bluuebunny/crossref_metadata_2025 huggingface dataset:
[RETRACTED ARTICLE] Gastric and jejunal histopathological changes in patients undergoing bariatric surgery
Authors: RODRIGUES Rosemary Simões Nomelini , ALMEIDA Élia Cláudia de Souza , TERRA JÚNIOR Júverson Alves , GUIMARÃES Lucinda Calheiros , DUQUE Ana Cristina da Rocha , ETCHEBEHERE Renata Margarida
Published: January 2017

ABSTRACT BACKGROUND Morbid obesity is a multifactorial disease that is increasingly treated by surgery. OBJECTIVE To evaluate gastric histopathological changes in obese, and to compare with patients who underwent gastrojejunal bypass and the jejunal mucosa after the surgery. METHODS This is an observational study performed at a tertiary public hospital, evaluating endoscopic biopsies from 36 preoperative patients and 35 postoperative. RESULTS In the preoperative group, 80.6% had chronic gastritis, which was active in 38.9% (77.1% and 20.1%, respectively, in the postoperative). The postoperative group had a significant reduction in Helicobacter pylori infection (P=0.0001). A longer length of the gastric stump and a time since surgery of more than two years were associated with Helicobacter pylori infection. The jejunal mucosa was normal in 91.4% and showed slight nonspecific chronic inflammation in 8.6%. CONCLUSION There was a reduction in the incidence of Helicobacter pylori infection in the postoperative group. A longer length of the gastric stump and longer time elapsed since surgery were associated with Helicobacter pylori infection. The jejunal mucosa was considered normal in an absolute majority of patients.
Is total lymphocyte count related to nutritional markers in hospitalized older adults?
Authors: LEANDRO-MERHI Vânia Aparecida , BRÁZ Vitória Negri , AQUINO José Luis Braga de
Published: January 2017

ABSTRACT BACKGROUND Older patients are commonly malnourished during hospital stay, and a high prevalence of malnutrition is found in hospitalized patients aged more than 65 years. OBJECTIVE To investigate whether total lymphocyte count is related to other nutritional markers in hospitalized older adults. METHODS Hospitalized older adults (N=131) were recruited for a cross-sectional study. Their nutritional status was assessed by the Nutritional Risk Screening (NRS), anthropometry, and total lymphocyte count. The statistical analyses included the chi-square test, Fisher's exact test, and Mann-Whitney test. Spearman's linear correlation coefficient determined whether total lymphocyte count was correlated with the nutritional markers. Multiple linear regression determined the parameters associated with lymphocyte count. The significance level was set at 5%. RESULTS According to the NRS, 41.2% of the patients were at nutritional risk, and 36% had mild or moderate depletion according to total lymphocyte count. Total lymphocyte count was weakly correlated with mid-upper arm circumference (r=0.20507); triceps skinfold thickness (r=0.29036), and length of hospital stay (r= -0.21518). Total lymphocyte count in different NRS categories differed significantly: older adults who were not at nutritional risk had higher mean and median total lymphocyte count ( P =0.0245). Multiple regression analysis showed that higher lymphocyte counts were associated with higher triceps skinfold thicknesses and no nutritional risk according to the NRS. CONCLUSION Total lymphocyte count was correlated with mid-upper arm circumference, triceps skinfold thickness, and nutritional risk according to the NRS. In multiple regression the combined factors that remained associated with lymphocyte count were NRS and triceps skinfold thickness. Therefore, total lymphocyte count may be considered a nutritional marker. Other studies should confirm these findings.
Predictive factors of atrial fibrillation after coronary artery bypass grafting
Authors: Folla Cynthia de Oliveira ,   Universidade de São Paulo,  Brazil, Melo Cinthia Cristina de Santana , Silva Rita de Cassia Gengo e ,   Universidade de São Paulo,  Brazil
Published: January 2017

ABSTRACT Objective To analyze predictive demographic and perioperative variables of postoperative atrial fibrillation in patients who underwent exclusively coronary artery bypass grafting. Methods This was a retrospective cohort. We randomly selected 105 medical records of patients who underwent exclusively coronary artery bypass grafting in 2014. Demographic, clinical (preoperative and immediate postoperative) data and related with surgical procedure were collected from medical records. The occurrence of postoperative atrial fibrillation was considered until the third day after the surgery. Variables were analyzed using descriptive and inferential statistics. To identify predictive factors of postoperative atrial fibrillation we used a decision tree model with Classification and Regression Trees algorithm. Results Atrial fibrillation incidence was 19.0% (n=20). Patients with left atrial >40.5mm and aged >64.5 years were more likely to develop the arrhythmia during the post-surgical period. Conclusion Left atrial diameter and advanced age were predictive factors of atrial fibrillation in patients who underwent exclusively coronary artery bypass grafting.
Prevalence of inter-hemispheric asymetry in children and adolescents with interdisciplinary diagnosis of non-verbal learning disorder
Authors: Wajnsztejn Alessandra Bernardes Caturani ,   Faculdade de Medicina do ABC,  Brazil, Bianco Bianca , Barbosa Caio Parente
Published: January 2017

