bluuebunny/crossref_metadata_2025 huggingface dataset:
Hazlitt, Horne, and the Spirit of the Age
Authors: Schlicke Paul
Published: July 2012

The 1820s and '30s are routinely ignored as a lacuna in literary history, yet they were years of transformation, the seedbed of great achievement thereafter. Commentators at the time responded variously with alarm or optimism, but all agreed that it was an age of profound change. In 1824, William Hazlitt diagnosed the end of an era in The Spirit of the Age; in 1844, Richard Henry Horne, in conscious emulation, celebrated A New Spirit of the Age. These works stand as landmarks in the transition from Romanticism to Victorianism and offer insight into the ferment of the era.
Confidence Intervals and Power Calculations for Within-Person Biological Variation: Effect of Analytical Imprecision, Number of Replicates, Number of Samples, and Number of Individuals
Authors: Røraas Thomas , Petersen Per H , Sandberg Sverre
Published: July 2012

BACKGROUND

Reliable estimates of within-person biological variation and reference change value are of great importance when interpreting test results, monitoring patients, and setting quality specifications. Little information has been published regarding what experimental design is optimal to achieve the best estimates of within-person biological variation.

METHOD

Expected CIs were calculated for different balanced designs for a 2-level nested variance analysis model with varying analytical imprecision. We also simulated data sets based on the model to calculate the power of different study designs for detection of within-person biological variation.

RESULTS

The reliability of an estimate for biological variation and a study's power is very much influenced by the study design and by the ratio between analytical imprecision and within-person biological variation. For a fixed number of measurements, it is preferable to have a high number of samples from each individual. Shortcomings in analytical imprecision can be controlled by increasing the number of replicates.

CONCLUSIONS

The design of an experiment to estimate biological variation should take into account the analytical imprecision of the method and focus on obtaining the highest possible reliability. Estimates of biological variation should always be reported with CIs.
Pillow Girl
Authors: Cramer Ronnie
Published: July 2012

Pillow Girl was half of a two-part project demonstrating the use of digital technology to create new components for existing works. In the case of Pillow Girl this entailed the creation of a visual element to compliment an existing audio work. The projects' second part used this same
process in reverse, creating a new audio component for an existing visual work (specifically, the production of a soundtrack for a silent motion picture). This article will focus on the first part of the project (Pillow Girl), the creation of a new visual component for an existing audio source.
Pictures that do not really exist: Mitigating the digital crisis in traditional animation production
Authors: Tarantini Tony
Published: July 2012

The period between 1994 and 2004 was a unique moment in time for the TV animation community. It was a time of transition, when the introduction of digital tools caused irreversible changes to long-established 2D animation production pipelines. These new digital pipelines altered the
time-honoured traditional roles of ‘old timers’ (senior artists) and ‘new comers’ (junior artists) and caused unparalleled revisions to conven¬tional production models. This article uses Lave and Wenger’s concept of ‘legitimate peripheral participation’
and Basil Bernstein’s ideas on ‘trainability’ and ‘recontextualization’ to discuss the changes brought on by the introduction of digital applications to a community of practice in flux. It focuses on the Toronto animation community as a microcosm of a global experience
and uses Nelvana – one of Canada’s most influential and successful animation production companies – as a case study. By means of an interpretive phenomenological approach it analyses and evaluates the crisis during this period of time and describes the animation artists passage
from resenting change to directing change within their industry and community.
The anamorphic cinema
Authors: Loader Alison Reiko
Published: July 2012

The anamorphic cinema is a research/creation project that proposes new ways to engage with moving images by applying digital imaging and animation to catoptric anamorphosis, a perspectival technique from the seventeenth century that deforms pictures so they appear to re-form in the
reflection of a curvilinear mirror. Culminating in Ghost in the Machine: The Inquest of Mary Gallagher, a looping fifteen- minute, site-specific video installation investigating the culpability of a working class woman in the 1879 murder and beheading of another, this project problematizes
representation as re-presentation. Dramatic performances of witness testimonies and newspaper texts, layered with diverse archival images form a network of narratives that revise the case within a context of nineteenth-century spectatorship, visual culture and disciplinary discourses. Made
for exhibition in the historic Montreal neighbourhood called Griffintown, the location where the events it depicts took place, Ghosts emplaces and embodies multi-perspectival views, encouraging mobile spectatorship and passive interaction. Audience members cannot alter the work directly but
their experiences are dependent on their relative positions and angles of view. The anamorphic cinema literally re-presents partial perspective and situated knowledge, materializing theory into phenomenological practice.
Neuroanimatics: Hyperrealism and digital animation’s accidental mark
Authors: Owen Ann
Published: July 2012

Digital animation is arguably a medium that can produce any image that the human brain can imagine, but is this all that it can do? It is not without good reason that animation has become a popular and enduring medium: animators and artists have long known that certain forms of simplification
and exaggeration are more pleasing than others. This article will argue that animation has the ability to not only match the human imagination, but also to improve on it via the mark-making process itself, or more accurately via the ‘accidental’ mark-making process. Utilizing discoveries
in neuroscience and neuroaesthetics I will examine the effects of this ‘accidental’ mark on both traditional and digital animation production and spectatorship. I will establish that there are intrinsic qualities in the digital pixel that render the digital animation medium truly
unique in terms of its representational qualities. However, this unique ability does not lie, as might be expected, in the area of digital realism, but rather in the domain of the hyperreal.
Smooth movement/Frenetic motion/flicker – Vice Versa Et Cetera
Authors: Payne Simon
Published: July 2012

