Mini-Mental State Examination performance in frail, pre-frail, and non-frail community dwelling older adults in Ermelino Matarazzo, Sao Paulo, Brazil

Background: Frailty in older adults is a multifactorial syndrome defined by low metabolic reserve, less resistance to stressors, and difficulty in maintaining organic homeostasis due to cumulative decline of multiple physiological systems. The relationship between frailty and cognition remains unclear and studies about Mini-Mental State Examination (MMSE) performance and frailty are scarce. The objective was to examine the association between frailty and cognitive functioning as assessed by the MMSE and its subdomains. Methods: A cross-sectional population-based study (FIBRA) was carried out in Ermelino Matarazzo, a poor subdistrict of the city of Sao Paulo, Brazil. Participants were 384 community dwelling older adults, 65 years and older who completed the MMSE and a protocol to assess frailty criteria as described in the Cardiovascular Health Study (CHS). Results: Frail older adults had significantly worse performance on the MMSE (p < 0.001 for total score). Linear regression analyses showed that the MMSE total score was influenced by age (p < 0.001), education (p < 0.001), family income (p < 0.001), and frailty status (p < 0.036). Being frail was associated more significantly with worse scores in Time Orientation (p < 0.004) and Immediate Memory (p < 0.001). Conclusions: Our data suggest that being frail is associated with worse cognitive performance, as assessed by the MMSE. It is recommended that the assessment of frail older adults should include the investigation of their cognitive status.

Magnetic susceptibility study of Ce3+ in PbCeA (A=Te, Se, S)

The magnetic susceptibility of Pb(1-x)Ce(x)A (A=S, Se and Te) crystals with Ce3+ concentrations 0.006 <= x <= 0.036 was investigated in the temperature range from 2 K to 300 K. The magnetic susceptibility data was found to be consistent with a E-2(5/2) lowest manifold for Ce3+ ions with a crystal-field splitting Delta=E(Gamma(8))-E(Gamma(7)) of about 340 K, 440 K and 540 K for Pb1-xCexTe, Pb1-xCexSe, and Pb1-xCexS, respectively. For all the three compounds the doublet Gamma(7) lies below the Gamma(8) quadruplet which confirms the substitution of Pb2+ by Ce3+ ions in the host crystals. The observed values for the crystal-field splitting are in good agreement with the calculated ones based on the point-charge model. Moreover, the effective Lande factors were determined by X-band (similar to 9.5 GHz), electron paramagnetic measurements (EPR) to be g=1.333, 1.364, and 1.402 for Ce ions in PbA, A = S. Se and Te, respectively. The small difference with the predicted Lande factor g of 10/7 for the Gamma(7) (J=5/2) ground state was attributed to crystal-field admixture. (C) 2012 Elsevier B.V. All rights reserved.

The effect of CCL3 and CCR1 in bone remodeling induced by mechanical loading during orthodontic tooth movement in mice

Bone remodeling is affected by mechanical loading and inflammatory mediators, including chemokines. The chemokine (C–C motif) ligand 3 (CCL3) is involved in bone remodeling by binding to C–C chemokine receptors 1 and 5 (CCR1 and CCR5) expressed on osteoclasts and osteoblasts. Our group has previously demonstrated that CCR5 down-regulates mechanical loading-induced bone resorption. Thus, the present study aimed to investigate the role of CCR1 and CCL3 in bone remodeling induced by mechanical loading during orthodontic tooth movement in mice. Our results showed that bone remodeling was significantly decreased in CCL3−/− and CCR1−/− mice and in animals treated with Met-RANTES (an antagonist of CCR5 and CCR1). mRNA levels of receptor activator of nuclear factor kappa-B (RANK), its ligand RANKL, tumor necrosis factor alpha (TNF-α) and RANKL/osteoprotegerin (OPG) ratio were diminished in the periodontium of CCL3−/− mice and in the group treated with Met-RANTES. Met-RANTES treatment also reduced the levels of cathepsin K and metalloproteinase 13 (MMP13). The expression of the osteoblast markers runt-related transcription factor 2 (RUNX2) and periostin was decreased, while osteocalcin (OCN) was augmented in CCL3−/− and Met-RANTES-treated mice. Altogether, these findings show that CCR1 is pivotal for bone remodeling induced by mechanical loading during orthodontic tooth movement and these actions depend, at least in part, on CCL3.

