bluuebunny/crossref_metadata_2025 huggingface dataset:
Anterior cruciate ligament reconstruction using autologous double hamstrings: a comparison of standard versus minimal debridement techniques using MRI to assess revascularisation
Authors: Gohil S. , Annear P. O. , Breidahl W.
Published: September 2007

Animal studies have shown that implanted anterior cruciate ligament (ACL) grafts initially undergo a process of revascularisation prior to remodelling, ultimately increasing mechanical strength. We investigated whether minimal debridement of the intercondylar notch and the residual stump of the ruptured ACL leads to earlier revascularisation in ACL reconstruction in humans. We undertook a randomised controlled clinical trial in which 49 patients underwent ACL reconstruction using autologous four-strand hamstring tendon grafts. Randomised by the use of sealed envelopes, 25 patients had a conventional clearance of the intercondylar notch and 24 had a minimal debridement method. Three patients were excluded from the study. All patients underwent MR scanning postoperatively at 2, 6 and 12 months, together with clinical assessment using a KT-1000 arthrometer and International Knee Documentation Committee (IKDC) evaluation. All observations were made by investigators blinded to the surgical technique. Signal intensity was measured in 4 mm diameter regions of interest along the ACL graft and the mid-substance of the posterior cruciate ligament.

Our results indicate that minimal debridement leads to earlier revascularisation within the mid-substance of the ACL graft at two months (paired t-test, p = 0.002). There was a significant reduction of mid-substance signal six months after the minimal debridement technique (paired t-test, p = 0.00007). No statistically significant differences were found in tunnel placement, incidence of Cyclops lesions, blood loss, IKDC scores, range of movement or Lachman test between the two groups.
Panton-Valentine leukocidin-secreting Staphylococcus aureus causing severe musculoskeletal sepsis in children
Authors: Mitchell P. D. , Hunt D. M. , Lyall H. , Nolan M. , Tudor-Williams G.
Published: September 2007

Panton-Valentine leukocidin secreted by Staphylococcus aureus is known to cause severe skin, soft tissue and lung infections. However, until recently it has not been described as causing life-threatening musculoskeletal infection. We present four patients suffering from osteomyelitis, septic arthritis, widespread intravascular thrombosis and overwhelming sepsis from proven Panton-Valentine leukocidin-secreting Staphylococcus aureus. Aggressive, early and repeated surgical intervention is required in the treatment of these patients.

The Panton-Valentine leukocidin toxin not only destroys host neutrophils, immunocompromising the patient, but also increases the risk of intravascular coagulopathy. This combination leads to widespread involvement of bone with glutinous pus which is difficult to drain, and makes the delivery of antibiotics and eradication of infection very difficult without surgical intervention.
Recommendations for the Clinical Evaluation of Agents for Treatment of Osteoporosis: Consensus of an Expert Panel Representing the American Society for Bone and Mineral Research (ASBMR), the International Society for Clinical Densitometry (ISCD), and the National Osteoporosis Foundation (NOF)
Authors: Silverman Stuart L , Cummings Steven R , Watts Nelson B ,   for the Consensus Panel of the ASBMR, ISCD, and NOF
Published: September 2007

A panel of experts representing ASBMR, NOF, and ISCD reviewed evidence and reached consensus that regulatory approval of treatments for osteoporosis should be based on trials with fracture endpoints, lasting 18-24 mo, and extending treatment to 5 yr; other indications could be approved based on BMD and turnover markers.

Introduction: In response to an FDA request for clinical trial guidance in osteoporosis, an expert panel was convened with representatives from the American Society of Bone and Mineral Research, the International Society of Clinical Densitometry, and the National Osteoporosis Foundation.

Materials and Methods: The panel used a validated evidence-based expert panel process (the Rand Appropriateness Method) to address issues of trial duration, trial design, use of intermediate endpoints as outcomes, and use of placebo-controlled trials in high-risk patients.

Results and Conclusions: The panel concluded that placebo-controlled trials with fracture endpoints are appropriate and, with informed consent, are ethical for registration of new compounds. Trials may be 18-24 mo in duration for efficacy, assuming longer duration to 5 yr for safety and demonstration of sustained fracture reduction. Once fracture efficacy has been established for a particular agent, intermediate endpoints (e.g., BMD and bone turnover markers) may be used as outcomes for new indications other than corticosteroid-induced osteoporosis.
High-Protein Intake Enhances the Positive Impact of Physical Activity on BMC in Prepubertal Boys
Authors: Chevalley Thierry , Bonjour Jean-Philippe , Ferrari Serge , Rizzoli René
Published: September 2007

In 232 healthy prepubertal boys, increased physical activity was associated with greater BMC at both axial and appendicular sites under high-protein intake.

Introduction: Physical activity is an important lifestyle determinant of bone mineral mass acquisition. Its impact during childhood can be modulated by nutrition, particularly by protein and calcium intakes. We analyzed the relationship between physical activity levels and protein compared with calcium intake on BMC.

Materials and Methods: In 232 healthy prepubertal boys (age: 7.4 ± 0.4 [SD] yr; standing height: 125.7 ± 5.9 cm; body weight: 25.3 ± 4.6 kg), physical activity and protein and calcium intakes were recorded. BMC was measured by DXA at the radial metaphysis, radial diaphysis, total radius, femoral neck, total hip, femoral diaphysis, and L2-L4 vertebrae.