ABSTRACT Objective To describe clinical and epidemiological features of children and adolescents with interdisciplinary diagnosis of non-verbal learning disorder and to investigate the prevalence of inter-hemispheric asymmetry in this population group. Methods Cross-sectional study including children and adolescents referred for interdisciplinary assessment with learning difficulty complaints, who were given an interdisciplinary diagnosis of non-verbal learning disorder. The following variables were included in the analysis: sex-related prevalence, educational system, initial presumptive diagnoses and respective prevalence, overall non-verbal learning disorder prevalence, prevalence according to school year, age range at the time of assessment, major family complaints, presence of inter-hemispheric asymmetry, arithmetic deficits, visuoconstruction impairments and major signs and symptoms of non-verbal learning disorder. Results Out of 810 medical records analyzed, 14 were from individuals who met the diagnostic criteria for non-verbal learning disorder, including the presence of inter-hemispheric asymmetry. Of these 14 patients, 8 were male. Conclusion The high prevalence of inter-hemispheric asymmetry suggests this parameter can be used to predict or support the diagnosis of non-verbal learning disorder.
Short version of the Depression Anxiety Stress Scale-21: is it valid for Brazilian adolescents?
Authors: Silva Hítalo Andrade da ,   Universidade de Pernambuco, Brazil, Passos Muana Hiandra Pereira dos , Oliveira Valéria Mayaly Alves de , Palmeira Aline Cabral , Pitangui Ana Carolina Rodarti , Araújo Rodrigo Cappato de
Published: January 2017

ABSTRACT Objective To evaluate the interday reproducibility, agreement and validity of the construct of short version of the Depression Anxiety Stress Scale-21 applied to adolescents. Methods The sample consisted of adolescents of both sexes, aged between 10 and 19 years, who were recruited from schools and sports centers. The validity of the construct was performed by exploratory factor analysis, and reliability was calculated for each construct using the intraclass correlation coefficient, standard error of measurement and the minimum detectable change. Results The factor analysis combining the items corresponding to anxiety and stress in a single factor, and depression in a second factor, showed a better match of all 21 items, with higher factor loadings in their respective constructs. The reproducibility values for depression were intraclass correlation coefficient with 0.86, standard error of measurement with 0.80, and minimum detectable change with 2.22; and, for anxiety/stress: intraclass correlation coefficient with 0.82, standard error of measurement with 1.80, and minimum detectable change with 4.99. Conclusion The short version of the Depression Anxiety Stress Scale-21 showed excellent values of reliability, and strong internal consistency. The two-factor model with condensation of the constructs anxiety and stress in a single factor was the most acceptable for the adolescent population.
Applicability of the Spoken Knowledge in Low Literacy Patients with Diabetes in Brazilian elderly
Authors: Souza Jonas Gordilho ,   Universidade de São Paulo,  Brazil, Apolinario Daniel , Farfel José Marcelo , Jaluul Omar , Magaldi Regina Miksian , Busse Alexandre Leopold , Campora Flávia , Jacob-Filho Wilson ,   Universidade de São Paulo,  Brazil
Published: January 2017

ABSTRACT Objective To translate, adapt and evaluate the properties of a Brazilian Portuguese version of the Spoken Knowledge in Low Literacy Patients with Diabetes, which is a questionnaire that evaluate diabetes knowledge. Methods A cross-sectional study with type 2 diabetes patients aged ≥60 years, seen at a public healthcare organization in the city of Sao Paulo (SP). After the development of the Portuguese version, we evaluated the psychometrics properties and the association with sociodemographic and clinical variables. The regression models were adjusted for sociodemographic data, functional health literacy, duration of disease, use of insulin, and glycemic control. Results We evaluated 129 type 2 diabetic patients, with mean age of 75.9 (±6.2) years, mean scholling of 5.2 (±4.4) years, mean glycosylated hemoglobin of 7.2% (±1.4), and mean score on Spoken Knowledge in Low Literacy Patients with Diabetes of 42.1% (±25.8). In the regression model, the variables independently associated to Spoken Knowledge in Low Literacy Patients with Diabetes were schooling (B=0.193; p=0.003), use of insulin (B=1.326; p=0.004), duration of diabetes (B=0.053; p=0.022) and health literacy (B=0.108; p=0.021). The determination coefficient was 0.273. The Cronbach a was 0.75, demonstrating appropriate internal consistency. Conclusion This translated version of the Spoken Knowledge in Low Literacy Patients with Diabetes showed to be adequate to evaluate diabetes knowledge in elderly patients with low schooling levels. It presented normal distribution, adequate internal consistency, with no ceiling or floor effect. The tool is easy to be used, can be quickly applied and does not depend on reading skills.
Sarcopenia and chemotherapy-mediated toxicity
Authors: Vega Maria Cecília Monteiro Dela ,   Centro Brasileiro de Radioterapia, Oncologia e Mastologia,  Brazil, Laviano Alessandro , Pimentel Gustavo Duarte ,   Sapienza University,  Italy,   Universidade Federal de Goiás,  Brazil
Published: January 2017

ABSTRACT This narrative review focuses on the role of sarcopenia and chemotherapy-induced toxicity in cancer patients. Consistent evidence shows that sarcopenia in cancer patients leads to decreased overall survival by influencing treatment discontinuation and dose reduction. Therefore, sarcopenia should be considered a robust prognostic factor of negative outcome as well as a determinant of increased healthcare costs.
The halo sign: HRCT findings in 85 patients
Authors: Alves Giordano Rafael Tronco ,   Universidade Federal do Rio de Janeiro, Brazil, Marchiori Edson , Irion Klaus , Nin Carlos Schuler , Watte Guilherme , Pasqualotto Alessandro Comarú , Severo Luiz Carlos , Hochhegger Bruno ,   Liverpool Heart and Chest Hospital, United Kingdom,   Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil
Published: January 2017

