bluuebunny/crossref_metadata_2025 huggingface dataset:
Antibiogram of Salmonella Isolates from Blood with an Emphasis on Nalidixic Acid and Chloramphenicol Susceptibility in a Tertiary Care Hospital in Coastal Karnataka: A Prospective Study
Authors: Shetty Anup Kumar , Shetty Ichlampady Nagaraj , Furtado Zevita Venisha , Antony Beena , Boloor Rekha
Published: February 2014

Background: Enteric fever is caused by the serotypes Salmonella Typhi, Salmonella Paratyphi A, Salmonella Paratyphi B and Salmonella Paratyphi C. After emergence of multidrug resistant Salmonellae Ciprofloxacin, a fluorquinolone antibiotic was the first-line therapy. Treatment failure was observed with Ciprofloxacin soon and such strains showed in-vitro resistance to Nalidixic acid. Recent reports suggest re-emergence of Chloramphenicol sensitive strains and increasing Nalidixic acid resistance. This study is aimed at detecting the current trend in the antibiogram of Salmonella isolates from blood culture in coastal Karnataka, with an emphasis on antibiotic susceptibility of Nalidixic acid and Chloramphenicol and evaluate, if there is a need to modify the strategies in the antibiotic therapy for enteric fever.

Materials and Methods: Blood samples received for culture in the laboratory between June 2009 and August 2011 was cultured in Brain Heart infusion broth, bile broth or in a commercial BACTEC culture media. The growth from blood cultures were processed for identification and antibiotic susceptibility as per standard methods. Antibiotic susceptibility for Ampicillin, Trimethoprim-sulphamethoxazole, Chloramphenicol, Ciprofloxacin, Ceftriaxone and Nalidixic acid were noted.

Results: Out of 9053 blood culture specimens received, Salmonella was isolated from 103 specimens. There were 85 Salmonella Typhi isolates, 16 Salmonella Paratyphi A and two Salmonella Paratyphi B. Salmonella Typhi and Salmonella Paratyphi A showed the highest resistance to Nalidixic acid. Salmonella Typhi showed highest susceptibility to Ceftriaxone and Salmonella Paratyphi A to trimethoprim-sulphamethoxazole and Chloramphenicol. Two isolates were multidrug resistant. One Salmonella Paratyphi A was resistant to Ceftriaxone.

Conclusion: Routine screening of Nalidixic acid susceptibility is practical to predict fluorquinolone resistance in Salmonella and preventing therapeutic failure while treating with it. It is worthwhile to consider replacing fluorquinolones with Chloramphenicol or Ceftriaxone as the first line of therapy for enteric fever. Periodic analysis of Salmonella antibiogram should be done to formulate the best possible treatment strategies.
Rapid Identification and Drug Susceptibility Testing of Mycobacterium tuberculosis: Standard Operating Procedure for Non- Commercial Assays: Part 2: Nitrate Reductase Assay v1.3.12
Authors: Singh Sarman , Kumar Parveen , Sharma Shreya , Mumbowa Francis , Martin Anandi , Durier Nicolas
Published: February 2014

In the previous part, we presented the standard operating procedure (SOP) of the microscopic observation drug susceptibility assay drug susceptibility testing (DST) for Mycobacterium tuberculosis. The present SOP is devoted to another non-commercial culture and DST method known as nitrate reductase assay (NRA). As the name implies, the NRA detects the ability of M. tuberculosis to reduce nitrate to nitrite. In the assay, the presence of nitrite is detected by the addition of p-nitrobenzoate into the growth yield. The reaction is detected by the naked eye. The incorporation of drugs in the medium allows to use the test for DST, which can be interpreted with naked eyes. The identification and drug susceptibility results can be obtained in 2-3 weeks. This SOP document has been developed through the culture and DST subgroup of the STOP tuberculosis (TB) Partnership New Diagnostic Working Group. It is intended for laboratories that would want to use or already using this rapid non-commercial method for culture identification and DST of M. tuberculosis, notably in resource-constraint settings in Asia and Africa.
Menopause—Nonhormonal Approach: What's New?
Authors: Verma Urvashi
Published: February 2014

Like birth, menarche, puberty, pregnancy/delivery, menopause is also a very important natural biological event in any woman's life. Practically it's the time when a woman can enjoy life more freely with other responsibilities. As with increased life expectancy about one third of life span has to be spent without menstruation. For so long period a woman can not afford estrogen replacement especially because of its side effects and complications. That's why we have to search for better and safer options.

How to cite this article

Malhotra J, Verma U, Garg R, Malhotra N. Menopause—Nonhormonal Approach: What's New? J South Asian Feder Menopause Soc 2013;1(2):70-74.
Postinfarct Intracardiac Mass with Severe Mitral Regurgitation: Late Rupture of One of the Heads of Posteriomedial Papillary Muscle
Authors: Panduranga Prashanth
Published: February 2014

Acute ischemic mitral regurgitation is due to complete or partial rupture of either anterolateral or posteriomedial papillary muscles occurring within a week of acute myocardial infarction. Chronic ischemic mitral regurgitation is due to postinfarct remodeling leading to imbalance between tethering and closing forces of mitral valve apparatus. We present a 64-year-old male, presenting with acute pulmonary edema secondary to severe mitral regurgitation, a week after his myocardial infarction. Transthoracic echocardiogram detected a mobile intracardiac mass near anterior mitral leaflet with no clear-cut intracardiac origin of this mass. Perioperative transesophageal echocardiography detected rupture of one of the heads of posteriomedial papillary muscle. This case illustrates a rare presentation of postinfarct rupture of one of the heads of posteriomedial papillary muscle occurring late after infarction presenting as an intracardiac mass, which can have surgical implications.

