Perfil das mulheres submetidas à cesareana e assistência obstétrica na maternidade pública em Ribeirão Preto

O artigo apresenta o perfil social e obstétrico das mulheres submetidas ao parto cesárea em uma maternidade pública do interior do Estado de São Paulo. Trata-se de estudo quantitativo, retrospectivo, do tipo descritivo, com pesquisa documental. Os dados coletados referem-se ao período entre os meses de junho e dezembro de 2005, e janeiro a junho de 2006. Foram consultados 670 prontuários. A taxa de parto cesárea na instituição-campo foi calculada em 23% para o período supracitado. Foram características da população estudada a baixa escolaridade formal, a união consensual e o trabalho não remunerado. As principais indicações para as cesarianas foram a iteratividade e o sofrimento fetal agudo. Como desdobramento dos achados está a ênfase pela valorização da enfermagem obstétrica no cenário de atendimento ao parto normal de baixo risco, considerando seu caráter não-intervencionista inerente à sua formação.

Dynamical Elastic Moduli of the Ti-13Nb-13Zr biomaterial alloy by mechanical spectroscopy

Dynamical Elastic Moduli of the Ti-13Nb-13Zr biomaterial alloy were obtained using the mechanical spectroscopy technique. The sample with heat treatment at 1170K for 30 minutes and water quenched with subsequent aging treatment at 670 K for 3 hours (TNZ + WQ + 670 K/3 h), was characterized through decay of free oscillations of the sample in the flexural vibration mode. The spectra of anelastic relaxation (internal friction and frequency) in the temperature range from 300 K to 625 K not revealed the presence of relaxation process. As shown in the literature, the hcp structure usually does not exhibit any relaxation due to the symmetry of the sites in the crystalline lattice, but if there is some relaxation, this only occurs in special cases such as low concentration of zirconium or saturation of the stoichiometric ratio of oxygen for zirconium. Dynamical elastic modulus obtained for TNZ + WQ + 670 K/3 h alloy was 87 GPa at room temperature, which is higher than the value for Ti-13Nb-13Zr alloy (64 GPa) of the literature. This increment may be related to the change of the proportion of α and β phases. Besides that, the presence of precipitates in the alloy after aging treatment hardens the material and reduces its ductility.

Effects of low-salinity and high-turbidity waters one mpirical ocean colour algorithms: an example for Southwestern Atlantic waters

The spectral reflectance of the sea surface recorded using ocean colour satellite sensors has been used to estimate chlorophyll-a concentrations for decades. However, in bio-optically complex coastal waters, these estimates are compromised by the presence of several other coloured components besides chlorophyll, especially in regions affected by low-salinity waters. The present work aims to (a) describe the influence of the freshwater plume from the La Plata River on the variability of in situ remote sensing reflectance and (b) evaluate the performance of operational ocean colour chlorophyll algorithms applied to Southwestern Atlantic waters, which receive a remarkable seasonal contribution from La Plata River discharges. Data from three oceanographic cruises are used, in addition to a historical regional bio-optical dataset. Deviations found between measured and estimated concentrations of chlorophyll-a are examined in relation to surface water salinity and turbidity gradients to investigate the source of errors in satellite estimates of pigment concentrations. We observed significant seasonal variability in surface reflectance properties that are strongly driven by La Plata River plume dynamics and arise from the presence of high levels of inorganic suspended solids and coloured dissolved materials. As expected, existing operational algorithms overestimate the concentration of chlorophyll-a, especially in waters of low salinity (S<33.5) and high turbidity (Rrs(670)>0.0012 sr−1). Additionally, an updated version of the regional algorithm is presented, which clearly improves the chlorophyll estimation in those types of coastal environment. In general, the techniques presented here allow us to directly distinguish the bio-optical types of waters to be considered in algorithm studies by the ocean colour community.

