bluuebunny/crossref_metadata_2025 huggingface dataset:
Remittances and immigration enforcement
Authors: Amuedo-Dorantes Catalina , Puttitanun Thitima
Published: March 2014

Recent increases in U.S. immigration enforcement at the local and state level may be impacting remittance flows to developing countries by curtailing undocumented immigration, restricting the cyclicality of migration flows and limiting employment opportunities for the undocumented. We examine how the remitting patterns of Mexican migrants in the United States are being impacted by two types of immigration enforcement policies: police-based initiatives, such as 287(g) agreements and Secure Communities, and employment-based programs, as is the case with employment verification mandates. We find that increased enforcement reduces the share of migrants sending money home. However, legal migrants remitting money home increase their money outflows enough to offset any reductions in remittance payments from their undocumented counterparts. As a result, the average dollar amount remitted per Mexican migrant rises in the midst of increased uncertainty, safeguarding remittances as one of the least volatile sources of income in the developing world.
Variability is adaptability…also during weaning!
Authors: Brochard Laurent
Published: March 2014

Heart rate variability in the frequency domain can now be obtained at the bedside in the ICU. Promising data suggest that it may help to characterize a patient response to a spontaneous breathing trial. Refinement of the analysis could even help to predict the outcome of extubation or at least help to detect early patients at risk of failure. It is possible that combining this type of analysis, the breathing pattern variability, and other objective indices could help clinicians in the decision-making process of weaning and extubation.
Use of probiotics in the treatment of severe acute pancreatitis: a systematic review and meta-analysis of randomized controlled trials
Authors: Gou Shanmiao , Yang Zhiyong , Liu Tao , Wu Heshui , Wang Chunyou
Published: March 2014

Introduction

Necrotic tissue infection can worsen the prognosis of severe acute pancreatitis (SAP), and probiotics have been shown to be beneficial in reducing the infection rate in animal experiments and primary clinical trials. However, the results of multicenter randomized clinical trials have been contradictory. Our aim in this study was to systematically review and quantitatively analyze all randomized controlled trials with regard to important outcomes in patients with predicted SAP who received probiotics.

Methods

A systematic literature search of the PubMed, Embase and Cochrane Library databases was conducted using specific search terms. Eligible studies were randomized controlled trials that compared the effects of probiotic with placebo treatment in patients with predicted SAP. Mean difference (MD), risk ratio (RR) and 95% confidence interval (95% CI) were calculated using the Mantel-Haenszel fixed- and random-effects models. A meta-analysis on the use of probiotics in the treatment of critically ill patients was also performed to serve as a reference.

Results

In this study, 6 trials comprising an aggregate total of 536 patients were analyzed. Significant heterogeneities were observed in the type, dose, treatment duration and clinical effects of probiotics in these trials. Systematic analysis showed that probiotics did not significantly affect the pancreatic infection rate (RR = 1.19, 95% CI = 0.74 to 1.93; P = 0.47), total infections (RR = 1.09, 95% CI = 0.80 to 1.48; P = 0.57), operation rate (RR = 1.42, 95% CI = 0.43 to 3.47; P = 0.71), length of hospital stay (MD = 2.45, 95% CI = −2.71 to 7.60; P = 0.35) or mortality (RR = 0.72, 95% CI = 0.42 to 1.45; P = 0.25).

Conclusions

Probiotics showed neither beneficial nor adverse effects on the clinical outcomes of patients with predicted SAP. However, significant heterogeneity was noted between the trials reviewed with regard to the type, dose and treatment duration of probiotics, which may have contributed to the heterogeneity of the clinical outcomes. The current data are not sufficient to draw a conclusion regarding the effects of probiotics on patients with predicted SAP. Carefully designed clinical trials are needed to validate the effects of particular probiotics given at specific dosages and for specific treatment durations.
Microbial community in microbial fuel cell (MFC) medium and effluent enriched with purple photosynthetic bacterium (Rhodopseudomonas sp.)
Authors: Park Tae-Jin , Ding Weijun , Cheng Shaoan , Brar Manreetpal Singh , Ma Angel Po Yee , Tun Hein Min , Leung Frederick C
Published: March 2014

High power densities have been obtained from MFC reactors having a purple color characteristic of Rhodopseudomonas. We investigated the microbial community structure and population in developed purple MFC medium (DPMM) and MFC effluent (DPME) using 16S rRNA pyrosequencing. In DPMM, dominant bacteria were Comamonas (44.6%), Rhodopseudomonas (19.5%) and Pseudomonas (17.2%). The bacterial community of DPME mainly consisted of bacteria related to Rhodopseudomonas (72.2%). Hydrogen oxidizing bacteria were identified in both purple-colored samples: Hydrogenophaga and Sphaerochaeta in the DPMM, and Arcobacter, unclassified Ignavibacteriaceae, Acinetobacter, Desulfovibrio and Wolinella in the DPME. The methanogenic community of both purple-colored samples was dominated by hydrogenotrophic methanogens including Methanobacterium, Methanobrevibacter and Methanocorpusculum with significantly lower numbers of Methanosarcina. These results suggeste that hydrogen is actively produced by Rhodopseudomonas that leads to the dominance of hydrogen consuming microorganisms in both purple-colored samples. The syntrophic relationship between Rhodopseudomonas and hydrogenotrophic microbes might be important for producing high power density in the acetate-fed MFC under light conditions.
Repetitive Hypoglycemia Increases Circulating Adrenaline Level with Resultant Worsening of Intimal Thickening After Vascular Injury in Male Goto-Kakizaki Rat Carotid Artery
Authors: Yasunari Eisuke , Mita Tomoya , Osonoi Yusuke , Azuma Kosuke , Goto Hiromasa , Ohmura Chie , Kanazawa Akio , Kawamori Ryuzo , Fujitani Yoshio , Watada Hirotaka
Published: March 2014

