bluuebunny/crossref_metadata_2025 huggingface dataset:
Applicability of a “Pick a Winner” trial design to acute myeloid leukemia
Authors: Hills Robert K. , Burnett Alan K.
Published: July 2011

Randomized clinical trials remain the gold standard to establish efficacy and safety of new treatments. In acute myeloid leukemia, large trials have been associated with gradual improvement in outcome over 2 decades in younger patients without major differences emerging between treatments. By contrast, in older patients, improvement has been minimal, which justifies a new approach to identifying effective treatments. Given the urgent unmet need, and with the emergence of several novel agents or combinations that are likely to be expensive, large benefits are probably required to change clinical practice. To address this issue, we have evolved a “Pick a Winner” randomized progressive design with a rolling incorporation of novel treatments (drug X), which has been tested in older patients with acute myeloid leukemia. The rationale, operational characteristics, and initial experience of such an approach in the context of the United Kingdom National Cancer Research Institute AML16 trial are presented.
Bone morphogenetic protein-2 functions as a negative regulator in the differentiation of myoblasts, but not as an inducer for the formations of cartilage and bone in mouse embryonic tongue
Authors: Aoyama Kayoko , Yamane Akira , Suga Takeo , Suzuki Erika , Fukui Tadayoshi , Nakamura Yoshiki
Published: July 2011

Background

In vitro studies using the myogenic cell line C2C12 demonstrate that bone morphogenetic protein-2 (BMP-2) converts the developmental pathway of C2C12 from a myogenic cell lineage to an osteoblastic cell lineage. Further, in vivo studies using null mutation mice demonstrate that BMPs inhibit the specification of the developmental fate of myogenic progenitor cells. However, the roles of BMPs in the phases of differentiation and maturation in skeletal muscles have yet to be determined. The present study attempts to define the function of BMP-2 in the final stage of differentiation of mouse tongue myoblast.

Results

Recombinant BMP-2 inhibited the expressions of markers for the differentiation of skeletal muscle cells, such as myogenin, muscle creatine kinase (MCK), and fast myosin heavy chain (fMyHC), whereas BMP-2 siRNA stimulated such markers. Neither the recombinant BMP-2 nor BMP-2 siRNA altered the expressions of markers for the formation of cartilage and bone, such as osteocalcin, alkaline phosphatase (ALP), collagen II, and collagen X. Further, no formation of cartilage and bone was observed in the recombinant BMP-2-treated tongues based on Alizarin red and Alcian blue stainings. Neither recombinant BMP-2 nor BMP-2 siRNA affected the expression of inhibitor of DNA binding/differentiation 1 (Id1). The ratios of chondrogenic and osteogenic markers relative to glyceraldehyde-3-phosphate dehydrogenase (GAPDH, a house keeping gene) were approximately 1000-fold lower than those of myogenic markers in the cultured tongue.

Conclusions

BMP-2 functions as a negative regulator for the final differentiation of tongue myoblasts, but not as an inducer for the formation of cartilage and bone in cultured tongue, probably because the genes related to myogenesis are in an activation mode, while the genes related to chondrogenesis and osteogenesis are in a silencing mode.
SR-A ligand and M-CSF dynamically regulate SR-A expression and function in primary macrophages via p38 MAPK activation
Authors: Nikolic Dejan , Calderon Lindsay , Du Liqin , Post Steven R
Published: July 2011

Background

Inflammation is characterized by dynamic changes in the expression of cytokines, such as M-CSF, and modifications of lipids and proteins that result in the formation of ligands for Class A Scavenger Receptors (SR-A). These changes are associated with altered SR-A expression in macrophages; however, the intracellular signal pathways involved and the extent to which SR-A ligands regulate SR-A expression are not well defined. To address these questions, SR-A expression and function were examined in resident mouse peritoneal macrophages incubated with M-CSF or the selective SR-A ligand acetylated-LDL (AcLDL).

Results

M-CSF increased SR-A expression and function, and required the specific activation of p38 MAPK, but not ERK1/2 or JNK. Increased SR-A expression and function returned to basal levels 72 hours after removing M-CSF. We next determined whether prolonged incubation of macrophages with SR-A ligand alters SR-A expression. In contrast to most receptors, which are down-regulated by chronic exposure to ligand, SR-A expression was reversibly increased by incubating macrophages with AcLDL. AcLDL activated p38 in wild-type macrophages but not in SR-A-/- macrophages, and p38 activation was specifically required for AcLDL-induced SR-A expression.

Conclusions

These results demonstrate that in resident macrophages SR-A expression and function can be dynamically regulated by changes in the macrophage microenvironment that are typical of inflammatory processes. In particular, our results indicate a previously unrecognized role for ligand binding to SR-A in up-regulating SR-A expression and activating p38 MAPK. In this way, SR-A may modulate inflammatory responses by enhancing macrophage uptake of modified protein/lipid, bacteria, and cell debris; and by regulating the production of inflammatory cytokines, growth factors, and proteolytic enzymes.
Pharmacogenetics and pharmacogenomics: a clinical reality
Authors: Ferraldeschi Roberta , Newman William G
Published: July 2011

Pharmacogenetics and pharmacogenomics strive to explain the interindividual variability in response to drugs due to genetic variation. For certain drugs, genetic tests can reduce adverse drug reactions and improve treatment efficacy. In this review, we will briefly consider some successful tests introduced into clinical practice and potential future developments.
European priorities for research on health care organizations and service delivery
Authors: Hansen Johan , Schäfer Willemijn , Black Nick , Groenewegen Peter
Published: July 2011

Objectives:

To provide an overview of the principal areas of research on health care organization and service delivery and to identify priority areas from a European comparative perspective. Given the large quantity of articles produced on health care organizations, we focus on primary care and hospital care.

