bluuebunny/crossref_metadata_2025 huggingface dataset:
The Anchor Contraction Effect in International Marketing Research
Authors: De Langhe Bart , Puntoni Stefano , Fernandes Daniel , Van Osselaer Stijn M.J.
Published: April 2011

In an increasingly globalized marketplace, it is common for marketing researchers to collect data from respondents who are not native speakers of the language in which the questions are formulated. Examples include online customer ratings and internal marketing initiatives in multinational corporations. This raises the issue of whether providing responses on rating scales in a person's native versus second language exerts a systematic influence on the responses obtained. This article documents the anchor contraction effect (ACE), the systematic tendency to report more intense emotions when answering questions using rating scales in a nonnative language than in the native language. Nine studies (1) establish ACE, test the underlying process, and rule out alternative explanations; (2) examine the generalizability of ACE across a range of situations, measures, and response scale formats; and (3) explore managerially relevant and easily implementable corrective techniques.
Shaping Consumer Imaginations: The Role of Self-Focused Attention in Product Evaluations
Authors: Hung Iris W. , Wyer Robert S.
Published: April 2011

Consumers’ attraction to a product can often be based on the subjective reactions that they imagine they would have if they personally used it. Three experiments examine the effects of self-focused attention on the use of this criterion and the conditions in which it is applied. When features of the judgment (social or nonsocial) context are similar to those of the situation in which the products are normally used, self-focused attention increases participants’ disposition to imagine themselves using the products they evaluate, and in turn, these imaginings increase both their evaluations of these products and their likelihood of choosing these products as a gift for taking part in the experiment. The effects occur when features of the judgment context are manipulated both by incidental background music and by the presence of others in the situation at hand. However, when either self-focused attention is low or features of the judgment context are dissimilar to those in which the products are normally used, these effects are not apparent.
Aesthetic Incongruity Resolution
Authors: Patrick Vanessa M. , Hagtvedt Henrik
Published: April 2011

Four studies demonstrate how consumers resolve the aesthetic incongruity that arises between a newly acquired product and the existing consumption environment. The novel insight on which this research is based is that the aesthetic incongruity involving products high in design salience is more likely than aesthetic incongruity involving products low in design salience to be resolved by accommodating the product within the consumption environment, often through additional purchases. Furthermore, the relative presence of frustration versus regret is shown to mediate the relationship between design salience and the decision to buy more.
Self-Regulatory Strength and Consumers’ Relinquishment of Decision Control: When Less Effortful Decisions Are More Resource Depleting
Authors: Usta Murat , Häubl Gerald
Published: April 2011

Using the self-regulatory strength model and prior research on self-esteem threats, the authors predict and show that delegating decisions to surrogates (e.g., financial advisors, physicians) depletes consumers’ limited self-regulatory resources more than making the same decisions independently, thus impairing their subsequent ability to exercise self-control. This is the case even though decision delegation actually requires less decision-making effort than independent decision making (Study 1). However, the resource-depleting effect of decision delegation vanishes when consumers have an opportunity to affirm their belief in free will (Study 2). Moreover, when people remember a past decision that they delegated, their self-control is impaired more than when they remember a decision made independently (Studies 3 and 4). The authors conclude with a discussion of the theoretical and practical implications of these findings.
Inhibition of Staphylococcus aureus cysteine proteases by human serpin potentially limits staphylococcal virulence
Authors: Kantyka Tomasz , Plaza Karolina , Koziel Joanna , Florczyk Danuta , Stennicke Hennig R. , Thogersen Ida B. , Enghild Jan J. , Silverman Gary A. , Pak Stephen C. , Potempa Jan
Published: April 2011

Bacterial proteases are considered virulence factors and it is presumed that by abrogating their activity, host endogenous protease inhibitors play a role in host defense against invading pathogens. Here we present data showing thatStaphylococcus aureuscysteine proteases (staphopains) are efficiently inhibited by Squamous Cell Carcinoma Antigen 1 (SCCA1), an epithelial-derived serpin. The high association rate constant (kass) for inhibitory complex formation (1.9×104m/s and 5.8×104 m/s for staphopain A and staphopain B interaction with SCCA1, respectively), strongly suggests that SCCA1 can regulate staphopain activityin vivoat epithelial surfaces infected/colonized byS. aureus. The mechanism of staphopain inhibition by SCCA1 is apparently the same for serpin interaction with target serine proteases whereby the formation of a covalent complex result in cleavage of the inhibitory reactive site peptide bond and associated release of the C-terminal serpin fragment. Interestingly, the SCCA1 reactive site closely resembles a motif in the reactive site loop of nativeS. aureus-derived inhibitors of the staphopains (staphostatins). Given thatS. aureusis a major pathogen of epithelial surfaces, we suggest that SCCA1 functions to temper the virulence of this bacterium by inhibiting the staphopains.
Accelerated Laboratory Pavement Model Test on Cemented Base and Clay Subgrade
Authors: Gnanendran C. T. , Piratheepan J. , Ramanujam J. , Arulrajah A.
Published: April 2011

This paper examines the pavement model test box (PMTB) testing method and its suitability for determining the stiffness modulus, fatigue and permanent deformation properties of a pavement structure constructed with a cementitiously stabilized granular base layer of 250 mm thickness and a clay subgrade layer of 330 mm thickness that are required for the design of a pavement structure involving these materials. A new laboratory PMTB test setup with extensive instrumentations to measure soil deformations and strains is presented in this paper. The suitability of this testing arrangement for determining the stiffness, fatigue and permanent deformation characteristics of a pavement structure was examined by studying the characteristics of a granular base material stabilized with 1.5 % general blend (GB) cement-flyash and a clay subgrade material. The test was continued at a frequency of 3 Hz up to 8 millions load cycles and measured horizontal tensile strain at the bottom of the stabilised base layer was used to determine the fatigue life of the stabilised layer. This study indicates that the deformation and strain measurement setups used for PMTB testing is suitable for undertaking cyclic load PMTB tests to determine the stiffness, fatigue and permanent deformation properties of the materials reliably.
Ovine corpus luteum proteins, with functions including oxidative stress and lipid metabolism, show complex alterations during implantation
Authors: Arianmanesh Mitra , McIntosh Rebecca H , Lea Richard G , Fowler Paul A , Al-Gubory Kaïs H
Published: April 2011

