bluuebunny/crossref_metadata_2025 huggingface dataset:
Senile parathyroid dysfunction: Characteristics of its diagnosis and treatment
Authors: Yan Shuang-Tong , Tian Hui
Published: December 2016

Senile parathyroid dysfunction is mainly seen in primary or secondary hyperparathyroidism (pHPT or sHPT). pHPT in the elderly usually occurs in women, with fatigue and osteoporosis as the common symptoms. Screening of blood calcium and further evaluation of parathyroid hormone (PTH) for subjects with serum calcium >2.6 mmol/L can be helpful for early identification of patients. For pHPT patients with no contraindications to surgery and whose lesions can be well-localized, surgical treatment can be more beneficial. sHPT is mainly found in patients with end-stage chronic renal dysfunction necessitating hemodialysis or peritoneal dialysis. For these patients, monitoring of PTH level, early supplement of calcium preparations and use of large-dose calcitriol will facilitate maintaining levels of blood calcium and PTH.
Marked elevation of CA19-9 in a patient with rheumatoid arthritis-associated pulmonary fibrosis
Authors: Zhang Wei-Wei , Wang Qing , Xie Xiang-Jun , Si Jun-Li
Published: December 2016

We report a case of a 78-year-old male was admitted for 2 years of blood CA19-9 >1000 kU/L found at physical examination. Abdominal computed tomography, barium meal and gastrointestinal endoscopy did not find any malignancy. Position emission tomography indicated interstitial pulmonary fibrosis (IPF) (severe) accompanied with reactive hyperplasia of mediastinal lymph node and bilateral pleural thickening. The patient also claimed to have rheumatoid arthritis (RA) for more than 40 years. Then final diagnosis was RA with IPF. The patient’s blood CA19-9 was improved after 5-day treatment of hormone inhalation.
Anticoagulation treatments related
different types of vascular access on
maintenance hemodialysis patient:
A multicenter epidemiological
investigation
Authors: Huang Qi , Sun Xue-Feng , Lin Hong-Li , Zhang Zhi-Min , Hao Li-Rong , Yao Li , Li Ji-Jun , Zhao De-Long , Wang Yong , Zhu Han-Yu , Chen Xiang-Mei
Published: December 2016

Objective: The objective was to increase the understanding of vascular access in hemodialysis
and evaluate hemodialysis-related anticoagulation treatments and the associated hemorrhagic
or thrombotic complications. Materials and Methods: In this study, an epidemiological
investigation was conducted in 1175 patients who underwent hemodialysis in seven blood
purification centers in northern Chinese. The patients were divided into two groups based on
the vascular access they used: Arteriovenous fistula (AVF) group and central venous catheter
(CVC) group. The similarities and differences of anticoagulation and hemorrhagic, thrombotic
complications were compared between two groups. Results: Arteriovenous fistula was the
most frequently used vascular access, and heparin was the most commonly used anticoagulant.
Patients in CVC group experienced significantly greater rates of low molecular weight heparin
(LMWH) administration and had a higher rate in achieving thrombotic complications than
those in AVF group. There were no significant differences in LMWH dosages in patients with
thrombotic complications, as well as the proportion of patients who received anti-platelet drugs.
Heparinized catheter lock solutions were excessively high in this study, which may lead to a
risk of hemorrhage. Conclusion: Hemodialysis-related anticoagulation treatments in China
require additional improvements, especially for the patients using CVC as vascular access.
There is an urgent need to develop clinical evaluation studies of anticoagulation treatments
for achieving more standardized and targeted treatments.
Clinical presentation of
extrahepatic portal vein obstruction:
10-year experience at a tertiary care
hospital in Pakistan
Authors: Hanif Farina M. , Soomro Ghous Bux , Akhund Sara Nazir , Luck Nasir Hassan , Laeeq Syed Mudassir , Abbas Zaigham , Hassan Syed Mujahid , Mubarak Muhammed
Published: December 2016

Objective: To evaluate the clinical presentation, possible etiological factors, management and
outcome of patients in our hospital with extrahepatic portal vein obstruction (EHPVO). Materials
and Methods: This study included patients with EHPVO followed up in our department during
last 10 years. Patients of cirrhosis with EHPVO were excluded. Patients’ clinical presentation,
etiology of EHPVO, management and outcome results were analyzed. Results: Of 30 patients,
19 (67.9%) were males. Median age was 12 years. Of 14 patients who underwent liver biopsy
9 had histological activity index stage of 1/6. History of omphalitis and pulmonary tuberculosis
was present in one case each. Of 22 patients with the available thrombophilia profile, nine
patients had a deficiency of protein C, five patients had a deficiency of protein S, one each
had reduced level S of anti-thrombin III and factor V mutation. The predominant presenting
symptom was hematemesis (15 patients, 53.6%). Seven patients (25%) had splenomegaly.
Three patients (10.7%) had no esophageal varices on endoscopy. Three patients underwent
splenectomy due to severe pancytopenia. Endoscopic retrograde cholangipancreatography
was performed in four patients (14.3%) due to portal biliopathy. Common bile duct stenting was
performed in all four patients. Of them, one patient underwent splenorenal shunt operation for
indication of hemobilia. One patient died at the age of 40 years, due to cholangitis and sepsis.
Conclusions: Results from this study show that the anticoagulant deficiency is a common
cause of EHPVO in our setup. Hematemesis is a common presenting symptom. Some of these
patients have symptomatic portal biliopathy.
Rapunzel syndrome
Authors: Altonbary Ahmed Youssef , Bahgat Monir Hussein
Published: December 2016