Method:

A combination of methods was used for describing past and current research: (i) bibliometric analyses of published research in Pubmed and Embase 2000-09; (ii) a further classification of research based on a sample of 1,010 articles; and (iii) an identification of relevant EU-funded projects over the period 2000-10. An online survey of experts was carried out to identify priorities. The results were refined through conference discussions.

Results:

Research into health care organizations varies considerably across Europe. This is only partly associated with differences in countries’ gross domestic product or population. Studies were categorized into four main domains: intra-organizational control; inter-organizational relations; patient relations; and governance and accountability. Past and current research may not reflect future priorities as the domain of ‘inter-organizational relations’ is regarded by most experts as the top priority for the future, while the smallest share in the sample of published research and EU-funded projects fell into that category. Expert views show considerable homogeneity, regardless of their role in the health care system or their country. Specific future priorities include the integration of care across organizational boundaries (including the relationship between primary and secondary care), patient involvement and participation and workforce skill-mix.

Conclusions:

The research priorities identified in this study relate to important shared challenges in Europe's health care systems. This makes cross-border learning important, especially given the clear geographical variation in health services research (HSR) funding and capacity in Europe.
Health technology assessment: Research trends and future priorities in Europe
Authors: Nielsen Camilla PalmhøJ , Funch Tina Maria , Kristensen Finn Børlum
Published: July 2011

Objective:

To provide an overview of health services research related to health technology assessment (HTA) and to identify research priorities from a European perspective.

Methods:

Several methods were used: systematic review of articles indexed with the MeSH term ‘technology assessment’ in PubMed from February 1999-2009; online survey among experts; and conference workshop discussions.

Results:

Research activity in HTA varies considerably across Europe. The research was categorised into six areas: (1) the breadth of analysis in HTA (such as economic, organizational and social aspects); (2) HTA products developed to meet the needs of policy-makers (such as horizon scanning, mini-HTA, and core HTA); (3) handling life-cycle perspectives in relation to technologies; (4) topics that challenge existing methods and for which HTA should be developed to address the themes more comprehensively (such as public health interventions and organizational interventions); (5) development of HTA capacity and programmes; and (6) links between policy and HTA. An online survey showed that the three areas that were given priority were the relationship between HTA and policy-making (71%), the impact of HTA (62%) and incorporating patient aspects in HTA (50%). Policy-makers highlighted HTA and innovation processes as their main research priority (42%). Areas that the systematic review identified as future priorities include issues within the six existing research areas such as disinvestment, developing evidence for new technologies, assessing the wider effects of technology use, and determining how HTA affects decision-making. In addition, relative effectiveness and individualized treatments are areas of growing interest.

Conclusions:

The research priorities identified are important for obtaining high quality and cost-effective health care in Europe. Managing the introduction, use and phasing out of technologies challenges health services throughout Europe, and these processes need to be improved to successfully manage future more general challenges. An ageing population and a diminishing workforce both require strong efforts to ensure effective and well-organized use of human resources and technologies. Furthermore, Europe needs to focus on innovation. This is closely linked to use of technologies and calls for future research.
Estimation of blood velocity, volumetric flow and wall shear rate using Doppler ultrasound
Authors: Hoskins Peter R
Published: July 2011

Commercial ultrasound systems can make a number of measurements related to haemodynamics which are relevant to clinical practice and to clinical research. These include maximum velocity, volumetric flow and wall shear rate. Using appropriate protocols, measurements can be made averaged over the cardiac cycle, or as a function of time through the cardiac cycle. Maximum velocity underpins most of these measurements. Maximum velocity is overestimated as a result of geometric spectral broadening, by typically up to 30%, but by much larger amounts as the angle approaches 90°. Though not used in clinical practice, a simple correction technique using a string phantom can substantially reduce these errors. For volumetric flow and wall shear rate, methods such as specialist multi-gate ultrasound systems, magnetic resonance imaging and image guided modelling are available. Before resorting to these more complex methods users might consider that, with care and attention to procedure, high quality information may be obtained using commercial ultrasound systems. Manufacturers could make more use of the colour flow image for quantification of velocity, and adopt vector Doppler techniques.
Synthesis of high-performance magnetic garnet materials and garnet-bismuth oxide nanocomposites using physical vapor deposition followed by high-temperature crystallization
Authors: Nur-E-Alam Mohammad , Vasiliev Mikhail , Alameh Kamal , Kotov Viacheslav
Published: July 2011

Bi-substituted iron garnet (Bi:IG) compounds synthesized in thin film form are the best semi-transparent magneto-optical (MO) materials for applications in magnetic recording, optical sensors, and photonics. These materials can possess attractive magnetic properties and the highest specific Faraday rotation in the visible and near-infrared spectral regions, if the deposited layers contain a high volumetric fraction of the garnet phase and possess high-quality surfaces and microstructure. In this paper, we study the effects of various deposition and annealing process parameters on the properties of Bi:IG and garnet-oxide nanocomposite films of several composition types fabricated using radio-frequency (RF) sputtering deposition followed by high-temperature isothermal crystallization. We also investigate the kinetics of garnet phase formation within a garnet-Bi-oxide nanocomposite material.
Enxaqueca complicada: a propósito de três casos
Authors: Sanvito Wilson Luiz , Monzillo Paulo Hélio
Published: July 2011