Progesterone (P4) secreted by the corpus luteum (CL) is critical for in utero embryo survival and development, although CL proteins are key regulatory factors during the luteal phase. We, therefore, characterised protein expression patterns in ovine CL of pregnancy (days 12, 16 and 20) compared with those of controls, CL of oestrous cycle (days 12 and 16), using two-dimensional gel electrophoresis (2DE) gel-based proteomics. Proteins in 24 significantly altered spots were identified by tandem mass spectroscopy. At the time of embryo implantation (day 16), 77 spots were up-regulated and 101 spots were down-regulated in CL of pregnancy compared with regressed CL. Vimentin, lamin A/C (LMNA), [Mn] superoxide dismutase (SOD2), isocitrate dehydrogenase 1, annexin A1 and elongation factor Tu, mitochondrial (TUFM) altered during CL regression, whereas glutathione S-transferase A1, apolipoprotein A-1, myxovirus resistance protein 1, ornithine aminotransferase and enoyl-CoA hydratase, mitochondrial (ECHS1) tended to be altered during CL maintenance. biliverdin reductase B (BLVRB), FDXR, guanine nucleotide-binding protein G(I)/G(S)/G(T) subunit beta-2 (GNB2) and cytochrome b-c1 complex subunit 1, mitochondrial (UQCRC1) showed divergent expression during CL regression and maintenance. The expression of two representative proteins, SOD2 and BLVRB, by western blot increased in CL of non-pregnant ewes on day 16 compared with that on day 12. SOD2 and BLVRB were localised in the large and small luteal cells and endothelial cells of CL over peri-implantation periods. 2DE gel and mass spectrometry have been used, for the first time, to study ovine CL function. We have identified proteins involved in key pathways, including oxidative stress, steroidogenesis, signal transduction and apoptosis, which have not previously been associated with changes occurring in the CL during the peri-implantation period. These proteins are most likely involved with mechanisms allowing the CL to produce P4 during early pregnancy.
Insulin treatment attenuates diabetes-increased atherosclerotic intimal lesions and matrix metalloproteinase 9 expression in apolipoprotein E-deficient mice
Authors: Schuyler Corinne A , Ta Nga N , Li Yanchun , Lopes-Virella Maria F , Huang Yan
Published: April 2011

Patients with diabetes mellitus have increased mortality and morbidity of cardiovascular diseases compared with nondiabetic patients. Although clinical studies have shown that effective glycemic control with insulin treatment in patients with type 1 diabetes is associated with reduced cardiovascular events, the underlying mechanisms have not been well understood. In this study, we treated diabetic apolipoprotein E-deficient (apoE−/−) mice with insulin for 20 weeks and studied the effect of insulin treatment on intimal lesion size and matrix metalloproteinase (MMP) 9 expression known to be involved in plaque destabilization. Results showed that insulin treatment, which effectively reduced plasma glucose level in diabetic mice, attenuated diabetes-increased intimal lesion size and significantly inhibited diabetes-increased MMP9 expression, but had no effect on tissue inhibitor of metalloproteinase 1 in atherosclerotic plaques. Furthermore, we observed that insulin treatment did not reduce diabetes-increased macrophage content but inhibited interleukin 6 expression, a stimulator for MMP expression. Taken together, this study has shown for the first time that insulin treatment in diabetic apoE−/− mice changes atherosclerotic lesions and gene expression to a state that favors plaque stability.
Influence of thyroidectomy on thyroxine metabolism and turnover rate in rats
Authors: Nagao Hidenori , Imazu Tetsuya , Hayashi Hiroyuki , Takahashi Kenjo , Minato Kouichi
Published: April 2011

Little is known about the kinetics and metabolism of thyroid hormones in the hypothyroid state. To investigate these factors, we developed a reliable method for measurement of serum thyroxine (T4), triiodothyronine (T3), reverse-T3 (rT3) and stable isotope-labeled T4 ([13C9]T4), using online solid-phase extraction liquid chromatography–mass spectrometry/mass spectrometry (online SPE LC–MS/MS). We measured supply and turnover rates of T4 in thyroidectomized (Tx) rats using [13C9]T4 as a tracer. In rats, serum T4, T3 and rT3 were decreased but not completely ablated after surgical Tx. Endogenous T4 and T3 levels in Tx rats were maintained at a constant low level throughout the experimental period. [13C9]T4 levels declined with a half-life of ∼1.2 days after it was administered to Tx rats intravenously. These findings strongly suggest that serum T4 levels in Tx rats are maintained by T4 supplied by extra-thyroidal tissues (e.g. secretion of extra-thyroidal storage, enhancement of enterohepatic recirculation, and production in extra-thyroidal tissues). Moreover, the turnover rate of T4 in Tx rats was approximately twofold lower than in controls. This finding suggests that degradation of serum T4 is repressed by Tx. In conclusion, serum T4 is maintained at a constant low level by T4 supply from extra-thyroidal tissues and repression of T4 degradation in Tx rats. The powerful online SPE LC–MS/MS tool can be used to investigate thyroid hormones kinetics and metabolism, and thus has the potential to be used as a diagnostic tool and to investigate the pathogenesis of thyroid disease.
Proximodistal Patterning in the Drosophila Leg: Models and Mutations
Authors: Baker Nicholas E
Published: April 2011

