bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantity and quality of retrograde menstruation: a case control study
Authors: Bokor Attila , Debrock Sophie , Drijkoningen Maria , Goossens Willy , Fülöp Vilmos , D'Hooghe Thomas
Published: October 2009

Background

The purpose of this study was to test the hypothesis that menstruation is associated with a higher concentration of endometrial cells in peritoneal fluid(PF) and with increased white and red blood cell concentration in PF when compared to nonmenstrual phases of the cycle.

Methods

PF was obtained at laparoscopy from 107 women with endometriosis (n = 59) and controls with a normal pelvis (n = 48) during the luteal (n = 46), follicular (n = 38) or menstrual (n = 23) phase of the cycle. Endometriosis was classified according to the classification of the American Society for Reproductive Medicine (rAFS into minimal (n = 25), mild(n = 20), moderate(n = 6) and severe(n = 8) disease. Cell counts (leucocytes, erythrocytes, thrombocytes) were determined on a cell counter. In a subset of 32 patients (13 controls and 19 women with endometriosis), PF was fixed, processed and thinlayers were prepared and stained with Papanicolaou method and with immunocytochemistry using monoclonal antibodies against cytokeratin 7(CK 7), CK 8/18, Ber-Ep4, vimentin, calretinin and CD68. Ber-Ep4 is a marker for cells with epithelial origin (in some cases for mesothelial cells as well). CD68 is specific for cells from monocyte/macrophage lineage; CK7 and CK8/18 are markers for both endometrial epithelial and mesothelial cells, whereas calretinin and vimentin are markers for both endometrial stromal and mesothelial cells.

Results

In comparison with the nonmenstrual phase of the cycle, analysis of PF during menstruation showed an increased concentration of leucocytes (3.3 × 109/L vs 0.8 × 109/L, P = 0.03), erythrocytes (0.3 × 1012/L vs 0.02 × 1012/L, P = 0.006), hematocrit (0.03 L/L vs 0.003 L/L, P = 0.01) and hemoglobin (0.8 g/dL vs 0.1 g/dL, P = 0.01). Mesothelial cells stained positively with CK7, CK8/18, vimentin, and calretinin. Cells positive for Ber-Ep4 were not observed, except in 2 patients with endometriosis investigated during menses. In all patients 50-98% of single cells were strongly positive for both vimentin and CD68.

Conclusion

When compared to nonmenstrual phases of the cycle, menstruation is associated with an increased concentration of red and white blood cells in PF. However, the presence of EM cells that are detectable by immunohistochemistry in PF is low during all phases of the cycle, including menstruation.
The effect of provider- and workflow-focused strategies for guideline implementation on provider acceptance
Authors: Flanagan Mindy E , Ramanujam Rangaraj , Doebbeling Bradley N
Published: October 2009

Background

The effective implementation of clinical practice guidelines (CPGs) depends critically on the extent to which the strategies that are deployed for implementing the guidelines promote provider acceptance of CPGs. Such implementation strategies can be classified into two types based on whether they primarily target providers (e.g., academic detailing, grand rounds presentations) or the work context (e.g., computer reminders, modifications to forms). This study investigated the independent and joint effects of these two types of implementation strategies on provider acceptance of CPGs.

Methods

Surveys were mailed to a national sample of providers (primary care physicians, physician assistants, nurses, and nurse practitioners) and quality managers selected from Veterans Affairs Medical Centers (VAMCs). A total of 2,438 providers and 242 quality managers from 123 VAMCs participated. Survey items measured implementation strategies and provider acceptance (e.g., guideline-related knowledge, attitudes, and adherence) for three sets of CPGs--chronic obstructive pulmonary disease, chronic heart failure, and major depressive disorder. The relationships between implementation strategy types and provider acceptance were tested using multi-level analytic models.

Results

For all three CPGs, provider acceptance increased with the number of implementation strategies of either type. Moreover, the number of workflow-focused strategies compensated (contributing more strongly to provider acceptance) when few provider-focused strategies were used.

Conclusion

Provider acceptance of CPGs depends on the type of implementation strategies used. Implementation effectiveness can be improved by using both workflow-focused as well as provider-focused strategies.
Can foot anthropometric measurements predict dynamic plantar surface contact area?
Authors: McPoil Thomas G , Vicenzino Bill , Cornwall Mark W , Collins Natalie
Published: October 2009

Background

Previous studies have suggested that increased plantar surface area, associated with pes planus, is a risk factor for the development of lower extremity overuse injuries. The intent of this study was to determine if a single or combination of foot anthropometric measures could be used to predict plantar surface area.

Methods

Six foot measurements were collected on 155 subjects (97 females, 58 males, mean age 24.5 ± 3.5 years). The measurements as well as one ratio were entered into a stepwise regression analysis to determine the optimal set of measurements associated with total plantar contact area either including or excluding the toe region. The predicted values were used to calculate plantar surface area and were compared to the actual values obtained dynamically using a pressure sensor platform.

Results

A three variable model was found to describe the relationship between the foot measures/ratio and total plantar contact area (R2 = 0.77, p < 0.0001)). A three variable model was also found to describe the relationship between the foot measures/ratio and plantar contact area minus the toe region (R2 = 0.76, p < 0.0001).