Bezoars are concretions of human or vegetable fibers that accumulate in the gastrointestinal
tract. Trichobezoars are common in patients with underlying psychiatric disorders who chew
and swallow their own hair. Rapunzel syndrome is a rare form of gastric trichobezoar with a
long tail extending into the small bowel. This syndrome was first described in 1968 by Vaughan
et al. and since then till date just 64 cases have been described in the literature. We present
the only documented case with Rapunzel syndrome in Egypt.
A historical perspective: Are inhaled corticoids sufficient to control asthma?
Authors: Louis Renaud , Demarche Sophie , Schleich Florence
Published: December 2016

Inhaled corticoids (ICS) made a dramatic breakthrough in the management of asthma in the late eighties resulting in a sharp reduction in morbidity and mortality in the following decades. Soon after, the association between ICS and long acting β2 agonists (LABA) soon became the gold standard of maintenance asthma treatment. With the advent of sputum induction it has become clear that asthma could not be considered as a unique entity but rather a display of several inflammatory phenotypes. Eosinophilic phenotype shows good response to ICS while non-eosinophilic, and in particular the neutrophilic phenotype, seems to be more resistant. Severe asthmatics show insufficient asthma control despite ICS/LABA. Those who are allergic and eosinophilic may benefit from add-on treatment with anti-IgE or anti-IL-5. Severe neutrophilic asthma could benefit from maintenance treatment with macrolides while thermoplasty offers some promise to those in whom airway smooth muscle hypertrophy contributes to disease instability
Prevalence and impact of diabetes, hypertension, and cardiovascular diseases in chronic obstructive pulmonary diseases: A hospital-based cross-section study
Authors: Mahishale Vinay , Angadi Naveen , Metgudmath Vijayanand , Eti Ajith , Lolly Mitchelle , Khan Sujeer
Published: December 2016

Background: Chronic obstructive pulmonary disease (COPD) is associated with important chronic comorbid diseases, including diabetes, hypertension and cardiovascular diseases. As very limited data is available in India, the aim of the present study was to determine the relationship between COPD and the common, chronic comorbid conditions of diabetes mellitus (DM), hypertension (HTN), and cardiovascular diseases (CVD) and also to determine how these affect the clinical course of COPD.

Methods: All the COPD cohorts diagnosed as per Global Initiative for Chronic Obstructive Lung Disease-2013 (GOLD-2013) criteria were screened for DM, HTN, and CVD as per stipulated national and WHO guidelines.

Results: The prevalence of DM, HTN, and CVD in the 2432 COPD subjects was 25.94%, 37.25%, and 13.93%, respectively. In multivariate analyses, very severe COPD was associated with a higher risk of DM (odds ratio [OR] 1.6, 95% confidence interval [CI] 1.2–2), HTN (OR 1.6, 95% CI 1.4–1.9), and CVD (OR 2.5, 95% CI 1.9–3.0).

Conclusion: A significant relationship was found between COPD and the presence of comorbid DM, HTN, and CVD. It was also found that subjects with advanced COPD were more likely to have at least two of these conditions and hugely affect the outcome of the disease. These findings suggest that the presence of COPD could provide a rationale to look for other comorbid disease and, conversely, that the presence of DM, HTN, or CVD might be the basis for the assessment of patients for airflow limitation and COPD as the tobacco smoking and advancing age were common risk factors.
Medicolegal implications of radial and femoral access for coronary angiography and intervention in 2016: Focus on retroperitoneal hemorrhage
Authors: Voudris Konstantinos V. , Vidovich Mladen I.
Published: December 2016

Background and Objectives

Retroperitoneal hemorrhage is a rare but serious complication of transfemoral approach (TFA) and TFA percutaneous coronary intervention (PCI). Radial approach for coronary angiography and intervention (transradial approach, TRA) is associated with lower access site complications and reduced blood transfusion rates. Retroperitoneal bleeding has not been described with TRA. This study sought to evaluate the relationship between femoral access for coronary angiography (TFA) and PCI-induced retroperitoneal hemorrhage and the resulting medical litigation in the United States.

Methods

From 342 lawsuit claim records identified in LexisNexis database search, 17 cases of TFA and TFAPCI-related retroperitoneal hemorrhage decided between 1995 and 2015 were included in the study. Claims were thoroughly reviewed and information about the date the case was decided, patient outcome, the plaintiff, the defendant, the claim, and the trial outcome were extracted.

Results

The most common filled claim was medical malpractice (53% of the cases), followed by wrongful death (18%) and review of the Commissioner's decision to deny the application for supplemental security income (12%). Forty-seven percent of the cases were won by the defense, 29% by the plaintiff, and 24% were remanded for a new trial. In 82% of the cases, physicians were sued, but only 14% of the cases were won by the plaintiff. In 59% of the claims, the patient died; however, 70% of those cases were decided in favor of the defending physician and hospital.

