bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of Forest Fires by means of Pseudo Phase Plane and Multidimensional Scaling Methods
Authors: Tenreiro Machado J. A. , Lopes António M.
Published: June 2014

Forest fires dynamics is often characterized by the absence of a characteristic length‐scale, long range correlations in space and time, and long memory, which are features also associated with fractional order systems. In this paper a public domain forest fires catalogue, containing information of events for Portugal, covering the period from 1980 up to 2012, is tackled. The events are modelled as time series of Dirac impulses with amplitude proportional to the burnt area. The time series are viewed as the system output and are interpreted as a manifestation of the system dynamics. In the first phase we use the pseudo phase plane (PPP) technique to describe forest fires dynamics. In the second phase we use multidimensional scaling (MDS) visualization tools. The PPP allows the representation of forest fires dynamics in two‐dimensional space, by taking time series representative of the phenomena. The MDS approach generates maps where objects that are perceived to be similar to each other are placed on the map forming clusters. The results are analysed in order to extract relationships among the data and to better understand forest fires behaviour.
Life Satisfaction and Work-Related Satisfaction among Anesthesiologists in Poland
Authors: Gaszynska Ewelina , Stankiewicz-Rudnicki Michal , Szatko Franciszek , Wieczorek Andrzej , Gaszynski Tomasz
Published: June 2014

The aim of the study was to assess the level of life and job satisfaction of Polish anesthesiologists and to explore the impact of extrinsic-hygiene and intrinsic-motivating determinants.Materials and Methods.A cross-sectional questionnaire study was conducted among consultant anesthesiologists in Lodz region. The questionnaire concerned patient care, burden, income, personal rewards, professional relations, job satisfaction in general, and life satisfaction. Respondents were asked to rate their level of satisfaction for each item on a seven-point Likert scale (1: extremely dissatisfied; 7: extremely satisfied).Results.86.03% of anesthesiologists were satisfied with their economic status, 77.94% found their health status satisfactory, and 52.21% viewed their personal future optimistically. In general, 71.32% of anesthesiologists were satisfied with their current job situation. Among the less satisfying job aspects were work-related stress (2.49; SD = 1.23), administrative burden (2.85; SD = 1.47), workload (3.63; SD = 1.56), and leisure time (3.09; SD = 1.44).Conclusions.Considerable work-related stress leads to job dissatisfaction among anesthesiologists. There is an association between job satisfaction and health status, social life, and economic status. Working for long hours by anesthesiologists results in a high risk of burnout.
Expression of Genes Encoding Enzymes Involved in the One Carbon Cycle in Rat Placenta is Determined by Maternal Micronutrients (Folic Acid, Vitamin B12) and Omega-3 Fatty Acids
Authors: Khot Vinita , Kale Anvita , Joshi Asmita , Chavan-Gautam Preeti , Joshi Sadhana
Published: June 2014

We have reported that folic acid, vitamin B12, and omega-3 fatty acids are interlinked in the one carbon cycle and have implications for fetal programming. Our earlier studies demonstrate that an imbalance in maternal micronutrients influence long chain polyunsaturated fatty acid metabolism and global methylation in rat placenta. We hypothesize that these changes are mediated through micronutrient dependent regulation of enzymes in one carbon cycle. Pregnant dams were assigned to six dietary groups with varying folic acid and vitamin B12levels. Vitamin B12deficient groups were supplemented with omega-3 fatty acid. Placental mRNA levels of enzymes, levels of phospholipids, and glutathione were determined. Results suggest that maternal micronutrient imbalance (excess folic acid with vitamin B12deficiency) leads to lower mRNA levels of methylene tetrahydrofolate reductase (MTHFR) and methionine synthase , but higher cystathionine b-synthase (CBS) and Phosphatidylethanolamine-N-methyltransferase (PEMT) as compared to control. Omega-3 supplementation normalized CBS and MTHFR mRNA levels. Increased placental phosphatidylethanolamine (PE), phosphatidylcholine (PC), in the same group was also observed. Our data suggests that adverse effects of a maternal micronutrient imbalanced diet may be due to differential regulation of key genes encoding enzymes in one carbon cycle and omega-3 supplementation may ameliorate most of these changes.
A Case of Emphysematous Osteomyelitis of the Midfoot: Imaging Findings and Review of the Literature
Authors: Mautone Marcela , Gray Jessica , Naidoo Parm
Published: June 2014

Emphysematous osteomyelitis is a rare but potentially fatal condition that must be considered whenever intraosseous gas is identified on imaging. The organisms implicated in most cases of emphysematous osteomyelitis are anaerobes or members of theEnterobacteriaceaefamily. Significant comorbidities, such as malignancy and diabetes mellitus, frequently predispose to this condition, and high mortality rates have been reported. The radiologist must be aware of the implications of identifying intraosseous gas in order to facilitate early diagnosis and expedite management. We report a unique case of a 58-year-old male with diabetes mellitus who presented with emphysematous osteomyelitis of the midfoot and necrotising fasciitis of the ipsilateral distal lower limb. Specimen cultures in this case revealed a pure growth of Group GStreptococcus.
Genetic Diversity Analysis ofHypsizygus marmoreuswith Target Region Amplification Polymorphism
Authors: Qiu Chengshu , Yan Wenjuan , Deng Wangqiu , Song Bin , Li Taihui
Published: June 2014

Hypsizygus marmoreusis an industrialized edible mushroom. In the present paper, the genetic diversity among 20 strains collected from different places of China was evaluated by target region amplification polymorphism (TRAP) analysis; the common fragment of TRAPs was sequenced and analyzed. Six fixed primers were designed based on the analysis ofH. marmoreussequences from GenBank database. The genomic DNA extracted fromH. marmoreuswas amplified with 28 TRAP primer combinations, which generated 287 bands. The average of amplified bands per primer was 10.27 (mean polymorphism is 69.73%). The polymorphism information content (PIC) value for TRAPs ranged from 0.32 to 0.50 (mean PIC value per TRAP primer combination is 0.48), which indicated a medium level of polymorphism among the strains. A total of 36 sequences were obtained from TRAP amplification. Half of these sequences could encode the known or unknown proteins. According to the phylogenetic analysis based on TRAP result, the 20 strains ofH. marmoreuswere classified into two main groups.
Hierarchical Genetic Algorithm for B‐Spline Surface Approximation of Smooth Explicit Data
Authors: Garcia-Capulin C. H. , Cuevas F. J. , Trejo-Caballero G. , Rostro-Gonzalez H.
Published: June 2014

