bluuebunny/crossref_metadata_2025 huggingface dataset:
Utility and safety of draining pleural effusions in mechanically ventilated patients: a systematic review and meta-analysis
Authors: Goligher Ewan C , Leis Jerome A , Fowler Robert A , Pinto Ruxandra , Adhikari Neill KJ , Ferguson Niall D
Published: February 2011

Introduction

Pleural effusions are frequently drained in mechanically ventilated patients but the benefits and risks of this procedure are not well established.

Methods

We performed a literature search of multiple databases (MEDLINE, EMBASE, HEALTHSTAR, CINAHL) up to April 2010 to identify studies reporting clinical or physiological outcomes of mechanically ventilated critically ill patients who underwent drainage of pleural effusions. Studies were adjudicated for inclusion independently and in duplicate. Data on duration of ventilation and other clinical outcomes, oxygenation and lung mechanics, and adverse events were abstracted in duplicate independently.

Results

Nineteen observational studies (N = 1,124) met selection criteria. The mean PaO2:FiO2 ratio improved by 18% (95% confidence interval (CI) 5% to 33%, I
2
= 53.7%, five studies including 118 patients) after effusion drainage. Reported complication rates were low for pneumothorax (20 events in 14 studies including 965 patients; pooled mean 3.4%, 95% CI 1.7 to 6.5%, I
2
= 52.5%) and hemothorax (4 events in 10 studies including 721 patients; pooled mean 1.6%, 95% CI 0.8 to 3.3%, I
2
= 0%). The use of ultrasound guidance (either real-time or for site marking) was not associated with a statistically significant reduction in the risk of pneumothorax (OR = 0.32; 95% CI 0.08 to 1.19). Studies did not report duration of ventilation, length of stay in the intensive care unit or hospital, or mortality.

Conclusions

Drainage of pleural effusions in mechanically ventilated patients appears to improve oxygenation and is safe. We found no data to either support or refute claims of beneficial effects on clinically important outcomes such as duration of ventilation or length of stay.
Interactions between the mat‐forming algaDidymosphenia geminataand its hydrodynamic environment
Authors: Larned Scott T. , Packman Aaron I. , Plew David R. , Vopel Kay
Published: February 2011

Lay Abstract

Algae require dissolved nutrients to grow, but nutrient concentrations are often very low in unpolluted streams and rivers. The supply of dissolved nutrients to benthic (bottom‐dwelling) algae increases with increasing river flow, but higher flows also produce drag forces that can damage the algae. To persist under high‐flow, low‐nutrient conditions, benthic algae must balance the conflicting requirements of minimal drag (to minimize detachment risks) and maximal exposure to turbulent flow (to maximize nutrient supplies). We explored flow‐algae interactions using the freshwater algaDidymosphenia geminata. D. geminataforms dense mats in swift, nutrient‐poor rivers, and is of particular interest because it is a highly invasive species in North American and New Zealand. To identify the properties that helpD. geminatagrow rapidly and resist detachment, we transplanted cobbles with attachedD. geminatamats from a river to a laboratory flow chamber and measured flow properties above and within the mats. We then removed the mats from the cobbles and repeated the measurements. We found that water flow near the streambed is strongly altered in the presence ofD. geminatamats. The dense, interwovenD. geminatastalks produce high friction and reduce flow fluctuations around and within the mats. The reduction in flow fluctuations around mats may reduce the risk of detachment and help retain dissolved nutrients within mats. We also found thatD. geminatamats increase the roughness of riverbeds relative to bare cobbles, which may increase the rate of nutrient supply from the water to mat surfaces.
Asymmetric localisation of cytokine mRNA is essential for JAK/STAT activation during cell invasiveness
Authors: Van De Bor Véronique , Zimniak Geordie , Cérézo Delphine , Schaub Sébastien , Noselli Stéphane
Published: February 2011

The transition from immotile epithelial cells to migrating cells occurs in all organisms during normal embryonic development, as well as during tumour metastasis. During Drosophila oogenesis, border cells (BCs) are recruited and delaminate from the follicular epithelium. This process is triggered by the polar cells (PCs), which secrete the cytokine Unpaired (Upd) and activate the JAK/STAT pathway in neighbouring cells, turning them into invasive BCs. Interestingly, either a decrease or an increase in BC number alters migration, indicating that mechanisms controlling the level of JAK/STAT signalling are crucial in this process. Here, we show that PCs have a highly stable and polarised network of microtubules along which upd transcripts are asymmetrically transported in a Dynein-dependent manner. We demonstrate that in the absence of upd mRNA localisation the ligand is no longer efficiently secreted, leading to a loss of signalling strength as well as recruitment and migration defects. These findings reveal a novel post-transcriptional regulatory mechanism of JAK/STAT signalling in the control of epithelial cell invasiveness.
Drosophila hedgehogsignaling andengrailed-runtmutual repression direct midline glia to alternative ensheathing and non-ensheathing fates
Authors: Watson Joseph D. , Wheeler Scott R. , Stagg Stephanie B. , Crews Stephen T.
Published: February 2011

