bluuebunny/crossref_metadata_2025 huggingface dataset:
Hemolysis and hyperhomocysteinemia caused by cobalamin deficiency: three case reports and review of the literature
Authors: Acharya Utkarsh , Gau Jen-Tzer , Horvath William , Ventura Paolo , Hsueh Chung-Tsen , Carlsen Wayne
Published: December 2008

Concurrent hemolysis in patients with vitamin B12 deficiency is a well-recognized phenomenon and has been attributed to intramedullary destruction of erythrocytes (ineffective erythropoiesis). Recent studies revealed that homocysteine increased the risk of hemolysis in vitamin B12 deficiency in vitro and there is a high frequency (30%) of vitamin B12 deficiency in asymptomatic patients with homozygous methylene tetrahydrofolate reductase (MTHFR) C677T mutation, a known cause of hyperhomocysteinemia. Here we report three patients with MTHFR mutations and vitamin B12 deficiency presenting with hemolytic anemia and severely elevated homocysteine levels. Patients demonstrated complete resolution of hemolysis with simultaneous normalization of serum homocysteine levels after vitamin B12 treatments. We reviewed pertinent literature, and hypothesized that hemolytic anemia may be more prevalent in patients who have a coexisting MTHFR gene mutation and vitamin B12 deficiency possibly related to severely elevated homocysteine levels. The hemolysis in these cases occurred predominantly in peripheral blood likely due to the combined effects of structurally defective erythrocytes and homocysteine-induced endothelial damage with microangiopathy.
Increased expression of lipocalin-type prostaglandin D2synthase in osteoarthritic cartilage
Authors: Zayed Nadia , Li Xinfang , Chabane Nadir , Benderdour Mohamed , Martel-Pelletier Johanne , Pelletier Jean-Pierre , Duval Nicolas , Fahmi Hassan
Published: December 2008

Introduction

Prostaglandin D synthase (PGDS) is responsible for the biosynthesis of PGD and J series, which have been shown to exhibit anti-inflammatory and anticatabolic effects. Two isoforms have been identified: hematopoietic- and lipocalin-type PGDS (H-PGDS and L-PGDS, respectively). The aims of this study were to investigate the expressions of H-PGDS and L-PGDS in cartilage from healthy donors and from patients with osteoarthritis (OA) and to characterize their regulation by interleukin-1-beta (IL-1β) in cultured OA chondrocytes.

Methods

The expressions of H-PGDS and L-PGDS mRNA and protein in cartilage were analyzed by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) and immunohistochemistry, respectively. Chondrocytes were stimulated with IL-1β, and the expression of L-PGDS was evaluated by real-time RT-PCR and Western blotting. The roles of de novo protein synthesis and of the signalling pathways mitogen-activated protein kinases (MAPKs), nuclear factor-kappa-B (NF-κB), and Notch were evaluated using specific pharmacological inhibitors.

Results

L-PGDS and H-PGDS mRNAs were present in both healthy and OA cartilage, with higher levels of L-PGDS than H-PGDS (> 20-fold). The levels of L-PGDS mRNA and protein were increased in OA compared with healthy cartilage. Treatment of chondrocytes with IL-1β upregulated L-PGDS mRNA and protein expressions as well as PGD2 production in a dose- and time-dependent manner. The upregulation of L-PGDS by IL-1β was blocked by the translational inhibitor cycloheximide, indicating that this effect is indirect, requiring de novo protein synthesis. Specific inhibitors of the MAPK p38 (SB 203580) and c-jun N-terminal kinase (JNK) (SP600125) and of the NF-κB (SN-50) and Notch (DAPT) signalling pathways suppressed IL-1β-induced upregulation of L-PGDS expression. In contrast, an inhibitor of the extracellular signal-regulated kinase (ERK/MAPK) (PD98059) demonstrated no significant influence. We also found that PGD2 prevented IL-1β-induced upregulation of L-PGDS expression.

Conclusions

This is the first report demonstrating increased levels of L-PGDS in OA cartilage. IL-1β may be responsible for this upregulation through activation of the JNK and p38 MAPK and NF-κB signalling pathways. These data suggest that L-PGDS might have an important role in the pathophysiology of OA.
Filter survival time and requirement of blood products in patients with severe sepsis receiving drotrecogin alfa (activated) and requiring renal replacement therapy
Authors: Camporota Luigi , Corno Eleonora , Menaldo Eleonora , Smith John , Lei Katie , Beale Richard , Wyncoll Duncan
Published: December 2008

Introduction

Drotrecogin alfa (activated) (DrotAA) is licensed in the United States and the European Union for the treatment of severe sepsis with multiple organ failure. Patients with severe sepsis on renal replacement therapy (RRT), who typically receive additional anticoagulation to prevent circuit clotting, may be at higher risk of bleeding when DrotAA is administered in addition to standard anticoagulation. However, the effects of DrotAA on filter duration in the absence of additional anticoagulation have not been established. The aim of this study was to analyse the filter survival time (FST), and to quantify the requirement of packed red cells (PRC) and blood products during DrotAA infusion.

Methods

This was a single-centre, retrospective observational study conducted in an adult intensive care unit (ICU). Thirty-five patients with severe sepsis who had received both RRT and DrotAA were identified, and all relevant clinical and laboratory data were retrieved from the departmental electronic patient record. We compared haemofilter parameters, requirement of blood products and haemodynamic data recorded during RRT and the infusion of DrotAA with those recorded on RRT with standard anticoagulation after the DrotAA infusion had been completed (post-DrotAA).

