bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical management for acute type A aortic dissection in patients over 70 years-old
Authors: Zheng Jiayu , Lu Shuyang , Sun Xiaoning , Hong Tao , Yang Shouguo , Lai Hao , Wang Chunsheng
Published: April 2013

Background

This study aimed to retrospectively investigate our experience of surgical treatment for acute type A aortic dissection in patients older than 70 years.

Methods

From September 2005 to January 2012, eleven patients who were older than 70 years underwent surgical treatment for type A aortic dissection at our center and were included in this study. Total arch replacement was performed in three patients, seven patients underwent subtotal arch replacement and one with single-branched stent graft implantation. One patient underwent a valve-sparing (David) procedure while another underwent a concomitant aortic valve replacement (Wheat procedure). One patient required coronary artery bypass grafting. All operations were performed under deep hypothermic circulatory arrest and selective antegrade cerebral perfusion.

Results

There was one in-hospital death (9.1%) and no operative mortality within 30 days. Cardiopulmonary bypass time, myocardial ischemic time and antegrade cerebral perfusion time accounted for 151.4±33.5 minutes, 68.5±41.4 minutes and 30.3±12.9 minutes, respectively. Overall in-hospital duration, intensive care unit (ICU) time and mean ventilation time were 40.9±40.3 days, 16.5±22.5 days and 90.5±139.4 hours, respectively. New postoperative permanent neurological dysfunction and temporary neurological dysfunction were observed in one patient (9.1%) and in three patients (27.3%), respectively. Mean follow-up was 49.0±19.9 months and nine patients are still alive, one patient died of cancer after 24 months postoperation.

Conclusions

Surgical management for acute type A dissection in patients older than 70 years is a safe alternative with acceptable risk of death and the early and late results are satisfactory.
Treatment of hepatitis C virus infection in the future
Authors: Kanda Tatsuo , Yokosuka Osamu , Omata Masao
Published: April 2013

Two direct‐acting antivirals (DAAs) against hepatitis C virus (HCV): telaprevir and boceprevir, are now available in combination with peginterferon plus ribavirin for the treatment of chronic hepatitis C infection. Although these drugs are potent inhibitors of HCV replication, they occasionally result in severe adverse events. In the present clinical trials, in their stead, several second‐generation DAAs are being investigated. Most of them are being viewed with high expectations, but they also require the combination with peginterferon plus ribavirin. In the near future, we might be using all‐oral DAAs and interferon‐free regimens for the treatment of HCV‐infected patients, and these would be potent inhibitors of HCV and have less adverse events.
Using Bayesian-PBPK modeling for assessment of inter-individual variability and subgroup stratification
Authors: Krauss Markus , Burghaus Rolf , Lippert Jörg , Niemi Mikko , Neuvonen Pertti , Schuppert Andreas , Willmann Stefan , Kuepfer Lars , Görlitz Linus
Published: April 2013

Purpose

Inter-individual variability in clinical endpoints and occurrence of potentially severe adverse effects represent an enormous challenge in drug development at all phases of (pre-)clinical research. To ensure patient safety it is important to identify adverse events or critical subgroups within the population as early as possible. Hence, a comprehensive understanding of the processes governing pharmacokinetics and pharmacodynamics is of utmost importance. In this paper we combine Bayesian statistics with detailed mechanistic physiologically-based pharmacokinetic (PBPK) models. On the example of pravastatin we demonstrate that this combination provides a powerful tool to investigate inter-individual variability in groups of patients and to identify clinically relevant homogenous subgroups in an unsupervised approach. Since PBPK models allow the identification of physiological, drug-specific and genotype-specific knowledge separately, our approach supports knowledge-based extrapolation to other drugs or populations.

Methods

PBPK models are based on generic distribution models and extensive collections of physiological parameters and allow a mechanistic investigation of drug distribution and drug action. To systematically account for parameter variability within patient populations, a Bayesian-PBPK approach is developed rigorously quantifying the probability of a parameter given the amount of information contained in the measured data. Since these parameter distributions are high-dimensional, a Markov chain Monte Carlo algorithm is used, where the physiological and drug-specific parameters are considered in separate blocks.

Results

Considering pravastatin pharmacokinetics as an application example, Bayesian-PBPK is used to investigate inter-individual variability in a cohort of 10 patients. Correlation analyses infer structural information about the PBPK model. Moreover, homogeneous subpopulations are identifieda posterioriby examining the parameter distributions, which can even be assigned to a polymorphism in the hepatic organ anion transporter OATP1B1.

Conclusions

The presented Bayesian-PBPK approach systematically characterizes inter-individual variability within a population by updating prior knowledge about physiological parameters with new experimental data. Moreover, clinically relevant homogeneous subpopulations can be mechanistically identified. The large scale PBPK model separates physiological and drug-specific knowledge which allows, in combination with Bayesian approaches, the iterative assessment of specific populations by integrating information from several drugs.
An approach for predicting stress-induced anisotropy around a borehole
Authors: Fang Xinding , Fehler Michael , Zhu Zhenya , Chen Tianrun , Brown Stephen , Cheng Arthur , Toksöz M. Nafi
Published: April 2013