The Drosophila CNS contains a variety of glia, including highly specialized glia that reside at the CNS midline and functionally resemble the midline floor plate glia of the vertebrate spinal cord. Both insect and vertebrate midline glia play important roles in ensheathing axons that cross the midline and secreting signals that control a variety of developmental processes. The Drosophila midline glia consist of two spatially and functionally distinct populations. The anterior midline glia (AMG) are ensheathing glia that migrate, surround and send processes into the axon commissures. By contrast, the posterior midline glia (PMG) are non-ensheathing glia. Together, the Notch and hedgehog signaling pathways generate AMG and PMG from midline neural precursors. Notch signaling is required for midline glial formation and for transcription of a core set of midline glial-expressed genes. The Hedgehog morphogen is secreted from ectodermal cells adjacent to the CNS midline and directs a subset of midline glia to become PMG. Two transcription factor genes, runt and engrailed, play important roles in AMG and PMG development. The runt gene is expressed in AMG, represses engrailed and maintains AMG gene expression. The engrailed gene is expressed in PMG, represses runt and maintains PMG gene expression. In addition, engrailed can direct midline glia to a PMG-like non-ensheathing fate. Thus, two signaling pathways and runt-engrailed mutual repression initiate and maintain two distinct populations of midline glia that differ functionally in gene expression, glial migration, axon ensheathment, process extension and patterns of apoptosis.
Pleomorphic xanthoastrocytoma: MR imaging findings in 19 patients
Authors: Yu Shenping , He Li , Zhuang Xiaozhao , Luo Boning
Published: February 2011

Background

Pleomorphic xanthoastrocytoma (PXA) is a rare and special type of astrocytoma which occurs in childhood and adolescence, and usually with a favorable prognosis. Since its initial description, PXA cases have been reported infrequently in the literature, mostly as single cases or small series.

Purpose

To review the imaging characteristics of PXA.

Material and Methods

MR imaging findings of 19 pathologically confirmed PXAs were retrospectively analyzed and correlated with the clinical and pathological features.

Results

The clinical presentation in 18 patients included: dizziness (8); headache (9); and epilepsy (8). One patient was asymptomatic. On MR imaging, the tumors were located in the brain surface (17), thalamus (1) or deep in the right frontal lobe (1). The tumors were cystic (4), mixed cystic-solid (7), or solid (8) with well-defined (11) or poorly-defined borders (8). Peritumoral edema was marked (8), mild (9) or absent (2). Cystic components of tumors were hypointense on T1- and hyperintense on T2-weighted images whereas the solid components of tumors were hypointense or isointense on T1- and slightly hyperintense on T2-weighted images. There was marked (10), moderate (7) or no (2) contrast enhancement in the solid tumors with surrounding leptomeningeal enhancement (7). The tumors were located in the frontal lobes (8), temporal lobes (7), occipital lobe (1), cerebellum (1), thalamus (1), and sellar region (1). Histologically, 18 tumors were classified as WHO grade 2 comprising of pleomorphic giant cells, spindle cells and foamy cells. One PXA with anaplastic features was composed of pleomorphic polygonal cells and spindle cells, and with high mitotic activity ( ≥5 mitoses per 10 HPF). Immunohistochemical reactions to glial fibrillary acidic protein (GFAP) were positive in all 19 cases.

Conclusion

The pathological appearances of PXA are distinctive. MR imaging could display the morphologic features exactly, and has important diagnostic value for PXA.
Whole-body diffusion-weighted imaging compared with FDG-PET/CT in staging of lymphoma patients
Authors: Abdulqadhr Goran , Molin Daniel , Åström Gunnar , Suurküla Madis , Johansson Lars , Hagberg Hans , Ahlström Håkan
Published: February 2011

Background

Diffusion-weighted imaging (DWI) has become increasingly valuable in lymph node imaging, yet the clinical utility of this technique in the staging of lymphoma has not been established.

Purpose

To compare whole-body DWI with FDG-PET/CT in the staging of lymphoma patients.

Material and Methods

Thirty-one patients, eight with Hodgkin lymphoma (HL) and 23 with non-Hodgkin's lymphoma (18 aggressive and five indolent) underwent both whole-body DWI, whole-body MRI (T1W and T2W-STIR) and FDG-PET/CT. Lesions on whole-body DWI were only considered positive if they correlated with lesions on T1W and T2W-STIR images. The staging given by each technique was compared, according to the Ann Arbor staging system. Differences in staging were solved using biopsy results, and clinical and CT follow-ups as standard of reference.

Results

The staging was the same for DWI and FDG-PET/CT in 28 (90.3%) patients and different in three (9.7%). Of the 28 patients with the same staging, 11 had stage IV in both techniques and 17 had stages 0–III. No HL or aggressive non-Hodgkin's lymphoma patients had different staging. Three indolent small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL) lymphoma had higher staging with DWI when compared with FDG-PET/CT. One small subcutaneous breast lymphoma was not seen but all other extranodal sites were detected by both techniques.

Conclusion

Whole-body DWI is a promising technique for staging of both (aggressive and indolent) non-Hodgkin's lymphoma and HL.
Clinical experience of photon counting breast tomosynthesis: comparison with traditional mammography
Authors: Svane Gunilla , Azavedo Edward , Lindman Karin , Urech Mattias , Nilsson Jonas , Weber Niclas , Lindqvist Lars , Ullberg Christer
Published: February 2011

Background

In two-dimensional mammography, a well-known problem is over- and underlying tissue which can either obstruct a lesion or create a false-positive result. Tomosynthesis, with an ability to layer the tissue in the image, has the potential to resolve these issues.

Purpose

To compare the diagnostic quality, sensitivity and specificity of a single tomosynthesis mammography image and a traditional two-view set of two-dimensional mammograms and to assess the comfort of the two techniques.

Material and Methods

One hundred and forty-four women, mainly chosen because of suspicious features on standard mammograms (76 malignant), had a single tomosynthesis image taken of one breast using a novel photon counting system. On average, the dose of the tomosynthesis images was 0.63 times that of the two-view images and the compression force during the procedure was halved. The resulting images were viewed by two radiologists and assessed both individually and comparing the two techniques.

