bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparação do risco de queda em idosos sedentários e ativos por meio da escala de equilíbrio de Berg
Authors: Pimentel Renata Martins , Scheicher Marcos Eduardo
Published: April 2012

O envelhecimento da população é um fenômeno mundial, do qual o Brasil apresenta um dos mais agudos processos. A prática regular de exercícios por idosos pode melhorar a capacidade física, proporcionar ganho de auto-estima e confiança, contribuindo para diminuição do risco de quedas, comuns em idosos. Este estudo visou comparar o risco de quedas entre idosos sedentários e ativos, verificando como a prática de exercício físico se reflete no desempenho dos sujeitos na escala de Berg. Foram avaliados por esse instrumento 70 idosos, divididos em 2 grupos: sedentários (n=35) e ativos (n=35). Os escores médios na escala de Berg dos grupos sedentário e ativo foram 47,7±5,6 pontos e 53,6±3,7, respectivamente (p<0,0001). A análise dos escores evidenciou que o grupo sedentário apresentou 15,6 vezes mais risco de quedas do que o grupo ativo (p=0,002). O desempenho na escala de Berg foi pior no grupo sedentário do que no ativo, sugerindo que a prática regular de atividades físicas pode interferir nesse desempenho e que os sujeitos ativos têm menor risco de queda.
Avaliação das propriedades mecânicas do músculo gastrocnêmio de ratas imobilizado e submetido à corrente russa
Authors: Abdalla Douglas Reis , Bertoncello Dernival , Carvalho Leonardo César
Published: April 2012

A eletroestimulação neuromuscular por corrente russa, recurso utilizado na reabilitação, pode aumentar o trofismo e restabelecer a força muscular, sobretudo dos músculos que apresentam deficit pós-imobilização, como é o caso de lesões durante a prática esportiva. Objetivou-se avaliar as propriedades mecânicas do músculo gastrocnêmio de ratas imobilizadas por 14 dias e posteriormente submetidas à eletroestimulação por corrente russa durante 10 dias. Utilizaram-se 32 ratas Wistar divididas em quatro grupos: controle (G1), imobilizado (G2); imobilizado e liberado por 10 dias (G3) e imobilizado e submetido à corrente russa por 10 dias (G4). A avaliação das propriedades mecânicas - carga, alongamento, rigidez e resiliência - foi feita por ensaio de tração longitudinal. Quanto à carga no limite máximo, o G4 apresentou valores mais elevados quando comparado ao grupo apenas imobilizado (G2, p<0,001), embora sem atingir o valor do G1. Na análise da propriedade de alongamento no limite máximo, G3 e G4 alcançaram valores significativamente maiores que o G2 (p<0,001). No que se refere à rigidez, apenas G2 alcançou valores maiores (p<0,05) que o G1. Quanto à resiliência, G4 apresentou valores inferiores ao grupo controle (p<0,05), mas ainda superiores aos do G2 (p<0,001). Portanto conclui-se que a corrente russa, quando aplicada por 10 dias após 14 dias de imobilização, é benéfica, embora não seja capaz de restabelecer todas as propriedades mecânicas do músculo em nível controle.
Evaluation of water quality parameters for monitoring natural, urban, and agricultural areas in the Brazilian Cerrado
Authors: Muniz Daphne Heloisa de Freitas , Moraes Aline Silva , Freire Ingrid de Souza , Cruz Carlos José Domingos da , Lima Jorge Enoch Furquim Werneck , Oliveira-Filho Eduardo Cyrino
Published: April 2012

INTRODUCTION: Brazil's Federal District (FD) has seen steep population growth in recent years, and this has increased demand for high-quality water. AIM: The present work aims to evaluate the quality of surface water from two water bodies in the FD at six sampling points, three of which are in the Sobradinho River (the receiving body of a sewage treatment plant effluent) and three in the Jardim River (located in an agricultural region). METHODS: Analyses were carried out every thirty days, for twelve months, covering rainy and dry seasons. Parameters were analyzed such as temperature, pH, dissolved oxygen (DO), conductivity, turbidity, total hardness, main ions, total and fecal coliforms (E. coli) in water. Ecotoxicological evaluation was also performed, using the micro-crustacean Ceriodaphnia dubia. RESULTS: Data of physical and chemical determinations showed DO, conductivity, Cl-, NO3-, SO4(2-) and Na+ to be important in indicating contamination by urban effluents. On the subject of biological parameters - E. coli and ecotoxicological evaluation - the former was seen to be more effective in the urban area. However, in the countryside, the assay with C. dubia proved to be the most sensitive, although less than ideal, because the organism is very sensitive to low water hardness. CONCLUSIONS: The fecal coliform indicator (E. coli) was the most effective one for comparing water quality in the two basins, mainly for the urbanized one, while ecotoxicity assays with C. dubia were harmed by the natural chemical composition of the water.
Advances in First-Line Treatment for Patients with HER-2+ Metastatic Breast Cancer
Authors: De Mattos-Arruda Leticia , Cortes Javier
Published: April 2012

Learning Objectives:

After completing this course, the reader will be able to: Discuss the optimal strategies to treat HER-2+ metastatic breast cancer patients in the first-line setting and after recurrence with adjuvant trastuzumab.Identify the current first-line therapeutic options for HER-2+ metastatic breast cancer, including HER-2/hormone receptor copositive tumors.Discuss the most important advances for HER-2+ metastatic breast cancer and the potential of novel anti-HER-2 therapies.

CME This article is available for continuing medical education credit at CME.TheOncologist.com

Background.

