bluuebunny/crossref_metadata_2025 huggingface dataset:
Modified Combustion Synthesis of γ-Alumina Nano Powders
Authors: Norouzbeigi R. , Edrissi M
Published: July 2011

Alumina nano powders have been prepared by a chemical method named combustion synthesis using new fuels. The effect of key factors on the synthesis of nanoparticles was studied and optimized using Taguchi L16 (45
) array design. The products were characterized by XRD, TGA, EDX, FESEM, and TEM analyses. Results show that aluminum oxide powders had crystal sizes between 7.2 nm and 13 nm and specific surface areas between 21 m2 g-1 and 70 m2 g-1. It was found that there is a good linear correlation (R
2=0.953) between crystallite size and specific surface area of the synthesized γ-alumina. The surface area of the sample prepared under optimum condition was 72 m2 g-1 and its average particle size measured by DLLS was 81 nm. The synthesis of γ-alumina was modified in order to achieve higher specific surface area (123 m2 g-1). A network of nano-fibers was successfully obtained by the modified route. The length and diameter of fibers were about 160 nm and 10 nm respectively.
The Phenomenon of Jewish Buddhists in Light of the History of Jewish Suffering
Authors: Gez Yonatan N.
Published: July 2011

Studies on the practice of Buddhism in the West clearly show that, ever since the 1960s, Buddhism has won a significant following from individuals of Jewish background. This article explores the links between Jewish adoption of Buddhism (as a form of spiritual practice, philosophy, therapy or overarching religion) and the pains of Jewish history, and proposes that conversion may be an attempt to disassociate one's self not only from her or his own Jewishness, but from the entire Abrahamic religious model. At the same time, the trend is confronted by its countertrend, by which the disassociation from Judaism for the sake of engagement with Buddhism often seems to be temporary, partial, or both. It is argued that in such instances, engagement with Buddhism may serve post-Holocaust needs for spiritual convalescence while at the same time instilling a pluralistic spirit that holds vicarious ramifications for Jewish attitudes towards and relations with other faiths, Abrahamic and non-Abrahamic alike.
Blurring the Boundaries: American Messianic Jews and Gentiles
Authors: Power Patricia A.
Published: July 2011

Messianic Judaism is usually equated with Jews for Jesus, an overtly missionizing form of ethnically Jewish Evangelical Christianity that was born in the American counter-culture revolution of the 1970s. The ensuing and evolving hybrid blend of Judaism and Christianity that it birthed has evoked strong objections from both the American Jewish and mainline Christian communities. What begs an explanation, though, is how a Gentile Protestant missionary project to convert the Jews has become an ethnically Jewish movement to create community, continuity, and perhaps a new form of Judaism. This paper explores the way in which Messianic Jews have progressively exploited the space between two historically competitive socio-religious cultures in order to create an identity of their own in the American religious landscape. It also introduces Messianic Israelites, non-Jewish but sympathetic believers who are struggling with the implications of an ethnically divided church where Jews are the categorically privileged members.
High prevalence of AIP gene mutations following focused screening in young patients with sporadic pituitary macroadenomas
Authors: Tichomirowa Maria A , Barlier Anne , Daly Adrian F , Jaffrain-Rea Marie-Lise , Ronchi Cristina , Yaneva Maria , Urban Jonathan D , Petrossians Patrick , Elenkova Atanaska , Tabarin Antoine , Desailloud Rachel , Maiter Dominique , Schürmeyer Thomas , Cozzi Renato , Theodoropoulou Marily , Sievers Caroline , Bernabeu Ignacio , Naves Luciana A , Chabre Olivier , Fajardo Montañana Carmen , Hana Vaclav , Halaby Georges , Delemer Brigitte , Labarta Aizpún José Ignacio , Sonnet Emmanuel , Ferrandez Longás Ángel , Hagelstein Marie-Thérèse , Caron Philippe , Stalla Günter K , Bours Vincent , Zacharieva Sabina , Spada Anna , Brue Thierry , Beckers Albert
Published: July 2011

Background

Aryl hydrocarbon receptor interacting protein (AIP) mutations (AIPmut) cause aggressive pituitary adenomas in young patients, usually in the setting of familial isolated pituitary adenomas. The prevalence ofAIPmutamong sporadic pituitary adenoma patients appears to be low; studies have not addressed prevalence in the most clinically relevant population. Hence, we undertook an international, multicenter, prospective genetic, and clinical analysis at 21 tertiary referral endocrine departments.

Methods

We included 163 sporadic pituitary macroadenoma patients irrespective of clinical phenotype diagnosed at <30 years of age.

Results

Overall, 19/163 (11.7%) patients had germlineAIPmut; a further nine patients had sequence changes of uncertain significance or polymorphisms.AIPmutwere identified in 8/39 (20.5%) pediatric patients. TenAIPmutwere identified in 11/83 (13.3%) sporadic somatotropinoma patients, in 7/61 (11.5%) prolactinoma patients, and in 1/16 non-functioning pituitary adenoma patients. Large genetic deletions were not seen using multiplex ligation-dependent probe amplification. Familial screening was possible in the relatives of seven patients withAIPmut and carriers were found in six of the seven families. In total, pituitary adenomas were diagnosed in 2/21AIPmut-screened carriers; both had asymptomatic microadenomas.

Conclusion

GermlineAIPmutoccur in 11.7% of patients <30 years with sporadic pituitary macroadenomas and in 20.5% of pediatric patients.AIPmutmutation testing in this population should be considered in order to optimize clinical genetic investigation and management.
Low 25(OH)D3 levels are associated with total adiposity, metabolic syndrome, and hypertension in Caucasian children and adolescents
Authors: Pacifico L , Anania C , Osborn J F , Ferraro F , Bonci E , Olivero E , Chiesa C
Published: July 2011

Objectives

Evidence of the association between vitamin D and cardiovascular risk factors in the young is limited. We therefore assessed the relationships between circulating 25-hydroxyvitamin D3(25(OH)D3) and metabolic syndrome (MetS), its components, and early atherosclerotic changes in 452 (304 overweight/obese and 148 healthy, normal weight) Caucasian children.

