bluuebunny/crossref_metadata_2025 huggingface dataset:
Tumour diameter is not reliable for management of non-secreting pancreatic neuroendocrine tumours
Authors: Mills Logan , Drymousis Panagiotis , Vashist Yogesh , Burdelski Christoph , Prachalias Andreas , Srinivasan Parthi , Menon Krishna , Cotoi Corina , Khan Saboor , Cave Judith , Armstrong Thomas , Weickert Martin O , Izbicki Jakob , Schrader Joerg , Frilling Andreja , Ramage John K , Srirajaskanthan Raj
Published: November 2017

Small non-functioning pancreatic NETs (pNETs) ≤2 cm can pose a management dilemma in terms of surveillance or resection. There is evidence to suggest that a surveillance approach can be considered since there are no significant radiological changes observed in lesions during long-term follow-up. However, other studies have suggested loco-regional spread can be present in ≤2 cm pNETs. The aim of this study was to characterise the prevalence of malignant features and identify any useful predictive variables in a surgically resected cohort of pNETs. 418 patients with pNETs were identified from 5 NET centres. Of these 227 were included for main analysis of tumour characteristics. Mean age of patients was 57 years, 47% were female. The median follow-up was 48.2 months. Malignant features were identified in 38% of ≤2 cm pNETs. ROC analysis showed that the current cut-off of 20 mm had a sensitivity of 84% for malignancy. The rate of malignant features is in keeping with other surgical series and challenges the belief that small pNETs have a low malignant potential. This study does not support a 20 mm size cut-off as being a solitary safe parameter to exclude malignancy in pNETs.
The Influence of Genetic Stability onAspergillus fumigatusVirulence and Azole Resistance
Authors: dos Reis Thaila Fernanda , Silva Lilian Pereira , de Castro Patrícia Alves , Almeida de Lima Pollyne Borborema , do Carmo Rafaela Andrade , Marini Marjorie Mendes , da Silveira José Franco , Ferreira Beatriz Henriques , Rodrigues Fernando , Malavazi Iran , Goldman Gustavo H
Published: November 2017

Genetic stability is extremely important for the survival of every living organism, and a very complex set of genes has evolved to cope with DNA repair upon DNA damage. Here, we investigated the Aspergillus fumigatus AtmA (Ataxia-telangiectasia mutated, ATM) and AtrA kinases, and how they impact virulence and the evolution of azole resistance. We demonstrated that A. fumigatus atmA and atrA null mutants are haploid and have a discrete chromosomal polymorphism. The ΔatmA and ΔatrA strains are sensitive to several DNA-damaging agents, but surprisingly both strains were more resistant than the wild-type strain to paraquat, menadione, and hydrogen peroxide. The atmA and atrA genes showed synthetic lethality emphasizing the cooperation between both enzymes and their consequent redundancy. The lack of atmA and atrA does not cause any significant virulence reduction in A. fumigatus in a neutropenic murine model of invasive pulmonary aspergillosis and in the invertebrate alternative model Galleria mellonela. Wild-type, ΔatmA, and ΔatrA populations that were previously transferred 10 times in minimal medium (MM) in the absence of voriconazole have not shown any significant changes in drug resistance acquisition. In contrast, ΔatmA and ΔatrA populations that similarly evolved in the presence of a subinhibitory concentration of voriconazole showed an ∼5–10-fold increase when compared to the original minimal inhibitory concentration (MIC) values. There are discrete alterations in the voriconazole target Cyp51A/Erg11A or cyp51/erg11 and/or Cdr1B efflux transporter overexpression that do not seem to be the main mechanisms to explain voriconazole resistance in these evolved populations. Taken together, these results suggest that genetic instability caused by ΔatmA and ΔatrA mutations can confer an adaptive advantage, mainly in the intensity of voriconazole resistance acquisition.
Rapid and Efficient CRISPR/Cas9-Based Mating-Type Switching of Saccharomyces cerevisiae
Authors: Xie Ze-Xiong , Mitchell Leslie A , Liu Hui-Min , Li Bing-Zhi , Liu Duo , Agmon Neta , Wu Yi , Li Xia , Zhou Xiao , Li Bo , Xiao Wen-Hai , Ding Ming-Zhu , Wang Ying , Yuan Ying-Jin , Boeke Jef D
Published: November 2017

Rapid and highly efficient mating-type switching of Saccharomyces cerevisiae enables a wide variety of genetic manipulations, such as the construction of strains, for instance, isogenic haploid pairs of both mating-types, diploids and polyploids. We used the CRISPR/Cas9 system to generate a double-strand break at the MAT locus and, in a single cotransformation, both haploid and diploid cells were switched to the specified mating-type at ∼80% efficiency. The mating-type of strains carrying either rod or ring chromosome III were switched, including those lacking HMLα and HMRa cryptic mating loci. Furthermore, we transplanted the synthetic yeast chromosome V to build a haploid polysynthetic chromosome strain by using this method together with an endoreduplication intercross strategy. The CRISPR/Cas9 mating-type switching method will be useful in building the complete synthetic yeast (Sc2.0) genome. Importantly, it is a generally useful method to build polyploids of a defined genotype and generally expedites strain construction, for example, in the construction of fully a/a/α/α isogenic tetraploids.
Delayed Encounter of Parental Genomes Can Lead to Aneuploidy in Saccharomyces cerevisiae
Authors: Tartakoff Alan Michael , Dulce David , Landis Elizabeth
Published: November 2017

