bluuebunny/crossref_metadata_2025 huggingface dataset:
Delusions and belief flexibility in psychosis
Authors: Colbert S. M. , Peters E. R. , Garety P. A.
Published: August 2009

Objectives. A defining characteristic of delusions is inflexibility. However, it is not known if this is specific to the deluded individual's thinking about delusional beliefs, or whether this might apply more generally to the thinking style of people with delusions.

Design. A cross‐sectional design was employed comparing belief flexibility, belief dimensions, and extreme responding (ER) across three groups.

Methods. Belief flexibility and dimensions were assessed for two types of beliefs, personally meaningful beliefs (delusional or idiosyncratic beliefs) and standard beliefs. The number of extreme responses endorsed on a questionnaire was also measured. Participants consisted of a currently deluded group (N=17), a remitted delusions group (N=17), both recruited from an early psychosis service, and a non‐clinical control group (N=35).

Results. Personally meaningful beliefs, whether delusions or other idiosyncratic beliefs, were held with equal conviction and belief flexibility in the three groups. However, on the standard belief, the clinical groups showed less belief flexibility than the control group (with only the remitted group significantly so) and greater ER. Individuals who showed belief flexibility about both types of beliefs displayed less ER than those who were inflexible, and belief flexibility was related to less delusional conviction in the clinical groups.

Conclusion. These results suggest that belief inflexibility and ER may be characteristics of the thinking styles of individuals with delusions, rather than being specific to the delusional beliefs themselves. This has implications for cognitive behavioural therapy, which might usefully focus on generally thinking style as a preparation for working more directly with delusional beliefs.
Oxygen Compatibility of Brass-Filled PTFE Compared to Commonly Used Fluorinated Polymers for Oxygen Systems
Authors: Herald Stephen D. , Frisby Paul M. , Davis Samuel Eddie
Published: August 2009

Safe and reliable seal materials for high-pressure oxygen systems sometimes appear to be extinct species when sought out by oxygen systems designers. Materials that seal well are easy to find, but these materials are typically incompatible with oxygen, especially in cryogenic liquid form. This incompatibility can result in seals that leak, or much worse, seals that easily ignite and burn during use. Scientists at the Materials Combustion Research Facility (MCRF), part of NASA/Marshall Space Flight Center, are constantly searching for better materials and processes to improve the safety of oxygen systems. One focus of this effort is improving the characteristics of polymers used in the presence of an oxygen enriched environment. Very few systems can be built which contain no polymeric materials; therefore, materials which have good impact resistance, low heat of combustion, high auto-ignition temperature, and those that maintain good mechanical properties are essential. The scientists and engineers at the MCRF, in cooperation with seal suppliers, are currently testing a new formulation of polytetrafluoroethylene (PTFE) with brass filler. This brass-filled PTFE is showing great promise as a seal and seat material for high-pressure oxygen systems. Early research has demonstrated very encouraging results, which could rank this material as one of the best fluorinated polymers ever tested. This paper will compare the data obtained for brass-filled PTFE with other fluorinated polymers, such as TFE-polytetrafluoroethylene (PTFE), polychlorotrifluoroethylene 81, Viton® A, Viton® A-500, Fluorel®, and Algoflon®. A similar metal-filled fluorinated polymer, Salox-M®, was tested in comparison to brass-filled PTFE to demonstrate the importance of the metal chosen and relative percentage of filler. General conclusions on the oxygen compatibility of this formulation are drawn, with an emphasis on comparing and contrasting the materials performance to the performance of the current state-of-the-art oxygen compatible polymers.
Virtuelle Raumluftströmungssensoren zur Regelung der thermischen BehaglichkeitVirtual Airflow Sensors for Thermal Comfort Control
Authors: Felgner Felix
Published: August 2009

Diese Arbeit schafft eine Grundlage für bessere thermische Behaglichkeit in klimatisierten Räumen. Es wird eine Methodik entwickelt, mit der die Raumluftströmung in Echtzeit geschätzt werden kann. Basierend auf mathematischen Modellen berechnen virtuelle Sensoren die Lufttemperatur und -geschwindigkeit an beliebigen Orten im Raum. Zu diesem Zweck wird ein rechentechnisch effizientes, datenbasiertes Raumluftströmungsmodell entwickelt. Um den Komfortgewinn zu demonstrieren, der mit Hilfe der neuen virtuellen Sensoren erreichbar ist, werden Ergebnisse einer Regelung des Predicted Mean Vote (PMV gemäß Standard ISO 7730) in einem realen Konferenzraum gezeigt.
A Case-Based Approach to Decision AnalysisEin fallbasiertes Verfahren zur Beschlussanalyse
Authors: Xiong Ning
Published: August 2009

This paper proposes a novel approach for integrating case-based reasoning (CBR) and decision theory for casebased decision analysis. CBR is employed as a methodology to reason from previous cases for building a decision model given a current situation, while decision theory is applied to the decision model learnt from previous cases to identify the most promising, secured, and rational choices. We have also tackled the issue of imprecise utility in individual cases and explained how fuzzy decision analysis can be conducted when case specific utilities are represented with fuzzy data.
Modellierung und Simulation vernetzter Automatisierungs- und Regelungssysteme in ModelicaModeling and Simulation of Networked Automation and Control Systems in Modelica
Authors: Frey Georg , Liu Liu
Published: August 2009

