Correlation between maxillofacial radiographic features and systemic severity as sickle cell disease severity predictor

This study was conducted to investigate the relationship among radiographic features observed on panoramic radiographs of sickle cell disease patients and analyze their relationship with history of systemic severity of the disease. Panoramic radiographs of 71 subjects with sickle cell disease were evaluated for the presence of the following radiographic bony alterations: radiopaque areas, increased spacing of bony trabeculae, horizontal arrangement of bony trabeculae and corticalization of mandibular canal. History of clinical systemic severity was assessed through direct questioning about the frequency of vaso-occlusive crisis, history of stroke, clinical jaundice, femur head necrosis, and leg ulceration. Chi-square or Fisher's exact test were applied in order to analyze possible associations between radiographic features and history of complications, with < 0.05 significance level. Increased spacing of bony trabeculae was statistically associated with absence of corticalization of mandibular canal ( < 0.01) and horizontal arrangement of bony trabeculae ( = 0.04). Statistically significant associations were demonstrated between history of clinical jaundice and presence of increased spacing of bony trabeculae ( = 0.02) and between history of stroke and presence of horizontal arrangement of bony trabeculae ( = 0.04). Based on the results of the current study, maxillofacial radiographic features may be associated with clinical parameters of systemic complications in sickle cell disease patients. The relationship between radiographic features and history of complications associated with clinical severity of sickle cell disease has not been demonstrated in the literature. Acknowledgment of such possible association may help establish prognosis and influence clinical treatment of systemic and oral complications.

Comparative electrical behavior at low and high current of SnO(2)- and ZnO-based varistors

The complete I-V characteristics of SnO(2)-based varistors, particularly of the Pianaro system SCNCr consisting in 98.9%SnO(2)+1%CoO+0.05%Nb(2)O(5)+0.05%Cr(2)O(3), all in mol%, have been seldom reported in the literature. A comparative study at low and high currents of the nonohmic behavior of SCNCr- and ZnO-based varistors (modified Matsuoka system) is proposed in this work. The SCNCr system showed higher nonlinearity coefficients in the whole range of measured current. The electrical breakdown field (E(b)) was twice as high for the SCNCr system (5400 V/cm) than for the ZnO varistor (2600 V/cm) due to a smaller average grain size of the former (4.5 mu m) with respect to the latter (8.5 mu m). Nevertheless, we consider that another important factor responsible for the high E(b) in the SCNCr system is the great number of electrically active interfaces (85%) as determined with electrostatic force microscopy (EFM). It was also established that the SCNCr system might be produced in disks of smaller dimensions than that of commercial ZnO-based product, with a 5.0 cm(-1) minimal area-volume (A/V) ratio. The SCNCr reached the saturation current in a short time because of the high resistivity of the grains, which is five times higher than that of the grains in ZnO-based varistors.

Lipidic and proteic absorption in digestive tract of tropical fat snook (Centropomus parallelus, POEY 1860)

The tropical fat snook Centropomus parallelus is a species of recognized ecological importance and with a high economical potential for fisheries and aquaculture. The investigations of digestive tube morphology in association with their feeding abilities are fundamental to improve techniques for aquaculture feeding procedures. Sudan black staining and Perl`s method were used to evaluate their absorption capacity of fat and protein respectively. The Sudan black stain was performed 12 h after the ingestion of lipids. The lipids are intensely absorbed in the ceca epithelium and less intensely in the intestine and rectum. The Perl`s method was performed 12 h after the ingestion of ferritin. The proteins are absorbed only in the rectum. This is the first description of fat and protein absorption ability by the digestive tube of fat snook. These data enhance the possibility of the addition of macromolecules in rations that can show a diversity of physiological effects. The histological implications of each segment of the digestive tube in association with fish biology are further discussed. (C) 2010 Elsevier B.V. All rights reserved.

