Safety of intramuscular influenza vaccine in patients receiving oral anticoagulation therapy: a single blinded multi-centre randomized controlled clinical trial

Influenza vaccines are recommended for administration by the intramuscular route. However, many physicians use the subcutaneous route for patients receiving an oral anticoagulant because this route is thought to induce fewer hemorrhagic side effects. Our aim is to assess the safety of intramuscular administration of influenza vaccine in patients on oral anticoagulation therapy. Methods: Design: Randomised, controlled, single blinded, multi-centre clinical trial. Setting: 4 primary care practices in Barcelona, Spain. Participants: 229 patients on oral anticoagulation therapy eligible for influenza vaccine during the 20032004 season. Interventions: intramuscular administration of influença vaccine in the experimental group (129 patients) compared to subcutaneous administration in the control group (100 patients). Primary outcome: change in the circumference of the arm at the site of injection at 24 hours. Secondary outcomes: appearance of local reactions and pain at 24 hours and at 10 days; change in INR (International Normalized Ratio) at 24 hours and at 10 days. Analysis was by intention to treat using the 95% confidence intervals of the proportions or mean differences. Results: Baseline variables in the two groups were similar. No major side effects or major haemorrhage during the follow-up period were reported. No significant differences were observed in the primary outcome between the two groups. The appearance of local adverse reactions was more frequent in the subcutaneous administration group (37,4% vs. 17,4%, 95% confidence interval of the difference 8,2% to 31,8%). Conclusion: This study shows that the intramuscular administration route of influenza vaccine in patients on anticoagulant therapy does not have more side effects than the subcutaneous administration route

MARCADORES RAPD PARA MAPEAMENTO GENÉTICO E SELEÇÃO DE HÍBRIDOS DE CITROS

Os marcadores moleculares apresentam várias aplicações no melhoramento de plantas, permitindo uma série de análises genéticas. Este trabalho foi realizado com o objetivo de estabelecer marcadores RAPD para serem utilizados em estudos de mapeamento genético e na seleção de híbridos entre tangerina-'Cravo' (Citrus reticulata Blanco) e laranja-'Pêra' (C. sinensis (L.) Osbeck). Extraiu-se DNA de folhas dos parentais e de seis híbridos F1. As reações de amplificação foram preparadas em 13 uL de solução, constituída por tampão 1x GIBCO BRL; soluções 1,54 mM de MgCl2 e 0,2 mM de cada dNTP; 15 ng de cada 'primer'; 1,5 unidade de 'Taq DNA Polymerase' e 15 ng de DNA genômico. As reações foram realizadas em termocicladores programados para 36 ciclos de 1 min a 92ºC, 1 min a 36ºC, 2 min a 72ºC e 10 min de extensão a 72ºC. Foram testados 'primers' decâmeros arbitrários dos 'kits' A, AB, AT, AV, B, C, D, E, G, H, M, N, P, Q, R e U da Operon, sendo selecionados 113 por apresentarem polimorfismo, com número de marcadores variando de 1 a 6 por 'primer'. Esses 'primers' amplificaram 201 (23,13%) bandas polimórficas, aplicáveis no mapeamento genético e seleção de híbridos. A freqüência de 'primers' com 1; 2; 3; 4; 5 e 6 bandas polimórficas foi de 49,5%, 33,6%, 9,7%, 4,4%, 1,8% e 1,0%, respectivamente.

Multi-slice three-dimensional myocardial strain tensor quantification using zHARP.

In this article we propose a novel method for calculating cardiac 3-D strain. The method requires the acquisition of myocardial short-axis (SA) slices only and produces the 3-D strain tensor at every point within every pair of slices. Three-dimensional displacement is calculated from SA slices using zHARP which is then used for calculating the local displacement gradient and thus the local strain tensor. There are three main advantages of this method. First, the 3-D strain tensor is calculated for every pixel without interpolation; this is unprecedented in cardiac MR imaging. Second, this method is fast, in part because there is no need to acquire long-axis (LA) slices. Third, the method is accurate because the 3-D displacement components are acquired simultaneously and therefore reduces motion artifacts without the need for registration. This article presents the theory of computing 3-D strain from two slices using zHARP, the imaging protocol, and both phantom and in-vivo validation.

