bluuebunny/crossref_metadata_2025 huggingface dataset:
Stockouts in Online Retailing
Authors: Jing Xiaoqing , Lewis Michael
Published: April 2011

Demand uncertainty and supply rigidity often create inventory shortages. Inventory shortages can have adverse consequences on both short- and long-term customer behaviors. Using data from an online grocer, this study has the following three main objectives: First, the authors empirically investigate the true nature of shortage costs by examining how stockouts and fulfillment rates affect customer's purchase behavior in both the short and long run. Second, the authors study how consumers’ reactions to inventory shortages differ across customer segments. They use these observations to illustrate how the seller might benefit from prioritizing fulfillment policies according to customer traits. Third, the authors study how the impact of inventory shortages varies across product categories. Using these insights, the authors discuss how the seller should allocate limited resources to improve order fulfillment across these categories. Overall, the authors find that stockout rates have a dramatic but nonlinear impact on the seller's profitability. This suggests that the firm can achieve many of the benefits of improving fulfillment rates through small decreases in stockout rates. They also find significant differences in how different types of customers respond to stockouts and that prioritizing inventory according to transaction history measures and basket contents can lead to large increases in contribution while only requiring moderate reductions in stockout rates.
Synthesis of recombinant high density lipoprotein with apolipoprotein A-I and apolipoprotein A-V
Authors: Zhang Xinbo , Chen Baosheng
Published: April 2011

It has been shown that apolipoprotein A-V (apoA-V) over-expression significantly lowers plasma triglyceride levels and decreases atherosclerotic lesion development. To assess the feasibility of recombinant high density lipoprotein (rHDL) reconstituted with apoA-V and apolipoprotein A-I (apoA-I) as a therapeutic agent for hyperlipidemic disorder and atherosclerosis, a series of rHDL were synthesizedin vitrowith various mass ratios of recombinant apoA-I and apoA-V. It is interesting to find that apoA-V of rHDL had no effect on lipoprotein lipase (LPL) activationin vitroand very low density lipoprotein (VLDL) clearance in HepG2 cells andin vivo. By contrast, LPL activation and VLDL clearance were inhibited by the addition of apoA-V to rHDL. Furthermore, the apoA-V of rHDL could not redistribute from rHDL to VLDL after incubation at 37°C for 30 min. These findings suggest that an increase of apoA-V in rHDL could not play a role in VLDL clearancein vitroandin vivo, which could, at least in part, attribute to the lost redistribution of apoA-V from rHDL to VLDL and LPL binding ability of apoA-V in rHDL. The therapeutic application of rHDL reconstituted with apoA-V and apoA-I might need the construction of rHDL from which apoA-V could freely redistribute to VLDL.
In vitro conversion and seeded fibrillization of posttranslationally modified prion protein
Authors: Stöhr Jan , Elfrink Kerstin , Weinmann Nicole , Wille Holger , Willbold Dieter , Birkmann Eva , Riesner Detlev
Published: April 2011

The conversion of the cellular isoform of the prion protein (PrPC) into the pathologic isoform (PrPSc) is the key event in prion diseases. To study the conversion process, anin vitrosystem based on varying the concentration of low amounts of sodium dodecyl sulfate (SDS) has been employed. In the present study, the conversion of full-length PrPCisolated from Chinese hamster ovary cells (CHO-PrPC) was examined. CHO-PrPCharbors native, posttranslational modifications, including the GPI anchor and two N-linked glyco-sylation sites. The properties of CHO-PrPCwere compared with those of full-length and N-terminally truncated recombinant PrP. As shown earlier with recombinant PrP (recPrP90-231), transition from a soluble α-helical state as known for native PrPCinto an aggregated, β-sheet-rich PrPSc-like state could be induced by dilution of SDS. The aggregated state is partially proteinase K (PK)-resistant, exhibiting a cleavage site similar to that found with PrPSc. Compared to recPrP (90-231), fibril formation with CHO-PrPCrequires lower SDS concentrations (0.0075%), and can be drastically accelerated by seeding with PrPScpurified from brain homogenates of terminally sick hamsters. Our results show that recPrP 90-231 and CHO-PrPC behave qualitatively similar but quantitatively different. Thein vivosituation can be simulated closer with CHO-PrPCbecause the specific PK cleave site could be shown and the seed-assisted fibrillization was much more efficient.
Influence of Curing Time on the Resilient Modulus of Chemically Stabilized Soils
Authors: Pinilla Juan D. , Miller Gerald A. , Cerato Amy B. , Snethen Donald S.
Published: April 2011

Research was conducted to investigate the influence of soil properties, additive type and curing time on the resilient modulus (MR) of chemically stabilized soils. Interest in characterizing the rate of MR improvement through curing time was the primary motivation for this study. Soils stabilized with cement kiln dust and Class C fly ash were collected at five construction sites in Oklahoma. Specimens were prepared at optimum compaction parameters and tested after various curing periods; a total of 58 MR tests were performed. Properties of both soils and admixtures were evaluated in order to correlate those with the enhanced behavior of the mixed soils measured as improved MR values. Regression equations were developed so that MR evolution with time could be quantitatively described. After 28 days of curing, tested soils showed improved MR values ranging from 7 to 46 times larger than those of untreated soil. Rates of improvement were characterized using a power type regression analysis. Although data are limited, correlations between improvement rate (Rt) and raw soil properties including fines fraction, pH, and to a lesser extent, specific surface area and cation exchange capacity, indicate these factors show promise as predictors of MR improvement with time.
Development of Botanical Pesticides for Public Health
Authors: Paluch Gretchen , Bradbury Rod , Bessette Steven
Published: April 2011

