bluuebunny/crossref_metadata_2025 huggingface dataset:
Insuficiência cardíaca congestiva em crianças: do tratamento farmacológico ao transplante cardíaco
Authors: Azeka Estela , Vasconcelos Luciana Marques de , Cippiciani Tarcila Marinho , Oliveira Adriana Santos de , Barbosa Denise Fabron , Leite Rafael Marcondes Gonçalves , Gapit Vânia Löschi
Published: June 2014

A insuficiência cardíaca em crianças ocorre basicamente por: 1) defeitos cardíacos congênitos que levam à sobrecarga pressórica ou volumétrica na presença ou ausência de cianose; 2) cardiomiopatias congênitas ou adquiridas por erros inatos do metabolismo, distrofias musculares, infecções, drogas, toxinas e doença de Kawasaki; e 3) disfunção miocárdica após correção de defeitos cardíacos. Suas manifestações variam com a idade. Os sintomas mais comuns em lactentes são taquipnéia, taquicardia e dispnéia às mamadas; em crianças maiores fadiga e intolerância ao exercício; já em adolescentes são similares aos dos adultos. Seu tratamento pode ser a correção do defeito cardíaco congênito, com o uso ou não de drogas para otimizar o quadro clínico antes da cirurgia. Faz-se uso prolongado de medicação anti-congestiva em pacientes com defeitos cardíacos com tendência a fechamento espontâneo. As drogas utilizadas são digitálicos, diuréticos, inibidores da enzima conversora de angiotensina e os beta-bloqueadores. Estudos sobre eficácia das drogas mostram que a digoxina tem efeito benéfico modesto em crianças e os beta-bloqueadores melhoram a função ventricular. Há poucos estudos sobre a eficácia dos diuréticos e sobre os benefícios dos inibidores de angiotensina em crianças, principalmente se os inibidores possuem efeitos similares aos dos adultos e se apresentam efeitos no desenvolvimento da criança ao longo prazo. O transplante cardíaco tem sido indicado como tratamento principalmente para o estágio D de insuficiência cardíaca.
Escroto agudo
Authors: Mosconi Alcides , Claro Joaquim Francisco de Almeida , Andrade Enrico , Vicentini Fábio , Paranhos Mario Luiz da Silva
Published: June 2014

O escroto agudo, caracterizado pela presença de dor local intensa, edema e alteração da consistência das estruturas da bolsa testicular, constitui uma urgência urológica e corresponde a 0,5% dos atendimentos nos serviços de emergência. As causas mais freqüentes de escroto agudo são os processos inflamatórios locais (orquiepididimites) e vasculares isquêmicos (torção testicular), cujo diagnóstico diferencial nem sempre é feito de forma simples. Nesse sentido, dois exames podem evidenciar as alterações locais, incluindo o fluxo sanguíneo: o ultrassom Doppler e a cintilografia escrotal. A ultrassonografia com Doppler do escroto constitui exame pouco invasivo, de custo acessível, alta disponibilidade, rápida execução e elevada sensibilidade (cerca de 90%) e especificidade (99%). Por outro lado, a cintilografia escrotal permite definir com precisão a irrigação dos testículos, porém demanda maior tempo e não é disponível na maioria dos serviços. Quando com esses recursos propedêuticos o diagnóstico final permanece incerto, a exploração cirúrgica é indicada e deve ser realizada sem demora, de modo a permitir a preservação testicular nos casos de torção do cordão.
Trauma urológico
Authors: Cury José , Mesquita José Luiz Borges de , Pontes José , Oliveira Luiz Carlos Neves de , Cordeiro Mauricio , Coelho Rafael Ferreira
Published: June 2014

Os traumas geniturinários representam 10% de todos os traumas em nosso serviço de emergência (HC-FMUSP). O rim é, em geral, o órgão mais freqüentemente envolvido, sendo os traumas de ureter e bexiga mais raros e associados a traumas de alta energia e a outras lesões severas concomitantes. As lesões de ureter são causadas em sua maioria por traumas penetrantes ou por lesões cirúrgicas iatrogênicas. As lesões de uretra, por sua vez, são quase sempre associadas a fraturas do anel pélvico, estando associadas a lesões vesicais em 10 a 17% dos casos. Um princípio primordial a ser aplicado no diagnóstico do trauma urológico é suspeitar-se da lesão pela avaliação do seu mecanismo e das forças envolvidas no traumatismo, pois os sinais envolvidos são inespecíficos, principalmente em vítimas de trauma fechado. O conhecimento da etiologia, fisiopatologia, diagnóstico e tratamento das principais lesões traumáticas do trato urinário é fundamental para a abordagem adequada do paciente politraumatizado no serviço de emergência. A interação do urologista com o cirurgião do trauma desde os momentos iniciais do atendimento permite guiar as decisões terapêuticas de maneira integrada e congruente. Neste artigo discutiremos os aspectos centrais do diagnóstico e do tratamento das principais lesões do trato geniturinário (TGU).
A história do Congresso Médico Universitário da FMUSP - COMU
Authors: Ramalho Alan Saito , Vasconcelos Luciana Marques de , Cippiani Tarcila Marinho
Published: June 2014

Em 2008, o Congresso Médico Universitário da FMUSP – COMU – chega à sua vigésima sétima edição. O COMU é composto de cursos, palestras, mesas redondas, workshops, jantares e apresentação de trabalhos científicos de acadêmicos que visam contribuir para aformação profissional dos estudantes de medicina, incentivar a pesquisa científica e promover a integração cultural dos participantes. Realizado anualmente desde 1982, o COMU mantém seu sucesso e cresce cada vez mais em infra-estrutura. Para entender o sucesso do COMU, é essencial conhecer sua história e lembrar como e o COMU surgiu.
Dispepsia: caracterização e abordagem
Authors: Silva Fernando Marcuz
Published: June 2014

