bluuebunny/crossref_metadata_2025 huggingface dataset:
Recent advances in pathophysiology of disseminated intravascular coagulation: the role of circulating histones and neutrophil extracellular traps
Authors: Alhamdi Yasir , Toh Cheng-Hock
Published: December 2017

Disseminated intravascular coagulation (DIC) is an acquired condition that develops as a complication of systemic and sustained cell injury in conditions such as sepsis and trauma. It represents major dysregulation and increased thrombin generationin vivo. A poor understanding and recognition of the complex interactions in the coagulation, fibrinolytic, inflammatory, and innate immune pathways have resulted in continued poor management and high mortality rates in DIC. This review focuses attention on significant recent advances in our understanding of DIC pathophysiology. In particular, circulating histones and neutrophil extracellular traps fulfil established criteria in DIC pathogenesis. Both are damaging to the vasculature and highly relevant to the cross talk between coagulation and inflammation processes, which can culminate in adverse clinical outcomes. These molecules have a strong potential to be novel biomarkers and therapeutic targets in DIC, which is still considered synonymous with ‘death is coming’.
Unexpected results in Chernozem soil respiration while measuring the effect of a bio-fertilizer on soil microbial activity
Authors: Bautista Gabriela , Mátyás Bence , Carpio Isabel , Vilches Richard , Pazmino Karina
Published: December 2017

The number of studies investigating the effect of bio-fertilizers is increasing because of their importance in sustainable agriculture and environmental quality. In our experiments, we measured the effect of different fertilizers on soil respiration. In the present study, we were looking for the cause of unexpected changes in CO2 values while examining Chernozem soil samples. We concluded that CO2 oxidizing microbes or methanotrophs may be present in the soil that periodically consume CO2 . This is unusual for a sample taken from the upper layer of well-ventilated Chernozem soil with optimal moisture content.
A hidden burden of neonatal illness? A cross-sectional study of all admissions aged less than one month across twelve Kenyan County hospitals
Authors: Murphy Georgina A.V. , Nyakangi Vivian N. , Gathara David , Ogero Morris , English Mike ,   Clinical Information Network
Published: December 2017

Background: Small and sick newborns need high quality specialised care within health facilities to address persistently high neonatal mortality in low-income settings, including Kenya.

Methods: We examined neonatal admissions in 12 public-sector County (formerly District) hospitals in Kenya between November 2014 and November 2016. Using data abstracted from newborn unit (NBU) admission registers and paediatric ward (PW) medical records, we explore the magnitude and distribution of admissions. In addition, interviews with senior staff were conducted to understand admission policies for newborns in these facilities.

Results: Of the total 80,666 paediatric admissions, 28,884 (35.8%) were aged ≤28 days old. 24,212 (83.8%) of newborns were admitted to organisationally distinct NBU and 4,672 (16.2%) to general PW, though the proportion admitted to NBUs varied substantially (range 59.9-99.0%) across hospitals, reflecting widely varying infrastructure and policies. Neonatal mortality was high in NBU (12%) and PW (11%), though varied widely across facilities, with documentation of outcomes poor for the NBU.

Conclusion: Improving quality of care on NBUs would affect almost a third of paediatric admissions in Kenya. However, comprehensive policies and strategies are needed to ensure sick newborns on general PWs also receive appropriate care.
Zinc and copper concentration do not differentiate bipolar disorder from major depressive disorder
Authors: Styczeń Krzysztof , Sowa-Kućma Magdalena , Dudek Dominika , Siwek Marcin , Reczyński Witold , Szewczyk Bernadeta , Misztak Paulina , Topór-Mądry Roman , Opoka Włodzimierz , Nowak Gabriel
Published: December 2017

Cel pracy

Celem niniejszej pracy było porównanie stężeń mikroelementów, cynku i miedzi w grupie pacjentów z rozpoznaniem choroby afektywnej dwubiegunowej (bipolar disorder – BD) i jednobiegunowej (major depressive disorder – MDD).

Metoda

Do badania zakwalifikowano 110 pacjentów z rozpoznaniem choroby afektywnej dwubiegunowej oraz 114 pacentów z rozpoznaniem choroby afektywnej jednobiegunowej. W celu przeprowadzenia oceny stężeń mikroelementów pomiędzy chorobą afektywną dwubiegunową i jednobiegunową wykorzystano metodę płomieniowej atomowej spektrometrii absorpcyjnej (flame atomic absorption spectrometry - FAAS) w przypadku cynku, natomiast metodę elektrotermicznej atomowej spektrometrii absorpcyjnej (electrothermal atomic absorption spectrometry - ET AAS) w przypadku miedzi.

Wyniki

Stężenia miedzi i cynku w grupie pacjentów z chorobą afektywną dwubiegunową i jednobiegunową zarówno w fazie remisji jak i depresji nie różniły się. Uwzględnienie w porównaniach typu I i II jak i fazy wczesnej i później choroby afektywnej dwubiegunowej z jednobiegunowej również nie wykazało żadnych różnic istotnych statystycznie.