Alterações de parâmetros relacionados ao metabolismo ósseo em mulheres submetidas à derivação gástrica em Y de Roux

OBJETIVO: Avaliar o metabolismo ósseo e a densidade mineral óssea (DMO) em mulheres adultas pós-derivação gástrica em Y de Roux (DGYR). SUJEITOS E MÉTODOS: Estudo transversal com 48 mulheres submetidas a DGYR há três anos e 41 saudáveis. Dados obtidos: índice de massa corporal (IMC), atividade física, consumo alimentar e DMO da coluna lombar, colo e fêmur total. Dosagem de cálcio, fósforo, magnésio, albumina, fosfatase alcalina, telopeptídeo-C (CTX), paratormônio (PTH), 25-hidroxivitamina D (25OHD), osteocalcina e cálcio urinário. RESULTADOS: Maiores alterações no grupo DGYR observadas nos níveis de osteocalcina (p < 0,001), CTX (p < 0,001) e PTH (p < 0,001). Deficiência de 25OHD foi a mais frequente no grupo DGYR (p = 0,010). Deficiência/insuficiência de 25OHD associou-se com hiperparatiroidismo secundário (p = 0,025). Não houve diferença entre os grupos em relação à DMO. A ingestão de energia (p = 0,036) e proteína (p = 0,004) foi maior no grupo controle. CONCLUSÃO: Em mulheres pós-DGYR, encontraram-se alta frequência de deficiência de vitamina D, hiperparatireoidismo secundário e elevação nos marcadores de remodelação óssea, sem alteração na DMO quando comparado com o grupo controle não obeso.

Eficácia da auriculoterapia para estresse segundo experiência do terapeuta: ensaio clínico

OBJETIVO: Ensaio clínico objetivou avaliar a eficácia da auriculoterapia com agulhas semipermanentes sobre níveis de estresse na equipe de Enfermagem de um hospital-escola, entre janeiro e julho de 2010. MÉTODOS: Quarenta e nove pessoas foram randomizadas em três grupos: grupo 1 (controle), grupo 2 (terapeutas menos experientes) e grupo 3 (terapeutas mais experientes). Os sujeitos receberam oito sessões nos pontos Shen Men, Rim e Tronco Cerebral tendo sido avaliados no início, com quatro e oito, sessões e follow-up (15 dias). RESULTADOS: A ANOVA constatou diferenças estatisticamente significativas entre os resultados antes e depois entre os grupos na 3ª avaliação (F=3,404/p=0,042) e follow-up (F=4,106/p=0,023). Tais diferenças foram entre grupo 1/3 na 3ª avaliação (p=0,036) e follow-up (p=0,033). Resultado marginalmente significante foi encontrado no follow-up entre grupo 1/2 (p=0, 059). CONCLUSÃO: A auriculoterapia com terapeutas mais experientes reduziu eficazmente o estresse em profissionais de Enfermagem, no entanto, considera-se a necessidade de mais estudos com este procedimento.

Primary diffuse large B-cell lymphoma or lymphomatoid granulomatosis grade 3: a still-puzzling diagnosis in autopsy

Primary lung lymphoma is a rare entity accounting for approximately 0.3% of all primary neoplasia of the lung and includes diffuse large B-cell lymphoma (DLBL) and lymphomatoid granulomatosis (LYG). Considering that clinical features may be similar, whereas epidemiology, morphology, and radiological features are different, the authors report a case of a middle-aged man who presented multiple pulmonary nodules in the lower lobes and groundglass opacities scattered bilaterally on computed tomography. Clinically, he presented a consumptive syndrome with respiratory failure and pleurisy, which progressed until death. The autopsy findings were consistent with lymphomatoid granulomatosis (LYG) grade 3/ diffuse large B-cell lymphoma (DLBL). The authors call attention to the difficulty of establishing an accurate diagnosis, mainly when the demonstration of EBV-infected atypical B-cells fails.