Results

In 56% of the cases the radiologists rated the diagnostic quality of the lesion details higher in the tomosynthesis images than in the conventional images (and in 91% equal or higher), which means there is a statistically significant preference for the tomosynthesis technique. This included the calcifications which were rated as having better quality in 41% of the cases. While sensitivity was slightly higher for traditional mammography the specificity was higher for tomosynthesis. However, neither of these two differences was large enough to be statistically significant.

Conclusion

The overall accuracy of the two techniques was virtually equal despite the radiologist's very limited experience with tomosynthesis images and vast experience with two-dimensional mammography. As the diagnostic quality of the lesion details in the tomosynthesis images was valued considerably higher this factor should improve with experience. The patients also favored the tomosynthesis examination, rating the comfort of the procedure as much higher than regular mammography which might affect screening attendance.
Step-and-shoot prospectively ECG-gated versus retrospectively ECG-gated with tube current modulation coronary CT angiography using the 128-slice MDCT: comparison of image quality and radiation dose
Authors: Jeong Dong Wook , Choo Ki Seok , Baik Seung Kug , Kim Yong Woo , Jeon Ung Bae , Kim Jeong Soo , Lim Soo Jin
Published: February 2011

Background

Little is known regarding image quality and the required radiation dose for step-and-shoot and retrospective coronary computed tomography angiography (CCTA) with tube current modulation (TCM) in 128-slice multidetector CT (MDCT) coronary angiography.

Purpose

To compare image quality and radiation dose in patients who underwent 128-slice MDCT by the step-and-shoot method with those in patients who underwent 128-slice MDCT with retrospective CCTA with TCM.

Material and Methods

CCTA obtained with 128-slice MDCT was retrospectively evaluated in 160 patients. Two independent reviewers separately scored the subjective image quality of the coronary artery segments (1, excellent; 4, poor) for step-and-shoot (68, mean heart rate [HR]: 59.3 ± 6.8) and retrospective CCTA with TCM (77, mean HR: 59.1 ± 9.8). Interobserver variability was calculated. Effective radiation doses of both scan techniques were calculated with dose-length product.

Results

There was good agreement for quality scores of coronary artery segment images between the independent reviewers (κ = 0.72). The number of coronary artery segments that could not be evaluated was 2.85% (27 of 947) in the step-and-shoot and 1.87% (20 of 1071) in retrospective CCTA with TCM. Image quality scores were not significantly different (P > .05). Mean patient radiation dose was 63% lower for step-and-shoot (1.94 ± 0.70 mSv) than for retrospective CCTA with TCM (4.51 ± 1.18 mSv) (P < 0.0001). For patients who underwent step-and-shoot or retrospective CCTA with TCM, an average HR of 63.5 beats per minute was identified as the threshold for the prediction of non-diagnostic image quality for both protocols. There were no significant differences in the image quality of both methods between obese (body mass index [BMI] ≥ 25) and non-obese patients (BMI < 25), but radiation doses were higher in the obesity group than in the non-obesity group for both methods.

Conclusion

Both step-and-shoot and retrospective CCTA with TCM using 128-slice MDCT had similar subjective image quality scores, but step-and-shoot required a lower radiation dose than retrospective CCTA with TCM.
Thoracic epithelioid hemangioendothelioma: imaging and pathologic features
Authors: Kim Eun Young , Kim Tae Sung , Han Joungho , Choi Joon Young , Kwon O Jung , Kim Jhingook
Published: February 2011

The purpose of this article is to review the imaging features of thoracic epithelioid hemangioendotheliomas with pathologic correlation. The thoracic manifestation of epithelioid hemangioendotheliomas is one of three different CT patterns: multiple pulmonary nodules, multiple pulmonary reticulonodular opacities, or diffuse infiltrative pleural thickening. Without any evidence of histological malignancy, malignant features (multiplicity of pulmonary nodules, hepatic or bone involvement, lymphangitic tumor spread, and infiltrative pleural masses) are characteristic of these infrequent tumors.
Central venous device-related thrombosis as imaged with MDCT in oncologic patients: prevalence and findings
Authors: Catalano Orlando , de Lutio di Castelguidone Elisabetta , Sandomenico Claudia , Petrillo Mario , Aprea Pasquale , Granata Vincenza , D'Errico Adolfo Gallipoli
Published: February 2011

Background

Venous thrombosis is a common occurrence in cancer patients, developing spontaneously or in combination with indwelling central venous devices (CVD).

Purpose

To analyze the multidetector CT (MDCT) prevalence, appearance, and significance of catheter-related thoracic venous thrombosis in oncologic patients and to determine the percentage of thrombi identified in the original reports.

Material and Methods

Five hundred consecutive patients were considered. Inclusion criteria were: presence of a CVD; availability of a contrast-enhanced MDCT; and cancer history. Exclusion criteria were: direct tumor compression/infiltration of the veins; poor image quality; device tip not in the scanned volume; and missing clinical data. Seventeen (3.5%) out of the final 481 patients had a diagnosis of venous thrombosis.

Results

Factors showing the highest correlation with thrombosis included peripherally-inserted CVD, right brachiocephalic vein tip location, patient performance status 3, metastatic stage disease, ongoing chemotherapy, and longstanding CVD. The highest prevalence was in patients with lymphoma, lung carcinoma, melanoma, and gynecologic malignancies. Eleven out of 17 cases had not been identified in the original report.

