Whole-body computerized tomography and concomitant spine and head injuries A study of 355 cases

The authors present a prospective study on the coexistence of spinal injury (SI) and severe traumatic brain injury (TBI) in patients who were involved in traffic accidents and arrived at the Emergency Department of Hospital das Clinicas of the University of Sao Paulo between September 1, 2003 and December 31, 2009. A whole-body computed tomography was the diagnostic method employed in all cases. Both lesions were observed simultaneously in 69 cases (19.4%), predominantly in males (57 individuals, 82.6%). Cranial injuries included epidural hematoma, acute subdural hematoma, brain contusion, ventricular hemorrhage and traumatic subarachnoid hemorrhage. The transverse processes were the most fragile portion of the vertebrae and were more susceptible to fractures. The seventh cervical vertebra was the most commonly affected segment, with 24 cases (34.78%). The distribution of fractures was similar among the other cervical vertebrae, the first four thoracic vertebrae and the lumbar spine. Neurological deficit secondary to SI was detected in eight individuals (11.59%) and two individuals (2.89%) died. Traumatic subarachnoid hemorrhage was the most common intracranial finding (82.6%). Spinal surgery was necessary in 24 patients (34.78%) and brain surgery in 18 (26%). Four patients (5.79%) underwent cranial and spinal surgeries. The authors conclude that it is necessary a judicious assessment of the entire spine of individuals who presented in coma after suffering a brain injury associated to multisystemic trauma and whole-body CT scan may play a major role in this scenario.

Morphological Alterations in Newly Born Dentate Gyrus Granule Cells That Emerge after Status Epilepticus Contribute to Make Them Less Excitable

Computer simulations of external current stimulations of dentate gyrus granule cells of rats with Status Epilepticus induced by pilocarpine and control rats were used to evaluate whether morphological differences alone between these cells have an impact on their electrophysiological behavior. The cell models were constructed using morphological information from tridimensional reconstructions with Neurolucida software. To evaluate the effect of morphology differences alone, ion channel conductances, densities and distributions over the dendritic trees of dentate gyrus granule cells were the same for all models. External simulated currents were injected in randomly chosen dendrites belonging to one of three different areas of dentate gyrus granule cell molecular layer: inner molecular layer, medial molecular layer and outer molecular layer. Somatic membrane potentials were recorded to determine firing frequencies and inter-spike intervals. The results show that morphologically altered granule cells from pilocarpine-induced epileptic rats are less excitable than control cells, especially when they are stimulated in the inner molecular layer, which is the target area for mossy fibers that sprout after pilocarpine-induced cell degeneration. This suggests that morphological alterations may act as a protective mechanism to allow dentate gyrus granule cells to cope with the increase of stimulation caused by mossy fiber sprouting.

Burnt sugarcane harvesting: Particulate matter exposure and the effects on lung function, oxidative stress, and urinary 1-hydroxypyrene

Non-mechanised sugarcane harvesting preceded by burning exposes workers and the people of neighbouring towns to high concentrations of pollutants. This study was aimed to evaluate the respiratory symptoms, lung function and oxidative stress markers in sugarcane workers and the residents of Mendonca, an agricultural town in Brazil, during the non-harvesting and harvesting periods and to assess the population and individual exposures to fine particulate matter (PM2.5). Sugarcane workers and healthy volunteers were evaluated with two respiratory symptom questionnaires, spirometry, urinary 1-hydroxypyrene levels, and the measurement of antioxidant enzymes and plasma malonaldehyde during the non-harvesting and harvesting periods. The environmental assessment was determined from PM2.5 concentration. PM2.5 level increased from 8 mu g/m(3) during the non-harvesting period to 23.5 mu g/m(3) in the town and 61 mu g/m(3) on the plantations during the harvesting period. Wheezing, coughing, sneezing, and breathlessness increased significantly in both groups during the harvesting period, but more markedly in workers. A decrease in lung function and antioxidant enzyme activity was observed in both populations during harvesting; this decrease was greater among the sugarcane workers. The urinary 1-hydroxypyrene levels only increased in the sugarcane workers during the harvesting period. The malonaldehyde levels were elevated in both groups, with a higher increase observed in the workers. This research demonstrates the exposure of sugarcane workers and the inhabitants of a neighbouring town to high PM2.5 concentrations during the sugarcane harvest period. This exposure was higher among the sugarcane workers, as illustrated by both higher PM2.5 concentrations in the sugarcane fields and higher urinary 1-hydroxypyrene levels in the volunteers in this group. The higher incidence of respiratory symptoms, greater decrease in lung function and more marked elevation of oxidative stress markers among the sugarcane workers during the harvest confirms the greater effect magnitude in this population and a dose-dependent relationship between pollution and the observed effects. (C) 2012 Elsevier B.V. All rights reserved.

