bluuebunny/crossref_metadata_2025 huggingface dataset:
Continuous spinal anesthesia versus combined spinal epidural block for major orthopedic surgery: prospective randomized study
Authors: Imbelloni Luiz Eduardo , Gouveia Marildo Assunção , Cordeiro José Antonio
Published: May 2009

CONTEXT AND OBJECTIVES: In major orthopedic surgery of the lower limbs, continuous spinal anesthesia (CSA) and combined spinal epidural anesthesia (CSE) are safe and reliable anesthesia methods. In this prospective randomized clinical study, the blockading properties and side effects of CSA were compared with single interspace CSE, among patients scheduled for major hip or knee surgery. DESIGN AND SETTING: Prospective clinical study conducted at the Institute for Regional Anesthesia, Hospital de Base, São José do Rio Preto. METHODS: 240 patients scheduled for hip arthroplasty, knee arthroplasty or femoral fracture treatment were randomly assigned to receive either CSA or CSE. Blockades were performed in the lateral position at the L3-L4 interspace. Puncture success, technical difficulties, paresthesia, highest level of sensory and motor blockade, need for complementary doses of local anesthetic, degree of technical difficulties, cardiocirculatory changes and postdural puncture headache (PDPH) were recorded. At the end of the surgery, the catheter was removed and cerebrospinal fluid leakage was evaluated. RESULTS: Seven patients were excluded (three CSA and four CSE). There was significantly lower incidence of paresthesia in the CSE group. The resultant sensory blockade level was significantly higher with CSE. Complete motor blockade occurred in 110 CSA patients and in 109 CSE patients. Arterial hypotension was observed significantly more often in the CSE group. PDPH was observed in two patients of each group. CONCLUSION: Our results suggest that both CSA and CSE provided good surgical conditions with low incidence of complications. The sensory blockade level and hemodynamic changes were lower with CSA.
Immunoarchitectural characterization of a human skin model reconstructed in vitro
Authors: Souto Luís Ricardo Martinhão , Vassallo José , Rehder Jussara , Pinto Glauce Aparecida , Puzzi Maria Beatriz
Published: May 2009

CONTEXT AND OBJECTIVE: Over the last few years, different models for human skin equivalent reconstructed in vitro (HSERIV) have been reported for clinical usage and applications in research for the pharmaceutical industry. Before release for routine use as human skin replacements, HSERIV models need to be tested regarding their similarity with in vivo skin, using morphological (architectural) and immunohistochemical (functional) analyses. A model for HSERIV has been developed in our hospital, and our aim here was to further characterize its immunoarchitectural features by comparing them with human skin, before it can be tested for clinical use, e.g. for severe burns or wounds, whenever ancillary methods are not indicated. DESIGN AND SETTING: Experimental laboratory study, in the Skin Cell Culture Laboratory, School of Medical Sciences, Universidade Estadual de Campinas. METHODS: Histological sections were stained with hematoxylin-eosin, Masson's trichrome for collagen fibers, periodic acid-Schiff reagent for basement membrane and glycogen, Weigert-Van Gieson for elastic fibers and Fontana-Masson for melanocytes. Immunohistochemistry was used to localize cytokeratins (broad spectrum of molecular weight, AE1/AE3), high molecular weight cytokeratins (34βE12), low molecular weight cytokeratins (35βH11), cytokeratins 7 and 20, vimentin, S-100 protein (for melanocytic and dendritic cells), CD68 (KP1, histiocytes) and CD34 (QBend, endothelium). RESULTS: Histology revealed satisfactory similarity between HSERIV and in vivo skin. Immunohistochemical analysis on HSERIV demonstrated that the marker pattern was similar to what is generally present in human skin in vivo. CONCLUSION: HSERIV is morphologically and functionally compatible with human skin observed in vivo.
Measurement of tibial slope angle after medial opening wedge high tibial osteotomy: case series
Authors: Yanasse Ricardo Hideki , Cavallari Carlos Eduardo , Chaud Felipe Lourenço , Hernandez Arnaldo José , Mizobuchi Roberto Ryuiti , Laraya Marcos Henrique
Published: May 2009

CONTEXT AND OBJECTIVE: In the past, changes in tibial slope were not considered when planning or evaluating osteotomies, and success in high tibial osteotomy was related to the alignment and amount of femorotibial angular correction. The aim here was to measure changes in tibial slope after medial opening wedge tibial osteotomy and investigate the effect of tibial slope angle on the clinical results. DESIGN AND SETTING: Retrospective review study on a series of cases, at the Department of Orthopedics and Traumatology, Faculdade de Medicina de Marília (Famema), Marília, Brazil. METHODS: Twenty-eight patients were studied, and a total of thirty-one knees. Lateral roentgenograms of the tibia were used pre and postoperatively to measure the tibial slope based on the proximal tibial anatomical axis. The clinical results were measured using the Lysholm knee score. RESULTS: There was an average increase in tibial slope angle after surgery of 2.38° (95% confidence interval: ± 0.73°). There was no correlation (r = -0.28) between the postoperative Lysholm knee score and the difference in tibial slope angle from before to after surgery (P = 0.13). CONCLUSION: Medial opening wedge tibial osteotomy led to a small increase in tibial slope. No significant correlation was found between increased tibial slope and short-term clinical results after high tibial osteotomy. Other clinical studies are needed in order to establish whether extension or flexion osteotomy could benefit patients with medial compartment gonarthrosis.
Description of the ootheca of Turbinella laevigata (Mollusca, Gastropoda)
Authors: Matthews-Cascon Helena , Rocha-Barreira Cristina de Almeida , Meirelles Carlos , Bigatti Gregorio , Penchaszadeh Pablo
Published: May 2009