Results: In univariate analysis, the correlation coefficients r with BMC of the various skeletal sites were as follows: physical activity, from 0.26 (p = 0.0001) to 0.40 (p = 0.0001); protein intake, from 0.18 (p = 0.005) to 0.27 (p = 0.0001); calcium intake, from 0.09 (p = 0.181) to 0.17 (p = 0.007). By multiple regression analysis, the β-adjusted values remained correlated with BMC, ranging as follows: physical activity, from 0.219 (p = 0.0007) to 0.340 (p < 0.0001); protein intake, from 0.120 (p = 0.146) to 0.217 (p = 0.009). In contrast, it was not correlated for calcium intake: from −0.069 (p = 0.410) to 0.001 (p = 0.986). With protein intake (mean = 2.0 g/kg body weight/d) above the median, increased physical activity from 168 to 321 kcal/d was associated with greater mean BMC Z-score (+0.6, p = 0.0005). In contrast with protein intake (mean = 1.5 g/kg body weight/d) below the median, increased physical activity from 167 to 312 kcal/d was not associated with a significantly greater mean BMC Z-score (+0.2, p = 0.371). The interaction between physical activity and protein intake was close to statistical significance for mean BMC Z-score (p = 0.055) and significant for femoral neck BMC (p = 0.012). In keeping with the results derived from multiple regression analysis, the increased physical activity on mean BMC Z-score was not influenced by difference in calcium intake above (mean = 945 mg/d) and below (mean = 555 mg/d) the median.

Conclusion: In healthy prepubertal boys, the impact in increased physical activity on BMC seems to be enhanced by protein intake within limits above the usual recommended allowance.
Heavy-Duty Diesel Engine Cavitation Test
Authors: Davis Glen , Sarlo Mark
Published: September 2007

The objective of this study was to develop a test procedure to evaluate the ability of a heavy-duty diesel engine coolant to provide protection against damage resulting from a phenomenon known as cylinder liner cavitation corrosion. The engine cavitation test procedure was developed by modifying a production OEM diesel engine to consistently produce the operating conditions that accelerate damage from cylinder liner cavitation. The resulting, 250-h test procedure was able to quantify a coolant’s ability to protect wet-sleeve cylinder liners from cavitation corrosion. Dozens of coolants were evaluated using this test procedure. The ranking of cylinder liner pit area counts from this procedure’s discrimination matrix was in agreement with the ranking of pit area results seen in high-mileage field tests. Conversely, upon investigation, an acceptable correlation could not be established between field test pit area counts and the results from a known bench test. Obtaining results in a few weeks from a short duration procedure such as this can offer a coolant formulator advantages compared to waiting for the completion of a properly conducted field test. This test procedure creates an accelerated, yet realistic level of liner cavitation that ranks protection levels of coolants being evaluated. This ranking or discrimination is often not possible in field testing because the field test is run under mild service conditions or the engine components have little tendency to promote liner pitting. In addition, the difficulty in controlling field tests often yields unusable, inaccurate results. The test procedure was shown to be repeatable within labs and reproducible between labs thus confirming the viability of this test procedure as a useful tool to assess a coolant’s ability to protect against cylinder liner cavitation damage. It is recommended that the presently developed test procedure be considered for adoption as an ASTM test method.
The Divine Feminine in Geometric Consciousness
Authors: Hagens Bethe
Published: September 2007

Plato spoke of geometry as an extremely rare natural gift of consciousness, but also as a mode of perception accessible to anyone initiated into the tradition by a master. Such teachers were the shamans of his day, and it was these individuals who convened the mystery schools and sponsored initiations into the esoteric philosophies of geomancy that have grown from their vision. Though the history of women in ancient mystery traditions is largely lost to us, Greek mythology holds that our human capacity for geometric vision is a gift of the divine feminine—energetic sources of wisdom conceptualized as a lineage of goddesses. Born from primal Chaos is Gaia, from whose name comes "geometry"—geo (earth) + metr (measure, mother). She gives birth to Mnemosyne, goddess of Memory, from whose name comes "mnemonic." The daughters of Mnemosyne are the Muses—the arts and sciences. Memory is the legacy of the sacred Earth, and the arts enable humans to actively remember. The essence of this divine feminine lineage is sustainability of sacred place (Chora) through enduring values of order, proportion, a universal aesthetic, and connectivity. In this essay, I explore the ways in which I learned to embrace myself as a physical and spiritual geomantic consciousness and how I have used geometric vision as an interdisciplinary teaching and learning process.
Experimental Study of Ostensibly Shamanic Journeying Imagery in Naïve Participants II: Phenomenological Mapping and Modified Affect Bridge
Authors: Rock Adam J. , Rock Paul J. Casey , Baynes Peter B.
Published: September 2007

This study develops the methodological framework advanced in Rock, Baynes, and Casey's (2005) experimental study of ostensibly shamanic journeying imagery in naïve participants. Specifically, the present study experimentally investigates the impact of the word landscape, featured in Harner's (1990) shamanic journeying to the Lower World instructions, on the number of landscape‐related images reported; examines the origins of ostensibly shamanic journeying images; and maps the phenomenological state effects of shamanic journeying to the Lower World. Sixtyeight naïve participants were randomly assigned to one of three conditions: either the original or a revised version of Harner's (1990) instructions coupled with monotonous percussion drumming at 8 beats‐per‐second for 15 minutes, or sitting quietly with eyes open for 15 minutes. Each participant's subjective experience was retrospectively assessed using the Phenomenology of Consciousness Inventory (PCI) (Pekala 1991) and a mental imagery checklist. Subsequently, participants were administered the Modified Affect Bridge for the purpose of exploring the origins of mental imagery experienced during the experimental conditions. The results indicated that there was a statistically significant difference between conditions with regard to the number of ostensibly shamanic journeying images reported, but not between treatment conditions with regard to the number of landscaperelated images reported. There were no significant relationships between condition and mental imagery derived from autobiographical memories. There were statistically significant differences between conditions with regard to the PCI dimensions of fear, altered state of awareness, and arousal.
Reviews
Authors: De Rios Marlene Dobkin
Published: September 2007