Conclusion

CVD-related thrombosis is not uncommon in cancer patients and can also be observed in outpatients with a good performance status and a non-metastatic disease. Thrombi can be very tiny. Radiologists should be aware of the possibility to identify (or overlook) small thrombi.
MR imaging findings of high-voltage electrical burns in the upper extremities: correlation with angiographic findings
Authors: Lee Gyung Kyu , Suh Kyung Jin , Kang Ik Won , Hwang Dae Hyun , Min Seon Jung , Han You Mie , Choi Min Ho
Published: February 2011

Background

A high-voltage electrical burn is often associated with deep muscle injuries. Hidden, undetected deep muscle injuries have a tendency for progressive tissue necrosis, and this can lead to major amputations or sepsis. MRI has excellent soft tissue contrast and it may aid in differentiating the areas of viable deep muscle from the areas of non-viable deep muscle.

Purpose

To describe the MR imaging findings of a high-voltage electrical burn in the upper extremity with emphasis on the usefulness of the gadolinium-enhanced MRI and to compare the MR imaging findings with angiography.

Material and Methods

We retrospectively reviewed the imaging studies of six patients with high-voltage electrical burns who underwent both MRI and angiography at the burn center of our hospital from January 2005 to December 2009. The imaging features were evaluated for the involved locations, the MR signal intensity of the affected muscles, the MR enhancement pattern, the involved arteries and the angiographic findings (classified as normal, sluggish flow, stenosis or occlusion) of the angiography of the upper extremity. We assessed the relationship between the MR imaging findings and the angiographic findings.

Results

The signal intensities of affected muscles were isointense or of slightly high signal intensity as compared with the adjacent unaffected skeletal muscle on the T1-weighted MR images. Affected muscles showed heterogenous high signal intensity relative to the adjacent unaffected skeletal muscle on the T2-weighted images. The gadolinium-enhanced T1-weighted images showed diffuse inhomogeneous enhancement or peripheral rim enhancement of the affected muscles. The angiographic findings of the arterial injuries showed complete occlusion in three patients, severe stenosis in two patients and sluggish flow in one patient. Of these, the five patients with complete occlusion or severe stenosis on angiography showed non-perfused and non-viable areas of edematous muscle on MRI. On the other hand, one patient with sluggish flow on angiography showed a perfused and viable area of edematous muscle on MRI.

Conclusion

Gadolinium-enhanced MRI is a useful non-invasive imaging modality to detect the site and extent of hidden, undetected deep muscle injuries in a group of patients with high-voltage electrical burns of the upper extremities.
A telemedicine service for HIV/AIDS physicians working in developing countries
Authors: Zolfo Maria , Bateganya Moses H , Adetifa Ifedayo M , Colebunders Robert , Lynen Lutgarde
Published: February 2011

In 2003, the Institute of Tropical Medicine (ITM) in Antwerp set up an Internet-based decision support service to assist health-care workers in the management of difficult HIV/AIDS cases. This service is available to physicians working in resource-limited settings. Between April 2003 and December 2009, the telemedicine service received 1058 queries, from more than 40 countries, mostly resource-constrained. In the first six years there were 952 queries, of which 459 (49%) were posted on the web-based telemedicine discussion forum and the rest sent by email. All queries were handled by a co-ordinator who forwarded them to a network of specialists, based at the ITM and at other institutions. The average time to provide a first reply was 24 hours. Almost half of the queries received in the first six years ( n = 466) were related to the use of antiretroviral medications. The response rate to a user questionnaire was 19% (73 questionnaires returned out of 387 delivered): half of those ( n = 37) came from active users and the remainder ( n = 36) from clinicians who had never used the system. The user survey showed that telemedicine advice was valuable in the management of specific cases, and significantly influenced the way that clinicians managed other similar cases subsequently. Nonetheless, there was a declining trend in the rate of use of the service.
Key challenges in the development and implementation of telehealth projects
Authors: Joseph Victor , West Robert M , Shickle Darren , Keen Justin , Clamp Susan
Published: February 2011

A literature review was carried out to identify the key challenges in the implementation of telehealth. This was followed by a survey of organisations in England involved in telehealth projects in order to understand the challenges they faced. Ten of the 13 health or local authority organisations surveyed had telehealth projects and three were at the planning stage. The analysis revealed seven key challenges facing implementers of telehealth in England. Based on the findings from the literature review and the survey, a model was constructed and a checklist drawn up. The model contained the following elements: identifying issues, needs and partners; producing a strategy; securing funding; implementing changes; and monitoring and evaluating a telehealth project. The checklist was validated by using key informants from the organisations originally surveyed. The checklist may be useful to guide telehealth development and implementation in the future.
A study of online consultations for paediatric renal patients in Russia
Authors: Braverman Julia , Samsonov Dmitry V
Published: February 2011

We developed an educational website for parents of paediatric patients with kidney diseases in Russia. Parents could ask questions regarding their child's illness and submit information, including medical summaries and scanned or electronic images. A US-trained specialist in paediatric nephrology reviewed the information provided and advised about further evaluation or referral, as well as discussing possible treatment plans. In the first nine months, 141 distinct users communicated through the website. Fifty-eight percent of patients were female. An analysis of 70 cases suggested that in 45% there had been overdiagnosis of common paediatric problems, such as urinary tract infection and pyelonephritis. Users completed an anonymous satisfaction survey. The response rate was 84% ( n = 59/70). The majority of respondents found the consultation useful (mean = 4.6 on a 5-point scale). The online consultation answered the questions of most respondents, provided useful information and relieved uncertainty regarding a follow-up. The majority of the respondents (>90%) confirmed that they trusted the online consultation and would recommend the technique to other parents. Online consultation for parents can provide reliable information that results in improved parental satisfaction and education. This approach may be useful in improving care and providing patient education in underserved areas in the USA and elsewhere.
Homoleptic star-shaped Ru(II) complexes
Authors: Zhang Yongyi , Galoppini Elena , Johansson Patrik G. , Meyer Gerald J.
Published: February 2011

