The risk of subsequent cancer and arterial cardiovascular events in patients with superficial vein thrombosis in the legs.

Although it has been clearly demonstrated that venous thromboembolism is associated with an increased risk of subsequent overt cancer and arterial cardiovascular events in comparison with control populations, whether this association also applies to patients with isolated (ie, without concomitant involvement of the deep vein system) superficial vein thrombosis (SVT) in the legs is unknown. In 737 consecutive patients with isolated SVT not involving the sapheno-femoral junction, we conducted a retrospective investigation to assess the rate of cancer and that of arterial cardiovascular events occurring during follow-up. The event rates were compared with those occurring in 1438 controls having comparable characteristics. Both cases and controls were followed-up for an average period of 26 ± 8 months (range, 3-45). Malignancy was diagnosed in 26 cases (3.5%) and 56 controls (3.9%), leading to a hazard ratio of 0.86 (95% confidence interval, 0.55%-1.35%). Arterial cardiovascular events occurred in 32 cases (4.3%) and 63 controls (4.4%), leading to a hazard ratio of 0.97 (95% confidence interval, 0.63%-1.50%). We conclude that the occurrence of isolated SVT in the legs does not place patients at an increased risk of malignancies or arterial cardiovascular events. Whether this conclusion also applies to patients whose thrombosis involves the sapheno-femoral junction remains to be demonstrated.

Kilpa-aerobiccia harrastaville suoritettu lihastasapainokartoitus

Opinnäytetyömme tarkoituksena oli selvittää, millainen on yhteistyöseuramme kilpa-aerobiccia harrastavien lihastasapaino ja näiden tulosten pohjalta laatia heille lihashuoltoharjoitteita. Työ tehtiin yhteistyössä urheiluseura Fliku 82:n kanssa. Otimme yhteyttä Fliku 82:sen valmentajaan ja hän kertoi, että tällaiselle testaukselle ja lihashuoltotunnille olisi tarvetta. Testeihin osallistui yhteensä 11 13-26-vuotiasta naispuolista kilpa-aerobiccaajaa. Testeihimme kuuluivat ryhtitutkimus, selkärangan sekä ylä- ja alaraajojen liikkuvuustestit. Testimittareina toimivat universaali goniometri ja mittanauha. Lisäksi apuna käytettiin plinttiä, tussia ja luotisuoraa. Toteutimme testit kahtena päivänä helmikuun 2007 aikana. Aikaa yhdelle testattavalle oli varattu 30 minuuttia. Kilpa-aerobiccaajilla löytyi yhteneviä tuloksia lihastasapainohäiriöiden suhteen. Etenkin liikkuvuustesteissä havaittiin yli puolella urheilijoista puolieroja vasemman ja oikean puolen välillä sekä ylä- että alaraajojen osalta. Selkärangan liikkuvuustesteissä löytyi kireyttä selän ekstensoreista. Ryhdissä havaittiin erityisesti pään ja olkapäiden eteenpäin työntyneisyyttä ja lapaluiden korkeuksien puolieroja sekä siirrotusta. Liikkuuvuustesteissä yhtenäistä rajoittuneisuutta liikkuvuudessa löytyi muun muassa olkanivelen ekstensoreista, lonkan abduktoreista ja adduktoreista sekä m.rectus femoriksesta. Saamistamme tuloksista on hyötyä erityisesti yhteistyökumppanimme urheilijoille. He saavat henkilökohtaisen palautteen omasta lihastasapainostaan ja asioista, joihin heidän kannattaisi kiinnittää huomiota harjoittelussaan tulevaisuudessa. Laatimamme lihashuoltoharjoitteet auttavat parantamaan lihastasapainoa ja täten vähentämään urheiluvammojen syntymistä.

Occipitoaxial spinal interarticular stabilization with vertebral artery preservation for atlantal lateral mass failure.

