bluuebunny/crossref_metadata_2025 huggingface dataset:
Oral vitamin A as an adjunct treatment for canine sebaceous adenitis
Authors: Lam Andrea T. H. , Affolter Verena K. , Outerbridge Catherine A. , Gericota Barbara , White Stephen D.
Published: May 2011

Medical records of dogs with sebaceous adenitis diagnosed by histopathology over an 18‐year period were reviewed. From a total of 40 cases, 24 were treated with oral vitamin A. Dogs ranged from 9 months to 12 years of age at the time of disease onset. Purebred as well as mixed‐breed dogs were affected. Akitas represented approximately one‐third of the affected population. No sex predilections were observed. Vitamin A was administered for a minimum of 1 month. Doses varied from 380 to 2667 IU/kg/day, with a mean of 1037 IU/kg/day. Two dogs received oral vitamin A exclusively. Concurrent treatments included systemic antibiotics, systemic antifungal medications, fatty acid supplementation and various topical treatments. Of 24 dogs treated with vitamin A, three were lost to follow‐up. Twelve owners were satisfied with the overall appearance of their dogs, reporting ≥25% improvement in clinical signs, including level of pruritus, amount of scale, alopecia and overall coat quality, compared with pretreatment appearance. Three owners observed adequate initial improvement, with regression to pretreatment state within 6 months of starting treatment. Two owners reported 25–50% improvement in clinical signs while on oral vitamin A supplementation; however, changes were attributed to concurrent topical treatment. Six owners reported no improvement and discontinued oral administration of vitamin A within 7 months. No correlations could be made between vitamin A dosage and response to treatment; prognoses could not be made based on clinical and histopathological findings.
An unidentified ulcer on the dorsum of the hand
Authors: Abdull Gaffar Badr , Almualla Alia
Published: May 2011

What is your diagnosis?
Prolactin level is significantly elevated in lesional skin of patients with psoriasis
Authors: El‐Khateeb Ekramy A. , Zuel‐Fakkar Nehal M. , Eid Safaa M. , Abdul‐Wahab Soha E.
Published: May 2011

Background  Accumulating data point to a potential role of prolactin in the pathogenesis of psoriasis.

Methods  We initiated a study including psoriasis patients (n = 15) and healthy volunteers (n = 15) as controls. Psoriasis area and severity index (PASI) score was evaluated, and prolactin levels in serum and blister fluid were assessed by enzyme‐linked immunosorbent assay (ELISA).

Results  Prolactin levels were significantly (P < 0.01) elevated in blister fluid of psoriatic lesional skin. Correlations between PASI score and different serum prolactin levels in lesional and non‐lesional skin were insignificant. Significant positive correlations of prolactin level were observed between lesional and non‐lesional skin in psoriasis (P < 0.05) and between serum and clinically normal skin in both psoriasis and control subjects (P < 0.05).

Conclusions  Locally produced prolactin may be involved in the pathogenesis of psoriatic lesions.
Parental attitudes towards head lice infestation in Greece
Authors: Doulgeraki Artemis , Valari Manthoula
Published: May 2011

Background  Pediculosis capitis constitutes a growing problem worldwide and is usually considered as an inconvenience. Parents often handle this infestation on their own initiative.

Objective  We conducted a survey in order to depict the parental attitudes towards head lice infestation in Greece.

Methods  Parents of children aged 3–14 years, attending a dermatology outpatient clinic at a children’s hospital, were given a questionnaire regarding head lice. Demographic data, management, and prevention strategies were included in the questionnaire.

Results  Three‐hundred and seventy‐two complete questionnaires were analyzed (response rate: 89%). Pediculosis capitis was more prevalent in the age groups 3–5 years and 6–8 years. The percentage of parents of infested children who sought advice on treatment from the pharmacist was 73%, and only 15% consulted their doctor. Chemical agents to treat head lice were used by 59% of them, products containing natural oils by 38%, and wet combing in parallel was employed by 79% of them. Preventive measures were employed by 66% of the respondents, and 54% applied botanical and synthetic products commercially available for this purpose.

Conclusion  There is a trend towards the use of natural oils for either prevention or treatment. More needs to be done to promote public education and rational use of either pediculicides or non‐pharmacological agents for pediculosis capitis infestation.
Cryoanalgesia for post‐herpetic neuralgia: a new treatment
Authors: Calandria Liliana
Published: May 2011

The existent therapeutic options for post‐herpetic neuralgia (PHN) are varied, albeit not sufficiently effective. The aim of this study was to try a new treatment modality for PHN. A spray of liquid nitrogen (LN) was used in 47 patients suffering from PHN as a stimulator of a mechanism not yet completely understood. The LN spray was carefully applied (so as not to freeze the skin surface) along the diseased sensory nerve dermatome, at weekly sessions lasting for 30 seconds each, with a mean of three applications per patient. The area corresponding to the dermatomes affected by the herpes zoster satisfactorily attenuated the herpetic neuralgia in all patients. Before the sixth treatment session, good or excellent improvement was obtained in 94% of the study patients. Pain was eliminated with one session in nine patients (19%), and with two sessions in eight patients (17%). We conclude that this non‐freezing technique is absolutely safe and injury‐free, and is very efficient in calming PHN.
Successful treatment of argyria using a low‐fluence Q‐switched 1064‐nm Nd:YAG laser
Authors: Han Tae Young , Chang Hee Sun , Lee Hyun Kyung , Son Sook‐Ja
Published: May 2011

Background  Argyria is a rare skin disease caused by cutaneous deposits of silver granules as a result of exposure to silver substrates or ingestion of silver salt. This pigmentation change causes cosmetic problems, and there was previously no recognized effective treatments for argyria.