Pesticide science is faced with a growing demand for green or sustainable pesticide chemistries that offer reduced risks to human health and the environment. Efforts are placed on the development of new pesticides containing novel active ingredients and/or formulations from natural sources. These products continue to drive innovation and have been proven to present effective alternatives to conventional pesticides. The use of botanical extracts for management of arthropods can be traced back through centuries, and their biological properties continue to be explored in the scientific literature. Many of the terpenoid compounds contained in plant essential oil extracts are capable of eliciting strong inhibitory effects against arthropods in laboratory settings; however, effective delivery can pose many challenges in the formulation process including selection of active ingredients, emulsifiers, spreaders, and other necessary components. Recent data demonstrates that select botanical terpenes/plant essential oils can control public health pests under field and laboratory settings, but current products may not necessarily encompass the full potential of their active ingredients. Further research continues to improve on botanical formulations and offer new approaches, such as microencapsulation, for use in product development. These findings highlight improvements in the formulation of plant essential oil active ingredients, and provide support for using botanicals to control public health pests.
Versican V0 and V1 Direct the Growth of Peripheral Axons in the Developing Chick Hindlimb
Authors: Dutt Shilpee , Cassoly Estelle , Dours-Zimmermann María T. , Matasci Mattia , Stoeckli Esther T. , Zimmermann Dieter R.
Published: April 2011

Peanut agglutinin-binding disaccharides and chondroitin sulfate mark transient mesenchymal barriers to advancing motor and sensory axons innervating the hindlimbs during chick development. Here we show that the vast majority of these carbohydrates are at the critical stage and location attached to the versican splice variants V0 and V1. We reveal that the isolated isoforms of this extracellular matrix proteoglycan suppress axon extension at low concentrations and induce growth cone collapse and rapid retraction at higher levels. Moreover, we demonstrate that versican V0 and/or V1, recombinantly expressed in collagen-I gels or ectopically deposited in the hindlimbs of chicken embryosin ovo, cause untimely defasciculation and axon stalling. Consequently, severe disturbances of nerve patterning are observed in the versican-treated embryos. Our experiments emphasize the inhibitory capacity of versicans V0 and V1 in axonal growth and evidence for their function as basic guidance cues during development of the peripheral nervous system.
Brain Mechanisms Supporting the Modulation of Pain by Mindfulness Meditation
Authors: Zeidan Fadel , Martucci Katherine T. , Kraft Robert A. , Gordon Nakia S. , McHaffie John G. , Coghill Robert C.
Published: April 2011

The subjective experience of one's environment is constructed by interactions among sensory, cognitive, and affective processes. For centuries, meditation has been thought to influence such processes by enabling a nonevaluative representation of sensory events. To better understand how meditation influences the sensory experience, we used arterial spin labeling functional magnetic resonance imaging to assess the neural mechanisms by which mindfulness meditation influences pain in healthy human participants. After 4 d of mindfulness meditation training, meditating in the presence of noxious stimulation significantly reduced pain unpleasantness by 57% and pain intensity ratings by 40% when compared to rest. A two-factor repeated-measures ANOVA was used to identify interactions between meditation and pain-related brain activation. Meditation reduced pain-related activation of the contralateral primary somatosensory cortex. Multiple regression analysis was used to identify brain regions associated with individual differences in the magnitude of meditation-related pain reductions. Meditation-induced reductions in pain intensity ratings were associated with increased activity in the anterior cingulate cortex and anterior insula, areas involved in the cognitive regulation of nociceptive processing. Reductions in pain unpleasantness ratings were associated with orbitofrontal cortex activation, an area implicated in reframing the contextual evaluation of sensory events. Moreover, reductions in pain unpleasantness also were associated with thalamic deactivation, which may reflect a limbic gating mechanism involved in modifying interactions between afferent input and executive-order brain areas. Together, these data indicate that meditation engages multiple brain mechanisms that alter the construction of the subjectively available pain experience from afferent information.
Inhibition of PKMζ in Nucleus Accumbens Core Abolishes Long-Term Drug Reward Memory
Authors: Li Yan-qin , Xue Yan-xue , He Ying-ying , Li Fang-qiong , Xue Li-fen , Xu Chun-mei , Sacktor Todd Charlton , Shaham Yavin , Lu Lin
Published: April 2011

During abstinence, memories of drug-associated cues persist for many months, and exposure to these cues often provokes relapse to drug use. The mechanisms underlying the maintenance of these memories are unknown. A constitutively active atypical protein kinase C (PKC) isozyme, protein kinase M ζ (PKMζ), is required for maintenance of spatial memory, conditioned taste aversion, and other memory forms. We used conditioned place preference (CPP) and conditioned place aversion (CPA) procedures to study the role of nucleus accumbens PKMζ in the maintenance of drug reward and aversion memories in rats. Morphine CPP training (10 mg/kg, 4 pairings) increased PKMζ levels in accumbens core but not shell. Injections of the PKMζ inhibitor ζ inhibitory peptide (ZIP) into accumbens core but not shell after CPP training blocked morphine CPP expression for up to 14 d after injections. This effect was mimicked by the PKC inhibitor chelerythrine, which inhibits PKMζ, but not by the conventional and novel PKC inhibitor staurosporine, which does not effectively inhibit PKMζ. ZIP injections into accumbens core after training also blocked the expression of cocaine (10 mg/kg) and high-fat food CPP but had no effect on CPA induced by naloxone-precipitated morphine withdrawal. Accumbens core injections of Tat-GluR23Y, which inhibits GluR2-dependent AMPA receptor endocytosis, prevented the impairment in morphine CPP induced by local ZIP injections, indicating that the persistent effect of PKMζ is on GluR2-containing AMPA receptors. Results indicate that PKMζ activity in accumbens core is a critical cellular substrate for the maintenance of memories of relapse-provoking reward cues during prolonged abstinence periods.
Hydration State Controls Stress Responsiveness and Social Behavior
Authors: Krause Eric G. , de Kloet Annette D. , Flak Jonathan N. , Smeltzer Michael D. , Solomon Matia B. , Evanson Nathan K. , Woods Stephen C. , Sakai Randall R. , Herman James P.
Published: April 2011