Wnioski

Brak różnic w stężeniu cynku i miedzi pomiędzy pacjentami z rozpoznaniem choroby afektywnej dwubiegunowej i jednobiegunowej może wskazywać na wspólną etiologię tych zaburzeń.
Metastatic carcinoid tumor with severe double valve disease at diagnosis: Case report and review of literature
Authors: Juarez Edna , Adiga Avinash , Sanchez Paloma , Fanasch Hilal
Published: December 2017

A 27-year-old woman with a history of anxiety presented with three months of diarrhea. Onphysical examination, she had a grade 3/6 systolic heart murmur at the lower left sternal borderwhich increased with inspiration, a grade 2/6 decrescendo diastolic murmur at the left sternalborder, and lower extremity edema. Stool studies were negative. The abdominal ultrasounddemonstrated multiple complex liver cysts. Transthoracic echocardiogram reported tricuspidvalvular thickening with stenosis and regurgitation, severe pulmonary stenosis, and mild aorticregurgitation with valvular thickening. 5-hydroxyindole acetic acid and chromogranin A levelswere elevated. The patient’s symptoms improved after octreotide therapy, and she underwenttricuspid and pulmonary valve replacement.The incidence of carcinoid tumors is 1.2 to 2.1 per 100,000 people in the general population.Carcinoid heart disease occurs in one-half to two-thirds of patients with carcinoid syndromeand is associated with poorer clinical outcomes. Left side cardiac involvement occurs in lessthan 10% of patients. The presence of both left and right sided valvular disease in the contextof gastrointestinal carcinoid is associated with severe and poorly controlled disease. Up to4% of these cases have metastatic disease on the valves, and 3.8% have direct myocardialinvolvement.
Fibrosing Mediastinitis
Authors: Denega Tatiana , Edriss Hawa , Sotello David , Nugent Kenneth
Published: December 2017

Fibrosing mediastinitis is an uncommon thoracic disorder characterized by the extensiveproliferation of fibrous tissue in the mediastinum. This disorder frequently develops followingHistoplasma capsulatum infection with involvement of mediastinal lymph nodes. The fibroustissue can invade and compress mediastinal structures, including vessels, large airways, andthe esophagus. These patients may present with cough, sputum production, and dyspneadepending on location and extent of fibrosis. The radiographic presentation depends on thetype and extent of obstruction. Diagnosis requires computed tomography with angiography,ventilation-perfusion scans, and pulmonary function tests. Management depends on thestructures involved and the extent of infiltration and/or compression. Possible approachesinclude the use of endobronchial stents, intravascular stents, vascular bypass grafts, andthe resection of nonfunctional pulmonary tissue. Extensive surgical procedures are usuallynot warranted. These patients usually do not respond to antifungal or anti-inflammatorymedications. Several patients have responded to rituximab, and this drug is a possibleconsideration in patients with ongoing inflammation in the mediastinum.
Kcentra® (Prothrombin Complex Concentrate [Human]): Its indications, side effects, and contraindications
Authors: Ismail Amr
Published: December 2017

Patients with a high risk for thromboembolic events can be on long-term warfarin. Thesepatients need close monitoring of their INR and for signs of bleeding. Conventionally, freshfrozen plasma (FFP) is used for reversal of INR in patients with major bleeding or who needurgent surgery or invasive procedures. Kcentra is now available as an alternative to FFP forrapid reversal of INR and urgent hemostasis.
Tooth wear and occlusal ageing
Authors: Murchie Bryan Daniel
Published: December 2017

Occlusal changes occur slowly throughout each person's lifetime via the process of physiological tooth wear (TW). Importantly, once the occlusal scheme has been irreversibly changed beyond a certain point, then a chain reaction of restoration failures may commence. The trigger varies for each individual and it cannot always be predicted when, where or if this occurrence will take place. Importantly, when the patient attends with failing or failed dental treatment, particularly following repeated attempts to resolve it, then a detailed investigation of the occlusion must precede treatment. Any immediate repair or replacement without consideration of the underlying aetiology would simply suffer the same consequences.

CPD/Clinical Relevance: Understanding the impact of occlusal changes on the overall survival of restorations and the health of the remaining dentition can help in early diagnoses, prevention and treatment.
eHealth in Wound Care: from conception to implementation
Authors: Moore Zena , Angel Donna , Bjerregaard Julie , O'Connor Tom , McGuiness William , Kröger Knut , Rasmussen Benjamin Schnack Brandt , Yderstrœde Knud Bonnet
Published: December 2017

Executive summary

Purpose

This document aims to provide wound care clinicians with a rapid and structured overview of the key issues related to use of eHealth applications (telemedicine and telehealth) within wound care. This includes: An overview of terminology and available literature Guidance on the methodology for evaluation of eHealth solutions An introduction to and discussion of the potential benefits of eHealth technologies in wound care, and the possible barriers to their implementation Recommendations for ensuring a good implementation process and supporting involvement of wound care professionals in safeguarding that eHealth solutions meet the needs of the patients.

Methodology

The document sections lean on the structure and focus areas of the Model for ASsessment of Telemedicine (MAST) which defines crucial items to evaluate an eHealth application. The content of the document is developed on the basis of a literature review, identifying available documentation for use of eHealth solutions in wound care. Furthermore, it draws on various key documents recently published on the general development, evaluation and implementation of eHealth solutions. These include valuable up-to-date information relevant for any group of clinicians wishing to follow and influence the way eHealth solutions are integrated into clinical practice.