Results

The proportion of filter changes due to filter clotting was similar during DrotAA infusion and with conventional anticoagulation post-DrotAA infusion. There was no difference in the FST and filter parameters during DrotAA in the presence or absence of additional anticoagulation with heparin or epoprostenol. A similar proportion of patients required red cell transfusion, although a greater proportion of patients received platelet and fresh frozen plasma during DrotAA infusion compared with the post-DrotAA period with no difference between medical and surgical patients.

Conclusions

Additional anticoagulation during DrotAA infusion does not appear to improve FST. The use of DrotAA in patients with severe sepsis requiring RRT is safe and is not associated with an increased need for PRC transfusion or major bleeding events.
Antimicrobial properties of melanocortins: comment to the manuscript “Anti-Candidaactivity of α-melanocyte-stimulating hormone (α-MSH) peptides” by Isabella Rauch et al.
Authors: Catania Anna , Lipton James M
Published: December 2008

In their report, Rauch et al. did not find candidacidal activity of α-melanocyte-stimulating hormone (α-MSH) in Sabouraud dextrose broth. The lack of killing activity by the natural α-MSH in broth medium may occur because of accelerated Candida replication or peptide degradation by fungal enzymes. It should be considered that in physiological conditions, there is sustained peptide release by host cells in an autocrine/paracrine manner. However, when the procedure described in the paper published in the Journal Leukocyte Biology was used, the investigation by Rauch et al. found that concentrations of α-MSH in the high micromolar range have candidacidal activity.
Dyskeratosis congenita mutations in the H/ACA domain of human telomerase RNA affect its assembly into a pre-RNP
Authors: Trahan Christian , Dragon François
Published: December 2008

Dyskeratosis congenita (DC) is an inherited disorder that implicates defects in the biology of telomeres, which are maintained by telomerase, a ribonucleoprotein with reverse transcriptase activity. Like all H/ACA RNAs, the H/ACA domain of nascent human telomerase RNA (hTR) forms a pre-RNP with H/ACA proteins NAF1, dyskerin, NOP10, and NHP2 in vivo. To assess the pre-RNP assembly of hTR mutants that poorly accumulate in vivo, we developed an in vitro system that uses components of human origin. Pre-RNPs were reconstituted with synthetic32P-labeled RNAs and35S-labeled proteins produced in rabbit reticulocyte lysate, and immunoprecipitations were carried out to analyze RNP formation. We show that human NAF1 cannot bind directly to the H/ACA domain of hTR, and requires the core trimer dyskerin-NOP10-NHP2 to be efficiently incorporated into the pre-RNP. This order of assembly seems common to H/ACA RNAs since it was observed with snoRNA ACA36 and scaRNA U92, which are predicted to guide pseudouridylation of 18S rRNA and U2 snRNA, respectively. However, the processing H/ACA snoRNA U17 did not conform to this rule, as NAF1 alone was able to bind it. We also provide the first evidence that DC-related mutations of hTR C408G and Δ378-451 severely impair pre-RNP assembly. Integrity of boxes H and ACA of hTR are also crucial for pre-RNP assembly, while the CAB box is dispensable. Our results offer new insights into the defects caused by some mutations located in the H/ACA domain of hTR.
Networking as a job search behaviour: A social network perspective
Authors: Van Hoye Greet , van Hooft Edwin A. J. , Lievens Filip
Published: December 2008

Although networking is typically recommended as a job search strategy in the popular press, research on networking as a job search behaviour is scarce. On the basis of social network theory, the present study investigated whether the structure and composition of job seekers' social network determined their networking behaviour and moderated its relationship with job search and employment outcomes. The data were collected in a large, representative sample of 1,177 unemployed Flemish job seekers, using a two‐wave longitudinal design. Job seekers with a larger social network and with stronger ties in their network spent more time networking, beyond individual differences in extraversion and conscientiousness. Networking explained incremental variance in job offers beyond job seekers' use of print advertising, the internet, and public employment services, but not in employment outcomes. Some evidence was found indicating that networking might be more effective for job seekers whose social network contains weaker and higher‐status ties.
Delayed Ettringite Formation (DEF) Within Pre-Cast Concrete Cladding Panels on a Mid-Rise Commercial Office Building: A Case Study
Authors: French Warren R. , Schroeder Joshua S.
Published: December 2008

This paper will present the findings of multiple forensic investigations on a fourteen-story office building located in Houston, Texas. During our initial survey, widespread cracking was observed within the concrete cladding panels that warranted a more extensive investigation. Construction of the building was completed in 1985; 17 years prior to our initial investigation. Exterior cladding components are comprised of pre-cast concrete panels over each of the floor lines, with a continuous, structurally glazed, horizontal window system at each floor level. The cladding panels are nonload bearing, pre-cast concrete panels, installed at the time of the building’s construction. The concrete panels are attached to the structure via steel plates that are welded and bolted to the building’s frame. It is intended that this paper will present the results of observations made at the site over a period of several years, as well as the results of testing conducted to assist in the evaluation. A system was developed to locate and catalog the visible anomalies on the panels; including cracks, exposed steel, spalls, pop-outs, and efflorescence on the panels. Full-depth cores were removed from select panels to perform a petrographic analysis and scanning electron microscopy/energy dispersive x-ray microanalysis (SEM/EDXA). The results revealed the presence of delayed ettringite formation (DEF) and alkali-silica reactivity (ASR), with varying degrees of severity. Specific conclusions will be derived related to the conditions at this project and how these anomalies have affected the cladding system performance. Current repair and maintenance provisions will be discussed, in addition to the necessary recladding that will be required in the future. Recommendations will be developed regarding construction practices so that the cladding panel failure observed may be avoided in the future.
Sharing Data and Results with Study Participants: Report on a Survey of Cultural Anthropologists
Authors: Cooper Matthew
Published: December 2008

