bluuebunny/crossref_metadata_2025 huggingface dataset:
Tratamento cirúrgico da escoliose em pacientes com amiotrofia espinhal com parafusos pediculares (instrumental de 3ª geração) e complicações precoces
Authors: Santos Daniel Cantarelli dos , Cavali Paulo Tadeu Maia , Santos Marcus Alexandre Mello , Lehoczki Maurício Antonelli , Rossato Alexander Junqueira , Landim Elcio
Published: February 2011

OBJETIVO: avaliar a utilização de artrodese via posterior com parafusos pediculares para correção da escoliose em pacientes com amiotrofia espinhal. MÉTODOS: realizou-se um estudo retrospectivo de 16 pacientes com amiotrofia espinhal submetidos à artrodese via posterior exclusiva, com parafusos pediculares. Foi avaliado o perfil geral dos pacientes e o potencial de correção do ângulo de Cobb e da obliquidade pélvica, além das complicações precoces. RESULTADOS: o ângulo de Cobb pré-operatório foi em média de 94,6º (65 a 132º), no pós-operatório de 40,4º (2 a 70º), percentual de correção de 57,2%. A obliquidade pélvica pré-operatória foi em média 34,7º (25 a 56º), no pós-operatório foi para 11,3º (0 a 20º), com percentual de correção de 67,4%. Cinco pacientes tiveram complicações precoces (31,2%) com boa resolução. CONCLUSÕES: o tratamento cirúrgico da escoliose em pacientes com amiotrofia espinhal por meio de artrodese via posterior utilizando parafusos pediculares tem grande potencial de correção da deformidade coronal e da obliquidade pélvica, sem grandes complicações no pós-operatório precoce.
Avaliação radiográfica do colapso sagital na fratura toracolombar tipo B de Magerl
Authors: Esperidião Adriano Passaglia , Umeta Ricardo Shigueaki Galhego , Caffaro Maria Fernanda Silber , Meves Robert , Landim Elcio , Avanzi Osmar
Published: February 2011

INTRODUÇÃO: a cifose pós-traumática é uma complicação do tratamento conservador da fratura toracolombar tipo flexo-distrativa de Magerl (B21). A maioria das séries avalia todos os subtipos de Magerl e discute seus achados com base na perda média de cifose no acompanhamento. OBJETIVO: avaliar o desfecho radiográfico quanto à cifose nos portadores de fraturas do subtipo B21 de Magerl, de acordo com a variação das médias entre os indivíduos após acompanhamento mínimo de seis meses. MÉTODOS: estudo retrospectivo com 34 pacientes submetidos à realização de gesso antigravitacional ou colete TLSO. A mensuração da cifose foi realizada pelo método de Cobb no momento da admissão no hospital e no final do acompanhamento médio de 84,5 meses. RESULTADOS: não houve diferença estatística entre a cifose antes e após o tratamento (14,18º versus 14,15º; (p=0,967). CONCLUSÃO: a cifose radiográfica no final do acompanhamento é similar à cifose encontrada nas radiografias iniciais nesse grupo de pacientes.
Análise radiológica comparativa entre espondilodiscite tuberculosa e inespecífica
Authors: Couto Bruno Brasil do , Umeta Ricardo Shigueaki Galhego , Caffaro Maria Fernanda Silber , Meves Robert , Landim Elcio , Avanzi Osmar
Published: February 2011

OBJETIVO: comparar as imagens radiológicas da espondilodiscite tuberculosa e a inespecífica. MÉTODOS: estudo retrospectivo mediante revisão de prontuários e exames de imagem dos pacientes portadores de discite inespecífica e específica pelo Micobacterium tuberculosis, que realizaram tratamento, pelo Grupo de Coluna do Departamento de Ortopedia e Traumatologia no período de 1989 a Agosto de 2009. RESULTADOS: foram analisados 48 prontuários e arquivos de imagens de pacientes portadores de discite tuberculosa (Tbc) e 31 de pacientes portadores de discite inespecífica. Dos portadores de espondilite tuberculosa, também denominada mal de Pott, 54% eram do sexo masculino. A idade variou de 3 a 87 anos com média de 44,1 anos. Nos pacientes portadores de discite inespecífica, 68% eram do sexo masculino, e a idade variou de 2 meses a 76 anos. O padrão radiográfico predominante na discite por Tbc foi o acunhamento da região anterior do corpo vertebral em 88,2% dos casos. Nos pacientes com discite inespecífica, a diminuição do espaço discal foi o achado mais prevalente, encontrado em 87% dos casos. CONCLUSÃO: A discite por Tbc apresentou nesta série uma maior prevalência de alterações estruturais importantes na coluna vertebral, como a cifose, e reação paravertebral em relação à discite inespecífica. Enquanto a prevalência de infecção inespecífica foi maior em pacientes pediátricos, a discite por Tbc teve prevalência progressivamente maior com o aumento da idade dos pacientes.
Corticoterapia em altas doses no traumatizado medular: benefício ou prejuízo?
Authors: Rodrigues Eurico Bandeira , Duarte Rui , Maia Ricardo , Ribeiro Juvenália , Vaz Helena , Pereira Elso
Published: February 2011

As sequelas das lesões traumáticas da espinal medula representam um elevado prejuízo pessoal, familiar e social. Desde 1984, foi investigado e proposto o tratamento com succinato sódico metilprednisolona em altas doses, como forma de reverter ou prevenir o agravamento dessas lesões. Apresentamos uma revisão da literatura sobre essa temática. Sabe-se que essa terapêutica tem uma elevada taxa de complicações, mas, acerca das suas vantagens e real eficácia, não existe concordância entre autores de trabalhos. Enquanto uns a defendem, outros chegam a considerar provada a sua total contraindicação nessa patologia. Já existem, em nível mundial, alguns centros que não fazem a sua administração. Em Portugal é prática generalizada a sua utilização. Não o fazer poderia mesmo ser difícil de defender em situação de litígio. Mas será que estamos mesmo a ajudar os nossos doentes?
Repensando a historicidade discursiva no exame das trajetórias políticas de dois líderes nacionalistas da Colômbia
Authors: Faulhaber Priscila
Published: February 2011