A quantitative TaqMan PCR assay for the detection of Ureaplasma diversum

Ureaplasma diversum in veterinary studies is an undesirable microbe, which may cause infection in bulls and may result in seminal vesiculitis, balanopostitis, and alterations in spermatozoids, whereas in cows, it may cause placentitis, fetal alveolitis, abortion, and birth of weak calves. U. diversum is released through organic secretions, especially semen, preputial and vaginal mucus, conjunctival secretion, and milk. The aim of the present study was to develop a TaqMan probe, highly sensitive and specific quantitative PCR (qPCR) assay for the detection and quantification of U. diversum from genital swabs of bovines. Primers and probes specific to U. diversum 16S rRNA gene were designed. The specificity, detection limit, intra- and inter-assay variability of qPCR to detect this ureaplasma was compared with the results of the conventional PCR assay (cPCR). Swabs of vaginal mucus from 169 cows were tested. The qPCR assay detected as few as 10 copies of U. diversum and was 100-fold more sensitive than the cPCR. No cross-reactivity with other Mollicutes or eubacteria was observed. U. diversum was detected in 79 swabs (46.42%) by qPCR, while using cPCR it was detected in 42 (25%) samples. The difference in cPCR and qPCR ureaplasma detection between healthy and sick animals was not statistically significant. But the U. diversum load in samples from animals with genital disorders was higher than in healthy animals. The qPCR assay developed herein is highly sensitive and specific for the detection and quantification of U. diversum in vaginal bovine samples.

A simple-versatile approach to achieve all-Si-based optical micro-cavities

At present, solid thin films are recognized by their well established and mature processing technology that is able to produce components which, depending on their main characteristics, can perform either passive or active functions. Additionally, Si-based materials in the form of thin films perfectly match the concept of miniaturized and low-consumption devices-as required in various modern technological applications. Part of these aspects was considered in the present work that was concerned with the study of optical micro-cavities entirely based on silicon and silicon nitride thin films. The structures were prepared by the sputtering deposition method which, due to the adopted conditions (atmosphere and deposition rate) and arrangement of layers, provided cavities operating either in the visible (at ~ 670 nm) or in the near-infrared (at ~ 1560 nm) wavelength ranges. The main differential of the work relies on the construction of optical microcavities with a reduced number of periods whose main properties can be changed by thermal annealing treatments. The work also discusses the angle-dependent behavior of the optical transmission profiles as well as the use of the COMSOL software package to simulate the microcavities.

Analyzing the dependence structure of microarray data: a copula–based approach

The main aim of this Ph.D. dissertation is the study of clustering dependent data by means of copula functions with particular emphasis on microarray data. Copula functions are a popular multivariate modeling tool in each field where the multivariate dependence is of great interest and their use in clustering has not been still investigated. The first part of this work contains the review of the literature of clustering methods, copula functions and microarray experiments. The attention focuses on the K–means (Hartigan, 1975; Hartigan and Wong, 1979), the hierarchical (Everitt, 1974) and the model–based (Fraley and Raftery, 1998, 1999, 2000, 2007) clustering techniques because their performance is compared. Then, the probabilistic interpretation of the Sklar’s theorem (Sklar’s, 1959), the estimation methods for copulas like the Inference for Margins (Joe and Xu, 1996) and the Archimedean and Elliptical copula families are presented. In the end, applications of clustering methods and copulas to the genetic and microarray experiments are highlighted. The second part contains the original contribution proposed. A simulation study is performed in order to evaluate the performance of the K–means and the hierarchical bottom–up clustering methods in identifying clusters according to the dependence structure of the data generating process. Different simulations are performed by varying different conditions (e.g., the kind of margins (distinct, overlapping and nested) and the value of the dependence parameter ) and the results are evaluated by means of different measures of performance. In light of the simulation results and of the limits of the two investigated clustering methods, a new clustering algorithm based on copula functions (‘CoClust’ in brief) is proposed. The basic idea, the iterative procedure of the CoClust and the description of the written R functions with their output are given. The CoClust algorithm is tested on simulated data (by varying the number of clusters, the copula models, the dependence parameter value and the degree of overlap of margins) and is compared with the performance of model–based clustering by using different measures of performance, like the percentage of well–identified number of clusters and the not rejection percentage of H0 on . It is shown that the CoClust algorithm allows to overcome all observed limits of the other investigated clustering techniques and is able to identify clusters according to the dependence structure of the data independently of the degree of overlap of margins and the strength of the dependence. The CoClust uses a criterion based on the maximized log–likelihood function of the copula and can virtually account for any possible dependence relationship between observations. Many peculiar characteristics are shown for the CoClust, e.g. its capability of identifying the true number of clusters and the fact that it does not require a starting classification. Finally, the CoClust algorithm is applied to the real microarray data of Hedenfalk et al. (2001) both to the gene expressions observed in three different cancer samples and to the columns (tumor samples) of the whole data matrix.