B‐spline surface approximation has been widely used in many applications
such as CAD, medical imaging, reverse engineering, and geometric modeling.
Given a data set of measures, the surface approximation aims to find a surface
that optimally fits the data set. One of the main problems associated with
surface approximation by B‐splines is the adequate selection of the number
and location of the knots, as well as the solution of the system of equations
generated by tensor product spline surfaces. In this work, we use a hierarchical
genetic algorithm (HGA) to tackle the B‐spline surface approximation of
smooth explicit data. The proposed approach is based on a novel hierarchical
gene structure for the chromosomal representation, which allows us to determine
the number and location of the knots for each surface dimension and
the B‐spline coefficients simultaneously. The method is fully based on genetic
algorithms and does not require subjective parameters like smooth factor or
knot locations to perform the solution. In order to validate the efficacy of the
proposed approach, simulation results from several tests on smooth surfaces
and comparison with a successful method have been included.
Inhibition of Hepatitis B Virus Replication by Helper Dependent Adenoviral Vectors Expressing Artificial Anti-HBV Pri-miRs from a Liver-Specific Promoter
Authors: Mowa Mohube Betty , Crowther Carol , Ely Abdullah , Arbuthnot Patrick
Published: June 2014

Research on applying RNA interference (RNAi) to counter HBV replication has led to identification of potential therapeutic sequences. However, before clinical application liver-specific expression and efficient delivery of these sequences remain an important objective. We recently reported short-term inhibition of HBV replicationin vivoby using helper dependent adenoviral vectors (HD Ads) expressing anti-HBV sequences from a constitutively active cytomegalovirus (CMV) promoter. To develop the use of liver-specific transcription regulatory elements we investigated the utility of the murine transthyretin (MTTR) promoter for expression of anti-HBV primary microRNAs (pri-miRs). HD Ads containing MTTR promoter effected superior expression of anti-HBV pri-miRs in mice compared to HD Ads containing the CMV promoter. MTTR-containing HD Ads resulted in HBV replication knockdown of up to 94% in mice. HD Ads expressing trimeric anti-HBV pri-miRs silenced HBV replication for 5 weeks. We previously showed that the product of the codeliveredlacZgene induces an immune response, and the duration of HBV silencingin vivois likely to be attenuated by this effect. Nevertheless, expression of anti-HBV pri-miRs from MTTR promoter is well suited to countering HBV replication and development of HD Ads through attenuation of their immunostimulatory effects should advance their clinical utility.
No Evidence of Viral Transmission following Long-Term Implantation of Agarose Encapsulated Porcine Islets in Diabetic Dogs
Authors: Gazda Lawrence S. , Vinerean Horatiu V. , Laramore Melissa A. , Hall Richard D. , Carraway Joseph W. , Smith Barry H.
Published: June 2014

We have previously described the use of a double coated agarose-agarose porcine islet macrobead for the treatment of type I diabetes mellitus. In the current study, the long-term viral safety of macrobead implantation into pancreatectomized diabetic dogs treated with pravastatin (n=3) was assessed while 2 dogs served as nonimplanted controls. A more gradual return to preimplant insulin requirements occurred after a 2nd implant procedure (days 148, 189, and >652) when compared to a first macrobead implantation (days 9, 21, and 21) in all macrobead implanted animals. In all three implanted dogs, porcine C-peptide was detected in the blood for at least 10 days following the first implant and for at least 26 days following the second implant. C-peptide was also present in the peritoneal fluid of all three implanted dogs at 6 months after 2nd implant and in 2 of 3 dogs at necropsy. Prescreening results of islet macrobeads and culture media prior to transplantation were negative for 13 viruses. No evidence of PERV or other viral transmission was found throughout the study. This study demonstrates that the long-term (2.4 years) implantation of agarose-agarose encapsulated porcine islets is a safe procedure in a large animal model of type I diabetes mellitus.
Weak Localization in Graphene: Theory, Simulations, and Experiments
Authors: Hilke Michael , Massicotte Mathieu , Whiteway Eric , Yu Victor
Published: June 2014

We provide a comprehensive picture of magnetotransport in graphene monolayers in the limit of nonquantizing magnetic fields. We discuss the effects of two-carrier transport, weak localization, weak antilocalization, and strong localization for graphene devices of various mobilities, through theory, experiments, and numerical simulations. In particular, we observe a minimum in the weak localization and strong localization length reminiscent of the minimum in the conductivity, which allows us to make the connection between weak and strong localization. This provides a unified framework for both localizations, which explains the observed experimental features. We compare these results to numerical simulation and find a remarkable agreement between theory, experiment, and numerics. Various graphene devices were used in this study, including graphene on different substrates, such as glass and silicon, as well as low and high mobility devices.
Automatic Segmentation of High Speed Video Images of Vocal Folds
Authors: Koç Turgay , Çiloğlu Tolga
Published: June 2014