ABSTRACT Objective: The halo sign consists of an area of ground-glass opacity surrounding pulmonary lesions on chest CT scans. We compared immunocompetent and immunosuppressed patients in terms of halo sign features and sought to identify those of greatest diagnostic value. Methods: This was a retrospective study of CT scans performed at any of seven centers between January of 2011 and May of 2015. Patients were classified according to their immune status. Two thoracic radiologists reviewed the scans in order to determine the number of lesions, as well as their distribution, size, and contour, together with halo thickness and any other associated findings. Results: Of the 85 patients evaluated, 53 were immunocompetent and 32 were immunosuppressed. Of the 53 immunocompetent patients, 34 (64%) were diagnosed with primary neoplasm. Of the 32 immunosuppressed patients, 25 (78%) were diagnosed with aspergillosis. Multiple and randomly distributed lesions were more common in the immunosuppressed patients than in the immunocompetent patients (p < 0.001 for both). Halo thickness was found to be greater in the immunosuppressed patients (p < 0.05). Conclusions: Etiologies of the halo sign differ markedly between immunocompetent and immunosuppressed patients. Although thicker halos are more likely to occur in patients with infectious diseases, the number and distribution of lesions should also be taken into account when evaluating patients presenting with the halo sign.
Perme Intensive Care Unit Mobility Score and ICU Mobility Scale: translation into Portuguese and cross-cultural adaptation for use in Brazil
Authors: Kawaguchi Yurika Maria Fogaça ,   Universidade de São Paulo,  Brazil, Nawa Ricardo Kenji , Figueiredo Thais Borgheti , Martins Lourdes , Pires-Neto Ruy Camargo ,   Universidade de São Paulo,  Brazil,   Hospital Sírio-Libanês,  Brazil,   Universidade de São Paulo,  Brazil,   Universidade Católica de Santos,  Brazil,   Universidade de São Paulo,  Brazil
Published: January 2017

ABSTRACT Objective: To translate the Perme Intensive Care Unit Mobility Score and the ICU Mobility Scale (IMS) into Portuguese, creating versions that are cross-culturally adapted for use in Brazil, and to determine the interobserver agreement and reliability for both versions. Methods: The processes of translation and cross-cultural validation consisted in the following: preparation, translation, reconciliation, synthesis, back-translation, review, approval, and pre-test. The Portuguese-language versions of both instruments were then used by two researchers to evaluate critically ill ICU patients. Weighted kappa statistics and Bland-Altman plots were used in order to verify interobserver agreement for the two instruments. In each of the domains of the instruments, interobserver reliability was evaluated with Cronbach's alpha coefficient. The correlation between the instruments was assessed by Spearman's correlation test. Results: The study sample comprised 103 patients-56 (54%) of whom were male-with a mean age of 52 ± 18 years. The main reason for ICU admission (in 44%) was respiratory failure. Both instruments showed excellent interobserver agreement ( > 0.90) and reliability ( > 0.90) in all domains. Interobserver bias was low for the IMS and the Perme Score (−0.048 ± 0.350 and −0.06 ± 0.73, respectively). The 95% CIs for the same instruments ranged from −0.73 to 0.64 and −1.50 to 1.36, respectively. There was also a strong positive correlation between the two instruments (r = 0.941; p < 0.001). Conclusions: In their versions adapted for use in Brazil, both instruments showed high interobserver agreement and reliability.
Association between severe asthma and changes in the stomatognathic system
Authors: Carvalho-Oliveira Mayra ,   Programa de Controle da Asma e Rinite Alérgica da Bahia,  Brasil, Salles Cristina , Terse Regina , D'Oliveira Júnior Argemiro ,   Universidade Federal da Bahia,  Brazil,   Escola Bahiana de Medicina e Saúde Pública,  Brazil,   Universidade Federal da Bahia,  Brazil,   Universidade Federal da Bahia,  Brazil
Published: January 2017

ABSTRACT Objective: To describe orofacial muscle function in patients with severe asthma. Methods: This was a descriptive study comparing patients with severe controlled asthma (SCA) and severe uncontrolled asthma (SUA). We selected 160 patients, who completed a sociodemographic questionnaire and the 6-item Asthma Control Questionnaire (ACQ-6), as well as undergoing evaluation of orofacial muscle function. Results: Of the 160 patients evaluated, 126 (78.8%) and 34 (21.2%) presented with SCA and SUA, respectively, as defined by the Global Initiative for Asthma criteria. Regardless of the level of asthma control, the most frequent changes found after evaluation of muscle function were difficulty in chewing, oronasal breathing pattern, below-average or poor dental arch condition, and difficulty in swallowing. When the sample was stratified by FEV1 (% of predicted), was significantly higher proportions of SUA group patients, compared with SCA group patients, showed habitual open-mouth chewing (24.8% vs. 7.7%; p < 0.02), difficulty in swallowing water (33.7% vs. 17.3%; p < 0.04), and voice problems (81.2% vs. 51.9%; p < 0.01). When the sample was stratified by ACQ-6 score, the proportion of patients showing difficulty in swallowing bread was significantly higher in the SUA group than in the SCA group (66.6% vs. 26.6%; p < 0.01). Conclusions: The prevalence of changes in the stomatognathic system appears to be high among adults with severe asthma, regardless of the level of asthma control. We found that some such changes were significantly more common in patients with SUA than in those with SCA.
Temporal analysis of reported cases of tuberculosis and of tuberculosis-HIV co-infection in Brazil between 2002 and 2012
Authors: Gaspar Renato Simões ,   Universidade Federal do Maranhão, Brazil, Nunes Natália , Nunes Marina , Rodrigues Vandilson Pinheiro ,   Força Aérea Brasileira, Brasil,   Universidade Federal do Maranhão, Brazil
Published: January 2017