O trabalho parte do exame de textos literários e biográficos que evocam aspectos das trajetórias do general Rafael Uribe Uribe (1859-1914) e do líder político Jorge Eliecer Gaitán (1898-1948). Gabriel García Márquez (1928-) se inspirou em Uribe para a criação do protagonista do romance "Cem Anos de Solidão". Márquez iniciou sua carreira de escritor em 1948, ano da morte de Gaitán. O assassinato desse líder resultou na chamada 'Violência', catalisada com a impossibilidade, no campo político colombiano, de transformação social de 'baixo para cima', proposta por Gaitán. É interessante considerar, na historicidade de mitos e práticas da cultura política colombiana, as circunstâncias singulares dos assassinatos desses dois líderes.
Heloisa Alberto Torres e o inquérito nacional sobre ciências naturais e antropológicas, 1946
Authors: Domingues Heloisa Maria Bertol
Published: February 2011

O objetivo do trabalho é analisar um documento elaborado pela então diretora do Museu Nacional do Rio de Janeiro, Heloisa Alberto Torres (1895-1977), que propôs fazer um estudo sobre o estado das ciências naturais e da antropologia com a finalidade de reestruturar a pesquisa científica em função do desenvolvimento econômico, político e social do Brasil. O documento foi enviado ao reitor da Universidade do Brasil, Pedro Calmon (1902-1985), em 1946, ao fim do Estado Novo e da Segunda Guerra Mundial, quando a diretora foi reempossada no cargo que exercia desde 1938. De acordo com o documento, o papel político das ciências naturais e da antropologia deveria ser exercido nos marcos teóricos da Ecologia, que se chocavam, no entanto, com as demandas políticas de exploração desmedida dos recursos naturais. As ideias da diretora do Museu Nacional acabaram por se limitar a projetos institucionais, levados a efeito pela política internacional de cooperação científica, que facilitou a circulação dos cientistas e beneficiou a pesquisa com financiamento interno e externo.
Passagens do livro "Itinerário para Párocos de Índios", de Peña Montenegro (1668), em um confessionário jesuítico setecentista da Amazônia
Authors: Barros Maria Cândida Drumond Mendes , Fonseca Vitor Manoel Marques da
Published: February 2011

A proposta do artigo é transcrever e analisar um trecho final de um confessionário manuscrito anônimo em circulação em missões do Pará em 1751. O confessionário foi escrito em tupi, mas a conclusão do documento está em português. O missionário se dirige a outros confessores relatando as dificuldades encontradas na confissão dos índios e propondo soluções para salvar a consciência dos religiosos. A influência intelectual do autor do confessionário foi o livro do arcebispo de Quito, Alonso de la Peña Montenegro, autor de "Itinerário para Párocos de Índios", publicado em 1668. O manuscrito pertence ao acervo da Biblioteca Nacional do Rio de Janeiro. A transcrição está acompanhada de notas com remissões ao livro do arcebispo de Quito.
Integração ensino-trabalho-cidadania na formação de enfermeiros
Authors: Tanji Suzelaine , Silva Carmen Maria dos Santos Lopes Monteiro Dantas da , Albuquerque Verônica Santos , Viana Lígia de Oliveira , Santos Neiva Maria Picinini dos
Published: February 2011

O presente estudo tem como objetivo identificar os conflitos encontrados no cotidiano do trabalho no decorrer do curso de especialização Processo de Mudança no Ensino Superior e nos Serviços de Saúde. Estudo qualitativo descritivo, tipo estudo de caso; o cenário foi um centro universitário privado situado no estado do Rio de Janeiro. Os sujeitos foram 18 estudantes do curso de especialização, que se dispuseram espontaneamente a participar do estudo. A coleta de dados ocorreu em abril de 2009, os dados foram analisados e descritos em cinco unidades temáticas que descrevem os focos de conflitos no mundo do trabalho: A integração ensino, trabalho e cidadania; O trabalho em equipe; A educação permanente; A responsabilidade social; O estabelecimento da linha de cuidado. A interseção entre a seara acadêmica e os serviços de saúde produz tensões e conflitos, que na maioria das vezes estão latentes, mas não manifestos.
Principais causas de hospitalização de pacientes em hemodiálise no município de Guarapuava, Paraná, Brasil
Authors: Pivatto Daiane Roberta , Abreu Isabella Schroeder
Published: February 2011

Estudo quantitativo que teve como objetivo caracterizar pacientes renais crônicos em hemodiálise segundo variáveis sócio-demográficas e identificar as principais causas de internação destes pacientes no ano de 2007. A coleta de dados foi realizada em uma clínica de Guarapuava, Paraná, com 29 pacientes, em prontuários e através do programa informatizado Nefrodata, específico para centros de diálise e analisados através de estatística descritiva, onde 58,7% eram do sexo masculino, 62% casados e a idade média foi de 53,7 anos. Quanto às doenças de base houve um predomínio da nefropatia diabética com 31,1% e a crise hipertensiva com 11,8% entre as causas de internação. Estas causas estão em sua maioria relacionadas com a própria doença renal, sendo necessário orientações e intervenções da equipe multidisciplinar com enfoque no tratamento da insuficiência renal crônica e na adesão à terapia, com o objetivo de reduzir e até mesmo evitar estas hospitalizações.
Ações em saúde mental às famílias nos diferentes contextos de trabalho: revisão integrativa
Authors: Aires Marinês , Roos Cristine Moraes , Gonçalves Ana Valéria Furquim , Schneider Jacó Fernando , Olschowsky Agnes
Published: February 2011