Turbinella laevigata is found since the intertidal zone up to 40 m depth, being endemic of Brazil where it occurs from the state of Amapá to the state of Espirito Santo. The objective of this study was to describe the ootheca of this species. Fifteen samples collected in the Olho d'Água Beach, City of Icapuí and Fleixeiras Beach, City of Trairí, both in Ceará State, Northeast Brazil, were studied. The spawns were composed by 15 +/- 1.4 SD capsules and had 63 +/- 6.4 SD mm of length with 41 +/- 2.5 SD mm of width. They had a convex and a concave surface, and plaited edges that drew out until the basal membrane, to which they joined forming a medial ridge. This species apparently produced a high amount of nurse eggs. The early juveniles measured 6.4 +/- 0.7 SD mm of length and they presented a protoconch with three whorls.
Length-weight relationship and condition factor of the mangrove crab Ucides cordatus (Linnaeus, 1763) (Crustacea, Brachyura, Ucididae)
Authors: Pinheiro Marcelo Antonio Amaro , Fiscarelli Ana Gláucia
Published: May 2009

The relationship of wet weight (WT) to cephalothorax width (CW) and temporal and seasonal variations in the condition factor were analyzed for each sex of the mangrove crab Ucides cordatus, using specimens collected monthly from September 1998 through September 2000, at Iguape, state of São Paulo. The WT/CW relationship, determined by the regression analysis and the condition factor were evaluated individually, monthly and seasonally, for each sex. The WT/CW relationship indicated isometric growth in males and negative allometric growth in females. Body weight was higher in males than in females of equivalent size and this difference was associated with the males' faster growth and heavier chelipeds. On the other hand, the means for condition factor were always higher for females than for males; the mean condition factor was lower in spring and summer and higher in autumn and winter.
Plant population structure and insect herbivory on Solanum mauritianum Scopoli (Solanaceae) in southern Brazil: a support to biological control
Authors: Barboza Deise Mari , Marques Márcia Cristina Mendes , Pedrosa-Macedo José Henrique , Olckers Terence
Published: May 2009

Solanum mauritianum Scopoli (Solanaceae), a native Brazilian shrub, has become naturalized and invasive in several countries. In South Africa, where invasions are severe, herbivorous insects that attack S. mauritianum in its native area have been considered for introduction as biological control agents. To assess the action of such herbivores on the plant, studies were carried out on a population of S. mauritianum in an area undergoing regeneration in southern Brazil. An analysis of the structure of that population was performed, as well as of herbivory by insects, in particular of Anthonomus (Curculionidae). The population structure showed an "inverted J" pattern in diameter classes, but not in height classes. Individual plants showed an aggregate distribution. The damage caused by Anthonomus did not amount to the loss of a large leaf area, but since it was inflicted on young leaves and in a large proportion, could lead to the survival decrease.
Evaluation of the water quality of tidal creeks of Pontal do Paraná, Paraná, Brazil
Authors: Siqueira Adriana , Godinho Mirna Januária Leal , Kolm Hedda Elisabeth , Machado Eunice da Costa
Published: May 2009

The aim of this wat was to evaluate the water quality in four tidal creeks of Paraná, Brazil, with different anthropic influences. Samples were collected every three months. Temperature, salinity, pH, alkalinity, total CO2, dissolved O2, nitrite, nitrate, N-ammoniacal, phosphate, silicate, particulate suspended matter, humic matter, total chlorophyll, total and fecal coliform bacteria of surface water were measured in each sample and compared. For all the stations water temperature was lower in winter, but ranged within typically subtropical values. Salinity (7 - 25) and pH (7.08 - 7.91) were higher in Perequê tidal creek indicating that only this tidal creek was strongly influenced by the nearby ocean waters. Lower dissolved O2, reaching anoxic levels along with higher phosphate and N-ammoniacal concentrations and higher total (<200 - 160,000 MPN 100 ml-1) and thermotolerant coliforms (<200 - 50,000 MPN 100 ml-1) in Olho d´Água suggested euthrophication, especially in summer when rainfall was higher and tourism was at its peak. Perequê, Penedo and Barranco Creeks were characterized as meso- and oligotrophic environments.
Análise da pozolanicidade da cinza da casca da castanha do caju pelo método de difratometria de raios X
Authors: Lima S.A. , Rossignolo J.A.
Published: May 2009

Atualmente, o aproveitamento de resíduos na construção civil tem sido estimulado, uma vez que esse setor apresenta-se como um dos maiores consumidores de materiais naturais em seus processos e produtos. As cinzas ocupam lugar de destaque entre os resíduos agroindustriais por resultarem de processos de geração de energia. Grande parte dessas cinzas possui atividade pozolânica, podendo ser utilizada como substituto parcial do cimento Portland, resultando numa economia significativa de energia e custo. Este trabalho faz parte de uma pesquisa mais ampla, a qual busca avaliar a viabilidade técnica da cinza da casca da castanha de caju (CCCC) como adição mineral em matrizes de cimento Portland, como também, propor uma metodologia de análise de cinzas agroindustriais. Aplicou-se a técnica de difratometria de raios X para avaliar a reatividade do hidróxido de cálcio pela cinza da casca da castanha de caju em pastas, empregaram-se teores de substituição entre 2,5 e 30,0% e os difratogramas das pastas foram comparados com os das pastas confeccionadas com sílica ativa, executados sobre as mesmas condições de ensaio. Os resultados apontam para a ausência de reatividade pozolânica da CCCC com o cimento Portland.
Desenvolvimento de um equipamento para ensaio de fadiga térmica
Authors: Brandim A.S. , Sousa R.R.M. , Alves Jr. C.
Published: May 2009

