bluuebunny/crossref_metadata_2025 huggingface dataset:
Hyperglycemia in the Posttransplant Period: NODAT vs Posttransplant Diabetes Mellitus
Authors: Gupta Suruchi , Pollack Teresa , Fulkerson Candice , Schmidt Kathleen , Oakes Diana Johnson , Molitch Mark E , Wallia Amisha
Published: October 2018

Objective

To characterize the types of hyperglycemia that occur up to 1 year following liver transplant and to clarify the nomenclature for posttransplant hyperglycemia.

Design

We analyzed 1-year glycemic follow-up data in 164 patients who underwent liver transplant and who had been enrolled in a randomized controlled trial comparing moderate to intensive insulin therapy to determine if patients had preexisting known diabetes, transient hyperglycemia, persistent hyperglycemia, or new-onset diabetes after transplantation (NODAT).

Results

Of 119 patients with posttransplant hyperglycemia following hospital discharge, 49 had preexisting diabetes, 5 had insufficient data for analysis, 48 had transient hyperglycemia (16 resolved within 30 days and 32 resolved between 30 days and 1 year), 13 remained persistently hyperglycemic out to 1 year and most likely had preexisting diabetes that had not been diagnosed or insulin resistance/insulinopenia prior to transplant, and 4 had NODAT (i.e., patients with transient hyperglycemia after transplant that resolved but then later truly developed sustained hyperglycemia, meeting criteria for diabetes).

Conclusions

Distinct categories of patients with hyperglycemia following organ transplant include known preexisting diabetes, persistent hyperglycemia (most likely unknown preexisting diabetes or insulin resistance/insulinopenia), transient hyperglycemia, and NODAT. Those with preexisting diabetes for many years prior to transplant may well have very different long-term outcomes compared with those with true NODAT. Therefore, it would be prudent to classify patients more carefully. Long-term outcome studies are needed to determine if patients with true NODAT have the same poor prognosis as patients with preexisting diabetes (diagnosed and undiagnosed) undergoing transplant.
Sonographic Volumetric Assessment Is a More Accurate Measure Than Maximum Diameter Alone in Papillary Thyroid Cancer
Authors: Pennington Thomas E , Thwin May , Sywak Mark , Delbridge Leigh , Sidhu Stan
Published: October 2018

Background

Tumor size is an important prognostic factor in papillary thyroid cancer (PTC). Management guidelines, staging systems, and pathological definitions use maximum diameter (Dmax) as a surrogate marker of tumor size. However, PTC nodules are three-dimensional (3D) structures, with behavior reflective of tumor cell count, which is directly proportional to volume. We explored the relationship between sonographically determined Dmax, volume, and lymph node status (LNS) in a cohort of patients with PTC.

Methods

All patients treated for PTC between 2003 and 2015 in our institution who had sonographic 3D nodule measurements available were evaluated. We examined the relationship between diameter, volume, and LNS.

Results

A total of 159 nodules in 153 patients met the inclusion criteria. Mean nodule dimensions were 2.4 × 1.9 × 1.5 cm, giving “ideal” nodule dimensions of y × 0.78y × 0.62y, where y is the Dmax. Observed volumes differed from predicted nodule volumes by an average of 26.2%. For PTC ≤2 cm, the coefficient of variation was 26.7%. Dmax did not correlate with the presence of lymph node metastases (Pearson coefficient 0.08), whereas volume very weakly correlated with LNS (Pearson coefficient 0.22). However, both Dmax and volume correlated very strongly with the number of nodal metastases (Pearson coefficients 0.93 and 0.89, respectively).

Conclusions

PTC nodules demonstrated significant volume heterogeneity, rendering Dmax an inaccurate marker of true tumor size. Although there was little difference between Dmax and volume in predicting nodal status or nodal disease burden, we propose that a prospective, randomized trial might demonstrate a clear clinical advantage of 3D sonographic nodule measurement over Dmax alone.
Rapid Titration of Intravenous Treprostinil to Treat Severe Pulmonary Arterial Hypertension Postpartum: A Retrospective Observational Case Series Study
Authors: Wang Tengke , Lu Jiakai , Li Qiang , Chen Yao , Ye Qing , Gao Jie , Yang Dong , Zhao Liyun , Huang Jiapeng , Zhang Jinglan
Published: October 2018

BACKGROUND:

Pulmonary hypertension during pregnancy carries high mortality rate. The relatively long-acting, specific pulmonary vasodilator treprostinil has been used to improve survival in these parturients. Slow uptitration is performed in most cases, and rapid titration has not been reported in the postpartum period.

METHODS:

We retrospectively reviewed 17 pregnant patients with severe pulmonary arterial hypertension who were treated with intravenous treprostinil in our institution between 2014 and 2016. Patients’ demographic characteristics, etiology, functional status, mode of delivery, anesthetic administration, medical therapy, echocardiographic and hemodynamic measurements, subsequent clinical course, and maternal–fetal outcomes were assessed. The a priori primary outcome is maternal mortality in this study.

RESULTS:

Rapid titration of intravenous treprostinil was initiated at 1.25 ng/kg/min and increased to effective dose of 10 ng/kg/min by 1.25–2.5 ng/kg/min every 3 hours. In the next 24 hours, we adjusted the dosage to a median maximum dose of 15 ng/kg/min (interquartile range, 15–20 ng/kg/min) over a median uptitration period of 34 hours (interquartile range, 24–41 hours) for 17 parturients with severe pulmonary hypertension. Treprostinil was weaned off by 0.50–1.25 ng/kg/min every 3 hours in 94.3 ± 42.4 hours. Fifteen patients survived to discharge, and only 2 patients died of pulmonary hypertensive crisis (maternal mortality rate, 11.7%). No treprostinil infusion-related postpartum complication was observed.