A dispepsia é uma síndrome de alta prevalência, embora somente uma pequena parte dos pacientes que sofrem com ela procure atenção médica. Os conceitos e abordagens relacionadas à síndrome, apoiados nas sugestões do Consenso de Roma III, são apresentados neste artigo. Casos da síndrome na prática médica são propostos para auto-avaliação, e suas soluções e comentários são também apresentados.
Insuficiência cardíaca
Authors: Santos Itamar de Souza , Bittencourt Márcio Sommer
Published: June 2014

A insuficiência cardíaca é síndrome comum, com taxas de prevalência estimadas de 2 a 4%. As duas últimas décadas aumentaram significativamente o conhecimento sobre a doença. Este artigo revisa importantes aspectos fisiopatológicos, semiológicos e da investigação complementar necessários para o manejo clínico. O tratamento, farmacológico e não farmacológico, é detalhado, incluindo suas indicações e contra-indicações.
Síndromes funcionais somáticas
Authors: Pilan Luís Augusto , Benseñor Isabel M.
Published: June 2014

As síndromes funcionais somáticas são muito freqüentes na prática clínica e estão na fronteira entre a clínica e a psiquiatria. Embora não sejam doenças graves, comprometem a qualidade de vida e sobrecarregam os gastos no sistema de saúde. Embora muito prevalentes, ainda geram polêmica em relação ao diagnóstico e tratamento.
Síndrome metabólica: diagnóstico e tratamento
Authors: Penalva Daniele Q. Fucciolo
Published: June 2014

A síndrome metabólica é definida com um grupo de fatores de risco que diretamente contribuem para o desenvolvimento de doença cardiovascular e/ou diabetes do tipo 2. A obesidade abdominal e a resistência à insulina parecem ter um papel fundamental na gênese desta síndrome. Seu tratamento deve ter como objetivo estimular mudanças no estilo de vida, que promovam a perda de peso.
Prevalência de tabagismo em estudantes de faculdade de medicina
Authors: Magliari Rafael Thiesen , Pagliusi Alexandre Lima , Previero Bruno Manetti , Menezes Fernando Reis , Feldman Andre , Novo Neil Ferreira
Published: June 2014

O tabagismo é atualmente a principal causa de enfermidades evitáveis e incapacidades prematuras em âmbito mundial, sendo que a Organização Mundial de Saúde (OMS) estima cerca de 10 milhões de mortes anuais nos próximos 30 a 40 anos em virtude de complicações de saúde decorrentes do tabaco. Apesar de possuir uma função preventiva em programas antitabagistas, estudos recentes revelam que a classe médica possui porcentagem significativa de profissionais fumantes, abalando a credibilidade da mensagem de que fumar é lesivo à saúde. Devido a diversos fatores, dentre eles as dificuldades acadêmicas impostas pelo treinamento médico, parcela significativa de médicos começa a fumar durante a faculdade. O trabalho atual tem como meta analisar a prevalência de tabagismo entre 241 acadêmicos de medicina, através de questionário validado. Verificou-se uma incidência média de 17,8% de fumantes cuja idade média foi de 21,6 anos e tempo médio de consumo de tabaco de 5,9 anos. Os autores do trabalho concluem a importância de se conhecer os dados de tabagismo dentre os estudantes de medicina consiste em reforçar a necessidade de campanhas de cessação do fumo em todas as classes da sociedade, inclusive e, principalmente, dentre os futuros profissionais médicos que serão os principais agentes na prevenção do tabagismo.
Penicilina: oitenta anos
Authors: Ferreira Marina Vilela Chagas , Paes Vitor Ribeiro , Lichtenstein Arnaldo
Published: June 2014

Há oitenta anos, Alexander Fleming descobriu a penicilina. O trabalho enfatiza o contexto no qual foi descoberto a penicilina e suas repercussões na prática clínica e na epidemiologia.
PR Interval Identifies Clinical Response in Patients With Non–Left Bundle Branch Block
Authors: Kutyifa Valentina , Stockburger Martin , Daubert James P. , Holmqvist Fredrik , Olshansky Brian , Schuger Claudio , Klein Helmut , Goldenberg Ilan , Brenyo Andrew , McNitt Scott , Merkely Bela , Zareba Wojciech , Moss Arthur J.
Published: June 2014

Background—

In Multicenter Automatic Defibrillator Implantation Trial–Cardiac Resynchronization Therapy (MADIT-CRT), patients with non–left bundle branch block (LBBB; including right bundle branch block, intraventricular conduction delay) did not have clinical benefit from cardiac resynchronization therapy with defibrillator (CRT-D). We hypothesized that baseline PR interval modulates clinical response to CRT-D therapy in patients with non-LBBB.

Methods and Results—

Non-LBBB patients (n=537; 30%) were divided into 2 groups based on their baseline PR interval as normal (including minimally prolonged) PR (PR <230 ms) and prolonged PR (PR ≥230 ms). The primary end point was heart failure or death. Separate secondary end points included heart failure events and all-cause mortality. Cox proportional hazards regression models were used to compare risk of end point events by CRT-D to implantable cardioverter defibrillator therapy in the PR subgroups. There were 96 patients (22%) with a prolonged PR and 438 patients (78%) with a normal PR interval. In non-LBBB patients with a prolonged PR interval, CRT-D treatment was associated with a 73% reduction in the risk of heart failure/death (hazard ratio, 0.27; 95% confidence interval, 0.13–0.57;
P
<0.001) and 81% decrease in the risk of all-cause mortality (hazard ratio, 0.19; 95% confidence interval, 0.13–0.57;
P
<0.001) compared with implantable cardioverter defibrillator therapy. In non-LBBB patients with normal PR, CRT-D therapy was associated with a trend toward an increased risk of heart failure/death (hazard ratio, 1.45; 95% confidence interval, 0.96–2.19;
P
=0.078; interaction
P
<0.001) and a more than 2-fold higher mortality (hazard ratio, 2.14; 95% confidence interval, 1.12–4.09;
P
=0.022; interaction
P
<0.001) compared with implantable cardioverter defibrillator therapy.

