bluuebunny/crossref_metadata_2025 huggingface dataset:
An Assessment of Specialist Physician Referral Practices for Long-Term Cardiovascular Risk Reduction in the Community: Are We Using Our Available Resources?
Authors: Watson Kathryn , Desy Janeve , Castillo Eliana , Hawkins T. Lee-Ann , Metcalfe Amy
Published: July 2018

Background: Our aim was to evaluate specialist physicians’ referral patterns for cardiovascular risk reduction (CRR) while identifying existing CRR programs in a large Canadian city.

Methods: This was a cross-sectional study involving an electronic survey of cardiologists and internists in Calgary, Alberta, to assess CRR referral patterns. A concurrent online search for programs addressing CRR was undertaken.

Results: Twenty-four CRR programs were identified. Nine (37.5%, 95% CI: 21.2–57.2) required physician referral. Half (50.0%, 95% CI: 31.4–68.6) had no direct patient cost.

A majority of surveyed physicians estimated that more than half of their patients have at least one modifiable risk factor. However, 75.0% (95% CI: 61.2–85.1) had referred less than half of these patients for CRR.

Conclusion: Our study demonstrates a gap in specialist physician referral practices for CRR. Patients with modifiable risk factors may not be accessing valuable CRR resources.

Résumé

Contexte : Notre but consistait à évaluer les habitudes d’orientation des médecins spécialistes en ce qui a trait à la réduction du risque cardiovasculaire (RRCV) et à recenser les programmes de RRCV présents à l’intérieur d’une grande ville canadienne.

Méthodologie: Une étude de prévalence a été menée par sondage électronique auprès des cardiologues et des internistes de la ville de Calgary, Alberta, dans le but d’évaluer les habitudes d’orientation en ce qui a trait à la réduction du risque cardiovasculaire (RRCV). Parallèlement, une recherche sur les programmes de RRCV a été entreprise, en ligne également.

Résultats: On a répertorié 24 programmes de RRCV. Neuf (37,5 %; IC de 95 % : 21,2–57,2) nécessitent que le patient soit recommandé par un médecin. La moitié (50,0 %; IC de 95 % : 31,4–68,6) n’engendre aucun coût direct pour le patient.

La plupart des médecins interrogés évaluent que plus de la moitié de leurs patients présente au moins un facteur de risque modifiable. Cependant, 75,0 % (IC de 95 % : 61,2–85,1) ont orienté moins de la moitié de ces patients vers un programme de RRCV.

Conclusion : Notre étude montre qu’il y a une lacune dans les pratiques d’orientation des médecins spécialistes relativement aux programmes de RRCV. Ainsi, des patients ayant des facteurs de risque modifiables n’ont pas accès à des ressources précieuses en matière de RRCV.
Investing in the Future: A Comprehensive Evaluation of Mentorship Networks for Residents
Authors: Khan Omar Farooq , Walzak Alison , Kachra Rahim , Kline Theresa J.B. , Clement Fiona M. , Quan Hude , Bharwani Aleem M.
Published: July 2018

Background: Formal mentorship plays a key career development role in medicine. Traditional mentorship consists of dyadic relationships between mentors and their mentees. However, research favours utilization of mentorship networks involving individuals at multiple levels.Objective: This study aimed to rigorously evaluate a formalized mentorship network program within a Canadian Internal Medicine residency program from 2012 to 2013.Methods: Residents participated in one-on-one semi-structured interviews at baseline and after one year of participation in the mentorship network. Closed-ended surveys assessed affective organizational commitment, self-efficacy, career satisfaction and overall wellness among residents and faculty members. 89 residents and 28 faculty members were invited to participate; 40 residents and 18 faculty members completed the survey after one year.Results: Residents perceived mentorship networks to add value across multiple domains, including self-awareness, overall efficiency, and physician wellness. Satisfaction with the program was very high, with 98% (n = 39/40) of residents and 89% of faculty members (n = 16/18) wanting the program to continue after year one. Male mentors were more likely to report benefits from serving as a mentor than their female counterparts. In contrast to this, female mentees found mentorship more useful than male mentees.Conclusions: Network mentorship is associated with personal and system benefits, though these benefits are difficult to quantify. The network model is feasible and well-received by mentors and mentees. Further research considering both short- and long-term endpoints is required to delineate the true cost-benefit ratio of mentorship programs to both mentors and mentees.
Calcific Pericarditis
Authors: Wilson MD Ben J.
Published: July 2018

An 84-year-old woman presented to the emergency department with progressive shortness of breath, orthopnea, paroxysmal nocturnal dyspnea, and fatigue. She had a past history of atrial fibrillation and was taking digoxin. Clinical examination revealed normal vital signs, 6 cm of jugular venous distension with Kussmaul’s sign, a pericardial knock, and pedal edema.
General Internal Medicine Subspecialty Training Update
Authors: Card MD MSc Sharon E.
Published: July 2018

The vast majority of general internal medicine (GIM) programs in Canada have become distinct entities that provide training in additional competencies and leadership above and beyond those required for the specialty of internal medicine. In December 2010, after many years of effort, GIM finally achieved recognition as a distinct subspecialty by the Royal College of Physicians and Surgeons of Canada. A GIM Working Group has finalized the objectives and requirements for a 2-year subspecialty training program in GIM that will follow after the existing 3-year core internal medicine training program. These documents have now been approved by the Royal College.
Rheumatoid Arthritis Management for General Internists
Authors: Uh MD FRCPC Mitchell , Collins MD FRCPC ABIM David
Published: July 2018

