bluuebunny/crossref_metadata_2025 huggingface dataset:
On the limits of genetic responsibility: Communication and consent for tumour testing for Lynch syndrome
Authors: Shipman Hannah Elizabeth , Arribas-Allyon Michael , Murray Alexandra , Gaff Clara Louise
Published: May 2014

Testing cancers for mismatch repair (MMR) gene defects assists selection of families for genetic testing for cancer predisposing Lynch syndrome. Performing MMR tumour testing without consent is debated, though little empirical work has been undertaken. We address this by examining the significance of testing for those who have consented without prior genetic counselling, particularly their ‘accounts’ of testing via displays of knowledge and responsibility. Semi-structured interviews were conducted with participants recruited from a UK genetics service. Participants had difficulties in formulating the benefits of testing when consent was facilitated by a relative or by mail. Discourse analysis revealed that in the absence of specific or accurate understandings of tumour testing, participants displayed responsibility towards themselves and others by generalising and diminishing the implications of testing. Within the framework of ‘genetic responsibility’, MMR tumour testing seems less important in participants’ accounts compared to more definitive genetic testing. If facilitating genetic knowledge and responsibility are goals of genetic testing then developing appropriate consent procedures for MMR tumour testing is an important consideration. Further research is required to differentiate whether genetic counselling is a precondition for enacting genetic responsibility or whether intrinsic differences between types of testing make the concept less relevant.
Communicative practices in talking about death and dying in the context of Thai cancer care
Authors: Wilainuch Pairote
Published: May 2014

This article explores communicative practices surrounding how nurses, patients and family members engage when talking about death and dying, based on study conducted in a province in northern Thailand. Data were collected from three environments: a district hospital (nine cases), district public health centres (four cases), and in patients’ homes (27 cases). Fourteen nurses, 40 patients and 24 family members gave written consent for participation. Direct observation and in-depth interviews were used for supplementary data collection, and 40 counselling sessions were recorded on video. The raw data were analysed using Conversation Analysis. The study found that Thai counselling is asymmetrical. Nurses initiated the topic of death by referring to the death of a third person – a dead patient – with the use of clues and via list-construction. As most Thai people are oriented to Buddhism, religious support is selected for discussing this sensitive topic, and nurses also use Buddhism and list-construction to help their clients confront uncertain futures. However, Buddhism is not brought into discussion on its own, but combined with other techniques such as the use of euphemisms or concern and care for others.
O efeito da sibutramina na perda de peso de adolescentes obesos
Authors: Franco Ruth Rocha , Cominato Louise , Damiani Durval
Published: May 2014

Objetivo : Avaliar o efeito da sibutramina na perda de peso de adolescentes obesos.Sujeitos e métodos : Estudo duplo-cego placebo controlado tipo cross over com duração de 13 meses. Foram incluídos no estudo 73 adolescentes obesos de ambos os sexos com idades entre 10 e 18 anos. A avaliação antropométrica foi realizada a cada 40 dias em média. Os exames laboratoriais e de imagem foram realizados antes, no período de wash-out e ao final dos 13 meses.Resultados : A porcentagem de pacientes que perderam 10% do peso inicial no placebo foi de 46% e, no grupo sibutramina, foi de 75%. Quando usaram o placebo, o peso em média se elevou em 1,61 kg, e o IMC reduziu em média 0,24 kg/m2, enquanto com o uso da sibutramina o peso reduziu em média 4,47 kg e o IMC reduziu em média 2,38 kg/m2 com p < 0,001.Conclusões : A sibutramina induziu significantemente mais perda de peso em adolescentes obesos em comparação ao placebo, sem efeitos colaterais significativos. A curva de evolução ponderal foi diferente de acordo com o momento em que a sibutramina foi introduzida. Esse achado indica que o melhor momento de introdução da sibutramina é quando a adesão começa a falhar. Arq Bras Endocrinol Metab. 2014;58(3):243-50
Successful parathyroid tissue autograft after 3 years of cryopreservation: a case report
Authors: Leite Ana K. N. , Junior Climério P. do N. , Arap Sérgio S. , Massoni Ledo , Lourenço Delmar M. , Brandão Lenine Garcia , Montenegro Fábio L. de M.
Published: May 2014

After a total parathyroidectomy, well-established protocols for the cryopreservation of parathyroid tissue and for the delayed autograft of this tissue exist, especially in cases of secondary hiperparathyroidism (HPT) or familial or sporadic parathyroid hyperplasia. Although delayed autografts are effective, the published success rates vary from 10% to 83%. There are numerous factors that influence the viability, and therefore the success, of an autograft, including cryopreservation time. Certain authors believe that the tissue is only viable for 24 months, but there is no consensus on how long the parathyroid tissue can be preserved. A 63-year-old male who was diagnosed with sporadic multiple endocrine neoplasia type 1 and primary hyperparathyroidism, and was submitted to a total parathyroidectomy and an autograft in the forearm. The implant failed, and the patient developed severe hypoparathyroidism in the months following the surgery. Thirty-six months after the total parathyroidectomy, the cryopreserved autograft was successfully transplanted, and hypoparathyroidism was reversed (most recent systemic parathyroid hormone, PTH, of 36 pg/mL, and total calcium of 9.1 mg/dL; no oral calcium supplementation). The case presented here indicates that cryopreserved parathyroid tissue may remain viable after 24 months in storage, and may retain the capacity to reverse permanent postsurgical hypoparathyroidism. These data provide reasonable evidence that the time limit for cryopreservation remains undetermined and that additional research would be valuable. Arq Bras Endocrinol Metab. 2014;58(3):313-6
Decisões em saúde no relacionamento entre o profissional e o paciente com transtorno alimentar
Authors: Souza Laura Vilela e , Santos Manoel Antônio dos
Published: May 2014