Trata-se de uma revisão integrativa da literatura que objetivou identificar e analisar os estudos nos periódicos de enfermagem que focalizam as ações em Saúde Mental direcionadas às famílias. Para a coleta dos dados foram utilizados os descritores saúde mental, família e enfermagem, nas bases de dados da Literatura Latino-Americano e do Caribe em Ciências da Saúde (LILACS) e Scientific Electronic Library Online (SciELO). Os critérios de inclusão foram: artigos originais publicados em português, espanhol e inglês nos periódicos na área da enfermagem entre os anos de 2003 a 2008. Este trabalho evidenciou uma predominância de estudos enfocando questões referentes à equipe de saúde e/ou profissionais. Os achados indicam necessidade em produzir pesquisas voltadas para os usuários e familiares, o que pode contribuir para as ações em saúde mental da equipe nos cenários da atenção psicossocial e apontar caminhos na direção de novas pesquisas.
Nine Equivalents of Nursing Manpower Use Score (NEMS): um estudo de seu processo histórico
Authors: Canabarro Simone Travi , Velozo Kelly Dayane Stochero , Eidt Olga Rosária , Piva Jefferson Pedro , Garcia Pedro Celiny Ramos
Published: February 2011

Este estudo visa, por meio de uma revisão integrativa da literatura, descrever o percurso histórico dos escores de intervenções terapêuticas com ênfase no Nine Equivalents of Nursing Manpower Use Score (NEMS) em Unidade de Terapia Intensiva. Foram utilizados os descritores "Unidades de terapia intensiva" e "escalas" para publicações entre 2000 e 2009. Foram selecionados "Nine Equivalents of Nursing Manpower Use Score" ou "NEMS", "Unidade de Terapia Intensiva", "Therapeutic Intervention Scoring System-76", "Therapeutic Intervention Scoring System-28 ou "TISS-28". Selecionaram-se publicações das bases Medical Literature Analysis and Retrieval System Online (MEDLINE) e Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS). Dos 295 artigos capturados, 18 foram incluídos, sendo 55,5% em inglês. Os estudos abordam o NEMS (33,3%), Therapeutic Intervention Scoring System-76 (11,1%), TISS-28 (33,3%), entre outros. Pesquisas destacaram que o NEMS vem demonstrando ser uma ferramenta útil, operacional e sucinta.
A Multicenter Retrospective Study on Clinical Characteristics, Treatment Patterns, and Outcome in Elderly Patients with Hepatocellular Carcinoma
Authors: Kozyreva Olga N. , Chi Dorcas , Clark Jeffrey W. , Wang Hejing , Theall Kathy P. , Ryan David P. , Zhu Andrew X.
Published: February 2011

Background.

There is a paucity of information on the clinical presentation and outcome of elderly hepatocellular carcinoma (HCC) patients. We performed a multicenter retrospective comparative study to assess the impact of age on potential differences in clinical characteristics, treatment patterns, and outcome in HCC patients.

Methods.

We retrospectively analyzed HCC patients treated at two U.S. tertiary institutions from 1998 to 2008. Demographics, tumor parameters, etiology and severity of cirrhosis, treatment, and survival from diagnosis were collected and analyzed. After exclusion of transplanted patients, survival analyses were performed using the Kaplan-Meier method with log-rank tests and Cox proportional hazards models.

Results.

Three hundred thirty-five HCC patients were divided into two groups: “elderly” (95 patients, age ≥70 years) and “younger” (240 patients, aged <70 years). The male/female (M/F) ratio was 5.8:1 and 1.7:1 in the younger and elderly groups, respectively (p < .0001). Hepatitis C virus (HCV) infection rate was 48.3% in younger and 21.1% in elderly patients (p < .0001); Child class B and C cirrhosis accounted for 35.8% in younger and 25.3% in elderly patients (p = .063). Compared with younger patients, the elderly received transplant less frequently (19.6% versus 5.3%, p = .0002) and were more likely to receive supportive care only (22.9% versus 36.8%, p = .01). No significant differences between the two age groups were seen in tumor parameters or other treatments received. Overall (p = .47) and HCC-specific survival rates (p = .38) were similar in both age groups.

Conclusions.

Characteristics that distinguish elderly from younger HCC patients include lower M/F ratio, worse performance status, lower rate of HCV infection, and less advanced underlying cirrhosis. Elderly patients were less likely to have a liver transplant and more likely to receive supportive care only. However, overall and HCC-specific survival were similar between the two groups.
Special and Differential Treatment, Trade and Sustainable Development
Authors: Irish Maureen
Published: February 2011

This article examines the objective of sustainable development, listed in the preamble to the Marrakesh Agreement Establishing the World Trade Organization. It discusses the relationship between rights to special and differential treatment included in various WTO agreements and the principle of common but differentiated responsibilities that is part of sustainable development.
Export Promotion Policies, Export Composition and Economic Development of Korea
Authors: Mah Jai S.
Published: February 2011

Korea has achieved rapid economic development for the past few decades, raising its economic stature from one of the most impoverished countries in the world to an advanced industrial nation. Korea will host the G20 summit meeting in November 2010. What is the reason for the rapid economic development of Korea? This paper discusses the policy measures taken by the Korean government to promote exports, analyse their contribution and problems, and provide developing countries with the implications for their economic development process under the WTO system drawn from the experience of export-led economic development of Korea.
International Development Disputes
Authors: Broude Tomer
Published: February 2011

