bluuebunny/crossref_metadata_2025 huggingface dataset:
A regulator’s view of comparative effectiveness research
Authors: Temple Robert
Published: October 2011

Background ‘Comparative effectiveness’ is the current enthusiasm, and for good reason. After knowing a treatment works, the most critical question is how it compares with alternatives. Comparative studies are not commonly conducted by drug companies and they represent a significant methodological challenge. Comparative data could include evidence of overall superiority to an alternative or advantages in identifiable subsets, for example, people who do not respond to or tolerate alternatives, or members of a genetic subset and could also include convincing evidence that there is little difference between two treatments.

Purpose To describe regulations, guidance, and Food and Drug Administration experience related to studies of comparative effectiveness, including approaches to showing superiority and problems encountered in showing similarity.

Methods Review of Food and Drug Administration regulations and guidance and experience with showing superiority and similarity, particularly related to randomized trials and epidemiologic studies.

Results Methods exist, and they have been successful for showing overall superiority of one drug over another, advantages in specific population subsets. Efforts to show true equivalence face problems of definition and very large sample sizes needed to rule out small differences.

Limitations There is need for further discussion of what is meant by similarity or equivalence of two treatments.

Conclusion Comparative studies are challenging because differences between effective therapies are likely to be small and can be detected reliably only in randomized trials, often large ones. Despite the difficulties, comparative trials have been successful and we clearly would like to see more of them.
The consequences of executive turnover
Authors: Duffield Christine , Roche Michael , Blay Nicole , Thoms Debra , Stasa Helen
Published: October 2011

The high rate of executive turnover in the healthcare industry is a major issue for health service organisations and their staff both in Australia and internationally. In the course of planning a research project examining nurse turnover at the clinical level within three Australian States/Territories, the researchers became aware of frequent executive turnover at all levels (State Department of Health, Area Health Service, hospital). Over a period of approximately 2 years there were 41 executives occupying 18 different positions, highlighting the scope of this issue in Australia. Few studies have examined the causes and consequences of this phenomenon in depth. Factors such as age, gender, education, lack of career advancement opportunities and remuneration have all been identified in the literature as important contributors to executive turnover. High turnover rates have been found to be associated with a number of negative consequences, including organisational instability, high financial costs, loss of human capital and adverse effects on staff morale and patient care. While the use of ‘acting’ roles may assist in filling executive positions on a temporary basis, consequences for the rest of the organisation are associated with their extended use. Steps which health services planners may take to attempt to minimise executive turnover include providing staff members with appropriate challenges and opportunities for growth and ensuring that a clear succession plan is in place to minimise the impact for the organisation and its staff.
Elevation Puts Moral Values Into Action
Authors: Schnall Simone , Roper Jean
Published: October 2011

Moral elevation has been shown to increase helping behavior. However, this might be due to a threatened moral self-image because people engage in a social comparison with a moral exemplar and conclude that their own moral integrity is inferior. Alternatively, feelings of elevation might provide a motivational impetus to act on one’s moral values. We provided participants with an opportunity to engage in self-affirmation, which was followed by an induction of moral elevation or a neutral control mood. Compared to the neutral mood, participants experiencing moral elevation showed higher levels of helping behavior following self-affirmation. This effect was especially pronounced in participants experiencing moral elevation who reminded themselves of previous prosocial behavior; they showed more helping than participants experiencing moral elevation who had not engaged in self-affirmation. Thus, rather than posing a threat to moral self-worth, feelings of elevation can provide the motivational trigger to act on affirmed moral values.
Value Activation and Processing of Persuasive Messages
Authors: Blankenship Kevin L. , Wegener Duane T.
Published: October 2011

Basing attitudes on one’s core values has long been thought to result in strong, consequential attitudes. Recent research suggests a less direct route for values to influence attitude strength—by influencing the extent to which people process attitude-relevant information. That research induced research participants to explicitly consider important or unimportant values in relation to the persuasive message. In contrast, the current research examined whether mere activation of important values before encountering a persuasive message could enhance message processing. Normatively important or unimportant values were subtly activated by simply presenting values (Experiment 1) including the values in a previous “unrelated” study (Experiment 2) or rating the importance of values in a questionnaire prior to the persuasive message. Experiment 3 suggested that important values are not equivalent to any other important constructs. Activation of important values increased information processing but activation of equally important alternative attitudes did not.
Neck of Femur Fractures in Patient’s Aged More Than 85 Years—are They a Unique Subset?
Authors: Moon Andrew , Gray Andrew , Deehan David
Published: October 2011

Background. The UK population is ageing with the largest increase expected to occur in people aged more than 85 years (85+). We have examined the hypothesis that neck of femur (NOF) fractures in the 85+ group exhibit demonstrable key outcome measurement differences after surgery when compared to a standard NOF population. Patients and Methods. A prospective observational cohort study of the demographics, clinical features, and key clinical outcome measurements for 2 groups of patients (65-84 and 85+ years of age at presentation) was performed in a single trauma unit over a 3-year period. Results. A total of 699 patients with a median age of 78 in the 65 to 84 cohort were compared with 523 patients with a median age of 88 in the 85+ cohort. Despite a dedicated orthogeriatric service and no difference in time to surgery between the 2 groups, the 30-day and 1-year mortality rates were significantly higher in the 85+ cohort at 10% and 30%, respectively, compared with 5% and 19% in the younger patient group. In our 85+ group, 34% had evidence of significant measured cognitive impairment compared to only 19% in the 65 to 84 group ( P < .001). The length of hospital inpatient stay was also longer in the 85+ cohort with a median of 20 days compared to 16 days in the younger cohort ( P = .001). In the 85+ cohort, 60% of patients were discharged back to their usual (preinjury) place of residence compared to 72% in the 65 to 84 cohort ( P = .001). Conclusions. Patients in 85+ group presenting with an NOF fracture represent a unique high-risk patient group. Despite adherence to published key principles of care, this group is at higher risk and as such merits focused clinical attention, with adequate patient and family member counseling with regard to prognosis and overall expectation.
Outliers
Authors: Cram Peter , Lu Xin , Kates Stephen L. , Li Yue , Miller Benjamin J.
Published: October 2011