Higher Wisdom. Eminent Elders Explore the Continuing Impact of Psychedelics. Roger Walsh and Charles S. Grob eds. Albany, NY: State University of New York Press, 2005. 267 pp. ISBN 0‐7914‐6518‐7. $24.95 (paper); ISBN: 0791465179. $81.50 (hardback).
Reviews
Authors: Reidhead Mary Ann
Published: September 2007

Jesus in Our Wombs: Embodying Modernity in. Mexican Convent. Rebecca J. Lester. Berkeley: University of California Press, 2005. 344 pp. Bibli. ISBN: 0520242661. $50.00 (hardback); $19.95 (paper).
Local Produce, Foreign Labor: Labor Mobility Programs and Global Trade Competitiveness in Canada*
Authors: Preibisch Kerry L.
Published: September 2007

Abstract Temporary visa workers are increasingly taking on a heightened profile in Canada, entering the workforce each year in greater numbers than immigrant workers with labor mobility rights (Sharma 2006). This paper examines the incorporation of foreign workers in Canadian horticulture under the Seasonal Agricultural Workers Program (SAWP). I argue that foreign labor supplied under the SAWP secures a flexible workforce for employers and thus improves Canada's trade competitiveness in the global agrifood market. Using multiple research strategies, I track the evolution of Canadian horticulture in the global market and the transformation of labor in this industry. I outline the steady growth in the employment of temporary visa workers in the horticultural industry and show how they have become the preferred and, in some cases, core workforce for horticulture operations. The benefits of SAWP workers to employers include the provision of a workforce with limited rights relative to domestic workers and considerable administrative support in selecting, dispatching, and disciplining workers provided at no cost by labor supply countries. I conclude that the SAWP is a noteworthy example of the role of immigration policy in regulating the labor markets of high‐income economies and thus ensuring the position of labor‐receiving states within the global political economy.
Genetic variation in receptor protein tyrosine phosphatase σ is associated with type 2 diabetes in Swedish Caucasians
Authors: Långberg Ewa-Carin , Gu Harvest F , Nordman Sofia , Efendic Suad , Östenson Claes-Göran
Published: September 2007

Objective: Previously, it has been demonstrated that receptor protein tyrosine phosphatase σ (RPTPσ) is involved in glucose homeostasis and insulin signaling in several animal models. The aim of this study was to evaluate whether polymorphisms in this gene influence the development of type 2 diabetes (T2D) in humans.

Design: We investigated how genetic variations in the RPTPσ gene influence susceptibility to impaired glucose tolerance (IGT) and T2D, in Swedish men and women.

Methods: Genotyping of single nucleotide polymorphisms (SNPs) was performed by dynamic allele-specific hybridization in a total of 1057 Swedish Caucasians including 497 subjects with normal glucose tolerance (NGT), 262 subjects with IGT, and 298 patients with T2D.

Results: SNPs rs1143699, rs4807015, and rs1978237 were found to be associated with T2D. SNP rs1143699 was associated with male T2D patients when compared with NGT controls (odds ratio; OR = 1.57; P = 0.029). SNP rs4807015 showed association with T2D patients when compared with NGT controls (OR = 1.32; P = 0.025). Finally, SNP rs1978237 was associated with T2D patients when compared with NGT controls (OR = 1.59; P = 0.002). Logistic regression analysis demonstrated that for SNP rs1143699 in men, C/C homozygosity conveys an increased risk of T2D (OR = 2.19; P = 0.035), while SNP rs4807015 was associated with an increased risk of T2D in both men and women (OR = 1.74; P = 0.029). SNP rs1978237 also demonstrated a risk of T2D in men and women (OR = 1.59; P = 0.026).

Conclusions: This study provides evidence for association of SNPs in the RPTPσ gene with T2D in Swedish Caucasians. SNPs rs1143699, rs4807015, and rs1978237 confer an increased risk of developing T2D.
Low sex hormone-binding globulin as a predictive marker for insulin resistance in women with hyperandrogenic syndrome
Authors: Kajaia Natia , Binder Helge , Dittrich Ralf , Oppelt Patricia G , Flor Bianca , Cupisti Susanne , Beckmann Matthias W , Mueller Andreas
Published: September 2007

Background: The aim of the present study is to assess insulin resistance (IR) in women with hyperandrogenic syndrome, which was suggested to replace the term polycystic ovary syndrome by the Androgen Excess Society, and to evaluate whether sex hormone-binding globulin (SHBG) can be used as a predictive marker of IR in hyperandrogenic women.

Methods: Clinical, metabolic, and endocrine parameters were measured, and an oral glucose tolerance test was carried out. The women were classified as IR group or non-IR group, in accordance with defined cutoff points for the homeostatic model assessment of IR (HOMA-IR) at ≥2.5, the quantitative insulin sensitivity check index at ≤ 0.33, and the Matsuda insulin sensitivity index (ISI) at ≤ 5.

Results: The women classified as having IR had a significantly higher body mass index (BMI) and free androgen index (FAI) and showed significantly lower SHBG and high-density lipoprotein (HDL) levels, regardless of the indices used. However, with the Matsuda ISI, generally more women were diagnosed as having IR, and this group had significantly higher total testosterone and triglyceride values, as well as a higher incidence of hirsutism.