How to cite this article

Panduranga P. Postinfarct Intracardiac Mass with Severe Mitral Regurgitation: Late Rupture of One of the Heads of Posteriomedial Papillary Muscle. J Perioper Echocardiogr 2014;2(1)29-31.
Transesophageal Echocardiography Guided Ligation of Right Pulmonary Artery to Left Atrial Fistula
Authors: Devagourou V , Das Sambhunath , Irpachi Kalpna
Published: February 2014

Right pulmonary artery to left atrial fistula is a rare congenital cardiac anomaly. A 23 years old man visited an ophthalmologist for complains of diplopia and diminished vision with cyanosis. Computerized tomography angiography diagnosed the presence of right pulmonary artery to left atrium fistula. Intraoperative use of transesophageal echocardiography confirmed the diagnosis and guided in real time for the successful ligation of fistula. Transesophageal echocardiography helped to perform the surgery without cardiopulmonary bypass.

How to cite this article

Das S, Irpachi K, Devagourou V. Transesophageal Echocardiography Guided Ligation of Right Pulmonary Artery to Left Atrial Fistula. J Perioper Echocardiogr 2014;2(1):38-39.
Ground-based all-sky mid-infrared and visible imagery for purposes of characterizing cloud properties
Authors: Klebe D. I. , Blatherwick R. D. , Morris V. R.
Published: February 2014

Abstract. This paper describes the All Sky Infrared Visible Analyzer (ASIVA), a multi-purpose visible and infrared sky imaging and analysis instrument whose primary function is to provide radiometrically calibrated imagery in the mid-infrared (mid-IR) atmospheric window. This functionality enables the determination of diurnal fractional sky cover and estimates of sky/cloud temperature from which one can derive estimates of sky/cloud emissivity and cloud height. This paper describes the calibration methods and performance of the ASIVA instrument with particular emphasis on data products being developed for the meteorological community. Data presented here were collected during the Solmirus' ASIVA campaign conducted at the Atmospheric Radiation Measurement (ARM) Southern Great Plains (SGP) Climate Research Facility from 21 May to 27 July 2009. The purpose of this campaign was to determine the efficacy of IR technology in providing reliable nighttime sky cover data. Significant progress has been made in the analysis of the campaign data over the past several years and the ASIVA has proven to be an excellent instrument for determining sky cover as well as the potential for determining sky/cloud temperature, sky/cloud emissivity, precipitable water vapor (PWV), and ultimately cloud height.
Exploring local adaptation and the ocean acidification seascape – studies in the California Current Large Marine Ecosystem
Authors: Hofmann G. E. , Evans T. G. , Kelly M. W. , Padilla-Gamiño J. L. , Blanchette C. A. , Washburn L. , Chan F. , McManus M. A. , Menge B. A. , Gaylord B. , Hill T. M. , Sanford E. , LaVigne M. , Rose J. M. , Kapsenberg L. , Dutton J. M.
Published: February 2014

Abstract. The California Current Large Marine Ecosystem (CCLME), a temperate marine region dominated by episodic upwelling, is predicted to experience rapid environmental change in the future due to ocean acidification. The aragonite saturation state within the California Current System is predicted to decrease in the future with near-permanent undersaturation conditions expected by the year 2050. Thus, the CCLME is a critical region to study due to the rapid rate of environmental change that resident organisms will experience and because of the economic and societal value of this coastal region. Recent efforts by a research consortium – the Ocean Margin Ecosystems Group for Acidification Studies (OMEGAS) – has begun to characterize a portion of the CCLME; both describing the spatial mosaic of pH in coastal waters and examining the responses of key calcification-dependent benthic marine organisms to natural variation in pH and to changes in carbonate chemistry that are expected in the coming decades. In this review, we present the OMEGAS strategy of co-locating sensors and oceanographic observations with biological studies on benthic marine invertebrates, specifically measurements of functional traits such as calcification-related processes and genetic variation in populations that are locally adapted to conditions in a particular region of the coast. Highlighted in this contribution are (1) the OMEGAS sensor network that spans the west coast of the US from central Oregon to southern California, (2) initial findings of the carbonate chemistry amongst the OMEGAS study sites, and (3) an overview of the biological data that describes the acclimatization and the adaptation capacity of key benthic marine invertebrates within the CCLME.
A cusp catastrophe model for alluvial channel regime and classification of channel patterns
Authors: Xiao Y. , Shao X. J. , Yang Y.
Published: February 2014

Abstract. A cusp catastrophe model for alluvial channel regime is established by selecting suitable parameters to reflect channel stability. An equation is obtained from the equilibrium state of channel regime, which is a cusp catastrophe surface in a translated three dimensional coordinate. The stability of channel patterns can be identified by such a model in a direct way, and the 2-D projection of the cusp catastrophe surface can be used to classify alluvial channel patterns. Predictions based on this model are consistent with field observations involving about 100 natural rivers. The results indicate that this method may be applied to study the regime of natural rivers and to assist decision making in river engineering.
Lagrangian study of surface transport in the Kuroshio Extension area based on simulation of propagation of Fukushima-derived radionuclides
Authors: Prants S. V. , Budyansky M. V. , Uleysky M. Yu.
Published: February 2014