Automatisierungssysteme werden zunehmend in vernetzten Strukturen realisiert. Die Untersuchung solcher Systeme durch Simulation erfordert Modelle, die das Zeitverhalten der Automatisierungsgeräte und der eingesetzten Netzwerke beschreiben. Im vorliegenden Beitrag wird eine entsprechende Bibliothek vorgestellt, die in der Modellierungssprache Modelica entwickelt wurde und beispielsweise im Simulationswerkzeug Dymola eingesetzt werden kann. Die Anwendung der entwickelten Modelle zur Antwortzeitanalyse im offenen Kreis sowie zur Analyse vernetzter Regelungssysteme im geschlossenen Kreis wird anhand von Beispielen illustriert. Schließlich wird ein Ansatz vorgestellt, der es erlaubt den Aufwand zur Simulation der entstehenden hybriden Modelle zu reduzieren.
Testosterone stimulates progesterone production and STAR, P450 cholesterol side-chain cleavage and LH receptor mRNAs expression in hen (Gallus domesticus) granulosa cells
Authors: Rangel P L , Rodríguez A , Rojas S , Sharp P J , Gutierrez C G
Published: August 2009

The chicken ovary is organized into a hierarchy of yellow yolky follicles that ovulate on successive days. Active or passive immunization of laying hens against testosterone blocks ovulation without affecting follicle development. Testosterone may play a role in pre-ovulatory follicle maturation by stimulating granulosa progesterone production. We assessed whether this stimulus is dose-related and depends on the maturity of the donor follicle, and if it does so by stimulating granulosa cell STAR, P450 cholesterol side-chain cleavage (P450scc), and LH receptor (LHCGR) mRNAs expression. Progesterone production by granulosa cells from F1, F3, and F4 follicles, cultured for 3 h without testosterone was greater in cells collected 11–14 h than 1–4 h after ovulation. These differences in progesterone production were less pronounced after granulosa cells had been cultured for 24 h. Culture of granulosa cells for 3 or 24 h with testosterone (1–100 ng/ml) stimulated progesterone production in cells collected from F4, F3, or F1 follicles 1–4, or 11–14 h after ovulation. Testosterone (0–4000 ng/ml) alone or in combination with LH (0–100 ng/ml) increased progesterone production by F1 granulosa cells, collected 1–4 and 11–14 h after ovulation and cultured for 3 h. Finally, testosterone (10 or 100 ng/ml) increased STAR, P450scc, and LHCGR mRNAs, when added to 3 h cultures of F1 granulosa cells. In conclusion, testosterone stimulates granulosa cell progesterone production in hen pre-ovulatory hierarchical follicles irrespective of maturational state, acting alone or additively with LH. We propose that testosterone promotes granulosa cell maturation to facilitate the pre-ovulatory release of LH.
Future perspective for diagnosis in autoimmune diseases
Authors: Andrade Luis E. C.
Published: August 2009

Human beings have taken successive approaches for the understanding and management of diseases. Initially brewed in supernatural concepts and mystical procedures, a vigorous scientific approach has emerged on the grounds of fundamental disciplines such as anatomy, microbiology, biochemistry, physiology, immunology, pathology, and pharmacology. The resulting integrated knowledge contributed to the current classification of diseases and the way Medicine is carried out today. Despite considerable progress, this approach is rather insufficient when it comes to systemic inflammatory conditions, such as systemic lupus erythematosus, that covers clinical conditions ranging from mild pauci-symptomatic diseases to rapidly fatal conditions. The treatment for such conditions is often insufficient and novel approaches are needed for further progress in these areas of Medicine. A recent breakthrough has been achieved with respect to chronic auto-inflammatory syndromes, in which molecular dissection of underlying gene defects has provided directions for target-oriented therapy. Such approach may be amenable to application in systemic auto-immune diseases with the comprehension that such conditions may be the consequence of interaction of specific environmental stimuli and an array of several and interconnected gene polymorphisms. On the bulk of this transformation, the application of principles of pharmacogenetics may lead the way towards a progressively stronger personalized Medicine.
The use of Fluorescence Resonance Energy Transfer (FRET) peptidesfor measurement of clinically important proteolytic enzymes
Authors: Carmona Adriana K. , Juliano Maria Aparecida , Juliano Luiz
Published: August 2009

Proteolytic enzymes have a fundamental role in many biological processes and are associated with multiple pathological conditions. Therefore, targeting these enzymes may be important for a better understanding of their function and development of therapeutic inhibitors. Fluorescence Resonance Energy Transfer (FRET) peptides are convenient tools for the study of peptidases specificity as they allow monitoring of the reaction on a continuous basis, providing a rapid method for the determination of enzymatic activity. Hydrolysis of a peptide bond between the donor/acceptor pair generates fluorescence that permits the measurement of the activity of nanomolar concentrations of the enzyme. The assays can be performed directly in a cuvette of the fluorimeter or adapted for determinations in a 96-well fluorescence plate reader. The synthesis of FRET peptides containing ortho-aminobenzoic acid (Abz) as fluorescent group and 2, 4-dinitrophenyl (Dnp) or N-(2, 4-dinitrophenyl)ethylenediamine (EDDnp) as quencher was optimized by our group and became an important line of research at the Department of Biophysics of the Federal University of São Paulo. Recently, Abz/Dnp FRET peptide libraries were developed allowing high-throughput screening of peptidases substrate specificity. This review presents the consolidation of our research activities undertaken between 1993 and 2008 on the synthesis of peptides and study of peptidases specificities.
Heparan sulfate proteoglycans: structure, protein interactions and cell signaling
Authors: Dreyfuss Juliana L. , Regatieri Caio V. , Jarrouge Thais R. , Cavalheiro Renan P. , Sampaio Lucia O. , Nader Helena B.
Published: August 2009