Limbs have a proximodistal axis that usually is not apparent early in development, a striking example of epigenesis. The proximodistal axis was the subject of experimental and theoretical study before any molecular genetic understanding emerged. As developmental genetic studies in Drosophila advanced, the descriptive polar coordinate model of the 1970s evolved into an understanding of how preexisting developmental compartments interact to express signaling molecules, including Hedgehog, Wingless, and Decapentaplegic, and how these define a proximodistal axis as limbs appear.
Explicit and implicit modeling of nanobubbles in hydrophobic confinement
Authors: Dzubiella Joachim
Published: April 2011

Water at normal conditions is a fluid thermodynamically close to the liquid-vapor phase coexistence and features a large surface tension. This combination can lead to interesting capillary phenomena on microscopic scales. Explicit water molecular dynamics (MD) computer simulations of hydrophobic solutes, for instance, give evidence of capillary evaporation on nanometer scales, i.e., the formation of nanometer-sized vapor bubbles (nanobubbles) between confining hydrophobic surfaces. This phenomenon has been exemplified for solutes with varying complexity, e.g., paraffin plates, coarse-grained homopolymers, biological and solid-state channels, and atomistically resolved proteins. It has been argued that nanobubbles strongly impact interactions in nanofluidic devices, translocation processes, and even in protein stability, function, and folding. As large-scale MD simulations are computationally expensive, the efficient multiscale modeling of nanobubbles and the prediction of their stability poses a formidable task to the'nanophysical' community. Recently, we have presented a conceptually novel and versatile implicit solvent model, namely, the variational implicit solvent model (VISM), which is based on a geometric energy functional. As reviewed here, first solvation studies of simple hydrophobic solutes using VISM coupled with the numerical level-set scheme show promising results, and, in particular, capture nanobubble formation and its subtle competition to local energetic potentials in hydrophobic confinement.
Plate motions, Gondwana Dinosaurs, Noah's Arks, Beached Viking Funeral Ships, Ghost Ships, and Landspans
Authors: Jacobs Louis L. , Strganac Christopher , Scotese Christopher
Published: April 2011

Gondwana landmasses have served as large-scale biogeographic Noah's Arks and Beached Viking Funeral Ships, as defined by McKenna. The latitudinal trajectories of selected Gondwana dinosaur localities were traced through time in order to evaluate their movement through climate zones relative to those in which they originally formed. The dispersal of fauna during the breakup of Gondwana may have been facilitated by the presence of offshelf islands forming landspans (sensu Iturralde-Vinent and MacPhee) in the Equatorial Atlantic Gateway and elsewhere.
Mesozoic dinosaurs from Brazil and their biogeographic implications
Authors: Bittencourt Jonathas S. , Langer Max C.
Published: April 2011

The record of dinosaur body-fossils in the Brazilian Mesozoic is restricted to the Triassic of Rio Grande do Sul and Cretaceous of various parts of the country. This includes 21 named species, two of which were regarded as nomina dubia, and 19 consensually assigned to Dinosauria. Additional eight supraspecific taxa have been identified based on fragmentary specimens and numerous dinosaur footprints known in Brazil. In fact, most Brazilian specimens related to dinosaurs are composed of isolated teeth and vertebrae. Despite the increase of fieldwork during the last decade, there are still no dinosaur body-fossils of Jurassic age and the evidence of ornithischians in Brazil is very limited. Dinosaur faunas from this country are generally correlated with those from other parts of Gondwana throughout the Mesozoic. During the Late Triassic, there is a close correspondence to Argentina and other south-Pangaea areas. Mid-Cretaceous faunas of northeastern Brazil resemble those of coeval deposits of North Africa and Argentina. Southern hemisphere spinosaurids are restricted to Africa and Brazil, whereas abelisaurids are still unknown in the Early Cretaceous of the latter. Late Cretaceous dinosaur assemblages of south-central Brazil are endemic only to genus or, more conspicuously, to species level, sharing closely related taxa with Argentina, Madagascar, Indo-Pakistan and, to a lesser degree, continental Africa.
Transportadores de glicose
Authors: Machado Ubiratan Fabres
Published: April 2011

A glicose, principal fonte de energia celular, é transportada na maioria das células por difusão facilitada, através de proteínas transportadoras presentes na membrana plasmática. Está caracterizada a existencia de urna familia de transportadores (GLUT1-GLUT7), com características funcionáis e distribuição tecidual distintas. Por outro lado, em epitelios intestinal e tubular renal, o transporte é contra gradiente e acoplado ao Na+ na membrana apical das células através de cotransportadores (SGLT1-SGLT2), com posterior difusão para o intersticio através de GLUTs presentes na membrana basolateral. As alterações fisiopatológicas do transporte de glicose passaram a ser investigadas através da análise dos transportadores, objetivando futuras abordagens preventivas ou terapêuticas. Uma mutação em um aminoácido do SGLT1 já foi descrita na malabsorção de glicose/galactose. Na glicosúria renal familiar, a participação do SGLT2 e do SGLT1 parece ser fundamental, seja por perda da capacidade de transporte, seja por diminuição na afinidade do transportador. A síndrome de De Vivo, descrita em recém-nascidos com quadro convulsivo, e hipoglicorraquia na vigência de normoglicemia, foi atribuída a uma redução no conteúdo de GLUT1, nas células endoteliais da barreira hematoencefálica. Extensas investigações têm sido conduzidas para avaliar o papel do GLUT4 em alterações de sensibilidade insulínica, tais como diabete melito tipo 2 (DM2). Os estudos revelam que no DM2, o GLUT4 reduz-se dramaticamente o que desempenha um importante papel na resistência insulínica. Na obesidade, o conteúdo de GLUT4 não está diminuído enquanto a sensibilidade à insulina estiver preservada. É plausível propor-se que a modulação do GLUT4 seja acionada por uma conjunção de fatores que expressam a sensibilidade celular à insulina. Além disso, o DM altera o conteúdo de GLUT 1 e GLUT2 no túbulo renal, mas o papel dessa modulação no processo de reabsorção da glicose ainda é desconhecido.
Alterações metabólicas e funcionais do zinco em diabetes mellitus
Authors: Pedrosa Lúcia de F. Campos , Cozzolino Sílvia Maria F.
Published: April 2011