Rheumatoid arthritis (RA) is a chronic systemic inflammatory disorder that causes progressive joint destruction, deformity, and significant disability. In addition to arthritis, RA is associated with numerous extra-articular features with attendant morbidity and mortality. These include but are not limited to ocular inflammation, interstitial lung disease, pleuropericardial disease, vasculitis, accelerated atherosclerosis, and increased risk of lymphoma. The prevalence of RA in the Canadian population is approximately 1%.
Statins and Diabetes: Evaluating the Truth?
Authors: Barry PharmD Arden R. , Pearson PharmD Glen J.
Published: July 2018

We are currently faced with yet another controversy surrounding an exceedingly common pharmacological therapy: are statins associated with an increased incidence of diabetes? In this article, the authors aim to explore the truth behind this recently contentious debate.
A Tale of Two Specialties: Differences between Heart Failure Patients Admitted to Internal Medicine and Cardiology
Authors: Petrovic MD Vanja , Ibrahim MD Sirar , Palda MD MSc Valerie A.
Published: July 2018

The authors described and compared the clinical profiles of patients hospitalized with heart failure (HF) to internal medicine (IM) and cardiology services. Data on age, gender, length of stay, and left ventricular systolic function, as well as specific co-morbidities and clinical parameters, were recorded retrospectively to allow the assessment of provider-related differences in HF populations.IM patients were significantly older, more likely to be female, and more likely to have preserved left ventricular function. IM patients also suffered a significantly greater number of co-morbidities, in particular chronic obstructive pulmonary disease, pneumonia, other lung diseases, thromboembolic disease, anemia, and arthritis. Finally, significantly more IM patients had a high risk of mortality at the time of hospital admission compared with cardiology patients. In summary, IM patients were older, “sicker,” and more likely to die within the next year. Complex disease and advanced age may affect outcomes, therapeutic strategies, and impact on diagnostic accuracy.
Acute Care SINS: Surgical Insights for the Non-surgeon - Chapter 1: Introduction and Surgical Definitions
Authors: Khadaroo MD PhD Rachel G. , Sutherland MD J Drew , Brindley MD Peter G.
Published: July 2018

“Surgical Insights for the Non-surgeon,” or SINS, is composed of several short chapters intended to cover fundamental surgical knowledge for non-surgeons. The authors focus on surgical pearls, operative insights, and applied anatomy. Chapter 1 of the series presents surgical definitions.
The Turkey Gets the Last Laugh
Authors: Lush MD Richard B.
Published: July 2018

A 52-year-old man was referred to a general internal medicine service due to recurrent pneumonia. After physical examination, laboratory tests, and resection to check for malignancy, it was discovered that the patient had a fragment of turkey bone in his lung. This case stresses the importance of considering chronic foreign body aspiration, and remembering that not all lung masses are malignant.
Lithium Toxicity
Authors: Corriveau MD Sophie , Gardhouse MD Amanda , Soth MD Mark , Ainsworth MD Craig
Published: July 2018

Lithium is commonly prescribed for mood stabilization in bipolar disorder. Lithium has a narrow therapeutic range (0.8−1.2 mmol/L), and even chronic users may unexpectedly develop toxic levels. Toxicities manifest in various ways. The authors report the case of a patient who developed sinus bradycardia and asystolic arrest with an elevated serum lithium level.
Peri-operative Cardiovascular Risk and the General Internist
Authors: Fisher MD MSc Bruce
Published: July 2018

Peri-operative cardiovascular risk assessment and management remain important and challenging tasks for the general internist. Since the 1999 publication of the now-widely-used revised cardiac risk index assessment model, there have been further risk factor qualifiers identified and newer predictive models developed. These include patient and surgical characteristic qualifiers, biomarkers, and new predictive models for non-cardiac and vascular surgery patients. These qualifiers and models inform improvements to our risk predictive performance and better guide our peri-operative surveillance and care. New evidence also reinforces the need for judicious and timelier preoperative consultation and medical management, and supports the targeted use of biomarker surveillance in the post-operative period to detect important but often otherwise-asymptomatic cardiovascular events. On the basis of this evidence review, the author invites discussion, debate, and the development of a more comprehensive and collaborative approach and guide to peri-operative risk assessment and management.
Scrotal and Orbital Involvement in Extramedullary De-differentiated Multiple Myeloma
Authors: Docherty Gavin , Rush Barret , Victor Gary , Dueck Greg
Published: July 2018

