bluuebunny/crossref_metadata_2025 huggingface dataset:
Was an increase in cocaine use among injecting drug users in New South Wales, Australia, accompanied by an increase in violent crime?
Authors: Degenhardt Louisa , Day Carolyn , Hall Wayne , Conroy Elizabeth , Gilmour Stuart
Published: April 2005

Background

A sharp reduction in heroin supply in Australia in 2001 was followed by a large but transient increase in cocaine use among injecting drug users (IDU) in Sydney. This paper assesses whether the increase in cocaine use among IDU was accompanied by increased rates of violent crime as occurred in the United States in the 1980s. Specifically, the paper aims to examine the impact of increased cocaine use among Sydney IDU upon police incidents of robbery with a weapon, assault and homicide.

Methods

Data on cocaine use among IDU was obtained from the Illicit Drug Reporting System (IDRS). Monthly NSW Police incident data on arrests for cocaine possession/use, robbery offences, homicides, and assaults, were obtained from the Bureau of Crime Statistics and Research. Time series analysis was conducted on the police data series where possible. Semi-structured interviews were conducted with representatives from law enforcement and health agencies about the impacts of cocaine use on crime and policing.

Results

There was a significant increase in cocaine use and cocaine possession offences in the months immediately following the reduction in heroin supply. There was also a significant increase in incidents of robbery where weapons were involved. There were no increases in offences involving firearms, homicides or reported assaults.

Conclusion

The increased use of cocaine among injecting drug users following the heroin shortage led to increases in violent crime. Other States and territories that also experienced a heroin shortage but did not show any increases in cocaine use did not report any increase in violent crimes. The violent crimes committed did not involve guns, most likely because of its stringent gun laws, in contrast to the experience of American cities that have experienced high rates of cocaine use and violent crime.
Neck dissections: radical to conservative
Authors: Harish K
Published: April 2005

Background

Neck dissection is an important surgical procedure for the management of metastatic nodal disease in the neck. The gold standard of neck nodal management has been the radical neck dissection. Any modification in the neck dissection is always compared with this standard. Over the last few decades, in order to alleviate the morbidity of radical neck dissection, several modifications and conservative procedures have been advocated. These procedures retain certain lymphatic or non-lymphatic structures and have been shown not to compromise oncological safety.

Methods

A literature search of the Medline was carried out for all articles on neck dissections. The articles were systematically reviewed to analyze and trace the evolution of neck dissection. These were then categorized to address the nomenclature, management of node positive and node negative neck including those who had received chemoradiation.

Results

The present article discusses the neck nodal nomenclature, the radical neck dissection, its modifications and migration to more conservative procedures and possible advances in the near future.

Conclusion

Radical neck dissection is now replaced with modified radical neck dissections in most situations. Attempts are being made to replace modified radical neck dissections with selective neck dissections for early node positivity. Sentinel node biopsy is being studied to address the issue of node negative neck. More conservative surgeries are likely to replace the 'radical' surgeries of bygone era. This process is facilitated by earlier detection of the disease and better understanding of cancer biology.
VTE Risk assessment – a prognostic Model: BATER Cohort Study of young women
Authors: Heinemann Lothar AJ , DoMinh Thai , Assmann Anita , Schramm Wolfgang , Schürmann Rolf , Hilpert Jan , Spannagl Michael
Published: April 2005

Background

Community-based cohort studies are not available that evaluated the predictive power of both clinical and genetic risk factors for venous thromboembolism (VTE). There is, however, clinical need to forecast the likelihood of future occurrence of VTE, at least qualitatively, to support decisions about intensity of diagnostic or preventive measures.

Materials and methods

A 10-year observation period of the Bavarian Thromboembolic Risk (BATER) study, a cohort study of 4337 women (18–55 years), was used to develop a predictive model of VTE based on clinical and genetic variables at baseline (1993). The objective was to prepare a probabilistic scheme that discriminates women with virtually no VTE risk from those at higher levels of absolute VTE risk in the foreseeable future. A multivariate analysis determined which variables at baseline were the best predictors of a future VTE event, provided a ranking according to the predictive power, and permitted to design a simple graphic scheme to assess the individual VTE risk using five predictor variables.

Results

Thirty-four new confirmed VTEs occurred during the observation period of over 32,000 women-years (WYs). A model was developed mainly based on clinical information (personal history of previous VTE and family history of VTE, age, BMI) and one composite genetic risk markers (combining Factor V Leiden and Prothrombin G20210A Mutation). Four levels of increasing VTE risk were arbitrarily defined to map the prevalence in the study population: No/low risk of VTE (61.3%), moderate risk (21.1%), high risk (6.0%), very high risk of future VTE (0.9%). In 10.6% of the population the risk assessment was not possible due to lacking VTE cases. The average incidence rates for VTE in these four levels were: 4.1, 12.3, 47.2, and 170.5 per 104 WYs for no, moderate, high, and very high risk, respectively.

Conclusion

Our prognostic tool – containing clinical information (and if available also genetic data) – seems to be worthwhile testing in medical practice in order to confirm or refute the positive findings of this study. Our cohort study will be continued to include more VTE cases and to increase predictive value of the model.
Electroporation by nucleofector is the best nonviral transfection technique in human endothelial and smooth muscle cells
Authors: Iversen Nina , Birkenes Baard , Torsdalen Kari , Djurovic Srdjan
Published: April 2005

Background

The aim of this study was to determine the optimal non-viral transfection method for use in human smooth muscle cells (SMC) and endothelial cells (EC).

