bluuebunny/crossref_metadata_2025 huggingface dataset:
ICTs and Human Development in Nigeria
Authors: Imhonopi David , Urim Ugochukwu Moses , Igbadumhe Friday Abaye
Published: May 2014

ICTs have successfully changed the social, economic and political spaces globally. Through globalisation, ICTs have reduced the world to a global clan and assumed a cyclopean force driving human civilisation by the scruff. The impact of ICTs has virtually diffused through all sectors, forcing technological changes and creating a culture of dependence on technology. In Nigeria, the presence of ICTs has become ubiquitous and its knowledge has deepened. However, the use of ICTs for human development purposes has remained grossly limited. ICTs have only been co-opted for the creation of web portals, email addresses, B2B, B2C interactions and for inconsequential undertakings. The use of ICTs for educational and manpower development, knowledge transmission, health education, research and development, medical treatment and others for human development purposes is yet embryonic. This may not be unconnected with the byzantine socio-economic crises like spotty power supply, moribund infrastructure, witless political leadership, lack of priority in investments by the state, endemic official corruption and a host of challenges facing the Nigerian state. To assume a pole position in the present knowledge economy, Nigeria needs to find that nexus between ICTs and its human development needs. This study is cast against the backcloth of the Diffusion of Innovations and Human Development Theories which support the diffusion of ICT-enabled human development programmes in Nigeria to realise true development. This paper argues that the political leadership in Nigeria will benefit more at a fragment of the cost when it adopts ICTs in catalysing its human development programmes. In addition, resolving some of the embedded social and ethical problems facing the country will free resources for the government to invest massively in ICTs that could help it leap-frog its human development challenges and improve the lives of its citizens.
Performance Studies of Integrated Network Scenarios in a Hospital Environment
Authors: Sarkar Nurul I. , Kuang Anita Xiao-min , Nisar Kashif , Amphawan Angela
Published: May 2014

Hospital network is evolving towards a more integrated approach by interconnecting wireless technologies into backbone networks. Although various integrated network scenarios have been published in the networking literature, a generic hospital model has not yet been fully explored and it remains a challenging topic in practice. One of the problems encountered by network practitioners is the seamless integration of network components into healthcare delivery. A good understanding of the performance of integrated networks is required for efficient design and deployment of such technologies in hospital environments. This research paper discuss on the modelling and evaluation of integrated network scenarios in hospital environments. The impact of traffic types (e.g. data, voice and video), traffic load, network size and signal strength on network performance is investigated by simulation. Three piloted case studies look at client performance in radiology Accident and Emergency (A & E and Intensive Care Unit (ICU)) scenarios. Each scenario reflects the need for various traffic types that end up distinct network behaviours. In the radiology scenario, email and File Transfer Protocol (FTP) traffic is found to perform well for medium-to-large networks. In the A & E scenario, Voice over Internet Protocol (VoIP) traffic is shown to generate very limited jitter and data loss. The performance is aligned with the Quality of Service (QoS) requirements. In the ICU scenario, the performance of video conference degrades with network size, thus, a QoS-enabled device is recommended to reduce the packet delay and data loss. IEEE 802.11a suits in hospital environment because it mitigates interference on the 2.4GHz band where most wireless devices operate.
Hospital Environment Scenarios using WLAN over OPNET Simulation Tool
Authors: Sarkar Nurul I. , Kuang Anita Xiao-min , Nisar Kashif , Amphawan Angela
Published: May 2014

For the past ten years, heterogeneous networks wired and wireless had tended to integrate seamlessly, offering effective and reliable service for medical operations. One of the problems encountered by network practitioners is the seamless integration of network components into healthcare delivery. As a multiplexing hospital model, the implementation certainly presents some challenges. The major technical and performance issues involve are as following. The operating parameters should keep aligned to the Quality of Service (QoS) requirement throughout simulation. Bandwidth utilisation of wireless networking is a challenging issue for real-time multimedia transmission. IEEE 802.11 provides relatively lower data rate than wired networks, thus the developer tends to adopt a more compromised solution: either reduce the file size or compress the image packets. Communication performance that varies constantly with the impact of signal strength, traffic load and interference. As stated radio signal senses as a curve and attenuates greatly while metallic object and microwave exist within the active range. To ensure devices do not interfere with other electronic equipments (e.g. heart monitors), assert wireless spectrum has to be managed appropriately. This research paper aims to develop a generic hospital network scenarios using Wireless Local Area Network (WLAN) over OPNET Simulation, to evaluate the performance of the integrated network scenario for Intensive Care Units (ICU). This research makes use of computer simulation and discusses various aspects of the network design, so as to discover the performance behaviour pertaining to effect of traffic type, traffic load and network size. In the ICU scenario, the performance of video conference degrades with network size, thus, a QoS-enabled device is recommended to reduce the packet delay and data loss. IEEE 802.11a suits in hospital environment because it mitigates interference on the 2.4GHz band where most wireless devices operate. Experiment examines the effect of signal strength in WLAN. It is convinced that -88dBm is the best signal strength threshold. Although 802.11a generates slightly lower throughput than 802.11g, this issues can be addressed by placing more APs in the service area. It is convinced that 802.11a suits the hospital environments, because it mitigates interference on the popular 2.4GHz band where most wireless devices operate. It is important for medical devices which require future upgrade and Bluetooth deployment.
Professional Social Network Participation of Business School Graduates
Authors: Claybaugh Craig C. , Haried Peter
Published: May 2014