ABSTRACT Objective: To investigate the reported cases of tuberculosis and of tuberculosis-HIV co-infection in Brazil between 2002 and 2012. Methods: This was an observational study based on secondary time series data collected from the Brazilian Case Registry Database for the 2002-2012 period. The incidence of tuberculosis was stratified by gender, age group, geographical region, and outcome, as was that of tuberculosis-HIV co-infection. Results: Nationally, the incidence of tuberculosis declined by 18%, whereas that of tuberculosis-HIV co-infection increased by 3.8%. There was an overall decrease in the incidence of tuberculosis, despite a significant increase in that of tuberculosis-HIV co-infection in women. The incidence of tuberculosis decreased only in the 0- to 9-year age bracket, remaining stable or increasing in the other age groups. The incidence of tuberculosis-HIV co-infection increased by 209% in the ≥ 60-year age bracket. The incidence of tuberculosis decreased in all geographical regions except the south, whereas that of tuberculosis-HIV co-infection increased by over 150% in the north and northeast. Regarding the outcomes, patients with tuberculosis-HIV co-infection, in comparison with patients infected with tuberculosis only, had a 48% lower chance of cure, a 50% greater risk of treatment nonadherence, and a 94% greater risk of death from tuberculosis. Conclusions: Our study shows that tuberculosis continues to be a relevant public health issue in Brazil, because the goals for the control and cure of the disease have yet to be achieved. In addition, the sharp increase in the incidence of tuberculosis-HIV co-infection in women, in the elderly, and in the northern/northeastern region reveals that the population of HIV-infected individuals is rapidly becoming more female, older, and more impoverished.
The role of physical exercise in obstructive sleep apnea
Authors: Andrade Flávio Maciel Dias de ,   Universidade de Pernambuco, Brazil, Pedrosa Rodrigo Pinto ,   Instituto de Medicina Integral Professor Fernando Figueira, Brazil
Published: January 2017

ABSTRACT Obstructive sleep apnea (OSA) is a common clinical condition, with a variable and underestimated prevalence. OSA is the main condition associated with secondary systemic arterial hypertension, as well as with atrial fibrillation, stroke, and coronary artery disease, greatly increasing cardiovascular morbidity and mortality. Treatment with continuous positive airway pressure is not tolerated by all OSA patients and is often not suitable in cases of mild OSA. Hence, alternative methods to treat OSA and its cardiovascular consequences are needed. In OSA patients, regular physical exercise has beneficial effects other than weight loss, although the mechanisms of those effects remain unclear. In this population, physiological adaptations due to physical exercise include increases in upper airway dilator muscle tone and in slow-wave sleep time; and decreases in fluid accumulation in the neck, systemic inflammatory response, and body weight. The major benefits of exercise programs for OSA patients include reducing the severity of the condition and daytime sleepiness, as well as increasing sleep efficiency and maximum oxygen consumption. There are few studies that evaluated the role of physical exercise alone for OSA treatment, and their protocols are quite diverse. However, aerobic exercise, alone or combined with resistance training, is a common point among the studies. In this review, the major studies and mechanisms involved in OSA treatment by means of physical exercise are presented. In addition to systemic clinical benefits provided by physical exercise, OSA patients involved in a regular, predominantly aerobic, exercise program have shown a reduction in disease severity and in daytime sleepiness, as well as an increase in sleep efficiency and in peak oxygen consumption, regardless of weight loss.
Inhibition of αvβ5 Integrin Attenuates Vascular Permeability and Protects against Renal Ischemia-Reperfusion Injury
Authors: McCurley Amy , Alimperti Stella , Campos-Bilderback Silvia B. , Sandoval Ruben M. , Calvino Jenna E. , Reynolds Taylor L. , Quigley Catherine , Mugford Joshua W. , Polacheck William J. , Gomez Ivan G. , Dovey Jennifer , Marsh Graham , Huang Angela , Qian Fang , Weinreb Paul H. , Dolinski Brian M. , Moore Shaun , Duffield Jeremy S. , Chen Christopher S. , Molitoris Bruce A. , Violette Shelia M. , Crackower Michael A.
Published: January 2017