Heparan sulfate proteoglycans are ubiquitously found at the cell surface and extracellular matrix in all the animal species. This review will focus on the structural characteristics of the heparan sulfate proteoglycans related to protein interactions leading to cell signaling. The heparan sulfate chains due to their vast structural diversity are able to bind and interact with a wide variety of proteins, such as growth factors, chemokines, morphogens, extracellular matrix components, enzymes, among others. There is a specificity directing the interactions of heparan sulfates and target proteins, regarding both the fine structure of the polysaccharide chain as well precise protein motifs. Heparan sulfates play a role in cellular signaling either as receptor or co-receptor for different ligands, and the activation of downstream pathways is related to phosphorylation of different cytosolic proteins either directly or involving cytoskeleton interactions leading to gene regulation. The role of the heparan sulfate proteoglycans in cellular signaling and endocytic uptake pathways is also discussed.
Portal hypertensive response to kinin
Authors: Kouyoumdjian Maria , Nagaoka Marcia R. , Loureiro-Silva Mauricio R. , Borges Durval R.
Published: August 2009

Portal hypertension is the most common complication of chronic liver diseases, such as cirrhosis. The increased intrahepatic vascular resistance seen in hepatic disease is due to changes in cellular architecture and active contraction of stellate cells. In this article, we review the historical aspects of the kallikrein-kinin system, the role of bradykinin in the development of disease, and our main findings regarding the role of this nonapeptide in normal and experimentalmodels of hepatic injury using the isolated rat liver perfusion model (mono and bivascular) and isolated liver cells. We demonstrated that: 1) the increase in intrahepatic vascular resistance induced by bradykinin is mediated by B2 receptors, involving sinusoidal endothelial and stellate cells, and is preserved in the presence of inflammation, fibrosis, and cirrhosis; 2) the hepatic arterial hypertensive response to bradykinin is calcium-independent and mediated by eicosanoids; 3) bradykinin does not have vasodilating effect on the pre-constricted perfused rat liver; and, 4) after exertion of its hypertensive effect, bradykinin is degraded by angiotensin converting enzyme. In conclusion, the hypertensive response to BK is mediated by the B2 receptor in normal and pathological situations. The B1 receptor is expressed more strongly in regenerating and cirrhotic livers, and its role is currently under investigation.
Calcium and cell death signaling in neurodegeneration and aging
Authors: Smaili Soraya , Hirata Hanako , Ureshino Rodrigo , Monteforte Priscila T. , Morales Ana P. , Muler Mari L. , Terashima Juliana , Oseki Karen , Rosenstock Tatiana R. , Lopes Guiomar S. , Bincoletto Claudia
Published: August 2009

Transient increase in cytosolic (Cac2+) and mitochondrial Ca2+ (Ca m2+) are essential elements in the control of many physiological processes. However, sustained increases in Ca c2+ and Ca m2+ may contribute to oxidative stress and cell death. Several events are related to the increase in Ca m2+, including regulation and activation of a number of Ca2+ dependent enzymes, such as phospholipases, proteases and nucleases. Mitochondria and endoplasmic reticulum (ER) play pivotal roles in the maintenance of intracellular Ca2+ homeostasis and regulation of cell death. Several lines of evidence have shown that, in the presence of some apoptotic stimuli, the activation of mitochondrial processes maylead to the release of cytochrome c followed by the activation of caspases, nuclear fragmentation and apoptotic cell death. The aim of this review was to show how changes in calcium signaling can be related to the apoptotic cell death induction. Calcium homeostasis was also shown to be an important mechanism involved in neurodegenerative and aging processes.
The challenge of the reference and counter-reference system in the prenatal assistance to pregnant women with infectious diseases
Authors: Figueiredo Elisabeth N. , Vianna Lucila A. C. , Peixe Marina B. , Ramos Valdete M. , Succi Regina C. M.
Published: August 2009

The objective of this study was to determine the prevalence of infectious diseases, such as syphilis, acquired immune deficiency syndrome (AIDS) and hepatitis B and C, in pregnant women who undertook their prenatal care in thirteen basic health units (BHU) in São Paulo city. The efficiency of the reference and counter-reference system in such prenatal infectious diseases was evaluated considering the medical recordings of the final result of the pregnancy and the vertical transmission rates of these diseases. It consists of an epidemiologic study whose observations were based on the notes of the prenatal medical and nurse records of pregnant women who had infectious diseases susceptible to vertical transmission and final infectious status registers of their concepts. Women's syphilis prevalence was 0. 86%, HIV and Hepatitis B was 0. 22% and Hepatitis C was 0. 36%. It's possible to conclude that there is no register of the reference and counter-reference system of these infectious diseases analyzed at the thirteen basic health units of the south-east region of São Paulo city evaluated in 2005. This lack of register makes it impossible to know the preventive measures taken and the vertical transmission rates. Making the professionals and the Health Coordination authorities aware of the importance of the dynamic of the prenatal attendance is necessary.
Human neutrophil alloantigens systems
Authors: Moritz Elyse , Norcia Ângela M. M. I. , Cardone José D. B. , Kuwano Sachie T. , Chiba Akemi K. , Yamamoto Mihoko , Bordin José O.
Published: August 2009

Neutrophil alloantigens are involved in a variety of clinical conditions including immune neutropenias, transfusion-related acute lung injury (TRALI), refractoriness to granulocyte transfusions and febrile transfusion reactions. In the last decade, considerable progress has been made in the characterization of the implicated antigens. Currently, seven antigens are assigned to five human neutrophil antigen (HNA) systems. The HNA-1a, HNA-1b and HNA-1c antigens have been identified as polymorphic forms of the neutrophil Fcγ receptor IIIb (CD16b), encoded by three alleles. Recently, the primary structure of the HNA-2a antigen was elucidated and the HNA-2a-bearing glycoprotein was identified as a member of the Ly-6/uPAR superfamily, which has been clustered as CD177. The HNA-3a antigen is located on a 70-95 kDa glycoprotein; however, its molecular basis is still unknown. Finally, the HNA-4a and HNA-5a antigens were found to be caused by single nucleotide mutations in the αM (CD11b) and αL (CD11a) subunits of the leucocyte adhesion molecules (β2 integrins). Molecular and biochemical characterization of neutrophil antigenshave expanded our diagnostic tools by the introduction of genotyping techniques and immunoassays for antibody identification. Further studies in the field of neutrophil immunology will facilitate the prevention and management of transfusion reactions and immune diseases caused by neutrophil antibodies.
Surveillance programs for detection and characterization of emergent pathogens and antimicrobial resistance: results from the Division of Infectious Diseases, UNIFESP
Authors: Colombo Arnaldo L. , Janini Mario , Salomão Reinaldo , Medeiros Eduardo A. S. , Wey Sergio B. , Pignatari Antonio C. C.
Published: August 2009