Três casos de enxaqueca complicada são relatados, de acordo com critérios previamente estabelecidos. A expressão enxaqueca complicada deve ser reservada para os casos em que sintomas neurológicos focais ultrapassam a crise enxaquecosa por mais de 24 horas ou quando déficit neurológico permanente se desenvolve em virtude de infarto cerebral. Outro critério para firmar o diagnóstico é a presença de infarto na tomografia computadorizada, mesmo na ausência dos critérios clínicos mencionados. O papel da agregação plaquetária, do espasmo vascular e da hipercoagulabilidade do sangue é considerado na causa do infarto. Todos os doentes, do presente relato, apresentaram déficit neurológico prolongado e infarto ao exame tomográfico.
Tratamento da miastenia grave mediante imunossupressão medicamentosa não esteróide
Authors: Assis José Lamartine de , Marchiori Paulo Eurípedes , Scaff Milberto , Zambon Antonio Alberto
Published: July 2011

São estudados 14 pacientes (doze dos quais eram mulheres) com miastenia grave severa e resistente aos procedimentos terapêuticos habituais. Em um paciente a prednisona foi substituída pela imunossupressão com citotóxicos e em outro o emprego destes permitiu redução da dose do esferóide, que passou a ser bem tolerado. Nos dois casos o emprego dos citostáticos foi decorrência de complicações da prednisona. São empregadas azatioprina e ciclosfosfamida em programas em que estão associadas, na maioria dos casos, prednisona e plasmaférese. Todos os pacientes mantiveram o uso de anticolinesterásicos. A azatioprina é administrada pela via oral nas doses de 100-200mg/dia por período de 20 meses, enquanto a ciclofosfamida é empregada pela via oral nas doses de 100-200mg/dia por 6 meses ou lg pela via intravenosa a intervalos de 15-30 dias durante 6 meses. O período mais longo de observação até o momento é de 32 meses. Ocorreram melhoras importantes em 71,4% dos pacientes, sendo que em 8 (57%) as melhoras começaram entre um e 6 meses após o início do tratamento. Efeitos colaterais foram infreqüentes e de pouca monta, não tendo ocorrido complicações graves dependentes diretamente das drogas até o momento.
Síndrome de calcificações dos gânglios da base, leucodistrofia e pleocitose linfomonocitária crônica do líquido cefalorraqueano: registro de um caso
Authors: Diament Aron J. , Machado Luís R. , Cypel Saul , Ramos José L. A.
Published: July 2011

Em 1966 Norman e Tingey descreveram síndrome de micrencefalia, calcificações estrio-cerebelares e leucodistrofia, síndrome esta que, em 1968, acrescida de nanismo, Lyon e col. tornaram a relatar. Esses autores não descreveram alterações do LCR. Em 1984, Aicardi e Goutièrres descreveram 8 crianças pertencentes a 5 famílias, com a síndrome antes referida, porém com a diferença de as calcificações serem dos gânglios de base, além de haver pleocitose do LCR crônica linfomononuclear. Todos os pacientes tiveram evolução progressiva e caráter familiar, com provável herança autossômica recessiva. É propósito deste registro relatar caso semelhante, num paciente branco do sexo masculino, com 6 meses e meio de idade e que apresentou quadro semelhante, diagnosticado aos 3 meses de idade: nanismo e microcefalia limiares, calcificações dos gânglios de base e leucodistrofia à TC. Seis exames de LCR sucessivos mostraram pleocitose de predomínio linfomononuclear. Fez-se estudo das subpopulações de linfócitos T-ativos e T-ávidos, o qual sugeriu sinalização local no sistema do LCR. São discutidos o diagnóstico diferencial e a estranha combinação de provável etiologia genética associada a mecanismo imunitário, revelando processo inflamatório local. Processaram-se pesquisas no intuito de afastar etiologia a vírus, as quais se revelaram negativas, o que não afasta esta hipótese.
Paralisia do olhar conjugado lateral associada a oftalmoplegia internuclear unilateral em hemorragia mesencéfalo-pontina alta: relato de um caso
Authors: Fontanari Juliano L. , Vaitses Vívian D. C. , Cruz Carlos E. R. Nova , Tichauer Thomas A. T. , Lisboa Liana , Souza Emanuel S.
Published: July 2011

Os autores relataram um caso de hemorragia mesencéfalo-pontina alta direita, com oftalmoplegia extrínseca, permanecendo apenas a convergência bilateral, a abdução voluntária e automático-reflexa do olho esquerdo, e a adução deste olho na pesquisa dos reflexos vestíbulo-oculares ("one-and-a-half syndrome"). Ainda, havia dissociação voluntária-automática da motricidade das pálpebras e dos movimentos conjugados verticais e, também, hemiplegia sensitivo-motora à esquerda e asterixis.
Miastenia grave: evolução das pesquisas na clínica neurológica do hospital das clínicas da Faculdade de Medicina da USP
Authors: Assis José Lamartine de
Published: July 2011

A autor sintetiza a evolução das pesquisas sobre miastenia grave na Clínica Neurológica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, no período de 1956 a 1986. São relatados os principais resultados observados na terapêutica, na Clínica e na fisiopatologia da miastenia grave, sendo destacados os trabalhos realizados no campo da imunologia.
Primary progressive aphasia patients evaluated using diffusion tensor imaging and voxel based volumetry-preliminary results
Authors: Oliveira Fábio Pascotto de , Costa Jaderson Costa da , Marroni Sabine Possa , Silva Ana Maria Marques da , Barreiro Sthefanie Hansen , Maeda Fábio Kunihiro , Portuguez Mirna Wetters
Published: July 2011