Conclusions—

The data support the use of CRT-D in MADIT-CRT non-LBBB patients with a prolonged PR interval. In non-LBBB patients with a normal PR interval, implantation of a CRT-D may be deleterious.

Clinical Trial Registration—

http://clinicaltrials.gov
; Unique Identifier: NCT00180271.
Validity of Claims-Based Stroke Algorithms in Contemporary Medicare Data
Authors: Kumamaru Hiraku , Judd Suzanne E. , Curtis Jeffrey R. , Ramachandran Rekha , Hardy N. Chantelle , Rhodes J. David , Safford Monika M. , Kissela Brett M. , Howard George , Jalbert Jessica J. , Brott Thomas G. , Setoguchi Soko
Published: June 2014

Background—

The accuracy of stroke diagnosis in administrative claims for a contemporary population of Medicare enrollees has not been studied. We assessed the validity of diagnostic coding algorithms for identifying stroke in the Medicare population by linking data from the REasons for Geographic And Racial Differences in Stroke (REGARDS) Study to Medicare claims.

Methods and Results—

The REGARDS Study enrolled 30 239 participants ≥45 years in the United States between 2003 and 2007. Stroke experts adjudicated suspected strokes, using retrieved medical records. We linked data for participants enrolled in fee-for-service Medicare to claims files from 2003 through 2009. Using adjudicated strokes as the gold standard, we calculated accuracy measures for algorithms to identify incident and recurrent strokes. We linked data for 15 089 participants, among whom 422 participants had adjudicated strokes during follow-up. An algorithm using primary discharge diagnosis codes for acute ischemic or hemorrhagic stroke (
International Classification of Diseases, Ninth Revision, Clinical Modification
codes: 430, 431, 433.x1, 434.x1, 436) had a positive predictive value of 92.6% (95% confidence interval, 88.8%–96.4%), a specificity of 99.8% (99.6%–99.9%), and a sensitivity of 59.5% (53.8%–65.1%). An algorithm using only acute ischemic stroke codes (433.x1, 434.x1, 436) had a positive predictive value of 91.1% (95% confidence interval, 86.6%–95.5%), a specificity of 99.8% (99.7%–99.9%), and a sensitivity of 58.6% (52.4%–64.7%).

Conclusions—

Claims-based algorithms to identify stroke in a contemporary Medicare cohort had high positive predictive value and specificity, supporting their use as outcomes for etiologic and comparative effectiveness studies in similar populations. These inpatient algorithms are unsuitable for estimating stroke incidence because of low sensitivity.
Characterization of
SEMA3A
-Encoded Semaphorin as a Naturally Occurring K
v
4.3 Protein Inhibitor and its Contribution to Brugada Syndrome
Authors: Boczek Nicole J. , Ye Dan , Johnson Eric K. , Wang Wei , Crotti Lia , Tester David J. , Dagradi Federica , Mizusawa Yuka , Torchio Margherita , Alders Marielle , Giudicessi John R. , Wilde Arthur A.M. , Schwartz Peter J. , Nerbonne Jeanne M. , Ackerman Michael J.
Published: June 2014

Rationale
:

Semaphorin 3A (
SEMA3A
)-encoded semaphorin is a chemorepellent that disrupts neural patterning in the nervous and cardiac systems. In addition, SEMA3A has an amino acid motif that is analogous to hanatoxin, an inhibitor of voltage-gated K
+
channels.
SEMA3A
-knockout mice exhibit an abnormal ECG pattern and are prone to ventricular arrhythmias and sudden cardiac death.

Objective
:

Our aim was to determine whether SEMA3A is a naturally occurring protein inhibitor of K
v
4.3 (I
to
) channels and its potential contribution to Brugada syndrome.

Methods and Results
:

K
v
4.3, Na
v
1.5, Ca
v
1.2, or K
v
4.2 were coexpressed or perfused with SEMA3A in HEK293 cells, and electrophysiological properties were examined via whole-cell patch clamp technique. SEMA3A selectively altered K
v
4.3 by significantly reducing peak current density without perturbing K
v
4.3 cell surface protein expression. SEMA3A also reduced I
to
current density in cardiomyocytes derived from human-induced pluripotent stem cells. Disruption of a putative toxin binding domain on K
v
4.3 was used to assess physical interactions between SEMA3A and K
v
4.3. These findings in combination with coimmunoprecipitations of SEMA3A and K
v
4.3 revealed a potential direct binding interaction between these proteins. Comprehensive mutational analysis of
SEMA3A
was performed on 198 unrelated SCN5A genotype–negative patients with Brugada syndrome, and 2 rare SEMA3A missense mutations were identified. The SEMA3A mutations disrupted SEMA3A’s ability to inhibit K
v
4.3 channels, resulting in a significant gain of K
v
4.3 current compared with wild-type SEMA3A.

