bluuebunny/crossref_metadata_2025 huggingface dataset:
Recognizing rhetoric in health care policy analysis
Authors: Russell Jill , Greenhalgh Trisha , Byrne Emma , Mcdonnell Janet
Published: March 2008

Critiques of the ‘naïve rationalist’ model of policy-making abound in the sociological and political science literature. Yet academic debate on health care policy-making continues to be couched in the dominant discourse of evidence-based medicine, whose underlying assumptions - that policies are driven by facts rather than values and these can be clearly separated; that ‘evidence’ is context-free, can be objectively weighed up and placed unproblematically in a ‘hierarchy’; and that policy-making is essentially an exercise in decision science - have constrained both thinking and practice. In this paper, drawing on theoretical work from political science and philosophy, and innovative empirical work in the health care sector, we argue that health care is well overdue for a re-defining of what policy-making is.

Policy-making is the formal struggle over ideas and values, played out by the rhetorical use of language and the enactment of social situations. While the selection, evaluation and implementation of research evidence are important in the policy-making process, they do not equate to that process. The study of argument in the construction of policy has the potential to illuminate dimensions of the process that are systematically occluded when policy-making is studied through a naïve rationalist lens. In particular, a rhetorical perspective highlights the struggle over ideas, the ‘naming and framing’ of policy problems, the centrality of audience and the rhetorical use of language in discussion to increase the audience's adherence to particular framings and proposals. Rhetorical theory requires us to redefine what counts as ‘rationality’ - which must extend from what is provably true (by logic) and probably true (by Bayesian reasoning) to embrace, in addition, that which is plausibly true (i.e. can convince a reasonable audience).

Future research into health care policy-making needs to move beyond the study of ‘getting evidence into practice’ and address the language, arguments and discourse through which policy is constructed and enacted.
‘Nurse entrepreneurs’ a case of government rhetoric?
Authors: Traynor Michael , Drennan Vari , Goodman Claire , Mark Annabelle , Davis Kathy , Peacock Richard , Banning Maggi
Published: March 2008

Introduction

Nursing has come to play a prominent role in government health policy since 1997. Extending the scope of nursing practice into activities previously carried out by doctors can assist a managerialist and ‘modernizing’ project of increasing National Health Service (NHS) efficiency by removing demarcations between professional groups.

Methods

Drawing on elements of poststructuralist linguistics, this paper presents an analysis of a key government speech in the context of a discussion of overall policy intentions.

Results

The speech can be seen as an example of how government has attempted to use rhetoric to make its goals attractive to nurses.

Conclusion

Policy-makers have to make their policies acceptable to those whom they expect to implement them. In this case, organizational efficiency, chiefly in terms of broader access to NHS services, as well as role substitution, is aligned with government policy promoting social enterprise and ‘sold’ to the nursing profession as enhancing its status compared with medicine.
Citizen and staff involvement in health service decision-making: Have National Health Service foundation trusts in England given stakeholders a louder voice?
Authors: Lewis Richard , Hinton Lisa
Published: March 2008

Objectives

National Health Service (NHS) foundation trusts have been created to decentralize the management of NHS provider organizations through the substitution of central government control with local accountability to citizens and employed staff. Our aim was to explore the roles adopted by elected and appointed governors of a first wave NHS foundation trust and the extent to which governors shared power with trust directors and influenced the management of the trust.

Methods

A one-year case study of a single NHS foundation trust (Homerton Hospital in East London) was conducted. Data were collected using face-to-face interviews with a sample of governors and directors, as well as through non-participant observation of public and private meetings of governors and documentary analysis.

Results

Governors and directors found the new role of foundation trust governor ambiguous and difficult to define. This lack of clarity impeded the development of the new governance function. Governors perceived that they had made little impact on the decisions of the Trust during the year of study. However, evidence was found of an increased involvement of governors and the public in the activities of the Trust.

Conclusions

Government plans to decentralize accountability of public hospitals to local communities appear problematic, at least in the short term. Unless the effectiveness of the new local governance arrangements is addressed, an accountability ‘gap’ may emerge as prior mechanisms for public accountability to the centre are dismantled. In these circumstances, decentralization may lead in practice to a loss of public accountability.
Will reputational incentives stimulate a reversal of the physician brain drain?
Authors: Mclean Thomas
Published: March 2008

An increased supply of physicians in high income countries both from domestic production and from immigration from low and middle income countries has made medical employment increasingly competitive. This has been heightened by the introduction of reputational incentives, such as public reporting of physicians’ outcomes, and the use of other health care professionals, such as nurses. An unanticipated consequence might be a reversal of the ‘brain drain’, with physicians migrating to low and middle income countries.
Incidence and prevalence of diseases
Authors: Light Kate , Golder Su , Stirk Lisa
Published: March 2008

Finding statistics on the incidence and prevalence of disease can be daunting. Although many resources, both free and commercial, exist, there are gaps in the collection of data and the material may be summarized in a manner that makes it hard to access specific information. If you would like to alert readers to useful web pages or suggest topics for this column please send details to:
Questions and answers
Authors: Caon Martin , Schneider Nils
Published: March 2008

The aim of this section is for you to identify and try to answer puzzles, especially methodological ones, in health services research and policy. Readers are invited both to submit questions, which they think will be of general interest or which are particularly topical, and to offer answers to questions.

Questions can be ones that you feel have not been satisfactorily answered in the existing literature, ones that relate to ‘self-evident’ definitions which need to be made problematic, or paradoxes.

