Variability of radioiodine measurements in the thyroid.

Monte Carlo simulations were carried out to study the response of a thyroid monitor for measuring intake activities of (125)I and (131)I. The aim of the study was 3-fold: to cross-validate the Monte Carlo simulation programs, to study the response of the detector using different phantoms and to study the effects of anatomical variations. Simulations were performed using the Swiss reference phantom and several voxelised phantoms. Determining the position of the thyroid is crucial for an accurate determination of radiological risks. The detector response using the Swiss reference phantom was in fairly good agreement with the response obtained using adult voxelised phantoms for (131)I, but should be revised for a better calibration for (125)I and for any measurements taken on paediatric patients.

Increase of [(18)F]FLT tumor uptake in vivo mediated by FdUrd: toward improving cell proliferation positron emission tomography.

PURPOSE: 3'-deoxy-3'-[(18)F]fluorothymidine ([(18)F]FLT), a cell proliferation positron emission tomography (PET) tracer, has been shown in numerous tumors to be more specific than 2-deoxy-2-[(18)F]fluoro-D-glucose ([(18)F]FDG) but less sensitive. We studied the capacity of a nontoxic concentration of 5-fluoro-2'-deoxyuridine (FdUrd), a thymidine synthesis inhibitor, to increase uptake of [(18)F]FLT in tumor xenografts. METHODS: The duration of the FdUrd effect in vivo on tumor cell cycling and thymidine analogue uptake was studied by varying FdUrd pretreatment timing and holding constant the timing of subsequent flow cytometry and 5-[(125)I]iodo-2'-deoxyuridine biodistribution measurements. In [(18)F]FLT studies, FdUrd pretreatment was generally performed 1 h before radiotracer injection. [(18)F]FLT biodistributions were measured 1 to 3 h after radiotracer injection of mice grafted with five different human tumors and pretreated or not with FdUrd and compared with [(18)F]FDG tumor uptake. Using microPET, the dynamic distribution of [(18)F]FLT was followed for 1.5 h in FdUrd pretreated mice. High-field T2-weighted magnetic resonance imaging (MRI) and histology were used comparatively in assessing tumor viability and proliferation. RESULTS: FdUrd induced an immediate increase in tumor uptake of 5-[(125)I]iodo-2'-deoxyuridine, that vanished after 6 h, as also confirmed by flow cytometry. Biodistribution measurements showed that FdUrd pretreatment increased [(18)F]FLT uptake in all tumors by factors of 3.2 to 7.8 compared with controls, while [(18)F]FDG tumor uptake was about fourfold and sixfold lower in breast cancers and lymphoma. Dynamic PET in FdUrd pretreated mice showed that [(18)F]FLT uptake in all tumors increased steadily up to 1.5 h. MRI showed a well-vascularized homogenous lymphoma with high [(18)F]FLT uptake, while in breast cancer, a central necrosis shown by MRI was inactive in PET, consistent with the histomorphological analysis. CONCLUSION: We showed a reliable and significant uptake increase of [(18)F]FLT in different tumor xenografts after low-dose FdUrd pretreatment. These results show promise for a clinical application of FdUrd aimed at increasing the sensitivity of [(18)F]FLT PET.

O efeito protetor do bicarbonato de sódio na nefropatia induzida por contraste radiológico em ratos

Contrastes radiológicos iodados - CI são causa de lesão renal aguda - LRA. Avaliar o efeito renoprotetor do bicarbonato de sódio (Bic) sobre a função renal (clearance de creatinina, Jaffé, Clcr-ml/min/100g) e o perfil oxidativo (excreção de peróxidos, PU e de malondealdeído urinários, FOX-2 e TBARs, nmol/mgCr ) em ratos com CI. Ratos machos adultos Wistar, 250-300g, tratados 1x/dia, por 5 dias, foram divididos nos grupos: Salina (solução salina 0,9%, 3ml/kg/dia, intraperitoneal-i.p.); CI (ioxitalamato de meglumina e sódio, 3ml/kg, i.p); Bic+Salina (Bic 3ml/kg, i.p, 1 hora antes e 1 hora depois da Salina); Bic+CI (Bic 3ml/kg, i.p, 1 hora antes e 1 hora depois do CI). CI induziu LRA e o Bic confirmou seu efeito renoprotetor antioxidante (Clcr/TBARs/PU Salina: 0,59±0,03/0,11±0,02/1,29±0,24 vs Bic+Salina 0,58±0,03/0,13±0,02/1,32±0,64 vs CI 0,22±0,02A/0,19±0,02A/4,77±0, 24A vs Bic+CI 0,51±0,04B/0,13±0,3B/1,80± 0,04B, A/B p<0,05). O Bic confirmou efeito protetor na LRA por CI, podendo ser considerado como possibilidade terapêutica para pacientes submetidos a CI.