Objective  To evaluate the treatment effect of a low‐fluence Q‐switched 1064‐nm Nd:YAG laser on argyria.

Subjects and Methods  Case report of a 49‐year‐old with a history of ingestion of a colloidal silver solution daily for approximately one year as a traditional remedy.

Results  After seven sessions of treatment, the patient’s skin color returned to normal.

Conclusion  A low‐fluence Q‐switched 1064‐nm Nd:YAG laser provided safe and effective treatment for the skin discoloration associated with argyria
Isolation of both Pseudozyma aphidis and Nocardia otitidiscaviarum from a mycetoma on the leg
Authors: Chen Bin , Zhu Lin‐yu , Xuan Xuan , Wu Ling‐jian , Zhou Tie‐li , Zhang Xue‐qi , Li Bing‐xu
Published: May 2011

We describe a case of mycetoma which typified the classic presentation of the disease: a male farmer with affection of the lower limbs and a history of trauma. The patient presented with a swollen right lower limb showing multiple discharging sinuses for 25 years. Histopathologically, grains were found by HE stain, and clustered yeast‐like cells were observed by PAS stain. The distinctive ‘dot‐in‐circle’ sign was found through MRI. Besides Nocardia otitidiscaviarum, Pseudozyma aphidis was isolated from deep tissue culture, and the identification of the etiologic species was ascertained by DNA sequencing. Generally speaking, Nocardia otitidiscaviarum is an infrequent cause of mycetoma, and Pseudozyma species are usually isolated from plant material rather than clinical specimens. This is the first case of mycetoma from which both Nocardia otitidiscaviarum and Pseudozyma aphidis were isolated.
Epidural needle for recipient site preparation in hair restoration surgery
Authors: Zor Fatih , Kulahci Yalcin , Sever Celalettin , Bayram Yalcin , Benlier Erol , Bozkurt Mehmet
Published: May 2011

Background  The mini‐ and micro‐grafting method is still one of the most current treatment methods for male pattern baldness and female androgenic alopecia. The preparation of the recipient area with 16G needle has been reported in the literature. However, during the insertion of grafts, the neighboring grafts tend to `pop out'. The study presents our experience in the hair implantation for recipient site preparation with 16G epidural needle.

Methods  The 16G epidural needle was used during preparation of the recipient field in eight patients. Approximately 500 micrografts were grafted in each patient to reconstruct the anterior hairline.

Results  During insertion of the micrografts, almost none of the previously inserted grafts tended to `pop out'. The anterior hairline of the patients was natural without obvious scarring. The mean follow‐up period of these patients was 1.5 years. The amount of graft survival was found to be satisfactory.

Conclusion  According to the surgeon’s clinical observations, application of this technique was found to be easier than standard needle techniques. It can be used by inexperienced surgeons. Use of epidural needle for recipient hole preparation works well in reducing the popping out, and the curved fashion of the holes reduced the angle of the hair follicle.
Sexual selection and temporal phenotypic variation in a damselfly population
Authors: STEELE D. B. , SIEPIELSKI A. M. , McPEEK M. A.
Published: May 2011

Temporal variation in selection can be generated by temporal variation in either the fitness surface or phenotypic distributions around a static fitness surface, or both concurrently. Here, we use within‐ and between‐generation sampling of fitness surfaces and phenotypic distributions over 2 years to investigate the causes of temporal variation in the form of sexual selection on body size in the damselfly Enallagma aspersum. Within a year, when the average female body size differed substantially from the average male body size, male body size experienced directional selection. In contrast, when male and female size distributions overlapped, male body size experienced stabilizing selection when variances in body size were large, but no appreciable selection when the variances in body size were small. The causes of temporal variation in the form of selection can only be inferred by accounting for changes in both the fitness surface and changes in the distribution of phenotypes.
Nutrient profile and availability of co‐products from bioethanol processing
Authors: Azarfar A. , Jonker A. , Hettiarachchi‐Gamage I. K. , Yu P.
Published: May 2011