Life stress frequently occurs within the context of homeostatic challenge, requiring integration of physiological and psychological need into appropriate hormonal, cardiovascular, and behavioral responses. To test neural mechanisms underlying stress integration within the context of homeostatic adversity, we evaluated the impact of a pronounced physiological (hypernatremia) challenge on hypothalamic-pituitary-adrenal (HPA), cardiovascular, and behavioral responses to an acute psychogenic stress. Relative to normonatremic controls, rats rendered mildly hypernatremic had decreased HPA activation in response to physical restraint, a commonly used rodent model of psychogenic stress. In addition, acute hypernatremia attenuated the cardiovascular response to restraint and promoted faster recovery to prestress levels. Subsequent to restraint, hypernatremic rats had significantly more c-Fos expression in oxytocin- and vasopressin-containing neurons within the supraoptic and paraventricular nuclei of the hypothalamus. Hypernatremia also completely eliminated the increased plasma renin activity that accompanied restraint in controls, but greatly elevated circulating levels of oxytocin. The endocrine and cardiovascular profile of hypernatremic rats was predictive of decreased anxiety-like behavior in the social interaction test. Collectively, the results indicate that acute hypernatremia is a potent inhibitor of the HPA, cardiovascular, and behavioral limbs of the stress response. The implications are that the compensatory responses that promote renal-sodium excretion when faced with hypernatremia also act on the nervous system to decrease reactivity to psychogenic stressors and facilitate social behavior, which may suppress the anxiety associated with approaching a communal water source and support the social interactions that may be encountered when engaging in drinking behavior.
The Cost and Benefit of Juvenile Training on Adult Perceptual Skill
Authors: Sarro Emma C. , Sanes Dan H.
Published: April 2011

Sensory experience during development can modify the CNS and alter adult perceptual skills. While this principle draws support from deprivation or chronic stimulus exposure studies, the effect of training is addressed only in adults. Here, we asked whether a brief period of training during development can exert a unique impact on adult perceptual skills. Juvenile gerbils were trained to detect amplitude modulation (AM), a stimulus feature elemental to animal communication sounds. When the performance of these juvenile-trained animals was subsequently assessed in adulthood, it was superior to a control group that received an identical regimen of training as adults. The juvenile-trained animals displayed significantly better AM detection thresholds. This was not observed in an adult group that received only exposure to AM stimuli as juveniles. To determine whether enhanced adult performance was due solely to learning the conditioned avoidance procedure, juveniles were trained on frequency modulation (FM) detection, and subsequently assessed on AM detection as adults. These animals displayed significantly poorer AM detection thresholds than all other groups. Thus, training on a specific auditory task (AM detection) during development provided a benefit to performance on that task in adulthood, whereas an identical training regimen in adulthood did not bring about this enhancement. In contrast, there was a cost, in adulthood, following developmental training on a different task (FM detection). Together, the results demonstrate a period of heightened sensitivity in the developing CNS such that behavioral training in juveniles has a unique impact on adult behavioral capabilities.
The Basis for Diminished Functional Recovery after Delayed Peripheral Nerve Repair
Authors: Gordon Tessa , Tyreman Neil , Raji Mukaila A.
Published: April 2011

The postsurgical period during which neurons remain without target connections (chronic axotomy) and distal nerve stumps and target muscles are denervated (chronic denervation) deleteriously affects functional recovery. An autologous nerve graft and cross-suture paradigm in Sprague Dawley rats was used to systematically and independently control time of motoneuron axotomy, denervation of distal nerve sheaths, and muscle denervation to determine relative contributions of each factor to recovery failure. Tibial (TIB) nerve was cross-sutured to common peroneal (CP) nerve via a contralateral 15 mm nerve autograft to reinnervate the tibialis anterior (TA) muscle immediately or after prolonging TIB axotomy, CP autograft denervation, or TA muscle denervation. Numbers of motoneurons that reinnervated TA muscle declined exponentially from 99±15 to asymptotic mean (±SE) values of 35 ± 1, 41 ± 10, and 13 ± 5, respectively. Enlarged reinnervated motor units fully compensated for reduced motoneuron numbers after prolonged axotomy and autograft denervation, but the maximal threefold enlargement did not compensate for the severe loss of regenerating nerves through chronically denervated nerve stumps and for failure of reinnervated muscle fibers to recover from denervation atrophy. Muscle force, weight, and cross-sectional area declined. Our results demonstrate that chronic denervation of the distal stump plays a key role in reduced nerve regeneration, but the denervated muscle is also a contributing factor. That chronic Schwann cell denervation within the nerve autograft reduced regeneration less than after the denervation of both CP nerve stump and TA muscle, argues that chronic muscle denervation negatively impacts nerve regeneration.
Signals in Human Striatum Are Appropriate for Policy Update Rather than Value Prediction
Authors: Li Jian , Daw Nathaniel D.
Published: April 2011