There are individuals who have a progressive language deficit without presenting cognitive deficits in other areas. One of the diseases related to this presentation is primary progressive aphasia (PPA). OBJECTIVE: Identify by means of diffusion tensor imaging (DTI) and measurements of cortical volume, brain areas that lead to dysphasia when presenting signs of impaired connectivity or reduced volume. METHOD: Four patients with PPA were evaluated using DTI, and measurements of cortical volumes in temporal areas. These patients were compared with two normal volunteers. RESULTS: There is a trend to a difference in the number and volume of related fibers between control group and patients with PPA. Comparing cortical volumes in temporal areas between groups yielded a trend to a smaller volume in PPA patients. CONCLUSION: Patients with PPA have a trend to impairment in cortical and subcortical levels regarding relevant areas.
Outcomes from intracerebral hemorrhage among patients pre-treated with statins
Authors: Romero Flávio Ramalho , Bertolini Eduardo de Freitas , Veloso Vanessa Nogueira , Venturini Leandro , Figueiredo Eberval G.
Published: July 2011

OBJECTIVE: 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, or statins, have been associated with improved clinical outcomes after ischemic stroke and subarachnoid hemorrhage, but with an increased risk of incidental spontaneous intracerebral hemorrhage (ICH). We investigated whether the statin use before ICH, was associated with functional independence, 90 days after treatment. METHOD: We analyzed 124 consecutive ICH patients with 90-day outcome data who were enrolled in a prospective cohort study between 2006 and 2009. Eighty-three patients were included in this study. Among ICH survivors, univariate Cox regression models and Kaplan-Meier plots were used to determine subject characteristics that were associated with an increased risk of recurrence. Statin usage was determined through interviewing the patient at the time of ICH and confirmed by reviewing their medical records. Independent status was defined as Glasgow Outcome Scale grades 4 or 5. RESULTS: Statins were used by 20 out of 83 patients (24%) before ICH onset. There was no effect from pre-ICH statin use on functional independence rates (28% versus 29%, P=0.84) or mortality (46% versus 45%, P=0.93). CONCLUSION: Pre-ICH statin use is not associated with changes to ICH functional outcome or mortality.
Chemokines in CSF of Alzheimer's disease patients
Authors: Corrêa Jôice Dias , Starling Daniela , Teixeira Antônio Lúcio , Caramelli Paulo , Silva Tarcília Aparecida
Published: July 2011

Some studies have linked the presence of chemokines to the early stages of Alzheimer's disease (AD). Then, the identification of these mediators may contribute to diagnosis. Our objective was to evaluate the levels of beta-amyloid (BA), tau, phospho-tau (p-tau) and chemokines (CCL2, CXCL8 and CXCL10) in the cerebrospinal fluid (CSF) of patients with AD and healthy controls. The correlation of these markers with clinical parameters was also evaluated. The levels of p-tau were higher in AD compared to controls, while the tau/p-tau ratio was decreased. The expression of CCL2 was increased in AD. A positive correlation was observed between BA levels and all chemokines studied, and between CCL2 and p-tau levels. Our results suggest that levels of CCL2 in CSF are involved in the pathogenesis of AD and it may be an additional useful biomarker for monitoring disease progression.
Balance Rehabilitation Unit (BRU TM) posturography in relapsing-remitting multiple sclerosis
Authors: Kessler Natália , Ganança Maurício Malavasi , Ganança Cristina Freitas , Ganança Fernando Freitas , Lopes Sabrina Chiogna , Serra Ana Paula , Caovilla Heloisa Helena
Published: July 2011

OBJECTIVE: To evaluate balance control with Balance Rehabilitation Unit (BRU TM) posturography in patients with multiple sclerosis (MS). METHOD: A cross controlled study was performed including 39 relapsing-remitting multiple sclerosis patients with scores less than or equal to 4 in the Expanded Disability Status Scale (EDSS), and a homogeneous control group consisting of 65 healthy individuals, matched by the age and gender. The experimental group was distributed according to the EDSS scale scores in 0-2.5 and 3-4. To assess the vestibular system function, the patients underwent a neurotological evaluation, including posturography of the Balance Rehabilitation Unit (BRU TM). RESULTS: Statistically significant differences were observed when comparing the values of the sway velocity and the ellipse area of the MS 0-2.5 group with the control and the MS 3-4 group with the control. A statistically significant difference was verified between the MS 0-2.5 and the MS 3-4 groups in the condition 3 ellipse area values. CONCLUSION: The evaluation of the balance control with posturography of Balance Rehabilitation Unit (BRU TM) enables the identification of abnormalities of the sway velocity and confidential ellipse in patients with relapsing-remitting multiple sclerosis.
Oral and maxillofacial trauma in patients with epilepsy: prospective study based on an outpatient population
Authors: Nonato Eduardo Ruocco , Borges Moacir Alves
Published: July 2011

OBJECTIVE: This study aimed to evaluate oral and maxillofacial trauma caused by falls during epileptic seizures. METHOD: A prospective case-control study was carried out among patients recruited from both the Epileptic Outpatient Clinic and the Emergency Room of Hospital de Base during 2006. The study group was composed of patients with epilepsy that had been diagnosed by a specialist. Oral and maxillofacial trauma was diagnosed using a questionnaire together with physical and radiographic examinations. A control group was formed from non-epileptic relatives or neighbors of the patients. The two groups were compared with regard to the number and type of oral and maxillofacial trauma events suffered. Odds ratios with a 95% confidence interval, dependency analysis and the Pearson c² test were used for statistical analysis, and the significance level was set at p≤0.05. RESULTS: A total of 159 patients with epilepsy (91 males; 57.3%) and 68 control individuals (28 males; 41.1%) were enrolled in the study. The frequencies of oromaxillary trauma in the study and control groups were 23.9% and 4.4%, respectively. Generalized tonic-clonic, generalized and non-classified seizures were strongly associated with trauma. The commonest lesions were fractures of dental tooth crowns (32.9%), followed by tooth avulsion (7.6%), tooth luxation (5%) and fracturing of prostheses in edentulous patients (3.8%). CONCLUSION: This work shows that injuries to the face and teeth are statistically more common in patients with epilepsy than in the general population, and that individuals who suffer seizures without aura are the most affected.
Acquired hepatocerebral degeneration and hepatic encephalopathy: correlations and variety of clinical presentations in overt and subclinical liver disease
Authors: Romeiro Fernando G. , Américo Madileine F. , Yamashiro Fábio S. , Caramori Carlos A. , Schelp Arthur O. , Santos Antonio C. , Silva Giovanni F.
Published: July 2011