Methods

Coronary Artery (CoA) and Aortic (Ao) SMC and EC were transfected with a reporter plasmid, encoding chloramphenicol acetyltransferase type 1 (CAT), with seven different transfection reagents, two electroporation methods and a photochemical internalization (PCI) method. CAT determination provided information regarding transfection efficiency and total protein measurement was used to reflect the toxicity of each method.

Results

Electroporation via the nucleofector machine was the most effective method tested. It exhibited a 10 to 20 fold (for SMC and EC, respectively) increase in transfection efficiency in comparison to the lipofection method combined with acceptable toxicity. FuGene 6 and Lipofectamine PLUS were the preferred transfection reagents tested and resulted in 2 to 60 fold higher transfection efficiency in comparison to the PCI which was the least effective method.

Conclusion

This study indicates that electroporation via the nucleofector machine is the preferred non-viral method for in vitro transfection of both human aortic and coronary artery SMC and EC. It may be very useful in gene expression studies in the field of vascular biology. Through improved gene transfer, non-viral transfer techniques may also play an increasingly important role in delivering genes to SMC and EC in relevant disease states.
A balanced review of the status T cell-based therapy against cancer
Authors: Marincola Francesco M
Published: April 2005

A recent commentary stirred intense controversy over the status of anti-cancer immunotherapy. The commentary suggested moving beyond current anti-cancer vaccines since active-specific immunization failed to match expectations toward a more aggressive approach involving the adoptive transfer of in vitro expanded tumor antigen-specific T cells. Although the same authors clarified their position in response to others' rebuttal more discussion needs to be devoted to the current status of T cell-based anti-cancer therapy. The accompanying publications review the status of adoptive transfer of cancer vaccines on one hand and active-specific immunization on the other. Hopefully, reading these articles will offer a balanced view of the current status of antigen-specific ant-cancer therapies and suggest future strategies to foster unified efforts to complement either approach with the other according to specific biological principles.
Platelet-activating factor enhancement of calcium influx and interleukin-6 expression, but not production, in human microglia
Authors: Sattayaprasert Prasongchai , Choi Hyun B , Chongthammakun Sukumal , McLarnon James G
Published: April 2005

Calcium-sensitive fluorescence microscopy and molecular biology analysis have been used to study the effects of platelet-activating factor (PAF) on intracellular calcium [Ca2+]iand IL-6 expression in human microglia. PAF (applied acutely at 100 nM) elicited a biphasic response in [Ca2+]iconsisting of an initial rapid increase of [Ca2+]idue to release from internal stores, followed by a sustained influx. The latter phase of the [Ca2+]iincrease was blocked by SKF96365, a non-selective store-operated channel (SOC) inhibitor. RT-PCR analysis showed PAF treatment of microglia induced expression of the pro-inflammatory cytokine IL-6 in a time-dependent manner which was blocked in the presence of SKF96365. However, ELISA assay showed no production of IL-6 was elicited at any time point (1–24 h) for microglial exposures to PAF. These findings suggest that PAF stimulation of human microglia induces expression, but not production, of IL-6 and that SOC-mediated [Ca2+]iinflux contributes to the enhanced expression of the cytokine.
Transmission of human hepatitis C virus from patients in secondary cells for long term culture
Authors: Revie Dennis , Braich Ravi S , Bayles David , Chelyapov Nickolas , Khan Rafat , Geer Cheryl , Reisman Richard , Kelley Ann S , Prichard John G , Salahuddin S Zaki
Published: April 2005

Infection by human hepatitis C virus (HCV) is the principal cause of post-transfusion hepatitis and chronic liver diseases worldwide. A reliable in vitro culture system for the isolation and analysis of this virus is not currently available, and, as a consequence, HCV pathogenesis is poorly understood. We report here the first robust in vitro system for the isolation and propagation of HCV from infected donor blood. This system involves infecting freshly prepared macrophages with HCV and then transmission of macrophage-adapted virus into freshly immortalized B-cells from human fetal cord blood. Using this system, newly isolated HCV have been replicated in vitro in continuous cultures for over 130 weeks. These isolates were also transmitted by cell-free methods into different cell types, including B-cells, T-cells and neuronal precursor cells. These secondarily infected cells also produced in vitro transmissible infectious virus. Replication of HCV-RNA was validated by RT-PCR analysis and by in situ hybridization. Although nucleic acid sequencing of the HCV isolate reported here indicates that the isolate is probably of type 1a, other HCV types have also been isolated using this system. Western blot analysis shows the synthesis of major HCV structural proteins. We present here, for the first time, a method for productively growing HCV in vitro for prolonged periods of time. This method allows studies related to understanding the replication process, viral pathogenesis, and the development of anti-HCV drugs and vaccines.
Loess record of dry climate and aeolian activity in the early-to mid-Holocene, central Great Plains, North America
Authors: Miao Xiaodong , Mason Joseph , Goblet Ronald J. , Hanson Paul R.
Published: April 2005

