bluuebunny/crossref_metadata_2025 huggingface dataset:
Buried or unburied K-wires for lateral condyle elbow fractures
Authors: McGonagle L , Elamin S , Wright DM
Published: September 2012

INTRODUCTION

Lateral humeral condyle fractures typically require a longer period of internal fixation than other distal humeral fractures due to the increased risk of non-union. K-wires can be buried and left in situ until union or they can be left unburied and require removal after four weeks, with plaster immobilisation until union. There is no consensus as to whether wire burial is preferable or not. The aim of this study was to determine whether K-wire burial is associated with more complications than non-buried wires in treating lateral condyle fractures of the elbow.

METHODS

All patients with lateral humeral condyle fractures treated with K-wire fixation at our institution from May 2008 to August 2011 were included in the study. Fracture configuration, mode of reduction, wire burial and complications were assessed.

RESULTS

Sixty-seven patients (19 girls and 48 boys, mean age: 6.5 years, range: 1–17 years) were included in the study. All had closed injuries and were treated with open reduction and K-wire fixation. K-wires were buried in 55 patients. Thirteen cases of buried wires eroded through skin and were removed on average 45 days (range: 30–58 days) post-operatively. Of the wire erosion cases, three developed microbiologically proven infections, one of which was a deep infection. There were a further three superficial wound infections in the absence of wire erosion through the skin. There were complications in 2 of the 12 cases in the unburied wires group: 1 microbiologically proven superficial wire site infection and 1 wire backed out after 11 days, requiring refixation.

CONCLUSIONS

Wire erosion through the skin is the most common complication of K-wire burial. This may be due to the decrease in swelling after fracture fixation, making the wires more prominent under the skin. Skin integrity should be monitored closely if wires are buried.
Graduated compression stockings in hip fractures
Authors: Alsawadi A , Loeffler M
Published: September 2012

INTRODUCTION

Hip fractures are the most common cause of acute admissions to orthopaedics and in the UK approximately 70,000–75,000 hip fractures occur annually. Hip fractures carry a significant risk of developing a venous thromboembolism. The National Institute for Health and Clinical Excellence (NICE) estimated that the risk of developing a venous thromboembolism in patients with hip fractures who do not receive thromboprophylaxis is 43%. In their recent guidelines, NICE recommended that combined mechanical and pharmacological thromboprophylaxis should be offered to patients undergoing hip fracture surgery and mechanical prophylaxis should be commenced at admission. The aim of this review was to search for available evidence that could support using graduated compression stockings combined with low molecular weight heparin (LMWH) in hip fracture patients.

METHODS

NICE guidelines and the reference list of the guidance were reviewed and a thorough literature search was performed on main electronic databases (MEDLINE®, Embase™ and the Cochrane Library).

RESULTS

A literature search was unable to find sufficient evidence to support the use of graduated compression stockings combined with LMWH in hip fracture settings. The guidelines are critically reviewed and the available evidence discussed.

CONCLUSIONS

The evidence supporting these recommendations is very limited and there is considerable concern regarding the safety and efficacy of the mechanical devices used in thromboprophylaxis. Further studies are needed urgently before specific guidelines can be agreed confidently for patients with hip fractures.
Congenital absence of the anterior arch of the atlas: a normal variant
Authors: Thavarajah D , McKenna P
Published: September 2012

Congenital absence of the anterior arch of the atlas is incredibly rare with only two cases reported previously in the literature. We present a third case of a medically fit patient who suffered neck trauma with an abnormal odontoid peg x-ray, which subsequently demonstrated a congenital non-fusion of the anterior vertebral arch of C1 on computed tomography. This case highlights the need to have an open diagnosis to include congenital anomaly when interpreting abnormal odontoid peg x-rays.
The clinical relevance of microbiology specimens in orofacial abscesses of dental origin
Authors: Fowell C , Igbokwe B , MacBean A
Published: September 2012

INTRODUCTION

It is common surgical practice to take a specimen for microbial culture and susceptibility (MC&S) when draining an orofacial abscess. The aim of this study was to determine if routine MC&S has any therapeutic value in the care of these patients.

METHODS

A retrospective study was undertaken of records of patients admitted for surgical management of orofacial abscesses between January 2010 and December 2011. Records were reviewed for bacteriology specimen and result, admission details, antimicrobial treatment and outcome.

RESULTS

A total of 79 patients were included in the study and specimens sent from 62 patients (78.4%). Samples were positive in 86.2% of cases, of which Streptococcus viridans was the most commonly isolated organism (54.7%). Interim reports were published on average after 3.25 days, with 89.9% of patients having been discharged within 2 post-operative days. According to clinical records, no patients in the cohort required further intervention or alteration of prescribed antimicrobial treatments following discharge.

CONCLUSIONS

Almost 90% of patients were discharged before bacteriology results were available, without complication. This study suggests bacteriology culture has no therapeutic value in these patients. Omission of this practice in the case of uncomplicated orofacial abscesses could improve efficiency in the National Health Service without affecting patient care.
Management of recurrent stress urinary incontinence and urinary retention following midurethral sling insertion in women
Authors: Hashim H , Terry TR
Published: September 2012

INTRODUCTION

Synthetic midurethral slings are the most common operations performed for women with stress urinary incontinence (SUI). However, there is only very scarce evidence regarding the management of complications from these operations. The aim of this survey was to canvass expert opinion regarding the management of recurrent SUI and urinary retention following insertion of these slings.