Acquired hepatocerebral degeneration (AHD) and hepatolenticular degeneration can have similar clinical presentations, but when a chronic liver disease and atypical motor findings coexist, the distinction between AHD and hepatic encephalopathy (HE) can be even more complicated. We describe three cases of AHD (two having HE) with different neuroimaging findings, distinct hepatic diseases and similar motor presentations, all presenting chronic arterial hypertension and weight loss before the disease manifestations. The diagnosis and physiopathology are commented upon and compared with previous reports. In conclusion, there are many correlations among HE, hepatolenticular degeneration and AHD, but the overlapping of AHD and HE could be more common depending on the clinical knowledge and diagnostic criteria adopted for each condition. Since AHD is not considered a priority that affects the liver transplant list, the prognosis in AHD patients remains poor, and flow interruption in portosystemic shunts must always be taken into account.
The use of a neck brace does not influence visual vertical perception
Authors: Funabashi Martha , Silva Natya N.L. , Watanabe Luciana M. , Santos-Pontelli Taiza E.G , Colafêmina José Fernando , Carneiro Antonio A.O. , Takayanagui Osvaldo M.
Published: July 2011

Subjective visual vertical (SVV) evaluates the individual's capacity to determine the vertical orientation. Using a neck brace (NB) allow volunteers' heads fixation to reduce cephalic tilt during the exam, preventing compensatory ocular torsion and erroneous influence on SVV result. OBJECTIVE: To analyze the influence of somatosensory inputs caused by a NB on the SVV. METHOD: Thirty healthy volunteers performed static and dynamic SVV: six measures with and six without the NB. RESULTS: The mean values for static SVV were -0.075º±1.15º without NB and -0.372º±1.21º with NB. For dynamic SVV in clockwise direction were 1.73º±2.31º without NB and 1.53º±1.80º with NB. For dynamic SVV in counterclockwise direction was -1.50º±2.44º without NB and -1.11º±2.46º with NB. Differences between measurements with and without the NB were not statistically significant. CONCLUSION: Although the neck has many sensory receptors, the use of a NB does not provide sufficient afferent input to change healthy subjects' perception of visual verticality.
Application of International Classification of Functioning, Disability and Health (ICF) in individuals with spinal cord injury
Authors: Vall Janaina , Costa Carlos Mauricio de Castro , Pereira Laura França , Friesen Tatiane Temmy
Published: July 2011

After spinal cord injury is common functionality is affected. OBJECTIVE: To evaluate the functionality of patients with spinal cord injury. METHOD: Cross-sectional study by means of the International Classification of Functionality (ICF). 109 adults with spinal cord injury in the city of Curitiba, Brazil were evaluated. RESULTS: The categories most compromised in body were intestines and bladder, sexuality, energy, sleep, emotion and weight. In the domain activities and participation, there was greater difficulty in tasks of bathing, toilet and dressing, self care and leisure. In the domain environmental factors, the categories classified as facilitators were: medications, orthoses and wheelchair, attitude of family, transport, social foresight and health services. The categories classified as barriers were: attitude of authorities, social attitudes, education and work. CONCLUSION: The application of the ICF in persons with spinal cord injury demonstrated a series of disabilities and limitations.
Distal anterior interosseous nerve transfer to the deep ulnar nerve and end-to-side suture of the superficial ulnar nerve to the third common palmar digital nerve for treatment of high ulnar nerve injuries: experience in five cases
Authors: Flores Leandro Pretto
Published: July 2011

OBJECTIVE: To demonstrate the results of a double nerve transfer at the level of the hand for recovery of the motor and sensory function of the hand in cases of high ulnar nerve injuries. METHOD: Five patients underwent a transfer of the distal branch of the anterior interosseous nerve to the deep ulnar nerve, and an end-to-side suture of the superficial ulnar nerve to the third common palmar digital nerve. RESULTS: Two patients recovered strength M3 and three cases were graded as M4; recovery of protective sensation (S3+ in three patients and S4 in two) was observed in the fourth and fifth fingers, and at the hypothenar region. The monofilament test showed values of 3.61 or less in all cases and the two-point discrimination test demonstrated values of 7 mm in three cases and 5 mm in two. CONCLUSION: This technique of double nerve transfer is effective for motor and sensory recovery of the distal ulnar-innervated side of the hand.
Surgical treatment of adult traumatic brachial plexus injuries: an overview
Authors: Siqueira Mario G. , Martins Roberto S.
Published: July 2011

Traumatic injuries to the brachial plexus in adults are severely debilitating. They generally affect young individuals. A thorough understanding of the anatomy, clinical evaluation, imaging and electrodiagnostic assessments, treatment options and proper timing of surgical interventions will enable nerve surgeons to offer optimal care to patients. Advances in microsurgical technique have improved the outcome for many of these patients. The treatment options offer patients with brachial plexus injuries the possibility of achieving elbow flexion, shoulder stability with limited abduction and the hope of limited but potentially useful hand function.
Classical immunomodulatory therapy in multiple sclerosis: how it acts, how it works
Authors: Mendes Amélia , Sá Maria José
Published: July 2011