Conclusions
:

This study is the first to demonstrate SEMA3A as a naturally occurring protein that selectively inhibits K
v
4.3 and
SEMA3A
as a possible Brugada syndrome susceptibility gene through a K
v
4.3 gain-of-function mechanism.
Apolipoprotein A-I Mimetic Peptide 4F Rescues Pulmonary Hypertension by Inducing MicroRNA-193-3p
Authors: Sharma Salil , Umar Soban , Potus Francois , Iorga Andrea , Wong Gabriel , Meriwether David , Breuils-Bonnet Sandra , Mai Denise , Navab Kaveh , Ross David , Navab Mohamad , Provencher Steeve , Fogelman Alan M. , Bonnet Sébastien , Reddy Srinivasa T. , Eghbali Mansoureh
Published: June 2014

Background—

Pulmonary arterial hypertension is a chronic lung disease associated with severe pulmonary vascular changes. A pathogenic role of oxidized lipids such as hydroxyeicosatetraenoic and hydroxyoctadecadienoic acids is well established in vascular disease. Apolipoprotein A-I mimetic peptides, including 4F, have been reported to reduce levels of these oxidized lipids and improve vascular disease. However, the role of oxidized lipids in the progression of pulmonary arterial hypertension and the therapeutic action of 4F in pulmonary arterial hypertension are not well established.

Methods and Results—

We studied 2 different rodent models of pulmonary hypertension (PH): a monocrotaline rat model and a hypoxia mouse model. Plasma levels of hydroxyeicosatetraenoic and hydroxyoctadecadienoic acids were significantly elevated in PH. 4F treatment reduced these levels and rescued preexisting PH in both models. MicroRNA analysis revealed that microRNA-193-3p (miR193) was significantly downregulated in the lung tissue and serum from both patients with pulmonary arterial hypertension and rodents with PH. In vivo miR193 overexpression in the lungs rescued preexisting PH and resulted in downregulation of lipoxygenases and insulin-like growth factor-1 receptor. 4F restored PH-induced miR193 expression via transcription factor retinoid X receptor α.

Conclusions—

These studies establish the importance of microRNAs as downstream effectors of an apolipoprotein A-I mimetic peptide in the rescue of PH and suggest that treatment with apolipoprotein A-I mimetic peptides or miR193 may have therapeutic value.
Plasma Levels of Fetuin‐A and Risk of Coronary Heart Disease in US Women: The Nurses' Health Study
Authors: Sun Qi , Jiménez Monik C. , Townsend Mary K. , Rimm Eric B. , Manson JoAnn E. , Albert Christine M. , Rexrode Kathryn M.
Published: June 2014

Background

Fetuin‐A may be involved in the etiology of coronary heart disease (
CHD
) through opposing pathways (ie, promoting insulin resistance and inhibiting ectopic calcification). We aimed to explicitly examine whether systemic inflammation, a factor leading to elevated vascular calcification, may modify the association between fetuin‐A and
CHD
risk.

Method and Results

During 16 years of follow‐up (1990–2006), we prospectively identified and confirmed 466 incident fatal or nonfatal
CHD
case in the Nurses' Health Study. For each case, 1 healthy control was selected using risk‐set sampling from 26 245 eligible participants. Cases and controls were matched for age, smoking status, fasting status, and date of blood draw. After multivariate adjustment for lifestyle factors, body mass index, diet, and blood lipids, fetuin‐A levels were not associated with
CHD
risk in the whole population: odds ratio (
OR
) (95%
CI
) comparing extreme quintiles of fetuin‐A was 0.79 (0.44 to 1.40). However, a significant inverse association was observed among participants with higher C‐reactive protein levels (
P
interaction
=0.04). The
OR
(95%
CI
) comparing highest versus lowest quintiles of fetuin‐A was 0.50 (0.26 to 0.97;
P
trend
=0.004) when
C‐reactive protein
levels were above population median (0.20 mg/dL), whereas among the remainder of the participants, the corresponding
OR
(95%
CI
) was 1.09 (0.58 to 2.05;
P
trend
=0.75).

Conclusions

In this population of
US
women, fetuin‐A levels were associated with lower
CHD
risk when
C‐reactive protein
levels were high, but null association was observed among participants with lower
C‐reactive protein
levels. This divergent pattern of association needs replication in future studies.
Endoplasmic Reticulum Stress Effector CCAAT/Enhancer‐binding Protein Homologous Protein (CHOP) Regulates Chronic Kidney Disease–Induced Vascular Calcification
Authors: Miyazaki‐Anzai Shinobu , Masuda Masashi , Demos‐Davies Kimberly M. , Keenan Audrey L. , Saunders Sommer J. , Masuda Rumiko , Jablonski Kristen , Cavasin Maria A. , Kendrick Jessica , Chonchol Michel , McKinsey Timothy A. , Levi Moshe , Miyazaki Makoto
Published: June 2014

Background

Cardiovascular diseases such as atherosclerosis and vascular calcification are a major cause of death in patients with chronic kidney disease (
CKD
). Recently, the long‐awaited results of the Study of Heart and Renal Protection trial were reported. This large randomized clinical trial found that an extensive cholesterol‐lowering therapy through the combination of simvastatin and ezetimibe significantly reduced cardiovascular diseases in a wide range of patients with
CKD
. However, the mechanism by which this cholesterol‐lowering therapy reduces
CKD
‐dependent vascular diseases remains elusive. The objective of the present study was to determine the contribution of the oxysterol‐induced pro‐apoptotic transcription factor CCAAT/enhancer‐binding protein homologous protein (
CHOP
) on the pathogenesis of
CKD
‐dependent cardiovascular diseases through endoplasmic reticulum stress signaling.

Methods and Results

CKD
increased levels of serum oxysterols such as 7‐ketocholesterol in human patients and ApoE
−/−
mice. Treatment with simvastatin plus ezetimibe strongly reduced levels of serum oxysterols and attenuated
CKD
‐dependent atherosclerosis, vascular cell death, vascular calcification, and cardiac dysfunction. This therapy also reduced aortic endoplasmic reticulum stress induced by
CKD
. The short hairpin
RNA
‐mediated knockdown of
CHOP
and activating transcription factor‐4 in vascular smooth muscle cells attenuated oxysterol‐induced mineralization, osteogenic differentiation, and endoplasmic reticulum stress. In addition,
CHOP
deficiency protected ApoE
−/−
mice from
CKD
‐dependent vascular calcification, cardiac dysfunction, and vascular cell death.