Background: Little is known about readmission rates for total hip and total knee arthroplasty (THA and TKA). Our objective was to examine readmission rates and whether hospitals with high and low readmission rates at baseline remain outliers in subsequent years. Methods: We identified Medicare beneficiaries who underwent THA (N = 245 995) and TKA (N = 517 867) between 2003 and 2005. We created four different hospital cohorts: low and high volume for THA and TKA. We calculated 30-day risk-standardized readmission rates (RSRRs) for each hospital for each year. Hospitals were defined as having low (lowest 25% of all hospitals), high (highest 25% of hospitals), and intermediate readmission rates (all others) for each year. Hospitals were labeled outliers if they had consistently low or high readmission rates for all years. We examined the number and characteristics of outlier and nonoutlier hospitals. Results: Unadjusted readmission rates in 2003 for THA ranged from 0% to 94.7% (inter-quartile range: 0%-7.0%) and for TKA from 0% to 94.4% (inter-quartile range: 0.7%-5.9%). Of 255 low-volume THA hospitals with low readmission rates in 2003 (RSRRs ≤3.5%), 34 were outliers for all 3 years—significantly more than predicted ( P < .0001). Likewise, of 256 low-volume THA hospitals with high readmission rates (RSRRs ≥5.8%) in 2003, 33 were outliers for all 3 years ( P < .0001). Outlier and nonoutlier hospitals did not differ in meaningful ways (teaching status and staffing ratios). Results were similar for other hospital cohorts. Conclusions: Using a 3-year window allows for identification of hospitals with consistently higher and lower readmission rates than predicted.
Assessing Results After Distal Radius Fracture Treatment
Authors: Kwok Iris H. Y. , Leung Frankie , Yuen Grace
Published: October 2011

Objectives: Functional outcomes following distal radius fractures are directly influenced by the choice of outcome assessment instruments used. Our objective was to compare scoring systems in measuring patient functional outcomes and to determine which scoring system compared most favorably with the widely used Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. Methods: In all, 108 patients between May 2004 and November 2006 were treated operatively following distal radius fractures. Follow-up was at 3 months, 6 months, 1 year, and 2 years postsurgery, during which anatomical and functional assessments were performed. Patient outcomes were recorded using DASH, Green and O’Brien system, Gartland and Werley system, and Sarmiento radiological scoring system. Results: There was a stronger correlation between the Green and O’Brien scoring system and DASH ( r = −.54) than Gartland and Werley and DASH ( r = .44). The Green and O’Brien scoring system was more demanding so patients rated “excellent” or “good” had better functional outcome than those bearing the same grade in the Gartland and Werley system. Nonetheless, the Green and O’Brien score and Gartland and Werley score showed good correlation with each other ( r = .66). The Sarmiento radiological score had no significant correlation with any of the other scoring systems. Significant predictors of the DASH score were function ( r = .42), power grip ( r = .41), pain ( r = .37), and range of motion ( r = .28). Conclusion: The Green and O’Brien scoring system correlated most strongly with the DASH score. Radiological scoring (reflecting anatomical deformity) was not significantly correlated with functional outcome. While subjective parameters “pain” and “function” are influenced by psychosocial factors and thus highly variable, it is paramount to include subjective tools in outcome assessment in future studies on wrist fractures.
Phase 1/2 study to assess the safety, efficacy, and pharmacokinetics of barasertib (AZD1152) in patients with advanced acute myeloid leukemia
Authors: Löwenberg Bob , Muus Petra , Ossenkoppele Gert , Rousselot Philippe , Cahn Jean-Yves , Ifrah Norbert , Martinelli Giovanni , Amadori Sergio , Berman Ellin , Sonneveld Pieter , Jongen-Lavrencic Mojca , Rigaudeau Sophie , Stockman Paul , Goudie Alison , Faderl Stefan , Jabbour Elias , Kantarjian Hagop
Published: October 2011

The primary objective of this 2-part phase 1/2 study was to determine the maximum-tolerated dose (MTD) of the potent and selective Aurora B kinase inhibitor barasertib (AZD1152) in patients with newly diagnosed or relapsed acute myeloid leukemia (AML). Part A determined the MTD of barasertib administered as a continuous 7-day infusion every 21 days. In part B, the efficacy of barasertib was evaluated at the MTD. In part A, 32 patients were treated with barasertib 50 mg (n = 3), 100 mg (n = 3), 200 mg (n = 3), 400 mg (n = 4), 800 mg (n = 7), 1200 mg (n = 6), and 1600 mg (n = 6). Dose-limiting toxicities (stomatitis/mucosal inflammation events) were reported in the 800 mg (n = 1), 1200 mg (n = 1), and 1600 mg (n = 2) groups. The MTD was defined as 1200 mg. In part B, 32 patients received barasertib 1200 mg. In each part of the study, 8 of 32 patients had a hematologic response according to Cheson AML criteria. The most commonly reported grade ≥ 3 events were febrile neutropenia (n = 24) and stomatitis/mucosal inflammation (n = 16). We concluded that the MTD of barasertib is 1200 mg in patients with relapsed or newly diagnosed AML. Toxicity was manageable and barasertib treatment resulted in an overall hematologic response rate of 25%. This study is registered at www.ClinicalTrials.gov as NCT00497991.
Polyphosphate is a cofactor for the activation of factor XI by thrombin
Authors: Choi Sharon H. , Smith Stephanie A. , Morrissey James H.
Published: October 2011