A series of homoleptic Ru(II) star complexes were synthesized and bound to semiconductor metal oxide nanoparticle films. In the nanosized, highly symmetrical “star”-shaped complexes, the Ru(II) center is coordinated to three identical bipyridine ligands carrying conjugated oligophenylenethynylene (OPE) rigid linker units terminating with carboxylic anchor groups. In this report, we describe how this concept is being applied toward the development of chromophoric units that are isolated from the surface of the semiconductor, and some possible advantages of this surface engineering strategy.
Study on the Role of Second Phase Particles in Hydrogen Uptake Behavior of Zirconium Alloys
Authors: Yao M. Y. , Wang J. H. , Peng J. C. , Zhou B. X. , Li Q.
Published: February 2011

In an effort to better understand the role of second phase particles (SPPs) in the hydrogen uptake of zirconium alloys, four alloys and four heat treatments for each alloy were chosen to prepare specimens with different SPPs size distributions and area fractions. The hydrogen uptake performance of these specimens was investigated after autoclave testing in 400°C/10.3 MPa steam. Results show that the hydrogen uptake is not always in a strict corresponding relationship with the corrosion resistance among the specimens, but it is closely related to the size, area fraction, and compositions of the SPPs. In the case of Zry-2 and Zry-4, the hydrogen uptake fraction (HUF) increased with increasing size and area fraction of the SPPs. The dependence was more notable for the Zry-2 than the Zry-4. In the case of N36 and N18, the HUF had only a slight variation with the size and area fraction of the SPPs. No matter which heat treatment was employed, the corrosion resistance of the N18 specimens was superior to the N36 specimens, but the HUF of the former was larger than that of the latter. These results clearly demonstrate that the effect of the size and area fraction of SPPs on the hydrogen uptake depends on the SPP compositions. Pressure-composition-temperature and kinetics of absorbing and desorbing hydrogen tests were conducted on Zr(Fe,Cr)2, Zr2(Fe,Ni), Zr(Nb,Fe)2, and β-Nb alloys (which may be found as SPPs in the four zirconium alloys tested) as well as on pure zirconium. Results show that Zr(Nb,Fe)2, Zr2(Fe,Ni), and Zr(Fe,Cr)2 alloys have a stronger reversible ability for hydrogen absorption and desorption than β-Nb alloy and pure zirconium. Based on the testing results, a model correlating the hydrogen uptake performance to the reversible ability of the SPPs to absorb and desorb hydrogen is proposed. The model can successfully explain the results.
Verteilte koordinierte Lastflusssteuerung in elektrischen Energieübertragungsnetzen
Authors: Häger Ulf , Lehnhoff Sebastian , Rehtanz Christian
Published: February 2011

Energiemarktaktivitäten und die zunehmende Windenergieeinspeisung führen zu einer erhöhten Belastung der elektrischen Energieübertragungsnetze. Um dabei entstehende Netzengpässe zu beheben sind Netzausbaumaßnahmen erforderlich. Neue Leitungen können aufgrund von Umweltauflagen nur zögerlich errichtet werden. Leistungsflussregler (LFR) werden zunehmend eingesetzt, um Engpässe zu entschärfen. Dieser Beitrag stellt einen agentenbasierten verteilten Koordinationsansatz vor, bei dem LFR weitestgehend autonom auf kritische Belastungssituationen reagieren und eine weiträumige Ausregelung ermöglichen.
Characterization of Electrodeposited NiCo Films with Incorporated Ferrite (BaFe12O19) Nano-Particles
Authors: Cojocaru Paula , Pahari Sougata , Magagnin Luca , Dietrich Dagmar , Liebig Andreas , Lampke Thomas
Published: February 2011

NiCo films with incorporated ferrite (BaFe12O19) nano-particles were studied with the motivation of future MEMS application. The microstructure was characterized by SEM, TEM, EBSD and XRD. Magnetic properties were derived from SQUID magnetometry. Two types of layers were electrodeposited distinguished by their microstructure. One type is a pure NiCo nano-grained matrix without particle incorporation; the other is a composite of the nano-grained NiCo matrix with co-deposited nano-sized ferrite particles with a content of about 0.2 wt. %. The soft magnetic matrix dominates the global magnetization behavior expected for NiCo alloys. Despite the low incorpotation rate, the influence of the BaFe12O19 particles in the matrix is apparent in the in-plane measurement.
Precise Analysis of Small Wavenumber Shift of Pyridine on Dilution with H2O and D2O Using RDS Technique
Authors: Mishra Shivangi , Meyer Tobias , Popp Jürgen , Singh Ranjan K.
Published: February 2011