Synthesis, characterization, optical absorption, luminescence and defect centres in Er3+ and Yb3+ co-doped MgAl2O4 phosphors

The Er3+-Yb3+ co-doped MgAl2O4 phosphor powders have been prepared by the combustion method. The phosphor powders are well characterized by X-ray diffraction (XRD) and energy dispersive (EDX) techniques. The absorption spectrum of Er3+/Er3+-Yb3+ doped/co-doped phosphor powder has been recorded in the UV-Vis-NIR region of the electro-magnetic spectrum. The evidence for indirect pumping under 980 nm excitation of Er3+ from Yb3+ was observed in the MgAl2O4 matrix material. Electron spin resonance (ESR) studies were carried out to identify the defect centres responsible for the thermally stimulated luminescence (TSL) process in MgAl2O4:Er3+ phosphor. Three defect centres were identified in irradiated phosphor by ESR measurements which were carried out at room temperature and these were assigned to an O- ion and F+ centres. O- ion (hole centre) appears to correlate with the low temperature TSL peak at 210 A degrees C and one of the F+ centres (electron centre) is related to the high temperature peak at 460 A degrees C.

Metabolic engineering of beta-oxidation in Penicillium chrysogenum for improved semi-synthetic cephalosporin biosynthesis

Industrial production of semi-synthetic cephalosporins by Penicillium chrysogenum requires supplementation of the growth media with the side-chain precursor adipic acid. In glucose-limited chemostat cultures of P. chrysogenum, up to 88% of the consumed adipic acid was not recovered in cephalosporinrelated products, but used as an additional carbon and energy source for growth. This low efficiency of side-chain precursor incorporation provides an economic incentive for studying and engineering the metabolism of adipic acid in P. cluysogenum. Chemostat-based transcriptome analysis in the presence and absence of adipic acid confirmed that adipic acid metabolism in this fungus occurs via beta-oxidation. A set of 52 adipate-responsive genes included six putative genes for acyl-CoA oxidases and dehydrogenases, enzymes responsible for the first step of beta-oxidation. Subcellular localization of the differentially expressed acyl-CoA oxidases and dehydrogenases revealed that the oxidases were exclusively targeted to peroxisomes, while the dehydrogenases were found either in peroxisomes or in mitochondria. Deletion of the genes encoding the peroxisomal acyl-CoA oxidase Pc20g01800 and the mitochondrial acyl-CoA dehydrogenase Pc20g07920 resulted in a 1.6- and 3.7-fold increase in the production of the semi-synthetic cephalosporin intermediate adipoyl-6-APA, respectively. The deletion strains also showed reduced adipate consumption compared to the reference strain, indicating that engineering of the first step of beta-oxidation successfully redirected a larger fraction of adipic acid towards cephalosporin biosynthesis. (C) 2012 Elsevier Inc. All rights reserved.