A first-ever survey of cultural anthropologists was conducted concerning the sharing of data, interpretations, and results with study participants. Briefly summarized, the study showed that almost all of the survey respondents had shared data or results with participants and almost all found this to be a positive experience. They had carried out research in many countries, some over long periods of time, and many had completed several field projects. Most believe that researchers, either alone or in consultation with participants and their groups, should decide whether, when, and what to share. Anthropologists find that sharing produces many benefits, for themselves as individuals and as researchers, for individual participants, and for the communities, groups, or institutions to which the latter belong. The perceived harms that might result from sharing have to do particularly with potential threats to privacy, confidentiality or anonymity, as well as the possibilities of social conflict and oppression. Thus, researchers have serious concerns about the sharing of certain kinds of data that might lead to such consequences. While many or most respondents think that sharing is the ethically proper course of action, they are very aware of the complexities of particular situations and the need for nuanced decision making. Most think that the researcher should play a major role in deciding whether sharing should take place and what should be shared. Hence, for these cultural anthropologists, in the end, sharing requires trying to balance the good of sharing with the good of doing no harm to those with whom they have done research.
International Analysis of Institutional Review Boards Registered with the U.S. Office for Human Research Protections
Authors: Bartlett Edward E.
Published: December 2008

Institutional review boards form the backbone of the human subject protection system. Yet little is known about the characteristics of these committees. This study compiles and analyzes the data on 1,326 IRBs in 113 countries registered with the Office for Human Research Protections. The study analyzes data on the following IRB characteristics: Institutional affiliation, number of full-time administrative positions, approximate total number of protocols, and number of currently active protocols supported by DHHS or regulated by the Food and Drug Administration. The analysis found that the most common IRB profile is to be affiliated with a clinical organization (41.9% of IRBs) and to have one full-time staff member (40.0%). Regarding protocol volume, the most common IRB profile was to have 26–99 currently active protocols (42.0% of IRBs), to have 1–25 DHHS protocols (46.6%), and 1–25 FDA-regulated protocols (45.6%). Further analyses reveal considerable differences among countries. This study can provide a baseline for future IRB evaluations.
Partnering for Care in HIV Prevention Trials
Authors: MacQueen Kathleen M. , McLoughlin Kerry , Alleman Patty , Burke Holly McClain , Mack Natasha
Published: December 2008

Qualitative case studies were conducted at seven international sites conducting HIV prevention research in Africa, Asia, and the Americas to identify strategies for ensuring that health needs of research participants identified in the course of research are adequately addressed. Key factors were identified that contribute to the balance between direct care and healthcare referrals at a research site, as well as the overall quality of the healthcare made available to research participants. The case studies exemplify the concept of “moral negotiation” in research (Weijer & LeBlanc, 2006), that is, a process where researchers and sponsors negotiate with increasingly empowered local communities and host countries to achieve meaningful and substantive benefits from biomedical research for all stakeholders.
Adverse effects of nonsteroidal antiiflammatory drugs in the lower gastrointestinal tract
Authors: Angi Andrea , Lakatos László
Published: December 2008

A nemszteroid gyulladásgátlók (NSAID) az egyik legszélesebb körben alkalmazott gyógyszercsoport világszerte. Számos jótékony hatásuk mellett az évtizedek során kedvezőtlen mellékhatásaik is kiderültek. Az NSAID-ek károsíthatják a tápcsatorna bármely szakaszát. Korábban alsó tápcsatornai mellékhatásaikat kisebb jelentőségűnek gondolták, egyre több megfigyelés igazolja azonban, hogy legalább olyan mértékben károsítják az alsó tápcsatornát, mint a felsőt, csupán a diagnosztikai lehetőségek korlátozottabbak. Az NSAID-ek károsíthatják az ép nyálkahártyát, de meglévő bélbetegség fellángolását is okozhatják. Alsó tápcsatornai mellékhatásokat elsősorban a duális (COX-1- és COX-2-) gátlók idéznek elő. A patomechanizmusban a ciklooxigenáz-gátlás mellett fontos a helyi hatás, amely az epithelsejt sérülésével megindítja a további károsodás láncreakcióját (permeabilitás növekedése, luminalis faktorok beáramlása, gyulladásos mediátorok termelődése stb.). A tanulmányban a szerzők a legújabb irodalmi adatok alapján tárgyalják a jelentősebb alsó tápcsatornai NSAID-mellékhatásokat, valamint a jelenleg rendelkezésre álló prevenciós és terápiás lehetőségeket.
Removal of Black Drum on Louisiana Reefs to Increase Survival of Eastern Oysters Crassostrea virginica
Authors: George Gerald J. , Brown Kenneth M. , Peterson Gary W. , Thompson Bruce A.
Published: December 2008

Black drum Pogonias cromis are large, molluscivorous fish that severely limit the abundance of eastern oysters Crassostrea virginica in the northern Gulf of Mexico. In field experiments, we tested two fish removal methods—baited trot lines and gill nets—near commercial oyster leases to determine whether the removal of black drum would increase eastern oyster survival. Both methods removed fish and increased oyster survival in the spring but not in the fall, when little mortality occurred. The numbers and biomass of black drum caught varied with gear type: 10-cm (bar mesh) gill nets landed the most fish, while trot lines and 10-cm gill nets were equally effective in landing the greatest biomass. Eastern oysters were more common in the diet of black drum in the spring than in the fall and increased in importance with fish size. Fish of 70–75 cm (standard length) had the greatest impact on oyster production. These fish can be removed most effectively with 12.5-cm gill nets, though trot lines are preferable because they require less effort and produce less bycatch. The removal techniques used here may also be successful in aiding other bivalve fisheries suffering from predation.
Transportation of Steelhead Kelts to Increase Iteroparity in the Columbia and Snake Rivers
Authors: Evans Allen F. , Wertheimer Robert H. , Keefer Matthew L. , Boggs Charles T. , Peery Christopher A. , Collis Ken
Published: December 2008