Social networks are having a profound impact on how professionals communicate and connect with each other. Online professional social networks have become a significant resource for building and maintaining invaluable business connections. Recent university graduates are a particular population often in search of building social networks to further professional development. Participation in online social networks provides a valuable tool for recent university graduates to create and sustain their professional connections and business relationships. This paper seeks to gain a better understanding of the effect university (nationally ranked, large urban, and regional), gender and degree type (undergraduate and graduate) has on online professional social network participation. The authors' business school college graduate findings suggest that university, degree type, and gender were associated with the likelihood of joining the online professional social network LinkedIn. An analysis of the results and future research directions are presented.
Qualitative Upward Mobility, the Mass-Media and ‘Posh’ Masculinity in Contemporary North-East Britain: A Micro Sociological Case-Study
Authors: Giazitzoglu Andreas
Published: May 2014

The Changers are seven British men who have experienced upward mobility in their lives. A vast body of quantitative insights into upward mobility exist. Yet the qualitative, experiential dimensions of upward mobility are understudied; especially in relation to the lives of upwardly mobile males. This article presents an empirically rigours corrective that qualitatively outlines the Changers’ upwardly mobile existences and views. In particular, this article examines how sections of the mass-media have produced a didactic notion of ‘middleclass’ masculinity which the Changers feel compelled to replicate in their everyday lives, largely via the men consuming specific, expensive commodities. Attention is drawn to the anxieties which the Changers endure because of their social mobility and associated attempts to qualitatively appear ‘middleclass’.
A Historical and Comparative Analysis of Colonial and Post Colonial Bureaucracy in Nigeria
Authors: Abiodun Akinwale Emmanuel Jude
Published: May 2014

The purpose of this paper is to examine the historical and comparative analysis of colonial and post-colonial civil service in Nigeria and to probe issues connected with Nigerianisation of the civil service. It attempts to justify that both colonial and post-colonial civil service recorded bureaucratic successes but quota and federal character policies partly affected post-colonial bureaucratic practice in Nigeria. The paper applies historical and comparative analysis of colonial and post-colonial civil service in Nigeria. The paper finds that colonial administration introduced representation of indigenous officials in administration and recognized the strength of the merit principle in the practice of representative bureaucracy in Nigeria but post-colonial administration mixed meritocracy with federal character and quota policies. The paper presents elaborative discussions on strategies to break up the power hegemony of national executive with constitutional provisions of federal character policy and effects of its application subsumed in the analysis that administrative decentralization has its flaws.
Decentralization as a Strategy for improving Service Delivery in the Botswana Public service Sector
Authors: Tshukudu Theophilus Tebetso
Published: May 2014

The Botswana public Service has been faced with service delivery challenges since independence in 1966. Like other developing and under developed countries, the Botswana government has reviewed its service delivery processes and initiatives with a view to better productivity across the public service sector. Many strategies and initiatives were introduced by the Botswana government over a long period of time to mitigate poor service delivery across the public service sector. One of these initiatives were the decentralization of certain functions from central to local government.However, the implementation of this initiative was not without problems. This paper will highlight the decentralization in general terms will be discussed and the focus will be narrowed to how decentralisation has to improved public service delivery in thepublic service sector. The evaluation of the process will be highlighted; recommendations and closing remarks will be made.
Development and Initial Validation of a Project-Based Rubric to Assess the Systems-Based Practice Competency of Residents in the Clinical Chemistry Rotation of a Pathology Residency
Authors: Vitek Carolyn R. , Dale Jane C. , Homburger Henry A. , Bryant Sandra C. , Saenger Amy K. , Karon Brad S.
Published: May 2014

Context.— Systems-based practice (SBP) is 1 of 6 core competencies required in all resident training programs accredited by the Accreditation Council for Graduate Medical Education. Reliable methods of assessing resident competency in SBP have not been described in the medical literature.

Objective.— To develop and validate an analytic grading rubric to assess pathology residents' analyses of SBP problems in clinical chemistry.

Design.— Residents were assigned an SBP project based upon unmet clinical needs in the clinical chemistry laboratories. Using an iterative method, we created an analytic grading rubric based on critical thinking principles. Four faculty raters used the SBP project evaluation rubric to independently grade 11 residents' projects during their clinical chemistry rotations. Interrater reliability and Cronbach α were calculated to determine the reliability and validity of the rubric. Project mean scores and range were also assessed to determine whether the rubric differentiated resident critical thinking skills related to the SBP projects.

Results.— Overall project scores ranged from 6.56 to 16.50 out of a possible 20 points. Cronbach α ranged from 0.91 to 0.96, indicating that the 4 rubric categories were internally consistent without significant overlap. Intraclass correlation coefficients ranged from 0.63 to 0.81, indicating moderate to strong interrater reliability.

Conclusions.— We report development and statistical analysis of a novel SBP project evaluation rubric. The results indicate the rubric can be used to reliably assess pathology residents' critical thinking skills in SBP.
An Overview of Molecular and Genetic Alterations in Selected Benign Odontogenic Disorders
Authors: Cabay Robert J.
Published: May 2014

Context.— Some dental abnormalities have environmental causes. Other odontogenic alterations are idiopathic and may have hereditary etiologies. Investigations of these conditions are ongoing.

Objective.— —To provide a discussion of developmental odontogenic abnormalities and benign odontogenic overgrowths and neoplasms for which genetic alterations have been well demonstrated and well documented.

Data Sources.— Relevant peer-reviewed literature.

