bluuebunny/crossref_metadata_2025 huggingface dataset:
Visual error augmentation enhances learning in three dimensions
Authors: Sharp Ian , Huang Felix , Patton James
Published: September 2011

Because recent preliminary evidence points to the use of Error augmentation (EA) for motor learning enhancements, we visually enhanced deviations from a straight line path while subjects practiced a sensorimotor reversal task, similar to laparoscopic surgery. Our study asked 10 healthy subjects in two groups to perform targeted reaching in a simulated virtual reality environment, where the transformation of the hand position matrix was a complete reversal--rotated 180 degrees about an arbitrary axis (hence 2 of the 3 coordinates are reversed). Our data showed that after 500 practice trials, error-augmented-trained subjects reached the desired targets more quickly and with lower error (differences of 0.4 seconds and 0.5 cm Maximum Perpendicular Trajectory deviation) when compared to the control group. Furthermore, the manner in which subjects practiced was influenced by the error augmentation, resulting in more continuous motions for this group and smaller errors. Even with the extreme sensory discordance of a reversal, these data further support that distorted reality can promote more complete adaptation/learning when compared to regular training. Lastly, upon removing the flip all subjects quickly returned to baseline rapidly within 6 trials.
Traditional-medical knowledge and perception of pangolins (Manis sps) among the Awori people, Southwestern Nigeria
Authors: Soewu Durojaye A , Adekanola Temilolu A
Published: September 2011

Background

Animals have been used as medicinal resources throughout human history. Majority of wildlife used in traditional medicines is taken from the wild; hence demand by traditional medicine is a cause of over-exploitation of wild animals. Indiscriminate use of endangered species portends grievous implications for biodiversity conservation. This study investigated the dynamics of the use of pangolin in trado-medicinal preparations amongst the Awori people.

Methods

Forty traditional Yorubic-medical practitioners (tymps) selected through stratified random-sampling technique were interviewed using open-ended questionnaires. Various aspects of the utilisation of pangolin in traditional medicinal practices were investigated. Data collected were analysed using simple frequencies and percentages.

Results

An average of 1.6 pangolins were utilised per tymp per month. About 43% of respondents contracted hunters for deliberate searches for the animals. More than 92% believed that pangolins' abundance is steadily decreasing. Above 97% reported a continuous decline in the size of pangolin. Pangolin was used in treating 47 conditions. Situations accommodated included those that can be treated by orthodox medicine like rheumatism and venereal diseases as well as some that are out of range for orthodox medicine including kleptomania and good luck charms. Some substitute animals like gorilla are under a greater conservation threat than pangolin.

Conclusions

Utilisation of pangolin in traditional medicine has no consideration for sustainability. Awareness should be created on people as regards the implications of unsustainable depletion of medicinal resources. Efforts should be intensified on ex-situ breeding of pangolin while subjecting the scales and other parts to laboratory studies to determine the bioactive constituents.
Low triglyceride levels are associated with a better metabolic control in patients with type 1 diabetes
Authors: Alcantara Leticia M , Silveira Nathalia E , Dantas Joana R , Araujo Paula B , de Oliveira Marcus M , Milech Adolpho , Zajdenverg Lenita , Rodacki Melanie , de Oliveira José EP
Published: September 2011

Background

Although it is well known in the literature that high triglyceride serum (TG) levels can jeopardize the metabolic control, little is known about the influence of low TG on type 1 diabetes patients (T1D). The aim of this study is to investigate the distribution of TG serum levels in individuals with T1D and its relationship with metabolic control.

Findings

We reviewed the medical charts of 180 patients with T1D, who were classified in groups according to TG levels: 1) low (below 50 mg/dL); 2) normal (50-150 mg/dL); 3) high (above 150 mg/dL). TG were low in 21.1% (n = 38; group 1), normal in 68.6% (n = 123; group 2) and high in 10.6% (n = 19; group 3). High TG was associated with a poor metabolic control (p < 0.001). Patients with TG lower than 50 mg/dL had a lower HbA1c than those with TG between 50 and 150 mg/dL (7.41+/-1.50% vs 8.56%+/-1.94%; p = 0.002).

Conclusion

TG lower than 50 mg/dL was common and might be associated with a better metabolic control in patients with T1D, although it is not clear whether the former is the cause or consequence for the latter.
Novel dimeric DOTA-coupled peptidic Y1-receptor antagonists for targeting of neuropeptide Y receptor-expressing cancers
Authors: Chatenet David , Cescato Renzo , Waser Beatrice , Erchegyi Judit , Rivier Jean E , Reubi Jean Claude
Published: September 2011

Background

Several peptide hormone receptors were identified that are specifically over-expressed on the cell surface of certain human tumors. For example, high incidence and density of the Y1 subtype of neuropeptide Y (NPY) receptors are found in breast tumors. Recently, we demonstrated that the use of potent radiolabeled somatostatin or bombesin receptor antagonists considerably improved the sensitivity of in vivo imaging when compared to agonists. We report here on the first DOTA-coupled peptidic Y1 receptor affine dimer antagonists.

Methods

Based on a Y1 affine dimeric peptide scaffold previously reported to competitively antagonize NPY-mediated processes, we have developed new dimeric DOTA-coupled Y1 receptor affine antagonists for scintigraphy and radiotherapy. These dimeric peptides were tested for their specific binding to Y1 expressed in SK-N-MC cells and Y2 expressed in SH-SY5Y as well as for their ability to mediate cAMP production in SK-N-MC cells.