Abstract. Lagrangian approach is applied to study near-surface large-scale transport in the Kuroshio Extension area using a simulation with synthetic particles advected by AVISO altimetric velocity field. A material line technique is proposed and applied to find out the origin of water masses in cold-core cyclonic rings pinched off from the jet in summer 2011. Tracking and Lagrangian maps provide the evidence of cross-jet transport. Fukushima-derived caesium isotopes are used as Lagrangian tracers to study transport and mixing in the area a few months after the 11 March 2011 tsunami that caused heavy damage of the Fukushima Nuclear Power Plant (FNPP). Tracking maps are computed to trace the origin of water parcels with measured levels of 134Cs and 137Cs concentrations collected during two research vessel (R/V) cruises in June and July 2011 in the large area of the northwest Pacific (Kaeriyama et al., 2013; Buesseler et al., 2012). It is shown that Lagrangian simulations are useful for finding the surface areas that are potentially dangerous due to the risk of radioactive contamination. The results of simulation are supported by tracks of the surface drifters that were deployed in the area.
The instability of diffusive convection and its implication for the thermohaline staircases in the deep Arctic Ocean
Authors: Zhou S.-Q. , Qu L. , Lu Y.-Z. , Song X.-L.
Published: February 2014

Abstract. In the present study, the classical description of diffusive convection is updated to interpret the instability of diffusive interfaces and the dynamical evolution of the bottom layer in the deep Arctic Ocean. In the new consideration of convective instability, both the background salinity stratification and rotation are involved. The critical Rayleigh number of diffusive convection is found to vary from 103 to 1011 in the deep Arctic Ocean as well as in other oceans and lakes. In such a wide range of conditions, the interface-induced thermal Rayleigh number is shown to be consistent with the critical Rayleigh number of diffusive convection. In most regions, background salinity stratification is found to be the main hindrance to the occurrence of convecting layers. With the new parameterization, it is predicted that the maximum thickness of the bottom layer is 1051 m in the deep Arctic Ocean, which is close to the observed value of 929 m. The evolution time of the bottom layer is predicted to be ~ 100 yr, which is on the same order as that based on 14C isolation age estimation.
Decadal variability of heat content in the South China Sea inferred from observation data and an ocean data assimilation product
Authors: Song Wei , Lan Jian , Liu Qinyan , Sui Dandan , Zeng Lili , Wang Dongxiao
Published: February 2014

Abstract. Using an observation data set of temperature and the Simple Ocean Data Assimilation (SODA), the decadal variability of upper ocean heat content (0–400 m; hereafter, OHC) in the South China Sea (SCS) was investigated for the period from 1958 to 2007. Decadal variability was identified as the dominant mode of upper OHC besides the seasonal cycle. According to decreasing or increasing OHC, four periods were chosen to discuss detailed processes behind OHC variability in the SCS; the four periods are 1958–1968, 1969–1981, 1982–1992, and 1993–2003. Results show that advection was the major factor for decreasing (increasing) OHC during 1958–1968 (1968–1981). During 1982–1992 and 1993–2003, the net surface heat flux was the main contributor to the variability of OHC besides the advection. The OHC, advection and net surface heat flux had significant positive trends during 1992–2003. The spatial characteristics of OHC variability and heat budget in the Luzon Strait, west of Luzon Island, and in the Xisha warm eddy region are also discussed.
A aplicação da terapia manual em paciente diabético com amputação transfemoral usuário de prótese – relato de caso
Authors: Enéas Roberto Araújo , De Vasconcelos Thiago Brasileiro
Published: February 2014

Introdução: A diabetes mellitus é uma doença metabólica crônica que pode causar amputações. Aperfeiçoar o atendimento para o paciente amputado é uma atividade complexa e pouco tem sido descrito na literatura científica sobre este assunto. Objetivo: Verificar os efeitos das técnicas da terapia manual na reabilitação de um paciente diabético com amputação transfemoral usuário de prótese. Método: Foi realizada uma avaliação dos dados clínicos do paciente antes e após a aplicação da terapia manual, que consistiu em técnicas de alongamento neural, manobras manipulativas lombares, liberações miofasciais e alongamentos manuais. Resultados: O paciente estudado apresentou uma melhora de 15º na flexão do quadril do lado amputado e ausência de dor na região anterior do coto, na coluna lombar e no joelho oposto à amputação. Conclusão: A terapia manual proporcionou uma melhor mobilidade articular e redistribuição do peso corporal, beneficiando o quadro clínico do paciente.
Relação entre força muscular e equilíbrio de idosos no programa de equilíbrio*
Authors: Hauser Eduardo , Martins Valéria Feijó , Teixeira Adriane Ribeiro , Zabaleta Ariane Dias , Gonçalves Andréa Kruger
Published: February 2014

Introdução: Diversos fatores podem estar associados ao aumento do risco de quedas com o envelhecimento. A força muscular de membros inferiores (FMI), passível de treinamento, tem demandado a atenção de pesquisadores da área da Educação Física. Objetivo: Verificar a relação entre equilíbrio e FMI de idosos ingressantes em um programa de prevenção de quedas. Métodos: Formou-se a amostra com 32 idosos, com idade média de 76,54(±8,3) anos, participantes de um projeto de extensão. Realizaram-se os testes: sentar e levantar (FMI), apoio unipodal (equilíbrio estático), TUG (equilíbrio dinâmico) e alcance funcional (equilíbrio recuperável). Para análise estatística, usou-se correlação de Spearman (p
Avaliação do peso corporal em portadores de cardiopatias congênitas
Authors: Lima Zilda Dos Santos , França Carolina Nunes , Juliano Yara , Amaral Jônatas Bussador do , Colombo-Souza Patrícia , Lopes Luiz Anderson
Published: February 2014