CONCLUSIONS:

Our experience suggested that rapid uptitration of intravenous treprostinil combined with oral sildenafil in the postpartum period may be a safe and effective approach for these very sick parturients with severe pulmonary hypertension.
Spectral sensitivity in ray-finned fishes: diversity, ecology, and shared descent
Authors: Schweikert Lorian E. , Fitak Robert R. , Caves Eleanor M. , Sutton Tracey T. , Johnsen Sönke
Published: October 2018

A major goal of sensory ecology is to identify factors that underlie sensory-trait variation. One open question centers on why fishes show the greatest diversity among vertebrates in their capacity to detect color (i.e., spectral sensitivity). Over the past several decades, λmax values (photoreceptor class peak sensitivity) and chromacy (photoreceptor class number) have been cataloged for hundreds of fish species, yet the ecological basis of this diversity and the functional significance of high chromacy levels (e.g., tetra- and pentachromacy) remain unclear. In this study, we examined phylogenetic, physiological, and ecological patterns of spectral sensitivity of ray-finned fishes (Actinoptergyii) via a meta-analysis of data compiled from 213 species. Across the fishes sampled, our results indicate that trichromacy is most common, ultraviolet λmax values are not found in monochromatic or dichromatic species, and increasing chromacy, including from tetra- to pentachromacy, significantly increases spectral sensitivity range. In an ecological analysis, multivariate phylogenetic latent liability modeling was performed to analyze correlations between chromacy and five hypothesized predictors (depth, habitat, diet, body coloration, and body size). In a model not accounting for phylogenetic relatedness, each predictor with the exception of habitat significantly correlated with chromacy: a positive relationship in body color and negative relationships with body size, diet, and depth. However, after phylogenetic correction, the only remaining correlated predictor was depth. The findings of this study indicate that phyletic heritage and depth are important factors in fish spectral sensitivity and impart caution about excluding phylogenetic comparative methods in studies of sensory trait variation.
Transition from Competitive to Non-Competitive Solubilization with the Decrease in Number of Oxyethylene (OE) Units of Non-Ionic Surfactants towards Polycyclic Aromatic Hydrocarbons
Authors: Lone Mohd Sajid , Chat Oyais Ahmad , Vashishtha Manu , Dar Aijaz Ahmad
Published: October 2018

This study investigates the effect of the number of oxyethylene (OE) groups on the solubilization and cosolubilization of two polycyclic aromatic hydrocarbons (PAHs) viz, naphthalene and pyrene in the conventional nonionic surfactants of the Brij series viz., Brij30, Brij56, Brij58 and Brij35 using various techniques like UV-visible spectrophotometry, spectrofluorometry, 1H NMR, and time resolved anisotropy measurements. In Brij56, Brij58 and Brij35 surfactant systems with relatively higher number of OE units, the micellar palisade layer is more hydrated than that of the Brij30 micelle which has only 4 OE groups constituting the palisade layer. Hence in these micellar systems the palisade layer being more hydrated is a less preferred choice for the hydrophobic compounds to reside. As a result of this, the two PAHs compete for the same hydrophobic core of the micelle which leads to the decrease in the solubilization of naphthalene as pyrene competes with it successfully because of its more hydrophobic character. In the case of Brij30, as the palisade layer of the micelle is less hydrated, naphthalene resides in the palisade layer whereas pyrene resides in the core because of its higher hydrophobicity. This leads to elimination of the competition between the two PAHs for the same solubilization site.
The Congress Impact Factor: A proposal from board members of the World Society of Emergency Surgeons.it (WSES) and Academy of Emergency Medicine and Care (AcEMC)
Authors: De Simone Belinda , Ansaloni Luca , Kelly Micheal Denis , Coccolini Federico , Sartelli Massimo , Di Saverio Salomone , Pisano Michele , Cervellin Gianfranco , Baiocchi Gianluca , Catena Fausto
Published: October 2018

Many scientific congresses and conferences are held every year around the world. The aim of the World Society of Emergency Surgeons.it (WSES) and Academy of Emergency Medicine and Care (AcEMC) was to develop a simple mathematical parameter as an indicator of academic quality and scientific validity of a congress. In this opinion article, a new metric, the Congress Impact Factor (IFc), is proposed taking into consideration the widely used Impact Factor as an indicator of journals’ prestige and using H-index analysis.

The IFc is derived from the mathematical ratio between the mean H-index of invited lecturers normalized for lecture topic and number of lectures in the conference. In case of multiple sessions, the mean of all IFc is calculated along with its standard deviation.  We conclude that the IFc can be a useful measure for evaluating and comparing congress prestige, and may also represent a potentially useful parameter for improving academic curriculum and helping participants to choose the more prestigious meetings for their education.
Sharing health research data – the role of funders in improving the impact
Authors: Terry Robert F. , Littler Katherine , Olliaro Piero L.
Published: October 2018

Recent public health emergencies with outbreaks of influenza, Ebola and Zika revealed that the mechanisms for sharing research data are neither being used, or adequate for the purpose, particularly where data needs to be shared rapidly.

A review of research papers, including completed clinical trials related to priority pathogens, found only 31% (98 out of 319 published papers, excluding case studies) provided access to all the data underlying the paper - 65% of these papers give no information on how to find or access the data. Only two clinical trials out of 58 on interventions for WHO priority pathogens provided any link in their registry entry to the background data.

