bluuebunny/crossref_metadata_2025 huggingface dataset:
The vasomotor function of endothelium and elasticity of the arterial wall in the patients with type 1 diabetes mellitus at different stages of diabetic retinopathy
Authors: Kosobian E P , Iarek-Martynova I Ia , Parfenov A S , Shestakova M V
Published: March 2014

The objective of the present work was to estimate the degree of rigidity of the vascular wall and endothelial function in the patients with type 1 diabetes mellitus at different stages of diabetic retinopathy and in its absence. The study included 118 patients at the age from 18 to 40 years presenting with type 1 diabetes mellitus more than 5 years in duration. The patients were divided into several groups based on the stage of diabetic retinopathy (DR). The control group was comprised of 23 healthy subjects. The contour pulsed wave analysis and the reactive hyperemia test were performed with the use of an Angioscan device. All the patients gave the informed consent to participate in the study. The aortic stiffness index (SI) in all groups of the patents with DM1 and DR was higher than in the healthy subjects. However, the SI values remained normal in the DM1 patients without DR. An increase of SI values was unrelated to the presence of arterial hypertension. The analysis of RI values revealed no statistically significant differences between the groups. The reactive hyperemia test has demonstrated a decrease in the increment of the post-occlusive signal amplitude in a large number of patients suggesting endothelial dysfunction. This decrease was apparent even in the patients exhibiting no signs of retinal damage. However, despite the overall decrease of this parameter, many patients showed its paradoxically high values that probably reflected the elevated baseline level of nitric oxide. The increase of aortic stiffness index with the progression of diabetic retinopathy may be used as an early marker of macrovascular complications even in the patients without arterial hypertension. The lowering of the increment of the post-occlusive signal amplitude in the patients having no signs of retinal damage is indicative of endothelial dysfunction as early as the preclinical stage of DR development. The paradoxically high increment of the signal amplitude is supposed to be associated with the elevation of the baseline level of nitric oxide that in its turn reflects the severity of inflammation and is a factor of high risk of progression of angiopathies.
The use of the SWOT analysis to improve the quality of provision of medicines for the patients with diabetes mellitus and bronchial asthma in the Republic of Kazakhstan
Authors: Sataeva L G , Moshkova L V
Published: March 2014

The results of analysis of the legislation pertaining to the quality of provision of medicines for the patients with diabetes mellitus and bronchial asthma (SWOT analysis) are presented with special reference to its current status in the Republic of Kazakhstan.
Current views of the screening and diagnostics of endogenous hypercorticism
Authors: Belaia Zh E , Rozhinskaia L Ia , Mel'nichenko G A , Dedov I I
Published: March 2014

The present review is concerned with the up-to-date methods currently available for diagnostics of endogenous hypercorticism. The clinical picture of this condition is considered in conjunction with the epidemiological data, identification of risk groups and the choice of the patients for the screening studies. The main attention is given to the diagnostic modalities of the highest informative value, technically simple and providing readily interpretable results, viz. measurement of cortisol in daily urine, minor dexamethasone test, determination of cortisol in evening saliva). The estimation of sensitivity of these techniques, their specificity, and cut-off values is discussed. The procedures and limitations of each test are described in much detail. In addition, an algorithm for the performance of two or more tests is proposed allowing to lower the maximum sensitivity and specificity levels of the determination. The methods of screening are presented in such a way as to facilitate their practical application by the general practitioners and specialists in related disciplines for the establishment of diagnosis of endogenous hypercorticism (but not elucidation of its origin).
Clinical manifestations of prolactin-secreting pituitary tumors in children and adolescents
Authors: Zhurtova I B , Strebkova N A , Peterkova V A , Vorontsov A V , Il'in A V
Published: March 2014

Scarce clinical manifestations of prolactin-secreting pituitary tumors in children and adolescents make it difficult to timely diagnosis. Girls have more prevalence of microprolactinomas, manifests as a rule, menstrual irregularities. In males, the greater incidence of macroadenomas results in the presence of neuroophthalmologic signs. The diagnosis of prolactinomas requires both radiographic evidence of pituitary adenoma and laboratory analysis of sustained hyperprolactinemia.
The results of analysis of the major epidemiological characteristics of primary hyperparathyroidism in Russia based on the registry data
Authors: Mokrysheva N G , Rozhinskaia L Ia , Peretokina E V , Rostomian L G , Mirnaia S S , Pronin V S , Markina N V , Shebesheva E N , Antsiferov M B , Dedov I I
Published: March 2014

The view of the clinical picture of primary hyperparathyroidism (PHPT) has essentially changed during the recent years under the influence of new data about its prevalence and the structure of the disease. The analysis of the database created at the Endocrinological Research Centre and including 1053 patients was used to obtain an epidemiological characteristics of various forms of PHPT recorded in Russia. PHPT morbidity in Moscow was estimated, based on the incidence of outpatient visits, to reach 0.05 per 1,000 adult population. This figure is significantly lower than that reported in foreign publications. The manifest form appears to be the most widespread form of PHTP in this country. The relative prevalence of the mild form has increased in the last years (till 2012) but does not exceed 28% or significantly lower than abroad where it is reported to prevail in the structure of PHPT morbidity. The asymptotic form accounts for 7.5% of all PHPT cases in the framework of type 1 multiple endocrine neoplasia syndrome (MEN-1) where it most frequently occurs in combination with pituitary adenomas (81%), in the first place prolactinomas, somatotropinomas, and pancreatic tumours (45%).
The results of DINASTIYA study - Diabeton MB: the observational program among the patients with type 2 diabetes mellitus under conditions of routine clinical practice
Authors: Shestakova M V , Vikulova O K , Avaliani D A , Avdeeva S N , Aĭdinian G P , Akishina L P , Aleĭnikova N V , Aleksandrova E G , Aleksandrova O V
Published: March 2014