Findings and conclusions

The literature review revealed that the amount and level of evidence for use of eHealth applications in wound care is still limited. Some MAST domains are not examined in any of the available studies. Thus, more research is required to identify the potential benefits and harms to patients, and the possible challenges related to implementation of eHealth solutions in wound care. Potential barriers and facilitators for the implementation of eHealth applications into wound care practice are identified in the document, and these may all either enhance or impede the process. However, the available research does demonstrate patient satisfaction, improved access to health services for all client cohorts, and increased job satisfaction for clinicians. The document recommends that wound management clinicians, considering the use of eHealth applications in their clinical practice, consult widely and conduct regular evaluation of the outcomes to ensure efficient implementation of these services. To support this approach, steps to ensure a good implementation process within a given organisation have been proposed. These are synthesised into a three circle model.
MORTA POR DENTRO: SUBJETIVIDADE E ALEGORIA EM THE ADDICTION
Authors: Branco Sérgio Dias
Published: December 2017

The Addiction (Os Viciosos, 1994), realizado por Abel Ferrara, é uma obra cinematográfica que questiona a fronteira entre modos indiretos e diretos de representação. A alegoria como modo indireto de representação surge neste filme através de uma ligação indissociável a um modo direto, quase cru, de representação do drama existencial da protagonista. Ela chamase Kathleen e é uma doutoranda em filosofia na Universidade de Nova Iorque. A análise que este artigo desenvolve incide, primeiro, na forma como Kathleen se vai definindo face ao horror do mal e, depois, no caminho moral que ela percorre até ao fim do filme. A conclusão desta leitura inclui o enquadramento de The Addiction na filmografia de Ferrara, sem o qual este filme não pode ser apreciado em toda a sua riqueza artística.
FESTA E FRONTEIRA: AS CELEBRAÇÕES INTERSTICIAIS DO QUILOMBO DE CONCEIÇÃO DAS CRIOULAS
Authors: Pimentel Águas Carla Ladeira
Published: December 2017

O presente artigo explora os vínculos entre festa, identidade e resistência, baseando-se na trajetória do quilombo pernambucano de Conceição das Crioulas e a partir do conceito de fronteira – aqui entendido como um instável espaço intersticial de encontro e articulação. Através da discussão de três aspetos – a festa de Sábado de Aleluia, a novena de Nossa Senhora da Assunção e a comemoração abrangente dedicada à santa – busca identificar fenômenos tipicamente fronteiriços, em termos intra e interculturais, sinalizando para o papel da festa para a manutenção dos elos identitários e para a negociação e afirmação perante o «outro». No primeiro momento, discute-se a fluidez do espaço fronteiriço através da celebração de Semana Santa realizada na exata fronteira geográfica que divide o território quilombola e o território indígena Atikum, de quem a comunidade é vizinha. No segundo momento, analisa-se a cerimôniade passagem de testemunho realizada nas noites de novena de Nossa Senhora da Assunção, quando cada subgrupo que compõe o quilombo reafirma seu pertencimento a Conceição das Crioulas. No terceiro momento, é discutido o papel da celebração de Nossa Senhora da Assunção perante o «outro» externo à comunidade, explorando-se desde as origens do protagonismo dos quilombolas sobre a festa até as suas grandes dimensões atuais, de maneira a reunir uma variada gama de atores.
HUMANO, PÓS-HUMANO E TRANSUMANO: FRONTEIRAS DÚBIAS E INDEFINIDAS NUM MUNDO DESIGUAL
Authors: Machadinha Maia João Jerónimo
Published: December 2017

O debate comparativo entre os conceitos de humano, pós-humano e  transumano tem vindo a realizar-se no meio académico e científico em face dos desenvolvimentos da ciência e da tecnologia. O próprio conceito de humanismo, na visão europeísta, sempre comportou teologismos que ambicionaram a transcendência das capacidades humanas. Este artigo pretende evidenciar a dificuldade da delimitação destes conceitos devido à relação entre a evolução humana e o desenvolvimento da técnica. No entanto, perante as dinâmicas de globalização do atual sistema mundial também se demonstra a iminência de se originarem fraturas entre as populações humanas atuais.
TREND, SCALE AND LIMIT. PORTUGAL AND THE END OF THE «GOLDEN AGE» OF WELFARE STATE
Authors: Jorge Martins Carlos Miguel
Published: December 2017

Contrary to the general trend of welfare state retrenchment that began in the 1970s, the Portuguese case presents itself as an exception, expressing the particularity of developing an welfare state during a time of crisis for welfare policies. Neoliberalism, as a significant influence on welfare state changes, did not play a role during the creation of the welfare state in Portugal. The key variables to understanding the rather particular path of Portugal were a very specific group of political contingencies, as well as a particular institutional environment framed by economic and political ideas that were antagonistic to neoliberal proposals. That path can be illustrated by the construction of the SNS(1), a body functioning in opposition to neoliberal logic. The singularity of the Portuguese case opens the door for defining new scales, limits and possibilities regarding welfare state studies.
FRONTEIRA INEXPUGNÁVEL. A HISPANOFOBIA DE FRANCO NOGUEIRA ENTRE O ESTADO NOVO E A DEMOCRACIA
Authors: Sardica José Miguel
Published: December 2017

Na narrativa da nação portuguesa, a Espanha foi muitas vezes olhada como um perigoso «outro», uma ameaça que justificava a demonização do vizinho ibérico. Séculos de anti castelhanismo, ou de pura hispanofobia, constituíram assim um ingrediente definidor do nacionalismo português. Um dos mais fortes defensores deste discurso foi, na segunda metade do século XX, Alberto Franco Nogueira, ministro dos Negócios Estrangeiros do Estado Novo, entre 1961 e 1969, e conhecido crítico de qualquer amizade ibérica no quadro da Democracia e da Europa. Explorando os seus escritos sobre as relações luso-espanholas, e a forma como intransigentemente se opôs a qualquer abordagem política ou cultural de cariz hispanófilo, o objetivo deste texto é o de evocar uma disposição e discurso públicos que, longe de constituírem uma excentricidade individual, informaram muitas opiniões portuguesas anti cosmopolitas, criando ou reforçando uma noção de fronteira inexpugnável contra a Espanha, que foi tanto realidade física quanto, sobretudo, representação e barreira mental.
FRONTEIRAS E CAMINHOS-DE-FERRO: DA QUIMERA SAINT-SIMONIANA AO DESENCANTO TECNODIPLOMÁTICO (C. 1850-C. 1900)
Authors: Pereira Hugo Silveira
Published: December 2017