Multi-analyte detection for biological fluids. Towards continous monitoring of glucose, ionized calcium and pH using a viscometric affinity biosensor.

We present a viscometric affinity biosensor that can potentially allow continuous multi-analyte monitoring in biological fluids like blood or plasma. The sensing principle is based on the detection of viscosity changes of a polymeric solution which has a selective affinity for the analyte of interest. The chemico-mechanical sensor incorporates an actuating piezoelectric diaphragm, a sensing piezoelectric diaphragm and a flow-resisting microchannel for viscosity detection. A free-standing Anodic Alumina Oxide (AAO) porous nano-membrane is used as selective interface. A glucose-sensitive sensor was fabricated and extensively assessed in buffer solution. The sensor reversibility, stability and sensitivity were excellent during at least 65 hours. Results showed also a good degree of stability for a long term measurement (25 days). The sensor behaviour was furthermore tested in fetal bovine serum (FBS). The obtained results for glucose sensing are very promising, indicating that the developed sensor is a candidate for continuous monitoring in biological fluids. Sensitive solutions for ionized calcium and pH are currently under development and should allow multi-analyte sensing in the near future.

Synthesis and multi-target biological profiling of a novel family of rhein derivatives as disease-modifying anti-Alzheimer agents

We have synthesized a family of rheinhuprine hybrids to hit several key targets for Alzheimer"s disease. Biological screening performed in vitro and in Escherichia coli cells has shown that these hybrids exhibit potent inhibitory activities against human acetylcholinesterase butyrylcholinesterase, and BACE-1, dual Aβ42 and tau anti-aggregating activity, and brain permeability. Ex vivo studies with the leads (+)- and ()-7e in brain slices of C57bl6 mice have revealed that they efficiently protect against the Aβ-induced synaptic dysfunction , preventing the loss of synaptic proteins and/or have a positive effect on the induction of long term potentiation. In vivo studies in APP-PS1 transgenic mice treated i.p. for 4 weeks with (+)- and ()-7e have shown a central soluble Aβ lowering effect, accompanied by an increase in the levels of mature amyloid precursor protein (APP). Thus, (+)- and ()-7e emerge as very promising disease-modifying anti-Alzheimer drug candidates.

Synthesis and multi-target biological profiling of a novel family of rhein derivatives as disease-modifying anti-Alzheimer agents

We have synthesized a family of rheinhuprine hybrids to hit several key targets for Alzheimer"s disease. Biological screening performed in vitro and in Escherichia coli cells has shown that these hybrids exhibit potent inhibitory activities against human acetylcholinesterase butyrylcholinesterase, and BACE-1, dual Aβ42 and tau anti-aggregating activity, and brain permeability. Ex vivo studies with the leads (+)- and ()-7e in brain slices of C57bl6 mice have revealed that they efficiently protect against the Aβ-induced synaptic dysfunction , preventing the loss of synaptic proteins and/or have a positive effect on the induction of long term potentiation. In vivo studies in APP-PS1 transgenic mice treated i.p. for 4 weeks with (+)- and ()-7e have shown a central soluble Aβ lowering effect, accompanied by an increase in the levels of mature amyloid precursor protein (APP). Thus, (+)- and ()-7e emerge as very promising disease-modifying anti-Alzheimer drug candidates.

Associated anomalies in multi-malformed infants with cleft lip and palate: An epidemiologic study of nearly 6 million births in 23 EUROCAT registries.