Conclusions

These data reveal that the cholesterol‐lowering therapy of simvastatin plus ezetimibe attenuates
CKD
‐dependent vascular diseases through a reduction of oxysterol‐mediated endoplasmic reticulum stress.
CHOP
plays a crucial role in the pathogenesis of
CKD
‐dependent vascular calcification.
Persistent Cognitive Impairment After Transient Ischemic Attack
Authors: van Rooij Frank G. , Schaapsmeerders Pauline , Maaijwee Noortje A.M. , van Duijnhoven Dirk A.H.J. , de Leeuw Frank-Erik , Kessels Roy P.C. , van Dijk Ewoud J.
Published: June 2014

Background and Purpose—

By definition, the symptoms of a transient ischemic attack (TIA) subside completely within 24 hours. Imaging studies show signs of persistent ischemic tissue damage in a substantial amount of patients with TIA. Cerebral infarction can cause permanent cognitive impairment. Whether permanent cognitive impairment occurs after TIA is unclear, as is its profile.

Methods—

Patients with TIA aged 45 to 65 years without prior stroke or dementia underwent comprehensive neuropsychological testing within 3 months.
Z
scores per cognitive domain were obtained, based on the mean of a control group within the same age range. Cognitive impairment was defined as a domain
z
score <−1.65. Patients underwent either computed tomography or MRI brain imaging.

Results—

One hundred seven patients with TIA (63% women, mean age, 56.6 years) were included and compared with 81 controls (56% women, mean age, 52.9 years). Patients performed worse on all cognitive domains except episodic memory. Working memory (25%), attention (22%), and information processing speed (16%) were most frequently impaired and more often than in the control group (age- and sex-adjusted odds ratios, respectively, 22.5 [95% confidence interval, 2.9–174.3], 6.8 [1.9–24.3], 7.1 [1.5–32.5]). More than 35% of patients with TIA had impairment of ≥1 cognitive domain. Presence of silent brain infarcts was related to worse executive functioning but did not explain the whole relationship between TIA and cognitive impairment.

Conclusions—

More than a third of patients with TIA have impairment of ≥1 cognitive domain within 3 months after their TIA. The affected domains fit in the vascular cognitive impairment profile.
ATP-Evoked Sustained Vasoconstrictions Mediated by Heteromeric P2X1/4 Receptors in Cerebral Arteries
Authors: Harhun Maksym I. , Povstyan Oleksandr V. , Albert Anthony P. , Nichols Claire M.
Published: June 2014

Background and Purpose—

Current knowledge states that vasoconstrictor responses to ATP are mediated by rapidly desensitizing ligand-gated P2X1 receptors in vascular smooth muscle cells (VSMCs). However, ATP is implicated in contributing to pathological conditions involving sustained vasoconstrictor response such as cerebral vasospasm. The purpose of this study is to test the hypothesis that the stimulation of VSMC P2XR receptors (P2XRs) contributes to ATP-evoked sustained vasoconstrictions in rat middle cerebral arteries (RMCAs).

Methods—

Reverse transcription- polymerase chain reaction, Western blot, and immunocytochemistry were used to analyze expression of mRNA and proteins in RMCAs VSMCs. Ionic currents and calcium responses were investigated using patch-clamp and confocal imaging techniques, respectively. Functional responses were confirmed using wire myography.

Results—

Expression of mRNA and protein for P2X1R and P2X4R subunits was identified in RMCA VSMCs. Confocal imaging in fluo-3-loaded VSMCs showed that ATP and a selective P2XR agonist, αβmeATP, evoked similar dose-dependent increases in [Ca
2+
]
i
. Patch-clamp experiments identified 2 components of P2XR-mediated currents: consisting of a fast desensitizing phase mediated by homomeric P2X1Rs and a slowly desensitizing phase involving heteromeric P2X1/4Rs. Isometric tension measurements showed that ≈80%:20% of initial ATP-evoked vasoconstriction in RMCA is mediated by homomeric P2X1Rs and heteromeric P2X1/4Rs, respectively. The sustained slowly desensitizing and rapidly recovering from desensitization responses are mediated by heteromeric P2X1/4Rs.

Conclusions—

This study reveals for the first time that apart from rapidly desensitizing homomeric P2X1Rs, heteromeric P2X1/4Rs contribute to the sustained component of the purinergic-mediated vasoconstriction in RMCA. Our study, therefore, identifies possible novel targets for therapeutical intervention in cerebral circulation.
A new Allium species from section Molium from Israel: A. akirense (Amaryllidaceae)
Authors: Friesen Nikolai , Fragman-Sapir Ori
Published: June 2014

As part of the phylogenetic revision of the Eurasian representatives of the subgenus Amerallium we have discovered a new Allium species (section Molium) in Israel, related to A. qasyunense. It is described here as Allium akirense, based on living plants and recent herbarium specimens. Independence of the new species is confirmed by morphological and ecological features, and also by molecular ones. To learn more about the phylogenetic relationships within a group of closely related species of section Molium, we used maximum parsimony and Bayesian analyses of combined nuclear (ITS—internal transcribed and ETS—external transcribed spacers of rRNA genes) and chloroplast (rpl32–trnL intergenic spacer) dataset of 7 taxa. Discussion on geographic distribution, conservation status and habitat is provided, as well as an identification key including the closest related species.
Guatteria darienensis (Annonaceae), a new species from Panama and Colombia
Authors: ARIAS GUERRERO SUSANA , SANCHEZ SANCHEZ DARIO , MAAS PAUL J.M. , ERKENS ROY H.J.
Published: June 2014