Conclusions.— —The understanding of benign odontogenic lesions at a molecular level is rather well developed for some lesions and at the initial stages for many others. Further characterization of the molecular underpinnings of these and other odontogenic lesions would result in an enhanced comprehension of odontogenesis and the pathogenesis of a variety of odontogenic aberrations. These advancements may lead to better prevention and treatment paradigms and improved patient outcomes.
Squamous Cell Carcinoma Variants of the Upper Aerodigestive Tract: A Comprehensive Review With a Focus on Genetic Alterations
Authors: Shah Akeesha A. , Jeffus Susanne K. , Stelow Edward B.
Published: May 2014

Context.— Squamous cell carcinoma of the upper aerodigestive tract is a heterogenous entity. Although conventional squamous cell carcinomas are easily recognized, the morphologic variants of squamous cell carcinoma can present a diagnostic challenge. Familiarity with these variants is necessary because many are associated with unique risk factors and are characterized by specific molecular alterations (eg, nuclear protein in testis midline carcinomas). Perhaps the most important distinction is in identifying viral-related from nonviral-related carcinomas. The accurate diagnosis of these variants is necessary for prognostic and therapeutic reasons.

Objectives.— To provide a clinicopathologic overview and summary of the molecular alterations of the common squamous cell carcinoma variants, including verrucous, spindle cell, acantholytic, adenosquamous, basaloid, and papillary squamous cell carcinoma, as well as nuclear protein in testis midline carcinoma, and to discuss the distinguishing features of human papillomavirus- and Epstein-Barr virus-related squamous cell carcinomas.

Data Sources.— Published peer-reviewed literature.

Conclusions.— Familiarity with squamous cell carcinoma variants is essential for proper diagnosis and to guide appropriate clinical management. Further insight into the molecular alterations underlying those variants may lead to alterations in existing treatment approaches and to evolution of novel treatment modalities.
Study of Circulating MicroRNA-125b Levels in Serum Exosomes in Advanced Melanoma
Authors: Alegre Estibaliz , Sanmamed Miguel F. , Rodriguez Carmen , Carranza Omar , Martín-Algarra Salvador , González Álvaro
Published: May 2014

Context.—Malignant melanoma is an aggressive tumor that produces exosomes, which contain microRNAs (miRNAs) that could be of utility in following tumoral cell dysregulation. MicroR-125b is a miRNA whose down-regulation seems to be implicated in melanoma progression.

Objective.—To analyze miR-125b levels in serum, and in exosomes obtained from serum, from patients with advanced melanoma.

Design.—Serum samples were obtained from 21 patients with advanced melanoma, from 16 disease-free patients with melanoma, and from 19 healthy volunteers. Exosomes were isolated from serum by precipitation, and miR-16 and miR-125b levels were quantified by real-time polymerase chain reaction.

Results.—MicroR-16, but not miR-125b, was detected in all samples, and miR-16 levels were significantly higher in serum than they were in exosomes. MicroR-16 expression levels did not differ significantly between the 2 groups (patients with melanoma and healthy donors). There was a significant relationship between miR-125b and miR-16 levels in exosomes. Additionally, miR-125b levels in exosomes were significantly lower in patients with melanoma compared with disease-free patients with melanoma and healthy controls.

Conclusions.—Exosomes can provide a suitable material to measure circulating miRNA in melanoma, and miR-16 can be used as an endogenous normalizer. Lower levels of miR-125b in exosomes obtained from serum are associated with advanced melanoma disease, probably reflecting the tumoral cell dysregulation.
Molecular Pathology of Skin Neoplasms of the Head and Neck
Authors: Kraft Stefan , Granter Scott R.
Published: May 2014

Context.— Skin neoplasms include the most common malignancies affecting humans. Many show an ultraviolet (UV)–induced pathogenesis and often affect the head and neck region.

Objective.— To review literature on cutaneous neoplasms that show a predilection for the head and neck region and that are associated with molecular alterations.

Data Sources.— Literature review.

Conclusions.— Common nonmelanoma skin cancers, such as basal and squamous cell carcinomas, show a UV-induced pathogenesis. Basal cell carcinomas are characterized by molecular alterations of the Hedgehog pathway, affecting patched and smoothened genes. While squamous cell carcinomas show UV-induced mutations in several genes, driver mutations are only beginning to be identified. In addition, certain adnexal neoplasms also predominantly affect the head and neck region and show interesting, recently discovered molecular abnormalities, or are associated with hereditary conditions whose molecular genetic pathogenesis is well understood. Furthermore, recent advances have led to an increased understanding of the molecular pathogenesis of melanoma. Certain melanoma subtypes, such as lentigo maligna melanoma and desmoplastic melanoma, which are more often seen on the chronically sun-damaged skin of the head and neck, show differences in their molecular signature when compared to the other more common subtypes, such as superficial spreading melanoma, which are more prone to occur at sites with acute intermittent sun damage. In summary, molecular alterations in cutaneous neoplasms of the head and neck are often related to UV exposure. Their molecular footprint often reflects the histologic tumor type, and familiarity with these changes will be increasingly necessary for diagnostic and therapeutic considerations.
Loss of Heterozygosity and Microsatellite Instability Are Rare in Sporadic Dedifferentiated Liposarcoma: A Study of 43 Well-Characterized Cases
Authors: Davis Jessica L. , Grenert James P. , Horvai Andrew E.
Published: May 2014

Context.—Defects in mismatch repair proteins have been identified in Lynch syndrome–associated liposarcomas, as well as in rare sporadic sarcomas. However, it is unclear if mismatch repair defects have a role in sarcoma tumorigenesis. Microsatellite instability is a surrogate marker of mismatch repair defects.

