Treatment of pediatric myelodysplastic syndromes and juvenile myelomonocytic leukemia: the Brazilian experience in the past decade

Background: Therapy strategies for myelodysplastic syndromes (MDS) and juvenile myelomonocytic leukemia (JMML) vary considerably. Objective: To review the treatment of Brazilian children who were diagnosed with MDS or JMML in the past decade and reported to the Brazilian Cooperative Group on Pediatric Myelodysplastic syndromes (BCG-MDS-PED). Results: of 173 children reported to the BCG-MDS-PED from January 1997 to January 2003 with a suspected diagnosis of MDS or JMML, 91 had the diagnosis confirmed after central review of the bone marrow aspirate and biopsy. Information on previous treatments was available for 78 MDS/JMML patients. Treatment varied from different schedules of low-dose (14%) and standard-dose chemotherapy (50%), granulocyte-colony-stimulating factor (G-CSF 7%), interferon (5%), steroids (2%) and erythropoietin (2%) to allogeneic stem-cell transplantation (SCT) (14%). No survival advantage could be demonstrated based on Hasle's classification or based on treatment. Conclusion: This report reflects the current practice in treating Brazilian children with MDS/JMML without specific Cooperative Group guidelines. Treatment modalities were very heterogeneous. The strategies for implementing a national protocol should consider international guidelines and focus on local experience and available resources. (C) 2004 Elsevier Ltd. All rights reserved.

Homonymy in natural language processes: A representation using Pustejovsky's Qualia Structure and ontological information

This paper presents a proposal for the semantic treatment of ambiguous homographic forms in Brazilian Portuguese, and to offer linguistic strategies for its computational implementation in Systems of Natural Language Processing (SNLP). Pustejovsky's Generative Lexicon was used as a theoretical model. From this model, the Qualia Structure - QS (and the Formal, Telic, Agentive and Constitutive roles) was selected as one of the linguistic and semantic expedients for the achievement of disambiguation of homonym forms. So that analyzed and treated data could be manipulated, we elaborated a Lexical Knowledge Base (LKB) where lexical items are correlated and interconnected by different kinds of semantic relations in the QS and ontological information.

Long-term effectiveness and treatment timing for bionator therapy

The aim of the present investigation was to provide information about the long-term effects and optimal timing for class-II treatment with the Bionator appliance. Lateral cephalograms of 23 class-II patients treated with the Bionator were analyzed at three time periods: T1, start of treatment; T2, end of Bionator therapy; and T3, long-term observation (after completion of growth). T3 includes a phase with fixed appliances. The treated sample was divided into two groups according to their skeletal maturity as evaluated by the cervical vertebral maturation (CVM) method. The early-treated group (13 subjects) initiated treatment before the peak in mandibular growth, which occurred after completion of Bionator therapy. The late-treated group (10 subjects) received Bionator treatment during the peak. The T1-T2, T2-T3, and T1-T3 changes in the treated groups were compared with changes in control groups of untreated class-II subjects by nonparametric statistics (P < .05). The findings of the present study on Bionator therapy followed by fixed appliances indicate that this treatment protocol is more effective and stable when it is performed during the pubertal growth spurt. Optimal timing to start treatment with the Bionator is when a concavity appears at the lower borders of the second and the third cervical vertebrae (CVMS 11). In the long term, the amount of significant supplementary elongation of the mandible in subjects treated during the pubertal peak is 5.1 mm more than in the controls, and it is associated with a backward direction of condylar growth. Significant increments in mandibular ramus height also were recorded.

A comparison between diuretics and angiotensin-receptor blocker agents in patients with stage I hypertension (PREVER-treatment trial): Study protocol for a randomized double-blind controlled trial