The treatment of craniocervical instability caused by diverse conditions remains challenging. Different techniques have been described to stabilize the craniocervical junction. The authors present 2 cases in which tumoral destruction of the C-1 lateral mass caused craniocervical instability. A one-stage occipitoaxial spinal interarticular stabilization (OASIS) technique with titanium cages and posterior occipitocervical instrumentation was used to reconstruct the C-1 lateral mass and stabilize the craniocervical junction. The ipsilateral vertebral artery was preserved. The OASIS technique offers single-stage tumor resection, C-1 lateral mass reconstruction, and stabilization with a loadsharing construct. It could be an option in the treatment of select cases of C-1 lateral mass failure.

A tumor-specific cellular environment at the brain invasion border of adamantinomatous craniopharyngiomas.

Craniopharyngiomas (CP) are benign epithelial tumors of the sellar region and can be clinicopathologically distinguished into adamantinomatous (adaCP) and papillary (papCP) variants. Both subtypes are classified according to the World Health Organization grade I, but their irregular digitate brain infiltration makes any complete surgical resection difficult to obtain. Herein, we characterized the cellular interface between the tumor and the surrounding brain tissue in 48 CP (41 adaCP and seven papCP) compared to non-neuroepithelial tumors, i.e., 12 cavernous hemangiomas, 10 meningiomas, and 14 metastases using antibodies directed against glial fibrillary acid protein (GFAP), vimentin, nestin, microtubule-associated protein 2 (MAP2) splice variants, and tenascin-C. We identified a specific cell population characterized by the coexpression of nestin, MAP2, and GFAP within the invasion niche of the adamantinomatous subtype. This was especially prominent along the finger-like protrusions. A similar population of presumably astroglial precursors was not visible in other lesions under study, which characterize them as distinct histopathological feature of adaCP. Furthermore, the outer tumor cell layer of adaCP showed a distinct expression of MAP2, a novel finding helpful in the differential diagnosis of epithelial tumors in the sellar region. Our data support the hypothesis that adaCP, unlike other non-neuroepithelial tumors of the central nervous system, create a tumor-specific cellular environment at the tumor-brain junction. Whether this facilitates the characteristic infiltrative growth pattern or is the consequence of an activated Wnt signaling pathway, detectable in 90% of these tumors, will need further consideration.

Criptosistemas baseados em curvas elípticas: Âmbitos e Limitações

As curvas elípticas têm um papel de relevo na criptogra a actual, estando na origem de um dos métodos para estudo da factorização e da primalidade. O problema do logaritmo discreto no grupo de uma curva elíptica é utilizado como fonte para uma função de uma via numdos mais e cientes sistemas criptográ cos. Não se obteve ainda umalgoritmo com um tempo de execução subexponencial que permitisse resolver esse problema relativamente ao grupo de uma curva elíptica e que pudesse pôr em causa a segurança de um sistema criptográ co fundamentado nas curvas elípticas. Os critérios de primalidade baseados em curvas elípticas são ainda entre os melhores métodos utilizados para passar certi cado de primalidade a um número com mais de mil dígitos decimais. A e ciência dos métodos para factorizar um número inteiro N, baseados em curvas elípticas, é tanto maior quanto maior for a diferença entre pN e um dos divisores primos de N, o que impõe critérios preferenciais no uso do software mais adequado para as aplicações informáticas.

Evaluation of prenatal care in unit with family health strategy

We analyzed prenatal care (PN) provided at a unit of the Family Health Strategy Service in São Paulo, according to the indicators of the Program for the Humanization of Prenatal and Birth (PHPB). We compared adequacy of PN in terms of sociodemographic variables, procedures, examinations and maternal and perinatal outcomes. Cross-sectional study with data from records of 308 pregnant women enrolled in 2011. We observed early initiation of PN (82.1%), conducting of a minimum of six consultations (84.1%), puerperal consultation (89.0%); to the extent that there is a sum of the actions, there is a significant drop in the proportion of adequacy. Prenatal care was adequate for 67.9%, with a significant difference between adequacy groups in relation to gestational age and birth weight. Prenatal care deficiencies exist, especially in regards to registration of procedures, exams and immunization. The difference between adequacy groups with respect to perinatal outcomes reinforces the importance of prenatal care that adheres to the parameters of the PHPB.