This article reviews a variety of compelling motion effects in a series of canonical avant-garde films and experimental videos, with a view to contextualizing the author’s own recent digital video work Vice Versa Et Cetera. It begins with the smooth but perplexing movement in
two key examples of video art drawn from the pioneering work of Woody Vasulka, in the 1970s, and David Larcher’s high-end video works of the late 1990s. These videos are contrasted with an account of the ‘flicker effect’ in films that span avant-garde films of the 1920s through
to Paul Sharits’ films of the 1960s, in which striking optical/stroboscopic phenomena dominate movement. The third point of reference concerns the perception of ‘frenetic motion’ in a range of works where the illusion of movement seems to resolve itself, or break through,
despite the radical discontinuity between frames. The discussion of these films and videos, which define three different models of time-based imaging, provides grounds for the account and description of the perceptual phenomena in the author’s own work.
Motion comics: Modes of adaptation and the issue of authenticity
Authors: Smith Craig
Published: July 2012

Motion comics can be considered as an emerging form of digital animation that typically appropriates and remediates an existing comic book narrative and artwork into a screen-based animated narrative. One such example of motion comic adaptation is The Watchmen, which was released on
DVD and is also available on the iTunes online store as a digital download. This article argues that this new hybrid media raises unique considerations in terms of adaptation, and therefore provides a brief summary of key debates in adaptation studies, with a particular emphasis on the issue
of authenticity. This is followed by a study of conventional adaptation practices from a comic book source and the emerging digital post-production approaches of animators and creative practitioners in the motion comic field, including a discussion on the importance of sound.
Happy accidents: Participatory culture and the public reconstruction of Bob Ross
Authors: Falvey L. D.
Published: July 2012

Using American populist landscape artist Bob Ross as a case study, I examine how participatory culture can challenge elitist notions of 'high art'. Traditionally, the act of consecrating the artist and her work has been a polarizing, marginalizing 'private' performance that privileges a powerful cadre of 'taste makers' at the exclusion of the masses. Through the evaluation of a body of work on YouTube by amateurs who seek to replicate and parody Ross' thematic ideological and instructional messages, I suggest that this type of amateur production offers an alternate, oppositional read of Ross and provides him with a posthumous success that negates the elitist criticism that otherwise dismisses his work as trite and transparent.
Security for sale! The visual rhetoric of marketing counter-terrorism technologies
Authors: Feigenbaum Anna
Published: July 2012

While much is written on government, legal and media discourses of security and counter-terrorism, very few studies turn a critical eye towards 'mediation' as it applies to the marketing of counter-terrorism technologies. Counter-terrorism technologies include everything from surveillance cameras to biometric scanners, data protection software to perimeter-security fencing. Together they comprise one of the largest, most profitable product sectors in the global economy. In this article I look at the visual corporate communication strategies used to market counter-terrorism technologies to both governments and the private sector. I use a dual method approach to perform this investigation. First, I conduct a visual analysis of promotional material produced by counter-terrorism technology manufacturers including product brochures and advertisements in defence magazines. Second, I draw from participant-observation research carried out over the past three years at counter-terrorism expos. This research offers insight into how discourses around security and counter-terrorism are shaped not only through government and military PR (as it is often spread through the mass media), but also by defence technology manufacturers and marketers ranging from major security conglomerates such as Group4Securicor and Magal Security Systems, to telecommunication giants including AT&T and IBM.
The renaissance of 'Keep Calm and Carry On'
Authors: Lewis Bex
Published: July 2012

In the twenty-first century, 'Keep Calm and Carry On' and other Second World War posters have grown in popularity, particularly in the United Kingdom, but also globally. This article returns us to the original history of 'Keep Calm and Carry On': how it was planned, prepared, created and then abandoned in 1939. We consider why the Second World War remains important in British memories, and how the poster, rediscovered in 2000, has become so important in more recent times of recession.
The DPP4 inhibitor linagliptin delays the onset of diabetes and preserves β-cell mass in non-obese diabetic mice
Authors: Jelsing Jacob , Vrang Niels , van Witteloostuijn Søren B , Mark Michael , Klein Thomas
Published: July 2012

Recent data indicate that dipeptidyl peptidase 4 (DPP4) inhibitors have anti-inflammatory and β-cell-sparing effects in animal models of type 1 diabetes. To evaluate the effects of the DPP4 inhibitor linagliptin on β-cell mass and insulinitis, we examined the progression of diabetes (blood glucose >11 mmol/l) in non-obese diabetic (NOD) mice with terminal stereological assessment of cellular pancreatic changes. Female NOD mice were fed a normal chow diet or a diet containing linagliptin 0.083 g/kg chow for 60 days. At study end, the incidence of diabetes in linagliptin-treated mice was reduced by almost 50% compared with vehicle (10 of 31 mice vs 18 of 30 mice, P=0.021). The total islet mass and total β-cell mass, identified by insulin immunoreactivity, were greater in non-diabetic linagliptin-treated mice compared with non-diabetic vehicle-treated mice (P<0.01 for both) but were greatly reduced in diabetic mice irrespective of treatment. No changes were seen in the α, δ and γ endocrine cell pool. Moreover, the total mass of lymphocyte insulinitis was significantly reduced in linagliptin-treated mice compared with vehicle. The data indicate that linagliptin treatment delays the onset of diabetes in NOD mice by protecting β-cell mass.
Duplicated zebrafish co-orthologs of parathyroid hormone-related peptide (PTHrP, Pthlh) play different roles in craniofacial skeletogenesis
Authors: Yan Yi-Lin , Bhattacharya Poulomi , He Xin Jun , Ponugoti Bhaskar , Marquardt Ben , Layman Jason , Grunloh Melissa , Postlethwait John H , Rubin David A
Published: July 2012