Conclusion

The results of this study indicate that the clinician can use a combination of simple, reliable, and time efficient foot anthropometric measurements to explain over 75% of the plantar surface contact area, either including or excluding the toe region.
Endovascular stenting of traumatic extracranial carotid artery dissections in the pediatric population: a case report
Authors: Chern Joshua J , Chamoun Roukoz B , Mawad Michel E , Whitehead William E , Curry Daniel J , Luerssen Thomas G , Jea Andrew
Published: October 2009

Background

Traumatic extracranial carotid artery injuries are rare in children. Treatment options include surgery, anticoagulation therapy and endovascular treatment. There have been only limited reports in the literature documenting endovascular carotid stent placement in the pediatric population. In these reports, stent deployment was utilized in the setting of pseudoaneurysm formation.

Case report

Here we report a case of endovascular carotid stenting for traumatic carotid dissection in a 15 year-old boy. An uncovered bare self-expanding stent was used to treat progressive high-grade stenosis in the early post-injury period.

Conclusion

At 6 months post-procedure, complete healing of the carotid artery was demonstrated on follow-up angiogram.
Changes in serum creatinine in the first 24 hours after cardiac arrest indicate prognosis: an observational cohort study
Authors: Hasper Dietrich , von Haehling Stephan , Storm Christian , Jörres Achim , Schefold Joerg C
Published: October 2009

Introduction

As patients after cardiac arrest suffer from the consequences of global ischemia reperfusion, we aimed to establish the incidence of acute kidney injury (AKI) in these patients, and to investigate its possible association to severe hypoxic brain damage.

Methods

One hundred and seventy-one patients (135 male, mean age 61.6 +/- 15.0 years) after cardiac arrest were included in an observational cohort study. Serum creatinine was determined at admission and 24, 48 and 72 hours thereafter. Serum levels of neuron-specific enolase (NSE) were measured 72 hours after admission as a marker of hypoxic brain damage. Clinical outcome was assessed at intensive care unit (ICU) discharge using the Pittsburgh cerebral performance category (CPC).

Results

AKI as defined by AKI Network criteria occurred in 49% of the study patients. Patients with an unfavourable prognosis (CPC 3-5) were affected significantly more frequently (P = 0.013). Whilst serum creatinine levels decreased in patients with good neurological outcome (CPC 1 or 2) over the ensuing 48 hours, it increased in patients with unfavourable outcome (CPC 3-5). ROC analysis identified DeltaCrea24 <-0.19 mg/dl as the value for prediction with the highest accuracy. The odds ratio for an unfavourable outcome was 3.81 (95% CI 1.98-7.33, P = 0.0001) in cases of unchanged or increased creatinine levels after 24 hours compared to those whose creatinine levels decreased during the first 24 hours. NSE levels were found to correlate with the change in serum creatinine in the first 24 hours both in simple and multivariate regression (both r = 0.24, P = 0.002).

Conclusions

In this large cohort of patient after cardiac arrest, we found that AKI occurs in nearly 50% of patients when the new criteria are applied. Patients with unfavourable neurological outcome are affected more frequently. A significant association between the development of AKI and NSE levels indicating hypoxic brain damage was observed. Our data show that changes in serum creatinine may contribute to the prediction of outcome in patients with cardiac arrest. Whereas a decline in serum creatinine (> 0.2 mg/dL) in the first 24 hours after cardiac arrest indicates good prognosis, the risk of unfavourable outcome is markedly elevated in patients with constant or increasing serum creatinine.
A retrospective cohort pilot study to evaluate a triage tool for use in a pandemic
Authors: Christian Michael D , Hamielec Cindy , Lazar Neil M , Wax Randy S , Griffith Lauren , Herridge Margaret S , Lee David , Cook Deborah J
Published: October 2009

Introduction

The objective of this pilot study was to assess the usability of the draft Ontario triage protocol, to estimate its potential impact on patient outcomes, and ability to increase resource availability based on a retrospective cohort of critically ill patients cared for during a non-pandemic period.

Methods

Triage officers applied the protocol prospectively to 2 retrospective cohorts of patients admitted to 2 academic medical/surgical ICUs during an 8 week period of peak occupancy. Each patient was assigned a treatment priority (red -- 'highest', yellow -- 'intermediate', green -- 'discharge to ward', or blue/black -- 'expectant') by the triage officers at 3 separate time points (at the time of admission to the ICU, 48, and 120 hours post admission).

Results

Overall, triage officers were either confident or very confident in 68.4% of their scores; arbitration was required in 54.9% of cases. Application of the triage protocol would potentially decrease the number of required ventilator days by 49.3% (568 days) and decrease the total ICU days by 52.6% (895 days). On the triage protocol at ICU admission the survival rate in the red (93.7%) and yellow (62.5%) categories were significantly higher then that of the blue category (24.6%) with associated P values of < 0.0001 and 0.0003 respectively. Further, the survival rate of the red group was significantly higher than the overall survival rate of 70.9% observed in the cohort (P < 0.0001). At 48 and 120 hours, survival rates in the blue group increased but remained lower then the red or yellow groups.