A 71-year-old Indian male presented with a five-month history of progressive bilateral testicular swelling and swelling of the left orbit or one month duration. Nine months ago, he had undergone four cycles of chemotherapy (bortezomib, cyclophosphamide, and dexamethasone) for an immunoglobulin A (IgA) lambda multiple myeloma (3.8 grams per decilitre [g/dL]). This was stage 3 according to the International Staging System (ISS) and had no adverse cytogenetics. The patient had undergone six more cycles of treatment prior to presentation. Physical examination revealed gross distension of the left orbital tissues with violaceous colouring (Figure 1A). The abdomen was distended with ascites. Genitourinary examination revealed testicular enlargement (Figure 1B). There was no erythema or warmth associated with either area. Laboratory tests failed to demonstrate monoclonal paraproteinemia, but his lactate dehydrogenase (LDH) level was elevated at 2068 units per litre (units/L). Abdominal paracentesis revealed a fluid cell count of 16,180 106/L and a fluid LDH of 10,591 units/L. Cytology showed CD138 positivity, 80% for Ki-67, and lambda light chain restriction. These findings supported a diagnosis of dedifferentiated extramedullary multiple myeloma. The prognosis and available management plans were discussed with the patient, and he was discharged to the community to be placed in the care of the palliative care team per his wishes.
Clinical Medicine: Advances in Implantable Cardiac Devices
Authors: Palazollo MD Jorge , Singh MD Sheldon M.
Published: July 2018

The use of implantable cardiac devices has increased and will continue to increase as the population ages. For more than 50 years, patients with a slow pulse have enjoyed the benefits of cardiac pacing to alleviate symptoms and, in some cases, prolong life. Implantable cardiac devices have evolved; in addition to providing pacing support, some devices – namely, implantable cardioverter defibrillators (ICDs) – can also terminate malignant ventricular arrhythmias, facilitate the synchronization of ventricular function, monitor clinical variables, and store a wealth of information to assist clinical management. This review discusses currently available device diagnostics, highlights some advances in implantable cardiac device therapy, and provides a preview of future technologies that may improve the care of patients who have these devices.
A Forgetful Experience: A Case of Transient Global Amnesia
Authors: Shah MD PGY2 Kalpa , Sheasgreen MD PGY3 Chris , Patel MB Ameen
Published: July 2018

We present a case of a 67-year-old man with transient global amnesia, a clinical syndrome that presents with an acute onset of temporary amnesia lasting less than 24 hours, without impairment of consciousness or cognition. In this article, we discuss the clinical criteria for diagnosis, the pathophysiology of the condition, and an approach to its diagnostic work-up and prognosis. It is important to differentiate TGA from other entities because it is a benign condition that does not require treatment.
Is ‘Gluten-Free’ Gluten-Free? Celiac Disease in Canada in 2015
Authors: Forbes Nauzer , Kassam Zain , Morgan David
Published: July 2018

Our understanding of celiac disease (CD) has improved dramatically in recent years. Once considered a rare childhood malabsorption syndrome, we now recognize CD as a complex enteropathy mediated by immune, genetic, and environmental factors. CD affects a large proportion of the Canadian population, and its disease burden is substantial in terms of proven reduction in quality of life. Symptom recognition and referral to a gastroenterologist for diagnosis are crucial. As CD is caused by intolerance to gluten, the only effective treatment is strict gluten avoidance. Canadian food product guidelines have only recently become sufficiently rigid, incorporating newer evidence that suggests lower limits of gluten tolerability in this patient population than previously thought.
Medical Education and Duty Hours: Do We Really Care?
Authors: Brindley Peter
Published: July 2018

The Canadian Society of Internal Medicine has a noble mission statement that bears repeating. The goal is to “go beyond simple transmission of information, and to make a lasting impact on the knowledge, skills and attitudes of clinicians and future clinicians; to narrow the theory-to-practice gap; to improve the health of our patients and of all Canadians.” I agree wholeheartedly; in fact, I presume we all agree. How could you not? But the devil is always in the details. What does this really mean for how we prepare future doctors? More contentiously, what does this mean for duty hours? This (reactionary?) author believes it is worth routinely examining whether we live up to our lofty mission. If not, then we should accept a few inconvenient truths.
Resident Duty Hours: A Review
Authors: Melvin Lindsay , Corriveau Sophie , Alak Aiman , Patel Ameen
Published: July 2018

Residents are physicians undertaking further training to become independently licensed practitioners. Historically, resident duty hour periods were long and intense. The goal was to maximize learning through high patient volume and to teach doctors how to take responsibility. Recently, concerns over patient and resident safety have led to restricted trainee work hours. The putative justification is to improve resident education, resident well-being, and patient care. In light of this recent shift in the medical culture, resident duty hours have become a controversial topic. Restricted duty hours take many forms. In the United States, the Accreditation Council for Graduate Medical Education (ACGME) mandated junior residents work no longer than 16 consecutive hours, while senior residents could work up to 26 hours.1 In Canada, no nationwide mandate exists and the issue falls within provincial jurisdiction. In Ontario, under the Professional Association of Residents of Ontario agreement, call-periods are no more than 26 consecutive hours in-house, no more than one in four nights in-house, or no more than one in three nights of home-call. After a 2011 Quebec court ruling, resident duty hours were restricted to 16 consecutive hours in that province. This resulted from the court concluding that traditional hours violate the Canadian Charter of Rights and Freedoms. Regardless, the Quebec ruling prompted other Canadian programs to further reduce resident duty hours and consecutive hours on-call. To better understand this complex issue, the following review discusses resident safety, resident performance, resident education, and patient safety. Our goal is to present a balanced, evidence-based discussion, addressing both patient safety and resident fatigue management.
FORMAÇÃO PARA A REFORMA PSIQUIÁTRICA: A EXPERIÊNCIA DO CURSO DE QUALIFICAÇÃO EM SAÚDE MENTAL PARA PROFISSIONAIS COM FORMAÇÃO DE NÍVEL MÉDIO DA EPSJV/FIOCRUZ
Authors: Soalheiro Nina , Pereira Danúbiah Mendes
Published: July 2018