Thick Holocene Bignell Loess sections provide new evidence for the timing of early to middle Holocene aridity in the central Great Plains. The immediate source of loess in these sections was dune fields just upwind, based on thickness trends and grain size data. Thus, periods of rapid loess accumulation indicate episodes of extensive dune activity under drier-than-present climate. In typical Bignell Loess sections, a thick zone of coarse-textured loess with minimal pedogenic alteration is interpreted as a record of the most rapid, sustained Holocene loess accumulation. Optical ages indicate that loess in this zone was deposited beginning about 9000-10000 years ago at five study sites. Accumulation ended shortly after 6500 years ago at three sites, but possibly earlier at the other two. In two well-dated sections, the average rate of loess accumulation between 9000-10000 and 6500 years ago was about 1.6-3.5 times greater than in the late Holocene. Thus, we infer that the most extensive, sustained Holocene dune field activity, reflecting sustained aridity, occurred from around 9000-10000 years ago to just after 6500 years ago. Comparison of the Bignell Loess record with other proxy data from the Great Plains indicates general agreement on an earlymiddle Holocene dry period, but also provides new evidence for spatial variation of early to middle Holocene climatic change, with possible time transgression, both from west to east and from north to south.
Hormone Receptor Status of a Contralateral Breast Cancer Is Independent of the Receptor Status of the First Primary in Patients Not Receiving Adjuvant Tamoxifen
Authors: Arpino G. , Weiss H.L. , Clark G.M. , Hilsenbeck S.G. , Osborne C.K.
Published: April 2005

Purpose

To determine whether the hormone receptor status of the primary breast cancer (PBC) is predictive of the hormone receptor status of the subsequent contralateral breast cancer (CBC).

Patients and Methods

We identified patients in our database with known estrogen receptor (ER; n = 193) and/or progesterone receptor (PgR; n = 178) status in their PBC and in their subsequent CBC. One hundred twenty-six of these patients had received no adjuvant therapy, 34 had received adjuvant tamoxifen, and 33 had received adjuvant chemotherapy alone. The median interval between the first diagnosis of PBC and the development of the subsequent CBC was 3 years. ER and PgR assays were assessed biochemically in two central reference laboratories using identical quality-controlled ligand-binding methods.

Results

Among systemically untreated patients (n = 126), 88% of patients with ER-positive PBC and 75% of patients with ER-negative PBC developed an ER-positive CBC (P = .11). Among the tamoxifen-treated patients, those with an ER-positive PBC were almost equally likely to develop an ER-positive (47%) or ER-negative (53%) CBC (P = .99). PgR status was similar. In the untreated group (n = 112), 59% of patients with a PgR-positive PBC and 66% with a PgR-negative PBC developed a PgR-positive CBC (P = .48). Among tamoxifen-treated patients (n = 33), 50% of patients with a PgR-positive PBC versus 27% of patients with a PgR-negative PBC developed a PgR-positive CBC (P = .28).

Conclusion

ER and PgR status of the primary tumor does not predict the hormone receptor status of the subsequent CBC in the absence of selective pressure of adjuvant therapy. Thus, other reasons should be considered to clarify the failure of tamoxifen to reduce the incidence of CBC in patients with a receptor-negative PBC.
Phase I Trial of 177Lutetium-Labeled J591, a Monoclonal Antibody to Prostate-Specific Membrane Antigen, in Patients With Androgen-Independent Prostate Cancer
Authors: Bander Neil H. , Milowsky Matthew I. , Nanus David M. , Kostakoglu Lale , Vallabhajosula Shankar , Goldsmith Stanley J.
Published: April 2005

Purpose

To determine the maximum tolerated dose (MTD), toxicity, human anti-J591 response, pharmacokinetics (PK), organ dosimetry, targeting, and biologic activity of 177Lutetium-labeled anti–prostate-specific membrane antigen (PSMA) monoclonal antibody J591 (177Lu-J591) in patients with androgen-independent prostate cancer (PC).

Patients and Methods

Thirty-five patients with progressing androgen-independent PC received 177Lu-J591. All patients underwent 177Lu-J591 imaging, PK, and biodistribution determinations. Patients were eligible for up to three retreatments.

Results

Thirty-five patients received 177Lu-J591, of whom 16 received up to three doses. Myelosuppression was dose limiting at 75 mCi/m2, and the 70-mCi/m2 dose level was determined to be the single-dose MTD. Repeat dosing at 45 to 60 mCi/m2 was associated with dose-limiting myelosuppression; however, up to three doses of 30 mCi/m2 could be safely administered. Nonhematologic toxicity was not dose limiting. Targeting of all known sites of bone and soft tissue metastases was seen in all 30 patients with positive bone, computed tomography, or magnetic resonance images. No patient developed a human anti-J591 antibody response to deimmunized J591 regardless of number of doses. Biologic activity was seen with four patients experiencing ≥ 50% declines in prostate-specific antigen (PSA) levels lasting from 3+ to 8 months. An additional 16 patients (46%) experienced PSA stabilization for a median of 60 days (range, 1 to 21+ months).

Conclusion

The MTD of 177Lu-J591 is 70 mCi/m2. Multiple doses of 30 mCi/m2 are well tolerated. Acceptable toxicity, excellent targeting of known sites of PC metastases, and biologic activity in patients with androgen-independent PC warrant further investigation.
A review of telemedicine in Uzbekistan
Authors: Doarn Charles R , Adilova Fatima , Lam David
Published: April 2005

The government of Uzbekistan has recognized the need for telemedicine. With the support of several international groups, three telemedicine programmes have been established. This international assistance has provided equipment and training. There is a national network of emergency medical services, and two e-referral projects, one led by the Swinfen Charitable Trust and the other by NATO. Although these have been successful, they continue to face similar difficulties. However, telemedicine has shown its value.
Determinants of the inherent strength of human 5′ splice sites
Authors: ROCA XAVIER , SACHIDANANDAM RAVI , KRAINER ADRIAN R.
Published: April 2005