Please send your questions to: Gillian Parker, SPRU, University of York, Alcuin College, Heslington, York YO10 5DD, UK. Email: gmp501@york.ac.uk . Fax: 144 (0)1904 321953.
Spontaneous osteonecrosis of the knee
Authors: Takeda M. , Higuchi H. , Kimura M. , Kobayashi Y. , Terauchi M. , Takagishi K.
Published: March 2008

We prospectively examined the physical and imaging findings, including MRI, of 23 patients with spontaneous osteonecrosis of the knee after obtaining informed consent to acquire tissue specimens at surgery. There were four men and 19 women, with a mean age of 67.5 years (58 to 77). Plain radiographs were designated as stages 1, 2, 3 or 4 according to the classification of Koshino. Five knees were classified as stage 1, five as stage 2, seven as stage 3 and six as stage 4. The histological specimens were stained with haematoxylin and eosin and tetrachrome.

In the early stages of the condition, a subchondral fracture was noted in the absence of any features of osteonecrosis, whereas in advanced stages, osteonecrotic lesions were confined to the area distal to the site of the fracture which showed impaired healing. In such cases, formation of cartilage and fibrous tissue, occurred indicating delayed or nonunion. These findings strongly suggest that the histopathology at each stage of spontaneous osteonecrosis is characterised by different types of repair reaction for subchondral fractures.
Birmingham hip resurfacing
Authors: Moonot P. , Singh P. J. , Cronin M. D. , Kalairajah Y. E. , Kavanagh T. G. , Field R. E.
Published: March 2008

Hip resurfacing is a bone-conserving procedure with respect to proximal femoral resection, but there is debate in the literature as to whether the same holds true for the acetabulum. We have investigated whether the Birmingham hip resurfacing conserves acetabular bone.

Between 1998 and 2005, 500 Birmingham hip resurfacings were performed by two surgeons. Between 1996 and 2005 they undertook 700 primary hip replacements, with an uncemented acetabular component. These patients formed the clinical material to compare acetabular component sizing. The Birmingham hip resurfacing group comprised 350 hips in men and 150 hips in women. The uncemented total hip replacement group comprised 236 hips in men and 464 hips in women. Age- and gender-matched analysis of a cohort of patients for the sizes of the acetabular components required for the two types of replacement was also undertaken. Additionally, an analysis of the sizes of the components used by each surgeon was performed.

For age-matched women, the mean outside diameter of the Birmingham hip resurfacing acetabular components was 2.03 mm less than that of the acetabular components in the uncemented total hip replacements (p < 0.0001). In similarly matched men there was no significant difference (p = 0.77). A significant difference was also found between the size of acetabular components used by the two surgeons for Birmingham hip resurfacing for both men (p = 0.0015) and women (p = 0.001). In contrast, no significant difference was found between the size of acetabular components used by the two surgeons for uncemented total hip replacement in either men or women (p = 0.06 and p = 0.14, respectively). This suggests that variations in acetabular preparation also influence acetabular component size in hip resurfacing.
Outcome of total elbow replacement for distal humeral fractures in the elderly
Authors: Prasad N. , Dent C.
Published: March 2008

We analysed the outcome of the Coonrad-Morrey total elbow replacement used for fracture of the distal humerus in elderly patients with no evidence of inflammatory arthritis and compared the results for early versus delayed treatment. We studied a total of 32 patients with 15 in the early treatment group and 17 in the delayed treatment group. The mean follow-up was 56.1 months (18 to 88). The percentage of excellent to good results based on the Mayo elbow performance score was not significantly different, 84% in the early group and 79% in the delayed group. Subjective satisfaction was 92% in both the groups.

One patient in the early group developed chronic regional pain syndrome and another type 4 aseptic loosening. Two elbows in the early group also showed type 1 radiological loosening.

Two patients in the delayed group had an infection, two an ulnar nerve palsy, one developed heterotopic ossification and one type 4 aseptic loosening. Two elbows in this group also showed type 1 radiological loosening. The Kaplan-Meier survivorship analysis for the early and delayed treatment groups was 93% at 88 months and 76% at 84 months, respectively.

No significant difference was found between the two groups.
Bisphosphonates can block the deterioration in implant fixation after withdrawal of intermittent doses of parathyroid hormone
Authors: Johansson H. R. , Skripitz R. , Aspenberg P.
Published: March 2008

We have examined the deterioration of implant fixation after withdrawal of parathyroid hormone (PTH) in rats. First, the pull-out force for stainless-steel screws in the proximal tibia was measured at different times after withdrawal. The stimulatory effect of PTH on fixation was lost after 16 days. We then studied whether bisphosphonates could block this withdrawal effect. Mechanical and histomorphometric measurements were conducted for five weeks after implantation. Subcutaneous injections were given daily. Specimens treated with either PTH or saline during the first two weeks showed no difference in the mechanical or histological results (pull-out force 76 N vs 81 N; bone volume density 19% vs 20%). Treatment with PTH for two weeks followed by pamidronate almost doubled the pull-out force (152 N; p < 0.001) and the bone volume density (37%; ANOVA, p < 0.001). Pamidronate alone did not have this effect (89 N and 25%, respectively). Thus, the deterioration can be blocked by bisphosphonates. The clinical implications are discussed.
Degenerative lumbosacral spondylolisthesis
Authors: Hosoe H. , Ohmori K.
Published: March 2008

We have analysed a number of radiological measurements in an attempt to clarify the predisposing factors for degenerative spondylolisthesis of the lumbosacral junction. We identified 57 patients with a slip and a control group of 293 patients without any radiological abnormality apart from age-related changes. The relative thickness of the L5 transverse process, the sacral table angle and the height of the iliac crest were measured and evaluated. The difference in these measurements between men and women was analysed in the control group.