Interviews with researchers revealed a reluctance to share data included a lack of confidence in the utility of the data; an absence of academic-incentives for rapid dissemination that prevents subsequent publication and a disconnect between those who are collecting the data and those who wish to use it quickly.  The role of the funders of research needs to change to address this. Funders need to engage early with the researchers and related stakeholders to understand their concerns and work harder to define the more explicitly the benefits to all stakeholders.  Secondly, there needs to be a direct benefit to sharing data that is directly relevant to those people that collect and curate the data. Thirdly more work needs to be done to realise the intent of making data sharing resources more equitable, ethical and efficient.  Finally, a checklist of the issues that need to be addressed when designing new or revising existing data sharing resources should be created. This checklist would highlight the technical, cultural and ethical issues that need to be considered and point to examples of emerging good practice that can be used to address them.
What Works Best When? A Systematic Evaluation of Heuristics for Max-Cut and QUBO
Authors: Dunning Iain , Gupta Swati , Silberholz John
Published: October 2018

Though empirical testing is broadly used to evaluate heuristics, there are shortcomings with how it is often applied in practice. In a systematic review of Max-Cut and quadratic unconstrained binary optimization (QUBO) heuristics papers, we found only 4% publish source code, only 14% compare heuristics with identical termination criteria, and most experiments are performed with an artificial, homogeneous set of problem instances. To address these limitations, we implement and release as open-source a code-base of 10 Max-Cut and 27 QUBO heuristics. We perform heuristic evaluation using cloud computing on a library of 3,296 instances. This large-scale evaluation provides insight into the types of problem instances for which each heuristic performs well or poorly. Because no single heuristic outperforms all others across all problem instances, we use machine learning to predict which heuristic will work best on a previously unseen problem instance, a key question facing practitioners.

The online supplement is available at https://doi.org/10.1287/ijoc.2017.0798 .
Physician Staffing for Emergency Departments with Time-Varying Demand
Authors: Liu Ran , Xie Xiaolan
Published: October 2018

Fluctuations in emergency department (ED) patient arrivals during the day are one of the main causes of the long waiting times that are frequently encountered, and ED staffing is one of the key drivers of ED service quality improvement. This paper first proposes discrete-time models for approximating the patient waiting times for any given ED staffing. The waiting time approximation is based on three simple ideas: the separation of patients served in a period and patients overflowed, the combination of M/M/c approximation for patients served and waiting time analysis of overflow patients, and the transformation of the performance evaluation into an optimization problem with the number of overflow patients as decision variables. The resulting waiting time approximations are then integrated into ED staffing optimization models, and variable neighborhood search algorithms are developed to solve the ED staffing models. Numerical experiments with real-life data from Chinese hospitals are performed to validate the proposed models and algorithms. The results show that the proposed methodology is able to significantly reduce the total waiting time of patients without increasing staff capacity.

The online appendix is available at https://doi.org/10.1287/ijoc.2017.0799 .
Microbiota and infection prevention: making space for probiotics in healthcare
Authors: Naghibi Malwina M , Day Richard
Published: October 2018

The human microbiome plays a vital role in patients' susceptibility to infections. A change to the composition of the microbiome—be it a change in the presence or abundance of microbial species or the introduction of new pathogens—may result in dysbiosis, which has been identified in patients with acute gastroenteritis (AGE) and antibiotic-associated diarrhoea (AAD). Probiotics can ameliorate dysbiosis, and there is extensive research into their use in AGE and AAD. Recently, national and international bodies—inlcuding the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) and the National Institute for Health and Care Excellence (NICE) Clinical Knowledge Summaries (CKS)—have recommended the use of probiotics in the treatment of AGE and the prevention of AAD and Clostridium difficile infections (CDI). Also, there is emerging evidence suggesting that the perioperative use of probiotics in elective surgery can reduce rates of surgical infections (SI) and reduce the need for postoperative antibiotics. A growing body of evidence suggests that probiotics should be considered as an adjunct to standard protocols in AGE, AAD, CDI and SI, and this review summarises recent developments in probiotic research in these conditions.
Research roundup: October 2018
Authors: Odd Dawn , Seal Joanne , Brook Judy
Published: October 2018

In this section, a range of brief synopses of recently published articles that may be of interest to health visitors is presented. The aim of this roundup is to provide an overview, rather than a detailed summary, of the research papers selected. Should you wish to look at any of the papers in more detail, a full reference is provided.
Newly qualified health visitor: A mindful transition to parenthood
Authors: Bewick Jessica
Published: October 2018

Jessica Bewick reflects on the importance of raising awareness of mindfulness during contacts by normalising preventive steps to protect emotional wellbeing
Recurrent limb pain in children
Authors: Tinsley Elizabeth
Published: October 2018

Growing pains are aches or pains in children usually aged between 3 and 12 years. They are generally felt in the lower legs and tend to be worse in the evening or at night. Although they can be distressing, growing pains are common and do not usually cause long-term harm. There is no clear evidence to show that growing pains are associated with growth spurts in children; therefore, the preferred term has become ‘recurrent nocturnal limb pain in children’.
Supporting refugees under the Voluntary Person Resettlement Programme
Authors: Frazer Dionne
Published: October 2018

A recent UN High Commissioner For Refugees report found that 8000 people have been settled in the UK under the voluntary persons resettlement scheme and that it is working ‘relatively well’. Under the scheme, Walsall accommodated eight families from Syria with the support of Walsall local authority and Refugee Migrant Centre. This provides a seamless, comprehensive approach that covers many issues related to the settlement and integration of new and emerging communities. It has contributed to an improvement in the quality of life of asylum seekers, refugees and migrants living in this area.
Study and Comparison of Integrated Circuits in Digital and Analog Form of Present Day Technology – Review
Authors: Ganesh E.N.
Published: October 2018