Methods

We determined serum 25(OH)D3concentrations in relation to MetS, its components (central obesity, hypertension, low high-density lipoprotein (HDL)-cholesterol, hypertriglyceridemia, glucose impairment, and/or insulin resistance (IR)), and impairment of flow-mediated vasodilatation (FMD) and increased carotid intima–media thickness (cIMT) – two markers of subclinical atherosclerosis.

Results

Higher 25(OH)D3was significantly associated with a reduced presence of MetS. Obesity, central obesity, hypertension, hypertriglyceridemia, low HDL-cholesterol, IR, and MetS were all associated with increased odds of having low 25(OH)D3levels, after adjustment for age, sex, and Tanner stage. After additional adjustment for SDS-body mass index, elevated blood pressure (BP) and MetS remained significantly associated with low vitamin D status. The adjusted odds ratio (95% confidence interval) for those in the lowest (<17 ng/ml) compared with the highest tertile (>27 ng/ml) of 25(OH)D3for hypertension was 1.72 (1.02–2.92), and for MetS, it was 2.30 (1.20–4.40). A similar pattern of association between 25(OH)D3, high BP, and MetS was observed when models were adjusted for waist circumference. No correlation was found between 25(OH)D3concentrations and either FMD or cIMT.

Conclusions

Low 25(OH)D3levels in Caucasian children are inversely related to total adiposity, MetS, and hypertension.
Thyroid hormone contributes to the hypolipidemic effect of polyunsaturated fatty acids from fish oil: in vivo evidence for cross talking mechanisms
Authors: Souza Luana Lopes , Cordeiro Aline , Oliveira Lorraine Soares , Paula Gabriela Silva Monteiro de , Faustino Larissa Costa , Ortiga-Carvalho Tania Maria , Oliveira Karen Jesus , Pazos-Moura Carmen Cabanelas
Published: July 2011

n-3 polyunsaturated fatty acids (n-3 PUFA) from fish oil (FO) exert important lipid-lowering effects, an effect also ascribed to thyroid hormones (TH) and TH receptor β1 (TRβ1)-specific agonists. n-3 PUFA effects are mediated by nuclear receptors, such as peroxisome proliferator-activated receptors (PPAR) and others. In this study, we investigated a role for TH signaling in n-3 PUFA effects. Euthyroid and hypothyroid adult rats (methimazole-treated for 5 weeks) received FO or soybean oil (control) by oral administration for 3 weeks. In euthyroid rats, FO treatment reduced serum triglycerides and cholesterol, diminished body fat, and increased protein content of the animals. In addition, FO-treated rats exhibited higher liver expression of TRβ1 and mitochondrial α-glycerophosphate dehydrogenase (mGPD), at protein and mRNA levels, but no alteration of glutathione S-transferase or type 1 deiodinase. In hypothyroid condition, FO induced reduction in serum cholesterol and increase in body protein content, but lost the ability to reduce triglycerides and body fat, and to induce TRβ1 and mGDP expression. FO did not change PPARα liver abundance regardless of thyroid state; however, hypothyroidism led to a marked increase in PPARα liver content but did not alter TRβ1 or TRα expression. The data suggest that part of the effect of n-3 PUFA from FO on lipid metabolism is dependent on TH signaling in specific steps and together with the marked upregulation of PPARα in liver of hypothyroid rats suggest importantin vivoconsequences of the cross-talking between those fatty acids and TH pathways in liver metabolism.
Postpartum Discharge Preferences of Pediatricians: Results From a National Survey
Authors: Britton John R. , Baker Alison , Spino Cathie , Bernstein Henry H.
Published: July 2011

Objective. To identify practice/physician characteristics that influence pediatricians’ self-reported newborn discharge practices.

Methods. Of the pediatricians randomly surveyed through a national American Academy of Pediatrics periodic survey conducted in 2000, 490 were identified as routinely providing care for newborns in the nursery. These respondents rated the importance of 22 infant, maternal, and peripartum factors in determining readiness for nursery discharge on a 5-point Likert scale and reported their perceptions of optimal and minimal lengths of stay (LOS) for healthy term newborns. Importance of readiness factors was dichotomized as “high” (very important or important) versus “low” (neither, unimportant, or very unimportant). Relationships between pediatricians’ responses and demographic information were explored using multivariate logistic regression.

Results. Most pediatricians (at least 81%) rated all 7 infant clinical factors (eg, stable, normal vital signs, successful feeding) as highly important determinants of discharge readiness. Women were 2 to 3 times more likely to rate maternal and peripartum factors such as maternal fatigue and stress, demonstration of maternal skills, breastfeeding knowledge or experience, adequacy of social support, maternal age <18 years, and low income/lack of financial resources as highly important. With respect to hospital LOS, women were twice as likely to identify an optimal LOS as >36 hours and a minimal LOS as >24 hours. Pediatricians in group settings were 3 times as likely as those in solo or 2-physician practices to advocate an optimal LOS >36 hours, and those with a high proportion of publicly insured or uninsured patients were less likely to identify an optimal LOS as >36 hours (odds ratio: 0.53).