We found that the transverse process of L5 was extremely slender, the sacral table more inclined, and the L5 vertebra was less deeply placed in the pelvis in patients with a slip compared with the control group. The differences in these three parameters were statistically significant.

We believe that the L5 vertebra is predisposed to slip when these factors act together on a rigidly-stabilised sacrum. This occurs more commonly in women, probably as a result of constitutional differences in the development of the male and female spine.
The relationship between obesity and the age at which hip and knee replacement is undertaken
Authors: Changulani M. , Kalairajah Y. , Peel T. , Field R. E.
Published: March 2008

We audited the relationship between obesity and the age at which hip and knee replacement was undertaken at our centre. The database was analysed for age, the Oxford hip or knee score and the body mass index (BMI) at the time of surgery. In total, 1369 patients were studied, 1025 treated by hip replacement and 344 by knee replacement. The patients were divided into five groups based on their BMI (normal, overweight, moderately obese, severely obese and morbidly obese).

The difference in the mean Oxford score at surgery was not statistically significant between the groups (p > 0.05). For those undergoing hip replacement, the mean age of the morbidly obese patients was ten years less than that of those with a normal BMI. For those treated by knee replacement, the difference was 13 years. The age at surgery fell significantly for those with a BMI > 35 kg/m2 for both hip and knee replacement (p > 0.05). This association was stronger for patients treated by knee than by hip replacement.
Expression of hypoxia-inducible factor-1α and its relationship to tumour angiogenesis and cell proliferation in cartilage tumours
Authors: Kubo T. , Sugita T. , Shimose S. , Matsuo T. , Arihiro K. , Ochi M.
Published: March 2008

We investigated the use of hypoxia-inducible factor (HIF) proteins as prognostic markers in chondrosarcoma and the relationship of HIF to the biological characteristics of cartilage tumours. The expression of HIF-1α, HIF-2α, proliferating cell nuclear antigen (PCNA) and microvessel density (MVD) were measured immunohistochemically in 29 specimens of cartilage tumour.

There was no HIF-1α and HIF-2α staining in any of the nine benign cartilage tumours. In 20 specimens of chondrosarcoma, the rate of HIF-1α and HIF-2α expression was 40% and 25%, respectively. The tumour size (≥ 8 cm), histological grade (grade 2 and grade 3) surgical margin (marginal and intralesional) and HIF-1α expression (positive) correlated significantly with a shorter disease-free survival. There was a significant association between HIF-1α and the MVD and a strong trend towards a correlation between HIF-1α and the PCNA index or histological grade.

Our findings suggest that HIF-1α protein may be a useful objective marker in the assessment of the prognosis in chondrosarcoma, since it plays an important role in tumour angiogenesis and cell proliferation.
Rotational dislocation of the proximal interphalangeal joint of the finger
Authors: Boden R. A. , Srinivasan M. S.
Published: March 2008

We describe a case of rotational dislocation of the proximal interphalangeal joint of the ring finger. This injury was not initially appreciated and therefore closed reduction failed. The clinical findings included puckering of the skin on the dorsum of the joint and rotational incongruity on radiographs. At open reduction there was interposition of the lateral band. Identification of the pathology allows early successful treatment.
Vacuum-assisted closure for deep infection after spinal instrumentation for scoliosis
Authors: Canavese F. , Gupta S. , Krajbich J. I. , Emara K. M.
Published: March 2008

Our aim was to review the efficacy of the wound vacuum-assisted closure (VAC) system in the treatment of deep infection after extensive instrumentation and fusion for spinal deformity in children and adolescents.

A total of 14 patients with early deep spinal infection were treated using this technique. Of these, 12 had neuromuscular or syndromic problems. Clinical and laboratory data were reviewed. The mean follow-up was 44 months (24 to 72). All wounds healed. Two patients required plastic surgery to speed up the process. In no patient was the hardware removed and there was no loss of correction or recurrent infection.

We believe that the wound VAC system is a useful tool in the armamentarium of the spinal surgeon dealing with patients susceptible to wound infections, especially those with neuromuscular diseases. It allows for the retention of the instrumentation and the maintenance of spinal correction. It is reliable and easy to use.
Surgical site infection with methicillin-resistant Staphylococcus aureus after primary total hip replacement
Authors: Walls R. J. , Roche S. J. , O’Rourke A. , McCabe J. P.
Published: March 2008

We have analysed the management and clinical outcome of a series of consecutive patients who had a total hip replacement and developed post-operative surgical site infection (SSI) with methicillin-resistant Staphylococcus aureus. The incidence of this infection was 1% over a period of five years. We studied SSI in 15 patients (16 infections) with a mean age of 72.7 years (53 to 81). In all, 12 of the infections occurred early and half of the infections involved the prosthesis, resulting in an increase of 11-fold in the cumulative hospital stay.