O objetivo desta revisão foi relatar as alterações metabólicas e fisiológicas do zinco na presença do diabetes mellitus. O zinco é componente de várias enzimas e participa de vias metabólicas que envolvem a síntese de proteínas, metabolismo de carboidratos, de lipídeos e de ácidos nucléicos. Este mineral tem sido relacionado com a interação entre hormônios e seus receptores, e com melhoras no estímulo pós receptor. Estudos in vitro apontam que a insulina pode se complexar com o zinco melhorando a solubilidade e estocagem deste hormônio nas células beta do pâncreas. Em diabetes mellitus experimental, tem sido detectado alterações na concentração e na distribuição de zinco nos tecidos, assim como hiperzincúria logo após a indução da doença. Em pacientes com diabetes do tipo 1 ou tipo 2, as avaliações bioquímicas têm demonstrado concentrações de zinco no plasma inversamente proporcionais ao tempo de duração da doença, baixos valores em células sangüíneas, assim como hiperzincúria logo após a indução da doença. O mau controle metabólico nestes pacientes pode estar associado à depleção intracelular de zinco, predispondo a alterações no estado nutricional deste mineral. O conhecimento das funções do zinco no metabolismo de nutrientes, no crescimento, no sistema imunológico e nos tecidos oculares tem gerado especulações em relação ao envolvimento da deficiência deste micronutriente na gênese de algumas complicações da doença.
Doença de addison de etiologia auto-imune
Authors: Silva Regina C. , Kater Claudio E.
Published: April 2011

A doença de Addison de etiologia auto-imune é uma endocrinopatia rara e potencialmente fatal, que pode ocorrer de forma isolada ou como parte das síndromes poliglandulares auto-imunes (SPA) dos tipo I e II. Auto-anticorpos anti-cortex adrenal são considerados marcadores imunológicos sensíveis do processo auto-imune destrutivo, podendo identificar indivíduos na fase pré-clínica da doença. A enzima 21-hidroxilase (citocromo P450c21) representa o principal antígeno adrenocortical, embora outros citocromos P450 (17a-hidroxílase e colesterol desmolase) possam, também, desencadear a resposta auto-imune, principalmente na SPA do tipo I e na doença de Addison associada à falência ovariana precoce. O papel dos auto-anticorpos anti-P450c21 na patogênse da falência adrenal ainda não está bem estabelecido, assim como aquele dos anticorpos anti-receptor do ACTH.
Tiroidite pós-parto: prevalência e evolução clínica
Authors: Barros Andréa F. P. , Vaisman Mário
Published: April 2011

A tiroidite pós-parto (TPP) é uma disfunção tiroidiana, ainda pouco conhecida, que acomete mulheres no 1º ano pós-parto. Estudos em nosso meio são escassos. Estudamos um grupo de 115 gestantes entre a 16ª e 20ª semana de gestação, quanto a disfunção tiroidiana (T3, T4, T4L e TSH) e presença de anticorpos antitiroidianos (anti-tireoglobulina e anti-peroxidase tiroidiana). Reavaliamos estas gestantes no 6º mês pós-parto, quanto aos mesmos parâmetros. Encontramos 4/115 (3,4%) portadoras de TPP. Das 12 pacientes que apresentaram AATPO positivo na primeira avaliação, duas (16,6%) evoluiram para perda fetal entre o 5º e 6º mês de gestação, três (25%) mantiveram-se eutiroidianas, três (25%) apresentaram hipotiroidismo subclínico e quatro (33,3%) desenvolveram TPP, com diagnóstico realizado através da clínica (queixas de disfunção tiroidiana) e alteração das dosagens hormonais. O sintoma mais comumente apresentado pelas pacientes com TPP foi a fadiga (4/4). Todas as pacientes que desenvolveram TPP apresentaram fatores de risco para tal. Baseados nos resultados encontrados, recomendamos que gestantes com fatores de risco para o desenvolvimento da TPP devam ser monitoradas durante a gestação e no período pós-parto quanto ao desenvolvimento de disfunção tiroidiana.
Esteatose hepática em mulheres obesas
Authors: Araújo Leila Ma. Batista , Santiago Rodrigo , Oliveira Débora S. Angeli , Nunes Dhebora S.
Published: April 2011

Diversas alterações histológicas hepáticas são descritas em indivíduos obesos, sendo a esteatose a mais comum. Avaliamos 132 mulheres obesas assintomáticas pela ultra-sonografia hepática (USG), as quais foram divididas em: grupo 1 (n = 68), obesas com USG compatível com esteatose e grupo 2 (n = 64), obesas com USG normal. Estas pacientes foram pareadas quanto a idade e índice de massa corpórea (IMC). A idade média ± DP destes grupos foi 35,3 ± 7,2 anos e 34,7 ± 9,0 anos para o grupo 1 e 2, respectivamente, e o IMC médio ± DP do grupo 1 foi 40,5 ± 5,6 kg/m² e do grupo 2 foi 39,5 ±7,1 kg/m². Foi colhido amostra para dosagens bioquímicas e perfil hepático antes do início do tratamento. Os grupos foram comparados pelo teste "t" de Student e análise de variância. Os resultados mostraram que as obesas do grupo 1 tinham maiores níveis de triglicérides e ácido úrico do que as obesas do grupo 2 (p < 0,05). Os níveis de glicemia, colesterol total, HDL-colesterol, alanina aminotransferase, aspartato aminotransferase e gama-glutamil transpeptidase foram semelhantes. Concluímos que em mulheres obesas com USG sugestiva de esteatose, as alterações metabólicas são mais freqüentes do que em obesas sem esteatose.
Dietas com restrição de Iodo (DRI)
Authors: Wolff Henry
Published: April 2011