Formation elastic properties near a borehole may be altered from their original state due to the stress concentration around the borehole. This could result in a biased estimation of formation properties but could provide a means to estimate in situ stress from sonic logging data. To properly account for the formation property alteration, we propose an iterative numerical approach to calculate stress-induced anisotropy around a borehole by combining a rock physics model and a finite-element method. We tested the validity and accuracy of our approach by comparing numerical results to laboratory measurements of the stress-strain relation of a sample of Berea sandstone, which contains a borehole and is subjected to a uniaxial stress loading. Our iterative approach converges very fast and can be applied to calculate the spatially varying stiffness tensor of the formation around a borehole for any given stress state.
“Black Rage” And “Useless Pain”: Affect, Ambivalence, and Identity After King
Authors: Hussen Aida
Published: April 2013

This essay explores the psychic dimensions of post-civil rights black representation. I ask, what kinds of desire and identification, what vision of history and futurity, and what lost objects and forms of grief, drive nationalist approaches to black literature? In turn, what affective forces animate black literary and critical texts that are positioned, by will or by force, outside or against the contemporary black canon?

I address these questions through analyses of two divergent narratives of the civil rights era loss of black leadership. I contend that this loss—marked most explicitly by the sixties’ infamous succession of political assassinations— functions as a crisis moment for black representation in both politics and culture. The stories that are told about this moment of rupture in turn work to imagine and concretize vying representational possibilities for a black present and future. In this essay, I juxtapose black nationalist responses to Dr. Martin Luther King Jr.’s assassination alongside Andrea Lee’s controversial novella Sarah Phillips, to explore how contemporary representations of blackness, imbued with the civil rights movement’s revenants of political longing and loss, are achieved, invoked, and disputed in late twentieth-century African American literature.
Damage to Pig Bile Duct Caused by Intraluminal Brachytherapy Using a 125i Ribbon
Authors: Chen Yi , Wang Xiao-Lin , Yan Zhi-Ping , Wang Jian-Hua , Cheng Jie-Min , Gong Gao-Quan , Li Guo-Ping
Published: April 2013

Background

Stent occlusion by tumor ingrowth or overgrowth is the main cause of jaundice recurrence after metal stent insertion in patients with malignant obstructive jaundice (MOJ). The application of intraluminal brachytherapy (ILBT) in patients with MOJ results in local control of malignant tumors, which prolong stent patency.

Purpose

To evaluate the safety of ILBT in pig bile ducts using ribbons of iodine-125 (125I) seeds.

Material and Methods

Sixteen healthy pigs were randomly assigned to four groups of four pigs each. A 125I seed ribbon was implanted into the common bile duct of each animal through an incision in the duct wall, and was fixed by suturing. The four groups of animals were sacrificed at 15, 30, 60, and 120 days after ribbon implantation, respectively. Serum bilirubin concentrations, alanine aminotransferase concentrations, and white blood cell counts before and after implantation were compared within each group. Pathological changes to the bile duct wall were observed using a light microscope. Morphological changes in biliary epithelial cells and organelles were observed with electron microscopy.

Results

125I ribbons were successfully implanted in all animals without surgery-related death. We found no significant difference in pre- and post-implant serum bilirubin, alanine aminotransferase, or white blood cell counts. Light and electron microscopy showed that the most severe bile duct damage occurred in the 15-day group, which exhibited necrosis and detachment of numerous epithelial cells, and infiltration of inflammatory cells. Repair and proliferation of the bile duct epithelium began 30 days after implantation and was nearly complete at 60 days.

Conclusion

This study demonstrated the safety of ILBT using a 125I ribbon in the pig bile duct. 125I seed ribbons may be used in the treatment of MOJ in humans.
Relationship between the use of new or used computed tomography scanners and image retake rates in South Korea
Authors: Hong Jae-Seok , Kang Hee-Chung
Published: April 2013

Background

The use of high-cost imaging has increased worldwide, contributing to increased healthcare expenditures. Without proper quality verification, the installation of used imaging equipment may lead to wasteful increases in cost due to ineffective and poor-quality imaging that requires repeat scans.

Purpose

To examine the relationship between the use of new or used computed tomography (CT) scanners and image retake rates to evaluate the comparative quality of used and new CT scanners.

Material and Methods

This was a retrospective cohort study of patients who first underwent CT from January 1 to June 30, 2008 ( n = 258,572). Data were obtained by linking the Health Care Institution Registration Data with the Korean National Health Insurance Claims Database. Image retake rates within 30, 60, 90, and 180 days after the first CT scan were calculated, and differences in the image retake rate by new versus used CT scanners were assessed.

Results

After adjusting for confounders, use of a used CT scanner for the first scan increased the odds of retake within 30 days (odds ratio [OR]: 1.34, 95% confidence interval [CI]: 1.22–1.48), 60 days (OR: 1.59, 95% CI: 1.47–1.72), 90 days (OR: 1.48, 95% CI: 1.38–1.59), and 180 days (OR: 1.38, 95% CI: 1.30–1.46) compared with use of a new CT scanner. Such results were evident in scans of the spine, abdomen, chest, and face or skull base.