METHODS

Expert urologists and urogynaecologists in the UK with an interest in SUI were identified. Three clinical scenarios on recurrent SUI and one on urinary retention following midurethral sling placements were emailed twice to the experts.

RESULTS

The majority of the experts chose a repeat synthetic midurethral retropubic transvaginal tape (TVT) as the procedure of choice for recurrent SUI in patients who had had a previous TVT or midurethral transobturator tape inserted. In patients who continued to suffer SUI after a failed second TVT, there were mixed results with experts choosing fascial slings, colposuspension and bulking agents as their preferred method of treatment. In women who develop urinary retention following a TVT, tape pull-down within two weeks was the preferred method among the experts. However, division of the tape within two to six weeks following the procedure was also popular.

CONCLUSIONS

Based on expert opinion, it is difficult to make a recommendation as to the best method of treating recurrent SUI or urinary retention following tape insertion. There is an urgent requirement for well conducted, multicentre, randomised clinical trials to look at the management of these complications and also the tools used to assess the patient before salvage surgical management.
Ancient schwannoma of the parapharynx causing dysphagia: a rare entity
Authors: Sayed SI , Rane P , Deshmukh A , Chaukar D , Menon S , Arya S , D’cruz AK
Published: September 2012

A schwannoma is a benign, encapsulated tumour that is derived from neural sheath (Schwann) cells. Approximately 25–40% of schwannomas occur in the head and neck. The most common site is the parapharyngeal space of the neck; oropharyngeal occurrence is extremely rare. Among the various histological types of schwannomas reported to date, the ancient (degenerative) variant is the most rare. To our knowledge, this is the first report of an ancient schwannoma in the parapharynx with an extensive oropharyngeal component causing dysphagia. Dysphagia was the prominent symptom because of the location and volume of the lesion. The tumour was excised via a transcervical approach.
Biliary and portal vein strictures following treatment of Hodgkin’s lymphoma
Authors: Roberts KJ , Brown R , Patel JV , Toogood GJ
Published: September 2012

Treatment of abdominal lymphoma can be associated with bowel stricture or perforation. Rarely, the common bile duct or portal vein can be involved. This is the first case of stricture formation of both the portal vein and common bile duct in a patient following successful treatment of lymphoma. The development of extensive hilar varices rendered surgical management high risk. A staged approach to treatment was used. First, a percutaneous portal vein stent was placed, resulting in resolution of the hilar varices. This was followed by a surgical hepaticojejunostomy, performed without complication. Gastrointestinal complications are rare following treatment of lymphoma but may affect a variety of sites. The safe and effective treatment of this case highlights the benefit of a multidisciplinary approach to complex medical and surgical problems.
Multiple large enteroliths associated with an incisional hernia: a rare case
Authors: Wilson I , Parampalli U , Butler C , Ahmed I , Mowat A
Published: September 2012

The surgeon frequently encounters renal and biliary stones but rarely may also encounter enteric stones or enteroliths. An enterolith is a stony foreign body that is formed in the gastrointestinal tract. We present a rare case of multiple, large enteroliths found associated with a longstanding incarcerated incisional hernia.
Early results of a prospective study on the pyrolytic carbon (pyrocarbon) Amandys® for osteoarthritis of the wrist
Authors: Daruwalla ZJ , Davies KL , Shafighian A , Gillham NR
Published: September 2012

INTRODUCTION

The preliminary results of a pyrocarbon interpositional radiocarpal implant in a small cohort of patients were reviewed. As it is currently only a limited release product, we describe to potential users early complications and negative outcomes.

METHODS

Patients were assessed using pain levels, ranges of motion, grip strength, type of and time to return to work as well as pre-operative and post-operative DASH (Disabilities of the Arm, Shoulder and Hand) scores. Radiographs were taken and patient satisfaction was recorded.

RESULTS

All six patients were contacted. One was not satisfied. Three had reduced motion. None experienced squeaking. There were no immediate or late post-operative complications. There was one early volar displacement of an implant.

CONCLUSIONS

Although our early results are somewhat encouraging, further and longer studies are warranted before supporting the use of this particular pyrocarbon implant as a primary procedure.
An Initial Investigation into the Anti-inflammatory Activity and Antioxidant Capacity of alpha-Cyclodextrin-Complexed Manuka Honey
Authors: Chepulis Lynne M. , Francis Evelyn
Published: September 2012

The bioactive properties of Manuka honey are now well recognised, but the nature of honey (a sticky, viscous fluid) can make it hard to use as a health remedy. A new technology using encapsulation of Manuka honey with alpha-cyclodextrin molecules has been developed, creating a free-flowing powder that can easily be added to foods and beverages, or tableted / made into capsules for use in health. In this study, we investigated for antioxidant and anti-inflammatory activity. Antioxidant capacity of raw Manuka honeys and matched complexes was measured using the CUPRAC method. Results showed that the antioxidant activity of honey decreased when complexed, this being directly related to dilution of the final product with alpha-cyclodextrin. Anti-inflammatory activity was assessed by measuring inhibition of neutrophil TNF-alpha secretion. Contradictory results were produced, with both stimulation and inhibition of TNF-alpha being observed. Data from this study indicate that the formation of cyclodextrin-based complexes of Manuka honey may potentiate the anti-inflammatory activity of honey, but this may differ depending on methylglyoxal content and the presence of other factors.
Moisture in softwoods: fiber saturation point, hydroxyl site content, and the amount of micropores as determined from NMR relaxation time distributions
Authors: Telkki Ville-Veikko , Yliniemi Miikka , Jokisaari Jukka
Published: September 2012