O artigo apresenta os resultados de um estudo sobre o papel da Educação Profissional em Saúde/EPS no contexto da qualificação do trabalhador com escolarização de nível médio. O nosso campo de pesquisa foi o Curso de Qualificação Profissional em Saúde Mental da Escola Politécnica de Saúde Joaquim Venâncio/EPSJV/Fiocruz, onde analisamos o projeto pedagógico e o impacto do processo formativo na prática profissional dos alunos egressos. Os resultados apontam mudanças qualitativas no processo de trabalho, fortalecimento do seu papel na equipe e ampliação da visão política do campo da saúde mental.
ANÁLISE DA POSSIBILIDADE DE RIVALIDADE NO MERCADO BANCÁRIO BRASILEIRO ENTRE 2000-2012
Authors: Bottrel Mariana Araújo e Silva , Pitelli Mariusa Momenti , Figueiredo Adelson Martins
Published: July 2018

A crise financeira mundial de 2008 alterou a arquitetura do setor bancário brasileiro através de grandes fusões e aquisições, que proporcionaram um aumento da concentração. Essa mudança causa preocupação sobre os níveis de concorrência do setor. A metodologia abordada envolve a análise da parcela de mercado apropriada pelos cinco maiores bancos no período e a sua oscilação. Associa, portanto, através de testes de raiz unitária, a instabilidade das séries temporais de market shares à possibilidade de rivalidade e de exercício de poder de mercado. Pode-se dizer que para o mercado de depósito total existe possível rivalidade para os bancos estudados, o que reduz a possibilidade do exercício de poder de mercado devido a um aumento da concentração.
INTERAÇÃO ENTRE A POLÍTICA MONETÁRIA E OS PREÇOS DAS HABITAÇÕES: EVIDÊNCIAS PARA O CASO BRASILEIRO
Authors: Besarria Cássio Nóbrega , Nobrega Wellington Charles Lacerda , Galdino José Danilo Bezerra , Araujo Ewerton Felipe de Melo
Published: July 2018

Esta pesquisa tem o propósito de analisar o grau de interdependência entre os preços habitacionais e as decisões de política monetária no Brasil. Essa relação é analisada a partir do modelo SVAR com restrições de sinais, no período de 2001 a 2014. Os resultados mostram que a inflação, o consumo, o produto real da economia e os preços das habitações respondem negativamente ao choque monetário contracionista. Já o choque nos preços das habitações promove um efeito riqueza positivo, afetando positivamente o consumo e o PIB. Por outro lado, o aumento nos preços das habitações afeta negativamente a inflação nos três primeiros trimestres; logo após, o nível geral de preços da economia volta a subir, ficando acima do patamar inicial. Esse efeito sobre a inflação faz com que a taxa de juros acompanhe o comportamento descrito por esse indicador e responda inicialmente de forma negativa ao aumento nos preços das habitações, aumentando a partir do terceiro trimestre.
Infección por el virus de la hepatitis B en individuos con factores de exposición en Quibdó y Apartadó, Colombia
Authors: Ríos Patiño David , Di Filippo V Diana , Rendón Londoño Julio Cesar , Ríos Ocampo Wilson Alfredo , Medina Londoño Carlos Alberto , Hoyos García María Cristina , Montoya Guarín Carlos Julio , Navas N María Cristina , Insuasty E Margarita
Published: July 2018

Antecedentes: Colombia presenta un patrón de prevalencia heterogéneo para la infección por virus de la hepatitis B (VHB) con regiones de alta, moderada y baja prevalencia. Objetivo: identificar los casos de infección por VHB y caracterizar los genotipos virales en población con factores de exposición en las ciudades de Quibdó y Apartadó, Colombia. Materiales y métodos: la población del estudio correspondió a 768 individuos asintomáticos con factores de exposición a la infección por VHB. El primer análisis fue la detección del antígeno de superficie del VHB (HBsAg) por prueba rápida. En las muestras de individuos positivos para esta prueba, se confirmó la presen- cia del HBsAg por ELISA y se detectó el genoma del VHB por reacción en cadena de la polimerasa (PCR). El genotipo viral fue determinado por secuenciación y análisis filogenético. Resultados: se identificaron 17/768 individuos con infección por VHB (2,2%) según la detección del HBsAg por prueba rápida y por ELISA. Los análisis filogenéticos permitieron la identificación de los genotipos F, (subgenotipos F3 y F1a) y A en las muestras. Conclusiones: se reporta por primera vez la circulación del subgenotipo F1a en Colombia y se confirma la circulación del subgenotipo F3 y el genotipo A.
Cómo realizar e interpretar una manometría esofágica de alta resolución
Authors: Hani Albis Cecilia , Leguízamo Ana María , Carvajal Jhon Jaime , Mosquera-Klinger Gabriel , Costa Valeria Atenea
Published: July 2018