Distribuição geográfica e caracterização molecular de vírus da raiva de isolados herbívoros procedentes do norte do Brasil

Suporte Financeiro: CAPES

Fluorcalciomicrolite, (Ca,Na,□)2Ta2O6F, a new microlite-group mineral from Volta Grande pegmatite, Nazareno, Minas Gerais, Brazil

Fluorcalciomicrolite, (Ca,Na,□)2Ta2O6F, is a new microlite-group, pyrochlore supergroup mineral approved by the CNMNC (IMA 2012-036). It occurs as an accessory mineral in the Volta Grande pegmatite, Nazareno, Minas Gerais, Brazil. Associated minerals include: microcline, albite, quartz, muscovite, spodumene, "lepidolite", cassiterite, tantalite-(Mn), monazite-(Ce), fluorite, "apatite", beryl, "garnet", epidote, magnetite, gahnite, zircon, "tourmaline", bityite, hydrokenomicrolite, and other microlite-group minerals under study. Fluorcalciomicrolite occurs as euhedral, untwinned, octahedral crystals 0.1-1.5 mm in size, occasionally modified by rhombododecahedral faces. The crystals are colourless and translucent; the streak is white, and the lustre is adamantine to resinous. It does not fluoresce under ultraviolet light. Mohs' hardness is 4½- 5, tenacity is brittle. Cleavage is not observed; fracture is conchoidal. The calculated density is 6.160 g/cm3. The mineral is isotropic, ncalc. = 1.992. The Raman spectrum is dominated by bands of B-X octahedral bond stretching and X-B-X bending modes.The chemical composition (n = 6) is (by wavelength dispersive spectroscopy, H2O calculated to obtain charge balance, wt.%): Na2O 4.68, CaO 11.24, MnO 0.01, SrO 0.04, BaO 0.02, SnO2 0.63, UO2 0.02, Nb2O5 3.47, Ta2O5 76.02, F 2.80, H2O 0.48, O=F -1.18, total 98.23. The empirical formula, based on 2 cations at the B site, is (Ca1.07Na0.81□0.12)∑2.00(Ta1.84Nb0.14Sn0.02)∑2.00 [O5.93(OH)0.07]6.00[F0.79(OH)0.21]. The strongest eight X-ray powder-diffraction lines [d in Å(I)(hkl)] are: 5.997(59)(111), 3.138(83)(311), 3.005(100)(222), 2.602(29)(400), 2.004(23)(511), 1.841(23)(440), 1.589(25)(533), and 1.504(24)(444). The crystal structure refinement (R1 = 0.0132) gave the following data: cubic, Fd3m, a = 10.4191(6) Å, V = 1131.07(11) Å3, Z = 8.

Oxidation of Copper(I) in seawater at nanomolar levels

The oxidation and reduction of copper in air-saturated seawater and NaCl solutions has been measured as a function of pH (7.17-8.49), temperature (5-35ºC) and ionic strength (0.1-0.7 M). The oxidation rate was fitted to an equation for sodium chloride and seawater valid at different pH and media conditions: k . . pH- . /T- . I . I k . . pH- . /T- . I . I (sw) (NaCl) log 5 036 0 514 1764 915 1101 0 233 log 5 221 0 609 1915 433 1818 0 408 = + + = + + The reduction of Cu(II) was studied in both media for different initial concentration of copper(II). When the initial Cu(II) concentration was 200 nM, the copper(I) produced was 20% and 9% for NaCl and seawater, respectively. Considering the copper(I) reduced from Cu(II), the speciation and the contribution of these species to the kinetic process was studied. The Cu(I) speciation is dominated by the CuCl2 - species. On the other hand, the neutral chloride CuCl species dominates the Cu(I) oxidation in the range 0.1 M to 0.7 M chloride concentrations.