Conclusions: Women who were classified as being insulin resistant using insulin sensitivity indices showed significantly higher BMI and FAI values and lower SHBG and HDL levels. However, the Matsuda ISI may be more favorable for identifying IR in hyperandrogenic women. SHBG may serve as a predictive marker of IR in these women, particularly in those who are obese.
Elevated serum levels of adiponectin in children, adolescents and young adults with type 1 diabetes and the impact of age, gender, body mass index and metabolic control: a longitudinal study
Authors: Galler Angela , Gelbrich Götz , Kratzsch Jürgen , Noack Nicole , Kapellen Thomas , Kiess Wieland
Published: September 2007

Objective: Adiponectin plays an important role in pathophysiology of obesity, type 2 diabetes and cardiovascular disease. The aim of this study was to determine adiponectin concentrations in children and adolescents with type 1 diabetes in a longitudinal manner and to study the impact of age, gender, body mass index (BMI) and metabolic control.

Research design and methods: In this study, 88 children and adolescents with type 1 diabetes were followed longitudinally. At baseline and during follow-up, serum levels of adiponectin were measured by enzyme-linked immunoassay and correlated with clinical data, HbA1c and lipids. Healthy children (n = 259) were chosen as a control group.

Results: Serum adiponectin levels were significantly higher in children with type 1 diabetes compared with healthy children (13.1 vs 9.1 μg/ml at baseline, P < 0.001). Adiponectin concentrations inversely correlated with BMI s.d.s (P < 0.001). No significant difference of adiponectin levels regarding gender, diabetes duration or HbA1c was seen. Adiponectin concentrations decreased in males with type 1 diabetes during puberty (P = 0.03) while there was no significant change in females. In a subgroup of patients with new onset type 1 diabetes, adiponectin concentrations were not different from adiponectin levels in control subjects but increased during follow-up (P = 0.007). Stepwise multiple regression analysis showed that most important predictors of adiponectin levels in type 1 diabetes at the end of the study were adiponectin concentration at baseline (β = 0.574, P < 0.001) and BMI s.d.s (β = −0.302, P = 0.001, r2 = 0.56).

Conclusions: Children and adolescents with type 1 diabetes have BMI-dependent elevated serum concentrations of adiponectin compared with healthy children.
Health-related quality of life in acromegalic subjects: data from AcroBel, the Belgian Registry on acromegaly
Authors: T’Sjoen Guy , Bex Marie , Maiter Dominique , Velkeniers Brigitte , Abs Roger
Published: September 2007

Objective: To assess the impairment of quality of life (QoL), evaluated by the acromegaly QoL (AcroQoL) questionnaire, in patients with controlled and uncontrolled acromegaly.

Design: Cross-sectional evaluation of AcroBel, a national observational registry of acromegalic patients newly diagnosed or in follow-up.

Methods: Disease perception by the patients was evaluated by the disease-specific signs and symptoms score (SSS) and QoL was assessed by the AcroQoL questionnaire. Hormonal status was determined by central measurements of GH and IGF-I.

Results: Patients (n = 291) had a median GH of 1.43 μg/l (0.65–3.03; IQR), a median IGF-I of 231 μg/l (150–367), and a mean IGF-I z-score of +1.91 (s.d. 2.21). The AcroQoL total score in the whole group was 67.1 (51.1–78.4), with a score of 65.6 (43.8–78.1) for the physical dimension, 67.9 (53.6–80.4) for the psychological dimension, 78.6 (64.3–89.3) for personal relations and 57.1 (39.3–75) for appearance. The median SSS was 3 (1–5). There was a negative correlation between both questionnaires (r = −0.478; P < 0.001). There was no correlation between AcroQoL score and biochemical markers of disease activity. When subdividing patients into groups of biochemical control according to GH and IGF-I levels, no difference could be established for either SSS or AcroQoL scores.

Conclusions: The AcroQoL results from the AcroBel registry confirm the marked impairment of the patients’ QoL, especially in relation with appearance. A negative correlation between AcroQoL and SSS was confirmed. There was, however, no correlation between AcroQoL and biochemical markers of disease activity.
Long-term neurodevelopmental outcome in conservatively treated congenital hyperinsulinism
Authors: Mazor-Aronovitch K , Gillis D , Lobel D , Hirsch H J , Pinhas-Hamiel O , Modan-Moses D , Glaser B , Landau H
Published: September 2007

Background: Congenital hyperinsulinism (CH) is treated surgically in many centers (near-total and partial pancreatectomy for diffuse and focal disease respectively). Most patients treated with near-total pancreatectomy developed diabetes during childhood/puberty. CH patients are at increased risk of neurodevelopmental disorders, some being severe, which are reported to occur in 14–44% of patients from highly heterogenous cohorts. Over the last few decades, we have treated children with CH conservatively without surgery. The aim of this study was to assess the neurodevelopmental outcome of these patients.

Design and methods: The study included 21 Ashkenazi CH medically treated patients: 11 homozygotes (diffuse disease) and 9 heterozygotes with mutations on the paternal allele (presumed focal disease). The mean age was 13.7 years (range 8–23). Neurodevelopmental outcomes were assessed by telephone interviews of parents, using a standard questionnaire. Closest age siblings of CH patients served as controls.