No contexto do manuseio do câncer diferenciado de tireóide com 131I, faz-se histórico e descrição das dietas com restrição de iodo (DRI). Elabora-se DRI mais abrangente e auto-explícita. Expõem-se mecanismos de aumento de captação pelas DRI, baseados na expoliação de iodo. Comprova-se a eficacia das DRI em favorecer expoliação e rastreamento; o possível benefício quanto a dose ablativa; não ter-se demonstrado efeito em dose terapêutica, quiçá por insuficiente pesquisa; a importância de obter iodúria inferior a 50ug/dia ou 50ug/g creatinina, para prevenir contaminação e avaliar a eficácia e adesão a DRI. Diante da excessiva ingestão de iodo nos EUA, Reino Unido e países asiáticos, com resultante queda na atividade iodocaptante, deplora-se a escassa adoção de DRI, em relatos de centros de pesquisa, cuja credibilidade só é sustentável, admitindo-se tácita prescrição de DRI informal, raramente constando em "Materiais e Métodos". Outrossim, condena-se o aumento de dose de 131I, na contaminação: a rápida expoliação de iodo por DRI é eficiente e inócua. Comenta-se a inexistência de DRI publicada no Brasil, duvidando-se de sua necessidade, face à deficiência endêmica de iodo, em algumas regiões. O desconhecimento de seu conteúdo, e de eventual excesso, em alguns alimentos, conduz o autor a elaborar algoritmo: 1. Avaliação de quota de iodo alimentar das populações, ou 2. Exclusão de contaminação, pela medida da iodúria, ou 3. Prescrição de DRI. O autor propõe o axioma: "A DRI pode às vezes não ser benéfica, a contaminação é sempre maléfica".
Hypogonadism after traumatic brain injury
Authors: Hohl Alexandre , Mazzuco Tânia Longo , Coral Marisa Helena César , Schwarzbold Marcelo , Walz Roger
Published: April 2011

Traumatic brain injury (TBI) is the most common cause of death and disability in young adults. Post-TBI neuroendocrine disorders have been increasingly acknowledged in recent years due to their potential contribution to morbidity and, probably, to mortality after trauma. Marked alterations of the hypothalamic-pituitary axis during the post-TBI acute and chronic phases have been reported. Prospective and longitudinal studies have shown that some abnormalities are transitory. On the other hand, there is a high frequency (15% to 68%) of pituitary hormone deficiency among TBI survivors in a long term setting. Post-TBI hypogonadism is a common finding after cranial trauma, and it is predicted to develop in 16% of the survivors in the long term. Post-TBI hypogonadism has been associated with adverse results in the acute and chronic phases after injury. These data reinforce the need for identification of hormonal deficiencies and their proper treatment, in order to optimize patient recovery, improve their life quality, and avoid the negative consequences of non-treated hypogonadism in the long term.
Bone turnover assessment: a good surrogate marker?
Authors: Dreyer Patrícia , Vieira José Gilberto H.
Published: April 2011

To asses fracture risk, bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) is the most commonly used tool. The search for clinical risk factors is also advised and can provide a 10-year fracture probability (FRAX model). Another important determinant of bone strength is bone remodeling. High bone remodeling rates have been associated with a higher fracture risk and bone turnover markers (BTM) may offer dynamic information about skeletal status independent of BMD. The efficacy of antiresorptive agents in fracture prevention goes beyond what can be predicted by BMD especially in the beginning of the treatment. Inhibition of bone remodeling itself is certainly an important mechanism by which antiresorptive agents can rapidly reduce fracture risk. Thus, it seems quite logical to use BTM in patients with bone disease. It can also become a valuable surrogate marker in fracture prediction. However, BTM's pre-analytical and analytical variability should always be considered.
Normocalcemic primary hyperparathyroidism
Authors: Bilezikian John P. , Silverberg Shonni J.
Published: April 2011

Primary hyperparathyroidism is a common disorder of mineral metabolism characterized by incompletely regulated, excessive secretion of parathyroid hormone from one or more of the parathyroid glands. The historical view of this disease describes two distinct entities marked by two eras. When primary hyperparathyroidism was first discovered about 80 years ago, it was always symptomatic with kidney stones, bone disease and marked hypercalcemia. With the advent of the multichannel autoanalyzer about 40 years ago, the clinical phenotype changed to a disorder characterized by mild hypercalcemia and the absence of classical other features of the disease. We may now be entering a 3rd era in the history of this disease in which patients are being discovered with normal total and ionized serum calcium concentrations but with parathyroid hormone levels that are consistently elevated. In this article, we describe this new entity, normocalcemic primary hyperparathyroidism, a forme fruste of the disease.
Ion channelopathies in endocrinology: recent genetic findings and pathophysiological insights
Authors: Rolim Ana Luiza R. , Lindsey Susan C. , Kunii Ilda S. , Fujikawa Aline M. , Soares Fernando A. , Chiamolera Maria Izabel , Maciel Rui M. B. , Silva Magnus R. Dias da
Published: April 2011

