VIH/SIDA

Cabo Verde consiste num arquipélago situado no oceano Atlântico e tem uma extensão geográfica de 4.033 Km2. Segundo dados de 2006 estima-se uma população de 518.000 habitantes. O país está classificado pelo Banco Mundial como de renda média baixa. A expectativa de vida média ao nascer é de 72 anos. Segundo pesquisa de 2002/03, 37% da população foi considerada pobre e 20% muito pobre.1 A maior parte do sistema de saúde está descentralizada, o que facilita o acesso da população aos serviços de saúde.

Trabecular bone score: a noninvasive analytical method based upon the DXA image.

The trabecular bone score (TBS) is a gray-level textural metric that can be extracted from the two-dimensional lumbar spine dual-energy X-ray absorptiometry (DXA) image. TBS is related to bone microarchitecture and provides skeletal information that is not captured from the standard bone mineral density (BMD) measurement. Based on experimental variograms of the projected DXA image, TBS has the potential to discern differences between DXA scans that show similar BMD measurements. An elevated TBS value correlates with better skeletal microstructure; a low TBS value correlates with weaker skeletal microstructure. Lumbar spine TBS has been evaluated in cross-sectional and longitudinal studies. The following conclusions are based upon publications reviewed in this article: 1) TBS gives lower values in postmenopausal women and in men with previous fragility fractures than their nonfractured counterparts; 2) TBS is complementary to data available by lumbar spine DXA measurements; 3) TBS results are lower in women who have sustained a fragility fracture but in whom DXA does not indicate osteoporosis or even osteopenia; 4) TBS predicts fracture risk as well as lumbar spine BMD measurements in postmenopausal women; 5) efficacious therapies for osteoporosis differ in the extent to which they influence the TBS; 6) TBS is associated with fracture risk in individuals with conditions related to reduced bone mass or bone quality. Based on these data, lumbar spine TBS holds promise as an emerging technology that could well become a valuable clinical tool in the diagnosis of osteoporosis and in fracture risk assessment.

Blood pressure response to central and/or peripheral inhibition of phenylethanolamine N-methyltransferase in normotensive and hypertensive rats

We studied the effects on blood pressure and heart rate of two different phenylethanolamine N-methyltransferase (PNMT) inhibitors in normotensive, in two-kidney renal hypertensive, and in deoxycorticosterone-salt (DOC-salt) hypertensive rats. One compound (SK&F 64139) blocks the conversion of norepinephrine to epinephrine in both the central and the peripheral nervous system, whereas the other (SK&F 29661) does not cross the blood-brain barrier and therefore is active mostly in the adrenal glands. In the rats given SK&F 29661, practically no acute blood pressure changes were in the adrenal glands. In the rats given SK&F 64139 induced only a minor blood pressure and heart rate response in normotensive and two-kidney renal hypertensive rats. However, in DOC-salt hypertensive rats, it reduced arterial pressure to approximately normal levels and concomitantly slowed pulse rate. There was a close correlation between the magnitude of the blood pressure response observed in all SK&F 64139-treated animals and the control plasma norepinephrine (4 = -0.795, P less than 0.001) and epinephrine (r = -0.789, P less than 0.001) levels. These results suggest an important role for central epinephrine in regulating the peripheral sympathoadrenomedullary and the baroreceptor reflex activity, particularly when the maintenance of the high blood pressure is not renin-dependent.

How to manage the left subclavian artery during endovascular stenting of the thoracic aorta.

We performed a systematic review of the literature to establish whether revascularisation of the left subclavian territory is necessary when this artery is covered by a stent. We retrieved data from 99 studies incorporating 4906 patients. Incidences of left-arm ischaemia (0.0% vs 9.2%, p=0.002) and stroke (4.7% vs 7.2%, p<0.001) were significantly less following revascularisation, although mortality (10.5% vs 3.4%, p=0.032) and endoleak incidence (25.8% vs 12.6%, p=0.008) were increased. No significant differences in spinal-cord ischaemia were seen. Revascularisation may reduce downstream ischaemic complications but can cause significant risk. Indications must be carefully considered on an individual patient basis.

Location of hubs in a competitive environment

We offer a formulation that locates hubs on a network in a competitiveenvironment; that is, customer capture is sought, which happenswhenever the location of a new hub results in a reduction of thecurrent cost (time, distance) needed by the traffic that goes from thespecified origin to the specified destination.The formulation presented here reduces the number of variables andconstraints as compared to existing covering models. This model issuited for both air passenger and cargo transportation.In this model, each origin-destination flow can go through either oneor two hubs, and each demand point can be assigned to more than a hub,depending on the different destinations of its traffic. Links(``spokes'' have no capacity limit. Computational experience is provided.