Clinical Usefulness of Coronary Angiography in Patients with Left Ventricular Dysfunction

Background: Performing a coronary angiography in patients with heart failure of unknown etiology is often justified by the diagnostic assessment of ischemic heart disease. However, the clinical benefit of this strategy is not known. Objective: To evaluate the prevalence of ischemic heart disease by angiographic criteria in patients with heart failure and reduced ejection fraction of unknown etiology, as well as its impact on therapy decisions. Methods: Consecutive outpatients with heart failure and systolic dysfunction, who had an indication for coronary angiography to clarify the etiology of heart disease were assessed from 1 January 2009 to December 31, 2010. Patients diagnosed with coronary artery disease, positive serology for Chagas disease, congenital heart disease, valve disease or patients undergoing cardiac transplantation were excluded from the analysis. The sample was divided into two groups according to the indication for catheterization. Group-1: Symptomatic due to angina or heart failure. Group-2: Presence of >= 2 risk factors for coronary artery disease Results: One hundred and seven patients were included in the analysis, with 51 (47.7%) patients in Group 1 and 56 (52.3%) in Group 2. The prevalence of ischemic heart disease was 9.3% (10 patients), and all belonged to Group 1 (p = 0.0001). During follow-up, only 4 (3.7%) were referred for CABG; 3 (2.8%) patients had procedure-related complications. Conclusion: In our study, coronary angiography in patients with heart failure and systolic dysfunction of unknown etiology, although supported by current guidelines, did not show benefits when performed only due to the presence of risk factors for coronary artery disease. (Arq Bras Cardiol 2012;98(5):437-441)

Dental fluorosis in the primary dentition and intake of manufactured soy-based foods with fluoride

Background & aims: To identify manufactured soy-based products more recommended by pediatricians and nutritionists; to determine fluoride concentrations in these products; to evaluate children concerning fluorosis in primary teeth and its association with the consumption of soy-based products. Methods: Pediatricians and Nutritionists answered a questionnaire about soy-based products they most recommended to children. Fluoride concentrations of the 10 products more cited were analyzed with the ion-specific electrode. Dental fluorosis exams were performed in 315 4e6-year-old children. Dean’s Index was used to assess fluorosis. Among the children examined, 26 had lactose intolerance. Their parents answered a questionnaire about children’s and family’s profile, besides permitting the identification of soy-based products use. Chi-squared and Multivariable Logistic Regression tests were used (p < 0.05). Results: Fluoride content in the analyzed products ranged from 0.03 to 0.50 mg F /mL. Dental fluorosis was detected in 11% of the children, with very mild and mild degrees. Dental fluorosis in primary teeth was associated with lactose intolerance (p < 0.05), but there was no significant association with the use of manufactured soy-based products. Conclusions: Isolated consumption of soy-based products recommended by health professionals to children do not offer risk of dental fluorosis in primary teeth, which had a low prevalence and severity.

Utilidade clínica da angiografia coronariana em pacientes com disfunção ventricular esquerda

FUNDAMENTO: A realização da angiografia coronariana na insuficiência cardíaca sem etiologia definida é frequentemente justificada para avaliação diagnóstica de cardiopatia isquêmica. Porém, o benefício clínico dessa estratégia não é conhecido. OBJETIVO: Avaliar a prevalência de cardiopatia isquêmica mediante critérios angiográficos em pacientes com insuficiência cardíaca e fração de ejeção reduzida sem etiologia, assim como o seu impacto na decisão terapêutica. MÉTODOS: Foram avaliados pacientes ambulatoriais consecutivos com insuficiência cardíaca e disfunção sistólica, que tiveram a angiografia coronariana indicada para esclarecimento etiológico da cardiopatia, no período de 1º de janeiro de 2009 a 31 de dezembro de 2010. Os pacientes com diagnóstico de doença arterial coronariana, sorologia positiva para doença de Chagas, cardiopatia congênita, valvopatia grave ou pacientes submetidos a transplante cardíaco foram excluídos da análise. A amostra foi dividida em dois grupos conforme a indicação do cateterismo. Grupo-1: Sintomáticos em razão de angina ou insuficiência cardíaca refratária. Grupo-2: Presença de > 2 fatores de risco para doença arterial coronariana RESULTADOS: Cento e sete pacientes foram incluídos para análise, sendo 51 (47,7%) pacientes pertencentes ao Grupo-1 e 56 (52,3%), ao Grupo-2. A prevalência de cardiopatia isquêmica foi de 9,3% (10 pacientes), e todos pertenciam ao Grupo-1 (p = 0,0001). Durante o seguimento, apenas 4 (3,7%) tiveram indicação de revascularização miocárdica; 3 (2,8%) pacientes apresentaram complicações relacionadas ao procedimento. CONCLUSÃO: Em nosso trabalho, a realização da angiografia coronariana em pacientes com insuficiência cardíaca e disfunção sistólica sem etiologia, apesar de embasada pelas atuais diretrizes, não evidenciou benefício quando indicada apenas pela presença de fatores de risco para doença arterial coronariana.