Guatteria Ruiz & Pavón (1794: 85) is the largest genus of Annonaceae with about 210 recognized species (Chatrou et al. 2012, Maas et al. 2011). It comprises small- to medium- sized trees, rarely canopy trees or shrubs, and only two species are lianas, Guatteria scandens Ducke (1925:10) and G. fractiflexa Maas & Westra (2008: 491; Erkens et al. 2008). It is widely distributed throughout Mesoamerica, the Caribbean, and tropical South America (Erkens & Maas 2008). Species of Guatteria are common members of Neotropical forests where they occupy a wide variety of habitats, such as lowland rain forests, gallery forests, semideciduous forests, coastal forests, inundated forests, savannas and montane forests (Erkens et al. 2007b). However, the highest species diversity is found in the Amazon Basin with approximately half of the species occurring there. Central America harbours ca. 30 species, mostly endemics (Erkens et al. 2008) of which ca. 20 species occur in Panama, a highly under-collected country with respect to Guatteria (Erkens et al. 2006). In the adjacent Colombian Chocó region, we found ca. ten endemic species, and to date, only two species, Guatteria aberrans Erkens & Maas (2006: 201) and the new species described in this paper, are restricted to Panama and northwestern Colombia.
Effects of Different Configurations of the East Asian Subtropical and Polar Front Jets on Precipitation during the Mei-Yu Season
Authors: Li Li , Zhang Yaocun
Published: June 2014

Observational analysis indicates that the East Asian jet stream consists of two separate branches: the East Asian subtropical jet (EASJ) and the East Asian polar front jet (EAPJ). The impacts of different intensity configurations of the EASJ and EAPJ on precipitation during the mei-yu season are investigated using the NCEP–NCAR Reanalysis Project (NNRP) dataset and daily gauge observations in East China. The intensity and location of precipitation are associated with different configurations of the EASJ and EAPJ. Precipitation intensity increases with intensification of the EASJ and EAPJ. The rainband is located to the north of the mei-yu region when the EASJ intensifies and the EAPJ weakens. Further analyses indicate that the intensity changes of the EASJ and EAPJ are linked to the cold and warm airmass activities. For cases with strong EASJ and EAPJ, both the warm-moist and cold air masses are active. When the warm-moist and cold air masses meet near 30°N, abundant precipitation occurs in the Yangtze-Huai River basin (YHRB). For cases with weak EASJ and EAPJ, both the cold and warm-moist air masses are inactive, and no significant precipitation occurs in the YHRB. For cases with strong EASJ and weak EAPJ, the warm-moist air mass moves northward while the cold air mass is weak. Precipitation concentrates to the north of YHRB. For cases with weak EASJ and strong EAPJ, cold air extends farther south while the warm-moist air mass is inactive. Precipitation occurs to the south of YHRB.
Multiple Zonal Jets in a Differentially Heated Rotating Annulus
Authors: Smith Carlowen A. , Speer Kevin G. , Griffiths Ross W.
Published: June 2014

A laboratory experiment of multiple baroclinic zonal jets is described, thought to be dynamically similar to flow observed in the Antarctic Circumpolar Current. Differential heating sets the overall temperature difference and drives unstable baroclinic flow, but the circulation is free to determine its own structure and local stratification; experiments were run to a stationary state and extend the dynamical regime of previous experiments. A topographic analog to the planetary β effect is imposed by the gradient of fluid depth with radius supplied by a sloping bottom and a parabolic free surface. New regimes of a low thermal Rossby number (RoT ~ 10−3) and high Taylor number (Ta ~ 1011) are explored such that the deformation radius Lρ is much smaller than the annulus gap width L and similar to the Rhines length. Multiple jets emerge in rough proportion to the smallness of the Rhines scale, relatively insensitive to the Taylor number; a regime diagram taking the β effect into account better reflects the emergence of the jets. Eddy momentum fluxes are consistent with an active role in maintaining the jets, and jet development appears to follow the Vallis and Maltrud phenomenology of anisotropic wave–turbulence interaction on a β plane. Intermittency and episodes of coherent meridional jet migration occur, especially during spinup.
Interarytenoid Sodium Carboxymethylcellulose Gel Injection for Management of Pediatric Aspiration
Authors: Horn David L. , DeMarre Kim , Parikh Sanjay R.
Published: June 2014

Objective:

This study aimed to investigate the role of interarytenoid injection laryngoplasty (IL) for the management of pediatric aspiration.

Methods:

Medical records of 30 patients, 9 female, with radiographically confirmed chronic aspiration who underwent intraoperative IL were retrospectively reviewed. Clinical improvement was defined as successful advancement of feeds to thinner consistencies.

Results:

Clinical improvement was observed in 57% of patients. Six children with type 1 posterior laryngeal cleft (PLC-1) were not significantly more likely to show improvement compared to the children without PLC-1. Type 1 posterior laryngeal cleft was associated with older age and higher prevalence of neurodevelopmental risk factors relative to absence of PLC-1. Patients with PLC-1 were more likely than noncleft patients to show recurrence of symptoms after initial improvement with IL. Five patients underwent endoscopic repair. Repair was successful in 3 patients who improved after IL but not in 2 patients who did not improve after IL.

Conclusion:

Chronic aspiration can improve after IL even in patients with normal anatomy. Injection laryngoplasty can be performed to improve selection of PLC-1 patients for definitive endoscopic repair. Further prospective research, with a randomized control group, is needed to understand whether interarytenoid incompetence plays a role in some patients with chronic aspiration, who do not have a PLC-1.
Impact of Neuromuscular Electrical Stimulation on Upper Esophageal Sphincter Dynamics
Authors: Jungheim Michael , Janhsen Alexander Matthias , Miller Simone , Ptok Martin
Published: June 2014

Objectives:

Beside traditional dysphagia therapy, neuromuscular electrical stimulation (NMES) has been proposed to treat patients with dysphagia. Considering the complexity of the nerve-muscle interaction during swallowing, the underlying physiology of NMES remains unclear. Here, we addressed the question of whether NMES can modify upper esophageal sphincter (UES) dynamics.