Este trabalho apresenta a análise termo-mecânica do aço inoxidável martensítico 423Co quando submetido a um ensaio de fadiga térmica visando simular as condições de trabalho de rolos de lingotamento contínuo. Para tanto, foi desenvolvido um equipamento que reproduzisse o comportamento dos materiais quando submetidos a contínuos gradientes térmicos. Nesse estudo foram considerados os seguintes parâmetros: o sistema de aquecimento e resfriamento para geração dos ciclos térmicos; o tipo e geometria do corpo-de-prova; a restrição total e o controle do estado de tensões aplicados no corpo-de-prova durante o ensaio. O monitoramento e o controle desses parâmetros foram realizados por um sistema de aquisição de dados que permitiu a correção "in-locu" dos mesmos durante o ensaio. Foi observado que esses parâmetros propiciaram de forma eficaz a simulação eficientemente do fenômeno da fadiga térmica, nos materiais estudados, principalmente no aço inoxidável martensítico 423Co, foco desse trabalho. Os ensaios de fadiga térmica realizados no equipamento mostram a evolução dos principais mecanismos de deterioração nos metais, particularmente para o aço inoxidável martensítico 423Co utilizado como revestimento dos rolos de lingotamento contínuo.
Hipotensão pós-exercício aeróbio: uma revisão sistemática
Authors: Casonatto Juliano , Polito Marcos Doederlein
Published: May 2009

Diversos estudos investigaram os efeitos hipotensores após uma sessão de exercício aeróbio em humanos. No entanto, vários aspectos permanecem obscuros em relação à hipotensão pós-exercício (HPE), uma vez que diversas variáveis podem influenciar a resposta hipotensora, como intensidade, duração, tipo de exercício, estado clínico, faixa etária, etnia, sexo e estado de treinamento. Nesse sentido, o objetivo do presente estudo foi revisar sistematicamente a literatura, relacionando as principais variáveis da prescrição de uma sessão de exercício aeróbio e a HPE, assim como apresentar os possíveis mecanismos envolvidos. Foram encontrados 55 estudos que abrangeram a temática HPE e exercício aeróbio em humanos. A ocorrência da HPE está bem estabelecida na literatura, já que vários estudos identificaram reduções da pressão arterial em normotensos e hipertensos. Porém, os possíveis moduladores das respostas hipotensoras, como intensidade e duração da sessão de exercício, ainda são contraditórios. Em relação ao tipo de exercício, porém, existem indicativos de que os realizados de forma intermitente e que utilizam maior massa muscular podem acarretar maior HPE. Além disso, hipertensos devem apresentar maior magnitude e duração da HPE. Contudo, existem lacunas em relação aos diversos mecanismos fisiológicos envolvidos, que parecem ser diferentes entre normotensos e hipertensos.
Avaliação da estimulação elétrica transcutânea do nervo para alívio de dor após cesárea: ensaio clínico randomizado
Authors: Sousa Ligia , Gomes Flávia Azevedo , Pitangui Ana Carolina Rodarti , Nakano Ana Márcia Spanó
Published: May 2009

OBJETIVOS: avaliar a utilização da estimulação elétrica transcutânea do nervo no alívio de dor após cesárea. MÉTODOS: realizou-se um estudo clínico controlado randomizado e simples-cego. Participaram do estudo 20 puérperas no grupo experimental que recebiam a estimulação elétrica transcutânea do nervo e 20 no grupo controle. Para avaliar a dor foi usada a escala de categoria numérica e o questionário de dor McGill. Foram realizadas três avaliações: a primeira antes da intervenção com a estimulação elétrica transcutânea do nervo, a segunda após a intervenção e a terceira, uma hora após a intervenção. Para a análise estatística foi utilizado o teste nãoparamétrico de Mann-Whitney U. RESULTADOS: o grupo experimental apresentou redução maior da dor estatisticamente significante que o grupo controle na segunda e na terceira avaliação pela escala numérica de dor (p<0,001) e pelo McGill (p<0,001). CONCLUSÕES: a estimulação elétrica transcutânea do nervo é eficaz para a redução da dor e este alívio permanece por, pelo menos, uma hora após sua aplicação, podendo ser utilizada na prática clínica e como recurso não-farmacológico de humanização no puerpério de cesárea.
A Review of Side Effects and Adverse Events of Non-Drug Medicine (Nonpharmaceutical Complementary and Alternative Medicine): Psychotherapy, Mind-Body Medicine and Clinical Holistic Medicine
Authors: Ventegodt Søren , Merrick Joav
Published: May 2009

Background: Review of side effects of psychotherapy, bodywork (without high-energy manipulations), mind-body medicine, body-psychotherapy, sexology, clinical holistic medicine and complementary and alternative medicine (CAM).Method: We reviewed 857 records from a combined Medline/PubMed and PsycINFO search on psychotherapy AND side effects" We also searched for mind-body medicine," bodywork," body-psychotherapy," clinical holistic medicine," CAM," sexology," sexological examination," physiotherapy," and specific side effects like psychosis," re-traumatization," suicide," "hypomania," depersonalisation," derealization" and the drugs Lysergic acid diethylamide (LSD-25), psilosybin," mescaline," Peyote" and MDMA (3,4-methylenedioxy-N-methamphetamine (MDMA) for searches. We looked for all case reports 1950-2009 and studies that included data on side effects and negative events.Results: Non-drug medicine did not have significant side effects (NNH (number needed to harm)> 18,000) and the only severe side effect was rare, brief reactive psychosis, a temporary illness with full recovery (NNH >65,000). Non-drug therapy did not significantly cause re-traumatization, implanted memories, or induction of suicide (NNH>100,000). The most intensive psychotherapy enhanced with psychotropic (hallucinogenic) drugs had serious, but rare side effects and only for the mentally ill, psychiatric patients: brief reactive psychosis (NNH=556), suicide attempts (NNH=833), and suicide (NNH=2,500).Conclusions: Non-drug (non-pharmaceutical) medicine seems to be safe even for seriously physically and mentally ill patients and, whenever efficient, therefore recommended as treatment of choice.
Reputation, Career Concerns, and Job Assignments
Authors: Martinez Leonardo
Published: May 2009