Gestão e Organização das Forças de Segurança

A reorganização social da sociedade levou os governos a reverem as suas políticas de segurança. Consequentemente, tais políticas deram origens a várias reformas na área policial. Uma delas é precisamente a procura de formas suaves de resolução dos problemas que perturbem as sociedades, assim como a ordem pública e o bem-estar. O presente trabalho teve como objectivo analisar o actual modelo de policiamento da Polícia Nacional de Angola (PNA), numa fase em que a sociedade angolana, atenta as transformações do mundo dinâmico em que está inserida, cada vez mais se vai exigindo da mesma Polícia, um trabalho qualificado em prol da segurança comum. A partir da observação directa dos efectivos da Polícia nas ruas e nos comandos, procurou-se também compreender dos profissionais e da sociedade, acerca do trabalho dos efectivos da Polícia Nacional Angolana e do seu patrulhamento, de modo a concluirmos algo sobre a temática. Assim sendo pretende-se responder, com esta investigação, ao seguinte: a sociedade angolana está ou não preparada para uma policia menos militarizada?; Que tipo de politicas deve adoptar a PN A para atingir os seus objectivos?; As politicas de controlo e fiscalização dos actos dos efectivos do Comando-Geral da Polícia Nacional de Angola, será uma opção a considerar? Desta pesquisa concluímos que há uma necessidade do policiamento de proximidade na sociedade angolana, para a Polícia Nacional de Angola, alcançar com êxito os seus fins de promover a ordem pública e o bem-estar.

The expansion of 300 CTG repeats in myotonic dystrophy transgenic mice does not induce sensory or motor neuropathy.

Although many studies have been carried out to verify the involvement of the peripheral nervous system (PNS) in dystrophia myotonica (DM1) patients, the results remain controversial. The generation of DM1 transgenic mice displaying the human DM1 phenotype provides a useful tool to investigate the type and incidence of structural abnormalities in the PNS. In the present study, the morphological and morphometric analysis of semi-thin sections of sciatic and sural nerves, lumbar dorsal root ganglia (DRG) and lumbar spinal cords revealed that in DM1 transgenic mice carrying 300 CTG repeats, there is no change in the number and diameter of myelinated axons compared to wild type. Only a non-significant reduction in the percentage of thin myelinated axons was detected in electron micrographs of ultra-thin sciatic nerve sections. Analysis of the number of neurons did not reveal a loss in number of either sensory neurons in the lumbar DRG or motor neurons in the lumbar spinal cord in these DM1 mice. Furthermore, in hind limb muscle sections, stained with a neurofilament antibody and alpha-bungarotoxin, the intramuscular axon arborization appeared normal in DM1 mice and undistinguishable from that in wild-type mice. Moreover, in DM1 mice, there was no irregularity in the structure or an increase in the endplate area. Also statistical analysis did not show an increase in endplate density or in the concentration of acetylcholine receptors. Altogether, these results suggest that 300 CTG repeats are not sufficient to induce axonopathy, demyelination or neuronopathies in this transgenic mouse model.

Supercoiling, knotting and replication fork reversal in partially replicated plasmids.

To study the structure of partially replicated plasmids, we cloned the Escherichia coli polar replication terminator TerE in its active orientation at different locations in the ColE1 vector pBR18. The resulting plasmids, pBR18-TerE@StyI and pBR18-TerE@EcoRI, were analyzed by neutral/neutral two-dimensional agarose gel electrophoresis and electron microscopy. Replication forks stop at the Ter-TUS complex, leading to the accumulation of specific replication intermediates with a mass 1.26 times the mass of non-replicating plasmids for pBR18-TerE@StyI and 1.57 times for pBR18-TerE@EcoRI. The number of knotted bubbles detected after digestion with ScaI and the number and electrophoretic mobility of undigested partially replicated topoisomers reflect the changes in plasmid topology that occur in DNA molecules replicated to different extents. Exposure to increasing concentrations of chloroquine or ethidium bromide revealed that partially replicated topoisomers (CCCRIs) do not sustain positive supercoiling as efficiently as their non-replicating counterparts. It was suggested that this occurs because in partially replicated plasmids a positive DeltaLk is absorbed by regression of the replication fork. Indeed, we showed by electron microscopy that, at least in the presence of chloroquine, some of the CCCRIs of pBR18-Ter@StyI formed Holliday-like junction structures characteristic of reversed forks. However, not all the positive supercoiling was absorbed by fork reversal in the presence of high concentrations of ethidium bromide.