Ion channels serve diverse cellular functions, mainly in cell signal transduction. In endocrine cells, these channels play a major role in hormonal secretion, Ca2+-mediated cell signaling, transepithelial transport, cell motility and growth, volume regulation and cellular ionic content and acidification of lysosomal compartments. Ion channel dysfunction can cause endocrine disorders or endocrine-related manifestations, such as pseudohypoaldosteronism type 1, Liddle syndrome, Bartter syndrome, persistent hyperinsulinemic hypoglycemia of infancy, neonatal diabetes mellitus, cystic fibrosis, Dent's disease, hypomagnesemia with secondary hipocalcemia, nephrogenic diabetes insipidus and, the most recently genetically identified channelopathy, thyrotoxic hypokalemic periodic paralysis. This review briefly recapitulates the membrane action potential in endocrine cells and offers a short overview of known endocrine channelopathies with focus on recent progress regarding the pathophysiological mechanisms and functional genetic defects.
Hemodinâmica sistêmica e função ventricular esquerda de ratos hipertensos tornados diabéticos
Authors: Cesaretti Mário Luís Ribeiro , Ginoza Milton , Ribeiro Artur Beltrame , Kohlmann Jr Osvaldo
Published: April 2011

OBJETIVO: Avaliar a indução do diabetes melito tipo 1 (DM1) na hemodinâmica sistêmica e função ventricular de ratos normotensos e hipertensos. MATERIAIS E MÉTODOS: O DM1 foi induzido por estreptozotocina em ratos Wistar (WST), borderline hypertensive rats (BHR) e spontaneously hypertensive rats (SHR). A hemodinâmica sistêmica foi avaliada por termodiluição e a função ventricular, pela preparação de Langendorff. RESULTADOS: A indução de DM1 produziu aumento na pressão arterial de WST e BHR. O DM1 determinou aumento na resistência periférica total no grupo WST e diminuição do débito cardíaco e do volume sistólico nos grupos WST e BHR. Índices de função sistólica foram reduzidos e a rigidez ventricular, apenas nos ratos WST diabéticos. Todos esses efeitos foram mais proeminentes nos ratos WST diabéticos. CONCLUSÃO: O DM1 foi acompanhado por importantes alterações nas funções sistólica e diastólica, levando a uma diminuição nos valores hemodinâmicos sistêmicos que não foram alterados pela hipertensão arterial.
Dificuldades e armadilhas no diagnóstico da síndrome dos ovários policísticos
Authors: Marcondes José Antonio Miguel , Barcellos Cristiano Roberto Grimaldi , Rocha Michelle Patrocínio
Published: April 2011

A síndrome dos ovários policísticos é uma das endocrinopatias mais comuns, afetando aproximadamente 7% das mulheres na idade reprodutiva. Embora tenha sido descrita em 1935, somente em 1990 foi elaborado o primeiro consenso com relação ao seu diagnóstico. Hoje, a síndrome é considerada também um fator de risco cardiovascular, com uma alta prevalência de distúrbios metabólicos. Como reflexo dessa nova visão da síndrome, vários documentos, entre Consensos, Posicionamentos e Orientações, têm sido publicados, abordando diversos aspectos da síndrome. O objetivo desta revisão é uma análise crítica desses documentos, obtidos mediante um levantamento na base PubMed, por meio dos unitermos polycystic ovary syndrome, hyperandrogenism e hirsutism, separadamente, tendo como limitador o termo Type of Article (Practice Guideline, Consensus Development Conference, Guideline), sem limitação de data, língua e idade. Foram selecionados apenas os documentos elaborados sob patrocínio de Entidades Médicas e com mais de um autor.
Infecção pelo vírus da hepatite c em pacientes em hemodiálise: prevalência e fatores de risco
Authors: Leão José Rafael , Pace Fabio Heleno de Lima , Chebli Julio Maria Fonseca
Published: April 2011

CONTEXTO: Doentes com doença renal crônica em tratamento hemodialítico apresentam risco aumentado de aquisição do vírus da hepatite C (VHC). Elevadas taxas de prevalência têm sido detectadas em unidades de diálise do mundo inteiro. Estudos recentes têm demonstrado que a infecção pelo VHC interfere de forma negativa na sobrevida dos pacientes em hemodiálise e naqueles submetidos ao transplante renal. OBJETIVOS: Determinar a prevalência e os fatores de risco da infecção pelo VHC em pacientes submetidos a hemodiálise. MÉTODOS: Realizou-se estudo transversal entre janeiro e dezembro de 2007. Neste período, 236 pacientes em hemodiálise foram testados pelo ELISA de terceira geração. Os casos positivos foram submetidos a pesquisa qualitativa do HCV-RNA pelo método de PCR. Consideraram-se como portadores de infecção pelo VHC aqueles pacientes com anti-VHC e HCV-RNA positivos. Dosagens mensais de ALT e a média do valor de 12 meses foram obtidas em 195 pacientes. Do total de pacientes, 208 (88,1%) responderam ao questionário padronizado visando a identificação de fatores de risco associados à infecção pelo VHC. RESULTADOS: A prevalência de pacientes anti-VHC positivos encontrada entre os 236 testados foi de 14,8% (35/236); destes, a pesquisa do HCV-RNA foi positiva em 71,6% (25/35). Portanto, a prevalência da infecção crônica pelo VHC foi de 10,6% (25/236) dos pacientes. Pela análise bivariada, os principais fatores de risco associados à infecção pelo VHC foram o tempo de hemodiálise, o número de transfusões de sangue, a realização prévia de diálise peritonial e história de doença sexualmente transmissível. Contudo, após análise multivariada, somente o tempo de hemodiálise e história de doença sexualmente transmissível foram significativamente associados à infecção pelo VHC. Pacientes com mais de 10 anos de hemodiálise apresentaram risco de aquisição do VHC 73,9 (IC de 17,5 a 311,8) vezes maior quando comparados a pacientes com até 5 anos de tratamento. Indivíduos com doença sexualmente transmissível prévia apresentaram risco 4,8 (IC de 1,1 a 19,9) vezes superior de contaminação pelo VHC quando comparados àqueles sem doença sexualmente transmissível. O valor médio da ALT foi significantemente maior nos pacientes infectados pelo VHC (44,0 ± 13,5 U/L versus 33,5 ± 8,0 U/L, P<0,001). CONCLUSÃO: A infecção pelo VHC apresentou elevada prevalência na unidade de diálise analisada. O tempo de tratamento dialítico e história prévia de doença sexualmente transmissível foram os principais fatores de risco associados à infecção pelo VHC. Indivíduos em hemodiálise com infecção crônica pelo VHC apresentaram maior atividade de ALT que pacientes sem hepatite C crônica.
Endemic hepatitis b and c virus infection in a brazilian eastern amazon region
Authors: El Khouri Marcelo , Cordeiro Quirino , Luz Diogo Arantes Behling Pereira da , Duarte Leandro Savoy , Gama Mônica Elinor Alves , Corbett Carlos Eduardo Pereira
Published: April 2011