Results

Introduction of two DOTA moieties at the N-termini of the dimeric NPY analogs as well as the double Asn29 replacement by Dpr(DOTA) or Lys(DOTA) (6 and 10) moiety dramatically reduced binding affinity. However, asymmetric introduction of the DOTA moiety in one segment of the peptidic heterodimer (8 and 11) resulted in suitable antagonists for receptor targeting with high binding affinity for Y1. All compounds were devoid of Y2 binding affinity.

Conclusions

The design and the in vitro characterization of the first DOTA-coupled dimeric NPY receptor antagonist with high affinity and selectivity for Y1 over Y2 are described. This compound may be an excellent candidate for the imaging of Y1-positive tumors and their treatment.
Effects of short-term glucocorticoid treatment on changes in cartilage matrix degradation and chondrocyte gene expression induced by mechanical injury and inflammatory cytokines
Authors: Lu Yihong CS , Evans Christopher H , Grodzinsky Alan J
Published: September 2011

Introduction

Traumatic joint injury damages cartilage and causes adjacent joint tissues to release inflammatory cytokines, increasing the risk of developing osteoarthritis. The main objective of this study was to determine whether the combined catabolic effects of mechanical injury, tumor necrosis factor alpha (TNFα) and interleukin-6 (IL-6)/soluble IL-6 receptor (sIL-6R) on cartilage could be abolished by short-term treatment with glucocorticoids such as dexamethasone.

Methods

In an initial dexamethasone-dose-response study, bovine cartilage explants were treated with TNFα and increasing concentrations of dexamethasone. Bovine and human cartilage explants were then subjected to individual and combined treatments with TNFα, IL-6/sIL-6R and injury in the presence or absence of dexamethasone. Treatment effects were assessed by measuring glycosaminoglycans (GAG) release to the medium and synthesis of proteoglycans. Additional experiments tested whether pre-exposure of cartilage to dexamethasone could prevent GAG loss and inhibition of biosynthesis induced by cytokines, and whether post-treatment with dexamethasone could diminish the effects of pre-established cytokine insult. Messenger ribonucleic acid (mRNA) levels for genes involved in cartilage homeostasis (proteases, matrix molecules, cytokines, growth and transcription factors) were measured in explants subjected to combined treatments with injury, TNFα and dexamethasone. To investigate mechanisms associated with dexamethasone regulation of chondrocyte metabolic response, glucocorticoid receptor (GR) antagonist (RU486) and proprotein convertase inhibitor (RVKR-CMK) were used.

Results

Dexamethasone dose-dependently inhibited GAG loss and the reduction in biosynthesis caused by TNFα. The combination of mechanical injury, TNFα and IL-6/sIL-6R caused the most severe GAG loss; dexamethasone reduced this GAG loss to control levels in bovine and human cartilage. Additionally, dexamethasone pre-treatment or post-treatment of bovine explants lowered GAG loss and increased proteoglycan synthesis in cartilage explants exposed to TNFα. Dexamethasone did not down-regulate aggrecanase mRNA levels. Post-transcriptional regulation by dexamethasone of other genes associated with responses to injury and cytokines was noted. GR antagonist reversed the effect of dexamethasone on sulfate incorporation. RVKR-CMK significantly reduced GAG loss caused by TNFα + IL-6 + injury.

Conclusions

Short-term glucocorticoid treatment effectively abolished the catabolic effects exerted by the combination of pro-inflammatory cytokines and mechanical injury: dexamethasone prevented proteoglycan degradation and restored biosynthesis. Dexamethasone appears to regulate the catabolic response of chondrocytes post-transcriptionally, since the abundance of transcripts encoding aggrecanases was still elevated in the presence of dexamethasone.
cMyc Is a Principal Upstream Driver of β-Cell Proliferation in Rat Insulinoma Cell Lines and Is an Effective Mediator of Human β-Cell Replication
Authors: Karslioglu Esra , Kleinberger Jeffrey W. , Salim Fatimah G. , Cox Amy E. , Takane Karen K. , Scott Donald K. , Stewart Andrew F.
Published: September 2011

Adult human β-cells replicate slowly. Also, despite the abundance of rodent β-cell lines, there are no human β-cell lines for diabetes research or therapy. Prior studies in four commonly studied rodent β-cell lines revealed that all four lines displayed an unusual, but strongly reproducible, cell cycle signature: an increase in seven G1/S molecules, i.e. cyclins A, D3, and E, and cdk1, -2, -4, and -6. Here, we explore the upstream mechanism(s) that drive these cell cycle changes. Using biochemical, pharmacological and molecular approaches, we surveyed potential upstream mitogenic signaling pathways in Ins 1 and RIN cells. We used both underexpression and overexpression to assess effects on rat and human β-cell proliferation, survival and cell cycle control. Our results indicate that cMyc is: 1) uniquely up-regulated among other candidates; 2) principally responsible for the increase in the seven G1/S molecules; and, 3) largely responsible for proliferation in rat β-cell lines. Importantly, cMyc expression in β-cell lines, although some 5- to 7-fold higher than normal rat β-cells, is far below the levels (75- to 150-fold) previously associated with β-cell death and dedifferentiation. Notably, modest overexpression of cMyc is able to drive proliferation without cell death in normal rat and human β-cells. We conclude that cMyc is an important driver of replication in the two most commonly employed rat β-cell lines. These studies reverse the current paradigm in which cMyc overexpression is inevitably associated with β-cell death and dedifferentiation. The cMyc pathway provides potential approaches, targets, and tools for driving and sustaining human β-cell replication.
A multiparametric approach to monitor the effects of γ-secretase inhibition along the whole intestinal tract
Authors: Droy-Dupré Laure , Vallée Mickaël , Bossard Céline , Laboisse Christian L. , Jarry Anne
Published: September 2011