Conclusion

The quality control associated with import of used CT scanners should be improved. Moreover, regular and detailed quality inspections of used CT scanners currently operating in healthcare institutions are necessary.
Mercury Intrusion Effects Modelled in Pores with Axial Symmetry and Attenuated Cross Section
Authors: Kornhauser Isaac , Felipe Carlos , Esparza Juan Marcos , Domínguez Armando , Rojas Fernando
Published: April 2013

The study of Hg intrusion in axially symmetric pores modelled from a circular function, including a cross-sectional attenuation, unveils or ratifies some interesting effects. One of them is the influence of the pore-wall angle of inclination on the intrusion pressure and meniscus radius of curvature. Another one is that Hg penetration in pores of this sort cannot proceed gradually but only in a jump-like manner. Virtual penetration curves indicate Laplace stable or unstable states as well as the virulence of the irreversible penetration of pores with a varying cross section. It is also important to point out that, in structures depicting a sinuous cavity to throat inter-connections, a single meniscus can be transformed into more than one meniscus by a sort of snap-off mechanism. Hysteresis in these structures can be expected to be more intense as the pore entities become more sinuous. Finally, it is also important to mention that the onset of liquid penetration is not always occurring at the minimum cross section of a pore channel, but at a specific point beyond this occlusion.
Strategies to Improve Pore-Size Distribution Characterization of Activated Carbons Using CO2 and N2 Isotherms: Volume Regularization and Etched Slit Models
Authors: Silvino P. F. G. , Gonçalves D. V. , Gonçalves R. V. , de Lucena S. M. P. , Azevedo D. C. S.
Published: April 2013

The pore-size distribution (PSD) of an activated carbon (AC) sample, which is obtained by molecular simulation using a specific probe gas, does not always reproduce the adsorptive behaviour of that sample with other gases. Moreover, different gases generate distinct distributions for the same AC. These facts go against the concept of PSD, which must be unique for a given sample, irrespective of the probe gas used. We analyzed adsorption isotherms of WV-1050 AC sample with nitrogen at 77 K, carbon dioxide at 298 K and methane at 303 K, yielding their respective PSDs, based on local isotherms database (kernels) generated through grand canonical Monte Carlo simulation. The PSD obtained for nitrogen and carbon dioxide was used (individually) to reproduce the three experimental isotherms and significant deviations were observed. By applying a volume normalization methodology, the isotherm fitting was significantly enhanced. Furthermore, a more realistic model of AC pores considering etched slit walls was tested to improve PSD similarity. The new model presented tends to unify the PSDs obtained from different probe gases evaluated.
Adsorption of Heavy Metals on Diatomite: Mechanism and Effect of Operating Variables
Authors: Flores-Cano Jose Valente , Leyva-Ramos Roberto , Padilla-Ortega Erika , Mendoza-Barron Jovita
Published: April 2013

The adsorption capacity of diatomite towards heavy metals as well as the adsorption mechanism was investigated in the present study. The chemical and X-ray diffraction analyses revealed that the diatomite was mainly composed of SiO2 (95.91%) as cristobalite and quartz. The maximum uptake of Cd(II), Zn(II), Pb(II) and Cr(III) were 0.734, 0.232, 0.169 and 0.162 meq/g at pH of 7, 6, 4 and 4, respectively. The adsorption capacity of diatomite was enhanced by increasing the temperature because the adsorption process was endothermic. The effect of the pH on the capacity was studied, and the maximum capacity augmented 6.3 times while increasing the pH from 4 to 7. This trend was due to the electrostatic interactions between the metal cations in solution and the negatively charged surface of the diatomite. The predominant adsorption mechanism of Cd(II) on diatomite was chemisorption, while ion exchange was responsible for 10% to 50% of the adsorption.
Overcoming the Upfront Investment Barrier — Comparing the German Co2 Building Rehabilitation Programme and the British Green Deal
Authors: Rosenow Jan , Eyre Nick , Bürger Veit , Rohde Clemens
Published: April 2013

This paper compares two flagship policies in the area of energy efficient building refurbishment, the German CO2-Building Rehabilitation Programme and the Green Deal in the UK. Although both policies are essentially loan programmes to finance energy efficiency measures, the nature of the two policies is very different regarding scope, financial architecture, integration with other policies, and carbon reductions. The paper draws out the main differences of the programmes as well as similarities.
David Clutterbuck, Mentoring and Coaching
Authors: Jenkins Simon
Published: April 2013

David Clutterbuck is a prolific writer on management and business, who is also a thought leader, advocate and visionary in mentoring. He has distinguished between the traditional US sponsorship-based model of mentoring which emphasizes the use of the mentor's power, influence and authority on behalf of a protégé and the European, development-based model of mentoring which emphasizes the mentor's experience and wisdom to enable the mentee to become self-reliant and to take ownership of their personal and professional development. In order to stimulate commentaries from his peers in the world of mentoring, as well as stakeholders of mentoring in the world of sport, this article presents selected aspects of Clutterbuck's work on mentoring, such as formal vs. informal mentoring, mentoring vs. coaching, conversation, goals, and trends. A theme that runs through the article is the influence of Peter Drucker on Clutterbuck.
Personal Reasons for Withdrawal from Team Sports and the Influence of Significant others among Youth Athletes
Authors: Rottensteiner Christoph , Laakso Lauri , Pihlaja Tuomo , Konttinen Niilo
Published: April 2013