We previously showed that the authentic 5′ splice site (5′ss) of the first exon in the human β-globin gene is intrinsically stronger than a cryptic 5′ss located 16 nucleotides upstream. Here we examined by mutational analysis the contribution of individual 5′ss nucleotides to discrimination between these two 5′ss. Based on the in vitro splicing efficiencies of a panel of 26 wild-type and mutant substrates in two separate 5′ss competition assays, we established a hierarchy of 5′ss and grouped them into three functional subclasses: strong, intermediate, and weak. Competition between two 5′ss from different subclasses always resulted in selection of the 5′ss that belongs to the stronger subclass. Moreover, each subclass has different characteristic features. Strong and intermediate 5′ss can be distinguished by their predicted free energy of base-pairing to the U1 snRNA 5′ terminus (ΔG). Whereas the extent of splicing via the strong 5′ss correlates well with the ΔG, this is not the case for competition between intermediate 5′ss. Weak 5′ss were used only when the competing authentic 5′ss was inactivated by mutation. These results indicate that extensive complementarity to U1 snRNA exerts a dominant effect for 5′ss selection, but in the case of competing 5′ss with similarly modest complementarity to U1, the role of other 5′ss features is more prominent. This study reveals the importance of additional submotifs present in certain 5′ss sequences, whose characterization will be critical for understanding 5′ss selection in human genes.
A role for eIF4E and eIF4E-transporter in targeting mRNPs to mammalian processing bodies
Authors: ANDREI MARIA ALEXANDRA , INGELFINGER DIERK , HEINTZMANN RAINER , ACHSEL TILMANN , RIVERA-POMAR ROLANDO , LÜHRMANN REINHARD
Published: April 2005

mRNP remodeling events required for the transition of an mRNA from active translation to degradation are currently poorly understood. We identified protein factors potentially involved in this transition, which are present in mammalian P bodies, cytoplasmic foci enriched in 5′ → 3′ mRNA degrading enzymes. We demonstrate that human P bodies contain the cap-binding protein eIF4E and the related factor eIF4E-transporter (eIF4E-T), suggesting novel roles for these proteins in targeting mRNAs for 5′ → 3′ degradation. Furthermore, fluorescence resonance energy transfer (FRET) studies indicate that eIF4E interacts with eIF4E-T and the putative DEAD box helicase rck/p54 in the P bodies in vivo. RNAi-mediated knockdowns revealed that a subset of P body factors, including eIF4E-T, LSm1, rck/p54, and Ccr4 are required for the accumulation of each other and eIF4E in P bodies. In addition, treatment of HeLa cells with cycloheximide, which inhibits translation, revealed that mRNA is also required for accumulation of mRNA degradation factors in P bodies. In contrast, knockdown of the decapping enzyme Dcp2, which initiates the actual 5′ → 3′ mRNA degradation did not abolish P body formation, indicating it first functions after mRNPs have been targeted to these cytoplasmic foci. These data support a model in which mRNPs undergo several successive steps of remodeling and/or 3′ trimming until their composition or structural organization promotes their accumulation in P bodies.
Human mitochondrial TyrRS disobeys the tyrosine identity rules
Authors: BONNEFOND LUC , FRUGIER MAGALI , GIEGÉ RICHARD , RUDINGER-THIRION JOËLLE
Published: April 2005

Human tyrosyl-tRNA synthetase from mitochondria (mt-TyrRS) presents dual sequence features characteristic of eubacterial and archaeal TyrRSs, especially in the region containing amino acids recognizing the N1-N72 tyrosine identity pair. This would imply that human mt-TyrRS has lost the capacity to discriminate between the G1-C72 pair typical of eubacterial and mitochondrial tRNATyr and the reverse pair C1-G72 present in archaeal and eukaryal tRNATyr. This expectation was verified by a functional analysis of wild-type or mutated tRNATyr molecules, showing that mt-TyrRS aminoacylates with similar catalytic efficiency its cognate tRNATyr with G1-C72 and its mutated version with C1-G72. This provides the first example of a TyrRS lacking specificity toward N1-N72 and thus of a TyrRS disobeying the identity rules. Sequence comparisons of mt-TyrRSs across phylogeny suggest that the functional behavior of the human mt-TyrRS is conserved among all vertebrate mt-TyrRSs.
‘Innocence’ consumed: packaging Edith Wharton with Kathleen Norris in Pictorial Review magazine, 1920–21
Authors: Thornton Edith
Published: April 2005

The article discusses the friction between magazine editors, illustrators, art directors, and authors as a case study of the conflicts of modernity and Wharton's frustrated role in these struggles for interpretive authority. I examine the promotional material and the magazine's efforts to draw Wharton, a ‘literary’ figure, and Norris, a popular romance novelist, to an idealized ‘middle ground’ to appeal to the broadest possible readership. I then consider the illustrations from both serials in the light of filmic and theatrical conventions of representation from the period. This analysis allows me to discuss the uses of realism and melodrama, nostalgia and the modern, to ‘sell’ the two very different books and the two very different authors to the same readers/viewers. It is an example of the clash of authority over texts and images over which no one had sole control; and in the ensuing mixture of messages, readers/viewers were offered multiple points of entry into both texts provided by a host of interested, and competing, producers. This is the first sustained discussion of the original illustrations ofThe Age of Innocenceand the first time they have been published since 1919–20, to the best of my knowledge.
The American culture-industry of image-making; part I
Authors: Hadjiafxendi Kyriaki , Rapatzikou Tatiani
Published: April 2005