An automatic method for segmenting glottis in high speed endoscopic video (HSV) images of vocal folds is proposed. The method is based on image histogram modeling. Three fundamental problems in automatic histogram based processing of HSV images, which are automatic localization of vocal folds, deformation of the intensity distribution by nonuniform illumination, and ambiguous segmentation when glottal gap is small, are addressed. The problems are solved by using novel masking, illumination, and reflectance modeling methods. The overall algorithm has three stages: masking, illumination modeling, and segmentation. Firstly, a mask is determined based on total variation norm for the region of interest in HSV images. Secondly, a planar illumination model is estimated from consecutive HSV images and reflectance image is obtained. Reflectance images of the masked HSV are used to form a vertical slice image whose reflectance distribution is modeled by a Gaussian mixture model (GMM). Finally, estimated GMM is used to isolate the glottis from the background. Results show that proposed method provides about 94% improvements with respect to manually segmented data in contrast to conventional method which uses Rayleigh intensity distribution in extracting the glottal areas.
Facial Pain Associated with CPAP Use: Intra-Sinusal Third Molar
Authors: Mermod Maxime , Broome Martin , Hoarau Remy , Zweifel Daniel
Published: June 2014

Objective. This paper describes a patient with left hemifacial pain elicited by the use of a CPAP mask.Case Report. A 74-year-old man was referred with a history of pain in the left maxillary sinus related to the use of his CPAP interface, thereby prohibiting the use of the latter. Computed tomography revealed an intra-sinusal ectopic third molar in the left maxillary sinus floor corresponding to the painful area. After removal of the ectopic tooth under local anesthesia by a Caldwell-Luc approach, the patient was relieved of his symptoms.Conclusion. Although an ectopic tooth in the maxillary sinus is rare, this case points out the importance of actively looking for a regional problem if patients cannot tolerate the CPAP interface since this can lead to issues of incompliance and medical complications due to the untreated obstructive sleep apnoea syndrome.
Synthesis and Optical Enhancement of Amorphous Carbon Nanotubes/Silver Nanohybrids via Chemical Route at Low Temperature
Authors: Han Tan Kim , Fen Leo Bey , Nee Ng Meng , Johan Mohd Rafie
Published: June 2014

We report the synthesis of amorphous carbon nanotubes/silver (αCNTs/Ag) nanohybrids via simple chemical route without additional reactant and surfactant at low temperature. Field emission scanning microscope (FESEM) and transmission electron microscope (TEM) confirmed formation of CNTs. X-ray diffraction (XRD) pattern confirmed the amorphous phase of carbon and the formation of Ag nanoparticles crystalline phase. Raman spectra revealed the amorphous nature ofαCNTs. UV-visible spectroscopy showed enhancement of optical properties ofαCNTs/Ag nanohybrids.
The Stability of Two‐Step Runge‐Kutta Methods for Neutral Delay Integro Differential‐Algebraic Equations with Many Delays
Authors: Yuan Haiyan , Shen Jihong
Published: June 2014

This paper studies the asymptotic stability of the two‐step Runge‐Kutta methods for neutral delay integro differential‐algebraic equations with many delays. It proves that A‐stable two‐step Runge‐Kutta methods are asymptotically stable for neutral delay integro differential‐algebraic equations with many delays.
An Efficient Estimation of the Mean Residual Life Function with Length‐Biased Right‐Censored Data
Authors: Wu Hongping , Luan Yihui
Published: June 2014

The mean residual life (MRL) function for a lifetime random variable T0 is one of the basic parameters of interest in survival analysis. In this paper, we propose a new estimator of the MRL function with length‐biased right‐censored data and evaluate its performance through a small Monte Carlo simulation study. The results of the simulations show that the proposed estimator outperforms the existing one referred to in Data and Model Setup Section in terms of Monte Carlo bias and mean square error, especially when the censoring rate is heavy. We also show that the proposed estimator converges in distribution under some conditions.
Short-Term Wind Speed Forecasting Using Decomposition-Based Neural Networks Combining Abnormal Detection Method
Authors: Chen Xuejun , Zhao Jing , Hu Wenchao , Yang Yufeng
Published: June 2014

As one of the most promising renewable resources in electricity generation, wind energy is acknowledged for its significant environmental contributions and economic competitiveness. Because wind fluctuates with strong variation, it is quite difficult to describe the characteristics of wind or to estimate the power output that will be injected into the grid. In particular, short-term wind speed forecasting, an essential support for the regulatory actions and short-term load dispatching planning during the operation of wind farms, is currently regarded as one of the most difficult problems to be solved. This paper contributes to short-term wind speed forecasting by developing two three-stage hybrid approaches; both are combinations of the five-three-Hanning (53H) weighted average smoothing method, ensemble empirical mode decomposition (EEMD) algorithm, and nonlinear autoregressive (NAR) neural networks. The chosen datasets are ten-minute wind speed observations, including twelve samples, and our simulation indicates that the proposed methods perform much better than the traditional ones when addressing short-term wind speed forecasting problems.
Next-Generation Sequencing of Translocation Renal Cell Carcinoma Reveals Novel RNA Splicing Partners and Frequent Mutations of Chromatin-Remodeling Genes
Authors: Malouf Gabriel G. , Su Xiaoping , Yao Hui , Gao Jianjun , Xiong Liangwen , He Qiuming , Compérat Eva , Couturier Jérôme , Molinié Vincent , Escudier Bernard , Camparo Philippe , Doss Denaha J. , Thompson Erika J. , Khayat David , Wood Christopher G. , Yu Willie , Teh Bin T. , Weinstein John , Tannir Nizar M.
Published: June 2014

Purpose: MITF/TFE translocation renal cell carcinoma (TRCC) is a rare subtype of kidney cancer. Its incidence and the genome-wide characterization of its genetic origin have not been fully elucidated.

Experimental Design: We performed RNA and exome sequencing on an exploratory set of TRCC (n = 7), and validated our findings using The Cancer Genome Atlas (TCGA) clear-cell RCC (ccRCC) dataset (n = 460).