γ-secretase inhibitors (GSIs) have been recently proposed as chemopreventive agents in gastrointestinal neoplasia, because they lead, through inhibition of the Notch signaling pathway, to goblet cell conversion in some intestinal adenomas of the ApcMin mice, and halt epithelial cell proliferation. In this study, we examine in depth, in normal mice, the effects of a GSI, dibenzazepine (DBZ), intraperitoneally administered for 8 days at a non toxic dose, on the gene expression pattern of secretory mucin (MUC), goblet cell conversion, organization of the crypt structural-proliferative units, stem cell niche and apoptotic compartments, along the entire length of the small intestine and colon. We demonstrate that DBZ elicits a homogeneous goblet cell conversion all along the mouse intestinal tract, associated with an overexpression of the gene Muc2 without ectopic expression of the gastric genes Muc5ac and Muc6, and with the emergence of lysozyme-positive ‘intermediate cells’ in the colon. Furthermore, DBZ treatment induces a heterogeneous reorganization of the crypt structural-proliferative units along the intestinal tract and of the stem cell niche in the colon, without disturbing the apoptotic compartment. These findings point to uncoupled effects of a GSI on goblet cell conversion and reorganization of the intestinal crypt structural-proliferative units and stem cell niche, and suggest caution in the use of GSIs as chemopreventive agents for intestinal neoplasia.
Labelled antibody-based one-step time-resolved fluoroimmunoassay for measurement of free thyroxine in serum
Authors: Wang Zheng , Lao Hai-Miao , Liu Tiancai , Li Lai-Qing , Li Ming , Wu Ying-Song
Published: September 2011

Background

Valid assays measuring free thyroxine (FT4) must perform without bias despite large variations in the concentrations and affinities of serum thyroxine-binding proteins in the population. We developed a new, rapid one-step labelled-antibody time-resolved fluoroimmunoassay (TRFIA) for FT4.

Methods

Based on the heterologous combination of anti-T4 monoclonal antibody and triiodothyronine–immunoglobulin G conjugate, a one-step TRFIA for FT4 detection was established and compared with the two-step DELFIA® Free Thyroxine Assay. Matrix interference caused by endogenous binders and exogenous non-esterified fatty acids (NEFA) was also accessed in the proposed assay.

Results

The developed method generally took only one hour, had a detection limit of 0.6 pmol/L and a large linear range of 2.5–120 pmol/L. The inter- and intra-assay coefficients of variation were 3.5–6.6% and 4.4–9.8%, respectively. Results from 110 specimens showed apparent agreement with that from the DELFIA® FT4 Assay with the square of the correlation coefficient of 0.975. This assay indicated that there was no significant dependence on endogenous binders and displayed potential interference by exogenous NEFA up to 5 mmol/L.

Conclusions

The proposed one-step heterologous TRFIA FT4 assay possesses simplicity, accuracy, high sensitivity and exhibits great potential for FT4 measurement. The combination of heterologous immunoassay with TRFIA may be advantageous for FT4 immunoassay development.
Screening for drugs of abuse: which matrix, oral fluid or urine?
Authors: Allen Keith R
Published: September 2011

Urine is recognized as the prime matrix for drug test screening with well-established methods and testing protocols. Its major limitation is with regard to the inconvenience of sample collection and lack of integrity due to adulteration, dilution, drug spiking or sample exchange. The question is whether oral fluid, with its apparent better sample integrity, can replace urine for drug screening. This review examines the sample integrity problems and the advantages and limitations of oral fluid and urine in drug screening programmes. The variety of sample collection devices for oral fluid is shown to be a problem with recovery and detection for some drugs. This is examined in relation to the pharmacokinetics of drug metabolism and excretion in this matrix. Buccal contamination with drugs in oral fluid may also cause problems with interpretation. The clinical advantages of oral fluid analysis compared with urine testing are highlighted. Parent drugs are often found in oral fluid where only their metabolites may be found in urine, for example the benzodiazepines. 6-Monoacetylmorphine, an indicative marker of heroin, has a high prevalence in oral fluid from users of this drug but its detection in urine is limited due to its short half-life. Advances in analytical techniques, particularly chromatography linked to tandem mass spectrometry, are helping to promote oral fluid analysis. However, the lack of concordance studies examining both urine and oral fluid drug levels and kinetics in the clinical setting is of some concern.
Inflammatory effects of patagonfibrase, a metalloproteinase from Philodryas patagoniensis (Patagonia Green Racer; Dipsadidae) venom
Authors: Peichoto María Elisa , Zychar Bianca Cestari , Tavares Flávio Luiz , de Camargo Gonçalves Luis Roberto , Acosta Ofelia , Santoro Marcelo Larami
Published: September 2011

Patagonfibrase is a P-III class metalloproteinase isolated from the venom of Philodryas patagoniensis, a South-American, rear-fanged ‘colubrid’ snake responsible for accidents with clinical significance. Since local inflammatory reactions are conspicuous signs of snakebites inflicted by this species and taking into consideration that most snake venom metalloproteinases exhibit inflammatory activity, this study deals with the proinflammatory effects evoked by patagonfibrase. Herein, we demonstrate that patagonfibrase causes a time- and dose-dependent hemorrhagic edema when injected into mouse hind paws. The peak of edema occurred at 30 min after injection, and the minimum edematogenic dose was 0.021 μg. By histological analysis, the presence of moderate to marked edema and hemorrhage, and a mild inflammatory infiltrate was observed. When injected subcutaneously into the scrotal bag of mice, patagonfibrase induced cell recruitment with a significant alteration in physiological parameters of leukocyte–endothelium interaction. The presence of 1 mmol/L o-phenanthroline, which chelates metal ions, significantly inhibited the proinflammatory effects induced by patagonfibrase. Taken together, these results imply that patagonfibrase is an important contributor to local inflammation elicited by P. patagoniensis envenomation, which may pave the way for novel therapeutic strategies to treat this snakebite. Moreover, our findings demonstrate for the first time that a venom metalloproteinase from a rear-fanged snake elicits proinflammatory effects mainly mediated by its catalytic activity.
Condyloma acuminatum: atypical presentation during pregnancy
Authors: Nigam A , Mishra A
Published: September 2011