The prognosis for breast cancer patients overexpressing human epidermal growth factor receptor (HER)-2 has changed with anti–HER-2–targeted therapy. Although anti–HER-2 therapy with trastuzumab and chemotherapy is the standard first-line treatment, the best therapeutic regimen has yet to be defined, and new strategies are evolving.

Methods.

A literature review of well-established and recently published trials, reviews, and ongoing clinical trials addressing first-line treatment for HER-2+ metastatic breast cancer patients was performed.

Results.

Taxanes are the agents most commonly used in combination with trastuzumab, but other chemotherapy drugs, such as anthracyclines, vinorelbine, and gemcitabine and triple-combination therapies including platinum compounds, capecitabine, and taxanes have been studied. The combination of aromatase inhibitors with anti–HER-2 therapies is a new therapeutic option for some patients who coexpress HER-2 and hormone receptors, although its activity observed in randomized clinical trials seems to be inferior to that of chemotherapy plus anti–HER-2 therapies. In addition, new anti–HER-2 therapies have shown activity in HER-2+ tumors, both alone and in combination with trastuzumab.

Conclusions.

Trastuzumab plus chemotherapy is the current standard of care for the upfront treatment of HER-2+ breast cancer patients, though other anti–HER-2–targeting agents may appear as new standards in the upcoming years.
Can Intensive Longitudinal Monitoring of Individuals Advance Cancer Research?
Authors: Blau C. Anthony
Published: April 2012

Longitudinal monitoring of individual cancer patients is suggested as a way to generate novel insights and hypotheses that ultimately may allow causal relationships to be discerned.
Bone Mineral Density and Fracture Risk in Older Individuals with CKD
Authors: Yenchek Robert H. , Ix Joachim H. , Shlipak Michael G. , Bauer Douglas C. , Rianon Nahid J. , Kritchevsky Stephen B. , Harris Tamara B. , Newman Anne B. , Cauley Jane A. , Fried Linda F.
Published: April 2012

Background and objectives

Kidney Disease Improving Global Outcomes guidelines recommend against bone mineral density (BMD) screening in CKD patients with mineral bone disease, due to a lack of association of BMD with fractures in cross-sectional studies in CKD. We assessed whether BMD is associated with fractures in participants with and without CKD in the Health, Aging, and Body Composition study, a prospective study of well functioning older individuals.

Design, setting, participants, & measurements

Hip BMD was measured by dual-energy x-ray absorptiometry. Osteoporosis was defined as a femoral neck BMD (FNBMD) T score below −2.5 and CKD as an estimated GFR <60 ml/min per 1.73 m2. The association of BMD with incident nonspine, fragility fractures to study year 11 was analyzed using Cox proportional hazards analyses, adjusting for age, race, sex, body mass index, hyperparathyroidism, low vitamin D level, and CKD. Interaction terms were used to assess whether the association of BMD with fracture differed in those with and without CKD.

Results

There were 384 incident fractures in 2754 individuals (mean age 73.6 years). Lower FNBMD was associated with greater fracture, regardless of CKD status. After adjustment, the hazard ratios (95% confidence intervals) were 2.74 (1.99, 3.77) and 2.15 (1.80, 2.57) per lower SD FNBMD for those with and without CKD, respectively (interaction P=0.68), and 2.10 (1.23, 3.59) and 1.63 (1.18, 2.23) among those with osteoporosis in patients with and without CKD, respectively (interaction P=0.75).

Conclusions

BMD provides information on risk for fracture in older individuals with or without moderate CKD.
Inhibition of Hypothalamic Inflammation Reverses Diet-Induced Insulin Resistance in the Liver
Authors: Milanski Marciane , Arruda Ana P. , Coope Andressa , Ignacio-Souza Letícia M. , Nunez Carla E. , Roman Erika A. , Romanatto Talita , Pascoal Livia B. , Caricilli Andrea M. , Torsoni Marcio A. , Prada Patricia O. , Saad Mario J. , Velloso Licio A.
Published: April 2012

Defective liver gluconeogenesis is the main mechanism leading to fasting hyperglycemia in type 2 diabetes, and, in concert with steatosis, it is the hallmark of hepatic insulin resistance. Experimental obesity results, at least in part, from hypothalamic inflammation, which leads to leptin resistance and defective regulation of energy homeostasis. Pharmacological or genetic disruption of hypothalamic inflammation restores leptin sensitivity and reduces adiposity. Here, we evaluate the effect of a hypothalamic anti-inflammatory approach to regulating hepatic responsiveness to insulin. Obese rodents were treated by intracerebroventricular injections, with immunoneutralizing antibodies against Toll-like receptor (TLR)4 or tumor necrosis factor (TNF)α, and insulin signal transduction, hepatic steatosis, and gluconeogenesis were evaluated. The inhibition of either TLR4 or TNFα reduced hypothalamic inflammation, which was accompanied by the reduction of hypothalamic resistance to leptin and improved insulin signal transduction in the liver. This was accompanied by reduced liver steatosis and reduced hepatic expression of markers of steatosis. Furthermore, the inhibition of hypothalamic inflammation restored defective liver glucose production. All these beneficial effects were abrogated by vagotomy. Thus, the inhibition of hypothalamic inflammation in obesity results in improved hepatic insulin signal transduction, leading to reduced steatosis and reduced gluconeogenesis. All these effects are mediated by parasympathetic signals delivered by the vagus nerve.
Circulating Preproinsulin Signal Peptide–Specific CD8 T Cells Restricted by the Susceptibility Molecule HLA-A24 Are Expanded at Onset of Type 1 Diabetes and Kill β-Cells
Authors: Kronenberg Deborah , Knight Robin R. , Estorninho Megan , Ellis Richard J. , Kester Michel G. , de Ru Arnoud , Eichmann Martin , Huang Guo C. , Powrie Jake , Dayan Colin M. , Skowera Ania , van Veelen Peter A. , Peakman Mark
Published: April 2012