This article introduces the concept of "international development disputes". It argues that despite the well-acknowledged vagueness of 'development' as an operative legal concept, there exists a set of international legal differences (primarily international economic disputes, but not exclusively so) that should be identified as international disputes about development. This family of international disputes is discussed and categorized. Recognizing such disputes has implications for the ways in which such disputes are dealt with. In particular, the effectiveness and legitimacy of using judicial methods to address development disputes should be reconsidered.
Evaluation of agreement and correlation of three occlusal indices in an assessment of orthodontic treatment need
Authors: Djordjevic Jelena , Scepan Ivana , Glisic Branislav
Published: February 2011

Background/Aim. Occlusal indices are quantitative diagnostic indicators of malocclusion severity, orthodontic treatment need, complexity and outcome. The aim of this study was to determine correlations and agreement among three occlusal indices: the Index of Orthodontic Treatment Need (IOTN), the Peer Assessment Rating Index (PAR) and the Index of Complexity, Outcome and Need (ICON) in evaluating orthodontic treatment need. Methods. A total eighty study models of patients referred to the Department of Orthodontics, School of Dentistry, Belgrade, were assessed in this retrospective study. Malocclusions of various types and severity in the permanent dentition were included. Results. The Aesthetic and the Dental Health Component of IOTN determined orthodontic treatment need in 25% and 51% of the patients, respectively. PAR determined orthodontic treatment need in 59% and ICON in 53% of patients. The Aesthetic Component of IOTN and ICON had the highest correlation (Spearman's correlation coefficient 0.95, p < 0.01). Correlations between indices were 0.44 to 0.61 with statistical significance (p < 0.01). The agreement between indices, calculated using Kappa statistics, was 0.22 to 0.63. Conclusion. The most critical in malocclusion assessment was PAR. The Aesthetic Component of IOTN and ICON correlated highly (p < 0.01). Correlations between other pairs of indices were moderate (p < 0.01). The Aesthetic Component of IOTN and ICON had substantial agreement, whereas agreement between other indices was fair or moderate. ICON could replace PAR and IOTN. Application of occlusal indices enables objective evaluation of orthodontic treatment need and easier determination of the treatment priorities.
Importance of open and closed kinetic chain exercises after anterior cruciate ligament reconstruction
Authors: Dubljanin-Raspopovic Emilija , Kadija Marko , Mirkov Dragan , Bumbasirevic Marko
Published: February 2011

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A successful outcome of pregnancy in a patient with congenital antithrombin deficiency
Authors: Kovac Mirjana , Mikovic Zeljko , Rakicevic Ljiljana , Srzentic Snezana , Mandic Vesna , Djordjevic Valentina , Radojkovic Dragica
Published: February 2011

Background. Presence of inherited thrombophilia is an additional risk factor for maternal thromboembolism and certain adverse pregnancy outcomes, including recurrent fetal loss, placental abruption, intrauterine growth restriction and earlyonset severe preeclampsia. Pregnant women with thrombophilia, especially those with antithrombin (AT) deficiency, are at high risk of both kinds of complications. Case report. We presented a pregnant women with congenital antithrombin deficiency in the first pregnancy, whose mother had had four times pregnancy-related deep vein thrombosis, and antithrombin deficiency. With the regular laboratory monitoring of hemostatic parameters and gynaecology surveillance including the follow-up of placental vascular flow, the whole pregnancy proceeded without complications. The prophylactic therapy with low molecular weight heparin was introduced from the 20th week of gestation and one dose of substitution therapy with antithrombin concentrate was administrated before delivery. Pregnancy and labour were terminated without complications at the 37th week of gestation, resulting in the delivery of a healthy male newborn of 3.6 kg body weight, 52 cm long, and with the Apgar scores of 9/10. Conclusion. A timely made diagnosis of thrombophilia, accompanied with regular obstetrics check-ups and follow-ups of hemostatic parameters during pregnancy, as well as the use of adequate prophylactic and substitution therapy, are the successful tools for the prevention of possible maternal complications and pregnancy itself in our patient with congenital AT deficiency.
Novel Fat Depot–Specific Mechanisms Underlie Resistance to Visceral Obesity and Inflammation in 11β-Hydroxysteroid Dehydrogenase Type 1–Deficient Mice
Authors: Wamil Malgorzata , Battle Jenny H. , Turban Sophie , Kipari Tiina , Seguret David , de Sousa Peixoto Ricardo , Nelson Yvonne B. , Nowakowska Dominika , Ferenbach David , Ramage Lynne , Chapman Karen E. , Hughes Jeremy , Dunbar Donald R. , Seckl Jonathan R. , Morton Nicholas M.
Published: February 2011

OBJECTIVE

The study objective was to determine the key early mechanisms underlying the beneficial redistribution, function, and inflammatory profile of adipose tissue in 11β-hydroxysteroid dehydrogenase type 1 knockout (11β-HSD1−/−) mice fed a high-fat (HF) diet.

RESEARCH DESIGN AND METHODS

By focusing on the earliest divergence in visceral adiposity, subcutaneous and visceral fat depots from 11β-HSD1−/− and C57Bl/6J control mice fed an HF diet for 4 weeks were used for comparative microarray analysis of gene expression, and differences were validated with real-time PCR. Key changes in metabolic signaling pathways were confirmed using Western blotting/immunoprecipitation, and fat cell size was compared with the respective chow-fed control groups. Altered adipose inflammatory cell content and function after 4 weeks (early) and 18 weeks (chronic) of HF feeding was investigated using fluorescence (and magnetic)-activated cell sorting analysis, immunohistochemistry, and in situ hybridization.