The aim of the DINASTIYA study (the name of this study is the acronym composed of the selected letters from the Russian title: "DIabeton MB - Nablyudatel'naya programma sredi patsientov c Sakharnym diabeTom 2 tipa v uslovIYAkh rutinnoy praktiki") was to estimate the possibility of achieving the targeted parameters of glycemic control by means of the step by step increase of diabeton MB dose and to evaluate the safety of this therapy under conditions of routine clinical practice. Materials and methods: The program involved 2213 patients with poorly controlled type 2 diabetes mellitus who had been treated with diabeton MB during the preceding period (30-90 mg/day in the form of monotherapy or in combination with the maximum tolerated dose of metformin). The dose of diabeton MB was titrated under control of glycemia during 3 months. The combined treatment including metformin was given to 70% of the patients. The average daily dose of diabeton MB by the end of the study was 90.9 mg. As many as 70% of the petients received diabeton MB at a daily dose of 90-120 mg. Results: The statistically significant reduction of the fasting blood glucose (FG) level from 8.3±1.6 mmol/l to 6.2±0.9 mmol/l and postprandial glycemia (PPG) from 10.5±2.1 mmol/l to 7.6±1.0 mmol/l was documented within 3 month after the onset of therapy. The targeted FG and PPG levels (<6.5 mmol/l and <8.0 mmol/l) were achieved in 68.9% and 71.5% of the patients respectively. Simultaneously, the body weight decreased (by 1 kg on the average) and arterial pressure fell down (SAP - 8.4 and DAP - 3.9 mm HG respectively). Conclusion: The strategy of management of type 2 diabetes mellitus based on the step by step increase of the dose of diabeton MB allows the targeted parameters of glycemic control to be achieved in combination with the good tolerability of the treatment and the low risk of development of hypoglycemia.
Metabolic disorders in the adult patients presenting with congenital adrenal hyperpl
Authors: Sazonova A I , Troshina E A , Molashenko N V
Published: March 2014

A total of 55 patients at the age from 18 to 60 years presenting with the classical forms of congenital adrenal hyperplasia (CAH) were available for the estimation of the body mass index (BMI), measurement of AP, glycemia in OGTT, insulin level, HOMA index, and lipid content in blood sera. BMI ≥ 25 kg/m2 was documented in 56% of the women and in 47% of the men with CAH. Arterial hypertension occurred in 10% and 14% of the women and men respectively, disturbances of carbohydrate metabolism were diagnosed in 17% of the women and 7% of the men, but men alone suffered diabetes mellitus. 35% and 47% of the women and men presented with insulin resistance respectively. Dyslipidemia concomitant with CAH occurred in 69% of the women and 50% of the men. Disturbances of carbohydrate metabolism and arterial hypertension were largely associated with the elevated BMI while dyslipidemia in the first place correlated with the degree of CAH compensation. It is concluded that the patients with CAH are subject to the high prevalence of metabolic disorders. Special attention should be given to the patients with an excessive body mass and those having episodes of iatrogenic hypercorticism in their medical histories. Such patients most frequently exhibit a combination of metabolic disorders that constitutes a risk factor of the development of cardiovascular complications.
Carbohydrate metabolism in the patients presenting with polycystic ovary syndrome
Authors: Soboleva E L
Published: March 2014

This study with the participation of 117 patients was designed to characterize the clinical picture of polycystic ovary syndrome (POS), the state of carbohydrate metabolism, blood androgen and insulin levels. Impaired glucose tolerance was documented in 42 (36%) of the patients. Type 2 diabetes mellitus was diagnosed in one of them (0.9%). The occurrence of the normal and excessive body weight was unrelated to normal and impaired glucose tolerance. The same is true of the frequency of hyperinsulinemia even though abnormal insulin resistance indices and marked hyperinsulinemia were most frequently recorded in the patients having body mass index (BMI) in excess of 25. BMI was shown to directly correlate with the blood androgen level and the severity of manifestations of hirsutism. The study has demonstrated the necessity of estimating the state of carbohydrate metabolism in all the patients presenting with polycystic ovary syndrome for the timely prescription of pathogenetic therapy.
Minirin for the sublingual application to manage diabetes insipidus in the patients treated for brain tumours
Authors: Mazerkina N A
Published: March 2014

The objective of the present study was to compare the effectiveness of desmopressin (standard oral and sublingual minirin tablets) and patient compliance with these two therapeutic modalities. The study included 51 patients at the age from 1 to 23 years presenting with diabetes insipidus (DI) at least 6 months in duration who had undergone the surgical treatment of craniopharyngioma (n=25), germinoma (n=21, glioma (n=3), and pituitary adenoma (n=2). The patients were transferred from the oral minirin formulation to the sublingual one (the dose of 100 mcg of oral minirin is equivalent to a 60 mcg sublingual tablet). The patients were interviewed to estimate their preference as regards either therapeutic modality within one week after the onset of the treatment. It turned out after the completion of the study that 30 of the 51 patients (59%) adhered to the new sublingual formulation of minirin. Their preferences were unrelated to the age of the patients, diagnosis, and duration of the disease but significantly correlated with a single dose of the preparation. Specifically, the single dose was lower than 1 tablet in 71% of the patients who chose to use oral minirin. No adverse reactions in response to the treatment with sublingual minirin were documented.
The role of modern technologies in the management of azoospermia using microdissection TESE in the framework of the ECF-ICSI program. A literature review. Part I.
Authors: Vitiazeva I I , Bogoliubov S V , Dedov I I
Published: March 2014