Fifty years ago instrumentation and control (I&C) systems at nuclear power plants (NPP) were analog and relied on a mixture of mechanical, pneumatic and electric components. Today analog technology has been replaced with digital technology. Digital I&C has over the years experienced difficulties in the licensing process, which has delayed and escalated costs of both NPP and I&C projects. In the paper it is argued that some of the difficulties are connected to misunderstandings regarding differences between analog and digital I&C. These misunderstandings have led to unrealistic expectations regarding proofs that selected I&C systems can be considered acceptable. To ensure a successful licensing process it would be necessary to agree on evidence for safety that can be considered sufficient. Such evidence should be collected both from the I&C design process and from testing intermediate and final I&C solutions. By a combination of evidence from different sources it should be possible to build a safety case that can be agreed to give sufficient proofs for acceptability. The first component in building the safety case is to make use of safety principles to provide structural evidence that certain classes of design errors have been avoided. The second component is to use simulators and targeted testing to demonstrate functionality of the I&C in different plant situations.
Brain Natriuretic Peptide in Plasma as Predictor of All-Cause Mortality in a Large Danish Primary Health Care Population Suspected of Heart Failure
Authors: Hejl Julie L , Grand Mia K , Siersma Volkert , Goetze Jens P , de Fine Olivarius Niels , Andersen Christen L , Lind Bent
Published: October 2018

BACKGROUND

Measurement of B-type natriuretic peptide (BNP) in plasma may have its greatest potential in primary care, as general practitioners need to rapidly identify patients who warrant further medical review. The aim of the present study was to examine the prognostic information of BNP measurement on all-cause mortality in a large Danish primary care cohort.

METHODS

This study covered a cohort of Danish primary care patients (n = 61665) with a median follow-up period of 4.36 years (interquartile range, 2.29–6.62 years). BNP was measured in plasma using the ADVIA Centaur/CentaurXP platform. The association of BNP with mortality was assessed with a hazard ratio for all-cause mortality from a multivariable Cox proportional hazards model.

RESULTS

Kaplan–Meier curves showed decreasing survival probability with increasing BNP (P < 0.001). Each doubling of BNP increased mortality by 32.3% (95% CI, 30.8–33.8) when adjusted for sex and age, and by 25.3% (95% CI, 23.8–26.8) when further adjusted for Charlson comorbidity index, hemoglobin, estimated glomerular filtration rate, glycohemoglobin, and thyroid-stimulating hormone. Also, in a subcohort (n = 10824) without biochemical signs of severe kidney failure, anemia, polycythemia, hypothyroidism or hyperthyroidism, or dysregulated diabetes, each doubling of BNP increased mortality by 28.6% (95% CI, 22.8–34.7).

CONCLUSIONS

Our results show that even in a primary care population, BNP measurements contain prognostic information regarding all-cause mortality.
ILE655VAL Genotyping Study of HER2 - Positive Breast Cancer of Patients from Padang - Indonesia With High Resolution Melting Technique
Authors: Wulandari Dwi , Azamris Azamris , Nurhayati Isna , Warisman M Ali , Budiarto Bugi Ratno , Desriani Desriani
Published: October 2018

Transtuzumab has proven to be a great improvement in the treatment of HER2 + of breast cancer patients, but it is associated with relevant adverse cardiac events and with significantly elevated cost of treatment.  One of the risk factors for cardiotoxicity due to transtuzumab is the I655V HER2 polymorphism (GTC> ATC mutation) in which the allele mutant (Ile val or val / val) has a higher risk than the wild type (Ile/Ile). The detection of specific alleles is very important for therapeutic decision-making. In this study, our group have developed a HRM with EvaGreen dye method to discriminate specific allele of I655V HER2 (wild type, heterozygote mutant or homozygote mutant) in 66 frozen section samples of HER2+ of breast cancer patients. Our group reported the wild type is the most prevalent allele (77,27%), whereas heterozygous mutation is significantly present in this research (21,21%) and only 1,52% of sample detected as minor allele.  It showed that only one sample detected as a minor allele (val/val) and may have relatively low abundance in the population. This method has been compared with sanger sequencing and giving 100% of validity.
Medium Optimization for Antimicrobial Production By Newly Screened Lactic Acid Bacteria
Authors: Rohmatussolihat Rohmatussolihat , Lisdiyanti Puspita , Yopi Yopi , Widyastuti Yantyati , Sukara Endang
Published: October 2018

Lactic acid bacteria (LAB) are important for prevention of spoilage and pathogenic bacterial growth in foods due to their ability to generate antimicrobial substances. The objective of this study was to screen LAB for antimicrobial activity and to optimize culture medium for antimicrobial production using Response Surface Methodology (RSM) with Central Composite Design (CCD). Optimization of antimicrobial production of selected LAB was conducted with different combinations of glucose, NaCl, inoculum, and temperature. Our experimental results showed that from 129 LAB isolates, 55 showed significant inhibition against Bacillus subtilis, Escherichia coli, Micrococcus luteus, Staphylococcus aureus, Aspergillus niger, and Candida albicans. No isolates inhibited the growth of Aspergillus flavus. Lactobacillus plantarum LIPI13-2-LAB011 was selected for further study on culture medium optimization to inhibit the growth of C. albicans. From statistical analysis, the production of antimicrobial substances was significantly influenced by temperature, NaCl, and concentration of glucose. Furthermore, the optimum concentrations of glucose, concentration of inoculum, temperature, and NaCl were 1.63 %, 3.03%, 33.74°C, and 3.4%, respectively, with a maximum predicted inhibition index of 1.916, which increased 3.56-fold compared to that obtained in medium before optimization processes. The result was confirmed as when the optimum concentration of nutritions used, the inhibition index increased 3.12-fold.
Biological Analysis of Leydig Cells-Conditioned Medium To Support Rat Bone Marrow Mesenchymal Stem Cells Differentiation
Authors: Kaiin Ekayanti Mulyawati , Prasetyaningtyas Wahono Esthi , Mohamad Kusdiantoro , Djuwita Ita , Yusuf Tuty Laswardi , Setiadi Mohamad Agus
Published: October 2018