As elites tecnocratas portuguesas que, em meados do século XIX, apoiavam o Fontismo bebiam muito da ideologia saint-simoniana, desenvolvida em França na viragem de Setecentos para Oitocentos. O Saint-simonismo defendia a criação de civilizações de circulação, que caminhassem paulatinamente para uma federação europeia, através da construção de redes de caminhos-de-ferro, aproximando as diversas nações entre si. Este ideário foi assimilado por engenheiros e políticos nacionais e consubstanciado no projeto de ligar Porto, Lisboa e vários domínios ultramarinos aos países e colónias vizinhos. Contudo, este plano chocava contra as diferentes agendas económicas, políticas e diplomáticas dessas nações. Recorrendo ao conceito de tecnodiplomacia e ao modelo de análise dos cross-borders e dos large technological systems (LTS) transnacionais, procuraremos, neste artigo, demonstrar como o projeto saint-simoniano de criação de civilizações de circulação foi dificultado pelo surgimento de obstáculos tecnodiplomáticos e assim contribuir para o debate sobre os LTS transnacionais.
Campo cultural, violencia y mercado en el cuento chileno del siglo XXI
Authors: Hernández Tello Carlos Alexis , Álvarez Pastene Manuel
Published: December 2017

El presente artículo realiza una revisión crítica del desarrollo del cuento chileno actual, concentrándose, en una primera parte, en una descripción acotada del panorama de producción como también de las condiciones históricas y socioculturales del presente chileno. Así, el artículo, desde un sentido de vigencia, revisa algunos de los autores más relevantes en términos de tiempo de producción, además de hacer hincapié en la influencia que el auge de la edición independiente y el taller han tenido en el cultivo del género. En una segunda parte, el artículo realiza un análisis crítico de una serie de cuentos que reflejan las manifestaciones del género desde principio de la década del dos mil hasta la actualidad; concluyendo que los cuentos revisados dan una muestra orientadora de las condiciones postdictatoriales heredadas y, en ese sentido, son modos de representación que buscan posicionarse como decodificadores del presente chileno.
El cuento boliviano del siglo XXI: Ruptura de fronteras en los cuentos de Giovanna Rivero, Magela Baudoin y Liliana Colanzi
Authors: Gutiérrez León Anabel
Published: December 2017

En el artículo se repasa el recorrido del cuento en Bolivia durante los primeros diecisiete años del siglo XXI. El texto plantea un somero panorama que arranca con la publicación de una antología de cuentos el año 2000 e intenta señalar las líneas que ha tomado el género hasta la actualidad. Posteriormente se analiza la obra cuentística de tres de las escritoras bolivianas más relevantes del momento: Giovanna Rivero, Magela Baudoin, Liliana Colanzi. El análisis pone especial interés en el uso de las diferentes formas de la parodia en sus cuentos y la manera en que a partir del humor se rompe diferentes fronteras que marcan las contradicciones de la vida moderna en una sociedad donde aún perviven rasgos premodernos.
Influence of the North Atlantic Subtropical High on wet and dry sea-breeze events in North Carolina, United States
Authors: Luchetti Nicholas T. , Nieto Ferreira Rosana , Rickenbach Thomas M. , Nissenbaum Mark R. , McAuliffe Joel D.
Published: December 2017

The sea-breeze (SB) is an important source of summertime precipitation in North Carolina (NC, southeast United States). However, not all SB events produce precipitation. A climatology of wet and dry SB events in NC is used to investigate the conditions that are conducive to precipitation associated with the sea breeze. Radar imagery was used to detect 88 SB events that occurred along the NC coast between May-September of 2009-2012. The majority (85%) of SB events occurred during offshore flow (53%) or during flow that was parallel to the coast (22%). SB events were separated into dry (53%) and wet (47%) events and differences in the dynamic and thermodynamic parameters of the environment in which they formed were analyzed. Significant differences in dynamic and thermodynamic conditions were found. SB dry events occurred under stronger winds (6.00 ± 2.36 ms-1) than SB wet events (4.02 ± 2.16 ms-1). Moreover, during SB wet events larger values of convective available potential energy and lower values of convective inhibition were present, conditions that favor precipitation. Overall, the SB wet events accounted for 20-30% of the May-September precipitation along the NC coastal region. The position of the North Atlantic Subtropical High (NASH) controls both moisture availability and winds along the NC coast, thus providing a synoptic-scale control mechanism for SB precipitation. In particular, it was shown that when the NASH western ridge is located along the southeast coast of the United States, it causes a moist southwesterly flow along the NC coast that may favor the occurrence of SB wet events.
Problemática territorial y conservación de la biodiversidad en espacios protegidos de Argentina
Authors: Morea Juan Pablo
Published: December 2017

La problemática territorial en América Latina se ha profundizado en los últimos años a consecuencia de un importante proceso de expansión de las actividades productivas del sector primario. Esta problemática, que tiene basamento en la relación disfuncional sociedad-naturaleza, en un contexto de economía globalizada ha adquirido nuevas formas y ha instaurado nuevas lógicas que han impulsado a una profundización de los desequilibrios territoriales. Desequilibrios que han generado una degradación del ambiente que se contrapone con la tendencia mundial de conservar la biodiversidad, y producen un conflicto de intereses entre la conservación y el desarrollo económico. Mediante un abordaje que combina una exhaustiva revisión bibliográfica con el estudio del caso argentino, en este trabajo se explora la problemática territorial en torno a los espacios protegidos caracterizando las nuevas lógicas del proceso expansionista y la conflictividad social asociada a estos procesos. Los resultados demuestran que el avance de las fronteras productivas es cada vez mayor, que los espacios protegidos y la biodiversidad se encuentran fuertemente amenazados y que las políticas en materia de conservacionismo no han logrado contrarrestar el fenómeno expansionista.
DERECHO HUMANO AL AGUA Y ACCESO A LA JUSTICIA AMBIENTAL DE LAS COMUNIDADES AFECTADAS POR PROYECTOS HIDROELECTRICOS
Authors: Hernández Javier Gonzaga Valencia
Published: December 2017