Background: Cardiovascular disease is the leading cause of death in Brazil, and hypertension is its major risk factor. The benefit of its drug treatment to prevent major cardiovascular events was consistently demonstrated. Angiotensin-receptor blockers (ARB) have been the preferential drugs in the management of hypertension worldwide, despite the absence of any consistent evidence of advantage over older agents, and the concern that they may be associated with lower renal protection and risk for cancer. Diuretics are as efficacious as other agents, are well tolerated, have longer duration of action and low cost, but have been scarcely compared with ARBs. A study comparing diuretic and ARB is therefore warranted.Methods/design: This is a randomized, double-blind, clinical trial, comparing the association of chlorthalidone and amiloride with losartan as first drug option in patients aged 30 to 70 years, with stage I hypertension. The primary outcomes will be variation of blood pressure by time, adverse events and development or worsening of microalbuminuria and of left ventricular hypertrophy in the EKG. The secondary outcomes will be fatal or non-fatal cardiovascular events: myocardial infarction, stroke, heart failure, evidence of new subclinical atherosclerosis and sudden death. The study will last 18 months. The sample size will be of 1200 participants for group in order to confer enough power to test for all primary outcomes. The project was approved by the Ethics committee of each participating institution.Discussion: The putative pleiotropic effects of ARB agents, particularly renal protection, have been disputed, and they have been scarcely compared with diuretics in large clinical trials, despite that they have been at least as efficacious as newer agents in managing hypertension. Even if the null hypothesis is not rejected, the information will be useful for health care policy to treat hypertension in Brazil. Clinical trials registration number: ClinicalTrials.gov: NCT00971165. © 2011 Fuchs et al; licensee BioMed Central Ltd.

Archives information publishing new design in post-custodial regime: The National Archives Experience Digital Vaults

The uses of Information and Communication Technologies (ICT) and Web environments for creation, treatment and availability of information have supported the emergence of new social-cultural patterns represented by convergences in textual, image and audio languages. This paper describes and analyzes the National Archives Experience Digital Vaults as a digital publishing web environment and as a cultural heritage. It is a complex system - synthesizer of information design options at information setting, provides new aesthetic aspects, but specially enlarges the cognition of the subjects who interact with the environment. It also enlarges the institutional spaces that guard the collective memory beyond its role of keeping the physical patrimony collected there. Digital Vaults lies as a mix of guide and interactive catalogue to be dealt in a ludic way. The publishing design of the information held on the Archives is meant to facilitate access to knowledge. The documents are organized in a dynamic and not chronological way. They are not divided in fonds or distinct categories, but in controlled interaction of documents previously indexed and linked by the software. The software creates information design and view of documental content that can be considered a new paradigm in Information Science and are part of post-custodial regime, independent from physical spaces and institutions. Information professionals must be prepared to understand and work with the paradigmatic changes described and represented by the new hybrid digital environments; hence the importance of this paper. Cyberspace interactivity between user and the content provided by the environment design provide cooperation, collaboration and sharing knowledge actions, all features of networks, transforming culture globally. © 2011 - IOS Press and the authors. All rights reserved.

Archives information publishing new design in post-custodial regime: The National Archives Experience Digital Vaults

The uses of Information and Communication Technologies (ICT) and Web environments for creation, treatment and availability of information have supported the emergence of new social-cultural patterns represented by convergences in textual, image and audio languages. This paper describes and analyzes the National Archives Experience Digital Vaults as a digital publishing web environment and as a cultural heritage. It is a complex system - synthesizer of information design options at information setting, provides new aesthetic aspects, but specially enlarges the cognition of the subjects who interact with the environment. It also enlarges the institutional spaces that guard the collective memory beyond its role of keeping the physical patrimony collected there. Digital Vaults lies as a mix of guide and interactive catalogue to be dealt in a ludic way. The publishing design of the information held on the Archives is meant to facilitate access to knowledge. The documents are organized in a dynamic and not chronological way. They are not divided in fonds or distinct categories, but in controlled interaction of documents previously indexed and linked by the software. The software creates information design and view of documental content that can be considered a new paradigm in Information Science and are part of post-custodial regime, independent from physical spaces and institutions. Information professionals must be prepared to understand and work with the paradigmatic changes described and represented by the new hybrid digital environments; hence the importance of this paper. Cyberspace interactivity between user and the content provided by the environment design provide cooperation, collaboration and sharing knowledge actions, all features of networks, transforming culture globally.