Genital warts (condylomata acuminata) are caused by human papillomavirus (HPV) and are usually transmitted sexually. We present an atypical case of a vaginal wart presenting as a single pedunculated mass protruding outside the vagina in a pregnant woman in labour. On examination of the vulva, a soft, pink papilliferous growth of 6 × 4 cm size was seen hanging outside the vaginal introitus. Speculum examination revealed that the growth was attached to the posterior and lateral vaginal wall near the fornix. Genital warts can proliferate during pregnancy due to altered immunity and increased blood supply, as seen in this case. Vaginal warts can also cause problems during delivery, since they prevent the vagina from stretching appropriately.
Sexual health in general practice: do practitioners comply with the sexually transmitted infections guidelines for management of suspected chlamydial infections?
Authors: Bangor-Jones R D
Published: September 2011

Escalating notifications of chlamydia in Western Australia (WA) prompted an audit of the compliance of general practitioners (GPs) with the current guidelines for management. The audit consisted of a telephone survey of GPs known to have treated a case of chlamydia. GPs generally performed opportunistic screening well and complied with the guidelines for testing and treatment. Only 8% of GPs took a comprehensive sexual history from symptomatic cases, 53% routinely tested for blood-borne sexually transmitted infections and 29% recorded a discussion of partner notification in the medical records. The results of the audit form part of the review of the current edition of the guidelines, and will be noted in the plans for promotion and dissemination of the next edition.
Early syphilis in a man with a negative Treponema pallidum enzyme immunoassay-IgM
Authors: McCarty E J , Keane H , Quinn K , Dinsmore W W
Published: September 2011

Most serological tests for syphilis rely on an individual's ability to produce antibodies. A single screening test may be unreliable for screening in those with primary immunodeficiency. We present the first reported case of primary and secondary syphilis with negative Treponema pallidum enzyme immunoassay-IgM and Venereal Disease Research Laboratory tests in a man with common variable immunodeficiency.
Syphilis resurgence in Dublin, Ireland
Authors: Muldoon E , Mulcahy F
Published: September 2011

A large outbreak of syphilis was reported in Dublin, Ireland, in 2001. The mean age of patients in 2001 was 35 years and 22.5% of patients were HIV-positive. The number of new cases decreased from 2003 on, however, new diagnoses have again increased. All positive syphilis serology results from 2007–09 were identified. Patients were included if they had a newly positive syphilis serology or, in the case of patients with previously treated syphilis, had a four-fold rise in rapid plasma reagin titre. Four hundred and thirty-nine new diagnoses of syphilis were made. The mean age of patients at diagnosis was 35.7 years (range 17–73 years). Four hundred and twelve (93.8%) cases occurred in men. Three hundred and eighty-one (86.8%) cases occurred in men who have sex with men (MSM). The estimated crude incidence rate among MSM is 378.16 per 100,000 population. Where known, 126/421 (28.7%) occurred in HIV-positive patients. Sixty-eight (15.5%) episodes of syphilis infection were diagnosed in patients who had had previously been diagnosed and treated for syphilis; 43/68 (63.2%) cases of re-infection occurred in HIV-positive patients. The rising number of syphilis diagnoses and high associated HIV co-infection rate is concerning and prevention efforts must continue to decrease the number of new syphilis cases.
Dysaesthetic penoscrotodynia: nomenclature, classification, diagnosis and treatment
Authors: Markos A R
Published: September 2011

Male patients can present with a genital skin burning sensation that bears similarities to vulvodynia. The classification of vulvodynia by International Society for the Study of Vulvovaginal Disease of vulvodynia provides a blueprint for nomenclature and classification of Dysaesthetic penoscrotodynia (DPSD). Recognizing DPSD as generalized, localized, provoked, unprovoked and mixed will enable precise and objective communication between practitioners. Learning from research on the aetiology and management of vulvodynia can improve the care of patients suffering with DPSD. Scope remains for better acknowledgement of DPSD within the medical profession and improvement in its public profile in order to enhance patient care.
Survival of HIV-infected patients admitted to the intensive care unit in the era of highly active antiretroviral therapy
Authors: Adlakha A , Pavlou M , Walker D A , Copas A J , Dufty N , Batson S , Edwards S G , Singer M , Miller R F
Published: September 2011