Introdução: Os defeitos cardíacos congênitos são classificados, com base na repercussão hemodinâmica, em acianogênicos (quando não há misturas entre as frações oxigenada e não oxigenada na circulação sistêmica) e cianogênicos (em que ocorre mistura das frações). Objetivo: Investigar possíveis alterações de peso corporal em crianças portadoras de cardiopatias congênitas acianogênicas ou cianogênicas, nos períodos pré e pós-cirúrgico. Métodos: Foram avaliadas 40 crianças de dois a seis anos de idade, com diagnóstico de cardiopatia congênita acianogênica ou cianogênica. Resultados: Houve diferenças significativas no grupo acianogênico, evidenciando que, em média, as crianças estavam com -3,2% do peso ideal no pré-operatório, passando para 3,7% no terceiro retorno pós-cirurgia. Entretanto, não foram verificadas diferenças significantes no grupo de cianogênicos. Também não se observaram diferenças ao comparar os grupos, nos momentos pré e pós-operatório. Conclusão: O estudo mostra que há uma relação entre mudanças significativas do peso corporal e cardiomiopatia acianogênica.
Subclassificação da lombalgia crônica e nível de incapacidade: efeito no desempenho funcional e força muscular
Authors: Bertor Welds Rodrigo Ribeiro , Fracaro Giovanna De Araújo , Silva Lígia Inez da , Zilio Marina , Aragão Fernando Amâncio , Carvalho Alberito Rodrigo
Published: February 2014

Introdução: A lombalgia induz a redução das atividades físicas e, consequentemente, da aptidão física. Objetivo: Verificar o efeito, isolado e associado, da classificação clínica da dor lombar (efeito de grupo) e do nível de incapacidade sobre a capacidade funcional obtida pela distância percorrida no teste de caminhada de seis minutos (TC6), sobre a força muscular dorsal e sobre a de membros inferiores (MMII). Métodos: A amostra foi composta por 31 sujeitos divididos em três grupos: controle (GC/n=10), lombares inespecífico (GLI/n=7) e específico (GLE/n=14). Os procedimentos avaliativos foram: (a) determinação do nível de incapacidade; (b) dinamometria dorsal e de MMII; (c) TC6. Resultados: Houve efeito principal do grupo, e o GC apresentou força significativamente maior que o GLE e o GLI, para a musculatura dorsal e de MMII; porém, não houve tal efeito para o TC6. Conclusão: A força muscular dorsal e a de MMII foram influenciadas pela lombalgia crônica; entretanto, o desempenho funcional, não.
Modalidade de educação a distância na formação profissional em saúde da família: relato de experiência
Authors: Martins-Melo Francisco Rogerlândio , Lima Mauricélia da Silveira , Ramos Junior Alberto Novaes , Heukelbach Jorg , Campo Márcia Oliveira Coelho
Published: February 2014

O presente estudo relata a experiência de um aluno/profissional na realização do curso de Especialização em Saúde da Família da Universidade Federal do Ceará, oferecido por meio da estratégia de educação a distância. O curso teve como público-alvo médicos, enfermeiros e cirurgiões-dentistas inseridos na Estratégia Saúde da Família nos municípios do estado do Ceará. Foi utilizado o ambiente virtual de aprendizagem Moodle, um sistema de ensino-aprendizagem on-line em que diversas ferramentas de comunicação estavam integradas em uma página da internet, na qual se acessavam as disciplinas ofertadas e se interagia com um professor/tutor. Os pressupostos pedagógicos do curso foram baseados na educação contextualizada descentralizada, na aprendizagem colaborativa, significativa e problematizadora, além da articulação entre teoria-prática e ensino-serviço. A incorporação da educação a distância aos processos de formação/capacitação de profissionais na atenção primária aqui realizada se constitui em exemplo e incentivo para outras iniciativas de formação/qualificação de profissionais com atuação em outras áreas do Sistema Único de Saúde no Brasil.
Dificuldades dos médicos que atuam na Estratégia Saúde da Família de Minas Gerais para proverem atenção à saúde das mulheres
Authors: Melo Victor Hugo , Rio Suzana Maria Pires do , Bonito Rosuita Fratari , Lodi Claudia Teixeira Costa , Fonseca Maria Tereza Mohallem , Amaral Eliana
Published: February 2014

Objetivo: Avaliar as dificuldades de médicos da Estratégia Saúde da Família (ESF) para proverem assistência à saúde das mulheres em todos os estágios de suas vidas. Métodos: Foi aplicado questionário semiestruturado a 203 médicos que atuam na ESF, em três regiões do Estado de Minas Gerais, com questões específicas relativas à atenção à saúde da mulher: prevenção do câncer do colo e das mamas, cuidado pré-natal e no puerpério, cuidados à saúde reprodutiva e atenção à saúde no climatério. Resultados: O motivo mais comum para serem médicos da ESF foi o interesse em trabalhar na Atenção Primária à Saúde (38,4%). As dificuldades mais frequentes foram atender mulheres no climatério (61,9%) e prover atenção à saúde reprodutiva (41,9%). Comparando os médicos segundo o tempo de formação, verificou-se que os mais jovens (com até três anos de formação) apresentaram mais dificuldades em prover todos os tipos de cuidados à saúde das mulheres. A análise multivariada confirmou as limitações dos médicos mais jovens no atendimento ao climatério (p<0,009) e a sua baixa participação em atividades educativas voltadas para as mulheres (p<0,021). Conclusões: Os médicos mais jovens apresentaram mais dificuldades específicas em todos os tipos de cuidados à saúde das mulheres e menor participação em atividades educativas. Presume-se que as dificuldades desses médicos estejam ligadas a deficiências na sua formação durante a graduação e à escassa participação nas ações programáticas de atenção à saúde das mulheres.
Monitoramento e supervisão do Núcleo de Apoio à Saúde da Família (NASF) em uma região administrativa do Distrito Federal utilizando-se análise de entrevistas
Authors: Rodriguez Michelline Ribeiro , Leão Mônica Alvares , Souza Nubia Katia Teixeira de
Published: February 2014