Several epidemiological changes have occurred in the pattern of nosocomial and community acquired infectious diseases during the past 25 years. Social and demographic changes possibly related to this phenomenon include a rapid population growth, the increase in urban migration and movement across international borders by tourists and immigrants, alterations in the habitats of animals and arthropods that transmit disease, as well as the raise of patients with impaired host defense abilities. Continuous surveillance programs of emergent pathogens and antimicrobial resistance are warranted for detecting in real time new pathogens, as well as to characterize molecular mechanisms of resistance. In order to become more effective, surveillance programs of emergent pathogens should be organized as a multicenter laboratory network connected to the main public and private infection control centers. Microbiological data should be integrated to guide therapy, adapting therapy to local ecology and resistance patterns. This paper presents an overview of data generated by the Division of Infectious Diseases, Federal University of São Paulo, along with its participation in different surveillance programs of nosocomial and community acquired infectious diseases.
Control of the skin scarring response
Authors: Ferreira Lydia M. , Gragnani Alfredo , Furtado Fabianne , Hochman Bernardo
Published: August 2009

There comes a time when the understanding of the cutaneous healing process becomes essential due to the need for a precocious tissue repair to reduce the physical, social, and psychological morbidity. Advances in the knowledge on the control of interaction among cells, matrix and growth factors will provide more information on the Regenerative Medicine, an emerging area of research in medical bioengineering. However, considering the dynamism and complexity of the cutaneous healing response, it is fundamental to understand the control mechanism exerted by the interaction and synergism of both systems, cutaneous nervous and central nervous, via hypothalamus hypophysis-adrenal axis, a relevant subject, but hardly ever explored. The present study reviews the neuro-immune-endocrine physiology of the skin responsible for its multiple functions and the extreme disturbances of the healing process, like the excess and deficiency of the extracellular matrix deposition.
Determining ICH Score: can we go beyond?
Authors: Patriota Gustavo Cartaxo , Silva-Júnior João Manoel da , Barcellos Alécio Cristino Evangelista Santos , Silva Júnior Joaquim Barbosa de Sousa , Toledo Diogo Oliveira , Pinto Fernando Campos Gomes , Rotta José Marcus
Published: August 2009

Spontaneous intracerebral hemorrhage (SICH) still presents a great heterogeneity in its clinical evaluation, demonstrating differences in the enrollment criteria used for the study of intracerebral hemorrhage (ICH) treatment. The aim of the current study was to assess the ICH Score, a simple and reliable scale, determining the 30-day mortality and the one-year functional outcome. Consecutive patients admitted with acute SICH were prospectively included in the study. ICH Scores ranged from 0 to 4, and each increase in the ICH Score was associated with an increase in the 30-day mortality and with a progressive decrease in good functional outcome rates. However, the occurrence of a pyramidal pathway injury was better related to worse functional outcome than the ICH Score. The ICH Score is a good predictor of 30-day mortality and functional outcome, confirming its validity in a different socioeconomic populations. The association of the pyramidal pathway injury as an auxiliary variable provides more accurate information about the prognostic evolution.
Significance of background activity and positive sharp waves in neonatal electroencephalogram as prognostic of cerebral palsy
Authors: Nosralla Márcia de Oliveira Nicolini , Silva Délrio Façanha , Botelho Ricardo Vieira
Published: August 2009

OBJECTIVE: To study the significance of electroencephalographic background activity and positive sharp waves in neonatal electroencephalogram as prognostic of cerebral palsy. METHOD: We studied prospectively and sequentially 73 newborns who had severe neonatal complications (neonatal anoxia, seizures, respiratory distress, sepsis, and meningitis). Nineteen newborns were excluded and 54 children formed the object of our study and were followed for 2 years. We analyzed gestational age, conceptional age, electroencephalographic background activity and positive sharp waves, which were correlated with cerebral palsy. RESULTS: There were no statistically significant correlation between gestational age and conceptional age and cerebral palsy; the electroencephalographic background activity was correlated with cerebral palsy as well as the positive sharp waves. CONCLUSION: Children with electroencephalographic background activity markedly abnormal and accompanied by positive sharp waves were associated with a worse prognosis.
Prevalence of epilepsy and seizure disorders as causes of apparent life- threatening event (ALTE) in children admitted to a tertiary hospital
Authors: Anjos Alessandra Marques dos , Nunes Magda Lahorgue
Published: August 2009