Hypoglycemia associated with diabetes management is a potential risk for cardiovascular diseases. However, the effect of hypoglycemic episodes including a surge of sympathetic activity on the progression of neointima formation after vascular injury remains largely unknown. In this study, insulin was injected intraperitoneally into nonobese diabetic Goto-Kakizaki (GK) rats, once every 3 days for 4 weeks after balloon injury of carotid artery to induce hypoglycemia. Then, we evaluated balloon injury-induced neointima formation. Insulin treatment enhanced neointima formation and increased the number of proliferating cell nuclear antigen (PCNA)-positive cells in the carotid artery. Injection of glucose with insulin prevented hypoglycemia and abrogated intimal thickening. Also, bunazosin, an α1 adrenergic receptor antagonist, prevented intimal thickening and accumulation of PCNA-positive cells induced by insulin treatment despite the presence of concomitant hypoglycemia and high adrenaline levels. Incubation of cultured smooth muscle cells with adrenaline resulted in a significant increase in their proliferation and G0/G1 to S phase progression, which was associated with activation of extracellular signal-regulated kinase, enhanced expression of cell cycle regulatory molecules such as cyclin D1, and cyclin E, and phosphorylation of retinoblastoma protein. These adrenaline-induced effects were abrogated by bunazosin. Our data indicated that increased adrenaline induced by repetitive hypoglycemia promotes intimal thickening and smooth muscle cell proliferation after endothelial denudation in GK rats.
ZIC1 Is a Putative Tumor Suppressor in Thyroid Cancer by Modulating Major Signaling Pathways and Transcription Factor FOXO3a
Authors: Qiang Wei , Zhao Yuan , Yang Qi , Liu Wei , Guan Haixia , Lv Siqing , Ji Meiju , Shi Bingyin , Hou Peng
Published: March 2014

Context:

ZIC1 has been reported to be overexpressed and plays an oncogenic role in some brain tumors, whereas it is inactivated by promoter hypermethylation and acts as a tumor suppressor in gastric and colorectal cancers. However, until now, its biological role in thyroid cancer remains totally unknown.

Objectives:

The aim of this study is to explore the biological functions and related molecular mechanism of ZIC1 in thyroid carcinogenesis.

Setting and Design:

Quantitative RT-PCR (qRT-PCR) was performed to evaluate mRNA expression of investigated genes. Methylation-specific PCR was used to analyze promoter methylation of the ZIC1 gene. The functions of ectopic ZIC1 expression in thyroid cancer cells were determined by cell proliferation and colony formation, cell cycle and apoptosis, as well as cell migration and invasion assays.

Results:

ZIC1 was frequently down-regulated by promoter hypermethylation in both primary thyroid cancer tissues and thyroid cancer cell lines. Moreover, our data showed that ZIC1 hypermethylation was significantly associated with lymph node metastasis in patients with papillary thyroid cancer. Notably, restoration of ZIC1 expression in thyroid cancer cells dramatically inhibited cell proliferation, colony formation, migration and invasion, and induced cell cycle arrest and apoptosis by blocking the activities of the phosphatidylinositol-3-kinase (PI3K)/Akt and RAS/RAF/MEK/ERK (MAPK) pathways, and enhancing FOXO3a transcriptional activity.

Conclusions:

Our data demonstrate that ZIC1 is frequently inactivated by promoter hypermethyaltion and functions as a tumor suppressor in thyroid cancer through modulating PI3K/Akt and MAPK signaling pathways and transcription factor FOXO3a.
Downstream Effects of Maternal Hypothyroxinemia in Early Pregnancy: Nonverbal IQ and Brain Morphology in School-Age Children
Authors: Ghassabian Akhgar , El Marroun Hanan , Peeters Robin P. , Jaddoe Vincent W. , Hofman Albert , Verhulst Frank C. , Tiemeier Henning , White Tonya
Published: March 2014

Context:

Although maternal hypothyroxinemia is suggested to be related to various adverse consequences in a child's neurodevelopment, the underlying neurobiology is largely unknown.

Objective:

The objective of the study was to examine the relationship between maternal hypothyroxinemia in early pregnancy and children's nonverbal intelligence quotient (IQ). Furthermore, we explored whether global brain volumes, cortical thickness, and brain surface area differed between children exposed prenatally to hypothyroxinemia and healthy controls.

Design and Setting:

The study included a large population-based prospective birth cohort in The Netherlands.

Participants:

A total of 3727 mother-child pairs with data on prenatal thyroid function at less than 18 weeks of gestation and nonverbal IQ at 6 years participated in the study. In 652 children, brain imaging was performed at 8 years of age.

Main Measures:

Maternal hypothyroxinemia was defined as free T4 in the lowest 5% of the sample, whereas TSH was in the normal range. At 6 years, children's IQ was assessed using a Dutch test battery. Global brain volumetric measures, cortical thickness, and surface area were assessed using high-resolution structural magnetic resonance imaging.

Results:

The children of mothers with hypothyroxinemia in early pregnancy scored 4.3 points IQ lower than the children of mothers with normal thyroid status (95% confidence interval −6.68, −1.81; P = .001). After adjustment for multiple testing, we did not find any differences in brain volumetric measures, cortical thickness, and surface area between children exposed prenatally to hypothyroxinemia and controls.