Objetivo: Analisar o monitoramento e a supervisão das ações do Núcleo de Apoio à Saúde da Família (NASF) em uma região administrativa do Distrito Federal (DF), Riacho Fundo II. Métodos: Foram realizadas entrevistas semiestruturadas com cinco gestores do NASF nas esferas administrativas Regional, Distrital e Federal. Essas entrevistas foram gravadas, transcritas e feita análise de conteúdo de Bardin. Resultados: Não há um sistema de registro que contemple todas as ações que o NASF realiza. Percebe-se ausência de uniformidade na forma de supervisão do núcleo pelos órgãos responsáveis devido a um ineficiente fluxo de informações sobre o trabalho do NASF nas três esferas hierárquicas. Conclusão: A recente implantação do NASF no Distrito Federal e as dificuldades inerentes a essa etapa destacaram-se como principais fatores para a baixa qualidade dos registros de produção e a ausência de indicadores de avaliação para o NASF.
Avaliação do controle da asma em pacientes acompanhados em dois ambulatórios de pneumologia vinculados à Estratégia Saúde da Família em Tubarão, Santa Catarina, Brasil
Authors: Hygidio Daniel de Andrade , Silva Jane da , Silveira Sérgio , Schwinden Beatriz Camisão
Published: February 2014

Introdução: A asma é uma doença crônica debilitante, que pode gerar restrições diretamente ligadas a um mau controle da doença. O controle da asma pode ser avaliado por instrumentos padronizados. Objetivo: Determinar o controle da asma por meio do Questionário de Controle da Asma (QCA) e do Teste de Controle da Asma (TCA) e a classificação de acordo com as Diretrizes para o Manejo da Asma, de 2012. Métodos: Estudo observacional transversal com pacientes atendidos em ambulatórios de referência vinculados à Estratégia Saúde da Família em Tubarão-SC. A população foi composta por todos os pacientes asmáticos adultos que recorreram a consultas médicas durante o período de janeiro a novembro de 2010. Os dados foram compilados em uma planilha Excel e analisados pelo programa INSTAT 3. Foi realizada análise descritiva e aplicado teste quiquadrado para verificar associação entre respostas do TCA e QCA. Resultados: Foram avaliados 49 pacientes, tendo, a maioria deles, asma intermitente ou persistente leve (51%). Na avaliação do controle da asma o TCA mostrou que 69,3% dos pacientes não estavam controlados. Em relação ao QCA, foram considerados fora do alvo 75,5% dos pacientes. Houve associação significativa entre o TCA e QCA (p<0,05). Quanto às Diretrizes para o Manejo da Asma, 2012, 57,14% dos pacientes foram considerados não controlados; 30,6% estavam parcialmente controlados; e 12,2%, controlados. Conclusão: Os asmáticos estavam, em sua maioria, não controlados. Torna-se necessário identificar os fatores ligados ao descontrole e buscar estratégias, visando melhorar os escores para redução da morbimortalidade associada à asma.
Medicina de Família e Comunidade: breve histórico, desafios e perspectivas na visão de discentes de graduação
Authors: Oliveira Vinicius Gomes de , Queiroz Fernanda Navarini , Araújo Bruno Pereira , Silva Cássio Marques Menezes , Silva Flávio Dias
Published: February 2014

A Medicina de Família e Comunidade (MFC) é fundamentada em princípios que estão diretamente vinculados à Atenção Primária à Saúde (APS), que é a base de um sistema para otimizar recursos e serviços em saúde. O presente artigo procura analisar a atual conjuntura da MFC na visão de discentes de graduação em medicina, com enfoque na APS. Faz-se, então, um breve resgate dos principais eventos históricos que nortearam a criação dessa especialidade no Brasil, tais como conferências, programas de Residência Médica e criação do Sistema Único de Saúde (SUS). Por fim, retorna-se aos dias de hoje, para se estabelecer uma conexão entre as propostas iniciais e o contexto atual da saúde, oferecendo uma visão crítica acerca desses aspectos. Procura-se destacar o programa Mais Médicos e o Programa de Valorização da Atenção Básica (PROVAB), ambos propostos recentemente pelo governo federal, com o intuito de corroborar as estratégias traçadas há algumas décadas.
General Practice in the United Kingdom – A training evolution
Authors: Hutt Patrick
Published: February 2014

This article will outline the current state of training for UK General Practice, specifying some of the steps that must be taken in order to qualify, the challenges that trainees often face, and the career opportunities that may await them once completed. A historical perspective will be used to demonstrate the extent to which General Practice has evolved during the last sixty years. A few of the examples and explanations used in this article are by necessity simplistic, designed to highlight key areas of UK general practice in a bid to encourage readers to explore further if they wish to do so.
Uznání genocidy Arménů jako téma politického diskursu Arménie, Turecka a vybraných zemí EU
Authors: Souleimanov Emil , Ehrmann Maya , Kopeček Vincenc
Published: February 2014