In mammals, parathyroid hormone-related peptide (PTHrP, alias PTH-like hormone (Pthlh)) acts as a paracrine hormone that regulates the patterning of cartilage, bone, teeth, pancreas, and thymus. Beyond mammals, however, little is known about the molecular genetic mechanisms by which Pthlh regulates early development. To evaluate conserved pathways of craniofacial skeletogenesis, we isolated twoPthlhco-orthologs from the zebrafish (Danio rerio) and investigated their structural, phylogenetic, and syntenic relationships, expression, and function. Results showed thatpthlhduplicates originated in the teleost genome duplication. Zebrafishpthlhaandpthlhbwere maternally expressed and showed overlapping and distinct zygotic expression patterns during skeletal development that mirrored mammalian expression domains. To explore the regulation of duplicatedpthlhgenes, we studied their expression patterns in mutants and found that bothsox9aandsox9bare upstream ofpthlhain arch and fin bud cartilages, but onlysox9bis upstream ofpthlhain the pancreas. Morpholino antisense knockdown showed thatpthlharegulates bothsox9aandsox9bin the pharyngeal arches but not in the brain or otic vesicles and thatpthlhbdoes not regulate eithersox9gene, which is likely related to its highly degraded nuclear localization signal. Knockdown ofpthlhabut notpthlhbcausedrunx2boverexpression in craniofacial cartilages and premature bone mineralization. We conclude that in normal cartilage development,sox9upregulatespthlh, which downregulatesrunx2, and that the duplicated nature of all three of these genes in zebrafish creates a network of regulation by different co-orthologs in different tissues.
Physiological concentrations of interleukin-6 directly promote insulin secretion, signal transduction, nitric oxide release, and redox status in a clonal pancreatic β-cell line and mouse islets
Authors: da Silva Krause Mauricio , Bittencourt Aline , Homem de Bittencourt Paulo Ivo , McClenaghan Neville H , Flatt Peter R , Murphy Colin , Newsholme Philip
Published: July 2012

Interleukin-6 (IL6) has recently been reported to promote insulin secretion in a glucagon-like peptide-1-dependent manner. Herein, the direct effects of IL6 (at various concentrations from 0 to 1000 pg/ml) on pancreatic β-cell metabolism, AMP-activated protein kinase (AMPK) signaling, insulin secretion, nitrite release, and redox status in a rat clonal β-cell line and mouse islets are reported. Chronic insulin secretion (in μg/mg protein per 24 h) was increased from 128.7±7.3 (no IL6) to 178.4±7.7 (at 100 pg/ml IL6) in clonal β-cells and increased significantly in islets incubated in the presence of 5.5 mM glucose for 2 h, from 0.148 to 0.167±0.003 ng/islet. Pretreatment with IL6 also induced a twofold increase in basal and nutrient-stimulated insulin secretion in subsequent 20 min static incubations. IL6 enhanced both glutathione (GSH) and glutathione disulphide (GSSG) by nearly 20% without changing intracellular redox status (GSSG/GSH). IL6 dramatically increased iNOS expression (byca. 100-fold) with an accompanying tenfold rise in nitrite release in clonal β-cells. Phosphorylated AMPK levels were elevated approximately twofold in clonal β-cells and mouse islet cells. Calmodulin-dependent protein kinase kinase levels (CaMKK), an upstream kinase activator of AMPK, were also increased by 50% after IL6 exposure (in β-cells and islets). Our data have demonstrated that IL6 can stimulate β-cell-dependent insulin secretion via direct cell-based mechanisms. AMPK, CaMKK (an upstream kinase activator of AMPK), and the synthesis of nitric oxide appear to alter cell metabolism to benefit insulin secretion. In summary, IL6 exerts positive effects on β-cell signaling, metabolism, antioxidant status, and insulin secretion.
Lateral laryngopharyngeal diverticula: a videofluoroscopic study of laryngopharyngeal wall in wind instrumentalists
Authors: Costa Milton Melciades Barbosa , Alvite Fátima Lago
Published: July 2012

CONTEXT: This paper analyze healthy musicians who play wind instruments. OBJECTIVE: To identify possible diverticular formations on the laryngopharyngeal wall produced by pharyngeal overpressure during the use of these instruments. METHODS: Through a videofluoroscopic method, 22 professional musicians had their pharynx analyzed in frontal face and profile, by swallowing 20 mL of barium sulfate solution and blowing against resistance. RESULTS: All the volunteers showed lateral laryngopharyngeal diverticula (3 unilateral and 19 bilateral) with areas ranging from 0.7 to 6 cm². Trumpet and clarinet players showed larger diverticula, on both the right and left sides. Any important complaints were noted spontaneously or after questions. In the barium-swallow analyses, the 41 diverticula previously identified in the blowing tests were not seen or appeared to be smaller, because of the free flux passage from the pharynx to the esophagus. Despite the existence of the other, less resistant areas on the laryngopharyngeal segment, no other protrusions could be found in this group of wind instrumentalists. CONCLUSIONS: The lateral laryngopharyngeal diverticula that occur in blow instrumentalists is distinct of diverticula produced by laryngopharyngeal overpressure determined by abnormally high resistance to flux passage from pharynx to esophagus. In musicians is the persistent and continuous pharyngeal overpressure induced by the resistance of the instrument's mouthpiece will strongly distend the anatomically less resistant areas of the pharynx, producing a large protrusion. Laryngopharyngeal overpressure without abnormal resistance to flux passage explain the way blow instrumentalists protrusions did not appear as full sacs in a barium-swallow test, despite their larger dimensions. As final conclusion the musician-acquired diverticula must be considered as an "occupational overuse syndrome".
Comparative study of two modes of gastroesophageal reflux measuring: conventional esophageal pH monitoring and wireless pH monitoring
Authors: Azzam Rimon Sobhi , Sallum Rubens A. A. , Brandão Jeovana Ferreira , Navarro-Rodriguez Tomás , Nasi Ary
Published: July 2012