Results: Ten CH patients had perinatal seizures of short duration. Four had post-neonatal seizures, which remitted entirely. During early childhood, four patients (19%) had hypotonia, eight (38%) had fine motor problems, seven (33%) had gross motor problems (clumsiness), and one had mild cerebral palsy. Three patients (14%) had speech problems. Eight patients required developmental therapy, compared to one in the control group. Most of these problems were resolved by age 4–5 years. At school age, all were enrolled in regular education, some excelled in their studies, 6 out of 21 patients (29%) had learning problems (2 out of 21 controls). None had overt diabetes.

Conclusions: Good neurodevelopmental outcome was observed in our conservatively treated CH patients, with no diabetes as reported in patients undergoing pancreatectomy.
Variable pathological and clinical features of a large Brazilian family harboring a mutation in the aryl hydrocarbon receptor-interacting protein gene
Authors: Naves Luciana A , Daly Adrian F , Vanbellinghen Jean-François , Casulari Luiz A , Spilioti Cristina , Magalhães Albino V , Azevedo Monalisa F , Giacomini Leonardo A , Nascimento Paula P , Nunes Rousielysson O , Rosa Joao W C , Jaffrain-Rea Marie-Lise , Bours Vincent , Beckers Albert
Published: September 2007

Background: Germline aryl hydrocarbon receptor-interacting protein (AIP) mutations occur in 15% of familial isolated pituitary adenoma (FIPA) cases. To date, studies have focused on the identification of such mutations in large international cohorts. Detailed genetic and clinical studies within AIP mutation-positive families have been limited.

Aim: To undertake a comprehensive study of a large Brazilian FIPA kindred with an E174 frameshift (E174fs) AIP mutation to assess clinical, hormonal, and radiological features in mutation carriers.

Methods: The kindred included 122 subjects across six generations; all underwent clinical examination. Genetic studies were performed to identify E174fs mutation carriers. E174fs-positive subjects underwent magnetic resonance imaging (MRI) and hormonal assessments.

Results: Of the ten germline AIP mutation carriers, three had pituitary tumors, while seven were asymptomatic carriers. Three patients with pituitary tumors showed variability in terms of tumor phenotype (two with acromegaly, one with prolactinoma, or mixed prolactin/GH-secreting tumor) and age at diagnosis; both patients with acromegaly had poor responses to octreotide. Tumor AIP immunohistochemistry from the operated patient showed decreased expression when compared with normal tissue. Two adult subjects with normal MRI had elevated IGF-I in the absence of other causes. A 2-year-old child with the E174fs mutation and a normal MRI had premature thelarche, ovarian development, and advanced bone age in the absence of other underlying causes.

Conclusions: The penetrance of pituitary tumors in AIP mutation-positive adult subjects was 33.3%, while clinical/hormonal features were variable. The features noted in AIP-mutation carriers in this kindred suggest that clinical characteristics of such carriers may extend beyond pituitary tumors.
Effect of esophagogastric devascularization with splenectomy on schistossomal portal hypertension patients' immunity
Authors: Ferreira Fabio Gonçalves , Forte Wilma Carvalho Neves , Assef José Cesar , Capua Jr. Armando de
Published: September 2007

BACKGROUND: Surgical treatment of hemorrhagic complication in schistosomal portal hypertension in our hospital is an esophagogastric devascularization procedure with splenectomy. Infectious risks and immunological alterations imputed to splenectomy may have significant importance. To minimize the consequences of spleen absence, the use of subtotal splenectomy and spleen auto-transplantation were stimulated. AIM: To verify the immunologic alterations imposed by this procedure in our patients. METHOD: Twenty-eight patients with schistosomal portal hypertension and previous history of upper digestive bleeding due to esophagogastric varices rupture underwent elective esophagogastric devascularization and splenectomy. They were prospectively studied before esophagogastric devascularization procedure with splenectomy, 15 and 30 days, 3 and 6 months after the procedure. T and B-lymphocytes, CD4 and CD8 subpopulations were determinated by monoclonal antibodies. Immunoglobulins A, M, G and C3, C4 components of the complement were determinated by radial immunodiffusion. RESULTS: We observed important reduction of all immune cells, increase of IgG and normal levels of IgM, IgA, C3 and C4 at preoperative. CD4/CD8 relation was normal. Six months after esophagogastric devascularization procedure with splenectomy, significant increase in T-lymphocytes, CD4, CD8 and B-lymphocytes were observed. CD4/CD8 relation remained normal. We noted significant increase in C3. IgA, IgM, IgG and C4 had increased, but without significant difference. CONCLUSION: Esophagogastric devascularization procedure with splenectomy determines an increase in T and B-lymphocytes, CD4 and CD8 subpopulations without compromising immunoglobulins and components of complement levels.
Polymorphic variation of mononucleotide microsatellites in healthy humans and its implication for microsatellite instability screening
Authors: Cossio Silvia Liliana , Coura Renata dos Santos , Bortolini Maria Cátira , Giugliani Roberto , Ashton-Prolla Patricia , Prolla João Carlos
Published: September 2007