Distributions of nuclear magnetic resonance (NMR) relaxation times provide detailed information about the moisture absorbed in wood. In this work, T
2*, T
2, and T
1 distributions were recorded from fresh sapwood and heartwood samples of pine (Pinus sylvestris) and spruce (Picea abies) at various temperatures. Below the melting point of bulk water, free water is frozen and its signal disappears from the distributions. Then, the low-temperature distributions of the unfrozen bound water contain more information about its components, because the large free water peaks hiding some smaller bound water peaks are absent and the exchange between free and bound water is prevented. Comparison of the total moisture signal integrals above and below the bulk melting point enables the determination of fiber saturation point (FSP), which, in this context, denotes the total water capacity of cell wall. T
2*, T
2, and T
1 distributions offer different kinds of information about moisture components. All the peaks in the distributions were assigned, and it was demonstrated that the accessible hydroxyl site content and the amount of micropores can be estimated based on the peak integrals.
Dissecting the impact of Frizzled receptors in Wnt/β-catenin signaling of human mesenchymal stem cells
Authors: Kolben Thomas , Peröbner Iris , Fernsebner Katharina , Lechner Felix , Geissler Claudia , Ruiz-Heinrich Lourdes , Capovilla Simon , Jochum Marianne , Neth Peter
Published: September 2012

Wnt/β-catenin signaling is of fundamental importance in the regulation of self-renewal, migration/invasion, and differentiation of human mesenchymal stem cells (hMSCs). Because little information is available about the function of Frizzled receptors (Fzds) as the main receptors of Wnt proteins in hMSCs, we first performed comparative Fzd mRNA expression profiling. Fzd9 and Fzd10 were not expressed in hMSCs. While Fzd3 was expressed at low levels in hMSCs, the other Fzds exhibited high expression rates. Activation and repression of Wnt signaling in hMSCs revealed that the expression levels of Fzd1, Fzd6, and Fzd7 are positively correlated with the Wnt/β-catenin activation status, whereas Fzd8 exhibited an inverse relation. For studying the functional relevance of Fzds in Wnt/β-catenin signaling, RNA interference, ectopic expression studies, and rescue approaches were performed in hMSCs carrying a highly sensitive TCF/LEF reporter gene system (Gaussia luciferase). We found that, Fzd1, Fzd5, Fzd7, and Fzd8 are largely involved in Wnt/β-catenin signaling of hMSCs. Moreover, the knockdown of Fzd5 can be compensated by the ectopic expression of Fzd7. Conversely, the ectopic expression of Fzd5 in Fzd7-knockdown hMSCs resulted in a rescue of Wnt/β-catenin signaling, pointing to a functional redundancy of Fzd5 and Fzd7.
Phase Development in Carbothermal Reduction and Nitridation of Ilmenite Concentrates
Authors: Rezan Sheikh A. , Zhang Guangqing , Ostrovski Oleg
Published: September 2012

The phase development in the course of carbothermal reduction and nitridation of ilmentie concentrates and synthetic rutile was studied in temperature programmed reduction (623–1873 K) and isothermal reduction experiments. Ilmenites and synthetic rutile were reduced in a tube reactor with continuously flowing hydrogen-nitrogen mixture or pure nitrogen. The rate and extent of reduction were monitored by online off-gas analysis. Samples reduced to different extent were subjected to XRD and SEM/BSE analyses. Pseudorutile and ilmenite were the main phases in ilmenite concentrates; rutile was the main phase in synthetic rutile. Pseudorutile was first converted to ilmenite and titania which occurred at temperatures below 623 K; iron oxides in ilmenite were quickly reduced to metallic iron. Titania was reduced to titanium suboxides and further to titanium oxycarbonitride. Reduction of ilmenites and synthetic rutile in hydrogen-nitrogen mixture was much faster than in pure nitrogen. The rate of conversion of titanium oxides to oxycarbonitride was affected by iron content in the ilmenites. The rate of reduction increased with increasing iron content in ilmenite (decreasing grade) when ilmenites were reduced in the hydrogen-nitrogen gas mixture, but decreased with decreasing ilmenite grade in reduction experiments in nitrogen; reduction in nitrogen was the fastest for synthetic rutile. The difference in the reduction behaviour was attributed to different chemical compositions and morphologies of ilmenites of different grades.
The influence of oxonate-induced hyperuricemia and allopurinol on behavioral reactions of random-bred mice
Authors: Tovchiga Olga , Shtrygol Sergey
Published: September 2012

Background: Purine metabolism specificity, namely the high level of uric acid in the blood, is considered to be significant in the appearance of intellectually-developed primates, as well as in later periods of human development, for personal activity and achievements and even for the formation of genius. Nowadays hyperuricemia is mostly associated with the pathogenesis of hypertension and metabolic syndrome. Its influence on the central nervous system is predominantly set aside.

Methods: The behavioral reactions of random-bred mice with uricase inhibition due to potassium oxonate or xanthine oxidase suppression with allopurinol for three weeks were investigated.