Conclusion

Retroperitoneal hemorrhage is an uncommon complication of TFA and TFA PCI and is associated with high mortality rates. Physicians should able to identify this complication early and address it in a timely manner based on the applicable standard of care. TRA and TRA PCI is a reliable alternative and may potentially reduce medicolegal liability related to access site choice.
Zika virus: A pandemic in progress
Authors: Yadav Sankalp , Rawal Gautam , Baxi Mudit
Published: December 2016

The world is facing a number of emerging infections. The latest outbreak of Zika virus infection has only added to the suffering. The WHO declared a state of emergency in the affected countries and has issued alarms worldwide. The paucity of literature leading to lack of clear guidelines is one of the most important factors resulting in a higher number of cases. The absence of clinical vaccine and an antiviral drug may prove to be a really grave situation. The present paper throws some light on this new emerging virus that has been known to man since 1947.
Corticosteroids, the oldest agent in the prevention of chemotherapy-induced nausea and vomiting: What about the guidelines?
Authors: Van Ryckeghem Florence
Published: December 2016

Chemotherapy-induced nausea and vomiting (CINV) remains one of the most disturbing side effects of cancer treatment. Research in antiemetic therapy has progressed gradually since the early eighties, and the development of antiemetic agents continues. This review focuses on the current management of CINV based on the most recent guidelines, and adherence to the latter is examined more carefully. Setrons (5HT3 receptor antagonists), corticosteroids, and NK-1 receptor antagonists are the cornerstones of antiemetic therapy. Corticosteroids are one of the oldest agents in the prevention of CINV. They are highly effective, increase the effect of other antiemetic agents, and are cost-effective. The latest developed 5HT3 receptor antagonist palonosetron led to an update of the guidelines of CINV. Other types include benzodiazepines, cannabinoids, and olanzapine. Various factors contribute to the overall risk of developing CINV, such as patient characteristics, emetogenic potency of the chemotherapeutic agents, and correct prevention of CINV. Current guidelines determine which is the right preventive regimen for each cancer patient at risk for experiencing CINV. Adherence to these guidelines and implementation in daily practice seem to be below the optimal level. In Belgium, authorities use the guidelines as a base for reimbursement and this has increased the level of implementation.
Acute respiratory distress syndrome: An update and review
Authors: Rawal Gautam , Yadav Sankalp , Kumar Raj
Published: December 2016

Acute respiratory distress syndrome (ARDS) is a life threatening condition characterized by severe hypoxemia due to pulmonary gas exchange failure and was first recognized in 1960s.Since its first description, it has undergone intensive research in the past few decades to understand its pathogenesis and therapies. Despite this, the recommended therapies to decrease mortality in ARDS remain limited and include low-tidal volume mechanical ventilation, prone ventilation and recently, the ECMO rescue therapy in extreme cases. This review article will summarize the key features of ARDS with a brief overview of the therapeutic options in the management of ARDS.
Renin–angiotensin–aldosterone system in insulin resistance and metabolic syndrome
Authors: Das Undurti N.
Published: December 2016

Obesity and its consequent complications such as hypertension and metabolic syndrome are increasing in incidence in almost all countries. Insulin resistance is common in obesity. Renin– angiotensin system (RAS) is an important target in the treatment of hypertension and drugs that act on RAS improve insulin resistance and decrease the incidence of type 2 diabetes mellitus, explaining the close association between hypertension and type 2 diabetes mellitus. RAS influences food intake by modulating the hypothalamic expression of neuropeptide Y and orexins via AMPK dephosphorylation. Estrogen reduces appetite by its action on the brain in a way similar to leptin, an anorexigenic action that seems to be mediated via hypothalamic pro-opiomelanocortin (POMC) neurons in the arcuate nucleus and synaptic plasticity in the arcuate nucleus similar to leptin. Estrogen stimulates lipoxin A4, a potent vasodilator and platelet anti-aggregator. Since both RAS and estrogen act on the hypothalamic neuropeptides and regulate food intake and obesity, it is likely that RAS modulates LXA4 synthesis. Thus, it is proposed that Angiotensin-II receptor blockers and angiotensin-converting enzymes and angiotensin-II antagonists may have the ability to augment LXA4 synthesis and thus bring about their beneficial actions.
Decreased regional left ventricular myocardial strain in type 1 diabetic children: a first sign of diabetic cardiomyopathy?
Authors: Hodzic Amir , Ribault Virginie , Maragnes Pascale , Milliez Paul , Saloux Eric , Labombarda Fabien
Published: December 2016

Background and Objectives

Type 1 diabetes is a major cardiovascular risk factor associated with an excess of mortality in young adults due to premature cardiovascular events, which includes heart failure. The relation between type 1 diabetes and cardiac structure and function in children was poorly documented. Our study investigates (1) whether type 1 diabetic children have echocardiographic signs of subclinical cardiac dysfunction assessed by tissue Doppler strain and (2) whether state of metabolic control and diabetes duration have any influence on the cardiac event.

Methods

Standard echocardiography and tissue Doppler imaging were prospectively performed in type 1 diabetic children. Left ventricular dimensions, standard indices of systolic and diastolic function, and septal longitudinal strain were investigated.

Results

Thirty consecutive asymptomatic diabetic children (age: 12.4 [5–17] years; males: 53%) were compared to 30 age and sex-matched healthy control subjects. Left ventricular mass index and diastolic septal thickness were significantly increased in diabetic children. There was no difference between two groups as regards the left ventricular ejection fraction and conventional mitral Doppler parameters (E, A, Ea). The global longitudinal systolic strain and strain rate were found to be decreased in children with diabetes. The global longitudinal early diastolic strain rate (Esr) was negatively correlated with metabolic control. Longitudinal strain was not correlated with diabetes duration.