Connective tissue graft plus resin-modified glass ionomer restoration for the treatment of gingival recession associated with non-carious cervical lesions: Microbiological and immunological results

Objectives: It was previously reported the clinical results of placing subgingival resin-modified glass ionomer restoration for treatment of gingival recession associated with non-carious cervical lesions. The aim of this study was to evaluate the influence of this treatment on the subgingival biofilm and gingival crevicular fluid (GCF) inflammatory markers. Materials and methods: Thirty-four patients presenting the combined defect were selected. The defects were treated with either connective tissue graft plus modified glass ionomer restoration (CTG+R) or with connective tissue graft only (CTG). Evaluation included bleeding on probing and probing depth, 5 different bacteria targets in the subgingival plaque assessed at baseline, 45, and 180 days post treatments, and 9 inflammatory mediators were also assessed in the GCF. Results: The levels of each target bacterium were similar during the entire period of evaluation (p > 0. 05), both within and between groups. The highest levels among the studied species were observed for the bacterium associated with periodontal health. Additionally, the levels of all cyto/chemokines analyzed were not statistically different between groups (p > 0. 05). Conclusion: Within the limits of the present study, it can be concluded that the presence of subgingival restoration may not interfere with the subgingival microflora and with GCF inflammatory markers analyzed. Clinical relevance: This approach usually leads to the placement of a subgingival restoration. There is a lack of information about the microbiological and immunological effects of this procedure. The results suggest that this combined approach may be considered as a treatment option for the lesion included in this study. © 2012 Springer-Verlag.

Oral health-related quality of life and satisfaction before and after treatment with complete dentures in a Dental School in Brazil

Purpose: The aim of this study was to evaluate the impact of treatment with new complete dentures on oral health-related quality of life and satisfaction of edentulous patients attending the Prosthodontic Department in a Dental School in Brazil. Methods: A total of 70 edentulous subjects (37-86 years) treated by undergradute students at the Araçatuba Dental School, University of State of São Paulo, were accessed. A specific questionnaire for edentulous patients (EDENT) based on the Oral Health Impact Profile (OHIP-EDENT) was applied to collect information on patient oral health-related quality of life. Questions related to the personal satisfaction of the edentulous patients with their complete dentures were also included. The patients were accessed before the treatment, and 3 months after receiving the new dentures. Results: After rehabilitation with new complete dentures, all domains of OHIP-EDENT showed significant improvements. There was also a significant improvement in patient satisfaction after placement of new complete dentures. Furthermore, it was possible to observe association between upper denture satisfaction and age. Conclusion: Conventional complete dentures may have a positive impact on oral health-related quality of life and satisfaction of edentulous patients. © 2012 Japan Prosthodontic Society.

Treatment of geophysical data as a non-stationary process

ABSTRACT: The Kalman-Bucy method is here analized and applied to the solution of a specific filtering problem to increase the signal message/noise ratio. The method is a time domain treatment of a geophysical process classified as stochastic non-stationary. The derivation of the estimator is based on the relationship between the Kalman-Bucy and Wiener approaches for linear systems. In the present work we emphasize the criterion used, the model with apriori information, the algorithm, and the quality as related to the results. The examples are for the ideal well-log response, and the results indicate that this method can be used on a variety of geophysical data treatments, and its study clearly offers a proper insight into modeling and processing of geophysical problems.

Mucopolysaccharidosis I, II, and VI: brief review and guidelines for treatment

Mucopolysaccharidoses (MPS) are rare genetic diseases caused by the deficiency of one of the lysosomal enzymes involved in the glycosaminoglycan (GAG) breakdown pathway. This metabolic block leads to the accumulation of GAG in various organs and tissues of the affected patients, resulting in a multisystemic clinical picture, sometimes including cognitive impairment. Until the beginning of the XXI century, treatment was mainly supportive. Bone marrow transplantation improved the natural course of the disease in some types of MPS, but the morbidity and mortality restricted its use to selected cases. The identification of the genes involved, the new molecular biology tools and the availability of animal models made it possible to develop specific enzyme replacement therapies (ERT) for these diseases. At present, a great number of Brazilian medical centers from all regions of the country have experience with ERT for MPS I, II, and VI, acquired not only through patient treatment but also in clinical trials. Taking the three types of MPS together, over 200 patients have been treated with ERT in our country. This document summarizes the experience of the professionals involved, along with the data available in the international literature, bringing together and harmonizing the information available on the management of these severe and progressive diseases, thus disclosing new prospects for Brazilian patients affected by these conditions.