This special issue covers the early history of the American culture-industry of image-making up to the twentieth century. It argues that the expansion of print and visual culture into all realms of American economic and political life was not solely a characteristic of a specifically
postmodern form of social organization. Rather this process of acculturation, which dates back to the emergence of consumerism in the eighteenth century, coincided with the foundation of the American state. The articles by Eric Homberger and Edith Thornton see the quest for identity as the
very factor by which American realist art and culture have developed a social bond. They suggest that the examination of such a search in relation to developing technologies of image reproduction has serious implications for nineteenth- and early twentieth-century American literary authorship.
Homberger's and Thornton's investigation forms the basis for the exploration of image-making as a technique of self-fashioning, which the next two issues of the European Journal of American Culture will examine in greater depth in relation to gender and (post-)modernist aesthetics.
Task Workload and Cognitive Abilities in Dynamic Decision Making
Authors: Gonzalez Cleotilde
Published: April 2005

Researchers often treat workload as a task-dependent variable. To evaluate the effect of workload on individuals' performance, researchers commonly use several methods, such as varying the complexity or number of tasks that test participants are asked to handle or placing individuals under time constraints. Only rarely have researchers investigated workload as a variable dependent on individuals' cognitive abilities. This study investigated workload during dynamic decision making in terms of its dependence on both task workload and cognitive abilities. The findings demonstrate detrimental effects of both high task workload and low cognitive abilities. Further, the results show that high workload is more detrimental in individuals with low cognitive abilities than in individuals with high cognitive abilities. Potential applications of this research include the design of new workload studies and new training protocols in which psychometric tests are used.
Warrants for Prescription: Analytically and Empirically Based Approaches to Improving Decision Making
Authors: Lipshitz Raanan , Cohen Marvin S.
Published: April 2005

Efforts to improve decision making must appeal to some source of warrant - that is, specific criteria or models for guiding and evaluating decision-making performance. We examine and compare the warrants for two approaches to decision aids, decision training, and consulting: analytically based prescription, which obtains warrant from formal models, and empirically based prescription, which obtains warrant from descriptive models of successful performance. We argue that empirically based warrants can provide a meaningful and valid basis for prescriptive intervention without committing the naturalistic fallacy (i.e., confusing what is with what ought to be) and without the use of formal deduction from first principles. We describe points of divergence as well as convergence in the types of warrant appealed to by naturalistic decision making and decision analysis, letting each approach shed light on the other, and explore the application of empirically based prescription to cognitive engineering. Actual or potential applications of this research include the development of training programs to improve various aspects of naturalistic decision making.
Testing a Model of Suicide Ideation in College Students
Authors: Konick Lisa C. , Gutierrez Peter M.
Published: April 2005

This study examined several risk factors—negative life events (NLE), hopelessness, and depressive symptoms—believed to commonly precipitate suicide ideation in college students. A total of 345 undergraduates participated in the study. Students completed four self‐report questionnaires. Hierarchical regression analyses were used to construct a risk model of suicide ideation. This study confirmed depressive symptoms and hopelessness as predictors of suicide ideation in college students; however, NLE impacted suicidal thoughts through hopelessness and depressive symptoms. Interestingly, depressive symptoms exerted a stronger influence on suicide ideation than hopelessness. Hopelessness served as a partial mediator in the relationship between NLE and depressive symptoms; however, depressive symptoms fully mediated the relationship between NLE and hopelessness. Clinical implications for understanding suicide risk in college students are discussed.
Is Suicide Ideation a Surrogate Endpoint for Geriatric Suicide?
Authors: Links Paul S. , Heisel Marnin J. , Quastel Adam
Published: April 2005

The present study explored the validity of treating suicide ideation as a surrogate endpoint that can serve as a proxy for suicide in clinical intervention research with suicidal seniors. Two criteria; that suicide ideation is modulated by the proposed intervention and that modulation of suicide ideation leads to a quantitative reduction in suicide rates, were the focus of this review. A series of literature searches of the PsychINFO and Medline databases were conducted on the terms geriatric, elderly, seniors, suicide, self‐destruction, clinical, randomized, trial, treatment, intervention, and ideation. Articles were analyzed if they provided sufficient information to examine whether an intervention effectively led to a reduction in suicide ideation among seniors. Two hundred and eight articles were considered for potential inclusion in this study, with 19 articles meeting final inclusion criteria. The articles reviewed were divided into three broad categories: articles supporting suicide ideation as a surrogate endpoint for geriatric suicide (n = 6); those not supporting this hypothesis (n = 1); and those providing insufficient information to test the hypothesis (n = 12). The present analysis provided modest evidence for suicide ideation as a surrogate endpoint for geriatric suicide, due, in part, to a paucity of randomized controlled trials of treatment interventions for suicidal seniors, thus demonstrating a clear need for research in this area. Implications of utilizing surrogate endpoints in suicide research are discussed.
Selbstüberwachender Durchflusssensor mit diversitärer Redundanz (Self Monitoring Flowmeter with Diversity)
Authors: Müller Ralf , Nuber Michael , Werthschützky Roland
Published: April 2005

