% CI 0.08-0.2; p = 0.014), the proportion of transfused patients from 20.9% to 16.9% (4%, 95% C.I. 0.7-7.4%; p = 0.02), and the pre-transfusion haemoglobin from 82.6 to 78.2 g/l (4.4 g/l, 95% C. I. 2.15-6.62 g/l, p < 0.001). We did not observe any statistically significant changes in in-hospital mortality (0.4% vs. 0%) and morbidity (4.1% vs. 4.0%), median hospital length of stay (9 vs. 9 days), follow-up mortality (0.4% vs. 0.2%) and follow-up morbidity (6.9% vs. 6.0%). Conclusions: The introduction of a simple transfusion guideline reduces and standardises the use of RBCs by decreasing the haemoglobin transfusion trigger, without negative effects on the patient outcome. Local support, training, and monitoring of the effects are requirements for programmes optimising the use of blood.
High-Dose Toremifene for Fulvestrant-Resistant Metastatic Breast Cancer: A Report of Two Cases
Authors: Mori Ryutaro , Nagao Yasuko
Published: June 2014

Introduction: Hormone receptor (HR)-positive metastatic breast cancer (MBC) is usually treated with hormone therapy. In postmenopausal females, aromatase inhibitors (AIs) are usually used as first-line therapy, and fulvestrant is used subsequently. The optimal treatment beyond fulvestrant has not been established. We experienced two cases in which high-dose toremifene (hdTOR) was effective after the failure of AIs and fulvestrant. Case 1: A 73-year-old female with HR-positive left breast cancer (T2N1M0) underwent preoperative chemotherapy and mastectomy with axillary dissection. Computed tomography (CT) revealed liver tumors in S7 (23 mm) and S8 (25 mm) during adjuvant letrozole therapy, so fulvestrant was started. The tumors initially decreased in size (23 and 22 mm), but then progressed (36 and 25 mm). Treatment was changed to hdTOR, and the tumors shrunk to 26 mm (S7) and 24 mm (S8), and she was stable for 6 months while receiving hdTOR. Case 2: An 81-year-old female with HR-positive left breast cancer (T2N1M0) underwent left mastectomy and axillary dissection. CT revealed liver tumors in S7 (20 mm) and S8 (11 mm) during adjuvant letrozole therapy, so fulvestrant treatment was started. The tumor in S7 shrunk (13 mm), but the tumor in S8 slightly progressed (13 mm), and both tumors progressed (14 and 18 mm) after 6 months. Treatment was changed to hdTOR, and the tumors slightly shrunk (12 and 14 mm) after 6 months. hdTOR has been continued for 9 months. Conclusion: hdTOR was effective for MBC after multiple hormone therapies, likely because it acts via a different mechanism of action.
Desenvolvimento histórico da epidemiologia e do conceito de risco
Authors: Ayres José Ricardo De Carvalho Mesquita
Published: June 2014

A utilização do raciocínio probabilístico nas práticas de saúde foi originalmente introduzida pela epidemiologia e é hoje amplamente utilizado em todas as áreas da medicina. O objetivo deste trabalho foi revisitar o desenvolvimento histórico da epidemiologia e a formalização de seu elemento epistemológico nuclear, o conceito de risco, responsável pela emergência da probabilidade como parte do raciocínio causal nas ciências da saúde. O estudo situa-se na fronteira entre as disciplinas de medicina preventiva e social, história e filosofia das ciências, caracterizando-se como uma epistemologia histórico-crítica. O período de estudo abrangeu os anos de 1872 a 1965 e sua base documental foi constituída por trabalhos de periódicos científicos relacionados à construção do campo epidemiológico, em particular o American Journal of Hygiene, livros, anais de congressos, brochuras científicas etc. Foram identificadas e discutidas três etapas de desenvolvimento da epidemiologia: epidemiologia da constituição, epidemiologia da exposição e epidemiologia do risco, apontando-se aspectos epistemológicos e sócio-culturais relacionados a cada uma delas. Destacou-se a importância da reflexão crítica sobre a ciência epidemiológica, e as ciências da saúde de modo geral, para otimizar seu uso atual e propiciar sua constante e criativa transformação.
Abordagem diagnóstica de metástases hepáticas de câncer colorretal
Authors: Carvalho Paulo Afonso de , Saad William Abrão
Published: June 2014