Objectives.—To determine whether sporadic dedifferentiated liposarcomas display microsatellite instability and, if so, to evaluate whether such instability differs between the lipogenic and nonlipogenic components of these tumors.

Design.—The diagnoses of conventional dedifferentiated liposarcoma were confirmed by a combination of morphologic, immunophenotypic, and molecular studies. Standard fluorescence-based polymerase chain reaction, including 5 mononucleotide microsatellite markers (BAT25, BAT26, NR21, NR24, and MONO27), as well as 2 pentanucleotide repeat markers (Penta C and Penta D), was used to test for instability and loss of heterozygosity.

Results.—We demonstrated only a single case (1 of 43) with microsatellite instability at one mononucleotide marker. No sarcomas showed high-level microsatellite instability. However, loss of heterozygosity at the pentanucleotide markers was observed in 8 of 43 cases. The presence of loss of heterozygosity was overrepresented in the nonlipogenic (dedifferentiated) components compared with the paired lipogenic (well differentiated) components.

Conclusions.—Mismatch repair defects do not contribute to sporadic dedifferentiated liposarcoma tumorigenesis. Whether the observed loss of heterozygosity drives tumorigenesis in liposarcoma, for example by affecting tumor suppressor or cell cycle regulator genes, remains to be determined.
Multicolor Staining of Globin Subtypes Reveals Impaired Globin Switching During Erythropoiesis in Human Pluripotent Stem Cells
Authors: Ochi Kiyosumi , Takayama Naoya , Hirose Shoichi , Nakahata Tatsutoshi , Nakauchi Hiromitsu , Eto Koji
Published: May 2014

Adult hemoglobin composed of α- and β-globin reflects a change from expression of embryonic ε- and fetal γ-globin to adult β-globin in human erythroid cells, so-called globin switching. Human pluripotent stem cells (hPSCs) are a potential source for in vitro erythrocyte production, but they show prominent expression of γ-globin with little β-globin expression, which indicates incomplete globin switching. To examine the mechanism of this impaired globin switching, we optimized multicolor flow cytometry to simultaneously follow expression of different globin subtypes using different immunofluorescent probes. This enabled us to detect upregulation of β-globin and the corresponding silencing of γ-globin at the single-cell level during cord blood CD34+ cell-derived erythropoiesis, examined as an endogenous control. Using this approach, we initially characterized the heterogeneous β-globin expression in erythroblasts from several hPSC clones and confirmed the predominant expression of γ-globin. These hPSC-derived erythroid cells also displayed reduced expression of BCL11A-L. However, doxycycline-induced overexpression of BCL11A-L in selected hPSCs promoted γ-globin silencing. These results strongly suggest that impaired γ-globin silencing is associated with downregulated BCL11A-L in hPSC-derived erythroblasts and that multicolor staining of globin subtypes is an effective approach to studying globin switching in vitro.
L’enfant soldat confronté au processus de désarmement, démobilisation et réinsertion (ddr)
Authors: Diomandé Aboubacar Sidiki
Published: May 2014

Cet article analyse le phénomène des enfants soldats à l’aune du processus de désarmement, démobilisation et réinsertion (ddr). Ce processus qui vise à réintégrer socialement les soldats tient-il compte spécifiquement de ces derniers ? Le constat demeure que, si l’enfant soldat est pris en considération par les programmesddr, cette prise en compte reste lacunaire, faute d’intégration de certains facteurs constituant la pierre angulaire de son succès. C’est pourquoi cet article se propose de rendre plus efficaces les programmesddrpour une meilleure réinsertion sociale de l’enfant soldat. À défaut d’une application de ces mesures, ces programmes resteront incomplets et inefficaces pour les nombreux enfants soldats recrutés par les forces gouvernementales ou par des groupes armés.
Translation Skill-Sets in a Machine-Translation Age
Authors: Pym Anthony
Published: May 2014

The integration of data from statistical machine translation into translation memory suites (giving a range of TM/MT technologies) can be expected to replace fully human translation in many spheres of activity. This should bring about changes in the skill sets required of translators. With increased processing done by area experts who are not trained translators, the translator’s function can be expected to shift to linguistic postediting, without requirements for extensive area knowledge and possibly with a reduced emphasis on foreign-language expertise. This reconfiguration of the translation space must also recognize the active input roles of TM/MT databases, such that there is no longer a binary organization around a “source” and a “target”: we now have a “start text” (ST) complemented by source materials that take the shape of authorized translation memories, glossaries, terminology bases, and machine-translation feeds. In order to identify the skills required for translation work in such a space, a minimalist and “negative” approach may be adopted: first locate the most important decision-making problems resulting from the use of TM/MT, and then identify the corresponding skills to be learned. A total of ten such skills can be identified, arranged under three heads: learning to learn, learning to trust and mistrust data, and learning to revise with enhanced attention to detail. The acquisition of these skills can be favored by a pedagogy with specific desiderata for the design of suitable classroom spaces, the transversal use of TM/MT, students’ self-analyses of translation processes, and collaborative projects with area experts.
Traduction et politique canadienne : quel est le rôle des journalistes entre 1942 et 1995 ?
Authors: Gagnon Chantal
Published: May 2014