In diesem Beitrag wird ein Durchflusssensor mit Redundanz zur Selbstüberwachung für Flüssigkeiten vorgestellt. Der Sensor nutzt zeitgleich zwei unabhängige Verfahren zur Bestimmung des Durchflusses: das Wirkdruck- und das Wirbelfrequenzverfahren. Beide Messgrößen werden mit demselben Differenzdrucksensor aufgenommen, um die Zahl der zusätzlichen Komponenten möglichst gering zu halten. Die Selbstüberwachung wird dadurch realisiert, dass beide Messprinzipien unterschiedlich auf verschiedene Einflussgrößen reagieren und somit bei Störungen differierende Messwerte ausgeben.
Neues Messverfahren zur Bestimmung der Schirmwirkung mittels ultrabreitbandiger elektromagnetischer Feldimpulse (New Measuring Method for the Determination of the Shielding Properties by means of Ultra Wideband Electromagnetic Field Pulses)
Authors: Herlemann Helge , Koch Michael , Camp Michael , Sabath Frank
Published: April 2005

In diesem Beitrag wird ein Zeitbereichsmessverfahren mit doppelt-exponenziellen Pulsen vorgestellt, das zur Bestimmung der Schutzwirkung leitfähiger Schirme, die zum Schutz von Elektronik gegen pulsartige elektromagnetische Felder eingesetzt werden, genutzt werden kann. Mit den verwendeten Pulsen wird die Störfestigkeit eines im Betrieb befindlichen Testobjekts im geschirmten und ungeschirmten Zustand bestimmt. Die Schutzwirkung des Schirms ergibt sich aus den verschiedenen Feldstärken, bei denen bestimmte Ausfallerscheinungen auftreten. Das Messverfahren basiert auf Wahrscheinlichkeiten der Störung bzw. der Zerstörung des Testobjekts. Testreihen mit Mikrocontrollern und Mikroprozessorboards zeigen entgegen den Erwartungen eine überraschende Übereinstimmung der Testergebnisse.
Collapse as Cultural Revolution: Power and Identity in the Tiwanaku to Pacajes Transition
Authors: Janusek John Wayne
Published: April 2005

Inherent foundations of power are often made explicit in state collapse and ethnogenesis, among the most problematic processes tackled by archaeologists. Recent research on collapse globally indicates that conventional models prioritizing external change (e.g., environmental shift, immigration) fail to address the historical intricacies of and human agency involved in state fragmentation. Some recent models treat collapse as a sudden drop in political complexity, and most fail to elaborate how state collapse influenced postcollapse sociopolitical and cultural patterns. Synthesizing substantial recent research on Tiwanaku (A.D. 500–1150) and post‐Tiwanaku Pacajes (A.D. 1150–1450) polities in the south‐central Andes, I suggest that state collapse involved a fateful conjunction of sociopolitical and environmental transformations. Drought conditions descended upon a centralized yet highly fragile sociopolitical landscape that had become increasingly volatile during Tiwanaku's apogee. Collapse involved rapid transformation as well as slow, cumulative shifts and enduring continuities. It was a cultural revolution that began during Tiwanaku hegemony and drew heavily on existing practices and ideals. Grounded in practice theory, this case study finds human agency squarely in the center of macroprocesses such as collapse and situates Andean foundations of power in the matrix of local ideals, practices, and identities from which hegemonic regimes such as Tiwanaku were forged.
Arrowroot as a treatment for diarrhoea in irritable bowel syndrome patients: a pilot study
Authors: COOKE Caroline , CARR Irene , ABRAMS Keith , MAYBERRY John
Published: April 2005

Objectives - Arrowroot is an old-fashioned remedy for diarrhoea, but no clinical studies have been done to evaluate its effectiveness. The aim of this pilot study was to assess its efficacy as a treatment for diarrhoea in 11 patients, all of whom had irritable bowel syndrome with diarrhoea as a feature. Methods - The patients were interviewed and a questionnaire completed on entry into the trial. They then took 10 mL arrowroot powder three times a day for one month and discontinued the treatment for the subsequent month. Questionnaires were completed after one month on treatment and at the end of the trial after one month off treatment. Results - Arrowroot reduced diarrhoea and had a long-term effect on constipation. It also eased abdominal pain. Conclusion - Arrowroot is an effective treatment for diarrhoea. Its action could be explained by several theories which relate to an increase in faecal bulk and thus a more efficient bowel action. The number of patients was small, and further studies are needed to substantiate preliminary results.
Freqüência de pólipos em doentes operados de câncer colorretal
Authors: ROCHA Beatriz Pinho , FERRARI Ângelo Paulo , FORONES Nora Manoukian
Published: April 2005

Introdução - Estudos epidemiológicos e gênicos mostram que os pólipos colônicos do tipo adenoma são lesões pré-neoplásicas. O seguimento de um paciente com câncer colorretal visa principalmente o diagnóstico e retirada de pólipos adenomatosos. Objetivo - Estudar a freqüência do aparecimento de pólipos adenomatosos em doentes com câncer colorretal em acompanhamento clínico após ressecção tumoral. Casuística e Métodos - Foi estudada, retrospectivamente, a freqüência de pólipos do tipo adenoma em 68 pacientes com idade média de 59 anos, submetidos a cirurgia curativa para tratamento de câncer colorretal e a colonoscopia de controle. Resultados - A incidência de pólipos adenomatosos foi de 18%, sendo maior acima de 45 anos (20%) e no cólon esquerdo (38%). Em relação ao tipo histológico, 61% eram tubulares, 22% vilosos e 17% túbulo-vilosos. Discussão - Assim como em outros relatos da literatura, a incidência de pólipos foi superior em indivíduos com mais de 45 anos, sendo em mais da metade do tipo tubular. A freqüência de pólipos foi maior nos dois primeiros anos de acompanhamento.
Hipocontratilidade do esôfago em pacientes com doença de chagas e pacientes com acalásia idiopática
Authors: DANTAS Roberto Oliveira
Published: April 2005