Ischemia-reperfusion injury (IRI) is a leading cause of AKI. This common clinical complication lacks effective therapies and can lead to the development of CKD. The αvβ5 integrin may have an important role in acute injury, including septic shock and acute lung injury. To examine its function in AKI, we utilized a specific function-blocking antibody to inhibit αvβ5 in a rat model of renal IRI. Pretreatment with this anti-αvβ5 antibody significantly reduced serum creatinine levels, diminished renal damage detected by histopathologic evaluation, and decreased levels of injury biomarkers. Notably, therapeutic treatment with the αvβ5 antibody 8 hours after IRI also provided protection from injury. Global gene expression profiling of post-ischemic kidneys showed that αvβ5 inhibition affected established injury markers and induced pathway alterations previously shown to be protective. Intravital imaging of post-ischemic kidneys revealed reduced vascular leak with αvβ5 antibody treatment. Immunostaining for αvβ5 in the kidney detected evident expression in perivascular cells, with negligible expression in the endothelium. Studies in a three-dimensional microfluidics system identified a pericyte-dependent role for αvβ5 in modulating vascular leak. Additional studies showed αvβ5 functions in the adhesion and migration of kidney pericytes in vitro. Initial studies monitoring renal blood flow after IRI did not find significant effects with αvβ5 inhibition; however, future studies should explore the contribution of vasomotor effects. These studies identify a role for αvβ5 in modulating injury-induced renal vascular leak, possibly through effects on pericyte adhesion and migration, and reveal αvβ5 inhibition as a promising therapeutic strategy for AKI.
Kerkhoff v Minister of Justice and Constitutional Development 2011 2 SACR 109 (GNP): Intermediary Appointment Reports and a Child's Right to Privacy Versus the Right of an Accused to Access to Information
Authors: Bekink Mildred
Published: January 2017

General consensus exists that the adversarial nature of the South African criminal procedure with its often aggressive cross-examination of a witness, sometimes by an accused himself, will in most cases expose a child to undue mental stress or suffering when having to testify in court. In confirmation of this fact and with a notion to shield child witnesses from the stress or suffering when having to testify in the presence of an accused the function of an intermediary was introduced with the insertion of section 170A into the Criminal Procedure Act 51 of 1977. In terms of section 170A(1) a court may if it appears to such court that it would expose any witness under the biological or mental age of eighteen years to undue mental stress or suffering if he or she testified at such hearing, appoint a competent person as an intermediary in order for the witness to give evidence through that intermediary. Section 170A(1) contemplates that a child complainant will be assessed prior to testifying in court in order to determine whether the services of an intermediary should be used. If the assessment reveals that the services of an intermediary are needed, then the state must arrange for an intermediary to be available at the commencement of the trail. The aforementioned procedure of section 170A(1) was followed in Kerkhoff v Minister of Justice and Constitutional Development 2011 2 SACR 109 (GP) and is the subject of this discussion.
The Legal Nature of the Duty of Care and Skill
Authors: Stevens Richard Arno
Published: January 2017

Section 77(2)(b) of the Companies Act 71 of 2008 (“the Act”) provides that a director of a company may be held liable based on the common law principles relating to delict for any losses or damages which the company suffer due to a breach of the duty of care in skill in terms of s76(3)(c), losses due to a breach of a provision of the Act not mentioned in section 77 and losses due to the contravention of any provisions of the memorandum of incorporation (“MoI”) of the company. This article poses the question whether the legislature was correct in formulating the legal nature of the duty of care and skill as well as the liability of directors for losses flowing forth from any breach of the company’s MoI as delictual. The article will attempt to show that basis for liability is not necessarily delictual in nature but it could be argued that the basis could also be contractual.
The Search for Environmental Justice
Authors: Geduld Allison JN
Published: January 2017

This contribution provides a short overview of the book by Martin P, Bigdeli SZ, Daya-Winterbottom T, Du Plessis W and Kennedy K (eds) The Search for Environmental Justice (Edward Elgar UK 2015) ISBN 978-1-78471-941-8.
Microfluidics Lithography 2: UV Exposure and Development v1
Authors: Sevli Serhat , Seyfullah Yilmaz not provided , C. Yunus Sahan not provided
Published: January 2017

Nehir Biyoteknoloji Ltd. www.nehirbt.com
Causes of maternal mortality at tertiary care hospital
Authors: G. Vijayalakshmi , N. Usharani , Khazi A. A.
Published: January 2017

Background: Maternal mortality is a vital index of quality and efficiency of obstetric service, prevailing in a country. Women comprise an important section of any population and during child bearing period, the threat to life is protected by various preventive and therapeutic measures and many a time by surgical intervention.Methods: A thorough analysis of data collected. Information was obtained from case sheets, laboratory investigations. During the present study, total births include live births, still births and deaths due to abortions are also included, since it is ‘one of the important causes of maternal deaths.Results: According to the above table Eclampsia is the main cause of direct death. Out of 25vaginal deliveries 7 cases died due to PPH (26.92%).Conclusions: Maternal Mortality is a global problem every country in the world is facing .We need to target specific interventions for specific population.
Study to assess the changing pattern of clinical profile and determine the prognosis in hepatic encephalopathy
Authors: K. K. Sarosh Kumar , S. M. Sarin , Valliyot Balakrishnan , Joy Vinu , Beevi Kadeeja , Balakrishnan Sudha
Published: January 2017