Conclusions:

Our findings confirm a large adverse effect of maternal hypothyroxinemia on children's nonverbal IQ at school age. However, we found no evidence that maternal hypothyroxinemia is associated with differences in brain morphology in school-age children.
Multiproduct Price Optimization and Competition Under the Nested Logit Model with Product-Differentiated Price Sensitivities
Authors: Gallego Guillermo , Wang Ruxian
Published: March 2014

We study firms that sell multiple substitutable products and customers whose purchase behavior follows a nested logit model, of which the multinomial logit model is a special case. Customers make purchasing decisions sequentially under the nested logit model: they first select a nest of products and subsequently purchase one within the selected nest. We consider the multiproduct pricing problem under the general nested logit model with product-differentiated price sensitivities and arbitrary nest coefficients. We show that the adjusted markup, defined as price minus cost minus the reciprocal of price sensitivity, is constant for all the products within a nest at optimality. This reduces the problem's dimension to a single variable per nest. We also show that the adjusted nest-level markup is nest invariant for all the nests, which further reduces the problem to maximizing a single-variable unimodal function under mild conditions. We also use this result to simplify the oligopolistic multiproduct price competition and characterize the Nash equilibrium. We also consider more general attraction functions that include the linear utility and the multiplicative competitive interaction models as special cases, and we show that similar techniques can be used to significantly simplify the corresponding pricing problems.
Changes in hormonal and metabolic status in men of an ethnic group Komi with overweight and obesity
Authors: Osadchuk L V , Gutorova N V , Ludinina A Yu , Potolitsyna N N , Bojko E R
Published: March 2014

The aim of this study was to compare hormonal, anthropometric and metabolic parameters in men of the komi ethnic group with (n=23, BMI ≥25 kg/м2) or without (n=39, 18.4≤BMI 25 kg/м2) obesity. Totally 62 males living in Komi Republic were included in the study. It has been established that obesity was accompanied by an increase in serum concentrations of cholesterol and low density lipoprotein cholesterol in comparison with control group indicating metabolic disturbance. The data shows the significant effect of BMI on testosterone and FSH serum concentration, but not on LH, estradiol, thyrotrophic hormone, thyroxin and triiodthyronin levels. Overweight and obese men had lower circulating testosterone and higher FSH level in comparison with the controls. The reproductive hormone changes in overweight and obese men can result in deleterious effects on sexual functions including erectile dysfunction, reduced libido and alteration in spermatogenesis
Low-dose zoledronate in osteopenic postmenopausal women: a randomized controlled trial
Authors: Vorotnikova S Yu
Published: March 2014

Discussionты for the article "Low-Dose Zoledronate in Osteopenic Postmenopausal Women: A Randomized Controlled Trial" (Grey A. et al., 2012).
Endocrine and metabolic aspects of the management of patients undergoing bariatric surgery. Review of clinical recommendations.
Authors: Mazurina N V , Sviridonova M A
Published: March 2014

The incidence of morbid obesity increases worldwide. Therefore surgical methods of treatment are widely applied. A lot of patients after bariatric surgery requires lifelong control and therapy. The Endocrine Society offered detailed guideline for the management of boost-bariatric surgery patients. The basic recommendations are reviewed in this article.
The role of hormones of adipose tissue in the development pregnancy complications in obese women
Authors: Petunina N A , Kuzina I A
Published: March 2014

Obesity in pregnancy is a risk factor for complications for both the mother and of the fetus. Adipose tissue hormones (leptin, adiponectin, resistin) are secreted by the human placenta and regulate the function of trophoblast.The review presents data from the literature on the role of adipocytokines in the development of gestational diabetes and preeclampsia in obesity women. The article considers the criteria and algorithms for the diagnosis of gestational diabetes recommended by the World Health Organization and the International Association of research groups for diabetes and pregnancy.
Sleep-disordered breathing in acromegaly
Authors: Dzeranova L K , Kuznetsov D I , Bezunov E A , Artemova E V , Rozhinskaya L Ya , Vorontsov A V , Vladimirova V P , Averkieva E V
Published: March 2014

Sleep-disordered breathing is higly prevalent in acromegaly, disturbing patients quality of life and increasing the risk of acute cardiovascular compications. Presented clinical case discusses key considerations for timely diagnosis of sleep apnea syndrome and treatment planning. The case of 41 y.o. woman with newly diagnosed acromegaly and concomitant sleep apnea is typical for this disease.
Experience of using long-acting testosterone undecanoate in hypogonadism, obesity and metabolic syndrome in men
Authors: Rozhivanov R V
Published: March 2014

The paper outlines the author's experience on the efficacy and safety of androgen therapy of metabolic syndrome and obesity in men with hypogonadism. The study used testosterone undecanoate therapy that reduced body fat and the severity of the other components of the metabolic syndrome, improved sexual function without causing severe side effects. A number of patients on therapy observed suppression of spermatogenesis, which prevents the use of the drug in the reproductive rehabilitation.
Clinical case: multiple endocrine neoplasia type 1 (MEN 1)
Authors: Lipatenkova A K , Dzeranova L K , Pigarova E A , Rozhinskaya L Ya , Kochatkov A V
Published: March 2014

Multiple endocrine neoplasia syndrome type 1 (MEN1, Wermer syndrome) – group o а heterogeneous inherited deseases, caused by hyperlasia or neoplasia of several endocrine glands. The phenotype of MEN1 is broad, and over 20 different combinations of endocrine and non-endocrine metabolic manifestations have been described. This case demonstrates multiple formations of endocrine organs, starting non-classical with macroprolactonoma resistant to dopamine agonists therapy, other endocrine disorders developed gradually eventually: hyperparathyreoidism and hypoglycemia caused by pancreas lesions, produced proinsulin in high levels.
Familial isolated glucocorticoid deficiency: three clinical cases and a brief overview of the current literature
Authors: Orlova E M , Kareva M A , Melikian M A , Tiul'pakov A N , Peterkova V A
Published: March 2014