Factor XI deficiency is associated with a bleeding diathesis, but factor XII deficiency is not, indicating that, in normal hemostasis, factor XI must be activated in vivo by a protease other than factor XIIa. Several groups have identified thrombin as the most likely activator of factor XI, although this reaction is slow in solution. Although certain nonphysiologic anionic polymers and surfaces have been shown to enhance factor XI activation by thrombin, the physiologic cofactor for this reaction is uncertain. Activated platelets secrete the highly anionic polymer polyphosphate, and our previous studies have shown that polyphosphate has potent procoagulant activity. We now report that polyphosphate potently accelerates factor XI activation by α-thrombin, β-thrombin, and factor XIa and that these reactions are supported by polyphosphate polymers of the size secreted by activated human platelets. We therefore propose that polyphosphate is a natural cofactor for factor XI activation in plasma that may help explain the role of factor XI in hemostasis and thrombosis.
Increased intestinal permeability and tight junction disruption by altered expression and localization of occludin in a murine graft versus host disease model
Authors: Noth Rainer , Lange-Grumfeld Julia , Stüber Eckhard , Kruse Marie-Luise , Ellrichmann Mark , Häsler Robert , Hampe Jochen , Bewig Burkhard , Rosenstiel Philip , Schreiber Stefan , Arlt Alexander
Published: October 2011

Background

Hematopoietic stem cell transplantation is increasingly performed for hematologic diseases. As a major side effect, acute graft versus host disease (GvHD) with serious gastrointestinal symptoms including diarrhea, gastrointestinal bleeding and high mortality can be observed. Because surveillance and biopsies of human gastrointestinal GvHD are difficult to perform, rare information of the alterations of the gastrointestinal barrier exists resulting in a need for systematic animal models.

Methods

To investigate the effects of GvHD on the intestinal barrier of the small intestine we utilized an established acute semi allogenic GvHD in C57BL/6 and B6D2F1 mice.

Results

By assessing the differential uptake of lactulose and mannitol in the jejunum, we observed an increased paracellular permeability as a likely mechanism for disturbed intestinal barrier function. Electron microscopy, immunohistochemistry and PCR analysis indicated profound changes of the tight-junction complex, characterized by downregulation of the tight junction protein occludin without any changes in ZO-1. Furthermore TNF-α expression was significantly upregulated.

Conclusions

This analysis in a murine model of GvHD of the small intestine demonstrates serious impairment of intestinal barrier function in the jejunum, with an increased permeability and morphological changes through downregulation and localization shift of the tight junction protein occludin.
Adjusting for sampling variability in sparse data: geostatistical approaches to disease mapping
Authors: Hampton Kristen H , Serre Marc L , Gesink Dionne C , Pilcher Christopher D , Miller William C
Published: October 2011

Background

Disease maps of crude rates from routinely collected health data indexed at a small geographical resolution pose specific statistical problems due to the sparse nature of the data. Spatial smoothers allow areas to borrow strength from neighboring regions to produce a more stable estimate of the areal value. Geostatistical smoothers are able to quantify the uncertainty in smoothed rate estimates without a high computational burden. In this paper, we introduce a uniform model extension of Bayesian Maximum Entropy (UMBME) and compare its performance to that of Poisson kriging in measures of smoothing strength and estimation accuracy as applied to simulated data and the real data example of HIV infection in North Carolina. The aim is to produce more reliable maps of disease rates in small areas to improve identification of spatial trends at the local level.

Results

In all data environments, Poisson kriging exhibited greater smoothing strength than UMBME. With the simulated data where the true latent rate of infection was known, Poisson kriging resulted in greater estimation accuracy with data that displayed low spatial autocorrelation, while UMBME provided more accurate estimators with data that displayed higher spatial autocorrelation. With the HIV data, UMBME performed slightly better than Poisson kriging in cross-validatory predictive checks, with both models performing better than the observed data model with no smoothing.

Conclusions

Smoothing methods have different advantages depending upon both internal model assumptions that affect smoothing strength and external data environments, such as spatial correlation of the observed data. Further model comparisons in different data environments are required to provide public health practitioners with guidelines needed in choosing the most appropriate smoothing method for their particular health dataset.
PAX8 Mutation Disturbing Thyroid Follicular Growth: A Case Report
Authors: Narumi Satoshi , Yoshida Akira , Muroya Koji , Asakura Yumi , Adachi Masanori , Fukuzawa Ryuji , Kameyama Kaori , Hasegawa Tomonobu
Published: October 2011

Context:

Heterozygous inactivating PAX8 mutations cause congenital hypothyroidism. Although more than 30 mutation carriers have been reported, no histological examination of the thyroid has been conducted.

Objective:

The objective of this study was to document the histological characteristics of the thyroid tissue harboring a PAX8 mutation.