The wavenumber difference (Δν) of the ring breathing mode (ν
1), ring deformation mode (ν
12) and C–H stretching mode (ν
3) of pyridine (Py) dissolved in both H2O and D2O at equal mole fractions of the solute (Py) and the solvent (H2O/D2O) has been determined precisely by using the technique of Raman difference spectroscopy (RDS) in order to analyze the relative shift caused by these two solvents. The spectra of the two systems, for which the difference spectrum is to be generated, were recorded simultaneously and the wavenumber shifts up to almost one hundredth part of the linewidth of a band could be determined precisely. The values of Δν for the three modes as a function of mole fraction are compared with the Δν obtained by the solvation of Py molecule in the media of dielectric constants equal to that of the mixture of Py and H2O/D2O at the experimental mole fractions using DFT and MP2 methods. The variation in Δν with mole fraction seems to be the result of difference of dielectric constants of Py+H2O and Py+D2O at equal mole fraction. The absolute peak position and linewidth of the three modes as a function of mole fraction have been discussed in terms of relevant models, which show the effective role of diffusion and concentration fluctuation in the mixture.
Isentropic Compressibility Studies of Some Salts in Acetonitrile + N,N-dimethylacetamide Mixtures at 298 K
Authors: Rana Dilbag Singh , Gill Dip Singh , Chauhan Mohinder Singh , Gupta Rahul
Published: February 2011

Ultrasonic velocities and densities of some copper(I) and silver(I) salts have been measured in the concentration range 0.002–0.28 mol kg−1 in binary mixtures of acetonitrile (AN) + N,N-dimethylacetamide (DMA) containing 100, 80, 60, 40, 20 and 0 mol % AN at 298 K. The isentropic compressibility (K
s) and apparent molal isentropic compressibility in various solvent systems have been calculated by using ultrasonic velocity (u) and partial molal volume (V

φ
) respectively. Limiting apparent molal isentropic compressibilities (K
s,φ

0) for various salts have been evaluated from vs.
m
1/2 plots and split into the contributions of individual ions (K
s,φ

0)±. The (K
s,φ

0)± values for copper(I) and silver(I) ions are found to be negative over the entire composition range which indicate strong solvation of these complex ions. The (K
s,φ

0)± values for these ions increase with increase in DMA composition shows that the extent of solvation increases with increase in DMA composition.
Avaliação radiográfica do colapso sagital do Mal de Pott
Authors: Moreira Carlos Humberto Targa , Umeta Ricardo Shigueaki Galhego , Caffaro Maria Fernanda Silber , Meves Robert , Landim Elcio , Avanzi Osmar
Published: February 2011

OBJETIVO: avaliar o colapso sagital dos pacientes com tuberculose vertebral tratados pelo modo conservador. MÉTODOS: revisão dos prontuários de pacientes do Grupo de Cirurgia da Coluna atendidos na Santa Casa de Misericórdia de São Paulo. A deformidade em cifose foi aferida pelo método de Cobb e da cifose segmentar. RESULTADOS: do total de 123 pacientes, 33 (68,8) foram submetidos a tratamento conservador, sendo 17 (51%) pacientes do sexo masculino e 16 (48,8%) do sexo feminino. A idade variou de 3 a 87 anos com média de 44,1 anos. Houve aumento da cifotização local em 20 pacientes (60,6%) e da cifose segmentar em 23 (69,6%), sendo que o de pior prognóstico de progressão foi a nível toracolombar (11,3º; p<0,05). CONCLUSÃO: nesta série de casos de tuberculose vertebral tratados sem cirurgia a evolução radiológica foi satisfatória.
Correlação entre as classificações de Pfirrmann e Modic na degeneração do disco intervertebral lombar
Authors: Leite Marcio Squassoni , Luciano Rafael Paiva , Martins Délio Eulálio , Wajchenberg Marcelo , Puertas Eduardo Barros
Published: February 2011

OBJETIVO: correlacionar as alterações encontradas nas ressonâncias magnéticas lombares quanto às classificações de Pfirrmann e Modic. MÉTODOS: foram selecionadas 54 ressonâncias lombossacras de pacientes ambulatoriais (23 homens e 31 mulheres) que já se encontravam em investigação por sua comorbidade. Foram classificados 264 discos intervertebrais (L1 a S1) quanto ao grau de degeneração segundo Pfirrmann. A presença de alterações de sinal de corpo vertebral foi registrada quanto à classificação de Modic. Foi aplicado teste χ2, adotando níveis de significância inferiores a 0,05 (a=5%). RESULTADOS: a média de idade pesquisada foi de 48,4 anos (26 a 77 anos). Observou-se maior prevalência de Pfirrmann tipo IV (31,1%). Em 88,3% da amostra o sinal de Modic estava ausente, assim como Modic 3; 60% das alterações Modic 2 foram relacionadas ao Pfirrmann tipo V, e 36,4% das alterações Modic 1 foram igualmente distribuídas entre Pfirrmann tipo IV e V. Encontrou-se associação estatisticamente significante entre as alterações de Modic e de Pfirrmann (p<0,001). CONCLUSÃO: houve uma clara associação entre as classificações estudadas ao se comparar os estágios mais avançados de Pfirrmann (IV e V) com Modic tipo 1 e 2.
Influência do trauma cirúrgico no comportamento dos níveis séricos de albumina após cirurgia da coluna vertebral
Authors: Luciano Rafael Paiva , Leite Marcio Squassoni , Martins Délio Eulálio , Wajchenberg Marcelo , Puertas Eduardo Barros
Published: February 2011