Methicillin-resistant Staph. aureus was successfully eradicated in all the patients after a mean follow-up of 53.6 months (25 to 88). Superficial incisional infections resolved after antibiotic therapy alone while deep infections required multiple operative debridements. Attempted retention of the implant in early organ space infections was successful in only one of five patients. Only three patients with implant-level infections obtained a pain-free, functional prosthesis while a further three required excision arthroplasty. We have formulated a protocol of treatment which may serve as a guide in the management of these infections.
Understanding pain in osteoarthritis
Authors: Gwilym S. E. , Pollard T. C. B. , Carr A. J.
Published: March 2008

The majority of patients with osteoarthritis present to orthopaedic surgeons seeking relief of pain and associated restoration of function. Although our understanding of the physiology of pain has improved greatly over the last 25 years there remain a number of unexplained pain-related observations in patients with osteoarthritis. The understanding of pain in osteoarthritis, its modulation and treatment is central to orthopaedic clinical practice and in this annotation we explore some of the current concepts applicable. We also introduce the concept of the ‘phantom joint’ as a cause for persistent pain after joint replacement.
Near-misses and Missed Opportunities: Poor Patient Handover In General Surgery
Authors: Tokode M , Barthelmes L , O'Riordan B
Published: March 2008

Since the introduction of shift systems for junior doctors as part of the European Working Time Directive, different teams of doctors look after patients over the course of a day. This requires ro bust handover mechanisms to pass on inf ormation between differ ent teams of doctors to avoid misses and near-misses in patients' care. Modernising Medical Careers shortens the placements of doctors in foundation programmes in general surgery to four months compared with six-month placements as pre-registration house officers in the past. The reduction in working hours will therefore adv ersely aff ect exposur e and experience of junior doctors in general surg ery unless the learning potential of time spent at work is maximised.
EWTD 2009 – meeting the challenge in surgery
Authors: Horrocks Michael , Cripps Jo
Published: March 2008

With 17 months to go before the August 2009 European Working Time Directive (EWTD) deadline, work must begin now to give trainers and trainees time to test potential solutions and work out the best method of achieving compliance while protecting patient safety, training and service delivery. Team working is essential, not just among surgeons – all those involved in commissioning, planning, managing and delivering surgical services and training will need to work together.
An aesthetic fellowship: experience from the 'other side'
Authors: Berry MG
Published: March 2008

Gaining aesthetic plastic surgery experience as a trainee working in the NHS is not easy. Operating on patients for non-pathological conditions is an alien concept to the majority of surgeons working outside this field. This report gives some insight into the world of aesthetic surgery and offers some advice to trainees seeking aesthetic operative experience before becoming a consultant surgeon. Although I was due for the aesthetic rotation in the final year of my deanery's training scheme, I missed out on it. Feeling that this was unfair both on me and on future patients, I looked around for an alternative. A personal recommendation many years earlier led me to the post offered by the Institute of Cosmetic and Reconstructive Surgery (ICRS) in London. Like many of my colleagues, my experience until that point had been of the occasional afternoon or weekend reverting to the retractorholding and suture-cutting status of the neophyte surgeon, which followed a summons from the consultant surgeon, with the furtive handing over of an envelope at the end of the list. The selection of patients for procedures and how they appeared post-operatively remained mysteries.
Clinical Utility of Monoamine Neurotransmitter Metabolite Analysis in Cerebrospinal Fluid
Authors: Hyland Keith
Published: March 2008

Background: Measurements of monoamine neurotransmitters and their metabolites in plasma and urine are commonly used to aid in the detection and monitoring of neuroblastoma and pheochromocytoma and the evaluation of hypotension or hypertension. Measurements of these neurotransmitters and metabolites can also be helpful in the investigation of disorders that primarily affect the central nervous system, but only when the measurements are made in cerebrospinal fluid (CSF).

Content: I describe CSF profiles of monoamine metabolites in the primary and secondary defects affecting serotonin and catecholamine metabolism. I outline the methods required to analyze these metabolites together with details of specific sample handling requirements, sample stability, and interfering compounds, and I emphasize a need for age-related reference intervals.

Summary: Measured values of monoamine metabolites in CSF provide only a single-time snapshot of the overall turnover of the monoamine neurotransmitters within the brain. Because these measurements reflect the average concentrations accumulated from all brain regions plus the regional changes that occur within the spinal cord, they may miss subtle abnormalities in particular brain regions or changes that occur on a minute-to-minute or diurnal basis. Clearly defined diagnosed disorders are currently limited to those affecting synthetic and catabolic pathways. In many cases, abnormal monoamine metabolite concentrations are found in CSF and an underlying etiology cannot be found. Molecular screening of candidate genes related to steps in the neurotransmission process, including storage in presynaptic nerve vesicles, release, interaction with receptors, and reuptake, might be a fruitful endeavor in these cases.
Hemostasis in the Neonate
Authors: Manco-Johnson Marilyn J.
Published: March 2008

The coagulation system is finely tuned to arrest bleeding at the site of vascular injury and quickly remove clots that obstruct blood flow. In the fetus, components of the coagulation system show unique developmentally regulated patterns and times for maturation to normal adult protein quantities and functions. In addition, several coagulation proteins contribute to cellular proliferation and differentiation uniquely during fetal life. In spite of this, results of most screening tests of hemostasis vary modestly from adult normal values in the healthy term infant, and both hemorrhage and thrombosis are rare in the well infant.
International Perspectives
Authors: Sun Bo , Qian Liling , Liu Cuiqing , Wang Sannan , Yu Jialin , Cheng Xiuyong
Published: March 2008