Results: Using the TCGA dataset, we identified seven TRCC (1.5%) cases and determined their genomic profile. We discovered three novel partners of MITF/TFE (LUC7L3, KHSRP, and KHDRBS2) that are involved in RNA splicing. TRCC displayed a unique gene expression signature as compared with other RCC types, and showed activation of MITF, the transforming growth factor β1 and the PI3K complex targets. Genes differentially spliced between TRCC and other RCC types were enriched for MITF and ID2 targets. Exome sequencing of TRCC revealed a distinct mutational spectrum as compared with ccRCC, with frequent mutations in chromatin-remodeling genes (six of eight cases, three of which were from the TCGA). In two cases, we identified mutations in INO80D, an ATP-dependent chromatin-remodeling gene, previously shown to control the amplitude of the S phase. Knockdown of INO80D decreased cell proliferation in a novel cell line bearing LUC7L3–TFE3 translocation.

Conclusions: This genome-wide study defines the incidence of TRCC within a ccRCC-directed project and expands the genomic spectrum of TRCC by identifying novel MITF/TFE partners involved in RNA splicing and frequent mutations in chromatin-remodeling genes. Clin Cancer Res; 20(15); 4129–40. ©2014 AACR.
A Novel Small-Molecule Aurora Kinase Inhibitor Attenuates Breast Tumor–Initiating Cells and Overcomes Drug Resistance
Authors: Zheng Fei-Meng , Long Zi-Jie , Hou Zhi-Jie , Luo Yu , Xu Ling-Zhi , Xia Jiang-Long , Lai Xiao-Ju , Liu Ji-Wei , Wang Xi , Kamran Muhammad , Yan Min , Shao Shu-Juan , Lam Eric W.-F. , Wang Shao-Wu , Lu Gui , Liu Quentin
Published: June 2014

Chemoresistance is a major cause of cancer treatment failure. Tumor-initiating cells (TIC) have attracted a considerable amount of attention due to their role in chemoresistance and tumor recurrence. Here, we evaluated the small-molecule Aurora kinase inhibitor AKI603 as a novel agent against TICs in breast cancer. AKI603 significantly inhibited Aurora-A (AurA) kinase and induced cell-cycle arrest. In addition, the intragastric administration of AKI603 reduced xenograft tumor growth. Interestingly, we found that breast cancer cells that were resistant to epirubicin expressed a high level of activated AurA and also have a high CD24Low/CD44High TIC population. The inhibition of AurA kinase by AKI603 abolished the epirubicin-induced enrichment of TICs. Moreover, AKI603 suppressed the capacity of cells to form mammosphere and also suppressed the expression of self-renewal genes (β-catenin, c-Myc, Sox2, and Oct4). Thus, our work suggests the potential clinical use of the small-molecule Aurora kinase inhibitor AKI603 to overcome drug resistance induced by conventional chemotherapeutics in breast cancer. Mol Cancer Ther; 13(8); 1991–2003. ©2014 AACR.
Overexpression of DDX43 Mediates MEK Inhibitor Resistance through RAS Upregulation in Uveal Melanoma Cells
Authors: Ambrosini Grazia , Khanin Raya , Carvajal Richard D. , Schwartz Gary K.
Published: June 2014

The majority of uveal melanomas carry oncogenic mutations in the G proteins GNAQ and GNA11, with consequent activation of the MAPK pathway. Selective MEK inhibitors, such as selumetinib, have shown clinical benefit in uveal melanoma. However, mechanisms of drug resistance limit their efficacy in some patients. Analysis of MEK inhibitor–resistant uveal melanoma cell lines revealed the induction of RAS protein expression and activity. This effect was mediated by the RNA helicase DDX43, which was remarkably overexpressed in these cells. Depletion of DDX43 in MEK inhibitor–resistant cells decreased RAS proteins and inhibited ERK and AKT pathways. On the contrary, ectopic expression of DDX43 in parental uveal melanoma cells induced RAS protein levels and rendered cells resistant to MEK inhibition. Similar to DDX43 depletion, downregulation of KRAS, HRAS, and NRAS inhibited downstream pathways in the resistant cells, overcoming mutant GNAQ signaling. We also analyzed the expression of DDX43 in liver metastases of patients with uveal melanoma by RT-PCR, and found a significant overexpression of DDX43 in patients who did not benefit from selumetinib therapy. In conclusion, DDX43 induces RAS protein expression and signaling, mediating a novel mechanism of MEK inhibitor resistance. The detection of DDX43 in patients with uveal melanoma could lead to more targeted therapies for this disease. Mol Cancer Ther; 13(8); 2073–80. ©2014 AACR.
Comparison of Bioimpedance and Clinical Methods for Dry Weight Prediction in Maintenance Hemodialysis Patients
Authors: Jian Yusu , Li Xiang , Cheng Xuyang , Chen Yuqing , Liu Li , Tao Zhenhui , Zuo Li
Published: June 2014

Background: Bioelectrical impedance analysis (BIA) is a promising technique to evaluate dry weight. We compared the dry weight calculated by the three BIA equations Carlo Basile (CB) , Yanna Dou (YD) and the body composition spectroscopy (BCS) with clinical evaluation in maintenance hemodialysis (MHD) patients. Methods: The dry weight of enrolled MHD patients (DWClin) was evaluated under strict clinical surveillance. The whole-body resistances at 50 kHz, intra- and extracellular resistances were measured to calculate the dry weight (DWCB, DWYD and DWBCS) using each of the three equations. Results: Neither DWCB nor DWBCS were statistically different compared to DWClin (DWCB 63.2 ± 17.2 vs. 63.1 ± 16.1 kg; DWBCS 62.8 ± 16.8 vs. 63.1 ± 16.1 kg, p > 0.05). DWYD was significantly lower than DWClin (DWYD 62.0 ± 16.1 vs. 63.1 ± 16.1 kg, p < 0.05). The bias between DWCB and DWClin was the smallest among these three methods (ΔDWCB -0.1 ± 1.4 kg; ΔDWYD 1.1 ± 2.9 kg; ΔDWBCS 0.3 ± 1.8 kg). Conclusion: The CB equations have better consistency with clinical dry weight in MHD patients.
Effectiveness of Fluorescence-Based Methods to Detect in situ Demineralization and Remineralization on Smooth Surfaces
Authors: Moriyama C.M. , Rodrigues J.A. , Lussi A. , Diniz M.B.
Published: June 2014