Subjects and Methods:

The patient was a 40-yr-old female, whose two children had congenital hypothyroidism and an inactivating PAX8 mutation (p.K80_A84dup). She had normal thyroid function but had a thyroid nodule and received right hemithyroidectomy at age 28 yr. Mutation analyses using DNA derived from multiple sources, namely lymphocytes, nails, and laser capture microdissected thyroid samples, were performed.

Results:

The PAX8 mutation was detected in the lymphocytes; however, the level of the mutant allele was significantly lower than that of the wild-type allele. This finding was compatible with her somatic mosaic state. We reviewed the histology of her resected thyroid and found a characteristic lesion in the nonneoplastic tissue: dense aggregates of thyrocytes with absent or very small follicles, resembling a fetal thyroid in the late phase of development. Mutation analyses of laser capture microdissected thyroid samples revealed that the fetal-like tissue carried the PAX8 mutation, whereas surrounding morphologically normal tissue and adenoma tissue did not.

Conclusions:

In our case, the histology of PAX8 mutation-carrying thyroid tissue was characterized by the lack of follicular growth. Our observations provide the first evidence suggesting that the late phase of thyroid development is sensitive to the PAX8 gene dosage and can be disturbed by heterozygous inactivating PAX8 mutations.
Contrasting Trends in Firm Volatility
Authors: Thesmar David , Thoenig Mathias
Published: October 2011

Over the past decades, the real and financial volatility of listed firms has increased, while the volatility of private firms has decreased. We first provide panel data evidence that, at the firm level, sales and employment volatility are impacted by changes in the degree of ownership concentration. We then construct a model with private and listed firms where risk-taking is a choice variable at the firm-level. Due to general equilibrium feedback, we find that both an increase in stock market participation and integration in international capital markets generate opposite trends in volatility for private and listed firms. (JEL G15, G32, L25)
Forces Shaping Hours Worked in the OECD, 1960–2004
Authors: McDaniel Cara
Published: October 2011

The goal of this paper is to examine the role of taxes and productivity growth as forces influencing market hours. To achieve this goal, the paper considers a calibrated growth model extended to include home production and subsistence consumption, both of which are found to be key features influencing market hours. The model is simulated for 15 OECD countries. The primary force driving changes in market hours is found to be changing labor income tax rates. Productivity catch-up relative to the United States is found to be an important secondary force. (JEL E24, H24, H31, J22, J24)
Application of response surface methodology to study the influence of hydrothermal processing on phytochemical constituents of the Irish edible brown seaweed Himanthalia elongata
Authors: Cox Sabrina , Gupta Shilpi , Abu-Ghannam Nissreen
Published: October 2011

We used response surface methodology to investigate the effect of time and temperature of hydrothermal processing (blanching) on the phytochemical content, texture and colour of a semi-dried brown seaweed (Himanthalia elongata). A central composite design was employed with a hydrothermal processing time of 10–30 min and temperature of 60–90°C. Predicted models were found to be significant for total phenolic content, 2,2-diphenyl-1-picrylhydrazyl radical scavenging activity, total flavonoids, total condensed tannins, texture and colour. The predicted values for each of the responses were in good agreement with experimental values. Processing time had the most significant effect on phytochemical constituents of H. elongata. An acceptable edible texture and colour of seaweed was also achieved during the blanching procedure. Thus, central composite design and response surface methodology can be used to model phytochemical content, texture and colour of H. elongata while minimising the number of experiments required. Multiple response optimisation demonstrated that the phytochemical content of H. elongata may be maximised by blanching for 20.4 min at 80.5°C.
Folk uses and pharmacological properties of Casearia sylvestris: a medicinal review
Authors: Ferreira Paulo Michel P. , Costa-Lotufo Leticia V. , Moraes Manoel O. , Barros Francisco W.A. , Martins Aline M.A. , Cavalheiro Alberto J. , Bolzani Vanderlan S. , Santos Andre G. , Pessoa Claudia
Published: October 2011

Folk uses and scientific investigations have highlighted the importance of Casearia sylvestris extracts and their relevant bioactive potential. The aim of this work was to review the pharmacological properties of C. sylvestris, emphasizing its anti-ulcer, anti-inflammatory, anti-ophidian and antitumor potentialities. Ethanolic extracts and essential oil of their leaves have antiulcerogenic activity and reduce gastric volume without altering the stomach pH, which corroborates their consumption on gastrointestinal disorders. Leaf water extracts show phospholipase A2 inhibitory activity that prevents damage effects on the muscular tissue after toxin inoculation. This antiphospholipasic action is probably related to the use as an anti-inflammatory, proposing a pharmacological blockage similar to that obtained with non-steroidal anti-inflammatory drugs on arachidonic acid and cyclooxygenase pathways. Bioguided-assay fractionations lead to the identification of secondary metabolites, especially the clerodane diterpenes casearins (A-X) and casearvestrins (A-C), compounds with a remarkable cytotoxic and antitumor action. Therefore, the C. sylvestris shrub holds a known worldwide pharmacological arsenal by its extensive folk utilization, exciting searches for new molecules and a better comprehension about biological properties.
Heavy metal concentrations in soils from a remote oceanic island, Fernando de Noronha, Brazil
Authors: Oliveira Sonia M.B. de , Pessenda Luiz C.R. , Gouveia Suzy E.M. , Favaro Deborah I.T.
Published: October 2011