Con la introducción de la manometría esofágica de alta resolución se revelaron patrones no identificados previamente de la función esofágica normal así como hallazgos anormales. De igual forma, adiciona patrones de presión gráficos y topografía de la presión esofágica, lo que lleva al desarrollo de nuevas herramientas para el análisis y clasificación de desórdenes motores esofágicos. En la actualidad la clasificación de Chicago es el método diagnóstico de análisis de los diferentes trastornos motores esofágicos; en Colombia, día a día vemos el crecimiento en la realización de este estudio. El artículo propone hacer una revisión de cómo realizar e interpretar una manometría esofágica de alta resolución.
Stents autoexpandibles biodegradables en endoscopia intervencionista gastrointestinal y pancreatobiliar. Estado actual
Authors: Álvarez Óscar , Castaño Llano Rodrigo , Restrepo David
Published: July 2018

Los stents biodegradables son una opción muy atractiva para utilizar en pacientes con estenosis benignas recurrentes/recalcitrantes del tracto digestivo y biliar. En teoría, utilizando estos stents biodegradables, se pueden evitar dilataciones repetitivas de estenosis digestivas o biliares refractarias al manejo convencional, como también se podrían evitar resecciones quirúrgicas, principalmente en pacientes de alto riesgo quirúrgi- co, y se minimiza el número de procedimientos endoscópicos intervencionistas.
Determinación de la prevalencia de hepatitis C mediante la prueba rápida BIOLINE HCV en una población de alto riesgo
Authors: Martínez Julián David , Garzón Olarte Martín Alonso , Arteaga Juan , Hernández Geovanny , Manrique Camilo , Hormaza Arteaga Natán , Lizarazo Rodríguez Jorge Iván , Marulanda Gómez Juan Carlos , Molano Villa Juan Carlos , Rey Tovar Mario Humberto , Salinas Carolina
Published: July 2018

Introducción: la infección por el virus de la hepatitis C (HCV sus siglas en inglés) es un problema de salud pública en el mundo y la Organización Mundial de la Salud (OMS) calcula en más de 180 millones las perso- nas infectadas. El objetivo del presente estudio es determinar la prevalencia de anti-HCV en pacientes con alto riesgo de infección mediante una prueba rápida con sangre capilar, y la confirmación de la infección por la prueba de PCR en tiempo real. Método: se incluyeron pacientes atendidos en la Unidad de gastroenterología del Hospital Universitario de La Samaritana de Bogotá D.C, principal centro de referencia del departamento de Cundinamarca y que atiende pa- cientes de todo el país. Se definieron como factores de riesgo para hepatitis C: antecedentes de transfusiones, hemodiálisis, cirugías mayores (sistema nervioso central [SNC], tórax, abdomen, ortopédicas), drogadicción (farmacodependencia), tatuajes, piercing, acupuntura, presidiarios, trabajadores sexuales, VIH/sida, enferme- dades de trasmisión sexual, trabajadores de la salud, pacientes procedentes de la Orinoquía y/o Amazonía, e insuficiencia renal crónica; también se estudiaron pacientes remitidos por alteración del perfil hepático, hígado graso, masas hepáticas, cirrosis excepto por virus C, ascitis, y várices esofagogástricas. Se empleó el estuche comercial SD BIOLINE HCV (Standard Diagnostics, INC. Corea), esta prueba contiene una membrana precu- bierta con antígenos recombinantes del HCV (core, NS3, NS4, NS5); se combina una proteína A coloidal con la muestra de suero y se mueve a lo largo de la membrana cromatográfica formando una línea visible de reacción antígeno-anticuerpo-proteína A, con un alto grado de especificidad y sensibilidad. Resultados: entre enero y octubre de 2014 se estudiaron 391 pacientes, 161 mujeres (41%) y 230 (59%) hombres; edad promedio de 46,6 años y rango de edad de 14 a 86 años. Se detectaron, por la prueba rápida para hepatitis C, 4 pacientes positivos (3 mujeres y 1 hombre), todos ellos confirmados por la técnica de PCR-RT, lo que da una prevalencia de la infección del 1,02%. Conclusiones: en este estudio, realizado en una población altamente seleccionada por sus antecedentes y factores de riesgo asociados, el rendimiento de la prueba rápida supera el 1% como capacidad de detección de la enfermedad. Cabe esperar que esta sea la verdadera prevalencia en población seleccionada, sobre la base de los resultados del estudio de 2012 y además, sobre la base de la sensibilidad de la prueba rápida.
Utilidad de la endomicroscopia confocal láser basada en probes (Cellvizio) en gastroenterología
Authors: Forero Piñeros Elías Alfonso , Cardona Héctor José , Karia Kunal , Sethi Amrita , Kahaleh Michel
Published: July 2018

La endomicroscopia confocal láser basada en probes (Cellvizio de Mauna Kea Technologies, París) es una nueva tecnología que permite, durante cualquier procedimiento endoscópico, realizar análisis histológicos en tiempo real (biopsia óptica), mejorando el diagnóstico y ayudando a definir el tratamiento de múltiples patologías digestivas. Es de resaltar, para nuestro medio, su utilidad en patologías de difícil diagnóstico como son las estenosis biliares indeterminadas y las neoplasias quísticas pancreáticas, cuyo diagnóstico temprano y exacto es muy difícil con las técnicas actualmente disponibles, y que es necesario para definir la realización o la exclusión de tratamientos quirúrgicos de alta morbimortalidad y alto costo, como por ejemplo, la cirugía de Whipple. En esta revisión se muestran los aportes actuales de esta tecnología, ya disponible en nuestro medio, para el diagnóstico y estudio de las patologías digestivas.
Insuficiencia hepática aguda fulminante por virus de la hepatitis B: reporte de caso
Authors: Barrera Ana Madeleine , Rincón Laura Daniela , Peñaloza Cruz Fernando , Vargas Lina Patricia , Delgado Medina Farhi Alonso
Published: July 2018

