bluuebunny/crossref_metadata_2025 huggingface dataset:
Análise da alocação de recursos em saúde na região sudeste do Brasil
Authors: Santos Lucas Maia dos , Faria Adriana Moreira Bastos de , Faria Evandro Rodrigues de
Published: May 2016

Após a descentralização das ações e serviços de saúde, os recursos financeiros passaram a ser transferidos para os fundos municipais de saúde, ficando a cargo do gestor municipal, a administração dos recursos. Considerando a existência limitada de recursos, é oportuno questionar a forma como tem sido gerenciada a relação entre repasse e aplicação de recursos. Assim, o presente estudo teve como objetivo, investigar a performance da saúde pública, tomando como referência, 160 microrregiões administrativas da Região Sudeste do Brasil. Inicialmente, foram exploradas as variáveis de relevância, após análise descritiva com esforços quantitativos e qualitativos. Foram gerados os escores de eficiência por meio da análise envoltória de dados e utilizando o procedimento de bootstrap sobre as médias de eficiência das organizações, objetivando criar intervalos de confiança sobre as médias. Nos resultados observou-se maior eficiência para as microrregiões com mais de 500 mil habitantes e nas capitais em detrimento do interior. Percebeu-se grande amplitude dos escores de eficiência de 0,26 a 1. Destaca-se que 16,8% das microrregiões apresentaram escores máximos, estando a maioria estado de São Paulo. A média de eficiência está entre 0,68 e 0,75, a 95% de confiança. Desta maneira, os resultados demonstraram que, o desempenho das microrregiões do Sudeste pode ser considerado mediano e preocupa-se o fato da alta disparidade inter-regional. Por fim, assevera a importância de ser promover políticas para a melhoria da eficiência da saúde em função das particularidades inter-regionais.
O mapeamento de processos como ferramenta para tomada de decisão na implantação de SIG: estudo de caso de uma lavanderia hospitalar
Authors: Lara Gianni
Published: May 2016

Objetiva-se conceituar SIG - Sistema de Informações Gerenciais e Mapeamento dos Processos, suas correlações e relevância para a gestão hospitalar. Apontar sugestões e um modelo de SIG para a Lavanderia do Hospital Y. O SIG é um instrumento administrativo que aperfeiçoa a comunicação, melhora o processo decisório pelo uso eficiente dos seus recursos, mas que, para isso, exige da organização um investimento relativamente alto em tecnologia da informação (Hardware e Software) e capacitação de pessoal.  Ao levar em consideração os processos e mapeá-los, é possível conhecer e diagnosticar melhor as atividades desenvolvidas, conectar e difundir conhecimentos e potencializar o grau de sucesso na implantação do sistema. A metodologia adotada contemplou estudo de caso, pesquisa bibliográfica, pesquisa documental, observação participante e aplicação de entrevistas estruturadas junto aos empregados do setor. Concluiu-se que, ao conhecer melhor os processos que serão controlados pelo SIG, potencializa-se o grau de sucesso de sua implantação e que, a partir de uma visão integrada dos processos, os serviços de informação podem atingir seus objetivos de forma mais satisfatória.
PLANO DE CARREIRAS, CARGOS E SALÁRIOS (PCCS) E MOTIVAÇÃO DOS TRABALHADORES EM SAÚDE: A PERCEPÇÃO DOS FUNCIONÁRIOS DA SECRETARIA MUNICIPAL DE SAÚDE DE MANAUS
Authors: Soares Luiz Augusto De Carvalho Francisco , Soares Filho Afrânio De Amorim Francisco , Oliveira Junior Aristides Da Rocha , Nogueira Ricardo Jorge da Cunha Costa
Published: May 2016

A implantação do Plano de Carreira, Cargos e Salários (PCCS) nas diversas esferas do setor público brasileiro constitui fenômeno generalizado. Na medida em que expressa o atendimento a uma reivindicação recorrente dos servidores públicos, em prol da conquista de níveis maiores de segurança e satisfação com o trabalho por estes desempenhado, aumenta o interesse por sua implantação. Com foco específico para o setor de saúde pública, o presente estudo explora a relação entre remuneração percebida e a implantação de um PCCS, com base em estudo de caso realizado junto à Secretaria Municipal de Saúde (SEMSA) de Manaus. Os dados foram coletados com base na aplicação de questionários semi-estruturados, entrevistas e análise documental. Os achados da pesquisa indicam que existe uma forte correlação entre a carreira e os elementos que compõem a remuneração e os resultados apontam que no geral o PCCS precisa ser mais bem absorvido por seu público-alvo. Todos os indicadores macros levaram-nos a índices próximos a insatisfação, ou no máximo, a indiferença. Isto significa que o PCCS, nesta unidade de trabalho da SEMSA, está aquém de sua proposta original.
Orientação para o Mercado, Aprendizagem Geradora e Estratégias de Inovação: um estudo no setor hospitalar.
Authors: Monteiro Mariana Ribeiro , Bora Sarita Monteiro , Machado André Gustavo Carvalho
Published: May 2016

O objetivo deste artigo foi analisar práticas de estratégia de inovação explorative e exploitative respectivamente associadas à orientação ao mercado e aprendizagem geradora no setor hospitalar. Para isto, foi realizado um estudo de caso no Hospital Unimed João Pessoa. Para coleta de dados, foram realizadas entrevistas com cinco pessoas-chave da organização, observados documentos comprobatórios dos discursos e observações in loco do relacionamento entre os funcionários. Os resultados evidenciaram que o Hospital possui características mais predominantes da orientação para o mercado do que para a aprendizagem geradora e alinha-se mais com a estratégia exploitative do que a explorative, por meio da melhoria contínua, redução de custos, otimização do tempo para realização do serviço e busca pela adição de valor aos serviços.
Estudo sobre a importância da Capacitação do servidor Administrativo do Hospital das Clínicas da Universidade Federal de Goiás
Authors: Brito Marcia Yassunaga , Ziviani Fabricio , Oliveira Josmária Lima Ribeiro de Oliveira Lima Ribeiro de , Christino Juliana Maria Magalhães Christino Maria Magalhães Christino
Published: May 2016