This paper examines the role of parent rock, pedogenetic processes and airborne pollution in heavy metal accumulation in soils from a remote oceanic island, Fernando de Noronha, Brazil. We studied five soil profiles developed from different volcanic rocks. Mineralogical composition and total concentrations of major and trace elements were determined in 43 samples. The obtained concentrations range for heavy metals were: Co: 26-261 ppm; Cu: 35-97 ppm; Cr: 350-1446 ppm; Ni: 114-691 ppm; Zn: 101-374 ppm; Hg: 2-150 ppb. The composition of soils is strongly affected by the geochemical character of the parent rock. Pedogenesis appears to be responsible for the accumulation of Zn, Co, and, to a lesser extent, of Ni and Cu, in the upper, Mn- and organic carbon-enriched horizons of the soil profiles. Pedogenic influence may also explain the relationship observed between Cr and the Fe. Hg is likely to have been added to the soil profile by long-range atmospheric transport. Its accumulation in the topsoil was further favoured by the formation of stable complexes with organic matter. Clay minerals do not appear to play an important role in the fixation of heavy metals.
Ética e clínica na atenção psicossocial: contribuições da psicanálise de Freud e Lacan
Authors: Costa-Rosa Abílio
Published: October 2011

O objetivo central é discutir a possibilidade de uma ética pertinente ao conjunto de ações atualmente realizadas sob o enfoque da Atenção Psicossocial no campo da Saúde Mental Coletiva. Utilizando o método do ensaio, partirei da análise de algumas proposições importantes sobre a ética na Saúde Mental, presentes na literatura recente, e da experiência de vários anos no campo da Atenção Psicossocial como trabalhador, como assessor clínico-institucional do Ministério da Saúde e como formador de psicoterapeutas. Duas vertentes de análise são consideradas: éticas disciplinares, chamadas éticas da psiquiatria, incluindo uma tentativa importante de complementá-las criticamente sob o enfoque da "ética do cuidado", e éticas fundadas em concepções psicanalíticas do sujeito e seu sofrimento, que destacam as dimensões do sujeito como "entre" social e como "entre" subjetivo ou "entre sentido". Com base nas diretrizes do Sistema Único de Saúde e na psicanálise do campo freudiano, procura-se fundamentar a ética da Clínica na Atenção Psicossocial como ética do "cuidar-se" - base necessária para a construção do protagonismo dos sujeitos do sofrimento na produção do sentido necessário à superação do sofrimento e demais impasses que motivaram a procura de ajuda, e para a possibilidade de seu reposicionamento no "entre social" e no "entre sentido"; componentes da saúde em sintonia com a subjetividade singularizada referenciada nos Ideais socioculturais e no devir desejante. Demonstra-se que essa ética exige dos trabalhadores do campo a superação dialética dos modos de produção de saúde e subjetividade em sintonia com o Modo Capitalista de Produção e seus derivados autoritários.
Perfil de suscetibilidade a antifúngicos de dermatófitos isolados de pacientes com insuficiência renal crônica
Authors: Magagnin Cibele Massotti , Stopiglia Cheila Denise Ottonelli , Vieira Fabiane Jamono , Heidrich Daiane , Machado Madeline , Vetoratto Gerson , Lamb Flávia Maria , Scroferneker Maria Lúcia
Published: October 2011

FUNDAMENTOS: As dermatofitoses apresentam alta prevalência na população em geral e, principalmente, em pacientes com insuficiência renal crônica, necessitando tratamento com antifúngicos tópicos e/ou sistêmicos, cuja eficácia precisa ser avaliada. Estudos in vitro para avaliar a ação de antifúngicos são raros, especialmente, em fungos filamentosos. OBJETIVO: Avaliar o perfil de suscetibilidade de diferentes espécies de dermatófitos, isolados de pacientes com insuficiência renal crônica, em relação a nove antifúngicos disponíveis comercialmente para o tratamento de dermatofitoses. MÉTODO: Analisaram-se 26 isolados de dermatófitos de pacientes com insuficiência renal crônica em relação a nove antifúngicos (cetoconazol, ciclopirox olamina, fluconazol, griseofulvina, itraconazol, miconazol, piroctona olamina, terbinafina e tioconazol) pelo método de microdiluição em caldo proposto pelo Clinical and Laboratory Standards Institute (CLSI), com modificações para dermatófitos. RESULTADOS: Entre os antifúngicos testados, a terbinafina e o tioconazol obtiveram os melhores resultados de sensibilidade e o fluconazol apresentou baixa atividade, especialmente para as amostras da espécie M. gypseum. O ciclopirox olamina, apesar de menos eficaz que a terbinafina, também mostrou resultados satisfatórios. CONCLUSÕES: De modo geral, o perfil de sensibilidade dos antimicóticos testados seguiu o padrão de resultados mostrados por estudos anteriores, ratificando a necessidade de conhecimento da espécie causadora de dermatofitose, devido à variação do perfil de suscetibilidade entre as espécies. Além disso, nossos resultados demonstram a importância da realização de ensaios de sensibilidade in vitro, pois alguns isolados da mesma espécie apresentaram diferente perfil de sensibilidade
Granulomas do pênis: uma complicação rara da terapia intravesical com Bacilo Calmette-Guérin
Authors: Lestre Sara Isabel Alcântara , Gameiro Catarina Diogo , João Alexandre , Lopes Maria João Paiva
Published: October 2011