We studied 5,449 cases of cleft lip (CL) with or without cleft palate (CL/P) identified between 1980 and 2000 from the EUROCAT network of 23 registers (nearly 6 million births) in 14 European countries. We investigated specific types of defects associated with clefts. Among CL/P cases (prevalence = 9.1 per 10,000), 1,996 (36.6%) affected only the lip (CL) and 3,453 (63.4%) involved CL and palate (CLP). A total of 3,860 CL/P cases (70.8%) occurred as isolated anomalies and 1,589 (29.2%) were associated with other defects such as multiple congenital anomalies of unknown origin (970), chromosomal (455) and recognized syndromes (164). Associated malformations were more frequent in infants who had CLP (34.0%) than in infants with CL only (20.8%). Among multi-malformed infants, 2 unrelated anomalies were found in 351 cases, 3 in 242 cases, and 4 or more in 377 cases. Among 5,449 CL/P cases, 4,719 were live births (LB) (86.6%), 203 stillbirths (SB) (3.7%), while 508 (9.3%) were terminations of pregnancy (ToP). CL/P occurred significantly more frequently in males (M/F = 1.70), especially among total isolated cases (M/F = 1.87) and CLP isolated cases (M/F = 1.92). The study confirmed that musculoskeletal, cardiovascular, and central nervous system defects are frequently associated with CL/P. An association with reduction anomalies of the brain was found. This association suggests that clinicians should seek to identify structural brain anomalies in these patients with CL/P as the potential functional consequences may be important for rehabilitation and clinical management.

RAPDs na caracterização genético-molecular e no estudo da variabilidade genética de cultivares de ameixeira

Marcadores moleculares têm sido amplamente utilizados nas mais variadas espécies frutíferas para análise de "fingerprinting", para o processo de certificação de material vegetal e como ferramenta auxiliar em programas de melhoramento genético, para acessar a variabilidade genética entre genótipos. Dado a importância da cultura da ameixeira para a região Sul do Brasil, o presente trabalho teve por finalidade contribuir para a caracterização genético-molecular de 17 cultivares. As cultivares foram analisadas com 12 marcadores RAPD, que produziram 187 polimorfismos. O marcador OP A20 foi o mais polimórfico, produzindo 26 perfis diferentes. A análise de agrupamento, realizada com o método UPGMA, produziu um dendrograma que permitiu uma clara separação das cultivares em três grupos, correspondentes às suas respectivas espécies, Prunus salicina, Prunus domestica e Prunus cerasifera. O alto grau de polimorfismo detectado pelos marcadores RAPD confirma o potencial da técnica na análise de "fingerprinting" e sua utilidade na estimativa da variabilidade genética entre cultivares de ameixeira.

Ranking-Dominance Relation for (Evolutionary) Multi-Objective Optimization

An alternative relation to Pareto-dominance relation is proposed. The new relation is based on ranking a set of solutions according to each separate objective and an aggregation function to calculate a scalar fitness value for each solution. The relation is called as ranking-dominance and it tries to tackle the curse of dimensionality commonly observedin evolutionary multi-objective optimization. Ranking-dominance can beused to sort a set of solutions even for a large number of objectives when Pareto-dominance relation cannot distinguish solutions from one another anymore. This permits search to advance even with a large number of objectives. It is also shown that ranking-dominance does not violate Pareto-dominance. Results indicate that selection based on ranking-dominance is able to advance search towards the Pareto-front in some cases, where selection based on Pareto-dominance stagnates. However, in some cases it is also possible that search does not proceed into direction of Pareto-front because the ranking-dominance relation permits deterioration of individual objectives. Results also show that when the number of objectives increases, selection based on just Pareto-dominance without diversity maintenance is able to advance search better than with diversity maintenance. Therefore, diversity maintenance is connive at the curse of dimensionality.