Los proyectos hidroeléctricos generan importantes impactos en el medio ambiente y en las comunidades que se encuentran localizadas en su área de influencia. Dentro de los impactos negativos esta la vulneración a los derechos colectivos e individuales, especialmente a los derechos al medio ambiente adecuado y especialmente al derecho al agua potable. A partir de la revisión de fuentes bibliográficas y de la metodología de observación participante, se pretende demostrar la conexión directa que existe entre la construcción de proyectos hidroeléctricos y la vulneración al derecho humano al agua de las personas y las comunidades. Igualmente demostraremos a importancia que tiene la participación de la comunidad en la reclamación de sus derechos, a partir del uso de los mecanismos del acceso a la justicia ambiental y la eficacia de estos al momento de ser ejercidas ante las autoridades administrativas o judiciales, en el caso concreto de la construcción de hidroeléctricas en el departamento de Caldas-Colombia.
Análisis de los hábitos de la población como herramienta para la planificación de los espacios verdes públicos
Authors: Gómez Piovano Dra. Arq. Jimena , Mesa Dr. Arq. Alejandro
Published: December 2017

En las ciudades actuales la presencia o no de espacios públicos de recreación (parques, plazas, espacios verdes y ramblas) influye en la calidad de vida de los habitantes y en consecuencia, en los niveles de sostenibilidad de la misma. Existen numerosos estudios que describen los beneficios que los mismos producen a nivel social, económico y ambiental, a la vez que refieren lo favorable que es su uso, en la salud de los habitantes. A pesar de lo extenso de la bibliografía existente no se halla unanimidad en relación a los radios de influencia de los distintos tipos de espacios públicos de recreación. Por ello, este estudio tiene como objetivo analizar y  comprender los hábitos de la población de Área Metropolitana de Mendoza y así determinar si la ciudad posee la suficiente cantidad de superficie verde y si su disposición en la trama satisface a las necesidades de todos sus habitantes.
BENEFÍCIOS DECORRENTES DE PRÁTICA DO CUIDADO FARMACÊUTICO EM HIPERTENSÃO E DIABETES TIPO 2 PARA SUA EFETIVAÇÃO EM UNIDADES DE SAÚDE
Authors: Nicoletti Maria Aparecida , Kubota Lina Terumi
Published: December 2017

Pacientes portadores de doenças crônicas, em especial, hipertensão e diabetes, necessitam acompanhamento constante do profissional da saúde, pois o descontrole tanto da glicemia como da pressão arterial é precursora de crises fatais do funcionamento de rins, problemas cardiovasculares e motores, gerando custos evitáveis ao sistema público de saúde. O objetivo desse trabalho é buscar evidências que demonstrem os benefícios dos cuidados farmacêuticos a pacientes portadores de doenças crônicas não transmissíveis, em especial, hipertensão e diabetes tipo 2, por meio A pesquisa é uma revisão narrativa utilizando busca de artigos nas bases científicas de dados Web of Science, SciELO, Biblioteca Virtual em Saúde, Bancos de Dados Bibliográficos da USP (DEDALUS) e PubMed-NCBI, bem como dados epidemiológicos do DATASUS e diretrizes brasileiras, para a contextualização de hipertensão e diabetes. Foi observado que a prática de cuidados farmacêuticos impactou no índice de adesão ao tratamento em pacientes hipertensos e/ou diabéticos, proporcionando melhora clínica e na qualidade de vida gerando, ainda, um benefício socioeconômico. ɠimportante enfatizar que o cuidado farmacêutico não é praticado isoladamente de outros serviços de saúde, mas em colaboração com os pacientes e a equipe multidisciplinar em saúde; cada profissional deve atuar em seu âmbito de competência, o que resultará em benefício ao paciente e ao setor público.
TRIAGEM ANTIMICROBIANA DE EXTRATOS METANÓLICOS OBTIDOS DE PLANTAS FRUTÍFERAS SELECIONADAS DA FLORA CATARINENSE, BRASIL
Authors: Nesello Luciane Angela Nottar , Campos Adriana , Schinkel Gabriel Reis , Bella Cruz Alexandre , Cechinel Filho Valdir
Published: December 2017

Devido à crescente dificuldade de combater microrganismos resistentes a antimicrobianos, o potencial antimicrobiano de algumas plantas tem despertado o interesse de pesquisadores por serem uma alternativa natural, e pelas potencialidades consagradas. O presente estudo teve por objetivo realizar triagem do potencial antimicrobiano, contra microrganismos patogênicos aos seres humanos, de extratos de plantas frutíferas silvestres por meio da determinação da concentração inibitória mínima (CIM). As plantas foram selecionadas pela indicação de uso popular e domesticação na região do Vale do Itajaí e seus extratos metanólicos foram submetidos à análise fitoquímica por cromatografiaem camada delgada usando reveladores específicos. O extrato da polpa madura de Marlierea tomentosa apresentou excelente atividade antimicrobiana contra a bactéria Staphyllococcus aureus e o extrato das sementes de Plinia edulis mostrou boa atividade. Os extratos das sementes de Eugenia brasiliensis, galhos de M. tomentosa e sementes de Myrcianthes pungens foram considerados moderadamente ativos. Pode ser concluido que há potencial antimicrobiano em alguns extratos estudados, porém ensaios complementares se fazem necessários com diferentes linhagens bacterianas, com o intuito de assegurar e complementar os resultados apresentados, além de isolar e identificar os respectivos princípios ativos.
INDICADORES DE QUALIDADE EM INDÚSTRIA FARMACÊUTICA
Authors: Nunes Pinheiro Ana Débora
Published: December 2017