A imunoterapia com o Bacilo Calmette-Guérin é amplamente usada no tratamento e profilaxia da neoplasia urotelial superficial. As complicações associadas ao tratamento são comuns. Os autores relatam um caso de inflamação granulomatosa do pênis, associada à terapia intravesical com Bacilo Calmette-Guérin, com múltiplos nódulos eritematosos indolores localizados na glande. É também efetuada uma revisão da literatura. A balanopostite granulomatosa é uma complicação rara associada à imunoterapia com Bacilo Calmette-Guérin, com uma apresentação clinicamente heterogênea que pode dificultar o diagnóstico. O seu reconhecimento clínico é essencial para o início precoce de tuberculostáticos e interrupção de Bacilo Calmette-Guérin
Caso para diagnóstico
Authors: Santiago Felicidade , Reis José Pedro
Published: October 2011

Descreve-se um paciente com características clínicas e histopatológicas típicas da hiperplasia angiolinfoide com eosinofilia. Trata-se de uma hiperplasia vascular benigna que importa reconhecer e distinguir da doença de Kimura
A propaganda de alimentos: orientação, ou apenas estímulo ao consumo?
Authors: Marins Bianca Ramos , Araújo Inesita Soares de , Jacob Silvana do Couto
Published: October 2011

As mensagens sobre alimentação veiculadas nos meios de comunicação merecem atenção, pois estudos apontam que a mídia exerce papel fundamental na formação de novos hábitos alimentares. Visando atender a um novo perfil de consumidores preocupados com a saúde e o bem-estar físico e interessada nesse mercado promissor, a indústria intensifica as estratégias de estímulo ao consumo de determinadas categorias de alimentos, como os produtos diet e light. Este estudo analisou 20 peças publicitárias de alimentos veiculadas em revistas e jornais de circulação nacional entre junho e outubro de 2006, contemplando: o emissor; o destinatário; a linguagem e a mensagem. Constatou-se que o discurso publicitário focou principalmente as mulheres, propondo o consumo sem culpa e prometendo a combinação entre estética e saúde. Na busca da valorização do produto, as peças publicitárias secundarizaram informações nutricionais relevantes, outras realizaram combinações perigosas para a saúde, como a associação do alimento a medicamentos e a indução a substituição de refeições pelo produto em questão. Os resultados sinalizam a necessidade de se ampliar a discussão sobre as estratégias da publicidade de alimentos, pois o direito do cidadão à informação e à saúde não podem estar subjugados a valores de mercado.
Grau de acabamento e unidades equivalentes de produção: uma abordagem conceitual e empírica
Authors: Guerreiro Reinaldo , Cornachione Jr Edgard Bruno , Catelli Armando
Published: October 2011

Este artigo tem como objeto de estudo o problema da determinação do grau de acabamento utilizado no processo de cálculo das unidades equivalentes de produção no sistema de custeio por processo contínuo. Foi estabelecida a hipótese que a teoria da contabilidade de custos não oferece uma solução objetiva para o cálculo do grau de acabamento e, dessa forma, as empresas não adotam os conceitos teóricos fundamentais definidos pela teoria, no que diz respeito à valorização do estoque de produtos em processo e valorização dos produtos acabados em indústriais de produção contínua A revisão da literatura, considerando-se um grupo de obras de autores clássicos da contabilidade de custos, constatou que não existe indicação objetiva da forma de cálculo do grau de acabamento. Este trabalho apresenta um método para cálculo do grau de acabamento e um estudo exploratório desenvolvido com a finalidade de se obter um conhecimento pragmático sobre a realidade das empresas quanto ao tema em questão. As pesquisas bibliográfica e empírica indicam a validade da hipótese estabelecida.
Redução da proteína bruta com suplementação de aminoácidos em rações para alevinos de tambatinga
Authors: Alencar Araripe Maria de Nasaré Bona de , Alencar Araripe Hamilton Gondim de , Lopes João Batista , Castro Pollyanna Lima de , Braga Tony Ewerton Amorim , Ferreira Antônio Hosmylton Carvalho , Abreu Márvio Lobão Teixeira de
Published: October 2011

Foram avaliados o desempenho e a composição muscular da carcaça de alevinos de tambatinga, com peso inicial de 6,521 ± 0,300 g, alimentados com dietas isoenergéticas, isocálcicas e isofosfóricas contendo 40, 37, 34, 31 ou 28% de proteína bruta. Os peixes foram mantidos durante 40 dias em tanques de polietileno, com sistema de recirculação de água. No início e final do experimento, os peixes foram pesados e os dados utilizados para avaliação do ganho de peso diário, consumo diário de ração, conversão alimentar aparente, índice de conversão alimentar, consumo diário de proteína, taxa de crescimento específico e taxa de eficiência proteica. No início e final do experimento, foram selecionadas amostras de peixes para análise da composição muscular, e os resultados utilizados para avaliar a eficiência de retenção de proteína e a proporção de proteína e extrato etéreo no ganho de peso. Entre os parâmetros de desempenho, os níveis de PB influenciaram apenas o consumo de proteína e a taxa de eficiência proteica, com efeito linear. Os teores de proteína bruta, a proporção de proteína no ganho de peso e eficiência de retenção de proteína no músculo dos alevinos de tambatinga aumentaram linearmente com a redução de proteína bruta na dieta, enquanto o teor de extrato etéreo e sua proporção no ganho de peso diminuíram. O nível de 28% de PB, quando há suplementação com aminoácidos, pode ser utilizado em dietas para alimentação dos alevinos de tambatinga, pois não prejudica seu desempenho.
The Accuracy of Probabilistic Versus Temporal Clinician Prediction of Survival for Patients with Advanced Cancer: A Preliminary Report
Authors: Hui David , Kilgore Kelly , Nguyen Linh , Hall Stacy , Fajardo Julieta , Cox-Miller Tonye P. , Palla Shana L. , Rhondali Wadih , Kang Jung Hun , Kim Sun Hyun , Del Fabbro Egidio , Zhukovsky Donna S. , Reddy Suresh , Elsayem Ahmed , Dalal Shalini , Dev Rony , Walker Paul , Yennu Sriram , Reddy Akhila , Bruera Eduardo
Published: October 2011