CONTEXT: Hepatitis B and hepatitis C infection has been an important cause of morbidity and mortality around the world. However there are few investigations regarding the prevalence and possible risk factors for these diseases in Brazil, particularly in Amazon region, where there are some endemic focus. OBJECTIVES: To determine the prevalence of hepatitis B and hepatitis C in the city of Buriticupu, MA, located in the Brazilian Eastern Amazon region, and try to explore the risk factors for these infections in that area. METHODS: Two hundred forty three subjects (46.5% male and 53.5% female) were investigated. RESULTS: The prevalence of past or current infection of hepatitis B and C virus was, respectively, 40.74% and 5.76%. Positivity for HBsAg was found in 2.88% of the subjects. The prevalence of current infection or chronic virus carriers found was 2.88% (HBsAg). There was a statistically significant relationship between the sera-prevalence of anti-HBc and the distance of the residence from the city center which may reflect an indirect association between the infection and precarious conditions of existence. Individuals with age equal or greater than 60 years were also more likely to be anti-HBc positive which could only reflect that older people have a longer history of exposure to hepatitis B infection. The prevalence of hepatitis C is higher than the worldwide estimate. CONCLUSION: Buriticupu may be considered endemic for hepatitis B and C. Hepatitis B infection could be related to precarious living conditions and old age. Hepatitis C was not associated with the variables investigated in the present investigation.
Nutritional follow-up of patients with ulcerative colitis during periods of intestinal inflammatory activity and remission
Authors: Ripoli Juliana , Miszputen Sender Jankiel , Ambrogini Jr Orlando , Carvalho Luciana de
Published: April 2011

CONTEXT: Ulcerative colitis is an inflammatory bowel disease involving superficial inflammation of the mucosa of the colon, rectum, and anus, sometimes including the terminal ileum. When in clinical activity, the disease is characterized by various daily evacuations containing blood, mucus and/or pus alternating periods of remission. OBJECTIVE: To compare nutritional parameters (dietary, biochemical and anthropometric) among patients with ulcerative colitis followed up on an outpatient basis over a period of 1 year and during periods of intestinal inflammatory activity and remission. METHODS: Sixty-five patients were studied over a period of 1 year and divided into two groups: group 1 with inflammatory disease activity (n = 24), and group 2 without disease activity (n = 41). Anthropometric measures, biochemical parameters, quantitative food intake, and qualitative food frequency were analyzed. RESULTS: A significant reduction in body mass index and weight and in the intake of energy, proteins, lipids, calcium, iron and phosphorus was observed in the group with inflammatory activity (group 1) when compared to the period of clinical remission. The most affected food groups were cereals, legumes, oils, and fats. In contrast, in group 2 significant differences in triceps and sub scapular skin fold thickness, total protein, hemoglobin and hematocrit were observed between the first and final visit. Calcium and vitamin B6 intake, as well as the consumption of legumes, meat and eggs, and sugar and sweets, was significantly higher than on the first visit. CONCLUSION: Patients with ulcerative colitis followed up on an outpatient basis tend to be well nourished. However, the nutritional aspects studied tend to worsen during the period of inflammatory disease activity.
Effect of age on proximal esophageal response to swallowing
Authors: Dantas Roberto Oliveira , Alves Leda Maria Tavares , Dalmazo Juciléia , Santos Carla Manfredi dos , Cassiani Rachel de Aguiar , Nascimento Weslania Viviane do
Published: April 2011

CONTEXT: It has been demonstrated that the ageing process affects esophageal motility. OBJECTIVES: To evaluate the effect of the age on the proximal esophageal response to wet swallows. METHOD: We measured the proximal esophageal response to swallows of a 5 mL bolus of water in 69 healthy volunteers, 20 of them aged 18-30 years (group I), 27 aged 31-50 years (group II), and 22 aged 51-74 years (group III). We used the manometric method with continuous perfusion. The proximal esophageal contractions were recorded 5 cm from a pharyngeal recording site located 1 cm above the upper esophageal sphincter. The time between the onset of the pharyngeal and of the proximal esophageal recording (pharyngeal-esophageal time) and the amplitude, duration and area under the curve of the proximal esophageal contraction were measured. RESULTS: The pharyngeal-esophageal time was shorter in group I subjects than in group II and III subjects (P<0.05). The duration of proximal esophageal contractions was longer in group I than in groups II and III (P<0.001). There was no differences between groups in the amplitude or area under the curve of contractions. There were no differences between groups II and III for any of the measurements. CONCLUSION: We conclude that the age may affects the response of the proximal esophagus to wet swallows.
Suggestion of optimal patient characteristics for sentinel lymph node mapping in colorectal adenocarcinoma
Authors: Quadros Claudio A , Lopes Ademar , Araujo Iguaracyra
Published: April 2011