Results: Potassium oxonate reduced signs of anxiety in the elevated plus maze. A positive correlation appeared between latency to enter a dark arm and uricemia, so anxiety reduction can be associated with uric acid metabolism changes. Allopurinol reduced anxiety that was not related to the metabolic changes of uric acid, so the involvement of changes in uric acid precursor concentrations cannot be excluded. Potassium oxonate but not allopurinol reduced immobility in a tail suspension test. There was a tendency to increase the duration of swimming to exhaustion against the potassium oxonate background. At the same time, potassium oxonate reduced research activity in the combined open field test and increased the vegetative maintenance of behavioral responses. Allopurinol did not change the results of this test.

Conclusions: A reduction in anxiety and depression level and a tendency to augment physical performance against the potassium oxonate background partly conform to the beneficial evolutionary role of hyperuricemia.
L-Type Voltage-Gated Calcium Channels in the Basolateral Amygdala Are Necessary for Fear Extinction
Authors: Davis Stephanie E. , Bauer Elizabeth P.
Published: September 2012

L-type voltage-gated calcium channels (L-VGCCs) in the basolateral nucleus of the amygdala (BLA) are necessary for long-term memory of fear conditioning, where they are thought to drive the activation of protein kinases and to initiate gene transcription. However, their role in fear extinction learning is unclear given that systemic injections of VGCC antagonists induce a protracted stress response. Here we tested the effects of local infusions of the L-VGCC antagonists verapamil and nifedipine on both within-session extinction and fear extinction consolidation. Intra-BLA infusions of verapamil or nifedipine did not affect the expression of fear conditioning or the amount of within-session extinction but impaired extinction memory when rats were tested 24 h later drug-free. L-VGCC antagonists also prevented the increase in phosphorylated mitogen-activated protein kinase (MAPK) normally seen in the BLA following extinction learning. These results suggest that activation of L-VGCCs in the BLA at the time of fear extinction learning is necessary for the long-term retention of fear extinction via the MAPK pathway.
Quantitative Regional and Ultrastructural Localization of the Cav2.3 Subunit of R-type Calcium Channel in Mouse Brain
Authors: Parajuli Laxmi Kumar , Nakajima Chikako , Kulik Akos , Matsui Ko , Schneider Toni , Shigemoto Ryuichi , Fukazawa Yugo
Published: September 2012

R-type calcium channels (RTCCs) are well known for their role in synaptic plasticity, but little is known about their subcellular distribution across various neuronal compartments. Using subtype-specific antibodies, we characterized the regional and subcellular localization of Cav2.3 in mice and rats at both light and electron microscopic levels. Cav2.3 immunogold particles were found to be predominantly presynaptic in the interpeduncular nucleus, but postsynaptic in other brain regions. Serial section analysis of electron microscopic images from the hippocampal CA1 revealed a higher density of immunogold particles in the dendritic shaft plasma membrane compared with the pyramidal cell somata. However, the labeling densities were not significantly different among the apical, oblique, or basal dendrites. Immunogold particles were also observed over the plasma membrane of dendritic spines, including both synaptic and extrasynaptic sites. Individual spine heads contained <20 immunogold particles, with an average density of ∼260 immunoparticles per μm3spine head volume, in accordance with the density of RTCCs estimated using calcium imaging (Sabatini and Svoboda, 2000). The Cav2.3 density was variable among similar-sized spine heads and did not correlate with the density in the parent dendrite, implying that spines are individual calcium compartments operating autonomously from their parent dendrites.
Frequency-Selective Exocytosis by Ribbon Synapses of Hair Cells in the Bullfrog's Amphibian Papilla
Authors: Patel Suchit H. , Salvi Joshua D. , Maoiléidigh Dáibhid Ó , Hudspeth A. J.
Published: September 2012

The activity of auditory afferent fibers depends strongly on the frequency of stimulation. Although the bullfrog's amphibian papilla lacks the flexible basilar membrane that effects tuning in mammals, its afferents display comparable frequency selectivity. Seeking additional mechanisms of tuning in this organ, we monitored the synaptic output of hair cells by measuring changes in their membrane capacitance during sinusoidal electrical stimulation at various frequencies. Using perforated-patch recordings, we found that individual hair cells displayed frequency selectivity in synaptic exocytosis within the frequency range sensed by the amphibian papilla. Moreover, each cell's tuning varied in accordance with its tonotopic position. Using confocal imaging, we observed a tonotopic gradient in the concentration of proteinaceous Ca2+buffers. A model for synaptic release suggests that this gradient maintains the sharpness of tuning. We conclude that hair cells of the amphibian papilla use synaptic tuning as an additional mechanism for sharpening their frequency selectivity.
Antibody-Aided Clearance of Extracellular α-Synuclein Prevents Cell-to-Cell Aggregate Transmission
Authors: Bae Eun-Jin , Lee He-Jin , Rockenstein Edward , Ho Dong-Hwan , Park Eun-Bi , Yang Na-Young , Desplats Paula , Masliah Eliezer , Lee Seung-Jae
Published: September 2012