This paper presents a tractable model that allows us to study career concerns when the strength of a worker's incentives depends on his employment history. More specifically, the paper incorporates standard job assignments into the main model in Holmstrom (1999). Equilibrium wages, equilibrium job assignments, and the strength of career-concern incentives are the same for all employment histories that lead to the same worker's reputation. (With reputation we refer to beliefs about the worker's future productivity.) We show that, typically, workers with better reputation have stronger incentives than workers with worse reputation. Furthermore, we show that when the strength of incentives depends on employment history, (i) a ratchet effect may appear, (ii) in spite of this ratchet effect, incentives may be stronger, and (iii) incentives may be stronger when beliefs about ability are more precise.
How to Coerce a Multi-Dimensional System into a Undimensional Frame: Israel's 1996 Electoral Change
Authors: Zubida Hani , Doron Gideon
Published: May 2009

Political instability affects Israel's ability to govern itself. Many equate this instability with the problematic nature of its electoral institutions. This study examines the effects of the 1992 electoral institutions change by analyzing 1996 pre-election data and the actual 1999 electoral results. It argues that while policy-balancing theory and a decrease in the number of parties might have been a valid solution in a different context, in the Israeli case, due to its multi-dimensional political system, such an institutional change could not yield this outcome. Some concrete recommendations as to future changes are made.
New Definition for the Partial Remission Period in Children and Adolescents With Type 1 Diabetes
Authors: Mortensen Henrik B. , Hougaard Philip , Swift Peter , Hansen Lars , Holl Reinhard W. , Hoey Hilary , Bjoerndalen Hilde , de Beaufort Carine , Chiarelli Francesco , Danne Thomas , Schoenle Eugen J. , Åman Jan
Published: May 2009

OBJECTIVE

To find a simple definition of partial remission in type 1 diabetes that reflects both residual β-cell function and efficacy of insulin treatment.

RESEARCH DESIGN AND METHODS

A total of 275 patients aged <16 years were followed from onset of type 1 diabetes. After 1, 6, and 12 months, stimulated C-peptide during a challenge was used as a measure of residual β-cell function.

RESULTS

By multiple regression analysis, a negative association between stimulated C-peptide and A1C (regression coefficient −0.21, P < 0.001) and insulin dose (−0.94, P < 0.001) was shown. These results suggested the definition of an insulin dose–adjusted A1C (IDAA1C) as A1C (percent) + [4 × insulin dose (units per kilogram per 24 h)]. A calculated IDAA1C ≤9 corresponding to a predicted stimulated C-peptide >300 pmol/l was used to define partial remission. The IDAA1C ≤9 had a significantly higher agreement (P < 0.001) with residual β-cell function than use of a definition of A1C ≤7.5%. Between 6 and 12 months after diagnosis, for IDAA1C ≤9 only 1 patient entered partial remission and 61 patients ended partial remission, for A1C ≤7.5% 15 patients entered partial remission and 53 ended, for a definition of insulin dose ≤0.5 units · kg−1 · 24 h−1 5 patients entered partial remission and 66 ended, and for stimulated C-peptide (>300 pmol/l) 9 patients entered partial remission and 49 ended. IDAA1C at 6 months has good predictive power for stimulated C-peptide concentrations after both 6 and 12 months.

CONCLUSIONS

A new definition of partial remission is proposed, including both glycemic control and insulin dose. It reflects residual β-cell function and has better stability compared with the conventional definitions.
Higher Levels of Urinary Albumin Excretion Within the Normal Range Predict Faster Decline in Glomerular Filtration Rate in Diabetic Patients
Authors: Babazono Tetsuya , Nyumura Izumi , Toya Kiwako , Hayashi Toshihide , Ohta Mari , Suzuki Kumi , Kiuchi Yuka , Iwamoto Yasuhiko
Published: May 2009

OBJECTIVE

To assess the relationship between albuminuria, including elevation within the normal range, and decline in glomerular filtration rate (GFR) in diabetic patients.

RESEARCH DESIGN AND METHODS

A total of 5,449 Japanese diabetic patients were categorized according to sex and urinary albumin-to-creatinine ratio (ACR; <5, 5–9, 10–29, 30–99, 100–299, 300–999, 1,000–2,999, and ≥3,000 mg/g) and followed for at least 5 years. The rate of change in estimated GFR (eGFR) adjusted for age and baseline eGFR was compared among ACR categories.

RESULTS

A higher baseline ACR predicted a faster decline in eGFR for both sexes. Even within the normal range (<30 mg/g), ACR ≥10 mg/g in women and ≥5 mg/g in men was associated with a significantly greater rate of decline in eGFR relative to subjects with ACR <5 mg/g.

CONCLUSIONS

Elevated ACR, even within the normal range, is associated with a faster decline in eGFR in diabetic patients.
Pleiotropic Action of Short-Term Metformin and Fenofibrate Treatment, Combined With Lifestyle Intervention, in Type 2 Diabetic Patients With Mixed Dyslipidemia
Authors: Pruski Maciej , Krysiak Robert , Okopien Boguslaw
Published: May 2009

OBJECTIVE

To compare the effect of short-term metformin and fenofibrate treatment, administered alone or in sequence, on glucose and lipid metabolism, cardiovascular risk factors, and monocyte cytokine release in type 2 diabetic patients with mixed dyslipidemia.