We have investigated an extreme deviation from the norm of genome unification that occurs during mating in the yeast, Saccharomyces cerevisiae. This deviation is encountered when yeast that carry a mutation of the spindle pole body protein, Kar1, are mated with wildtype cells. In this case, nuclear fusion is delayed and the genotypes of a fraction of zygotic progeny suggest that chromosomes have “transferred” between the parental nuclei in zygotes. This classic, yet bizarre, occurrence is routinely used to generate aneuploid (disomic) yeast. [kar1 × wt] zygotes, like [wt × wt] zygotes, initially have a single spindle pole body per nucleus. Unlike [wt × wt] zygotes, in [kar1 × wt] zygotes, the number of spindle pole bodies per nucleus then can increase before nuclear fusion. When such nuclei fuse, the spindle pole bodies do not coalesce efficiently, and subsets of spindle pole bodies and centromeres can enter buds. The genotypes of corresponding biparental progeny show evidence of extensive haplotype-biased chromosome loss, and can also include heterotypic chromosomal markers. They thus allow rationalization of chromosome “transfer” as being due to an unanticipated yet plausible mechanism. Perturbation of the unification of genomes likely contributes to infertility in other organisms.
Autoethnographic writing inside and outside the academy and ethics
Authors: Andrew Martin Benedict , Rossignol Rachel Le
Published: November 2017

Published writers of fictional or semi-fictional works entering the academy as doctoral candidates express surprise at the requirements of formal human ethics reviews. Admitting an element of the autoethnographic exists in their writing, they may insist that they possess what Freeman called ‘narrative integrity’. This paper considers the ethics of autoethnography as they apply to both the academy, chiefly within the PhD by artefact and exegesis, and the world of published writers, seeking possible solace from such scholarly concepts as ‘relational ethics’, or ‘ethic of care’. Drawing methodologically on our experience as doctoral supervisor and student and with the permission of writer/students whose stories are inseparable from this work, this study unpacks in ethical terms the problems reported by students whose methodology involves evocative or performative autoethnography. As interpretatist methodologists, autoethnographers maintain it provides insights into the interplay between the personally engaged self and mediated cultural descriptions. Methodologically, it enacts the self and others as data. This connection between the personal and the social makes it difficult for autoethnographers to speak of themselves without speaking of others. Examining autoethnography involves a close scrutiny of the boundaries between the self and the other, a process that is both enlightening and essential for supervisory dyads in creative writing methodologically informed by autoethnography. These aspects of the ethics of autoethnography are crucial, but little attention has been paid to the problematic notion that practiceled research is emergent in practice and that its autoethnography requires a retrospective approach, looking backwards as well as forwards. The reality of applying this methodology in practice-led research clashes with the pro-active nature of ethics procedurals required by universities. The paper identifies nine praxical problems that arise from such clashes, and considers best-practice principles for responding to these problems, drawing strongly on indigenous research. Finally, it offers conclusions relating to consent, transparency and the need to open a dialogue around best practice in autoethnographic research in the academic field of Writing.
Outside the box
Authors: Cope Suzanne
Published: November 2017

There has been little scholarly work looking at the use of creative writing pedagogy within non-creative writing courses. However, ‘Outside the box: Incorporating high stakes creative writing assignments into non-major literature courses, a case study’ demonstrates promising findings when incorporating high stakes creative writing assignments into the curriculum for core English literature courses. This article gives an overview of the Progressive history of ‘creative’ writing in the academy and then outlines contemporary sources that reference the burgeoning field of Creative Writing Studies and how creative writing pedagogy may be used more broadly in classrooms in a variety of disciplines. Then the case study details the assignments and experience of teaching a high stakes creative assignment in a non-major literature course at an undergraduate liberal arts institution. Using 25 representative student responses from among 50 total students over multiple semesters, the article concludes by asserting the findings that the inclusion of a high stakes creative assignment – in this case an original short story that is workshopped by peers and then revised – results in students who note increased confidence and creativity, and who state making connections between the relevance of writing instruction and workshopping to their lives outside of the classroom. While further, more formalized study would be beneficial on this topic, this study provides a useful perspective not just to teachers within the English department but also has ramifications for interdisciplinary scholarship.
Language use in social network sites
Authors: Christiansen M. Sidury
Published: November 2017

The language used in digital communication has erroneously been considered a simple extension of spoken language. However, research has established that writers in digital environments reshape orthographies to construct identities and audiences and with the help of other social-semiotic resources such as images, sounds, and hyperlinks, they create new meanings (Androutsopoulos, 2015; Knobel and Lankshear, 2008; Mills, 2010). Such research has not thoroughly examined bilingual populations, who employ their often vast repertoire of language varieties to similar ends. The goal of this article is to explore a specific case of how orality influences writing in the digital spaces of members of a social network of Mexican bilinguals. By studying how these bilinguals communicate on Facebook, we can observe how in relationship to the semi-public platform, they create new meanings through linguistically innovative audience-based writing. This practice aids them in maintaining their bilingualism and their bilingual identity.
Interdisciplinary postgraduate writing
Authors: Kaufhold Kathrin
Published: November 2017