CONTEXT: Esophageal pH monitoring is considered to be the gold standard for the diagnosis of gastroesophageal acid reflux. However, this method is very troublesome and considerably limits the patient's routine activities. Wireless pH monitoring was developed to avoid these restrictions. OBJECTIVE: To compare the first 24 hours of the conventional and wireless pH monitoring, positioned 3 cm above the lower esophageal sphincter, in relation to: the occurrence of relevant technical failures, the ability to detect reflux and the ability to correlate the clinical symptoms to reflux. METHODS: Twenty-five patients referred for esophageal pH monitoring and with typical symptoms of gastroesophageal reflux disease were studied prospectively, underwent clinical interview, endoscopy, esophageal manometry and were submitted, with a simultaneous initial period, to 24-hour catheter pH monitoring and 48-hour wireless pH monitoring. RESULTS: Early capsule detachment occurred in one (4%) case and there were no technical failures with the catheter pH monitoring (P = 0.463). Percentages of reflux time (total, upright and supine) were higher with the wireless pH monitoring (P < 0.05). Pathological gastroesophageal reflux occurred in 16 (64%) patients submitted to catheter and in 19 (76%) to the capsule (P = 0.355). The symptom index was positive in 12 (48%) patients with catheter pH monitoring and in 13 (52%) with wireless pH monitoring (P = 0.777). CONCLUSIONS: 1) No significant differences were reported between the two methods of pH monitoring (capsule vs catheter), in regard to relevant technical failures; 2) Wireless pH monitoring detected higher percentages of reflux time than the conventional pH-metry; 3) The two methods of pH monitoring were comparable in diagnosis of pathological gastroesophageal reflux and comparable in correlating the clinical symptoms with the gastroesophageal reflux.
Eosinophilic esophagitis: manometric and pHmetric findings
Authors: Monnerat Monica Maria Cardoso , Lemme Eponina Maria De Oliveira
Published: July 2012

CONTEXT: Eosinophilic esophagitis is an entity characterized by an esophageal inflammatory infiltrate of eosinophils, manifested by dysphagia, intermittent food impactions and symptoms similar to gastroesophageal reflux disease (GERD), that predominantly affects young adults. There may be association of eosinophilic esophagitis with GERD, and motor abnormalities have been described. OBJECTIVE: The main objectives of this study are to describe the findings at esophageal manometry and pH monitoring in patients with eosinophilic esophagitis. METHODS: Cross-sectional study of 20 patients with a diagnosis of eosinophilic esophagitis, submitted to esophageal manometry and 24h pH monitoring. Were analysed the manometric changes and the presence of abnormal reflux on pH monitoring. RESULTS: Twenty patients (15 men, 5 women) had a mean age of 29 years. Motility disorders were found in 25% (5/20) patients with ineffective esophageal motility being the most common finding. pH monitoring revealed abnormal reflux on 25%, without any relationship with manometric findings. CONCLUSIONS: Manometric abnormalities were observed in 25% of patients and abnormal reflux on pH monitoring also in 25%. This study showed no relationship between abnormal reflux and the presence of manometric changes.
Risk factors for swallowing dysfunction in stroke patients
Authors: Baroni Anna Flávia Ferraz Barros , Fábio Soraia Ramos Cabette , Dantas Roberto Oliveira
Published: July 2012

CONTEXT: Stroke is a frequent cause of dysphagia. OBJECTIVE: To evaluate in a tertiary care hospital the prevalence of swallowing dysfunction in stroke patients, to analyze factors associated with the dysfunction and to relate swallowing dysfunction to mortality 3 months after the stroke. METHODS: Clinical evaluation of deglutition was performed in 212 consecutive patients with a medical and radiologic diagnosis of stroke. The occurrence of death was determined 3 months after the stroke. RESULTS: It was observed that 63% of the patients had swallowing dysfunction. The variables gender and specific location of the lesion were not associated with the presence or absence of swallowing dysfunction. The patients with swallowing dysfunction had more frequently a previous stroke, had a stroke in the left hemisphere, motor and/or sensitivity alterations, difficulty in oral comprehension, alteration of oral expression, alteration of the level of consciousness, complications such as fever and pneumonia, high indexes on the Rankin scale, and low indexes on the Barthel scale. These patients had a higher mortality rate. CONCLUSIONS: Swallowing evaluation should be done in all patients with stroke, since swallowing dysfunction is associated with complications and an increased risk of death.
Case study of stomach adenocarcinoma conducted at a cancer referral hospital in northern Brazil
Authors: Vinagre Ruth Maria Dias Ferreira , Campos Brenda Prazeres de , Sousa Rachid Marwan Pinheiro
Published: July 2012