La présente étude tente de jeter un éclairage nouveau sur l’apport des journalistes à la question du bilinguisme. Plus précisément, l’article porte sur la traduction politique dans les médias écrits canadiens. À certains égards, les journalistes restructurent la relation entre le public et le gouvernement en mettant au jour certains des mécanismes qui régissent les processus gouvernementaux de communication. Cet état de fait montre notamment que les phénomènes du bilinguisme officiel et de la traduction institutionnelle ne sont pas nécessairement dissimulés à la collectivité, puisque les grands quotidiens y prêtent attention en situation de crise. Le corpus de travail rassemble des articles rédigés entre 1942 et 1995, à propos de discours politiques traduits. La traduction de ces discours a été commentée d’une façon ou d’une autre dans les médias écrits au Québec et au Canada. Les quotidiens suivants ont été consultés :La Presse,Le Devoir,The GazetteetThe Globe and Mail. L’étude montre que les journalistes canadiens et québécois sont conscients des écarts entre les versions linguistiques des discours de leurs dirigeants. Trois rôles sont identifiés chez le journaliste : le journaliste-témoin du phénomène de la traduction, le journaliste-commentateur de la traduction et le journaliste-traducteur de discours politique.
La liturgie eucharistique de l’Église orthodoxe et l’histoire de sa traduction en
langue française
Authors: Dumas Felicia
Published: May 2014

Nous nous proposons d’étudier l’histoire des différentes versions françaises du
texte de la liturgie eucharistique de saint Jean Chrysostome, l’office central de l’Église
orthodoxe. En principe, on peut parler de deux types de traductions qui ont circulé dans les
différentes communautés orthodoxes qui sont établies en France et s’y sont développées. Nous
ferons exclusivement référence à ce pays. D’une part, il y a eu des versions françaises qui
accompagnaient le texte slavon surtout (mais aussi grec), qui était célébré dans des
paroisses de tradition slave (ou grecque). Elles circulaient sous forme de brochures
reliées, le plus souvent de façon artisanale. Leur rôle fondamental était d’accueillir
linguistiquement les fidèles français qui ne parlaient pas les langues des communautés
traditionnellement orthodoxes et qui participaient aux offices. D’autre part, il y a eu des
versions françaises faites par des personnalités ecclésiastiques remarquables pour servir
lors des célébrations dans des paroisses majoritairement francophones ou dans certaines
communautés monastiques (toujours francophones). Dans ce cas, on peut parler d’un rôle
liturgique-rituel par excellence de ces traductions, le texte de la divine liturgie ayant
été traduit explicitement pour permettre sa célébration en français.
La compétence universelle et l’Afrique : ingérence ou complémentarité ?
Authors: Lafontaine Fannie
Published: May 2014

L’exercice de la compétence universelle met en évidence une contradiction potentielle entre des principes fondamentaux du droit international, soit, d’un côté, la souveraineté des États et la non-ingérence dans leurs affaires internes et, de l’autre, la lutte contre l’impunité pour les crimes internationaux. L’Union africaine, si elle s’est fréquemment positionnée en faveur d’un renforcement de la lutte contre l’impunité, s’oppose par ailleurs à ce qu’elle considère comme un exercice abusif de la compétence universelle par certains États, surtout européens. Cet article aborde, à la lumière des positions juridiques de l’Union africaine, certaines limites potentielles à l’exercice de la compétence universelle qui permettent une utilisation raisonnable de celle-ci.
A necessidade do uso de animais para o ensino e a pesquisa
Authors: Colli Walter
Published: May 2014

Não disponível
Regras e política de portas abertas nos estudos com animais na Universidade Harvard
Authors: Bianco Antônio Carlos
Published: May 2014

Não disponível
O uso de animais em pesquisas científicas
Authors: Troncone Lanfranco Ranieri Paolo
Published: May 2014

Não disponível
Somatostatinoma de duodeno: relato de caso e revisão da literatura
Authors: Henriques Alexandre Cruz , Mader Ana Maria Antonio , Ramos Giselle Munhoz , Mendonça Rafaela Rosalba de , Costa Sergio Renato Pais , Matos Leandro Luongo de , Sperazini Manlio Basílio
Published: May 2014

Introdução: Somatostatinomas são tumores carcinóides produtores de somatostatina, localizados principalmente na cabeça do pâncreas e duodeno. A importância desse relato deve-se à raridade deste subtipo histológico. Relato de Caso: Mulher, 68 anos, portadora de diabetes mellitus há dois anos, com queixa de dor abdominal há cinco meses. Ao exame físico notava-se massa em epigástrio e hipocôndrio direito, fixa e dolorosa à palpação. A ultra-sonografia e a tomografia computadorizada de abdome evidenciaram, respectivamente, colelitíase e tumor sólido em topografia de cabeça de pâncreas, medindo cerca de 12 x 8 cm. A paciente foi submetida a procedimento cirúrgico, no qual foi encontrado um grande tumor envolvendo o duodeno e o pâncreas, optando-se pela gastroduodenopancreatectomia cefálica e colecistectomia. Os exames anátomo-patológico e imuno-histoquímico da peça operatória revelararam tratar-se de um somatostatinoma de duodeno (estadiamento: T4N0Mx). A paciente apresentou boa evolução no pós-operatório, e com 18 meses da cirurgia encontra-se sem sinais de recidiva tumoral. Discussão: Os somatostatinomas são tumores raros, geralmente malignos, mais freqüentemente encontrados no pâncreas, sendo que apenas 2,5% deles são funcionantes. O diagnóstico é realizado por exame anátomo-patológico e imuno-histoquímico e o tratamento de escolha é a ressecção cirúrgica. Quando a cirurgia curativa não pode ser realizada, alguns pacientes podem se beneficiar de procedimentos paliativos e/ou quimioterapia. O seguimento deve ser realizado a cada seis meses com tomografia abdominal e a dosagem sérica de somatostatina pode ser um método complementar. A sobrevivência em cinco anos após a retirada completa do tumor e na ausência de linfonodos comprometidos ou metástases chega a 100%.
Fatores ambientais, comportamentais e neuroendocrinológicos envolvidos na gênese da epidemia da obesidade
Authors: Serpa Neto Ary , Saheb Gabriel Cunha Barbosa , Arantes Bruno Schuind , Pedralli Júnior Jair , Silva Ricardo Boix Sanchez da , Buriti Nara Alves
Published: May 2014