Background: Hepatic encephalopathy (HE) is a common complication of liver disease that requires intensive care management. The prevalence of HE is increasing during recent period. The most important factors of HE are alcohol consumption, chronic hepatitis, hepatotoxic drugs and unhealthy changes in life style. There were only relatively few studies from our region on the changing profile of hepatic encephalopathy under the background of life style changes. This study was conducted with the aim to detect the changing pattern of clinical profile, precipitants and to assess the prognosis of patients with hepatic encephalopathy.Methods: This was a prospective study for a period of 18 months since January 2012 at Academy of Medical Sciences, Pariyaram, Kannur, a tertiary care centre situated in the northern part of Kerala. Patients admitted in the medical and gastroenterology wards and intensive care units that fulfilled the inclusion criteria were enrolled in this study.Results: Among the 76 patients with HE, 60 were suffering from CLD and 16 due to acute liver failure. The common etiologies for HE in CLD patients were Alcoholic cirrhosis (63%), Cryptogenic cirrhosis (17%) and cirrhosis due to chronic HBV (10%) and HCV hepatitis (7%) respectively. Among the CLD patients at the start of observation majority were in Child Pugh class B and C. Based on West Haven grading most of them had Grade 2 and 3 HE. Majority with Grade 1, 2 and 3 improved where as those with Grade 4 and Grade 3 in Child Pugh class C worsened. The common precipitants of HE were GI bleed, dyselectrolemia, constipation and infections. Among these precipitants a statistically significant association for a worse outcome was present only with infection. Leptospirosis and deliberate self-harm due to ingestion of hepatotoxic rodenticide and paracetamol were the leading cause of hepatic encephalopathy in acute liver failureConclusions: In present study HE was most commonly seen in patients with alcoholic liver disease. Cryptogenic cirrhosis associated with other life style diseases was the second common condition. Among all precipitating factors infection appeared as a statistically significant factor predicting a worse outcome. Health education among alcoholic patients and life style modifications to prevent cryptogenic cirrhosis are of paramount importance in curtailing the increase in incidence of HE in this region.
Reflectance Spectrum of a Color Blue Generated by Curved Multilayer and Iridescent of the Elytron of the Calidea Signata Bug
Authors: Ouedraogo Issaka , Igo Serge Wendsida , Simonis Priscilla , Ouedraogo Alioune , Zeghmati Belkacem
Published: January 2017

This paper focuses on the study of the origins of blue iridescent reflections of the elytron of Calidea Signata, of the pentatomidae family which is commonly known as bug. Indeed, we use the spectrophotometry measurements, scanning electron microscopy characterization technique, and a ray tracing code program combined with the transfer matrices method, to explain the structure which is responsible for the color of the blue reflections and the iridescent effect. Thus, we noticed that the color of the bug as a result of two peaks. The first and main peak is located at 485.5 nm, corresponding to the blue color. The second peak, is less intense at 525 nm, corresponding to the green-blue color. The numerical reproduction of the reflectance spectrum gives 510.25 nm for the main peak, and 539.5 nm for the secondary peak. These results confirm that the multilayer structure is responsible for the blue color of the Calidea Signata bug. Lastly, the curve of the multilayer is responsible for the iridescence.
Planar Curves out of Their Curvatures in R2
Authors: Alkhouli Talat
Published: January 2017

This research aims to introduce some of the main ideas of differential geometry. The research deals with the main concepts needed to understand this work. In this research properties of curves in 2 R are studied. The research is built on using the curvature of a curve in 2 R to derive a parametric formula for the velocity and acceleration. Also the geometry of focal points has been discussed. Examples are built to support the aim of this research.
Évaluation De La Vulnerabilite A La Pollution D'une Eau De Surface Destinee A L'adduction D'eau Potable D'une Metropole. Cas De La Lagune Aghein A Abidjan, (Sud De La Cote D'ivoire)
Authors: Larissa Eba Anowa Evrade , Kouame Kan Jean , Deh Serge , Balliet René , Touré Mahmoud , Anoh Armand Kouao , Roger Jourda Jean Patrice
Published: January 2017

The lagoon that is the subject of this study, was chosen as drinking water alternative source of supply for the city of Abidjan. However, this language is shown in a very favorable area of forest to agriculture. We observe large rubber plantations, food and oil palm crops spread throughout the lagoon basin. Also, fertilizers injected into these plantations, as well as releases from industries and homes they are potential sources of pollution of the lagoon. According Humbert (2012), this pollution is reflected in particular by widespread concentration of nitrates and pesticides. Given these observed problems related to the quality of this resource, this study was initiated. Its objective is to develop a methodology based on the functionality of a Geographic Information System (GIS) to assess the degree of threat to what the Aghein lagoon faces through the completion of a vulnerability map at pollution. The method used here is a spatial analysis model incorporating several parameters including the slope, land cover, soil type, runoff and drainage density. These parameters have been previously defined, prioritized and weighted, and then integrated into a GIS. The resulting map shows five classes of vulnerability indices to pollution of the lagoon Aghein. They are: very small classes, low, medium, high and very high. These indices highlight the areas from which the lagoon is threatened.
A Cone Beam Computed Tomography Study Among Dental Residents Based on a Questionnaire
Authors: Stoica Alexandra Mihaela , Monea Monica , Sita Dragos Dan , Buruian Mircea
Published: January 2017