Conclusion

Children with Type 1 diabetes had subclinical alterations in left ventricular size and longitudinal myocardial deformation.
Lipodystrophy HIV-related and FGF21: A new marker to follow the progression of lipodystrophy?
Authors: Benedini Stefano , Luzi Livio
Published: December 2016

Recently new evidence about fibroblast growth factor 21 (FGF21) highlights the opportunities to use this molecule in new pharmaceutical formulations to combat type 2 diabetes and metabolic syndrome. It is well known that HIV is per se a condition of insulin resistance and in particular the patient with HIV-related lipodystrophy has a condition strictly related to metabolic syndrome. Lipodystrophy is associated with severe metabolic side effects, including dyslipidemia, hepatic insulin resistance, and lipid oxidation impairment. Research carried out showed that FGF21 levels were significantly increased in untreated HIV-1-infected patients and the increase was much marked in HIV-1-infected antiretroviral-treated patients that have developed lipodystrophy and in the patients with greatest metabolic alterations. FGF21 is expressed mainly by the liver, but also by other tissues such as the thymus, adipose tissue, and skeletal muscle. Therefore, many researchers have considered the investigation of possible variations of FGF21 in patients with significant alterations in body composition both in regard to fat mass and lean mass. In the light of the possible interactions between FGF21 and metabolic syndrome, it seems interesting to evaluate the implication of this hormone in patients with HIV-related lipodystrophy who have a severe metabolic picture of insulin resistance with important alterations in body composition.
Management of hospitalized type 2 diabetes mellitus patients
Authors: Marín-Peñalver Juan José , Martín-Timón Iciar , del Cañizo-Gómez Francisco Javier
Published: December 2016

Both hyperglycemia and hypoglycemia in hospitalized patients are associated with adverse outcomes including increased rates of infection, longer hospital length of stay, and even death. Clinical trials in patients with type 2 diabetes mellitus proved that by improving glycemic control, we can reduce all of them. Insulin is the preferred treatment for glycemic control in most cases, but alternative treatment options that can normalize blood glucose levels without hypoglycemia are being sought. Moreover, hospitalized patients are particularly vulnerable to severe, prolonged hypoglycemia since they may be unable to sense or respond to the early warning signs and symptoms of low blood glucose. Finally, nutritional support, corticosteroid therapy, and surgery increase the risk of hyperglycemia that leads to an increased risk of morbidity and mortality. We review the management of type 2 diabetes mellitus patients who are admitted to the general medical wards of the hospital for a procedure of intercurrent illness.
Inhibition of cyst growth in PCK and Wpk rat models of polycystic kidney disease with low doses of peroxisome proliferator-activated receptor γ agonists
Authors: Flaig Stephanie M. , Gattone Vincent H. , Blazer-Yost Bonnie L.
Published: December 2016

Background and Objectives

The studies were designed to test the efficacy of two peroxisome proliferator-activated receptor γ (PPARγ) agonists in two rodent models of polycystic kidney disease (PKD).

Materials and Methods

The PCK rat is a slowly progressing cystic model while the Wpk
-/- rat is a rapidly progressing model. PCK rats were fed with a pharmacological (0.4 mg/kg body weight [BW]) and a sub-pharmacological (0.04 mg/kg BW) dose of rosiglitazone (week 4–28). Wpk
-/- rats were fed with pharmacological (2.0 mg/kg BW) and sub-pharmacologic (0.2 mg/kg BW) doses of pioglitazone from day 5 to 18. At termination, kidney weights of treated versus untreated cystic animals were used to determine efficacy. The current studies were also compared with previous studies containing higher doses of PPARγ agonists. The concentrations used in the animals were calculated with reference to equivalent human doses for both drugs.

Results

The current studies demonstrate: 1) that low, pharmacologically relevant, doses of the PPARγ agonists effectively inhibit cyst growth; 2) there is a class action of the drugs with both commercially available PPARγ agonists, rosiglitazone, and pioglitazone, inhibiting cyst growth; 3) the drugs showed efficacy in two different preclinical cystic models. In the PCK rat, animals fed with a sub-pharmacological dose of rosiglitazone for 24 weeks had significantly lower kidney weights than untreated animals (3.68 ± 0.13 g vs. 4.17 ± 0. 11 g, respectively, P < 0.01) while treatment with a pharmacologic dose had no significant effect on kidney weight. The rapidly progressing Wpk
-/- rats were fed with pharmacological and sub-pharmacologic doses of pioglitazone from day 5 to 18 and the kidneys were compared with non-treated, cystic animals. Kidney weights on the pharmacologic dose were not statistically lower than the untreated animals while rats fed a sub-pharmacologic dose showed a significant decrease compared with untreated animals (3.35 ± 0.15 g vs. 4.55 ± 0.46 g, respectively, P = 0.045).

Conclusion

Concentrations of PPARγ agonists below the human equivalent diabetic doses are effective in slowing cyst growth in two rodent models of PKD.
The relation of anthropometric measurements and insulin resistance in patients with polycystic kidney disease
Authors: Esen Bennur , Gokmen Emel Sağlam , Kaya Mahmut , Ozkan Burak , Atay Ahmet Engin
Published: December 2016

Objective

To examine the frequency of insulin resistance (IR) and its relation with anthropometric measurements in patients with autosomal dominant polycystic kidney disease (ADPKD).

Material and Methods

Nonobese 82 patients with ADPKD and 58 age matched healthy controls were enrolled into the study. None of participants were diabetic or receiving renal replacement therapies (RRT). IR was determined by homeostasis model assessment of insulin resistance (HOMA-IR) formula. Tanita body composition analyzer was used for anthropometric measurements. Creatinine clearance of participant were assessed by the modification of diet in renal diseases (MDRD).

Results

Patients with ADPKD had significantly higher level of urea and creatinine, microalbuminuria, and lower level of MDRD. Body fat distribution and HOMA-IR in both the groups were similar. Systolic and diastolic blood pressure of patients were higher than those of controls.