Type 1 diabetes results from T cell–mediated β-cell destruction. The HLA-A*24 class I gene confers significant risk of disease and early onset. We tested the hypothesis that HLA-A24 molecules on islet cells present preproinsulin (PPI) peptide epitopes to CD8 cytotoxic T cells (CTLs). Surrogate β-cell lines secreting proinsulin and expressing HLA-A24 were generated and their peptide ligandome examined by mass spectrometry to discover naturally processed and HLA-A24–presented PPI epitopes. A novel PPI epitope was identified and used to generate HLA-A24 tetramers and examine the frequency of PPI-specific T cells in new-onset HLA-A*24+ patients and control subjects. We identified a novel naturally processed and HLA-A24–presented PPI signal peptide epitope (PPI3–11; LWMRLLPLL). HLA-A24 tetramer analysis reveals a significant expansion of PPI3–11-specific CD8 T cells in the blood of HLA-A*24+ recent-onset patients compared with HLA-matched control subjects. Moreover, a patient-derived PPI3–11-specific CD8 T-cell clone shows a proinflammatory phenotype and kills surrogate β-cells and human HLA-A*24+ islet cells in vitro. These results indicate that the type 1 diabetes susceptibility molecule HLA-A24 presents a naturally processed PPI signal peptide epitope. PPI-specific, HLA-A24–restricted CD8 T cells are expanded in patients with recent-onset disease. Human islet cells process and present PPI3–11, rendering themselves targets for CTL-mediated killing.
Access to Health Care and Control of ABCs of Diabetes
Authors: Zhang Xuanping , Bullard Kai McKeever , Gregg Edward W. , Beckles Gloria L. , Williams Desmond E. , Barker Lawrence E. , Albright Ann L. , Imperatore Giuseppina
Published: April 2012

OBJECTIVE

To examine the relationship between access to health care and diabetes control.

RESEARCH DESIGN AND METHODS

Using data from the National Health and Nutrition Examination Survey, 1999–2008, we identified 1,221 U.S. adults (age 18–64 years) with self-reported diabetes. Access was measured by current health insurance coverage, number of times health care was received over the past year, and routine place to go for health care. Diabetes control measures included the proportion of people with A1C >9%, blood pressure ≥140/90 mmHg, and non-HDL cholesterol ≥130 mg/dL.

RESULTS

An estimated 16.0% of known diabetic adults were uninsured. Diabetes control profiles were worse among uninsured than among insured persons (A1C >9% [34.1 vs. 16.5%, P = 0.002], blood pressure ≥140/90 mmHg [31.8 vs. 22.8%, P < 0.05], and non-HDL cholesterol ≥130 mg/dL [67.1 vs. 65.4%, P = 0.7]). Compared with insured persons, uninsured persons were more likely to have A1C >9% (multivariate-adjusted odds ratio 2.4 [95% CI 1.2–4.7]). Compared with those who reported four or more health care visits in the past year, those who reported no health care visits were more likely to have A1C >9% (5.5 [1.2–26.3]) and blood pressure ≥140/90 mmHg (1.9 [1.1–3.4]).

CONCLUSIONS

In people with diabetes, lack of health care coverage is associated with poor glycemic control. In addition, low use of health care service is associated with poor glucose and blood pressure control.
Stability of a Numerical Method for a Space-time-fractional Telegraph Equation
Authors: Ford Neville J , Xiao Jingyu , Yan Yubin
Published: April 2012

In this paper, we introduce a numerical method for solving the space-time
fractional telegraph equation. The numerical method is based on a quadrature formula approach and
a stability condition for the numerical method is obtained. Two numerical examples are given and the stability regions are plotted.
The Impact Study of a Statcom on Commutation Failures in an HVDC Inverter Feeding a Weak AC System
Authors: Khatir Mohamed , Zidi Sid-Ahmed , Fellah Mohammed-Karim , Hadjeri Samir , Flitti Mohamed
Published: April 2012

The Impact Study of a Statcom on Commutation Failures in an HVDC Inverter Feeding a Weak AC System

The Static Synchronous Compensator (STATCOM) devices are pure power electronics devices that use voltage source, IGBT, IGCT or GTO based converters to generate reactive current. This paper illustrates the effect of STATCOM connected whit an HVDC inverter feeding a weak AC network, on the recovery from commutation failures following AC side disturbances. MATLAB/SIMULINK simulation results have demonstrated the robust performance of the proposed system based on the first CIGRÉ HVDC Benchmark model against commutation failures.
Effect of Sex Ratio in the Litter in Which Polish Large White and Polish Landrace Sows were Born on the Number of Piglets Born and Reared
Authors: Rekiel Anna , Więcek Justyna , Wojtasik Monika , Ptak Jarosław , Blicharski Tadeusz , Mroczko Leszek
Published: April 2012

Effect of Sex Ratio in the Litter in Which Polish Large White and Polish Landrace Sows were Born on the Number of Piglets Born and Reared