Influential reinforcement learning theories propose that prediction error signals in the brain's nigrostriatal system guide learning for trial-and-error decision-making. However, since different decision variables can be learned from quantitatively similar error signals, a critical question is: what is the content of decision representations trained by the error signals? We used fMRI to monitor neural activity in a two-armed bandit counterfactual decision task that provided human subjects with information about forgone and obtained monetary outcomes so as to dissociate teaching signals that update expected values for each action, versus signals that train relative preferences between actions (a policy). The reward probabilities of both choices varied independently from each other. This specific design allowed us to test whether subjects' choice behavior was guided by policy-based methods, which directly map states to advantageous actions, or value-based methods such as Q-learning, where choice policies are instead generated by learning an intermediate representation (reward expectancy). Behaviorally, we found human participants' choices were significantly influenced by obtained as well as forgone rewards from the previous trial. We also found subjects' blood oxygen level-dependent responses in striatum were modulated in opposite directions by the experienced and forgone rewards but not by reward expectancy. This neural pattern, as well as subjects' choice behavior, is consistent with a teaching signal for developing habits or relative action preferences, rather than prediction errors for updating separate action values.
The Interaction of the Dipeptide Carnosine With Alkali Metal Ions Studied by Ion Trap Mass Spectrometry
Authors: Menges Fabian , Riehn Christoph , Niedner-Schatteburg Gereon
Published: April 2011

The complexation of alkali metal ions and the proton X+ (X=H, Li, Na, K, Rb, Cs) by β-alanyl-L-histidine (carnosine, Car) was investigated by electrospray ionization mass spectrometry (ESI-MS) and MS/MS fragmentation studies. Collision-induced dissociation (CID) breakdown curves were recorded and the resulting apparent activation energies were compared to DFT calculations of binding energies at the B3LYP/cc-pVDZ level of theory. Additionally, the influence of metal complexation on hydrogen/deuterium exchange of CarX+ with D2O was tested. Our investigations characterize the structures of Car-alkali complexes and elucidate the interaction with the differently sized solvated metal cations.
Phase Behaviour of CoCl2-MnCl2Mixed Crystals
Authors: Davaasambuu Jav , Güthoff Friedrich , Hoelzel Markus , Senyshyn Anatoliy , Radulescu Aurel , Eckold Götz
Published: April 2011

Thermal properties of CoCl2, MnCl2and their mixed crystals are investigated by means of temperature dependent neutron powder diffraction and time-resolved small angle neutron scattering. The coefficients of thermal expansion of these crystals have been determined as a function of temperature. The temperature-induced structural variations can be explained by distortions of CoCl6/MnCl6octahedra and changes in Co/Mn–Cl bond lengths. CoCl2and MnCl2form homogeneous solid solutions in the entire temperature range between the solidus and 50 K. There is no indication of any miscibility gap as predicted from thermodynamic calculations.
Rosuvastatin induces apoptosis in cultured human papillary thyroid cancer cells
Authors: Zeybek N Dilara , Gulcelik Nese Ersoz , Kaymaz F Figen , Sarisozen Can , Vural Imran , Bodur Ebru , Canpinar Hande , Usman Aydan , Asan Esin
Published: April 2011

Statins show antiproliferative activity in various cancer cells. The aim of this study was to evaluate the effects of rosuvastatin treatment on papillary thyroid carcinoma. The papillary thyroid carcinoma (B-CPAP) and normal (Nthy-ori 3-1) thyroid cell lines were treated with rosuvastatin at 12.5, 18.5, 25, 50, 100, and 200 μM concentrations. After 48 and 72 h of rosuvastatin treatment, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide, Ki-67 immunolabeling, FACS analysis, electron microscopy, caspase-3, and terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) analysis were performed. Decreased cell viability and G1 phase arrest were detected in papillary thyroid cell line treated with rosuvastatin. Positive immunoreactivity of Ki-67 and dose-dependent increase in S phase on Nthy-ori 3-1 cells were also detected. B-CPAP cells showed intense vacuolisation and autophagosomes with low concentrations and 48 h incubations, while Nthy-ori 3-1 cells showed these changes at higher concentrations. A decrease in the percentage of cells showing autophagy was determined with increasing concentrations of rosuvastatin in B-CPAP cells. Rosuvastatin treatment also caused a dose- and time-dependent increase in caspase-3 activity and apoptotic index by TUNEL assay in B-CPAP cells compared with the Nthy-ori 3-1 cells. Apoptotic cells with nuclear condensation and fragmentation were observed in B-CPAP cell line. Rosuvastatin induced autophagic changes in B-CPAP papillary thyroid cancer cells in lower doses and caused a shift from autophagy to apoptosis. Rosuvastatin may be an alternative treatment for refractory papillary thyroid cancer. Further in vivo studies are necessary to clarify the effects of rosuvastatin in papillary thyroid carcinoma and the clinical implications of rosuvastatin treatment.
Patient Involvement in Problem Presentation and Diagnosis Delivery in Primary Care
Authors: Ijäs-Kallio Taru , Ruusuvuori Johanna , Peräkylä Anssi
Published: April 2011