Objectives: The aim of our study was to analyse the utility of the CBCT systems among the dental residents form the Dental University of TarguMures. Material and methods: We conducted an anonymous survey using a questionnaire that included 11 questions. All the 55 participants from all dental specialties studied at the Dental University Center Targu-Mures. The completed questionnaires were collected the results were evaluated and statistically analyzed using chi-square test. Results: Most residents have learnt about the CBCT during the university studied by participating at different radio-imagistic courses outside the curriculum. Only 33 (60%) residents recommend daily a CBCT for supporting their diagnosis most of them being oral surgeons and 7 (12.72%) of them occasionally recommend between 1 and 5 CBCTs a month. Conclusions: The CBCT system used as an imagistic evaluation in all dental specialties is essential and the advantages can be found in the accuracy of establishing a correct diagnosis, creating a treatment plan and results evaluation.
Mise En Evidence De Nouvelles Cibles De Forages A Partir De L’analyse De La Fracturation Du Prospect Aurifère De Dougbafla-OUME (Centre-Ouest De La Côte d’Ivoire)
Authors: Sidik Ouattara A. , Derving Baka , Gbele Ouattara , Amadou Nimaga
Published: January 2017

The mining research license of Oume (PR105) is located in the Centerwest forestry of Côte d’Ivoire on Fettekro greenstone belt. This furrow belongs to the Proterozoic Birimian series of West Africa. This concession which is our study area, is sheltered by the Bonikro gold deposit, which was discovered by sampling the geochemical gold soil anomaly. All around the latter within a radius of about 15 km, ten prospects or targets were highlighted by the method of soil geochemistry. These targets or potential anomalies are currently undergoing intensive drilling to identify potential resources that could feed into Bonikro mine processing unit. It is in this perspective that the aim of this work is to locate new targets likely to contain gold indices from the use of synthetic opening radar satellite imagery. The fracturing map was obtained by applying directional filters from Sobel on the radar images (N-S, E-W, NESW and NW-SE) and Yesou gradient filter. The enhanced lineaments were extracted manually. The report of the lineament direction on the specific tools called “Rosace” showed five (5) preferential direction classes [N00 - N10], [N20 - N30], [N40 - N80], [N90 - N100] and [N120 - N140]. The analysis of the relationship between the lineaments map and geochemical signature map of the study area shows that the area is intensely fractured and describes an anomaly that overlap with coarsely elongated gold content along the Birimian formations direction. The study permitted to identify four (4) potential targets within Oume license.
The Attitudes of Physiotherapy Students Toward Occupational Medicine
Authors: Prendushi Henrrik
Published: January 2017

Diseases and work-related injuries make an important part in the global burden of disease. These are studied, prevented and treated by occupational professionals as well as other health care professionals. Physiotherapists have an important role in rehabilitation of the people suffering from different workrelated injuries and diseases. Our study aims to know the attitudes of the students of Physiotherapy regarding the Occupational Medicine, in its general character, as well as their perceptions about the Albanian reality, the future of this medical science in Albania, and the relations with their profession. An anonymous questionnaire was distributed to the third year students of Physiotherapy at the University Luigj Gurakuqi in Shkodra, in their first lesson of Occupational Medicine. It consisted of 23 questions, some of them in the form of a 5 point Likert. The questionnaire was made in two parts: demographic data and the research data. The questionnaire was completed by 31 students. There is a good level of knowledge of foreign languages, 27 of them know English. The need to study the subject resulted in 3.90 points on a 5 point Likert. The degree of awareness of occupational medicine in Albania resulted in 2.03 points and the implementation of the laws in just 1.90 points, but more than 90% of the students affirm that there is an increased interest on occupational medicine during last 5 years in the country. They unanimously agree about the relationships between their profession and the occupational medicine. The majority of the students are interested about more training, and for more than one half it is a career option, too.
The Use of Aspirin for the Treatment of Malignancies: Review Study
Authors: Ra’ouf Alnsour Dana Ayman Abdel , Alkhatib Ahed J
Published: January 2017

The present review study reviewed the literature for the possible therapeutic roles of aspirin against tumors. Aspirin has various therapeutic properties among which is the anti-inflammatory property. Epidemiological studies have proved the efficacy of long term use of aspirin in reducing the incidence of colorectal cancer by up to 30%, and the cancer risk as well. Although no exact mechanism has been entirely proposed so far to explain the antineoplastic effect of aspirin against cancer, two mechanisms have been under focus, the first is related to its anti-inflammatory properties which are thought to suppress the inflammatory mediators and to inhibit carcinogenic mechanisms, and the other mechanism is through the deactivation of COX2. We would like to raise the possibility for aspirin to be regularly involved in preventive mechanisms.
The Variations in the Altitudes Between the Sea Level and Ajloun Impact Heart Variables, but not Angiotensin Ii
Authors: Sweis Jehan Fayez , Haddad Reema Kamal , Salmoneh Abdallah T , Aljabra Rabia Jamil , Alrefai Taghreed A , Abeeleh Mahmoud Abu , Abeeleh Jaafar Abu , Al-Shehabat Mustafa Ahmad , Alkhatib Ahed J
Published: January 2017