O paciente diagnosticado com transtorno alimentar pode ser visto como alvo de orientação ou ser posicionado, junto ao profissional, como especialista na condução do tratamento. Buscou-se compreender, a partir das práticas discursivas de pessoas diagnosticadas com esses transtornos, como profissionais e pacientes constroem as decisões sobre o tratamento. Foram realizadas entrevistas com 12 pacientes de um serviço especializado na área, e quatro foram selecionadas para análise, que teve como fundamento o discurso construcionista social. A análise permitiu abordar os movimentos denunciativos das participantes com relação às decisões unilaterais tomadas por profissionais de saúde, e seu pleito por maior participação do paciente nas decisões do tratamento. Essas realidades relacionais foram discutidas a partir dos discursos sociais privilegiados nas práticas discursivas empreendidas no relacionamento profissional-paciente, da problematização da organização das políticas públicas em saúde em nosso país e do modo de funcionamento das instituições hospitalares.
Esquemas desadaptativos e sua relação com o transtorno de estresse pós-traumático: uma revisão sistemática
Authors: Susin Nathália , Carvalho Clarissa Salle , Kristensen Christian Haag
Published: May 2014

Esquemas iniciais desadaptativos são elaborados ao longo da vida; embora duradouro e resistente à mudança, o esquema pode ser definido como uma rede de crenças estruturadas, inter-relacionadas, que norteiam o comportamento do indivíduo, podendo ser denominado de crença. Serve como modelo de processamento da informação para as vivências do indivíduo, fazendo da terapia um desafio. Este estudo visa investigar os principais esquemas/crenças disfuncionais e esquemas iniciais desadaptativos afetados no transtorno de estresse pós-traumático. Através de uma revisão sistemática em bases de dados eletrônicas entre os anos de 2000 e 2009, constatou-se uma associação entre o transtorno de estresse pós-traumático e esquemas/crenças disfuncionais; os esquemas mais afetados relacionam-se à visão de si, dos outros e do mundo. No que tange aos esquemas iniciais desadaptativos, os mais afetados são isolamento/alienação social e vergonha/defectividade. Esses resultados são clinicamente relevantes, pois é preciso considerar as distorções cognitivas subjacentes à sintomatologia pós-traumática.
Assessment of body composition, functional capacity and pulmonary function in patients with Chronic Obstructive Pulmonary Disease
Authors: Dias Fernanda Dultra , Gomes Evelim Leal de Freitas Dantas , Stirbulov Roberto , Alves Vera Lúcia Santos , Costa Dirceu
Published: May 2014

Chronic obstructive pulmonary disease (COPD) is related to a low body mass index (BMI), reduced functional capacity and reduced bone density, thus justifying the importance of evaluating all of these parameters in the patients with the disease. This is a cross-sectional study, with sample consisting of 20 patients who performed measurement of body composition by bioelectrical impedance, evaluation of functional capacity by the distance traveled in the Incremental Shuttle Walk Test (ISWT) and assessment of severity of obstruction by spirometry. Significant differences were found between the travelled and scheduled distance in the ISWT (p<0.01), positive correlations between muscle mass and distance walked in ISWT (r=0.54 with p=0.01), with FEV1 (r=0.488 with p=0.02), FEV1 and bone mass (r=0.497 with p=0.02) and distance traveled with FEV1 (r=0,541 with p=0.01). The correlations found in this study, besides confirming the hypothesis that the severity of the obstruction presented by the change in the lung parenchyma in patients with COPD is related to changes in body composition and functional capacity reduction, also highlight the correlation with bone mass.
Disuse induced by the spine rectification vest: experimental study
Authors: Guirro Rinaldo Roberto de Jesus , Arruda Eder João , Silva Carlos Alberto da
Published: May 2014

The spine is the main support and movement axis of the locomotor system, and numberless clinical conditions may require that this structure be submitted to functional restriction. Among the non-invasive treatments used in spinal or appendicular skeleton injuries, the immobilization of the spine is used as a rehabilitation strategy. Because of the functional restrictions generated by restraining devices used on the spine, the proposal of this study was to adapt a spinal orthosis on rats, thus mimicking the immobilization of corrective vests and assessing the energetic conditions of thoracic muscles after 12 weeks of application. Wistar rats that were 42 days old were used in this study (post-weaning period), followed-up for 12 weeks in 2 groups called control (C) and rectification vests (R), which were made of PVC to immobilize the spine. The following concentrations were evaluated: glycogen (GLY) of the paravertebral muscle and the thorax; total proteins and DNA (TP/DNA) and interleukin-6 (IL-6). The normality Kolmogorov-Smirnov test was used for statistical analysis, followed by the Tukey test. A 5% level was established for all of the calculations. It was observed that group R presented 12% less body mass and GLY stores 21% lower; the ratio between TP/DNA was in average 6.6% lower; IL-6 concentrations were in average 25% higher. The study shows that the movement restriction in the spine leads to energetic crisis and compromised muscular development. More studies should be conducted with this model to generate physical therapy strategies that could reduce muscle compromise after spine immobilization.
Respiratory muscle strength no influence the need for noninvasive ventilation after heart surgery
Authors: Daniel Christiane Riedi , Driessen Taissa , Fréz Andersom Ricardo , Mora Cintia Teixeira Rossato
Published: May 2014