Familial isolated glucocorticoid deficiency (FIGD) is a rare form of primary adrenal insufficiency associated with the resistance of the adrenal cortex to the action of ACTH. This pathology manifests itself in the form of cortisol deficiency despite the normal mineralocorticoid function. Approximately 50% of all FIGD cases are attributable to mutations in two genes (melanocortin 2 receptor gene, MC2R, and melanocortin 2 receptor accessory protein gene, MRAP). In addition, the relationship between FIGD and mutations in nicotinamide nucleotide transhydrogenase gene, NNT, minichromosome maintenance gene, MCM4, and STAR is documented. No genetic defect was found in almost 25% of the cases of isolated deficiency of gucocorticoids. The clinical descriptions of the patients presenting with FIGD including its molecular-genetic diagnostics are of great interest for the understanding of this rare disease.
The risk of development of perioperative myocardial lesions and acute left ventricular insufficiency in the patients presenting with pheochromocytoma
Authors: Kuznetsov A B , Bel'tsevich D G , Lysenko M A , Kats L E , Gomzhin I S , Iukina M Iu
Published: March 2014

Differential diagnostics of coronary heart disease (CHD) and catecholamine-induced cardiomyopathy was undertaken in 19 of the 106 patients presenting with pheochromocytoma. Group 1 included 13 patients having the history of acute myocardial infarction. Diagnostics of CHD was performed following the adequate preoperative alpha-blockade (supplemented by Β-blockade whenever indicated). Group 2 was comprised of 6 patients suffering pulmonary oedema (normotensive, 10-70 min after removal of the tumour) and showing the elevated levels of biomarkers of myocardial necrosis and/or ischemic-type changes of ECG in the early postoperative period. The clinically significant myocardial ischemia requiring correction was documented only in one of the 19 patients. The two groups were not significantly different in terms of the mean tumour size and duration of surgery, the quality of preoperative compensation, and intraoperative fluctuations of arterial pressure. The mean age of the patients in group 1 (47 years) was much higher than that in group 2 (29 years). All patients in group 2 exhibited the predominantly adrenalin-type secretion whereas 10 patients of group 1 had the noradrenalin-type secretion and two others mixed-type secretion with the predominance of noradrenalin release. It was shown that the patients with the predominantly adrenaline-type secretion by the tumour were at higher risk of pulmonary oedema. The possibility of application of alpha-methylparatyrosine having beneficial effect on contractile activity of myocardium as the main agent for preoperative preparation is discussed.
The comparative analysis of the results of clinical and hormonal investigations in the patients presenting with ACTH-producing neuroendocrine tumours
Authors: Marova E I , Arapova S D , Kolesnikova G S , Sitkin I I , Goncharov N P
Published: March 2014

This study included the patients presenting with neuroendocrine tumours (NET) and the clinical picture of hypercoticism caused by excessive ACTH secretion from the tumour. The overwhelming majority of the patients (85%) suffered Cushing's disease (CD) associated with a pituitary tumour. The remaining 15% of the patients presented with ACTH-ectopic syndrome (ACTH-ES). The clinical picture of CD and ACTH-ES was very similar. The latter condition was associated with the higher plasma ACTH and cortisol levels as well as the free cortisol content in 24 hour urine and saliva samples collected in the evening compared with CD even though the differences were insignificant due to data scattering. Decompressin administration and catheterization of inferior petrosal sinuses caused a much greater enhancement of the ACTH level in the patients with CS in comparison with those suffering ASTH-ES.
ACTH-ectopic syndrome with the cyclic clinical course; the cecal neuroendocrine tumour
Authors: Voronkova I A , Arapova S D , Marova E I , Kuznetsov N S , Abrosimov A Iu , Rozhinskaia L Ia
Published: March 2014

The authors report a rare case of ACTH-ectopic syndrome with the cyclic clinical course and localization of the primary neoplasm in the cecum of the 24-year old woman followed up for 6 years.
The combination of two monogenic diseases, congenital lamellar ichthyosis and type 2 MODY diabetes mellitus
Authors: Emel'ianov A O , Sozaeva L S
Published: March 2014

A 16-year old boy, P.E., is described in whom the diagnosis of congenital lamellar ichthyosis was established at birth based on the clinical picture and confirmed by a molecular genetic study. Diabetes mellitus was first suspected at the age of 10 years based on the elevated fasting blood glucose (7.1 mmol/l) and HbA1c (7.4%) levels. The patient's medical history revealed that his maternal grandmother suffered diabetes mellitus and his mother had gestational diabetes during the second pregnancy. The patient presented with impaired carbohydrate tolerance in the absence of insulin resistance. The molecular genetic study of the GCK gene revealed a Gly80Ser mutation in the third exon sequence. We failed to find a report of the combination of congenital lamellar ichthyosis and type 2 MODY diabetes mellitus in the available literature.
Continuous monitoring blood glucose level in clinical practice and new methods for its analysis
Authors: Dreval' A V , Dreval' O A , Starostina E G
Published: March 2014

The present study deals with the currently employed method for continuous monitoring blood glucose level, indications for its use, information and therapeutic potential, and major technical aspects. The authors emphasizes that routine application of the continuous monitoring technique fails to improve the blood glucose level. Its potential benefits for the patients presenting with diabetes mellitus are discussed with reference to certain clinical situations. Special attention is given to the methods of mathematical analysis of the results obtained by means of continuous monitoring blood glucose level.
The effectiveness and safety of the supplementation of therapy with oral hypoglycemic agents by basal insulin in the patients with type 2 diabetes mellitus. Results of the SOLOS observational program
Authors: Pavlova M G , Glinkina I V
Published: March 2014