BACKGROUND: Colorectal cancer is the sixth most common tumor and the fifth in mortality in Brazil. Molecular markers have been associated with disease prognosis, especially in relation to therapeutic response and overall survival rates. Among these, microsatellite instability has been extensively studied. Microsatellite stability status is usually determined by comparison of normal and tumoral tissues from the same patient and instability is characterized by the difference in the PCR-amplification profile of these tissues at a given locus. Usually, a panel of five markers is used for this purpose. Two of them (BAT-25 and BAT-26) are considered monomorphic in populations of European origin. AIM: To analyse the frequency of constitutive polymorphic variation at BAT-25 and BAT-26 loci in a sample of individuals from Southern Brazil. METHODS: Two-hundred and sixteen healthy and unrelated individuals were analised to assess the frequency of allelic variation at the BAT-25 and BAT-26 loci in DNA extracted from peripheral blood. Analysis was done by polymerase chain reaction - single strand conformation polymorphism (PCR-SSCP). RESULTS: From the sample of patients studied, 7% and 6% of the patients had possible constitutive allelic variation at the BAT-25 and BAT-26 loci, respectively. CONCLUSIONS: These results indicate that significant constitutive allelic variation of these loci does occur in heterogeneous populations such as ours, and reinforce the importance of comparative studies between tumoral and corresponding normal tissue to determine microsatellite stability status and correctly identify microsatellite instability in selected populations.
Internal consistency of a Brazilian version of the unified Huntington's disease rating scale
Authors: Tumas Vitor , Camargos Sarah Teixeira , Jalali Paulo Samandar , Galesso Adriano de Paula , Marques Jr Wilson
Published: September 2007

We evaluated the reliability of a translated Brazilian version of the Unified Huntington's Disease Rating Scale (UHDRS) to establish the reproducibility of the scale in a population that differs substantially from that on which the scale was originally validated. After a training period with the video and guidelines requested from the Huntington Study Group, we applied the UHDRS, except for the cognitive tests, to a group of 21 Brazilian patients with a molecular diagnosis of Huntington's disease (HD). We found a high degree of internal consistency of the motor section of the UHDRS (Cronbach's alpha= 0.841). There was a negative correlation between the total motor score and the functional assessment, the independence scale and the functional capacity. There was a positive correlation between these 3 scales of functional evaluation and a negative correlation between the age of onset of the disease and the number of CAG repeats. The behavioral scale and disease duration were not correlated with any factor. The clinical characteristics of this sample of patients as described by the UHDRS were roughly similar to those reported in the original validation studies and the correlations described were similar to those reported previously. We conclude that the Brazilian version of the UHDRS is reliable and valid to study patients with HD in the Brazilian setting, that this sample of Brazilian patients had clinical characteristics similar to those observed in other world regions, as expected, and that the clinical training method used for the application of the UHDRS was effective to insure a high degree of clinical reproducibility.
Sleep disturbances in 50 children with attention-deficit hyperactivity disorder
Authors: Neves Sergio Nolasco Hora das , Reimão Rubens
Published: September 2007

OBJECTIVE: This study assesses the relationship between sleep disturbances (SD) and attention-deficit and hyperactivity disorder (ADHD) to characterize clinical features and associated problems. METHOD: The medical records of 50 children and adolescents ranging in age from 4 to 17 years with ADHD without the diagnosis of mental retardation or pervasive developmental disorders were reviewed. RESULTS: Significant relationships were found between SD and drug therapy (p<0.01), co-morbidity (p<0.01) and greater adherence to treatment prescribed for ADHD disorders (p<0.05). CONCLUSION: The results of this study suggest that SD are an important problem in children with ADHD and may be linked to increased symptoms.
Avaliação cognitiva breve de pacientes atendidos em ambulatórios de neurologia geral
Authors: Vitiello Ana Paula P. , Ciríaco Jovana G.M. , Takahashi Daniel Y. , Nitrini Ricardo , Caramelli Paulo
Published: September 2007

INTRODUÇÃO: O exame das funções cognitivas é habitual na avaliação das demências, porém não é usualmente realizado em pacientes com outras doenças neurológicas. OBJETIVO: Investigar a relevância da semiologia cognitiva sistemática em pacientes com doenças neurológicas diversas. MÉTODO: Foram avaliados 105 pacientes consecutivamente atendidos no período de um ano em ambulatório de neurologia geral de hospital universitário público, sem queixas de alterações cognitivas. Os pacientes foram submetidos aos seguintes testes cognitivos: mini-exame do estado mental (MEEM), extensão de dígitos, testes de memória de figuras, fluência verbal e desenho do relógio. Sempre que possível as notas de corte foram corrigidas em função da escolaridade. RESULTADOS: Cerca de 2/3 dos pacientes apresentaram alterações do desempenho em pelo menos um teste. O MEEM mostrou-se alterado em 20% dos pacientes, o teste da extensão de dígitos apresentou alteração em 50,4% (29,5% na ordem direta e 20,9% na indireta). A evocação tardia esteve alterada em 14,2% dos casos, a fluência verbal esteve abaixo da nota de corte em 27,6% dos pacientes e o desenho do relógio, em 40,0%. CONCLUSÃO: Os dados obtidos comprovam a necessidade da inclusão da avaliação cognitiva como parte obrigatória do exame neurológico, mesmo em pacientes sem queixas relacionadas.
Lipofuscinose ceróide neuronal: achados clínicos e neurorradiológicos
Authors: Gama Rômulo Lopes , Nakayama Mauro , Távora Daniel Gurgel Fernandes , Alvim Thereza Christina de Lara , Nogueira Cleto Dantas , Portugal Dalton
Published: September 2007