Bioethanol production in North America has led to the production of considerable quantities of different co‐products. Variation in nutrient profiles as well as nutrient availability among these co‐products may lead to the formulation of imbalanced diets that may adversely affect animal performance. This study aimed to compare three types of dried distiller’s grains with solubles [100% wheat DDGS (WDDGS); DDGS blend1 (BDDGS1, corn to wheat ratio 30:70); DDGS blend2 (BDDGS2, corn to wheat ratio 50:50)] and their different batches within DDGS type with regard to: (i) protein and carbohydrate sub‐fractions based on Cornell Net Carbohydrate and Protein System (CNCPS); (ii) calculated energy values; and (iii) rumen degradation of dry matter (DDM), organic matter (DOM), crude protein (DCP), neutral detergent fibre (DNDF) and starch (Dstarch) at 36 and 72 h of ruminal incubations. Wheat DDGS had a lower intermediately (PB2, 136.4 vs. 187.4 g/kg DM) and a higher slowly degradable true protein (PB3, 142.2 vs.105.3 g/kg DM) than BDDGS1, but similar to those of BDDGS2. Sugar (CA4) was higher, whereas starch (PB1) and digestible fibre (PB3) were lower in WDDGS than in BDDGS1 and BDDGS2. All carbohydrate sub‐fractions determined differed significantly between the two batches of BDDGS2. The BDDGS2 had the highest calculated energy values (TDN, DE3×, ME3×, NEL3×, NEm and NEg) among the three DDGS types. The energy values were slightly different between the batches of the three DDGS types. At all incubation times, wheat DDGS had a significantly higher (p < 0.05) DDM, DOM, DCP and DNDF than both DDGS blends. Differences were observed between different batches within DDGS types with regard to in situ rumen degradation of DM, OM, CP, NDF and starch. In conclusion, differences were observed in protein and carbohydrate sub‐fractions and in situ ruminal degradation of DM, OM, CP, NDF and starch among the three DDGS types and different batches within DDGS type. This indicates that the nutrients supplied to ruminants may not only differ among different types of DDGS but it may also differ among different batches within DDGS type.
Central Injection of Exogenous IL‐1β in the Control Activities of Hypothalamic–Pituitary–Gonadal Axis in Anestrous Ewes
Authors: Herman AP , Misztal T , Romanowicz K , Tomaszewska‐Zaremba D
Published: May 2011

Contents

This study was performed to determine the effect of intracerebroventricular (icv) injection of interleukin (IL)‐1β on the gene expression, translation and release of gonadotropin‐releasing hormone (GnRH) and the GnRH receptor (GnRHR) gene expression in the hypothalamus of anestrous ewes. In the anterior pituitary gland (AP), the expression of genes encoding: GnRHR, β subunits of luteinizing hormone (LH) and folliculotropic hormone (FSH) was determined as well as the effect of IL‐1β on pituitary gonadotropins release. The relative mRNA level was determined by real‐time PCR, GnRH concentration in the cerebrospinal fluid (CSF) was assayed by ELISA and the plasma concentration of LH and FSH were determined by radioimmunoassay. Our results showed that icv injection of IL‐1β (10 or 50 μg/animal) decreased the GnRH mRNA level in the pre‐optic area (POA) (35% and 40% respectively; p ≤ 0.01) and median eminence (ME) (75% and 70% respectively; p ≤ 0.01) and GnRHR gene expression in ME (55% and 50% respectively; p ≤ 0.01). A significant decrease in GnRHR mRNA level in the AP in the group treated with the 50 μg (60%; p ≤ 0.01) but not with the 10 μg dose was observed. The centrally administrated IL‐1β lowered also GnRH concentration in the CSF (60%; p ≤ 0.01) and reduced the intensity of GnRH translation in the POA (p ≤ 0.01). It was not found any effect of icv IL‐1β injection upon the release of LH and FSH. However, the central injection of IL‐1β strongly decreased the LHβ mRNA level (41% and 50%; p ≤ 0.01; respectively) and FSHβ mRNA in the case of the 50 μg dose (49%; p ≤ 0.01) in the pituitary of anestrous ewes. These results demonstrate that the central IL‐1β is an important modulator of the GnRH biosynthesis and release during immune/inflammatory challenge.
Predicting health‐related quality of life by using a health promotion model among Iranian adolescent girls: A structural equation modeling approach
Authors: Mohamadian Hashem , Eftekhar Hasan , Rahimi Abas , Mohamad Hosein Taghdisi , Shojaiezade Davod , Montazeri Ali
Published: May 2011

Predicting the significant determinants of health‐related quality of life through the application of structural equation modeling in adolescents has received little attention in the health education and health promotion literature. The purpose of this study was to investigate the relationships between self‐efficacy, barriers, social support, health‐promoting lifestyle, and health‐related quality of life among Iranian adolescent girls. Pender's health promotion model guided this study. This was a cross‐sectional survey of 500 students who were recruited in Kashan, Iran. Their health‐related quality of life was measured by using the Short Form Health Survey. A path analysis was conducted to predict the health‐related quality of life determinants. The results indicated that 71% of the variance in health‐related quality of life could be predicted by the variables. The results affirmed that self‐efficacy was the most significant predictor of the students' health‐related quality of life. It was concluded that interventions that are aimed at improving self‐efficacy can lead to the enhancement of health‐related quality of life among adolescent girls in the developing country of Iran.
Turnover intention among Italian nurses: The moderating roles of supervisor support and organizational support
Authors: Galletta Maura , Portoghese Igor , Penna Maria Pietronilla , Battistelli Adalgisa , Saiani Luisa
Published: May 2011