Se reporta el caso de una mujer de 37 años de edad sin antecedentes relevantes, que consulta por cuadro febril ictérico asociado con alteración hepática importante con patrón necroinflamatorio, se documenta hepa- titis viral B y presenta una evolución tórpida rápida hasta la muerte. De esta forma, se exponen los posibles factores que influyen en la progresión hacia la insuficiencia hepática fulminante (IHF) descritos en la literatura.
Analiza kalibracji wyników sondowań CPT z próbnymi odwiertami kolumn przemieszczeniowych CMC
Authors: Kobrzyńska Karolina , Jakubowski Kuba , Kanty Piotr
Published: July 2018

The issue of calibration of the CPT results with test drillings of controlled modulus columns (CMC) columns is widely used in Poland, due to the analogy of drilling parameters for this type of geotechnical research. The values and types of drilling parameters used to correct perform of the calibration depend on the type of the machine executing displacement columns. The issue of calibration is accompanied by problems and technical details that may determine its proper performance. Presentation of three theoretical approaches to searching for one parameter corresponding to the cone resistance chart from the CPT test was developed based on literature and many years’ experience of Menard Polska executing ground improvement in CMC columns technology.
Relationship between mean annual temperatures and precipitation sums in Montenegro between 1951-1980 and 1981-2010 periods
Authors: Buric Dragan , Ducic Vladan , Mihajlovic Jovan
Published: July 2018

In the second half of the 20th and by the beginning of the 21st century the
area of Montenegro was dominated by positive air temperature fluctuations
and negative precipitation sums. This paper analyses a 60-year period
(1951-2010), with the aim to determine air temperature and precipitation
deviation between the two 30-year periods: 1951-1980 and 1981-2010.
Calculations of mean, mean maximum and mean minimum temperature have been
done, as well as annual values of precipitation sums. All three temperature
parameters, particularly maximum values, show that the 1981-2010 period was
significantly warmer in relation to previous three decades. Significant
changes in mean annual precipitation sums between the two observation
periods have been recorded on the coast and, locally, in the western part of
the country. The results also showed that there was a significant increase
in positive deviations of mean maximum temperature in most parts of
Montenegro during the 1981-2010 period in relation to the 1951-1980 period,
while changes of this type in other observation parameters were mostly
minor.
On a property of differential equations integrable using meromorphic double-periodic functions
Authors: Petrovitch Michel
Published: July 2018

nema
Asymptotic solution for the Darcy-Brinkman-Boussinesq flow in a pipe with helicoidal shape
Authors: Pazanin Igor
Published: July 2018

We study the fluid flow and heat transfer in a helical pipe filled with a sparsely packed porous medium. Motivated by the engineering applications, pipe?s thickness and the distance between two coils of the helix have the same small order of magnitude, whereas the fluid inside the pipe is assumed to be cooled (or heated) by the exterior medium. After writing the dimensionless Darcy?Brinkman?Boussinesq system in curvilinear coordinates, we employ the multi-scale expansion technique to formally derive the effective model valid for small Brinkman?Darcy number. The obtained asymptotic solution is given in the explicit form which is important with regards to numerical simulations. Comparison with our previous results on the straight-pipe flow is also provided.
Psychological aspects of child development of importance for judicial proceedings
Authors: Milosavljevic-Djukic Ivana , Tankosic Bojana
Published: July 2018

Children have the right to access the justice, to participate in the court
proceedings, their views and testimonies to be heard and taken into account,
and to be treated with utmost care during the court proceedings. However,
over the past twenty years, researchers have pointed out that participation
in the court proceedings may be traumatic for a child and a source of
secondary victimization. Therefore, it is necessary to establish a specific
approach to and different way of questioning children, which is adjusted to
child?s developmental needs. Children and adolescents differ from adults in
the way they function (cognitively, intellectually, emotionally). It is
therefore crucial for professionals who deal with children (victims or
witnesses) to be aware of and understand the specificities of each
developmental stage. Otherwise, they will not be able to approach the child
in the right way and ensure his/her understanding of newly born life
circumstances, remove child?s worries and fears, and enable a child to
answer questions, normalize his/her feelings, etc; consequently they will
not get a quality testimony, significant for the court proceedings, which is
also relevant for the child?s recovery process. The organ of the procedure
should avoid acts that could harm the child?s psychological life and resort
to techniques which are not harmful for the child?s development. One
suggestive interview can create fake memories. Knowing the psychological
life of a child in the context of his participation in the court proceedings
is relevant for improving the quality of the child?s expression. This can
help in making a child as spontaneous as possible, as well as more complete,
coherent and safer. Child?s statements can be reliable and unreliable, just
like the statements of adults. Thus, the quality, validity and accuracy of
the taken statement depends largely on the knowledge and skills of the
examiners. It is therefore of utmost importance that professionals who are
interviewing/ questioning children are well trained and aware of the child?s
development in general and of psychological aspects of child development in
particular since they are important from the legal point of view: general
understanding, memory, suggestiveness, language, social and emotional
development, and morality (truths). Taking that as a starting point, this
paper aims to present psychological aspects of child development relevant
for the court proceedings, and to point out to the challenges in dealing
with child victims and witnesses faced by professionals from the justice
system and the social protection system, and the ways of overcoming them in
order to protect the best interests of the child in the court proceedings.
Women as victims of environmental crime and the relation of their victimization to the victimization of animals: An ecofeminist perspective
Authors: Savic Neda
Published: July 2018