A obesidade constitui hoje um preocupante problema de saúde mundial, pois, além de prejudicar o bem estar físico de seu portador, traz consigo comorbidades associadas que aumentam as taxa de morbi-mortalidade. Entre elas incluem-se hipertensão arterial, diabetes mellitus, síndrome da apnéia obstrutiva do sono, osteoartrose, síndrome metabólica e outras. Os recentes avanços alcançados por importantes pesquisas na área molecular conseguiram elucidar grande parte dos mecanismos de controle central do peso corporal, expondo mais um possível sítio para a ação de drogas antiobesidade. A despeito dessas atualidades, o ambiente em que vivemos e determinados comportamentos que seguimos também apresentam forte influência sobre nosso balanço energético e peso corporal, tornando impossível tratar a obesidade por apenas uma frente de ataque. A atividade física e as mudanças no estilo de vida continuam sendo as medidas iniciais da terapêutica e, após estabelecerem-se estas condutas, as recentes descobertas na terapêutica medicamentosa passam a ter valia na tentativa de conter esta epidemia.
Avaliação clínica de palidez estratificada em cruzes: concordância entre observadores e comparação com níveis séricos de hemoglobina
Authors: Silva Rosemeri Maurici da , Bittencourt Laura , Sakae Thiago Mamôru
Published: May 2014

Objetivo: comparar o grau de palidez, estratificada em cruzes, com os níveis laboratoriais de hemoglobina e avaliar o grau de concordância entre observadores. Casuística e métodos: foram avaliados, no período de março a abril de 2007, por meio de estudo transversal observacional, os indivíduos com idade superior a 18 anos admitidos em cinco unidades do Hospital Nossa Senhora da Conceição, em Tubarão, Santa Catarina, para os quais haviam sido solicitadas dosagens de hemoglobina. Os pacientes foram avaliados por dois observadores quanto à presença e grau de palidez (de ausente a ++++/4) nos seguintes locais: mucosa ocular, leito ungueal e cristas palmares. O índice de concordância Kappa foi utilizado avaliar a concordância entre observadores e o teste de Kruskal-Wallis para avaliar a diferença entre a média dos níveis de hemoglobina para os diferentes graus de palidez atribuídos. Resultados: estudou-se uma amostra de 30 pacientes, com idade média de 63,1 anos, sendo 70% do gênero masculino. A comparação entre os níveis médios de hemoglobina com a palidez graduada em cruzes não apresentou valores estatisticamente significativos para os diferentes graus atribuídos. O índice de concordância Kappa foi de 0,25 nas cristas palmares, 0,06 no leito ungueal e 0,16 na mucosa ocular. Conclusões: não houve boa concordância entre os observadores na avaliação de palidez estratificada em cruzes. Os níveis médios de hemoglobina não apresentaram diferenças estatisticamente significativas entre os diferentes graus de palidez atribuídos.
Neste fascículo dos Arquivos Brasileiros de Ciências da Saúde
Authors: Amarantes Sandra Terezinha
Published: May 2014

Não disponível
Avaliação da dor no recém-nascido prematuro: parâmetros fisiológicos versus comportamentais
Authors: Nicolau Carla Marques , Modesto Kiliana , Nunes Priscila , Araújo Karina , Amaral Heloisa , Falcão Mário Cícero
Published: May 2014

Introdução: A dor no período neonatal é motivo de inúmeros estudos, sendo fundamental para a sua abordagem uma avaliação criteriosa e adequada. Objetivo: Comparar as variáveis fisiológicas com as comportamentais para a avaliação da dor em recém-nascido (RN) prematuro. Métodos: Estudo realizado entre fevereiro de 2003 e maio de 2004, com recém-nascidos de idade gestacional (IG) abaixo de 34 semanas e peso de nascimento menor que 1500 g, submetidos à ventilação mecânica e não sedados. As variáveis fisiológicas estudadas foram as freqüências cardíaca (FC) e respiratória (FR) e a saturação de oxigênio (SatO2); as variáveis comportamentais foram avaliadas por meio da escala de dor do recém-nascido - Neonatal Infant Pain Scale (NIPS). Todas as variáveis foram controladas no terceiro dia de vida do RN, antes, imediatamente após e cinco minutos após o procedimento de aspiração endotraqueal. Resultados: Foram estudados 50 RNs com IG média ao nascimento de 29,98 ± 2,24 semanas e peso médio de nascimento de 1087,20 ± 350,06 g, sendo 28 (56%) RN do sexo feminino e a doença das membranas hialinas foi diagnosticada em todos os RNs estudados. Pelo teste t-Student verificou-se diferença significante na SatO2 nos momentos estudados, sendo o mesmo não observado em relação a FC e FR. A mediana da NIPS foi maior nos momentos pós aspiração. As variáveis fisiológicas mostraram-se pouco sensíveis à detecção da dor (FC: 40,7%, FR: 24,1%, SatO2: 6,6%), e a escala NIPS mostrou-se mais específica para a mesma avaliação (86,6%). Conclusão: As variáveis fisiológicas apresentaram pouca sensibilidade e especificidade para a avaliação da dor no RN prematuro, quando avaliadas isoladamente.
O retalho músculo-cutâneo peitoral maior na reconstrução do câncer de cabeça e pescoço
Authors: Pfuetzenreiter Júnior Elio Gilberto , Andrade Cláudio Rogério Alves de , Lehn Carlos Neutzling , Dedivitis Rogério Aparecido
Published: May 2014