We retrospectively studied outcomes for HIV-infected patients admitted to the intensive care unit (ICU) between January 1999 and June 2009. Patient demographics, receipt of highly active antiretroviral therapy (HAART), reason for ICU admission and survival to ICU and hospital discharge were recorded. Comparison was made against outcomes for general medical patients contemporaneously admitted to the same ICU. One hundred and ninety-two HIV-infected patients had 222 ICU admissions; 116 patients required mechanical ventilation (MV) and 43 required renal replacement therapy. ICU admission was due to an HIV-associated diagnosis in 113 patients; 37 had Pneumocystis pneumonia. Survival to ICU discharge and hospital discharge for HIV-infected patients was 78% and 70%, respectively, and was 75% and 68% among 2065 general medical patients with 2274 ICU admissions; P = 0.452 and P = 0.458, respectively. HIV infection was newly diagnosed in 42 patients; their ICU and hospital survival was 69% and 57%, respectively. From multivariable analysis, factors associated with ICU survival were patient's age (odds ratio [OR] = 0.74 [95% confidence interval (CI) = 0.53–1.02] per 10-year increase), albumin (OR = 1.05 [1.00–1.09] per 1 g/dL increase), Acute Physiology and Chronic Health Evaluation (APACHE) II score (OR = 0.55 [0.35–0.87] per 10 unit increase), receipt of HAART (OR = 2.44 [1.01–4.94]) and need for MV (OR = 0.14 [0.06–0.36]). In the era of HAART, HIV-infected patients should be offered ICU admission if it is likely to be of benefit.
A cluster of infectious syphilis among young heterosexuals in south-east Hampshire
Authors: Morgan E , Blume A , Carroll R
Published: September 2011

A small cluster of infectious syphilis among young heterosexuals aged under 25 years in south-east Hampshire has highlighted the limitations of effective partner notification, the challenges of providing effective awareness raising and the need for increased accessibility to genitourinary (GU) medicine services. Evaluation of awareness raising to both the target age group and health care professionals indicated that the strategies employed did not increase testing and had limited impact on young people in terms of seeking further information.
An ongoing outbreak of heterosexually-acquired syphilis across Teesside, UK
Authors: Acheson P , McGivern M , Frank P , Kunonga E , Simms I , Tayal S , Thody E , Waldram A , Kibirige J
Published: September 2011

Prior to 2006, diagnoses of heterosexually acquired syphilis were rare in Teesside (an area in the north east of England, UK). Since 2006, there has been an increase in such cases, with 24 cases diagnosed in 2006 and 22 in 2007. There was a marked reduction in cases in 2008 with six cases reported, but a large increase in diagnoses in 2009 (34 cases). There have been 14 cases to date in 2010. Of concern is the increase noted in women and younger age groups. Geographical mapping of cases shows a wide dispersion across Teesside although some clusters were identified, mostly in areas of high deprivation. Little detailed information is available to help identify social and sexual networks widely and target intervention. A multiagency outbreak control team is addressing this problem, based on the principles of partner notification, increased awareness, increased screening and health promotion activities. A range of measures, including a detailed communications plan, have been implemented.
Heterosexual transmission of infectious syphilis in central Scotland, 2009
Authors: Abu-Rajab K , Wallace L A
Published: September 2011

A local outbreak of infectious syphilis among heterosexual men and women was noted among residents of a National Health Services board in central Scotland in 2009. This is the first, and remains the only, such outbreak in Scotland reporting transmission in the heterosexual population. It was characterized by the young age of those infected. This highlights the need for increasing knowledge and awareness of syphilis infection among this group.
An outbreak of infectious syphilis among young heterosexuals in an English town
Authors: Welfare W , Lacey H , Lighton L , Simms I
Published: September 2011

We describe a recent outbreak of syphilis in young heterosexuals in the north west of England. A cluster of 12 cases of syphilis (7 primary and 5 early latent) was identified in Rochdale in heterosexuals aged 20 or under. Nine were women. Five were asymptomatic at presentation. This outbreak occurred in a group not usually associated with syphilis transmission in the north west. Not all the identified cases could be linked, and so potentially this outbreak is a sentinel of a larger problem.
The public health response to the re-emergence of syphilis in Wales, UK
Authors: Thomas D Rh , Cann K F , Evans M R , Roderick J , Browning M , Birley H D L , Curley W , Clark P , Northey G , Caple S , Lyons M
Published: September 2011

During the 1990s, cases of infectious syphilis were uncommon in Wales. In 2002, an outbreak occurred in a sexual network of men who have sex with men (MSM) attending a sauna. A multidisciplinary outbreak control team was convened to raise awareness of the outbreak among MSM and health professionals, assess the extent of outbreak, and initiate surveillance measures. It is likely that early intensive control efforts dampened the epidemic curve. However, since 2006 the number of cases has increased steadily to a peak of four cases per 100,000 population in 2008. The majority of cases continue to occur in MSM (81% in 2009) and in those attending genitourinary (GU) medicine clinics in south east Wales (76%). Traditional sexual networks such as saunas, bars/clubs and cruising grounds remain frequently reported, but Internet-based networks are assuming increasing importance. Public health interventions have been sustained, using traditional partner notification, health promotion initiatives, and more innovative Internet network tracing methods.
Conflicts at the Bottom of the Pyramid: Profitability, Poverty Alleviation, and Neoliberal Governmentality
Authors: Varman Rohit , Skålén Per , Belk Russell W.
Published: September 2011

This article adopts the concept of neoliberal governmentality to critically analyze public policy failures in a bottom-of-the-pyramid (BOP) marketing initiative. This research shows that e-Choupal, an Indian BOP initiative, is hampered by a divide between poverty alleviation and profit seeking, which is inadequately reconciled by the neoliberal government policies that dominate contemporary India. The initiative sounds good, even noble, but becomes mired in divergent discourses and practices that ultimately fail to help the poor whom it targets. This research helps explicate the problems with BOP policy interventions that encourage profit seeking as a way to alleviate poverty.
Sequential hormonal changes in 21 patients with recurrent Cushing's disease after successful pituitary surgery
Authors: Bou Khalil Roula , Baudry Camille , Guignat Laurence , Carrasco Carmen , Guibourdenche Jean , Gaillard Stéphane , Bertagna Xavier , Bertherat Jérôme
Published: September 2011

Objective

To describe the sequence of hormonal changes during recurrence of Cushing's disease (CD) after successful transsphenoidal surgery (TSS).