Conclusions

Refinement of the triage protocol and implementation is required prior to future study, including improved training of triage officers, and protocol modification to minimize the exclusion from critical care of patients who may in fact benefit. However, our results suggest that the triage protocol can help to direct resources to patients who are most likely to benefit, and help to decrease the demands on critical care resources, thereby making available more resources to treat other critically ill patients.
Immune system dysregulation during spaceflight: clinical risk for exploration-class missions
Authors: Crucian Brian , Sams Clarence
Published: October 2009

Commentary on review by Gueguinou et al. on immune barriers and clinical risks to humans during prolonged, exploration-class space missions.
Puerperal psychosis: identifying and caring for women at risk
Authors: Jones Ian , Smith Sue
Published: October 2009

Puerperal (postpartum) psychosis – the acute onset of a manic or psychotic episode shortly after childbirth – most commonly occurs in women with a bipolar disorder diathesis who have a vulnerability to a specific childbirth-related trigger. Women with bipolar disorder are at particularly high risk of puerperal psychosis, with a severe affective episode following between 25 and 50% of deliveries. Suicide is a leading cause of maternal death in the UK and it is clear that we must do more to identify and better manage women at high risk of illness related to childbirth. The clinical picture of puerperal psychosis can vary dramatically from hour to hour and can escalate quickly to a true psychiatric emergency. It is vital that clinical services identify women who are unwell and can respond quickly to the severity of illness, delivering treatment in the most appropriate setting for the mother and her baby.
Interpersonal dynamics and multidisciplinary teamwork
Authors: Reiss David , Kirtchuk Gabriel
Published: October 2009

Analysing interpersonal dynamics is an approach through which the multidisciplinary team can develop a shared understanding of their patients. This empirically based method provides an insight into repeated patterns of dysfunctional behaviour, which not only have been evident in the past, but are currently having an impact on the patient's relationships with caring staff. The technique is accessible to any team member with only minimal training required. It provides the team with a coherent map of the patient's relationship patterns that underpins the formulation of an effective strategy for care. The multidisciplinary team is then able to work towards shared goals, supporting all members in their provision of effective interventions within the full range of therapeutic modalities. The approach promotes positive staff–patient interactions and provides an additional dimension to the assessment and management of risk.
Understanding community care law in England and Wales
Authors: Allen Danny
Published: October 2009

Although psychiatrists in England and Wales are generally familiar with the Mental Health Act 1983 and the Mental Capacity Act 2005, there is a body of law that is available to assist patients in the community with which they are generally less familiar. There are two main reasons for this. The first is that it is a rather confused amalgam of different statutes and case law affecting each other in ways that are less than clear. The other is that the care programme approach (CPA) was meant to cut through all this and make care provision straightforward. In fact, the latter has never been the case and community care law has always sat uneasily alongside the CPA, but in October 2008 the CPA was withdrawn from some patients with mental health problems. This article explains what is meant by community care law and how psychiatrists can use it to help their patients.
Atypical Progeroid Syndrome due to Heterozygous Missense LMNA Mutations
Authors: Garg Abhimanyu , Subramanyam Lalitha , Agarwal Anil K. , Simha Vinaya , Levine Benjamin , D'Apice Maria Rosaria , Novelli Giuseppe , Crow Yanick
Published: October 2009

Context: Hutchinson-Gilford progeria syndrome (HGPS) and mandibuloacral dysplasia are well-recognized allelic autosomal dominant and recessive progeroid disorders, respectively, due to mutations in lamin A/C (LMNA) gene. Heterozygous LMNA mutations have also been reported in a small number of patients with a less well-characterized atypical progeroid syndrome (APS).

Objective: The objective of the study was to investigate the underlying genetic and molecular basis of the phenotype of patients presenting with APS.

Results: We report 11 patients with APS from nine families, many with novel heterozygous missense LMNA mutations, such as, P4R, E111K, D136H, E159K, and C588R. These and previously reported patients now reveal a spectrum of clinical features including progeroid manifestations such as short stature, beaked nose, premature graying, partial alopecia, high-pitched voice, skin atrophy over the hands and feet, partial and generalized lipodystrophy with metabolic complications, and skeletal anomalies such as mandibular hypoplasia and mild acroosteolysis. Skin fibroblasts from these patients when assessed for lamin A/C expression using epifluorescence microscopy revealed variable nuclear morphological abnormalities similar to those observed in patients with HGPS. However, these nuclear abnormalities in APS patients could not be rescued with 48 h treatment with farnesyl transferase inhibitors, geranylgeranyl transferase inhibitors or trichostatin-A, a histone deacetylase inhibitor. Immunoblots of cell lysates from fibroblasts did not reveal prelamin A accumulation in any of these patients.

Conclusions: APS patients have a few overlapping but some distinct clinical features as compared with HGPS and mandibuloacral dysplasia. The pathogenesis of clinical manifestations in APS patients seems not to be related to accumulation of mutant farnesylated prelamin A.
Particulate organic matter as a food source for a coral reef sponge
Authors: Hadas E. , Shpigel M. , Ilan M.
Published: October 2009

The ability of sponges to feed in diverse (including oligotrophic)ecosystems significantly contributes to their ubiquitous aquatic distribution. It was hypothesized that sponges that harbour small amounts of symbiotic bacteria in their mass feed mainly on particulate organic matter (POM). We examined the nearly symbiont-free (by microscopic observation) filter-feeding Red Sea sponge Negombata magnifica in order to: (a) study removal efficiency of naturally occurring organic particles, (b) measure the total amount of absorbed particulate organic carbon (POC) and nitrogen (PON), and(c) estimate organic carbon and nitrogen flux in this sponge. Total amount of organic carbon and nitrogen in the Gulf of Aqaba was found to be 48.46±5.69 μg l–1 and 6.45±0.7 μg l–1, respectively. While detritus contributed 54% of POC,most PON (84%) came from planktonic microorganisms, mainly prokaryotes. Particle removal efficiency ranged from 99% (the cyanobacterium Synechococcus sp.) to 37% (for eukaryotic cells >8 μm). On average, N. magnifica ingested 480 μg C day–1g–1 (wet mass, WM) sponge and 76.6 μg N day–1 g–1 sponge. Ingested POC balanced 85%of the sponge's energetic demand but more is needed for biomass production because it cannot digest all of the carbon. 54.4±16.1 μg N day–1 g–1 (WM) nitrogen was excreted as total ammonia nitrogen (TAN); however, nitrogen allowance should be higher because more nitrogen is deposited for sponge biomass during growth. It is hypothesized that the discrepancy in the nutritional requirements should be covered by the sponge absorbing carbon and nitrogen from sources that are not dealt with in the present research, such as dissolved organic carbon and nitrogen. This study highlights the significance of detritus as a carbon source, and prokaryotes as a PON source in sponge feeding.
The effects of trapping and blade angle of notched dentitions on fracture of biological tissues
Authors: Anderson Philip S. L.
Published: October 2009