RESULTS

In subcutaneous fat, HF-fed 11β-HSD1−/− mice showed evidence of enhanced insulin and β-adrenergic signaling associated with accretion of smaller metabolically active adipocytes. In contrast, reduced 11β-HSD1−/− visceral fat accumulation was characterized by maintained AMP kinase activation, not insulin sensitization, and higher adipocyte interleukin-6 release. Intracellular glucocorticoid deficiency was unexpectedly associated with suppressed inflammatory signaling and lower adipocyte monocyte chemoattractant protein-1 secretion with strikingly reduced cytotoxic T-cell and macrophage infiltration, predominantly in visceral fat.

CONCLUSIONS

Our data define for the first time the novel and distinct depot-specific mechanisms driving healthier fat patterning and function as a result of reduced intra-adipose glucocorticoid levels.
Interleukin-21 Is Critically Required in Autoimmune and Allogeneic Responses to Islet Tissue in Murine Models
Authors: McGuire Helen M. , Walters Stacey , Vogelzang Alexis , Lee Carol M.Y. , Webster Kylie E. , Sprent Jonathan , Christ Daniel , Grey Shane , King Cecile
Published: February 2011

OBJECTIVE

Type 1 diabetes is an incurable chronic autoimmune disease. Although transplantation of pancreatic islets may serve as a surrogate source of insulin, recipients are subjected to a life of immunosuppression. Interleukin (IL)-21 is necessary for type 1 diabetes in NOD mice. We examined the efficacy of an IL-21–targeted therapy on prevention of diabetes in NOD mice, in combination with syngeneic islet transplantation. In addition, we assessed the role of IL-21 responsiveness in islet allograft rejection in mouse animal models.

RESEARCH DESIGN AND METHODS

NOD mice were treated with IL-21R/Fc, an IL-21–neutralizing chimeric protein. This procedure was combined with syngeneic islet transplantation to treat diabetic NOD mice. Survival of allogeneic islet grafts in IL-21R–deficient mice was also assessed.

RESULTS

Evidence is provided that IL-21 is continually required by the autoimmune infiltrate, such that insulitis was reduced and reversed and diabetes inhibited by neutralization of IL-21 at a late preclinical stage. Recovery from autoimmune diabetes was achieved by combining neutralization of IL-21 with islet transplantation. Furthermore, IL-21–responsiveness by CD8+ T-cells was sufficient to mediate islet allograft rejection.

CONCLUSIONS

Neutralization of IL-21 in NOD mice can inhibit diabetes, and when paired with islet transplantation, this therapeutic approach restored normoglycemia. The influence of IL-21 on a graft-mounted immune response was robust, since the absence of IL-21 signaling prevented islet allograft rejection. These findings suggest that therapeutic manipulation of IL-21 may serve as a suitable treatment for patients with type 1 diabetes.
Long-Term Impact of Neonatal Breastfeeding on Childhood Adiposity and Fat Distribution Among Children Exposed to Diabetes In Utero
Authors: Crume Tessa L. , Ogden Lorraine , Maligie MaryBeth , Sheffield Shelly , Bischoff Kimberly J. , McDuffie Robert , Daniels Stephen , Hamman Richard F. , Norris Jill M. , Dabelea Dana
Published: February 2011

OBJECTIVE

To evaluate whether breastfeeding attenuates increased childhood adiposity associated with exposure to diabetes in utero.

RESEARCH DESIGN AND METHODS

Retrospective cohort study of 89 children exposed to diabetes in utero and 379 unexposed youth with measured BMI, waist circumference, skinfolds, visceral (VAT) and subcutaneous (SAT) abdominal fat. A measure of breast milk–months was derived from maternal self-report and used to categorize breastfeeding status as low (<6) and adequate (≥6 breast milk–months). Multiple linear regression was used to model the relationship between exposure to diabetes in utero and offspring adiposity outcomes among youth stratified according to breastfeeding status.

RESULTS

Adequate (vs. low) breastfeeding status was associated with significantly lower BMI, waist circumference, SAT, and VAT at ages 6–13 years. Among youth in the low breastfeeding category, exposure to diabetes in utero was associated with a 1.7 kg/m2 higher BMI (P = 0.03), 5.8 cm higher waist circumference (P = 0.008), 6.1 cm2 higher VAT (P = 0.06), 44.6 cm2 higher SAT (P = 0.03), and 0.11 higher ratio of subscapular-to-triceps skinfold ratio (P = 0.008). Among those with adequate breastfeeding in infancy, the effect of prenatal exposure to diabetes on childhood adiposity outcomes was not significant.

CONCLUSIONS

Adequate breastfeeding protects against childhood adiposity and reduces the increased adiposity levels associated with exposure to diabetes in utero. These data provide support for mothers with diabetes during pregnancy to breastfeed their infants in order to reduce the risk of childhood obesity.
Heterogeneity of Diabetes Outcomes Among Asians and Pacific Islanders in the U.S.
Authors: Kanaya Alka M. , Adler Nancy , Moffet Howard H. , Liu Jennifer , Schillinger Dean , Adams Alyce , Ahmed Ameena T. , Karter Andrew J.
Published: February 2011

OBJECTIVE

Ethnic minorities with diabetes typically have lower rates of cardiovascular outcomes and higher rates of end-stage renal disease (ESRD) compared with whites. Diabetes outcomes among Asian and Pacific Islander subgroups have not been disaggregated.