OBJETIVO: avaliar a variação da concentração da albumina nas cirurgias de coluna vertebral e relacioná-la às repercussões clínicas no pós-operatório. MÉTODOS: estudo prospectivo observacional sobre os valores do nível sérico da albumina de 55 pacientes submetidos à cirurgia na coluna vertebral. As amostras de sangue foram coletadas um dia antes da cirurgia e 24 horas após o procedimento. Foi aplicado o teste t pareado na avaliação da variação (pré versus pós) nos parâmetros albumina, hemoglobina e hematócrito. A presença de associação entre grau de variação nos níveis de albumina (<1 g/dL ou >1 g/dL) e as variáveis de interesse: presença de complicações, necessidade de transfusão, procedimento realizado, idade e gênero do paciente e diagnóstico foram avaliadas pelo teste do χ2 de Pearson ou teste do χ2 da razão de verossimilhança quando apropriado. RESULTADOS: a redução média dessa proteína foi de 0,58 g/dL, variando de 0 a 1,8 g/dL. Dos pacientes, 78,2% apresentaram valores da albumina no período pós-operatório abaixo da faixa considerada normal. Somente dois pacientes da amostra apresentaram complicações durante os 30 dias de seguimento. O grupo com correção de deformidades apresentou 100% de pacientes com variação >1 g/dL. CONCLUSÃO: houve influência do trauma cirúrgico na redução sérica da albumina, em média, de 0,58 g/dL nas cirurgias da coluna vertebral. Não foi possível associar essa queda às complicações no período pós-operatório após seguimento de 30 dias desses pacientes.
Conduta na lesão dural intraoperatória em artrodese da coluna lombar
Authors: Grandese Fabiano de Mendonça , Yamazato Clóvis , Oliveira Fábio Mastromauro de , Ribeiro Iberê , Bastos Júnior José Olympio Catão , Kusabara René
Published: February 2011

OBJETIVO: estudo retrospectivo de pacientes com lesão dural intraoperatória de cirurgia da coluna vertebral lombar, conduzido por meio de um protocolo independente da extensão da lesão, complicações associadas e resultados após seguimento mínimo de um ano. MÉTODOS: um total de 10 pacientes com durotomia acidental em cirurgias de descompressão e artrodese da coluna vertebral lombar, no período de Janeiro de 2007 a Janeiro de 2009, para tratamento de doença degenerativa, tiveram seus prontuários revisados, após terem sido tratados por meio de um protocolo embasado em reparo primário da lesão, drenagem subaracnoidea fechada, subfascial e subcutânea aspirativa realizados por cirurgião experiente, associado a repouso relativo com mobilidade precoce e terapia medicamentosa. Suas anotações e exames radiológicos foram verificados com seguimento pós-operatório e direcionados para identificação de sintomas sugestivos de complicações. RESULTADOS: todos os pacientes apresentaram boa evolução, sem ocorrência de fístula liquórica ou infecção pós-operatória; três deles apresentaram cefaleia pós-operatória de leve intensidade. Não houve necessidade de reoperação em nenhum desses pacientes. CONCLUSÃO: concluiu-se que a conduta adotada é segura e de bom resultado para os pacientes quando ocorre esse tipo de lesão, independentemente da extensão da mesma.
Interações entre evolução sedimentar e ocupação humana pré-histórica na costa centro-sul de Santa Catarina, Brasil
Authors: Giannini Paulo César Fonseca , Villagran Ximena Suarez , Fornari Milene , Nascimento Junior Daniel Rodrigues do , Menezes Priscila Melo Leal , Tanaka Ana Paula Burgoa , Assunção Danilo Chagas , DeBlasis Paulo , Amaral Paula Garcia Carvalho do
Published: February 2011

Desde o começo da ocupação humana no litoral centro-sul de Santa Catarina, Brasil, a articulação entre processos naturais e antrópicos modelou uma paisagem fortemente domesticada, marcada pela construção massiva de concheiros de dimensões monumentais e pela permanência milenar. Na planície costeira entre Passagem da Barra (município de Laguna) e lago Figueirinha (município de Jaguaruna), 76 sambaquis foram mapeados, dos quais 48 possuem datação. O levantamento sistemático de sítios e datações permitiu identificar padrões de distribuição espacial nos sambaquis da região, quanto a contexto sedimentar da época de construção, estratigrafia e idade. Desse modo, reconheceram-se nos sítios da região: cinco contextos geológico-geomorfológicos de localização; três padrões estratigráficos; e quatro fases de ocupação sambaquieira baseadas na quantidade de sítios e no tipo de padrão construtivo dominante. O modelo integrado de evolução sedimentar e distribuição tempo-espacial de sambaquis indica que estes sítios eram construídos em áreas já emersas e pouco alagáveis, e que sítios interiores, afastados dos corpos lagunares, podem não se ter preservado ou não estarem expostos devido ao processo de assoreamento contínuo que caracterizou a região após a máxima transgressão holocênica. O cruzamento de dados aqui proposto evidencia a importância de abordagens integradas entre arqueologia e geociências no estudo da evolução das paisagens.
Adesão às consultas e ao tratamento medicamentoso de pacientes em ensaios clínicos randomizados da indústria
Authors: Silveira Luana Claudia Jacoby , Souza Emiliane Nogueira de , Goldmeier Silvia , Silva Andressa Freitas da , Rabelo Eneida Rejane
Published: February 2011

Estudo de coorte histórico que avaliou a taxa adesão dos pacientes de ensaios clínicos randomizados (ECR) da indústria farmacêutica na área de cardiologia às consultas de seguimento e ao tratamento medicamentoso. Estudo conduzido na unidade de pesquisa de cardiologia de um hospital público e universitário em Porto Alegre, Rio Grande do Sul. A adesão foi considerada como ≥ a 80%. Foram revisados os registros de sete ECR (120 prontuários). Verificou-se que 117 (97%) pacientes apresentaram adesão às visitas de seguimento ≥ a 80%; 83,3% dos pacientes apresentaram taxa de adesão ≥ 80% à medicação do estudo; a mediana do número de comprimidos ingeridos entre os pacientes com boa adesão foi de 175 (72-500) e entre os pacientes com menor adesão foi de 500 (500-962). Estes resultados indicam que pacientes em estudos com seguimento mais longo e maior número de comprimidos apresentam prejuízo na adesão.
Cuidado intergeracional com o idoso: autonomia do idoso e presença do cuidador
Authors: Flores Gisela Cataldi , Borges Zulmira Newlands , Denardin-Budó Maria de Lourdes , Mattioni Fernanda Carlise
Published: February 2011