L'intelligenza emotiva in età evolutiva

Emotional Intelligence (EI) has increasingly gained widespread popularity amongst both lay people and scientists in a wide range of contexts and across several research areas. In spite of rigorous inquiry into its applications in educational, social, health and clinical settings, substantial disagreement exists regarding the definition of EI, with respect to both terminology and operationalizations. Actually, there is a consensus about a conceptual distinction between Trait EI, or trait emotional self-efficacy (Petrides & Furnham, 2001), and Ability EI, or cognitive-emotional ability (Mayer & Salovey, 1997). Trait EI is measured via self-report questionnaires, whereas Ability EI is assessed via maximum performance tests. Moreover, EI is the broadest of the emotional constructs, and it subsumes various constructs, as Emotional Awareness (Lane & Schwartz, 1987). To date, EI research has focused primarily on adults, with fewer studies conducted with child samples. The aim of the present study is to investigate the role of different models of EI in childhood and early adolescence (N = 670; 353 females; Mage= 10.25 years ; SD = 1.57). In addition, a further goal is to evaluate the relationship of each construct with personality, non verbal cognitive intelligence, school performance, peer relationships, and affective disorders (anxiety and depression). Results shows significant correlations between Trait EI and Emotional Awareness, whereas Trait and Ability EI appear as independent constructs. We also found significant positive associations between age and Ablity EI and Emotional Awareness (although with add of verbal productivity), while gender differences emerged in favour of females in all EI-related measures. The results provide evidence that Trait EI is partially determined by all of the Big Five personality dimensions, but independent of cognitive ability. Finally, the present study highlights the role of EI on social interactions, school performance and, especially, a negative relationship between Trait EI and psychopathology.

Regulation der Phorbolester-induzierten Matrix-Metalloproteinase-9-Expression in humanen Brustkrebszelllinien durch Stickstoffmonoxid

Das Hauptziel dieser Arbeit war die Identifizierung der Regulationsebenen auf denen die TPA-induzierte Matrix-Metalloproteinase-9 (MMP-9) durch das nitrose Gas Stickstoffmonoxid (NO) in MCF-7-Zellen verändert wird. Dabei konnte sowohl mit Hilfe der Zymographie als auch mit einem MMP-9-Aktivitäts-ELISA gezeigt werden, dass die extrazellulären MMP-9-Spiegel durch die Behandlung der Zellen mit NO reduziert werden. Gleichzeitig zeigte sich auch eine durch NO bedingte Abnahme der intrazellulären MMP-9-Spiegel, wie mit Hilfe von Western-Blot-Analyse nachgewiesen werden konnte. Experimente mit dem Proteasominhibitor Lactacystin und dem Proteinsynthesehemmstoff Cycloheximid ließen darüber hinaus eine NO-bedingte Veränderung der MMP-9-Proteinstabilität ausschließen. Im Gegensatz dazu konnte mittels der metabolischen Markierung mit radioaktiv markiertem Methionin und Cystein gezeigt werden, dass die Proteinneusynthese der MMP-9 durch eine Behandlung der Zellen mit NO stark beeinträchtigt wird. In Übereinstimmung mit diesen Daten finden sich reduzierte MMP-9-mRNA-Spiegel auch in der polysomalen Zellfraktion von MCF-7-Zellen. Wie mit Hilfe des Transkriptionshemmstoffes Actinomycin D und durch Reportergenstudien mit hybriden MMP-9-Promotorkonstrukten gezeigt werden konnte, ist die NO-induzierte Reduktion der MMP-9-mRNA-Spiegel nicht auf eine Verringerung der MMP-9-mRNA-Stabilität zurückzuführen. Reportergenstudien mit einem 670bp langen Promotorfragment des 5’flankierenden Bereichs des humanen MMP-9-Gens zeigten jedoch auf, dass der hemmende Effekt des NOs zum Teil auf eine NO-vermittelte Abnahme der TPA-induzierten MMP-9-Promotoraktivität zurückgeführt werden kann. Demzufolge wurde in den nachfolgenden Experimenten nach den für die MMP-9-Expression notwendigen und von NO modulierten Transkriptionsfaktoren in MCF-7-Zellen gesucht. Anhand von Western-Blot-Analysen und Gelshiftanalysen konnte gezeigt werden, dass die Aktivität des Transkriptionsfaktors AP-1 in MCF-7-Zellen durch NO gehemmt wird, während weder die Expressionspiegel noch die Bindungsaffinität der Transkriptionsfaktoren NFκB und Sp1 durch die NO-Behandlung verändert sind. Weiterhin konnte unter Verwendung von pharmakologischen Inhibitoren der MAPK-Signalwege mit Hilfe der Western-Blot-Analyse nachgewiesen werden, dass MAPK-vermittelte Signalwege zwar für die Induktion der MMP-9-Expression essenziell sind, diese jedoch nicht von NO beeinflusst sind. Im Unterschied hierzu konnte mit Hilfe eines PKC-Aktivitätsassays gezeigt werden, dass die Gesamtaktivität von PKCs nach Behandlung von MCF-7-Zellen mit NO signifikant gehemmt ist. Zusammenfassend zeigen diese Untersuchungen, dass die NO-vermittelte Hemmung der TPA-induzierten MMP-9-Expression in MCF-7-Zellen im Wesentlichen auf eine NO-abhängige Reduktion der Protein-Kinase-C-Aktivität und einer daraus resultierenden Aktivitätshemmung des Transkriptionsfaktors AP-1 zurückgeführt werden kann.