The aim of the study was to determine the effect of sex ratio in the litter in which Polish Large White (PLW) and Polish Landrace (PL) sows were born on the number of piglets born and reared to 21 days of age. Results obtained in nucleus herds from one breeding region were analysed. A total of 518 multiparous sows (179 PLW and 339 PL) were evaluated based on data from their litters (790 PLW and 1540 PL litters). The proportion of females in the litter in which the sow was born served as a basis for dividing the females into groups: group 1 <40%, group 2 - 40-50%, group 3 - 50-60%, group 4 - 60-70%, group 5 >70%. Significant differences in the average number of piglets born were found between the groups for PLW sows; compared to sows from groups 1, 2 and 3, females from group 5 gave birth to 8.0% (P≤0.05), 9.4% (P≤0.01) and 6.6% more piglets (P≤0.01), respectively, and compared to sows from group 2, those from group 4 gave birth to 5.1% more piglets (P≤0.05). The average number of piglets born and reared to 21 days by PL sows did not differ significantly between groups. The greater the proportion of females in the litter in which the PLW sow was born, the greater the preweaning mortality of piglets: 0.79, 0.87, 0.99, 1.02 and 1.24 piglets in groups 1 to 5, respectively. Preweaning mortality of PL piglets (0.93, 0.89, 0.81, 0.76 and 0.65 in groups 1 to 5, respectively) decreased with increasing proportion of females in the litter of origin and was lower than that of PLW piglets. It seems appropriate to account for the sex ratio of the litter in which the gilts were born when selecting them as mothers of the next generation as part of herd replacement; this parameter may improve fertility and production efficiency.
Performance and Egg Quality of Hens from Conservation Flocks Fed a Diet Containing Maize Distillers Dried Grains with Solubles (DDGS)
Authors: Krawczyk Józefa , Sokołowicz Zofia , Świątkiewicz Sylwester , Koreleski Jerzy , Szefer Maja
Published: April 2012

Performance and Egg Quality of Hens from Conservation Flocks Fed a Diet Containing Maize Distillers Dried Grains with Solubles (DDGS)

The objective of the study was to evaluate laying performance and quality indices of consumption and hatching eggs in hens from conservation flocks fed a diet containing maize distillers dried grains with solubles (DDGS). A total of 360 Greenleg Partridge (Z-11) and Rhode Island Red (R-11) hens, included in the genetic resources conservation programme in Poland, were investigated. The good performance obtained by layers fed the DDGS diet indicates that maize distillers dried grains with solubles can serve as a useful source of protein in the nutrition of hens from conservation flocks, partly replacing imported soybean meal. The dietary inclusion of DDGS improved laying performance while maintaining hatchability traits and the quality of consumption eggs. The DDGS diet had an effect on nutritionally important egg quality traits, i.e. increased protein content of egg albumen and increased concentration of oleic and linoleic acids in yolk lipids, with a simultaneous increase inn-6:n-3PUFA ratio. Dietary inclusion of DDGS also increased yolk colour intensity and Haugh units while having no effect on eggshell quality.
Effect of Breed and Feeding System on Content of Selected Whey Proteins in Cow's Milk in Spring-Summer and Autumn-Winter Seasons
Authors: Brodziak Aneta , Barłowska Joanna , Król Jolanta , Litwińczuk Zygmunt
Published: April 2012

Effect of Breed and Feeding System on Content of Selected Whey Proteins in Cow's Milk in Spring-Summer and Autumn-Winter Seasons

The objective of the present study was to evaluate the effect of breed and feeding system on the content of selected whey proteins in cow's milk collected in the spring-summer and autumn-winter periods. A total of 2,278 milk samples from Black- and Red-and-White variety of Polish Holstein-Friesian cows and Simmental and Jersey cows were examined. In each sample the content of selected whey proteins, i.e. alpha-LA, beta-LG, lactoferrin, BSA and lysozyme, was analysed by RP-HPLC method. Evaluation of the simultaneous effect of breed and production season on whey protein content showed significant interactions (P≤0.05 and P≤0.01) for all analysed whey proteins. The milk of Simmental cows kept in the conventional system was characterized by a higher content of whey proteins (with the exception of BSA), in comparison to the cows managed under TMR system. Furthermore, for most of the evaluated components, except the content of BSA and lysozyme and the alpha-LA/beta-LG ratio, the simultaneous effect of feeding system and production season was also found.
Diagnosis of Primary Task-Specific Lower Extremity Dystonia in a Runner
Authors: McClinton Shane , Heiderscheit Bryan
Published: April 2012

Study Design

Resident's case problem.

Background

A 56-year-old man was referred to physical therapy for analysis of unusual gait, first noticed 3 years previously when running. Prior to this evaluation, the patient had seen multiple orthopaedic, sports medicine, and neurological specialists while undergoing repeated and extensive testing. Ten months of testing and treatment, including conservative and surgical management, did not provide an explanation for the gait abnormality or result in improvement of the patient's condition.

Diagnosis

The patient's physical examination was relatively unremarkable, considering the severity of the gait abnormality. Distinct abnormalities were apparent with computerized gait analysis and dynamic electromyography, and, when combined with the physical examination findings, led to a suspicion of the task-specific disorder of runner's dystonia. The patient was referred to a neurologist specializing in movement-related disorders, with a final confirmed diagnosis of primary task-specific dystonia with first onset during running (ie, runner's dystonia).

Discussion

Idiopathic, task-specific dystonia of the lower extremity is documented as a very rare occurrence, yet increasing trends in running participation may result in a higher incidence of this condition. Improved awareness of runner's dystonia in the present case might have enhanced the clinical decision-making process and resulted in more timely and effective treatment solutions. Clinical examination findings, including computerized gait analysis and electromyography, in conjunction with imaging, blood, and genetic testing, can aid in the diagnosis of runner's dystonia.

Level of Evidence

Differential diagnosis, level 4. J Orthop Sports Phys Ther 2012;42(8):688–697, Epub 20 April 2012. doi:10.2519/jospt.2012.3892
Short-Term Effects of Kinesio Taping Versus Cervical Thrust Manipulation in Patients With Mechanical Neck Pain: A Randomized Clinical Trial
Authors: Saavedra-Hernández Manuel , Castro-Sánchez Adelaida M. , Arroyo-Morales Manuel , Cleland Joshua A. , Lara-Palomo Inmaculada C. , Fernández-de-las-Peñas César
Published: April 2012

Study Design

Randomized clinical trial.