A qualidade de processos industriais farmacêuticos e como obtê-la é um tema de grande interesse na indústria farmacêutica, principalmente no que diz respeito a sua padronização. Com a normatização dos guias de boas práticas farmacêuticas e a padronização das práticas, passou a ocorrer uma maior preocupação, inclusive governamental, com o que seria qualidade e como alcançá-la. O objetivo deste trabalho foi reunir os principais guias de referência e as práticas utilizadas como indicadores de qualidade na indústria farmacêutica. Para tanto, foram selecionados 21 trabalhos obtidos por meio de pesquisa em bancos de dados disponíveis online, além de guias de referência de organizações internacionais, como Organização Mundial da Saúde (OMS), Food and Drug Administration (FDA) e International Council for Harmonization of Technical Requirements for Pharmaceuticals for Human Use (ICH). Após a organização e a leitura do material selecionado, foram descritas algumas práticas de qualidade atualmente utilizadas na indústria farmacêutica: gestão de risco, quality by design, ações corretivas e preventivas, lean manufacturing, sistema de qualidade total e séries ISO. Apesar de existir uma regulamentação bastante completa e atual acerca de indicadorese práticas de qualidade em indústria farmacêutica, as publicações não relatam informações específicas e experiências práticas da implementação desses sistemas de qualidade, dificultando assim, exemplificar melhor como essas estratégias influenciam positivamente no gerenciamento das indústrias farmacêuticas.
EVALUATION OF QUALITY ATTRIBUTES OF PROPRANOLOL SPLIT TABLETS: FOCUS ON DOSE VARIABILITY
Authors: Eserian Jaqueline Kalleian , Lombardo Márcia
Published: December 2017

Tablet splitting is a widespread practice among patients and health professionals aiming the administration of lower doses and the reduction of the cost of prescriptions. Nevertheless, potential concerns such as weight variation, stability and uneven drug content of the halves are related to this practice. The objective of this study was to evaluatethe uniformity of half-tablets regarding weight and drug content in three different commercial products containing propranolol. Also, it was assessed drug content for whole tablets. Weight variation and drug content uniformity tests were evaluated for whole and split tablets, as well as the weight loss due to the splitting process. Drug contentevaluation for whole tablets showed that all products were satisfactory. All the products were approved in the weight variation and drug content uniformity tests before splitting, with results close to 100%, but the halves of all products failed the tests, presenting a high variability between the portions. In one of the products, halves ranged from 75.5to 120.4% of the target drug content, indicating that when administered to patients, daily doses may vary around 45%. Splitting propranolol tablets might compromise clinical treatment, affecting blood pressure and consequently producing side effects. Clinical implications due to tablet splitting might not be critical in some cases. Nevertheless, the high variability between doses should be considered by healthcare  professionals when prescribing a therapy involving this practice.
Starizem v zdravstvenih ustanovah
Authors: Lešnik Amadeus , Tomažič Jožefa
Published: December 2017

Uvod: Starizem izhaja iz predsodkov in stereotipov o lastnostih, ki jih na podlagi kronološke starosti pripisujemo starostnikom. Namen raziskave je bil ugotoviti, ali starostniki v kliničnem okolju doživljajo starizem in v kolikšni meri jih le-ta prizadene. Metode: Opisna kvantitativna raziskava je bila izvedena v zdravstveni ustanovi na priložnostnem vzorcu 132 starostnikov, starih od 65 do 90 let. Uporabljen je bil na podlagi pregleda literature zasnovan vprašalnik z 11 vprašanji zaprtega tipa. Prisotnost starizma in stopnja prizadetosti je bila merjena s tristopenjsko številsko lestvico. Za opis vzorca in sistematičen prikaz odgovorov na raziskovalna vprašanja je bila uporabljena deskriptivna univariatna in bivariatna (hi-kvadrat test za neodvisne vzorce) analiza. Rezultati: Skupno je bilo zaznanih 319 diskriminatornih dogodkov. Od 132 anketiranih je najmanj en diskriminatorni dogodek doživelo 91 (69,0 %) starostnikov. Med slednjimi se je 40 (44,0 %) starostnikov počutilo vsaj enkrat prizadeto in 23 (25,2 %) vsaj enkrat zelo prizadeto. Pri zaznavanju prizadetosti statistično pomembne razlike med skupinami glede na spol (χ2 = 13,554, p = 0,825), izobrazbo (χ2 = 20,807, p = 0,409) in starost (χ2 =19,328, p = 0,501) nismo ugotovili. Diskusija in zaključek: Raziskava potrdi prisotnost starizma v kliničnem okolju. Ker ima starizem negativen vpliv na odnos do starostnika in kakovost njegove oskrbe, je profesionalno komunikacijo s starostniki treba uvesti v izobraževanje vseh profilov zdravstvenih delavcev.
Diplomske značke nekdanjih šol za medicinske sestre, otroške negovalke in babice v Sloveniji: interpretativna zgodovinska raziskava
Authors: Fischinger Janez , Fischinger Duša
Published: December 2017

Uvod: Novoizšolanim medicinskim sestram in babicam je mnogo šol po svetu podeljevalo značko za nošenje na njihovi uniformi. Značke so različno poimenovane: šolske, sestrske, babiške ali diplomske značke. Cilj zgodovinske raziskave, katere namen je ohraniti védenje o tej naši kulturni dediščini, je bil ugotoviti, katere slovenske zdravstvene šole so značke podeljevale in kakšne so le-te bile.