We tested the feasibility of transporting steelhead Oncorhynchus mykiss kelts (postspawned adults) around hydroelectric dams on the Snake and Columbia rivers to increase the returns of repeat spawners. Altogether, 5,878 kelts were collected, tagged with passive integrated transponder tags, and assigned to transported or in-river treatment groups at Lower Granite Dam (n = 5,320 [2002–2004]) on the Snake River and John Day Dam (n = 558 [2002]) on the Columbia River. Returns of repeat spawners differed by site and year: 11.1% (62/558) for the John Day Dam sample and 1.4% (27/1,959), 0.5% (6/1,241), and 0.8% (17/2,120) for the Lower Granite Dam samples in 2002, 2003, and 2004, respectively. Transportation tests indicated that kelts transported from the Snake River were approximately 2.3 times more likely to return than fish allowed to migrate in-river. Transport benefits were greatest for wild-origin female kelts, a demographic with high conservation value. There was no significant benefit for kelts transported from John Day Dam, although transported fish returned at a slighter higher rate (1.1 times). Comparisons between treatment groups (in-river versus transport) and locations (Snake River versus Columbia River) indicated that the greatest potential transport benefit may be for Snake River kelts owing to the population's low overall iteroparity rate and numerous potential kelt collection sites. The small sample sizes of returning fish limited our ability to examine more complex trends and environmental effects on return rates. Additional research is needed to fully evaluate the efficacy of kelt transportation in the context of regional steelhead recovery efforts.
Familial cerebral cavernous malformations: Rio de Janeiro study and review of the recommendations for management
Authors: Domingues Flávio , Gasparetto Emerson L. , Andrade Ricardo , Noro Fabio , Eiras Antônio , Gault Judith , Correia Carlos Eduardo Silva , Souza Jorge Marcondes de
Published: December 2008

OBJECTIVE: Multiple cerebral cavernous malformation (CCM) is the hallmark of familial presentation of cavernous malformation in the brain. We describe an ongoing Familial Cerebral Cavernous Malformation Project in the Rio de Janeiro state showing genetic profile and the pattern of emergent neuroimaging findings of this particular population besides a review of the updated recommendations for management of familial CCM versus patients harboring sporadic lesions. METHOD: Four families of our cohort of 9 families were genetically mapped showing mutational profile linked to CCM1. The neuroimaging paradigm was shifted from T2*gradient-echo (GRE) sequence to susceptibility weighting MR phase imaging (SWI). RESULTS: Only two index cases were subjected to surgery. There was no surgical intervention in any of the kindreds of our entire cohort of 9 families of our Neurovascular Program within seven years of follow-up. The genetic sequencing for mutacional profile in four of these families has demonstrated only CCM1 gene affected. Our management of the familial CCM is according to the review of the literature recommendations. CONCLUSIONS: The Project of Familial Cerebral Cavernous Malformations of Rio de Janeiro detected mutations of the gene CCM1 in the first four families studied. Familial cavernous malformation are to be settled apart from the more common sporadic lesion. A set of recommendations was searched for in the literature in order to deal with these specific patients and kindreds.
Clinical features of dystonia in atypical parkinsonism
Authors: Godeiro-Junior Clecio , Felício Andre C. , Barsottini Orlando G.P. , Aguiar Patricia M. de Carvalho , Silva Sonia M.A. , Borges Vanderci , Ferraz Henrique B.
Published: December 2008

BACKGROUND: The association between Dystonia and Parkinson's disease (PD) has been well described especially for foot and hand dystonia. There is however few data on dystonic postures in patients with atypical parkinsonism. OBJECTIVE: To evaluate the frequency and pattern of dystonia in a group of patients with atypical parkinsonism (multiple system atrophy - MSA, progressive supranuclear palsy - PSP, and corticobasal degeneration - CBD) and to investigate whether dystonia could be the first presenting symptom at disease onset in those patients. METHOD: A total of 38 medical charts were reviewed (n=23/MSA group; n=7/CBD group; n=8/PSP group) and data values were described as means/standard deviations. The variables evaluated were sex, age at onset, disease duration, first symptom, clinical features of dystonia and other neurological signs, response to levodopatherapy, Hoehn&Yahr scale >3 after three years of disease, and magnetic resonance imaging findings. RESULTS: The overall frequency of dystonia in our sample was 50% with 30.4% (n=7) in the MSA group, 62.5% (n=5) in the PSP group, and 100% (n=8) in the CBD group. In none of these patients, dystonia was the first complaint. Several types of dystonia were found: camptocormia, retrocollis, anterocollis, blepharoespasm, oromandibular, and foot/hand dystonia. CONCLUSION: In our series, dystonia was a common feature in atypical parkinsonism (overall frequency of 50%) and it was part of the natural history although not the first symptom at disease onset. Neuroimaging abnormalities are not necessarily related to focal dystonia, and levodopa therapy did not influence the pattern of dystonia in our group of patients.
Head tremor in patients with cervical dystonia: different outcome?
Authors: Godeiro-Junior Clecio , Felicio Andre C. , Aguiar Patricia C. , Borges Vanderci , Silva Sonia M.A. , Ferraz Henrique B.
Published: December 2008