CONTEXT: In a previously published study, the variables lower rectal tumor site, preoperative chemoradiotherapy and large tumors were considered as independent risk factors for the inability of sentinel lymph node identification in patients with colorectal adenocarcinoma. OBJECTIVES: To determine if these variables could interfere in the precision and upstaging benefit of sentinel lymph node mapping in colorectal cancer. METHODS: A database composed of 52 patients submitted to lymphatic mapping using technetium-99m-phytate and patent blue was reviewed. Only patients with tumors smaller than 5.0 cm, not submitted to preoperative chemoradiotherapy and without lower rectal cancer were included. RESULTS: With these parameters, 11 patients remained to be studied. The sentinel lymph node identification rate was 100%, with a sensitivity of 100%, negative predictive value of 100%, no false negatives and accuracy of 100%. Sentinel lymph nodes were the only metastatic nodes in 36.4% of the patients, micrometastases (<0.2 cm or only identified by immunohistochemistry) provided an upstaging rate of 27.1% and metastases an upstaging rate of 9.1%. CONCLUSION: The parameters proposed in this study for selection of colorectal adenocarcinoma patients to be submitted to sentinel lymph node mapping identified optimal accuracy and good upstaging results. As the number of included patients was low, these results could serve as guidance for proper patient selection in further prospective lymph node mapping studies in colorectal cancer patients.
Grade of esophageal cancer and nutritional status impact on postsurgery outcomes
Authors: Marin Flávia Andréia , Lamônica-Garcia Vânia Cristina , Henry Maria Aparecida Coelho de Arruda , Burini Roberto Carlos
Published: April 2011

CONTEXT: Undernutrition is a well known underlying cause in both disease onset and outcome. OBJECTIVE: To associate disease severity with pre surgical nutritional status, the main postsurgical complications, and mortality in esophagus cancer patients. METHOD: Retrospective data from 100 patients (38-81 years old, 85% males) who had undergone esophagectomy (G1/n = 25) or gastro/jejunostomy (G2/n = 75) between 1995 and 2004. Data included clinical, endoscopic, histological (TNM-UICC), dietary, anthropometric, blood chemistry, and postsurgical (>30 days) complications and mortality. Surgical groups were compared by Student's test and existing associations between variables by either c² or Fisher exact tests with P = 0.05. RESULTS: The studied sample was predominantly male (85%), white (80%), smokers and alcoholics (95%), dysphagics (95%) mostly presenting body weight loss before cancer diagnosis (78%). TNM III and IV predominated over I and II, associated (P<0.005) with higher body mass index and hypoalbuminemia (<3.5 mg/dL) frequency. Esophagic obstructions (n = 77) were associated (P = 0.002) with lower body mass index (kg/m²). Postsurgical complications were more common in G1 (69.2%) than G2, predominantly with infections in G2 (80%) and pleura-pulmonary in G1 (61%). Body mass index and lower lymphocyte counts were associated with early infections and postsurgical complications in G2. Plasma albumin levels were lower in this group than G1, and were associated with postsurgical complications and mortality whereas lower lymphocyte counts was associated with mortality in G1. CONCLUSIONS: Disease severity (or late diagnosis) is associated with poor nutritional status and palliative surgery which lead to more complicated postsurgery outcome and mortality. Early diagnosis and nutritional intervention are the recommended actions.
A short review of the anthelmintic role of mirazid
Authors: Yakoot Mostafa
Published: April 2011

Mirazid® is a patented preparation from a plant that had been used in folk medicine since ancient Egyptians (Myrrh). It was registered in Egypt for the treatment of schistosomiasis and fascioliasis. Over 32 independent studies for efficacy of Mirazid had been reviewed and their results analyzed. The majority of these studies reported higher than 90% cure rates, that even higher in mixed than single trematodal infections in humans and in farm animals. Only two groups of investigators reported lower cure rates as they used lower doses and estimated cure rates at a shorter period from treatment than recommended by innovators.
Hematomas intracerebral espontâneos estudo de 121 casos
Authors: Werneck Lineu Cesar , Scola Rosana Hermínia , Ferraz Leila Elizabeth
Published: April 2011

Foram analisados retrospectivamente 121 pacientes com hematomas intracerebrais espontâneos (HIE): com média de idade de 53,4 ±14,8 anos, 62,8% do sexo masculino, tempo médio de sangramento na admissão de 36 horas (3 horas a 12 dias); 63,5% estavam acima de 7 na escala de Glasgow e 81,9% com grau igual ou maior que 3 na escala de Botterel. Os HIE eram: em gânglios da base em 45,5%, multilobares em 14,7%, lobares em 22,8%, no tronco cerebral em 4% e cerebelares em 2%. Seus diâmetros médios eram de 46,6 mm (16 a 33) e a área média de 1422,9 mm2 (60 a 4818). O LCR em 67 casos revelou pressão inicial média de 234 mmH20 (30 a 700) e concentrarão proteica média de 416,9 mg/dl (30 a 1960). O tratamento foi conservador em 107 casos e cirúrgico em 14. Sobreviveram 55,8% dos pacientes; a maioria dos que faleceram estava em grau acima de 3 na escala de Boterell e abaixo de 9 na de Glasgow. Houve correlação estatística entre a sobrevida e óbito com a escala de Glasgow e com a de Boterell, paralisia de músculos oculares, déficit motor, sinais de descerebração, broncopneumonia, diâmetro e área do hematoma; não houve relação estatística com uso de dexametasona, antifibrinolítico, anticonvulsivantes e diuréticos. O uso de manitol e a queda da pressão arterial nos primeiros dias tiveram relação com maior mortalidade Dos 14 casos submetidos a cirurgia, 11 faleceram. A principal complicação que levou a óbito foi broncopneumonia. São feitos comentários sobre a patogenia dos HIE, incidência atual, sinais clínicos» localização, tamanho, causas de óbito e tratamento empregado em relação ao prognóstico.