Conclusion

We failed to determine a higher frequency of IR among patients with ADPKD.
Persistent Homology Analysis of RNA
Authors: Mamuye Adane L. , Rucco Matteo , Tesei Luca , Merelli Emanuela
Published: December 2016

Topological data analysis has been recently used to extract meaningful information frombiomolecules.
Here we introduce the application of persistent homology, a topological data analysis tool, for computing
persistent features (loops) of the RNA folding space. The scaffold of the RNA folding space is a complex
graph from which the global features are extracted by completing the graph to a simplicial complex via the
notion of clique and Vietoris-Rips complexes. The resulting simplicial complexes are characterised in terms
of topological invariants, such as the number of holes in any dimension, i.e. Betti numbers. Our approach
discovers persistent structural features, which are the set of smallest components to which the RNA folding
space can be reduced. Thanks to this discovery, which in terms of data mining can be considered as a space
dimension reduction, it is possible to extract a new insight that is crucial for understanding the mechanism
of the RNA folding towards the optimal secondary structure. This structure is composed by the components
discovered during the reduction step of the RNA folding space and is characterized by minimum free energy.
Ultrafast electron and hole transfer in bulk heterojunctions of low-bandgap polymers
Authors: Kozlov Oleg V. , Pavelyev Vlad G. , de Gier Hilde D. , Havenith Remco W. A. , van Loosdrecht Paul H.M. , Hummelen Jan C. , Pshenichnikov Maxim S.
Published: December 2016

In modern bulk heterojunction (BHJ) organic solar
cells, blends of low-bandgap polymer and [70]PCBM acceptor
are used in the active layer. In this combination, the
polymer absorbs photons from the red and near-IR parts
of the solar spectrum, while the blue and near-UV photons
are harvested by [70]PCBM. As a result, both electron
transfer from polymer to [70]PCBM and hole transfer
from [70]PCBM to polymer are of utmost importance
in free charge generation and have to be optimized simultaneously.
Here we study electron and hole transfer
processes in BHJ blends of two low-bandgap polymers,
BTT-DPP and PCPDTBT, by ultrafast photoinduced spectroscopy
(PIA). By tracking the PIA dynamics, we observed
substantially different charge separation pathways
in BHJs of the two polymers with [70]PCBM. From the photoinduced
anisotropy dynamics, we demonstrated that in
the PCPDTBT:[70]PCBM system both electron and hole
transfer processes are highly efficient, while in the BTTBPP:[
70]PCBM electron transfer is blocked due to the unfortunate
energy level alignment leaving hole transfer the
only pathway to free charge generation. Calculations at the
density functional theory level are used to gain more insight
into our findings. The presented results highlight the importance of the energy level alignment on the charge
separation process.
Acoustic trapping in bubble-bounded micro-cavities
Authors: O’Mahoney P. , McDougall C. , Glynne-Jones P. , MacDonald M. P.
Published: December 2016

We present a method for controllably producing longitudinal acoustic trapping sites inside microfluidic channels. Air bubbles are injected into a micro-capillary to create bubble-bounded ‘micro-cavities’. A cavity mode is formed that shows controlled longitudinal acoustic trapping between the two air/water interfaces along with the levitation to the centre of the channel that one would expect from a lower order lateral mode. 7 μm and 10 μm microspheres are trapped at the discrete acoustic trapping sites in these micro-cavities.We show this for several lengths of micro-cavity.
Oxygen Saturation Targets in Preterm Infants and Outcomes at 18–24 Months: A Systematic Review
Authors: Manja Veena , Saugstad Ola D. , Lakshminrusimha Satyan
Published: December 2016

CONTEXT:

The optimal oxygen saturation target for extremely preterm infants remains unclear.

OBJECTIVE:

To systematically review evidence evaluating the effect of lower (85%–89%) versus higher (91%–95%) pulse oxygen saturation (Spo2) target on mortality and neurodevelopmental impairment (NDI) at 18 to 24 months.

DATA SOURCES:

Electronic databases and all published randomized trials evaluating lower versus higher Spo2 target in preterm infants.

STUDY SELECTION:

A total of 2896 relevant citations were identified; 5 trials were included in the final analysis.

DATA EXTRACTION:

Data from 5 trials were analyzed for quality of evidence and risk of bias.

LIMITATIONS:

Limitations include heterogeneity in age at enrollment and comorbidities between trials and change in oximeter algorithm midway through 3 trials.

RESULTS:

There was no difference in the incidence of primary outcome (death/NDI at 18–24 months) in the 2 groups; risk ratio,1.05, 95% confidence interval 0.98–1.12, P = .18. Mortality before 18 to 24 months was higher in the lower-target group (risk ratio,1.16, 95% confidence interval 1.03–1.31, P = .02). Rates of NDI and severe visual loss did not differ between the 2 groups. Proportion of time infants spent outside the target range while on supplemental oxygen ranged from 8.2% to 27.4% <85% and 8.1% to 22.4% >95% with significant overlap between the 2 groups.

CONCLUSIONS:

There was no difference in primary outcome between the 2 Spo2 target groups. The collective data suggest that risks associated with restricting the upper Spo2 target limit to 89% outweigh the benefits. The quality of evidence was moderate. We speculate that a wider target range (lower alarm limit, 89% and upper, 96%) may increase time spent within range, but the safety profile of this approach remains to be determined.
Islamism and gender relations in the Muslim world as reflected in recent World Values Survey data
Authors: Tausch Arno , Heshmati Almas
Published: December 2016