This study aimed to evaluate the effectiveness of fluorescence-based methods (DIAGNOdent, LF; DIAGNOdent pen, LFpen, and VistaProof fluorescence camera, FC) in detecting demineralization and remineralization on smooth surfaces in situ. Ten volunteers wore acrylic palatal appliances, each containing 6 enamel blocks that were demineralized for 14 days by exposure to a 20% sucrose solution and 3 of them were remineralized for 7 days with fluoride dentifrice. Sixty enamel blocks were evaluated at baseline, after demineralization and 30 blocks after remineralization by two examiners using LF, LFpen and FC. They were submitted to surface microhardness (SMH) and cross-sectional microhardness analysis. The integrated loss of surface hardness (ΔKHN) was calculated. The intraclass correlation coefficient for interexaminer reproducibility ranged from 0.21 (FC) to 0.86 (LFpen). SMH, LF and LFpen values presented significant differences among the three phases. However, FC fluorescence values showed no significant differences between the demineralization and remineralization phases. Fluorescence values for baseline, demineralized and remineralized enamel were, respectively, 5.4 ± 1.0, 9.2 ± 2.2 and 7.0 ± 1.5 for LF; 10.5 ± 2.0, 15.0 ± 3.2 and 12.5 ± 2.9 for LFpen, and 1.0 ± 0.0, 1.0 ± 0.1 and 1.0 ± 0.1 for FC. SMH and ΔKHN showed significant differences between demineralization and remineralization phases. There was a negative and significant correlation between SMH and LF and LFpen in the remineralization phase. In conclusion, LF and LFpen devices were effective in detecting demineralization and remineralization on smooth surfaces provoked in situ.
Cost Savings Using a Protocol Approach to Manage Anemia in a Hemodialysis Unit
Authors: Charlesworth Emily C. , Richardson Robert M. , Battistella Marisa
Published: June 2014

Background: National guidelines recommend using anemia management protocols to guide treatment. The objective of this study was to determine if an anemia management protocol would improve hemoglobin (Hgb) indices in hemodialysis patients and to measure whether the protocol would reduce the use and cost of darbepoetin alfa (DBO) and intravenous (IV) iron in hemodialysis patients. Methods: An anemia management protocol was created and implemented for hemodialysis patients at our institution. A retrospective observational review of the use of DBO and IV iron as well as changes in Hgb, transferrin saturation and ferritin in 174 patients was conducted 6 months before and after implementation of the anemia protocol. Results: The number of Hgb measurements in the target range increased from 44.3 to 46.0% (p = 0.48) after protocol implementation. The mean weekly dose of DBO was reduced from 34.56 ± 31.12 to 31.11 ± 28.64 μg post-protocol implementation (p = 0.011), which translated to a cost savings of USD 41,649 over 6 months. The mean monthly IV iron dose also decreased from 139.56 ± 98.83 to 97.65 ± 79.05 mg (p < 0.005), a cost savings of USD 18,594 over the same time period. Conclusion: The use of an anemia management protocol resulted in the deprescribing of DBO and iron agents while increasing the number of patients in the target Hgb range, which led to significant cost savings in the treatment of anemia.
Uma breve revisão do atendimento médico pré-hospitalar
Authors: Lopes Sérgio Luiz Brasileiro , Fernandes Rosana Joaquim
Published: June 2014

O atendimento médico pré-hospitalar é uma área de atuação médica relativamente recente, tendo sido implantado no Brasil nos últimos dez anos, conforme modelo francês da década de 50. Pela falta de legislação pertinente, vários modelos regionais foram criados em vários municípios do Brasil, sendo que, em Ribeirão Preto, este sistema medicalizado de atendimento pré-hospitalar é realizado desde outubro de 1996, pela equipe local do SAMU.
Trauma raquimedular
Authors: Defino Helton L. A.
Published: June 2014

O trauma raquimedular é uma lesão que predomina em adultos jovens do sexo masculino e, pelas características da sua etiologia, sua prevenção pode ser muito efetiva, por meio de campanhas de esclarecimentos junto à população e adoção de medidas de segurança individuais ou coletivas. A abordagem terapêutica do TRM deve ser multidisciplinar, desde o momento do resgate e remoção dos pacientes até a sua fase final de reabilitação. Até o momento, não existe nenhum tratamento efetivo capaz de restaurar as funções da medula espinhal lesada. O tratamento é realizado para a reabilitação dos pacientes, de modo que todos os esforços devem ser realizados na prevenção desse tipo irreversível de lesão.
Diagnóstico por imagem no trauma abdominal
Authors: Lucchesi Fabiano R. , Laguna Claudio B. , Monteiro Carlos R. , Prado Cecília H. M. A. , Elias Junior Jorge
Published: June 2014

A presente revisão objetiva descrever os recentes avanços tecnológicos dos métodos de diagnóstico por imagem e sua atual aplicabilidade no manuseio dos pacientes com trauma abdominal, bem como as principais apresentações pelos métodos de imagem dos diversos órgãos envolvidos.
Papel da unidade de terapia intensiva no manejo do trauma
Authors: Pereira Júnior Gerson Alves , Coletto Francisco Antônio , Martins Maria Auxiliadora , Marson Flávio , Pagnano Rosana Claudia Lovato , Dalri Maria Célia Barcellos , Basile-Filho Anibal
Published: June 2014

O objetivo deste artigo de revisão é fazer uma apresentação da Unidade de Terapia Intensiva no contexto hospitalar, particularmente em situações de emergência, traumáticas ou não, discorrendo sobre os diferentes aspectos do suporte avançado de vida; alternativas para monitorização do paciente; enfoque multidisciplinar dos casos, envolvendo profissionais de diferentes especialidades médicas e não médicas; gerenciamento e perfil do profissional para trabalhar neste ambiente de cuidados intensivos e a problemática do diagnóstico de morte encefálica para captação de órgãos de possíveis doadores.
Transfusão maciça
Authors: Faggioni Luiz P. C. , Covas Dimas Tadeu , Balbi Filho Eduardo Mendel , Pádua Marcos Antonio , Tobias Raphael A. , Rosa Maurice J. De , Papa Fábio
Published: June 2014