The aim of this study was to investigate the relation between preoperative respiratory muscle strength and indication and performance of noninvasive ventilation in the planned heart surgery. We conducted a retrospective study using data collected from clinical records and analyzed 109 medical records and noninvasive ventilation accompanying paper. We analyzed the values of respiratory muscle strength, peak flow and respirometry, as well as the postoperative respiratory complications, correlating them with indication and performance of the noninvasive ventilation. The t test was performed for continuous variables; the chi-square was used to investigate the influence of preoperative respiratory muscle strength values in the indication of noninvasive ventilation. Noninvasive ventilation was used in 32 (29%) subjects and the prime motive indication was hipercapy (44%). The successful use of noninvasive ventilation was observed in 94%. The decrease in preoperative strength, despite having a lower performance, showed no significant difference in relation to its use and outcome (p=0.73). The preoperative respiratory muscle strength was not able to provide for the use of noninvasive ventilation or its performance.
Relationship between the work developed in maximal and submaximal exercise capacity tests and the degree of airflow obstruction in individuals with Chronic Obstructive Pulmonary Disease
Authors: Oliveira Lucas Araújo de , Mesquita Rafael , Brito Igor Lopes de , Laburú Viviane de Moraes , Pitta Fabio , Probst Vanessa Suziane
Published: May 2014

The aim of this study was to investigate the relationship between the work in two exercise capacity tests, a maximum and a submaximal exercise, and the level of airflow obstruction in patients with Chronic Obstructive Pulmonary Disease (COPD). Fifty-three subjects with COPD (29 men, 70±9 years old, 65±14 kg, forced expiratory volume in the first second [FEV1] 38[31-54]% predicted) had their lung function assessed by spirometry, and maximal and submaximal exercise capacity were evaluated by the Incremental Shuttle Walking test (ISWT) and the 6-Minute Walk Test (6MWT), respectively. The work in the tests was calculated by multiplying the covered distance and the individual's body weight (W). To evaluate the contribution of weight on the developed work, subjects were separated into two groups: higher weight (n=32), and lower weight (n=21). FEV1 correlated with the distance on the ISWT and with the ISWT*W (r=0.43 and r=0.49, respectively; p<0.05 for both). Moreover, the distance on the ISWT correlated with the ISWT*W (r=0.88, p<0.0001). Regarding the 6MWT, it was observed that FEV1 had a weak correlation with the covered distance (r=0.29, p=0.03) and a moderate one with the 6MWT*W (r=0.51, p<0.0001). Moreover, the distance covered in the 6MWT was moderately correlated with the 6MWT*W (r=0.47, p=0.0004). The higher weight group showed worse performance only in the 6MWT compared to the lower weight group (407±85 versus 469±64 meters, respectively; p=0.004). The work on the used exercise tests was similarly related to the level of airflow obstruction. The submaximal test, however, appears to have its performance more influenced by the individuals' body weight.
Immediate effects of using ankle-foot orthoses in the kinematics of gait and in the balance reactions in Charcot-Marie-Tooth disease
Authors: Pereira Rouse Barbosa , Felício Lílian Ramiro , Ferreira Arthur de Sá , Menezes Sara Lúcia de , Freitas Marcos Raimundo Gomes de , Orsini Marco
Published: May 2014

The Charcot-Marie-Tooth (CMT) disease is a peripheral hereditary neuropathy with progressive distal muscle atrophy and weakness, mainly in lower limbs, that evolves limiting the gait and balance. The objective of the study was to analyse the immediate effects of using Ankle-Foot Orthosis (AFO) in the gait's kinematics and balance in patients with CMT. Nine individuals were evaluated by Tinetti scales and Dynamic Gait Index (DGI) and gait's kinematics parameters through the motion capturing system. These evaluations were done before and during the use of AFO. Two-Way repeated analysis of variance was done to try the main or interaction effects related to "orthoses" and "repetition". A significant interaction effect was observed between the gait cycle and use the AFO to the average velocity (Wilks' Lambda=0.156, p=0.030, η2=0.844) like significant main effects in the ankle joint to the gait cycle (Wilks' Lambda=0.091, p=0.008, η2=0.909) and the use of AFO (Wilks' Lambda=0.444, p=0.013, η2=0.556). It was observed a significant change in the DGI scale during the use of AFO (p<0.05). The use of AFO promoted immediate effects on gait kinematics and in balance reactions. The results suggest that the use of AFO is an efficient strategy to stabilize the ankle joint, besides avoiding foot drop in patients with CMT.
Leaf anatomical features of three Theobroma species (Malvaceae s.l.) native to the Brazilian Amazon
Authors: Garcia Tarcymara Barata , Potiguara Raimunda Conceição de Vilhena , Kikuchi Tatiani Yuriko Souza , Demarco Diego , Aguiar-Dias Ana Cristina Andrade de
Published: May 2014

Theobroma species have economic importance due to their use in the cosmetic and food industries, mainly in the production of chocolate. However, the anatomy of their vegetative structures remains poorly studied. The goal of this study was to describe the anatomical features of Theobroma grandiflorum, T. speciosum and T. subincanum to contribute to the biological knowledge of these species, as well as provide support to the biotechnological studies of native fruit plants of the Amazon. Leaves at different developmental stages were collected and analyzed under light microscopy and scanning electron microscopy. Sessile and stalked stellate trichomes and digitiform glandular trichomes were observed in the expanded leaves of T. grandiflorum and T. subincanum. These species were also similar in the morphology of the midrib, the organization of the mesophyll and the presence of starch grains in the midrib pith cells. Claviform glandular trichomes and mucilage cells in the epidermis occurred only in the expanded leaves of T. speciosum. The presence of mucilage secretory trichomes in shoot apices (colleters) of all species is a new finding for the genus Theobroma.
Rotary peeling yield of Schizolobium amazonicum (Leguminosae - Caesalpinioideae)
Authors: Melo Rafael Rodolfo de , Del Menezzi Cláudio Henrique Soares , Pavan Bruno Ettore , Rodolfo Júnior Francisco
Published: May 2014