Ever since Goldin (1995) proposed the idea that there is a U-shaped female labor force participation rate function in economic development, empirical research is stunned by the question why the countries of the Middle East and North Africa (MENA) are characterized by such low rates of female labor force participation. This gap in labor economics research is all the more perplexing since gender equality, particularly in education and employment, significantly contributes to economic growth. The research strategy of this paper is within a relatively new tradition in labor market research, initiated by Besamusca et al. (2015), which does not exclude the “religious factor” and what the authors call “gender ideology”. Our analysis of the “gender ideology” of Islamism and gender values is based on an empirical analysis of World Values Survey data. In recent economic theory, Carvalho (2013) maintained that Muslim veiling is a strategy for integration, enabling women to take up outside economic opportunities while preserving their reputation within the community. The empirical data clearly support a pessimistic view. We show that Muslim Feminism, which according to our analysis implies the rejection of Islamism and the veil, and the democracy movement in the Muslim world, are closely interrelated. Thus, it is imperative that Western Feminism develops solidarity with Muslim Feminism, and that labor economics stop excluding the religious factor from the analytical frameworks explaining low female labor force participation rates.
Autoantibodies to Neuropeptides in the Different States of Opium Addiction
Authors: Sharkova V. A. , Kovalev I. A. , Shivanova A. Yu.
Published: December 2016

Background: During the last years the addiction rate remains stable high. While the neurochemical drug effect remains unclear.Aims: To analyze the changes of the idiotypic (аАТ1) and anti-idiotypic (аАТ2) autoantibodies to the neuroproteins S100, MBP, GFAP, NGF on the different stages of opium addiction and to indicate prognosis criteria of their effect.Materials and methods: 70 patients (only men, aged 22−38) with diagnosis opium addiction underwent examination. According to the results of testing, we detected the intoxication in 24 patients, withdrawal ― in 24, and 22 patients were at remission stage of 21−28 days. The control group included only healthy people (n=18). The survey was focused on the rate detection of the idiotypic and anti-idiotypic IgG class antibodies in relation to the rate of neural proteins (S100, MBP, GFAP, NGF) in the serum with the IEA.Results: in patients with opium intoxication, we revealed statistical assurance in the rate of autoantibodies amount and their counterweights to the neural proteins rate between control and experimental groups. Only the rate of the аАТ2 protein significantly decreased relatively to the MBP. In patients with abstinence, the rate of аАТ1 to the MBP, GFAP (р≤0,05) increased. The rate of аАТ2 in relation to the GFAP and MBP also increased (р≤0,05), at the same time it decreased in relation to the S100 and NGF (р≤0,05). The autoantibodies amount at the remission stage corresponded to the amount at the intoxication stage. The comparative analysis of the patient groups with the different stages of opium addiction detected the identity criteria both in the intoxication and remission. We revealed statistical assurance in the rates of аАТ1 to MBP and аАТ2 to NGF in patients with intoxication and abstinence, and in the rates of аАТ1 to GFAP, MBP, and аАТ2 to GFAP (decreased in the remission) and to S100, MBP (increased in the remission) in patients with abstinence and at remission.Conclusion: Levels of idiotypic and anti-idiotypic antibodies to the neural proteins S100, MBP, GFAP, NGF (especially аАТ2 to MPB) could be used as diagnostic factor and for accessing different states of opium addiction.
Methods of Molecular Transfusion in Intensive Care of Critical States in Pediatric Postoperative Cardiac Surgery Patients
Authors: Yaroustovsky M. B. , Abramyan M. V. , Komardina E. V.
Published: December 2016

Molecular techniques in transfusion medicine have become popular in the clinical practice of pediatric intensive care units when the patient needs blood purification, more recently, in children in critical condition. Considering the anatomical and physiological characteristics of the child’s body, pronounced severity, and rapid progression of multiple organ disorders, the key problems defining the treatment results are instrument reading, choice and timely initiation of extracorporeal therapy. Today, along with the methods of renal replacement therapy in children albumin dialysis therapy and high-volume plasmapheresis are successfully applied in the treatment of acute liver dysfunction; extracorporeal membrane oxygenation — in the treatment of biventricular cardiac and/or respiratory failure. Selective endotoxin sorption methods (LPS-adsorption) are implemented in the treatment of severe gram-negative sepsis.
Optimisation of ground anchor head for non-destructive testing
Authors: Ivanović Ana , Monese Alberto , Neilson Richard D.
Published: December 2016

Ground anchorages and rock bolts are used widely in retaining walls, mines, dry docks, dams and prestressed structures to provide effective support for unstable rock strata. This paper offers a new design for ground anchor heads to maximise the quality of load estimation using the non-destructive ground anchorage integrity testing method. When using this method, the anchor head assembly needs to have a non-linear stiffness characteristic to permit changes in anchorage load to be detected. The initial estimate of the optimal stiffness characteristic is found using a lumped parameter dynamic model of the bolt assembly. Finite-element models of the proposed patented plate designs are then presented along with the corresponding load–displacement diagrams. The optimised bearing plate which was designed in this process was manufactured and tested experimentally, both statically and dynamically as part of a rock bolt assembly. The results from the experiments and the dynamic model are presented, and show good agreement. The resulting frequency shifts with a change of load prove the viability of building in the flexibility required to make non-destructive monitoring of load possible. The proposed design provides excellent load estimation.
A continuidade do cuidado de crianças e adolescentes com mielomeningocele: estudo descritivo
Authors: Freitas Giselle Lima de , Sena Roseni Rosângela de
Published: December 2016

Problema: a complexidade dos cuidados a crianças e adolescentes com mielomeningocele e a necessidade de continuidade no domicílio representam um desafio para o cuidador. Objetivo: analisar a continuidade do cuidado no domicílio a crianças e adolescentes com mielomeningocele. Método: estudo descritivo-exploratório, com metodologia qualitativa e referencial teórico-metodológico da dialética. Os dados foram coletados com 16 famílias, representadas por crianças e adolescentes com mielomeningocele e suas mães, por meio de entrevista e observação no período de maio a agosto de 2015. A observação ocorreu durante as três visitas domiciliares realizadas a cada família. A entrevista foi realizada durante a primeira visita domiciliar. Os dados foram submetidos à análise de conteúdo temática. Resultados preliminares: as famílias possuem baixa renda e enfrentam desafios sociais relacionados à aquisição de materiais para os cuidados e acessibilidade.
Dependência de cuidados de enfermagem de pessoas idosas hospitalizadas: estudo transversal
Authors: Brito Fabiana Medeiros , Fernandes Maria das Graças Melo
Published: December 2016