The issue whether to legally recognize the tragic events of 1915 in Eastern Anatolia as a genocide remains a key  political issue which drives an edge between Armenia and the Republic of Turkey. Through their European diaspora communities, the issue has also entered the domain of the European Union (EU), becoming even more controversial as Turkey is in the process of hotly contested EU accession talks. The present article uses the instruments of discourse analysis to focus on the current perceptions of the Armenian genocide in the various countries involved, specifically within the EU, Armenia and Turkey, in order to explore the political rationale behind the commitment of various states to recognize or deny the aforementioned historical events as an act of genocide. After providing a brief historical overview of the 1915 events, we analyse internal EU perceptions of the “reality” of the Armenian genocide recognition, primarily in relation to Turkey's accession efforts. We then focus on the domestic discourses in Armenia and Turkey, with the goal of shedding light on the rationale behind both Yerevan's encouragement of genocide recognition and Ankara's unwillingness to recognize the genocide, as well as on the political implications of recognition and denial.
Rejstřík transparentnosti EU: Hodnocení regulačních pravidel podle CPI
Authors: Kubová Radana , Pitrová Markéta
Published: February 2014

A common initiative of the European Parliament and the European Commission resulted in the unification of the rules governing lobbyists at EU level in June 2011. The aim of this paper is to fill the gap in the literature as regards evaluation of the new system of the EU Transparency Register using the CPI methodology and to generate a numerical value for the scheme for further comparative purposes. Detailed analysis of relevant documents indicates that the current EU scheme’s index is 26, which mirrors its supposed low level of stringency. Thorough comparison with past regulatory schemes of the Parliament and Commission reveals that, surprisingly, it is the European Parliament which has made greater steps in lobby regulation, especially towards enhancing transparency in lobbying. Although the new scheme represents a compromise between both institutional approaches, regarding its individual elements, there is a clear dominance of the Commission’s approach, which can be regarded as the true leader of reform.
Les effets de la réforme sur le sentiment de professionnalisation des futurs enseignants
Authors: Danner Magali
Published: February 2014

S’inscrivant dans un cadre européen, la formation des enseignants en France fait l’objet, depuis 2005, de réformes profondes dont l’enjeu porte sur un renforcement des compétences professionnelles et un adossement des savoirs enseignés à la recherche. Partant de données longitudinales recueillies auprès de 3 générations d’étudiants inscrits dans le nouveau master « enseigner, éduquer, apprendre » ouvert à l’université de Bourgogne en 2010, cette recherche met en lumière la façon dont les étudiants se destinant au professorat des écoles perçoivent la qualité de leur professionnalisation. Malgré le sentiment de ne pas être suffisamment préparés pour l’exercice de leur métier, le discours des étudiants révèle une appropriation des logiques institutionnelles de professionnalisation. Dans le contexte actuel de création des ESPE, ce discours paradoxal invite à s’interroger sur la capacité de l’institution à rendre lisible ses processus de formation face à des publics qui restent déterminés par un idéal vocationnel.
L’apprentissage professionnel par compétence
Authors: Jammoul Zoualfakar
Published: February 2014

Dans les années 1980, l’introduction du concept de compétence dans les programmes d’apprentissage a fait l’objet d’une tentative expérimentale pour faire face à l’évolution des métiers. Ce concept a été appliqué dés la fin des années 1960 par les entreprises en vue d’augmenter leur efficience de production. Aujourd’hui, nous observons qu’un bon nombre de centres de recherche et d’apprentissage ainsi que des chercheurs continuent à travailler à l’amélioration des processus d’apprentissage basés sur le concept de compétence. La question qui se pose est de savoir quelles sont les limites d’adéquation de la démarche théorique aux réalités pratiques de terrain.
Structural and electrical transport properties of MOVPE-grown pseudomorphic AlAs/InGaAs/InAs resonant tunneling diodes on InP substrates
Authors: Sugiyama Hiroki , Teranishi Atsushi , Suzuki Safumi , Asada Masahiro
Published: February 2014

We report metal–organic vapor-phase epitaxy (MOVPE) growth of pseudomorphic AlAs/InGaAs/InAs resonant tunneling diodes (RTDs) on InP substrates for the first time. X-ray diffraction (XRD) measurements and transmission electron microscopy (TEM) observations reveal that a uniform strained InAs subwell is coherently grown in the double-barrier (DB) structure. The AlAs/InGaAs/InAs RTDs exhibit excellent current–voltage characteristics with a high peak current density (J
P) of around 2 × 105 A/cm2 and peak-to-valley ratio (PVR) of around 6. A comparison with control RTDs consisting of AlAs/In0.8Ga0.2As DB confirms the effectiveness of InAs subwell insertion for the improvement of PVR.
Simulation study on electrical characteristic of AlGaN/GaN high electron mobility transistors with AlN spacer layer
Authors: Man Shrestha Niraj , Li Yiming , Chang Edward Yi
Published: February 2014

Two-dimensional electron gas (2DEG) property is crucial for the performance of GaN-based high electron mobility transistors (HEMTs). The 2DEG-related concentration and mobility can be improved as device’s performance booster. Electrical characteristics of AlGaN/AlN/GaN HEMT are numerically simulated and compared with conventional AlGaN/GaN HEMT. The main findings of this study indicate that 2DEG’s concentration level is increased when a spacer layer of AlN in the interface of AlGaN/AlN/GaN is inserted owing to large conduction band off set, high polarization field, and high barrier. Notably, when a thin spacer layer of AlN is introduced, the 2DEG’s distribution virtually shifts away from the interface which reduces the interface scattering. The scattering appearing in conventional AlGaN/GaN HEMT includes alloy and interface roughness scatterings. They are reduced in AlGaN/AlN/GaN HEMT due to binary nature of AlN material. A critical thickness of spacer layer for mobility is 0.5 nm and the maximum drain current and transconductance (G
m) are at 1.5 and 1.2 nm thickness of AlN spacer layer. Increasing thickness of AlN spacer layer deteriorates the ohmic resistance of source/drain contact and hence degrades the performance of device beyond 1.5-nm-thick AlN spacer layer.
Hospital‐Wide Survey of Bacterial Contamination of Point‐of‐Care Ultrasound Probes and Coupling Gel
Authors: Lawrence Matthew W. , Blanks James , Ayala Ruben , Talk Douglas , Macian Diana , Glasser Jessie , Schofer Joel M.
Published: February 2014

Objectives

The purpose of this study was to determine the hospital‐wide incidence of bacterial contamination of point‐of‐care (bedside) ultrasound probes and coupling gel at a single academic medical center to predict the risk of nosocomial spread of infection.