Lipofuscinose ceróide neuronal (LCN) constitui um grupo de doenças neurodegenerativas caracterizadas pelo depósito anormal de uma substância autofluorescente de lipopigmentos, que lembra ceróide e lipofuscina, dentro dos lisossomos dos neurônios e outros tipos de células. Os principais subtipos fenotípicos, baseando-se na idade de início, curso clínico e morfologia ultraestrutural, são classificados em formas infantil, infantil tardia, juvenil e adulta. Seis genes associados a lipofuscinose ceróide foram identificados e aproximadamente 150 mutações também são descritas. Relatamos sete pacientes com LCN baseados na história clínica, achados neurorradiológicos e patológicos avaliados na Rede Sarah de Hospitais de Reabilitação - Fortaleza - Ceará - Brasil. Cinco casos foram confirmados com biópsia de pele, sendo dois casos irmãos de pacientes confirmados. O diagnóstico precoce de LCN, uma doença com herança autossômica recessiva, é mandatório para aconselhamento genético e prevenção de outros casos na família. Os achados de imagem podem contribuir no diagnóstico diferencial.
Ganglioneuroblastoma of the cerebellum: neuroimaging and pathological features of a case
Authors: Gasparetto Emerson L. , Rosemberg Sérgio , Matushita Hamilton , Leite Claudia da Costa
Published: September 2007

OBJECTIVE: To report a case of ganglioneuroblastoma of cerebellum, with emphasis to the neuroimaging and pathological findings. CASE REPORT: A one year and eight-month-old girl presented with a two-month history of hypoactivity and tremor in the legs. The MRI showed an enhancing cerebellar mass hypointense on T1 and hyperintense on T2-weighted images. The patient underwent a craniotomy with resection of the lesion. The histological and immunohistochemical studies defined the diagnosis of ganglioneuroblastoma. CONCLUSION: The MRI findings of our case showed no features which could help in the differentiation between ganglioneuroblastoma and the other common types of posterior fossa neoplasms in the pediatric population.
Aplication of the stereolithography technique in complex spine surgery
Authors: Paiva Wellingson Silva , Amorim Robson , Bezerra Douglas Alexandre França , Masini Marcos
Published: September 2007

Many techniques have been proposed for surgical training as a learning process for young surgeons or for the simulation of complex procedures. Stereolithograpfy, a rapid prototyping technique, has been presented recently as an option for these purposes. We describe the case of a 12 years old boy, diagnosed with Ewing´s sarcoma in the cervical spine. After a surgical simulation accomplished in the prototype, built by stereolithography, the patient was submitted to a C4 corpectomy and to a C4 and C3 laminectomy with anterior and posterior fixation, a non intercurrence procedure. This technique is an innovative and complementary tool in diagnosis and therapy. As a result, it is easier for the surgeon to understand the complexity of the case and plan the approach before any surgical procedure.
Avaliação neuropsicológica em portadores de epilepsia do lobo temporal
Authors: Silva Alisson N.S. , Andrade Vivian M. , Oliveira Hélio A.
Published: September 2007

Investigamos a cognição de pacientes com epilepsia de lobo temporal que apresentavam ou não lesão mesial segundo exame de ressonância magnética. Utilizamos testes neuropsicológicos clássicos e ecológicos com objetivo de identificar possíveis alterações funcionais, e comparar resultados entre instrumentos tradicionais e ecológicos. Trinta e quatro pessoas pareadas em idade e escolaridade foram separadas em três grupos: 12 pacientes com lesão mesial; 12 sem lesão e 10 pessoas saudáveis. Para a avaliação funcional utilizamos: subtestes da escala de inteligência para adultos e de memória de Wechsler; fluência verbal, e o teste comportamental de memória de Rivermead. Os pacientes com lesão apresentaram desempenho cognitivo rebaixado em relação aos controles em diversas atividades: span atencional, memória, linguagem, resolução de problemas do cotidiano, enquanto os pacientes sem lesão mostraram-se mais compensados, apenas com alterações atencionais sutis. Tanto os testes tradicionais de memória, quanto os ecológicos foram eficientes para descrever o perfil cognitivo de pacientes com epilepsia.
Sintomas neuropsiquiátricos nas demências: relato preliminar de uma avaliação prospectiva em um ambulatório do Brasil
Authors: Vega Úrsula Maria , Marinho Valeska , Engelhardt Eliasz , Laks Jerson
Published: September 2007

Este estudo teve o objetivo de avaliar sintomas comportamentais e psicológicos na demência e correlacionar o nível de dependência funcional, declínio cognitivo e sintomas neuropsiquiátricos em pacientes ambulatoriais. Foram avaliados, em 12 meses, 35 idosos com demência (critérios do DSM-IV) com o mini-exame do estado mental (MEEM), escala de estadiamento clínico das demências (CDR), inventário neuropsiquiátrico (INP) e escala de atividades funcionais (QAF). Através da correlação de Spearman foram comparados os estados cognitivo, funcional e comportamental na primeira e na última entrevista. Os subgrupos com e sem psicose foram comparados entre si quanto ao desempenho cognitivo e funcional, utilizando-se o teste de Mann-Whitney. Houve declínio do MEEM e melhora do INP ao longo de 12 meses. Do total da amostra, 58,8% apresentaram sintomas depressivos, 55,9% agitação, e 41,2% delírios. Houve correlação significativa entre QAF e o MEEM, a escolaridade e o INP, mas não com tempo de doença. A presença de sintomas psicóticos foi mais prejudicial para a independência dos pacientes. Sintomas psicóticos podem ser um importante fator preditivo para maior declínio funcional em pacientes ambulatoriais com síndrome demencial.
Benign monomelic amyotrophy with proximal upper limb involvement: case report
Authors: Neves Marco Antonio Orsini , Freitas Marcos R.G. de , Mello Mariana Pimentel de , Dumard Carlos Henrique , Freitas Gabriel R. de , Nascimento Osvaldo J.M.
Published: September 2007