CONTEXT: Stomach cancer is the second leading cause of death due to cancer in the world and the incidence of this disease continues to be high in Brazil. In the Northern region, gastric cancer is the second most frequent cancer among men and the third among women. In the State of Pará, stomach adenocarcinoma is a public health problem since mortality rates are above the Brazilian average. OBJECTIVE: To analyze the clinical and anatomopathological profile of stomach adenocarcinoma in patients seen at Ofir Loiola Hospital. METHODS: In a retrospective study, records from 302 patients with gastric cancer undergoing surgery between 2006 and 2008 were analyzed. Data regarding patient profile, early symptoms, alterations upon physical examination, type of surgery, and macroscopic and histological findings were obtained from the records. RESULTS: Most patients (63.9%) were men, 48% were older than 60 years, 50.9% were from the metropolitan region of Belém, 68.2% presented epigastric pain as an early symptom, and abdominal tenderness upon palpation was observed in 63.7%. The antrum was the most affected anatomical site (62.1%), followed by the gastric body (26.9%). Borrmann III (ulcerated-infiltrative) was the predominant endoscopic type. Adenocarcinoma accounted for 95.4% of all cases, including the intestinal type in 56.6% and the diffuse type in 41.3%. Most patients had stage IIIB and IV tumors and total gastrectomy was the most frequent type of surgery (37.4%). CONCLUSION: The present study demonstrated that gastric adenocarcinoma mainly affected men over the age of 60 who were from the metropolitan region of Belém. Most adenocarcinomas were in an advanced stage at the time of diagnosis, a fact requiring more aggressive surgical resection in these cases. These data highlight the urgent need for the implementation of preventive measures and early detection programs of gastric cancer.
Toxicity of azathioprine: why and when? analysis of the prevalence of polymorphism in Joinville, SC, Brazil
Authors: Gastal Gabriela Roncone , Moreira Simone , Noble Caroline Furtado , Ferreira Leslie Ecker , França Paulo Henrique Condeixa de , Pinho Mauro
Published: July 2012

CONTEXT: The use of thiopurine drugs such as azathioprine and 6-mercaptopurine has become quite common in the treatment of inflammatory bowel disease, transplantation and acute leukemias. Despite their effectiveness, these drugs are capable of causing drug-induced toxicity with the risk of death by myelosuppression. It is now known that these complications occur because of genetic polymorphisms of the thiopurinemethyltransferase (TPMT) enzyme, responsible for its metabolism. OBJECTIVE: To assess the prevalence of thiopurine methyltransferase polymorphisms in the population of Joinville, SC, Brazil. METHODS: We analyzed the frequency of four main allelic variants of the TPMT gene in 199 blood donors from Joinville, from February to April 2010. RESULTS: The normal allele ("wild-type") was found in 93.9% of subjects studied. TPMT variants were detected in 12 subjects (6.03%). CONCLUSIONS: From this study, it was estimated at 6% the risk of toxicity by the administration of azathioprine and 6-mercaptopurine to patients in Joinville.
Mortality and complications in patients with portal hypertension who underwent transjugular intrahepatic portosystemic shunt (TIPS) - 12 years experience
Authors: Funes Fernanda Ribeiro , Silva Rita de C. M. A. da , Arroyo Jr. Paulo César , Duca William José , Silva Adinaldo Adhemar Menezes da , Silva Renato Ferreira da
Published: July 2012

CONTEXT: Transjugular intrahepatic portosystemic shunt (TIPS) is the non-surgical treatment option with low level of morbi-mortality and possibility of accomplishment in patients with severe hepatic dysfunction which aims at decompressing the portal system treating or reducing the portal hypertension complications. OBJECTIVE: Outline the profile analyze global and early mortality, and the complications presented by cirrhotic patients who underwent TIPS for treatment of digestive hemorrhage by portal hypertension. METHOD: Retrospective study based on the data bank of cirrhotic patients' medical reports, who underwent TIPS for digestive hemorrhage by portal hypertension treatment who did not respond to clinical endoscopic treatment, and were assisted from 1998 to 2010 in the Liver Transplant Service at a university hospital. The study was approved by the Committee of Ethics and Research. RESULTS: The sample was comprised of 72 (84.7%) patients, being 57 (79.2%) males, average age 47.7 years (age range from 16 to 85 years and SD = 13), 21 (29.2%) patients presented liver disease as cause excessive intake of alcoholic drinks; 21 (29.2%) contamination by hepatitis virus, 16 (22.2%) excessive alcohol intake associated with virus and 14 (19.4%) patients presented other causes. As for initial classification, 14 (20%) had Child-Pugh A, 33 (47.1%) Child-Pugh B and 23 (32.9%) Child-Pugh C. Initial MELD was obtained in 68 patients being 37 (54.4%) higher than 15 points while 31 (45.6%) had up to 15 points. Early death occurred in 19 (26.4%). Global mortality occurred in 41 (60.3%). CONCLUSIONS: Mortality is directly related to clinical factors of patients, being Child-Pugh and MELD classifications predictors of mortality, with more impact in patients with Child-Pugh class C and MELD > 15. The complications found were similar to those described in the literature, although the dysfunction by stent stenosis (26.4%) was lower than in the most of the studies and the encephalopathy incidence (58.3%) was higher. Probably, the high incidence of encephalopathy is explained by the low incidence of stenosis.
Effectiveness of alpha interferon (+ ribavirin) in the treatment of chronic viral hepatitis C genotypes 2 and 3 in a brazilian sample
Authors: Gonçalves Candice Beatriz Treter , Amaral Karine Medeiros , Sander Guilherme Becker , Martins Norberto Luis Campos , Pereira Lisandra , Picon Paulo Dornelles
Published: July 2012