The present review is focused on the modern methods for the treatment of male infertility related to obstructive and unobstructive azoospermia. The criteria and prognostic factors for obtaining spermatozoa by means of invasive manipulations on the testicles are considered. Special attention is given to the results of investigations into the state of the AZF-region of Y-chromosome and of the studies of patients presenting with Klinefelter's syndrome. The modern classification of testicular biopsies is presented that allows to discriminate between different forms of compromised spermatogenesis.
Endocrine ophthalmopathy: state-of-the-art approaches
Authors: Petunina N. A. , Trukhina L. V. , Martirosyan N. S.
Published: March 2014

The issues pertaining to etiology, pathogenesis, clinical manifestations, and treatment of endocrine ophthalmopathy (EOP) are discussed. EOP is a heterogeneous autoimmune eye disease most frequently associated with Graves’ disease even though it is just as well encountered both in the patients presenting with chronic autoimmune thyroiditis and in the absence of thyroid dysfunction. Although pathogenesis of EOP remains to be elucidated its autoimmune nature with the involvement of sensitized T-lymphocytes and autoantibodies against orbital tissues leaves no doubt. The understanding of mechanisms underlying the development of EOP gave impetus to the creation of new groups of medicines selectively acting on various pathogenic processes associated with this disease. The management of EOP remains a challenging problem requiring a multi-disciplinary approach for its solution.
Modern possibilities for the intensification of hypoglycemic therapy in the patients presenting with type 2 diabetes mellitus
Authors: Ametov A. S. , Abaeva F. T.
Published: March 2014

The results of the UKPDS study have demonstrated the importance of achieving an ideal level of glycemic control to guarantee the prevention or significant slowdown of the development of complications of diabetes mellitus (DM). However, a later study put in question the necessity of strict control in all the patients presenting with type 2 diabetes mellitus (DM2) because low HbA1c levels proved to be by no means always associated with the improvement of prognosis and even increased the risk of cardiovascular complications. Further investigations revealed the expediency of the treatment of diabetes mellitus on an individual basis with respect to both hypoglycemic therapy and formulation of its goals. The notion of safety of DM therapy acquired the primary significance. In this context, any novel approach ensuring the safety of treatment deserves serious attention. One such approach consists of taking advantage of the physiological benefits provided by the use of incretins that are intestinal hormones possessed of hypoglycemic activity. Our experience with the use of one of the DPP-4 inhibitors, vildagliptin, allows to recommend this preparation for the treatment of diabetic patients.
In memory of Professor Victor Vasilievich Trusov
Authors: Kazakova I. A. , Rudenko I. B.
Published: March 2014

June 29, 2012 died a famous scientist, doctor, teacher - prof. Viktor Vasilievich Trusov.
The clinical and instrumental rationale for the choice of therapy of arterial hypertension in the patients presenting with diabetes mellitus
Authors: Tatarchenko I. P. , Pozdnyakova N. V. , Mordovina A. G.
Published: March 2014

Cardiovascular disorders are the main cause of high disability and mortality rates among the patients with diabetes mellitus. The objective of the present work was to estimate the clinical and hemodynamic characteristics during the treatment of arterial hypertension with the use of olmesartan (hypertension/angiotensin II receptor antagonist, ARA) in the patients with type 2 diabetes mellitus suffering diastolic heart failure. The study included 56 patients (26 men and 30 women) of the mean age 58.2±5.3 years. They were given a course of olmesartan (cardosal) therapy 40 weeks in duration. This treatment was shown to result in positive dynamics of structural and geometric characteristics of the left ventricle and its diastolic function in conjunction with the improvement of the vasomotor function of arterial endothelium.
Predictors of the effectiveness of the treatment of symptoms of the chronic painful form of diabetic polyneuropathy with the use of alpha-lipoic acid
Authors: Khutornaia O E , Bregovskiĭ V B , Demina A G , Karpova I A , Grineva E N
Published: March 2014

This work was designed to study dynamics of the symptoms of chronic painful form of diabetic polyneuropathy under the influence of the short-term treatment with alpha-lipoic acid (ALA) and to identify the predictors of its effectiveness. Lipoic acid was administered by means of 10 infusions dosed 600 mg each. ALA had the most pronounced therapeutic effect on convulsions, gnawing pain, the feeling of "pins and needles", burning sensation, and neuralgia. Dynamics of allodynia, hyperalgesia, and negative symptoms was insignificant. The predictors of low effectiveness of ALA were high intensity of painful and other sensations underlain by central pain maintaining mechanisms.
The relationship between the pituitary somatotrophic function and the immune system, its role in the development of neoplasia
Authors: Dogadin S A , Dudina M A , Savchenko A A
Published: March 2014

The present review is focused on the relationship between growth hormone (GH) production and the state of the immune system. The influence of growth factors on the population and subpopulation composition of CD-expressing lymphocytes, functional activity of immune cells, and apoptosis is discussed. The detailed description of the role of disturbances in the pituitary somatotrophic function and the concomitant immune disorders is presented with special reference to the development of neoplastic processes. Changes in the immune system of the patients with chronic hypersecretion of growth factors are described. Tight interactions between the immune and endocrine systems appear to greatly contribute to tumour pathogenesis and have direct effect on the survivorship rate among the patients with acromegaly.
Detection and treatment of type 2 diabetes mellitus - an interdisciplinary problem
Authors: Ostroukhova E N
Published: March 2014