Este trabalho realizou uma pesquisa descritiva quantitativa que teve como campo de pesquisa, o Hospital das Clínicas da Universidade Federal de Goiás. Buscou-se elucidar questões relativas ao processo de capacitação oferecido pela instituição para os servidores administrativos com o interesse de verificar a contribuição da capacitação para a melhoria do desempenho profissional individual e organizacional. Dentre os resultados, verificou-se que na visão dos entrevistados, a melhoria que a capacitação promove no ambiente hospitalar é de crucial importância, trazendo benefícios para os servidores, para a organização e para a sociedade que usufrui desses serviços. Os resultados também apontaram, como sugestões dos participantes da pesquisa, a necessidade de melhoria no próprio processo de capacitação para que o mesmo possa alcançar o seu objetivo principal, a melhoria da produtividade na organização hospitalar.
INFLUÊNCIA DA ESCALA DE ALDRETE E KROULIK NAS ESTRATÉGIAS DE GESTÃO DA SALA DE RECUPERAÇÃO PÓS-ANESTÉSICA
Authors: Volquind Daniel , Fellini Roberto Taboada , Schnor Otávio Haygert , Flores Rafael Py Gonçalves , Londero Bruno Bertagnolli
Published: May 2016

Os critérios de alta da sala de recuperação pós-anestésica (SRPA) podem ser sistematizados através de protocolos assistenciais, como a escala de Aldrete e Kroulik, por critérios empíricos ou pelo anestesiologista que realizou o procedimento anestésico ao estabelecer um horário para alta. Este estudo objetiva validar a utilização da escala de Aldrete e Kroulik como uma ferramenta na gestão eficiente da SRPA. Foram analisados restrospectivamente os dados coletados de 233 prontuários  e constaram da classificação ASA, tempo programado para alta da SRPA determinado pelo anestesiologista, a pontuação estabelecida pela escala de Aldrete e Kroulik na admissão e na alta da SRPA e o tempo de permanência na SRPA determinado pelo escala de Aldrete e Kroulik. A média do escore de Aldrete e Kroulik na admissão dos pacientes na SRPA foi 7,1 (DP=0,05) com mínimo de 6 e máximo de 9. Na alta da SRPA, a média do escore de Aldrete e Kroulik foi 9,9 (DP =0,02) com mínimo de 9 e máximo de 10. Houve significância estatística na comparação do tempo estimado para alta pelo anestesiologista e tempo médio real estabelecido pela escala de Aldrete e Kroulik. A escala de Aldrete e Kroulik, como um critério sistematizado de alta da SRPA, é validada como uma ferramenta na gestão eficiente da sala de recuperação pós-anestésica.
ANÁLISE DAS CONDIÇÕES DE ACESSIBILIDADE DE PESSOAS COM DEFICIÊNCIA AUDITIVA EM UNIDADES PÚBLICAS DE SAÚDE DO MUNICÍPIO DE MANAUS
Authors: SOARES LUIZ AUGUSTO DE CARVALHO FRANCISCO , DE SOUZA LAYLA KELLY LOPES , SOUZA JUNIOR ARMANDO ARAÚJO DE , NOGUEIRA RICARDO JORGE DA CUNHA COSTA
Published: May 2016

A maciça difusão dos direitos e deveres da sociedade, previstos pela Constituição Federal, tem alertado a população marginalizada sobre a necessidade de construção de políticas públicas inclusivas, além de ser parâmetro para a exigência do cumprimento de tais direitos. Nota-se que a parcela da população que apresenta algum tipo de deficiência não usufrui de tais direitos por falta de recursos físicos ou humanos. O presente trabalho tem como objetivo expor as condições de acesso de pessoas com deficiência auditiva no uso de serviços públicos de saúde. A metodologia desta pesquisa foi por abordagem quantitativa qualitativa dos dados coletados em cinco unidades de saúde administradas pelo Estado e Prefeitura, além de 30 pessoas com deficiência auditiva. Os dados coletados foram analisados e o conteúdo permitiu expressar os fenômenos estudados e a relação entre o que a Legislação Brasileira prevê e o que de fato é cumprido. Foi possível evidenciar que o uso dos serviços públicos de saúde por pessoas com deficiência auditiva no município de Manaus está em desencontro com o que é previsto por lei.
ANÁLISE DA GESTÃO DA QUALIDADE NAS AQUISIÇÕES DE PRODUTOS E SERVIÇOS DE SAÚDE DE UM HOSPITAL PÚBLICO DE SÃO PAULO
Authors: CAVALCANTI ANETTE CRISTINE FERREIRA , MARTENS CRISTINA DAI PRÁ , BIANCOLINO CÉSAR AUGUSTO
Published: May 2016

Partindo-se do trade off entre qualidade e custo, este artigo analisa a adoção de práticas de gestão da qualidade desde a introdução do pregão eletrônico nos processos licitatórios de um hospital público específico do Estado de São Paulo. O referencial teórico aborda as aquisições públicas, os sistemas eletrônicos de aquisição e a qualidade nas aquisições. A metodologia usada foi a pesquisa documental de informações das atas de pregão eletrônico de um hospital público no site da Bolsa Eletrônica de Compras. O estudo teve por fim os seguintes resultados: o hospital passou a exigir amostras de produtos para análise da equipe técnica do pregão antes da finalização da aquisição; a instituição incorporou, em suas aquisições, indicadores de qualidade para fins de desclassificação de fornecedores e os editais de pregão da instituição passaram a exigir que os produtos entregues no hospital não apresentem menos que metade do seu prazo de validade.
ANÁLISE COMPARATIVA DA APLICAÇÃO DA lOGÍSTICA REVERSA DE RESÍDUOS ENTRE UM HOSPITAL UNIVERSITÁRIO E O PRO-HOSP: UM ESTUDO DE CASO
Authors: DROHOMERETSKI EVERTON , FERNANDES NATASHA ZUTYLIS , RIBEIRO LUCIANA DE OLIVEIRA
Published: May 2016