Methods:

In a prospective study, 26 healthy volunteers performed water swallows with and without NMES. The stimulus was applied in a participant- and operator-initiated stimulation above, near, and below the motor threshold. Swallowing parameters were measured using high-resolution manometry.

Results:

The UES relaxation time was found to be extended by 10%, indicating a modification in UES dynamics.

Conclusions:

The chosen NMES paradigm influenced the involuntary swallowing phase by extending relaxation time, providing more time for bolus passage into the esophagus. Future studies will have to evaluate if this effect can be found in patients with dysphagia and whether it is beneficial for treatment.
Problem gambling among a group of male prisoners: Lifetime prevalence and association with incarceration
Authors: Riley Ben , Oakes Jane
Published: June 2014

Studies have shown an association between criminal offending and problem gambling; however, research concerning problem gambling among prisoners is limited. Although reported prevalence rates are high among the offending population, different screening tools have been used making them difficult to compare. The purpose of this study was to investigate the lifetime prevalence of both level 2 and 3 problem gambling among a group of incarcerated male offenders in South Australia and to examine the relationship between gambling and current term of imprisonment. The Early Intervention Gambling Health Test (EIGHT Screen) was completed by 105 prisoners. Fifty-five (52%) indicated a lifetime prevalence of problem gambling. One-fifth of all respondents reported their current term of imprisonment was related to gambling. This paper aims to draw attention to the prevalence of problem gambling among Australian prisoners. Implications are discussed with regards to problem gambling, health promotion and rehabilitation, and the importance of screening for gambling-related problems among this high-risk population.
A Meta-Analysis of Writing Interventions for Students With Learning Disabilities
Authors: Gillespie Amy , Graham Steve
Published: June 2014

In this meta-analysis, the impact of writing interventions on the quality of writing produced by students with learning disabilities (LD) was assessed. Ancestral and electronic searches were used to locate experimental, quasi-experimental, and within-subjects design studies with participants in Grades 1–12 with documented LD. The effects of writing interventions on participants’ writing quality were averaged across 43 eligible studies to calculate an average weighted mean effect size ( ES). Average weighted mean ES were also calculated for six writing treatment subgroups that contained four or more studies each (i.e., strategy instruction, dictation, procedural facilitation, prewriting, goal setting, and process writing). Overall, writing interventions had a statistically significant positive impact on the writing quality of students with LD ( ES = 0.74). All writing treatment subgroups also had positive average weighted ES, but only four were statistically different from zero (i.e., strategy instruction ES = 1.09, dictation ES = 0.55, goal setting ES = 0.57, and process writing ES = 0.43). In addition, treatments designed specifically to enhance writing processes (e.g., planning, revising) were only effective when instruction was provided. Implications for the types of writing treatments and the types of instruction that may be most beneficial to students with LD are discussed and directions for future research are provided.
Effects of Blended Instructional Models on Math Performance
Authors: Bottge Brian A. , Ma Xin , Gassaway Linda , Toland Michael D. , Butler Mark , Cho Sun-Joo
Published: June 2014

A pretest-posttest cluster-randomized trial involving 31 middle schools and 335 students with disabilities tested the effects of combining explicit and anchored instruction on fraction computation and problem solving. Results of standardized and researcher-developed tests showed that students who were taught with the blended units outscored students in Business As Usual classes. Students made the largest gains in computing with fractions and on problems related to ratios, proportions, and geometry. The findings suggest important implications for the way curriculum is designed for middle school students with disabilities who exhibit low performance in math.
Damage behaviors of woven basalt-unsaturated polyester laminates under low-velocity impact
Authors: Gideon Rotich K , Zhang Fa , Wu Liwei , Sun Baozhong , Gu Bohong
Published: June 2014

This paper describes the damage behaviors of plain-woven basalt-unsaturated polyester laminates under low-velocity impact from experimental and finite-element approach. Experimental tests were carried out in an INSTRON® drop-weight machine with different initial impact energy levels varying from 15 J, 30 J, 50 J, and 70 J with specimen thicknesses of 4 mm. The results showed that as the impact energy increased, the peak force, the energy absorbed, i.e. area under the force–displacement curve, and the damage area increased. The damage mechanism included matrix crack, delamination with fiber bending, and breakage. Finite-element analyses were carried out to verify further the impact mechanism and correlation between these parameters with the induced damage by using software ABAQUS®. The finite-element method results were in good accord with the experimental results regarding peak force, maximum absorbed energy, and damage area.
Childhood Intelligence and the Emergence of Self-Control
Authors: Petkovsek Melissa A. , Boutwell Brian B.
Published: June 2014

Self-control represents, perhaps, one of the most robust predictors of antisocial behavior uncovered by behavioral scientists. What remains more unclear, however, are the exact sources of individual differences in levels of self-control. Emergent evidence along these lines is beginning to suggest that levels of intelligence—another robust correlate of antisocial behavior—may play an important role in predicting the development of self-control. Moreover, the influence of intelligence may begin to manifest very early in development. Building on prior work, the current study seeks to explore the role of intelligence in predicting levels of self-control in children. Our findings suggest that higher levels of intelligence predict higher levels of self-control beyond other traditional criminological and sociological variables including parenting practices and parental levels of self-control. These findings further underscore the relevance of intellectual functioning for a host of impactful traits in humans.
Needs and Pretrial Failure
Authors: Gehring Krista S. , van Voorhis Patricia
Published: June 2014