Biological, physical and chemical properties at the Subtropical Shelf Front Zone in the SW Atlantic Continental Shelf

The physical aspects of the Subtropical Shelf Front (STSF) for the Southwest Atlantic Continental Shelf were previously described. However, only scarce data on the biology of the front is available in the literature. The main goal of this paper is to describe the physical, chemical and biological properties of the STSF found in winter 2003 and summer 2004. A cross-section was established at the historically determined location of the STSF. Nine stations were sampled in winter and seven in summer. Each section included a series of conductivity-temperature-depth (CTD) stations where water samples from selected depths were filtered for nutrient determination. Surface samples were taken for chlorophyll a (Chl-a) determination and plankton net tows carried out above and below the pycnocline. Results revealed that winter was marked by an inner-shelf salinity front and that the STSF was located on the mid-shelf The low salinity waters in the inner-shelf indicated a strong influence of freshwater, with high silicate (72 mu M), suspended matter (45 mg l(-1)), phosphate (2.70 mu M) and low nitrate (1.0 mu M) levels. Total dissolved nitrogen was relatively high (22.98 mu M), probably due to the elevated levels of organic compound contribution close to the continental margin. Surface Chl-a concentration decreased from coastal well-mixed waters, where values up to 8.0 mg m(-3) were registered, to offshore waters. Towards the open ocean, high subsurface nutrients values were observed, probably associated to South Atlantic Central Waters (SACW). Zooplankton and ichthyoplankton abundance followed the same trend; three different groups associated to the inner-, mid- and outer-shelf region were identified. During summer, diluted waters extended over the shelf to join the STSF in the upper layer; the concentration of inorganic nutrients decreased in shallow waters; however, high values were observed between 40 and 60 m and in deep offshore waters. Surface Chl-a ranged 0.07-1.5 mg m(-3); winter levels were higher. Three groups of zoo and ichthyoplankton, separated by the STSF, were also identified. Results of the study performed suggest that the influence of freshwater was stronger during winter and that abundance distribution of Chl-a, copepods and ichthyoplankton was related to the Plata Plume Waters (PPW), rather than to the presence of the STSF. During summer, when the presence of freshwater decreases, plankton interactions seem to take place in the STSF. (C) 2008 Elsevier Ltd. All rights reserved.

Uma resenha, mesmo que tardia: Roberto Pontual e a sobrevida da questão da identidade nacional na arte brasileira dos anos 1980

Partindo do panorama traçado pelo crítico carioca Roberto Pontual em Explode Geração!, livro publicado em 1985, pretende-se analisar em que medida a questão da identidade brasileira na arte realizada no país encontrou respaldo na cena dos anos 1980, momento em que a produção de uma jovem geração de artistas foi alinhada à tradição do barroco brasileiro, tradição esta que, segundo o crítico, perpassaria e alinhavaria alguns dos trabalhos do período, fornecendo-lhes uma espécie de chancela de uma brasilidade insuspeita, a despeito de todo contato que travavam com a arte internacional. Esta "resenha tardia" propõe-se tão somente indicar caminhos possíveis para futuros estudos mais detalhados acerca de tal questão.

Potent Antiretroviral Therapy for Human Immunodeficiency Virus Infection Increases Aortic Stiffness

Background: Highly active antiretroviral therapy for AIDS is known to increase cardiovascular risk, but the effects of potent antiretroviral agents according to gender are unknown. Objective: The present study evaluated the impact of HIV infection treatment on aortic stiffness according to gender. Methods: From university-affiliated hospitals, we recruited 28 AIDS patients undergoing highly active antiretroviral treatment (HAART), 28 treatment-naive HIV-infected patients, 44 patients with type 2 diabetes, and 30 controls. Aortic stiffness was determined by measuring pulse wave velocity (PWV) using a validated and non-invasive automatic device. Results: The crude mean PWV values and 95% confidence intervals (95% CI) for HAART, diabetics, and controls were 9.77 m/s (95% CI 9.17-10.36),, 9.00 m/s (95% CI 8.37-9.63), 9.90 m/s (95% CI 9.32-10.49), and 9.28 m/s (95% CI 8.61-9.95), respectively, for men (P-value for trend = 0.14), and 9.61 m/s (95% CI 8.56-10.66), 8.45 m/s (95% CI 7.51-9.39), 9.83 (95% CI 9.21-10.44), and 7.79 m/s (95% CI 6.99-8.58), respectively, for women (P-value for trend <0.001). Post-hoc analysis revealed a significant difference between the mean PWV values in the HAART group and controls in women (P-value <0.01). After adjusting for other potential covariates, including systolic blood pressure and diabetes, these results did not change. The findings indicate that the impact of HAART treatment on aortic stiffness was amplified in women with hypertension, dyslipidemia, and metabolic syndrome. Conclusion: Potent anti-retroviral agents used in the treatment of HIV infection increases aortic stiffness, mainly among women with higher cardiovascular risk. (Arq Bras Cardiol 2012;99(6):1100-1107)