Conclusions. Female pediatricians report a more biopsychosocial approach to determining discharge readiness than their male counterparts, taking into account infant characteristics, maternal skills, and socioemotional issues that may affect the mother-infant pair’s adjustment at home. The finding that those who provide care for the most financially vulnerable patients do not see the need for longer LOS is both surprising and of concern. The results support the need for a prospective critical examination of perinatal hospital discharge practices, such as the Pediatric Research in Office Settings Life Around Newborn Discharge Study.
The Relationship Between Chinese Language Skills and Language Awareness
Authors: Wong Pui Kwong
Published: July 2011

The paper proposes an explanatory framework of language abilities which involves the relationship between Chinese language skills and language awareness. It also examines the differences between language awareness and yugan (??, language intuition), which is a commonly used term in China. The language intuition includes three abilities to: (1) judge whether a language unit is appropriate; (2) locate which part of a language unit is not appropriate; (3) correct the inappropriate part of a language unit. In addition to the three abilities, language awareness includes the fourth ability: (4) to give reasons for the corrections. There are no significant correlation coefficients between the fourth ability and the first three abilities, and four language skills; while there are close correlations coefficients between the three abilities. The findings offer an evidential basis for enhancing pedagogical procedures which improves language skills through upgrading language awareness.
Chemical composition and natural durability of juvenile and mature heartwood of Robinia pseudoacacia L.
Authors: Latorraca João V.F , Dünisch Oliver , Koch Gerald
Published: July 2011

The aim of this study was to characterize the properties of juvenile and mature heartwood of Robinia pseudoacacia L. (black locust). The content, the composition, and subcellular localization of heartwood extractives were studied in 14 old-grown trees from forest sites in Germany and Hungary, as well as in 16 younger trees of four clone types. Heartwood extractives (methanol and acetone extraction) were analysed by HPLC-chromatography. UV microspectrophotometry was used to localize the extractives in the wood cell walls. The natural durability of juvenile and mature heartwood was analysed according to the European standard EN 350-1. Growth analyses, as well as the chemical analyses, showed that in Robinia the formation of juvenile wood is restricted to the first 10-15 years of cambial growth. In the heartwood high contents of phenolic compounds and flavonoids were present, which were in high concentrations in the cell walls of the axial parenchyma and of the vessels. In the juvenile heartwood, the content of these extractives is significantly lower than in the mature heartwood. In agree, the juvenile heartwood had a lower resistance to decay by Coniophora puteana (brown rot fungus) and Coriolus versicolor (white rot fungus) compared to the mature.
Morpho-anatomical features of underground systems in six Asteraceae species from the Brazilian Cerrado
Authors: Appezzato-da-Glória Beatriz , Cury Graziela
Published: July 2011

In the Brazilian Cerrado (neotropical savanna), the development of bud-bearing underground systems as adaptive structures to fire and dry periods can comprise an important source of buds for this ecosystem, as already demonstrated in the Brazilian Campos grasslands and North American prairies. Asteraceae species from both woody and herbaceous strata have subterranean organs that accumulate carbohydrates, reinforcing the adaptive strategy of these plants to different environmental conditions. This study aims to analyse the morpho-anatomy of underground systems of six species of Asteraceae (Mikania cordifolia L.f. Willd., Mikania sessilifolia DC, Trixis nobilis (Vell.) Katinas, Pterocaulon alopecuroides (Lam.) DC., Vernonia elegans Gardner and Vernonia megapotamica Spreng.), to describe these structures and to verify the occurrence and origin of shoot buds, and to analyse the presence of reserve substances. Individuals sampled in Cerrado areas in São Paulo State showed thick underground bud-bearing organs, with adventitious or lateral roots and presence of fructans. Xylopodium was found in all studied species, except for Trixis nobilis, which had stem tuber. The presence of fructans as reserve, and the capacity of structures in the formation of buds indicate the potential of herbaceous species of Asteraceae in forming a viable bud bank for vegetation regeneration in the Brazilian Cerrado.
Transitory increase in creatinine levels after parathyroidectomy: evidence of another action of the parathyroid glands?
Authors: Montenegro Fábio M. , Brandão Lenine G. , Ferreira Gustavo F. , Lourenço Jr. Delmar M. , Martin Regina M. , Cunha-Neto Malebranche B. , Helou Claudia B. , Toledo Sergio A. , Cordeiro Anói C. , Ianhez Luiz E.
Published: July 2011

OBJECTIVE: Little information is available on glomerular function changes after surgical treatment of primary hyperparathyroidism. The acute effects of some head and neck operations on renal function were studied. MATERIAL AND MATHODS: Retrospective analysis of changes in creatinine levels and estimated glomerular filtration rate (eGFR) after surgery. Preoperative values were compared with values available until 72 hours after the operation. RESULTS: In tertiary hyperparathyroidism, mean preoperative and postoperative eGFR values were 57.7 mL/min and 40.8 mL/min (p < 0.0001), respectively. A similar decrease was observed after parathyroidectomy for primary hyperparathyroidism, from 85.4 mL/min to 64.3 mL/min (p < 0.0001). After major head and neck procedures, there was a slight increase in eGFR (from 94.3 mL/min to 105.4 mL/min, p = 0.002). CONCLUSION: Parathyroidectomy may be followed by a transient decrease in eGFR that is not often observed in other head and neck operations.
Effectiveness of adding vildagliptin to the treatment of diabetic patients nonresponsive to the combination of metformin and a sulphonylurea
Authors: Vilar Lucio , Gusmão Amaro , Albuquerque José Luciano , Pontes Lisete , Montenegro Larissa , Pontes Soraya , Ibiapina George Robson , Cunha Rodrigo Andrade , Alves Gercivan dos Santos , Canadas Viviane , Ferreira Vera Maria Santos G. , Nóbrega Lucia Helena Coelho , Lima Josivan Gomes de
Published: July 2011