Metode: Pisnih virov o tej temi skoraj ni, zato je bilo opravljenih 346 intervjujev z upokojenimi in aktivnimi medicinskimi sestrami, babicami, otroškimi negovalkami ali njihovimi svojci. Značke, ki jih še hranijo, so bile dokumentirane s fotografiranjem. Zbranih je bilo tudi nekaj arhivskih fotografij, na katerih je nošenje značk na uniformah dobro vidno. Raziskava je potekala od junija 2013 do decembra 2016.

Rezultati: V Sloveniji so vse nekdanje šole za medicinske sestre, babice in otroške negovalke vsem ob uspešno zaključenem šolanju poleg listine podelile tudi značko šole. Prve značke so bile podeljene leta 1925. Po reformi srednjega šolstva (1981/82) značk niso več podeljevali. Dokumentiranih je pet značk z različnimi simbolnimi motivi in njihove številne variante zaradi preimenovanja šol. Nekaj manj kot petina (19 %) intervjuvanih svojo značko še hrani.

Diskusija in zaključek: Značke so dokaz nastanka in razvoja zdravstvenih šol in so del slovenske zgodovine zdravstvene nege. Svoje mesto bi morale najti v muzeju, morda tudi v samostojnem muzeju zdravstvene nege, v kakršnih so hranjene drugod po svetu.
Women's satisfaction with the childbirth experience: a descriptive research
Authors: Menhart Lara , Prosen Mirko
Published: December 2017

Introduction: Satisfaction is a complex concept, which we often come across when evaluating the childbirth experience. The purpose of the research was to find out the childbirth experiences of women in Slovenia with regard to their level of satisfaction with the provided perinatal care. Methods: The Slovenian version of the Birth Satisfaction Scale – Revised was used in a non-experimental quantitative descriptive research (Cronbach α = 0.81). The data were collected through an online questionnaire in February 2017. Convenience sampling was used and 301 women, who gave birth in 2016 in Slovenia, participated. Data were analysed with descriptive statistics, the Mann-Whitney U test and Spearman's correlation coefficient. Results: The results of the study have shown that the number of births (U = 6802, p = 0.150), education (U = 7493, p = 0.317), age (U = 5142, p = 0.061) and presence of birth partner (U = 2841, p = 0.730) are not statistically significantly correlated with the assessment of childbirth satisfaction. A lower level of satisfaction was also found in cases of caesarean sections of primiparous, in comparison with multiparous, women (U = 430, p = 0.001). A statistically significant difference was established in the correlation between satisfaction and respondents' residential environment (U = 7029, p = 0.039), professional communication, and level of anxiousness of birthing mothers (rs = 0.397, p = 0,000). Discussion and conclusion: The results have shown that healthcare professionals who are present in childbirth are the key factor in contributing to a positive birth experience. The obtained results open up an opportunity for further research on the communication and attitude of health professionals towards birthing mothers.
Confirming the Existence of the Kingdom: The Efforts of Territorial Consolidation and Formation of Cultural Identity During the Reign of Hamengku Buwana I, 1755 – 1792
Authors: Sutarwinarno Sutarwinarno , Supriyono Agustinus , Puguh Dhanang Respati
Published: December 2017

This article discusses the efforts of territorial Consolidation and formation of cultural identity during the reign of Hamengku Buwana I. This article is written using the historical method and utilizing primary sources in the form of VOC archives stored in the National Archives of the Republic of Indonesia and Java manuscripts stored in Yogyakarta Sultanate, as well as secondary sources in the form of articles and books. After Giyanti Agreement in 1755, Sultan Hamengku Buwana I attempted to consolidate his territory through negotiation, dispute settlement and law enforcement in order to preserve the sovereignty and territorial integrity of his kingdom. He also developed Ringgit Swargen, Yogyakarta style leather puppets that have the different shape from Surakarta style leather puppets developed by Surakarta Sunanate as one of the cultural identity of Yogyakarta Sultanate. The leather puppet show was used to control the areas that were in the territory of the Sultanate of Yogyakarta, as the leather puppet show performed outside the palace must obtain permission from the palace puppet master. The efforts of Sultan Hamengku Buwana I failed, due to the conflict that caused the war destroyed the boundaries and the peace agreement that had been made.
Rola miłości w przeżywaniu cierpienia i śmierci
Authors: Bernaciak Jerzy
Published: December 2017