The aim of this study was to identify the main reasons for withdrawal from team sports and to examine the influence of significant others (i.e., coaches, parents, peers, and siblings) in the decision making concerning withdrawal from youth sports. An attempt was also made to compare withdrawal components and the influence of significant others in terms of gender, level of competition and years of involvement in youth sports. The participants in this study were young football (American soccer) (n=397), ice hockey (n=88) and basketball (n=50) players who had terminated their participation in their sports. Principal component analysis was used to reduce the number of withdrawal items and identify principal withdrawal components. The results indicated that having other things to do and a decline in excitement were the most important reasons for withdrawal. Coaches and teammates appeared to be the two main groups of significant others who influenced young player's decision making related to their withdrawal. Statistically significant differences in withdrawal components related to ability and social issues were found between gender and years of involvement. The present findings highlight the factors that are related to the incidence of withdrawal, and at the same time, underline the role of significant others within the contexts of sport participation. Recommendations and practical implications for coaches and policy makers to reduce the withdrawal rate among young athletes are provided.
The NIE Intermittent High-Intensity Running Test: A Reliable and Valid Test for Assessment of Soccer-Specific Fitness
Authors: Mukherjee Swarup , Chia Michael
Published: April 2013

The overall activity pattern of soccer is that of intermittent high-intensity (Int-HINT) type and elite players have a greater repeated high-intensity running capability. Since soccer involves rapidly changing work intensities in an unpredictable manner, tests simulating overall activity pattern in a cyclical sequence have limited practical usefulness in testing of soccer fitness. The primary aim of this study was to develop a laboratory-based protocol to specifically assess the Int-HINT running capability in soccer players.

University team games athletes (n=8, Mean ± SD; age 22.30 ± 1.65 years, stature 1.73 ± 0.04 m, body mass 69.36 ± 6.04 kg) participated in the reliability study and male youth professional soccer players (n=20, Mean ± SD age, 17.5 ± 0.3 yrs; stature, 1.73 ± 0.04 m; body mass, 67.2 ± 7.5 kg) participated in the validity study. The players performed on the NIE Intermittent High-intensity (NIE Int-HINT) Running Test during the preseason, early in-season and end mid-season phases of the soccer season. Performance was measured as total distance covered on the treadmill. The participants also performed the YoYo Intermittent Recovery Test Level 2 (YoYo IRT L2) during each phase of the competition season.

The NIE Int-HINT test was found to be of high reliability (ICC, 0.98; CV, 2.1%; ratio limits of agreement (rLOA) 0.99 ×/÷ 1.03). A positive and significant correlation (p< 0.05) was found between the performance in the NIE Int-HINT test and the YoYo IRT L2 performance (r = 0.68-0.77) during different phases of the soccer season.

The NIE Int-HINT test provided a reliable measure of intermittent high-intensity running capability and a valid and sensitive method of estimating soccer-specific fitness in youth professional soccer players. Further studies are needed to evaluate the applicability of this test in adult elite soccer players and other intermittent team game athletes.
Reviews Books
Authors: Playle Jade , Boyle Brendan , Miles Melinda
Published: April 2013

Heritage Film: Nation, Genre and Representation, Belén Vidal, (2012) New York: Columbia University Press, 150pp., ISBN: 9780231162036 (pbk), $20.00

Urban Cinematics: Understanding Urban Phenomena Through the Moving Image, Francois Penz and Andong Lu (eds.), (2011) Bristol:
Intellect, 324pp., ISBN: 9781841504285 (pbk), $40.00

Alejandro Gonzalez Inarritu, Maria del Mar Azcona and Celestino Deleyto, (2010) Champagne, IL: University of Illinois Press, 153 pp., ISBN: 9780252077616 (pbk), $22.00.
Exhibition 1: Still/Moving
Authors: Eamon Christopher
Published: April 2013

PUBLIC 46: Prime Mover is a selection of five essays corresponding to five hypothetical exhibitions of works from an influential private collection with which Eamon was professionally involved for more than ten years. The collection, one of the first in private hands to focus almost
exclusively on time-based media, has been the subject of a number of graduate theses and museum catalogues, but this publication aims to bolster these efforts towards better understanding of a collection that has altered the field of media art. In a sense, these essays constitute a history
of moving-image art starting from around 1900 that is meant to be a resource for students of film and video art, on the one hand, and for scholars investigating the history of collections on the other. Although the five exhibitions imagined here evolved separately, they can be read as chapters
of a continuous story, or, alternatively, they can be read as different lenses through which one can look at the history of media art itself, as a necessarily fragmentary history. The different formats and different approaches in this publication all come from the curator’s toolbox,
where one is able to place works of art in a variety of contexts, grouping them in ways that both illuminate the works and, hopefully, the history of art as well.
Exhibition 2: Prime Mover: Conceptualism in Motion
Authors: Eamon Christopher
Published: April 2013

PUBLIC 46: Prime Mover is a selection of five essays corresponding to five hypothetical exhibitions of works from an influential private collection with which Eamon was professionally involved for more than ten years. The collection, one of the first in private hands to focus almost
exclusively on time-based media, has been the subject of a number of graduate theses and museum catalogues, but this publication aims to bolster these efforts towards better understanding of a collection that has altered the field of media art. In a sense, these essays constitute a history
of moving-image art starting from around 1900 that is meant to be a resource for students of film and video art, on the one hand, and for scholars investigating the history of collections on the other. Although the five exhibitions imagined here evolved separately, they can be read as chapters
of a continuous story, or, alternatively, they can be read as different lenses through which one can look at the history of media art itself, as a necessarily fragmentary history. The different formats and different approaches in this publication all come from the curator’s toolbox,
where one is able to place works of art in a variety of contexts, grouping them in ways that both illuminate the works and, hopefully, the history of art as well.
Toward Development of a New Thermal Cracking Test Using the Dynamic Shear Rheometer
Authors: Wen Haifang , Bhusal Sushanta
Published: April 2013