Design

Retrospective study in a single center.

Patients and methods

We studied 101 of the 127 patients treated by TSS for CD between 1996 and 2009, who had hypocortisolism or eucortisolism for at least 3 months post-TSS. We arbitrarily defined ‘overt recurrence’, as presence of two classical parameters of excess cortisol (increased midnight – either serum or salivary – and 24 h urinary cortisol (UC)), leading to further specific therapeutic action, and ‘mild recurrence’, as presence of a single classical parameter, leading to simple surveillance.

Results

Of the 101 patients, 21 (20.8%) presented with recurrence, ‘mild’ or ‘overt’, during long-term follow-up (median 50.4 months, range 7–99). Recurrence occurred less frequently (16.8 vs 50%, P=0.02), and later (mean 44.7 months, median 43, range 7–94 vs mean 21.5 months, median 17, range 3–61, P=0.05), in patients with early post-TSS hypocortisolism compared with those with eucortisolism. Increase in midnight cortisol occurred in a mean time of 38.2 months, while UC elevation was observed at 50.6 months. Vasopressin analogs and CRH tests were eventually positive in 85 and 93% of all patients respectively; a positive response to one of the two dynamic tests preceded the increase in midnight cortisol or UC in 71 and 64% of the patients respectively.

Conclusion

A positive response to vasopressin analogs and/or CRH tests occurs early in recurrence, followed by an increase in midnight cortisol, while UC elevation is at a later stage.
A role for the putative cannabinoid receptor GPR55 in the islets of Langerhans
Authors: Romero-Zerbo Silvana Y , Rafacho Alex , Díaz-Arteaga Adenis , Suárez Juan , Quesada Ivan , Imbernon Mónica , Ross Ruth A , Dieguez Carlos , Rodríguez de Fonseca Fernando , Nogueiras Rubén , Nadal Ángel , Bermúdez-Silva Francisco J
Published: September 2011

The cannabinoid CB1 receptor is a well-known player in energy homeostasis and its specific antagonism has been used in clinical practice for the treatment of obesity. The G protein-coupled receptor GPR55 has been recently proposed as a new cannabinoid receptor and, by contrast, its pharmacology is still enigmatic and its physiological role is largely unexplored, with no reports investigating its putative role in metabolism. Thus, we aim to investigate in rats the presence, distribution and putative physiological role of GPR55 in a key metabolic tissue, the endocrine pancreas. We found high Gpr55 mRNA content in pancreatic islets and considerable protein distribution in insulin-secreting β-cells. Activation of GPR55 by the agonist O-1602 increased calcium transients (P<0.01) and insulin secretion (P<0.001) stimulated by glucose. This latter effect was blunted in Gpr55 KO mice suggesting that O-1602 is acting, at least in part, through GPR55. Indeed, acute in vivo experiments showed that GPR55 activation increases glucose tolerance (P<0.05) and plasma insulin levels (P<0.05), suggesting an in vivo physiological relevance of GPR55 systemic stimulation. Taken together, these results reveal the expression of GPR55 receptors in the endocrine pancreas as well as its function at stimulus-secretion coupling of insulin secretion, suggesting a role in glucose homeostasis. In this context, it may also represent a new target for consideration in the management of type 2 diabetes and related diseases.
Acerca de diretrizes curriculares e projetos pedagógicos: um início de reflexão - comentários ao texto
Authors: Ramos Flávia Regina Souza
Published: September 2011

O texto desenvolve idéias desencadeadas a partir de reflexões contidas no artigo que ancora esta seção de debate acerca das diretrizes curriculares nacionais, quais sejam: as idéias de interdisciplina, do currículo como produto e produtor de cultura e identidade e a emergência da noção de competência. A partir desta discussão indica que não se pode negar que a aprendizagem é codificada disciplinarmente e curricularmente, se organiza no tempo e no espaço e se torna base cultural para uma área de conhecimento. Conclui, sugerindo que enfermeiros/docentes se voltem para si mesmos, para definir que competências precisam conquistar, como professores, para responder aos requerimentos dessa prática pedagógica.
Reflexões acerca do fazer pedagógico a partir de referências e diretrizes educacionais para a formação em enfermagem
Authors: Timoteo Rosalba Pessoa de Souza , Liberalino Francisca Nazaré
Published: September 2011

O texto visa a fornecer elementos para a reflexão acerca da formação em Enfermagem, considerando a divulgação nacional das diretrizes curriculares e a necessidade da elaboração de projetos político-pedagógicos dos cursos. Tomando como referência alguns fatores constituintes do fazer pedagógico, busca-se oportunizar a reflexão crítica sobre o campo, as bases e o plano da ação pedagógica, bem como a relação teórico-prática e os papéis dos sujeitos envolvidos no processo ensino-aprendizagem.
O ensino de enfermagem em tempos de mudança
Authors: Germano Raimunda Medeiros
Published: September 2011

Trata o presente texto de uma reflexão acerca do ensino de enfermagem no Brasil. Tem como principal objetivo analisar sua trajetória ao longo do período 1923-2003, buscando identificar, nesse lapso de tempo, as mudanças ocorridas e a direção dessa formação. Concentra a análise, sobretudo, nos últimos anos (décadas 80/90), quando se inicia o processo de redemocratização do país e, com ele, a abertura de um grande debate em torno da saúde e da educação. Nessa perspectiva, focalizamos o Movimento da Reforma Sanitária, e sua contribuição, em torno da defesa da formação de recursos humanos para o setor saúde, no qual o ensino de enfermagem se insere. A partir de então, abre-se uma ampla discussão entre professores, estudantes, enfermeiros de serviços, entre outros segmentos, com vistas à construção de um projeto político pedagógico, configurando, assim, um avanço político da categoria. Essa construção coletiva supera todas as mudanças ocorridas na história do seu ensino, pela relevância social contida nos seus marcos conceituais, bem como pelo fato de contar com a participação efetiva dos atores envolvidos com o processo educativo.
A construção do projeto pedagógico: uma experiência coletiva
Authors: Silva Maria Josefina da , Araújo Maria Fátima Maciel , Leitão Glória da Conceição Mesquita
Published: September 2011