Clinicians have limited accuracy in the prediction of patient survival. We assessed the accuracy of probabilistic clinician prediction of survival (CPS) and temporal CPS for advanced cancer patients admitted to our acute palliative care unit, and identified factors associated with CPS accuracy. Eight physicians and 20 nurses provided their estimation of survival on admission by (a) the temporal approach, “What is the approximate survival for this patient (in days)?” and (b) the probabilistic approach, “What is the approximate probability that this patient will be alive (0%–100%)?” for ≥24 hours, 48 hours, 1 week, 2 weeks, 1 month, 3 months, and 6 months. We also collected patient and clinician demographics. Among 151 patients, the median age was 58 years, 95 (63%) were female, and 138 (81%) had solid tumors. The median overall survival time was 12 days. The median temporal CPS was 14 days for physicians and 20 days for nurses. Physicians were more accurate than nurses. A higher accuracy of temporal physician CPS was associated with older patient age. Probabilistic CPS was significantly more accurate than temporal CPS for both physicians and nurses, although this analysis was limited by the different criteria for determining accuracy. With the probabilistic approach, nurses were significantly more accurate at predicting survival at 24 hours and 48 hours, whereas physicians were significantly more accurate at predicting survival at 6 months. The probabilistic approach was associated with high accuracy and has practical implications.
Relationship between SSR‐based Genetic Distance and Cotton F2 Hybrid Performance for Lint Yield and Fiber Properties
Authors: Zeng Linghe , Meredith William R.
Published: October 2011

Analysis of relationships between genetic distance and hybrid performance may promote utilization of exotic germplasm in hybrid production. This study was designed to determine the relationship between SSR‐based genetic distance (GD) and F2 hybrid performance in cotton (Gossypium hirsutum L.). Forty‐eight F2 hybrids derived from crosses between four elite germplasm (EL) lines and 12 exotic germplasm lines, that is, six Species Polycross (SP) germplasm lines and six John Cotton (JC) germplasm lines, were evaluated in four environments during 2008 and 2009. One hundred and fourteen primer pairs amplified 284 polymorphic fragments among the 16 parental lines. Parents divided into three groups in a dendrogram of UPGMA clusters based on pair‐wise GD among parents. The correlations between the GD and F2 performance were significant for some fiber properties, but low with the highest r value in fineness (r = –0.43). The highest correlation between GD and mid‐parent heterosis was −0.43 for short fiber content. Population differentiation (P < 0.001) was identified between the JC and EL germplasm, but not between the SP and EL germplasm. Moderate correlations with r values ranging from −0.42 to 0.62 were detected between GD and fiber properties in the JC‐derived F2 hybrids. The results suggest that prediction of F2 performance by GD may be effective when crosses are made between parents from genetically differentiated groups in cotton germplasm.
Evaluating a Germplasm Collection of the Cover Crop Hairy Vetch for Use in Sustainable Farming Systems
Authors: Maul Jude , Mirsky Steven , Emche Sarah , Devine Thomas
Published: October 2011

Understanding the association between genotype and agronomically important phenotypes (early flowering, hard seed, and winter hardiness) will facilitate cultivar selection and inform breeding programs concerned with the cover crop hairy vetch (Vicia villosa Roth). We used molecular, observational, and biochemical techniques to identify and evaluate 64 accessions of hairy vetch that originated throughout the world and comprise the USDA National Plant Germplasm System. Time to flowering, percent C, and percent N were measured on plants of each accession grown in the field at Beltsville, MD. Amplified fragment length polymorphisms were assayed on each accession. We related parameters of genetic, phenotypic, and biochemical diversity to the geographical origins of the accessions. Country of origin explained little of the marker genetic diversity in this collection. Climate factors of geographical origins, however, explained larger amounts of the marker genetic diversity observed. These results provide baseline information to identify a core genetic subset of the V. villosa germplasm collection. Information presented here may facilitate future V. villosa breeding efforts and directly assist farmers in cover crop varietal selection.
Integrating Phenotypic Evaluations with a Molecular Diversity Assessment of a Brazilian Collection of Common Bean Landraces
Authors: Burle Marília Lobo , Fonseca Jaime Roberto , José del Peloso Maria , Melo Leonardo Cunha , Temple Steve R. , Gepts Paul
Published: October 2011