Thermal cracking is one of the primary distresses in asphalt pavements. Asphalt binder, an important component of asphaltic concrete, plays a significant role in the thermal cracking performance of asphalt pavement and should be characterized accurately for proper binder selection. The current Superpave binder specifications for low-temperature cracking, based on creep stiffness and m-values, are not applicable to modified binders. Fracture-based tests are most promising for the prediction of low-temperature cracking of binders, especially modified binders. This study develops a new performance indicator for low-temperature cracking using properties from monotonic testing at a semi-low temperature, 5°C, based on the dynamic shear rheometer (DSR). It is found that the complex shear modulus of binders does not correlate with field thermal cracking performance. Fracture energy shows a moderate correlation with field thermal cracking performance. The correlation is improved when the shear rate is increased. However, failure strain at 5°C correlates very well with field thermal cracking. In addition, failure strain is not sensitive to the shear rate at 5°C. This new test could significantly reduce the costs associated with the purchase of various types of equipment, such as that needed to conduct bending beam rheometer (BBR) or direct tension tests, and could also reduce the amount of testing time. Further study is needed to validate the findings in this study.
A Study on the Residual Fatigue Strain and Damage of Steel Fiber Reinforced Recycled Concrete Under Constant Amplitude Flexural Fatigue Loading
Authors: Runnian Yang , Demin Wei
Published: April 2013

Flexural fatigue tests under constant amplitude fatigue loading were carried out in order to obtain the residual fatigue strain of two kinds of steel fiber reinforced concrete (SFRC): steel fiber reinforced recycled concrete (SFRRC) and steel fiber reinforced pebble concrete (SFRPC). The experimental results show that the residual fatigue strain of SFRC follows the three-stage law, and the residual fatigue strain of SFRRC develops more slowly than that of SFRPC at the same stress level. A residual fatigue strain equation is suggested. The fatigue damage of SFRC has also been studied. A fatigue damage evolution equation is proposed, and comparisons are made with other expressions, showing that the suggested model is in the best agreement with the experimental results.
Statistical Analysis of the Stress-Energy Methodology Applied to Cushion Curve Determination
Authors: Paulin Kendalyn , Batt Gregory , Daum Matthew
Published: April 2013

The stress-energy method is a proposed alternative to ASTM D1596 that reduces all drop height, thickness, and static load combinations into a single equation that can be used to generate any reasonable cushion curve for a particular material. There remains a question as to how accurately the stress-energy method can predict deceleration values and whether it is statistically comparable to the method described in ASTM D1596. There are three phases to this research that attempt to determine the accuracy of the stress-energy method: gathering data using the stress-energy method and analyzing the goodness of fit of the stress-energy equation, predicting a cushion curve and observing the upper and lower bounds for a given drop height and thickness, and using ASTM D1596 to create a cushion curve with the same drop height and thickness and comparing it to the predicted cushion curve. Analyzing ten stress-energy data sets using the root mean square error in addition to the coefficient of determination provided a more thorough goodness of fit analysis. Utilizing the stress-energy method to predict cushion curves produced minimal errors and similar decelerations when compared to six actual cushion curve data sets.
Validating Computational Models from Laser Scanning Data for Historic Facades
Authors: Truong-Hong Linh , Laefer Debra F.
Published: April 2013

Increasingly, remote sensing is being used as the basis for computational models. With new approaches rapidly emerging, questions arise as to how to validate and assess the resulting models, as they tend to include at least some level of geometric inexactitude. This paper proposes a set of parameters and procedures for evaluating the usefulness of computational models for structural analysis of historic facades subjected to adjacent construction work. To test the usability of such an approach, three brick buildings were scanned with a terrestrial laser scanner. The data were processed with a recently proposed set of algorithms, and the reliability of the resulting solid models was evaluated by comparing finite-element results from auto-generated solid models versus those based on measured drawings. The proposed validation process considers overall response, as well as local behavior. The results show the importance of using both conventional values and project specific parameters.
Síndrome de Kocher-Debré-Semelaigne
Authors: Fortes-Rego J.
Published: April 2013

É relatado um caso de síndrome de Kocher-Debré-Semelaigne diagnosticado em um paciente de 8 anos, não tendo sido encontrados relatos similares na literatura nacional consultada. Apesar do início tardio do tratamento, a evolução mostrou-se bastante favorável.
Citomegalia e malformações do sistema nervoso central: relato de dois casos associados à agenesia do corpo caloso e encefalopatia cística
Authors: Becker Paulo F. L.
Published: April 2013