Com o crescimento da preocupação com o meio ambiente, a discussão referente ao destino dos resíduos e seus impactos na natureza vem ocupando espaço. Devido à tecnologia crescente e a rapidez no lançamento de novos produtos, o ciclo de vida útil tem diminuído, gerando um desequilíbrio entre as quantidades de resíduos descartados e reaproveitados, tornando o lixo urbano um grave problema ambiental da atualidade. Tendo isso em vista, o gerenciamento destes resíduos passa a ser uma alternativa para a aplicação da logística reversa e desta forma amenizar os impactos ambientais causados por esses resíduos. A preocupação é ainda maior quando se refere aos resíduos gerados pelos estabelecimentos da saúde. Os produtos médicos trouxeram facilidade no atendimento aos pacientes, porém o volume de resíduos aumentou proporcionalmente. Nessa linha, o objetivo da pesquisa foi estudar os impactos gerados pela logística reversa em uma organização hospitalar na cidade de Curitiba-PR. Para atingir o objetivo proposto, foi adotado, como estratégia de pesquisa, o estudo de caso em um hospital referência na região. Para o desenvolvimento da pesquisa foram realizadas entrevistas, observações diretas e análise de documentos. Para a análise dos dados além da triangulação entre os entrevistados e demais instrumentos de coleta, também se utilizaram os resultados da pesquisa Pro-Hosp como parâmetro para a análise. Os resultados evidenciaram a significativa preocupação do hospital com o gerenciamento adequado dos seus resíduos, por implementar desde 2003 o Plano de Gerenciamento de Resíduos do Serviço da Saúde (PGRSS),que trata de ações que visam à preservação e proteção da saúde pública, dos recursos naturais e do trabalhador.
INOVAÇÃO SOCIAL EM EMPREENDIMENTO ECONÔMICO SOLIDÁRIO: ALTERNATIVAS PARA O ENFRENTAMENTO DA MARGINALIZAÇÃO
Authors: Pinheiro Neto Guipson Fontes , Abreu Mônica Cavalcanti Sá de
Published: May 2016

O artigo apresenta o processo de inovação social num empreendimento econômico solidário para enfrentar a marginalização de pacientes com distúrbios psiquiátricos. Este trabalho classifica-se como uma pesquisa qualitativa, do tipo exploratório e descritivo, tendo o estudo de caso como estratégia. Os dados da pesquisa foram analisados segundo a técnica de análise de conteúdo. Sob o olhar da inovação social, a Cooperativa Social do Centro de Atenção Psicossocial (COOPCAPS) representa ser a própria inovação, pois foi nova solução encontrada pelos indivíduos, com o apoio de distintas entidades da sociedade, motivados para o enfrentamento da situação de marginalização.
Ações e estratégias sustentáveis em uma empresa de coleta de resíduos de serviços de saúde.
Authors: Silva Vanessa Almeida da , Balsan Laércio André Gassen , Beuron Thiago , Faller Lisiane Pellini , Madruga Lucia Rejane da Rosa Gama
Published: May 2016

O presente estudo analisa uma organização responsável pela coleta, transporte, tratamento e destinação final de resíduos especiais. Seu objetivo foi analisar as ações e estratégias sustentáveis da empresa relacionados aos resíduos de serviços de saúde, de modo a caracterizar as especificidades da organização, bem como descrever a gestão dos resíduos. Este estudo de caso envolveu opiniões e percepções dos gestores de uma filial da empresa quanto às ações e estratégias sustentáveis adotadas. Devido a sua atuação na área de resíduos especiais, a empresa possui características próprias que lhe conferem especificidades. A conclusão do estudo demonstrou que existe uma percepção por parte dos gestores quanto aos objetivos econômicos, sociais e ambientais definidos pela organização, onde a adoção de práticas ambientais deve refletir a responsabilidade social da empresa, enfatizando a importância de gerar uma imagem legitimada e institucionalizada na sociedade.
Planejamento e Gestão Logística de Medicamentos em uma Central de Abastecimento Farmacêutico Hospitalar
Authors: Andreoli Gustavo Luís Meffe , Dias Cleidson Nogueira
Published: May 2016

Este trabalho aborda sobre planejamento e gestão logística de medicamentos na Central de Abastecimento Farmacêutico (CAF) de um Hospital situado em Brasília no Distrito Federal.  Os objetivos centram-se em detectar e priorizar as deficiências no abastecimento de medicamentos e identificar ações para o problema priorizado relacionado à logística de medicamentos desse Hospital. Como metodologia, optou-se por uma pesquisa qualitativa baseada em instrumentos de entrevista do tipo grupo focal. Os resultados mostraram que a maioria dos problemas de logística identificados está relacionada à programação inadequada de compra dos medicamentos, sendo esse um dos motivos da irregularidade no abastecimento farmacêutico do hospital.
História da acreditação hospitalar na América Latina – o caso Brasil
Authors: Novaes Humberto De Moraes
Published: May 2016