OBJECTIVE: To evaluate the effectiveness of adding vildagliptin to the treatment of patients with inadequately controlled type 2 diabetes mellitus (T2DM) treated with a combination of metformin and a sulphonylurea. SUBJECTS AND METHODS: 37 T2DM patients with HbA1c ranging from 7.7% to 12.4% (mean of 9.30 ± 1.38), despite the use of metformin in combination with a sulphonylurea, were additionally treated with vildagliptin (100 mg/day) for at least 6 months. RESULTS: During triple oral therapy (TOT) HbA1c levels < 7% were achieved in 11 patients (29.7%), whereas levels of fasting plasma glucose (FPG) < 120 mg/dL were observed in 12 patients (32.4%). Both findings were observed in 10 patients (27.0%). Compared to nonresponsive subjects, lower mean baseline HbA1c and FPG levels were seen in responsive patients, but the difference was only statistically significant for fasting plasma glucose (FPG). Moreover, there was considerable overlap between the two groups. CONLUSION: Our preliminary results suggest that TOT with metformin, a sulphonylurea and vildagliptin may be useful for some T2DM patients nonresponsive to combination therapy with metformin and sulphonylurea.
Clomiphene fails to revert hypogonadism in most male patients with conventionally treated nonfunctioning pituitary adenomas
Authors: Ribeiro Rogerio Silicani , Abucham Julio
Published: July 2011

OBJETIVE: To evaluate the effect of clomiphene in men with hypogonadism and conventionally treated nonfunctioning pituitary adenomas (NFPA). PATIENTS AND METHODS: Open label, single-arm, prospective trial. Nine hypogonadal men (testosterone < 300 ng/dL and low/normal LH) with previously treated NFPA. Clomiphene (50 mg/day orally) for 12 weeks. Testosterone, estradiol, LH, FSH, prolactin and erectile function were evaluated before and after 10 days, 4, 8 and 12 weeks of clomiphene treatment. RESULTS: After clomiphene treatment, testosterone and erectile function improved in only one patient. In the remaining eight patients, testosterone levels decreased whereas LH, FSH, and estradiol remained unchanged. Insulin sensitivity increased in unresponsive patients. CONCLUSIONS: Compared with hypogonadal men with prolactinomas under dopaminergic therapy, clomiphene treatment failed to restore normal testosterone levels in most patients with conventionally treated NFPA.
The effects of discontinuing long term alendronate therapy in a clinical practice setting
Authors: Silva André Gonçalves da , Vieira José Gilberto H. , Kunii Ilda Sizue , Lana Janaína Martins de , Lazaretti-Castro Marise
Published: July 2011

OBJECTIVE: To assess bone turnover markers (BTM) and bone mineral density (BMD) after discontinuation of alendronate treatment used for five or more years. SUBJECTS AND METHODS: 40 patients (pt) with post-menopausal osteoporosis treated with alendronate (10 mg/d) for at least five years (Group 1, G1) had their medication discontinued. Group 2 (G2): 25 pt treated with alendronate for at least one year. Group 3 (G3): 23 treatment-naïve osteoporotic pt. BMD was evaluated in G1 and G2 at baseline and after 12 months. Collagen type I cross-linked C-telopeptide (CTX) and procollagen type 1 N-terminal propeptide (P1NP) levels were measured in all pt at baseline, and in G1 and G2 every three months for 12 months. Data were analyzed using ANOVA on ranks and Mann-Whitney tests. RESULTS: Mean BMD values in G1 and G2 did not differ during follow-up. However, 16 pt (45.7%) in G1 and one (5.2%) in G2 lost BMD (P < 0.001). BTM at baseline was not different between G1 and G2, and both were lower than G3. A significant increase in BTM levels was detected in G1 pt after three months, but not in G2. CONCLUSION: Observed BMD loss and BTM rise after alendronate withdrawal imply that bone turnover was not over suppressed, and alendronate discontinuation may not be safe.
Spontaneous pregnancy in a patient with a combination of ovarian and thyroid failure
Authors: Laway Bashir Ahmad , Tufail Syed , Bashir Mir Iftikhar , Ganie Mohd Ashraf , Zargar Abdul Hamid
Published: July 2011

Premature ovarian failure has an overall prevalence of 0.3% to 0.9% in general population. If fertility is a concern, treatment usually consists of estrogen therapy as hormone replacement and oocyte donation. Spontaneous pregnancy in affected women is uncommon. We report a case of a 34-year old woman, who had premature ovarian failure and primary hypothyroidism, and conceived spontaneously eleven years after the development of premature ovarian failure and correction of hypothyroidism.
Trabalho, suporte social e lazer protegem idosos da perda funcional: estudo epidoso
Authors: d'Orsi Eleonora , Xavier André Junqueira , Ramos Luiz Roberto
Published: July 2011

OBJETIVO: Identificar fatores de risco para perda da capacidade funcional de idosos. MÉTODOS: Estudo de coorte Epidoso (Epidemiologia do Idoso) com idosos residentes em São Paulo, SP. Foram selecionados os 326 participantes da primeira entrevista (1991-1992) independentes ou com dependência leve (uma a duas atividades da vida diária). Aqueles que apresentaram perda funcional na segunda (1994-1995) ou terceira entrevistas (1998-1999) foram comparados aos que não a apresentaram. A incidência de perda funcional foi calculada segundo variáveis sociodemográficas, hábitos de vida, estado cognitivo, morbidade, internação hospitalar, autopercepção de saúde, edentulismo, suporte social e atividades de lazer. Calcularam-se riscos relativos brutos e ajustados com intervalos de 95% de confiança pela análise bivariada e múltipla com regressão de Poisson. Critério de inclusão das variáveis no modelo p < 0,20 e de exclusão p > 0,10. RESULTADOS: A incidência de perda funcional foi de 17,8% (13,6;21,9). Foram fatores de risco no modelo final: faixa etária 70 a 74 anos RR = 1,9(0,9;3,9); faixa etária 75 a 79 RR = 2,8(1,4;5,5); faixa etária 80 ou mais RR = 5,4(3,0;9,6); minimental < 24 RR = 1,8(1,1;2,9); asma RR = 2,3(1,3;3,9); hipertensão RR = 1,7(1,1;2,6) e diabetes RR = 1,7(0,9;3,0). Trabalho remunerado RR = 0,3 (0,1;1,0); relacionamento mensal com amigos RR = 0,5(0,3;0,8); assistir TV RR = 0,5 (0,3;0,9) e realizar atividades manuais RR = 0,7(0,4;1,0) foram fatores de proteção. CONCLUSÕES: A prevenção da perda funcional deve incluir o adequado controle das patologias crônicas, como hipertensão, asma e diabetes, além de estímulo à atividade cognitiva. Atividades de trabalho e lazer devem ser valorizadas por seu efeito protetor, assim como relacionamento com amigos.
Condições de vida de portadores de transtornos psicóticos vivendo em cortiços em Santos, SP
Authors: Martin Denise , Andreoli Sergio Baxter , Pinto Rosa Maria Ferreiro , Barreira Tânia Maria Hourneaux de Mendonça
Published: July 2011