Hochgenaue Berechnungen von Energien und molekularen Eigenschaften mit Hilfe der Coupled-Cluster-Theorie

Coupled-Cluster-Theorie (CC) ist in der heutigen Quantenchemie eine der erfolgreichsten Methoden zur genauen Beschreibung von Molekülen. Die in dieser Arbeit vorgestellten Ergebnisse zeigen, daß neben den Berechnungen von Energien eine Reihe von Eigenschaften wie Strukturparameter, Schwingungsfrequenzen und Rotations-Schwingungs-Parameter kleiner und mittelgrofler Moleküle zuverlässig und präzise vorhergesagt werden können. Im ersten Teil der Arbeit wird mit dem Spin-adaptierten Coupled-Cluster-Ansatz (SA-CC) ein neuer Weg zur Verbesserung der Beschreibung von offenschaligen Systemen vorgestellt. Dabei werden zur Bestimmung der unbekannten Wellenfunktionsparameter zusätzlich die CC-Spingleichungen gelöst. Durch dieses Vorgehen wird gewährleistet, daß die erhaltene Wellenfunktion eine Spineigenfunktion ist. Die durchgeführte Implementierung des Spin-adaptierten CC-Ansatzes unter Berücksichtigung von Einfach- und Zweifachanregungen (CCSD) für high-spin Triplett-Systeme wird ausführlich erläutert. Im zweiten Teil werden CC-Additionsschemata vorgestellt, die auf der Annahme der Additivität von Elektronenkorrelations- und Basissatzeffekten basieren. Die etablierte Vorgehensweise, verschiedene Beiträge zur Energie mit an den Rechenaufwand angepassten Basissätzen separat zu berechnen und aufzusummieren, wird hier auf Gradienten und Kraftkonstanten übertragen. Für eine Beschreibung von Bindungslängen und harmonischen Schwingungsfrequenzen mit experimenteller Genauigkeit ist die Berücksichtigung von Innerschalenkorrelationseffekten sowie Dreifach- und Vierfachanregungen im Clusteroperator der Wellenfunktion nötig. Die Basissatzkonvergenz wird dabei zusätzlich mit Extrapolationsmethoden beschleunigt. Die quantitative Vorhersage der Bindungslängen von 17 kleinen Molekülen, aufgebaut aus Atomen der ersten Langperiode, ist so mit einer Genauigkeit von wenigen Hundertstel Pikometern möglich. Für die Schwingungsfrequenzen dieser Moleküle weist das CC-Additionsschema basierend auf den berechneten Kraftkonstanten im Vergleich zu experimentellen Ergebnissen einen mittleren absoluten Fehler von 3.5 cm-1 und eine Standardabweichung von 2.2 cm-1 auf. Darüber hinaus werden zur Unterstützung von experimentellen Untersuchungen berechnete spektroskopische Daten einiger größerer Moleküle vorgelegt. Die in dieser Arbeit vorgestellten Untersuchungen zur Isomerisierung von Dihalogensulfanen XSSX (X= F, Cl) oder die Berechnung von Struktur- und Rotations-Schwingungs-Parametern für die Moleküle CHCl2F und CHClF2 zeigen, daß bereits störungstheoretische CCSD(T)-Näherungsmethoden qualitativ gute Vorhersagen experimenteller Resultate liefern. Desweiteren werden Diskrepanzen von experimentellen und berechneten Bindungsabständen bei den Molekülen Borhydrid- und Carbenylium durch die Berücksichtigung des elektronischen Beitrages zum Trägheitsmoment beseitigt.