The tropical tree Schizolobium amazonicum is native from the Amazonian forest, naturally occurring in Brazil, Peru and Colombia. This work aimed to study the veneer yield made from this species. For this purpose, 50 logs from S. amazonicum were rotary peeled in a plywood industry installed in Brazilian Amazon region. The results indicated that S. amazonicum had a peeling yield similar or even higher than those usually obtained for species traditionally used for this purpose in Brazil, like those of Pinus and Eucalyptus. It was also observed that the dendrometric parameters of the log can be used to estimate the peeling yield in this species.
Nicolas Sanson and his Map: The Course of the Amazon River
Authors: Cintra Jorge Pimentel , Oliveira Rafael Henrique de
Published: May 2014

One of the first scientific maps of the Amazon region, The Course of the Amazon River (Le Cours de La Rivière des Amazones), was constructed by Nicolas Sanson, a French cartographer of the seventeenth century, and served as the prototype for many others. The evaluation of this chart, until now, has been that it is a very defective map, a sketch based on a historical account, according to the opinion of La Condamine. Thus, the aim of the present work was to prove that the map of the Amazon River traced by Nicolas Sanson is a scientific work, a map that presents precise geographic coordinates considering its time, shows a well-determined prime meridian, and also employs a creative methodology to deduce longitudes from latitudes and distances that had been covered. To show such characteristics, an analysis of the accuracy of the map was made by comparing its latitudes and longitudes with those of a current map. We determined the prime meridian of this map and analyzed the methodology used for the calculation of longitudes. The conclusion is that it is actually a good map for the time, particularly considering the technology and the limited information that Sanson had at his disposal. This proves that the negative assertion of La Condamine is unfounded.
A carreira moral da vergonha na visão de homens e mulheres "alcoólatras"
Authors: Alzuguir Fernanda Vecchi
Published: May 2014

Neste artigo, analisamos a carreira moral de tratamento do alcoolismo em um serviço público de saúde a partir de depoimentos de homens e mulheres "alcoólatras" sobre a moral da vergonha. A carreira moral é a sequência de mudanças que produzem efeitos na identidade e no esquema de imagens da pessoa para julgar os outros e a si própria. Foram entrevistados 20 pacientes do serviço, sendo dez homens e dez mulheres em acompanhamento ambulatorial e/ou internados. Além disso, observações de campo das relações entre pacientes e destes com os profissionais de saúde foram conduzidas. Aspectos da carreira moral foram analisados, entre eles, a "conscientização" do alcoolismo como doença e da condição alcoólatra e a construção da vergonha e da responsabilidade no contexto de tratamento. A vergonha expressa o reconhecimento dos entrevistados da inobservância de normas sociais, entre as quais, a repercussão do gênero na definição da ética do homem provedor e da boa mãe. Comprovando a dimensão médico-moral do dispositivo terapêutico, a vergonha é reconfigurada nos momentos de (re)internação como expressão da desaprovação de um estilo de vida com a bebida, e se alia ao projeto terapêutico no sentido de dificultar a "recaída" e impedir a desmoralização alcoólatra. Concluímos que a medicalização do alcoolismo se inscreve num campo moral englobante, produtor de moralidades e formas particulares de perceber e agenciar o alcoolismo.
A imagem corporal nas ações educativas em autocuidado para pessoas que tiveram hanseníase
Authors: Batista Talitha Vieira Gonçalves , Vieira Carmen Silvia de Campos Almeida , Paula Maria Angela Boccara de
Published: May 2014

Os comprometimentos físicos ocasionados pela hanseníase são pactuados nas ações do Plano Nacional de Controle da Hanseníase e são considerados um grave problema de saúde pública. Como forma de prevenir o avanço de incapacidades, o Ministério da Saúde propõe ações educativas em autocuidado. No entanto, apesar da enfática importância da realização do autocuidado, observa-se a não aderência dos pacientes ao programa, que pode ser justificada, dentre outros motivos, pela desestruturação de sua imagem corporal e pelo estigma advindo das representações sociais do corpo "leproso". Sendo assim, acredita-se na importância de ampliar o discurso tecnicista nas ações educativas em autocuidado, considerando a imagem corporal como aspecto importante nas estratégias de tratamento da doença. Objetiva-se conhecer a imagem corporal de pessoas que tiveram hanseníase e que desenvolveram incapacidades físicas. Para tanto, aplicou-se o teste psicológico Desenho da Figura Humana (DFH), com ênfase na análise interpretativa das mãos e dos pés, locais mais afetados pela hanseníase, em cinco mulheres cadastradas e em acompanhamento no Programa de Autocuidado em Hanseníase de um Ambulatório Regional de Especialidades de um município do Vale do Paraíba Paulista. O teste foi realizado no período de março a dezembro de 2009. Os resultados revelaram a não inclusão ou a desfiguração de mãos e pés. Existe uma falta de integração dessas regiões à consciência, acarretando desestruturação da imagem corporal, que pode decorrer tanto da perda de sensibilidade cutânea como da deformidade advindas da doença. Infere-se que essa desestruturação da imagem corporal dificulta a aderência ao autocuidado e a sociabilização dessas pessoas, aumentando o estigma da hanseníase.
Conocimiento científico y problemas de salud. Una enfermedad emergente en Argentina, el Síndrome Urémico Hemolítico
Authors: Belardo Marcela Beatriz
Published: May 2014