Abnormal deposition and intercellular propagation of α-synuclein plays a central role in the pathogenesis of disorders such as Parkinson's Disease (PD) and dementia with Lewy bodies (DLB). Previous studies demonstrated that immunization against α-synuclein resulted in reduced α-synuclein accumulation and synaptic loss in a transgenic (tg) mouse model, highlighting the potential for immunotherapy. However, the mechanism by which immunization prevents synucleinopathy-associated deficits remains unknown. Here, we show that antibodies against α-synuclein specifically target and aid in clearance of extracellular α-synuclein proteins by microglia, thereby preventing their actions on neighboring cells. Antibody-assisted clearance occurs mainly in microglia through the Fcγ receptor, and not in neuronal cells or astrocytes. Stereotaxic administration of antibody into the brains of α-synuclein tg mice prevented neuron-to-astroglia transmission of α-synuclein and led to increased localization of α-synuclein and the antibody in microglia. Furthermore, passive immunization with α-synuclein antibody reduced neuronal and glial accumulation of α-synuclein and ameliorated neurodegeneration and behavioral deficits associated with α-synuclein overexpression. These findings provide an underlying mechanistic basis for immunotherapy for PD/DLB and suggest extracellular forms of α-synuclein as potential therapeutic targets.
Spatial Localization of Auditory Stimuli in Human Auditory Cortex is Based on Both Head-Independent and Head-Centered Coordinate Systems
Authors: Schechtman Eitan , Shrem Talia , Deouell Leon Y.
Published: September 2012

In humans, whose ears are fixed on the head, auditory stimuli are initially registered in space relative to the head. Eventually, locations of sound sources need to be encoded also relative to the body, or in absolute allocentric space, to allow orientation toward the sounds sources and consequent action. We can therefore distinguish between two spatial representation systems: a basic head-centered coordinate system and a more complex head-independent system. In an ERP experiment, we attempted to reveal which of these two coordinate systems is represented in the human auditory cortex. We dissociated the two systems using the mismatch negativity (MMN), a well studied EEG effect evoked by acoustic deviations. Contrary to previous findings suggesting that only primary head-related information is present at this early stage of processing, we observed significant MMN effects for both head-independent and head-centered deviant stimuli. Our findings thus reveal that both primary head-related and secondary body- or world-related reference frames are represented at this stage of auditory processing.
Perceptual Learning Reconfigures the Effects of Visual Adaptation
Authors: McGovern David P. , Roach Neil W. , Webb Ben S.
Published: September 2012

Our sensory experiences over a range of different timescales shape our perception of the environment. Two particularly striking short-term forms of plasticity with manifestly different time courses and perceptual consequences are those caused by visual adaptation and perceptual learning. Although conventionally treated as distinct forms of experience-dependent plasticity, their neural mechanisms and perceptual consequences have become increasingly blurred, raising the possibility that they might interact. To optimize our chances of finding a functionally meaningful interaction between learning and adaptation, we examined in humans the perceptual consequences of learning a fine discrimination task while adapting the neurons that carry most information for performing this task. Learning improved discriminative accuracy to a level that ultimately surpassed that in an unadapted state. This remarkable improvement came at a price: adapting directions that before learning had little effect elevated discrimination thresholds afterward. The improvements in discriminative accuracy grew quickly and surpassed unadapted levels within the first few training sessions, whereas the deterioration in discriminative accuracy had a different time course. This learned reconfiguration of adapted discriminative accuracy occurred without a concomitant change to the characteristic perceptual biases induced by adaptation, suggesting that the system was still in an adapted state. Our results point to a functionally meaningful push–pull interaction between learning and adaptation in which a gain in sensitivity in one adapted state is balanced by a loss of sensitivity in other adapted states.
Optogenetic Analysis of Neuronal Excitability during Global Ischemia Reveals Selective Deficits in Sensory Processing following Reperfusion in Mouse Cortex
Authors: Chen Shangbin , Mohajerani Majid H. , Xie Yicheng , Murphy Timothy H.
Published: September 2012

We have developed an approach to directly probe neuronal excitability during the period beginning with induction of global ischemia and extending after reperfusion using transgenic mice expressing channelrhodopsin-2 (ChR2) to activate deep layer cortical neurons independent of synaptic or sensory stimulation. Spontaneous, ChR2, or forepaw stimulation-evoked electroencephalogram (EEG) or local field potential (LFP) records were collected from the somatosensory cortex. Within 20 s of ischemia, a >90% depression of spontaneous 0.3–3 Hz EEG and LFP power was detected. Ischemic depolarization followed EEG depression with a ∼2 min delay. Surprisingly, neuronal excitability, as assessed by the ChR2-mediated EEG response, was intact during the period of strong spontaneous EEG suppression and actually increased before ischemic depolarization. In contrast, a decrease in the somatosensory-evoked potential (forepaw-evoked potential, reflecting cortical synaptic transmission) was coincident with the EEG suppression. After 5 min of ischemia, the animal was reperfused, and the ChR2-mediated response mostly recovered within 30 min (>80% of preischemia value). However, the recovery of the somatosensory-evoked potential was significantly delayed compared with the ChR2-mediated response (<40% of preischemia value at 60 min). By assessing intrinsic optical signals in combination with EEG, we found that neuronal excitability approached minimal values when the spreading ischemic depolarization wave propagated to the ChR2-stimulated cortex. Our results indicate that the ChR2-mediated EEG/LFP response recovers much faster than sensory-evoked EEG/LFP activityin vivofollowing ischemia and reperfusion, defining a period where excitable but synaptically silent neurons are present.
The Conserved Dopaminergic Diencephalospinal Tract Mediates Vertebrate Locomotor Development in Zebrafish Larvae
Authors: Lambert Aaron M. , Bonkowsky Joshua L. , Masino Mark A.
Published: September 2012