Tomosyn-1 is involved in a post-docking event required for pancreatic beta-cell exocytosis.

Although the assembly of a ternary complex between the SNARE proteins syntaxin-1, SNAP25 and VAMP2 is known to be crucial for insulin exocytosis, the mechanisms controlling this key event are poorly understood. We found that pancreatic beta-cells express different isoforms of tomosyn-1, a syntaxin-1-binding protein possessing a SNARE-like motif. Using atomic force microscopy we show that the SNARE-like domain of tomosyn-1 can form a complex with syntaxin-1 and SNAP25 but displays binding forces that are weaker than those observed for VAMP2 (237+/-13 versus 279+/-3 pN). In pancreatic beta-cells tomosyn-1 was found to be concentrated in cellular compartments enriched in insulin-containing secretory granules. Silencing of tomosyn-1 in the rat beta-cell line INS-1E by RNA interference did not affect the number of secretory granules docked at the plasma membrane but led to a reduction in stimulus-induced exocytosis. Replacement of endogenous tomosyn-1 with mouse tomosyn-1, which differs in the nucleotide sequence from its rat homologue and escapes silencing, restored a normal secretory rate. Taken together, our data suggest that tomosyn-1 is involved in a post-docking event that prepares secretory granules for fusion and is necessary to sustain exocytosis of pancreatic beta-cells in response to insulin secretagogues.

RAGBRAI Learn about the Land; Day 6, July 2008

Today you will be biking over the Iowa and Cedar rivers, two major rivers hit by the Iowa flood of 2008. Three miles northeast of North Liberty you’ll cross the Iowa River. The river crested on June 15, 2008 at a record 31.53 ft., three feet higher than the previous record during the flood of 1993. The flooding river caused extensive damage to the University of Iowa (see cover photo of Iowa Memorial Union taken by Univ. Relations, Univ. of Iowa), Coralville, and numerous smaller towns. The flooding of the Cedar River, which RAGBRAI will cross at Sutliff, caused even greater damage. At Cedar Rapids, the 2008 flood crest of 31.12 ft. was over 11 ft. higher than the previous record set in 1851! This massive amount of water inundated downtown Cedar Rapids, Palo, and Columbus Junction and caused massive damage to buildings and infrastructure. When crossing the Cedar River at Sutliff, be sure to look to your right to see the remains of the Historic Sutliff Bridge, one of the many casualties of the Iowa flood of 2008.

Vitamin C requirements in parenteral nutrition.

Some biochemical functions of vitamin C make it an essential component of parenteral nutrition (PN) and an important therapeutic supplement in other acute conditions. Ascorbic acid is a strong aqueous antioxidant and is a cofactor for several enzymes. The average body pool of vitamin C is 1.5 g, of which 3%-4% (40-60 mg) is used daily. Steady state is maintained with 60 mg/d in nonsmokers and 140 mg/d in smokers. Shocked surgical, trauma, and septic patients have a drastic reduction of circulating plasma ascorbate concentrations. These low concentrations require 3-g doses/d to restore normal plasma ascorbate concentrations, questioning the recommended PN dose of 100 mg/d. Determination of intravenous requirements is usually based on plasma concentrations, which are altered during the inflammatory response. There is no clear indicator of deficiency: serum or plasma ascorbate concentrations <0.3 mg/dL (20 micromol/L) indicates inadequate vitamin C status. On the basis of available pharmacokinetic data the 100 mg/d dose for patients receiving home PN and 200 mg/d for stable adult patients receiving PN are adequate, but requirements have been shown to be higher in perioperative, trauma, burn, and critically ill patients, paralleling oxidative stress. One recommendation cannot fit all categories of patients. Large vitamin C supplements may be considered in severe critical illness, major trauma, and burns because of increased requirements resulting from oxidative stress and wound healing. Future research should distinguish therapeutic use of high-dose ascorbic acid antioxidant therapy from nutritional PN requirements.