Humanities departments across European universities have established an increasing number of interdisciplinary, international master’s programmes that culminate in thesis projects. Yet, the challenges of such interdisciplinary research-based writing have been largely neglected in EAP research. This article investigates how postgraduate students in interdisciplinary fields express and develop genre knowledge during an EAP course for Humanities students preparing for their thesis writing. In two case studies, the article qualitatively explores students’ perspectives on their writing along the related dimensions of disciplinary positioning and genre knowledge. Students’ explicit expressions of such knowledge in course tasks and interviews are analysed. In addition, students’ research-based writing is compared to trace manifestations of this knowledge. The results highlight the students’ use of individual reference points to evaluate writing within their heterogeneous research fields. In terms of their research-based writing, the cases illustrate two related trajectories, namely, the development from writer to topic focus and the combination of themes into a coherent argument. Tracing the textual developments reveals the significance of mapping interdisciplinary studies on the interrelated epistemological, thematic and discoursal levels in postgraduate writing. Developing an awareness of these levels requires an understanding of the situatedness of postgraduates’ writing in interdisciplinary, departmental and biographical contexts.
Secondary school students’ source reporting and evaluation in project writing
Authors: Li Yongyan , Ge Meng , Chen Qianshan , Hu Xiao , Chu Samuel Kai Wah
Published: November 2017

In Hong Kong schools, source-based writing has risen in prominence in recent years with the incorporation of inquiry project-based learning (PjBL) into the curricula. Understanding how school students write from sources in this context will constitute a crucial step toward identifying potential problems and targeting educational strategies. In this paper we report an exploratory study of how junior secondary school (Forms 1–3) students reported sources in their research-based group project reports in the Liberal Studies subject in the environment of a Wiki online platform. Our analyses of a sample of 30 project reports focused on discovering how the students used reporting verbs and expressions to report information from sources, and how they expressed positive and critical evaluation of their sources. Our study addressed a gap in the literature by examining school students’ source-use practices in their first language, with valuable pedagogical insights generated and avenues of future research suggested.
Tackling text types through grammar
Authors: O'Dowd Elizabeth
Published: November 2017

This article addresses the challenge of writing instruction in a standards-based environment where students are accountable for mastering different genres and text types. The Common Core State Standards (CCSS), now adopted by the majority of states in the USA, provide exemplars of successful papers in the different disciplines, but offer no guidelines for teaching, particularly to inexperienced writers or English language learners. Since a text in any genre can be developed in a limitless variety of ways, students need a methodology for analyzing effective texts, and for developing their own. This article proposes that focusing on grammatical choice offers an entry point into understanding the craft of Explanations and Arguments. To illustrate, four samples of high school writing are analyzed from the published CCSS exemplars: two Explanations and two Arguments, all with very different purposes and development. The analysis demonstrates the central role that grammar plays in constructing these differences. Specifically, the analysis focuses on information management across noun groups for the Explanations, and on verb choice and modality for the Arguments. Drawing on functional grammar insights, this article proposes a pathway for students from the analysis of model texts to the effective construction of their own.
Microsurgical treatment of basilar tip aneurysms: is it still acceptable?
Authors: Pahl Felix Hendrik , Oliveira Matheus Fernandes de , Rotta José Marcus
Published: November 2017

ABSTRACT Basilar tip aneurysms (BTAs) have a complex anatomy, making them difficult to treat. We describe our surgical results for BTAs. Methods: From 2004 to 2015 (12 years), a total of 25 small BTAs and two giant BTAs were treated in the Hospital do Servidor Público Estadual de São Paulo. Results: In 23 patients harboring aneurysms positioned anteriorly or straight, all aneurysms were clipped (complete exclusion in all on follow-up angiography). In two patients with posteriorly positioned aneurysms, there was residual neck. All patients submitted to surgical treatment of small aneurysms presented with late Glasgow Outcome Scale scores of 4 or 5. Two patients with giant aneurysms died. Conclusion: Surgical treatment of these lesions may be accomplished with quite high success rates and low morbidity.
Physicians are not well informed about the new guidelines for the treatment of acute stroke
Authors: Gatto Luana Antunes Maranha , Koppe Gelson Luis , Demartini Junior Zeferino , Zétola Viviane de Hiroki Flumignan
Published: November 2017

ABSTRACT Treatment of cerebrovascular disease has advanced rapidly in the last two decades. Recent data has added challenges to the treatment of ischemic stroke in the acute phase. Objective: To evaluate the knowledge of physicians about the treatment of ischemic stroke in the acute phase. Methods: An online questionnaire was submitted to all physicians enrolled in the Regional Council of Medicine in Brazil. Results: 456 physicians from different specialties answered the questions. Most of them did not know that mechanical endovascular thrombectomy is often considered as the gold standard treatment in cases of ischemic stroke in the acute phase; and 85% of them did not realize that thrombectomy together with intravenous thrombolysis was possible. The maximum time to act in an acute event also presented many divergences, even with regard to the infusion of rtPA. The lack of structure, medication and absence of a neurologist were considered the main barriers to treatment. Conclusion: Physicians are not well informed about the new guidelines for the treatment of acute stroke. Most physicians incorrectly answered most of the questions on the questionnaire.
Could infarct location predict the long-term functional outcome in childhood arterial ischemic stroke?
Authors: López-Espejo Mauricio , Hernández-Chávez Marta
Published: November 2017