Expansion of neonatal care has reduced morbidity and mortality among newborns in China, although differences remain among various regions of the country. Efforts have focused on educational programs in neonatal asphyxia and resuscitation, expansion of neonatal emergency transportation, and research in the treatment of neonatal hypoxic-ischemic encephalopathy as well as neonatal respiratory and intensive care. Future challenges include expansion of clinical epidemiologic studies and clinical trials of new drugs and therapies, greater international collaboration, and wider dissemination of research findings.
Envelhecimento e família: uma nova perspectiva para o cuidado de enfermagem
Authors: Souza Rosangela Ferreira de , Skubs Thais , Brêtas Ana Cristina Passarella
Published: March 2008

Este estudo qualitativo objetiva compreender o processo de envelhecimento no âmbito da família tomando como parâmetro a intergeracionalidade. Foram entrevistados nove idosos e nove familiares atendidos por duas equipes do Programa Saúde da Família de áreas da cidade de São Paulo com diferenças sócio-economicas. Com os resultados obtidos concluímos que a questão intergeracional é um ponto importante a ser trabalhado em relação ao cuidado para com idosos e sua família, pois, se por um lado a relação entre os mesmos traz consigo conflitos, por outro, pode ser considerada uma relação de ajuda mútua, uma vez que os idosos não são apenas cuidados e ajudados por seus familiares mas também cuidam e ajudam, fato este mais visível nas famílias mais pobres.
A ONU tem autoridade? Um exercício de contabilidade política (1945-2006)
Authors: Lopes Dawisson Belém
Published: March 2008

Buscaremos analisar o estatuto da autoridade política da ONU, recorrendo a referenciais quantitativos e qualitativos, por meio da proposição de uma relação positiva entre a "autoridade onusiana" e um conjunto de variáveis. Após avaliação dos resultados, pretende-se gerar discussão a respeito dos limites institucionais e da natureza da autoridade da ONU na política internacional contemporânea, corroborando-se a hipótese de que o quantum de autoridade de que está investida a ONU é crescente no curso das últimas seis décadas.
Evolvimento de dióxido de carbono e mineralização de nitrogênio em Latossolo Vermelho-Escuro com diferentes manejos
Authors: MARQUES TERESA CRISTINA LARA LANZA DE SÁ E MELO , VASCONCELLOS CARLOS ALBERTO , PEREIRA FILHO ISRAEL , FRANÇA GONÇALO EVANGELISTA DE , CRUZ JOSÉ CARLOS
Published: March 2008

Este trabalho foi elaborado com o objetivo de verificar o efeito das palhas de milho e lab-lab, dos tipos de manejos do solo e da presença de uma fonte externa de N, no evolvimento de CO2 e na mineralização de N. Usou-se um Latossolo Vermelho-Escuro distrófico textura argilosa fase cerrado, da região de Sete Lagoas (MG), com histórico de uso envolvendo cinco anos sob plantio direto e plantio convencional com arado de disco e arado de aiveca. Amostras de solo (0-20 cm) foram incubadas a 25ºC durante 55 dias, na presença e na ausência de palhada residual e de fonte externa de N aplicada no início e 25 dias após. De modo geral, a palhada de milho apresentou maior taxa de CO2 evolvido do que o lab-lab (935 e 764 mig CO2 g-1 solo, respectivamente). O tipo de palhada residual influenciou mais o evolvimento de CO2 do que os manejos de solo. A adição de N aumenta a taxa de CO2 evolvida, apenas quando N é aplicado no início do período de incubação. A disponibilidade de N e o tempo de imobilização são alterados pela relação C/N da palhada incorporada e pelo preparo do solo.
Ação gênica, heterose e depressão endogâmica de caracteres de produção em linhagens mutantes de algodoeiro herbáceo
Authors: Bertini Cândida Hermínia Campos de Magalhães , Silva Fanuel Pereira da , Nunes Raimundo de Pontes , Santos José Higino Ribeiro dos
Published: March 2008

Este trabalho teve por objetivo estimar parâmetros hereditários no algodoeiro herbáceo (Gossypium hirsutum L.) a partir de análise genética convencional envolvendo dois progenitores e as gerações F1, F2, RC1 e RC2. A ação gênica, a heterose e a depressão endogâmica foram calculadas em relação aos caracteres número de dias para a floração, número de capulhos, peso do capulho, produção de algodão em caroço, porcentagem de fibra, e peso de 100 sementes. Os valores de herdabilidade no sentido restrito variaram de 2,27%, em peso médio de capulho, a 67,57%, em porcentagem de fibra. A ação gênica de natureza dominante predominou em número de dias para a floração, número de capulhos, peso médio do capulho, produção de algodão em caroço e fibra. Os valores heteróticos calculados variaram de -0,77%, em número de dias para a floração, a 96,41%, na produção de fibra. Depressão endogâmica estatisticamente significativa foi obtida em peso médio de capulho e porcentagem de fibra. A presença de ação gênica aditiva sugere que avanços genéticos podem ser alcançados por meio dos métodos comuns de seleção, enquanto a predominância de ação dominante ou epistática indica a necessidade do uso de variedades híbridas ou outros métodos que aproveitem este tipo de variabilidade genética.
Avaliação do estado nutricional de seringais implantados na região da Zona da Mata de Minas Gerais
Authors: Carmo Ciríaca Arcangela Ferreira de Santana do , Meneguelli Neli do Amaral , Lima Jorge Araújo de Sousa , Eira Paulo Augusto da , Cunha Tony Jarbas Ferreira
Published: March 2008