This article examines how physicians orient to their patients’ problem presentations both in receiving it and in the diagnostic phase in primary care encounters. Four types of patients’ problem presentation are discussed: 1) symptoms only, 2) candidate diagnosis 3) diagnosis implicative symptom description and 4) candidate diagnosis as background information. Both in receiving the problem and in diagnosis delivery, doctors address the patients’ problem presentations in cases where the presentation involved or implied a candidate diagnosis, whereas with ‘symptoms only’ –type of problem presentation such references predominantly are not made. In terms of patient participation, the study suggests that a patient's problem presentation has a crucial role in shaping the doctors’ communication patterns also in the phases of consultation in which the patient's active participation is of lesser role, such as the diagnostic phase. The data used in this study consist of 86 Finnish primary care visits with adult and child patients suffering from an upper respiratory tract infection. The method of the study is conversation analysis.
Collaborative Work and Medical Talk: Opportunities for Learning Through Knowledge Sharing
Authors: Nilsen Line Lundvoll , Ludvigsen Sten R.
Published: April 2011

Teleconsultations provide new opportunities for learning in medical settings. This study explores the conditions under which learning can take place. The empirical context is 47 real-time videoconferences carried out to examine collaborative work and the medical talk involved. Sixteen of the observations were consultations wherein general practitioners (GPs) and specialists shared knowledge with the purpose of solving a medical problem related to a patient under treatment. Eight interviews were done face-to-face with a focus on the content in talk, with the purpose of examining our findings from the observations. The learning opportunities could be seen as what medical practitioners achieve through interaction and working with patients over periods of time. The analysis of medical talk in consultations shows that collaborative work among GPs and specialists creates a shared understanding of the patient's clinical history and treatment regiments. As knowledge is demanded and attributed, consultations create a work tool that expands the medical work and talk. Collaborative work in and between levels of health care service expands knowledge, creates opportunities for learning in everyday settings, and improves the quality of knowledge in the health care system.
Systems with the integer rounding property in normal monomial subrings
Authors: Dupont Luis A. , Rentería-Márquez Carlos , Villarreal Rafael H.
Published: April 2011

Let C be a clutter and let A be its incidence matrix. If the linear system x > 0; x A < 1 has the integer rounding property, we give a description of the canonical module and the a-invariant of certain normal subrings associated to C. If the clutter is a connected graph, we describe when the aforementioned linear system has the integer rounding property in combinatorial and algebraic terms using graph theory and the theory of Rees algebras. As a consequence we show that the extended Rees algebra of the edge ideal of a bipartite graph is Gorenstein if and only if the graph is unmixed.
Educação em diabetes: papel e resultados das colônias de férias
Authors: Vivolo Marco Antonio , Oliveira Odete de , Ferreira Sandra R. G.
Published: April 2011

É essencial atuar na atenção ao indivíduo diabético, visando sua qualidade de vida e a longevidade. O sucesso desta meta depende da educação em diabetes (DM). Características regionais e disponibilidade de recursos fizeram com que centros de atenção ao DM criassem programas específicos de educação. Mostramos a experiência de educação de jovens com DM1 através de Colônias de Férias (CF) da UNIFESP-ADJ, mediante o convívio com equipe multiprofissional de saúde, que tem a oportunidade de adquirir experiência no manejo do DM. Um total de 790 jovens já participaram das 18 CF realizadas. Oferece-se 9 dias de lazer programado, com dieta adequada e exercícios nos 3 períodos do dia. Glicemia capilar é feita sobre a qual se baseiam ajustes nas doses de insulina. Questionário de avaliação de conhecimentos é aplicado no primeiro e último dias e ocorrem seminários abordando temas diversos. Reuniões da equipe visam discutir casos e condutas. São obtidas medidas antropométricas, pressão arterial e amostras de sangue e urina e relatórios fornecidos ao final. Para o jovem as CF representam oportunidade de conscientizar-se da possibilidade de uma vida normal. A melhora dos conhecimentos teóricos é comprovada pela comparação da pontuação obtida nos questionários. Observam os benefícios da alimentação adequada associada ao exercício e assimilam a importância do bom controle na prevenção de complicações crônicas. Vivenciam hipoglicemias, mas aprendem a programar suas doses segundo o exercício a ser realizado, identificar seus sintomas e tratá-la. Melhoram os níveis pressóricos, o controle glicêmico e o perfil lipídico. A equipe multiprofissional recebe subsídios para atuar com mais eficácia na educação do jovem e melhorar o relacionamento médico-paciente. As CF permitem reconhecer a complexidade do tratamento do DM e a necessidade de trabalho integrado com o paciente e sua família para a obtenção de bom controle metabólico. Assumindo-se que o controle metabólico é importante para a prevenção das complicações crônicas do DM, também a longo prazo benefícios da educação nas CF devem ser detectados. O modelo proposto de educação em DM através de CF se mostrou viável e eficaz, contribuindo para melhora da qualidade de vida do jovem diabético e formação de profissionais nesta área. Concluímos que esta proposta, já compartilhada por outros centros no Brasil, deva ser amplamente divulgada.
Paraganglioma funcionante do pescoço
Authors: Pimenta Tania A. , Victoria Ivana M.N. , Bambirra Eduardo A. , Villela José R. , Darwich Rogério Z. , Souza Atos A. , Purisch Saulo , Pardini Victor C.
Published: April 2011