The results of numerous clinical investigations carried out during the last years provide convincing evidence of the high effectiveness and safety of early initiation of insulin therapy. Of special interest are the studies conducted under conditions of real clinical practice. One of them is the Russian SOLOS observational program designed to evaluate the influence of intensification of the treatment of type 2 diabetes mellitus with oral hypoglycemic agents (OHA) supplemented by using insulin glargine in the patients who failed to be adequately compensated by OHA therapy alone. Another objective of this program was to find out the opinion of the patients and physicians about the SoloStar pen employed for injecting insulin glargine. The data concerning 1309 patients at the mean age of 59.5±8.8 years with type 2 diabetes mellitus and the mean duration of the disease 6.9±5.0 years were available for the analysis. The overwhelming majority of the patients presented with severe decompensation of carbohydrate metabolism, the mean fasting blood glucose level being 10.7±2.4 mmol/l and the HbA1c level varying from 7.2 to 18.2% (mean 9.6±1.5%). Supplementation of OHA therapy with insulin glargine caused the significant reduction of the HbA1c level to 8.1±1.0% (p<0.001) within 3 months after the onset of the combined treatment. The HbA1c level fell down to 7.2±0.9% (p<0.001) after 6 months 40.6% of the patients had HbA1c at the level below 7%. Fasting blood glucose levels decreased to 7.4±1.4 mmol/l and 6.3±1.0 mmol/l (p<0.001) at 3 and 6 months after the onset of insulin administration respectively. The number of daytime and nocturnal hypoglycemic episodes under effect of insulin glargine injections significantly decreased by the end of the study. Severe hypoglycemic episodes suffered initially by 8 (0.5%) patients totally disappeared 6 months after the initiation of the combined therapy. Most patients did not need hospitalization after supplementation of OHA treatment with insulin. The results of combined therapy with the use of disposable SoloStar pens were positively assessed by the overwhelming majority of both the patients and the physicians involved in the study.
Enfoques de enseñanza de profesores universitarios en México
Authors: Estévez Nenninger Etty Haydee , Arreola Olivarría Claudia Gabriela , Valdés Cuervo Angel Alberto
Published: March 2014

Esta investigación se realizó con el objetivo de establecer el grado en el que profesores universitarios realizan, según su percepción, actividades acordes con un enfoque de enseñanza cognitivo-constructivista y de formación integral, así como explorar relaciones significativas entre el enfoque de enseñanza expresado por el profesor y variables de tipo socio-demográfico, académico y de carrera docente. Se elaboró un cuestionario para medir la frecuencia de actividades de enseñanza propias de un enfoque cognitivo-constructivista y de formación integral (Estévez, 2002; Reigeluth, 1983, 1999). Se seleccionaron, de manera no probabilística,  250 docentes de las dos universidades públicas más importantes de Sonora, México. El análisis de los resultados se realizó con pruebas Anovas de una vía y de medidas repetidas, post hoc y pruebas t de Student para muestras independientes. Se concluyó que los profesores encuestados desarrollan con una alta frecuencia actividades de planeación didáctica según un enfoque cognitivo-constructivista y de formación integral, sin embargo, manifiestan un nivel medio en la definición de  objetivos y estrategias para enseñar a aprender. La realización de actividades con orientación cognitivo-constructivista fue mayor en las mujeres, en los docentes con contrato por asignatura, en los que cuentan con más horas de capacitación docente y en los que dedican menos tiempo a la investigación. Lo anterior implica que la práctica de actividades propias de un enfoque cognitivo-constructivista e integral es irregular en los docentes y que se encuentra afectada por variables personales, académicas y laborales.
Ivy Sign in Mildly Symptomatic β-Thalassemia Intermedia, with Development of Moyamoya Disease
Authors: El Beltagi Ahmed H. , El-Sheikh Ahmed , El-Saif Reem , Norbash Alexander
Published: March 2014

Cerebrovascular occlusive disease with secondary proliferative angiogenesis can be idiopathic as a standalone disease state, known as moyamoya disease, or it may develop secondary to different disease entities, such as chronic hemoglobinopathies, in which case it is known as moyamoya syndrome. Although moyamoya syndrome has been well described with sickle cell anemia, its association with other hemoglobinopathies is rarely reported. We describe a 16-year-old girl with β-thalassemia intermedia who presented with recurrent headaches and focal seizures non-responsive to medical treatment. Magnetic resonance imaging showed diffuse intrasulcal bright signal intensity on fluid-attenuated inversion recovery and leptomeningeal enhancement previously termed the “ivy sign“, and her magnetic resonance angiography was consistent with bilateral moyamoya disease. The literature describing and explaining the pathogenesis of the “ivy sign” and its relationship to moyamoya disease was reviewed.
Evaluation of Apparent Diffusion Coefficient Thresholds for Diagnosis of Medulloblastoma Using Diffusion-Weighted Imaging
Authors: Pierce Theodore Thomas , Provenzale James M.
Published: March 2014