RESEARCH DESIGN AND METHODS

We studied 128 type 2 diabetic patients with mixed dyslipidemia complying throughout the study with lifestyle intervention who were randomized twice, initially to either metformin or placebo, and then to micronized fenofibrate or placebo.

RESULTS

Fenofibrate alleviated diabetic dyslipidemia–induced changes in plasma high-sensitivity C-reactive protein, fibrinogen, and plasminogen activator inhibitor (PAI)-1 and in monocyte cytokine release, whereas metformin or lifestyle intervention improved mainly glucose and lipid metabolism. The strongest pleiotropic effect was observed when fenofibrate was added to metformin.

CONCLUSIONS

Fenofibrate, particularly administered together with metformin, is superior to metformin and lifestyle intervention in exhibiting beneficial effects on systemic inflammation, hemostasis, and monocyte secretory function in type 2 diabetic patients with mixed dyslipidemia.
Basal-State Hyperinsulinemia in Healthy Normoglycemic Adults Is Predictive of Type 2 Diabetes Over a 24-Year Follow-Up
Authors: Dankner Rachel , Chetrit Angela , Shanik Michael H. , Raz Itamar , Roth Jesse
Published: May 2009

OBJECTIVE

We examined the predictive value of hyperinsulinemia in the basal state on the 24-year progression from normoglycemia to dysglycemia.

RESEARCH DESIGN AND METHODS

A sample of 515 normoglycemic men and women were studied again after 24 years for glycemic status.

RESULTS

Half of the participants developed dysglycemia: 11.1% progressed to impaired fasting glucose (IFG), 9.9% to impaired glucose tolerance (IGT), 4.5% to both IFG and IGT, and another 24.3% to type 2 diabetes. Elevated levels of overnight fasting (basal) insulin, triglycerides, BMI ≥27 kg/m2, fasting blood glucose, blood pressure, North African or Yemenite background, and male sex each favored conversion to dysglycemia after 24 years. In multiple ordered logistic regression analysis, the most significant predictor of progression to dysglycemia was hyperinsulinemia (upper quintile), after adjusting for BMI, ethnic origin, sex, age, smoking, physical activity, blood pressure, and triglycerides.

CONCLUSIONS

Basal hyperinsulinemia in normoglycemic adults constitutes an independent risk factor for developing dysglycemia over 24 years.
Sex and Racial/Ethnic Differences in Cardiovascular Disease Risk Factor Treatment and Control Among Individuals With Diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA)
Authors: Winston Ginger J. , Barr R. Graham , Carrasquillo Olveen , Bertoni Alain G. , Shea Steven
Published: May 2009

OBJECTIVE

To examine sex and racial/ethnic differences in cardiovascular risk factor treatment and control among individuals with diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA).

RESEARCH DESIGN AND METHODS

This study was an observational study examining mean levels of cardiovascular risk factors and proportion of subjects achieving treatment goals.

RESULTS

The sample included 926 individuals with diabetes. Compared with men, women were 9% less likely to achieve LDL cholesterol <130 mg/dl (adjusted prevalence ratio 0.91 [0.83–0.99]) and systolic blood pressure (SBP) <130 mmHg (adjusted prevalence ratio 0.91 [0.85–0.98]). These differences diminished over time. A lower percentage of women used aspirin (23 vs. 33%; P < 0.001). African American and Hispanic women had higher mean levels of SBP and lower prevalence of aspirin use than non-Hispanic white women.

CONCLUSIONS

Women with diabetes had unfavorable cardiovascular risk factor profiles compared with men. African American and Hispanic women had less favorable profiles than non-Hispanic white women.
Tooth Discoloration in Patients With Neonatal Diabetes After Transfer Onto Glibenclamide
Authors: Kumaraguru Janani , Flanagan Sarah E. , Greeley Siri Atma W. , Nuboer Roos , Støy Julie , Philipson Louis H. , Hattersley Andrew T. , Rubio-Cabezas Oscar
Published: May 2009

OBJECTIVE

To assess if tooth discoloration is a novel side effect of sulfonylurea therapy in patients with permanent neonatal diabetes due to mutations in KCNJ11.

RESEARCH DESIGN AND METHODS

A total of 67 patients with a known KCNJ11 mutation who had been successfully transferred from insulin injections onto oral sulfonylureas were contacted and asked about the development of tooth discoloration after transfer.

RESULTS

Altered tooth appearance was identified in 5 of the 67 patients. This was variable in severity, ranging from mild discoloration/staining (n = 4) to loss of enamel (n = 1) and was only seen in patients taking glibenclamide (glyburide).

CONCLUSIONS

These previously unreported side effects may relate to the developing tooth and/or to the high local concentrations in the children who frequently chewed glibenclamide tablets or took it as a concentrated solution. Given the multiple benefits of sulfonylurea treatment for patients with activating KCNJ11 mutations, this association warrants further investigation but should not preclude such treatment.
Suitability of Maraging Steel Weld Cladding for Repair of Die-Casting Tooling
Authors: Klobčar Damjan , Tušek Janez , Kosec Ladislav
Published: May 2009