No ano em que a Organização Nacional de Acreditação ou ONA comemora seus 15 anos vale a pena contar a história da sua criação, pelo menos do período pré-ONA, ou imediatamente após o seu nascimento. No período anterior, nos anos 90, a Organização Pan-americana da Saúde mantinha e mantém até hoje uma estreita relação com os Ministérios da Saúde de todos países desta Região. Estes Ministérios, inclusive o Brasil, relacionavam-se raramente com outros setores, especialmente com os hospitais privados. Conscientes da necessidade de desenvolver assessoria aos Hospitais, não somente aos públicos, mas também aos privados desta Região a OPAS firmou um acordo, em 1986, de cooperação técnica com a Federação Latino-americana de Hospitais, membro permanente do Conselho Diretor da OPAS, para contornar o obstáculo desta resistência dos Ministérios com o setor privado, em especial hospitais privados, e assim poderíamos oferecer consultoria a estes hospitais em programas de acreditação de hospitais.
Gerenciamento dos medicamentos em hospitais públicos
Authors: Miranda Viviane Alves , Arruda Vivianne Lins de , Branco Elisângela Sousa
Published: May 2016

A farmácia hospitalar é uma unidade clínica que, através do farmacêutico habilitado, busca garantir a qualidade de assistência aos pacientes fornecendo o uso de seus medicamentos. Por isto este estudo teve como objetivo mostrar a importância da farmácia hospitalar para os clientes/pacientes, tanto internos quanto externos em hospitais públicos, sabendo que a obtenção da cura ocorre através do correto tratamento medicamentoso. Esta pesquisa baseou-se em levantamento bibliográfico referente aos anos de 1995 a 2010, enfatizando o gerenciamento de medicamentos em hospitalares públicos. A compra destes pode ser realizada através de várias maneiras, tais como, compra direta, licitação pública ou através de cooperativas visando economia de escala. A distribuição dos medicamentos para os pacientes é feita por dose única (paciente internado que recebe o medicamento por dosagem e no horário indicado na prescrição médica) e pela distribuição geral (pacientes externos que fazem a consulta e recebe o medicamento prescrito pelo médico para o tratamento por um mês ou até mesmo por mais tempo, e estão disponíveis nas farmácias públicas). Portanto, cabe ao administrador executar as tarefas de planejamento, controle e uma série de requisitos favoráveis a uma boa administração da farmácia hospitalar. Pois, atualmente ainda há muito para ser melhorado no gerenciamento e na distribuição dos medicamentos através dos órgãos públicos aos pacientes que deles necessitam.
Perceptions of research structures and service quality within various faculties at Durban University of Technology: staff and students perspective
Authors: Ngibe Musawenkosi , Mpele Lekhanya Lawrence
Published: May 2016

In order to compete, retain and attract postgraduate students, and overcome the lack of postgraduate throughput, universities of technology need to be more customer orientated. Therefore, to gain competitive advantage, university management needs to identify and assess the service quality gaps in research support structures and analyze the impact they have on students and staff within the university. The purpose of the study is to investigate the perceptions of staff and postgraduate students with regard to research structures and service quality support by relevant offices with specific reference to Durban University of Technology. Data were collected from academic staff and students across six faculties at the Durban University of Technology. The sample consisted of 278 academic staff and 260 postgraduate students, using a simple random sampling. A mixed method approach of qualitative and quantitative techniques was used, with a closed and open-ended questionnaire developed, by adapting the SERVQUAL instrument developed by Parasuraman et al. (1985), to evaluate and assess the quality dimensions (gap) for reliability, responsiveness, assurance and empathy. The findings of the study indicated that staff and students were dissatisfied with the research support structures across six faculties. Further research should aim at assessing performance management of research support structures and service within the relevant research offices
Confirmatory analysis of the model to measure employee engagement
Authors: Imandin Lailah , Bisschoff Christo , Botha Christoff
Published: May 2016

A model to measure the employee engagement was developed by researching historical employee engagement models. These models, consisting of employee engagement constructs and their measuring criteria, have been empirically validated and factorized into seven employee engagement factors. The seven employee engagement factors (of which factor one consists of two sub-factors) were subjected to confirmatory factor analysis to ensure the inclusion of the factors in the validated model to measure employee engagement. The model was also tested for goodness of fit, and the model shows good fit indices with the Comparative Fit Index (0.799), while the good model fit of the secondary fit indices RMSEA (0.078 within a narrow margin of 0.004) and Hoelter (113 at p <= 0.1; 111 at p <= 0.05) also show satisfactory model fit. Management can use the model as diagnostic tool to measure employee engagement and to apply it in managerial decision-making. On the other hand, academics could apply the model to extend their research in employee engagement
Effect of competing amines on the removal of tetramethylammonium hydroxide from solution using ion exchange
Authors: Citraningrum H. M. , Liu Jhy-Chern
Published: May 2016

Tetramethylammonium hydroxide (TMAH, TMA+) has been widely used as the photoresist developer in semiconductor and thin film transistor liquid crystal display manufacturing. In this study, TMAH-containing wastewater was treated by ion exchange method. Strong acid cation exchange resin was used. A kinetics study revealed that the ion exchange reaction reached equilibrium within 20 min and it could be described by a pseudo-second-order model. To assess the effects of competing ions, wastewater was spiked with three different amines, namely ethylamine (EA+), diethylamine (DEA+), and triethylamine (TEA+). TMAH uptake decreased when in the presence of amines, and it decreased in the order EA+ < DEA+ < TEA+. It could be attributed to different proton affinity (PA) and the strength of affinity between amine molecules and resin matrix, as found from the ab initio calculation values and Langmuir isotherm parameters. However, the interaction energy between sulphonic acid groups and interfering amines in solution using density functional theory (DFT) calculation resulted in a different trend compared with that of PA. The difference might be caused by stabilization of amines by resin matrix and different molecular structures.
Are Uremia, Diabetes, and Atherosclerosis Linked with Impaired Antioxidant Mechanisms?
Authors: Dursun Belda , Dursun Evrim , Capraz Irfan , Ozben Tomris , Apaydin Ali , Suleymanlar Gultekin
Published: May 2016

Background

Oxidative stress is a new risk factor for atherosclerosis. Increased oxidative stress in hemodialysis (HD) patients may arise from uremia-associated metabolic/humoral abnormalities and bioincompatibility of dialysis. Patients with diabetes mellitus (DM) may be subject to an additional risk. Respective influences of uremia, diabetes, and HD duration in accelerated atherosclerosis and oxidative stress have not been clarified yet.