The purpose of this study was to examine the variables that are related to person–environment fit in Italian nurses, highlighting the role of supervisor support and organizational support in the relationship between nurses' perceptions of care adequacy, job satisfaction, and turnover intention. Therefore, 1240 nurses from three hospitals completed a self‐administered questionnaire. The results showed that supervisor support and organizational support act differently as moderators of the care adequacy–job satisfaction–turnover intention relationship. Finally, job satisfaction was a mediating variable between care adequacy and turnover intention. These findings have important implications for hospitals because they help to promote effective work environments and to reduce turnover intention.
Views of Iranian patients on life with cancer: A phenomenological study
Authors: Nasrabadi Alireza Nikbakht , Bahabadi Abbas Houshmand , Hashemi Fatemeh , Valiee Sina , Seif Hadi
Published: May 2011

Cancer is one of the major causes of death worldwide. The diagnosis of this disease can cause significant stress, which destroys the patient's hopes, dreams and expectations. The aim of this qualitative phenomenological study was to explore the perceptions of 23 Iranian patients about life with cancer using in‐depth and semi‐structured interviews as the method of data collection. The data were analyzed using Benner's interpretive thematic analysis method. Four main themes were clarified by studying the patients' experiences of life with cancer: (i) cancer as a kind of divine test; (ii) a very bitter and debilitating experience; (iii) chemotherapy as the most difficult experience of cancer; and (iv) a continuous struggle. Life with cancer is full of suffering, stress and bitterness. Fear and hope are intertwined; this phase can be successfully endured by patience, tolerance and stability. It is also helpful if close relatives can raise the patient's morale. Certainly, in this process, religious beliefs, faith and culture‐oriented interventions can significantly help patients deal with cancer.
Contributions of food web modelling to the ecosystem approach to marine resource management in the Mediterranean Sea
Authors: Coll Marta , Libralato Simone
Published: May 2011

Ecological modelling tools are applied worldwide to support the ecosystem‐based approach of marine resources (EAM). In the last decades, numerous applications were attempted in the Mediterranean Sea, mainly using the Ecopath with Ecosim (EwE) tool. These models were used to analyse a variety of complex environmental problems. Many applications analysed the ecosystem impacts of fishing and assessed management options. Other studies dealt with the accumulation of pollution through the food web, the impact of aquaculture or the ecosystem effects of climate change. They contributed to the scientific aspects of an ecosystem‐based approach in the region because they integrated human activities within an ecosystem context and evaluated their impact on the marine food web, including environmental factors. These studies also gathered a significant amount of information at an ecosystem level. Thus, in the second part of this review, we used this information to quantify structural and functional traits of Mediterranean marine ecosystems at regional scales as the illustration of further potentialities of EwE for an EAM. Results highlighted differential traits between ecosystem types and a few between basins, which illustrate the environmental heterogeneity of the Mediterranean Sea. Moreover, our analysis evidenced the importance of top predators and small pelagic fish in Mediterranean ecosystems, in addition to the structural role of benthos and plankton organisms. The impact of fishing was high and of a similar intensity in the western, central and eastern regions and showed differences between ecosystem types. The keystone role of species was more prominent in protected environments.
Verbal Style, Gubernatorial Strategies, and Legislative Success
Authors: Crew, Jr. Robert E. , Lewis Christopher
Published: May 2011

This article examines the relationship between a governor's verbal style and his success in achieving his legislative goals. We add a measure of verbal style developed by Roderick Hart to a traditional model used by scholars of political chief executives to explain legislative success. We apply this model to the State of the State addresses of six governors of Florida who served between 1966 and 2006. Our findings reflect the validity of the truism “words matter.” Governors who use words and phrases that connote enthusiasm, activity, and realism are more successful in the legislative arena than those who do not.
Allocating Homes for People with Intellectual Disability: Needs, Mix and Choice
Authors: Wiesel Ilan
Published: May 2011

Allocation of housing and support services for people with intellectual disability is based on three major sets of criteria: an assessment of the applicants' needs; considerations of social mix; and the applicants' own choices. This article examines the philosophical and institutional rationales underlying each of these notions and the tensions arising when seeking to achieve a balance between them. The first section of the article is based on a review of related studies in the UK, the USA and Australia, mainly on allocation policies in mainstream social housing. The second section presents original empirical work carried out in the state of Victoria, Australia, in 2007–08, illustrating some of the implications of a new balance that was created between needs, mix and choice in allocation of housing and support for people with intellectual disability. The article argues that the concepts of needs, mix and choice should be redefined in a way which reflects the interdependencies between them. Further, the article calls for more extensive mutual learning between studies of mainstream social housing and housing for people with intellectual disability.
The Role of Non‐profit Organizations in the Mixed Economy of Welfare‐to‐Work in the UK and Australia
Authors: Wright Sharon , Marston Greg , McDonald Catherine
Published: May 2011