The material properties of food can exert a significant influence on tooth morphology. Although the stiffness or toughness of a material is usually of prime concern, other aspects of material properties (such as extensibility)can be of equal importance. Previous experimental work on the effect blade shape has on fracturing biological materials indicated a notched blade greatly reduced the work required to cut tough tissue. As a notched blade both traps materials and cuts at an angle, it is not clear which of these features leads to increased cutting efficiency. This paper tests whether the ability to cut at an angle or trap the material has the greater effect on the work to fracture required to cut tough tissues with different levels of extensibility(asparagus and fish muscle). Results show that the work to fracture required to cut more extensible materials is reduced by up to 50% when a trapping mechanism alone is used in comparison with an angled blade alone. For less extensible materials, the trapping ability of a notch seems to have no effect,whereas the angled blade reduces work to fracture by up to 25% relative to a straight blade. The aspects of blade shape most important to the breaking down of foods depend upon the relative stiffness or toughness, as well as other material properties.
Stress hormones and the fitness consequences associated with the transition to a novel diet in larval amphibians
Authors: Ledón-Rettig Cris C. , Pfennig David W. , Crespi Erica J.
Published: October 2009

Closely related species often specialize on different types of prey, but little is known about the fitness consequences of making an evolutionary transition to a novel diet. Spadefoot toad larvae provide a unique opportunity to reconstruct these evolutionary events. Although most anuran larvae feed on detritus or plankton, Spea larvae have also evolved the ability to consume large anostracan fairy shrimp. To investigate the changes that may have accompanied the shift to shrimp prey, we compared shrimp-induced physiological responses of Spea larvae with those of its sister genus, Scaphiopus, that has not made this transition. Although Spea larvae performed equally well on either diet, shrimp-fed Scaphiopus larvae experienced reduced growth and developmental rates,as well as elevated levels of the stress hormone corticosterone when compared with those that ate the ancestral detritus diet. These results suggest that ancestral Spea likely experienced reduced fitness when they first adopted a carnivorous feeding strategy.
Concentrated and linked epidemics of both HSV-2 and HIV-1/HIV-2 infections in Senegal: public health impacts of the spread of HIV
Authors: Kane C Toure , Diawara S , Ndiaye H D , Diallo P A N , Wade A S , Diallo A G , Belec L , Mboup S
Published: October 2009

The objective of this article is to report seroprevalences on HIV and herpes simplex virus 2 (HSV-2) in female sex workers (FSW) and in two sentinel populations of pregnant women living in Senegal. Serosurveys of HIV and HSV-2 were conducted in two unselected sentinel populations from Dakar, Senegal, and its provinces, including in 2003 only pregnant women and 2006 pregnant women and FSW. The population study involved 888 pregnant women and 604 FSW.

In pregnant women, HIV and HSV-2 seroprevalences were, respectively, 1.01% and 15.65%. There was no association between HSV-2 and HIV infection, whatever the age. In contrast, the seroprevalence of HIV infection in the group of FSW was high, reaching 22.9% in women over 30 years old. FSW above 20 years of age harboured much higher HSV-2 seroprevalences that those found in pregnant women of similar age groups. In FSW, strong associations between HSV-2 and age, and among HSV-2 and HIV-1 as well HIV-2, were evidenced. In conclusion, HIV epidemic remains concentrated in high-risk groups of the Senegalese population, such as the FSW population in which the seroprevalence of HSV-2 infection is very high. Intervention against STI including HSV-2 is urgently needed to prevent the spreading of HIV epidemic.
Local Anaesthetic Inguinal Hernia Repair Performed Under Supervision: Early and Long-Term Outcomes
Authors: Sanjay P , Woodward A
Published: October 2009

INTRODUCTION

Local anaesthetic inguinal hernia repair may be technically demanding. There are minimal data regarding the outcomes of local anaesthetic hernia repair by trainees in comparison with consultants.

PATIENTS AND METHODS

All consecutive local anaesthetic repairs performed by trainees and one consultant over a 9-year period were reviewed. Operation time, volume of local anaesthetic used, early and long-term complications were assessed. A postal survey was conducted to assess chronic groin pain and satisfaction rates.

RESULTS

A total of 369 repairs were reviewed of which 265 repairs were performed by the consultant and 104 by trainees. The male-to-female ratio was 25:1 and the median age of the study group was 61 years (range, 18–93 years). The volume of local anaesthetic used was significantly higher for trainees than the consultant (42 ml versus 69 ml; P = 0.03). The operative time for the consultant and the trainees was 35 min and 40 min (P = 0.8). The day-case rate was higher for the consultant than the trainees (84% versus 69%; P = 0.02). Three patients operated by trainees required conversion to a general anaesthetic repair. No difference was noted in chronic groin pain (consultant 28% versus trainees 32%; P = 0.52) on the postal survey. The median follow-up was 5 years (range, 2–7 years).