ABSTRACT Objective: To explore the influence of infarct location on long-term functional outcome following a first-ever arterial ischemic stroke (AIS) in non-neonate children. Method: The MRIs of 39 children with AIS (median age 5.38 years; 36% girls; mean follow-up time 5.87 years) were prospectively evaluated. Infarct location was classified as the absence or presence of subcortical involvement. Functional outcome was measured using the modified Rankin scale (mRS) for children after the follow-up assessment. We utilized multivariate logistic regression models to estimate the odds ratios (ORs) for the outcome while adjusting for age, sex, infarct size and middle cerebral artery territory involvement (significance < 0.05). Results: Both infarcts ≥ 4% of total brain volume (OR 9.92; CI 1.76 – 55.9; p 0.009) and the presence of subcortical involvement (OR 8.36; CI 1.76 – 53.6; p 0.025) independently increased the risk of marked functional impairment (mRS 3 to 5). Conclusion: Infarct extension and location can help predict the extent of disability after childhood AIS.
Implementing an epilepsy surgery center. Initial experience at a university hospital in Brazil
Authors: Escudeiro Gabriel Pereira , Leal Rafael Teixeira Magalhães , Almeida Heros Henrique Melo de , Acioly Marcus Andre , Landeiro José Alberto , Pessoa Bruno Lima
Published: November 2017

ABSTRACT Epilepsy is a serious neurological condition, often without a full and effective treatment. In some cases, surgery is beneficial, despite being underused. Our aim herein is to describe the implementation of an epilepsy surgery center in a federal university hospital, sharing the initial experience gained, as well as describing the main challenges and first results. Methods: Experience report of an epilepsy surgery center implementation. Retrospective review of 13 drug-resistant patients who underwent surgical treatment. Results: Thirteen patients underwent surgical epilepsy treatment, five patients categorized as the International League Against Epilepsy class 1, two in class 2, three in class 3, zero in class 4, and two in class 5; with a 30.76% complication rate. Conclusion: Despite the challenges, it was possible to implement an epilepsy surgery center with favorable results and acceptable incidence of complications, which were not higher than the incidences found in more experienced centers.
Paula Coutinho’s outstanding contribution to the definition of Machado-Joseph disease
Authors: Garcia Bruno Carniatto Marques , Germiniani Francisco Manoel Branco , Marques Paula , Sequeiros Jorge , Teive Hélio Afonso Ghizoni
Published: November 2017

ABSTRACT Machado-Joseph disease, also known as spinocerebellar ataxia type 3, is the most common form of autosomal dominant ataxia in the world. Paula Coutinho, a highly-regarded Portuguese neurologist worldwide, had a seminal participation in the definition of this disease, more than 40 years ago.
Charles Miller Fisher: the 65th anniversary of the publication of his groundbreaking study “Transient Monocular Blindness Associated with Hemiplegia”
Authors: Araújo Tiago Fernando Souza de , Lange Marcos , Zétola Viviane H. , Massaro Ayrton , Teive Hélio A. G.
Published: November 2017

ABSTRACT Charles Miller Fisher is considered the father of modern vascular neurology and one of the giants of neurology in the 20th century. This historical review emphasizes Prof. Fisher's magnificent contribution to vascular neurology and celebrates the 65th anniversary of the publication of his groundbreaking study, “Transient Monocular Blindness Associated with Hemiplegia.”
Neurological complications of solid organ transplantation
Authors: Pedroso José Luiz , Dutra Lívia Almeida , Braga-Neto Pedro , Abrahao Agessandro , Andrade João Brainer Clares de , Silva Gabriel Lopes da , Viana Laila Almeida , Pestana José Osmar Medina , Barsottini Orlando G.
Published: November 2017

ABSTRACT Solid organ transplantation is a significant development in the treatment of chronic kidney, liver, heart and lung diseases. This therapeutic approach has increased patient survival and improved quality of life. New surgical techniques and immunosuppressive drugs have been developed to achieve better outcomes. However, the variety of neurological complications following solid organ transplantation is broad and carries prognostic significance. Patients may have involvement of the central or peripheral nervous system due to multiple causes that can vary depending on time of onset after the surgical procedure, the transplanted organ, and the intensity and type of immunosuppressive therapy. Neurological manifestations following solid organ transplantation pose a diagnostic challenge to medical specialists despite extensive investigation. This review aimed to provide a practical approach to help neurologists and clinicians assess and manage solid organ transplant patients presenting with acute or chronic neurological manifestations.
Presumed Zika virus-related congenital brain malformations: the spectrum of CT and MRI findings in fetuses and newborns
Authors: Castro José Daniel Vieira de , Pereira Licia Pacheco , Dias Daniel Aguiar , Aguiar Lindenberg Barbosa , Maia Joanira Costa Nogueira , Costa Jesus Irajacy Fernandes da , Castro Eveline Campos Monteiro de , Feitosa Francisco Edson de Lucena , Carvalho Francisco Herlânio Costa
Published: November 2017