Background: hypertension affects many people worldwide and it is highly prevalent in Jordan. Living at different areas with different attitudes may have impacts in hypertension. Study objectives: to identify the prevalence of hypertension in two areas in Jordan with different attitudes and to determine the impact of attitudes in hypertension and angiotensin II to be able to determine the appropriate antihypertensive drug for such population. Methodology: a cross-sectional study design was conducted to collect data from participants. The study included 1000 participants, 500 from each area. A constructed questionnaire was used in this study. Blood samples were taken from participants to assay for angiotensin II. Blood pressure was measured for all patients. Data was analyzed using SPSS version 20. Data was presented as means, frequencies, percentages. The relationship between variables was examined using independent T-test. Significance was considered at alpha level 0.05). Conclusions: living in high altitude is associated with increased potential to have increased levels of cardiac parameters independently of the level of angiotensin II and the therapeutic options for patients with hypertension should be taken into account.
Barriers to Practice of Rural and Remote Nursing in Canada
Authors: Hunt Steve , Hunt Elena
Published: January 2017

The delivery of rural and remote healthcare has been identified in the literature as a unique and complex working environment for Nursing practice. This Canadian setting integrative review looks at barriers associated with rural and remote nursing. Nine articles were retained after filtering over 200 articles extracted from 4 databases. Critical Appraisal Skills Programme Checklist (CASP) for qualitative research and Quality Assessment Tool for Quantitative Studies (QATQ) were used for assessment of a total sample of N=3402 participants. Four (4) main themes (barriers) were extracted: 1) Professional Isolation, 2) Competing Demands, 3) Lack of Sustainable Continuing Educational Initiatives and 4) Lack of Organizational Support. Following analysis of the demographic data, an emerging theme of an aging workforce was also seen as a potential future barrier to rural nursing practice. Future research is required in order for sufficient and appropriate action to be taken in addressing aforementioned barriers. Recommendations for nursing practice and policy in rural and remote areas revolve around exposing nursing students to rural / remote settings, incentives for new graduate students to practice in these areas, as well as support and educational initiatives encouraging practitioners to work to their full scope of practice.
Efecto De Di`Ferentes Intensidades De Poda De Formación En El Crecimiento Inicial De Melina (Gmelina Arborea Roxb.)
Authors: Lara  Vasconez Norma Ximena , Cevallos Eduardo , Almeida Santiago , Lara Sulema
Published: January 2017

This research aims to evaluate the effect of different intensities of formation pruning in the initial development of the Melina (Gmelina arborea Roxb.) in the Pedro Vicente Maldonado canton located in the Pichincha Province. An established Melina (beech wood) plantation, with three different intensities of pruning were used; the experimental design utilized 3 pruning treatments on randomized complete blocks and the control plot, 4 repetitions with a total of 16 experimental units, the investigation began at 3 months after planting and finished when they were 8 months old. The results being that the best diameter was obtained with the pruning of 60% of the tree, the height didn't have any significant statistical difference between treatments, the best straightness was obtained with 50% and 70% pruning, the highest number of branches pruned were pruned 70%, the control tree has the biggest number of broken off branches. The conclusion being that the best increments in diameters were obtained by the control plot; however, this pruning treatment is rejected because the purpose is to obtain wood free of knots. Without taking into consideration the control plot, the best diameters were obtained by pruning 60%, but the form of the tree trunk presents a slight curve in relationship to the intensity of pruning 50% and 70%, where the trees are straighter but with smaller diameters. The formation pruning doesn’t influence the height growth of the plant, but it is positive in the increment of the diameter and the straightness. The lack of pruning in the Gmelina causes the breaking off of branches causing damage to the trunk of the tree.
European Mitochondrial DNA Haplogroups are Associated with Cerebrospinal Fluid Biomarkers of Inflammation in HIV Infection
Authors: Samuels David C. , Kallianpur Asha R. , Ellis Ronald J. , Bush William S. , Letendre Scott , Franklin Donald , Grant Igor , Hulgan Todd
Published: January 2017

Background: Mitochondrial DNA (mtDNA) haplogroups are ancestry-related patterns of single-nucleotide polymorphisms that are associated with differential mitochondrial function in model systems, neurodegenerative diseases in HIV-negative populations, and chronic complications of HIV infection, including neurocognitive impairment. We hypothesized that mtDNA haplogroups are associated with neuroinflammation in HIV-infected adults.Methods: CNS HIV Antiretroviral Therapy Effects Research (CHARTER) is a US-based observational study of HIV-infected adults who underwent standardized neurocognitive assessments. Participants who consented to DNA collection underwent whole blood mtDNA sequencing, and a subset also underwent lumbar puncture. IL-6, IL-8, TNF-α (high-sensitivity), and IP-10 were measured in cerebrospinal fluid (CSF) by immunoassay. Multivariable regression of mtDNA haplogroups and log-transformed CSF biomarkers were stratified by genetic ancestry using whole-genome nuclear DNA genotyping (European [EA], African [AA], or Hispanic ancestry [HA]), and adjusted for age, sex, antiretroviral therapy (ART), detectable CSF HIV RNA, and CD4 nadir. A total of 384 participants had both CSF cytokine measures and genetic data (45% EA, 44% AA, 11% HA, 22% female, median age 43 years, 74% on ART).Results: In analyses stratified by the 3 continental ancestry groups, no haplogroups were significantly associated with the 4 biomarkers. In the subgroup of participants with undetectable plasma HIV RNA on ART, European haplogroup H participants had significantly lower CSF TNF-α (P = 0.001). Conclusions: Lower CSF TNF-α may indicate lower neuroinflammation in the haplogroup H participants with well-controlled HIV on ART.