Paragangliomas funcionantes são tumores raros, produtores de catecolaminas que se originam da crista neural. Apresentamos o caso de um paciente de 11 anos com quadro de hipertensão arterial grave e massa em região cervical direita. Apresentou aumento das catecolaminas e metabólitos urinários: epinefrina, 97,8 mg/24hs (Valor de Referência (VR)= 0,5 a 20); norepinefrina, 184,8 mg/24hs (VR= 15 a 80); dopamina, 513,5 mg/24hs (VR= 65 a 400); metanefrina, 0,08 mg/g de creatinina (VR< 0,31); normetanefrina, 0,64 mg/g de creatinina (VR< 0,43); ácido vanilmandélico, 69,3 mmol/24hs (VR= 10 a 35). A cintilografia com meta-iodo-benzil-guanidina (MIBG) mostrou a presença de massa hiperfixante em região cervical direita, a qual foi confirmada pela ressonância magnética (RM), que mostrou também uma lesão contra-lateral, que entretanto, não apresentou captação pelo MIBG. Foi realizada a exérese da lesão cervical direita, evoluindo com normalização dos níveis da pressão arterial, catecolaminas e metabólitos urinários. A imuno-histoquímica identificou grânulos de secreção para enolase neuroespecífica, neurofilamentos, cromogranina, somatostatina e serotonina, que confirmaram o diagnóstico de paraganglioma funcionante, e identificou a presença de anti-proteína S100, que é um preditor de bom prognóstico. O paciente será acompanhado com exames clínicos e laboratoriais periódicos, devido à lesão contra-lateral e para se detectar uma eventual recidiva do tumor à direita. Apesar da presença de fatores de bom prognóstico, estes tumores são considerados potencialmente malignos.
Long-term response to sulfonylurea in a patient with diabetes due to mutation in the KCNJ11 gene
Authors: Vendramini Marcio F. , Gurgel Lucimary C. , Moisés Regina S.
Published: April 2011

OBJECTIVE: To report the long-term (30-month) effect of the switch from insulin to sulfonylurea in a patient carrying the p.G53D (c.158G>A) mutation in KCNJ11 gene. SUBJECT AND METHOD: A 29-year-old male patient was diagnosed with diabetes in the third month of life and after identification of a heterozygous p.G53D mutation in the KCNJ11 gene, the therapy was switched from insulin to sulfonylurea. RESULTS: Long-term follow-up (30 months) showed that good metabolic control was maintained (HbA1c: 6.6%) and the glibenclamide dose could be reduced. CONCLUSION: Long-term therapy with sulfonylureas in patients with neonatal diabetes due to mutation in the KCNJ11 gene is safe and promotes sustained improvement of glycemic control.
Controle hormonal dos adenomas hipofisários pela cirurgia transesfenoidal: evolução dos resultados nos primeiros cinco anos de experiência
Authors: Barbosa Erika Ribeiro , Zymberg Samuel Tau , Santos Rodrigo de Paula , Machado Helio Rubens , Abucham Julio
Published: April 2011

OBJETIVO: Avaliar os resultados iniciais de uma equipe cirúrgica no controle hormonal dos adenomas hipofisários secretores. MATERIAIS E MÉTODOS: Em cinco anos, foram operados 51 adenomas secretores (31 GH, 14 ACTH, 5 prolactina, 1 TSH). O controle hormonal foi GH basal < 2,5 ng/dL, cortisol livre urinário normal, redução dos níveis de prolactina, e T3 e T4 livre normais. RESULTADOS: As taxas de controle foram 36% na acromegalia e 57% no Cushing. Dois prolactinomas (40%) normalizaram a prolactina. Os hormônios tiroidianos normalizaram no adenoma secretor de TSH. O controle do hipercortisolismo correlacionou-se com o tempo de experiência da equipe (p = 0,01). CONCLUSÃO: Nossos resultados, limitados aos primeiros anos de experiência cirúrgica, situam-se abaixo da variação reportada em grandes casuísticas com maior tempo de experiência. Ao longo do tempo, observou-se melhora progressiva nos níveis de cortisol urinário no pós-operatório inicial da doença de Cushing em função da experiência cirúrgica.
Coordination of respiration and swallowing: functional pattern and relevance of vocal folds closure
Authors: Costa Milton Melciades Barbosa , Lemme Eponina Maria de Oliveira
Published: April 2011

CONTEXT: Breathing and swallowing coordination, despite the expressive number of study, remain as theme deserving further research. OBJECTIVE: To identify a coordination pattern between swallowing and the natural breathing pause that occur in association with it (swallowing apnea) and also the relevance of the vocal folds closure in this process. METHODS: Sixty-six adults, male and female, including normal health people, post-laryngectomy individuals and patients with digestive complaints without dysphagia were analyzed. The respiratory air flux interruptions produced by wet requested swallows and dry, requested and spontaneous swallows, were registered using thermo and piezoelectric receptors coupled to synectics medical manometry equipment, using Polygram upper 4.21 software. The results were analyzed with the Chi-square (3×2) and (2×2) nonparametric independency test with P = 0.05. RESULTS: Swallowing apnea is a preventive breathing stop that start just before and stay present during all deglutition pharyngeal phase. It is a well coordinated phenomena that occur as pattern in association with low elastic resistance of the lung, on the expiratory final phase until inspiration initial phase. This breathing stoppage it is usually followed by a short expiraton preceding a new breathing cycle. The swallow apnea and vocal folds closure are both independents mechanisms. CONCLUSION: It is possible to suppose that in the subconscious condition, swallowing apnea is integrated under coordination of the same control mechanism that also involves the elastic resistance of the lung.
Serological screening for celiac disease in symptomatic 12 to 36 month-old children
Authors: Modelli Inês Cristina , Gandolfi Lenora , Almeida Rodrigo Coutinho de , Araújo Gloria Maria A. C , Picanço Marilúcia de Almeida , Pratesi Riccardo
Published: April 2011

