Basilar artery occlusive disease in stroke survivors in a multiethnic population

Objectives: To describe clinical, radiological findings, and outcome in a multiethnic population of stroke survivors with basilar artery occlusive disease (BAOC). Methods: Forty patients with infarcts in the basilar artery (BA) territory, alive 30 days after the ictus, participated in the study. BA stenosis (>50%) or occlusion was shown by magnetic resonance or digital subtraction angiography in all patients. Demographical, clinical and radiological characteristics were described. Modified Rankin Scale (MRS) scores at 30 days and 6 months after the ischemic event were evaluated. Association between demographical, clinical, radiological features and outcome were analyzed with Chi-square and Fisher`s exact tests. MRS scores at 30 days and 6 months were compared with the Wilcoxon test. Results: Sixty percent of the patients were men, and 33% were Afro-Brazilian. Mean age was 55.8 +/- 12.9 years. Most (90%) had multiple vascular risk factors. Stroke was preceded by TIA in 48% of the patients, and 80% had a history of arterial hypertension. The most common neurological symptom was vertigo/dizziness (60%) and the sign, hemiparesis (60%). Most of the infarcts were located in the pons (85%) and the BA middle third was the most frequently affected segment (33%). BA occlusion occurred in 58% of the patients. More severe vascular occlusive lesions were present in Whites (p = 0.002) and in patients with involvement of the middle third of the BA (p = 0.021). Large-artery atherosclerosis was the most common stroke etiology (88%) and was more frequent in older patients (p < 0.001). Most patients were treated with anticoagulation. MRS scores improved significantly at 6 months (p < 0.001): at this time, 78% of the patients had MRS scores between 0 and 2. Conclusions: We observed different results compared with other series: greater proportion of Afro-descendents, higher frequency of atherosclerosis and BA occlusion. Rates of preceding TIAs and good outcome at 6 months were similar to previously published data. These results represent a step forward towards understanding BAOC in a multiethnic context. (C) 2009 Elsevier B.V. All rights reserved.

Um retrato da área de Neurociência e comportamento no Brasil

A neurociência compreende o estudo do controle neural das funções vegetativas, sensoriais e motoras; dos comportamentos de locomoção, reprodução e alimentação; e dos mecanismos da atenção, memória, aprendizagem, emoção, linguagem e comunicação. Tem, portanto, uma importante área de interface com a Psicologia. Dentre seus objetivos, a neurociência busca esclarecer os mecanismos das doenças neurológicas e mentais por meio do estudo do sistema nervoso normal e patológico. Sua evolução no Brasil tem ocorrido desde meados do século passado, e seu desenvolvimento foi incentivado pela criação de sociedades científicas específicas. O presente artigo relata esse desenvolvimento e descreve os principais grupos atuantes na neurociência brasileira.

Questões contemporâneas sobre natureza e cultura: notas sobre a Saúde Coletiva e a sociologia no Brasil

O presente artigo discute alguns aspectos da relação entre biológico e social, tomando por objeto o campo da Saúde Coletiva no Brasil e o campo das Ciências Sociais, mais especificamente a sociologia. Parte-se do pressuposto de que o conceito que norteia o campo da Saúde Coletiva, o da determinação social (formulado em meados dos anos 1970 e 1980), foi profundamente marcado por certa leitura do social, impregnada dos marcos teóricos clássicos das ciências sociais e marcada pelo cenário político-institucional em que os campos - da Saúde Coletiva e das Ciências Sociais - encontravam-se historicamente. O objetivo é discutir o esgotamento dessa formulação teórica tendo em vista o cenário das profundas mudanças ocorridas nas sociedades contemporâneas em sua etapa industrial tardia, pós-industrial ou tardo-moderna. Acredita-se que a discussão sobre os marcos teóricos constitutivos do campo da Saúde Coletiva contribuirá para um enfrentamento das questões de saúde mais consoante com as mudanças sociais ocorridas.