The developed Leydig cells-conditioned medium (LCM) contains bioactive materials secreted by Leydig cells in vitro.  LCM was used to evaluate the ability of bone marrow mesenchymal stem cells differentiation. Bone marrow mesenchymal stem cells (1x 106 cell/ml) were cultured in : 1) DMEM supplemented with 10% NBCS as a control (M), 2) M supplemented with 10 ng/ml testosterone; 3) M supplemented with 50%  LCM ; 4) M supplemented with 50% LCM and 2.5 IU/ml hCG. Bone marrow mesenchymal stem cells that were cultured with  LCM has a positive reaction (57.4%) to histochemistry staining 3β-HSD and produced 1.87 ng/ml testosterone. Supplementation of hCG to LCM  increased the positive number of Leydig cells and testosterone production by 74.6% and 12.33 ng/ml (P<0.05). It can be concluded that Leydig cells-conditioned medium can support differentiation of bone marrow mesenchymal stem cells into Leydig cells.
Gênero: perspectivas africanas e latino-amefricanas
Authors: Coutinho Ferreira Renata
Published: October 2018

Pretendo, neste breve artigo, promover um panorama entre as teorias feministas africanas e as teorias amefricanas de Lélia Gonzalez. Buscando a possibilidade de observação entre os respectivos estudos, visando a compreensão da relevância que cada teoria tem a partir dos locais de onde se desenvolve. Compreendendo as diferentes localidades, conjunturas e temporalidades as quais cada teórica pronuncia-se.
“Ave Maria, chegou a macumbeira!”: tensões no ensino da história e cultura afro-brasileira na escola.
Authors: Figueiredo Roniel Santos , Souza Marcos Lopes de
Published: October 2018

As discussões sobre história e cultura africana e afro-brasileira entraram no currículo escolar de maneira mais enfática após a lei 10639/2003. Contudo, tendo em vista o contexto histórico eurocêntrico que faz parte da constituição simbólica das escolas brasileiras, os agentes que se arriscam a dialogar sobre essas questões podem ser desaprovados. Portanto, esse trabalho apresenta e discute o processo de estigmatização vivenciado por Santos, uma professora, mulher negra e umbandista ao discutir história e cultura afro-brasileira na educação básica por meio do resgate dos aspectos culturais e de luta do povo negro. Nesse sentido, é perceptível que os discentes utilizam da religiosidade da professora para colocar em xeque a sua docência, gerando conflitos e abjeções.
Plantas medicinais e fitoterapia em Oriximiná – Pará, Brasil: percepção e intenção de uso pelos profissionais do Sistema Único de Saúde (SUS)
Authors: Santos Stela Souza , Léda Paulo , Oliveira Danilo Ribeiro de
Published: October 2018

A Política Nacional de Plantas Medicinais e Fitoterápicos tem como diretrizes ampliar as opções terapêuticas, o uso sustentável da biodiversidade brasileira, valorizar e preservar do conhecimento de povos tradicionais, fortalecer a agricultura familiar, gerar emprego e renda, inclusão social, dentre outras. O presente estudo busca avaliar desafios e perspectivas à inserção da fitoterapia no SUS em Oriximiná-Pará. Para tal, foram entrevistados 65 profissionais de saúde de nível superior, vinculados ao SUS no Município. Algumas questões levantadas junto aos entrevistados mereceram destaque, tais como: 1- considerar viável a utilização de fitoterápicos em substituição aos medicamentos alopáticos, em certos casos; 2- relatar a prática da automedicação, principalmente, através de chás caseiros e/ou alimentos funcionais; 3- nunca ter recebido qualquer tipo de treinamento, capacitação ou especialização sobre plantas medicinais e fitoterápicos; 4- ter interesse em receber a capacitação necessária para atuar na fitoterapia. Estes dados demonstram que a inserção da fitoterapia no SUS em Oriximiná pode ser uma estratégia da Secretaria Municipal de Saúde, sendo fundamental a participação dos gestores e a qualificação dos profissionais de saúde.
Tratamento da Tenossinovite de Quervain por Acupuntura – Relato de Caso
Authors: Sant'Anna Fernando Mendes , Rangel Vanessa Maia , Mota Durval Dionísio Souza
Published: October 2018

A tenossinovite de De Quervain (TDQ), decorrente da inflamação dos tendões dos músculos abdutor longo e extensor curto do polegar, vem aumentando sua incidência no mundo nos últimos anos, sendo mais uma dentre as doenças ocupacionais relacionadas ao trabalho. Seu tratamento clássico é realizado através de anti-inflamatórios não esteroides, infiltração de corticoide local e cirurgia reparadora. A acupuntura desponta co-mo alternativa terapêutica válida e de baixo custo para tratamento dessa e de outras síndromes, dentro das práticas integrativas e complementares. Relatamos nesse artigo um caso de TDQ encaminhado ao nosso ambulatório, no qual o tratamento por acupuntura dentro dos princípios da medicina tradicional chinesa (MTC) propiciou breve retorno ao trabalho e completa resolução dos sintomas em curto prazo de tempo.
Estratégia de ensino e avaliação do curso de extensão em cultivo de plantas medicinais do jardim botânico do Rio de Janeiro
Authors: Oliveira-Silva Karen Lorena , Ramos Ygor Jessé , Oliveira Gilberto Do Carmo , Fonseca Irene Cândido , Gonçalves Jeferson Ambrósio , Souza Ulisses Carvalho de , Antunes e Defaveri Anna Carine , Silva João Carlos , Pantoja Sonia Cristina S. , Almeida Mara Zélia de
Published: October 2018