ABSTRACT The new epidemic of Zika virus infection raises grave concerns, especially with the increasingly-recognized link between emerging cases of microcephaly and this infectious disease. Besides small cranial dimensions, there are striking morphologic anomalies in the fetal brain. Key anomalies include cortical developmental malformations and a peculiar distribution of pathologic calcifications. These potentially indicate a new pattern of congenital central nervous system infection. Methods: Eight women underwent fetal MRI. Four infants also underwent postnatal CT. Five of the women underwent amniocentesis. Results: All neonates were born with microcephaly. On fetal MRI, ventriculomegaly, marked reduction of white matter thickness, severe sylvian fissure simplification, abnormal sulcation, and diffuse volumetric loss of cerebellar hemispheres were consistently seen. On postnatal CT, diffuse subcortical and basal ganglia calcifications were observed. The Zika virus was detected in two amniocenteses by polymerase chain reaction assays. Conclusion: We hope to assist the medical community in recognizing the spectrum of encephalic changes related to congenital Zika virus infection.
Cross-cultural adaptation to Brazilian Portuguese of the Waterloo Footedness Questionnaire-Revised: WFQ-R-Brazil
Authors: Camargos Monike Barros , Palmeira Andressa da Silva , Fachin-Martins Emerson
Published: November 2017

ABSTRACT Post-stroke hemiparesis causes compensated postures, which can modify the footedness established before the impairment. Recently, a paresis severity-modulated dominance hypothesis stated that measures to detect footedness become crucial to float new ideas for neurorehabilitation strategies. The Waterloo Footedness Questionnaire-Revised (WFQ-R) represents the most acceptable measure but it had not yet been cross-culturally adapted for Portuguese spoken in Brazil. Our aim was to cross-culturally adapt the WFQ-R to Brazilian Portuguese, verifying its reliability. We completed the essential steps to cross-culturally adapt one version, tested in 12 patients with post-stroke hemiparesis and 12 able-bodied individuals, sampled by convenience, to verify reliability. Measurements were taken by two independent raters during the test and by one of them at the one-week retest. No great semantic, linguistic or cultural differences were found, and acceptable reliability was recorded. The WFQ-R-Brazil is reliable and ready for use in the Brazilian able-bodied and post-stroke hemiparesis population.
Frecuencia y variables asociadas a estigma-discriminación percibido en víctimas del conflicto armado colombiano
Authors: Campo-Arias Adalberto , Ospino Anyelly C. , Sanabria Adriana R. , Guerra Valeria M. , Caamaño Beatriz H. , Herazo Edwin
Published: November 2017

Resumen: Se desconoce la frecuencia de complejo estigma-discriminación percibido en víctimas del conflicto armado colombiano. El objetivo del estudio fue establecer la frecuencia y variables asociadas al estigma-discriminación percibido en víctimas del conflicto armado, en municipios del Departamento del Magdalena, Colombia. Se realizó un estudio transversal con víctimas registradas en el Programa de Atención Psicosocial y Salud Integral a Víctimas. Los síntomas depresivos se cuantificaron con cuatro ítems dicotómicos (tres o más se clasificaron como alto nivel de síntomas depresivos) y el estigma-discriminación percibido se cuantificó con seis incisos dicotómicos (dos o más afirmaciones se categorizó como alto estigma-discriminación percibido). Participaron 943 adultos (M = 47,9; DE = 14,2); 67,4%, mujeres; 109 (11,6%) informaron alto nivel de síntomas depresivos y 217 (23%) presentaron alto estigma-discriminación percibido. El alto estigma-discriminación percibido se asoció a alto nivel de síntomas depresivos (OR = 6,47; IC95%: 4,23-9,88). Se concluye que un cuarto de las víctimas del conflicto armado en Magdalena informa alto estigma-discriminación percibido; éste se asocia significativamente a alto nivel de síntomas depresivos.
Proposta de um instrumento para avaliar eventos adversos em odontologia
Authors: Corrêa Claudia Dolores Trierweiler Sampaio de Oliveira , Mendes Walter
Published: November 2017

Resumo: O objetivo deste estudo foi propor um conjunto de rastreadores para a pesquisa de eventos adversos em odontologia ambulatorial no Brasil. O instrumento foi elaborado em duas etapas: (i) para construir um conjunto preliminar de rastreadores foi realizada uma revisão da literatura, a fim de identificar a composição das ferramentas de rastreamento utilizadas nas demais áreas da saúde e os principais eventos adversos encontrados em odontologia; (ii) para validar os rastreadores preliminarmente construídos foi organizado um painel de especialistas empregando o método Delphi modificado. Foram elaborados quatorze rastreadores para compor um instrumento com critérios explícitos para identificar potenciais eventos adversos no cuidado odontológico, essenciais para os estudos de revisão retrospectiva de prontuários. Pesquisas relacionadas à segurança do paciente em odontologia ainda são bastante incipientes em relação às demais áreas da saúde. Este trabalho pretendeu contribuir para a investigação nesse campo. O aporte da literatura e a ajuda da expertise do painel de especialistas permitiram a elaboração de um conjunto de rastreadores para a detecção de eventos adversos odontológicos, no entanto, são necessários estudos adicionais para testar a validade do instrumento.
Consumo de leite materno e fatores associados em crianças menores de dois anos: Pesquisa Nacional de Saúde, 2013
Authors: Flores Thaynã Ramos , Nunes Bruno Pereira , Neves Rosália Garcia , Wendt Andrea T. , Costa Caroline dos Santos , Wehrmeister Fernando C. , Bertoldi Andréa Dâmaso
Published: November 2017