Variação do diâmetro da artéria braquial em crianças obesas: presente e futuro

OBJETIVO: Revisão da literatura acerca do uso da medida da variação do diâmetro da artéria braquial por ultrassonografia de alta resolução (dilatação mediada por fluxo) como preditor de risco para doença cardiovascular em crianças e adolescentes obesos. FONTES DE DADOS: Levantamento de publicações indexadas no Medline/PubMed de trabalhos publicados entre 2002 e 2011, rastreadas com a combinação dos descritores: "endothelium", "child", "ultrasonography" e "obesity", além de estudos e textos clássicos sobre o tema. Foram encontradas 54 publicações e 32 delas foram incluídas na presente revisão do tema. SINTESE DOS DADOS: O estudo da disfunção endotelial tem sido empregado como preditor de risco para doenças cardiovasculares, tais como aterosclerose e doença cardíaca coronariana, visto que a lesão endotelial é um importante evento na fisiopatologia de tais doenças. CONCLUSÕES: A dilatação mediada por fluxo da artéria braquial mostra-se importante como ferramenta diagnóstica e prognóstica na avaliação da função endotelial de crianças e adolescentes com excesso de peso por ser um método não invasivo, com boa aplicabilidade quanto ao custo, à inocuidade e ao benefício.

Ocupações exercidas por adolescentes e sua relação com a participação escolar

OBJETIVOS: Identificar as ocupações exercidas por adolescentes participantes de um programa social de atendimento para jovens e avaliar sua inserção na escola, após a entrada no mundo do trabalho. MÉTODOS: Estudo descritivo, quantitativo, realizado junto a um programa de apoio e atendimento aos jovens, por meio do qual 437 jovens trabalhadores foram entrevistados. RESULTADOS: A maioria era do gênero masculino (54%), com média de idade de 16 anos, cursando o ensino médio; trabalhavam como office boys (36,4%), auxiliares administrativos (25,4%), recepcionistas (16,0%) e no estacionamento rotativo (12,6%). Atraso escolar foi constatado em 95,8% dos indivíduos, indicando descompasso entre a série cursada e a idade cronológica; entretanto, o desempenho na escola pareceu não ter sido prejudicado pelo trabalho. CONCLUSÃO: Deve-se ter cautela ao introduzir o adolescente no mercado de trabalho, pois aspectos como cansaço, falta de tempo para estudar, entre outros, podem ter implicações nas atividades escolares.

A simple method to evaluate, correlate and predict boiling and flash points of alkynes

Boiling points (T B) of acyclic alkynes are predicted from their boiling point numbers (Y BP) with the relationship T B(K) = -16.802Y BP2/3 + 337.377Y BP1/3 - 437.883. In turn, Y BP values are calculated from structure using the equation Y BP = 1.726 + Ai + 2.779C + 1.716M3 + 1.564M + 4.204E3 + 3.905E + 5.007P - 0.329D + 0.241G + 0.479V + 0.967T + 0.574S. Here Ai depends on the substitution pattern of the alkyne and the remainder of the equation is the same as that reported earlier for alkanes. For a data set consisting of 76 acyclic alkynes, the correlation of predicted and literature T B values had an average absolute deviation of 1.46 K, and the R² of the correlation was 0.999. In addition, the calculated Y BP values can be used to predict the flash points of alkynes.