Diabetes morbidity exceeds the predicted level. The Russian diabetes registry contains the data on more than 3 million patients suffering from type 2 diabetes mellitus (DM2), but their actual number in the country is supposed to be several times greater. The main causes behind this increase are ageing of the general population and widespread obesity. The number of patients with DM2 is now so large that endocrinologists are unable to render medical assistance to all of them; therefore therapists and general practitioners have to take care of such patients. In order to improve the quality of therapeutic and prophylactic aids for the diabetic patients, the Endocrinological Research Centre of the Russian Ministry of Health supported by Novo Nordisk has developed the "Medical Ambitions" project . In the framework of this project, the education program was elaborated and implemented designed to enhance the awareness among therapists and general practitioners about modern approaches to the management of type 2 diabetes mellitus. The present paper reports the results of analysis of the work of educational seminars carried out by the specialists of I.P. Pavlov Sank-Peterburg State Medical University. The work included lectures, interactive seminars, clinical case studies, and discussions. Special attention was given to the new groups of medications for the treatment of DM2. The effectiveness of these activities was estimated from questionnaires distributed among the participants before and after the seminars. The therapists showed great interest in the program, the level of their knowledge about up-to-date strategies of DM2 treatment appreciably increased.
The role of insulin sensitizers and calcium plus vitamin D3 preparations in the combined treatment of polycystic ovary syndrome
Authors: Kuznetsova I V
Published: March 2014

Polycystic ovary syndrome (PCOS) is a multifactor diseases associated with genetic predisposition to this pathology that develops under effect of the unfavourable environmental factors. One of the main causes that provokes hyperandrogenic anovulation in PCOS is pathologic insulin resistance arising in the predisposed subjects as a result of supranormal dietary intake and low physical activity. Such factors as calcium and vitamin D insufficiency, besides other metabolic disturbances and ovarian dysfunction, play an important role in the energy imbalance associated with PCOS. Moreover, these factors along with obesity and insulin resistance are responsible for a broad spectrum of PCOS complications. There is a wealth of data suggesting the positive influence of insulin sensitizers (in the first place, metformin) on the ovarian function and their prophylactic effect on the risk of PCOS. The effectiveness of therapy using such micronutrients as calcium and vitamin D is less known. However, the results of the relevant studies give evidence of good prospects for their application for the prevention of PCOS and its consequences.
Organization and functioning of the neuroendocrine system
Authors: Babichev V N
Published: March 2014

Recent progress in neuroendocrinology provided a basis for the formulation of the integral strategy for the systemic treatment of endocrine diseases. This review presents experimental and clinical evidence of the presence in the hypothalamus of specific receptors of hormones produced by the peripheral endocrine glands and trophic pituitary hormones. Synthesis of specific hypothalamic substances (releasing hormones) maintains the interplay between the neural and endocrine structures. The positive and negative feedback mechanisms in the body ensure the stable functioning of all its organs and systems.
Results of growth hormone substitution therapy in children with brain tumours
Authors: Mazerkina N A , Gorelyshev S K , Zheludkova O G , Ozerov S S , Kobiakov G L , Kholodov B V
Published: March 2014

Aim of the study. To estimate the effectiveness and safety of substitution therapy with growth hormone (GH) in children with various brain tumours. Materials and methods. The study involved 68 patients admitted to N.N. Burdenko Institute of Neurosurgery between 2001 and 2011 including 35 ones with craniopharyngioma, 18 with medulloblastoma, and 15 with germ cell tumours (GCT) in the chiasmosellar region. All patients suffered growth hormone insufficiency and received GH replacement therapy. Their antropometric characteristics (height and growth rate) and IGF-1 levels were measured before, 6 and 12 months after the onset of the treatment. The doses of GH varied from 0.03 to 0.034 mg/kg/day. Results. The substitution therapy with GH resulted in an increase of the growth rate in patients with craniopharyngioma from 2.3±1.6 to 9.4±1.9 cm/year (p<0.001), in those with GCT from 1.2±0.9 to 7.4±2.6 cm/year (p=0.01), and in patients with medulloblastoma from 2.3±1.5 to 6.2±2.6 cm/year (p<0.01). The growth rate in patients treated by spinal irradiation was lower than that in those given no such treatment (6.0±2.3 cm/year and 9.2±2.1 cm/year respectively; p<0.001). The tumour recurred in eight of 35 (23%) patients with craniopharyngioma during GH therapy. The frequency of relapses was not significantly different from that in patients who did not receive growth hormone. Patients with medulloblastoma and GCT did not develop relapses. No adverse reactions to GH therapy were documented in this study.
The application of the ACTH (5 mcg) test for diagnostics of the non-classical form of congenital adrenal hyperplasia (results of a study)
Authors: Chagaĭ N B , Fadeev V V , Prokof'ev S A , Ivanova O N , Smirnova N B , Atamanova T M , Tishina Iu V
Published: March 2014

This study has demonstrated high sensitivity and specificity of the low-dose (5 mcg) 1-24-ACTH stimulation test used for diagnostics of the non-classical form of congenital adrenal hyperplasia (21-hydroxilase deficiency).
Circadian rhythms of melatonin secretion during nocturnal sleep deprivation
Authors: Tsfasman A Z , Gorokhov V D , Alpaev D V
Published: March 2014