Suprapineal recess: an alternate site for third ventriculostomy? Case report.

This 30-year-old woman presented with clinical symptoms and signs of intracranial hypertension and Parinaud syndrome secondary to ventriculoperitoneal shunt dysfunction. Magnetic resonance (MR) imaging revealed gross triventricular hydrocephalus with a large suprapineal recess due to aqueductal stenosis. Using an endoscopic approach, a ventriculostomy was performed within the floor of the dilated suprapineal recess. Following this procedure the patient experienced alleviation of all her neurological symptoms and signs. Postoperative MR imaging and cerebrospinal fluid flow studies demonstrated a functioning ventriculostomy. The anatomy of the suprapineal recess and its suitability for endoscopic ventriculostomy are discussed.

Distribución, concentración y biomasa de anchoveta y otros recursos pelágicos en la primavera de 1997

Se trabajó entre Huacho y Chicama la distribución de los principales recursos pelágicos mostró que la anchoveta estaba replegada sobre la zona litoral con altos índices de agregación en diversas zonas. Similar comportamiento fue mostrado por la sardina y la caballa, aunque con índices de abundancia bastante menores. El jurel estuvo prácticamente ausente de la zona de estudio. Los estimados de biomasa de anchoveta fueron hechos acústicamente utilizando las nuevas relaciones de Fuerza de Blanco a 38 (2.000.789 t) y 120 (2.101.957 t). El estimado acústico de la biomasa sardina, jurel y caballa, para las cuales se utilizó la ecuación de Fuerza de Blanco del arenque del mar del norte, fueron de 146.645 t, 29.518 t y 198.639 t, respectivamente.

Yleisradion pääjohtaja Eino S. Repo 3/2 1966

Kirje

A Qualidade Educativa no Ensino Básico Integrado Estudo de Caso – Escola Amor de Deus

Hoje, é cada vez mais evidente que, face às constantes mudanças sociais e consequentemente as necessidades provenientes dessas mudanças, surge novos desafios às instituições educativas que devem estar comprometidas com a qualidade da educação de modo a formar indivíduos competentes, responsáveis e pró-activos e que estejam comprometidos com o desenvolvimento do país. É nesta linha de raciocínio, que a qualidade da educação deve constituir uma das grandes prioridades das políticas educativas, visto que, a aquisição de um conhecimento útil, competências, capacidades de raciocínio, atitudes e valores são considerados condições fundamentais para uma cidadania activa, o que representa um meio importante para moldar o próprio futuro. Deste modo, a preocupação com a qualidade é um desafio que toda a organização deve procurar atingir nos seus serviços e que à semelhança das outras organizações, a escola também começou a ser pressionada para melhorar a sua eficácia interna de forma a preparar trabalhadores e cidadãos capazes de enfrentar a economia global e o rápido desenvolvimento tecnológico.No que se refere à realidade cabo-verdiana, a questão da qualidade da educação tem sido objecto de muitos debates quer por parte do Ministério da Educação e Desporto, quer pela sociedade civil através dos meios de comunicação social. A título exemplificativo, ilustramos citando o extracto de um artigo publicado num dos jornais on-line cabo-verdiano, datado de 29 de Novembro de 2010, assinado por Silva, opinando que “a qualidade do nosso sistema educativo é um tema que nos preocupa a todos, de uma forma ou de outra, porque dela depende, em grande parte, o “salto” que o país precisa dar para se afirmar como um País, realmente, de Rendimento Médio”. É mister ainda reforçar a mundividência do tema qualidade educativa, quando o próprio Ministério da Educação e Desporto apresenta como lema “Juntos por uma educação de qualidade”, por dois anos lectivos consecutivos, 2011-2012 e 2012-2013, respectivamente.No que concerne ao Ensino Básico Integrado, nosso campo de actuação, o caminho para alcançar o desidrato da qualidade educativa começou a ser desenhado com a reforma educativa de 1990, mas que teve maior impacto na massificação desse nível de ensino, conforme apuramos dos dados publicados no site do MED 1 ( www.minedu.gov.cv ) , que indica o registo de uma taxa líquida 2 de escolarização na ordem dos 96% e uma taxa bruta de 117%, sendo o acesso quase igualitário em ambos os sexos, meninas com uma taxa de 49% e meninos com 51%, e, um índice de paridade ( F/M) à volta dos 0,96 %. Nesta perspectiva emergiu a ideia de desenvolver uma pesquisa científica que aborde a Qualidade Educativa no Ensino Básico Integrado na escola “Amor de Deus”. Deste modo, ambicionamos realizar um estudo claro, objectivo, coerente e, fundamentalmente, que seja importante e útil na nossa vida profissional, o que aliás justifica o tema escolhido para este trabalho.