This article charts the development of welfare‐to‐work policies and compares and contrasts the traditions of delivery in the UK and Australia. We find that in the UK, employment services and social security benefit administration have been dominated by the central state, traditionally affording a key role to civil servants as direct delivery agents. However, in federal Australia, mixed economies of welfare‐to‐work operate in the different states, there is a far greater role for social services and non‐profit organizations are firmly established as key providers of frontline employment services. Since the late 1990s, UK welfare reforms have been gradually following the Australian lead in contracting non‐state actors as delivery agents. As this trend seems set to continue and intensify, we examine the Australian experience in order to reflect on the role of non‐profits in policy reform.
Migration and Displacement Triggered by Floods in the Mekong Delta
Authors: Dun Olivia
Published: May 2011

The links between environmental change and migration is a theme which has caused much public debate. This debate is driven partially by the lack of empirical research on the linkages and relationship between environment and migration. This article offers a contribution to the limited literature which examines the ways in which migration is linked to environmental push factors. Initial research into the current dynamics of population displacement and migration linked to flooding in the upper reaches of the Vietnamese Mekong Delta was carried out in late 2007. Annual cyclical flooding in the Mekong Delta of Vietnam is a regular event and essential to the livelihoods of people living in the region. Over the last decade, however, there have been unusually large flooding events in the Mekong Delta region which have adversely impacted the lives and livelihoods of local communities. The research aimed to determine whether flooding could be considered a cause for migration or displacement. Results show that the impacts of regular flooding of the Mekong Delta can trigger independent household or individual migration decisions and are a cause for government‐initiated resettlement of households. This research contributes to an increased understanding of the role of environmental change/degradation in causing displacement and migration, since forced migration and migration studies have more commonly focused on economic, political and social reasons for population displacement.
Experiences of living with increased risk of developing colorectal and gynaecological cancer in individuals with no identified gene mutation
Authors: Persson Eva , Lindholm Elisabet , Berndtsson Ina , Lundstam Ulf , Hultén Leif , Carlsson Eva
Published: May 2011

Scand J Caring Sci; 2012; 26; 20–27
 
Experiences of living with increased risk of developing colorectal and gynaecological cancer in individuals with no identified gene mutation

Background:  In most families with familial cancers, mutations have not been demonstrated; thus, healthy individuals cannot be tested for mutation status. As a consequence, many persons at risk of familial cancer live with an unknown, but presumably high, risk of developing cancer.

Aim:  The aim of this study was to describe individuals’ perceptions of living with an increased risk of colorectal and gynaecologic cancer where the gene mutation is unknown.

Methods:  Interviews were conducted with 30 individuals with familial colorectal cancer. These persons have no known mutation and therefore should be considered presumptive carriers. In connection with the interviews, all participants were offered to take part in a surveillance programme consisting of a colonoscopy and gynaecological examinations. The interview transcriptions were analysed by the use of qualitative content analysis.

Results:  Two themes emerged from the analyses: first, living under a threat with two subthemes, threat awareness and distancing oneself from the threat. The second theme, living with uncertainty, was divided into four subthemes: influencing one’s family, being on the safe side, facing emotions evoked by examinations and trust and disappointment to the medical services.

Conclusion:  These persons live with a lifelong uncertainty with a varying intensity depending on what happens throughout the life trajectory. They have no diagnosis or patient group to relate to; therefore, the entire situation is often perceived as abstract. Thus, providing information and counselling needs to be more deeply elucidated, and we need to address both situational and existential ways of uncertainty. This will, however, require professionals of all disciplines to understand the meaning of uncertainty and help ensure that its adverse effects are decreased with adequate nursing interventions.
A New Model of Centrifugal Blood Pump for Cardiopulmonary Bypass: Design Improvement, Performance, and Hemolysis Tests
Authors: Leme Juliana , Fonseca Jeison , Bock Eduardo , da Silva Cibele , da Silva Bruno Utiyama , dos Santos Alex Eugênio , Dinkhuysen Jarbas , Andrade Aron , Biscegli José F.
Published: May 2011

A new model of blood pump for cardiopulmonary bypass (CPB) application has been developed and evaluated in our laboratories. Inside the pump housing is a spiral impeller that is conically shaped and has threads on its surface. Worm gears provide an axial motion of the blood column. Rotational motion of the conical shape generates a centrifugal pumping effect and improves pumping performance. One annular magnet with six poles is inside the impeller, providing magnetic coupling to a brushless direct current motor. In order to study the pumping performance, a mock loop system was assembled. Mock loop was composed of Tygon tubes (Saint‐Gobain Corporation, Courbevoie, France), oxygenator, digital flowmeter, pressure monitor, electronic driver, and adjustable clamp for flow control. Experiments were performed on six prototypes with small differences in their design. Each prototype was tested and flow and pressure data were obtained for rotational speed of 1000, 1500, 2000, 2500, and 3000 rpm. Hemolysis was studied using pumps with different internal gap sizes (1.35, 1.45, 1.55, and 1.7 mm). Hemolysis tests simulated CPB application with flow rate of 5 L/min against total pressure head of 350 mm Hg. The results from six prototypes were satisfactory, compared to the results from the literature. However, prototype #6 showed the best results. Best hemolysis results were observed with a gap of 1.45 mm, and showed a normalized index of hemolysis of 0.013 g/100 L. When combined, axial and centrifugal pumping principles produce better hydrodynamic performance without increasing hemolysis.
Development of a Voxel Model of the Heart for Dosimetry
Authors: Fonseca Keila R. , Trindade Bruno M. , Campos Tarcísio P.R.
Published: May 2011