A comprehensive study of 18 % Ni maraging steel welds is done in order to determine the suitability of repair welding of aluminum die-casting dies and to prolong the in-service tool life. This study emphasizes the influence of welding parameters and post-welding precipitation annealing heat treatment on the welds' mechanical and metallurgical properties. A series of U-grooved specimens of 1.2344 tool steel is prepared. These grooves are filled with 1.6356 maraging steel as filler wire using multi-pass Gas Tungsten Arc welding. The metallurgical properties of the filler welds, in the as-welded condition and after precipitation annealing with a series of different parameters, are studied. The influence of preheat temperature, heat input during welding, and hot working of maraging steel welds is evaluated regarding mechanical and metallurgical properties. The response surface models for the prediction of mechanical properties (i. e. hardness, toughness, tensile strength, and yield stress after post-welding heat treatment) are developed. The results show that metallurgical and mechanical properties significantly depend on welding technology and post-welding heat treatment parameters. Gas Tungsten Arc welding with low heat input permits the omission of solution heat treatment after welding, while hot working of welds during welding increases the mechanical properties. Developed models for the prediction of mechanical properties enable selection of precipitation annealing parameters for a particular application based on desired mechanical properties.
Effects of Lanthanum on Magnetic Behavior and Hardness of Electroless Ni–Fe–P Deposits
Authors: Huang Wei-Qing , Huang Gui-Fang , Wang Xing , Xie Chun-Lin , Liang Bing
Published: May 2009

In this paper, the effects of lanthanum on the deposition rate, composition, structure, hardness, magnetic and anti-corrosion behaviors of electroless Ni – Fe – P deposits prepared from sulphate bath were investigated. In order to characterize the deposits, gravimetric and electrochemical measurement, scanning electron microscopy, X-ray diffraction, and magnetic measurement were applied. The results show that the deposition rate decreases with increasing LaCl3· 7 H2O concentration in the bath due to the competition adsorptions between rare earth lanthanum, metal ions, and hypophosphite on the surface of the substrate. The magnetic behavior of the deposit is strongly dependent on the LaCl3· 7 H2O concentration in the bath. The coercive force of the deposit increases, while its saturation magnetization decreases with LaCl3· 7 H2O concentration increase. When the LaCl3· 7 H2O concentration reaches 1.50 g l– 1, the deposit shows a rectangular hysteresis loop with high coercivity. The moderate addition of lanthanum in the bath will increase the hardness of the deposits as a result of the change of composition and structure of deposits. However, the addition of lanthanum has little effect on the corrosion resistance of the deposits.
Interfacial Reactions between Lead-Free Solders and the Multilayer Au/Ni/SUS304 Substrate
Authors: Yen Yee-Wen , Lee Chun-Yu , Kuo Meng-Han , Chao Kuo-Sing , Chen Kuen-Da
Published: May 2009

Interfacial reactions between Sn, Sn-3.0 wt.% Ag-0.5 wt.% Cu (SAC) and an Au/Ni/SUS304 stainless steel (SUS304) substrate were conducted using the reaction couple technique at 240, 255 and 270 °C for 1 – 5 h. In the earliest stage of the reaction, only the Ni3Sn4 phase was formed on the Sn/Au/Ni/SUS304 interface. As the reaction time increased to 4 h, the Ni layer was gradually consumed and the Ni3Sn4 phase detached from the interface. Meanwhile, the Sn reacted with the SUS304 to form the FeSn2 phase. In the SAC/Au/Ni/SUS304 reaction couple, both Ni3Sn4 and Cu6Sn5 phases were formed on the interface. When the reaction time exceeded 4 h, the Ni3Sn4 phase disappeared; the Cu6Sn5 phase was spread over the SUS304 surface and the FeSn2 phase was formed on the SUS304 surface. The growth of intermetallic compounds can be described by the parabolic law and the reactions were diffusion-controlled.
Melting Behavior of Sn–Bi Alloy Powder Compacts Observed Using Optical Dilatometry
Authors: Nakamoto Masashi , Heikinheimo Erkki , Kekkonen Marko , Friman Michael , Holappa Lauri
Published: May 2009

The melting behavior of Sn – Bi alloy powder compacts was observed using optical dilatometry. The change in standard deviation of compact width with temperature obtained by dilatometry was used to evaluate the melting behavior by considering the factors in the shape change of the compact under heating. The effects on melting behavior of alloy composition, particle size and pressing load at compacting are discussed in this study.

The difference in composition affected the melting behavior in accordance with the phase diagram. Smaller particle size showed a lower degree of melting. The effects of these two parameters, viz. composition and particle size, however, are highly dependent on surface oxidation of powders. The influence of surface oxidation, on the other hand, was reduced by producing the compacts with a higher pressing load.
Sintering Behavior of ZnO: Mn Ceramics Fabricated from Sol-Gel Derived Nanocrystalline powders
Authors: Bahşi Z. B. , Büyükaksoy A. , Köseoğlu N. C. , Oral A. Y. , Aslan M. H.
Published: May 2009

Undoped and Mn doped ZnO ceramics, sintered at 1200 °C, were produced from sol-gel derived nanocrystalline powders calcined at 750 °C. Mn doped powders showed trace amounts of spinel (ZnMn2O4) phase in addition to a dominant zincite phase, while Mn doped ceramics were comprised solely of zincite structure. X-ray mapping of the powders did not reveal any Mn concentrated areas, indicating that the ZnMn2O4 phase was homogeneously distributed with a very small grain size. The grain size of the undoped powders was around 50 nm, and there was a minor increase in the grain size when powders were doped with Mn. Undoped ceramics exhibited grain sizes distributed in the range 2 – 10 μm while Mn doped ceramics displayed slightly smaller grains. Relative densities of the undoped and Mn doped ceramics were measured as 0.695 and 0.950, respectively.
Enhanced properties of functionally graded Cu–Cr powder compacts
Authors: Lahiri Indranil , Bhargava Sanjeev
Published: May 2009