Ecofeminism, as a socio- political movement/ ideology, emphasizes the
conceptual connections between oppression against woman and oppression
against nature. On the other hand, environmental crime victims are the
subject matter of green victimology, which defines environmental crime in
the wider sense, so that it consists not only of criminal offences, but also
of all the non-incriminated ecologically harmful acts. As its victims mostly
appear to be women, nature/ ecosystems, animals and vulnerable groups,
therefore ecofeminism serves as the fundamental theory in exposing the
andocentric context of their victimization. Taking that as a starting point,
an overview of the victimological patterns and roots of victimization by
environmental crime, as it is defined in green victimology, is presented in
the paper. This is done from an ecofeminist perspective. The focus is on the
most frequent victims of environmental crime - woman and animal. The
objective is to find certain common denominators of their victimological
patterns and roots of victimization in order to make proposals for a more
adequate response to their victimization.
Crime reporting practices among traders at Alaba International Market, Lagos
Authors: Ayodele Johnson
Published: July 2018

In the field of contemporary study of victims in most developing countries
worldwide, the reporting of personal victimization has received more
attention by scholars than business victimization. Therefore, the aim of the
current study is to examine the influence of business crimes reporting
practices among traders on the development of the Alaba International Market,
the traders and national economy. The study was conducted between October 3
and 8, 2015, in Lagos, Nigeria. It collected quantitative data from 245
respondents that were randomly selected from traders at the market. These
were complemented by qualitative data collected through In-depth Interviews
and Focus Group Discussions with purposively selected participants. The data
were analyzed. The quantitative data found that 82.1% of the respondents
attributed the victimization of small businesses to organized crimes by
youth. The qualitative data indicated that the Alaba Market investors will
reduce the unemployment rate in Lagos if the government stop frustrating the
traders with the tax burden. The study concluded that business crimes prevent
economic development. It suggests partnership among stakeholders for the
provision of closed-circuit television cameras to prevent business violence
and induce economic development at Alaba International Market.
European union and the technocracy-based guardianship
Authors: Losonc Alpar
Published: July 2018

The article consists of three parts. In the first part, the discussions on
technocracy in the twentieth century are related to the problems of dynamics
of technocracy in the European Union. In the second part, the paper tries to
point to the fact that the problem of technocracy is already determined by
the genesis of EU. In this section the paper articulates the special
contribution of German ordoliberalism in relation to EU structures and
technocratic governmentality. Specifically, the juridization and
economization of politics, and the economization of constitutionality are
mentioned. The third part deals with the momentum of technocracy after the
crisis in 2008 and the technocracy is treated as a crisis-based
guardianship. The paper concludes that given modalities of technocracy in EU
are not accidental or by products; it can be derived from the genesis and
structure of the EU.
Europe’s federative Republic and Leviathan - friends or foes?
Authors: Lalovic Dragutin
Published: July 2018

Seen from the perspective of classical state theory (Bodin, Hobbes, Hegel),
to appropriately confront the dilemma whether federalism and modern state
are friends or enemies in the process of European integration necessitates
previous clarifications of some key features of a modern state. In contrast
to the pre-modern orders of personalized power, state implies impersonal
sovereign rule as a condition of legal order establishing and subjectivation
of man as legal person. In the process of European political community
building continental Leviathan is not a barrier to federalist democratic
integration of Europe as a republic but its precondition. Their common enemy
is Behemoth as a symbol of not only civil war (in the sense of Hobbes and
Schmitt) but also Nazi totalitarian regime as a non-state (Neumann).
From hidden federalism to hidden hegemonism
Authors: Samardzic Slobodan
Published: July 2018

Bojan Kovacevic?s book serves as a starting point for considering the major
topic, which is the crisis of the EU?s prevailing model of governance. The
author?s argument about ?hidden federalism? constitutes a solid ground for
fruitful theoretic discussion. The author?s approach explains a long lasting
and well established project of integration that has developed within the
framework of elitist and technocratic model of public affairs governing. By
accepting this perspective in this paper the EU crisis is conceptualized as
a process that leads from ?hidden federalism? to ?hidden hegemonism? as a
constitutional outcome of concrete anti-crisis politics.
The road to Nobel prize is paved with the conceptualisations of rationality from homo economicus to homo heuristicus
Authors: Stajkic Bojana , Damnjanovic Kaja
Published: July 2018