The most conserved part of the vertebrate dopaminergic system is the orthopedia (otp)-expressing diencephalic neuronal population that constitutes the dopaminergic diencephalospinal tract (DDT). Although studies in the neonatal murine spinal cordin vitrosuggest an early locomotor role of the DDT, the function of the DDT in developing vertebratesin vivoremains unknown. Here, we investigated the role of the DDT in the locomotor development of zebrafish larvae. To assess the development of the behavioral and neural locomotor pattern, we used high-throughput video tracking in combination with peripheral nerve recordings. We found a behavioral and neural correspondence in the developmental switch from an immature to mature locomotor pattern. Blocking endogenous dopamine receptor 4 (D4R) signalingin vivoeither before or after the developmental switch prevented or reversed the switch, respectively. Spinal transections of post-switch larvae reestablished the immature locomotor pattern, which was rescued to a mature-like pattern via spinal D4R agonism. Selective chemogenetic ablation ofotp b(otpb) neurons that contribute to the DDT perpetuated the immature locomotor patternin vivo. This phenotype was recapitulated by diencephalic transections that removed the dopaminergicotpbpopulation and was rescued to a mature-like locomotor pattern by D4R agonism. We conclude that the dopaminergicotpbpopulation, via the DDT, is responsible for spinal D4R signaling to mediate the developmental switch to the mature locomotor pattern of zebrafish. These results, integrated with the mammalian literature, suggest that the DDT represents an evolutionarily conserved neuromodulatory system that is necessary for normal vertebrate locomotor development.
Neural Mechanisms of Attentional Reorienting in Three-Dimensional Space
Authors: Chen Qi , Weidner Ralph , Vossel Simone , Weiss Peter H. , Fink Gereon R.
Published: September 2012

How the human brain reconstructs the three-dimensional (3D) world from two-dimensional (2D) retinal images has received a great deal of interest as has how we shift attention in 2D space. In contrast, it remains poorly understood how visuospatial attention is shifted in depth. In this fMRI study, by constructing a virtual 3D environment in the MR scanner and by presenting targets either close to or far from the participants in an adapted version of the Posner spatial-cueing paradigm, we investigated the behavioral and neural mechanisms underlying visuospatial orienting/reorienting in depth. At the behavioral level, although covering the same spatial distance, attentional reorienting to objects unexpectedly appearing closer to the observer and in the unattended hemispace was faster than reorienting to unexpected objects farther away. At the neural level, we found that in addition to the classical attentional reorienting system in the right temporoparietal junction, two additional brain networks were differentially involved in aspects of attentional reorienting in depth. First, bilateral premotor cortex reoriented visuospatial attention specifically along the third dimension of visual space (i.e., from close to far or vice versa), compared with attentional reorienting within the same depth plane. Second, a network of areas reminiscent of the human “default-mode network,” including posterior cingulate cortex, orbital prefrontal cortex, and left angular gyrus, was involved in the neural interaction between depth and attentional orienting, by boosting attentional reorienting to unexpected objects appearing both closer to the observer and in the unattended hemispace.
Cognitive Regulation during Decision Making Shifts Behavioral Control between Ventromedial and Dorsolateral Prefrontal Value Systems
Authors: Hutcherson Cendri A. , Plassmann Hilke , Gross James J. , Rangel Antonio
Published: September 2012

Cognitive regulation is often used to influence behavioral outcomes. However, the computational and neurobiological mechanisms by which it affects behavior remain unknown. We studied this issue using an fMRI task in which human participants used cognitive regulation to upregulate and downregulate their cravings for foods at the time of choice. We found that activity in both ventromedial prefrontal cortex (vmPFC) and dorsolateral prefrontal cortex (dlPFC) correlated with value. We also found evidence that two distinct regulatory mechanisms were at work: value modulation, which operates by changing the values assigned to foods in vmPFC and dlPFC at the time of choice, and behavioral control modulation, which operates by changing the relative influence of the vmPFC and dlPFC value signals on the action selection process used to make choices. In particular, during downregulation, activation decreased in the value-sensitive region of dlPFC (indicating value modulation) but not in vmPFC, and the relative contribution of the two value signals to behavior shifted toward the dlPFC (indicating behavioral control modulation). The opposite pattern was observed during upregulation: activation increased in vmPFC but not dlPFC, and the relative contribution to behavior shifted toward the vmPFC. Finally, ventrolateral PFC and posterior parietal cortex were more active during both upregulation and downregulation, and were functionally connected with vmPFC and dlPFC during cognitive regulation, which suggests that they help to implement the changes to the decision-making circuitry generated by cognitive regulation.
The ligand-mediated nuclear mobility and interaction with estrogen-responsive elements of estrogen receptors are subtype specific
Authors: Muyan Mesut , Callahan Linda M , Huang Yanfang , Lee Andrew J
Published: September 2012