Objetivou-se verificar o uso de espécies botânicas pelos estudantes do curso de extensão em “Técnicas de cultivo de plantas medicinas” do Centro de Responsabilidade Socioambiental do Jardim Botânico do Rio de Janeiro (CRS-JBRJ) como estratégia para melhoria do ensino-aprendizado e como base para elaboração de um modelo de ensino

sobre o tema. Para tanto, foi realizado um estudo exploratório descritivo com 35 alunos de ambos os sexos das edições de 2016 e 2017 do curso através de um questionário estruturado composto por dez questões. As plantas informadas pelos alunos foram utilizadas em aula visando validar sua identificação. Foram citadas 48 espécies, com destaque para Matricaria chamomilla L. (n=13) e Cymbopogon citratus (D.C.) Stapf (n=11), e a infusão foi o uso relatado por todos. Em relação às plantas medicinais, os alunos informaram a forma de obtenção, o motivo do uso, a frequência em que as utilizam em substituição a medicamentos alopáticos, a quantidade de espécies utilizadas simultaneamente e a credibilidade no tratamento e na possibilidade de toxidade decorrente da utilização. As relações expressas com os usos e elevado número de

citações das etnoespécies levantadas demonstram uma alta difusão do conhecimento, importante para construção dinâmica estratégica em sala de aula e para potencializar a relação do ensino-aprendizado dos estudantes do curso. A elaboração curricular proposta neste estudo foi construída a partir do somatório da experiência estratégica de ensino e das experiências relatadas na literatura. Os dados fornecerão embasamento para elaboração de oficinas, cursos de curta e longa-duração e especializações, bem como serão subsídio para um modelo de educação emancipatória, participativa e popular.
Mídias Sociais como ferramenta de apoio às práticas integrativas em saúde na área de plantas medicinais
Authors: Sá Kellen Miranda , Freire Amélia Maria Ramos , Pereira Maria Francilene Caetano , Do Nascimento Karla Magalhães , Cavalcante Sueli Maria de Araújo , Bandeira Mary Anne Medeiros
Published: October 2018

A universidade se insere na Política Nacional de Plantas Medicinais e Fitoterápicos (PNPMF) como instrumento estratégico para a promoção da educação e da saúde através do ensino, pesquisa e extensão. Essa pesquisa descreve o desempenho de uma mídia social de um projeto de extensão universitária em fitoterapia com foco na melhoria da qualidade de vida e promoção do uso racional de plantas medicinais. Trata-se de um estudo de caso de natureza exploratória e descritiva com abordagem qualitativa. Verificou-se que as mídias sociais são importantes ferramentas para disseminação da informação e alcance das ações de extensão universitária com foco nas práticas integrativas em saúde na área da fitoterapia.
Revisão sistemática evidencia ausência de estudos observacionais, objetivando o conhecimento da política nacional de plantas medicinais e fitoterápicos
Authors: Silva Augusto Santana Palma , Feitosa Sheila Torres
Published: October 2018

Introdução: A Política Nacional de Plantas Medicinais e Fitoterápicos (PNPMF)assegura o acesso seguro e o uso racional de plantas medicinais e fitoterápicos no Brasil à população usuária do Sistema Único de Saúde (SUS), representando estratégia de influência em saúde pública. Estudos mais recentes sugerem pouco interesse pela prescrição (por parte de médicos e outros profissionais) e concepções equivocadas (por parte dos usuários) acerca da eficácia e segurança destes produtos naturais, o que sugere um desconhecimento, por parte de profissionais, usuários e gestores da saúde acerca da PNPMF, problemática norteadora do presente estudo. Materiais e Métodos: Revisão Sistemática qualitativa pautada na triagem de estudos observacionais que objetivassem identificar o conhecimento da PNPMF por parte de gestores e ou profissionais e ou usuários do SUS. A busca foi realizada em seis bancos de dados entre os dias 28 e 29 de outubro de 2017 envolvendo uso de 16 descritores combinados utilizando-se operador booleano em três idiomas. A busca e elaboração da presente revisão obedeceram às diretrizes propostas pela recomendação PRISMA. Revisão Sistemática: Das 20 estratégias de busca utilizadas, não foram identificados estudos que objetivassem o conhecimento da PNPMF por parte de usuários e ou gestores e ou profissionais do SUS. Considerações Finais: Identifica-se a necessidade por estudos envolvendo gestores e profissionais do SUS acerca do conhecimento, por parte destes, da PNPMF, ação quepode auxiliar na garantia do principal objetivo da política pública em questão: o estímulo à prescrição, recomendação e uso racional de plantas medicinais e fitoterápicos.
Revisão sistemática evidencia baixo nível de conhecimento acerca da política nacional de práticas integrativas e complementares por parte de gestores e profissionais da saúde
Authors: Silva Augusto Santana Palma , Feitosa Sheila Torres
Published: October 2018