CONCLUSIONS

Local anaesthetic inguinal hernia repair can be performed safely by surgical trainees under consultant supervision with minimal short- and long-term morbidity. A large volume dilute solution of Lignocaine and Marcaine is recommended when hernia repair is undertaken by trainees.
The Central Urology Multidisciplinary Team – Is it Time to Change the Referral Criteria? An Audit of Practice in a District General Hospital in London
Authors: Sooriakumaran Prasanna , Dick John A , Thompson Alan C , Morley Roland
Published: October 2009

INTRODUCTION

All cancer patients are discussed in multidisciplinary team meetings (MDTs). Certain patients are referred to the Central MDT based on specific national criteria. We wanted to see whether the Central MDT aided in the decision-making process above that of the Local MDT alone.

PATIENTS AND METHODS

All MDT forms (local and central) for 2007 were retrospectively reviewed.

RESULTS

A total of 217 patients were reviewed at the Local MDT. Of these 217 cases, 102 (47.0%) cases were referred to the Central MDT and 15 of the 102 (14.7%) cases were awaiting investigations at the time of the Local MDT and were, therefore, excluded. For the prostate cancer cases (n = 67), the Central MDT did not change outright the Local MDT decision in any case, but in 6 of 67 (9.0%), advised/excluded patients from clinical trials. For bladder cancer cases (n = 19), 4 of 19 (21.0%) patients had their management changed by the Central MDT. The one kidney cancer case had its Local MDT decision changed by the Central MDT.

CONCLUSIONS

This audit suggests that the Central MDT plays a useful role in the decision-making process for bladder and kidney cancers, and helps determine eligibility for clinical trials in metastatic prostate cancer patients. Its value over the Local MDT alone in the decision-making process for non-metastatic prostate cancer is questionable.
Spontaneous implementation intentions and impulsivity: Can impulsivity moderate the effectiveness of planning strategies?
Authors: Churchill Sue , Jessop Donna
Published: October 2009

Objective. Self‐initiated plans relating to when, where, and how behaviour will be performed have been shown to be effective in promoting goal progress. The current study (N =256) explored whether any impact of self‐initiated implementation intentions on the avoidance of snacking was moderated by impulsivity.

Design and methods. The study employed a prospective design. At Time 1, participants reported the extent to which they had formed self‐initiated implementation intentions to avoid eating high‐calorie snacks. At Time 2, participants reported their snack consumption over the preceding 2 weeks and completed a measure of impulsivity.

Results. Impulsivity (urgency) moderated the effect of self‐initiated implementation intentions on snack consumption. Specifically, self‐initiated implementation intentions benefited the avoidance of snacking most for those low in impulsivity and least for those high in impulsivity.

Conclusion. The findings suggest that impulsivity might form an important boundary condition to the effectiveness of self‐initiated implementation intention formation in relation to snacking.
The Couples' Illness Communication Scale (CICS): Development and evaluation of a brief measure assessing illness‐related couple communication
Authors: Arden‐Close Emily , Moss‐Morris Rona , Dennison Laura , Bayne Louise , Gidron Yori
Published: October 2009

Objectives. When one member of a couple has a chronic illness, communication about the illness is important for both patient and partner well‐being. This study aimed to develop and test a brief self‐report measure of illness‐related couple communication.

Design. A combination of correlations and multiple regression were used to assess the internal consistency and validity of the Couples' Illness Communication Scale (CICS).

Methods. A scale to provide insight into both patient and partner illness communication was developed. The CICS was then tested on patients with ovarian cancer (N =123) and their partners (N =101), as well as patients with early stage multiple sclerosis (MS) who had stable partnerships (N =64).

Results. The CICS demonstrated good acceptability, internal consistency, convergent validity (correlations with general couple communication and marital adjustment), construct validity (correlations with intrusive thoughts, social/family well‐being, emotional impact of the illness, and psychological distress), and test–retest reliability.

Conclusions. The CICS meets the majority of psychometric criteria for assessment measures in both a life‐threatening illness (ovarian cancer) and a chronic progressive disease (MS). Further research is required to understand its suitability for use in other populations. Adoption of the CICS into couple‐related research will improve understanding of the role of illness‐related communication in adjustment to illness. Use of this short, simple tool in a clinical setting can provide a springboard for addressing difficulties with illness‐related couple communication and could aid decision making for referrals to couple counselling.
Liquid-phase hydrodechlorination of chlorobenzene by molecular hydrogen: The influence of reaction medium on process efficiency
Authors: Simagina Valentina I. , Tayban Elena S. , Grayfer Ekaterina D. , Gentsler Anna G. , Komova Oksana V. , Netskina Olga V.
Published: October 2009

Catalytic hydrodechlorination (HDCl) of chlorobenzene was carried out in a two-phase aqueous–organic solvent system and a single-phase solvent composed of saturated KOH solution in a secondary alcohol over Pd-based catalysts at 50 °C and atmospheric pressure of H2. It was shown that an aqueous–organic solvent system containing propan-2-ol and aqueous KOH increases catalyst activity by promoting mass transfer of the formed chloride ions to water phase that prevents catalyst deactivation. It is inferred that propan-2-ol favors hydrogen activation during the HDCl process. Use of the Pd catalysts based on hydrophobic carbon support enables chlorobenzene HDCl to proceed in a two-phase solvent at a satisfactory rate, even in the absence of phase-transfer catalysts.
Nanocatalysts based on dendrimers
Authors: Karakhanov Edward A. , Maximov Anton L. , Skorkin Vitaliy A. , Zolotukhina Anna V. , Smerdov Alexey S. , Tereshchenko Andrey Yu.
Published: October 2009