In this paper we present the main psychological conceptions of rationality:
unbounded rationality, bounded rationality, optimization under constraints,
and ecological rationality. We show how these concepts directed the research
questions, and how they shaped psychological models of complex cognitive
processes. In its symbolic tradition, for more than a century, the
psychology, as a fundamental cognitive science, has been focused on the
question of how the environment is represented in the cognitive system, how
the cognitive system operates with those information, and, ultimately, what
are the outcomes of these processes. The basis on which the research efforts
focusing on complex cognitive processes, such as judgment, decision-making,
and reasoning - are rooted in is the stance of authors, and psychological
models regarding rationality. The conceptualizations of rationality are, at
the beginning of the psychological research, implicit, because they are taken
from a normative approach, and the research focus is on the outcome of
cognitive processes, while the functions and the processes themselves are
neglected. Later, as the research diverge from the normative approach, the
psychological conceptualization of rationality becomes more explicit and
subjective, and more nested in the environment, and the empirical studies aim
to describe the structure and dynamics of complex cognitive processes.
miR-30a Remodels Subcutaneous Adipose Tissue Inflammation to Improve Insulin Sensitivity in Obesity
Authors: Koh Eun-Hee , Chernis Natasha , Saha Pradip K. , Xiao Liuling , Bader David A. , Zhu Bokai , Rajapakshe Kimal , Hamilton Mark P. , Liu Xia , Perera Dimuthu , Chen Xi , York Brian , Trauner Michael , Coarfa Cristian , Bajaj Mandeep , Moore David D. , Deng Tuo , McGuire Sean E. , Hartig Sean M.
Published: July 2018

Chronic inflammation accompanies obesity and limits subcutaneous white adipose tissue (WAT) expandability, accelerating the development of insulin resistance and type 2 diabetes mellitus. MicroRNAs (miRNAs) influence expression of many metabolic genes in fat cells, but physiological roles in WAT remain poorly characterized. Here, we report that expression of the miRNA miR-30a in subcutaneous WAT corresponds with insulin sensitivity in obese mice and humans. To examine the hypothesis that restoration of miR-30a expression in WAT improves insulin sensitivity, we injected adenovirus (Adv) expressing miR-30a into the subcutaneous fat pad of diabetic mice. Exogenous miR-30a expression in the subcutaneous WAT depot of obese mice coupled improved insulin sensitivity and increased energy expenditure with decreased ectopic fat deposition in the liver and reduced WAT inflammation. High-throughput proteomic profiling and RNA-Seq suggested that miR-30a targets the transcription factor STAT1 to limit the actions of the proinflammatory cytokine interferon-γ (IFN-γ) that would otherwise restrict WAT expansion and decrease insulin sensitivity. We further demonstrated that miR-30a opposes the actions of IFN-γ, suggesting an important role for miR-30a in defending adipocytes against proinflammatory cytokines that reduce peripheral insulin sensitivity. Together, our data identify a critical molecular signaling axis, elements of which are involved in uncoupling obesity from metabolic dysfunction.
A comparative study on ABO blood group and fertility hormones in infertile women in Calabar, Southern Nigeria
Authors: Akpan Uwem Okon , Bassey Iya Eze , Nwatu Nnenna Nkiruka , Offor Sunday Jeremiah
Published: July 2018

Infertility, a disorder of the reproductive system, is commonly linked to hormonal, pituitary, cervical, uterine, immunological or psychological factors. Besides these factors, it can also be idiopathic or unexplained. Hence, there is a need for more research to unravel the causes of the unexplained infertility. This work aimed at finding out whether there is any relationship between ABO blood group system and female infertility. The study design was cross-sectional. Three hundred women between 18 and 40 years attending fertility clinic at the University of Calabar Teaching Hospital, Calabar between 2011 and 2012 were recruited for this study. Serum progesterone, prolactin, follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol were determined using Enzyme linked immunosorbent assay (ELISA) while ABO blood grouping was determined using the tube method. Statistical analysis was done using SPSS version 18. The confidence level was set at 95% where p-value less than 0.05 was considered statistically significant. The mean age of the women was 30.65 ± 5.47 years and the percentage distributions of the blood groups among the women were as follows: 24% A, 12% B, 4% AB and 60% O. The mean FSH levels of blood groups A and O individuals were significantly higher (p<0.05) than that of groups B. However, there was no significant difference (p>0.05) in the mean levels of progesterone, prolactin, LH and estradiol in the respective groups. From this study, 38% of the population had increased levels of progesterone, 58% and 18.7% had elevated prolactin and FSH levels respectively while 11.33% and 43.3% had reduced levels of LH and estradiol levels respectively. Though, there was high prevalence of hyperprolactinemia observed in this study, there was no strong association between ABO blood group and female infertility but, the increased FSH levels observed in blood groups A and O may be a potential link between blood group and infertility and therefore may be beneficial for further study.
Consumer preferences of apples in Estonia and changes in attitudes over five years
Authors: Moor Ulvi , Moor Argo , Põldma Priit , Heinmaa Lagle
Published: July 2018

Apple preferences of Estonian consumers (n=336 in 2007 and 332 in2012) were determined regarding apple origin, production method and different quality attributes. The aim was to find out whether apple preferences of young people raised in a capitalistic system differ from older people raised in the Soviet Unionand also to determine if and how these preferences have changed over five years. The majority of the respondents preferred domestic apples (91% and 81% in 2007 and 2012, respectively), the main motivation being food safety: domestic apples were believed to contain fewer chemical residues. Apple taste was the most important quality attribute, followed by appearance which was rated equally important as health benefits and finally, price. Young people (<25 years) were significantly more indifferent towards apple origin compared to others. However, the preference for apple taste and colour was similar in all age groups. Over the five year period surveyed, the preference for domestic and organic apples had decreased, but taste and colour preference had remained unchanged.