Objective

To compare the effectiveness of cervical spine thrust manipulation to that of Kinesio Taping applied to the neck in individuals with mechanical neck pain, using self-reported pain and disability and cervical range of motion as measures.

Background

The effectiveness of cervical manipulation has received considerable attention in the literature. However, because some patients cannot tolerate cervical thrust manipulation, alternative therapeutic options should be investigated.

Methods

Eighty patients (36 women) were randomly assigned to 1 of 2 groups: the manipulation group, which received 2 cervical thrust manipulations, and the tape group, which received Kinesio Taping applied to the neck. Neck pain (11-point numeric pain rating scale), disability (Neck Disability Index), and cervical-range-of-motion data were collected at baseline and 1 week after the intervention by an assessor blinded to the treatment allocation of the patients. Mixed-model analyses of variance were used to examine the effects of the treatment on each outcome variable, with group as the between-subjects variable and time as the within-subjects variable. The primary analysis was the group-by-time interaction.

Results

No significant group-by-time interactions were found for pain (F = 1.892, P = .447) or disability (F = 0.115, P = .736). The group-by-time interaction was statistically significant for right (F = 7.317, P = .008) and left (F = 9.525, P = .003) cervical rotation range of motion, with the patients who received the cervical thrust manipulation having experienced greater improvement in cervical rotation than those treated with Kinesio Tape (P<.01). No significant group-by-time interactions were found for cervical spine range of motion for flexion (F = 0.944, P = .334), extension (F = 0.122, P = .728), and right (F = 0.220, P = .650) and left (F = 0.389, P = .535) lateral flexion.

Conclusion

Patients with mechanical neck pain who received cervical thrust manipulation or Kinesio Taping exhibited similar reductions in neck pain intensity and disability and similar changes in active cervical range of motion, except for rotation. Changes in neck pain surpassed the minimal clinically important difference, whereas changes in disability did not. Changes in cervical range of motion were small and not clinically meaningful. Because we did not include a control or placebo group in this study, we cannot rule out a placebo effect or natural changes over time as potential reasons for the improvements measured in both groups.

Level of Evidence

Therapy, level 1b. J Orthop Sports Phys Ther 2012;42(8):724–730, Epub 20 April 2012. doi:10.2519/jospt.2012.4086
Histopathological pattern of malignancy in solitary thyroid nodule
Authors: Huque SM Nazmul , Ali Mohammad Idrish , Huq Md Mahmudul , Rumi Sk Nurul Fattah , Sattar Md Abdus , Khan AF Mohiuddin
Published: April 2012

Objective: To find out relative frequency and type of malignancy in solitary thyroid nodule (STN).Methods: This cross sectional study done in the Department of Otolaryngology Head & Neck Surgery, Dhaka Medical College Hospital (DMCH), Dhaka and Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka during the period of July 2008 to June 2009. For this study, 118 patients who were admitted a case of solitary thyroid nodule for operation. Diagnosed the case by detailed history, clinical examination, investigations, analyzed data presented by various tables, graphs and figures. Total 118 patients were selected as per described criteria from the Department of otolaryngology and head-neck surgery DMCH & BSMMU, Dhaka from July 2008 to July 2009.Results: In this study of 118 patients of STN, majority of the patients were within 21-40 years age group with female predominance. In thyroid malignancy male and female ratio was 1:1.75. Among 118 cases of solitary thyroid nodule 22 cases were malignant. Out of 22 malignant cases, 16(73%) were papillary carcinoma, 4(18%) were follicular carcinoma and 2(9%) were anaplastic carcinoma. Thyroid swelling was the common presentation in all cases (100%), some patients also presented with other symptoms like cervical lymphadenopathy in 6 (5.08%) cases, dysphagia 2(1.69%) cases and hoarseness of voice 1(0.85%) case. Study showed very significant difference (p <0.01) between papillary and follicular carcinoma, highly significant difference (p<0.001) between papillary and anaplastic carcinoma. So, papillary carcinoma was more common among all thyroid malignancies in patients with solitary thyroid nodule.Conclusion: Significant proportion of solitary thyroid nodule (18.65%) was malignant. So, careful assessment of thyroid nodule is important for early diagnosis.DOI: http://dx.doi.org/10.3329/bjo.v18i1.10407Bangladesh J Otorhinolaryngol 2012; 18(1): 5-10
Clinical presentation of congenital neck mass in children
Authors: Siddique Mazharul Alam , Hossen Mahbuba , Taous Ahmmad , Salam Kazi Shamimus , Siddiquee Belayat Hossain , Tarafder Kamrul Hasan
Published: April 2012