CONTEXT: The correct diagnosis of celiac disease in environmentally deprived children is frequently hindered by the common presence of other causes for the classical celiac disease symptoms: malnutrition, failure to thrive and frequent diarrheas. OBJECTIVES: To determine the prevalence of celiac disease in a group of 12 to 36 month-old children using immunoglobulin antibodies against gliadin (IgG and IgA-AGA), against endomysium (IgA-EMA), and against human tissue transglutaminase (IgA-tTG) as screening method. METHODS: A total of 214 children (114 boys), aged 12 to 36 months, on gluten-containing diet, were admitted to the study. IgG and IgA-AGA, IgA-tTG and IgA-EMA tests were performed in all sera. Biopsy was obtained from all children showing positive result in one or more of the serologic tests, excluding those in which IgG-AGA had been the only positive result. In those cases, polymerase chain reaction (PCR) HLA genotyping for the identification of celiac disease predisposing alleles was applied. HLA genotyping was also performed to confirm the diagnosis in children identified as celiac by means of positive serologic testing and compatible biopsy results. RESULTS: Normal results were obtained in 131 children. Ten children out of 68 identified as positive exclusively on the IgG-AGA test disclosed the presence of celiac disease predisposing alleles on PCR and underwent jejunal biopsy with normal results. All serologic tests were positive in four children. A fifth child showed positive IgG and IgA-AGA and IgA-tTG results but disclosed a negative IgA-EMA test. Jejunal biopsy of these five children revealed characteristic lesions of celiac disease. CONCLUSION: A prevalence of 2.3% was found among symptomatic 12- to 36-month-old children that had not been previously diagnosed as celiac.
Experimental induction of steatosis in different tissues after the ingestion of a carbohydrate-rich diet: effect on the liver, on the heart and on indicators of oxidation
Authors: Haubert Nadia Juliana Beraldo Goulart Borges , Padovan Gilberto João , Zucoloto Sérgio , Vannucchi Hélio , Marchini Julio Sergio
Published: April 2011

CONTEXT: The western dietary pattern is characterized by a high calorie intake with a high proportion of simple sugars. This diet is associated with comorbidities such as hepatic fat deposition and is possibly related to non-alcoholic fatty liver disease. OBJECTIVE: To evaluate the capacity of a hyperglucidic diet to induce steatosis in adult male Wistar rats. After the administration of a carbohydrate-rich diet, we also evaluated the presence of hepatic and cardiac steatosis and the levels of intrinsic antioxidants in the liver. METHODS: Forty-six eutrophic adult male Wistar rats were used and 10 of them were chosen, at random, to serve as controls, while the remaining ones formed the experimental group. Control animals received the standard ration offered by the animal house and the experimental group received the hyperglucidic diet. The diets were offered for 21 days and, at the end of this period, tissue samples were collected for analysis of indicators of oxidative stress (malondialdehyde, and reduced glutathione) and of vitamin E. The animals were then sacrificed by decapitation and their viscera were removed for analysis of liver and heart fat. RESULTS: The hyperglucidic diet used induced hepatic fat deposition, with lipid vacuoles being detected in 83% of the livers analyzed by histology. No lipid vacuoles were observed in the heart. Malondialdehyde and reduced glutathione levels remained unchanged when the animals were submitted to the hyperglucidic diet, probably because there was no liver development of fibrosis or inflammation. In contrast, the levels of vitamin E (antioxidant) were reduced, as confirmed in the literature for steatotic animals. CONCLUSION: The hyperglucidic diet induced hepatic steatosis. In the heart there was an increase in fat content, although no histological changes were observed. These alterations cannot be explained by the presence of malondialdehyde or reduced glutathione (indicators of oxidation), since the values were similar in the groups studied. However, a significant reduction of vitamin E was observed in the experimental group.
Infarto cerebral e edema avaliação prognóstico-evolutiva por sinais neurológicos
Authors: Gagliardi Rubens José , Guedes Marilda Lauretti da Silva , Covo Pedro
Published: April 2011

Trata-se de estudo prospectivo abrangendo 92 doentes com infarto cerebral (IC). O seguimento foi feito durante 10 dias com avaliação diária, sendo os doentes analisados por escala de notas para diferentes sinais costumeiramente pesquisados nesses casos. A metodologia foi especialmente desenvolvida no sentido de analisar exclusivamente alterações devidas ao edema oriundo da isquemia e IC. As conclusões foram obtidas por comparação isolada das médias das notas de cada sinal com a média do total das notas. Os resultados mostram que o exame da «consciência», isoladamente, é o melhor parâmetro clínico para averiguar a evolução do doente após um IC, sem outras complicações que não o edema.
Cognitive functions of epileptic patients on monotherapy with phenobarbitone and healthy controls
Authors: Bigarella Mônica M. , Mäder Maria J. , Doro Maribel P. , Gorz Ana M. , Marcourakis Tânia , Tsanaclis Lolita , Bittencourt Paulo R. M.
Published: April 2011

Quantitative measurements have indicated that heredity, cerebral damage, psycho-social aspects, ictal and inter-ictal phenomena and antiepileptic drugs may interfere in the cognitive dysfunction of epileptic patients. In the present study objective methods included immediate and late recall and recognition of pictures, Stroop test and auditory selection. Twenty patients with symptomatic localized epilepsy aged 17-52 years (27±10, mean ±sd) were compared to age and socially matched healthy controls. Patients were on therapeutic serum concentrations (25±12 m/mi) of phenobarbitone and had active epilepsy with 1.94 generalized tonic-clonic, 0.85 simple partial and 6.28 complex partial seizures monthly (means). Patients performed worse than controls in all 6 tests (p<0.05 to p<0.001), indicating a generalized cognitive deficit related to seizures and/or barbiturate therapy. We suggest further studies should be carried out in populations with uniform monotherapeutic regimens and epileptic syndromes in order to isolate factors related to the cognitive dysfunction of epileptic patients.
Aderência em epilepsias II: aspectos práticos
Authors: Alonso Neide Barreira , Silva Délrio Façanha da , Pereira Sandra Daisy , Campos Carlos J. Reis de
Published: April 2011