Nanostructured regular materials based on dendrimers bound by covalent or coordination bonds between surface functional groups were synthesized. Bimetallic Cu(II) and Pd(II) metal complexes with nitrile-based dendrimers demonstrated high activity in Wacker oxidation of terminal alkenes along with good selectivity for methylketone formation. New heterogeneous catalysts based on Pd nanoparticles and cross-linked polypropylene imine (PPI) and polyamidoamine (PAMAM) dendrimers were prepared and examined for selective hydrogenation of unsaturated compounds.
Bone microstructure at the distal tibia provides a strength advantage to males in late puberty: An HR-pQCT study
Authors: Burrows Melonie , Liu Danmei , Moore Sarah , McKay Heather
Published: October 2009

Bone is a complex structure with many levels of organization. Advanced imaging tools such as high-resolution (HR) peripheral quantitative computed tomography (pQCT) provide the opportunity to investigate how components of bone microstructure differ between the sexes and across developmental periods. The aim of this study was to quantify the age- and sex-related differences in bone microstructure and bone strength in adolescent males and females. We used HR-pQCT (XtremeCT, Scanco Medical, Geneva, Switzerland) to assess total bone area (ToA), total bone density (ToD), trabecular bone density (TrD), cortical bone density (CoD), cortical thickness (Cort.Th), trabecular bone volume (BV/TV), trabecular number (Tb.N), trabecular thickness (Tb.Th), trabecular separation (Tb.Sp), trabecular spacing standard deviation (Tb.Sp SD), and bone strength index (BSI, mg2/mm4) at the distal tibia in 133 females and 146 males (15 to 20 years of age). We used a general linear model to determine differences by age- and sex-group and age × sex interactions (p < 0.05). Across age categories, ToD, CoD, Cort.Th, and BSI were significantly lower at 15 and 16 years compared with 17 to 18 and 19 to 20 years in males and females. There were no differences in ToA, TrD, and BV/TV across age for either sex. Between sexes, males had significantly greater ToA, TrD, Cort.Th, BV/TV, Tb.N, and BSI compared with females; CoD and Tb.Sp SD were significantly greater for females in every age category. Males' larger and denser bones confer a bone-strength advantage from a young age compared with females. These structural differences could represent bones that are less able to withstand loads in compression in females. © 2010 American Society for Bone and Mineral Research
Capacity of omega-3 fatty acids or eicosapentaenoic acid to counteract weightlessness-induced bone loss by inhibiting NF-κB activation: From cells to bed rest to astronauts
Authors: Zwart Sara R , Pierson Duane , Mehta Satish , Gonda Steve , Smith Scott M
Published: October 2009

NF-κB is a transcriptional activator of many genes, including some that lead to muscle atrophy and bone resorption—significant concerns for astronauts. NF-κB activation is inhibited by eicosapentaenoic acid (EPA), but the influence of this omega-3 fatty acid on the effects of weightlessness are unknown. We report here cellular, ground analogue, and spaceflight findings. We investigated the effects of EPA on differentiation of RAW264.7 monocyte/macrophage cells induced by receptor activator of NF-κB ligand (RANKL) and on activation of NF-κB by tumor necrosis factor α (TNF-α) or exposure to modeled weightlessness. EPA (50 µM for 24 hours) inhibited RANKL-induced differentiation and decreased activation of NF-κB induced by 0.2 µg/mL of TNF-α for 30 minutes or by modeled weightlessness for 24 hours (p < .05). In human studies, we evaluated whether NF-κB activation was altered after short-duration spaceflight and determined the relationship between intake of omega-3 fatty acids and markers of bone resorption during bed rest and the relationship between fish intake and bone mineral density after long-duration spaceflight. NF-κB was elevated in crew members after short-duration spaceflight, and higher consumption of fish (a rich source of omega-3 fatty acids) was associated with reduced loss of bone mineral density after flight (p < .05). Also supporting the cell study findings, a higher intake of omega-3 fatty acids was associated with less N-telopeptide excretion during bed rest (Pearson r = –0.62, p < .05). Together these data provide mechanistic cellular and preliminary human evidence of the potential for EPA to counteract bone loss associated with spaceflight. © 2010 American Society for Bone and Mineral Research
Chapter 5: Molecule Films and Boundary Lubrication
Authors: Hu Yuanzhong
Published: October 2009