RESEARCH DESIGN AND METHODS

We performed a prospective cohort study (1996–2006) of patients enrolled in the Kaiser Permanente Northern California Diabetes Registry. There were 64,211 diabetic patients, including whites (n = 40,286), blacks (n = 8,668), Latinos (n = 7,763), Filipinos (n = 3,572), Chinese (n = 1,823), Japanese (n = 951), Pacific Islanders (n = 593), and South Asians (n = 555), enrolled in the registry. We calculated incidence rates (means ± SD; 7.2 ± 3.3 years follow-up) and created Cox proportional hazards models adjusted for age, educational attainment, English proficiency, neighborhood deprivation, BMI, smoking, alcohol use, exercise, medication adherence, type and duration of diabetes, HbA1c, hypertension, estimated glomerular filtration rate, albuminuria, and LDL cholesterol. Incidence of myocardial infarction (MI), congestive heart failure, stroke, ESRD, and lower-extremity amputation (LEA) were age and sex adjusted.

RESULTS

Pacific Islander women had the highest incidence of MI, whereas other ethnicities had significantly lower rates of MI than whites. Most nonwhite groups had higher rates of ESRD than whites. Asians had ~60% lower incidence of LEA compared with whites, African Americans, or Pacific Islanders. Incidence rates in Chinese, Japanese, and Filipinos were similar for most complications. For the three macrovascular complications, Pacific Islanders and South Asians had rates similar to whites.

CONCLUSIONS

Incidence of complications varied dramatically among the Asian subgroups and highlights the value of a more nuanced ethnic stratification for public health surveillance and etiologic research.
Applying Motor-Control Theory to Physical Therapy Practice: A Case Report
Authors: Kenyon Lisa K. , Blackinton Mary T.
Published: February 2011

Purpose: This case report describes the application of an integrated, systems-based theory of motor control to physical therapy practice.

Client Description: The patient was a 5-year-old boy with spastic hemiplegic cerebral palsy who was entering kindergarten. Parent concerns related to the child's safety in playground activities such as playing on the slide.

Interventions: Motor-control theory, including factors related to the task, the environment, and the individual, was used to guide and direct physical therapy management related to the patient goal of safely and effectively climbing the ladder to the playground slide.

Patient Outcomes: When the child entered kindergarten, he was able to safely ascend the ladder to the playground slide, using a modified movement pattern, when distractions were minimized. However, attentional issues continued to affect task execution when other children were present.

Implications: This case report demonstrates a means by which current knowledge and theory can be integrated into clinical practice.

Future Directions: Applying motor-control theory to this case led to the development of clinical questions for future research.
Femoral branch to obturator nerve transfer for restoration of thigh adduction following iatrogenic injury
Authors: Spiliopoulos Konstantinos , Williams Ziv
Published: February 2011

Obturator nerve injury is a rare complication of pelvic surgery. A variety of management strategies have been reported, with conservative measures being the preferred treatment in most cases. While nerve transfer has become more commonly used for restoring brachial plexus injuries, it has rarely been applied to the lower extremities. To the authors' knowledge, this is the first report of an obturator nerve neurotization. A patient presented 7 months after an iatrogenic right obturator nerve palsy due to pelvic surgery for gynecological malignancy. She underwent a femoral branch to obturator nerve transfer to restore right thigh adduction. Ten months after the neurotization procedure, there was electromyographic evidence of almost complete obturator nerve reinnervation. At 1 year postoperatively, the patient had regained full muscle strength on thigh adduction and a normal gait. Nerve transfer could therefore be a good option in patients with obturator nerve injury whose symptoms fail to respond to conservative medical therapy.
Early changes measured by CT perfusion imaging in tumor microcirculation following radiosurgery in rat C6 brain gliomas
Authors: Guan Li-ming , Qi Xi-Xun , Xia Bin , Li Zhen-hua , Zhao Yu , Xu Ke
Published: February 2011

Object

In this paper, the authors' aim was to use CT perfusion imaging to evaluate the early changes in tumor microcirculation following radiosurgery in rat C6 brain gliomas.

Methods

C6 glioma cells were inoculated into the right caudate nucleus of 25 Wistar rats using a stereotactic procedure. Tumor-bearing rats were randomly divided into 2 groups (tumor group and treatment group). Rats in the treatment group received maximal doses of 20 Gy delivered by the X-knife unit 16 days postimplantation. Computed tomography perfusion imaging was performed in all rats 3 weeks after tumor implantation prior to death and histopathological analysis.

Results

Hypocellular regions and tumor edema were increased in the treatment group compared with the tumor group. Parameters of CT perfusion imaging including cerebral blood volume (CBV) and mean transit time (MTT) of the tumors as well as the permeability surface area (PSA) product in the tumor-brain districts were decreased in the treatment group compared with the tumor group (p < 0.05). Although microvascular density (MVD) in the periphery of the tumors in the treatment group was higher than that in the normal contralateral brain (p < 0.05), MVD of the tumors in the treatment group was less than that in the tumor group (p < 0.01). There was a positive correlation between cerebral blood flow (CBF) and MVD as well as CBV and MVD in the center and periphery of tumors in both groups (p < 0.05).

Conclusions

A decrease in the perfusion volume of rat C6 brain gliomas was observed during the acute stage following X-knife treatment, and CBF and CBV were positively correlated with MVD of rat C6 brain gliomas. Thus, CT perfusion imaging can be used to evaluate the early changes in tumor microcirculation following radiosurgery.
Treatment of cervical stenotic myelopathy: a cost and outcome comparison of laminoplasty versus laminectomy and lateral mass fusion
Authors: Highsmith Jason M. , Dhall Sanjay S. , Haid Regis W. , Rodts Gerald E. , Mummaneni Praveen V.
Published: February 2011

Object

Cervical stenotic myelopathy due to spondylosis or ossification of the posterior longitudinal ligament is often treated with laminoplasty or cervical laminectomy (with fusion). The goal of this study was to compare outcomes, radiographic results, complications, and implant costs associated with these 2 treatments.