O presente estudo relata a experiência, em andamento, da reformulação do projeto pedagógico do curso de enfermagem da UFC, tendo como marco referencial as diretrizes curriculares aprovados pelo CNE/CES em 2001. Expõe o processo de aproximação dos docentes e discentes da proposta expressa pela LDB/96 e as várias etapas de construção dos marcos referencial conceitual e filosófico. As dificuldades apresentadas são relacionadas ao pouco envolvimento dos docentes no processo, dada a situação peculiar vivida pelo curso: saída de muitos docentes por aposentadoria, um alto número de substitutos, que, em situação provisória, não assume compromissos a longo prazo, como deve ser a adoção de um projeto político pedagógico que se comprometa com a transformação do ensino em enfermagem.
Construindo um conhecimento sensível em saúde mental
Authors: Rocha Ruth Mylius , Kestenberg Célia Caldeira F. , Oliveira Elias Barbosa de , Silva Alexandre Vicente da , Nunes Márcia Batista Gil
Published: September 2011

Este é um relato de experiência apresentado por professores da subárea Promovendo e Recuperando a Saúde Mental, da Faculdade de Enfermagem da Universidade do Estado do Rio de Janeiro. A subárea é oferecida em oito do total de nove períodos do curso de Graduação, integrando-se aos temas das demais subáreas em cada período. Partindo dos saberes do aluno sobre os vários temas e conectando-os posteriormente à teoria, procura-se desenvolver sua sensibilidade e empatia, com o objetivo de fortalecê-lo em seu papel de cuidador da clientela nos diferentes campos. A avaliação da subárea aponta para a mudança qualitativa no processo ensino/aprendizagem.
O currículo integrado da faculdade de enfermagem UERJ: uma reflexão sobre a formação de recursos humanos para o SUS
Authors: Freire Renata Pascoal , Guimarães Raphael Mendonça , Henriques Regina Lúcia Monteiro , Mauro Maria Yvone Chaves
Published: September 2011

O presente trabalho trata de um estudo exploratório, com abordagem qualitativa, baseado nos moldes de estudo de caso, cujo objeto é uma análise da formação de recursos humanos em enfermagem considerando o Currículo Integrado da FENF/UERJ. O locus da pesquisa é a Faculdade de Enfermagem da Universidade do estado do Rio de Janeiro. Os objetivos traçados foram: (a) Levantar a história da construção do Cuirrículo Integrado da FENF/UERJ; (b) confrontar a proposta inovadora da FENF/UERJ com a proposta de formação de recursos humanos do SUS.. Dada a análise de documentos e da revisão bibliográfica, vislumbrou-se uma proposta de ensino integrada, que atende às demandas do perfil profissional desejado pelo SUS, além de se propor a formar um aluno crítico, politicamente ativo e capaz de reconhecer situações-problema e empenhar-se em resolve-la, de acordo com os rigores técnicos e científicos.
A pesquisa na graduação em enfermagem: requisito para conclusão do curso
Authors: Heyden Maria Silvana Totti , Resck Zélia Marilda Rodrigues , Gradim Clícia Valim Côrtes
Published: September 2011

O presente texto apresenta as diretrizes de implantação do Trabalho de Conclusão de Curso (TCC) na graduação em Enfermagem do Centro Universitário Federal de Alfenas-MG, apontando as facilidades, dificuldades e os resultados destes quatro primeiros anos, utilizando-se dos registros de atas do Departamento e do Colegiado de Enfermagem e a vivência dos autores como coordenadores do processo. Relatam-se como pontos facilitadores: incentivo ao trabalho multidisciplinar; aumento das parcerias com os profissionais de campo; maior utilização da informática, da biblioteca e do banco de dados; aumento da participação em eventos de pesquisas. E, como dificultadores: estabelecimento de normas para apresentação de trabalhos científicos, uma vez que na época a Escola não tinha uma norma. Concluímos que apesar das dificuldades, a pesquisa é possível de acontecer, sendo um processo dinâmico em que o aprender a aprender está presente, tanto para os discentes como para os docentes.
O processo de mudança na educação de enfermagem nos cenários uni: potencialidades e desafios
Authors: Silva Kênia Lara , Sena Roseni Rosângela de
Published: September 2011

O estudo aborda as mudanças ocorridas no processo ensino-aprendizagem de enfermagem nas Escolas brasileiras que desenvolvem o Projeto UNI, descrevendo o movimento de mudança, as resistências / conflitos e os desafios presentes. Caracteriza-se como estudo qualitativo, do qual os dados foram obtidos de Grupos Focais e de documentos fornecidos pelas instituições. Os resultados evidenciam o movimento de mudança como gradual, dinâmico e contínuo na busca de modelos de ensino que superam a racionalidade técnica para uma proposta crítico-reflexiva. Apesar dos desafios relativos à avaliação e capacitação dos sujeitos na superação das resistências / conflitos, conclui-se que o processo de mudança sustentou-se na criação de espaços participativos e em relações horizontais, permitindo uma nova valorização na educação de enfermagem.
Repensando a licenciatura em enfermagem à luz das diretrizes curriculares
Authors: Motta Maria de Graça Corso da , Almeida Miriam de Abreu
Published: September 2011