Field Sales Management Control: Towards a Multi-Level Theory

The purpose of this dissertation is to increase the understanding and knowledge of field sales management control systems (i.e. sales managers monitoring, directing, evaluating and rewarding activities) and their potential consequences on salespeople. This topic is important because research conducted in the past has indicated that the choice of control system type can on the other hand have desirable consequences, such as high levels of motivation and performance, and on the other hand leadto harmful unintended consequences, such as opportunistic or unethical behaviors. Despite the fact that marketing and sales management control systems have been under rigorous research for over two decades, it still is at a very early stage of development, and several inconsistencies can be found in the research results. This dissertation argues that these inconsistencies are mainly derived from misspecification of the level of analysis in the past research. These different levels of analysis (i.e. strategic, tactical, and operational levels) involve very different decision-making situations regarding the control and motivation of sales force, which should be taken into consideration when conceptualizing the control. Moreover, the study of salesperson consequences of a field sales management control system is actually a cross-level phenomenon, which means that at least two levels of analysis are simultaneously involved. The results of this dissertation confirm the need to re-conceptualize the field sales management control system concept. It provides empirical evidence for the assertion that control should be conceptualized with more details atthe tactical/operational level of analysis than at the strategic levelof analysis. Moreover, the results show that some controls are more efficiently communicated to field salespeople than others. It is proposed that this difference is due to different purposes of control; some controls aredesigned for influencing salespersons' behavior (aim at motivating) whereas some controls are designed to aid decision-making (aim at providing information). According to the empirical results of this dissertation, the both types of controls have an impact to the sales force, but this impactis not as strong as expected. The results obtained in this dissertation shed some light to the nature of field sales management control systems, and their consequences on salespeopl

Propuesta de algoritmo para el diagnóstico de hipocalcemia tras tiroidectomía

Para diagnosticar la hipocalcemia, que a veces se presenta tras una tiroidectomia, habitualmente se recurre a la medida del ion calcio y a la evaluación de síntomas específicos de hipocalcemia (tetania, signo de Trousseau) o inespecíficos (parestesia, vómitos, etc) en los días posteriores a la intervención. Sería ideal que existiesen magnitudes bioquímicas que permitieran diagnosticar precozmente esta hipocalcemia y sintomatologia. Recientemente, se ha demostrado que las concentraciones intraoperatorias de paratirina (PTH) informan sobre el estado funcional de las glándulas paratiroides tras la tiroidectomia, por lo que éstas serian las magnitudes ideales que buscamos.

Mancha fisiológica do mamão: uma perspectiva de obtenção de material genético tolerante

A ocorrência do distúrbio fisiológico conhecido como "Mancha Fisiológica do Mamão" (MFM) tem comprometido a qualidade do mamão (Carica papaya L.) produzido no Brasil. A obtenção de material genético tolerante à MFM faz parte das estratégias de ação de médio a longo prazo para minimizar os prejuízos decorrentes da ocorrência desse distúrbio. No presente trabalho, buscou-se avaliar a tolerância de vinte e dois híbridos de mamão à ocorrência da MFM, na região norte do Estado do Rio de Janeiro. Os frutos foram colhidos de um ensaio de competição instalado na Estação Experimental da PESAGRO-Rio, no município de Macaé-RJ. O ensaio consistiu de quatro repetições, num delineamento em blocos ao acaso, sendo que cada parcela foi constituída de oito plantas. Os dados foram submetidos a uma análise de variância e teste de média. Efetuou-se, inicialmente, uma análise conjunta, envolvendo os dois estádios de maturação avaliados - verde-maduro e ¾ maduro; considerando a significância da interação Estádio x Genótipo, procedeu-se a uma análise específica, por estádio de desenvolvimento do fruto. Em função da análise de variância, também, foi calculado o coeficiente de determinação genotípica (H²) para o caráter em estudo, o qual demonstrou que a avaliação do nível de severidade da MFM, no estádio ¾ maduro, caracteriza melhor as diferenças genotípicas. Com base nesses resultados, inferimos que há uma expressiva variabilidade genética, para o caráter MFM, dentre os genótipos avaliados. Isto sugere um bom potencial em se obter, através do melhoramento genético, material vegetal (híbridos e variedades) com maior tolerância à MFM. O melhoramento genético associado ao manejo do ambiente poderá permitir o cultivo do mamoeiro sem as limitações advindas da ocorrência da MFM.