The paper aims to present the processing and development of functionally graded Cu – Cr materials, widely used as a monolithic contact material in vacuum circuit breakers. Simple and novel processing routes, used in this study, in addition to being cost-effective and energy efficient, generate higher density and electrical conductivity of the Cu – Cr compacts. It is shown that the use of mechanically alloyed Cu – Cr powders enhances the properties of the compacts, as compared to those prepared from as-received powders. Furthermore, explosive compaction and application of coated powder were found to result in still better properties. Scanning electron microscopy and atomic force microscopy were used to explain the scientific significance of this development.
Influence of Cr on the microstructure and mechanical properties of Ti–Si Eutectic Alloys
Authors: Zhan Yongzhong , He Linbin , Ma Jianbo , Zhang Xinjiang , Hu Zhaohua
Published: May 2009

As promising candidates for new high-temperature structural materials, Ti – Si eutectic alloys are required for the next generation of advanced aircraft engines. In this paper, microstructures of the Ti – Si eutectic alloys with various Cr contents were investigated by means of X-ray diffraction, scanning electron microscopy and light optical microscopy. The results show that with the increase of Cr content up to 9 wt.%, β-Ti (Si, Cr)ss matrix and Ti5Si3 form in the as cast alloy, however, the α-Ti (Si, Cr)ss phase disappears. Cr element solute in β-Ti and Ti5Si3 can significantly change the morphology and distribution of Ti5Si3 intermetallic phase. This greatly affects the fracture behavior and mechanical properties of as-cast Ti – Si eutectic alloys.
Nd–Fe–B permanent magnets a quarter century later: implications for patentability
Authors: Stadelmaier Hans H.
Published: May 2009

Events are described that precede the announcement of the high performance permanent magnets based on the neodymium-iron boride Nd2Fe14B. When accounts of innovations stem from the principals initiating them, they can be distorted in the interest of establishing a patent position of high commercial value. The problems of finding objective criteria to assess inventiveness in this technological breakthrough are discussed.
Penetrating craniocerebral injuries in the Israeli involvement in the Lebanese conflict, 1982–1985
Authors: Brandvold Benny , Levi Lion , Feinsod Moshe , George Eugene D.
Published: May 2009

✓ From June, 1982, through June, 1985, 113 patients were evacuated to Rambam Maimonides Medical Center with penetrating craniocerebral injuries sustained in ongoing military hostilities in Lebanon. Two factors distinguished this group of patients from those presenting in earlier conflicts: 1) this was the first large series in which computerized tomography (CT) was routinely used to initially evaluate combat head injuries; and 2) in an effort to preserve maximum cerebral tissue, intracranial debridement was significantly less vigorous than that advocated during the Korean or Vietnam conflicts. No efforts were made to locate or remove indriven bone or metal fragments visualized on CT unless they readily presented themselves on gentle irrigation. In fact, it was elected to treat a number of patients without intracranial hematomas nonoperatively. The acute outcome was quite similar to that reported in Vietnam series in respect to both complications and mortality.

Of the 83 survivors, 46 were Israeli citizens and thus were available for follow-up review. These 46 patients were reevaluated in late 1988, a mean follow-up period of 5.9 years. None had died in the interim; 10 had developed chronic seizure disorders, and there was one case of delayed meningitis in a patient with no retained fragments. Repeat CT scans were performed on 43 patients; 22 (51%) were found to have retained intracranial bone fragments. No relationship existed between the presence of retained fragments and the development of either a seizure disorder or an infection of the central nervous system. These findings suggest that not only is it unnecessary to reoperate for retained bone fragments, but it may also be possible to temper the initial debridement in an effort to preserve additional cerebral tissue.
Diagnosis and treatment of vascular brain-stem malformations
Authors: Kashiwagi Shiro , van Loveren Harry R. , Tew John M. , Wiot J. Geoffrey , Weil Stuart M. , Lukin Robert A.
Published: May 2009

✓ Vascular malformations are a common cause of spontaneous brain-stem hemorrhage in young normotensive individuals. These lesions are no longer cryptic. Magnetic resonance (MR) imaging has renewed interest in the treatment of this disorder because of the precise accuracy in diagnosis and localization of these lesions that it affords. The MR image demonstrates characteristic findings of multiple hemorrhages of varying ages surrounded by a hypointense peripheral zone of hemosiderin. Five cases of vascular brain-stem malformation diagnosed with MR imaging are described. The vascular malformations could be demonstrated as “flow void” areas in three cases. Three patients were treated surgically and vascular malformations were confirmed; all three patients improved postoperatively. Two patients were treated nonsurgically; one of these recovered from a second hemorrhage and the other experienced neurological deterioration after a single hemorrhage. High-energy radiotherapy was not effective for the one vascular malformation treated by this method. This experience suggests that surgical exploration should be considered for vascular brain-stem malformations when the diagnosis is confirmed by MR criteria and the clinical course and lesion are both progressive in character.
A 10-year follow-up review of percutaneous microcompression of the trigeminal ganglion
Authors: Lichtor Terry , Mullan John F.
Published: May 2009

✓ Percutaneous microcompression of the trigeminal ganglion for the relief of trigeminal neuralgia is a technically simple, nonpainful procedure, carried out under brief general anesthesia. One hundred patients treated by this method have been followed for 1 to 10 years; treatment has been technically successful in 97% of cases. Relief persisted at five years in 80%, and it is estimated that at 10 years the figure will be 70%. There were no deaths, no cerebral damage, no keratitis, and no analgesia dolorosa; 4% of the patients reported dysesthesia.
Nerve transposition for the restoration of elbow flexion following brachial plexus avulsion injuries
Authors: Friedman Allan H. , Nunley James A. , Goldner Richard D. , Oakes W. Jerry , Goldner J. Leonard , Urbaniak James R.
Published: May 2009