El artículo analiza la relación entre la producción de conocimiento científico y una enfermedad infantil llamada Síndrome Urémico Hemolítico. Nuestro objetivo es hacer hincapié en la forma en que la ciencia biomédica construye una forma de "mirar" y definir los problemas sociales, que en este caso es un problema de salud que afecta, principalmente en Argentina, a la población menor de cinco años de edad, y cómo a partir de esas características objetivas definidas por biomedicina, la salud pública, ha sostenido formas de abordar e intervenir en el asunto. A partir de una metodología cualitativa, la recolección de datos se llevó a cabo a través de un conjunto de técnicas que incluyó el análisis de fuentes secundarias tales como la revisión de los artículos científicos sobre la enfermedad, entrevistas semi-estructuradas con científicos y funcionarios públicos y la observación directa de los debates que se produjeron en distintas conferencias en torno a las propuestas de intervención para prevenir y controlar a la enfermedad. Se presentan las principales características por las cuales la biomedicina comprendió a la enfermedad para luego analizar las implicancias que tuvo en el diseño de políticas de salud. La planificación de políticas de salud siguió la lógica de la producción de conocimiento científico. Los nuevos descubrimientos que se fueron produciendo a lo largo del tiempo cambiarán casi de forma lineal el diseño de las políticas de prevención y control de la enfermedad.
Itinerários terapêuticos de pacientes com diagnóstico de hanseníase em Salvador, Bahia
Authors: Martins Patricia Vieira , Iriart Jorge Alberto Bernstein
Published: May 2014

A hanseníase e seu diagnóstico tardio, que favorece o agravamento dos sintomas e o surgimento de sequelas físicas, permanecem como um grave problema de saúde pública no Brasil. O objetivo deste artigo é analisar o itinerário terapêutico de pessoas com hanseníase, buscando compreender sua experiência da enfermidade, assim como os fatores que contribuíram para o diagnóstico tardio. Foram realizadas 18 entrevistas narrativas com pacientes em tratamento de hanseníase na cidade de Salvador, Bahia, entre 2009 e 2011. Os resultados apontam que, na maioria dos casos, os pacientes percorreram um longo itinerário terapêutico até a realização do diagnóstico. Entre os fatores que contribuem para o diagnóstico tardio está falta de capacitação dos profissionais de saúde nos serviços de saúde para diagnosticar precocemente a enfermidade, assim como o estigma e o preconceito, que favorecem o silêncio em torno da doença e a automedicação.
Proprioceptive neuromuscular facilitation and strength training to gain muscle strength in elderly women
Authors: Cesário Denise Ferreira , Mendes Geovânia Barbosa da Silva , Uchôa Érica Patrícia Borba Lira , Veiga Paulo Henrique Altran
Published: May 2014

Introduction: The world population is aging, and this leads to progressive physiological changes and increased incidence of acute and chronic degenerative diseases. In this sense, one of the main changes occurring during this period is sarcopenia, characterized by decreased skeletal muscle mass. Objective: To perform comparative analyze of results of proprioceptive neuromuscular facilitation (PNF) techniques and strength training to gain muscle strength of biceps and quadriceps and grip in the elderly. Method: This is a prospective randomized study with purposive sample of 17 elderly patients undergoing a program of strength training and evaluation with a dynamometer, before and after applying the treatment protocol. After evaluation, subjects were randomly divided into two groups: PNF and Bodybuilding. Results: The group trained with PNF had more significant gain in muscle strength, biceps (p=0.0392*) and quadriceps (p=0.0230*) did not show statistically significant relevance in the grip (p=0.1075). In the group trained with weights there was no statistically significant difference: biceps (p=0.5338), quadriceps femoris (p=0.0679) and palmar (p=0.3758). Comparing both techniques, however, there was no statistical difference: biceps (p=0.5739), quadriceps (p=0.8450) and palmar (p=0.2457). Conclusion: This study showed that the period of 12 weeks of intervention seems to be sufficient to achieve gains in muscle strength with PNF technique, but when comparing the two techniques it was not statistically significant.
Revisão de dois instrumentos clínicos de avaliação para predizer risco de quedas em idosos
Authors: Ansai Juliana Hotta , Glisoi Soraia Fernandes das Neves , Oliveira Tamara de , Soares Aline Thomaz , Cabral Kelem de Negreiros , Sera Celisa Tiemi Nakagawa , Paschoal Sérgio Marcio Pacheco
Published: May 2014

Introdução: Quedas são um problema clínico comum nos idosos, que pode reduzir sua mobilidade e independência. O uso de instrumentos simples para detecção do risco de quedas é fundamental para prevenção e tratamento de tais eventos. Não há, porém, consenso quanto aos testes mais adequados para cada situação. Objetivo: Revisar estudos sobre eficácia, sensibilidade e especificidade dos testes Timed Up and Go Test e Berg Balance Scale, a fim de verificar qual é o mais apropriado para predizer quedas em idosos. Métodos: Realizou-se revisão bibliográfica nas bases de dados MEDLINE, PubMed, ISI, LILACS e Portal de Periódicos CAPES, entre os anos de 2001 e 2011. Resultados: Foram selecionados 37 artigos, sendo 17 sobre a Berg Balance Scale e 20 sobre o Timed Up and Go Test. A revisão mostrou que os dois testes podem ser bons preditores de quedas, mas os artigos diferiram quanto à definição de queda e caidor, tipo de estudo, quantidade e característica da amostra e avaliação de quedas, levando a diferentes resultados quanto a nota de corte, sensibilidade, especificidade e predição de quedas. Há controvérsias quanto à capacidade de predição em perfis específicos, como os idosos ativos. Conclusão: Os testes avaliados são eficazes para predição de quedas, desde que adaptados para cada perfil. Novos estudos devem ser realizados com metodologia homogênea, a fim de favorecer a comparação de resultados sobre a eficácia desses testes.
Dupla-tarefa na doença de Parkinson: uma revisão sistemática de ensaios clínicos aleatorizados
Authors: Marinho Marina Santos , Chaves Priscila de Melo , Tarabal Thaís de Oliveira
Published: May 2014