Background: Congenital neck mass is a very common problem in children in Otolaryngology & Head-Neck Surgery and Paediatric Surgery Department but data of our country is inadequate and there is lack of published study. This study will help to diagnose congenital neck masses, evaluate the success of surgical treatment in our country.Objective: To assess the frequency of congenital neck mass in children and to see the clinical presentation of different congenital neck mass.Study design: Cross sectional prospective study.Place of study: Department of Otolaryngology  Head & Neck Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Dhaka Medical College Hospital (DMCH)l, Dhaka and Mymensingh Medical College Hospital (MMCH), Mymensingh.Methodology: Patients below the age of 18 years with congenital neck mass who presented to three tertiary level hospitals from January 2010 to December 2010 were included in this study. Total thirty six patients were purposively selected. Age, gender, types of swelling and location were examined, investigations were done. Data was analyzed with SPSS software and was presented in the form of tables, diagrams and pie charts.Results: 36 patients with different congenital neck swelling were examined. Out of 36 patients, thyroglossal cysts were commonest- 21(58.33%). Other congenital lesions were as follows: Branchial cyst 7(19.44), Lymphangioma 3(8.33%), Haemangioma 3(8.33%), Dermoid cyst 2(5.55%). Midline was most common location 21 (58.33%).Conclusion: Congenital neck masses constitute important differential diagnosis for neck masses. These masses constitute diagnostic and therapeutic challenges for many clinicians. Correct diagnosis, safe and complete surgical excision requires sound knowledge of the location and extent of these masses.   DOI: http://dx.doi.org/10.3329/bjo.v18i1.10409  Bangladesh J Otorhinolaryngol 2012; 18(1): 16-22
Analyzing various non-surgical treatment modalities for laryngopharyngeal reflux
Authors: Owais M , Rahil M , Anees M , Aakib H , Raul A
Published: April 2012

Objective:To compare the outcomes of various medical treatment modalities for laryngopharyngeal reflux.Study design: Prospective study design.Methods: 150 patients were divided into three groups (A, B, C) based on the mode of intervention used for the control of LPR. Each study group enrolled 50 patients using random tables. Group A: These patients were put on a twice daily dosage of esomeprazole(20 mg b.d.) and domeperidone(10 mg b.d. ) for four months Group B: These patients were put on b.d. dosage of esomeprazole(20 mg) and domeperidone(10 mg): and also received counseling for dietary and lifestyle changes. The duration of treatment was for four months. Group C: These patients received, in addition to above, 10 mg of amitriptyline (tricyclic antidepressant) b.i.d , again for four months.Results: The success achieved in controlling LPR was defined as greater than 50 % improvement in baseline symptoms. The success achieved in Group A was 46 %, in Group B was 54 % and in Group C was 40 %. The relative change in RSI over any given period of time was significantly higher than the relative change in RFS. The relative change in RSI over first month was 30.99%, which is significantly higher than the relative change of RFS (6.39%) over the same period. The mean RSI scores during four months of treatment fell from 20.67 to 8.9 (p < 0.01) in Group A, from 23.3 to 8.6 (p < 0.01) and from 21.3 to 10.8 (p < 0.05) in Group C. The mean RFS during four months fell from 15 to 6.5 (p < 0.05) in Group A, from 16 to 6.4 (p < 0.05) and from 15 to 6.4 (p < 0.05) in Group C.Conclusions: All the three interventions had a statistically significant impact on the signs and symptoms of LPR. However, higher success rates were achieved in Group B where patients were put on a b.i.d dosage esomeprazole and domeperidone nad counseled for lifestyle and dietary changes. Paradoxically, success rates achieved in Group C was lower than other groups, possibly because of the anticholinergic effects of amitriptyline causing dry mouth and dry throat. The symptomatic improvement was seen much earlier than the improvement in laryngoscopic findings. This was evidenced by the fact that relative change in RSI was much higher than the relative change of RFS over a given period of time. If diagnosed with enough surety and certainty, patients of LPR do not need any antidepressant medications as these medications may not have any role in the treatment of same and may, however, worsen the condition owing to their anticholinergic side effects.  DOI: http://dx.doi.org/10.3329/bjo.v18i1.10413  Bangladesh J Otorhinolaryngol 2012; 18(1): 42-47
Incidence of haemorrhage after tonsillectomy
Authors: Kamal Mohammad Shah , Farzana Rubina , Humayun Abu Hena Mohammad Parvez , Huq AHM Zahurul , Rahman Md Mostafizur
Published: April 2012

Tonsillectomy is probably the most common operation performed by an Otolaryngologist. One of the most significant complications is post-operative haemorrhage. Episodes of post tonsillectomy haemorrhage are unpredictable and sometimes life threatening. The aim of the present study was to find out the incidence of reactionary haemorrhage after tonsillectomy. A prospective study was conducted at Shaheed Shamsuddin Ahmed Hospital, Sylhet from April 2010 to March 2011. We had selected 112 cases undergoing tonsillectomy. Tonsillectomy was done by cold steel dissection technique and bipolar diathermy haemostasis. Post operatively every patient was treated with pain killer (diclofenac sodium and paracetamol), antibiotics (amoxicillin and cloxacillin) and hydrogen peroxide mouth wash. Postoperative follow-up was done till the tonsillar fossa healed. The incidence of reactionary haemorrhage was 2.68%, primary and secondary haemorrhage was 0%. In our series haemorrhage (2.68%) was higher than that reported in most publications and may be due to inadequate per-operative haemostasis. DOI: http://dx.doi.org/10.3329/bjo.v18i1.10415  Bangladesh J Otorhinolaryngol 2012; 18(1): 55-58
Benign fibrous histiocytoma of the external auditory canal: Case report and literature review
Authors: Rashid Nur Hashima A , Goh Bee See , Ghani Fauzah A , Saim Lokman
Published: April 2012

Background: The benign fibrous histiocytoma (BFH) is a mainly dermal neoplasm composed of a mixture of fibroblastic and histiocytic cells. It is usually reported as occurring on the extremity, retroperitoneum or orbit but not commonly in the other head and neck regions.Methods: A ten-year old girl presented with a right external auditory meatal mass for 6 months. Clinical examination showed a small, firm non-tender swelling on the antero-inferior part of the cartilagenous external auditory canal. An excisional biopsy was performed without complication.Results: Clinical and histopathological examinations with immunohistochemical studies were consistent with the diagnosis of BFH of the external auditory canal. There was no local recurrence to date.Conclusions: BFH is an uncommon benign neoplasm of the head and neck and none has been previously described occurring in the external auditory canal. Complete local excision is the mainstay of treatment with excellent prognosis.  DOI: http://dx.doi.org/10.3329/bjo.v18i1.10424  Bangladesh J Otorhinolaryngol 2012; 18(1): 77-80
Preauricular pilomatrixoma in a 3 year-old girl: A case study
Authors: Hirbod H , Ameli F , Swamintanhan M , Goh BS
Published: April 2012