OBJECTIVE: The association of cervical dystonia (CD) with other movement disorders have been already described, but data on clinical outcome regarding these patients are scant. The aim of this paper was to investigate whether patients with CD and head tremor (HT) would have a different outcome regarding to botulinum toxin type-A (BTX-A) treatment response and clinical and demographic parameters. METHOD: We retrospectively evaluated 118 medical charts of patients with CD and divided them into two groups: with (HT+) and without (HT-) head tremor. We compared the following clinical and demographic parameters: age at onset, disease duration, progression of symptoms, etiology, familial history, presence of hand tremor. We also analyzed the response to BTX-A according to Tsui score in both groups. RESULTS: The occurrence of head tremor in our sample was of 38.2%. The occurrence of postural hand tremor in the patients from the HT+ group was higher than in the HT- one (p=0.015) and if we compare BTX-A response in each group, we observe that patients with HT present a better outcome in a setting of longer follow-up. In HT+ group, Tsui score pre treatment was 10 (6-12.5) and after follow-up was 8 (5.5-10.5); p<0.001. In HT- group there was no significant difference 9 (7-12) in pre treatment and after follow-up; p=0.07. CONCLUSION: According to our data it seems that head tremor may influence the clinical outcome or treatment response with BTX-A in patients with CD.
Impact of cognitive performance on the functional capacity of an elderly population in Natal, Brazil
Authors: Castro Keithlen Cruz Moreira de , Guerra Ricardo Oliveira
Published: December 2008

Functional incapacity and cognitive impairment are conditions related to the process of human aging. Cognitive impairment is considered an important predicitve factor for functional impairment in elderly populations. This cross-sectional study analyzes the association between cognitive performance and functional capacity in an elderly population sample in Natal, Brazil. A total of 213 elderly persons were assessed by the BOAS Multidimensional Questionnaire (Brazil Old Age Schedule) and the Mini-Mental State Examination (MMSE). The results of multivariate analysis and linear regression showed that age and schooling level are factors associated with cognitive performance in the elderly of this study. The final explicative model, elaborated by logistic regression, found that cognitive performance was the only predicitve variable of functional incapacity for the activities of daily living even when adjusted for sociodemographic variables.
Quality of life and sleep impairment in chronic cocaine dependents
Authors: Lima Adriana , Rossini Sueli , Reimão Rubens
Published: December 2008

OBJECTIVE: To evaluate quality of life (QL) and sleep quality impairment of cocaine chronic dependents in use of cocaine. METHOD: 40 patients, chronic cocaine dependents were evaluated (37 M; 3 F), with mean age of 28.92 years, along with 40 controls paired for gender and age. The following instruments were used: a) the semi-structured clinical interview; b) the Brazil Economic Classification; c) the Pittsburgh Sleep Quality Index; d) World Heath Organization Quality of Life-BREF (WHOQOL-BREF). RESULTS: The cocaine dependents showed QL impairment, with deficits in the physical, psychological and social relations domains. Impaired sleep quality was also observed in the cocaine dependents. However, the QL impairment was not directly due to sleep deficit. CONCLUSION: Chronic cocaine dependents showed impairment in QL and sleep impairment. However, for the cocaine dependent group, sleep impairment was not regarded as compromising QL probably because cocaine, rather than sleep, was the main factor negatively influencing QL.
Interferência do intervalo de administração da droga sobre a nefrotoxicidade da gentamicina em ratos
Authors: Oliveira Verônica Cunha Rodrigues , Tejos Carla Roberta , Hosaka Elisabeth Mie , Andrade Sara Cogo , Araújo Magali , Vattimo Maria de Fátima Fernandes
Published: December 2008

A insuficiência renal aguda (IRA) que apresenta índice de mortalidade em torno de 50%, pode ser definida como um abrupto declínio da filtração glomerular, resultante de isquemia ou toxicidade. A nefrotoxicidade por drogas é uma das etiologias mais freqüentes (27%) e sugere-se que o intervalo de administração da droga pode interferir neste efeito colateral, entretanto o melhor regime de administração ainda não está bem estabelecido. Este conhecimento proporcionaria uma atuação mais direcionada de enfermagem na prevenção desta IRA hospitalar. Os resultados obtidos nesta pesquisa, indicam que a infusão única de gentamicina determina menor nefrotoxicidade, provavelmente devido à redução da sua concentração plasmática nas 24hs, diminuindo o acúmulo intracelular deste fármaco, um dos principais mecanismos celulares deste tipo de lesão. Este regime de tratamento mostra portanto vantagens quanto ao custo, efeito nefrotóxico e segurança quanto à eficácia terapêutica.
Utilização do brinquedo terapêutico, como um instrumento de intervenção de enfermagem, no preparo de crianças submetidas a coleta de sangue
Authors: Ribeiro Patrícia de Jesus , Sabatés Ana Llonch , Ribeiro Circéa Amalia
Published: December 2008

O estudo é um quase-experimento, que teve como objetivo verificar o efeito da aplicação do Brinquedo Terapêutico sobre o comportamento de crianças pré-escolares, durante a coleta de sangue para exames laboratoriais. A amostra constituiu-se de 42 crianças divididas nos grupos controle e experimental. Todas as crianças tiveram seu comportamento observado, sendo apenas as do grupo experimental preparadas com o uso do Brinquedo Terapêutico. Os resultados foram analisados comparando-se o comportamento das crianças dos dois grupos e demonstraram que o preparo com o Brinquedo Terapêutico foi eficaz na compreensão do procedimento e no controle de suas reações comportamentais.
Conhecimento do cliente diabético em relação os cuidados com os pés
Authors: Barbui Elaine Cristina , Cocco Maria Inês Monteiro
Published: December 2008