Análise de 84 pacientes em relação à aderência ao tratamento. O método empregado para a avaliação da aderência constou de duas entrevistas com cada paciente, uma realizada pelo médico e outra pela enfermeira. Em nossos resultados detectamos maior número de pacientes epilépticos não-aderentes na entrevista realizada pela enfermeira (72,6%) em relação àquela conduzida pelo médico (23,3%). O esquecimento foi a principal barreira à aderência (50%). A duração do tratamento e a mudança de serviços médicos influenciaram negativamente na aderência. Por este estudo verificamos a importância de análise dos fatores que possam interferir na aderência e a utilidade da entrevista minuciosa para o diagnostico da não-aderência.
Epilepsia rolândica relato de 53 casos
Authors: kowacs Pedro André , Muszkat Mauro , Albuquerque Marly de , Campos Carlos J. Reis de
Published: April 2011

Descrição das características clínicas e do EEG de 53 pacientes de ambulatório atendidos no Setor de Investigação e Tratamento das Epilepsias da Escola Paulista de Medicina com diagnóstico de epilepsia rolândica. A média de idade (em anos) de início da epilepsia foi 5,5±3,2. As crises parciais simples motoras foram as mais frequentemente encontradas. Sete pacientes apresentaram déficit cognitivo. Observamos correlação clínico-EEG e manifestação clínica contralateral, nos focos localizados no hemisfério cerebral esquerdo; nos focos à direita, a manifestação clínica foi ipsilateral ao foco.
Mensuração do deslocamento da dura-máter na punção suboccipital mediana
Authors: Rossitti Sandro L. , Thomaz Igor R. , Balbo Roque J.
Published: April 2011

Estudo da anatomia dinâmica da punção suboccipital mediana da cisterna magna em cadáveres frescos. O deslocamento («tenda») da dura-máter foi observado em todas as punções (n = 30), medindo 3,12 (2,0-4,2) mm.
Correlatos bioquímicos da depressão em crianças
Authors: Queiroz E.A. , Lombardi A. B. , Furtado C.R.H. Santos , Peixoto C. C. D. , Soares T. A. , Fabre Z. L. , Basques J. C. , Fernandes M. L. M. , Lippi J. R. S.
Published: April 2011

O grau de depressão em 88 crianças abandonadas foi analisado por escala de avaliação de depressão adaptada para crianças na pré-puberdade. Os itens da escala foram agrupados em três dimensões: sociológico-relacional, psicológica e biológica. Em 46 crianças desta amostra foram dosados o Cortisol plasmático e a excreção urinária de. catecolamina, VMA, HVA e 5-HIAA. Pela análise dos principais componentes, mostraram-se mais importantes, na amostra, as dimensões sociológica e psicológica, seguidas dos componentes idade e catecolamina. O grupo de crianças do sexo masculino com depressão apresentava maior nível de excreção urinária de catecolamina e menor pico de Cortisol plasmático que o grupo sem depressão. A variável idade, em ambos os sexos, correlacionava-se à variável catecolamina. Alterações bioquímicas estão presentes em crianças com depressão, mas é difícil demonstrar correlação de dependência entre elas e aspectos fenomenológicos da depressão.
O papel da academia brasileira de neurologia no ensino da neurologia uma visão pessoal
Authors: Lana-Peixoto Marco Aurélio
Published: April 2011

A Academia Brasileira de Neurologia (ABN) tem demonstrado crescente interesse pelo ensino da neurologia, tanto na graduação quanto na residência médica. Ela deve definir o padrão da prática da neurologia no país, traçar o perfil de competência mínima do neurologista, determinar a competência mínima em neurologia do médico não-neurologista, desenvolver suas próprias atividades de ensino, e definir e propiciar o desenvolvimento das qualidades humanísticas desejáveis no neurologista. A ABN deve formular um currículo mínimo de neurologia na graduação e na residência médica e esforçar por sua adoção pelas escolas médicas e pelos Programas de Residência. Além disso, a ABN deve, por si própria, tornar-se agente efetora do ensino através: de um Programa de Educação Continuada, promovendo cursos e simpósios; da elaboração de um sistema de ensino programado em neurologia, via postal; da implantação de videoteca e de banco de dados da literatura. A Comissão de Ensino deve desempenhar papel fundamental em todas as atividades de ensino promovida pela ABN, definindo sua política, estabelecendo prioridades e coordenando as ações de ensino dos Grupos de Trabalho e Pesquisa.
HTLV-I associated myelopathy in salvador (northeastern Brazil)
Authors: Meireles A. , Moreira Jr. E. D. , Moreno-Carvalho O. A. , Badaro R. , Melo A.
Published: April 2011

Recent studies of tropical spastic paraparesis have confirmed the existence of human T-cell leukemia virus type-1 (HTLVI) in several tropical areas of the world. In order to determine the role of HTLVI as an etiologic agent of myelopathies in Salvador, we conducted a clinical and serological study in 43 patients with non-traumatic and non-tumoral myelopathies. We found 9 patients with HTLVI associated myelopathy (HAM) which points to a new endemic area of HAM.