A questão social na França contemporânea: uma experiência de pesquisa

A França passou por conflitos urbanos em seus bairros populares. Incidentes com a polícia marcados pela morte de um morador, geralmente jovem ou adolescente, são seguidos por manifestações violentas: quebra-quebras, incêndios de carros e/ou estabelecimentos públicos e privados, enfrentamentos com a polícia. Nos conflitos da "banlieue" francesa podem ser percebidos elementos comuns a eventos ingleses e/ou americanos de outras décadas.OBJETIVO: consiste em identificar a percepção e as representações de moradores sobre suas condições de vida e saúde na França.MÉTODO: pesquisa qualitativa realizada em Les Aubiers, bairro popular de Bordeaux, nos anos de 2002 e 2005. A população de moradores desse bairro e é composta principalmente por imigrantes ou fanceses de origem estrangeira, provenientes de diferentes locais: África do Norte, África Sub-Sahariana, Turquia, Portugal , Ilha de Reunião. Os indicadores sociais e econômicos apresentam níveis significativamente mais baixos do que os de outros bairros de Bordeaux, acompanhando as tendências encontradas nas outras "banlieues". Entre esses indicadores, a taxa de desemprego, principalmente entre jovens, é alarmante (40 por cento).RESULTADOS E DISCUSSÃO: as políticas sociais deveriam ser mais voltadas para os indivíduos do que para o território, pois este só poderá ser transformado pelos primeiros e não o contrário. Um bairro e uma população estigmatizados, estão contemplados por uma ampla política social. Ainda que passível de crítica, não se pode ignorar a existência de esforços sistematicos de integração, nem a existência de políticas sociais. Se elas são inadequadas, trata-se de ampliar o espaço de discusão para sua reforma. Trata-se de saber qual a disposição das sociedades contemporâneas, como um todo, para lutar contra as inequidades e segregações

Brazilian territorial dynamics and the inversion of the ""frontier thesis"" in the southern new world

It is a generally acknowledged fact that the dynamics of frontier advance deeply influenced the broad experience of American post colonial societies. The colonization, which started most from the east boundaries of the continent, appropriated and gradually transformed the American territories from east to west. The advance, initially represented by the arrival of the European settlers, went on to become an important trace of that society which did not come to know any physical limits of a restricted territory. However, despite the common identity granted by these territorial dynamics, the later developments and consequences seem to have shaped differently the Northern representatives from their Southern counterparts. In addition, the interpretation of these facts bore in each of these regions different meanings and traits.

Como implementar uma diretriz - da teoria à prática: exemplo da profilaxia para Tromboembolismo Venoso

The objective of this manuscript is to discuss the existing barriers for the dissemination of medical guidelines, and to present strategies that facilitate the adaptation of the recommendations into clinical practice. The literature shows that it usually takes several years until new scientific evidence is adopted in current practice, even when there is obvious impact in patients' morbidity and mortality. There are some examples where more than thirty years have elapsed since the first case reports about the use of a effective therapy were published until its utilization became routine. That is the case of fibrinolysis for the treatment of acute myocardial infarction. Some of the main barriers for the implementation of new recommendations are: the lack of knowledge of a new guideline, personal resistance to changes, uncertainty about the efficacy of the proposed recommendation, fear of potential side-effects, difficulties in remembering the recommendations, inexistence of institutional policies reinforcing the recommendation and even economical restrains. In order to overcome these barriers a strategy that involves a program with multiple tools is always the best. That must include the implementation of easy-to-use algorithms, continuous medical education materials and lectures, electronic or paper alerts, tools to facilitate evaluation and prescription, and periodic audits to show results to the practitioners involved in the process. It is also fundamental that the medical societies involved with the specific medical issue support the program for its scientific and ethical soundness. The creation of multidisciplinary committees in each institution and the inclusion of opinion leaders that have pro-active and lasting attitudes are the key-points for the program's success. In this manuscript we use as an example the implementation of a guideline for venous thromboembolism prophylaxis, but the concepts described here can be easily applied to any other guideline. Therefore, these concepts could be very useful for institutions and services that aim at quality improvement of patient care. Changes in current medical practice recommended by guidelines may take some time. However, if there is a broader participation of opinion leaders and the use of several tools listed here, they surely have a greater probability of reaching the main objectives: improvement in provided medical care and patient safety.

Work disability remains a major problem in rheumatoid arthritis in the 2000s: data from 32 countries in the QUEST-RA Study

Introduction: Work disability is a major consequence of rheumatoid arthritis (RA), associated not only with traditional disease activity variables, but also more significantly with demographic, functional, occupational, and societal variables. Recent reports suggest that the use of biologic agents offers potential for reduced work disability rates, but the conclusions are based on surrogate disease activity measures derived from studies primarily from Western countries. Methods: The Quantitative Standard Monitoring of Patients with RA (QUEST-RA) multinational database of 8,039 patients in 86 sites in 32 countries, 16 with high gross domestic product (GDP) (>24K US dollars (USD) per capita) and 16 low-GDP countries (<11K USD), was analyzed for work and disability status at onset and over the course of RA and clinical status of patients who continued working or had stopped working in high-GDP versus low-GDP countries according to all RA Core Data Set measures. Associations of work disability status with RA Core Data Set variables and indices were analyzed using descriptive statistics and regression analyses. Results: At the time of first symptoms, 86% of men (range 57%-100% among countries) and 64% (19%-87%) of women <65 years were working. More than one third (37%) of these patients reported subsequent work disability because of RA. Among 1,756 patients whose symptoms had begun during the 2000s, the probabilities of continuing to work were 80% (95% confidence interval (CI) 78%-82%) at 2 years and 68% (95% CI 65%-71%) at 5 years, with similar patterns in high-GDP and low-GDP countries. Patients who continued working versus stopped working had significantly better clinical status for all clinical status measures and patient self-report scores, with similar patterns in high-GDP and low-GDP countries. However, patients who had stopped working in high-GDP countries had better clinical status than patients who continued working in low-GDP countries. The most significant identifier of work disability in all subgroups was Health Assessment Questionnaire (HAQ) functional disability score. Conclusions: Work disability rates remain high among people with RA during this millennium. In low-GDP countries, people remain working with high levels of disability and disease activity. Cultural and economic differences between societies affect work disability as an outcome measure for RA.