Interferon beta (IFNβ) and glatiramer acetate (GA) were the first immunomodulators approved to the treatment of relapsing-remitting multiple sclerosis (MS) and clinically isolated syndromes. Despite the enlargement of the therapeutic armamentarium, IFNβ and GA remain the most widely drugs and the therapeutic mainstay of MS. OBJECTIVE: To review the mechanisms of action of IFNβ and GA and main clinical results in MS. RESULTS: IFNβ modulates T and B-cell activity and has effects on the blood-brain barrier. The well proved mechanism of GA is an immune deviation by inducing expression of anti-inflammatory cytokines. Some authors favor the neuroprotective role of both molecules. Clinical trials showed a 30% reduction on the annualized relapse rate and of T2 lesions on magnetic resonance. CONCLUSION: Although the precise mechanisms how IFNβ and GA achieve their therapeutics effects remain unclear, these drugs have recognized beneficial effects and possess good safety and tolerability profiles. The large clinical experience in treating MS patients with these drugs along almost two decades deserves to be emphasized, at a time where the appearance of drugs with more selective mechanisms of action, but potentially less safer, pave the way to a better selection of the most appropriate individualized treatment.
The paradoxical effects of analgesics and the development of chronic migraine
Authors: Bigal Marcelo E.
Published: July 2011

In a subgroup of individuals episodic migraine evolves into a stage where individuals have headaches on more days than not. Among the risk factors for chronification, excessive use of analgesic medications figure prominently and reviewing this topic is the scope of this article. The issue of causality is discussed and evidence suggesting that specific medications, at critical doses, are risk factors for chronic migraine (CM) is reviewed. The concept of critical dose of exposure for different classes is presented and biological plausibility and putative mechanisms are reviewed.
Historical aphasia cases: "Tan-tan", "Vot-vot", and "Cré nom!"
Authors: Teive Hélio A.G. , Munhoz Renato P. , Caramelli Paulo
Published: July 2011

We describe three cases of aphasia in patients who were internationally famous historical personalities, such as the case of Mr. Leborgne ("Tan") published by Paul Broca in 1861, which became a reference for the study of aphasias. The other cases described here are those of the Russian revolutionary and politician Vladimir Ilyitch Ulianov (Lenin) ("Vot-vot") and the French poet Charles Baudelaire ("Cré nom!"). Besides their historical relevance and the clinical picture of aphasia, these three cases share as a common feature the occurrence of speech automatisms or stereotypes.
Competências da enfermeira para a triagem clínica de doadores de sangue
Authors: Padilha Débora Zmuda , Witt Regina Rigatto
Published: July 2011

O objetivo desta pesquisa foi identificar competências da enfermeira para a triagem de doadores de sangue, dentre as preconizadas pelo Conselho Internacional de Enfermagem. Tratpu-se-se de um estudo qualitativo do tipo estudo de caso. Foi realizado no Serviço de Hemoterapia Unidade Banco de Sangue de um hospital universitário da cidade de Porto Alegre, RS, Brasil. Foram observadas 25 entrevistas de cinco enfermeiras que trabalhavam no setor. Para a análise das observações foi utilizada a adequação ao padrão. Foram identificadas seis competências da área prática profissional, ética e legal e onze da área provisão e gerenciamento do cuidado. As competências identificadas neste estudo contribuem para o preparo e prática das enfermeiras generalistas na a realização da triagem clínica de doadores de sangue.
Análise dos dispositivos de saúde mental em municípios do Vale do Paraíba
Authors: Pereira Maria Odete , Oliveira Márcia Aparecida Ferreira de
Published: July 2011

Estudo que teve como objetivo identificar e analisar a relação entre a população quanto à quantidade e modalidade de dispositivos de saúde mental existentes. Tratou-se de pesquisa descritivo-exploratória realizada nos 27 municípios da Regional da Saúde XVII do Estado de São Paulo. Dos municípios participantes, sete possuíam algum dispositivo de saúde mental, totalizando 12 em cinco diferentes modalidades: dois Centros de Atenção Psicossocial tipo I; dois do tipo II; um hospital dia; 12 leitos em hospital geral; quatro ambulatórios e sete leitos em unidades de emergência. Elevado número de pessoas residentes nos municípios participantes encontra-se sem cobertura assistencial.
Formação em aleitamento materno e suas repercussões na prática clínica
Authors: Galvão Dulce Garcia
Published: July 2011

O estudo objetivou identificar as orientações que o enfermeiro disponibiliza às mães quanto à amamentação e verificar que habilidades de comunicação são utilizadas no aconselhamento em aleitamento materno. Tratou-se de estudo descritivo-exploratório sendo aplicado um questionário o qual foi preenchido por 45 enfermeiros estudantes de um curso de especialização em pediatria. A média de idade dos participantes foi 32,7 anos, sendo a maioria do sexo feminino. Verificou-se que após o aprendizado os participantes passaram a estar mais despertos para a postura corporal materna e anatomia da mama. Houve modificação dos informações disponibilizadas às mães para práticas mais adequadas relativas ao posicionamento e modo de mamar, mas foram poucas as habilidades comunicacionais utilizadas. Concluiu-se que a formação sobre aconselhamento não foi suficiente, requerendo maior desenvolvimento.
Perspectiva educativa do cuidado de enfermagem sobre a manutenção da estomia de eliminação
Authors: Martins Paula Alvarenga de Figueiredo , Alvim Neide Aparecida Titonelli
Published: July 2011