O objetivo foi avaliar a prevalência do consumo de leite materno e os fatores associados em crianças brasileiras com menos de dois anos de idade. Estudo transversal, de base nacional, realizado em 2013. Os desfechos foram amamentação entre crianças menores de 24 meses e amamentação exclusiva entre aquelas menores de seis meses de idade. Realizou-se análise hierárquica para fatores associados. As análises foram estratificadas por idade (0-5 meses e 29 dias; 6-11 meses e 29 dias; 12-23 meses e 29 dias de idade). A prevalência de aleitamento materno foi de 56% para o total estudado e, segundo idade, foi de 80% (0-5 meses e 29 dias), 62,3% (6-11 meses e 29 dias) e 40,1% (12-23 meses e 29 dias). Nas análises ajustadas, em todas as faixas etárias, a maior prevalência de ingestão de leite materno esteve associada ao menor número de alimentos lácteos consumidos. Entre crianças de 6-11 meses e 29 dias, residir na Região Norte, ter cor da pele preta e situar-se no menor quinto de posse de bens associaram-se a maior prevalência de amamentação. Naquelas entre 12-23 meses e 29 dias, maior prevalência de consumo de leite materno foi associado à cor da pele preta, consumo de líquidos e de alimentos saudáveis, residência na zona urbana, maior escolaridade do chefe da família e posse de maior número de bens. A prevalência de aleitamento exclusivo foi de 20,6%, sendo maior na Região Sul, nos maiores níveis de escolaridade do chefe da família e naquelas crianças com maior número de bens. As prevalências de amamentação e amamentação exclusiva nas crianças brasileiras menores de dois anos podem ser consideradas baixas. As políticas já existentes para aumentar as prevalências de consumo de leite materno, em qualquer faixa etária, devem ser reforçadas.
Impacto da deficiência intelectual moderada na dinâmica e na qualidade de vida familiar: um estudo clínico-qualitativo
Authors: Tomaz Rodrigo Victor Viana , Santos Vanessa de Arruda , Silva de Avó Lucimar Retto da , Germano Carla Maria Ramos , Melo Débora Gusmão
Published: November 2017

Este estudo clínico-qualitativo investigou o impacto da deficiência intelectual moderada na dinâmica e na qualidade de vida familiar. Os dados foram coletados por meio de entrevistas individuais com 15 mães de deficientes, escolhidas por conveniência, e examinados pela técnica de análise de conteúdo categorial temática. Os resultados foram discutidos usando-se abordagem compreensiva e interpretativa. Da análise das entrevistas apreendeu-se que o cuidado do filho deficiente é centrado na mãe, o que contribuiu para a modificação das relações familiares. O enfrentamento religioso apareceu como estratégia comum de ajuste. Os filhos deficientes tiveram acesso a menos serviços e suportes do que necessitavam, nas áreas de saúde, educação e lazer. Restrições financeiras e dificuldades no convívio comunitário impactaram negativamente na qualidade de vida familiar. Apoio emocional e psicológico para todos os membros da família, e apoio prático e social, incluindo distribuição de renda e acesso a serviços adequados, mostraram-se essenciais para o bem-estar do deficiente e de sua família.
Fórum PrEP: um debate on-line sobre uso da profilaxia pré-exposição no Brasil
Authors: Queiroz Artur Acelino Francisco Luz Nunes , Sousa Alvaro Francisco Lopes de
Published: November 2017

Este estudo objetivou identificar conteúdos promotores de saúde voltados à prevenção do HIV/aids, em postagens veiculadas em um grupo do Facebook destinado a debates sobre uso da profilaxia pré-exposição (PrEP). Trata-se de um estudo observacional, prospectivo, desenvolvido por meio de observação sistemática não-participativa. Durante o período de julho de 2015 a junho de 2016, todas as postagens realizadas no grupo foram catalogadas e formaram um corpus. Tudo foi processado no software IRaMuTeQ e analisado pela classificação hierárquica descendente. Os dados obtidos foram agrupados em três classes: (1) prevenção do HIV/aids: discutindo sobre profilaxia, tratamento, público alvo e efeitos colaterais; (2) acesso universal a PrEP no Brasil: discutindo as responsabilidades governamentais; (3) compra on-line da truvada: expondo uma situação de vulnerabilidade. Os achados alertam para um problema de saúde pública em potencial, e fornecem subsídios para compreender aspectos facilitadores e barreiras ao uso da PrEP no país, por meio da identificação de conteúdo promotores de saúde articulados com marcadores individuais, sociais e institucionais.
Abortion and sex-related conditions in substance-dependent Brazilian patients
Authors: Diehl Alessandra , Pillon Sandra Cristina , Santos Manoel Antonio dos , Laranjeira Ronaldo
Published: November 2017