Dupla-tarefa, ou tarefas simultâneas, envolve a execução de uma tarefa primária, que é o foco principal de atenção, e uma tarefa secundária, executada ao mesmo tempo. Portadores da doença de Parkinson apresentam uma deterioração na marcha quando performances de dupla-tarefa são requeridas. Sendo assim, o objetivo desta pesquisa foi realizar uma revisão sistemática de ensaios clínicos aleatorizados do efeito da intervenção da dupla-tarefa na marcha em portadores da doença de Parkinson. Foi realizada uma busca, por ensaios clínicos aleatórios, nas bases de dados MEDLINE, LILACS, SciELO, Cochrane e PEDro. Dois revisores extraíram os dados de forma independente e a qualidade metodológica foi avaliada utilizando-se a escala PEDro. Foram selecionados dois artigos, que abrangeram 175 participantes. Foi demonstrado que o treino com marcadores externos e com a música, que são formas de se treinar a dupla-tarefa, apresentou durante a marcha melhora na performance da marcha. Entretanto, são necessários ainda muitos estudos do tipo ensaios clínicos aleatorizados para verificar, principalmente, os efeitos da intervenção com a dupla-tarefa na marcha em portadores da doença de Parkinson.
As quedas no cenário da velhice: conceitos básicos e atualidades da pesquisa em saúde
Authors: Gasparotto Lívia Pimenta Renó , Falsarella Gláucia Regina , Coimbra Arlete Maria Valente
Published: May 2014

Quedas têm sido referidas como importante fator de risco para redução da capacidade funcional em indivíduos idosos. Por sua alta prevalência nesta população, um dos objetivos das pesquisas foi delinear a queda sob seus aspectos causais e respectivas consequências. Com base nessas definições, é possível apontar perspectivas para a atuação da saúde na mitigação dos efeitos deste evento, bem como reduzir o alto gasto hospitalar destes idosos para a saúde pública. Dentro da lógica citada, este trabalho traz algumas das principais considerações e consensos da atualidade sobre queda, a partir da análise de pesquisas recentes. Tem como objetivo propor uma visão ampliada, capaz de divulgar os aspectos ligados à queda que são de interesse comum a todos os profissionais de saúde que lidam com essa população. Metodologia: utilizaram-se as bases Cochrane, Pubmed e Medline para busca das informações pretendidas através de descritores correspondentes às palavras Envelhecimento e Quedas e tendo como limite os anos 2009 a 2013. Resultados: Definiu-se para esta discussão os artigos ligados a aspectos epidemiológicos, fatores associados, consequências da queda, prevenção e intervenção nas quedas. Conclusão: Em resumo, o suporte multiprofissional está alicerçado nas práticas preventivas de quedas e necessita, portanto, de uma postura compartilhada de informações entre os profissionais da saúde que trabalham com este público.
Haematological and parasitological assessment of silver catfish Rhamdia quelen farmed in Southern Brazil
Authors: Figueredo Aline Brum , Tancredo Karen Roberta , Hashimoto Gabriela Sayuri de Oliveira , Roumbedakis Katina , Marchiori Natália da Costa , Martins Maurício Laterça
Published: May 2014

This study evaluated for two years the haematological parameters and the occurrence of gill parasites in silver catfish Rhamdia quelen, farmed in the state of Santa Catarina, southern Brazil. Between March 2010 and January 2012, a total of 137 fish were caught in a fish farm to compare the haematological and parasitological analysis, during hot and cold seasons. Simultaneously, water quality parameters were measured in the pond to analyze the relationship between environmental conditions and haematology and parasitism. During the hot season, there was an increase in water temperature, electrical conductivity and ammonia followed by a decrease in dissolved oxygen, pH, transparency and alkalinity. Two species of Monogenea were observed in the gills, Aphanoblastella mastigatus (Dactylogyridae) and Scleroductus sp. (Gyrodactylidae). Additionally, during this season, there was a significant increase (p<0.05) in the mean intensity of infection by Monogenea, as well as total leukocytes number, thrombocytes and lymphocytes, and a reduction in monocytes. The changes might be caused by parasitism and/or environmental variations between seasons.
Comparative evaluation of several methods for Canine Visceral Leishmaniasis diagnosis
Authors: Silva Diogo Tiago da , Starke-Buzetti Wilma Aparecida , Alves-Martin Maria Fernanda , Paixão Mirian dos Santos , Tenório Michely da Silva , Lopes Mara Lúcia Martins
Published: May 2014