Objetivou-se descrever e interpretar a autonomia e a presença como determinantes e significantes do cuidado intergeracional com o idoso. Pesquisa qualitativa, etnográfica, com dados coletados por entrevista e observação participante. Utilizou-se análise de conteúdo para análise dos dados. Os sujeitos foram dez idosos e seus respectivos cuidadores. Emergiram duas categorias temáticas: a autonomia como determinante do cuidado e a presença como significante do cuidado. A relação dos idosos com seus cuidadores está baseada na garantia da preservação da sua autonomia, a qual os faz se sentirem cuidados. A presença significou cuidado para a maioria dos idosos, determinada pela disponibilidade e por estar perto, o que representou segurança. Dessa forma, o cuidado intergeracional com o idoso deve ser norteado pelo respeito e pela preservação da sua autonomia, considerando-se, ainda, a importância da presença condicionada ao respeito à totalidade e à complexidade das pessoas aos seus modos de vida e valores culturais.
O viver do portador chagásico crônico: possibilidades de ações do enfermeiro para uma vida saudável
Authors: Oliveira Angélica Porto de , Gomes Luciane Feira , Casarin Sidnéia Tessmer , Siqueira Hedi Crecencia Heckler de
Published: February 2011

Objetivou-se conhecer como vivem os portadores chagásicos crônicos em dois municípios da região sul do Rio Grande do Sul, traçando possíveis ações do enfermeiro para uma vida mais saudável. O estudo foi de caráter descritivo e exploratório com uma abordagem qualitativa. Os dados foram coletados nos domicílios de dez clientes portadores crônicos da Doença de Chagas através de entrevista semiestruturada. Os resultados mostraram que a sintomatologia da doença não se manifestou na fase aguda, sendo que a maioria dos sujeitos faz uso de medicações paliativas para alívio dos sintomas, existindo grandes limitações no desenvolvimento das atividades cotidianas, principalmente nos portadores da forma cardíaca. Reitera-se o valor da equipe de saúde, em especial do enfermeiro, no manejo clínico, pois quando iniciado precocemente, propicia uma melhor qualidade de vida e uma elevação da expectativa de sobrevivência.
Análise da produção científica acerca da atenção ao recém-nascido de baixo peso em UTI
Authors: Tronco Caroline Sissy , Paula Cristiane Cardoso de , Padoin Stela Maris de Mello , Langendorf Tassiane Ferreira
Published: February 2011

O objetivo deste estudo foi analisar a natureza e tendência dos artigos na temática saúde do recém nascido de baixo peso. Trata-se de uma revisão integrativa desenvolvida em agosto de 2009, a partir dos descritores: "recém-nascido de baixo peso" or "recém-nascido de muito baixo peso" and "unidades de terapia intensiva neonatal", no recorte temporal 1990-2008. A amostra de 608 resumos foi submetida à análise de conteúdo temática. Nos resultados, os estudos de natureza clínico-epidemiológica contemplam os fatores de risco do baixo peso e morbimortalidade neonatal e os de tendência assistencial contribuem com as rotinas e cuidados prestados. Evidenciam-se os avanços na atenção a saúde do recém-nascido, a complexidade clínica e as implicações para sua assistência. Destaca-se a lacuna de pesquisas que aponte a subjetividade, o apoio e a inclusão das famílias nos cuidados e no enfrentamento dessa situação.
What Patients Value When Oncologists Give News of Cancer Recurrence: Commentary on Specific Moments in Audio-Recorded Conversations
Authors: Back Anthony L. , Trinidad Susan B. , Hopley Elizabeth K. , Arnold Robert M. , Baile Walter F. , Edwards Kelly A.
Published: February 2011

Learning Objectives

After completing this course, the reader will be able to: Incorporate the three themes identified in this study to refine discussion with patients of their cancer recurrence.Manage discussion with patients of cancer recurrence with recognition of the impact of the news on the patient and guidance as to next steps.

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

Purpose.

Recommendations for communicating bad or serious news are based on limited evidence. This study was designed to understand patient perspectives on what patients value when oncologists communicate news of cancer recurrence.

Study Design and Methods.

Participants were 23 patients treated for a gastrointestinal cancer at a tertiary U.S. cancer center within the past 2 years, who had semistructured qualitative interviews in which they listened to audio recordings of an oncology fellow discussing news of cancer recurrence with a standardized patient. Participants paused the audio recording to comment on what they liked or disliked about the oncologist's communication.

Results.

Three themes were identified that refine existing approaches to discussing serious news. The first theme, recognition, described how the oncologist responded to the gravity of the news of cancer recurrence for the patient. Participants saw the need for recognition throughout the encounter and not just after the news was given. The second theme, guiding, describes what participants wanted after hearing the news, which was for the oncologist to draw on her biomedical expertise to frame the news and plan next steps. The third theme, responsiveness, referred to the oncologist's ability to sense the need for recognition or guidance and to move fluidly between them.

Conclusion.

This study suggests that oncologists giving news of cancer recurrence could think of the communication as going back and forth between recognition and guidance and could ask themselves: “Have I demonstrated that I recognize the patient's experience hearing the news?” and “Have I provided guidance to the next steps?”