O texto aborda, sucintamente, a fisiopatologia e as complicações de transfusões maciças em pacientes politraumatizados, mostrando a correlação entre a apresentação clínica inicial e perdas sangüíneas estimadas, assim como a terapêutica transfusional racional a ser utilizada.
Complicações tardias do transplante de células-tronco hematopoéticas
Authors: Flowers Mary E.D. , Kansu Emin
Published: June 2014

Com os avanços significativos no transplante de células-tronco hematopoéticas, (TCTH) nas duas últimas décadas, um grande grupo de pacientes sobreviveu mais de vinte anos após o transplante para doenças hematológicas e oncológicas. O grande número de sobreviventes de longo prazo propiciou uma oportunidade única de se estudar a evolução desses transplantes a longo prazo. Esta revisão descreve as complicações tardias dos TCTH relacionadas ao regime de condicionamento, a recidiva da neoplasia primária e a toxicidade relacionada ao transplante, com ênfase no diagnóstico e tratamento da doença enxerto-contra-hospedeiro crônica.
Tempo de permanência do dispositivo venoso periférico, in situ, relacionado ao cuidado de enfermagem, em pacientes hospitalizados
Authors: Pereira Renata Cristina de C. , Zanetti Maria Lúcia , Ribeiro Kátia P.
Published: June 2014

O desenvolvimento tecnológico da terapia intravenosa impõe ao enfermeiro competência técnica e científica. Este estudo descritivo teve como objetivo relacionar o tempo de permanência in situ dos dispositivos venosos, periféricos com o cuidado de enfermagem. Os dados obtidos apontam que, em 50% das punções venosas, com tempo de permanência inferior a 24 h, o grau de cuidado de enfermagem foi insatisfatório, tendo 9,4 % delas permanecido in situ por um período superior a 72 h. O tempo médio de permanência do dispositivo venoso periférico, in situ foi de 29,2 h, o que demonstra necessidade de intensificar estudos visando à qualificação do cuidado de enfermagem.
Avaliação da maturação do processo de raciocínio diagnóstico de estudantes de medicina
Authors: Sobral Dejano T.
Published: June 2014

O propósito do estudo foi averiguar a utilidade do Inventário de Raciocínio Diagnóstico (IRD) na avaliação da maturação do processo de diagnóstico clínico, em conexão com percepções sobre o aprendizado na formação médica. O inventário foi aplicado entre 88 estudantes de Medicina, de ambos os sexos, em dois semestres consecutivos na fase de iniciação clínica. Foram, também, obtidos dados de percepções do aprendizado (valorização do aprendizado, autoconfiança do aprendiz e reflexão na aprendizagem) e de rendimento acadêmico. Os resultados revelaram diferenças significantes, porém pequenas, entre as duas medidas dos escores do IRD e correlações positivas e significantes desses escores com pontuações das três medidas de percepção do aprendizado. Observou-se uma relação significativa entre o tamanho do efeito e a percepção de autodeterminação do processo diagnóstico. Os dados indicam que o IRD reflete, além de conhecimento e habilidades específicas, a percepção de eficácia pessoal no processo de diagnóstico, que pode ser influenciada por diferentes fatores do contexto do aprendizado e de atitudes do aprendiz. Em conclusão, os achados apontam a sensibilidade discriminativa do instrumento e sugerem sua utilidade no acompanhamento da maturação do processo de diagnóstico clínico.
Transporte do paciente crítico
Authors: Pereira Júnior Gerson Alves , Nunes Taciana Leonel , Basile-Filho Aníbal
Published: June 2014

O transporte intra-hospitalar do paciente crítico faz-se necessário para seu encaminhamento da sala de admissão ao Centro Cirúrgico ou à Unidade de Terapia Intensiva e para a realização de testes diagnósticos não portáteis, partindo da sala de admissão ou da unidade de terapia intensiva. A duração do transporte pode ser prolongada, ficando o paciente fora do ambiente “protegido” de um área de cuidados intensivos, sendo um período de potenciais complicações. O transporte inter-hospitalar deve ocorrer, quando os benefícios esperados para o paciente crítico excedem os riscos inerentes ao transporte e, também, quando o paciente necessita de cuidados que não existam no hospital onde está. A decisão e a efetuação do transporte são responsabilidade do médico que o assiste. Tal transporte envolve a presença de um veículo adaptado com todos os equipamentos necessários para a monitorização e suporte avançado de vida. Neste artigo, os autores discutem o papel do transporte intra e inter-hospitalar do paciente crítico.
Avaliação de indicadores do controle da contaminação ambiental da sala de operação
Authors: Nobre Luciane F. , Galvão Cristina M. , Graziano Kazuko U. , Corniani Fabiana
Published: June 2014

O controle da contaminação ambiental, na sala de operação, é uma das medidas de prevenção da infecção do sítio cirúrgico. Assim, o presente estudo teve como objetivo identificar se os padrões mínimos para o controle da contaminação ambiental estão sendo considerados pelos profissionais de saúde que atuam na unidade de Centro Cirúrgico. A investigação foi desenvolvida em um hospital geral, público; a coleta de dados realizou-se através de observação das cirurgias, utilizando instrumentos previamente elaborados, na especialidade de ginecologia e obstetrícia, no mês de janeiro de 2000, perfazendo um total de 23 procedimentos anestésicocirúrgicos observados. Realizamos uma análise descritiva e matemático-estatística, utilizando freqüência absoluta e porcentagem. Ao analisarmos o conjunto de itens do Padrão 1, que retrata a limpeza e montagem da sala de operação, e do Padrão 2, relativo aos princípios de assepsia cirúrgica, constatamos que a maioria dos procedimentos foi realizada pelos profissionais que atuavam na unidade, da forma preconizada pela literatura, entretanto, alguns itens avaliados evidenciaram a necessidade de reavaliação das práticas desenvolvidas pela equipe de saúde em relação ao controle da contaminação ambiental, bem como a atualização sobre os avanços técnico-científicos para o controle da infecção do sítio cirúrgico.
Transplante de fígado
Authors: França Alex V.C. , Martinelli Ana L.C. , Sankanrankutty Ajith K. , Rizzo Cláudia C. , Silva Junior Orlando Castro
Published: June 2014