Abstract: Abortion is a very sensitive issue with relevance to public health; however few clinical or population-based studies have examined induced abortion among drug users. The study aims to evaluate the prevalence of induced abortion and sex-related conditions in an inpatient drug user sample. A cross-sectional design study was conducted in an inpatient addiction treatment unit in São Paulo, Brazil, with a sample of 616 patients, aged 18-75. Sociodemographic data, sexual behavior, and dependence severity were evaluated in relation to induced abortion. Approximately 27% of patients reported having a history of abortion (themselves in the case of women or partners in the case of men). The mean age was 34.6±10.9 years old, 34.9% diagnosed with severe alcohol dependence, 33% were diagnosed with severe levels of dependence on other drugs, 69.6% were diagnosed cocaine users (inhaled and smoked), and alcohol was the drug of choice for 30.4%. Chances of having a history of abortion is greater for women than for men with a odds ratio (OR = 2.9; 95%CI: 1.75-4.76), (OR = 1.7; 95%CI: 1.09-2.75) of no condom use; (OR = 2.0; 95%CI: 1.35-3.23) of history of STI and (OR = 3.2; 95%CI: 1.29-5.73) use of morning-after pill. Drug- and alcohol-dependent patients have high-risk behaviours of sporadic use or no-condom use which contribute to unplanned pregnancy and induced abortion, making this vulnerable population a group which deserves special attention in sexual health prevention programmes and health promotion efforts for the reduction of induced abortion.
Processed and ultra-processed food consumption among children aged 13 to 35 months and associated factors
Authors: Batalha Mônica Araujo , França Ana Karina Teixeira da Cunha , Conceição Sueli Ismael Oliveira da , Santos Alcione Miranda dos , Silva Francelena de Sousa , Padilha Luana Lopes , Silva Antônio Augusto Moura da
Published: November 2017

Abstract: The aim of this study was to evaluate the consumption of processed and ultra-processed foods among children aged 13-35 months and its associated factors. We studied 1,185 children within the BRISA cohort in São Luís, Maranhão State, Brazil. The food consumption was investigated using a 24-hour recall, and the percentages of daily caloric intake and nutrients were estimated by food groups according to “NOVA” classification. We chose to categorize children belonging to the upper tertile of the distribution as having a high consumption of processed and ultra-processed food products. The Poisson regression model with robust variance estimation using a hierarchical modeling approach was used to calculate the prevalence ratios (PRs) of variables associated with high consumption of processed and ultra-processed food products. The mean energy intake was 1,226Kcal/day. After adjustments, there was a higher proportion of high consumption of processed and ultra-processed food products among children whose mothers had < 12 years of education and among children who were older than 16 months. Mothers with low schooling and children older than 16 months should be the targets of interventions aimed at reducing consumption of these food products and preventing adverse health outcomes in later life.
Assessing the role of appropriate primary health care on the use of dental services by Brazilian low-income preschool children
Authors: Baldani Márcia Helena , Rocha Juliana Schaia , Fadel Cristina Berger , Nascimento Antonio Carlos , Antunes José Leopoldo Ferreira , Moysés Samuel Jorge
Published: November 2017

Abstract: This cross-sectional study aimed to assess the association between the quality of primary health care (PHC) and the use of dental services by preschoolers served by the Family Health Strategy (FHS), controlling for socio-demographic determinants and perceived need. The sample encompassed 438 children aged 3-5 years, enrolled in 19 FHS facilities in Ponta Grossa, Paraná State, Brazil. Individual level variables were collected by interviewing parents or caregivers at home. They answered a questionnaire on socioeconomic conditions, oral hygiene habits and use of dental services. Parental perception of child’s oral health related quality of life, as perceived need, was assessed by the Brazilian version of Early Childhood Oral Health Impact Scale (ECOHIS). Normative need was assessed by oral examinations, according to guidelines standardized by the World Health Organization. The contextual level factor was defined as the extent of implementation of PHC in the facilities. Managers responded to PCATool-Brazil, a validated questionnaire which measures the extent of PHC. Dentists answered to a version of PCATool, which was adapted and pretested for dental services. Multilevel analysis, based on Andersen’s behavioral model, fitted the adjustment of “having ever consulted a dentist” to contextual and individual covariates. We observed high prevalence of dental caries. Almost half of the sample had had dental appointments in life. Social gradients were observed for the use of dental services. Although it was not able to eliminate the impact of adverse social conditions, higher levels of PHC attributes in dental services favored the effective use of such services by low-income children.
Narrativas de usuários de saúde mental em uma experiência de gestão autônoma de medicação
Authors: Gonçalves Laura Lamas Martins , Campos Rosana Teresa Onocko
Published: November 2017