The aim of the present study was to evaluate the serological methods using ELISA with recombinant-rK39 (ELISA-rK-39) and soluble extract-SE (ELISA-SE) antigens, the indirect fluorescence antibody test (IFAT) in comparison to an immunochromatography rapid diagnostic test (RDT-rK39) and with a direct parasitological exam (PA) for Canine Visceral Leishmaniasis (CVL) diagnosis. The results showed that 89% (60/67) of the dogs were positive for at least one serological diagnostic test. ELISA-SE was the test that detected anti-Leishmania antibodies in the serum of the highest number of dogs (71.6%) followed by ELISA-rK39 (65.7%), IFAT (65.7%) and RDT-rK39 (55.2%). PA detected the lowest numbers (40.3%) of positive dogs. In relation to the total of examined dogs, the Kappa indexes (p ≤ 0.05) showed a good agreement between ELISA-SE and IFAT (88.1%; k = 0.7237), and it was also observed in the comparison of RDT-rK39 with ELISA-SE (83.6%, k= 0.6561), IFAT (83.5%, k= 0.6605) and PA (85.0%, k= 0.7074). A bad agreement was detected in any association of ELISA-rk39 with the other tests in either symptomatic or asymptomatic animals. ELISA as well as RDT using recombinant antigenic protein (rK39) were the methods that detected the lowest prevalence rates (33.3%) of CVL in asymptomatic dogs. In conclusion, only one test does not adequately identify dogs with CVL and it is necessary the association of two or more diagnostic tests. Because of the good agreement indexes of RDT-rK39 when evaluated with ELISA-SE, IFAT and PA it was suggested as a complementary method to be used in association with either ELISA-SE or IFAT, particularly in the symptomatic dogs. Furthermore, new studies are recommended in order to improve the sensitivity of tests mainly for asymptomatic dogs.
Dental Arch Relationship Outcomes in One- and Two-Stage Palatoplasty for Japanese Patients with Complete Unilateral Cleft Lip and Palate
Authors: Mikoya Tadashi , Shibukawa Toyoko , Susami Takafumi , Sato Yoshiaki , Tengan Toshimoto , Katashima Hirotaka , Oyama Akihiko , Matsuzawa Yusuke , Ito Yumi , Funayama Emi
Published: May 2014

Objective

To compare dental arch relationship outcomes following one- and two-stage palatal repair.

Design

Nonrandomized, clinical trial with concurrent control.

Setting

Hokkaido University Hospital.

Patients

Sixty-eight consecutively treated Japanese patients with complete unilateral cleft lip and palate.

Interventions

Thirty-one of the 68 patients underwent two-stage palatoplasty with delayed hard palate closure, and 37 patients underwent one-stage pushback palatoplasty.

Main Outcome Measures

Dental casts were taken at 4.9 to 6.3 (mean: 5.2) years of age in the two-stage group and at 4.0 to 6.3 (mean: 5.1) years of age in the one-stage group, and dental arch relationships were assessed using the 5-Year-Olds’ Index (5-Y) by four raters and the Huddart/Bodenham Index (HB) by two raters.

Results

Intrarater and interrater reliabilities evaluated using weighted kappa statistics were good or better for the 5-Y and HB ratings. The mean 5-Y score was 2.94 in the two-stage group and 3.13 in the one-stage group ( P value was not significant). However, there was a significant difference in distributions between the groups ( P < .05). The HB scores of molars were significantly greater in the two-stage group than in the one-stage group ( P < .05). The rank correlation coefficients between the 5-Y and total HB score (ρ = −0.840, P < .01) and between the 5-Y and the score of the incisors in the HB (ρ = −0.814, P < .01) were significantly increased.

Conclusions

These results suggest that the anteroposterior relationship was not significantly different between the groups, but the transversal relationship was better in the two-stage group than in the one-stage group.
Plasmonic enhancement of light trapping in photodetectors
Authors: Jaksic Zoran , Obradov Marko , Vukovic Slobodan , Belic Milivoj
Published: May 2014

We consider the possibility to use plasmonics to enhance light trapping in
such semiconductor detectors as solar cells and infrared detectors for night
vision. Plasmonic structures can transform propagating electromagnetic waves
into evanescent waves with the local density of states vastly increased
within subwavelength volumes compared to the free space, thus surpassing the
conventional methods for photon management. We show how one may utilize
plasmonic nanoparticles both to squeeze the optical field into the active
region and to increase the optical path by Mie scattering, apply ordered
plasmonic nanocomposites (subwavelength plasmonic crystals or plasmonic
metamaterials), or design nanoantennas to maximize absorption within the
detector. We show that many approaches used for solar cells can be also
utilized in infrared range if different redshifting strategies are applied.
Demonstration of protein hydrogen bonding network application to microelectronics
Authors: Hristov Marin , Rusev Rostislav , Angelov George , Gieva Elitsa
Published: May 2014

Model of hydrogen bonding networks in active site of ?-lactamase during the
last intermediate EY of acylenzyme reaction semicycle is presented. The I-V
characteristics of each hydrogen bond are calculated following Marcus theory
and theory of protein electrostatics. Simulations showed that HBN
characteristics are similar to the characteristics of microelectronic
devices such as amplifier, signal modulator, triangular pulse source. The
results demonstrated the analogy of HBNs in the active site of ?-lactamase
protein to microelectronic integrated circuit with multiple outputs each
with different characteristics.
Execution time - area tradeoff in gausing residual load decoder: Integrated exploration of chaining based schedule and allocation in HLS for hardware accelerators
Authors: Sengupta Anirban , Sedaghat Reza , Mishra Vipul
Published: May 2014

Design space exploration is an indispensable segment of High Level Synthesis
(HLS) design of hardware accelerators. This paper presents a novel technique
for Area-Execution time tradeoff using residual load decoding heuristics in
genetic algorithms (GA) for integrated design space exploration (DSE) of
scheduling and allocation. This approach is also able to resolve issues
encountered during DSE of data paths for hardware accelerators, such as
accuracy of the solution found, as well as the total exploration time during
the process. The integrated solution found by the proposed approach satisfies
the user specified constraints of hardware area and total execution time (not
just latency), while at the same time offers a twofold unified solution of
chaining based schedule and allocation. The cost function proposed in the
genetic algorithm approach takes into account the functional units,
multiplexers and demultiplexers needed during implementation. The proposed
exploration system (ExpSys) was tested on a large number of benchmarks drawn
from the literature for assessment of its efficiency. Results indicate an
average improvement in Quality of Results (QoR) greater than 26% when
compared to a recent well known GA based exploration method.
Situating Diverse Young Learners in Diverse Times
Authors: Souto-Manning Mariana
Published: May 2014