Methods

Bacterial cultures were performed on all point‐of‐care ultrasound probe surfaces and associated gel bottles in our institution (82 total probes in 9 separate departments). This process was repeated every 2 weeks for a total of 8 weeks; therefore, each probe was cultured 4 times during the study period.

Results

Of the 320 probe cultures, 18 (5.6%), resulted in positive growth, all of which identified nonpathogenic organisms common to human skin flora and the environment. No methicillin‐resistant Staphylococcus aureus or other notable pathogens were identified. No gel cultures resulted in bacterial growth.

Conclusions

Bacterial contamination of point‐of‐care ultrasound probes and coupling gel is low at this single academic medical center and involves nonpathogenic organisms only.
Three‐Dimensional Sonography in the Evaluation of Primary Hyperparathyroidism
Authors: Frank Susan J. , Koenigsberg Tova C. , Lee Jennifer , Sternschein Rebecca M. , Koenigsberg Mordecai
Published: February 2014

Three‐dimensional sonography is useful in the preoperative evaluation of patients with primary hyperparathyroidism. In this pictorial essay, we review the characteristic spectrum of grayscale and Doppler appearances of parathyroid glands on 2‐dimensional sonography and demonstrate the additional benefits of 3‐dimensional scanning.
Aberrant Drainage of the Umbilical Vein Into the Coronary Sinus Without Ductus Venosus Agenesis
Authors: Brahim Foued Ben , Hazelzet Tristan , Cohen Laurence , Durand Isabelle , Blanc Julie , Barre Elise , Daudruy Marie Brasseur , David Nadine
Published: February 2014

We describe a case series of 4 fetuses with ectopic connections of the ductus venosus to the coronary sinus detected prospectively between August 2011 and February 2012 in 2 congenital cardiologic centers. An enlarged coronary sinus alerted the sonographer. Fetal echocardiography showed ectopic connection of the ductus venosus in an enlarged coronary sinus in all 4 cases. To our knowledge, this anatomic form of ectopic umbilical vein drainage has not previously been reported. The infants were doing well. This venous variant should be considered in cases of isolated coronary sinus dilatation after elimination of a left superior vena cava and a totally anomalous pulmonary vein connection.
Moving Beyond Statements to Protect Transgender Youth
Authors: Santos Melissa , Zempsky William T. , Shmerling Jim
Published: July 2024

This Viewpoint explores the politicized nature of gender-affirming care for transgender and nonbinary youth and how children’s hospitals can provide education, resources, and access to families seeking care.
Don’t Waste Your Cancer
Authors: Lim Monica J.
Published: July 2024

In this narrative medicine essay, a pediatric neurology resident who survived childhood cancer reflects on her experience and later how it affected her mother and by extension how life-threatening diagnoses of children impact their parents, grandparents, and siblings.
BRCA1, BRCA2, and Associated Cancer Risks and Management for Male Patients
Authors: Cheng Heather H. , Shevach Jeffrey W. , Castro Elena , Couch Fergus J. , Domchek Susan M. , Eeles Rosalind A. , Giri Veda N. , Hall Michael J. , King Mary-Claire , Lin Daniel W. , Loeb Stacy , Morgan Todd M. , Offit Kenneth , Pritchard Colin C. , Schaeffer Edward M. , Szymaniak Brittany M. , Vassy Jason L. , Katona Bryson W. , Maxwell Kara N.
Published: July 2024

Importance

Half of all carriers of inherited cancer-predisposing variants in BRCA1 and BRCA2 are male, but the implications for their health are underrecognized compared to female individuals. Germline variants in BRCA1 and BRCA2 (also known as pathogenic or likely pathogenic variants, referred to here as BRCA1/2 PVs) are well known to significantly increase the risk of breast and ovarian cancers in female carriers, and knowledge of BRCA1/2 PVs informs established cancer screening and options for risk reduction. While risks to male carriers of BRCA1/2 PVs are less characterized, there is convincing evidence of increased risk for prostate cancer, pancreatic cancer, and breast cancer in males. There has also been a rapid expansion of US Food and Drug Administration–approved targeted cancer therapies, including poly ADP ribose polymerase (PARP) inhibitors, for breast, pancreatic, and prostate cancers associated with BRCA1/2 PVs.

Observations

This narrative review summarized the data that inform cancer risks, targeted cancer therapy options, and guidelines for early cancer detection. It also highlighted areas of emerging research and clinical trial opportunities for male BRCA1/2 PV carriers. These developments, along with the continued relevance to family cancer risk and reproductive options, have informed changes to guideline recommendations for genetic testing and strengthened the case for increased genetic testing for males.