OBJETIVO: Descrever condições de vida e sociabilidade de portadores de transtornos mentais graves moradores de cortiços. PROCEDIMENTOS METODOLÓGICOS: Estudo qualitativo com moradores adultos de cortiços da região central de Santos, SP, realizado em 2004-2006. Foram realizadas observações etnográficas em quatro cortiços e entrevistas semi-estruturadas em profundidade com oito mulheres que conviviam com portadores de transtornos psicóticos. A forma de análise empregada foi a qualitativa fundamentada na Antropologia. ANÁLISE DOS RESULTADOS: Os cortiços apresentaram características específicas quanto à sociabilidade. As dificuldades com os pacientes psicóticos decorriam da quebra mínima das regras mínimas. Em um dos cortiços, uma moradora agia como cuidadora dos pacientes e mantinha contato próximo com o serviço de saúde. Apesar do convívio cotidiano com os portadores, as participantes não possuíam informações sobre o transtorno e os consideravam loucos, nervosos ou mentalmente fracos. Acreditavam que deveriam morar em outro local que não o cortiço. CONCLUSÕES: A população moradora de cortiços não trata os portadores de transtorno psicótico de forma diferente da população geral, devido a desconhecimento, discriminação e estigma. As condições de vida são precárias para todos e não são diferentes para os moradores portadores de transtorno psicótico, exceto para aqueles que residiam na moradia coletiva com maior número de pacientes, organizada em função deles e dependente economicamente de seus benefícios.
Análise de Impacto Regulatório: uma nova ferramenta para a melhoria da regulação na Anvisa
Authors: Alves Flávia Neves Rocha , Peci Alketa
Published: July 2011

A Análise de Impacto Regulatório é recomendada para os órgãos reguladores, a fim de melhorar a qualidade da regulação pela avaliação dos seus custos, benefícios e dificuldades e como subsídio para a tomada de decisão. O artigo analisou a importância da Análise de Impacto Regulatório no contexto da atuação da Agência Nacional de Vigilância Sanitária e em sua fase atual de melhoria da regulação para o fortalecimento da instituição. Foram apresentados os principais conceitos relacionados à área regulatória, assim como experiências internacionais.
Social contextual factors contributing to child and adolescent labor: an ecological analysis
Authors: Santana Vilma Sousa , Itaparica Martha Suely
Published: July 2011

OBJECTIVE: To examine the relationship between social contextual factors and child and adolescent labor. METHODS: Population-based cohort study carried out with 2,512 families living in 23 subareas of a large urban city in Brazil from 2000 to 2002. A random one-stage cluster sampling was used to select families. Data were obtained through individual household interviews using questionnaires. The annual cumulative incidence of child and adolescent labor was estimated for each district. New child and adolescent labor cases were those who had their first job over the two-year follow-up. The annual cumulative incidence of child and adolescent labor was the response variable and predictors were contextual factors such as lack of social support, social deprivation, unstructured family, perceived violence, poor school quality, poor environment conditions, and poor public services. Pearson's correlation and multiple linear regression were used to assess the associations. RESULTS: There were selected 943 families corresponding to 1,326 non-working children and adolescents aged 8 to 17 years. Lack of social support, social deprivation, perceived violence were all positively and individually associated with the annual cumulative incidence of child and adolescent labor. In the multiple linear regression model, however, only lack of social support and perceived violence in the neighborhood were positively associated to child and adolescent labor. No effect was found for poor school quality, poor environment conditions, poor public services or unstructured family. CONCLUSIONS: Poverty reduction programs can reduce the contextual factors associated with child and adolescent labor. Violence reduction programs and strengthening social support at the community level may contribute to reduce CAL.
Patterns of deliveries in a Brazilian birth cohort: almost universal cesarean sections for the better-off
Authors: Barros Aluísio J D , Santos Iná S , Matijasevich Alicia , Domingues Marlos Rodrigues , Silveira Mariângela , Barros Fernando C , Victora Cesar G
Published: July 2011

OBJECTIVE: To describe the patterns of deliveries in a birth cohort and to compare vaginal and cesarean section deliveries. METHODS: All children born to mothers from the urban area of Pelotas, Brazil, in 2004, were recruited for a birth cohort study. Mothers were contacted and interviewed during their hospital stay when extensive information on the gestation, the birth and the newborn, along with maternal health history and family characteristics was collected. Maternal characteristics and childbirth care financing - either private or public healthcare (SUS) patients - were the main factors investigated along with a description of C-sections distribution according to day of the week and delivery time. Standard descriptive techniques, Χ² tests for comparing proportions and Poisson regression to explore the independent effect of C-section predictors were the methods used. RESULTS: The overall C-section rate was 45%, 36% among SUS and 81% among private patients, where 35% of C-sections were reported elective. C-sections were more frequent on Tuesdays and Wednesdays, reducing by about a third on Sundays, while normal deliveries had a uniform distribution along the week. Delivery time for C-sections was markedly different among public and private patients. Maternal schooling was positively associated with C-section among SUS patients, but not among private patients. CONCLUSIONS: C-sections were almost universal among the wealthier mothers, and strongly related to maternal education among SUS patients. The patterns we describe are compatible with the idea that C-sections are largely done to suit the doctor's schedule. Drastic action is called for to change the current situation.
Longitudinal anthropometric assessment of infants born to HIV-1-infected mothers, Belo Horizonte, Southeastern Brazil
Authors: Fausto Maria Arlene , Carneiro Mariângela , Antunes Carlos Maurício F , Colosimo Enrico Antonio , Pinto Jorge Andrade
Published: July 2011