The circadian rhythm of melatonin secretion was studied by measuring the amount of its decomposition product (6-sulfatoxymelatonin) in discrete urine sample collected during daytime and night-time periods. The study included a total of 29 subjects ten of whom suffered nocturnal sleep deprivation. 6-sulfatoxymelatonin in the patients of the latter group was measured twice throughout the study: during the 24-hour period with normal sleep and during the 24-hour period with nocturnal sleep deprivation. It was shown that nocturnal sleep deprivation resulted in the disturbances of the circadian rhythms of melatonin production. It sharply decreased at night-time to the levels characteristic of daytime secretion. In the subjects with the normal sleep regimen (i.e. without nocturnal deprivation) the daytime adiponectin levels amounted to 63-75% of the average daily value.
Mutations in the genes encoding for leptin and its mediators: induction of obesity with various concomitant pathological conditions
Authors: Pankov Iu A
Published: March 2014

g15384delG(G133fsX15), c.215T⇒C(p.L72S), c.309C⇒A(p.N103K), c.313C⇒T(p.R105W), c.422C⇒G(p.S141C), c.104_106delTCA, c.481_482delC⇒T, and c.135del13bp mutations in LEP in the homozygous state are known to be associated with the early onset of severe obesity and disturbances of many physiological functions. Similar pathological changes are induced by mutations in LEPR, such as G⇒A substitution in the splicing donor site, deletions of 4 and 11 base pairs in the 5'-terminus of cDNA, deletion of 66 bp in the CRH domain of LEPR, compound deletion of 1 base pair in the 5'-terminus/p.R612H, and missense mutations P316T, A409E, W664R, and H684P. Disturbances in LEP and LEPR expression in homozygous subjects are associated with severe obesity, retarded sexual development, insulin resistance, disordered secretion of adenohypophyseal hormones, and immunodeficiency. Mutations in LEP cause more serious pathological changes than LEPR mutations. In the homozygous state, mutations in POMC, such as 3804C⇒A, 6906delC, 6922insC, and compound heterozygous mutations 7134delG/7013G⇒T, 6996del/6851A⇒T, 3804CA/7100insGG are associated in man with morbid obesity and acute adrenal cortical insufficiency. In the heterozygous state, these mutations predispose to obesity in the absence of concomitant disorders. Mutations in MC4R are the most common cause of obesity. They are known to induce severe pathology in homozygous subjects but significantly milder disturbances of adipose tissue metabolism in heterozygotes. In both cases, obesity is not accompanied by serious disturbances of other functions.
The relationship between characteristics of calcinosis of the arteries of the lower extremities and the severity of distal neuropathy in the patients with diabetes mellitus
Authors: Molitvoslovova N A , Manchenko O V , Iaroslavtseva M V , Galstian G R
Published: March 2014

Aim. To estimate the degree of arterial calcinosis in the distal segments of the lower extremities in the patients presenting with diabetes mellitus (DM) and varying severity of distal diabetic polyneuropathy (DPN). Materials and methods. The study involved 61 patients with DM ( 21 men and 40 women, mean age 51.4 +- 11.68 years) of whom 27 suffered DM1 and 34 DM2. Group 1 was comprised of 37 patients with diabetic osteoarthropathy (DOAP), group 2 included 13 patients with severe DPN, and group 3 11 patients having moderate DPN. All the patients underwent comprehensive laboratory and instrumental examination including measurement of peripheral sensitivity and electromyography. The degree of arterial calcinosis in the distal segments of the lower extremities was determined using multispiral computed tomography (MSCT) with the calculation of the Agatston tibial artery calcification scores. Results. The groups were matched for the patients' age, duration of disease, total cholesterol and creatinin levels, and glomerular filtration rate. Moreover, the patients of groups 1 and 2 were matched for the functional state of nerve fibers in the lower extremities and were significantly different in respect to this characteristic from the patients of group 3. Median of the Agatston tibial artery calcification scores in group 1 was 365.4 (min - 0, max - 1600) and in group 2 2.7 (min - 0, max - 74.6). Groups 1 and 2 were comparable in terms of the degree of calcinosis and were significantly different from group 3 (p < 0.05 1 vs 3; p < 0.005 2 vs 3). The Agatston tibial artery calcification scores negatively correlated with the motor response (r = -0.3; p < 0.05) and vibrational sensitivity (r = -0.4, p < 0.01). Conclusion. Results of the study suggest the leading role of DPN in the development and progression of arterial calcinosis in the distal segments of the lower extremities in the patients with diabetes mellitus.
The ubiquitin–proteasome system: opportunities for therapeutic intervention in solid tumors
Authors: Johnson Daniel E
Published: March 2014

The destruction of proteins via the ubiquitin–proteasome system is a multi-step, complex process involving polyubiquitination of substrate proteins, followed by proteolytic degradation by the macromolecular 26S proteasome complex. Inhibitors of the proteasome promote the accumulation of proteins that are deleterious to cell survival, and represent promising anti-cancer agents. In multiple myeloma and mantle cell lymphoma, treatment with the first-generation proteasome inhibitor, bortezomib, or the second-generation inhibitor, carfilzomib, has demonstrated significant therapeutic benefit in humans. This has prompted United States Food and Drug Administration (US FDA) approval of these agents and development of additional second-generation compounds with improved properties. There is considerable interest in extending the benefits of proteasome inhibitors to the treatment of solid tumor malignancies. Herein, we review progress that has been made in the preclinical development and clinical evaluation of different proteasome inhibitors in solid tumors. In addition, we describe several novel approaches that are currently being pursued for the treatment of solid tumors, including drug combinatorial strategies incorporating proteasome inhibitors and the targeting of components of the ubiquitin–proteasome system that are distinct from the 26S proteasome complex.
Tamoxifen as the first targeted long-term adjuvant therapy for breast cancer
Authors: Jordan V Craig
Published: March 2014