Studio multicentrico sulla prevalenza e sulle principali caratteristiche cliniche e biochimiche nei pazienti in dialisi paratiroidectomizzati in italia

Lo studio CAVE PTX ha lo scopo di valutare la reale prevalenza della paratiroidectomia nei pazienti dializzati in Italia, verificare l’aderenza ai targets ematochimici proposti dalle linee guida internazionali K/DOQI e ricercare la presenza di fratture vertebrali e calcificazioni vascolari. Al momento attuale riportiamo i dati preliminari sulla prevalenza e le caratteristiche cliniche generali dei pazienti finora arruolati. Il nostro studio ha ricevuto contributi da 149 centri dialisi italiani, su un totale di 670, pari al 22%. La popolazione dialitica dalla quale sono stati ottenuti i casi di paratiroidectomia è risultata pari a 12515 pazienti;l’87,7% dei pazienti effettuava l’emodialisi mentre il 12,3% la dialisi peritoneale. Cinquecentoventotto, pari al 4,22%, avevano effettuato un intervento di paratiroidectomia (4,5%emodializzati, 1,9% in dialisi peritoneale;p<0.001). Abbiamo considerato tre gruppi differenti di PTH: basso (<150 pg/ml), ottimale (150 -300 pg/ml) ed elevato (>300 pg/ml). I valori medi di PTH e calcemia sono risultati significativamente diversi (più alti) tra casi e controlli nei due gruppi con PTH basso (PTX = 40±39 vs controllo = 92±42 pg/ml; p<.0001) e PTH alto (PTX= 630 ± 417 vs controllo 577 ±331; p<.05). La percentuale di pazienti con PTH troppo basso è risultata più elevata nei pazienti chirurgici rispetto al resto della popolazione (64vs23%; p<0.0001), mentre la percentuale dei casi con PTH troppo alto è risultata significativamente più alta nel gruppo di controllo (38%vs19%; p<0.003). Il 61% dei casi assumeva vitamina D rispetto al 64 % dei controlli; l’88% vs 75% un chelante del fosforo ed il 13%vs 35% il calciomimentico. In conclusione, la paratiroidectomia ha una bassa prevalenza in Italia, i pazienti sono più spesso di sesso femminile, in emodialisi e con età relativamente giovane ma da più tempo in dialisi.