We assess a diffusion-weighted imaging (DWI) analysis technique as a potential basis for computer-aided diagnosis (CAD) of pediatric posterior fossa tumors. A retrospective medical record search identified 103 children (mean age: 87 months) with posterior fossa tumors having a total of 126 preoperative MR scans with DWI. The minimum ADC (ADCmin) and normalized ADC (nADC) values [ratio of ADCmin values in tumor compared to normal tissue] were measured by a single observer blinded to diagnosis. Receiver operating characteristic (ROC) curves were generated to determine the optimal threshold for which the nADC and ADCmin values would predict tumor histology. Inter-rater reliability for predicting tumor type was evaluated using values measured by two additional observers. At histology, ten tumor types were identified, with astrocytoma (n=50), medulloblastoma (n=33), and ependymoma (n=9) accounting for 89%. Mean ADCmin (0.54 times 10−3 mm2/s) and nADC (0.70) were lowest for medulloblastoma. Mean ADC-min (1.28 times 10−3 mm2/s) and nADC (1.64) were highest for astrocytoma. For the ROC analysis, the area under the curve when discriminating medulloblastoma from other tumors using nADC was 0.939 and 0.965 when using ADCmin. The optimal ADCmin threshold was 0.66 times 10−3 mm2/s, which yielded an 86% positive predictive value, 97% negative predictive value, and 93% accuracy. Interobserver variability was very low, with near perfect agreement among all observers in predicting medulloblastoma. Our data indicate that both ADCmin and nADC could serve as the basis for a CAD program to distinguish medulloblastoma from other posterior fossa tumors with a high degree of accuracy.
New classes of spatial central configurations for the 7-body problem
Authors: FERNANDES ANTONIO CARLOS , MELLO LUIS FERNANDO
Published: March 2014

In this paper we show the existence of new families of spatial central configurations for the 7-body problem. In the studied spatial central configurations, six bodies are at the vertices of two equilateral triangles , and one body is located out of the parallel distinct planes containing and . The results have simple and analytic proofs.
A new Xenacanthiformes shark (Chondrichthyes, Elasmobranchii) from the Late Paleozoic Rio do Rasto Formation (Paraná Basin), Southern Brazil
Authors: PAULIV VICTOR E. , DIAS ELISEU V. , SEDOR FERNANDO A. , RIBEIRO ANA MARIA
Published: March 2014

The Brazilian records on Xenacanthiformes include teeth and cephalic spines from the Parnaíba, Amazonas and Paraná basins. This work describes a new species of Xenacanthidae, collected in an outcrop of Serrinha Member of Rio do Rasto Formation (Wordian to Wuchiapingian), Paraná Basin, municipality of Jacarezinho, State of Paraná. The teeth of the new species are two or three-cuspidated and the aboral surface show a smooth concavity and one rounded basal tubercle. The coronal surface presents one semi-spherical and subcircular coronal button, and also two lateral main cusps and one central (when present) with less than one fifth of the size of the lateral cusps in the labial portion. The lateral cusps are asymmetric or symmetric, rounded in transversal section, lanceolate in longitudinal section, devoid of lateral carinae and lateral serrations, and with few smooth cristae of enameloid. In optical microscope the teeth show a trabecular dentine (osteodentine) base, while the cusps are composed by orthodentine, and the pulp cavities are non-obliterated by trabecular dentine. The fossil assemblage in the same stratigraphical level and in the whole Rio do Rasto Formation indicates another freshwater record for xenacanthid sharks.
Patterns of Antimicrobial therapy in acute tonsillitis: A cross-sectional Hospital-based study from UAE
Authors: JOHN LISHA J. , CHERIAN MEENU , SREEDHARAN JAYADEVAN , CHERIAN TAMBI
Published: March 2014

Background: Diseases of the ear, nose and throat (ENT) are associated with significant impairment of the daily life and a major cause for absenteeism from work. Aim: The study determined antimicrobial prescription pattern in patients with acute tonsillitis. Materials and Methods: A cross-sectional study was carried out among all the patients attending the ENT department with acute tonsillitis. Data were retrieved from the medical records using a proforma. Statistical analysis was carried out using SPSS.19. Results: Total of 238 patients included (Males 138; females 100). About 96% of total drugs were prescribed by generic name. Median number of drugs prescribed was four (range 1-7). Eighty eight percent of prescriptions contained antimicrobials, (78.5%) analgesics and (57.9%) antipyretics. Amoxicillin / Clavulanic acid (24.8%) and Ceftriaxone (12.2%) were the most commonly prescribed antimicrobials. Parenteral route was preferred in 41.6%. About 23.7% of the patients on Amoxicillin / Clavulanic acid had received the drug as intravenous injection. Culture and sensitivity tests were carried out in 106 (44.5%) of the cases. Antimicrobials were changed / added after the culture and sensitivity test in 25 patients. Conclusion: Study findings highlighted rational practices in drug prescribing. Therapeutic guidelines based on current sensitivity pattern optimize the use of antimicrobial agents.
Atmospheric particle dry deposition of major ions to the South Atlantic coastal area observed at Baía de Todos os Santos, Brazil
Authors: MKOMA STELYUS L. , ROCHA GISELE O. DA , DOMINGOS JOSÉ S.S. , SANTOS JOÃO V.S. , CARDOSO MANUELA P. , SILVA ROGERIO L. DA , ANDRADE JAILSON B. DE
Published: March 2014