This article investigates the dosimetry of a radioactive stent and radioactive liquid balloon placed into the heart vasculature to prevent restenosis after atherosclerosis treatment. The research aims to know the dosages to establish a suitable activity which achieves restenosis control and thereafter minimize radiation effects in the cardiac muscle. In order to accomplish the dosimetric analysis, a heart voxel model was assembled based on tomographic images. The computational model consists of a three‐dimensional matrix taken from 60 tomographic images representing the major heart tissues. A radioactive 153Sm liquid balloon is simulated as well as a 32P radioactive stent, inserted in an arbitrary heart artery. After simulation processing, the absorbed dose rate was evaluated in the heart musculature. The models are presented in two‐ and three‐dimensional previews and the dosage profiles are shown by isodose curves superimposed onto the heart model.
In Vitro Properties and Performance of Glutaraldehyde‐Crosslinked Bovine Pericardial Bioprostheses Treated With Glutamic Acid
Authors: Braile Maria Christiane Valéria Braga , Carnevalli Nelly Cristina , Goissis Gilberto , Ramirez Vladimir Aparecido , Braile Domingo Marcolino
Published: May 2011

Calcification is one of the major causes of failure of heart valve bioprostheses (HVBs) derived from glutaraldehyde (GA)‐processed bovine pericardium (BP) or porcine aortic valves. New crosslinking reagent procedures are still far from giving satisfactory results, and this is the main reason why GA is still the reagent of choice for the fixation of native tissue intended for HVB manufacture. Nevertheless, two new findings with respect to GA processing may significantly improve HVB performance postimplantation: the finding that increasing concentrations of GA result in a decrease in calcification; the blocking of free aldehyde usually by nucleophyles or the treatment of processed material at low pH. This work investigates the in vitro properties of BP fixed with GA followed by the treatment with glutamic acid under alkaline conditions in order to prepare BP materials with lower calcification potential postimplantation. In comparison to conventional processing, except for the tensile strength that was slightly lower, elongation and toughness were higher than the accepted values. No significant differences were observed in the performance indexes (mean pressure gradient, mean effective area, regurgitant fraction, performance and efficiency indexes) with wear resistance over 150 × 106 cycles. These results indicate that the processing of BP described in this work may be of potential use in the manufacture of HVBs.
Single Axis Controlled Hybrid Magnetic Bearing for Left Ventricular Assist Device: Hybrid Core and Closed Magnetic Circuit
Authors: da Silva Isaias , Horikawa Oswaldo , Cardoso Jose R. , Camargo Fernando A. , Andrade Aron J.P. , Bock Eduardo G.P.
Published: May 2011

In previous studies, we presented main strategies for suspending the rotor of a mixed‐flow type (centrifugal and axial) ventricular assist device (VAD), originally presented by the Institute Dante Pazzanese of Cardiology (IDPC), Brazil. Magnetic suspension is achieved by the use of a magnetic bearing architecture in which the active control is executed in only one degree of freedom, in the axial direction of the rotor. Remaining degrees of freedom, excepting the rotation, are restricted only by the attraction force between pairs of permanent magnets. This study is part of a joint project in development by IDPC and Escola Politecnica of São Paulo University, Brazil. This article shows advances in that project, presenting two promising solutions for magnetic bearings. One solution uses hybrid cores as electromagnetic actuators, that is, cores that combine iron and permanent magnets. The other solution uses actuators, also of hybrid type, but with the magnetic circuit closed by an iron core. After preliminary analysis, a pump prototype has been developed for each solution and has been tested. For each prototype, a brushless DC motor has been developed as the rotor driver. Each solution was evaluated by in vitro experiments and guidelines are extracted for future improvements. Tests have shown good results and demonstrated that one solution is not isolated from the other. One complements the other for the development of a single‐axis‐controlled, hybrid‐type magnetic bearing for a mixed‐flow type VAD.
Specification of Supervisory Control Systems for Ventricular Assist Devices
Authors: Cavalheiro André C.M. , Santos Fo Diolino J. , Andrade Aron , Cardoso José Roberto , Horikawa Osvaldo , Bock Eduardo , Fonseca Jeison
Published: May 2011