Un projet multicentrique suisse pour améliorer la prévention et la récidive après un syndrome coronarien aigu [A Swiss multicentric project to improve the prevention of cardiovascular event recurrence after acute coronary syndromes].

Recurrence of cardiovascular events and mortality remain high after acute coronary syndromes. A Swiss multicentric study, "Inflammation and acute coronary syndromes (ACS)--Novel strategies for prevention and clinical managements", is currently underway with the support of the Swiss National Science Foundation. The study includes a clinical research subproject of which the aim is to assess the impact of the ELIPS program (multi-dimEnsionaL prevention Program after acute coronary Syndrome) on the recurrence of cardiovascular events after an ACS. The basic research sub-projects aim to investigate novel cardiovascular risk biomarkers and genetic determinants of recurrence and to study the role of stem cells after an ACS. Another sub-project will evaluate intracoronary imaging techniques and the efficacy of different types of stents.

Autosomal-dominant distal myopathy associated with a recurrent missense mutation in the gene encoding the nuclear matrix protein, matrin 3.

Distal myopathies represent a heterogeneous group of inherited skeletal muscle disorders. One type of adult-onset, progressive autosomal-dominant distal myopathy, frequently associated with dysphagia and dysphonia (vocal cord and pharyngeal weakness with distal myopathy [VCPDM]), has been mapped to chromosome 5q31 in a North American pedigree. Here, we report the identification of a second large VCPDM family of Bulgarian descent and fine mapping of the critical interval. Sequencing of positional candidate genes revealed precisely the same nonconservative S85C missense mutation affecting an interspecies conserved residue in the MATR3 gene in both families. MATR3 is expressed in skeletal muscle and encodes matrin 3, a component of the nuclear matrix, which is a proteinaceous network that extends throughout the nucleus. Different disease related haplotype signatures in the two families provided evidence that two independent mutational events at the same position in MATR3 cause VCPDM. Our data establish proof of principle that the nuclear matrix is crucial for normal skeletal muscle structure and function and put VCPDM on the growing list of monogenic disorders associated with the nuclear proteome.

Naturphilosophie als metaphysik der Natur

Naturphilosophie und Metaphysik scheinen zwei unterschiedliche, ja, sich ausschließende philosophische Ansätze zu sein. Bestimmt man aber Naturphilosophie als Metaphysik der Natur im Sinne des Projekts, im Ausgang von den naturwissenschaftlichen Erkenntnissen zu einer kohärenten und vollständigen Sicht der Welt zu gelangen, ergibt sich eine neue und überraschende Konstellation. Die Bezugnahme auf die Naturwissenschaften verleiht der Metaphysik einerseits die Berechtigung dazu, revisionär zu sein, das heißt, Erkenntnisansprüche, die aus dem alltäglichen Weltverständnis stammen, zu revidieren. Andererseits ist eine solche Metaphysik ebenso hypothetisch wie die Wissenschaften selbst. Michael Esfeld zeigt zunächst, wie man in diesem Rahmen einen wissenschaftlichen Realismus vertreten kann, und begründet dann so umstrittene Thesen wie die eines vierdimensionalen Blockuniversums mit Ereignissen und Prozessen statt Substanzen oder die eines naturphilosophischen Holismus und Strukturenrealismus statt eines Atomismus und rehabilitiert die Idee notwendiger Verbindungen in der Natur.

Neuropsychological outcome after extra-temporal epilepsy surgery.

BACKGROUND: The neuropsychological results of temporal lobe epilepsy surgery are well reported in the literature. The aim of this study was to analyse the neuropsychological outcome in a consecutive series of patients with extra-temporal epilepsy. METHODS: We retrospectively analysed the data of patients operated between 1996 and 2008 for extra-temporal epilepsy. Standard neuropsychological tests were applied. We assessed the neuropsychological outcome after surgery and the correlation of the neuropsychological outcome with (1) side and localisation of surgery, (2) Engel scale for seizure outcome and (3) timing of surgery. FINDINGS: Patients had a better neuropsychological outcome when undergoing non-frontal resection [χ2 (2) =6.66, p = 0.036]. Subjects who had undergone left or right resection showed no difference in outcome [χ2 (2) =0.533, p = 0.766]. The correlation between the Engel scale for seizure re-occurence and the neuropsychological scores showed only a tendency for better outcome (Spearman ρ = -0.437; p = 0.069). The global measure of change did not correlate significantly with delay of surgery (Spearman ρ = -0.163; p = 0.518). CONCLUSIONS: Resective epilepsy surgery improves neuropsychological status outcome in patients with extra-temporal epilepsy even if the patient did not become seizure free. The outcome is better for non-frontal localisation.