WHEN TWO SURFACES IN RELATIVE MOTION ARE completely separated by a liquid film that carries the applied load, a preferred state with low friction and without wear is achieved. This state of hydrodynamic or elasto-hydrodynamic lubrication (EHL), however, is not always the case in tribology practices. An increase in load, decrease in velocity or changes of surface roughness can lead to disappearance or discontinuity of hydrodynamic films and transition of the lubrication condition. Boundary lubrication refers to a lubrication regime where hydrodynamic lubrication is no longer effective, and the physics and chemistry of the interfacial substance play a dominant role in protecting the surfaces from direct contact [1]. The transition to boundary lubrication is a progressive process that goes across a region known as mixed lubrication where hydrodynamic films gradually disappear as the film thickness decreases continuously and the “asperity contacts” carry an increasing portion of the applied loads. In this sense, boundary lubrication can be regarded as a lower limit of the mixed lubrication region. The Stribeck curve shown in Fig. 1 provides an illustrative description for the transition from hydrodynamic lubrication to mixed and boundary lubrication. Due to the absence of a hydrodynamic effect, boundary film thickness is expected to be independent of speed of surface movement, as can be observed in the left part of the Stribeck curve. This is a significant criterion that distinguishes boundary lubrication from EHL and mixed lubrication, and provides an opportunity for measuring boundary film thickness using an interferometer, for example. More details will be presented in Section 2. Boundary lubrication is an extremely complex process in which numerous mechanisms, including rheology transition, adsorption, tribochemical reactions, selective transfer, etc., simultaneously participate in the play. In a sense, the term of boundary lubrication may take different meanings to different investigators. Physicists may regard boundary lubrication as a process where adsorbed monolayer plays a primary role in reducing friction; rheology scientists are investigating rheological transitions in confined lubricant films and their response to shearing, and chemists are more interested in tribochemical processes and formation of reaction layers that protect surfaces under severe conditions of wear. The essential function of boundary lubrication, however, is to reduce or eliminate immediate contacts between two solids, via adsorbed or reactive surface layers.
Enhanced insulin sensitivity after acute exercise is not associated with changes in high-molecular weight adiponectin concentration in plasma
Authors: Magkos Faidon , Mohammed B Selma , Mittendorfer Bettina
Published: October 2009

Background and objective

The effect of exercise on the plasma concentration of high-molecular weight (HMW) adiponectin (i.e. the biologically active form of circulating adiponectin) and the possible role of HMW adiponectin in mediating the exercise-induced enhancement of insulin action are not known. The aim of this study was to evaluate the relationship between the post-exercise increase in insulin sensitivity and plasma HMW adiponectin concentration.

Design and methods

We measured total and HMW adiponectin concentrations in plasma using an ELISA kit, and insulin sensitivity using the updated homeostasis model assessment of insulin sensitivity (HOMA2-IS) score in the basal, overnight fasted state, once ∼12 h after a single bout of moderate-intensity endurance exercise and once after an equivalent period of rest, in 27 healthy men and women (age: 29±1 years and body mass index: 24.7±0.8 kg/m2).

Results

The HOMA2-IS score was 18±7% greater after exercise than after rest (229±20 and 196±17 respectively;P=0.006), whereas the concentrations of total adiponectin (7.8±0.5 and 7.7±0.5 mg/l respectively;P=0.597) and HMW adiponectin (3.0±0.3 and 3.0±0.3 mg/l respectively;P=0.625) were not different. The exercise-induced change in HOMA2-IS score was not related to changes in total and HMW adiponectin concentrations (P>0.3).

Conclusions

Changes in HMW adiponectin concentration are not involved in the acute exercise-induced enhancement of insulin action.
Lipídeos na pele de ratos com lepra murina
Authors: Villela Gilberto G. , Linhares Hermínio
Published: October 2009

Os exames micropolariscópicos de cortes de tumores de ratos com lepra murina, não evidenciaram lipoides birefringentes. Os resultados obtidos na dosagem do colesterol na pele normal de ratos e nos tumores subcutâneos, mostraram valores quase iguais após a correção do teor em água dos tecidos. Sem esta correção, o tumos contem mais colesterol que a pele normal. Os lipídeos totais teem valores pouco maiores para o tumor do que para a pelo normal, mesmo referindo-se em gramas de tecino sêco. Esta pequena diferença não parece contudo significativa.
Anopheles (Shannoniezia) costalimai Fonseca e Ramos, 1940, novo nome e a redescrição da espécie (Diptera-Culicidae)
Authors: Coutinho J. O.
Published: October 2009

O autor trabalhando com material de Paranaguá (Paraná, Brasil) identificou varios exemplares de A. (Sh.) costalimais (=limai). Redescreveu a espécie, apresentando descrição da larva e pupa. Por sua solicitação os autores da espécie propuzeram um nome novo para a espécie pro achar-se o nome limai ocupado com uma variedade de A. (N) albitarsis descrita por Galvão de Lane, 1937. Conservou valido o sub-gênero Shannoniezia criado por Fonseca e Ramos 1940. Discute no trabalho o diagnóstico diferencial entre A. (Sh.) costalimai e A. (Sh.) mediopunctatus. Refere-se de passagem a A. (Sh.) costai não opina por sua validade. Refere-se ao material com que trabalharam Bonne e Bonne Webster achando que estes autores trabalharam com mais de uma espécie, pois não há concordância nas descrições para especimens de localidades diversas.
Endocardites sépticas: (contribuição etiopatogênica)
Authors: Lacorte J. Guilherme , Santos Mario
Published: October 2009

In the present paper the A. A. reviewed the more fundamental problems in the ethiopathogenic process of bacterial endocardits and report the bacte¬riological observations done by them in 20 cases of the disecase observed at the Section of Pathological Anatomy and Bacteriology of the Hospital S. Francisco de Assis in charge of the Instituto Oswaldo Cruz. The A.A. isolated Pneumococcus from 10 out the 20 cases, Gonococcus from 2, Staphylococcus from 2, Streptococcus from 5 and Friedlaender bacil¬lus from 1 . The A.A. mainly lay stress on the necessity of the bacteriological exa¬minations being made by a specialist, owing to the difficulties sometimes met with and to the consequences of a detailed examination of the isolated germ.
Contribuição ao conhecimento das paralisias periféricas, múltiplas, uni-laterais, dos nervos craneanos (Síndrome de Villaret)
Authors: Magalhães Octavio de
Published: October 2009