O transplante de fígado constitui o principal tratamento para os pacientes portadores de doença hepática crônica ou aguda, em situações em que outras opções terapêuticas clínicas e/ou cirúrgicas não tenham sido eficazes no controle da doença. Dentre as doenças do fígado, o carcinoma hepatocelular, quando de pequeno tamanho, constitui uma das indicações para a realização do transplante. Relatamos o caso do primeiro paciente submetido ao transplante de fígado no Hospital das Clínicas da Faculdade de Medicina de Ribeirão - USP. Ele era portador de cirrose hepática pelo vírus da hepatite C, associada à presença de carcinoma hepatocelular; enquanto em lista de espera pelo transplante, foi submetido à embolização arterial e alcoolização tumoral com o intuito de ser impedida a progressão da neoplasia. O transplante de fígado foi realizado sem intercorrências cirúrgicas, utilizando-se a técnica de piggyback com anastomose biliar colédoco-colédoco com permanência de dreno de Kher. O esquema imunossupressor utilizado foi o duplo, associando-se ciclosporina A e prednisona. No nono dia de pós-operatório, ocorreu episódio de rejeição celular, tratado com sucesso com metilprednisolona (1.0 g/dia, IV durante três dias). O paciente recebeu alta hospitalar no 13 o dia de pósoperatório. O caso evidencia a importância do diagnóstico precoce e a indicação do transplante de fígado em portadores de carcinoma hepatocelular, bem como, uma das possíveis complicações no pós-operatório. A concretização de mais um grupo especializado no tratamento das doenças crônicas do fígado e o desenvolvimento científico, tecnológico e de ensino da Região de Ribeirão Preto, no interior do Estado de São Paulo, possibilitaram a realização, com sucesso, do caso aqui relatado.
Apendicite crônica e apendicite recorrente
Authors: Rocha José Joaquim Ribeiro , Aprilli Francisco , Féres Omar
Published: June 2014

A apendicite crônica e a apendicite recorrente são condições patológicas que diferem da apendicite aguda, a afecção mais comum do apêndice vermiforme. O propósito deste artigo é decifrar, com critério, os aspectos clínicos, o diagnóstico e a histopatologia da apendicite crônica e da apendicite recorrente. Os dados da literatura e as experiências, clínica e cirúrgica, dos autores, demonstradas dentre 10 pacientes com idade média entre 40 e 45 anos, com distribuição similar quanto ao sexo, sendo seis pacientes com apendicite recorrente e quatro com apendicite crônica, permitem concluir que a apendicite crônica e a recorrente já não devem ser mais uma controvérsia ou dúvida, mas um fato inequívoco, de importância clínica e acadêmica, cujos conceitos, por isso mesmo, merecem difusão na literatura científica e nas escolas médicas.
Otite média recorrente na infância
Authors: Genov Isabel Ruguê , Roxo Júnior Pérsio
Published: June 2014

Os autores fazem revisão sobre otite média recorrente, na infância, abordando aspectos clínicoepidemiológicos, seus principais agentes etiológicos, alterações imunológicas envolvidas e enfocam a necessidade de adequada propedêutica diagnóstica, propondo os principais exames complementares necessários.
Análise quantitativa das células das ilhotas pancreáticas em ratos sob efeito de aloxana
Authors: Lima Marcus Aurelho , Lima Lilian Margareth Biagioni , Rita Danielle Patrícia Castanheira , Navarro Fábio Castilho , Tatsukawa Ranaia Santana , Pereira Gilberto Araújo , Reis Luiz Carlos , Abreu Marta Elena Araújo , Borges Maria de Fátima
Published: June 2014

In the present study, we verified the influence of alloxan over the cells of pancreatic islet of rats, performing quantitative analysis of a, b and d  cells through immunohistochemical study.

Twenty male rats (Rattus norvegiccus) were used of Wistar line, disposed in 2 groups of 10 rats on each, being a control group and an experimental one. After fasting of 36 hours, 40 ml/Kg of monohydrated of alloxan was administrated by intravenous via and about 30 minutes after, the animal was offered food. At the end of 10 days of observation, animals were sacrificed. Samples of different regions of pancreas were selected and undergone to a histological process and stained with hematoxilin-eosin. To the immunohistochemical study, anti-insulin, anti-glucagon and anti-somatostatin antibodies were used. Quantitative analysis was performed in eight most representative pancreatic islets of each animal. Results were considered significative when p<0.05. There was a significative reduction in the number of cells, destructing the islets and over the pancreatic-cells, which has already been observed in other studies. However, the action mechanism of alloxan over the pancreatic cells was not completely shown, therefore having necessity of more studies to its elucidation.
AVALIAÇÃO DE MÉTODOS INVASIVOS PARA DIAGNÓSTICO DA INFECÇÃO POR Helicobacter pylori EM CRIANÇAS E ADOLESCENTES COM SINTOMAS DISPÉPTICOS
Authors: Ogata Silvio K. , Kawakami Elisabete , Reis Francy P. S.
Published: June 2014