OBJECTIVE: To evaluate the growth parameters in infants who were born to HIV-1-infected mothers. METHODS: The study was a longitudinal evaluation of the z-scores for the weight-for-age (WAZ), weight-for-length (WLZ) and length-for-age (LAZ) data collected from a cohort. A total of 97 non-infected and 33 HIV-infected infants born to HIV-1-infected mothers in Belo Horizonte, Southeastern Brazil, between 1995 and 2003 was studied. The average follow-up period for the infected and non-infected children was 15.8 months (variation: 6.8 to 18.0 months) and 14.3 months (variation: 6.3 to 18.6 months), respectively. A mixed-effects linear regression model was used and was fitted using a restricted maximum likelihood. RESULTS: There was an observed decrease over time in the WAZ, LAZ and WLZ among the infected infants. At six months of age, the mean differences in the WAZ, LAZ and WLZ between the HIV-infected and non-infected infants were 1.02, 0.59, and 0.63 standard deviations, respectively. At 12 months, the mean differences in the WAZ, LAZ and WLZ between the HIV-infected and non-infected infants were 1.15, 1.01, and 0.87 standard deviations, respectively. CONCLUSIONS: The precocious and increasing deterioration of the HIV-infected infants' anthropometric indicators demonstrates the importance of the early identification of HIV-infected infants who are at nutritional risk and the importance of the continuous assessment of nutritional interventions for these infants.
Recurrent herpes simplex infections: laser therapy as a potential tool for long-term successful treatment
Authors: Ferreira Dennis Carvalho , Reis Helena Lucia Barroso , Cavalcante Fernanda Sampaio , Santos Kátia Regina Netto dos , Passos Mauro Romero Leal
Published: July 2011

Herpes simplex virus types 1 and 2 are the main infectious agents associated with oral and genital ulcerations. These infections are now widely recognized as sexually transmitted diseases. Among treatment options, low-level laser therapy (LLLT) has shown promising clinical results as a longer-lasting suppression therapy. Two clinical cases are described with recurrent labial herpes for which LLLT was used. Following treatment, both patients remained symptom free during the 17-month clinical follow-up period.
Co-infection and risk factors of tuberculosis in a Mexican HIV+ population
Authors: Zenteno-Cuevas Roberto , Montes-Villaseñor Evangelina , Morales-Romero Jaime , Coronel-Martín del Campo Gastón , Cuevas Betzaida
Published: July 2011

INTRODUCTION: The situation of tuberculosis (TB) is being modified by the human immunodeficiency virus (HIV), which is increasing the occurrence of new cases and the generation of drug resistant strains, affecting not only the people infected with HIV, but also their close contacts and the general population, conforming a serious public health concern. However, the magnitudes of the factors associated to this co-infection differ considerably in relation to the population groups and geographical areas. METHODS: In order to evaluate the prevalence and risk factors for the co-infection of tuberculosis (TB) in a population with human immunodeficiency virus (HIV+) in the Southeast of Mexico, we made the analysis of clinical and epidemiological variables and the diagnosis of tuberculosis by isolation of mycobacteria from respiratory samples. RESULTS: From the 147 HIV+ individuals analyzed, 12 were culture positive; this shows a prevalence of 8% for the co-infection. The only variable found with statistical significance for the co-infection was the number of CD4-T < 200 cells/mm³, OR 13 (95%, CI 2-106 vs 12-109). CONCLUSIONS: To our knowledge this is the first report describing the factors associated with tuberculosis co -infection with HIV in a population from Southern Mexico. The low number of CD4 T-cells was the only variable associated with the TB co-infection and the rest of the variables provide scenarios that require specific and particular interventions for this population group.
Study of infection by Rickettsiae of the spotted fever group in humans and ticks in an urban park located in the City of Londrina, State of Paraná, Brazil
Authors: Toledo Roberta Santos , Tamekuni Katia , Silva Filho Mauro de Freitas , Haydu Valeska Bender , Pacheco Richard Campos , Labruna Marcelo Bahia , Dumler John Stephen , Vidotto Odilon
Published: July 2011

INTRODUCTION: Spotted fevers are emerging zoonoses caused by Rickettsia species in the spotted fever group (SFG). Rickettsia rickettsii is the main etiologic agent of Brazilian spotted fever (BSF) and it is transmitted by Amblyomma spp. ticks. METHODS: The study aimed to investigate SFG rickettsiae in the Arthur Thomas Municipal Park in Londrina, PR, by collecting free-living ticks and ticks from capybaras and blood samples from personnel working in these areas. Samples from A. dubitatum and A. cajennense were submitted for PCR in pools to analyze the Rickettsia spp. gltA (citrate synthase gene). RESULTS: All the pools analyzed were negative. Human sera were tested by indirect immunofluorescence assay with R. rickettsii and R. parkeri as antigens. Among the 34 sera analyzed, seven (20.6%) were reactive for R. rickettsii: four of these had endpoint titers equal to 64, 2 titers were 128 and 1 titer was 256. None of the samples were reactive for R. parkeri. An epidemiological questionnaire was applied to the park staff, but no statistically significant associations were identified. CONCLUSIONS: The serological studies suggest the presence of Rickettsiae related to SFG that could be infecting the human population studied; however, analysis of the ticks collected was unable to determine which species may be involved in transmission to humans.
Desenvolvimento, produtividade e sobrevivência de maracujazeiro-amarelo enxertado e cultivado em área com histórico de morte prematura de plantas
Authors: Cavichioli José Carlos , Corrêa Luiz de Souza , Garcia Maria José de Marchi , Fischer Ivan Herman
Published: July 2011