Methods

The authors analyzed the records of 56 patients (age range 42–81 years) who were surgically treated for cervical stenosis. Of this group, 30 underwent laminoplasty and 26 underwent laminectomy with fusion. Patients who had cervical kyphosis or spondylolisthesis were excluded. An average of 4 levels were instrumented in the laminoplasty group and 5 levels in the fusion group (p < 0.01). Forty-two percent of the fusions crossed the cervicothoracic junction, but no laminoplasty instrumentation crossed the cervicothoracic junction, and it only reached C-7 in one-third of the cases. Preoperative and postoperative Nurick grades and modified Japanese Orthopaedic Association (mJOA) scores were obtained. Outcomes were also assessed with neck pain visual analog scale (VAS) scores and the Odom outcome criteria. Postoperative length of stay, complications, and implant costs were calculated.

Results

The mean duration of follow-up, average patient age, and length of hospital stay were similar for both groups. The mean Nurick scores were also similar in the 2 groups and improved an average of 1.4 points in both (p < 0.01 for preoperative-postoperative comparison in each group). The mean mJOA scores improved 2.7 points in laminoplasty patients and 2.8 points in fusion patients (p < 0.01 for each group). The mean VAS scores for neck pain did not change significantly in the laminoplasty cohort (3.2 ± 2.8 [SD] preoperatively vs 3.4 ± 2.6 postoperatively, p = 0.50). In the fusion cohort, the mean VAS scores improved from 5.8 ± 3.2 to 3.0 ± 2.3 (p < 0.01). Excellent or good Odom outcomes were observed in 76.7% of the patients in the laminoplasty cohort and 80.8% of those in the fusion cohort (p = 0.71). In the fusion group, complications were twice as common and implant costs were nearly 3 times as high as in the laminoplasty group. When cases involving fusions crossing the cervicothoracic junction were excluded, analysis showed similar complication rates in the 2 groups.

Conclusions

Patients treated with laminoplasty and patients treated with laminectomy and fusion had similar improvements in Nurick scores, mJOA scores, and Odom outcomes. Patients who underwent fusion typically had higher preoperative neck pain scores, but their neck pain improved significantly after surgery. There was no significant change in the neck pain scores of patients treated with laminoplasty. Our series suggests cervical fusion significantly reduces neck pain in patients with stenotic myelopathy, but that the cost of the implant and rate of reoperation are greater than in laminoplasty.
Molecular Endoscopic Ultrasound for Diagnosis of Pancreatic Cancer
Authors: Bournet Barbara , Pointreau Adeline , Delpu Yannick , Selves Janick , Torrisani Jerome , Buscail Louis , Cordelier Pierre
Published: February 2011

Endoscopic ultrasound-guided fine needle aspiration-biopsy is a safe and effective technique in diagnosing and staging of pancreatic ductal adenocarcinoma. However its predictive negative value does not exceed 50% to 60%. Unfortunately, the majority of pancreatic cancer patients have a metastatic and/or a locally advanced disease (i.e., not eligible for curative resection) which explains the limited access to pancreatic tissue specimens. Endoscopic ultrasound-guided fine needle aspiration-biopsy is the most widely used approach for cytological and histological material sampling in these situations used in up to two thirds of patients with pancreatic cancer. Based on this unique material, we and others developed strategies to improve the differential diagnosis between carcinoma and inflammatory pancreatic lesions by analysis of KRAS oncogene mutation, microRNA expression and methylation, as well as mRNA expression using both qRT-PCR and Low Density Array Taqman analysis. Indeed, differentiating pancreatic cancer from pseudotumoral chronic pancreatitis remains very difficult in current clinical practice, and endoscopic ultrasound-guided fine needle aspiration-biopsy analysis proved to be very helpful. In this review, we will compile the clinical and molecular advantages of using endoscopic ultrasound-guided fine needle aspiration-biopsy in managing pancreatic cancer.
Towards an Evolutionary Model of Animal-Associated Microbiomes
Authors: Yeoman Carl J. , Chia Nicholas , Yildirim Suleyman , Miller Margret E. Berg , Kent Angela , Stumpf Rebecca , Leigh Steven R. , Nelson Karen E. , White Bryan A. , Wilson Brenda A.
Published: February 2011

Second-generation sequencing technologies have granted us greater access to the diversity and genetics of microbial communities that naturally reside endo- and ecto-symbiotically with animal hosts. Substantial research has emerged describing the diversity and broader trends that exist within and between host species and their associated microbial ecosystems, yet the application of these data to our evolutionary understanding of microbiomes appears fragmented. For the most part biological perspectives are based on limited observations of oversimplified communities, while mathematical and/or computational modeling of these concepts often lack biological precedence. In recognition of this disconnect, both fields have attempted to incorporate ecological theories, although their applicability is currently a subject of debate because most ecological theories were developed based on observations of macro-organisms and their ecosystems. For the purposes of this review, we attempt to transcend the biological, ecological and computational realms, drawing on extensive literature, to forge a useful framework that can, at a minimum be built upon, but ideally will shape the hypotheses of each field as they move forward. In evaluating the top-down selection pressures that are exerted on a microbiome we find cause to warrant reconsideration of the much-maligned theory of multi-level selection and reason that complexity must be underscored by modularity.
The Function of E-Cadherin in Stem Cell Pluripotency and Self-Renewal
Authors: Soncin Francesca , Ward Christopher M.
Published: February 2011