Apesar do uso rotineiro de biópsias endoscópicas para o diagnóstico da infecção por Helicobacter pylori em nosso meio, há poucos estudos pediátricos, avaliando a acurácia dos métodos invasivos. Métodos: Foram avaliados prospectivamente 120 pacientes submetidos à endoscopia para investigação de sintomas dispépticos. Foram obtidos seis biópsias de região antral para detecção do Helicobacter pylori através do teste rápido da urease, histologia e cultura. Os pacientes foram considerados infectados, se a cultura ou a histologia e o teste rápido da urease resultaram positivos. Resultados: A idade variou de 3m a 17anos (média: 10a1m); 54% do sexo feminino e 46% masculino; 44% (53/120) estavam infectados. O exame endoscópico foi normal em 54% (65/120) e anormal em 46% (55/120). O diagnóstico foi gastrite - 69% (38/55), esofagite - 13% (13/55), úlcera duodenal - 13% (7/55) e duodenite - 5% (3/55). Os 3 métodos concordaram em 72,5% (87/120), foram todos negativos em 48% (58/120) e todos positivos em 24,5% (29/120). A melhor concordância ocorreu entre a histologia e o teste rápido da urease (91,7%), seguido pela cultura e histologia (78,3%) e, finalmente, a cultura e o teste rápido da urease (75%). A sensibilidade do teste rápido da urease foi 100%,  seguido pela histologia (98,1%) e pela cultura (56,6%). A especificidade da histologia foi de 97%, seguida pelo teste rápido da urease (89,5%). Conclusão: A associação histologia e o teste rápido da urease mostraram maior acurácia na detecção da infecção por Helicobacter pylori devido a sua alta sensibilidade (teste rápido da urease) e alta especificidade (histologia), além do baixo custo e praticidade. A cultura isolada não deve ser utilizada como padrão-ouro devido à baixa sensibilidade.
Influência da pineal sobre a morfologia do córtex da adrenal
Authors: Lima Lilian Margareth B. de , Lima Marcus Aurelho , Rita Cláudia Valéria C. , Oliveira Paulo Fernando , Reis Luis Carlos , Borges Maria de Fátima , Silva Gilberto Pereira da
Published: June 2014

Várias glândulas interferem na produção e secreção dos hormônios corticais da adrenal e, como previamente demonstrado por diversos estudos, a pineal exerce efeito inibitório sobre tais hormônios. A pinealectomia aumenta o nível dos hormônios do córtex e promove modifica ções morfológicas no córtex, tais como, diminuição da atividade mitótica e hipertrofia da cortical. A finalidade do presente estudo foi verificar a influência da pinealectomia, em ratos, sobre a morfologia das glândulas adrenais. Foram selecionados 4 grupos de animais, um grupo-controle normal, um submetido a cirurgia ficticial, dois pinealectomizados, sacrificados em intervalos de tempo diferentes. Realizou-se análise morfométrica e da proliferação celular das camadas corticais das adrenais. O estudo morfométrico demonstrou aumento da camada fasciculada dos animais pinealectomizados, em relação às adrenais dos ratos não pinealectomizados. Não foi observada proliferação celular em qualquer dos grupos estudados. Os resultados demonstram que a pineal exerce influência sobre as adrenais e a ausência desta glândula causa aumento do peso da adrenal por hipertrofia celular da zona fasciculada e não por hiperplasia.
Sonda nasogástrica/nasoentérica
Authors: Unamuno Maria do Rosário D. L. de , Marchini Julio S.
Published: June 2014

Cada dia mais, a terapia nutricional é reconhecida como importante fator na recuperação de doentes. As sondas modernas possibilitam a oferta de nutrientes e a melhora do estado nutricional, por meio de métodos pouco invasivos, desde que o aparelho digestivo tenha conservado, pelo menos, parte de sua capacidade de  absorção. O procedimento requer cuidados especializados, posto que não é isento de complicações. A equipe que assiste o paciente que recebe terapia nutricional através de sondas deve ter conhecimento da instalação das mesmas bem como da administração das dietas e treinamento para prevenir, reconhecer e tratar as complicações. Apresentamos, neste artigo, as técnicas de introdução das sondas, infusão das dietas e principais complicações, que podem advir dessa terapia.
Infecção de vias urinarias na comunidade de Ribeirão Preto – SP
Authors: Camargo Corina Bueno Siqueira de , Pedro Caroline Cássia , Lourenço Débora Silva , Gironi Rosa Helena A. Romaneilo , Martinez Roberto
Published: June 2014

Este estudo teve como objetivo avaliar a etiologia da infecção do trato urinário e a susceptibilidade das bactérias mais freqüentemente isoladas da urina de pacientes atendidos em Unidades Básicas de Saúde de Ribeirão Preto, SP. A urina foi coletada entre outubro de 1996 e maio de 2000. A identificação bacteriana e o teste de sensibilidade a antimicrobianos foram realizados pelo sistema automatizado Microscan (Dade — Behring ), menos nos seis meses iniciais do período acima citado, quando se recorreu à identificação bacteriológica convencional e ao método de difusão de disco.

Os agentes causais distribuíram-se em enterobactérias (87,6%), bacilos Gram-negativos não fermentadores (1,5%) e cocos Gram-positivos (11,9%). De um total de 1.638 bactérias, as espécies mais prevalentes foram Escherichia coli (1108 - 67,6% ), Klebsiella pneumoniae (107-6,5% ), Proteus mirabillis (67 - 4,1% ), Staphylococcus saprophyticus ( 63 - 3,8% ), Citrobacter koseri ( 26 — 1,6% ) e Enterococcus faecalis ( 25 — 1,5% ). A sensibilidade de E. coli foi baixa para ampicilina ( 45%) e cefalotina ( 54%), mediana para sulfametoxazol e trimetoprim (63%) e alta para amoxicilina e clavulanato, cefuroxima, ceftriaxona, ceftazidima, gentamicina, amicacina, nitrofurantoína, norfloxacina, ácidos pipemídico e nalidíxico e ciprofloxacina (92% - 100%). A sensibilidade geral dos uropatógenos sugere que norfloxacina e outras quinolonas, nitrofurantoina, cefuroxima e gentamicina são opções terapéuticas adequadas para as infecções de vias urinárias na comunidade.