PSA and androgen-related gene (AR, CYP17, and CYP19) polymorphisms and the risk of adenocarcinoma at prostate biopsy

The aim of the present study was to examine the impact of polymorphisms in prostate-specific antigen (PSA) and androgen-related genes (AR, CYP17, and CYP19) on prostate cancer (PCa) risk in selected high-risk patients who underwent prostate biopsy. Blood samples and prostate tissues were obtained for DNA analysis. Single-nucleotide polymorphisms in the 50-untranslated regions (UTRs) of the PSA (substitution A > G at position -158) and CYP17 (substitution T > C at 50-UTR) genes were detected by polymerase chain reaction (PCR)-restriction fragment length polymorphism assays. The CAG and TTTA repeats in the AR and CYP19 genes, respectively, were genotyped by PCR-based GeneScan analysis. Patients with the GG genotype of the PSA gene had a higher risk of PCa than those with the AG or AA genotype (OR = 3.79, p = 0.00138). The AA genotype was associated with lower PSA levels (6.44 +/- 1.64 ng/mL) compared with genotypes having at least one G allele (10.44 +/- 10.06 ng/mL) (p = 0.0687, 95% CI - 0.3146 to 8.315, unpaired t-test). The multivariate analysis confirmed the association between PSA levels and PSA genotypes (AA vs. AG+GG; chi(2) = 0.0482) and CYP19 (short alleles homozygous vs. at least one long allele; chi(2) = 0.0110) genotypes. Genetic instability at the AR locus leading to somatic mosaicism was detected in one PCa patient by comparing the length of AR CAG repeats in matched peripheral blood and prostate biopsy cores. Taken together, these findings suggest that the PSA genotype should be a clinically relevant biomarker to predict the PCa risk.

The number of reproductive workers in highly eusocial Hymenoptera: monogyny and monandry

Haplodiploidy results in relatedness asymmetries between colony members of highly eusocial Hymenoptera. As a consequence, queen and reproductive workers are more related to their own sons than to each other's male offspring. Kin selection theory predicts multiple optima in male parentage: either the queen or the workers should produce all the males. Nevertheless, shared male parentage is common in highly eusocial hymenopterans. An inclusive fitness model was used to analyze the effect of the number of reproductive workers on male parentage shared by the queen and laying workers by isolating the male component from an inclusive fitness equation using the equal fitness through male condition for each pairwise combination of the three female classes comprised of the queen, laying workers and non-laying workers. The main result of the theoretical analyses showed that the fraction of males produced by workers increases asymptotically with the number of laying workers at an increasingly diminishing rate, tending to an asymptotic value of 0.67. In addition, as the number of laying workers increases, the share of male parentage converges to that of non-laying workers. The diminishing return effect on male parentage share depending on the number of reproductive workers leads us to expect the number of reproductive workers to be relatively small in a stingless bee colony, even in the absence of productivity costs. The available data confirms this hypothesis, as there is an unusually small number of reproductive workers in stingless bee colonies.

The queen is dead-long live the workers: intraspecific parasitism by workers in the stingless bee Melipona scutellaris

Insect societies are well known for their high degree of cooperation, but their colonies can potentially be exploited by reproductive workers who lay unfertilized, male eggs, rather than work for the good of the colony. Recently, it has also been discovered that workers in bumblebees and Asian honeybees can succeed in entering and parasitizing unrelated colonies to produce their own male offspring. The aim of this study was to investigate whether such intraspecific worker parasitism might also occur in stingless bees, another group of highly social bees. Based on a large-scale genetic study of the species Melipona scutellaris, and the genotyping of nearly 600 males from 45 colonies, we show that similar to 20% of all males are workers` sons, but that around 80% of these had genotypes that were incompatible with them being the sons of workers of the resident queen. By tracking colonies over multiple generations, we show that these males were not produced by drifted workers, but rather by workers that were the offspring of a previous, superseded queen. This means that uniquely, workers reproductively parasitize the next-generation workforce. Our results are surprising given that most colonies were sampled many months after the previous queen had died and that workers normally only have a life expectancy of similar to 30 days. It also implies that reproductive workers greatly outlive all other workers. We explain our results in the context of kin selection theory, and the fact that it pays workers more from exploiting the colony if costs are carried by less related individuals.