There is a very puzzling contrast — really an awesome disconnect — between the breathtaking diversity of schoolchildren and the uniformity, homogenization, and regimentation of classroom practices, from pre-kindergarten onward. (Genishi & Dyson, 2009, p. 4)
‘¿Tu Te Acuerdas De Ganchulinas?’: Longitudinal Research with Young Emergent Bilinguals
Authors: Axelrod Ysaaca
Published: May 2014

Drawing on the work of Celia Genishi, this article discusses data from an ethnographic case study of young Latina/o children, starting in their four-year-olds classroom in a Head Start Program through their first grade year in a dual-language program in a public school. The children attended a bilingual Head Start program that followed a play-based curriculum and focused on the socio-emotional development of the children. The flexibility of the curriculum in this setting allowed time and space for the children to play and develop at their own pace, positioning them as knowers and learners. The children then moved into a public school setting with a narrow ‘literacy focused’ curriculum, with strict boundaries established between languages and a narrower definition of what ‘counts' as literacy. In spite of this, these children continued to draw on their linguistic resources, making space for play and developing their identities as multilingual children in ways that are often not captured by the curriculum, but are visible to those who seek to listen to the children and see their strengths and growth over time.

‘Remember, remember when I was in prekinder and I drew a flower in your notebook’ says Javier to me. ‘Yes, I remember’, I say, and flip back through my field notebook to show him his drawing. ‘Yo también dibujé una flor’ says Luna, and we flip back until we find it. ‘She [pointing to me] was in my mines preschool’ says Javier to the other children who have gathered around my table in this first grade classroom. ‘Yeah, yeah, she was in mine too’ says a boy who has joined us. ‘No, no you wasn't!’ says Javier, ‘he wasn't, right Ysaaca?’ I nod and agree, ‘Yeah, Javier is right, you weren't in the preschool with me, but I remember you from last year in kindergarten when I used to come visit’. ‘Oh yeah’ says the boy. Javier says: ‘Yeah, in preschool it was … [looks around his first grade classroom] me and Luna and Estrella and Flor and who else Ysaaca? Can we look at your notebook to see who was there?’
Progression of Early Retinal Dysfunction in Diabetes Over Time: Results of a Long-term Prospective Clinical Study
Authors: Hellgren Karl-Johan , Agardh Elisabet , Bengtsson Boel
Published: May 2014

We explored signs of retinal dysfunction over time in diabetic subjects before or early in the course of retinopathy. Patients with no, mild, or moderate retinopathy were consecutively recruited and underwent standard automated perimetry, visual acuity measurement, and fundus photography. These examinations and measurements of HbA1c and blood pressure were repeated for up to 5 years from baseline. Visual field improvement/deterioration in diabetic subjects was evaluated using significance limits for change. Progression or regression of retinopathy was defined as a two-step change on the Early Treatment Diabetic Retinopathy Study final severity scale. Seventy-four subjects completed at least 3 years of follow-up, and 22% showed visual field worsening, defined as repeated significant deterioration at ≥10% of the test points, whereas only 1% showed field improvement. Worsening occurred in subjects both with and without vascular lesions. The degree of retinopathy was stable throughout the observation period in 68 of 74 eyes, improved in 4, and worsened in 2. Visual field deterioration was not correlated with a change in retinopathy. By using perimetry with an analysis tailored for monitoring diabetic subjects, we were able to demonstrate progression of retinal dysfunction over time, which may represent early signs of retinal neurodegeneration.
Regulation of Substrate Oxidation Preferences in Muscle by the Peptide Hormone Adropin
Authors: Gao Su , McMillan Ryan P. , Jacas Jordi , Zhu Qingzhang , Li Xuesen , Kumar Ganesh K. , Casals Núria , Hegardt Fausto G. , Robbins Paul D. , Lopaschuk Gary D. , Hulver Matthew W. , Butler Andrew A.
Published: May 2014

Rigorous control of substrate oxidation by humoral factors is essential for maintaining metabolic homeostasis. During feeding and fasting cycles, carbohydrates and fatty acids are the two primary substrates in oxidative metabolism. Here, we report a novel role for the peptide hormone adropin in regulating substrate oxidation preferences. Plasma levels of adropin increase with feeding and decrease upon fasting. A comparison of whole-body substrate preference and skeletal muscle substrate oxidation in adropin knockout and transgenic mice suggests adropin promotes carbohydrate oxidation over fat oxidation. In muscle, adropin activates pyruvate dehydrogenase (PDH), which is rate limiting for glucose oxidation and suppresses carnitine palmitoyltransferase-1B (CPT-1B), a key enzyme in fatty acid oxidation. Adropin downregulates PDH kinase-4 (PDK4) that inhibits PDH, thereby increasing PDH activity. The molecular mechanisms of adropin’s effects involve acetylation (suggesting inhibition) of the transcriptional coactivator PGC-1α, downregulating expression of Cpt1b and Pdk4. Increased PGC-1α acetylation by adropin may be mediated by inhibiting Sirtuin-1 (SIRT1), a PGC-1α deacetylase. Altered SIRT1 and PGC-1α activity appear to mediate aspects of adropin’s metabolic actions in muscle. Similar outcomes were observed in fasted mice treated with synthetic adropin. Together, these results suggest a role for adropin in regulating muscle substrate preference under various nutritional states.