CONTEXT: Pharmacovigilance studies aim to detect, assess, understand and prevent risks of adverse effects of medications or any other possible drug related problem. Alpha interferon is being produced by Bio-Manguinhos/Fiocruz, Rio de Janeiro, RJ, Brazil and used in the treatment of chronic hepatitis C at Brazilian National Health System. OBJECTIVE: To study the safety profile and effectiveness of alpha interferon in a sample of Brazilian patients with chronic hepatitis C genotypes 2 and 3, in Porto Alegre, RS, Brazil. METHOD: We followed a cohort of chronic hepatitis C genotypes 2 and 3 patients treated with alpha interferon plus ribavirin in a specialized outpatient clinic in southern Brazil. Adverse events were collected and classified according to severity in monthly structured interviews. To measure effectiveness, hepatitis C viral load was evaluated before, at the end and 24 weeks after the treatment. RESULTS: We followed 141 patients during the study period, of which 52.5% were female with mean age of 52 years. The most frequent adverse events were fatigue (84%), headache (79%) and myalgia (75%). There were 13 treatment interruptions due to adverse events, 9 of those considered serious adverse events. Virological response at end of treatment was 54.6% and after 24 weeks 39.7%, considering all patients who started treatment. CONCLUSION: The product produced by Bio-Manguinhos has similar efficacy and adverse event and sustained virological response profiles comparable to those found in the literature. This is the first study of pharmacovigilance performed with the Brazilian product. These data will be useful for planning and management of this disease in Brazil.
Predictive factors of early graft loss in living donor liver transplantation
Authors: Alves Rogério Camargo Pinheiro , Fonseca Eduardo Antunes da , Mattos Carla Adriana Loureiro de , Abdalla Sofia , Gonçalves José Eduardo , Waisberg Jaques
Published: July 2012

CONTEXT: Living donor liver transplantation has become an alternative to reduce the lack of organ donation. OBJECTIVE: To identify factors predictive of early graft loss in the first 3 months after living donor liver transplantation. METHODS: Seventy-eight adults submitted to living donor liver transplantation were divided into group I with 62 (79.5%) patients with graft survival longer than 3 months, and group II with 16 (20.5%) patients who died and/or showed graft failure within 3 months after liver transplantation. The variables analyzed were gender, age, etiology of liver disease, Child-Pugh classification, model of end-stage liver disease (MELD score), pretransplantation serum sodium level, and graft weight-to-recipient body weight (GRBW) ratio. The GRBW ratio was categorized into < 0.8 and MELD score into >18. The chi-square test, Student t-test and uni- and multivariate analysis were used for the evaluation of risk factors for early graft loss. RESULTS: MELD score <18 (P<0.001) and serum sodium level > 135 mEq/L (P = 0.03) were higher in group II than in group I. In the multivariate analysis MELD scores > 18 (P<0.001) and GRBW ratios < 0.8 (P<0.04) were significant. CONCLUSIONS: MELD scores >18 and GRBW < 0.8 ratios are associated with higher probability of graft failure after living donor liver transplantation.
Bowel preparation for performing a colonoscopy: prospective randomized comparison study between a low-volume solution of polyethylene glycol and bisacodyl versus bisacodyl and a mannitol solution
Authors: Vieira Manoel Carlos , Hashimoto Claudio Lyoiti , Carrilho Flair José
Published: July 2012

CONTEXT: Colonoscopy is currently the gold standard method to examine the colon, the rectum and the terminal ileum. In order to perform the colonoscopy, it is necessary to clean the bowel and use medications that are generally poorly tolerated by the patients. OBJECTIVE: Compare the tolerability, acceptability, safety and efficacy of two solutions used for intestinal preparation for a colonoscopy. METHODS: One hundred patients matched for sex and age were prospective randomized into two groups. Polyethylene glycol group received bisacodyl 10 mg plus 1 L of polyethylene glycol the night before and 1 L on the day of the exam. Mannitol group received bisacodyl 20 mg the day before and 1 L of a 10% mannitol solution on the day of the exam. The diet was the same for both groups. Tolerability and acceptability were measured using previously validated questionnaires. In terms of safety, variations in vital signs before and after the preparation were recorded, in addition to any complications. The quality of the preparation was graded based on the Boston and Ottawa scales. RESULTS: Ninety-six percent (96%) completed the study. As for tolerability, the mannitol preparation group exhibited a significantly higher frequency of nausea, vomiting, abdominal pain, and abdominal distension than polyethylene glycol group (P < 0.05). Acceptability was significantly better in polyethylene glycol group. The polyethylene glycol solution has also previously been shown to be safer than mannitol. No difference was observed in the quality of the preparation between the two preparation methods. CONCLUSIONS: The following conclusions can be made: polyethylene glycol solution had higher tolerability, acceptability, and safety than the mannitol and should be used instead of mannitol. Both preparation solutions have similar efficacy.
The onset of psoriasis during the treatment of inflammatory bowel diseases with infliximab: should biological therapy be suspended?
Authors: Denadai Rafael , Teixeira Fábio Vieira , Saad-Hossne Rogério
Published: July 2012