In Patients With Acute Myocardial Infarction, the Impact of Hyperglycemia as a Risk Factor for Mortality Is Not Homogeneous Across Age-Groups

OBJECTIVE To assess the impact of hyperglycemia in different age-groups of patients with acute myocardial infarction (AM I). RESEARCH DESIGN AND METHODS A total of 2,027 patients with AMI were categorized into one of five age-groups: <50 years (n = 301), >= 50 and <60 (n = 477),>= 60 and <70 (n = 545), >= 70 and <80 (n = 495), and years (n = 209). Hyperglycemia was defined as initial glucose >= 115 mg/dL. RESULTS The adjusted odds ratios for hyperglycemia predicting hospital mortality in groups 1-5 were, respectively, 7.57 (P = 0.004), 3.21 (P 0.046), 3.50 (P = 0.003), 3.20 (P < 0.001.), and 2.16 (P = 0.021). The adjusted P values for correlation between glucose level (as a continuous variable) and mortality were 0.007, <0.001, 0.043, <0.001, and 0.064. The areas under the ROC curves (AUCs) were 0.785, 0.709, 0.657, 0.648, and 0.613. The AUC in group 1 was significantly higher than those in groups 3-5. CONCLUSIONS The impact of hyperglycemia as a risk factor for hospital mortality in AMI is more pronounced in younger patients.

Lorentz violation bounds on Bhabha scattering

We investigate the effect of Lorentz-violating terms on Bhabha scattering in two distinct cases correspondent to vectorial and axial nonminimal couplings in quantum electrodynamics ( QED). In both cases, we find significant modifications with respect to the usual relativistic result. Our results reveal an anisotropy of the differential cross section which implies new constraints on the possible Lorentz-violating terms.

Dose-dependent change in biomarkers during neoadjuvant endocrine therapy with fulvestrant: results from NEWEST, a randomized Phase II study

NEWEST (Neoadjuvant Endocrine Therapy for Women with Estrogen-Sensitive Tumors) is the first study to compare biological and clinical activity of fulvestrant 500 versus 250 mg in the neoadjuvant breast cancer setting. We hypothesized that fulvestrant 500 mg may be superior to 250 mg in blocking estrogen receptor (ER) signaling and growth. A multicenter, randomized, open-label, Phase II study was performed to compare fulvestrant 500 mg (500 mg/month plus 500 mg on day 14 of month 1) versus fulvestrant 250 mg/month for 16 weeks prior to surgery in postmenopausal women with ER+ locally advanced breast cancer. Core biopsies at baseline, week 4, and surgery were assessed for biomarker changes. Primary endpoint: change in Ki67 labeling index (LI) from baseline to week 4 determined by automated computer imaging system (ACIS). Secondary endpoints: ER protein expression and function; progesterone receptor (PgR) expression; tumor response; tolerability. ER and PgR were examined retrospectively using the H score method. A total of 211 patients were randomized (fulvestrant 500 mg: n = 109; 250 mg: n = 102). At week 4, fulvestrant 500 mg resulted in greater reduction of Ki67 LI and ER expression versus 250 mg (-78.8 vs. -47.4% [p < 0.0001] and -25.0 vs. -13.5% [p = 0.0002], respectively [ACIS]); PgR suppression was not significantly different (-22.7 vs. -17.6; p = 0.5677). However, H score detected even greater suppression of ER (-50.3 vs. -13.7%; p < 0.0001) and greater PgR suppression (-80.5 vs. -46.3%; p = 0.0018) for fulvestrant 500 versus 250 mg. At week 16, tumor response rates were 22.9 and 20.6% for fulvestrant 500 and 250 mg, respectively, with considerable decline in all markers by both ACIS and H score. No detrimental effects on endometrial thickness or bone markers and no new safety concerns were identified. This provides the first evidence of greater biological activity for fulvestrant 500 versus 250 mg in depleting ER expression, function, and growth.