Objectives: To report a case of preauricular pilomatrixoma in a 3-year-old girl.Methods: Retrospective review on a case reportResults: A three-year-old girl presented with six month history of painless right pre-auricular swelling that was gradually increasing in size. The mass was small, soft, non tender with normal overlying skin. She underwent excisional biopsy of lesion and histopathological examination showed pilomatrixoma. She was well post operatively and no recurrence after 2 years of follow up.Conclusion: Pilomatrixoma is often misdiagnosed clinically as epidermoid cyst, sebaceous cyst, dermoid cyst, foreign body reaction, calcification in lymph node, fat necrosis, pyogenic granuloma, chalazion and keratoacanthoma, but a high index of suspicion and careful histological examination of its characteristic clinical feature can help clinicians to differentiate it from other tumors.   DOI: http://dx.doi.org/10.3329/bjo.v18i1.10426  Bangladesh J Otorhinolaryngol 2012; 18(1): 84-86
Solitary posterior triangle neck mass as the rare sole presentation of papillary thyroid carcinoma
Authors: Mohamad Irfan , Win Thin Thin , Salleh Md Salzihan Md , Abdullah Baharudin
Published: April 2012

Introduction: Papillary thyroid carcinoma is the most common differentiated thyroid malignancy. It offers good prognosis and the presentation is usually consistent with an enlarged thyroid, mostly solitary nodule which biochemically euthyroid and radiologically normal appearance. On rare occasions, the thyroid gland enlargement can present together with multiple neck lymphadenopathy.Case report: We report a case of middle aged man presented with a posterior neck mass without any other symptom. Histopathology report of the excised mass confirmed the diagnosis of, papillary thyroid carcinoma which warranted total thyroidectomy and neck dissection.  DOI: http://dx.doi.org/10.3329/bjo.v18i1.10427 Bangladesh J Otorhinolaryngol 2012; 18(1): 87-90
Exostoses of the external auditory canal
Authors: Litu Mani Lal Aich , Al Mamun Abdullah , Alam Zahedul , Haque Rojibul , Hanif Abu , Hossain Amjad
Published: April 2012

Auditory exostoses are bone masses located in the external auditory canal. Currently, most researchers agree that the environment (especially water temperature, but also atmospheric temperature and wind action) plays a pivotal role in the development of exostosis. Exostoses are a condition in which the external auditory canal becomes stenotic secondary to hyperplastic bone formation. Also known as surfers ear, exostoses are thought to be a reactive process from repeated stimulation by cold water because it occurs commonly in populations such as beach lifeguards and surfers. Exostoses are usually asymptomatic and discovered on routine otoscopy. Rarely, exostoses become sufficiently obstructive to impair hearing or cause recurrent otitis externa. Exostoses are almost always bilateral, symmetric, and occurring in the medial portion of the external auditory canal. Tthe authors report a case of bilateral external auditory canal exostoses in an adult male treated with surgical excision.  DOI: http://dx.doi.org/10.3329/bjo.v18i1.10428  Bangladesh J Otorhinolaryngol 2012; 18(1): 91-95
Notes and News Vol18(1) 2012
Authors: Editor The
Published: April 2012

DOI: http://dx.doi.org/10.3329/bjo.v18i1.10429  Bangladesh J Otorhinolaryngol 2012; 18(1): 96-97
Dr Brig Gen Masundur Rahman Khan (1944-2012)
Authors: Editor The
Published: April 2012

DOI: http://dx.doi.org/10.3329/bjo.v18i1.10430Bangladesh J Otorhinolaryngol 2012; 18(1): 98
Drag reduction in wave‐swept macroalgae: Alternative strategies and new predictions
Authors: Martone Patrick T. , Kost Laurie , Boller Michael
Published: April 2012

• Premise of the study: Intertidal macroalgae must resist extreme hydrodynamic forces imposed by crashing waves. How does frond flexibility mitigate drag, and how does flexibility affect predictions of drag and dislodgement in the field?

• Methods: We characterized flexible reconfiguration of six seaweed species in a recirculating water flume, documenting both shape change and area reduction as fronds reorient. We then used a high‐speed gravity‐accelerated water flume to test our ability to predict drag under waves based on extrapolations of drag recorded at slower speeds. We compared dislodgement forces to drag forces predicted from slow‐ and high‐speed data to generate new predictions of survivorship and maximum sustainable frond size along wave‐swept shores.

• Key results: Bladed algae were generally “shape changers”, limiting drag by reducing drag coefficients, whereas the branched alga Calliarthron was an “area reducer”, limiting drag by reducing projected area in flow. Drag predictions often underestimated actual drag measurements at high speeds, suggesting that slow‐speed data may not reflect the performance of flexible seaweeds under breaking waves. Several seaweeds were predicted to dislodge at similar combinations of velocity and frond size, suggesting common scaling factors of dislodgement strength and drag.