CONTEXT: Several paradoxical cases of infliximab-induced or-exacerbated psoriatic lesions have been described in the recent years. There is disagreement regarding the need to discontinue infliximab in order to achieve the resolution of these adverse cutaneous reactions specifically in inflammatory bowel disease (IBD) patients. OBJECTIVE: To systematically review the literature to collect information on IBD patients that showed this adverse cutaneous reaction, focusing mainly on the therapeutic approach. METHODS: A systematic literature review was performed utilizing Medline, Embase, SciELO and Lilacs databases. Published studies were identified, reviewed and the data were extracted. RESULTS: Thirty-four studies (69 IBD patients) met inclusion criteria for review. There was inconsistency in reporting of some clinical and therapeutic aspects. Most patients included had Crohn's disease (89.86%), was female (47.83%), had an average age of 27.11 years, and no reported history of psoriasis (84.05%). The patients developed primarily plaque-type psoriasis (40.58%). There was complete remission of psoriatic lesions in 86.96% of IBD patients, existing differences in the therapeutic approaches; cessation of infliximab therapy led to resolution in 47.83% of cases and 43.48% of patients were able to continue infliximab therapy. CONCLUSION: As increasing numbers of IBD patients with psoriasis induced or exacerbated by infliximab, physicians should be aware of its clinical manifestations so that appropriate diagnosis and treatment are properly established. The decision whether to continue or discontinue infliximab should be individualized.
Nosocomial infections in a pediatric intensive care unit of a developing country: NHSN surveillance
Authors: Porto Juliana Pena , Mantese Orlando Cesar , Arantes Aglai , Freitas Claudete , Gontijo Filho Paulo Pinto , Ribas Rosineide Marques
Published: July 2012

INTRODUCTION: This study aimed to determine the epidemiology of the three most common nosocomial infections (NI), namely, sepsis, pneumonia, and urinary tract infection (UTI), in a pediatric intensive care unit (PICU) in a developing country and to define the risk factors associated with NI. METHODS: We performed a prospective study on the incidence of NI in a single PICU, between August 2009 and August 2010. Active surveillance by National Healthcare Safety Network (NHSN) was conducted in the unit and children with NI (cases) were compared with a group (matched controls) in a case-control fashion. RESULTS: We analyzed 172 patients; 22.1% had NI, 71.1% of whom acquired it in the unit. The incidence densities of sepsis, pneumonia, and UTI per 1,000 patients/day were 17.9, 11.4, and 4.3, respectively. The most common agents in sepsis were Enterococcus faecalis and Escherichia coli (18% each); Staphylococcus epidermidis was isolated in 13% of cases. In pneumonias Staphylococcus aureus was the most common cause (3.2%), and in UTI the most frequent agents were yeasts (33.3%). The presence of NI was associated with a long period of hospitalization, use of invasive devices (central venous catheter, nasogastric tube), and use of antibiotics. The last two were independent factors for NI. CONCLUSIONS: The incidence of NI acquired in this unit was high and was associated with extrinsic factors.
Incontinência urinária autorreferida no pós-parto: características clínicas
Authors: Lopes Daniela Biguetti Martins , Praça Neide de Souza
Published: July 2012

Este estudo transversal teve como objetivo caracterizar as manifestações de incontinência urinária autorreferida no pós-parto. Foram entrevistadas 288 mulheres atendidas em um Centro de Saúde Escola do município de São Paulo, entre janeiro e agosto de 2009. Os dados indicaram que, dentre as 71 mulheres incontinentes (24,6%), 44 destas (62%) referiram incontinência urinária aos esforços, 65 (91,5%) sentiam a urina escoar, 33 mulheres (46,5%) apresentavam perdas por mais de uma vez na semana e 24 (33,8%) acusaram perda urinária persistente no momento da entrevista. A gravidade, classificada como incontinência urinária moderada, foi constatada em 53 mulheres (74,7%). Os achados realçam a importância de investigações sobre incontinência urinária no período pós-parto, assim como sua abordagem no ensino e na assistência à mulher no período reprodutivo.
Tradução e adaptação para a cultura brasileira do Gaudenz-Fragebogen
Authors: Oliveira Léa Dolores Reganhan de , Guirardello Edinêis de Brito , Lopes Maria Helena Baena de Moraes
Published: July 2012

O artigo visa descrever o processo de tradução e adaptação para a cultura brasileira do Gaudenz-Fragebogen, instrumento de origem alemã, utilizado no diagnóstico da incontinência urinária feminina. Seguiram-se, nesse intuito, as etapas recomendadas pela literatura internacional: tradução, síntese das traduções, retrotradução, avaliação pelo comitê de especialistas e pré-teste. Os processos de tradução e adaptação foram realizados a contento e o instrumento demonstrou ser de fácil compreensão. Entretanto, este é um estudo que antecede o processo de validação e será premente o emprego do instrumento em novas pesquisas para que sejam avaliadas suas propriedades de medida.
Efeitos de intervenções em saúde sobre os hábitos alimentares e medidas físicas
Authors: Mendonça Raquel de Deus , Lopes Aline Cristine Souza
Published: July 2012

O estudo teve como objetivo determinar efeitos de intervenções em saúde sobre hábitos alimentares e medidas físicas. Trata-se de estudo de intervenção quase experimental com usuários de Serviço de Saúde. Avaliaram-se, portanto, hábitos alimentares, antropometria e pressão arterial (PA) e aplicou-se Questionário de Frequência Alimentar no ingresso dos indivíduos no serviço. Intervenções: grupos de atividade física e educação nutricional, e acompanhamento nutricional individual. Mensuraram-se os efeitos pela repetição das medidas físicas e pelo teste Como está sua alimentação. Foram avaliados 167 indivíduos (idade média=52,5±12,6; 92,8% mulheres). Após a intervenção, houve redução da PA sistólica (p=0,02) e do uso de banha animal (p<0,01); aumento do percentual de indivíduos com classificação normal para circunferência da cintura, do consumo diário de verduras/legumes e leite/derivados (p<0,01). Participar das intervenções foi efetivo para melhorar a alimentação e saúde dos usuários, denotando a importância de intervenções que associem práticas alimentares e atividade física para a promoção da saúde.
Crenças em saúde sobre a dieta: uma perspectiva de pessoas negras hipertensas
Authors: Pires Cláudia Geovana da Silva , Mussi Fernanda Carneiro
Published: July 2012