Este estudo foi desenvolvido com os objetivos de descrever os saberes e práticas de usuários estomizados sobre a manutenção da estomia de eliminação intestinal e urinária; e analisar a pertinência do compartilhamento de tais saberes e práticas com os cuidados fundamentais de enfermagem, desenvolvidos no contexto ambulatorial. Tratou-se de pesquisa qualitativa do tipo convergente-assistencial. Utilizou-se um formulário de identificação do estomizado e uma entrevista semi-estruturada para produção de dados. Os aspectos éticos foram atendidos. A pesquisa revelou a necessidade de maior divulgação sobre a realidade concreta desses usuários para que possam sentir-se mais acolhidos, fortificados no enfrentamento das dificuldades que, porventura, surjam no cotidiano de con(viver) com a derivação cirúrgica.
Importância da anamnese e do exame físico para o cuidado do enfermeiro
Authors: Santos Neuma , Veiga Patrícia , Andrade Renata
Published: July 2011

A anamnese e exame físico fazem parte da etapa do Histórico de Enfermagem do Processo de Enfermagem. Sua implementação visa o cuidado individualizado, holístico, humanizado e com embasamento científico. A revisão de literatura foi feita em bases indexadas como LILACS e SciELO, livros e revistas disponíveis nas bibliotecas locais publicadas entre os anos 2000 e 2009. O objetivo é descrever sobre a importância da anamnese e exame físico no cuidado prestado pelo enfermeiro. Os resultados desta pesquisa possibilitarão que graduandos de enfermagem e profissionais da área de saúde possam compreender melhor a importância da anamnese e exame físico para sua atuação profissional, aplicar devidamente todas as etapas da SAE e despertar o interesse por pesquisas sobre esta temática.
Elementos de vulnerabilidade individual de adolescentes ao HIV/AIDS
Authors: Toledo Melina Mafra , Takahashi Renata Ferreira , De-La-Torre-Ugarte-Guanilo Mónica Cecilia
Published: July 2011

A adolescência é caracterizada pela experimentação e descoberta, pelo desenvolvimento da autonomia e pela sexualidade. O objetivo desse estudo foi identificar as evidências científicas da literatura sobre os elementos da dimensão individual da vulnerabilidade de adolescentes ao HIV/AIDS. Através da revisão sistemática integrativa, em bases e bancos de dados eletrônicos (Cinahl PubMed, Scopus, LILACS, Adolec, Dedalus, BDTD e Portal de Teses da Universidade de São Paulo) rastrearam-se trabalhos publicados entre 1996 e 2006. Compuseram a amostra final 41 estudos. O elemento da vulnerabilidade individual mais freqUente nos estudos foi o grau e qualidade do conhecimento sobre HIV/AIDS. A revisão permitiu identificar evidências científicas da vulnerabilidade individual relevantes para o planejamento das ações de prevenção à infecção pelo HIV em adolescentes.
Fatores de risco e medidas de prevenção do câncer de próstata: subsídios para a enfermagem
Authors: Medeiros Adriane Pinto de , Menezes Maria de Fátima Batalha de , Napoleão Anamaria Alves
Published: July 2011

Apresenta-se um artigo de reflexão sobre fatores de risco e medidas de prevenção do câncer de próstata, visando contribuir para a abordagem de homens, especialmente durante a consulta de enfermagem. Idade avançada, origem étnica e hereditariedade são fatores de risco potenciais. Dieta pobre em gorduras, rica em frutas, verduras, legumes, grãos e outros é citada como minimizadora. A finasterida, droga inibidora da 5 alpha-redutase tem sido estudada como redutor de risco. O rastreamento da doença pela dosagem do Antígeno Prostático Específico (PSA) e toque retal é também medida recomendada. Entretanto, maiores evidências científicas ainda estão sendo buscadas sobre esses fatores. A abordagem dos homens na consulta de enfermagem pode contribuir para a identificação de fatores de risco, sinais e sintomas de possíveis alterações.
Associação Brasileira de Enfermagem - Seção Sergipe: 52 anos de vontade, garra e coração
Authors: Mattos Maria Cláudia Tavares de , Campos Maria Pontes de Aguiar
Published: July 2011

Trata-se de uma contribuição à história da Enfermagem sergipana e, por conseguinte a Enfermagem brasileira. Objetiva resgatar a história da Associação Brasileira de Enfermagem, Seção Sergipe (ABEn-SE) e documentar o desempenho dessa entidade nos cenários científico, cultural e político. Pesquisa qualitativa cujos dados foram coletados através de história oral e história oficial registrada em livros, atas, jornais e documentos. Os dados foram submetidos à análise de conteúdo.É apresentada a história através de algumas das personagens desse enredo mostrando que o presente pode ser um produto do passado já que encerra uma escrita da história construída e moldada pela vontade de seus atores. Conclui-se que repensar a história da ABEn-SE é repensar nossas próprias vidas e a capacidade de interagir com a categoria.
Oral cavity eumycetoma
Authors: Nai Gisele Alborghetti , Stuani Maria Luiza de Toledo , Stuani Luís Antonio Sasso
Published: July 2011