Esta pesquisa tem por objetivo avaliar o conhecimento dos clientes que freqüentam um Ambulatório de Diabetes, em relação à sua doença e cuidados com os pés. Na amostra estudada - diabéticos tipo 2 - houve predominância da faixa etária acima de cinqüenta anos e 71,8% tinham diabetes há menos de dez anos. Concluiu-se que os clientes sabem que os cuidados adequados com os pés são necessários para evitar as complicações, porém o autocuidado não é realizado corretamente. Para que isso seja incorporado em seu cotidiano, é fundamental que tenham acesso às informações sobre diabetes, participação da família, além de habilidade e motivação.
Tratamento cirúrgico do ameloblastoma com reconstrução de mandíbula com enxerto de crista ilíaca não vascularizado: estudo de sete casos
Authors: Lunardi Daniela Venturoli , Fava Antonio Sérgio , Martins Rui Henriques , Homem Maria da Graça Naclério , Rapoport Abrão , Carvalho Marcos Brasilino de
Published: December 2008

OBJETIVO: Determinar a validade do enxerto autólogo de crista ilíaca não vascularizado no tratamento cirúrgico do ameloblastoma de mandíbula. MÉTODO: Nos Serviços de Cirurgia de Cabeça e Pescoço e Semiologia Bucal do Complexo Hospitalar Heliópolis, de 1980 a 2000, foram tratados 31 pacientes com ameloblastoma de mandíbula, dos quais sete receberam enxerto de crista ilíaca autólogo, fixos com placa de titânio do sistema A-0 (quatro casos) e aço inox (três casos), sendo portadores da variedade folicular (seis casos) e plexiforme (um caso). RESULTADOS: Nesta análise, foi utilizado o Teste de Hipótese para a média populacional com a variança desconhecida, houve exposição da placa em três casos (40%) quando a neoplasia ultrapassava a linha média e em quatro casos (60%) não incidiu nenhuma complicação. CONCLUSÕES: Apesar da incidência de exposição de placa, o método é indicado na reconstrução da mandíbula de pacientes com ameloblastoma.
Controle de infecção em cirurgia geral: resultado de um estudo prospectivo de 23 anos e 42.274 cirurgias
Authors: Ferraz Edmundo Machado , Ferraz Álvaro Antônio Bandeira , Bacelar Tércio Souto , D'Albuquerque Helena Suely T. , Vasconcelos Maria das Dores Maia M. , Leão Cristiano Souza
Published: December 2008

OBJETIVO: O objetivo deste trabalho foi de avaliar uma metodologia simples adotada há 23 anos em um hospital público universitário no controle das infecções pós-cirúrgicas. MÉTODO: A casuística estudada compreende um total de 42.274 cirurgias realizadas no Serviço de Cirurgia Geral do Hospital das Clínicas da Universidade Federal de Pernambuco (UFPE) (janeiro de 1977 a dezembro de 1999). Os dados foram obtidos através um sistema de busca ativa de infecção e de um sistema de vigilância epidemiológica de seguimento pós-operatório, no ambulatório de egressos. A Comissão de Controle de Infecção Hospitalar (CCIH) do Hospital das Clínicas (HC) da UFPE concentrou sua atuação na prevenção, dando ênfase ao: diagnóstico preciso dos casos de infecção; higiene corporal; controle das afecções associadas; internamento pré-operatório; cuidados com tricotomia; anti-sepsia e assepsia; técnica cirúrgica adequada; divulgação dos resultados e da relação infecção/cirurgião/anestesista e rigoroso controle de antimicrobianos. RESULTADOS: A taxa de infecção de ferida passou de índices em torno de 15-20% para os atuais 7,7%. A infecção urinária foi reduzida de 18,2% para 0,4%, e a infecção respiratória de 22,9% para 2,7%. A mortalidade em decorrência de infecção foi reduzida de 2,8% para os atuais 0,9% e a taxa de infecção de ferida em cirurgia limpa de 12,8% para 3,4%. Na cirurgia ambulatorial, das 27.580 operações a taxa de infecção de ferida foi de 0,4% e a mortalidade de 0,007%. CONCLUSÃO: O que tentamos comprovar com a divulgação de nossos resultados é que controle de infecção se faz com decisão política, força de vontade e motivação em controlar o problema da infecção hospitalar.
Impacto prognóstico da recorrência local em pacientes com câncer inicial de mama submetidas a tratamento conservador
Authors: Tiezzi Daniel Guimarães , Andrade Jurandyr Moreira de , Reis Francisco Jose Candido dos , Deriggi Danilo Jorge Pinho , Zola Fabio Eduardo , Marana Heitor Ricardo Cosiski
Published: December 2008