Identification of an agrin mutation that causes congenital myasthenia and affects synapse function.

We report the case of a congenital myasthenic syndrome due to a mutation in AGRN, the gene encoding agrin, an extracellular matrix molecule released by the nerve and critical for formation of the neuromuscular junction. Gene analysis identified a homozygous missense mutation, c.5125G>C, leading to the p.Gly1709Arg variant. The muscle-biopsy specimen showed a major disorganization of the neuromuscular junction, including changes in the nerve-terminal cytoskeleton and fragmentation of the synaptic gutters. Experiments performed in nonmuscle cells or in cultured C2C12 myotubes and using recombinant mini-agrin for the mutated and the wild-type forms showed that the mutated form did not impair the activation of MuSK or change the total number of induced acetylcholine receptor aggregates. A solid-phase assay using the dystrophin glycoprotein complex showed that the mutation did not affect the binding of agrin to alpha-dystroglycan. Injection of wild-type or mutated agrin into rat soleus muscle induced the formation of nonsynaptic acetylcholine receptor clusters, but the mutant protein specifically destabilized the endogenous neuromuscular junctions. Importantly, the changes observed in rat muscle injected with mutant agrin recapitulated the pre- and post-synaptic modifications observed in the patient. These results indicate that the mutation does not interfere with the ability of agrin to induce postsynaptic structures but that it dramatically perturbs the maintenance of the neuromuscular junction.

Sistemas e Tecnologias de Informação para Serviços Policiais O Caso da Polícia Nacional de Cabo Verde

Este trabalho versa sobre a importância do uso da Tecnologia de Informação (TI) para o aumento da eficiência operacional da Polícia Nacional de Cabo Verde. Como premissa fundamental, utilizou-se a informação de que a polícia moderna, em várias partes do mundo, tem buscado o aumento da eficiência das suas acções por meio da utilização da informação nas actividades de inteligência, para o planeamento táctico e estratégico, bem como para formulação de indicadores sobre os seus resultados. Os benefícios da aplicação da TIC para o acréscimo da eficiência e eficácia do trabalho policial tornam-se cada vez mais evidentes, sobretudo devido ao aumento da capacidade dos sistemas de informação, à consolidação da integração em rede das unidades policiais e ao amadurecimento da compreensão do uso dessa nova tecnologia. No entanto, ainda permanece sem uma investigação mais detalhada a identificação dos benefícios do uso da TI na prestação do serviço policial, tendo em vista que a difusão desse aparato tecnológico oferece desafios para a sua administração. Para compreender esses e outros factores envolvidos no uso da TI, o presente trabalho tem como objectivo geral fazer uma análise da importância das Tecnologias de Informação e Comunicação (TIC) para a polícia, as soluções existentes, estudando o caso concreto da PN, sua situação actual em termos de TIC e sugestões de melhorias. Utilizou-se o modelo de pesquisa exploratória como método de investigação. Espera-se que o estudo efectuado nesta monografia possa contribuir para o aprofundamento da discussão sobre os conceitos envolvidos na gestão de tecnologia da informação nas actividades policiais.

detenção e a sua prática em Cabo Verde – O caso particular da Cidade da Praia

O presente estudo faz uma abordagem da prática da detenção em Cabo Verde. Apesar de não existir informações disponíveis sobre as estatísticas das detenções ilegais em Cabo Verde, a verdade é que frequentemente presenciamos situações que nos afiguram, no mínimo, como sendo uma privação ilegal da liberdade de outrem. Assim, consciente da existência de um número significativo de detenções ilegais, a obtenção dos dados processou-se mediante a aplicação de um inquérito por questionário a 28 agentes da Policia Nacional, sendo 24 agentes da Piquete da Esquadra da PN do Palmarejo e 4 agentes da Brigada Anti-crime e de Investigação Criminal na cidade da Praia. Os resultados deste estudo indicam que as detenções ilegais verificadas na Cidade da Praia estão intimamente ligadas ao diminuto conhecimento jurídico de quem as efectua.