Introdução: Descrito inicialmente por Ariyan na década de 1970, o retalho de peitoral maior tem grande aceitação nas reconstruções por câncer em cabeça e pescoço pela sua versatilidade. Ele é irrigado pela artéria toracoacromial com uma circulação adicional proveniente da artéria torácica lateral. Método e casuística: O retalho foi utilizado para a reconstrução de 104 pacientes com câncer de cabeça e pescoço, sendo: reconstrução de boca/língua (57); reconstrução do trânsito faringo-esofágico (12); reparo de perda de pele cervical (15); reconstrução de faringe (10); reparo de perda de pele de face (7); e reparo de fístula faringo-cutânea (3). Resultados: Necrose total do retalho foi observada em quatro pacientes, necrose parcial e deiscência em 22 pacientes e epidermólise em 31. Conclusão: O retalho foi funcionalmente adequado para a reconstrução de grandes defeitos cirúrgicos.
As conseqüências das deficiências nutricionais, associadas à imunossenescência, na saúde do idoso
Authors: Malafaia Guilherme
Published: May 2014

Atualmente tem-se registrado um aumento médio da expectativa de vida em diversos países, fazendo com que a prevalência de indivíduos idosos em relação aos indivíduos jovens, torne-se um quadro comum na população mundial. Entretanto, a longevidade está longe de significar um envelhecimento saudável. Das diversas funções do organismo afetadas pelo complexo processo do envelhecimento, o sistema imune em particular, sofre várias mudanças coletivamente chamadas de imunossenescência. Já as outras alterações observadas no idoso, em parte são condicionadas pelos processos inerentes ao envelhecimento, e outras influenciadas por fatores socioeconômicos, que levam a inúmeros distúrbios nutricionais. Desta forma, o presente trabalho, teve como objetivo apresentar as principais causas da má nutrição nos idosos, sintetizar os principais efeitos da idade na imunidade e, sobretudo, chamar a atenção para o fato de que a associação entre imunossenescência e as carências nutricionais, agrava ainda mais a saúde do idoso, tornando-o mais susceptível a doenças infecciosas. Para isso foram identificados e analisados 78 trabalhos publicados sobre o assunto entre os anos de 1969 e 2008, tendo como fontes principais para a pesquisa os bancos de dados LILACS -BIREME, MEDLINE - Index Medicus, SciELO e PubMed. Diversos estudos têm demonstrado que na medida em que intervenções nutricionais específicas são introduzidas na população de idosos, os efeitos deletérios da imunossenescência podem ser minimizados.
Revisores científicos em 2008
Authors: ABCS Arq Bras Ciênc Saúde
Published: May 2014

Não disponível
Diagnóstico: antes, durante e depois
Authors: Souto Ricardo Peres do
Published: May 2014

Não disponivel
Líquen plano mimetizando molusco contagioso
Authors: Laczynski Cristina Marta Maria , Silveira Geórgia Martins da , Menezes Bruna Fernandes Padilha , Brito Cláudia Moreira de , Rstom Sílvia Arroyo , Machado Filho Carlos D’Apparecida Santos , Ito Lúcia Mioko , Enokihara Mílvia Maria Sílvia e Silva
Published: May 2014

Introdução: Líquen plano é uma doença inflamatória e pruriginosa que afeta pele, mucosas e anexos, podendo apresentar achados clínicos incomuns. Possui etiologia desconhecida e pico de incidência na vida adulta, pouco comum em crianças. Por estas razões, os autores relatam um caso raro, de difícil diagnóstico, no qual uma criança apresentava manifestações cutâneas semelhantes a molusco contagioso. Descrição do caso: VCN, cinco anos, feminina, com lesões pruriginosas pelo corpo, há um ano. Negava história familiar, antecedentes de atopia ou uso de drogas prévias à erupção. Já havia recebido inúmeras medicações, sem melhora. Foi encaminhada ao serviço de Dermatologia da Faculdade de Medicina do ABC onde, ao exame dermatológico, apresentava pápulas violáceas, brilhantes e umbilicadas, disseminadas pelo tegumento, incluindo palmas e plantas, com a presença de fenômeno de Koebner, poupando couro cabeludo. Na mucosa jugal, placa esbranquiçada semelhante à leucoplasia, ligeiramente arboriforme. Apresentou exames laboratoriais inalterados e achados da biópsia compatíveis com líquen plano. Iniciou-se tratamento com corticoide e anti-histamínico oral e emoliente tópico levando à melhora progressiva, evoluindo com máculas hipercrômicas residuais após quatro meses de tratamento. Discussão: Há evidências de que ocorram modificações nos ceratinócitos basais, desencadeando resposta imune com recrutamento e ativação de linfócitos T. As lesões caracterizam-se por pápulas poligonais, violáceas, descamativas, achatadas, com distribuição bilateral e simétrica acometendo faces flexoras. O objetivo deste relato é descrever um caso atípico de líquen plano extenso numa criança, com algumas lesões simulando quadro clínico de molusco contagioso. Diagnóstico correto e precoce e tratamento adequado diminuem riscos de complicações e melhoram a qualidade de vida.
Professor Eric Roger Wroclawski
Authors: Pompeo Antonio Carlos Lima
Published: May 2014