Common bean (Phaseolus vulgaris L.) is the most important legume crop for direct human consumption in Brazil. Overall patterns of genetic diversity of common bean in the country are not well understood. Hence, this study sought to integrate morphological and agronomic evaluations with prior molecular diversity data from a geo‐referenced collection of Brazilian common bean. Our sample included 279 randomly chosen landrace accessions from the main growing regions of beans in Brazil. Eighteen morphological and three agronomic characters (yield and susceptibility to common bacterial blight and rust diseases) were evaluated in field conditions in Brazil or California. Results show that the sample was diverse morphologically but did not include all the morphological variability described in domesticated common bean outside Brazil. Several accessions showed clear morphological differences in spite of having the same name. The integration of the current morphological and agronomic evaluations with a prior 74‐marker diversity assessment of the same landraces improved the identification of five subpopulations identified on the basis of microsatellite diversity. These subpopulations could be distinguished by their morphology, the type and frequency of the market classes they included, and the frequency of susceptibility to diseases. This information will facilitate the management and use of P. vulgaris genetic diversity in Brazil.
Genetic Variation of High Molecular Weight Glutenin Subunits in Wheat Accessions in China
Authors: Guo Xiaomin , Li Hongqin , Xiang Jishan , Xu Xin , Liu Weihua , Gao Ainong , Yang Xinming , Wang Ruihui , Li Xiuquan , Li Lihui
Published: October 2011

The high molecular weight glutenin subunits (HMW‐GS) are essential in determining bread‐making quality, and knowing their composition can help in making appropriate decisions to improve wheat (Triticum aestivum L.) quality. The HMW‐GS compositions of 189 Chinese wheat landraces (CWLs), 61 introduced lines (ILs), and 840 Chinese improved varieties (CIVs) were investigated by sodium dodecyl sulfate‐polyacrylamide gel electrophoresis (SDS‐PAGE) in this study. The aim was to identify novel HMW‐GS alleles and to compare the genetic diversity among the three groups. A total of 31 HMW‐GS alleles and 86 allele combinations were found in all accessions. For CWL and CIV, the predominant pattern was (null, 7+8, 2+12), with a frequency of 71.6 and 26.0%, respectively. The predominant pattern in the IL was (null, 7+9, 2+12) with a frequency of 13.6%. The IL had the largest variation and the average index of genetic variation (H). The H was 0.6117, whereas CWL and CIV had H values of 0.2275 and 0.5161, respectively. In addition, the present study showed that an increase of 7+9 and 5+10 in the CIV came from the use of foreign parents. The results revealed that the IL was an important reservoir for improving Chinese wheat‐quality characteristics such as grain protein content, hardness, and sodium dodecyl sulfate (SDS) sedimentation. Although the genetic variation in the CWL was low, it contained novel alleles (1Bx7.1* and 1By8.1*), which indicated that this group was also a potential resource for wheat‐quality improvement.
Stocking Strategies as Related to Animal and Pasture Productivity of Endophyte‐Free Tall Fescue
Authors: Burns J. C. , Fisher D. S.
Published: October 2011

Tall fescue (Festuca arundinacea Schreb.) is a well adapted perennial grass used for pasture across the north–south transition zone in the United States. This 3‐yr trial evaluated three stocking strategies to utilize well‐fertilized spring (April to July) growth of endophyte‐free tall fescue for steer and pasture production. Continuous stocked (CS) was compared with a daily allowance (DA) or lax rotation (LR) (7 to 12 d). Forage mass (in kilograms per hectare) averaged 2673 for CS, 3057 at turn on and 2844 residual for DA, and 2851 at turn on and 2559 residual for the LR. Canopies were similar being mainly leaf (54.9%), followed by dead (32.6%), stem (11.9%), and head (0.5%) fractions. Steer daily gains (0.95 kg), stocking rate (6.7 steers ha−1), gain per hectare (585 kg), and effective feed units (3111 kg ha−1) were similar among stocking strategies. Canopy in vitro true organic matter disappearance (IVTOD) was similar (747 g kg−1) among treatments but differed in crude protein (CP), averaging 186 g kg−1 for CS vs. 198 g kg−1 for rotations. Furthermore, DA was less in CP than LR (189 vs. 207 g kg−1) but greater in neutral detergent fiber (NDF) (623 vs. 594 g kg−1). Diet selected was similar among treatments in IVTOD (885 g kg−1), CP (245 g kg−1), and NDF (457 g kg−1) as was daily grazing time of 11.5 h when monitored by Vibracorder or 12.3 h when monitored by computer. Well‐fertilized tall fescue pastures free of toxic endophyte can accommodate a range of stocking strategies when efficiently utilized in animal production systems.
A Method for Forage Yield and Quality Assessment of Tall Fescue Cultivars in the Spring
Authors: Cherney J. H. , Parsons D. , Cherney D. J. R.
Published: October 2011

Comparative evaluation of tall fescue (Festuca arundinacea Schreb.) cultivars for yield and quality is confounded with cultivar maturity differences if all cultivars are harvested on the same day; harvesting on different days at a similar morphological stage confounds quality with day‐to‐day environmental fluctuations. Forage grasses should be harvested at optimum fiber content for the class of livestock being fed. For lactating dairy cattle, optimum is approximately 500 g kg−1 neutral detergent fiber (NDF). Our goal was to develop a system to adjust yield and quality of each cultivar to the date of optimum NDF content for harvest. Tall fescue cultivars were sampled on five to eight dates during late spring growth for five trials in New York State. Rates of change per day for yield, NDF, and neutral detergent fiber digestibility (NDFD) were used to adjust these parameters to the date of optimum NDF content. Rates of change in yield and quality among cultivars were similar within an environment but were not similar across environments. Harvesting cultivars on a single date biased the yields of both early and late maturing cultivars. Cultivar heading dates were not well correlated with NDF or NDFD, indicating that heading date was not a useful adjustment parameter. Adjustment of yield and NDFD to the optimum spring harvest date for each cultivar in a trial significantly changed cultivar ranking. This method should be feasible for evaluating cultivars of any cool‐season grass species but requires further testing for other species.