Monomelic amyotrophy (MA) is a rare condition in which neurogenic amyotrophy is restricted to an upper or lower limb. Usually sporadic, it usually has an insidious onset with a mean evolution of 2 to 4 years following first clinical manifestations, which is, in turned, followed by stabilization. We report a case of 20-years-old man who presented slowly progressive amyotrophy associated with proximal paresis of the right upper limb, which was followed by clinical stabilization 4 years later. Eletroneuromyography revealed denervation along with myofasciculations in various muscle groups of the right upper limb. We call atention to this rare location of MA, as well as describe some theories concerning its pathophysiology .
Estado nutricional e produção do capim-pé-de-galinha e da soja cultivada em sucessão em sistema antecipado de adubação
Authors: Francisco Eros Artur Bohac , Câmara Gil Miguel de Sousa , Segatelli Cláudio Roberto
Published: September 2007

Argumenta-se sobre a viabilidade de manejo químico do solo estar relacionado à adubação de todo o sistema de cultivo (adubação antecipada) visando promover o incremento de material orgânico no agroecossistema, devido as suas inúmeras vantagens no aspecto da conservação do solo, preservação dos recursos naturais renováveis e na reciclagem dos nutrientes; ou mantém-se o tradicional sistema de adubação de base, isto é, aplicação de fertilizantes simultaneamente à semeadura da cultura. O objetivo deste trabalho foi avaliar o efeito da antecipação da adubação para a cultura da soja sobre: (a) produção de matéria seca e extração de nutrientes pelo capim-pé-de-galinha [Eleusine coracana (L.) Gaertn.] e (b) acúmulo de matéria seca, exportação de nutrientes e produtividade de grãos da cultura da soja semeada em sucessão ao capim-pé-de-galinha. O experimento foi desenvolvido em Piracicaba (SP), na safra agrícola 2001/2002, utilizando o delineamento de blocos completos casualizados com três repetições. A antecipação da adubação da soja, por ocasião da semeadura do capim-pé-de-galinha, não interferiu no acúmulo de matéria seca, na exportação de nutrientes pelos grãos, nem na produtividade agrícola da soja. O capim-pé-de-galinha respondeu positivamente à adubação da soja aumentando a produção de matéria seca e a extração de nutrientes. Os resultados deste estudo mostram que o manejo da adubação, visando ao rendimento operacional do processo de semeadura, pode ser utilizado para favorecer a instalação da cultura da soja na época recomendada.
Predição de ganhos genéticos por índices de seleção na população de milho pipoca UNB-2U sob seleção recorrente
Authors: Santos Fabrício Santana , Amaral Júnior Antonio Teixeira do , Freitas Júnior Silvério de Paiva , Rangel Ramon Macedo , Pereira Messia Gonzaga
Published: September 2007

Com o intento de selecionar progênies superiores para a efetiva concentração de alelos favoráveis em uma população de terceiro ciclo de seleção recorrente intrapopulacional em famílias de meios-irmãos de milho-pipoca, avaliaram-se 192 progênies em delineamento em blocos casualizados com duas repetições em dois ambientes distintos: Colégio Estadual Agrícola Antônio Sarlo, em Campos dos Goytacazes, e Estação Experimental da PESAGRO-RIO, em Itaocara, Rio de Janeiro, em 2004/05. Definiu-se a intensidade de seleção de 15,6%, correspondendo ao número de trinta famílias de meios-irmãos para continuidade do programa. Foram empregados os índices de seleção de Smith e Hazel, Pesek e Baker, Williams, e Mulamba e Mock. O índice de Mulamba e Mock proporcionou as magnitudes mais elevadas de ganhos preditos para a maioria das características, incluindo-se capacidade de expansão e produção, com valores respectivos de 7,16% e 10,00%, na utilização de pesos arbitrários atribuídos por tentativas.
Consulta de enfermagem a pacientes alcoolistas em um programa de assistência ao alcoolismo
Authors: Fornazier Mariana Lorencetti , Siqueira Marluce Miguel de
Published: September 2007

OBJETIVO: Descrever e analisar as atividades desenvolvidas pela enfermagem na consulta dirigida a alcoolistas do Programa de Atendimento ao Alcoolista do Hospital Universitário Cassiano Antônio Moraes da Universidade Federal do Espírito Santo (PAA/HUCAM/UFES). MÉTODOS: O estudo foi desenvolvido no PAA/HUCAM/UFES a partir de um levantamento das consultas de enfermagem (CE) realizadas com pacientes alcoolistas no período de janeiro a dezembro de 2002. A coleta de dados deu-se por meio de um questionário contendo dados de identificação e do seguimento de enfermagem. Foram empregadas as análises quantitativa, através da estatística descritiva, e qualitativa nas etapas da CE. RESULTADOS: Foram realizadas 603 CE (28,7% em primeiro atendimento e 71,3% em retornos). Quanto ao perfil da clientela, 28% eram da região metropolitana; 94% do sexo masculino e 6% do feminino; 50,6% casados, na faixa etária de 40 a 60 anos; e 73,6% apresentaram grau de severidade grave de dependência alcoólica. Nas orientações para o autocuidado na primeira consulta, priorizou-se a diminuição dos sinais e sintomas da síndrome de abstinência, e nas de seguimento, o alcoolismo como doença e suas complicações. CONCLUSÃO: A CE no PAA/HUCAM/UFES tem sido desenvolvida através do atendimento prioritário das necessidades humanas básicas (teoria de Horta), concentrando a atenção de enfermagem no autocuidado (teoria de Orem). Dessa forma, a enfermagem vem propiciando condições facilitadoras por meio de uma informação qualificada e contínua que vise a manutenção da abstinência do álcool e a reformulação no estilo de vida, objetivando uma melhor reinserção do usuário na sociedade.