Objetivo:  utilizando  o  Sistema  de  Classificação  de  Pacientes de Perroca,  verificar  a  dependência  de  cuidados  de  enfermagem  de  pessoas  idosas hospitalizadas  em  uma  unidade  clínica.  Método:  estudo  transversal,  realizado  com  112 pessoas idosas na unidade clínica de um hospital-escola de João Pessoa/PB. Resultado: constatou-se  que  a  maioria  dos  idosos  avaliados  apresentou  alto  grau  de  dependência quanto   aos   cuidados   de   enfermagem.   Apontou-se   associação   estatisticamente significativa entre o grau de dependência dos idosos e a característica sociodemográfica ocupação. Conclusão: os resultados empíricos obtidos por meio desta pesquisa emergem como   aspectos   de   essencial   relevância   relacionados   à   dependência   dos idosos hospitalizados  em  unidades  clínicas,  assim  como  o  desenvolvimento  de  outros  estudos semelhantes  voltados  para  elucidar  tal  dependência  e  corroborar para  uma  melhor qualidade de vida das pessoas idosas.
Óbitos fetais evitáveis por intervenções do Sistema Único de Saúde: estudo transversal
Authors: Pimentel Dayane da Rocha , Guimarães Aline Luzia Sampaio , Heráclio Isabela de Lucena , De Oliveira Conceição Maria , Do Bonfim Cristine Vieira
Published: December 2016

Objetivo:   Descrever   as   características   epidemiológicas   e   de assistência à saúde dos óbitos fetais e classificá-los de acordo com a Lista Brasileira de Causas  Evitáveis  por  intervenções  do  Sistema  Único  de  Saúde.  Método:  Estudo transversal  realizado  no  Recife  (PE)  no  ano  de  2014,  cujas  fontes  de  dados  serão  as fichas de investigação da Vigilância do Óbito Infantil e Fetal e o Sistema de Informação sobre  Mortalidade.  A  causa  básica  será  analisada  e  classificada  conforme a  Lista Brasileira de Causas Evitáveis. O teste de qui-quadrado de Pearson será empregado para avaliar  associação  entre  a  evitabilidade  dos  óbitos  fetais  segundo  faixa  de  peso. Resultados esperados: Pretende-se detectar as circunstâncias e fatores de evitabilidade da  mortalidade  fetal,  além  de  fornecer  subsídios  para  a  discussão  e  planejamento  de questões relacionadas à qualificação dos processos assistenciais em saúde.
Humanização da atenção pré-natal na ótica de gestantes: um estudo descritivo
Authors: Timm Marcella Simões , Prates Lisie Alende , Oliveira Gabriela , Cremonese Luiza , Possati Andrêssa Batista , Ressel Lúcia Beatriz
Published: December 2016

Objetivo:  conhecer  o  significado  da  humanização  na  atenção  pré-natal  para  as  gestantes.  Método:  estudo  qualitativo,  do  tipo  descritivo,  que  será desenvolvido  com  gestantes  em  acompanhamento  pré-natal,  vinculadas  a  serviços  da Atenção  Básica  de  um  município  do  Sul  do  Brasil.  Para  a  produção  dos  dados,  será utilizada  a  técnica  de  criatividade  e  sensibilidade  denominada  Almanaque,  associada  à entrevista  individual  semiestruturada.  A  análise  terá  como  referência  a  proposta operativa.  Resultados  esperados:  produzir  maior  conhecimento  acerca  da  temática  e fomentar  discussões  e  reflexões  que  possibilitem  a  qualificação  do  cuidado  pré-natal, além  de  fornecer  subsídios  para  que  os  profissionais  de  saúde  sejam  agentes  de mudança na realidade da humanização no pré-natal.
Percepção existencial das pessoas que vivem com úlceras venosas crônicas: estudo fenomenológico
Authors: Joaquim Fabiana Lopes , Silva Rose Mary Costa Rosa Andrade , Pereira Eliane Ramos
Published: December 2016

Objetivos:  compreender  como  as  pessoas  que  vivem  com  úlceras venosas  percebem  sua  existência  frente  às  lesões  das  úlceras  venosas;  descrever  e analisar, à luz da fenomenologia de Merleau-Ponty, como essas pessoas compreendem a própria  existência.  Método:  estudo  de  abordagem  qualitativa  do  tipo  fenomenologia descritiva. Cenário: ambulatório de Reparo de Feridas do Hospital Universitário Antônio Pedro,  localizado  em  Niterói/RJ.  Participantes: adultos  e idosos  que vivem com úlceras venosas crônicas em tratamento ambulatorial. Para a coleta de dados serão utilizados o Protocolo  I  B  -  Adaptado  -  Avaliação  de  clientes  com  úlceras  venosas  (registrado  na PROAP/UFF);   o   roteiro   da   entrevista   fenomenológica   e   registro   das expressões relacionadas  à  narratividade  do  corpo.  Os  dados  serão  tratados  por  meio  da  proposta metodológica de Amedeo Giorgi e receberão análise de discurso segundo o referencial de Merleau-Ponty.
Aplicações práticas da sociopoética no cuidado em saúde: uma visão contemporânea
Authors: Gauthier Jacques Henri Maurice
Published: December 2016