• Conclusions: Changing shape and reducing projected area in flow are two distinct strategies employed by flexible seaweeds to resist drag. Flexible reconfiguration contributes to the uncertainty of drag extrapolation, and researchers should use caution when predicting drag and dislodgement of seaweeds in the field.
L'euro à l'épreuve de la crise des dettes souveraines
Authors: Cohen Élie
Published: April 2012

Quatre crises successives de l’euro ont suivi la découverte de l’ampleur des déficits grecs. De sommets en accords, les dirigeants européens tentent de sauver la zone euro. Dérives de la finance, incompétence des politiques, défaillances institutionnelles, divergence des temps politique et économique, pressions concurrentes des marchés et des opinions: c’est en prenant en compte ces éléments des discours explicatifs que peuvent être ébauchés les avenirs de l’euro et donc de l’Europe.
La crise de l'union monétaire européenne
Authors: Ederer Stefan
Published: April 2012

La crise financière européenne s’est transformée en une crise des finances publiques qui interdit toute reprise économique dans la zone euro. Les multiples mesures prises jusqu’ici se sont révélées inopérantes. Il faut sans doute trouver une solution permettant d’européaniser les dettes des États. En même temps, il est nécessaire de prendre des mesures de court terme relançant la croissance. Et de réduire, mais cela n’est possible que sur le long terme, l’endettement global de la zone euro.
Maghreb : révolutions inachevées ?
Authors: Mokhefi Mansouria
Published: April 2012

Spécifiques à l’expérience et à l’histoire de chaque pays, les événements de 2011 bouleversent la donne sociopolitique, idéologique et culturelle du Maghreb. Les islamistes vont devoir se mesurer au pouvoir et se confronter à d’immenses problèmes. Le Maghreb ne se reconnaît plus sans doute dans les formes démocratiques du modèle occidental – et particulièrement européen. Et de nouveaux acteurs ou modèles émergent pour la région, de l’expérience turque à l’activisme qatari.
Le Groupe de Visegrad, 20 ans après
Authors: Vargovčíková Jana
Published: April 2012

Le Groupe de Visegrad (Pologne, Hongrie, République Tchèque, Slovaquie) a, en 20 ans, marqué de son empreinte la carte géopolitique de l’Europe centrale. Ce Groupe peut-il se constituer en acteur sous-régional dans l’Union européenne ? S’il démontre une efficacité locale incontestable, il semble n’avoir à Bruxelles qu’une efficacité réactive. Sa capacité à intervenir sur la politique européenne de voisinage ou dans la politique énergétique de l’Union sera un test de son poids pour l’avenir.
Fin de l'occupation et crise en Irak : la clé de voûte sunnite
Authors: Benraad Myriam
Published: April 2012

C’est un Irak profondément divisé, théâtre de violences quotidiennes et d’une crise sociale et politique profonde, que les États-Unis ont quitté en décembre 2011. L’un des éléments qui pèsent le plus sur la situation actuelle du pays est la marginalisation des sunnites durant toute l’occupation américaine. Le problème sunnite mine la perspective d’une réconciliation durable et fait surtout resurgir la menace d’une partition du pays, à la fois territoriale et symbolique.
Alternative Splicing Controlled by Heterogeneous Nuclear Ribonucleoprotein L Regulates Development, Proliferation, and Migration of Thymic Pre-T Cells
Authors: Gaudreau Marie-Claude , Heyd Florian , Bastien Rachel , Wilhelm Brian , Möröy Tarik
Published: April 2012

The regulation of posttranscriptional modifications of pre-mRNA by alternative splicing is important for cellular function, development, and immunity. The receptor tyrosine phosphatase CD45, which is expressed on all hematopoietic cells, is known for its role in the development and activation of T cells. CD45 is known to be alternatively spliced, a process that is partially regulated by heterogeneous nuclear ribonucleoprotein (hnRNP) L. To investigate the role of hnRNP L further, we have generated conditional hnRNP L knockout mice and found that LckCre-mediated deletion of hnRNP L results in a decreased thymic cellularity caused by a partial block at the transition stage between double-negative 4 and double-positive cells. In addition, hnRNP L−/− thymocytes express aberrant levels of the CD45RA splice isoforms and show high levels of phosphorylated Lck at the activator tyrosine Y394, but lack phosphorylation of the inhibitory tyrosine Y505. This indicated an increased basal Lck activity and correlated with higher proliferation rates of double-negative 4 cells in hnRNP L−/− mice. Deletion of hnRNP L also blocked the migration and egress of single-positive thymocytes to peripheral lymphoid organs in response to sphingosine-1-phosphate and the chemokines CCL21 and CXCL12 very likely as a result of aberrant splicing of genes encoding GTPase regulators and proteins affecting cytoskeletal organization. Our results indicate that hnRNP L regulates T cell differentiation and migration by regulating pre-TCR and chemokine receptor signaling.
Elementarisierung von Benkos Lösung des 3. Hilbertschen Problems
Authors: Wittmann Erich Ch.
Published: April 2012

Zwei Polygone, die sich in Polygone zerlegen lassen, die paarweise kongruent sind, haben wegen der Additivität des Flächeninhalts offensichtlich den gleichen Inhalt. Dass umgekehrt inhaltsgleiche Polygone auch zerlegungsgleich sind, lässt sich mit elementaren Mitteln beweisen (W. Bolyai 1832, P. Gerwien 1833). Ob im Raum aus der Volumengleichheit von Polyedern ebenfalls die Zerlegungsgleichheit folgt, war lange offen und wurde im Jahr 1900 von D. Hilbert als 3. Problem in seine berühmte Liste von 23 Problemen aufgenommen. M. Dehn hat bereits ein Jahr später mit Mitteln der Höheren Mathematik bewiesen, dass die Begriffe volumengleich und zerlegungsgleich bei Polyedern nicht aquivalent sind. Im vorliegenden Beitrag wird im Anschluss an Benko 2007 ein Beweis geliefert, der mit elementaren Mitteln auskommt. Entscheidend ist dabei eine bestimmte Approximation reeller durch rationale Zahlen.