Em pacientes com esofagopatia chagásica e pacientes com acalásia, a amplitude das contrações esofágicas está diminuída. Como nem todas as deglutições são seguidas de contrações com baixa amplitude, avaliamos o número de contrações com amplitude abaixo de 30 mm Hg em 40 voluntários assintomáticos, 99 pacientes com doença de Chagas e 14 pacientes com acalásia idiopática. Cada paciente ou voluntário realizou 10 deglutições de 5 mL de água e o registro das contrações foi feito a 5 cm, 10 cm e 15 cm proximal ao esfíncter inferior do esôfago. Neste registro foi utilizado o método manométrico com perfusão contínua. O número de contrações com hipocontratilidade foi maior nos pacientes com doença de Chagas e pacientes com acalásia do que nos voluntários (P <0,05). Pacientes chagásicos com trânsito lento no exame radiológico mas sem dilatação do esôfago tiveram mais contrações com baixa amplitude do que pacientes com exame radiológico normal (P <0,01). O mesmo resultado se obteve quando da análise do número de indivíduos com três ou mais contrações com baixa amplitude (P <0,01). Os pacientes chagásicos com disfagia tiveram mais contrações com hipocontratilidade do que aqueles sem disfagia (P <0,05). Concluímos que na doença de Chagas e na acalásia idiopática ocorre maior número de contrações esofágicas com baixa amplitude do que em pessoas normais, o que deve contribuir para a sintomatologia dos pacientes.
Avaliação qualitativa e quantitativa do esvaziamento gástrico através do método videofluoroscópico
Authors: FIRMAN Claudia M. G. , COSTA Milton M. B. , COSTA Manoel L. , LEMME Eponina
Published: April 2005

Estudo do esvaziamento gástrico de 21 voluntários sadios, usando dieta padrão composta por homogeneizado de lipídios, carboidratos, proteínas e solução de sulfato de bário. Efetuaram-se, para cada voluntário, seis registros videofluoroscópicos em incidência póstero-anterior, com duração de um minuto, a intervalos de 12 minutos na primeira hora e, a seguir, a cada 30 minutos, até o esvaziamento total. Oito exames foram selecionados para a quantificação do esvaziamento. A análise da seqüência de registros videofluoroscópicos permitiu observar e estimar, de modo subjetivo, o comportamento funcional e o ritmo do esvaziamento gástrico. A digitalização de imagens representativas dos diversos tempos do esvaziamento gástrico permitiu quantificar as observações e estabelecer uma curva índice deste. A quantificação foi realizada com o uso de rotina desenvolvida no software Image pro-plus da Media Cybernetics. Conclusões - 1. A videofluoroscopia permitiu, com adequada resolução, a análise qualitativa da motilidade e do esvaziamento gástrico. 2. É possível quantificar as variações de forma que se observa na seqüência de imagens registradas pelo método videofluoroscópico. 3. Os resultados expressam um índice de esvaziamento gástrico, determinado pela variação temporal da projeção da área gástrica em imagens radiológicas obtidas em incidência póstero-anterior. 4. A análise quantitativa não deve prescindir da análise qualitativa.
Apendicite aguda: modelo experimental em coelhos
Authors: EBRAM-NETO João , CELANO Rosa Maria Gaudioso , LANZONI Valéria Ferreira , JULIANO Yara , NOVO Neil Ferreira , CAUDURO Antonio Baptista , SPERANZINI Manlio Basilio
Published: April 2005

Com objetivo de estudar experimentalmente as diversas fases evolutivas da apendicite aguda, foram utilizados 60 coelhos (Oryctogalus cuniculus), fêmeas, da linhagem Nova Zelândia, com peso variando de 2510 a 3040 gramas. Os animais foram divididos em dois grupos denominados controle e experimento, e estes subdivididos em três subgrupos com períodos de observação de 12, 24 e 48 horas. No grupo experimento foi realizada a oclusão do lume apendicular por meio de sutura seromuscular circular a 8 cm da extremidade distal do apêndice cecal, com fio de polipropileno 4-0. No controle foi feita somente a simulação da cirurgia. Os aspectos macroscópicos (aumento do tamanho, necrose, perfuração, aderência e secreção na cavidade abdominal) bem como os microscópicos do grupo experimento, evidenciaram uma progressão das alterações anatomopatológicas mostrando haver uma relação entre a intensidade dos achados histopatológicos e o tempo de observação. Conclui-se que o método utilizado causa apendicite aguda com alterações anatomopatológicas distintas, de acordo com a fase evolutiva da doença.
Implicações do alcoolismo e da doença hepática crônica sobre o metabolismo de micronutrientes
Authors: MAIO Regiane , DICHI Jane Bandeira , BURINI Roberto Carlos
Published: April 2005

A doença hepática, alcoolismo e desnutrição são condições comumente associadas que interferem no metabolismo de micronutrientes. Como resultado da doença hepática pode ocorrer menor estocagem e conversão de vitaminas nas suas formas ativas, e má digestão e/ou má absorção. Há ainda o agravante do álcool diminuindo a ingestão e absorção de micronutrientes em virtude da redução da ingestão dietética e de sua associação com doença do intestino delgado ou pancreática. Outras causas de deficiências seriam: tratamento com drogas, peroxidação lipídica, déficit protéico, maior excreção urinária e aumento da necessidade e degradação de nutrientes. Como conseqüências dessas deficiências, esses pacientes apresentam usualmente anemia, esteatose hepática, estresse oxidativo e imunossupressão.
Carcinoma hepatocelular: parte 2. Tratamento
Authors: CONTE Vinício Paride
Published: April 2005