OBJECTIVE: To determine the prevalence and describe clinical characteristics of seizure disorders and epilepsy as causes of apparent life- threatening event (ALTE) in children admitted at the emergency and followed in a tertiary hospital. METHOD: Cross-sectional study with prospective data collection using specific guidelines to determine the etiology of ALTE. RESULTS: During the study, 30 (4.2%) children admitted to the hospital had a diagnosis of ALTE. There was a predominance of males (73%) and term infants (70%). Neonatal neurological disorders and neuropsychomotor development delay were found respectively in 13.4% and 10% of the cases. Etiological investigation revealed that 50% of the cases were idiopathic, and 13.4% were caused by epilepsy or seizure disorders. Although all patients had recurrent ALTE events, epilepsy had not been previously suspected. CONCLUSION: Epilepsy should be included in the differential diagnosis of ALTE, particularly when events are recurrent.
Intracranial and spinal ependymoma: series at Faculdade de Medicina, Universidade de São Paulo
Authors: Andrade Fernanda Gonçalves de , Aguiar Paulo Henrique Pires de , Matushita Hamilton , Taricco Mario Augusto , Oba-Shinjo Sueli Mieko , Marie Suely Kazue Nagahashi , Teixeira Manoel Jacobsen
Published: August 2009

OBJECTIVE: Ependymomas are rare intracranial neuroepithelial tumors and the most common location is intramedullary. The aim was to analyze the characteristics of these tumors to determine the patients' overall survival and the likelihood of recurrence. METHOD: Data of clinical presentation, tumor location, duration of symptoms, degree of resection and complementary treatment of 34 patients with intracranial ependymoma and 31 with intramedullary ependymoma who underwent surgery in the last ten years were collected and correlated with the recurrence time and overall survival. RESULTS: There was statistically significant correlation between the degree of resection and intracranial tumor location, although it is not a hallmark of recurrence. Data analyses of intramedullary ependymoma did not show correlation with overall survival and likelihood of recurrence. CONCLUSION: The location of the intracranial tumor is connected with the degree of resection; however it is not a predictive factor to overall survival.
The presence of antiautonomic membrane receptor antibodies do not correlate with brain lesions in Chagas' disease
Authors: Py Marco O. , Maciel Leonardo , Pedrosa Roberto C. , Nascimento Jose H. M. , Medei Emiliano
Published: August 2009

We previously demonstrated correlation between parasympathetic dysfunction and brain white matter lesions in chronic chagasic patients. OBJECTIVE: To correlate serum functional circulating antibodies with beta adrenergic (Ab-β), muscarinic (Ab-M) or muscarinic and beta adrenergic (Ab-Mβ) activity, the autonomic system function and brain lesions in chronic chagasic patients. METHOD: In fifteen consecutive chagasic patients, the autonomic nervous system was evaluated and brain magnetic resonance imaging (MRI) was performed. The sera of all patients were tested to the presence of circulating functional antibodies. RESULTS: Sera from 11 of 15 chronic chagasic patients had some activity (Ab-β: 7; Ab-M: 1; Ab-Mβ: 3); however, there was no significant correlation between the presence of antibodies and the autonomic system function or the presence of hyperintensities in MRI. CONCLUSION: The mechanism involved in the genesis of hyperintense lesions seen in brain MRI of chronic chagasic patients is still unresolved, although apparently related to parasympathetic dysfunction.
Acute disseminated encephalomyelitis: clinical features, HLA DRB1*1501, HLA DRB1*1503, HLA DQA1*0102, HLA DQB1*0602, and HLA DPA1*0301 allelic association study
Authors: Alves-Leon Soniza Vieira , Veluttini-Pimentel Maria Lucia , Gouveia Maria Emmerick , Malfetano Fabíola Rachid , Gaspareto Emerson L. , Alvarenga Marcos P. , Frugulhetti Izabel , Quirico-Santos Thereza
Published: August 2009

We evaluated the frequency, demographic, clinical, disability evolution and genetic association of HLA DRB1*1501, DRB1*1503, DQA1*0102, DQB1*0602 and DPA1*0301 alleles in patients diagnosed as acute disseminated encephalomyelitis (ADEM) among a population of CNS demyelinating diseases. Fifteen patients (8.4%) of our series were diagnosed as ADEM. The mean age onset was 35.23 years (range 12 to 77), 53.3% were male and follow-up range was 8.5 to 16 years. Two cases (13.3%) had a preceding infection before neurological symptoms, one presented a parainfectious demyelinating, and one case had been submitted to hepatitis B vaccination four weeks before the clinical onset. The EDSS range was 3.0 to 9.5. Eight patients (53.3%) presented MRI with multiple large lesions. CSF was normal in 73.3%. The severe disability observed at EDSS onset improved in 86.66% patients. The genetic susceptibility for ADEM was significantly associated with the HLA DQB1*0602, DRB1*1501 and DRB1*1503 alleles (<0.05) in monophasic ADEM.
MELAS: clinical features, muscle biopsy and molecular genetics
Authors: Lorenzoni Paulo José , Scola Rosana H. , Kay Cláudia S. Kamoi , Arndt Raquel C. , Freund Aline A. , Bruck Isac , Santos Mara Lúcia S.F. , Werneck Lineu C.
Published: August 2009

OBJECTIVE: The aim of the study was to analyze a series of Brazilian patients suffering from MELAS. METHOD: Ten patients with MELAS were studied with correlation between clinical findings, laboratorial data, electrophysiology, histochemical and molecular features. RESULTS: Blood lactate was increased in eight patients. Brain image studies revealed a stroke-like pattern in all patients. Muscle biopsy showed ralled-red fibers (RRF) in 90% of patients on modified Gomori-trichrome and in 100% on succinate dehydrogenase stains. Cytochrome c oxidase stain analysis indicated deficient activity in one patient and subsarcolemmal accumulation in seven patients. Strongly succinate dehydrogenase-reactive blood vessels (SSV) occurred in six patients. The molecular analysis of tRNA Leu(UUR) gene by PCR/RLFP and direct sequencing showed the A3243G mutation on mtDNA in 4 patients. CONCLUSION: The muscle biopsy often confirmed the MELAS diagnosis by presence of RRF and SSV. Molecular analysis of tRNA Leu(UUR) gene should not be the only diagnostic criteria for MELAS.
Amyotrophic lateral sclerosis (ALS): three letters that change the people's life. For ever
Authors: Oliveira Acary Souza Bulle , Pereira Roberto Dias Batista
Published: August 2009