Since the 1980s, increasing numbers of individuals entering into the criminal justice system have caused criminal justice professionals and researchers concern about the phenomenon of individuals continually returning to the system. It is possible that identifying and addressing needs in the pretrial stage of the criminal justice system could interrupt this cycle and contribute to pretrial success. Furthermore, attention to gender-responsive needs at this stage of the criminal justice process may prove beneficial for female pretrial defendants. This study contributes to both the pretrial and gender-responsive literature by investigating whether pretrial needs are predictive of pretrial outcomes and if there are gender differences in these needs. Results indicate that many of the examined needs are risk factors for pretrial failure, there are gender differences in the composition of several of these needs, and gender-responsive pretrial needs are important to predicting pretrial outcomes.
Goodwill Impairment Losses and CEO Compensation
Authors: Darrough Masako N. , Guler Lale , Wang Ping
Published: June 2014

Corporate acquisitions are arguably one of the most important and biggest decisions CEOs have to make; yet many acquisitions do not create value for shareholders. We examine whether CEO compensation is reduced when the fair values of the acquired business units are written down (i.e., goodwill impairment losses are recognized). We find that there is a significant reduction in cash- and option-based CEO compensation as firms recognize goodwill impairment losses. In particular, we find that the decrease in CEO option-based compensation is driven by firms that are not R&D intensive, while the decrease in CEO cash compensation is driven by firms that acquired larger targets in the recent past and have CEOs with a shorter tenure. Our results suggest that compensation committees make CEOs pay a price for non-value maximizing acquisitions and discourage them from further undertaking risky investments especially by reducing the risk-inducing component of their compensation packages.
Outcomes following Semicircular Canal Plugging
Authors: Goddard John C. , Wilkinson Eric P.
Published: June 2014

Objectives

To examine audiometric outcomes, symptom control rates, and complication rates following semicircular canal plugging for superior semicircular canal dehiscence syndrome.

Study Design

Retrospective chart review.

Setting

Private, neurotologic tertiary referral center.

Subjects and Methods

Patients undergoing semicircular canal plugging for superior semicircular canal dehiscence syndrome from January 1, 2007, to December 31, 2012. Pre‐ and postoperative audiometry, vestibular testing, operative findings, and clinical symptoms were assessed through chart review.

Results

A total of 24 ears underwent a canal plugging procedure during the study period for superior canal dehiscence syndrome. Pre‐ and postoperative air conduction pure‐tone averages were 21.1 and 22.5 dB (P =. 42, not significant [NS]). The average pre‐ and postoperative word recognition scores were 95.8% and 95.1% (P =. 48, NS). Vestibular evoked myogenic potential data showed reduced thresholds in 7 patients with canal dehiscence. Complications were limited to a single, temporary facial weakness. Complete symptom improvement was noted in 35.7% of all patients, while at least partial symptom improvement was found in over 80% of patients.

Conclusion

Semicircular canal plugging procedures are associated with excellent hearing outcomes and may reduce preoperative symptoms in patients with superior semicircular canal dehiscence.
Involvement of neuronal nitric oxide synthase in desensitisation of µ-opioid receptors in the rat locus coeruleus
Authors: Santamarta María T , Llorente Javier , Mendiguren Aitziber , Pineda Joseba
Published: June 2014

Nitric oxide (NO) has been recently shown to enhance µ-opioid receptor (MOR) desensitisation in locus coeruleus (LC) neurons. The aim of this study was to evaluate by single-unit extracellular recordings in rat brain slices whether the neuronal NO synthase is involved in MOR desensitisation in LC neurons. As expected, a high concentration of the opioid agonist Met5-enkephalin (ME; 10 µM, 10 min) strongly desensitised the inhibition induced by a test application of ME (0.8 µM, 1 min), whereas lower ME concentrations (1 and 3 µM) only weakly desensitised it. The neuronal NO synthase inhibitors 7-nitroindazole (10–100 µM), S-methyl-L-thiocitrulline (0.01–10 µM) and Nω-propyl-L-arginine (1–10 µM) attenuated ME (10 µM)-induced opioid desensitisation, although the endothelial NO synthase inhibitor N5-(1-iminoethyl)-L-ornithine (3–30 µM) failed to change it. The NO donor sodium nitroprusside (1 mM), but not its inactive analog potassium ferricyanide (1 mM), enhanced the ME (3 µM)-induced desensitisation and prevented the effect of S-methyl-L-thiocitrulline (10 µM). Sodium nitroprusside (1 mM) failed to change the desensitisation of α2-adrenoceptors by noradrenaline (100 µM, 10 min). These results suggest the contribution of NO and a neuronal type of NO synthase in homologous MOR desensitisation in rat LC neurons.
Serum miR-9 as a prognostic biomarker in patients with osteosarcoma
Authors: Fei Dan , Li Yang , Zhao Dongxu , Zhao Kaijun , Dai Lu , Gao Zhongli
Published: June 2014

Objectives

To quantify microRNA-9 (miR-9) concentrations in the serum of patients with osteosarcoma; to explore its relationship with clinicopathological characteristics and prognosis of osteosarcoma.

Method

Serum miR-9 was quantified via real-time reverse transcription–polymerase chain reaction in patients with osteosarcoma and healthy control subjects. Overall survival was evaluated using the Kaplan–Meier method.

Results

Serum miR-9 was significantly upregulated in patients with osteosarcoma ( n = 118) compared with healthy control subjects ( n = 60); its upregulation was significantly associated with advanced tumour–node–metastasis stage, larger tumour size and presence of distant metastasis. Overall survival duration was significantly shorter in patients with relatively high miR-9 concentrations compared with those with relatively low miR-9 concentrations.

Conclusions

Serum miR-9 concentrations are significantly increased in patients with osteosarcoma compared with healthy controls. Upregulation of miR-9 is associated with tumour stage, size and metastasis. Serum miR-9 quantification may represent a useful diagnostic and prognostic marker of osteosarcoma.