Methods

The study was performed on 24 nondiabetic HD patients, 23 diabetic HD patients, 20 stages 3 to 4 chronic kidney disease patients, and 21 diabetic patients without overt nephropathy. Carotid intima-media thickness, a surrogate of atherosclerosis, was measured by high-resolution B-mode ultrasonography. Oxidant status was determined by lipid peroxidation as expressed by malondialdehyde (MDA); antioxidant status was determined by superoxide dismutase, catalase, glutathione peroxidase, reduced intracellular glutathione, and plasma thiol.

Results

Intima-media thickness (IMT) was higher in patients undergoing HD but not different between nondiabetic HD patients and diabetic HD patients. No correlation was found between the duration of HD and intima-media thickness. Antioxidants were generally lower in HD patients. Intima-media thickness was positively correlated with MDA and negatively correlated with plasma thiol. Among other risk factors, only age was correlated with intima-media thickness.

Conclusions

Increased carotid IMT in HD patients is independent of duration of HD or diabetes status. Age and MDA are the significant predictors of carotid IMT. Increased oxidative stress due to impaired antioxidant mechanisms, particularly reduced plasma thiol redox potential, may account for accelerated atherosclerosis in high-risk patients with chronic kidney failure and/or DM.
Altered Kinetics of Interleukin-6 and other Inflammatory Mediators during Exercise in Children with Type 1 Diabetes
Authors: Rosa Jaime S. , Oliver Stacy R. , Mitsuhashi Masato , Flores Rebecca L. , Pontello Andria M. , Zaldivar Frank P. , Galassetti Pietro R.
Published: May 2016

Background

Leukocyte mobilization and secretions of cytokines, chemokines, and growth factors in children during exercise are necessary biochemical signals for physiological growth and long-term cardiovascular protection. Because of glycemic instability, altered exercise responses, particularly the proinflammatory cytokine interleukin (IL)-6, may occur in type 1 diabetes mellitus (T1DM) that could influence the onset/progression of diabetic vascular complications. Relatively little is known, however, on most molecular aspects of immunomodulatory adaptation to exercise in diabetic children.

Methods

We therefore studied 21 children (age, 13.4 ± 0.3 years; 13 boys/8 girls) with T1DM and 21 age-matched healthy controls during 30 minutes of intense and intermittent cycling exercise. Euglycemia was maintained during and for greater than 90 minutes before exercise; blood samples for IL-6 and other cytokines/chemokines were drawn before, during (every 6 minutes), and after (every 15 minutes) exercise.

Results

In T1DM, exercise-induced IL-6 peak occurred earlier and with greater magnitude than that in controls; an exploratory analysis of additional inflammatory mediators displayed a similarly accelerated/exaggerated pattern in T1DM, including the kinetic profiles of tumor necrosis factor α, IL-4, IL-12p70, IL-17, granulocyte-monocyte colony-stimulating factor, monocyte chemoattractant protein-1, macrophage inflammatory protein-1α, and eotaxin (interferon-inducible protein-10 was the only measured variable essentially indistinguishable between groups).

Conclusion

Therefore, during intense and intermittent exercise, significant alterations in the immunologic pattern of inflammatory regulation occurred in children with T1DM as compared with healthy controls. Our findings underscore how the understanding of all the underlying molecular mechanisms is a necessary prerequisite for achieving effective use of exercise and the full manifestation of its health benefits, particularly in understudied populations such as children with T1DM who are at increased risk for cardiovascular complications.
Effects of N-3 Fatty Acids on Hepatic Triglyceride Content in Humans
Authors: Vega Gloria Lena , Chandalia Manisha , Szczepaniak Lidia S. , Grundy Scott M.
Published: May 2016

Background

Because dietary N-3 fatty acids reduce plasma triglycerides, they may also decrease hepatic triglyceride content. If so, N-3 fatty acids might constitute a therapy for fatty liver.

Methods

Twenty-two subjects were recruited into a study designed to test the effects of N-3 fatty acids on liver fat content. Seventeen completed the trial that had a sequential design of 4-week placebo followed by an 8-week treatment with 9 g/d of fish oil. Liver fat was measured during placebo and treatment by magnetic resonance spectroscopy. Compliance was assessed by capsule count at the end of each study phase and measurement of fatty acid composition in plasma triglyceride and phospholipid. Plasma lipoproteins and adiponectin were also measured.

Results

Treatment with fish oils reduced significantly levels of plasma triglyceride by 46% ( P <.03), very low-density lipoprotein + intermediate density lipoprotein cholesterol by 21% ( P <.03), total apolipoprotein B by 15% ( P <.03). In contrast to the changes in plasma triglycerides, hepatic triglyceride content was not significantly reduced by fish oil treatment.

Conclusions

N-3 fatty acids at high doses lower plasma triglyceride levels, but there are no significant decreases in hepatic content of triglyceride for the group as a whole. Whereas the triglyceride lowering is uniform, the liver response is more variable.
Adenosine A2A Receptor Hyperexpression in Patients with Severe SIRS after Cardiopulmonary Bypass
Authors: Kerbaul François , Bénard Frédéric , Giorgi Roch , Youlet By , Carrega Louis , Zouher Ibrahim , Mercier Laurence , Gérolami Victoria , Bénas Vincent , Blayac Dorothée , Gariboldi Vlad , Collart Frédéric , Guieu Régis
Published: May 2016

Objective

Adenosine (ADO) is an endogenous nucleoside, which has been involved in blood pressure failure during severe systemic inflammatory response syndrome (severe SIRS) after cardiac surgery with cardiopulmonary bypass (CPB). Adenosine acts via its receptor subtypes, namely A1, A2A, A2B, or A3. Because A2A receptors are implicated in vascular tone, their expression might contribute to severe SIRS. We compared adenosine plasma levels (APLs) and A2A ADO receptor expression (ie, B, K, and mRNA amount) in patients with or without postoperative SIRS.