Effects of active and passive lacebacks on antero-posterior position of maxillary first molars and central incisors

The purpose of this study was to compare the effects of active and passive lacebacks on antero-posterior position of maxillary first molars and central incisors during leveling phase. Twenty-three subjects with Class I and Class II malocclusion were treated with first premolars extraction using preadjusted appliances (MBT 0.022-inch brackets). The leveling phase was performed with stainless steel archwires only. The sample was divided into 2 groups: 14 subjects received active lacebacks (Group 1) and 9 subjects received passive lacebacks (Group 2). Lacebacks were made from 0.008-inch ligature wire. Lateral cephalometric radiographs were taken pre- and post-leveling phase. Student's t-test was applied to determine the differences between pre- and post-leveling mean values and to determine the mean differences between groups. In Group I, the first molars showed a significant mesial movement, whereas no change was observed in Group 2. In both groups, maxillary central incisor crowns moved to lingual side. In conclusion, active laceback produced anchorage loss of maxillary first molars whereas passive laceback did not affect the position of these teeth. Active and passive lacebacks were effective in preventing central incisor proclination.

Analisando frames tecnológicos: um estudo das interpretações sociais da tecnologia da informação no contexto organizacional

Frames tecnológicos (estruturas cognitivas compartilhadas em relação à tecnologia) constituem a temática desta pesquisa. O objetivo foi analisar a natureza e a extensão de diferenças em frames tecnológicos de grupos sociais distintos, assim como compreender as razões para congruências e incongruências. A pesquisa foi realizada em uma instituição de ensino superior, e o objeto de estudo tratou-se de um sistema de informação acadêmico internacional, implementado e em uso nessa instituição. Com pressupostos epistemológicos sustentados pela perspectiva interpretativa, metodologicamente o estudo caracterizou-se por uma abordagem qualitativa. Entrevistas em profundidade, observação participante, revisão documental e artefato físico constituíram-se como as fontes de dados empíricos. Adotaram-se os fundamentos do método hermenêutico-dialético para análise e interpretação dos dados coletados. O estudo propiciou identificar que diferentes interpretações sobre o sistema de informação acadêmico são socialmente construídas pelos indivíduos inseridos em grupos sociais e fortemente afetadas pelo que acreditam, conhecem e esperam desse sistema. Características pessoais, contextuais e tecnológicas integram-se criando, reforçando e modificando frames tecnológicos, contribuindo para o delineamento de congruências e incongruências.

Educação ao ar livre pela aventura: o aprendizado de valores morais em expedições à natureza

A educação ao ar livre, por meio de cursos no formato expedição, ainda acontece de forma tímida no Brasil. Entende-se por expedição uma experiência educacional contínua, de múltiplos dias, em que alunos e instrutores aventuram-se em um trajeto em área remota da natureza de forma autossuficiente. O presente estudo analisa os cursos desse tipo. Por meio de entrevistas e questionários semiestruturados, investigou-se a aprendizagem dos alunos segundo suas próprias percepções e as dos educadores da instituição, com ênfase no desenvolvimento moral do indivíduo. Como parte do estudo de caso sobre um aluno adolescente participante de um dos cursos, entrevistou-se também uma psicóloga que coordena um abrigo para menores. Os resultados encontrados indicam que os cursos de educação ao ar livre caracterizam-se por experiências que estimulam trabalhos em grupo, debates sobre justiça e solidariedade, e reflexões sobre valores e princípios como coragem, esforço pessoal, disciplina, respeito e superação de limites. Os resultados também indicam que tal proposta educacional aufere experiências sensíveis e de conexão do ser humano com a natureza. Muito embora haja potencial educacional para a educação ao ar livre, a atuação do educador perante seus alunos é fundamental para que as experiências sejam física e psicologicamente seguras, alcancem seus potenciais pedagógicos de desenvolvimento da moralidade e ajudem as pessoas a desenvolverem uma consciência ambiental, manifestada por meio de ações concretas ao retornarem dos cursos para suas comunidades.