Intraspecific queen parasitism in a highly eusocial bee

Insect societies are well-known for their advanced cooperation, but their colonies are also vulnerable to reproductive parasitism. Here, we present a novel example of an intra-specific social parasitism in a highly eusocial bee, the stingless bee Melipona scutellaris. In particular, we provide genetic evidence which shows that, upon loss of the mother queen, many colonies are invaded by unrelated queens that fly in from unrelated hives nearby. The reasons for the occurrence of this surprising form of social parasitism may be linked to the fact that unlike honeybees, Melipona bees produce new queens in great excess of colony needs, and that this exerts much greater selection on queens to seek alternative reproductive options, such as by taking over other nests. Overall, our results are the first to demonstrate that queens in highly eusocial bees can found colonies not only via supersedure or swarming, but also by infiltrating and taking over other unrelated nests.

Pheromone paths attached to the substrate in meliponine bees: helpful but not obligatory for recruitment success

In contrast to marking of the location of resources or sexual partners using single-spot pheromone sources, pheromone paths attached to the substrate and assisting orientation are rarely found among flying organisms. However, they do exist in meliponine bees (Apidae, Apinae, Meliponini), commonly known as stingless bees, which represent a group of important pollinators in tropical forests. Worker bees of several Neotropical meliponine species, especially in the genus Scaptotrigona Moure 1942, deposit pheromone paths on substrates between highly profitable resources and their nest. In contrast to past results and claims, we find that these pheromone paths are not an indispensable condition for successful recruitment but rather a means to increase the success of recruiters in persuading their nestmates to forage food at a particular location. Our results are relevant to a speciation theory in scent path-laying meliponine bees, such as Scaptotrigona. In addition, the finding that pheromone path-laying bees are able to recruit to food locations even across barriers such as large bodies of water affects tropical pollination ecology and theories on the evolution of resource communication in insect societies with a flying worker caste.

A conserved dibasic site is essential for correct processing of the peptide hormone AtRALF1 in Arabidopsis thaliana

Prohormone proteins in animals and yeast are typically processed at dibasic sites by convertases. Propeptide hormones are also found in plants but little is known about processing. We show for the first time that a dibasic site upstream of a plant peptide hormone, AtRALF1, is essential for processing. Overexpression of preproAtRALF1 causes semidwarfism whereas overexpression of preproAtRALF1(R69A), the propeptide with a mutation in the dibasic site, shows a normal phenotype. RALF1(R69A) plants accumulate only the mutated proprotein and not the processed peptide. In vitro processing using microsomal fractions suggests that processing is carried out by a kexin-like convertase. (C) 2008 Federation of European Biochemical Societies. Published by Elsevier B. V. All rights reserved.

A lipocalin sequence signature modulates cell survival

Lipocalins are beta-barrel proteins, which share three conserved motifs in their amino acid sequence. In this study, we identified by a peptide mapping approach, a seven-amino acid sequence related to one of these motifs (motif 2) that modulates cell survival. A synthetic peptide based on an insect lipocalin displayed cytoprotective activity in serum-deprived endothelial cells and leucocytes. This activity was dependent on nitric oxide synthase. This sequence was found within several lipocalins, including apolipoprotein D, retinol binding protein, lipocalin-type prostaglandin D synthase, and many unknown proteins, suggesting that it is a sequence signature and a lipocalin conserved property. (C) 2010 Federation of European Biochemical Societies. Published by Elsevier B. V. All rights reserved.

The impact of life stage and societal culture on subordinate influence ethics: A study of Brazil, China, Germany, and the US

In this paper, we investigate the effects of societal values and life stage on subordinate influence ethics. Based on the evolving crossvergence theory of macro-level predictors of values evolution, we demonstrate the applicability of crossvergence theory in the micro-level context. Furthermore, our study provides the first empirical multi-level analysis of influence ethics utilizing a multi pie-country sample. Thus, we illustrate how the breath of crossvergence can be expanded to provide a multi-level theoretical foundation of values and behavior evolution across cultures. Specifically, we integrate micro-level life stage theory and macro-level societal culture theory to concurrently assess the contributions of each theory in explaining subordinate influence ethics across the diverse societies of Brazil. China, Germany and the U.S. Consistent with previous research, we found significant societal differences in influence ethics. However, we also found that life stage theory played a significant role in understanding influence ethics. Thus, our findings expand the crossvergence perspective on societal change, indicating that key micro-level predictors (e.g., life stage) should be included in cross-cultural research. (C) 2009 Elsevier Inc. All rights reserved.