O objetivo deste trabalho foi avaliar o desenvolvimento vegetativo, a produtividade e a sobrevivência do maracujazeiro-amarelo (Passiflora edulis Sims) enxertado sobre três porta-enxertos, em área com histórico de morte prematura de plantas. O experimento foi conduzido no município de Adamantina-SP, no período de maio de 2006 a fevereiro de 2007, adotando-se o delineamento de blocos ao acaso, com três tratamentos e sete repetições. Os porta-enxertos avaliados foram Passiflora edulis, P. alata e P. gibertii, utilizando-se da enxertia convencional por garfagem tipo fenda cheia. Avaliaram-se o diâmetro do caule do porta-enxerto e do enxerto, o comprimento do entrenó e dos ramos secundários, o número de ramos terciários e o de frutos, a massa média, o diâmetro e o comprimento médio dos frutos, a produtividade e a sobrevivência de plantas. Os resultados demonstraram que o uso da enxertia no maracujazeiro é uma opção viável como meio de propagação vegetativa, assim como forma de controle de alguns patógenos habitantes do solo, um dos problemas que têm limitado a expansão da cultura. As plantas enxertadas sobre P. edulis apresentaram melhor desenvolvimento inicial, seguido de P. gibertii e de P. alata. A menor produtividade ocorrreu em plantas sobre P. alata. Mesmo com a presença de Fusarium solani e Rotylenchulus reniformis nos solos, 91% das plantas enxertadas sobre P. gibertii sobreviveram após 12 meses de plantio no campo, enquanto em P. alata e P. edulis, esses índices foram de 60% e 8,6%, respectivamente, mostrando assim a maior tolerância às doenças causadas por patógenos habitantes do solo por P. gibertii.
Realce por contraste de lesões hepáticas em pacientes com cirrose: estudo cruzado comparativo de dois agentes de contraste para RM realizado em uma única instituição. Resultados preliminares
Authors: Burke Lauren M. B. , Vachiranubhap Busakorn , Tannaphai Penampai , Semelka Richard C.
Published: July 2011

OBJETIVO: Comparar, prospectivamente, gadopentato de dimeglumina (Gd-DTPA) e gadobenato de dimeglumina (Gd-BOPTA), ambos em dose plena, na detecção de lesões hepáticas focais, por meio de RM em pacientes com doença hepática crônica. MATERIAIS E MÉTODOS: Oito pacientes com cirrose hepática e forte suspeita de um pequeno carcinoma hepatocelular, baseada em RM anterior, foram submetidos a exames de RM contrastada, um com dose plena de Gd-DTPA e outro com dose plena de Gd-BOPTA. Os exames foram realizados com um intervalo de 72 a 108 horas. Dois radiologistas independentes realizaram avaliação às cegas das imagens, considerando número, caracterização e realce das lesões, além de preferências subjetivas. RESULTADOS: Não houve diferença estatisticamente significante entre os dois exames quanto à detecção e caracterização das lesões. Observou-se um incremento de 18% no realce da lesão dominante pelo Gd-BOPTA, em comparação com o Gd-DTPA. Na maioria dos casos, ambos os observadores cegos subjetivamente preferiram as imagens utilizando Gd-BOPTA àquelas com Gd-DTPA, com base no maior realce e melhor definição das margens das lesões. CONCLUSÃO: Em doses plenas equivalentes, Gd-BOPTA e Gd-DTPA são similares na detecção e caracterização de lesões hepáticas focais em pacientes com doença hepática crônica. Entretanto, o Gd-BOPTA foi superior em relação ao realce da lesão, assim como na preferência subjetiva dos observadores.
Sobrecarga de ferro transfusional em portadores de anemia falciforme: comparação entre ressonância magnética e ferritina sérica
Authors: Bourbon Filho Lécio dos Anjos , Ferrão Thiago de Oliveira , França Alex Vianey Callado , Rocha Ricardo Dantas , Dantas Lorena Dias , Carvalho Luciana Franco do Prado , Moreira Marcella Dornelas de Abreu Batalha , Cipolotti Rosana
Published: July 2011

OBJETIVO: Identificar variáveis preditoras de sobrecarga de ferro em portadores de anemia falciforme e correlacionar indicadores bioquímicos e imaginológicos. MATERIAiS E MÉTODOS: Foi realizado estudo transversal envolvendo 32 portadores de anemia falciforme, que foram submetidos a dosagem sérica de ferro, ferritina e a ressonância magnética do fígado. Foram realizadas cinco sequências gradiente-eco e uma spin-eco. A intensidade de sinal foi obtida em cada sequência pelas médias das regiões de interesse no fígado e musculatura paravertebral para obter a razão da intensidade de sinal (RIS) fígado/músculo. A partir da RIS foi obtida a concentração hepática estimada de ferro (CHEF) pela fórmula: e[5,808 - (0,877 × T2*) - (1,518 × PI)], onde T2* é a RIS na sequência com TE de 13 ms e PI é a RIS da sequência com ponderação intermediária. Os pacientes foram agrupados segundo o regime de transfusão de hemácias (regulares mensais versus esporádicas). RESULTADOS: Os grupos transfusionais foram comparados pelas variáveis clínico-laboratoriais, sendo significativas as diferenças entre RIS, CHEF e ferritina sérica: o grupo que recebeu transfusões regulares apresentou sobrecarga de ferro hepático mais intensa. CONCLUSÃO: A ressonância magnética foi ferramenta eficiente para avaliação de sobrecarga hepática de ferro em portadores de anemia falciforme.
Comparação entre ultrassonografia transvaginal e histerossonografia na avaliação de pacientes com sangramento uterino anormal
Authors: Feitosa Iêda Maria Silveira Diógenes , Feitosa Helvécio Neves , Carvalho Francisco Herlânio Costa , Pereira Silvia Menescal , Medeiros Francisco das Chagas
Published: July 2011