Dois casos de citomegalia do sistema nervoso central em lactentes, comprovados pelo encontro de inclusões virais típicas no tecido nervoso, associados à agenesia da comissura do corpo caloso e encefalopatía cística simétrica pós-infarto, são estudados sob o ponto de vista anátomo-clínico. O autor acredita que a agenesia tenha sido causada por transformação cística da lâmina reuniens e do sulco médio ocluido inoportunamente no período embrionário. Discute a possibilidade dessa malformação cerebral ter sido ocasionada pela virose, não excluindo, contudo, a hipótese de uma casual ocorrência da citomegalia num encéfalo previamente anômalo. Atribui a encefalopatia cística simétrica coexistente à uma redistribuição (desvio) do fluxo sangüíneo cerebral através do que denomina de sistema de irrigação prioritária. Este sistema, provavelmente, atua independentemente dos mecanismos de auto-regulação do fluxo sangüíneo cerebral e entra em ação em situações de emergência, com a finalidade de suprir os centros neurovegetativos homeostáticos de maior importância vital imediata, preservando-os em detrimento — se prolongado o desvio do fluxo sangüíneo — para os demais territórios do sistema nervoso central excluídos do circuito circulatório. Essas áreas, submetidas a uma isquemia relativa, manifestam infartos com características simétricas e sequelas subseqüentes, se o indivíduo sobreviver tempo suficiente para a reabsorpção dos detritos teciduais e substituição por áreas císticas, dada a extensão da necrose.
Síndrome de Wyburn Mason, uma facomatose mista
Authors: Mello Luís Renato
Published: April 2013

A síndrome de Wyburn-Mason é discutida apresentando-se uma revisão bibliográfica. Consiste na presença de angiomas anteriovenosos na face, retina e região mesodiencefálica, associada a alterações neurológicas e mentais. Um caso é apresentado, sendo comentadas suas particularidades pelas quais se evidencia que a classificação da síndrome como uma facomatose pura é discutível merecendo melhores estudos.
Ventriculografia e mieloradiculografia com contrastes iodados hidrosoluveis
Authors: Reixach-Granés Ricardo , Betting Luiz Carlos G.
Published: April 2013

Com base em casuística de 136 exames neuro-radiológicos (ventriculografias e mieloradiculografias) utilizando contrastes hidrosolúveis reabsorvíveis (iotalamato de metilglucamina e ácido iocármico), os autores ressaltam as vantagens destes produtos que permitem sem maiores complicações, perfeita visualização das estruturas examinadas.
Resultados preliminares de um projeto sobre a ecologia dos flebotomineos vetores de leishmaniose tegumenar no estado da Bahia
Authors: Sherlock Italo A. , Maia Helio , Dias-Lima Artur Gomes
Published: April 2013

São apresentados resultados preliminares de um projeto sobre a ecologia dos flebotomíneos, vetores de leishmaniose tegumentar, numa área de plantação de cacau no sul do Estado da Bahia, Brasil. Nesta área existem 60 casas, afastadas entre si, onde vivem 229 habitantes e 31 cães. Entre os moradores, 45% tinham reação de Montenegro positiva; destes, 8,8% eram portadores de úlceras em atividade e 37% de cicatrizes de úlceras. Dos cães, 22% eram soropositivos. Dos 7 cães com úlceras, apenas 3 eram soropositivos. Em 14% das casas inspecionadas, foram encontrados flebótomos. Durante dois anos, 72 hamsters foram mantidos como sentinelas em casas de pacientes com úlceras leishmanióticas, porém nehum adquiriu a infecção. Foram coletados e identificados 5.614 exemplares de flebótomos pertencentes a 14 diferentes espécies. Entre estas, Lutzomyia whitmani (92%) e Lutzomyia intermedia (4,8 %) eram as espécies mais abundantes. Esses flebótomos, muito antropofílicos, podiam ser encontrados dentro das casas e nas suas periferias e são provavelmente, os principais vetores da doença no ambiente doméstico. As outras 12 espécies eram menos frequentes e mais encontrados em ambientes silvestres, onde também picavam o homem. A maioria das espécies começava a aparecer às 17 horas, no crepúsculo, e alcançava sua densidade máxima às 24 horas, quando declinava até desaparecer às 6 horas da manhã. L. whitmani em todas as fases lunares foi capturada com a mesma densidade, enquanto L.intermedia foi mais abundante durante a fase de lua nova. Centenas de flebótomos coletados mensalmente durante o segundo ano de observações, permanecem preservados em nitrogênio líquido, aguardando o ajustamento de técnicas de PCR para a verificação da taxa de infecção natural desses vetores por leishmânia. Os resultadosfinais de todo o projeto serão publicados tão logo seja examinado esse material.
Estudo da eficácia e tolerância do artesunato oral isolado e em associação com mefloquina, no tratamento da malária falciparum não complicada em área endêmica do Pará, Brasil
Authors: Cardoso Bernardo da Silva , Dourado Heitor Vieira , Pinheiro Maria da Conceição Nascimento , Crescente José Angelo Barlleta , Amoras Walter Wanderley , Baena Jorge , Saraty Sandra
Published: April 2013