17β-Estradiol (E2) plays important roles in functions of many tissues. E2 effects are mediated by estrogen receptor (ER) α and β. ERs regulate transcriptions through estrogen-responsive element (ERE)-dependent and ERE-independent modes of action. ER binding to ERE constitutes the basis of the ERE-dependent pathway. Direct/indirect ER interactions with transcription complexes define ERE-independent signaling. ERs share functional features. Ligand-bound ERs nevertheless induce distinct transcription profiles. Live cell imaging indicates a dynamic nature of gene expressions by highly mobile ERs. However, the relative contribution of ER mobility at the ERE-independent pathway to the overall kinetics of ER mobility remains undefined. We used fluorescent recovery after a photo-bleaching approach to assess the ligand-mediated mobilities of ERE binding-defective ERs, EREBD. The decrease in ERα mobility with E2 or the selective ER modulator 4-hydroxyl-tamoxifen (4HT) was largely due to the interaction of the receptor with ERE. Thus, ERα bound to E2 or 4HT mediates transcriptions from the ERE-independent pathway with remarkably fast kinetics that contributes fractionally to the overall motility of the receptor. The antagonist Imperial Chemical Industries 182 780 immobilized ERαs. The mobilities of ERβ and ERβEBD in the presence of ligands were indistinguishable kinetically. Thus, ERβ mobility is independent of the nature of ligands and the mode of interaction with target sites. Chimeric ERs indicated that the carboxyl-termini are critical regions for subtype-specific mobility. Therefore, while ERs are highly mobile molecules interacting with target sites with fast kinetics, an indication of the hit-and-run model of transcription, they differ mechanistically to modulate transcriptions.
O uso da escala de Braden e fotografias na avaliação do risco para úlceras por pressão
Authors: Araújo Thiago Moura de , Araújo Márcio Flávio Moura de , Caetano Joselany Áfio
Published: September 2012

O objetivo deste artigo foi identificar casos de risco para úlcera por pressão (UP), em pacientes críticos, a partir da escala de Braden e de fotografias digitais. Uma amostra de 42 sujeitos foi avaliada durante 15 dias entre março a junho de 2009 em Fortaleza, Brasil. No total foram identificadas 47 lesões, sendo 23 (48,9%) com estágio I e 24 (51,1%) com estágio II. Conclui-se que é necessário que o enfermeiro que ainda não utiliza usualmente tecnologias na avaliação e tratamento procure se familiarizar com isso, a fim de diminuir as repercussões negativas deste problema de saúde coletiva.
Planejamento familiar de mulheres com transtorno mental: o que profissionais do CAPS têm a dizer
Authors: Moura Escolástica Rejane Ferreira , Guedes Tatiane Gomes , Freire Suellen Alves , Bessa Adriana Teofilo , Braga Violante Augusta , Silva Raimunda Magalhães da
Published: September 2012

O objetivo deste estudo foi verificar demandas de planejamento familiar que chegam ao Centro de Atendimento Psicossocial (CAPS) e investigar contribuições desse serviço para as mulheres portadoras de transtorno mental. Trata-se de estudo qualitativo, realizado com oito profissionais de um CAPS de Fortaleza-CE. A coleta de dados ocorreu por meio de entrevista, sendo utilizada para análise a técnica de conteúdo. As demandas detectadas foram: solicitação de informações pelos familiares para lidar com paciente sexualmente ativo; pacientes suscetíveis à violência sexual e gravidez; mulheres com depressão, em uso de carbonato de lítio. As contribuições: necessidade de rede integrada (atenção básica/CAPS), com profissionais conhecedores das particularidades do planejamento familiar dessas mulheres - parte defende atendimento na atenção básica, parte, atendimento no CAPS, destacando-se o matriciamento como estratégia a corresponsabilizar os dois polos, evitando encaminhamentos desnecessários aos CAPS, pelo fortalecimento da resolubilidade dos casos na atenção básica.
A análise de diagnósticos de enfermagem sob uma perspectiva bayesiana
Authors: Lopes Marcos Venícios de Oliveira , Silva Viviane Martins da , Araujo Thelma Leite de
Published: September 2012

O uso de técnicas de estatística bayesiana é uma abordagem que tem sido bem aceita e estabelecida em campos fora da enfermagem como um paradigma de redução da incerteza presente em uma dada situação clínica. O presente artigo tem como propósito apresentar um direcionamento para o uso específico do paradigma bayesiano na análise de diagnósticos de enfermagem. Para isso, as etapas e interpretações de análise bayesiana são discutidas; um exemplo teórico e outro prático sobre análise bayesiana de diagnósticos de enfermagem são apresentados; e há a descrição de como a abordagem bayesiana pode ser utilizada para resumir o conhecimento disponível e apresentar estimativas pontuais e intervalares da verdadeira probabilidade de um diagnóstico de enfermagem. Conclui-se que a aplicação de métodos estatísticos bayesianos é uma importante ferramenta para a definição mais acurada de probabilidades de diagnósticos de enfermagem.
Impacto da incontinência urinária na vida de esposas de homens com incontinência: revisão integrativa
Authors: Bicalho Mariana Bezzon , Lopes Maria Helena Baena de Moraes
Published: September 2012

A incontinência urinária masculina tem sido relacionada a vários fatores, destacando-se a hiperplasia prostática benigna e o tratamento de câncer de próstata. A incontinência urinária gera implicações negativas tanto para o indivíduo incontinente, como para seus familiares e cuidadores. No presente estudo foi realizada uma revisão integrativa a fim de identificar o impacto na vida das parceiras de homens incontinentes. A busca dos artigos foi realizada nas bases de dados CINAHL, EMBASE, SCOPUS, MEDLINE e PubMed. Foram incluídos artigos na língua portuguesa, inglesa e espanhola, e excluídos os que não citavam esposas. A amostra final foi composta por 15 artigos, de sete países. Os artigos foram distribuídos nas categorias: Sofrimento Psíquico, Fadiga, Mudança na Vida Sexual, e Limitação da Vida Social. A categoria Sofrimento Psíquico esteve presente em todos os artigos e foi avaliada como a mais prejudicial na vida dessas mulheres.
Triagem auditiva neonatal: motivos da evasão das famílias no processo de detecção precoce
Authors: Alvarenga Kátia de Feitas , Gadret Juliana Maria , Araújo Eliene Silva , Bevilacqua Maria Cecília
Published: September 2012