Decline in dental caries among 12-year-old children in Brazil, 1980-2005

Objectives This study was conducted to determine changes in values on the decayed, missing and filled teeth (DMFT) index in 12-year-old children in Brazil between 1980 and 2005, and to correlate DMFT values with human development index (HDI) values, time, population size of municipality and fluoridation of the water supply. Methods The present study represents a retrospective ecological study using secondary data from epidemiological surveys published in indexed journals, as well as data obtained from epidemiological official surveys carried out in Brazil in 1986, 1996 and 2003, and in the State of Sao Paulo in 1998 and 2002. Units of study were represented by Brazilian municipalities holding average DMFT index values for 12-year-old children. Multiple regression analysis was used to examine the correlations among DMFT and HDI values, and time, population size and fluoridation of the water supply. Results The final database included 550 records of DMFT values in 428 different towns. Regression analysis showed statistically significant correlations between DMFT index values and time (P < 0.001), fluoridation of the water supply (P < 0.001) and size of municipality (P < 0.001). Estimated mean DMFT index values were 8.36 in 1980, 6.08 in 1985, 4.45 in 1990, 3.29 in 1995, 2.46 in 2000 and 1.86 in 2005. Conclusions Data showed a significant decrease in dental caries across the entire country, with an average reduction of 25% occurring every 5 years. General trends indicated that a reduction in DMFT index values occurred over time, that a further reduction in DMFT index values occurred when a municipality fluoridated its water supply, and mean DMFT index values were lower in larger than in smaller municipalities.

Effective transport barriers in nontwist systems

In fluids and plasmas with zonal flow reversed shear, a peculiar kind of transport barrier appears in the shearless region, one that is associated with a proper route of transition to chaos. These barriers have been identified in symplectic nontwist maps that model such zonal flows. We use the so-called standard nontwist map, a paradigmatic example of nontwist systems, to analyze the parameter dependence of the transport through a broken shearless barrier. On varying a proper control parameter, we identify the onset of structures with high stickiness that give rise to an effective barrier near the broken shearless curve. Moreover, we show how these stickiness structures, and the concomitant transport reduction in the shearless region, are determined by a homoclinic tangle of the remaining dominant twin island chains. We use the finite-time rotation number, a recently proposed diagnostic, to identify transport barriers that separate different regions of stickiness. The identified barriers are comparable to those obtained by using finite-time Lyapunov exponents.

Nuclear rainbow in the O-16+(27)AL system: The role of couplings at energies far above the barrier

High precision elastic and inelastic angular distributions have been measured for the O-16 + Al-27 system at a beam energy of 100 MeV. The data analysis confirms a rainbow formation as already predicted by parameter-free Coupled Channel calculations. It also helps to reveal the crucial role of inelastic couplings in the rainbow formation for heavier systems even at energies far above the Coulomb barrier. This feature, well known in atomic/molecular scattering, is experimentally studied for the first time in Nuclear Physics. (C) 2012 Elsevier B.V. All rights reserved.