Uremic Neuropathy: Epiemiological Study in Hemodialysis Patients

Background/Aims. Uremic Neuropathy (UN) highly limits the individual self-sufficiency causing near-continuous pain. An estimation of the actual UN prevalence among hemodialysis patients was the aim of the present work. Methods. We studied 225 prevalent dialysis patients from two Italian Centres. The Michigan Neuropathy Score Instrument (MNSI), already validated in diabetic neuropathy, was used for the diagnosis of UN. It consisted of a questionnaire (MNSI_Q) and a physical-clinical evaluation (MNSI_P). Patients without any disease possibly inducing secondary neuropathy and with MNSI score  3 have been diagnosed as affected by UN. Electroneurographic (ENG) lower limbs examination was performed in these patients to compare sensory conduction velocities (SCV) and sensory nerve action potentials (SNAP) with the MNSI results. Results. Thirtyseven patients (16.4%) were identified as being affected by UN, while 9 (4%) presented a score <3 in spite of neuropathic symptoms. In the 37 UN patients a significant correlation was found between MNSI_P and SCV (r2 = 0.1959; p<0.034) as well as SNAP (r2 = 0.3454; p=0.027) both measured by ENG. Conclusions. UN is an underestimated disease among the dialysis population even though it represents a huge problem in terms of pain and quality of life. MNSI could represent a valid and simple clinical-instrumental screening test for the early diagnosis of UN in view of an early therapeutic approach.

Multidimensional item response theory models with general and specific latent traits for ordinal data

The aim of the thesis is to propose a Bayesian estimation through Markov chain Monte Carlo of multidimensional item response theory models for graded responses with complex structures and correlated traits. In particular, this work focuses on the multiunidimensional and the additive underlying latent structures, considering that the first one is widely used and represents a classical approach in multidimensional item response analysis, while the second one is able to reflect the complexity of real interactions between items and respondents. A simulation study is conducted to evaluate the parameter recovery for the proposed models under different conditions (sample size, test and subtest length, number of response categories, and correlation structure). The results show that the parameter recovery is particularly sensitive to the sample size, due to the model complexity and the high number of parameters to be estimated. For a sufficiently large sample size the parameters of the multiunidimensional and additive graded response models are well reproduced. The results are also affected by the trade-off between the number of items constituting the test and the number of item categories. An application of the proposed models on response data collected to investigate Romagna and San Marino residents' perceptions and attitudes towards the tourism industry is also presented.

Measurement of the unpolarized K+ Lambda and K+ Sigma 0 electroproduction cross-section off the proton with KAOS-spectrometer

The new stage of the Mainz Microtron, MAMI, at the Institute for Nuclear Physics of the Johannes Gutenberg-University, operational since 2007, allows open strangeness experiments to be performed. Covering the lack of electroproduction data at very low Q2, p(e,K+)Lambda and p(e,K+)Sigma0, reactions have been studied at Q^2 = 0.036(GeV/c)^2 andrnQ^2 = 0.05(GeV=c)^2 in a large angular range. Cross-section at W=1.75rnGeV will be given in angular bins and compared with the predictions of Saclay-Lyon and Kaon Maid isobaric models. We conclude that the original Kaon-Maid model, which has large longitudinal couplings of the photon to nucleon resonances, is unphysical. Extensive studies for the suitability of silicon photomultipliers as read out devices for a scintillating fiber tracking detector, with potential applications in both positive and negative arms of the spectrometer, will be presented as well.

Compliance- und Lebensqualitätsmessung bei Patienten vor einer Nieren- oder Lebertransplantation