Resumo: Numerosos estudos apontam a tendência à cronicidade dos tratamentos quando centrados no uso de medicamentos. Esta pesquisa foi realizada em uma grande cidade brasileira, com usuários de Centros de Atenção Psicossocial (CAPS), com o objetivo de avaliar os efeitos da experimentação do Guia pessoal da Gestão Autônoma da Medicação (Guia GAM) na relação desses usuários com seus tratamentos e nas suas ações de participação. Esse instrumento, criado no Canadá, traduzido e adaptado para o Brasil, foi experimentado, por meio de grupos de intervenção, com usuários de CAPS com transtorno mental grave e com história de participação política no campo da saúde. Foram realizados grupos focais e entrevistas em profundidade. As transcrições foram transformadas em narrativas, e foram definidas quatro categorias de análise: sujeitos de experiências radicais de sofrimento; experiências com a medicação; direitos de usuários; participação e militância política. Com a experimentação do Guia GAM, os usuários expressaram uma tensão entre a reprodução da identidade centrada na doença e a legitimidade da singularidade das suas experiências pessoais. Demonstraram maior conhecimento sobre os medicamentos que tomavam, passaram a reconhecer sua própria expertise, como o uso de medicamentos, e alguns buscaram ajustes no tratamento. Referiram necessidade de serem apoiados nos movimentos de reivindicação dos seus direitos e fortaleceram suas participações enquanto militantes da saúde mental. Conclui-se que a versão brasileira do Guia GAM tem potencial de contribuir com o empoderamento dos usuários, permitindo assim uma interlocução das avaliações de resultados em saúde mental com o cenário internacional.
Income inequality and high blood pressure in Colombia: a multilevel analysis
Authors: Lucumi Diego I. , Schulz Amy J. , Roux Ana V. Diez , Grogan-Kaylor Andrew
Published: November 2017

The objective of this research was to examine the association between income inequality and high blood pressure in Colombia. Using a nationally representative Colombian sample of adults, and data from departments and municipalities, we fit sex-stratified linear and logistic multilevel models with blood pressure as a continuous and binary variable, respectively. In adjusted models, women living in departments with the highest quintile of income inequality in 1997 had higher systolic blood pressure than their counterparts living in the lowest quintile of income inequality (mean difference 4.42mmHg; 95%CI: 1.46, 7.39). Women living in departments that were at the fourth and fifth quintile of income inequality in 1994 were more likely to have hypertension than those living in departments at the first quintile in the same year (OR: 1.56 and 1.48, respectively). For men, no associations of income inequality with either systolic blood pressure or hypertension were observed. Our findings are consistent with the hypothesis that income inequality is associated with increased risk of high blood pressure for women. Future studies to analyze pathways linking income inequality to high blood pressure in Colombia are needed.
Prevalence of syphilis and HIV infection during pregnancy in incarcerated women and the incidence of congenital syphilis in births in prison in Brazil
Authors: Domingues Rosa Maria Soares Madeira , Leal Maria do Carmo , Pereira Ana Paula Esteves , Ayres Barbara , Sánchez Alexandra Roma , Larouzé Bernard
Published: November 2017

Abstract: This study aimed to estimate the prevalence of syphilis and HIV infection during pregnancy, the mother to child transmission of syphilis and the incidence of congenital syphilis in incarcerated women in Brazil; to compare these rates to those observed in pregnant women outside of jail; and to verify the maternal factors associated with syphilis infection during pregnancy in free and incarcerated women. We used data from two nationwide studies conducted during the period 2011-2014. The Birth in Brazil study included 23,894 free women cared for in 266 hospitals. The Maternal and Infant Health in Prisons study included 495 incarcerated pregnant women or mothers living with their children, according to a census conducted in 33 female prisons. The same case definitions and data collection methods were used in both studies. The chi-square test was used to compare the characteristics of incarcerated and free women with a significance of 0.05. For incarcerated women, the estimated prevalence of syphilis during pregnancy was 8.7% (95%CI: 5.7-13.1) and for HIV infection 3.3% (95%CI: 1.7-6.6); the estimated mother to child transmission of syphilis was 66.7% (95%CI: 44.7-83.2) and the incidence of congenital syphilis was 58.1 per 1,000 living newborns (95%CI: 40.4-82.8). Incarcerated women had a greater prevalence of syphilis and HIV infection during pregnancy, lower quality of antenatal care and higher levels of social vulnerability. Syphilis infection showed to be an indicator of social vulnerability in free women, but not in incarcerated women. Health initiatives in prison are necessary to reduce healthcare inequalities and should include adequate antenatal and birth care.
Impact of Microabrasion on the Effectiveness of Tooth Bleaching
Authors: Perete-de-Freitas Camila Evelyn , Silva Paula Damasceno , Faria-e-Silva André Luis
Published: November 2017

Abstract The aim of the present study was to evaluate the effect of prior microabrasion on the teeth color change and tooth bleaching effectiveness. Eight sound molars were mesio-distally sectioned and the halves were randomly allocated to receive enamel microabrasion or non-abrasion (control) in one of surfaces (buccal or lingual), while the remaining surface received the other treatment. The tooth color on baseline was evaluated by spectrophotometer (CieL*a*b system). After the microabrasion procedure, the tooth color was measured again. Following, the specimens were bleached with 35% hydrogen peroxide for two sessions with one-week interval. The color was re-evaluated 7 days after each section and 30 days after the second session. The effect of enamel microabrasion on color changes was evaluated by paired T-test. Deltas L*, a*, b*, and E were calculated and data submitted to 2-way repeated measure ANOVA followed by Tukey`s test. Paired T-test was also used to assess possible differences on the ultimate color achieved after tooth bleaching. Enamel microabrasion reduced the lightness and increased the redness of specimens. Specimens that received microabrasion presented higher values of ∆L* than control after each bleaching procedure; and higher ∆a* after the 2nd bleaching session. However, the prior enamel microabrasion did not affect the ultimate values of color parameters. Despite enamel microabrasion have modified the tooth color, this procedure did not affect the ultimate results achieved with tooth bleaching using a high-concentrated hydrogen peroxide.