O objetivo deste trabalho foi avaliar o estado nutricional de seringais implantados na Zona da Mata, em Minas Gerais, visando contribuir com um programa racional de adubações. Em seringais do clone IAN 873 foram determinadas a classe do solo, fertilidade, nutrição e produção de borracha seca. Grande parte dos seringais encontra-se em Latossolos extremamente ácidos com Al alto e N, P, K, soma de bases trocáveis e capacidade de troca de cátions baixos. Os teores de Ca e Mg variaram de médios a altos nos Latossolos e foram muito altos nos Nitossolos, correlacionando-se negativamente com a produção de borracha seca. A análise foliar detectou desequilíbrios nutricionais no que se refere aos baixos teores de N e K evidenciados pela correlação positiva significativa com a produção de borracha seca. A correlação significativa negativa entre a produção de borracha seca e os teores de Ca foliares, associados aos altos teores de Mg, sugerem a redução desses nutrientes nas adubações. Dos micronutrientes, apenas o Cu apresentou correlação positiva e significativa com a produção de borracha seca.
Inferências pedológicas aplicadas ao perímetro irrigado de Custódia, PE
Authors: Oliveira Lindomário Barros de , Ribeiro Mateus Rosas , Ferreira Maria da Graça de Vasconcelos Xavier , Lima José Fernando Wanderley Fernandes de , Marques Flávio Adriano
Published: March 2008

O objetivo deste trabalho foi avaliar as propriedades e o comportamento de solos aluviais do perímetro irrigado de Custódia, PE, cujo uso agrícola foi interrompido em virtude de problemas de salinidade/sodicidade. Foram realizadas caracterizações morfológica, física, química e mineralógica de três perfis de solos afetados por sais do referido perímetro irrigado. Os solos foram classificados, de acordo com o Sistema Brasileiro de Classificação de Solos, como Neossolo Flúvico Ta eutrófico solódico, Neossolo Flúvico Sódico salino e Neossolo Flúvico Sódico típico. A estratificação, típica de solos de natureza aluvial, rege o comportamento físico e químico dos solos estudados no sentido vertical. Apesar da presença de minerais que podem contribuir com o processo de salinização/sodificação, tal contribuição deve ser irrisória quando comparada à das águas de rega de baixa qualidade. A reutilização destes solos com agricultura irrigada deve ser precedida do uso de corretivos e da introdução de um eficiente sistema de drenagem que impeça a ascensão do lençol freático e promova a lixiviação do sódio.
Genetic Similarities Between Latent Autoimmune Diabetes in Adults, Type 1 Diabetes, and Type 2 Diabetes
Authors: Cervin Camilla , Lyssenko Valeriya , Bakhtadze Ekaterine , Lindholm Eero , Nilsson Peter , Tuomi Tiinamaija , Cilio Corrado M. , Groop Leif
Published: March 2008

OBJECTIVE—Latent autoimmune diabetes in adults (LADA) is often considered a slowly progressing subtype of type 1 diabetes, although the clinical picture more resembles type 2 diabetes. One way to improve classification is to study whether LADA shares genetic features with type 1 and/or type 2 diabetes.

RESEARCH DESIGN AND METHODS—To accomplish this, we studied whether LADA shares variation in the HLA locus or INS VNTR and PTPN22 genes with type 1 diabetes or the TCF7L2 gene with type 2 diabetes in 361 LADA, 718 type 1 diabetic, and 1,676 type 2 diabetic patients, as well as 1,704 healthy control subjects from Sweden and Finland.

RESULTS—LADA subjects showed, compared with type 2 diabetic patients, increased frequency of risk for the HLA-DQB1 *0201/*0302 genotype (27 vs. 6.9%; P < 1 × 10−6), with similar frequency as with type 1 diabetes (36%). In addition, LADA subjects showed higher frequencies of protective HLA-DQB1 *0602(3)/X than type 1 diabetic patients (8.1 vs. 3.2%, P = 0.003). The AA genotype of rs689, referring to the class I allele in the INS VNTR, as well as the CT/TT genotypes of rs2476601 in the PTPN22 gene, were increased both in type 1 diabetic (P = 3 × 10−14 and P = 1 × 10−10, respectively) and LADA (P = 0.001 and P = 0.002) subjects compared with control subjects. Notably, the frequency of the type 2 diabetes–associated CT/TT genotypes of rs7903146 in the TCF7L2 were increased in LADA subjects (52.8%; P = 0.03), to the same extent as in type 2 diabetic subjects (54.1%, P = 3 × 10−7), compared with control subjects (44.8%) and type 1 diabetic subjects (43.3%).

CONCLUSIONS—LADA shares genetic features with both type 1 (HLA, INS VNTR, and PTPN22) and type 2 (TCF7L2) diabetes, which justifies considering LADA as an admixture of the two major types of diabetes.
Sedative and cardiopulmonary effects of medetomidine hydrochloride and xylazine hydrochloride and their reversal with atipamezole hydrochloride in calves
Authors: Rioja Eva , Kerr Carolyn L. , Enouri Saad S. , McDonell Wayne N.
Published: March 2008

Objective—To assess the sedative and cardiopulmonary effects of medetomidine and xylazine and their reversal with atipamezole in calves.

Animals—25 calves.