The coastal atmosphere adjacent to large urban areas can be strongly affected by the emission of air pollutants, among them, major ions species. In this study, the chemical composition and sources of carboxylates and other water-soluble ions in fine and coarse aerosols as well as estimates of particle dry deposition fluxes were studied at a tropical coastal site affected by an urban environment. The mean concentrations of the total carboxylates were 78 ng m–3 in fine fraction and 81 ng m–3 in coarse fraction of particulate matter (PM). The corresponding values for the total inorganic ions were 2143 ng m–3 and 4880 ng m–3 respectively. Main sources for fine particles were: (i) photochemical formation of carboxylic acids in vapor phase and a posterior gas-to-particle conversion onto sea salt particles; (ii) emissions from anthropic sources with long range transportation processes; and (iii) the interchanging of volatile species among atmospheric phases. In turn, for coarse particles, the predominant sources were: (i) gas-phase species and ab/adsorbed onto pre-existing particles afterwards; (ii) primary emission of coarse particles from anthropogenic sources; and (iii) sea salt spray and/or soil resuspension. Finally, particle dry deposition was a very important mechanism representing air-to-sea fluxes of major species.
Ovarian Leydig cell tumor in a post-menopausal patient with severe hyperandrogenism
Authors: Souto Selma B. , Baptista Pedro V. , Braga Daniel C. , Carvalho Davide
Published: March 2014

Leydig cell tumors are rare ovarian steroid cell neoplasms. More than 75% of patients show signs of virilization due to overproduction of testosterone. We report a case of an 8-year-old woman with progressive signs of virilization, and presenting vaginal bleeding. Clinical analyses revealed high levels of serum testosterone, delta 4-androstenedione and estradiol, and also inappropriate low levels of gonadotrophins for a post-menopausal woman. Transvaginal ultrasound showed no evidence of ovarian tumor, but pelvic and abdominal computerized axial tomography imaging revealed a left ovarian solid nodule, and no evidence of alteration in the adrenal glands. Total hysterectomy and bilateral salpingoophorectomy were performed. Histopathology and immunohistochemistry confirmed the diagnosis of Leydig cell tumor. After surgery, androgen levels returned to normal, and there was regression of the signs of virilization.
Evaluation of effectiveness and outcome of PKU screening and management in the State of Sergipe, Brazil
Authors: Ramalho Antônio R. O. , Ramalho Roberto J. R. , Oliveira Carla R. P. , Magalhães Marta M. G. S. , Santos Elenilde G. , Sarmento Polyana M. P. , Matos Diana O. , Oliveira Mario C. P. , Oliveira André L. P. , Aguiar-Oliveira Manuel H.
Published: March 2014

Objectives: Phenylketonuria (PKU) was the first inherited metabolic disease known to cause mental retardation for which a newborn screening program (NBS) was developed. The objective of this study was to evaluate the effectiveness of PKU NBS and the management of cases in the northeastern Brazilian state of Sergipe (SE).Materials and methods: We reviewed the phenylalanine concentrations in filter-paper collected from the heel (PKUneo) of 43,449 newborns; blood concentrations obtained by venipuncture in the subjects with abnormal PKUneo; the children’s age at several phases of the program, the incidence of the disease from January 2007 to June 2008; and metabolic control of the patients.Results: The coverage of NBS/SE was 78.93%. The children’s age was 10 ± 7 days at PKUneo collection. Twelve children were recalled based on the PKUneo cutoff value at 28 ± 13 days. From these, the concentrations of phenylalanine collected by venipuncture were normal in five children. The incidence of hyperphenylalaninemia was 1/43,449, and of PKU was 1/8,690 (5 cases). One suspected subject died. Another death occurred in the cohort, in a confirmed PKU case. PKU treatment began within 51 ± 12 days of life. In the four patients under dietary phenylalanine restriction, metabolic control was often difficult.Conclusions: PKU NBS/SE has satisfactory coverage and adequate cutoff for recalling patients and diagnosis, but the onset of treatment is delayed, and follow-up metabolic control is frequently inadequate.
Challenges and pitfalls in the diagnosis of hyperprolactinemia
Authors: Vilar Lucio , Fleseriu Maria , Bronstein Marcello D.
Published: March 2014

The definition of the etiology of hyperprolactinemia often represents a great challenge and an accurate diagnosis is paramount before treatment. Although prolactin levels > 200-250 ng/mL are highly suggestive of prolactinomas, they can occasionally be found in other conditions. Moreover, as much as 25% of patients with microprolactinomas may present prolactin levels < 100 ng/mL, which are found in most patients with pseudoprolactinomas, drug-induced hyperprolactinemia, or systemic diseases. On the other hand, some conditions may lead to falsely low PRL levels, particularly the so-called hook effect, that is an assay artifact caused by an extremely high level of PRL, and can be confirmed by repeating assay after a 1:100 serum sample dilution. The hook effect must be considered in all patients with large pituitary adenomas and PRL levels within the normal range or only modestly elevated (e.g., < 200 ng/mL). An overlooked hook effect may lead to incorrect diagnosis and unnecessary surgical intervention in patients with prolactinomas. Another important challenge is macroprolactinemia, a common finding that needs to be identified, as it usually requires no treatment. Although most macroprolactinemic patients are asymptomatic, many of them may present galactorrhea or menstrual disorders, as well as neuroradiological abnormalities, due to the concomitance of other diseases. Finally, physicians should be aware that pituitary incidentalomas are found in at least 10% of adult population. Arq Bras Endocrinol Metab. 2014;58(1):9-22
The prevalence of multiple sclerosis in Santa Maria, Rio Grande do Sul, Brazil
Authors: Finkelsztejn Alessandro , Lopes Juarez Silva , Noal Janaína , Finkelsztejn Juliana M.
Published: March 2014