Przedmiotem analizy podjętej w niniejszym artykule jest rola miłości w przeżywaniu cierpienia i śmierci. Zagadnienie to rozpatrywano z kilku perspektyw.W pierwszej kolejności uwzględniono wynikającą z prawa naturalnego potrzebę miłości oraz zdolność do przeżywania cierpienia. Z kolei, bazując na nauczaniu ojców Kościoła, przedstawiono religijny aspekt podjętego zagadnienia. Koresponduje z tym punkt widzenia zaprezentowany w nauczaniu św. Pawła Apostoła, dla którego miłość jest źródłem mocy potrzebnej do przeżywania cierpienia i śmierci. Rozważając psychologiczny aspekt analizowanego zagadnienia, posłużono się badaniami prowadzonymi nad osobami odznaczającymi się silną osobowością, które pragną przezwyciężyć swoją graniczną sytuację. Uwzględniono też zagadnienie eutanazji oraz rolę sakramentu namaszczenia chorych i wiatyku. Kolejną płaszczyzną, na której rozważano wpływ miłości na przeżywanie cierpienia i śmierci, jest mistyka. Natomiast sytuację człowieka chorego traktowanego jako członka tworzącego wspólnotę miłości we wspólnocie kościelnej rozpatrywano, uwzględniając aspekt eschatyczny. Z kolei przyjęcie perspektywy filozoficzno-antropologicznej prowokuje do zadania pytania: „Czy śmierć jest sensem życia?” W końcu rolę miłości w przeżywaniu cierpienia i śmierci rozpatrywano, uwzględniając aspekty: psychiczny, etyczny, transcendentny oraz socjologiczny. W rozważaniach o wpływie miłości na przeżywanie cierpienia i śmierci nie zabrakło aspektu socjologicznego. Problem ten omówiono, analizując sytuację osób przeżywających samotność i cierpienie.W kontekście przeżywania cierpienia i śmierci wskazano na realizację pełni człowieczeństwa i zjednoczenia ze wspólnotą, co osiąga się poprzez miłość Boga i ludzi, zwłaszcza osób cierpiących.
Odpowiedzialność za bliźnich w potrzebie w kontekście kategorii ordo caritatis (z uwzględnieniem problemu migracji)
Authors: Bartoszek Antoni
Published: December 2017

Artykuł analizuje, obecną w tradycji chrześcijańskiej od św. Augustyna, kategorię ordo caritatis. Przedstawia ją z perspektywy historycznej i podejmuje próbę wykazania jej aktualności, a także możliwości odniesienia jej do współczesnych problemów migracyjnych. W artykule zauważa się bowiem, że kategorię ordo caritatis przywoływało się zawsze wtedy, gdy trzeba było znaleźć odpowiedź na pytanie: Jak i komu pomóc w sytuacji, kiedy nie można pomóc wszystkim? Autor przekonuje, że kategoria ordo caritatis jest stale aktualna (także w duchu soborowej odnowy) i może być odnoszona do współczesnych problemów migracyjnych. Kategoria ta zabezpiecza przed kierowaniem się w procesie pomagania jedynie emocjami i przypomina o konieczności racjonalności działań i konieczności zachowania w nich logiki oraz porządku.
The typological debates around Le Jeu de la Hache (BnF MS Français 1996) and their stakes for HEMA practice
Authors: Le Coultre Anne-Caroline
Published: December 2017

Le Jeu de la Hache displays a fighting-system with the pollaxe in armour, but the weapon is never described with precision, which leads to debates regarding its typology – cutting edge or hammer/raven’s beak? Through a semi-quantitative survey, we tried to offer an overview of current HEMA practice around this specific source, with special emphasis on the typological question. Despite the rather narrow scope of the inquiry, some trends emerge. Besides the various choices regarding terminology and sources, we can underline the variety of materials used for the simulators: rubber components («hammer» typology) are leading, but wood and metal are also used, for both typologies. Advantages and disadvantages of each rely on the articulation of safety and realism dimensions, and the dangerousness inherent to this kind of weapon is largely highlighted. Even if most respondents declare not to be familiar with the typological debates amongst historians, it was usually mentioned to them during their practice. Only a minority has taken part in experiments in order to bring some elements of answer, but seldom in a systematic way. Therefore, a praxeological experimental approach could bring up new data, but is not devoid of difficulties, for instance the necessity of wearing armour.
A Mathematical Model for End-Product Toxicity
Authors: Ian Nelson Mark
Published: December 2017

Alcohol based biofuels, such as bio-butanol, have considerable potential to reduce the demand for petrochemical fuels. However, one of the main obstacles to the commercial development of biological based production processes of biofuels is end-product toxicity to the biocatalyst. We investigate the effect of end-product toxicity upon the steady-state production of a biofuel produced through the growth of microorganisms in a continuous flow bioreactor. The novelty of the model formulation is that the product is assumed to be toxic to the biomass. The increase in the per-capita decay rate due to the presence of the product is assumed to be proportional to the the concentration of the product. The steady-state solutions for the model are obtained, and their stability determined as a function of the residence time. These solutions are used to investigate how the maximum yield and the reactor productivity depend upon system parameters. Unlike systems which do not exhibit toxicity there is a value of the feed concentration which maximises the product yield. The maximum reactor productivity is shown to be a sharply decreasing function of both the feed concentration and the toxicity parameter. In conclusion, alternative reactor configurations are required to reduce the effects of highly toxic products.
Interest of systematic tomosynthesis (3D mammography) with synthetic 2D mammography in breast cancer screening
Authors: Liberatore Mathieu , Cucchi Jean-Michel , Fighiera Martine , Binet Anne , Missana Marie Christine , Brunner Philippe , Mourou Michel Yves , Iannessi Antoine
Published: December 2017

Full field digital mammography (FFDM) is the current pillar of breast cancer screening program. However, the emerging technique digital breast tomosynthesis (DBT) has demonstrated a significant increase in the sensibility of cancer detection in several large cohort trials. DBT is particularly helpful for young patients, dense breasts and soft masses due to its ability to reduce overlapping of tissue. In such a population of women, radiologists are more confident and the recall rates are reduced together with a higher positive predictive value. To reduce the breast absorbed doses of screened women and facilitate the workflow, a synthetized two-dimensional (2D) digital mammography (sDM) is obtained from DBT to replace the FFDM. No significant differences regarding detection of anomalies have been reported with respect to FFDM. These results validate a modern strategy for breast cancer screening supported by two views of DBT with sDM. In terms of mean absorbed doses, this strategy is around 1.5 mGy/view and almost equivalent to FFDM. In Europe, major limitations to such evolution are public health policies especially agreements and reimbursement for the technique being used in organized screening.