A  sociopoética  define  um  campo  de  pesquisa  e  atuação  na  área  de saúde  e  outras.  Numa  visão  do  ser  integrado  (em  si  próprio,  integrando  forças  e fraquezas,  e  holisticamente,  no  ambiente  humano  e  não  humano),  o  dispositivo  de Grupo-pesquisador  inspirado  em  Paulo  Freire  e  na  Análise  Institucional  (e  nos  Grupos operativos etc.) favorece o “trabalho” entre sombra e luz, entre opressão e libertação, pela profunda solidariedade e responsabilidade dos integrantes no decorrer do processo de conhecer, cuidar e aprender. O Grupo-pesquisador é o dono da pesquisa, do cuidado e  da  aprendizagem,  em  dialogicidade  com  a  instituição  que  nos  acolhe,  a  qual  tem direito de exigir retornos pela sua disponibilidade. Mas ele é ainda mais que isso: ele é um  Pensador,  um  Filósofo  coletivo,  um  Coletivo  inteligente  percorrido  de  afetos  pré-individuais  e  supra-individuais  rizomatizando  em  ambientes  ampliados,  conquistando sem prender, recebendo sem depender.
Cutaneous fungal infections in subjects with diabetes mellitus
Authors: S. Thilak , M. Anbumalar , Priya M. Sneha
Published: December 2016

Background: Diabetes mellitus is a chronic non-communicable disease causing an increase in blood glucose levels due to an ineffectiveness or insufficiency of secreted insulin. Infections have also been shown to be the most common skin changes in diabetics. In our study we aim to assess the susceptibility of diabetics to various superficial fungal infections. We will study candidiasis, tinea versicolor and dermatophytic infections in diabetics.

Methods: 400 diabetic individuals who gave consent were chosen at random from the patients attending the OPD. They were subjected to thorough clinical evaluation. Routine hematological investigations were done. FBS, PPBS, and HBA1C were done to assess diabetic control. Fungal infections were confirmed by KOH mounts.

Results: Of the 400 subjects 220 were male and 180 were female. 52.5% of the subjects had some fungal infections. 55.2% of the fungal infections were candidiasis. 27.6% of the fungal infections were dermatophytic infections. 17.1% of the fungal infections were tinea versicolor infections.

Conclusions: The study has analysed the epidemiology of cutaneous fungal infections in diabetics. A little over half the diabetics studied proved to have cutaneous fungal infections. Candidiasis was the most frequent form of cutaneous fungal infections accounting for 57% of the fungal infections. Dermatophytic infections were seen in 28% of infections and pityriasis versicolor for 17% of the infections. This high prevalence of cutaneous fungal infections among diabetics merits systematic screening for the same among this target group.
La Cuenta de los K’atuno’ob: rituales y regionalismos en el período Clásico maya
Authors: Graña-Behrens Daniel
Published: December 2016

Los mayas del Clásico (300-1000 d.C.) usaban varios calendarios, entre ellos la llamada Cuenta de los K’atunes o K’atuno’ob, que señala un período de 20 años (k’atun) mediante el signo ajaw, costumbre que continuó existiendo durante el Posclásico. Sin embargo, aunque se conoce su mecanismo calendárico, no se ha puesto mucha atención a la presentación morfológica y sintáctica en los textos epigráficos para distinguirla de otras formas que también permiten anotar una fecha del k’atun, como el día ajaw del Tzolk’in, el cual sólo marca el último día pero no el período en sí. Además de presentar los argumentos correspondientes, esta contribución hace también hincapié en algunos rituales regionales importantes relacionados con la Cuenta de los K’atuno’ob en el Clásico, como la llamada práctica del medio k’atun, descrita aún en el siglo XVI por fray Diego de Landa, y la relación que guarda esta cuenta para referirse a gobernantes muertos y ancestros.
Íikin y k’eex. Cronotopos del ritual terapéutico maya
Authors: Alejos García José Ovidio
Published: December 2016

En este artículo se discuten ideas de los mayas yucatecos sobre el tiempo en el espacio mitológico puestas de manifiesto en el ritual. Se analiza un ritual terapéutico para curar la rivalidad entre hermanos, proponiendo la ocurrencia de una transformación espacio-temporal que sucede en el acto ritual, así como un cambio en la “comida” como objeto de intercambio. El análisis aplica las perspectivas semióticas de Bajtín y Lotman, sobre todo sus reflexiones acerca del tiempo, el cronotopo, la memoria cultural y el papel de la mitología en la cultura.
El 'Arte de Lengua Cacchí para Bien comun' y los estudios diacrónicos de la gramática q’eqchi’
Authors: Vinogradov Igor
Published: December 2016

La gramática colonial titulada Arte de Lengua Cacchi para Bien comun es una de las fuentes principales para los estudios diacrónicos de la lengua q’eqchi’. El origen, autor y fecha de creación de la obra se desconocen. Una de las copias que fue hecha en 1875 por Hermann Berendt, un antropólogo alemán, también contiene sus observaciones sobre los ejemplos ofrecidos en el texto que recopiló con ayuda de un hablante nativo de q’eqchi’. Así pues, esta copia no sólo representa el estado de la lengua tal como se hablaba en los tiempos cuando fue creado el original sino que también proporciona datos de la lengua de la segunda mitad del siglo XIX. Considerando además los datos del habla contemporánea, se reconstruye etapa por etapa la evolución de algunos fragmentos de la gramática q’eqchi’ (pronombres, preposiciones, sistema verbal, procesos sintácticos) a lo largo de aproximadamente 400 años.