Tamoxifen is an unlikely pioneering medicine in medical oncology. Nevertheless, the medicine has continued to surprise us, perform, and save lives for the past 40 years. Unlike any other medicine in oncology, it is used to treat all stages of breast cancer, ductal carcinomain situ, and male breast cancer and pioneered the use of chemoprevention by reducing the incidence of breast cancer in women at high risk and induces ovulation in subfertile women! The impact of tamoxifen is ubiquitous. However, the power to save lives from this unlikely success story came from the first laboratory studies which defined that ‘longer was going to be better’ when tamoxifen was being considered as an adjuvant therapy. This is that success story, with a focus on the interdependent components of: excellence in drug discovery, investment in self-selecting young investigators, a conversation withNature, a conversation between the laboratory and the clinic, and the creation of the Oxford Overview Analysis. Each of these factors was essential to propel the progress of tamoxifen to evolve as an essential part of the fabric of society.
Upregulation of glucose metabolism by NF-κB2/p52 mediates enzalutamide resistance in castration-resistant prostate cancer cells
Authors: Cui Yuanyuan , Nadiminty Nagalakshmi , Liu Chengfei , Lou Wei , Schwartz Chad T , Gao Allen C
Published: March 2014

Cancer cells reprogram their metabolic pathways to facilitate fast proliferation. Previous studies have shown that overexpression of NF-κB2/p52 (p52) in prostate cancer cells promotes cell growth and leads to castration resistance through aberrant activation of androgen receptor (AR). In addition, these cells become resistant to enzalutamide. In this study, we investigated the effects of p52 activation on glucose metabolism and on response to enzalutamide therapy. Data analysis of gene expression arrays showed that genes includingGLUT1(SLC2A1),PKM2,G6PD, andME1involved in the regulation of glucose metabolism were altered in LNCaP cells overexpressing p52 compared with the parental LNCaP cells. We demonstrated an increased amount of glucose flux in the glycolysis pathway, as well as the pentose phosphate pathway (PPP) upon p52 activation. The p52-overexpressing cells increase glucose uptake and are capable of higher ATP and lactate production compared with the parental LNCaP cells. The growth of p52-overexpressing cells depends on glucose in the culture media and is sensitive to glucose deprivation compared with the parental LNCaP cells. Targeting glucose metabolism by the glucose analog 2-deoxy-d-glucose synergistically inhibits cell growth when combined with enzalutamide, and resensitizes p52-overexpressing cells to enzalutamide treatment. These results suggest that p52 modulates glucose metabolism, enhances glucose flux to glycolysis and PPPs, thus facilitating fast proliferation of the cells. Co-targeting glucose metabolism together with AR axis synergistically inhibits cell growth and restores enzalutamide-resistant cells to enzalutamide treatment.
Avaliação da satisfação do aluno com deficiência no ensino superior
Authors: Guerreiro Elaine Maria Bessa Rebello , Almeida Maria Amélia , Silva Filho José Humberto da
Published: March 2014

Neste início de século tem havido um crescimento do número de matrícula do aluno com deficiência no ensino superior. Porém, este fenômeno não está sendo avaliado para fins de averiguação da satisfação desse alunado quanto ao seu acesso e permanência. Este estudo tem por objetivo identificar o nível de satisfação desse alunado através de um instrumento construído pela pesquisadora. Trata-se de um estudo de caso, de caráter exploratório, em uma universidade do interior do Estado de São Paulo. Participaram do estudo oito com deficiência visual, seis com deficiência física, três com deficiência auditiva e uma com dificuldades de aprendizagem. O instrumento construído foi denominado de Escala de Satisfação e Atitudes de Pessoas com Deficiência - ESA. Em decorrência do tamanho da amostra, as técnicas estatísticas utilizadas foram no sentido exploratório e não inferencial. Verificou-se que as médias dos grupos diferenciaram-se de forma estatisticamente significativa (p=0,065) pelo Teste de Friedman, indicando que há diferenças entre os tipos de satisfação avaliados, no grupo estudado, a 90% de confiança. Os achados permitem-nos afirmar que a aplicação desse instrumento é viável e útil, no sentido de avaliar o rumo que a universidade está tomando com relação à garantia do acesso e permanência desse alunado.
Os alunos de administração estão em sintonia com o mercado de trabalho?
Authors: Moreira Fábio Mosso , Queiroz Timóteo Ramos , Macini Nayele , Campeão Gabriela Hermida
Published: March 2014