Vergleich der retinalen und dermalen mikrovaskulären endothelialen Funktion bei Gesunden, Insulinresistenten und Typ-2-Diabetikern

Die vorliegende klinische Studie hatte zum Ziel, die mikrovaskuläre Endothelfunktion retinaler und dermaler Gefäße von Insulinresistenten und Typ 2- Diabetikern ohne Zeichen einer diabetischen Retinopathie mit einer gesunden insulinsensitiven nicht-diabetischen Kontrollgruppe hinsichtlich früher morphologischer und funktioneller Veränderungen zu vergleichen.rnrnMethode:rnEs wurden 54 Patienten ohne Nachweis einer diabetischen Retinopathie eingeschlossen und in 3 Gruppen entsprechend ihren metabolischen Ergebnissen eingeteilt: 1.) Gruppe K (Kontrollgruppe) setzte sich aus gesunden, nicht-diabetischen, insulin-sensitiven rn(HOMA ≤ 2) Probanden mit einem BMI ≤ 28 kg/m2 zusammen; 2.) Gruppe IR bestand aus den nicht-diabetischen, insulin-resistenten (HOMAs > 2), übergewichtigen Patienten mit einem BMI > 28 kg/m2 und 3.) Gruppe DM war definiert als Patienten mit einem manifesten Typ 2-Diabetes mellitus.rnrnDie mikrovaskuläre Funktion der Retina wurde mittels eines Laserdoppler-Verfahrens (Heidelberg Retina Flowmeter) untersucht und hierbei der retinale Blutfluss und das Verhältnis der Gefäßwand zum Lumen (WLR, wall-to-lumen-ratio) basal und nach Flickerlicht-Stimulation (10 Hz, Photo Stimulator 750) gemessen. Letzterer gilt als Marker für vaskuläre Schädigung. rnZusätzlich wurde die dermale Mikrozirkulation (Blutfluss, O2-Sättigung) als weiterer Faktor der mikrovaskulären Endothelfunktion in den 3 Studiengruppen untersucht und miteinander verglichen.rnErgebnisse:rnEs zeigte sich kein signifikanter Unterschied des retinalen Blutflusses zwischen den 3 Gruppen weder basal noch nach Flickerlicht-Stimulation. Es zeigte sich keine Korrelation zwischen der mikrovaskulären Funktion der Haut und der Retina. rnDie arterielle WLR zeigte nur geringe Unterscheide zwischen den 3 Gruppen.rnrnMit zunehmendem Grad der Insulinresistenz wurde jedoch eine Reduktion des basalen als auch des flickerlicht-stimulierten retinalen Blutflusses deutlich, dabei zeigte sich unerwarteter Weise eine Abnahme der WLR.rnrnDer (prä-ischämische) muskuläre Blutfluss war in der IR-Gruppe signifikant geringer als in der K-Gruppe. Auch war die postischämische dermale O2-Sättigung in der DM und IR-Gruppe signifikant niedriger im Vergleich zur K-Gruppe. Jedoch war die postischämische hyperämische dermale Reaktion in der IR und DM-Gruppe nur geringgradig weniger als in der K-Gruppe. rnrnSchlussfolgerung:rnEine Korrelation zwischen der Entwicklung der Insulinresistenz und retinaler sowie dermaler mikrovaskulärer endothelialer Funktion wurde bei der Studie deutlich. Mithilfe des neuen Verfahrens der Laser Scanner Flowmeter zur Messung der retinalen Endothelfunktion lassen sich sehr frühe morphologische Veränderungen des mikrovaskulären Blutflusses erfassen. rnDie fehlende Korrelation zwischen retinaler und dermaler mikrovaskulärer Funktion als auch die geringen Unterschiede der WLR sollte Gegenstand weiterer Studien seinrn

Characteristics of Reflux Episodes and Symptom Association in Patients With Erosive Esophagitis and Nonerosive Reflux Disease: Study Using Combined Impedance–pH Off Therapy

We sought to compare reflux and symptom association patterns in patients with nonerosive reflux disease (NERD), erosive esophagitis (EE), and in healthy volunteers (HVs).

Imetelstat (GRN163L)--telomerase-based cancer therapy

Telomeres and telomerase play essential roles in the regulation of the lifespan of human cells. While normal human somatic cells do not or only transiently express telomerase and therefore shorten their telomeres with each cell division, most human cancer cells typically express high levels of telomerase and show unlimited cell proliferation. High telomerase expression allows cells to proliferate and expand long-term and therefore supports tumor growth. Owing to the high expression and its role, telomerase has become an attractive diagnostic and therapeutic cancer target. Imetelstat (GRN163L) is a potent and specific telomerase inhibitor and so far the only drug of its class in clinical trials. Here, we report on the structure and the mechanism of action of imetelstat as well as about the preclinical and clinical data and future prospects using imetelstat in cancer therapy.