OBJETIVO: investigar o impacto da recorrência local no prognóstico de pacientes com câncer de mama em estágio inicial tratado com cirurgia conservadora. MÉTODO: foi realizado estudo de coorte retrospectivo incluindo 192 pacientes com câncer de mama em estágio inicial submetidas a tratamento conservador. Utilizando critérios clínicos e patológicos (tempo para recorrência, local da recorrência e tipo histológico) classificamos as pacientes em três grupos. O grupo de recorrência local verdadeira (RLV), o grupo de novo tumor primário (NP) e o grupo livre de recorrência local (LRL). Foi comparada a evolução entre os diferentes grupos. RESULTADOS: menor idade e uma maior proporção de pacientes na pré-menopausa foram observas no grupo NP. A presença de RLV foi o mais importante fator prognóstico sendo que 40% das pacientes deste grupo desenvolveram doença metastática sincrônica à recorrência local. Doença metastática ocorreu em 28,5% e 4,7% nos grupos NP e LRL, respectivamente (p< 0,0001). A taxa de sobrevida global em cinco anos foi de 75% no grupo RLV, 100% no grupo NP e 98,2% no grupo LRL (p< 0,0001). Tipo histológico, margens cirúrgicas, metástase em linfonodos axilares e expressão de receptores hormonais não foram preditores de recorrência local. Pacientes que não foram submetidas a hormonioterapia adjuvante e a idade foram os mais importantes fatores preditores de recorrência local. CONCLUSÃO: recorrência local verdadeira é um fator prognóstico em pacientes com câncer de mama inicial tratado com cirurgia conservadora. A idade é o mais importante fator na recorrência local neste grupo de pacientes. O alto risco recorrência local nestas pacientes é um fator limitante da cirurgia conservadora.
Esofagojejunostomia após gastrectomia total: anastomose mecânica ou manual?
Authors: Lopes Fábio , Reis André Fonseca dos , Côrtes Bruno Juste Werneck , Fabrini Dreyfus Silva , Lima Henrique Ribeiro , Rocha Luiz Carlos Gomes
Published: December 2008

OBJETIVO: Os autores apresentam um estudo observacional, transversal, comparando a anastomose manual com a anastomose mecânica para reconstrução do trânsito digestivo em Y de Roux em pacientes submetidos à gastrectomia total para câncer gástrico. MÉTODOS: O estudo foi realizado no Hospital Governador Israel Pinheiro, no período de janeiro de 1997 a março de 2002. Um total de 40 pacientes neste período foram submetidos à gastrectomia total com reconstrução em Y de Roux. O Grupo I formado por 16 pacientes foi submetido à anastomose mecânica e o grupo II por 24 pacientes foi submetido à anastomose manual. Os dois grupos foram comparados quanto à incidência de complicações pós-operatórias, necessidade de re-operação, alta hospitalar e mortalidade per e pós-operatória. RESULTADOS: Quanto às complicações relacionadas à anastomose, fístula e abscesso intra-abdominal, elas ocorreram em nove pacientes do grupo com anastomose manual e em nenhum paciente no grupo com anastomose mecânica. (p= 0,006). A morbidade e a permanência hospitalar pós-operatória foram maiores no grupo submetido à sutura manual. Houve um óbito em cada grupo e 37% dos pacientes em cada grupo não apresentaram quaisquer tipos de complicações. CONCLUSÃO: Considerando a fístula e o abscesso intra-abdominal juntamente como complicações da anastomose esôfago-jejunal, os resultados deste estudo sugerem uma maior viabilidade da sutura mecânica.
Pesquisa nacional sobre condutas na pancreatite aguda
Authors: De Campos Tércio , Parreira José Gustavo , Utiyama Edivaldo , Rasslan Samir
Published: December 2008

OBJETIVO: Avaliar como a pancreatite aguda é vista e tratada pelo cirurgião brasileiro. MÉTODO: Trata-se de um questionário prospectivo enviado aos membros do Colégio Brasileiro de Cirurgiões (CBC). Dois mil questionários foram enviados obtendo-se 618 respostas (30,9%). O questionário constituía de perguntas relacionadas à experiência do cirurgião e ao tratamento da PA. RESULTADOS: Cento e oitente e dois entrevistados (33,6%) disseram tratar até cinco casos por ano e 147 (27,2%) tratam de seis a 10 casos por ano. Dentre os critérios utilizados para a definição de PA, o mais citado foi a avaliação clínica por 306 (57,4%) entrevistados, seguido dos critérios de Ranson por 294 (55,2%) e TC por 262 (49,2%). Com relação ao uso da TC, 275 (51,5%) entrevistados responderam que realizam a TC em todos os doentes com PA. O suporte nutricional parenteral foi o método de escolha indicado por 248 (46,6%) entrevistados. A infecção da coleção e/ou necrose pancreática é a principal indicação operatória com 447 (83,6%) respostas. O melhor período para operar um doente com PA grave foi considerado até quatorze dias por 278 (54,2%) entrevistados. Com relação aos antibióticos, 371 (68,6%) entrevistados disseram que utilizam antibióticos no tratamento da PA grave. CONCLUSÃO: Estes resultados demonstram uma ampla variação no tratamento da PA no Brasil. A pouca experiência dos cirurgiões e os temas controversos são os fatores principais responsável para esta falta de padronização. A realização de um Consenso nacional baseado nos novos conceitos e na experiência mundial é crucial para ajustar estas condutas.
Gramsci e Althusser como críticos de Maquiavel
Authors: Martuscelli Danilo Enrico
Published: December 2008

O artigo compara as análises de Antonio Gramsci e Louis Althusser a partir de um objeto de reflexão comum - o pensamento de Nicolau Maquiavel - e, a partir disso, apresenta a teoria da história implícita em cada um. Para cumprir esse objetivo, fazemos a análise em três partes: 1) apresentamos os elementos que conferem unidade às análises de Maquiavel feitas por Gramsci e Althusser, discutindo também suas interpretações da obra maquiavélica; 2) apresentamos os elementos de ruptura entre as análises de Gramsci e de Althusser e, por fim, 3) na tentativa de apresentar uma visão global da relação entre Althusser e Gramsci como críticos do pensamento de Maquiavel, indicamos o que diferencia esses autores em termos de teoria da história. Enquanto Maquiavel possuía uma visão cíclica da história, por acreditar em uma determinada natureza humana, Gramsci recusava qualquer tipo de natureza inata, embora possuísse uma visão teleológica da história, e Althusser, concordando com Gramsci quanto à ausência de uma natureza humana inata, discordava deste último quanto à concepção teleológica, preferindo uma concepção pluricausal, enraizada na concepção de coexistência de modos de produção e na coexistência de mais de duas classes sociais.
Atores sociais em espaços de ampliação da democracia: as redes sociais em perspectiva
Authors: Moura Joana Tereza Vaz de , Silva Marcelo Kunrath
Published: December 2008