Introdução: A Política Nacional de Práticas Integrativas e Complementares no Sistema Único de Saúde representa estratégia de inserção das Práticas Integrativas e Complementares (PNPIC) através de diretrizes que incluem a divulgação e informação dos conhecimentos basais relacionados às PIC à gestores, usuários e profissionais de saúde. Apesar de possuir 11 anos, o atual cenário brasileiro, escasso de abordagens terapêuticas centradas no cuidado integral sugere o seu desconhecimento. A presente revisão pretende sumarizar estudos cujo objetivo seja o de verificar, por parte de atores diretos e indiretos do SUS, o conhecimento acerca desta política. Materiais e Métodos: Revisão Sistemática pautada na triagem de estudos observacionais que objetivassem identificar o conhecimento da PNPMF por parte de gestores e ou profissionais e ou usuários do SUS. A busca foi realizada em seis bancos de dados entre os dias 28 e 29 de outubro de 2017 envolvendo uso de 22 descritores combinados utilizando-se operador booleano em três idiomas. A busca e elaboração da presente revisão obedeceram às diretrizes propostas pela recomendação PRISMA. Revisão Sistemática: Das 44 estratégias de busca utilizadas, foram identificados seis estudos que evidenciaram baixo nível de conhecimento da PNPIC por parte de gestores e ou profissionais do SUS. Considerações Finais: Identifica-se a necessidade por estudos envolvendo gestores e profissionais do SUS acerca do conhecimento, por parte destes, da PNPIC, ação que pode auxiliar na garantia do principal objetivo da política pública em questão: difusão de cuidados pautados em uma racionalidade médica para além do atual modelo biomédico.
As práticas integrativas e complementares em saúde como um caminho para a sensibilização e formação de acadêmicos da saúde: relato de experiência.
Authors: Duarte Vieira Ana Beatriz , Rezendeb Alexandre Staerke Vieira de , Marques Patrícia Falcão Paredes , Vargas Valéria , Oliveira Laís , Nascimento Bárbara Guimarães do , Moura Leides Barroso de Azevedo
Published: October 2018

Trata-se de um relato de experiência de atividades de aprendizagens ativas abordando a temática das Praticas Integrativas e Complementares em Saúde (PICS) desenvolvidas no âmbito do SUS - Brasília. Objetiva-se descrever o potencial das PICS como terapêutica de saúde e modelo de cuidado por intermédio de experiência com uma disciplina que permite vivências de acadêmicos de enfermagem, da Universidade de Brasília, em diferentes atividades e cenários de prática. Entende-se que as PICS potencializam as mudanças necessárias para o fortalecimento da rede de atenção em saúde. Considera-se que tais mudanças devem se processar prioritariamente na formação dos novos profissionais, na gestão dos serviços e na organização operacional do sistema de saúde. Os estudantes que participam dessas práticas observam a mudança de um modelo focado no doente para uma abordagem integrada e integral das necessidades de saúde da pessoa, família e comunidade. Essa visão ecológica do ser humano possibilita mudanças de comportamento em direção ao autocuidado, na perspectiva da corresponsabilização para a promoção da qualidade de vida e saúde. A interface PICS e estratégia ativas de aprendizagem fortalece a autonomia e a corresponsabilidade dos sujeitos envolvidos – usuários, equipes, comunidade. Esse empoderamento repercute na ação individual e coletiva e no aprimoramento de ser, estar e viver saudável no mundo. Conclui-se que a sensibilização dos futuros profissionais em PICS fortalece o SUS, a promoção da saúde, e o crescimento profissional para realizar ações que contribuam para a humanidade. Para os acadêmicos de enfermagem PICS representa novos olhares sobre as maneiras de cuidar em saúde.
A infecção pelo gênero Plasmodium: epidemiologia, profilaxia e controle no Brasil
Authors: Gomes Andreia Patrícia , Vitorino Rodrigo Roger , Mendes Thainara Aparecida , Pereira Sandra De Oliveira , Miguel Paulo Sérgio Balbino , Braga Luciene Muniz , Moreira Tiago Ricardo , Santana Luiz Alberto
Published: October 2018

OBJETIVO: apresentar revisão dos aspectos epidemiológicos, profiláticos e de controle da malária no Brasil. MÉTODOS: revisão da literatura, foram consultadas as fontes PubMed (U. S. National Library of Medicine), SciELO (Scientific Eletronic Library Online), e Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde). RESULTADOS: a malária constitui um importante problema de saúde pública no mundo e uma das principais causas de morte por doenças infecciosas, resultando em mais de 300 milhões de casos e cerca de um milhão de óbitos por ano. No Brasil, a ocorrência de malária é concentrada na área da Amazônia Legal, compreendendo os seguintes estados: Acre, Amazonas, Amapá, Rondônia, Roraima, Pará, Tocantins, Maranhão e Mato Grosso. CONCLUSÃO: a despeito dos avanços no tratamento da malária, destaca-se a grande relevância das ações de profilaxia e de controle da doença, as quais têm repercussões – positivas – em termos individuais e coletivos.
Cuidados com o recém-nascido: a contribuição do pai no aleitamento materno
Authors: Rocha Gutmann Victoria Leslyê , Silva Camila Daiane , Fazio Ihana Arrieche , Mota Marina Soares , Acosta Daniele Ferreira
Published: October 2018

Objetivou-se identificar a contribuição do pai no aleitamento materno e nos cuidados com o recém-nascido. Trata-se de um estudo exploratório, descritivo, com abordagem qualitativa, realizado na maternidade de um Hospital Universitário no sul do Rio Grande do Sul. Coletou-se os dados nos meses de agosto e outubro de 2016, através de uma entrevista semiestruturada, as quais foram tratadas pela Análise de Conteúdo. Participaram 30 pais. A análise dos dados resultou em três categorias: “As contribuições dos pais nos cuidados realizados quando o bebê chora”, “As contribuições dos pais durante o aleitamento materno” e “As contribuições positivas que os pais acreditam que poderão realizar durante o aleitamento materno”. Ao identificar a contribuição paterna é possível pensar em estratégias para incluir o pai desde antes ao nascimento, incluindo-o na vivência e responsabilização da paternidade.
PL-001 Home-Based High-Intensity Interval Training Improves Muscle Capillarisation and eNOS/NAD(P)Hoxidase Protein Ratio in Obese Individuals with Elevated Cardiovascular Disease Risk
Authors: Scott Sam , Shepherd Sam , Wright Jay , Copper Robert , Wagenmakers Anton , Cocks Matt
Published: October 2018

Objective Obesity and inactivity lead to structural and functional muscle microvascular impairments associated with development of chronic disease. This study is the first to investigate the effect of a novel home-based high-intensity interval training (HIT) (Home-HT) intervention in obese individuals with elevated cardiovascular disease (CVD) risk on capillarisation and muscle microvascular eNOS/NAD(P)Hoxidase ratio. Comparisons were made with home-based moderate-intensity continuous training (Home-MICT) and supervised laboratory-based low-volume HIT (Lab-HIT) as control groups.