Die Arzneimittelcompliance hat eine hohe Vorhersagekraft für den Ausgang einer Organtransplantation. Allerdings wurden soweit keine Studien zur Arzneimittelcompliance mittels eletronischen Compliancemessung bei Dialyse- und Leberzirrhosepatienten durchgeführt. Das primäre Ziel dieser Studie war die Arzneimittelcompliance dieser beiden Patientenkollektive zu evaluieren und als sekundäres Ziel wurden die Einflussfaktoren von Non-Compliance untersucht. rnLeberzirrhosepatinten, die Propranolol und Dialysepatienten, die Phosphatbinder, jeweils 3 x tgl. einnahmen, konnten in der Studie teilnehmen. Die Arzneimittelcompliance wurde mittels MEMSTM über einen Zeitraum von jeweils 6 Monaten bestimmt. Des Weiteren wurde nach Einflussfaktoren wie die demopraphischen Daten, Depression, Lebensqualität und der Gesundheitszustand, bei den Dialysepatienten zusätzlich die Formulierung der Phosphatbinder und die Anzahl evaluiert. Zwischen den organinsuffizienten Patientenkollektiven war ein signifikanter Unterschied in der Dosing Compliancerate auszumachen (p<0,023). Die mittlere DC Rate war bei 61%±6% für Leberzirrhosepatienten im Vergleich zu 43%±5% in Dialysepatienten. Nur 10 Leberzirrhosepatienten (30%) and 6 Dialysepatienten (17%) konnten als compliant eingestuft werden. Je höher die Phosphatbinderdosen waren, umso niedrigere Dosing Complianceraten wurden erzielt. Bei 1,5-3 Tabletten pro Tag betrug die Compliancerate 55%±8% (n=16), bei 4-6 Tabletten pro Tag nur noch 37%±7% (n=15) und bei mehr als 7 Tabletten lediglich 21%±10% (n=5) (p<0,036). Bei den Dialysepatienten war jedoch auffällig, dass die Dosing Compliancerate in Abhängigkeit von der Anzahl der dokumentierten Erkrankungen inkl. Grunderkrankung stieg (Dosing Compliancerate 34%±9% für ≤1 Grunderkrankung, 42%±6% für 1-4 Komorbiditäten, 83%±3% für ≥5 Komorbiditäten; p<0,036).Das geringe Patientenwissen über die Arzneimittel und die Erkrankung und die niedrige Compliancerate bedürfen weitere Untersuchungen um die Aspekte zu verbessern. Diese Studie zeigte das eine pharmazeutische Betreuung schon vor einer Transplantation benötigt wird. Aber eine pharmazeutische Betreuung ist sehr kosten- und zeitintensiv. Vielleicht müssen neue Modelle der pharmazeutische Betreuung untersucht werden oder non-compliante Patienten müssen noch besser identifiziert werden für eine selektive pharmazeutische Betreuung.

The role of central hypersensitivity in the determination of intradiscal mechanical hyperalgesia in discogenic pain

OBJECTIVE: The primary aim of the present study was to investigate whether there is a relationship between central hypersensitivity (assessed by pressure pain thresholds of uninjured tissues) and intradiscal pain threshold during discography. The secondary aim was to test the hypothesis that peripheral noxious stimulation dynamically modulates central hypersensitivity. PATIENTS: Twenty-four patients with positive provocation discography were tested for central hypersensitivity by pressure algometry before and after the intervention with assessments of pressure pain detection and tolerance thresholds. Intradiscal pain threshold was assessed by measuring intradiscal pressure at the moment of pain provocation during discography. Correlation analyses between intradiscal pain threshold and pressure algometry were made. For the secondary aim, pressure algometry data before and after discography were compared. RESULTS: Significant correlation with intradiscal pain threshold was found for pressure pain detection threshold at the toe (regression coefficient: 0.03, P = 0.05) and pressure pain tolerance thresholds at the nonpainful point at the back (0.02, P = 0.024). Tolerance threshold at the toe was a significant predictor for intradiscal pain threshold only in multiple linear regression (0.036, P = 0.027). Detection as well as tolerance thresholds significantly decreased after discography at the painful and the nonpainful point at the back, but not at the toe. CONCLUSIONS: Central hypersensitivity may influence intradiscal pain threshold, but with a modest quantitative impact. The diagnostic value of provocation discography is therefore not substantially impaired. Regional, but not generalized central hypersensitivity is dynamically modulated by ongoing peripheral nociceptive input.