Multiple sclerosis (MS) is one of the leading causes of neurologic deficits in young adults and can lead to physical, intellectual and emotional problems. Approved treatments are expensive and are among the 10 highest budgets of the Brazilian Health Ministry. Given the diverse prevalence of MS among Brazilian regions, it is important to determine prevalence rates across the country. Seven studies have assessed MS in Brazil and reported rates ranging from 15 cases to 18 cases per 100,000 inhabitants. It has been hypothesized that this rate is even higher in southern Brazil, which has a high proportion of European heritage (mostly German and Italian) immigrants. Here, we report that the prevalence of MS in the city of Santa Maria, Rio Grande do Sul, Brazil, is 27.2 cases/100,000 inhabitants.
Equidade no acesso ao rastreamento mamográfico do câncer de mama com intervenção de mamógrafo móvel no sul do Rio Grande do Sul, Brasil
Authors: Renck Décio Valente , Barros Fernando , Domingues Marlos Rodrigues , Gonzalez Maria Cristina , Sclowitz Marcelo Leal , Caputo Eduardo Lucia , Gomes Laura de Moraes
Published: March 2014

O objetivo foi avaliar um programa de prevenção e diagnóstico precoce de câncer de mama, realizado com uma unidade móvel de mamografia que visitou municípios da região sul do Rio Grande do Sul, Brasil, onde não havia um aparelho de mamografia disponível. As características das mulheres avaliadas pelo mamomóvel foram comparadas com as de mulheres encaminhadas para exame mamográfico na cidade de Pelotas. Com a unidade móvel foram examinadas 8.607 mulheres residentes em 33 municípios da zona sul, e foram identificados 37 casos de câncer de mama (4,7 casos por mil exames realizados). Em Pelotas, foram examinadas 1.312 pacientes, e a prevalência de câncer de mama foi de 6,9 casos por mil exames. A prevalência de casos positivos foi estatisticamente semelhante nos dois grupos, mesmo após o ajuste para possíveis fatores de confusão. A intervenção proposta demonstra que a disponibilização de exames é necessária na prevenção e diagnóstico precoce do câncer de mama, determinando a identificação de casos cujos diagnósticos teriam sido retardados se esta unidade não estivesse presente.
Qualidade da dieta de adolescentes e fatores associados
Authors: Wendpap Loiva Lide , Ferreira Márcia Gonçalves , Rodrigues Paulo Rogério Melo , Pereira Rosangela Alves , Loureiro Anarlete da Silva , Gonçalves-Silva Regina Maria Veras
Published: March 2014

Analisar a qualidade da dieta de adolescentes pelo Índice de Qualidade da Dieta Revisado (IQD-R) e os fatores associados. Foi realizado estudo transversal com 1.326 adolescentes de escolas públicas e privadas. O consumo alimentar foi obtido utilizando-se questionário de frequência alimentar. Utilizou-se razão de prevalência para avaliar a associação entre o IQD-R elevado (≥ percentil 75) e as variáveis independentes. Variáveis com valor de p <0,20 foram incluídas na regressão de Poisson. A média do IQD-R foi de 75,1 pontos (IC95%: 74,8-75,5). Tempo ≤ 2 horas diárias gasto em atividades sedentárias como assistir televisão, usar computador ou games; tempo ≥ 300 minutos por semana de atividade física e excesso de peso dos adolescentes foram associados a maiores pontuações do IQD-R. Estilo de vida saudável foi associado à dieta de melhor qualidade. Destaca-se a importância do incentivo à prática de atividade física, redução do número de horas diárias em atividades sedentárias e intervenção na prática alimentar dos adolescentes.
Não adesão ao tratamento medicamentoso contínuo: prevalência e determinantes em adultos de 40 anos e mais
Authors: Remondi Felipe Assan , Cabrera Marcos Aparecido Sarria , Souza Regina Kazue Tanno de
Published: March 2014

O presente estudo investiga os fatores associados a não adesão à terapia medicamentosa contínua em indivíduos de 40 anos e mais de idade. Foi realizado um inquérito de base populacional em Cambé, Paraná, Brasil. A adesão à terapia foi avaliada pela escala de quatro itens de Morisky et al. e analisaram-se também variáveis sociodemográficas, de utilização dos serviços de saúde e do uso de medicamentos. Foram entrevistados 1.180 indivíduos, dos quais 78% utilizaram medicamentos nos 15 dias anteriores à entrevista e em 55% registrou-se o uso contínuo. A amostra do estudo consistiu em 639 indivíduos, com predominância do sexo feminino, idade entre 40 e 59 anos, baixa escolaridade. A prevalência de não adesão foi de 63,5%. Após análise ajustada, permaneceram associados a não adesão: não ser acompanhado pelo agente comunitário de saúde, ter tido descontinuidade no acesso aos medicamentos e a elevada frequência de utilização dos medicamentos ao longo do dia. Os resultados indicam uma alta prevalência da não adesão com possíveis impactos negativos para os indivíduos e para a sociedade.
Conversas sobre formarfazer a nutrição: as vivências e percursos da Liga de Segurança Alimentar e Nutricional
Authors: Schneider Olívia Maria Ferreira , Neves Alden dos Santos
Published: March 2014

O presente artigo narra a trajetória da Liga Acadêmica de Segurança Alimentar e Nutricional (LASAN). Iniciativa pioneira de vivências práticas e discussões aprofundadas no tema segurança alimentar e nutricional. Surgiu como resposta aos desafios propostos em sala de aula sobre os modos de fazer a nutrição incluindo a responsabilidade da promoção do Direito Humano à Alimentação Adequada. Esta narrativa aborda a rede de temas sobre formação em nutrição e segurança alimentar e nutricional. Referencia-se nos conhecimentos de autores que debatem a formação e a educação crítica como prática social. A trajetória da LASAN aponta para caminhos renovados onde se podem transformar em ação os saberes relevantes em SAN, assim como experimentar renovadas formas de aprenderensinar Nutrição.