O presente artigo realiza o levantamento de demandas em relação ao perfil dos profissionais de Administração pelo mercado de trabalho, descreve tais características e analisa como os alunos do curso de Administração da UNESP/Tupã se encontram em relação a tais quesitos. Os pontos levantados demonstram interesses do mercado de trabalho não somente para conhecimentos de formação técnica-acadêmica, como também, conhecimentos e habilidades interpessoais e extracurriculares. Estes pontos foram identificados através de um estudo bibliográfico e da consulta a formulários de vagas de estágio e emprego do projeto de extensão Balcão de Estágios e Empregos, na UNESP/Tupã. A partir da comparação entre estas fontes, foi possível identificar as principais competências procuradas pelas empresas no perfil de um administrador. Com caracterização do objeto de estudo foi possível realizar comparações em relação ao termo em que o aluno se encontrava no curso (3º, 5º e 7º semestres), tanto como em relação ao período (diurno e noturno), verificando se tais competências evoluíam com o passar do curso. O trabalho conclui também que não basta para os alunos de administração restringir sua formação apenas com os conhecimentos acadêmicos, sendo necessário para a formação de um perfil adequado, o desenvolvimento de atividades extracurriculares que incrementem competências como conhecimento de informática e idiomas. Constatações relevantes demonstraram que a formação dos alunos, e a forma como reagem às demandas, estão fortemente conectadas às exigências de mercado.
Autoavaliação SINAES: uma estratégia de gestão de um hospital universitário
Authors: Rodrigues Marlene Kreutz , Quadros Juliane do Nascimento de , Godoy Leoni Pentiado , Lana Letice Dalla , Souza Antão Tadeu de , Rodrigues Lucas Kreutz , Portela Odete Teresinha
Published: March 2014

Objetivo: analisar as estratégias de gestão adotadas pelos gestores do HUSM a partir dos resultados da autoavaliação institucional. Metodologia: Foi elaborado um instrumento de autoavaliação, mantendo a estrutura e os fundamentos do Sistema Nacional de Avaliação do Ensino Superior (SINAES). A análise atendeu as dimensões do SINAES. Resultados: Dos gestores, 46,58% afirmam não ter domínio a respeito da legislação do serviço; 80,83% classificaram a atuação da equipe adequada com relação à Política Nacional de Humanização; 58,9% segregam o lixo de forma adequada; 68,50% consideram a comunicação interna adequada; 97,22% dos gestores avaliaram seu domínio técnico científico satisfatório. Com relação ao ensino, 89,41% dos gestores consideraram o hospital como bom campo e 90,41% avaliaram como adequado o acompanhamento aos discentes. Conclusão: O processo de avaliação permitiu reflexão e análise do HUSM na visão do gestor sobre vários aspectos nas dimensões consideradas importantes para oferecer um bom campo de ensino.
Gestão de competências profissionais na formação de administradores
Authors: Regio Maria de Lourdes Severo , Schuch Jr. Vitor Francisco , Gomes Clandia Maffini , Kneipp Jordana Marques
Published: March 2014

A avaliação da qualidade de um curso superior de graduação envolve, necessariamente, a identificação do perfil profissional dos egressos. A primeira pesquisa realizada com os egressos do Curso de Graduação em Administração da Universidade Federal de Santa Maria (UFSM), objeto deste estudo, foi efetuada por Schuch Jr. (1976). Esta pesquisa foi retomada agregando novas dimensões de análise, visando a abordar o desenvolvimento de competências conforme estabelecem as Diretrizes Curriculares Nacionais (DCNs). O estudo foi realizado com egressos formados no período de 2005 a 2009. Com a realização da pesquisa, buscou-se conhecer a realidade profissional, identificar as competências profissionais exigidas e a contribuição do curso em termos de formação acadêmica para o desenvolvimento das competências. A estratégia metodológica utilizada caracterizou-se como um estudo de caso descritivo e quantitativo. A coleta de dados foi realizada por meio da aplicação de dois tipos de questionários estruturados, com questões fechadas e abertas envolvendo uma amostra formada por 121 egressos A aplicação da técnica de análise fatorial permitiu identificar as principais competências exigidas pelo mercado profissional: padrões e valores, adaptação e negociação, conhecimento e técnico-profissional. Os resultados sugerem que as expectativas propostas pelas DCNs estão sendo plenamente desenvolvidas pelo Curso de Administração da UFSM.
Proposta de inclusão de carga horária semipresencial em cursos superiores presenciais
Authors: Rodrigues Junior Emílio , Fernandes Fabricio Juliano
Published: March 2014

Com as tecnologias digitais e educacionais, a aplicação de conceitos, teorias e metodologias mais interativas e dinâmicas estão sendo utilizadas na Educação a Distância (EaD), mudando o foco do processo de ensinar/aprender. O presente texto tem o objetivo de analisar a evolução da educação a distância e a possibilidade de inclusão da modalidade semipresencial em cursos superiores de graduação já reconhecidos pelo Ministério da Educação. A implantação da semipresencialidade, devidamente regulamentada pela portaria 4.059, deve ser discutida em cada Instituição de Ensino, uma vez que as realidades são distintas e as necessidades de formação dos professores que irão atuar nessa modalidade não são as mesmas. O presente estudo surge na seqüência de diversas preocupações e tem como problema de pesquisa: é possível e viável a implantação de 20% da carga horária a distancia? Com as novas tecnologias, as Instituições podem adaptar os projetos pedagógicos dos cursos prevendo a inclusão da semipresencialidade em cursos já reconhecidos. Essa modalidade pode favorecer o desenvolvimento da aprendizagem autônoma nos estudantes. Evidentemente que o professor tem papel decisivo na efetivação do processo e precisará estar preparado para esta nova situação de aprendizagem, sob pena de criar resistências e comprometer o espírito do ensino presencial. Não se trata de uma facilidade e sim de um acompanhamento do professor nas execuções das atividades complementares de estudo. Isso posto, não se pode prescindir de investigar a realidade em que estes sujeitos estão inseridos, especialmente sua prática pedagógica, formação e experiências e a relação que mantêm dentro e fora da escola, uma vez que esses elementos poderão ser determinantes na medida em que os objetivos e expectativas pela incorporação das novas tecnologias podem vir a modificar a ação docente. As novas tecnologias podem ser aliadas e melhor utilizadas nas interações com os alunos, sendo útil o seu aprendizado. A inclusão do ensino semipresencial nos cursos de graduação, portanto, é validada e benéfica quando realizada de forma coerente, com anuência dos envolvidos e com fins pedagógicos e não econômicos.
O evolucionismo econômico na pós-graduação brasileira: uma análise a partir da ótica da educação
Authors: Dias Evandro Dotto , Rorato Rodrigo
Published: March 2014