Universality in bibliometrics

Many discussions have enlarged the literature in Bibliometrics since the Hirsch proposal, the so called h-index. Ranking papers according to their citations, this index quantifies a researcher only by its greatest possible number of papers that are cited at least h times. A closed formula for h-index distribution that can be applied for distinct databases is not yet known. In fact, to obtain such distribution, the knowledge of citation distribution of the authors and its specificities are required. Instead of dealing with researchers randomly chosen, here we address different groups based on distinct databases. The first group is composed of physicists and biologists, with data extracted from Institute of Scientific Information (IS!). The second group is composed of computer scientists, in which data were extracted from Google-Scholar system. In this paper, we obtain a general formula for the h-index probability density function (pdf) for groups of authors by using generalized exponentials in the context of escort probability. Our analysis includes the use of several statistical methods to estimate the necessary parameters. Also an exhaustive comparison among the possible candidate distributions are used to describe the way the citations are distributed among authors. The h-index pdf should be used to classify groups of researchers from a quantitative point of view, which is meaningfully interesting to eliminate obscure qualitative methods. (C) 2011 Elsevier B.V. All rights reserved.

Pertuzumab plus Trastuzumab plus Docetaxel for Metastatic Breast Cancer

BACKGROUND The anti-human epidermal growth factor receptor 2 (HER2) humanized monoclonal antibody trastuzumab improves the outcome in patients with HER2-positive metastatic breast cancer. However, most cases of advanced disease eventually progress. Pertuzumab, an anti-HER2 humanized monoclonal antibody that inhibits receptor dimerization, has a mechanism of action that is complementary to that of trastuzumab, and combination therapy with the two antibodies has shown promising activity and an acceptable safety profile in phase 2 studies involving patients with HER2-positive breast cancer. METHODS We randomly assigned 808 patients with HER2-positive metastatic breast cancer to receive placebo plus trastuzumab plus docetaxel (control group) or pertuzumab plus trastuzumab plus docetaxel (pertuzumab group) as first-line treatment until the time of disease progression or the development of toxic effects that could not be effectively managed. The primary end point was independently assessed progression-free survival. Secondary end points included overall survival, progression-free survival as assessed by the investigator, the objective response rate, and safety. RESULTS The median progression-free survival was 12.4 months in the control group, as compared with 18.5 months in the pertuzumab group (hazard ratio for progression or death, 0.62; 95% confidence interval, 0.51 to 0.75; P<0.001). The interim analysis of overall survival showed a strong trend in favor of pertuzumab plus trastuzumab plus docetaxel. The safety profile was generally similar in the two groups, with no increase in left ventricular systolic dysfunction; the rates of febrile neutropenia and diarrhea of grade 3 or above were higher in the pertuzumab group than in the control group. CONCLUSIONS The combination of pertuzumab plus trastuzumab plus docetaxel, as compared with placebo plus trastuzumab plus docetaxel, when used as first-line treatment for HER2-positive metastatic breast cancer, significantly prolonged progression-free survival, with no increase in cardiac toxic effects. (Funded by F. Hoffmann-La Roche/Genentech; ClinicalTrials.gov number, NCT00567190.)

Thalidomide plus dexamethasone as a maintenance therapy after autologous hematopoietic stem cell transplantation improves progression-free survival in multiple myeloma

Despite the good response of stem cell transplant (SCT) in the treatment of multiple myeloma (MM), most patients relapse or do not achieve complete remission, suggesting that additional treatment is needed. We assessed the impact of thalidomide in maintenance after SCT in untreated patients with MM. A hundred and eight patients (<70 years old) were randomized to receive maintenance with dexamethasone (arm A; n = 52) or dexamethasone with thalidomide (arm B; n = 56; 200 mg daily) for 12 months or until disease progression. After a median follow-up of 27 months, an intention to treat analysis showed a 2-year progression-free survival (PFS) of 30% in arm A (95% CI 2238) and 64% in arm B (95% CI 5771; P = 0.002), with median PFS of 19 months and 36 months, respectively. In patients who did not achieve at least a very good partial response, the PFS at 2 years was significantly higher when in use of thalidomide (19 vs. 59%; P = 0.002). Overall survival at 2 years was not significantly improved (70 vs. 85% in arm A and arm B, respectively; P = 0.27). The addition of thalidomide to dexamethasone as maintenance improved the PFS mainly in patients who did not respond to treatment after SCT. Am. J. Hematol. (c) 2012 Wiley Periodicals, Inc.