Patients

This was a prospective comparative observational study. Forty-four patients who underwent cardiac surgery involving CPB. Ten healthy subjects served as controls.

Measurements and Results

Among the patients, 11 presented operative vasoplegia and postoperative SIRS (named complicated patients) and 33 were without vasoplegia or SIRS (named uncomplicated patients). Adenosine plasma levels, K, B, and mRNA amount (mean ± SD) were measured on peripheral blood mononuclear cells. Adenosine plasma levels, B, and K were significantly higher in complicated patients than in uncomplicated patients (APLs: 2.7 ± 1.0 vs 1.0 ± 0.5 μmol l−1, P < 0.05; B: 210 ± 43 vs 65 ± 26 fmol/mg, P < 0.05; K: 35 ± 10 vs 2 ± 1 nM, P < 0.05). In uncomplicated patients, APLs remain higher than in controls (1 ± 0.5 vs 0.6 ± 0.25 μmol/L; P < 0.05). Mean arterial pressure was inversely correlated to APLs (R = −0.58; P < 0.001) and B (R = −0.64; P < 0.001) leading to an increased requirement of vasoactive drugs during the postoperative period in vasoplegic patients.

Conclusions

High expression of A2A ADO receptor and high APLs may be a predictive factor of postoperative severe SIRS after CPB.
Association of TaqIB Polymorphism in the Cholesteryl Ester Transfer Protein Gene with Serum Lipid Levels in the Guangxi Hei Yi Zhuang and Han Populations
Authors: Yijiang Zhou , Ruixing Yin , Yiyang Li , Yaju Deng , Shangling Pan , Weixiong Lin , Dezhai Yang
Published: May 2016

Background

Cholesteryl ester transfer protein (CETP) plays an important role in lipoprotein metabolism. The present study was undertaken to compare the difference in the CETP TaqIB gene polymorphism and its association with serum lipid levels between the Guangxi Hei Yi Zhuang and Han populations.

Methods

A total of 758 subjects of Hei Yi Zhuang and 778 participants of Han Chinese were surveyed. Genotyping of the CETP TaqIB was performed using polymerase chain reaction and restriction fragment length polymorphism and then confirmed using direct sequencing.

Results

The genotypic and allelic frequencies were significant differences between smokers and nonsmokers, or between hypertensives and normotensives in Hei Yi Zhuang, and between drinkers and nondrinkers in Han. The levels of high-density lipoprotein cholesterol (HDL-C) and apolipoprotein AI in Hei Yi Zhuang but not in Han were higher in B2B2 genotype than in B1B1 genotype ( P < 0.01 for each). Higher HDL-C levels in Hei Yi Zhuang were found only in females, nondrinkers, nonsmokers, subjects with a body mass index of 24 kg/m2 or lesser, or normotensives in B2B2 genotype. Higher HDL-C levels in Han were found only in females in B2B2 genotype and in subjects with a body mass index of 24 kg/m2 or lesser or normotensives in B1B2 genotype. The levels of HDL-C in B1B1 and B1B2 individuals in both ethnic groups were higher in drinkers than in nondrinkers.

Conclusions

There were significant differences in the interactions between the CETP TaqIB genotypes and several environmental factors in the Hei Yi Zhuang and Han populations. The polymorphism predicted differences in HDL-C and ApoAI in the Hei Yi Zhuang but not in the Han Chinese, even after adjustment for confounding variables. This means that the gene may not be truly involved in regulation of high-density lipoprotein metabolism or that there is an ethnic-specific effect.
Writing and Publishing Your Research Findings
Authors: Quinn Charles T. , Rush A. John
Published: May 2016

Writing clearly is critical to the success of your scientific career. Unfortunately, this skill is not taught in medical school or postgraduate training. This article summarizes our approach to the writing and publication of your research. Here we focus on empirical or experimental reports of translational and clinically oriented research. We review the process of choosing what to write, how to write it clearly, and how to navigate the process of submission and publication.
Mouse Models of Fragile X-Associated Tremor Ataxia
Authors: Berman Robert F. , Willemsen Rob
Published: May 2016

Objective

To describe the development of mouse models of fragile X-associated tremor/ataxia (FXTAS) and the behavioral, histological and molecular characteristics of these mice.

Method

This paper compares the pathophysiology and neuropsychological features of FXTAS in humans to the major mouse models of FXTAS. Specifically, the development of a transgenic mouse line carrying an expanded CGG trinucleotide repeat in the 5′-untranslated region (5′-UTR) of the Fmr1 gene is described along with a description of the characteristic intranuclear ubiquitin-positive inclusions and the behavioral sequella observed in these mice.

Results

CGG KI mice model many of the important features of FXTAS, although some aspects are not well modeled in mice. Aspects of FXTAS that are modeled well include elevated levels of Fmr1 mRNA, reduced levels of Fmrp, the presence of intranuclear inclusions that develop with age and show similar distributions within neurons, and neuropsychological and cognitive deficits, including poor motor function, impaired memory and evidence of increased anxiety. Features of FXTAS that are not well modeled in these mice include intentional tremors that are observed in some FXTAS patients but have not been reported in CGG KI mice. In addition, although intranuclear inclusions in astrocytes are very prominent in FXTAS, there are relatively few observed in CGG KI mice. A number of additional features of FXTAS have not been systematically examined in mouse models yet, including white matter disease, hyperintensities in T2-weighted magnetic resonance imaging, and brain atrophy, although these are currently under investigation in our laboratories.