São revisadas as formas de tratamento, particularmente as ressecções cirúrgicas, a quimioembolização arterial e as injeções percutâneas de etanol e de ácido acético. Alguns aspectos relativos à dieta, com particular atenção à aflatoxina B1 e aos retinóides, são abordados quanto ao seu desempenho na etiopatogenia e no tratamento da afecção mais comumente encontrada nos países em desenvolvimento. Em relação ao tratamento, fazem-se considerações também referentes ao uso de octreotide, nitrosaminas e outras drogas. A coagulação intersticial a laser e as drogas de ação antivascular também mereceram abordagem sucinta. O problema do carcinoma hepatocelular precoce e a sua destruição é sinalizado de modo sumário. A quimioprevenção com o uso do interferon alfa recombinante considerado e o transplante de fígado encerram a revisão, antes dos comentários finais.
Gastric cryptosporidiosis as a clue for the diagnosis of the acquired immunodeficiency syndrome
Authors: CLEMENTE Cyntia Mendes , CARAMORI Carlos Antonio , PADULA Pedro , RODRIGUES Maria Aparecida Marchesan
Published: April 2005

Cryptosporidium parvum has been detected with increasing frequency in the gastrointestinal tract, but involvement of the stomach is rarely reported. Whenever found in the histologic examination of the gastrointestinal mucosa, it should raise the suspicion of an immunocompromised host. We report a case of Cryptosporidium-associated erosive gastritis in a 64-year-old woman, who was found later to have the acquired immunodeficiency syndrome. Gastroduodenoendoscopy and biopsy of the gastric mucosa played an invaluable role in the diagnosis of cryptosporidiosis and to disclose the underlying immunodeficiency state
Tratamento laparoscópico de coledocolitíase
Authors: MACHADO Marcel Autran C. , ROCHA Julio Rafael Mariano da , HERMAN Paulo , MONTAGNINI André Luís , MACHADO Marcel Cerqueira Cesar
Published: April 2005

Paciente com história de 18 meses de emagrecimento e icterícia foi encaminhado ao Serviço de Cirurgia Abdominal do Hospital do Câncer, São Paulo, SP., com hipótese diagnóstica de câncer de cabeça de pâncreas. Exames laboratoriais mostraram elevação de bilirrubinas e de enzimas canaliculares. Ultra-sonografia abdominal revelou dilatação de via biliar intra e extra-hepática. Tomografia computadorizada mostrou árvore biliar dilatada com presença de cálculo de cerca de 3 cm em colédoco distal. O paciente foi submetido a colecistectomia com coledocotomia, retirada do cálculo e anastomose colédoco-duodenal por laparoscopia. Evoluiu sem intercorrências, recebendo alta no sexto dia de pós-operatório. Conclui-se que o tratamento laparoscópico da coledocolitíase é factível em alguns pacientes, especialmente naqueles com dilatação de via biliar. A retirada de cálculos deve ser seguida de procedimento de drenagem da via biliar com dreno de Kehr. Em alguns pacientes com colédoco cronicamente dilatado, como o do presente caso, a anastomose colédoco-duodenal é o procedimento de escolha.
Esôfago em quebra-nozes -- avaliação clínica de 97 pacientes
Authors: SILVA Luiz Filipe Duarte , LEMME Eponina Maria de Oliveira
Published: April 2005

O esôfago em quebra-nozes é uma anormalidade manométrica, incluída entre os distúrbios motores primários do esôfago, caracterizada por ondas peristálticas que atingem elevada amplitude em esôfago distal, descrita inicialmente em pacientes com dor torácica não-cardíaca. Embora trabalhos posteriores tenham registrado o esôfago em quebra-nozes em pacientes com disfagia e, mais recentemente, o associado à doença do refluxo gastroesofágico, há bastante controvérsia em relação ao seu verdadeiro significado, sendo escassos os estudos clínicos envolvendo grande número de pacientes. Noventa e sete pacientes com o diagnóstico manométrico de esôfago em quebra-nozes, definido a partir de um grupo controle assintomático, foram estudados retrospectivamente quanto às características clínicas e propedêutica esofagiana, que incluiu endoscopia digestiva alta, esofagografia convencional e pHmetria esofagiana prolongada. Houve predomínio do sexo feminino (63,9 %), com média de idade de 54,3 anos. A queixa mais freqüente que determinou a realização do exame manométrico foi dor torácica, seguida de disfagia e pirose. As manifestações clínicas como um todo foram dor torácica (53,6%), disfagia (52,6%), pirose (52,6%), regurgitação (21,6%), queixas otorrinolaringológicas (15,4%), dispepsia (15,4%) e odinofagia (4,1%). A maior parte dos pacientes apresentou sintomas múltiplos, sendo queixa única observada em 28% dos mesmos. A endoscopia digestiva alta demonstrou esofagite erosiva em 8% dos pacientes e a esofagografia convencional revelou distúrbio motor esofagiano em 16,4%. A pHmetria esofagiana prolongada diagnosticou refluxo gastroesofagiano anormal em 41,2% dos exames realizados. Concluiu-se que, controvérsias à parte, são encontradas outras queixas além de dor torácica e disfagia associadas ao esôfago em quebra-nozes e que é importante definir a associação com a doença do refluxo gastroesofágico para orientar a conduta terapêutica.