OBJETIVO: Analisar os motivos da evasão familiar no programa de triagem auditiva neonatal realizado em um hospital público e correlacioná-los com a distribuição demográfica das famílias e as características do programa. MÉTODOS: Participaram 132 famílias, de um total de 739 contatadas, cujos filhos nasceram em uma maternidade no interior do estado de São Paulo de outubro/2003 a dezembro/2005 e que não haviam comparecido para a realização do teste ou reteste da triagem auditiva neonatal. Foi aplicado um questionário de levantamento das causas de evasão, contendo perguntas relacionadas à triagem auditiva, nível de escolaridade e profissão dos pais e também sobre a audição e o desenvolvimento de linguagem da criança. RESULTADOS: Realizou-se a aplicação do questionário com 132 famílias (17,86%); com as demais não foi obtido contato. Deste total, 82 haviam faltado na primeira etapa da triagem auditiva (teste) e 50 não haviam retornado para realização do reteste. Os motivos mais frequentes para justificar a evasão foram o desinteresse e a dificuldade em conciliar o agendamento com a rotina familiar. Não houve associação entre os motivos da evasão e o nível de escolaridade e ocupação dos pais, nem com o profissional que realizou a orientação acerca da triagem auditiva. Não foi referido nenhum caso de alteração auditiva, nem de atraso significativo no desenvolvimento da linguagem. CONCLUSÃO: Os motivos da evasão familiar independem de variáveis voltadas à família e à dinâmica do programa de triagem auditiva.
Relação entre as palavras eliciadas na Avaliação Fonológica da Criança e as variáveis idade, gênero e gravidade do desvio fonológico
Authors: Savoldi Angélica , Gubiani Marileda Barichello , Brancalioni Ana Rita , Keske-Soares Márcia
Published: September 2012

OBJETIVO: Verificar a relação entre as palavras pertencentes e não pertencentes à Avaliação Fonológica da Criança (AFC) e as variáveis idade, gênero e gravidade do desvio fonológico (DF), e analisar as palavras produzidas e as palavras substituídas com maior frequência na AFC. MÉTODOS: Fizeram parte do estudo 45 crianças com DF, de ambos os gêneros, com idades entre 4 anos e 7 anos e 11 meses. O corpus de fala foi composto por 6463 palavras, que foram divididas em palavras pertencentes ou não à AFC. A amostra foi dividida quanto à faixa etária, à gravidade do desvio fonológico e ao gênero. Os dados foram analisados estatisticamente. RESULTADOS: Houve maior produção de palavras não pertencentes à AFC e relação significativa entre a palavra pertencer ou não ao AFC quanto à faixa etária, gênero e gravidade do DF. As palavras-alvo enunciadas com maior frequência foram equivalentes a nomes de objetos do dia a dia da criança, ao contrário das substituições, que foram mais frequentes quando a palavra-alvo correspondia a objetos não conhecidos visualmente pelas crianças. CONCLUSÃO: A produção de palavras pertencentes à AFC é influenciada pela idade, gênero e gravidade do DF. É fundamental que nas palavras selecionadas para uma avaliação fonológica sejam consideradas tais variáveis, bem como, aspectos regionais, classe gramatical de substantivo, e o repertório da criança.
Fatores causais e aplicação de provas complementares relacionadas à gravidade no transtorno fonológico
Authors: Wertzner Haydée Fiszbein , Francisco Danira Tavares , Pagan-Neves Luciana de Oliveira
Published: September 2012

OBJETIVO: Verificar se o índice de gravidade, que mede a porcentagem de consoantes corretas, distingue as crianças com transtorno fonológico em relação às medidas de estimulabilidade e inconsistência de fala, bem como à presença dos históricos familial e de otite média. MÉTODOS: Participaram da pesquisa 15 sujeitos com idades entre 5 e 7 anos e 11meses, com diagnóstico de transtorno fonológico. O índice Porcentagem de Consoantes Corretas - Revisado (PCC-R) foi calculado para as provas de imitação de palavras e de nomeação de figuras, separadamente. A partir destas provas também foi computada a necessidade de aplicação da prova de estimulabilidade, de acordo com os critérios propostos em pesquisas anteriores. A prova de inconsistência de fala permitiu classificar os sujeitos como consistentes ou inconsistentes. Os dados foram submetidos à análise estatística. RESULTADOS: Na comparação entre os valores do PCC-R medido na prova de nomeação e de imitação foi observada diferença em relação à necessidade da aplicação da estimulabilidade. Em relação à prova de inconsistência de fala, não houve evidência desta relação. Não foi verificada diferença no PCC-R considerando-se a presença dos históricos de otite média e familial. CONCLUSÃO: O estudo indica que as crianças que precisaram da aplicação da prova de estimulabilidade apresentaram valores mais baixos de PCC-R. Entretanto, em relação à prova de inconsistência de fala e aos históricos de otite ou familial, o PCC-R não determinou diferenças entre as crianças.