Conclusions and Relevance

Despite increasing clinical actionability for male carriers of BRCA1/2 PVs, far fewer males than female individuals undergo cancer genetic testing. Oncologists, internists, and primary care clinicians should be vigilant about offering appropriate genetic testing to males. Identifying more male carriers of BRCA1/2 PVs will maximize opportunities for cancer early detection, targeted risk management, and cancer treatment for males, along with facilitating opportunities for risk reduction and prevention in their family members, thereby decreasing the burden of hereditary cancer.
The roles of interviewing conditions and individual differences in memory and suggestibility: An online interview study
Authors: Wong Yi Shan , Pye Rachel , Chung Kai Li
Published: July 2024

In existing studies of investigative interviewing, the effects of interviewing contexts have often been measured with little consideration of the reciprocal interviewee's stable characteristics. To clarify the factors and conditions under which adults are likely to retain accurate information and be resistant (or vulnerable) to suggestions during interviews, this study systematically explored the relative contributions of interviewing conditions (i.e., interviewer behaviour and exposure to post‐event misinformation) and individual differences (i.e., HEXACO personality traits, perceived parenting styles, social trait and state anxiety). A total of 159 Malaysian adults (M = 24.70; SD = 5.48) were assessed virtually using the Gudjonsson Suggestibility Scale 1. Hierarchical regression analyses revealed that higher recall accuracy was linked with supportive interviewer behaviour and non‐exposure to misinformation. Notably, individual's personality traits and developmental environment emerged as significant predictors of recall and suggestibility. The implications of remote interviewing in investigations are also discussed.
Sponge‐Like Microneedles Spatially Sequester Chemokines and Deplete Monocytes to Alleviate Inflammatory Skin Disorders
Authors: Le Zhicheng , Shou Yufeng , Li Renee R. , Liu Ling , Tan Runcheng , Charles Christopher John , Liu Zhijia , Chen Yongming , Tay Andy
Published: July 2024

Persistent inflammation, characterized by the intense interplay of inflammatory chemokine secretion and immune cell infiltration, is a hallmark of many skin disorders including diabetic wounds and psoriasis with inadequate therapeutic interventions. Monocyte chemotactic protein‐1 (MCP‐1) is an inflammatory chemokine that plays a key role in recruiting and polarizing monocytes into pro‐inflammatory macrophages to establish a vicious cycle that worsens the inflamed tissue microenvironment. Here, the sponge‐like microneedles (HPMN) technology is described to alleviate inflammatory skin disorders. Heparin/4‐arm PEG‐NH2 network crosslinked onto microneedle surface spatially attracted and sequestered multiple inflammatory chemokines including MCP‐1. Enrichment of MCP‐1 on microneedles recruits and traps inflammatory monocytes within the porous structure of microneedles. Subsequent removal of microneedles not only depletes inflammatory chemokine, MCP‐1, but also its cellular source. As a result, HPMN treatment facilitates 47.1% smaller open wound area in mice and 27.2% shorter wound length in pigs. To demonstrate the versatility of the HPMN technology, it is also shown that combining the method with standard‐of‐care immunosuppressants reduces 45.1% epidermis thickening and attenuated immune cell influx in a mouse psoriasis model. Overall, the HPMN technology is a novel demonstration of employing inflammatory chemokine and cell extraction to treat a broad range of inflammatory skin disorders.
Advances in Carbon Nanotubes and Carbon Coatings as Conductive Networks in Silicon‐based Anodes
Authors: He Ziying , Zhang Chenxi , Zhu Zhenxing , Yu Yaxiong , Zheng Chao , Wei Fei
Published: July 2024

Silicon‐based anode has high theoretical capacity but suffers from poor electrical conductivity, large volume expansion, and unstable solid electrolyte interphase (SEI). Adding carbon nanotubes (CNTs) and carbon coatings are both very effective methods for addressing the above issues. The intrinsic sp2 covalent structure endows CNTs with excellent electrical conductivity, mechanical strength, and chemical stability, which makes them suitable for various energy storage applications, such as in lithium‐ion batteries (LIBs). Apart from the conductive network, CNTs can serve as current collectors, mechanical probes, and mechanical frameworks, and they have potential in the construction of next‐generation battery architectures. Carbon coatings are mixed ionic‐electronic conductors with good chemical stability that provide mechanical support and mitigate the volume expansion of Si‐based materials. This review outlines the advances in CNTs and carbon coatings as conductive networks in Si‐based anodes, as well as insights into their future development. It provides an in‐depth analysis of the percolation and mechanical mechanism of conductive networks, highlights the importance of flexible long‐range conductivity, and decouples the relationships between stress, interface stability, and electron/ion transfer.
Fabrication of a Compliant Vascular Graft Using Extrusion Printing and Electrospinning Technique
Authors: Fazal Faraz , Melchels Ferry P.W. , McCormack Andrew , Silva Andreia F. , Handley Ella‐Louise , Mazlan Nurul Ain , Callanan Anthony , Koutsos Vasileios , Radacsi Norbert
Published: July 2024

Small‐diameter vascular grafts having biomechanical properties similar to those of native arteries for the treatment of cardiovascular diseases are still elusive. Here, a hybrid extrusion printing and electrospinning technique is presented in which a layer of electrospun nanofibers is deposited over the printed gelatin‐methacryloyl (gelMA) constructs to improve the mechanical performance of gelMA grafts. Various blends of polycaprolactone (PCL) and poly(L‐lactide‐co‐ε‐caprolactone) (PLCL) polymer solutions are used to produce electrospun nanofibers. The variation of gelMA concentration is found to have a negligible role in the overall strength of the graft. It is shown that the burst pressure and tensile strength of the fiber‐reinforced gelMA constructs are comparable to those of native human arteries. Moreover, the compliance of grafts reinforced by 100% PCL and 75/25% PCL/PLCL nanofibers are found to be similar to human muscular arteries and elastic arteries, respectively. The cytocompatibility assessment shows that gelMA presents a bioactive surface for the endothelial cells to survive and grow. Also, PCL/PLCL electrospun nanofibers offer cellular metabolic activity in the same order of magnitude as observed in the control. Therefore, this hybrid technique opens up new possibilities for the fabrication of tubular constructs in tissue engineering.