Com o objetivo de avaliar a eficácia e tolerância do artesunato no tratamento da malária falciparum não complicada em área endêmica do Estado do Pará, 153 pacientes foram randomizados e estudados em três grupos, distribuídos por esquema terapêutico (I recebeu mefloquina lOOOmg; II utilizou artesunato lOOOmg; III usou a combinação de 600mg de artesunato seguida de 500 de mefloquina). A avaliação constou de exame clínico e parasitológico diariamente nos primeiros 7 dias e semanalmente até o 35º dia do acompanhamento e de análise bioquímica e hematológica realizada antes e no 7º dia, visando o controle de ema e a identificação de possíveis efeitos associados á admmistração das drogas. Os grupos estudados foram homogêneos quanto ao sexo, parasitemia e presença de febre. O tempo para desaparecimento da parasitemia foi mais curto nos grupos II e III, respectivamente, cujos esquemas terapêuticos empregaram artesunato. O desaparecimento da febre foi mais rápido no grupo tratado com a combinação das drogas. Alterações clínicas e bioquímicas associadas a administração das drogas não mostraram diferenças significativas entre os grupos estudados. O desaparecimento precoce da febre e parasitemia, e a ausência de importantes efeitos indesejáveis, sugerem que artesunato administrado isoladamente ou em combinação com mefloquina constituem medidas terapêuticas capazes de contribuir para o controle da doença na região.
Repercussões do ruído na unidade de terapia intensiva neonatal
Authors: Grecco Gabriela Menossi , Tsunemi Miriam Harumi , Balieiro Maria Magda Ferreira Gomes , Kakehashi Tereza Yoshiko , Pinheiro Eliana Moreira
Published: April 2013

OBJETIVO: Identificar as repercussões do ruído da unidade de terapia intensiva neonatal sobre as mães, recém-nascidos e interações com o filho e profissionais de saúde, a partir da percepção materna. MÉTODOS: Estudo descritivo transversal, realizado em unidade de terapia intensiva neonatal. A amostra constitui-se de 95 mães. Um formulário foi utilizado como instrumento de coleta de dados. Para análise dos dados utilizou-se estatística descritiva. RESULTADOS: Na percepção das mães o ruído da unidade traz repercussões sobre o neonato provocando agitação, choro, irritabilidade entre outros; desencadeia-lhe cefaléia, agitação e vontade de chorar, levando-a tocar menos e falar mais baixo com o filho. Referem dificuldade em manter sua atenção durante a interação com o profissional. CONCLUSÃO: As repercussões do ruído percebidas pela mãe tanto sobre si como para o seu filho, abrangem alterações comportamentais e físicas; associadas à dificuldade materna de manter a atenção ao interagir com o profissional de saúde.
Revascularização miocárdica: estratégias para o enfrentamento da doença e do processo cirúrgico
Authors: Koerich Cintia , Baggio Maria Aparecida , Erdmann Alacoque Lorenzini , Lanzoni Gabriela Marcellino de Melo , Higashi Giovana Dorneles Callegaro
Published: April 2013

OBJETIVO: Conhecer as estratégias utilizadas por pacientes no enfrentamento da doença cardíaca coronária e do processo cirúrgico de revascularização miocárdica. MÉTODOS: Utilizou-se a Teoria Fundamentada nos Dados como referencial metodológico para a releitura dos dados de um estudo mais amplo intitulado: Significando a experiência cirúrgica e o processo de viver do paciente submetido à revascularização do miocárdio. A coleta de dados foi realizada de outubro de 2010 a agosto de 2011, por meio de entrevista semiestruturada, com três grupos amostrais (pacientes, familiares de pacientes e profissionais de saúde) e 23 participantes. RESULTADOS: Os resultados apontam as estratégias utilizadas pelos pacientes submetidos ao processo cirúrgico de revascularização miocárdica, quais sejam: apoio familiar, espiritual e profissional. CONCLUSÃO: A experiência da cirurgia cardíaca modifica o processo de viver do paciente cardíaco e as estratégias utilizadas tornam a vivência menos traumática ao paciente. Logo, tais dados fornecem base teórica para o cuidado de enfermagem.
Esterilização histeroscópica de paciente com dispositivo intrauterino Mirena®
Authors: Depes Daniella De Batista , Pereira Ana Maria Gomes , Yatabe Salete , Lopes Reginaldo Guedes Coelho
Published: April 2013

A esterilização tubária é o procedimento definitivo mais utilizado no mundo para controle da fecundidade. A ligadura laparoscópica é segura, porém invasiva e com possíveis riscos cirúrgicos e anestésicos. A via histeroscópica permite a oclusão tubária em ambiente ambulatorial, sem incisões ou anestesia. Um microdispositivo (Essure®) é inserido diretamente no interior das tubas e suas fibras internas de poliéster causam sua obstrução em até 3 meses. Durante esse período, deve ser mantido o método contraceptivo temporário utilizado pela paciente. Várias mulheres utilizam o sistema intrauterino liberador de levonorgestrel, denominado comercialmente Mirena®. O objetivo neste estudo foi de avaliar a possibilidade de inserção do Essure® sem a remoção do dispositivo intrauterino e a tolerância da paciente ao procedimento. O dispositivo foi colocado com sucesso em paciente portadora do Mirena® sem necessidade de retirada do mesmo. Após 3 meses o dispositivo intrauterino foi retirado sem intercorrências.
Molecular and Therapeutic Advances in the Diagnosis and Management of Malignant Pheochromocytomas and Paragangliomas
Authors: Lowery Aoife J. , Walsh Siun , McDermott Enda W. , Prichard Ruth S.
Published: April 2013

Learning Objectives

Discuss the advances in molecular genetics which have uncovered new hereditary and germline mutations contributing to the development of pheochromocytoma and paraganglioma and identify the genotype/phenotype patterns which facilitate more accurate determination of malignant potential. Describe the current imaging modalities used in the diagnosis of pheochromocytoma and paraganglioma and evaluate the efficacy of functional imaging modalities according to tumor genotype. Evaluate the current preclinical molecular research contributing to the selection of targeted therapies for malignant pheochromocytoma and paraganglioma.