Mycetoma is a pathological process in which eumycotic (fungal) or actinomycotic causative agents from exogenous source produce grains. It is a localized chronic and deforming infectious disease of subcutaneous tissue, skin and bones. We report the first case of eumycetoma of the oral cavity in world literature. CASE REPORT: A 43-year-old male patient, complaining of swelling and fistula in the hard palate. On examination, swelling of the anterior and middle hard palate, with fistula draining a dark liquid was observed. The panoramic radiograph showed extensive radiolucent area involving the region of teeth 21-26 and the computerized tomography showed communication with the nasal cavity, suggesting the diagnosis of periapical cyst. Surgery was performed to remove the lesion. Histopathological examination revealed purulent material with characteristic grain. Gram staining for bacteria was negative and Grocott-Gomori staining for the detection of fungi was positive, concluding the diagnosis of eumycetoma. The patient was treated with ketoconazole for nine months, and was considered cured at the end of treatment. CONCLUSION: Histopathological examination, using histochemical staining, and direct microscopic grains examination can provide the distinction between eumycetoma and actinomycetoma accurately.
Fusobacterium necrophorum causing infective endocarditis and liver and splenic abscesses
Authors: Handler Marc Zac , Miriovsky Benjamin , Gendelman Howard E. , Sandkovsky Uriel
Published: July 2011

A 25-year-old male without prior co-morbidities was admitted to hospital with Fusobacterium necrophorum bacteremia, where he was found to have liver and splenic abscesses. Further evaluation with echocardiography revealed a bicuspid aortic valve with severe insufficiency and a 1.68 x 0.86 cm vegetation. The patient required abscess drainage, intravenous antimicrobial therapy and aortic valve replacement. Complete resolution of the infection was achieved after valve replacement and a prolonged course of intravenous antimicrobial therapy. A brief analysis of the patient's clinical course and review of the literature is presented.
CMV and HSV-2 myeloradiculitis in an HIV infected patient
Authors: Pinto Adriana , Santos Edwiges , Correa Danusa F. , Escada Rodrigo , Vorsatz Carla de Mello , Cardoso Sandra Wagner , Lima Marco A.
Published: July 2011

While CMV myeloradiculitis is a known complication in AIDS patients with severe immunosuppression, HSV-2 necrotizing myeloradiculitis is rare and often associated with disabling a fatal outcome. We hereby describe a 46 year-old HIV infected patient with profound and sustained immunosuppression who presented with an acute ascending paraparesis and urinary retention. Lumbar spine MRI showed contrast enhancement at the conus medullaris and cauda equine, and both CMV and HSV-2 CSF PCR were positive. Despite treatment, the patient died 20 days later. We review the main diagnostic and therapeutic aspects of herpes virus associated myeloradiculitis and discuss the approach in similar cases.
Estudo da diversidade genética de Podosphaera xanthii através de marcadores AFLP e seqüências ITS
Authors: Naruzawa Erika Sayuri , Vale Raphaelle Komatsu Dalla , Silva Cynthia Maria , Camargo Luis Eduardo Aranha
Published: July 2011

O meloeiro (Cucumis melo L.) é uma frutífera largamente cultivada no Brasil, principalmente no nordeste brasileiro, onde é produzida principalmente para a exportação. Plantas da família do meloeiro, como pepino e abóbora, podem ser severamente afetadas pelo oídio, causado por Podosphaera xanthii.. Este fungo apresenta diversas raças fisiológicas cuja correta identificação é importante para o manejo da doença, já que o uso de variedades resistentes é o método mais eficaz de seu controle. No entanto, a identificação destas raças por meio da prática tradicional de inoculações em uma série diferenciadora de variedades de meloeiro é laboriosa e passível de erros. Devido a isso, um método alternativo seria o uso de marcadores moleculares para determinar de forma rápida a identidade das raças. O objetivo deste estudo foi o de analisar a variabilidade entre isolados de P. xanthii previamente classificados em raças através da técnica de AFLP e do seqüenciamento da região ITS 5.8S do rDNA. A partir dos marcadores AFLP obteve-se um dendrograma no qual não houve separação dos isolados quanto às suas raças, origem geográfica ou hospedeiro de origem. Com esta técnica verificou-se alta variabilidade entre isolados, com similaridade genética máxima de 69% e similaridade mínima de 23%. Ao contrário da informação gerada por AFLP, não foi observada variação na sequência da região ITS 5.8S entre isolados. Desta forma, a análise por AFLP indicou que os isolados tem composição genética heterogênea muito embora este fato não tenha sido evidenciado pelo sequenciamento da região ITS.
Cianobactérias e algas reduzem os sintomas causados por Tobacco vosaic virus (tmv) em plantas de fumo
Authors: Beltrame André B. , Pascholati Sérgio Florentino
Published: July 2011

As algas e as cianobactérias produzem uma grande diversidade de compostos com atividade biológica direta sobre microrganismos ou agem como ativadores de mecanismos de resistência em plantas. Em vista disso, foi investigada a manifestação dos sintomas causados pelo Tobacco mosaic virus (TMV) em plantas de fumo previamente tratadas com cianobactérias ou algas. Quando as folhas plantas de fumo foram tratadas dois dias antes da inoculação, foi verificado que suspensões de células dos isolados de cianobactérias 004/02, 008/02, Anabaena sp. e Nostoc sp. 61; e do isolado de alga 061/02, bem como as preparações do conteúdo intracelular do isolado 004/02 (4 C) e do filtrado do meio de cultivo do isolado 061/02 (61 M) apresentaram efeito na redução do número de lesões locais provocadas por TMV em folhas de plantas fumo, cultivar TNN. Além disso, foi observado que os isolados Anabaena sp., Nostoc sp. 21 (cianobactéria), Nostoc sp. 61 e 090/02 (alga) mostraram efeito direto sobre o vírus semi-purificado. Em vista disso, pode-se sugerir que os isolados estudados sintetizam compostos que agem diretamente sobre o TMV e/ou ativam o mecanismo de defesa de plantas contra fitopatógenos.