Pesquisa descritiva-exploratória, objetivou identificar as crenças em saúde, de pessoas negras com hipertensão arterial, sobre as barreiras e benefícios relacionados à dieta para o controle da doença, conhecendo os fatores sociodemográficos associados às crenças em saúde quanto aos benefícios para o controle da dieta. Cento e seis adultos, negros e hipertensos foram entrevistados utilizando-se instrumento específico. Os dados foram analisados em percentuais, frequência de casos, escores e razão de prevalência. A análise global sobre as crenças mostrou predomínio da categoria e benefícios para o controle da dieta. Foi observada tendência entre homens, pessoas mais jovens, sem companheiro e com baixas escolaridade e renda à menor crença quanto aos os benefícios atinentes à adoção da dieta. Concluiu-se que a promoção da saúde da população negra exige abordagem interdisciplinar e política de saúde, contemplando as suas especificidades e necessidades e dirigidas a aspectos preventivos e curativos.
Avaliação dos sintomas de ansiedade e depressão em fibromiálgicos
Authors: Santos Emanuella Barros dos , Quintans Junior Lucindo José , Fraga Byanka Porto , Macieira José Caetano , Bonjardim Leonardo Rigoldi
Published: July 2012

Este estudo teve como objetivo identificar a frequência de sintomas ansiosos e depressivos verificando a associação entre a ansiedade-traço, sintomas atuais de depressão e ansiedade nos fibromiálgicos. Foram entrevistados 60 sujeitos com diagnóstico de fibromialgia no Ambulatório de Reumatologia da Universidade Federal de Sergipe, entre agosto de 2007 a março de 2008, sendo aplicados dois questionários: Escala Hospitalar de Ansiedade e Depressão (EHAD) e o Inventário de Ansiedade Traço-Estado (IDATE-T). A frequência de sintomas depressivos e ansiosos foi, respectivamente, de 50% e 86% para os fibromiálgicos e a média do escore do traço ansioso foi de 59,38. Detectou-se associação entre a ansiedade-traço e estado. A ansiedade e a depressão foram sintomas frequentes nos pacientes com fibromialgia. Entretanto, a ansiedade revelou-se um sintoma secundário mais frequente que a depressão, apresentando-se uma forma mais grave, sendo uma comorbidade que deve ser melhor valorizada e estudada.
Avaliação do crescimento microbiano em sondas de uso único para vitrectomia reprocessadas na prática assistencial
Authors: Pinto Flávia Morais Gomes , Araújo Valéria Garcia Lopes , Souza Rafael Queiroz de , Goveia Vânia Regina , Missali Carmen Castilho , Luz Reginaldo Adalberto de , Graziano Kazuko Uchikawa
Published: July 2012

O objetivo deste estudo foi avaliar o crescimento microbiano em sondas para vitrectomia de uso único, reprocessadas na prática assistencial. Foram investigadas nove sondas reusadas e reprocessadas por diferentes métodos. As sondas foram segmentadas, individualmente, em porções de 3,5 cm, totalizando em 979 unidades amostrais (extensões, conectores e ponteiras) inoculadas em meio de cultura e incubadas a 37ºC, por 14 dias. Os resultados mostraram crescimento microbiano em 57 (5,8%) unidades amostrais, das quais, 25 foram esterilizadas por Óxido de Etileno, 16 por Plasma de Peróxido de Hidrogênio e 16 por Vapor à Baixa Temperatura e Formaldeído. Foram identificadas 17 espécies microbianas, sendo as mais prevalentes o Micrococcus spp., Staphylococcus coagulase negativa, Pseudomonas spp. e Bacillus subtilis. O reuso de sondas de uso único para vitrectomia não se mostrou seguro, portanto tal prática não é recomendada.
Trabalho educativo do enfermeiro na Estratégia Saúde da Família: dificuldades e perspectivas de mudanças
Authors: Roecker Simone , Budó Maria de Lourdes Denardin , Marcon Sonia Silva
Published: July 2012

Este estudo objetivou conhecer as dificuldades e perspectivas de mudanças que os enfermeiros identificam no desenvolvimento das ações educativas na Estratégia Saúde da Família (ESF). Trata-se de uma pesquisa qualitativa descritivo-exploratória. Os dados foram coletados junto a 20 enfermeiros que atuam na ESF, no âmbito da 10ª Regional de Saúde do Paraná, por meio de entrevistas semiestruturadas, no mês de abril de 2010, as quais foram submetidas à análise de conteúdo. Os resultados demonstraram que os enfermeiros enfrentam dificuldades no desenvolvimento da educação em saúde junto aos usuários, à equipe, aos gestores e quanto à falta de recursos físicos, materiais e financeiros. Mas, a partir das dificuldades sentidas, buscam alternativas diversificadas para superá-las e sugerem modificações visando à melhoria na atenção primária à saúde da população, principalmente, no que tange ao trabalho educativo.