One of the most important recent improvements in cardiology is the use of ventricular assist devices (VADs) to help patients with severe heart diseases, especially when they are indicated to heart transplantation. The Institute Dante Pazzanese of Cardiology has been developing an implantable centrifugal blood pump that will be able to help a sick human heart to keep blood flow and pressure at physiological levels. This device will be used as a totally or partially implantable VAD. Therefore, an improvement on device performance is important for the betterment of the level of interaction with patient's behavior or conditions. But some failures may occur if the device's pumping control does not follow the changes in patient's behavior or conditions. The VAD control system must consider tolerance to faults and have a dynamic adaptation according to patient's cardiovascular system changes, and also must attend to changes in patient conditions, behavior, or comportments. This work proposes an application of the mechatronic approach to this class of devices based on advanced techniques for control, instrumentation, and automation to define a method for developing a hierarchical supervisory control system that is able to perform VAD control dynamically, automatically, and securely. For this methodology, we used concepts based on Bayesian network for patients' diagnoses, Petri nets to generate a VAD control algorithm, and Safety Instrumented Systems to ensure VAD system security. Applying these concepts, a VAD control system is being built for method effectiveness confirmation.
Processing of hematopoietic stem cells from peripheral blood before cryopreservation: use of a closed automated system
Authors: Zinno Francesco , Landi Fabiola , Scerpa Maria Cristina , Aureli Viviana , Lanti Alessandro , Ceccarelli Stefano , Caniglia Maurizio , Miele Massimino Jan , Daniele Nicola , Landolfo Attilio , Cometa Angela Maria , Locatelli Franco , Isacchi Giancarlo
Published: May 2011

BACKGROUND: Hematopoietic stem cell transplantation is commonly used to treat several oncohematologic diseases. The autologous hematopoietic progenitor cells collected through apheresis (HPC‐A) must be cryopreserved and stored before use in vivo. Cell processing that precedes cryopreservation of HPC‐A includes volume reduction aimed at reducing the amount of dimethyl sulfoxide used, as well as storage space.

STUDY DESIGN AND METHODS: The aim of our study was to assess the effectiveness of volume reduction performed with an automated closed system, namely, the Sepax S100 cell separation device (Biosafe SA). A total of 165 procedures were carried out on concentrates collected from 104 adult and pediatric patients. As a control group, 30 HPC‐A units processed according to the standard method (i.e., centrifugation at a speed of 850 × g for 10 minutes, followed by manual plasma reduction) were evaluated.

RESULTS: The volume reduction obtained was 59% (range, 20.54%‐84.21%; standard deviation [SD], ±12.19%), going from 236 mL (range, 100‐443 mL; SD, ±80.41 mL) to 97 mL (range, 33.00‐263.00 mL; SD, ±47.41 mL); recovery of nucleated cells was 90% (range, 64.84%‐105.93%; SD, ±8.76%), while that of CD34+ cells was 91% (range, 59.30%‐119.37%; SD, ±13.30%). These values did not differ from those obtained using the standard method. Automated processing required 20 minutes versus 40 minutes of manual processing.

DISCUSSION: Our data demonstrate that volume reduction carried out with the Sepax S100 automated system was particularly effective; cell recovery was excellent and the time spent was short. Moreover, the closed system allows cell processing to be carried out in a contamination‐controlled environment, in accordance with good manufacturing practice guidelines.
Adjudicating bleeding events in a platelet dose study: impact on outcome results and challenges
Authors: Heddle Nancy M. , Wu Cynthia , Vassallo Ralph , Carey Patricia , Arnold Donald , Lozano Miguel , Pavenski Katerina , Sweeney Joseph , Stanworth Simon , Liu Yang , Traore Aicha , Barty Rebecca , Tinmouth Alan ,   for the BEST Collaborative
Published: May 2011

BACKGROUND: In the SToP platelet dose study, the World Health Organization (WHO) bleeding grade was assigned using adjudication. This study describes the challenges associated with adjudicating bleeding events and compares the adjudicated and bedside results for bleeding grade.

STUDY DESIGN AND METHODS: To categorize bleeding, the following information was provided to adjudicators: daily bleeding assessments, interventions to stop or control bleeding, daily blood counts, and transfused blood components. Each daily assessment was sent to two adjudicators who independently assigned a grade and anatomic site of bleeding. Discordant cases where disagreement occurred were sent to a third adjudicator and subsequently to a fourth or fifth adjudicator in an attempt to reach agreement. Disagreement after five adjudicators was resolved by consensus. The final adjudicated grade was compared with the grade of bleeding assigned at the bedside by study personnel.

RESULTS: A total of 1150 case report forms were adjudicated. Disagreement on grade of bleeding was common: 31.2% after the first two adjudicators, 4.0% after the third adjudicator, 0.7% after four, and 0.05% after five. Disagreement on anatomic site was less but still occurred in 17% of cases after two adjudicators. The frequency of bleeding (≥ Grade 2) based on adjudication was higher than bedside grading (standard‐dose arm, 47.5% vs. 34.4%; low‐dose arm, 50.0% vs. 43.1%).

CONCLUSION: The frequency of WHO bleeding varies depending on the method used to assign grade. Adjudication to assign bleeding grade resulted in significant disagreement when two adjudicators were used.
Platelet refractoriness in acquired hemophagocytic syndrome
Authors: George Melissa R. , Herman Jay H. , Holdbrook Thomas , Cui Chunhua , Vardhana Harsha G. , Behling Eric M.
Published: May 2011

BACKGROUND:Acquired hemophagocytic syndrome (AHPS) is a severe inflammatory disorder often caused by Epstein‐Barr virus (EBV). Proliferation of activated macrophages produces uncontrolled cytokine production. Thrombocytopenia is common in AHPS, previously attributed to inadequate or ineffective marrow platelet (PLT) production. PLT transfusion response is not well reported. Two patients with fatal AHPS developed unexplained PLT transfusion refractoriness before definitive diagnosis.