Archives information publishing new design in post-custodial regime: the national archives experience digital vaults

The uses of Information and Communication Technologies (ICT) and Web environments for creation, treatment and availability of information have supported the emergence of new social-cultural patterns represented by convergences in textual, image and audio languages. This paper describes and analyzes the National Archives Experience Digital Vaults as a digital publishing web environment and as a cultural heritage. It is a complex system - synthesizer of information design options at information setting, provides new aesthetic aspects, but specially enlarges the cognition of the subjects who interact with the environment. It also enlarges the institutional spaces that guard the collective memory beyond its role of keeping the physical patrimony collected there. Digital Vaults lies as a mix of guide and interactive catalogue to be dealt in a ludic way. The publishing design of the information held on the Archives is meant to facilitate access to knowledge. The documents are organized in a dynamic and not chronological way. They are not divided in fonds or distinct categories, but in controlled interaction of documents previously indexed and linked by the software. The software creates information design and view of documental content that can be considered a new paradigm in Information Science and are part of post-custodial regime, independent from physical spaces and institutions. Information professionals must be prepared to understand and work with the paradigmatic changes described and represented by the new hybrid digital environments; hence the importance of this paper. Cyberspace interactivity between user and the content provided by the environment design provide cooperation, collaboration and sharing knowledge actions, all features of networks, transforming culture globally.

Automatic Indexing and Information Visualization: A Study Based on Paraconsistent Logic

This paper reports a research to evaluate the potential and the effects of use of annotated Paraconsistent logic in automatic indexing. This logic attempts to deal with contradictions, concerned with studying and developing inconsistency-tolerant systems of logic. This logic, being flexible and containing logical states that go beyond the dichotomies yes and no, permits to advance the hypothesis that the results of indexing could be better than those obtained by traditional methods. Interactions between different disciplines, as information retrieval, automatic indexing, information visualization, and nonclassical logics were considered in this research. From the methodological point of view, an algorithm for treatment of uncertainty and imprecision, developed under the Paraconsistent logic, was used to modify the values of the weights assigned to indexing terms of the text collections. The tests were performed on an information visualization system named Projection Explorer (PEx), created at Institute of Mathematics and Computer Science (ICMC - USP Sao Carlos), with available source code. PEx uses traditional vector space model to represent documents of a collection. The results were evaluated by criteria built in the information visualization system itself, and demonstrated measurable gains in the quality of the displays, confirming the hypothesis that the use of the para-analyser under the conditions of the experiment has the ability to generate more effective clusters of similar documents. This is a point that draws attention, since the constitution of more significant clusters can be used to enhance information indexing and retrieval. It can be argued that the adoption of non-dichotomous (non-exclusive) parameters provides new possibilities to relate similar information.

Analysis of the chronic intake of and withdrawal from diazepam on emotional reactivity and sensory information processing in rats

It has been demonstrated that, on abrupt withdrawal, patients with chronic exposure can experience a number of symptoms indicative of a dependent state. In clinical patients, the earliest to arise and most persistent signal of withdrawal from chronic benzodiazepine (Bzp) treatment is anxiety. In laboratory animals, anxiety-like effects following abrupt interruption of chronic Bzp treatment can also be reproduced. In fact, signs that oscillate from irritability to extreme fear behaviours and seizures have been described already. As anxiety remains one of the most important symptoms of Bzp withdrawal, in this study we evaluated the anxiety levels of rats withdrawn from diazepam. Also studied were the effects on the motor performance and preattentive sensory gating process of rats under diazepam chronic treatment and upon 48-h withdrawal on three animal models of anxiety, the elevated plus-maze (EPM), ultrasonic vocalizations (USV) and startle + prepulse inhibition tests. Data obtained showed an anxiolytic- and anxiogenic-like profile of the chronic intake of and withdrawal from diazepam regimen in the EPM test, 22-KHz USV and startle reflex. Diazepam chronic effects or its withdrawal were ineffective in promoting any alteration in the prepulse inhibition (PPI). However, an increase of PPI was achieved in both sucrose and diazepam pretreated rats on 48-h withdrawal, suggesting a procedural rather than a specific effect of withdrawal on sensory gating processes. It is also possible that the prepulse can function as a conditioned stimulus to informing the delivery of an aversive event, as the auditory startling-eliciting stimulus. All these findings are indicative of a sensitization of the neural substrates of aversion in diazepam withdrawn animals without concomitant changes on the processing of sensory information

Pyridinic analog of the natural product (-)-spectaline as potential adjuvant for the treatment of central nervous system disorders

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)