El Open Journal Systems en la Universidade de São Paulo: la experiencia de gestión del Portal de Revistas da USP

El objeto de este poster es presentar la experiencia de manejamiento de un portal de revistas científicas de acceso abierto, en una universidad pública y que integra los editores científicos, profesores y bibliotecarios. Iniciativas de esta naturaleza tienen importancia estratégica para la consolidación y el fortalecimiento del Movimiento de Acceso Abierto en los países en desarrollo, puesto que ofrecen la oportunidad de se vivir plenamente una cultura de acceso abierto en todas las etapas de certificación del conocimiento. La experiencia de la Universidade de São Paulo, se convierte en relevante, ya que promueve la integración de los diversos actores involucrados en la producción de revistas científicas. El Portal de Revistas da USP (http://www.revistas.usp.br), lanzado en 2008, es una iniciativa del Departamento Técnico do Sistema Integrado de Bibliotecas de USP que tiene el Programa de Apoio às Publicações Científicas Periódicas da USP. Esta iniciativa, basada en los principios del Movimiento de Acceso Abierto, tiene como objetivo promover la visibilidad y la accesibilidad de las revistas científicas publicadas oficialmente por la USP. Considerase que las revistas cumplen con un doble papel, como objeto y también vehículo de comunicación. Con esto las inversiones para calificación de las revistas incluyen recursos informáticos para garantizar la interoperabilidad entre distintos sistemas de información (bases de datos, catálogos, repositorios etc.), sistemas de gestión editorial en línea (para agilizar la tramitación de los manuscritos y la disminución de la publicación); la formación de los equipos (técnicos y bibliotecarios), atribuición de nomes DOI (digital object identifier), software de verificación de plágio. En 2012 se cambió el software de gestión del Portal para Open Journal Systems - OJS por lo cual se reunió por la primera vez, en um mismo dominio web las revistas científicas editadas en USP. De las más de 100 revistas publicadas en el Portal 29 están en DOAJ, 27 en SciELO Brasil, 20 en Scopus, 11 en JCR entre outros. En el Portal hay revistas con distintos perfiles, unas más institucionales y otras de calidad internacional. Algunas revistas más antíguas y consolidadas se utilizan de distintos sistemas de gestión de los manuscriptos y en el Portal es como un espejo para garantizar la presencia en la Universidad. Con tantas y tan distintas publicaciones el OJS se presenta como una promisora herramienta para la gestión del Portal de Revistas. El OJS surge como un sistema para la gestión individual de revistas científicos y con los avances de las tecnologías y principalmente del uso por la comunidad se conviertió en herramienta de gestión de Portal. Para una mejor gestión del Portal se presenta algunas recomendaciones, basadas en la experiencia, y que podrán mejorar el trabajo de gestión del conjunto de las revistas: en la pantalla de creación de revistas se deberá incluir todos los datos del registro oficial en ISSN, sin posibilidad de edición por los editores-gerentes; en el listado general de revistas se podría incluir una indicación de las revistas que están en línea y las que están aún en configuración; clara identificación de las revistas vigentes y no-vigentes, una vinculación mas clara de las revistas que cambiaran su título y que están vigentes; una tabla para selección de fuentes de indización; edición de contenidos ya publicados solamente por el administrador del sistema; gestión centralizada del DOI y de la preservación digital en LOCKSS y un painel con los datos estadísticos (total de revistas, ediciones, estatísticas Counter, autores etc). Además el fortalecimiento y creación de centros de desarrollo de OJS en las Universidades Latinoamericanas podría impulsionar el uso del sistema en su totalidad por los editores de la región.