O Brasil assistiu, ao longo das décadas de 1980 e 1990, à proliferação de fóruns, conselhos, comitês e parcerias que instituíram, nos diversos níveis de governo e nas mais variadas áreas de atuação do Estado, canais institucionais abertos para a expressão política de atores e segmentos da sociedade civil. Entretanto, a literatura que analisa esse processo tem, em grande medida, adotado uma visão dicotômica e normativa da sociedade civil. Observa-se a necessidade de ruptura com uma apreensão estática e substancialista da sociedade civil, a partir da adoção de um enfoque processual e relacional que permita analisar o processo de construção dos atores sociais na sua relação com outros atores e instituições (em especial, com o campo político-institucional). Assim, este é um trabalho de proposição teórico-metodológica e não de apresentação de resultados de pesquisa, tendo como objetivo problematizar a literatura que trabalha com uma abordagem normativa e estilizada da sociedade civil e propor a incorporação da abordagem das redes de políticas à discussão e análise dos processos de formação e atuação dos atores da sociedade civil e, mais especificamente, de como esses processos relacionam-se com os espaços institucionais de participação. Como instrumento de operacionalização metodológica da abordagem das redes de políticas, propõe-se o emprego da análise de redes sociais, para apreender o processo de construção e atuação dos atores sociais a partir de seu pertencimento a um espaço relacional e dinâmico, no qual se inserem atores com distintas vinculações institucionais (sociedade civil, Estado, mercado).
O sujeito cerebral e o movimento da neurodiversidade
Authors: Ortega Francisco
Published: December 2008

Este artigo analisa o movimento da neurodiversidade organizado basicamente por autistas chamados de alto funcionamento que consideram que o autismo não é uma doença a ser tratada, mas uma diferença humana, a qual deve ser respeitada como outras diferenças. O movimento da "neurodiversidade" deve ser inserido em um marco sociocultural e histórico mais amplo que incorpore o impacto crescente no imaginário cultural dos saberes e das práticas neurocientíficas com o paradigma do sujeito cerebral e a expansão da neurocultura. No contexto do sujeito cerebral, o cérebro responde por tudo o que outrora costumávamos atribuir à pessoa e vem se tornando um critério biossocial de agrupamento fundamental. O artigo mostra como uma ideologia solipsista, reducionista e cientificista - o sujeito cerebral - pode servir de base para a formação de identidade e de redes de sociabilidade e comunidade.
Vinculação determinística de Bancos de Dados sobre mortalidade por Aids
Authors: Bronhara Bruna , Conde Wolney Lisboa , Liciardi Daniele Carli , França-Junior Ivan
Published: December 2008

A vinculação determinística de bancos de dados sobre mortalidade por aids tem apresentado problemas causados por falhas nos arquivos. Assim, os objetivos deste estudo foram: avaliar o desempenho da vinculação determinística em bancos de óbito por aids do Programa de Aprimoramento das Informações de Mortalidade no Município de São Paulo (PRO-AIM) e da Fundação SEADE entre os anos de 2000 e 2004 e estimar a cobertura de cada banco. Utilizou-se a rotina merge de um software para vincular os bancos. A primeira etapa pareou os registros automaticamente e, na segunda etapa, cada banco foi conferido para localizar novos pares. Estimaram-se os óbitos pela soma entre casos pareados e não pareados para calcular a cobertura dos bancos. A primeira etapa da vinculação identificou 91,6% dos pares. A segunda etapa adicionou 457 pares. O total de óbitos foi estimado em 5.855, com cobertura de 97,1% do PRO-AIM e 96% do SEADE. O uso da vinculação determinística cobriu grande parte dos casos. O banco do PRO-AIM proporcionou a maior cobertura, com maior quantidade de informações completas e melhor localização geográfica dos casos.
The expression of vulnerability through infant mortality in the municipality of Embu
Authors: Ventura Renato Nabas , Puccini Rosana Fiorini , Silva Nilza Nunes da , Silva Edina Mariko Koga da , Oliveira Eleonora Menicucci de
Published: December 2008

CONTEXT AND OBJECTIVE: Infant mortality expresses a set of living, working and healthcare access conditions and opens up possibilities for adopting interventions to expand equity in healthcare. This study aimed to investigate vulnerability and the consequent differences in access to health services and occurrences of deaths among infants under one year of age in the municipality of Embu. DESIGN AND SETTING: This was a descriptive study in the municipality of Embu. METHODS: Primary data were collected through interviews with the families of children living in the municipality of Embu who died in the years 1996 and 1997 before reaching one year of age. Secondary data were obtained from death certificates. The variables collected related to living conditions, income, occupation, prenatal care, delivery and the healthcare provided for children. These data were compared with the results obtained from a study carried out in 1996. RESULTS: Statistically significant differences were found with regard to income, working without a formal employment contract and access to private health plans among the families of the children who died. There were also differences in access to and quality of prenatal care, frequency of low birth weight and neonatal intercurrences. CONCLUSIONS: The employment/unemployment situation was decisive in determining the degree of family stability and vulnerability to the occurrence of infant deaths, in addition to the conditions of access to and quality of healthcare services.