OBJETIVO: Avaliar a eficácia da ultrassonografia transvaginal (USTV) e da histerossonografia (HSG) e compará-las na avaliação de alterações endometriais em portadoras de sangramento uterino anormal. MATERIAIS E MÉTODOS: Estudo transversal com 30 pacientes, idade entre 29 e 71 anos, 21 delas (70%) na pré-menopausa e 9 (30%) na pós-menopausa. Utilizou-se solução salina a 0,9% para contraste na HSG. Foi considerado o achado histeroscópico e/ou histopatológico como método padrão. Utilizou-se o teste de MacNemar para comparação dos testes diagnósticos. RESULTADOS: A histeroscopia diagnosticou 18 casos (60%) de alterações intracavitárias, sendo 10 pólipos (33,3%). A USTV apresentou sensibilidade e especificidade de 83,3% e a HSG mostrou sensibilidade de 94,4% e especificidade de 91,6%. O teste de MacNemar evidenciou sensibilidade (p = 0,500) e especificidade (p = 1,000) semelhantes entre a USTV e a HSG para detecção de alterações endometriais. No diagnóstico de pólipo, a HSG apresentou maior sensibilidade (90,9% × 27,3%; p = 0,016), com especificidade semelhante (89,5% × 94,7%; p = 1,000). CONCLUSÃO: A HSG e a USTV apresentam boas taxas de predição para doenças endometriais em pacientes com sangramento uterino anormal. A HSG apresenta sensibilidade e especificidade semelhantes às da USTV na detecção dessas doenças, porém apresenta sensibilidade maior para pólipos.
Ecoescleroterapia com espuma no tratamento da insuficiência venosa crônica
Authors: Ceratti Sandro , Okano Fabrício Macedo , Pontes Alexandre B. Góes , Pontes Antônio Luiz , Nastri Rogério
Published: July 2011

OBJETIVO: Descrever os resultados da ecoescleroterapia com espuma no tratamento de insuficiência venosa crônica. MATERIAIS E MÉTODOS: Série de casos longitudinal. Entre janeiro de 2007 e novembro de 2009, 18 pacientes com insuficiência venosa crônica foram tratados com ecoescleroterapia com espuma em uma clínica particular. O método de Tessari foi utilizado para produção da espuma e o seguimento dos pacientes variou de 4 a 44 meses. Os desfechos primários foram: oclusão total da veia tratada e reepitelização total das úlceras. Os desfechos secundários foram: recanalização parcial com redução do calibre da veia, melhora estética e satisfação do paciente. RESULTADOS: A taxa de oclusão total ou recanalização parcial foi de 83,4% na primeira revisão (55,6% de oclusão total e 27,8% de recanalização parcial) e de 66% (44,4% de oclusão total e 22,2% de recanalização parcial) entre os pacientes que tiveram uma segunda revisão. A taxa de remissão de varizes foi de 80% e a taxa de cura das úlceras foi de 70%. CONCLUSÃO: A ecoescleroterapia mostrou-se um procedimento seguro e eficaz para o tratamento de insuficiência venosa crônica nesse grupo de pacientes. As complicações observadas foram mínimas e a maioria dos pacientes referiu satisfação com os resultados do tratamento.
Ressalto no canto posteromedial do joelho relacionado ao músculo sartório
Authors: Nogueira-Barbosa Marcello Henrique , Lacerda Flávio de Moura
Published: July 2011

As causas da síndrome de ressalto no joelho relatadas com maior frequência são relacionadas a anormalidades meniscais, ao tendão do músculo bíceps femoral e aos tendões grácil e semitendíneo. Neste trabalho é descrito um caso de ressalto no canto posteromedial relacionado à junção miotendínea do músculo sartório em um paciente do sexo masculino, de 58 anos de idade, com hiperextensão do joelho.
Distribuição de pressão em rede de irrigação localizada otimizada por algoritmos genéticos
Authors: Marcuzzo Francisco F. N. , Wendland Edson
Published: July 2011

Modelos matemáticos computacionais de otimização de redes de irrigação, sob vazão em marcha, capazes de fornecer dados hidráulicos, são importantes para a verificação do comportamento do sistema quanto à distribuição da carga hidráulica (energia) e da pressão nas tubulações da rede. Este trabalho teve como objetivo estudar a distribuição da carga efetiva e hidráulica da unidade operacional de uma rede de irrigação localizada otimizada por algoritmos genéticos. As variáveis de decisão para otimização, com auxílio de algoritmos genéticos, foram os diâmetros de cada trecho da rede: dois para linhas laterais, quatro para linhas de derivação, quatro para linhas secundárias e um para a linha principal. Foi desenvolvido um código em linguagem MatLab, considerando todas as perdas de energia distribuídas e localizadas entre o início da rede e o conjunto motobomba. A análise de sensibilidade realizada foi baseada na variação, na declividade do terreno (0; 2,5 e 5%). Os resultados mostram que, para as tubulações com vazão em marcha, quando se aumenta a declividade do terreno, ocorre ganho de energia no início da tubulação, que vai perdendo-se de maneira gradual, e diminuição da pressão no início da tubulação, que aumenta gradualmente.