Procedures—A 2-phase (7-day interval) study was performed. Sedative characteristics (phase I) and cardiopulmonary effects (phase II) of medetomidine hydrochloride and xylazine hydrochloride administration followed by atipamezole hydrochloride administration were evaluated. In both phases, calves were randomly allocated to receive 1 of 4 treatments IV: medetomidine (0.03 mg/kg) followed by atipamezole (0.1 mg/kg; n = 6), xylazine (0.3 mg/kg) followed by atipamezole (0.04 mg/kg; 7), medetomidine (0.03 mg/kg) followed by saline (0.9% NaCl; 6) solution (10 mL), and xylazine (0.3 mg/kg) followed by saline solution (10 mL; 6). Atipamezole or saline solution was administered 20 minutes after the first injection. Cardiopulmonary variables were recorded at intervals for 35 minutes after medetomidine or xylazine administration.

Results—At the doses evaluated, xylazine and medetomidine induced a similar degree of sedation in calves; however, the duration of medetomidine-associated sedation was longer. Compared with pretreatment values, heart rate, cardiac index, and PaO2 decreased, whereas central venous pressure, PaCO2, and pulmonary artery pressures increased with medetomidine or xylazine. Systemic arterial blood pressures and vascular resistance increased with medetomidine and decreased with xylazine. Atipamezole reversed the sedative and most of the cardiopulmonary effects of both drugs.

Conclusions and Clinical Relevance—At these doses, xylazine and medetomidine induced similar degrees of sedation and cardiopulmonary depression in calves, although medetomidine administration resulted in increases in systemic arterial blood pressures. Atipamezole effectively reversed medetomidine- and xylazine-associated sedative and cardiopulmonary effects in calves.
Comparison of two canine registry databases on the prevalence of hip dysplasia by breed and the relationship of dysplasia with body weight and height
Authors: Comhaire Frank H. , Snaps Frédéric
Published: March 2008

Objective—To compare the results of 2 canine registries for classification of the hip joints for dysplasia by breed, and to relate the percentage of dysplastic dogs with body metric characteristics.

Sample Population—Data on the ranking order of hip dysplasia by breed from 2 registries for 156 dog breeds.

Procedures—The prevalence of hip dysplasia listed by the Orthopedic Foundation for Animals (OFA) and the breed mean score according to the list of the British Veterinary Association (BVA) Kennel Club Hip Dysplasia scheme were related to weight and height as well as the body mass index (BMI; kg/m2) by breed.

Results—The OFA ranking order and the percentage of dysplastic dogs were highly correlated with the BVA mean score (ρ = 0.74). A significant correlation was found between the prevalence of hip dysplasia and the BMI (r = 0.63). Receiver operating characteristic curve analysis revealed that the highest area under the curve, corresponding to the best discrimination, was at a BMI of 110 kg/m2 with a criterion value of 15% dysplastic dogs (area under the curve, 0.89). Because the ratio of dogs in the positive and negative groups reflected the prevalence of the condition among breeds in the OFA database, the positive likelihood ratio was 9.32 and the negative likelihood ratio was 0.24.

Conclusion and Clinical Relevance—The OFA statistics and the BVA mean scores reflected the prevalence of hip dysplasia among dog breeds. Body mass index accurately discriminated between breeds with high or low prevalence of hip dysplasia.
Comparison of two indirect techniques for local delivery of a high dose of an antimicrobial in the distal portion of forelimbs of horses
Authors: Errico Jason A. , Trumble Troy N. , Bueno Aloisio C. D. , Davis Jennifer L. , Brown Murray P.
Published: March 2008

Objective—To compare isolated limb retrograde venous injection (ILRVI) and isolated limb infusion (ILI) for delivery of amikacin to the synovial fluid of the distal interphalangeal and metacarpophalangeal joints and to evaluate the efficacy of use of an Esmarch tourniquet in standing horses.

Animals—6 healthy adult horses.

Procedures—Horses were randomly assigned in a crossover design. In ILRVI, the injection consisted of 1 g of amikacin diluted to a total volume of 60 mL administered during a 3-minute period. In ILI, the infusion consisted of 1 g of amikacin diluted to 40 mL administered during a 3-minute period followed by administration of boluses of diluent (82 mL total) to maintain vascular pressure. During ILI, the infusate and blood were circulated from the venous to the arterial circulation in 5-mL aliquots. Synovial fluid and serum samples were obtained to determine maximum amikacin concentrations and tourniquet leakage, respectively.

Results—Both techniques yielded synovial concentrations of amikacin > 10 times the minimum inhibitory concentration (MIC) for 90% of isolates (80 μg/mL) and > 10 times the MIC breakpoint (160 μg/mL) of amikacin-susceptible bacteria reported to cause septic arthritis in horses. These values were attained for both joints for both techniques. Esmarch tourniquets prevented detectable loss of amikacin to the systemic circulation for both techniques.

Conclusions and Clinical Relevance—Both techniques reliably achieved synovial fluid concentrations of amikacin consistent with concentration-dependent killing for bacteria commonly encountered in horses with septic arthritis. Esmarch tourniquets were effective for both delivery techniques in standing horses.
Evaluation of the renin-angiotensin system in cardiac tissues of cats with pressure-overload cardiac hypertrophy
Authors: Uechi Masami , Tanaka Yoshiyuki , Aramaki Yoshitaka , Hori Yasutomo , Ishikawa Yumi , Ebisawa Takashi , Yamano Shigeki
Published: March 2008

Objective—To clarify regulation of the renin-angiotensin (RA) system in cardiac tissues by measuring angiotensin-converting enzyme (ACE) and chymase activities in cats with pressure-overload cardiac hypertrophy.

Animals—13 adult cats.