✓ Despite technical advances, the ability to restore motor function following a brachial plexus avulsion is limited. Twenty patients who suffered the loss of elbow flexion following a brachial plexus avulsion injury underwent a neurotization procedure in an attempt to restore that lost function. Of 16 patients who underwent intercostal to musculocutaneous nerve anastomosis, seven obtained good elbow flexion. Four patients who no longer had a viable biceps brachialis muscle underwent an anastomosis between transposed intercostal nerves and a free vascularized gracilis muscle grafted to the position of the biceps. Two of these patients obtained good elbow flexion. Although synkinesis between the biceps brachialis and the inspiratory muscles can be demonstrated during coughing and deep inspiration, the patients learn to flex their reinnervated biceps brachialis muscle and maintain flexion independent of respiration.
Lumbar spinal stenosis: postoperative results in terms of preoperative posture-related pain
Authors: Ganz Jeremy C.
Published: May 2009

✓ Thirty-three consecutive patients with lumbar spinal stenosis were treated with decompressive surgery aimed at relieving pain. The selection criteria for surgery included marked symptoms and lumbar spinal stenosis demonstrated by myelography. Preoperatively, only 15 patients had claudication; however, 23 experienced relief or exacerbation of symptoms related to changes in posture. A good postoperative result was obtained in 82% of the entire series, but in only 50% of patients whose symptoms were not affected by posture. Of those whose symptoms did have a postural component, a good result was obtained in 96%.

The relief of back pain by decompressive surgery was significantly less successful than the relief of leg pain. It is therefore suggested that surgery be restricted to as few levels as possible.
Outcome in 134 patients with prolonged posttraumatic unawareness
Authors: Sazbon Leon , Groswasser Zeev
Published: May 2009

✓ A retrospective study of 134 patients in a condition of prolonged unawareness state (that is, in coma for over 1 month) following brain trauma was conducted in order to identify prognostic factors. Eight easily evaluated parameters were found to be significant for predicting nonrecovery of consciousness. The following six features were present during the early posttraumatic phase (that is, during the 1st week after trauma): fever of central origin; diffuse body sweating; disturbances in antidiuretic hormone secretion; abnormal motor reactivity; respiratory disturbances; and diffuse nonneurological injuries. The first three features were manifestations of hypothalamic damage. Two factors, evident at a late phase following injury (after the 1st week posttrauma), namely late epilepsy and communicating hydrocephalus, were also significant in predicting nonrecovery.
Outcome in 134 patients with prolonged posttraumatic unawareness
Authors: Groswasser Zeev , Sazbon Leon
Published: May 2009

✓ Most publications regarding the outcome of traumatic brain injury include patients with periods of unconsciousness of varying durations. The aim of the present paper is to describe the outcome of 72 patients who suffered from prolonged unawareness for more than 30 days and subsequently recovered consciousness. Almost half of the patients were independent in activities of daily living and another 20% were only partially dependent. Cognitive and behavioral deficits were the most common central nervous system sequelae of injury. Eight patients (11.1%) were able to resume working in the open job market and 35 (48.6%) were engaged in sheltered workshops. Most of the patients (72%), including all those who were working, were living with their families. Although the mean rehabilitation period was about 15 months, over 70% of these severely injured patients are considered to be socially integrated, enabling them to enjoy a reasonable quality of life.
The effect of steroids on gentamicin delivery to brain after blood-brain barrier disruption
Authors: Neuwelt Edward A. , Horaczek Alfred , Pagel Michael A.
Published: May 2009

✓ Osmotic modification of the blood-brain barrier (BBB) provides an experimental model of vasogenic edema, is totally reversible, and does not cause any structural damage. In the present communication, the effect of corticosteroids on drug delivery to normal rat brain was evaluated in this model. Intraperitoneal dexamethasone was administered at doses ranging from 12 to 48 mg/sq m for 3 days; gentamicin delivery to the brain was then evaluated after either intravenous or intracarotid administration in both control and BBB-modified animals. Only animals receiving the highest dose of dexamethasone and in which the gentamicin was given intravenously demonstrated a statistically significant decrease in drug delivery. The effect of dexamethasone over a wide range of dosages, therefore, exhibited only modest effects on drug delivery to normal brain after osmotic BBB disruption.
Gauze-induced granuloma (“gauzoma”): an uncommon complication of gauze reinforcement of berry aneurysms
Authors: Chambi Israel , Tasker Ronald R. , Gentili Fred , Lougheed William M. , Smyth Harley S. , Marshall John , Young Iain , Deck John , Shrubb Jane
Published: May 2009

✓ Incompletely and even adequately clipped berry aneurysms are often reinforced with finely shredded gauze. In seven female patients this practice led to a series of events including headache, pyrexia, seizures, cranial nerve deficits, endocrinopathy, cerebrospinal fluid pleocytosis, and an enhancing mass demonstrated by computerized tomography at the aneurysm site. One patient with blindness, hydrocephalus, and panhypopituitarism died and was examined at autopsy.

Three additional female patients have been identified in the literature with similar case histories. It is suggested that in these patients the gauze induced a foreign-body granuloma, accompanied by progressive occlusion of neighboring small arteries. It would seem prudent to reserve gauze reinforcement for aneurysms that cannot be securely obliterated surgically.
Treatment of bilateral coronal synostosis in infancy: a holistic approach
Authors: Persing John A. , Jane John A. , Delashaw Johnny B.
Published: May 2009

✓ Bilateral coronal synostosis often results in a turribrachycephalic skull shape. Reduction of skull height and elongation of the anteroposterior axis of the skull while preserving normal cerebral function are the major therapeutic goals. A surgical technique is described which can successfully accomplish these goals in a single operative procedure.