A metástase hepática de câncer de colo e reto, uma doença cada vez mais comume potencialmente agressiva, é discutida em âmbito internacional quanto à adequação da suaabordagem investigativa. Nesta revisão, este aspecto foi discutido tendo como parâmetros:custo, disponibilidade, sensibilidade, especificidade, uso de radiação e confiabilidade dométodo. A principal ideia é revisar, a partir de experiências adquiridas em diversos serviços desaúde, os principais métodos diagnósticos disponíveis para a detecção das lesões metastáticasno fígado originárias de câncer colorretal, discutindo em que situações eles devem ser utilizadose principalmente levando em conta a realidade do sistema médico hospitalar brasileiro
Perfil epidemiológico dos pacientes com hipertensão arterial sistêmica cadastrados na Casa Saúde da Família Águas Lindas II, Belém, PA
Authors: Dias Everton Mesquita , Pereira Roose Mary Nunes , Cavalcante Herlândia Soares , Ramalheiro Natasha Silva , Silva Noelle Freire da , Carvalho Júnior Moisés Ribeiro de
Published: June 2014

OBJETIVO: Identificar o perfil epidemiológico dos pacientes com Hipertensão Arterial Sistêmica (HAS) inscritos no Programa Nacional de Atenção à Hipertensão Arterial e Diabetes Mellitus (HIPERDIA) da Casa Saúde da Família Águas Lindas II, Belém – PA, no ano de 2007. MÉTODO: Estudo observacional, transversal e descritivo, realizado em um corte de 33 pacientes hipertensos, de 40 a 80 anos, de ambos os sexos, cadastrados no HIPERDIA da referida unidade de saúde e selecionados aleatoriamente, por meio de sorteio baseado nos números de matrícula. Aplicou-se um questionário acerca de características biossociais e hábitos de vida. Avaliou-se a pressão arterial (esfigmomanômetro aneróide Diasyst® e estetoscópio Littmann-Cardiology II®), o índice de massa corpórea (balança antropométrica com estadiômetro Fillizola®) e a circunferência da cintura (fita métrica inelástica), por meio de uma ficha de avaliação própria. Procedeu-se com análise estatística descritiva através dos programas Bioestat® 4.0 e Microsoft® Excel 2007. RESULTADOS: Observou-se que a maioria (40%) dos pacientes estava na faixa etária de 61 a 70 anos, sendo 82% do sexo feminino; predominaram a raça mulata (46%), renda salarial de 1 a 2 salários mínimos (61%), nível fundamental incompleto (52%), ocupação “do lar” (55%); a maioria era não tabagista (94%), não etilista (85%), sedentária (64%), sem antecedente familiar (52%) nem co-morbidades (61%); todos usavam medicação hipotensora; os níveis pressóricos estavam controlados na maioria (PAS-55%; PAD-67%); elevado percentual de obesidade generalizada e/ou sobrepeso (82%) e central (homens-50%; mulheres-93%). CONCLUSÃO: Houve predominância do sexo feminino; mulatos; baixo nível de escolaridade e de renda salarial; baixa ocorrência de etilismo, tabagismo e prática de exercício físico; baixo índice de co-morbidades e antecedentes familiares; alta ocorrência de sobrepeso e obesidade; além de níveis pressóricos controlados, embora um número significativo tenha apresentado PA descontrolada.
Relato de caso: síndrome de Guillain-Barré - atraso do desenvolvimento da linguagem
Authors: Lamônica Dionísia Aparecida Cusin , Pereira Tatiane Cristina , Silva Kellen Ribeiro , Lopes Andrea Cintra
Published: June 2014

O objetivo deste estudo foi descrever o desenvolvimento da síndrome de Guillain-Barré e manifestações fonoaudiológicas. É relatado breve histórico do quadro clínico e reavaliação fonoaudiológica 7 meses após o início dos sintomas, por meio de aplicação de testes formais, informais e avaliação audiológica. Na reavaliação, os resultados indicaram comunicação intencional, funções primárias, restrita participação em atividade dialógica, produções de palavras isoladas, compreensão de ordens ligadas ao contexto, retorno das habilidades alimentares. Foi constatada normalidade da audição periférica. Hospitalização, condutas familiares frente à doença e ausência de atividades escolares influenciaram no desempenho comunicativo. O aparecimento da Síndrome de Guillain-Barré influenciou de forma negativa no desenvolvimento da linguagem, assim como a resposta familiar à condição da criança.
Universidade de São Paulo, Faculdade de Medicina, Hospital do Servidor Público Estadual de São Paulo
Authors: Dias Cristiane Rabelo , Canuto Eliana , Alves Luíza Hama , Alves Rogério Camargo Pinheiro , Dias Cristiane Bitencourt
Published: June 2014