Trata-se de um relato da construção da proposta curricular para o curso de Licenciatura em Enfermagem da Universidade Federal do Rio Grande do Sul (UFRGS). Neste artigo é apresentado um breve histórico do curso de licenciatura, a estrutura curricular atual do curso da UFRGS, bem como a legislação pertinente no âmbito da educação e da enfermagem. Finalizando, são relatados os estudos da Coordenadoria das Licenciaturas (COORLICEN) da UFRGS e a proposta de alteração curricular do curso contemplando as Diretrizes Curriculares Nacionais para a Formação de Professores e a regulamentação do exercício profissional.
A cidadania e a ética como eixos norteadores da formacão do enfermeiro
Authors: Bellato Roseney , Gaíva Maria Aparecida Munhoz
Published: September 2011

A partir de nossa vivência como docentes de Enfermagem buscamos com a presente reflexão alimentar a discussão sobre a formação profissional do enfermeiro tendo por eixos norteadores a Ética, os Direitos Humanos e a Cidadania. Entendemos a saúde como valor humano agregador de outros valores, sendo que os desafios com que nos deparamos nessa área não são da ordem dos conflitos morais, da escolha entre o bem e o mal, mas sim dilemas éticos, resultante da pluralidade de imperativos contraditórios que se colocam em jogo nesse cenário. Faz-se necessário, portanto, promover a formação de profissionais enfermeiros competentes para refletirem criticamente sobre as interrogações fundamentais que se apresentam na sua prática quotidiana, atuando de maneira ética e cidadã.
Competências dos profissionais de saúde no referencial das funções essenciais de saúde pública: contribuição para a construção de projetos pedagógicos na enfermagem
Authors: Witt Regina Rigatto , Almeida Maria Cecília Puntel de
Published: September 2011

A construção de competências dos profissionais de saúde no referencial das Funções Essenciais de Saúde Pública (FESP) faz parte de um conjunto de iniciativas que buscam dar resposta às necessidades dos serviços para a resolução dos problemas de saúde, considerando-se as transformações ocorridas no setor saúde e no mundo do trabalho. O objetivo deste trabalho é fazer uma reflexão teórica sobre a temática de competências profissionais, a fim de contribuirmos para a construção de projetos político-pedagógicos para o ensino da saúde e da enfermagem em especial. Para isto, apresentamos o modelo de competências, essas, no referencial das FESP e as propostas apresentadas até então, tendo em vista a construção de modelos de formação interdisciplinares, críticos e reflexivos.
Educação sem distâncias: utilização do WebCT como ferramenta de apoio para o ensino da Terapia Intravenosa na graduação em Enfermagem
Authors: Dias Denise Costa , Cassiani Silvia Helena De Bortoli
Published: September 2011

Esta investigação focalizou o ambiente de aprendizagem por meio da Internet, onde foi abordado o ensino da terapia intravenosa(TIV). Dentre os vários conteúdos que poderiam ser ministrados em um ambiente de aprendizagem via Internet foi escolhida a TIV pois trata-se de um tema complexo que abrange não apenas os procedimentos técnicos mas também aspectos conceituais que podem ser discutidos em um ambiente virtual de aprendizagem. Os objetivos da investigação foram desenvolver material educacional sobre Terapia Intravenosa, utilizando a Internet para orientar o aprendizado de conceitos relacionados a terapia intravenosa, proceder avaliação por especialistas do material educacional sobre Terapia Intravenosa produzido e avaliar a utilização do mesmo pelos alunos em termos de dificuldades e/ou facilidades, participação/interação no ambiente, usabilidade das ferramentas disponíveis no ambiente. O ambiente utilizado para disponibilizar o curso na Internet foi o WebCT.
Formação por competência do enfermeiro: alternância teoria-prática, profissionalização e pensamento complexo
Authors: Nascimento Estelina Souto do , Santos Geralda Fortina dos , Caldeira Valda da Penha , Teixeira Virgínia Mascarenhas Nascimento
Published: September 2011

Pretende-se com este estudo refletir sobre a formação por competência do enfermeiro a partir da compreensão da alternância como condição necessária para a articulação teoria e prática, bem como discutir questões relativas à formação por competências e à profissionalização. Buscou-se a ampliação do entendimento do sentido de competência e da articulação entre teoria e prática. Discute-se a noção de profissionalização e formas de trabalhar competências conforme diferentes abordagens e objetivos distintos, chegando-se ao entendimento de competência como agir em situação, o que traz envolvimento para a formação e aponta para o pensamento contextual e complexo. Finalmente, indica-se a alternância como dispositivo para a formação profissional do enfermeiro.
Como será o amanhã? responda quem puder! perspectivas de enfermeirandos quanto ao seu futuro profissional
Authors: Souza Júnior José Gilmar Costa de , Cavalcanti Aracele Tenório de Almeida , Monteiro Estela Maria Leite Meireles , Silva Maria Inês da
Published: September 2011

Estudo qualitativo que teve como objetivos: Identificar os fatores significativos na formação do enfermeiro; descortinar o perfil do enfermeiro na percepção do graduando; conhecer as perspectivas dos enfermeirandos quanto ao seu amanhã profissional. Teve como sujeitos 12 alunos concluintes do Curso de Graduação em Enfermagem de três Universidades de Pernambuco. Foram realizadas entrevistas gravadas e observação assistemática, nos meses de março e abril de 2003. Como resultados foram construídas as seguintes categorias: Escolha pela profissão de enfermagem; envolvimento com a formação profissional; reflexões quanto à formação acadêmica e perspectivas em relação ao futuro profissional.