Não disponível
Incidência de fibro edema geloide em mulheres caucasianas jovens
Authors: Machado Aline Fernanda Perez , Tacani Rogério Eduardo , Schwartz Juliano , Liebano Richard Eloin , Ramos Juliane De Lemos Armada , Frare Thiago
Published: May 2014

O fibro edema geloide é uma alteração esteticamente indesejável que acomete mulheres em alguma época da vida. De acordo com a classificação proposta por Ulrich, existem três graus de fibro edema geloide: I, II e III. O objetivo deste estudo foi verificar a incidência da localização corporal e do grau do fibro edema geloide e analisar a porcentagem de gordura em mulheres caucasianas jovens. Foram selecionadas 30 mulheres com média de idade de 20 anos e queixa de fibro edema geloide. As voluntárias foram submetidas à avaliação composta de anamnese, exame físico, avaliação antropométrica e da composição corporal. A média da porcentagem de gordura foi de 27,18. Portanto, concluiu-se que as regiões glútea e posterior da coxa foram as mais acometidas, o grau I foi o mais incidente, e a média de porcentagem de gordura se mostrou elevada nesta população com queixa de fibro edema geloide.
Alterações dermatológicas em pacientes oncológicos – adultos e crianças
Authors: Fabra Dolores Gonzalez , Kayo Ana Paula , Leal Andrea Regina De Oliveira , Salzano Vanessa , Guglielmino Flávia
Published: May 2014

O tratamento oncológico, seja cirúrgico e/ou quimioterápico e/ou radioterápico, acarreta inúmeros efeitos adversos cutâneos – muitos deles já relatados na literatura. Por meio do Ambulatório de Reabilitação Dermato-Cosmiátrica da Faculdade de Medicina do ABC, pudemos catalogar as alterações dermatológicas e cosmiátricas decorrentes do tratamento oncológico, além de tratá-las durante a vigência do tratamento, sem interferir em seus resultados. O objetivo deste trabalho foi dividir as alterações dermatológicas e cosmiátricas decorrentes do tratamento oncológico em três grandes grupos: alterações desencadeadas, agravadas e não relacionadas ao tratamento oncológico – classificação esta ainda inédita na literatura médica. Além disso, o trabalho classificou as alterações de acordo com o tratamento oncológico realizado.
Revisores científicos em 2010
Authors: ABCS Arq Bras Ciênc Saúde
Published: May 2014

Não disponível
Três anos de Arquivos Brasileiros de Ciências da Saúde: conquistas e projeções para o futuro
Authors: Souto Ricardo Peres do
Published: May 2014

Não disponível
Contribuição da tomografia helicoidal no estadiamento pré-operatório do carcinoma gástrico
Authors: Oliveira Flávio Mendes de , Pavarini Nadia , Ortiz Juliana , Zanon Aline Biral , Martins Lourdes Conceição , Catapani Wilson Roberto , Mader Ana Maria Amaral Antonio , Waisberg Jaques
Published: May 2014

Objetivo: Analisar a sensibilidade da tomografia helicoidal abdominal na detecção do comprometimento linfonodal e de metástases hepáticas e peritoneais no estadiamento pré-operatório do carcinoma gástrico. Método: Foram estudados retrospectivamente 52 doentes operados por carcinoma gástrico e estadiados por tomografia helicoidal abdominal com contraste oral e intravenoso. Os resultados baseados nos laudos correspondentes foram correlacionados com os achados intraoperatórios e exame anatomopatológico dos espécimes cirúrgicos. Resultados: A neoplasia gástrica localizou-se na região do antropilórica em 38 (73,1%) doentes, na cárdia em 8 (15,4%) e no corpo e fundo em 6 (11,5%). A tomografia helicoidal abdominal detectou lesão gástrica em 25 (48,1%) doentes, metástases hepáticas em 6 (11,5%), acometimento de linfonodos em 5 (9,6%), ascite em 4 (7,7%) e comprometimento no fígado, baço e pâncreas em 1 (1,9%). Na laparotomia, constataram-se metástases hepáticas em 6 (11,5%) doentes e ascite em 12 (23,1%). Nos doentes submetidos à ressecção com intenção curativa da neoplasia, foram identificados pela tomografia helicoidal abdominal pré-operatória 27 (67,5%) linfonodos sugestivos de comprometimento. O exame anatomopatológico mostrou 16 (40,0%) doentes com linfonodos infiltrados pelo carcinoma gástrico. A sensibilidade do exame de tomografia helicoidal abdominal na identificação pré-operatória da lesão gástrica foi 48,1%, para linfonodos acometidos foi de 18,5% e para metástases hepáticas a sensibilidade foi 100,0%. Treze (25%) doentes apresentaram metástases peritoneais não reveladas pela tomografia helicoidal. Conclusões: O exame de tomografia computadorizada helicoidal abdominal no pré-operatório do carcinoma gástrico apresentou sensibilidade elevada na detecção de metástases hepáticas, sensibilidade baixa na detecção do comprometimento linfonodal pela neoplasia e não foi capaz de identificar metástases peritoneais.