Descrevemos um caso de hiponatremia grave, com um dos níveis séricos de sódio mais baixos da literatura, secundário ao uso de fluoxetina, captopril e hidroclorotiazida. Paciente do sexo feminino, 45 anos, portadora de hipertensão arterial, vinha assintomática em uso de hidroclorotiazida e captopril, quando, a um mês da internação, iniciou-se fluoxetina devido sintomas de depressão. Paciente foi internada por rebaixamento de nível de consciência, com tomografia computadorizada de crânio evidenciando edema cerebral. Análise bioquímica revelou sódio sérico de 97 meq/L. Paciente evoluiu bem após interrupção das medicações e após administração de solução salina a 3%. O mecanismo pelo qual as drogas citadas desencadeiam hiponatremia é variável e não totalmente compreendido. No caso dos diuréticos tiazídicos, alteração na homeostase do sódio e água nos túbulos renais são os principais fatores relacionados a esse distúrbio eletrolítico. Com relação aos antidepressivos, o aumento da produção do hormônio antidiurético é, mais provavelmente, o fator associado à hiponatremia.. Os inibidores da ECA também são relacionados à hiponatremia, pois bradicinina e angiotensina seriam estimulantes da liberação do Hormônio Antidiurético. Sendo assim, a equipe médica deve fazer o rastreamento, através de uma avaliação clínica atenta e das pesquisas regulares, das concentrações séricas de sódio nesses pacientes, a fim de detectar precocemente distúrbios eletrolíticos potencialmente fatais.
Transplante intestinal em ratos utilizando nova técnica de microanastomose sem sutura com cola e molde tubular (Cuff-Glue)
Authors: Waisberg Daniel Reis , Galvão Raoni De Castro , Galvão Flávio Henrique Ferreira , D'Albuquerque Luis Augusto Carneiro
Published: June 2014

INTRODUÇÃO: A necessidade de sutura microvascular complexa dificulta a pesquisa do transplante intestinal no rato. A técnica de microanastomose com dispositivo tubular (cuff) é simples, porém, a persistência do dispositivo na anastomose desencadeia reação de corpo estranho e trombose. Neste trabalho descrevemos um modelo de transplante intestinal no rato com nova técnica de anastomose sem sutura com cuff e cola. MÉTODO: O enxerto contém o intestino delgado, colo ascendente e pedículo vascular (conduto aorto-mesentérico e veia porta). Na extremidade da veia e do coto intestinal, fixa-se o cuff, sobre o qual a parede é evertida. No receptor, realiza-se microanastomose aorto-aórtica manual. O cuff é inserido na veia mesentérica superior e fixado por ligadura circular. A margem proximal é levantada, expondo a camada íntima dos vasos, onde se deposita cola. A margem proximal é abaixada, selando a anastomose. As ligaduras fixando o cuff são retiradas possibilitando a exclusão do cuff da anastomose. Após reperfusão do enxerto, o intestino correspondente do receptor é retirado em bloco e se restabelece o trânsito intestinal utilizando a mesma técnica descrita. RESULTADOS: Observou-se adequada reperfusão do enxerto e boa patência das anastomoses. CONCLUSÃO: O modelo descrito simplifica a realização de microanastomose no transplante intestinal em ratos.
Transplante de pâncreas
Authors: Chaib Eleazar , Meirelles Junior Roberto Ferreira , Santos Vinicius Rocha , Bacchella Telesforo , D'Albuquerque Luiz Augusto Carneiro
Published: June 2014

Diabéticos insulino-dependentes são susceptíveis a altas taxas de complicações secundárias. O transplante de pâncreas teve início na Universidade de Minesota em 1966, com altas taxas de insucessos. Porém, recentemente, este procedimento tem obtido melhores resultados, conjuntamente com outros transplantes de órgãos. Os autores analisam, retrospectivamente, os fatores associados a melhora nos resultados do transplante de pâncreas, entre eles a seleção dos doadores, a técnica de retirada do pâncreas, a cirurgia do receptor com drenagem da secreção pancreática exócrina na bexiga ou no jejuno, o protocolo de imunossupressão, as falhas técnicas como tromboses vasculares, hemorragias, rejeição e infecção no Hospital das Clinicas da Universidade de São Paulo. As sobrevidas do enxerto e dos pacientes são analisadas no período de 1997 a 2006.
A abordagem das dores recorrentes na infância
Authors: Ferrer Ana Paula Scoleze , Sucupira Ana Cecília Silveira Lins
Published: June 2014

A queixa de dores recorrentes é muito frequente na infância, sendo mais prevalentes a dor abdominal, a cefaleia e a dor em membros. O atendimento desses pacientes não é uma tarefa fácil, tanto pelo caráter vago e subjetivo do sintoma como pela complexidade de fatores que podem estar implicados em sua etiologia. O objetivo do presente artigo é apresentar uma proposta de abordagem dessas queixas de dores recorrentes em crianças.