Conclusions

The available mouse model has provided valuable insights into the molecular biology and pathophysiology of FXTAS and will be particularly useful for developing and testing new therapeutic treatments in the future.
Laboratory Markers as Predictors of Mortality in Patients with Clostridium difficile Infection
Authors: Pant Chaitanya , Madonia Phillip , Minocha Anil , Manas Kenneth , Jordan Paul , Bass Pat
Published: May 2016

Previous studies have identified laboratory markers for severe Clostridium difficile infection (CDI). The most consistent of these markers is the presence of marked leukocytosis. We examined the validity of these markers as predictors of mortality in patients with CDI. We excluded patients with preexisting hematologic conditions that would be expected to impair their ability to demonstrate leukocytosis. On univariate analysis, marked leukocytosis ( P = 0.02), thrombocytopenia ( P = 0.008), and increased blood urea nitrogen ( P < 0.001) and creatinine ( P = 0.001) levels were found to be significantly associated with mortality in patients with CDI. However, on logistic regression analysis, only renal impairment was found to be an independent predictor (odds ratio, 5.07). Importantly, in our study, leukocytosis was not an independent predictor after adjustment for other variables, which may be due to our selection criteria when adjusting for confounding variables. We are therefore of the opinion that in immunocompromised hosts who are leukopenic at the time of CDI diagnosis, other laboratory markers should be identified to serve as indicators for severe disease.
Particularly Interesting Cysteine- and Histidine-Rich Protein in Cardiac Development and Remodeling
Authors: Liang Xingqun , Sun Yunfu , Chen Ju
Published: May 2016

Integrin-mediated cell-extracellular matrix interaction plays key roles in tissue morphogenesis and integrity. The Lin11-Isl-1-Mec-3 (LIM) domain-only particularly interesting cysteine- and histidine-rich (PINCH) protein functions as an adaptor essential for the assembly and function of the focal adhesion complex that links integrin signaling to the cytoskeleton and other intracellular signaling pathways and regulates diverse cellular processes such as cell adhesion, migration, growth, differentiation, and survival. Recent biochemical and genetic studies have greatly advanced our knowledge surrounding the molecular interactions and functions of each component of the focal adhesion complex and revealed a requirement for PINCH in early embryogenesis, in morphogenesis of the neural crest and cardiac outflow, and in myocardial growth and remodeling. In this review article, we will provide an overview of the current knowledge of the molecular interactions of PINCH with other components of focal adhesions, highlighting recent discoveries of the in vivo role of PINCH and discuss its potential implication for human heart disease.
Creation and Use of a Database in Clinical and Translational Research
Authors: Smith Janet P. , Elliott Alan C. , Hynan Linda S. , Reisch Joan S. , Waddell Stan A.
Published: May 2016

Often data collection for clinical studies is an afterthought. The results of such an approach are incomplete or confusing data that can, as a worst case, result in scrapping and restarting the entire study. We discuss the planning process for data collection and storage to include encounter form development; data flow and capture; data checking, verification, and validation; advantage of relational databases over spreadsheets; data security; and aspects of a complete data system.
Low Level of Serum Interleukin 27 in Patients with Systemic Lupus Erythematosus
Authors: Li Ting-Ting , Zhang Tao , Chen Gui-Mei , Zhu Qing-Qing , Tao Jin-Hui , Pan Hai-Feng , Ye Dong-Qing
Published: May 2016

T helper 17 (TH17) cells are beginning to be implicated in the pathogenesis of systemic lupus erythematosus (SLE). Recent studies have shown that interleukin 27 (IL-27) controls the development of TH17. However, whether IL-27 plays a role in the development of SLE is still unclear. In the present work, we investigated the serum IL-27 level in SLE and its relations to disease activity. Fifty-six patients with SLE and 30 healthy volunteers were recruited. Serum IL-27 levels were detected by enzyme-linked immunosorbent assay. The clinical and laboratory parameters were collected from medical records or by questionnaire. The serum IL-27 level in SLE patients was significantly lower than that in healthy controls ( P < 0.001). Compared with SLE patients without nephritis, patients with nephritis had a significantly decreased serum IL-27 level ( P < 0.05). However, there was no significant difference between less active and more active SLE ( P > 0.05). Correlation analysis between serum IL-27 levels and SLE disease activity index showed no association ( P > 0.05). In summary, a decrease in serum IL-27 level in patients with SLE suggested that this cytokine might be implicated in the pathomechanism of this disease.
Regenerative Medicine
Authors: Corona Benjamin T. , Ward Catherine L. , Harrison Benjamin S. , Christ George J.
Published: May 2016

A recent report demonstrated that a laboratory-grown neobladder tissue could be successfully used for cystoplasty in young patients with myelomeningocele who were otherwise healthy. This remarkable achievement portends well for the application of tissue engineering/regenerative medicine technologies to the treatment of end-organ failure due to a variety of causes (ie, congenital, acquired, age or disease related). Nonetheless, the broader clinical use of these groundbreaking technologies awaits improved understanding of endogenous regenerative mechanisms, more detailed knowledge of the boundary conditions that define the current limits for tissue repair and replacement in vivo, and the parallel development of critical enabling technologies (ie, improved cell source, biomaterials, bioreactors). This brief report will review a number of the most salient features and recent developments in this rapidly advancing area of medical research and detail some of our own experience with bladder and skeletal muscle regeneration and replacement as examples that highlight both the promise and challenges facing regenerative medicine/tissue engineering.
Procalcitonin, C-Reactive Protein, and Cell Counts in the Diagnosis of Parapneumonic Pleural Effusions
Authors: San José M. Esther , Valdés Luis , Vizcaíno Luis H. , Mora Teresa , Pose Antonio , Soneira Esther , Crecente Carmen , González-Barcala Francisco J.
Published: May 2016

Background and Objective

Pleural effusion is relatively common in pneumonia. Because traditional methods for its diagnosis are not always effective, there is a need for new biomarkers to make its differential diagnosis easier.