Embryonic stem (ES) and induced-pluripotent stem (iPS) cells can be grown indefinitely under appropriate conditions whilst retaining the ability to differentiate to cells representative of the three primary germ layers. Such cells have the potential to revolutionize medicine by offering treatment options for a wide range of diseases and disorders as well as providing a model system for elucidating mechanisms involved in development and disease. In recent years, evidence for the function of E-cadherin in regulating pluripotent and self-renewal signaling pathways in ES and iPS cells has emerged. In this review, we discuss the function of E-cadherin and its interacting partners in the context of development and disease. We then describe relevant literature highlighting the function of E-cadherin in establishing and maintaining pluripotent and self-renewal properties of ES and iPS cells. In addition, we present experimental data demonstrating that exposure of human ES cells to the E-cadherin neutralizing antibody SHE78.7 allows culture of these cells in the absence of FGF2-supplemented medium.
Integrated Lipidomics in the Secreted Phospholipase A2 Biology
Authors: Murakami Makoto , Sato Hiroyasu , Taketomi Yoshitaka , Yamamoto Kei
Published: February 2011

Mammalian genomes encode genes for more than 30 phospholipase A2s (PLA2s) or related enzymes, which are subdivided into several subgroups based on their structures, catalytic mechanisms, localizations and evolutionary relationships. More than one third of the PLA2 enzymes belong to the secreted PLA2 (sPLA2) family, which consists of low-molecular-weight, Ca2+-requiring extracellular enzymes, with a His-Asp catalytic dyad. Individual sPLA2 isoforms exhibit unique tissue and cellular localizations and enzymatic properties, suggesting their distinct pathophysiological roles. Recent studies using transgenic and knockout mice for several sPLA2 isoforms, in combination with lipidomics approaches, have revealed their distinct contributions to various biological events. Herein, we will describe several examples of sPLA2-mediated phospholipid metabolism in vivo, as revealed by integrated analysis of sPLA2 transgenic/knockout mice and lipid mass spectrometry. Knowledge obtained from this approach greatly contributes to expanding our understanding of the sPLA2 biology and pathophysiology.
Zeranol Down-Regulates p53 Expression in Primary Cultured Human Breast Cancer Epithelial Cells through Epigenetic Modification
Authors: Ye Weiping , Xu Pingping , Jen Robert , Feng Eric , Zhong Saiyi , Li Hong , Lin Shu-Hong , Liu Jie-Yu , Lin Young C.
Published: February 2011

Epidemiological studies have suggested that there are many risk factors associated with breast cancer. Silencing tumor suppressor genes through epigenetic alterations play critical roles in breast cancer initiation, promotion and progression. As a growth promoter, Zeranol (Z) has been approved by the FDA and is widely used to enhance the growth of beef cattle in the United States. However, the safety of Z use as a growth promoter is still under debate. In order to provide more evidence to clarify this critical health issue, the current study investigated the effect of Z on the proliferation of primary cultured human normal and cancerous breast epithelial cells (PCHNBECs and PCHBCECs, respectively) isolated from the same patient using MTS assay, RT-PCR and Western blot analysis. We also conducted an investigation regarding the mechanisms that might be involved. Our results show that Z is more potent to stimulate PCHBCEC growth than PCHNBEC growth. The stimulatory effects of Z on PCHBCECs and PCHBCECs may be mediated by its down-regulating expression of the tumor suppressor gene p53 at the mRNA and protein levels. Further investigation showed that the expression of DNA methylatransferase 1 mRNA and protein levels is up-regulated by treatment with Z in PCHBCECs as compared to PCHNBECs, which suggests a role of Z in epigenetic modification involved in the regulation of p53 gene expression in PCHBCECs. Our experimental results imply the potentially adverse health effect of Z in breast cancer development. Further study is continuing in our laboratory.
Durability of Starch Based Biodegradable Plastics Reinforced with Manila Hemp Fibers
Authors: Ochi Shinji
Published: February 2011

The biodegradability of Manila hemp fiber reinforced biodegradable plastics was studied for 240 days in a natural soil and 30 days in a compost soil. After biodegradability tests, weights were measured and both tensile strength tests and microscopic observation were performed to evaluate the biodegradation behavior of the composites. The results indicate that the tensile strength of the composites displays a sharp decrease for up to five days, followed by a gradual decrease. The weight loss and the reduction in tensile strength of biodegradable composite materials in the compost soil are both significantly greater than those buried in natural soil. The biodegradability of these composites is enhanced along the lower portion because this area is more easily attacked by microorganisms.
Sol-Gel Entrapped Levonorgestrel Antibodies: Activity and Structural Changes as a Function of Different Polymer Formats
Authors: Shalev Moran , Miriam Altstein
Published: February 2011

The paper describes development of a sol-gel based immunoaffinity method for the steroid hormone levonorgestrel (LNG) and the effects of changes in the sol-gel matrix format on the activity of the entrapped antibodies (Abs) and on matrix structure. The best sol-gel format for Ab entrapment was found to be a tetramethoxysilane (TMOS) based matrix at a TMOS:water ratio of 1:8, containing 10% polyethylene glycol (PEG) of MW 0.4 kDa. Addition of higher percentages of PEG or a higher MW PEG did not improve activity. No activity was obtained with a TMOS:water ratio of 1:12, most likely because of the very dense polymer that resulted from these polymerization conditions. Only minor differences in the non-specific binding were obtained with the various formats. TMOS was found to be more effective than tetrakis (2-hydroxyethyl)orthosilicate (THEOS) for entrapment of anti-levonorgestrel (LNG) Abs. However, aging the THEOS-based sol-gel for a few weeks at 4 °C stabilized the entrapped Abs and increased its binding capacity. Confocal fluorescent microscopy with fluorescein isothiocyanate (FITC) labeled immunoglobulines (IgGs) entrapped in the sol-gel matrix showed that the entrapped Abs were distributed homogenously within the gel. Scanning electron microscopy (SEM) images have shown the diverse structures of the various sol-gel formats and precursors.