O autor descreve longamente uma observação dêste raro síndromo de lesão dos troncos nervosos periféricos dos nervos craneanos. No histórico do paciente, apurou a Micose pulmonar, pelo Neogeotrichum pulmoneum e úlcera estomacal, havendo-se curado de ambas. O síndromo nervoso atual foi de origem traumática, por arma de fogo, penetrando a bala no espaço retro-parotidiano e lesando, com maior ou menor intensidade, os nervos glossofaringeu, pneumogástrico, espinhal, hipoglosso e o simpatico cervical esquerdos. Além do síndromo nervoso, teve o paciente um aneurisma da artéria carótida primitiva, que foi ligado.
Aspectos epidemiológicos da peste no Brasil
Authors: Barreto João de Barros , Castro Almir de
Published: October 2009

Mostram os A. A. que não são rigorosamente comparaveis os dados disponiveis sôbre a incidência da peste no Brasil, dentro de um período largo, uma vez que só ultimamente se vem conhecendo em vida um alto percentual dos casos da doença. Distribuindo por triênios os 2610 casos ocorridos no período 1934-1945, verifica-se o contraste do primeiro (1934-36) com os demais, tendo tocado àquele 47% do total. Coincide esse declínio geral com a ação do Govêrno Federal, que, em 1936, iniciou campanha coordenada contra a peste, intensificada com a criação, em 1941, do S. N. P. Restrita agora a doença ao chamado Nordeste brasileiro, continua Pernambuco sendo o seu principal foco, cabendo-lhe, desde 1934, 40 a 50% dos casos. Examinando os ocorridos no quinquênio 1941-1945, sôbre o qual há informes mais complexos, mostram os A. A. que mais de 50% desses casos se verificaram em pessoas com menos de 20 anos de idade, mais de 50% entre pardos e mais de 50% no sexo masculino. Afora 9 casos de peste pulmonar e 13 de forma septicêmica, os demais 724 foram de peste bubônica, 2/3 dos quais com localização inguino-crural. Em favor da benignidade da peste no nordeste, fala a letalidade, de 26% no quinquênio referido, e que se reduz, aliás, a 12% entre os doentes vistos em vida e medicados pelo Serviço. A letalidade é mais alta a partir dos 50 anos, maior entre as mulheres e entre pardos e negros. O emprêgo das sulfas, em substituição ao sôro, trouxe redução da letalidade. Estudando as técnicas de laboratório usadas para o diagnóstico da peste, graças ás quais se positivaram cêrca de 50% dos casos, examinam o valor da digitotomia em comparação com a viscerotomia e o da pesquisa do germe no suco ganglionar e no sangue. Respeito aos roedores domésticos com responsabilidade epidemiológica, aludem ao papel talvez atribuível ao Mus musculus. Comentam os achados de peste em roedores silvestres. Estudam os índices pulicidianos levantados em 8 cidades e que, na maioria delas, parecem mais elevados na época das chuvas. A X. cheopis é a pulga que predomina no Brasil na região tropical, decrescendo a sua frequência com o aumento de latitude, ao inverso do que sucede com a X. brasiliensis que, em S. Paulo, cidade de clima temperado, é a espécie preponderante. Chuvas e temperatura parecem afetar diferentemente as duas espécies. Estudam, finalmente, a influência dos elementos climáticos sôbre a peste humana, mostrando que, no Brasil, a influência no período 1941-45 foi maior na época da primavera e do verão austrais; e que, em 4 distritos, para os quais há normais climatológicas disponiveis, a doença ocorreu mais intensamente em períodos posteriores aos de maior precipitação, e em que a temperatura média mensal variou entre 19] e 26º e a humildade relativa entre 66 e 83%.
Perdas de nutrientes via subsuperfície em colunas de solo sob fertilização mineral e orgânica
Authors: Piovesan Ricardo Prado , Favaretto Nerilde , Pauletti Volnei , Motta Antônio Carlos Vargas , Reissmann Carlos Bruno
Published: October 2009

O uso de dejetos de animais na produção agrícola pode ocasionar a contaminação ou poluição das águas por nutrientes, principalmente com aplicações consecutivas na mesma área. Nesse sentido, o objetivo deste trabalho foi avaliar o efeito da aplicação de dejeto líquido de bovinos e fertilizantes minerais na lixiviação de NH4+, NO3-, P e K. Para essa avaliação, foram coletadas colunas indeformadas de solo, num experimento de campo que estava sendo conduzido por sete anos consecutivos e que continha 12 tratamentos, resultantes da combinação de quatro doses de dejeto líquido de bovinos com três doses de fertilizante mineral. O experimento de campo era conduzido num Latossolo Bruno distrófico em sistema de plantio direto com sorgo, milho, aveia-preta e azevém em rotação. Em laboratório, essas colunas, de acordo com os respectivos tratamentos de campo, foram submetidas à aplicação do dejeto líquido de bovinos (0, 30, 60 e 90 m³ ha-¹, aplicados em dose única) e dos fertilizantes minerais (0, 50 e 100 % da dose recomendada para o milho - 120, 60 e 60 kg ha-1 de N, P2O5 e K2O). Imediatamente após a aplicação de dejeto e fertilizante, a água percolada por coluna foi coletada e analisada em cinco turnos contínuos, totalizando 516 mm - aproximadamente três volumes de poros. Constatou-se aumento nas concentrações de N-NH4+, P e K com as doses de dejeto e aumento de N-NO3- e K com as doses de fertilizante mineral. No entanto, com exceção do N-NO3-, as concentrações de N-NH4+ e P estiveram abaixo do limite máximo permitido pela legislação brasileira, indicando a importância da infiltração de água no solo na redução do potencial poluidor dos dejetos.