CASE REPORTS:PLT refractoriness was noted during the care of two patients. The refractoriness was determined to be nonimmune and both demonstrated various clinical signs and laboratory findings consistent with AHPS. The first patient's AHPS was attributable to EBV infection. In the other patient, no underlying cause could be found. Both patients had an aggressive clinical course and succumbed to this relatively rare syndrome. The PLT refractoriness was evident before the AHPS diagnosis was made.

DISCUSSION:AHPS is not generally a consideration in the evaluation of nonimmune PLT refractoriness. However, these illustrative cases make an argument for its consideration in the differential diagnosis of PLT refractoriness in severely ill patients. Once present, it is unclear if the refractoriness can be reversed by AHPS‐targeted therapy.
Blood product positive patient identification: comparative simulation‐based usability test of two commercial products
Authors: Anders Shilo , Miller Anne , Joseph Peggy , Fortenberry Tiercy , Woods Marcella , Booker Ray , Slaughter Jennifer , Weinger Matthew B. , France Daniel
Published: May 2011

BACKGROUND: The blood product administration process has been subject to various quality improvement initiatives aimed at reducing errors, including blood product labels that are missing, inaccessible, unreadable, or mismatched to orders and/or patients. This article reports the results of a formal simulation‐based usability test of two comparable technologies designed to reduce blood product administration errors.

STUDY DESIGN AND METHODS: Nineteen nurses and three anesthesia providers evaluated one of the two products during simulated use in realistic scenarios during 90‐minute test sessions. Both products required additional learning despite 15 minutes of dedicated vendor‐provided pretest training.

RESULTS: There were significant effectiveness differences between the two products, but use of both devices was less efficient than manual checking. Usability issues included poor access to subtasks, lack of process feedback, inadequate error messaging, and confusing device interactions.

CONCLUSION: While clinicians' subjective ratings of both devices were similarly high, both products had significant usability issues likely to lead to clinician frustration and workarounds during actual use. This study suggests that usability testing is a valuable and more effective method than preference surveys of determining the ability of blood administration products to meet clinicians' needs in the complex world of patient care.
Transnational Advocates and Labor Rights Enforcement in the North American Free Trade Agreement
Authors: Nolan García Kimberly A.
Published: May 2011

This article investigates the impact of trade-based social clauses on labor rights enforcement. Drawing on insights from recent theoretical work on transnational advocacy networks and labor rights, the study examines how transnational groups and domestic actors engage the labor rights mechanisms under the NAFTA labor side agreement, the NAALC. A statistical analysis of original data drawn from NAALC cases complements interviews with key participants to analyze the factors that predict whether the three national mediation offices review labor dispute petitions. This study suggests that transnational activism is a key factor in explaining petition acceptance. Transnational advocates craft petitions differently from other groups and, by including worker testimony in the petitions, signal to arbitration bodies the possibility of corroborating claims through contact with affected workers.
Coalition Erosion and Presidential Instability in Ecuador
Authors: Acosta Andrés Mejía , Polga-Hecimovich John
Published: May 2011

This article advances the idea that coalition formation and maintenance in highly fragmented presidential regimes is not only crucial to overcoming policy deadlock, but in some cases, critical to ensuring government survival. To advance this argument, the article looks at the formation and demise of legislative coalitions in Ecuador between 1979 and 2006. The empirical data suggest that paradoxically, government coalitions became more difficult to sustain after the adoption of institutional reforms intended to strengthen the president's legislative powers. The adoption of those reforms, it is argued, undermined the legislative incentives to cooperate with the government and helped to accelerate coalition erosion. Not only did the reforms fail significantly to avoid policy deadlock, but in some cases they contributed to the early termination of presidential mandates. This article contributes to the study of coalition survival and how it is linked to policymaking.
Influence de quelques variables liées à la plante Phaseolus vulgaris sur la ponte d'Acanthoscelides obtectus dans la nature
Authors: Jarry Marc , Debouzie Domitien , Chacon Alicia
Published: May 2011

L'influence de quelques variables liées aux plantes de Phaseolus vulgaris (date de maturation, hauteur et nombre de graines dans les gousses) sur la ponte de la bruche du haricot Acanthoscelides obtectus a été étudiée dans la nature sur 20 pieds de haricot dont toutes les gousses ont été suivies puis récoltées.

Les résultats montrent une bonne corrélation entre le nombre d'oeufs émis dans une gousse et le nombre de jours avec présence d'adultes sur cette gousse. La date de maturation influence fortement la contamination des gousses. Au niveau spatial, les pieds situés dans des zones non désherbées, où peuvent s'alimenter les adultes, sont les plus contaminés. Les autres variables semblent avoir moins d'importance.

On note une très forte agrégativité des pontes dans certaines gousses qui sont, en général, parmi les premières mǔres, mais cette agrégativité persiste měme si les femelles ont le choix, sur un mème pied, entre plusieurs gousses arrivées ensemble à maturité.

Mots clés: Acanthoscelides obtectus, Phaseolus vulgaris, comportement de ponte, distribution des pontes, structure spatio‐temporelle