Methods

A total of 233 patients with pleural effusion were admitted to our hospital between 2005 and 2008. Total and differential leukocyte counts, along with blood and pleural fluid procalcitonin and C-reactive protein (CRP) were performed on all of them. The patients were classified into 5 groups depending on the cause of their effusion: (1) parapneumonic, n = 28; (2) tuberculous, n = 49; (3) neoplastic, n = 57; (4) miscellaneous, n = 46; and (5) transudates, n = 53.

Results

Procalcitonin levels were higher in the pleural fluid of the parapneumonic group (PAR, 0.15 ng/mL) compared with those of the rest of the groups, but statistically significant differences were only observed with the miscellaneous and tuberculous groups ( P < 0.001). Levels of CRP were also higher in the PAR (0.67 mg/L) compared with those of the rest of the groups, with statistically significant differences observed ( P < 0.001-0.004) in all of them. The parameter with the largest area under the receiver operator characteristics curve was the product of the total neutrophil count and the CRP in the pleural fluid, in which an area of 0.836 had a sensitivity of 64.3% and a specificity of 93.4%.

Conclusions

Determination of procalcitonin and CRP, in the pleural fluid and blood, does not seem to provide great value to the diagnosis of PAR. However, calculating the product of the total neutrophil count and the CRP may be useful in the diagnosis of these effusions because increased values have a high specificity and predictive values.
Chromosome 9p21 Genetic Variants are Associated with Myocardial Infarction but Not with Ischemic Stroke in a Taiwanese Population
Authors: Lin Hsiu-Fen , Tsai Pei-Chien , Liao Yi-Chu , Lin Tsung-Hsien , Tai Chih-Ta , Juo Suh-Hang Hank , Lin Ruey-Tay
Published: May 2016

Background

Genetic variants on chromosome 9p21 confer a robust risk for coronary artery disease but inconsistent risk for stroke. This study investigated whether such genetic variants exert differential risks on myocardial infarction (MI) and ischemic stroke in a Taiwanese population.

Methods

The study recruited 425 MI patients, 687 patients with ischemic stroke, and 1377 healthy controls. Four key single nucleotide polymorphisms (SNPs) on chromosome 9p21 were genotyped.

Results

Multivariate permutation analyses demonstrated that the risk T allele of rs1333040 and G allele of rs2383207 were associated with MI ( P = 0.045 and 0.002, respectively). Subjects with the rs2383207 GG genotype had a 1.85-fold ( P = 0.021) risk for MI when compared with the subjects with the AA genotype. Further analysis showed that significant results only exist in the young MI group (<65 years) but not in the old MI group (≥65 years). These SNPs were not statistically significant for stroke (adjusted P ranged from 0.097 to 0.540). Haplotype analysis showed global P values of 0.032 for MI and 0.290 for stroke.

Conclusions

Genetic variations in the 9p21 region are associated with MI but not with stroke in a Taiwanese population. Early-onset MI was more likely to carry the risk genotypes of 9p21 SNPs.
Attrition Rates of Pediatric Emergency Medicine Fellowship Graduates
Authors: Klasner Ann Elizabeth
Published: May 2016

Objectives

To identify the percentage of alumni of one Pediatric Emergency Medicine (PEM) fellowship program who consider themselves to still practice in the field.

Methods

A brief survey (5 questions) was sent to all physicians who began the PEM fellowship program at the University of Alabama at Birmingham between the years 1986 and 2006. Survey included demographics, length of time out of fellowship, present work location, and whether the respondent considered themselves to be in the field of pediatric emergency medicine.

Results

Forty-three physicians were identified as beginning fellowship between 1986 and 2006. One physician was excluded as she was deceased. Forty (95%) of the 42 individuals graduated from a PEM fellowship program. Analyzing the 39 responding PEM graduates, 29 (74%) consider themselves practicing pediatric emergency medicine. Six (60%) of those not considered practicing in PEM (n = 10) are women. Four of these 10 individuals are still in academic medicine. Overall attrition rate for this cohort of PEM fellowship-trained physicians is 25.6% (95% confidence interval, 13.0-42.1).

Conclusion

Overall attrition rates of fellowship-trained PEM physicians seems to mirror that of adult trained counterparts.
Do Serum Angiopoietin-1, Angiopoietin-2, and Their Receptor Tie-2 and 4G/5G Variant of PAI-1 Gene Have a Role in the Pathogenesis of Preeclampsia?
Authors: Kamal Manal , El-Khayat Waleed
Published: May 2016

Objective

To evaluate whether serum angiogenesis markers such as angiopoietins (Ang-1, Ang-2) and their receptor (Tie-2) are altered in women with preeclampsia. We also performed genotyping to determine if the 4G/5G genotypes of −675 PAI-1 gene may play a role in the pathogenesis of preeclampsia.

Materials and Methods

Sixty-eight pregnant women with preeclampsia were compared to 35 normotensive pregnant women and 24 normotensive nonpregnant women in a cross-sectional study. Using enzyme-linked immunosorbent assay, levels of serum Ang-1 and Ang-2, and Tie-2 were measured. A single base pair insertion/deletion 4G/5G polymorphism of the PAI-1 gene was determined by polymerase chain reaction.

Results

Serum levels of Ang-1 and Tie-2 were significantly different among the study groups ( P = 0.001 and P = 0.025, respectively) being lower in the preeclamptic group. Positive significant correlation was found between Ang-2 and Tie-2, ( r = 0.26, P = 0.024). The frequency of the genotypes (4G/5G, 4G/4G, and 5G/5G) differed among the groups ( P = 0.001). Also, the mean of systolic and diastolic blood pressures differed significantly according to the PAI-1 genotype being higher in those bearing the 4G allele; P = 0.04 and P = 0.023, respectively.

Conclusion

Sera Ang-1 and Ang-2, and Tie-2 as well as variants of 4G/5G of PAI-1 polymorphism have positive implications in the pathogenesis of preeclampsia.