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease affecting the motor nervous system. It causes progressive and cumulative physical disabilities in patients, and leads to eventual death due to respiratory muscle failure. The disease is diverse in its presentation, course, and progression. We do not yet fully understand the cause or causes of the disease, nor the mechanisms for its progression; thus, we lack effective means for treating this disease. Currently, we rely on a multidisciplinary approach to symptomatically manage and care for patients who have ALS. Although amyotrophic lateral sclerosis and its variants are readily recognized by neurologists, about 10% of patients are misdiagnosed, and delays in diagnosis are common. Prompt diagnosis, sensitive communication of the diagnosis, the involvement of the patient and their family, and a positive care plan are prerequisites for good clinical management. A multidisciplinary, palliative approach can prolong survival and maintain quality of life. Treatment with Riluzole improves survival but has a marginal effect on the rate of functional deterioration, whereas non-invasive ventilation prolongs survival and improves or maintains quality of life. In this Review, we discuss the diagnosis, management, and how to cope with impaired function and end of life on the basis of our experience, the opinions of experts, existing guidelines, and clinical trials. Multiple problems require a multidisciplinary approach including aggressive symptomatic management, rehabilitation to maintain motor function, nutritional support (enteric feeding, gastrostomy), respiratory support (non invasive home ventilation, invasive ventilation, tracheotomy), augmentative communication devices, palliative care, psychological support for both patients and families (because family members so often play a central role in management and care), communication between the care team, the patient and his or her family, and recognition of the clinical and social effects of cognitive impairment. Social, bioethical, and financial issues as well as advance directives should be addressed. A plethora of evidence-based guidelines should be compiled into an internationally agreed guideline of best practice. The multidisciplinary team has changed the history of disease, with still no curative therapy available.
Form, entwicklung und funktion der hypodermalen druesen von rhinocricus padbergii (Diplopoda)
Authors: Barth Rudolf
Published: August 2009

Es werden die hypodermalen Druesen von rhinocricus padbergii (Diplopoda) histologisch beschrieben, sowie ihre Bildung in der Hypodermis sich frisch haeutender Tiere dargestellt. 1. Die Druesen bestehen aus vier wohldifferenzierten Zellen, von denen zwei als Kanalzellen und zwei als Druesenzellen funktionieren. 2. Die Druesenzellen entleeren ihr Sekret durch einen langen, sehr duennen Kanal auf die Oberflaeche der Cuticula im Anfang ihrer Neubildung, wo das Sekret hoechst wahrscheinlich zur Bildung der neuen Epicuticula beitraegt. 3. Der Ausleitungsapparat besteht aus einem in den beiden kanalzellen durch zwei aeussere Spiralfaeden verstaerkten, sehr duennen Kanal, der an der Basalflaeche der zweiten Kanalzelle eine klammerartige Verdickung zeigt. Er setzt sich als sehr duennhaeutiger, dehnbarer kanal in die erste Druesenzelle fort, an deren Basisflaeche er sich in zwei kurze Zweige aufteilt, von denen einer in die zweite Druesenzelle reicht. Um die offene Endigung der Zweige bildet sich eine kugelfoermige, radialstrahlige Ausfuehrzone, die vermutlich aus Mikrovilli aufgebaut ist. 4. Das Sekret kann in dem dehnbaren Teil des kanals innerhalb der ersten Druesenzelle gespeichert werden. Sein Austritt wird durch die Elastizitaet der erwaehnten Klammer des Kanals geregelt. 5. Die vier Kerne des Druesenkomplexes bilden sich durch zweifache amitotische Teilung aus einer Hypodermiszelle, besonders an den hinteren Raendern der Sklerite. 6. Der Ausfuehrkanal bildet sich als Invagination der aeussersten Ektocuticularlamelle.
Um estranho à minha porta: preparando estudantes de medicina para visitas domiciliares
Authors: Ramos-Cerqueira Ana Teresa de Abreu , Torres Albina Rodrigues , Martins Sueli Terezinha Ferreira , Lima Maria Cristina Pereira
Published: August 2009

Este trabalho descreve a experiência de preparação de alunos do primeiro ano da Faculdade de Medicina de Botucatu-Unesp para as visitares domiciliares da disciplina Interação Universidade-Serviço-Comunidade. Docentes de Psicologia e Psiquiatria coordenaram a atividade, realizada com dois grupos de 45 alunos por meio da técnica de sociodrama, que inclui as etapas de aquecimento, dramatização e compartilhamento. Os principais temas trazidos pelos alunos nas dramatizações foram: a) briga e violência; b) miséria e carência; c) desapontamento e desinteresse; d) impotência e fracasso; e) rejeição e desconfiança. Assim, muitas situações temidas e emoções raramente abordadas nos cursos médicos puderam ser vivenciadas e elaboradas em poucas horas. Esta experiência reforça a necessidade de preparar o graduando para entrar em contato com os múltiplos e complexos determinantes do processo saúde-doença e para atuar no cuidado à saúde segundo uma perspectiva interdisciplinar e intersetorial. É fundamental que o aluno tenha uma visão ampliada do paciente inserido na sua família e contexto sociocultural, se dispondo a um trabalho de parceria, colaboração e mútuo aprendizado.
Semiologia integrada: uma experiência curricular de aproximação antecipada e integrada à prática médica
Authors: Marco Mario Alfredo de , Lucchese Ana Cecília , Dias Cíntia Camargo , Abud Cristiane Curi , Martins Luiz Antonio Nogueira
Published: August 2009