Methods Thirty-two sedentary obese adults (age 36±2 years; BMI 34.3±0.8 kg∙m-2; O2peak24.6±1.0 ml∙kg-1∙min-1) were allocated to 12 weeks of Home-HIT (n=9), Home-MICT (n=13) or Lab-HIT (n=10). Muscle biopsies were taken pre- and post-training to assess specifically in the endothelial layer of muscle arterioles and capillaries the protein content of eNOS, serine1177phosphorylated eNOS, NOX2 and p47phox, and various capillarisation measures using quantitative immunofluorescence microscopy.

Results All interventions induced comparable increases in total eNOS content in terminal arterioles and capillaries (P<0.001). There was no change in ser1177phosphorylated eNOS (arterioles P=0.802; capillaries P=0.311), but eNOS ser1177/eNOS ratio significantly decreased following training in arterioles and capillaries (P<0.001). Training decreased NOX2 content (arterioles P<0.001; capillaries P<0.001), but there was no change in p47phoxcontent (arterioles P=0.101; capillaries P=0.345). All measures of capillarisation increased (P<0.05). These adaptations occurred alongside increased O2peak(P<0.001) and whole-body insulin sensitivity (P=0.033). There were no significant differences between training programmes.

Conclusions The training effects of Home-HIT on skeletal muscle microvascular adaptations are comparable to those of traditional training methods, with the advantage that Home-HIT reduces barriers to exercise in obese individuals with elevated CVD risk.
PL-003 BMSCs transplantation aggravate inflammation, oxidative stress, fibrosis and impair skeletal muscle regeneration
Authors: Liu Xiaoguang , Xiao Weihua , Zhen Lifang , Zhou Yongzhan , Shou Jian
Published: October 2018

Objective Skeletal muscle contusion is one of the most common muscle injury in sports medicine and traumatology. Bone marrow mesenchymal stem cells (BMSCs) transplantation is a promising strategy for muscle regeneration. However, the roles of BMSCs, especially the mechanisms involved, in the regeneration of contused skeletal muscle are still not fully recognized. The aim of the study is to evaluate the potential of BMSCs transplantation for muscle regeneration and mechanisms involved after contusion.

Methods Ninety-nine C57BL/6J mice were divided into three groups: control group (n=11), muscle contusion and BMSCs treated group (n=44), muscle contusion and sham treated group (n=44). BMSCs were immediately transplanted into gastrocnemius muscles (GMs) following direct contusion. At different time points (3, 6, 12 and 24 days) post-injury, the animals were killed and then GMs were harvested. Morphological and gene expression analyses were used to elevate the effect of BMSCs transplantation and mechanisms involved.

Results The results indicate that BMSCs transplantation impairs muscle regeneration, as well as more fibrotic scar formation after skeletal muscle contusion. Furthermore, macrophages, inflammatory cytokines, chemokines, matrix metalloproteinases and oxidative stress related enzymes were significantly increased after BMSCs transplantation. These results suggest that BMSCs transplantation impairs skeletal muscle regeneration and that macrophages, inflammatory cytokines, chemokines, matrix metalloproteinases and oxidative stress related enzymes may be involved in the process.

Conclusions BMSCs transplantation aggravates inflammation, oxidative stress and fibrosis, and impairs skeletal muscle regeneration, which shed new light on the role of BMSCs in regenerative medicine and cautions the application of BMSCs for muscle injury.
PL-006 Expression of molecular markers of hepatic cholesterol metabolism are altered by a short-term high-fat diet
Authors: Lavoie Jean-Marc
Published: October 2018

Objective Metabolic disorders are often associated with liver steatosis and increased plasma cholesterol levels. However, the link between excessive lipid accumulation and impairments in cholesterol metabolism remains uninvestigated in the liver. Hence, a short treatment with a high-fat diet (HFD) was previously shown to promote excessive lipid accumulation in liver prior to the development of metabolic disorders. The present study intended to characterize how increases in liver fat alter the expression of several key regulators of hepatic cholesterol metabolism in response to a short-term HFD.

Methods Young Wistar rats were randomly submitted either to HFD (n = 8) or a regular chow diet (RCD; n = 8) for 14 days.Liver tissue and blood were sampled .

Results Increases in triglycerides were highly significant (P< 0.01) in liver but marginal in plasma of HFD rats. In contrast, the HFD resulted in higher (P< 0.01) cholesterol levels in plasma but not in liver samples. Gene expression of key markers involved in cholesterol uptake (LDL particles) including low density lipoprotein receptor-related protein-1 (LRP-1) and protein convertase subtilisin/kexin type 9 (PCSK9) along with ATP-binding cassette, superfamily G, member 5 (ABCG5) involved in cholesterol exportation viabile ducts were found to be higher (P< 0.05) in response to the HFD. In contrast, expression of 3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR), involved in cholesterol synthesis was down-regulated in liver

Conclusions The data support the concept that excessive accumulation of lipids promptly alters the expression of key genes regulating cholesterol metabolism in liver. On a clinical point of view, this indicates that increases in plasma cholesterol occur after a short-term high fat diet.