As transformações proporcionadas pela globalização da economia influenciaram a pós-graduação brasileira, onde a pesquisa acadêmica passou a ocupar um ponto estratégico no Plano Nacional de Pós-Graduação (PNPG, 2011-2020), sendo considerada como uma poderosa ferramenta para o desenvolvimento econômico do país. Essa visão desenvolvimentista vai ao encontro da escola do pensamento econômico neoschumpeteriana (evolucionista), que preconiza a conjugação do conhecimento e aprendizado, com o estímulo à Pesquisa e Desenvolvimento (P), como fundamental à geração de inovações no sistema produtivo, e logo ao progresso tecnológico das nações. Diante desse contexto, este artigo apresenta uma análise crítica a essa formatação (economicista) presente no sistema de avaliação da pós-graduação brasileira, com base na concepção teórica de expoentes clássicos e contemporâneos da área de educação. Com isso, verificou-se a reificação do conhecimento e a (trans)formação do sujeito (docente-pesquisador), como um agente empreendedor, em detrimento de sua essência social, de sua consciência-de-si e da educação como um todo, dentro de um espectro in vivo, segundo a visão hegeliana. Além disso, constatou-se a pouca relevância dos demais pilares universitários, como ensino e extensão, com o direcionamento das políticas estatais para o fomento à pesquisa acadêmica voltada ao desenvolvimento econômico e à formação de produto(s) e produtor(es).
Distintas lecturas de la pregunta como mediación didáctica para la traducción de saberes en la educación superior o acerca de un estado en cuestión
Authors: Grisales Franco Lina María , González Agudelo Elvia María
Published: March 2014

A partir de una búsqueda documental en el Sistema de Bibliotecas de la Universidad de Antioquia, bibliotecas digitales, revistas y en bases de datos especializadas en educación, se seleccionaron 26 investigaciones desarrolladas entre 1997 y 2007 para tener una aproximación a lo que actualmente se está investigando en relación con la pregunta en la educación superior. Se identificaron tres perspectivas en las que se mueve la investigación respecto a la pregunta. La primera, se refiere a los tipos de preguntas que se utilizan frecuentemente en la enseñanza superior. La segunda, sobre estrategias didácticas que se fundamentan en la pregunta. Y la tercera, acerca de la pregunta para posibilitar la comprensión y el desarrollo del pensamiento crítico.
Autonomía y heteronomía de la educación militar: Un análisis de los procesos de evaluación institucional en los institutos universitarios de las Fuerzas Armadas Argentinas
Authors: Soprano Germán
Published: March 2014

A comienzos de los años 1990, las Fuerzas Armadas Argentinas tenían institutos universitarios que, además de ofrecer la tradicional formación básica y perfeccionamiento para sus oficiales, promovieron estudios para civiles y militares. A partir de una revisión de las principales recomendaciones de los pares evaluadores de la CONEAU en los procesos de evaluación institucional de los Institutos Universitarios de las Fuerzas Armadas, analizaremos las continuidades y cambios en el sistema de educación militar y sus grados de autonomía y heteronomía como resultado de su participación en esos procesos.
Possíveis relações entre percepções de violência dos alunos, clima escolar e eficácia coletiva
Authors: Cunha Marcela Brandão
Published: March 2014

Este artigo busca verificar a relação entre clima escolar e percepções de violência dos alunos, no que diz respeito ao testemunho e ao envolvimento em contextos de violência. O referencial teórico se baseia na articulação entre duas teorias de áreas distintas: clima escolar e eficácia coletiva, sendo a primeira originária de estudos a respeito da eficácia escolar e efeito-escola e a segunda desenvolvida no âmbito da sociologia urbana. Essa relação foi pensada ao serem identificadas convergências consistentes entre as referidas perspectivas. No que se refere à metodologia, foram analisados dados quantitativos provenientes de um survey realizado no Rio de Janeiro sobre juventude e violência, fruto de uma parceria entre pesquisadores de três universidades: Universidade Federal do Rio de Janeiro (UFRJ), Universidade Estadual do Rio de Janeiro (UERJ) e Universidade Cândido Mendes (UCAM). Resultados preliminares mostram associação negativa entre indicadores de clima escolar e de percepções de violência dentro da escola. Isso sugere que em escolas cujos alunos relatam um maior número ocorrências de violência o clima escolar é avaliado negativamente por eles. Além dessa convergência verificada com a hipótese do estudo, outros dados apontam relações entre percepções de violência dentro e fora da escola e associação entre percepções a respeito da existência de drogas e de violência no espaço escolar. Contudo, em relação aos referidos resultados, vale enfatizar o caráter exploratório das análises.