Para evitar a fragmentação e a estereotipia e favorecer uma aproximação antecipada da pratica médica, foi introduzido o curso de Semiologia Integrada no programa do segundo ano do curso médico da Unifesp. Este curso inclui a realização de anamneses no hospital, seguidas de discussões que contam com a participação conjunta dos professores de Psicologia Médica e de professores de diferentes áreas da Semiologia (Clínica Médica, Pediatria, Ginecologia, Obstetrícia e Geriatria). Foi dada atenção especial para apresentar ao estudante de Medicina um modelo que integrasse os aspectos biológicos, psicológicos e sociais do adoecer. Este artigo apresenta o projeto e as observações preliminares, que sugerem um importante potencial integrador tanto para os alunos quanto para os professores. São necessárias avaliações futuras para comprovar essas observações.
Relato de experiência: o uso de simulações no processo de ensino-aprendizagem em medicina
Authors: Varga Cássia Regina Rodrigues , Almeida Volia de Carvalho , Germano Carla Maria Ramos , Melo Débora Gusmão , Chachá Silvana Gama Florêncio , Souto Bernardino Geraldo Alves , Fontanella Bruno José Barcellos , Lima Valéria Vernaschi
Published: August 2009

Este trabalho relata a experiência, construída ao longo de dois anos, com o uso de estações de simulação da prática profissional no processo de ensino-aprendizagem do curso de graduação em Medicina da Universidade Federal de São Carlos. Seu referencial pedagógico está ancorado na concepção construtivista da aprendizagem e parte da premissa de que aprender não é reproduzir a realidade, mas ser capaz de elaborar uma representação pessoal sobre esta e seus conteúdos. Assim, a partir da vivência de situações simuladas, os estudantes são estimulados a ressignificar seus conhecimentos construindo novos saberes. Na Unidade Educacional Estações de Simulação da Prática Profissional, o estudante se defronta com pacientes simulados e tem a oportunidade de aprender fazendo, errando e aprendendo com os próprios erros. Ao refletir sobre o erro, constrói seu aprendizado por meio da identificação de lacunas de conhecimento e fundamenta cognitivamente suas capacidades. Professores acompanham o desenvolvimento dos estudantes, atuando ora como avaliadores, ora como facilitadores, ora como consultores. Esta estratégia pedagógica pode ser um instrumento poderoso para o desenvolvimento de competência na área clínica.
Teatralização do sagrado islâmico: a palavra, a voz e o gesto
Authors: Ferreira Francirosy Campos Barbosa
Published: August 2009

A proposta do artigo é apresentar um dos elementos performáticos da religião islâmica: a salat (oração islâmica). O modo como a salat é elaborada fisicamente, moldando o corpo do muçulmano, permite que esse seja visto como um veículo de comunicação entre o fiel e Deus. Nesse sentido, estabeleço uma proximidade entre o ator que repete, ensaia o seu papel várias vezes, e o muçulmano, que reza e se aprimora a cada oração. O argumento central do texto é que o aprimoramento do muçulmano (com o auxílio do comportamento restaurado) deve levar em consideração o conhecimento da palavra, o uso da voz (vocalidade) e o gesto. É no gesto da oração que percebemos a entrega desse muçulmano.
Conversão, com versões: a respeito de modelos de conversão religiosa
Authors: Banaggia Gabriel
Published: August 2009

Preferindo entender que não cabe ao antropólogo desautorizar os discursos nativos, quaisquer que sejam suas proposições, este trabalho pretende considerar afirmativas díspares a respeito de processos de conversão religiosa. Diferentes fenômenos de conversão são mobilizados não para serem explicados pelos modelos apresentados, mas para evidenciar quais os pressupostos e a aplicabilidade destes últimos. Deste modo, e calcando-se em exemplos etnográficos, almeja-se reposicionar certas perguntas a respeito daquilo que seria propriamente uma conversão e de como ela aconteceria. Por fim, analisa-se de que modo os movimentos de conversão contemplados implicam um desafio à consideração das noções de aculturação ou mudança social.
Alquimia, Ocultismo, Maçonaria: o ouro e o simbolismo hermético dos cadinhos (Séculos XVIII e XIX)
Authors: Lima Tania Andrade , Silva Marília Nogueira da
Published: August 2009

Este artigo apresenta a arqueologia das enigmáticas marcas impressas na base de cadinhos dos séculos XVIII e XIX recuperados nas escavações da Casa da Moeda do Rio de Janeiro, na década de 1980, e a explanação do seu significado simbólico à luz da alquimia, do ocultismo e da Maçonaria. Espraiando-se extraordinariamente mundo afora através de uma bem-sucedida estratégia de comunicação visual, a Maçonaria utilizou símbolos herméticos para a difusão de seus princípios nos mais diferentes suportes. Aparentemente estamos diante de um sinal de reconhecimento maçônico, o sinal exterior de uma organização oculta, só partilhado por iniciados e incompreensível para os demais, que contribuiu para difundir veladamente a doutrina maçônica por diferentes pontos do globo.
Uniformes da Guarda Nacional (1831-1852): a indumentária na organização e funcionamento de uma associação armada
Authors: Almeida Adilson José de
Published: August 2009

O objetivo desta pesquisa sobre uniformes da Guarda Nacional foi examinar a utilização de indumentária na organização e funcionamento de uma associação armada. Um passo inicial para estudarmos o vestuário como um vetor material da produção e reprodução social. Não se trata, portanto, do estudo de um artefato, mas de suas funções, pragmáticas, diacríticas e simbólicas, meios para análise de problemas mais amplos relativos à organização, desenvolvimento e mudança de sociedades.
Preditores de abandono de tratamento na psicoterapia psicanalítica de crianças
Authors: Gastaud Marina Bento , Nunes Maria Lúcia Tiellet
Published: August 2009