Pheochromocytomas (PCCs) and paragangliomas (PGLs) are rare catecholamine-secreting tumors derived from chromaffin cells originating in the neural crest. These tumors represent a significant diagnostic and therapeutic challenge because the diagnosis of malignancy is frequently made in retrospect by the development of metastatic or recurrent disease. Complete surgical resection offers the only potential for cure; however, recurrence can occur even after apparently successful resection of the primary tumor. The prognosis for malignant disease is poor because traditional treatment modalities have been limited. The last decade has witnessed exciting discoveries in the study of PCCs and PGLs; advances in molecular genetics have uncovered hereditary and germline mutations of at least 10 genes that contribute to the development of these tumors, and increasing knowledge of genotype-phenotype interactions has facilitated more accurate determination of malignant potential. Elucidating the molecular mechanisms responsible for malignant transformation in these tumors has opened avenues of investigation into targeted therapeutics that show promising results. There have also been significant advances in functional and radiological imaging and in the surgical approach to adrenalectomy, which remains the mainstay of treatment for PCC. In this review, we discuss the currently available diagnostic and therapeutic options for patients with malignant PCCs and PGLs and detail the molecular rationale and clinical evidence for novel and emerging diagnostic and therapeutic strategies.
Rehabilitation and modernisation of irrigation schemes
Authors: Donaldson Martin
Published: April 2013

Boosting agricultural productivity to increase food production and raise living standards is a policy in most developing countries as they face increasing populations, rising costs and deteriorating rural infrastructure. Many irrigation and drainage systems built over the last 100 years have suffered from a chronic lack of maintenance, resulting in canal networks that cannot deliver sufficient water. Crop yields and farmer incomes have thus fallen, exacerbating rural poverty. By this stage, deferred maintenance is not effective – comprehensive rehabilitation and modernisation is needed. This entails a hydraulic design review (possibly increasing capacity), improving water level control, water distribution and flow measurement by building new canal structures or modifying existing ones, lining canals as required and installing canal performance monitoring equipment. The author uses his experiences in Pakistan and Vietnam to discuss the different methods of water control used, the rehabilitation of canals and structures, lining criteria, monitoring equipment and cost estimates per hectare for rehabilitating and modernising gravity irrigation systems
Adult Attachment as a Criminological Construct in the Cycle of Violence
Authors: Marganski Alison
Published: April 2013

This study investigates whether the criminological construct of attachment plays a role in the link between family violence victimization experiences in childhood and adult violent behavior. Data collected from undergraduate students was used to estimate the independent effect of adult attachment type on the victimization-violence link and it was used to examine main effects and interactions between family violence-adult attachment types on adult violent behavior. Consistent with past research, results revealed significant associations between direct experiences of victimization and violent behavior. Multivariate analyses using interaction terms also found significant interactions, indicating moderation effects, which were further investigated. Results revealed that social learning theory may be useful in explaining violence among those who have experienced high victimization, whereas social control theory may be useful in explaining adult violence for those who have experienced low or no levels of violence early in life. Given this study’s findings, further research to examine the means by which family violence victimization experiences develop into violent behavioral patterns is recommended.
The Measurement of Uncertainty in Caregivers of Patients With Heart Failure
Authors: Harkness Karen , Arthur Heather , McKelvie Robert
Published: April 2013

Background and Purpose: Family caregivers of heart failure (HF) patients describe feelings of uncertainty; however, studies measuring uncertainty in caregivers of HF patients are extremely sparse. This study examined the validity and reliability of the Mishel Uncertainty in Illness Scale-Family Member form (PPUS-FM) in caregivers of HF patients. Methods: Caregivers (n = 50) of community-dwelling HF patients completed the PPUS-FM, Caregiver Reaction Assessment (CRA) and Hospital Anxiety and Depression Scale (HADS) in this cross-sectional study. Results: Significant correlations emerged among PPUS-FM and (a) CRA-schedule burden (r = .499, p < .01); (b) CRA-financial burden (r = .292, p < .05); (c) CRA-family burden (r = .385, p < .01); (d) CRA-health burden (r = .421; p < .01); and (e) HADS-depression scores (r = −.298, p < .05). Cronbach’s alpha for the PPUS-FM was .89. Conclusions: In this sample, the PPUS-FM had some evidence of construct validity and good internal consistency. However, the respondent burden and unidimensional nature of the PPUS-FM suggest that this tool needs further revision and testing for use with caregivers of HF patients.
Development and Initial Validation of a Complementary and Alternative Medicine (CAM) Knowledge Instrument
Authors: Wyatt Gwen , Sikorskii Alla , Wills Celia E.
Published: April 2013

Background and Purpose: Many patients with cancer use complementary and alternative medicine (CAM) therapies without essential knowledge to inform their decisions. A CAM knowledge instrument was developed and tested for initial validation. Methods: There were 20 items developed and refined via cognitive interviewing. The instrument was mailed to 800 breast cancer survivors, and mailed again 2 weeks later to assess test–retest reliability. Results: Exploratory factor analysis (EFA) revealed 13 items forming a unidimensional scale. A 2-factor solution was also plausible. One factor consisted of 7 items on knowledge about specific features of CAM, and a second 6-item factor on knowledge of regulatory issues. Conclusions: Based on factor-analytic validity considerations, the 13-item instrument can be used, or the 2 subscales can be used if a more detailed examination of knowledge is desired.