Procedures—Pressure-overload cardiac hypertrophy was induced by coarctation of the base of the ascending aorta in 6 cats, and 7 cats served as untreated control animals. Cats were examined before and 3 months and 2 years after surgery. Two years after surgery, cardiac hypertrophy was confirmed by echocardiography, and the blood pressure gradient was measured at the site of constriction. Cats were euthanized, and ACE and chymase activities were measured in cardiac tissues.

Results—Mean ± SD pressure gradient across the aortic constriction was 63 ± 6 mm Hg. Chymase activity predominated (75% to 85%) in the RA system of the cardiac tissues of cats. Fibrosis in the wall of the left ventricle was detected in cats with hypertrophy, and fibrosis of the papillary muscle was particularly evident.

Conclusions and Clinical Relevance—Chronic pressure overload on the heart of cats can activate the RA system in cardiac tissues. A local increase in angiotensin II was one of the factors that sustained myocardial remodeling.
Evaluation of the induction of vasoactive mediators from equine digital vein endothelial cells by endotoxin
Authors: Menzies-Gow Nicola J. , Bailey Simon R. , Berhane Yoel , Brooks Andrew C. , Elliott Jonathan
Published: March 2008

Objective—To determine the effect of endotoxin (lipopolysaccharide [LPS]) on vasoactive mediator production by cultured equine digital vein endothelial cells (EDVECs).

Sample Population—EDVECs obtained from forelimb digital veins of 7 healthy adult horses.

Procedures—EDVECs were incubated with or without LPS (1 μg/mL) for 0, 2, 4, 6, 22, and 24 hours. The EDVECs were incubated for 18 hours with LPS (10 pg/mL to 1 μg/mL) with or without ibuprofen, cycloheximide, or L-nitroarginine methyl ester. Medium concentrations of prostacyclin, cyclic guanosine monophosphate, endothelin-1, and thromboxane A2 were determined. Changes in inducible nitric oxide synthase and cyclooxygenase-2 expression were determined.

Results—LPS stimulated mean 4.2- and 14.1-fold increases in EDVEC prostacyclin and cyclic guanosine monophosphate production, respectively, after 22 hours. These effects were LPS concentration–dependent (LPS concentrations that induced a response halfway between the maximum response and baseline of 1.50 and 1.22 ng/mL, respectively). The LPS-induced cyclic guanosine monophosphate production was significantly inhibited (to basal concentrations) by L-nitroarginine methyl ester, and prostacyclin production was inhibited by cycloheximide and ibuprofen. Production of thromboxane A2 by EDVECs was not detected. Endothelin-1 accumulated in the medium, but LPS did not enhance its production. Inducible nitric oxide synthase expression in EDVECs was not detected with the available antibodies, whereas LPS stimulated cyclooxygenase-2 expression in a time- and concentration-dependent manner.

Conclusions and Clinical Relevance—LPS stimulated vasoactive mediator production by equine endothelial cells, which may play a role in LPS-induced digital hypoperfusion.
Myocardial fluid balance in dogs with naturally acquired heartworm infection
Authors: Stewart Randolph H. , Uray Karen , Cox Charles S. , Laine Glen A.
Published: March 2008

Objective—To determine the effect of naturally acquired heartworm (Dirofilaria immitis) infection on myocardial fluid balance as indicated by myocardial water content and the dynamics of transepicardial fluid flow.

Animals—7 dogs infected with adult heartworms and 8 dogs free of heartworm infection.

Procedures—Infected dogs had heartworms in the right ventricle, pulmonary artery, or both but no evidence of cardiovascular disease on physical examination. A hemispheric capsule was attached to the epicardial surface of all dogs for determination of transepicardial fluid dynamics and permeability of the epicardium to water and protein. Myocardial water content and hydroxyproline content were assessed at necropsy.

Results—Myocardial water content was significantly lower in heartworm-infected dogs. No differences in myocardial hydroxyproline content, transepicardial fluid flow, or epicardial water or protein permeability were detected.

Conclusions and Clinical Relevance—Heartworm infection significantly altered myocardial fluid balance in dogs, possibly because of a change in the myocardial interstitial pressure-volume relationship. These changes may be associated with increased vulnerability to cardiovascular stressors in heartworm-infected dogs.
Identification of hyperendemic foci of horses with West Nile virus disease in Texas
Authors: Wittich Courtney A. , Ward Michael P. , Fosgate Geoffrey T. , Srinivasan Raghavan
Published: March 2008

Objective—To determine whether West Nile virus (WNV) disease hyperendemic foci (hot spots) exist within the horse population in Texas and, if detected, to identify the locations.

Sample Population—Reports of 1,907 horses with WNV disease in Texas from 2002 to 2004.

Procedures—Case data with spatial information from WNV epidemics occurring in 2002 (1,377 horses), 2003 (396 horses), and 2004 (134 horses) were analyzed by use of the spatial scan statistic (Poisson model) and kriging of empirical Bayes smoothed county attack rates to determine locations of horses with WNV disease in which affected horses were consistently (in each of the 3 study years) clustered (hyperendemic foci, or hot spots).

Results—2 WNV hot spots in Texas, an area in northwestern Texas and an area in eastern Texas, were identified with the scan statistic. Risk maps of the WNV epidemics were qualitatively consistent with the hot spots identified.

Conclusions and Clinical Relevance—WNV hot spots existed within the horse population in Texas (2002 to 2004). Knowledge of disease hot spots allows disease control and prevention programs to be made more efficient through targeted surveillance and education.