INTRODUÇÃO: As altas taxas de abandono em psicoterapia e a lacuna na literatura sobre abandono de tratamento na psicoterapia de crianças justificam a realização de pesquisas com esse foco. A literatura aponta que algumas variáveis sociodemográficas e clínicas poderiam predizer o desfecho da psicoterapia. O presente estudo objetivou verificar preditores de abandono de tratamento na psicoterapia psicanalítica de crianças na amostra pesquisada. MÉTODO: Trata-se de um estudo documental, retrospectivo, com os prontuários de duas instituições de atendimento psicológico a crianças em Porto Alegre. RESULTADOS: Foram pesquisados prontuários de 2.106 crianças. Dessas, 200 tiveram alta e 793 abandonaram seus atendimentos. Os grupos foram comparados, e os resultados indicam que meninos apresentam mais risco de abandonar o tratamento; já crianças encaminhadas por neurologistas ou por psicólogos apresentam menos risco de abandono. Após o sexto mês de atendimento, o risco de abandono decai consideravelmente. DISCUSSÃO: Os resultados são discutidos à luz da literatura sobre gênero, abandono de tratamento e crianças em psicoterapia. Algumas hipóteses são levantadas para as associações e não-associações encontradas neste estudo. CONCLUSÕES: Conhecer preditores de abandono em psicoterapia possibilita aos terapeutas identificar precocemente pacientes pertencentes ao grupo de risco para abandono, oportunizando-lhes trabalhar preventivamente e mais diretamente aspectos de resistência e transferência negativa desses pacientes e seus familiares, principalmente nos primeiros 6 meses de tratamento. Criar técnicas de intervenção precoce com os pais de tais crianças e realizar tratamentos transdisciplinares também são saídas possíveis para evitar o abandono.
Jovens vivendo com HIV/AIDS: a influência da rede de relações, do coping e do neuroticismo sobre a satisfação de vida
Authors: Serafini Adriana Jung , Bandeira Denise Ruschel
Published: August 2009

OBJETIVOS: Verificar o efeito das variáveis rede de relações, neuroticismo e estratégias de coping sobre a variável satisfação de vida em jovens soropositivos. Também buscou-se apresentar um perfil descritivo da amostra para as variáveis investigadas. MÉTODO: Participaram 45 jovens soropositivos, com média de idade de 18,7 anos (desvio padrão = 2,7), procedentes de três centros de atendimento da Grande Porto Alegre. Os instrumentos utilizados foram um questionário de dados sociodemográficos, a Escala Multidimensional de Satisfação de Vida para Adolescentes, o Inventário de Rede de Relações, o Inventário de Estratégias de Coping e a Escala Fatorial de Ajustamento Emocional/Neuroticismo. Os dados dos instrumentos foram analisados através de análises de covariância e de variância multivariadas e análise de regressão múltipla. RESULTADOS: De forma geral, o nível de satisfação de vida dos jovens portadores do vírus HIV é bom, porém há um certo declínio na satisfação com as amizades. Em relação às estratégias de coping, as médias entre elas foram semelhantes. Níveis altos de neuroticismo foram evidenciados nos participantes, em especial no que se refere ao fator depressão. Esse foi o fator que melhor predisse a satisfação de vida total da amostra. CONCLUSÕES: Pode-se perceber onde residem as maiores dificuldades desse grupo e, dessa forma, elaborar programas de intervenção efetivos.
A experiência da Universidade São Francisco com o internato médico de psiquiatria utilizando a metodologia da aprendizagem baseada em problemas
Authors: Paulin Luiz Fernando Ribeiro da Silva , Poças Regina Caeli Guerra
Published: August 2009

Nos últimos anos, o ensino médico vem sofrendo modificações pedagógicas e curriculares, visando promover a formação de um novo profissional de saúde. Uma das alternativas pedagógicas propostas é a educação problematizadora, que trabalha essencialmente com a construção de conhecimentos a partir da vivência de experiências significativas. Tal modelo de aprendizagem tem viabilizado mudanças curriculares, em que a psiquiatria vem conquistando espaço significativo para o desenvolvimento de uma prática médica mais humanística e integral. O artigo se propõe a discutir a experiência do Curso de Medicina da Universidade São Francisco, em Bragança Paulista (SP) referente à implantação do internato de psiquiatria pela metodologia da aprendizagem baseada em problemas, desde 2003. O internato de psiquiatria ocorre no quinto ano do Curso de Medicina, com carga horária de 320 horas, correspondendo a 8 semanas de 40 horas. As atividades são desenvolvidas no hospital-dia e no ambulatório, e a interconsultoria é realizada no hospital geral. Observa-se significativa evolução no conhecimento adquirido dos alunos, que conseguem, ao término do internato, desenvolver raciocínio clínico e sedimentação de conceitos e práticas psiquiátricas adequadas à formação médica generalista, compatíveis ao que o curso de graduação propõe. A experiência relatada pode servir de modelo para a implantação de uma proposta de aprendizagem em saúde mental inserida nos preceitos da reforma psiquiátrica no Brasil, buscando-se implementar o desenvolvimento de práticas comunitárias e interdisciplinares.
The occurrence of Callinectes arcuatus ordway, 1863 (Crustacea, Decapoda, Portunidae) in Bahia, Brazil
Authors: Gouvêa Edilson Pires de
Published: August 2009

During the study of the Carcinofauna of the Bahian Coast, some Brachyura Portunidae were found. Some of these animals were Callinectes arcuatus Ordway, 1863 which has its distribution restricted to the Pacific Ocean, from California to Peru and the Galapagos Islands. This is the first occurrence of this species reported from the Atlantic Ocean and the Brazilian Coast (Bahia, 38º50'Wand 12º50'S).