Actitud ante el consumo y no consumo de alcohol en estudiantes de preparatoria – México

El objetivo del estudio fue identificar diferencias de actitud entre estudiantes de la educación secundaria consumidores y no de alcohol a través de la Teoría de la Conducta Planeada. Estudio descriptivo transversal con abordaje cuantitativo, con una muestra de 131 adolescentes. Se verifi có que 74% ya habían consumido alcohol y 18.3% tienen consumo dañino. Se constató que las creencias conductuales hacia el consumo eran más altas en los consumidores de alcohol (X=29.32, Mdn=27.50) que en los no consumidores, así con la evaluación de las creencias en sentido positivo son más altas en los consumidores de alcohol (X=17.72, Mdn=9.52) que en los no consumidores, haciéndose necesaria la implementación de programas preventivos que fortalezcan las creencias de los adolescentes, así como estimular las estrategias vinculadas con el fortalecimiento de factores protectores y estilos de vida saludables.

Helsinki 9/7 -29

Kirje 9.7.1929

Antigenicity and immunogenicity of a novel Plasmodium vivax circumsporozoite derived synthetic vaccine construct.

BACKGROUND: The circumsporozoite (CS) protein is a major malaria sporozoite surface antigen currently being considered as vaccine candidate. Plasmodium vivax CS (PvCS) protein comprises a dimorphic central repeat fragment flanked by conserved regions that contain functional domains involved in parasite invasion of host cells. The protein amino (N-terminal) flank has a cleavage region (region I), essential for proteolytic processing prior to parasite invasion of liver cells. METHODS: We have developed a 131-mer long synthetic polypeptide (LSP) named PvNR1R2 that includes the N-terminal flank and the two natural repeat variant regions known as VK210 and VK247. We studied the natural immune response to this region in human sera from different malaria-endemic areas and its immunogenicity in mice. RESULTS: PvNR1R2 was more frequently recognized by sera from Papua New Guinea (PNG) (83%) than by samples from Colombia (24%) when tested by ELISA. The polypeptide formulated in Montanide ISA51 adjuvant elicited strong antibody responses in both C3H and CB6F1 mice strains. Antibodies from immunized mice as well as affinity-purified human IgG reacted with native protein by IFA test. Moreover, mouse immune sera induced strong (90%) in vitro inhibition of sporozoite invasion (ISI) of hepatoma cell lines. CONCLUSIONS: These results encourage further studies in non-human primates to confirm the elicitation of sporozoite invasion blocking antibodies, to assess cell mediated immune responses and the protective efficacy of this polypeptide.

O balanced scorecard como instrumento de alinhamento estratégico nas organizações - Caso: Bento, S.A.

Diante da crescente competitividade, característica do mercado global, e da necessidade de melhorar a eficiência e a produtividade nas organizações, torne-se imperativo o aperfeiçoamento, incessante, na forma de actuação dos gestores. Consciente que, até então, as empresas suportam, essencialmente, no sistema contabilístico, este que, muitas vezes, fornece informações insuficientes e restringidos à tomada de decisões de curto prazo, mostra-se necessário investir em sistemas de medição, ligado à estratégia organizacional, que permitam melhor planeamento e controlo e, ainda, gerar e medir indicadores de longo prazo. No intuito de contribuir para a melhoria do paradigma da gestão, mais concretamente da gestão das empresas Cabo-Verdianas, e, em particular a da empresa em estudo, propomos, como objectivo desta dissertação, o estudo da utilização das ferramentas de gestão tradicional, face às novas ferramentas emergentes. Nisto, apresentamos, como estudo de caso, a avaliação do sistema de controlo de gestão da Empresa Bento - Comércio, Construtores, Imobiliária e Investimentos, Sociedade Anónima, (Bento S.A.), analisando, à luz da literatura consultada, o sistema de gestão estratégica, seguido pela empresa de modo a poder propor eventuais melhorias. Durante a revisão bibliográfica, foram estudadas várias ferramentas da gestão estratégica, das quais escolhemos o Balanced Scorecard (BSC) como um instrumento capaz de responder às lacunas detectadas na estratégia de gestão da Empresa, em que após uma breve descrição dos aspectos teóricos do conceito, suportado nos estudos empíricos publicados, apresentámos uma proposta para sua adopção, concepção e implementação. É de realçar que, durante o estudo constatou-se, por parte da administração da empresa, uma maior consciência da importância da comunicação e divulgação da sua estratégia entre os diferentes níveis hierárquicos, o que evidencia que ela está, mesmo, disposta a apostar na sua inovação estratégica. With the raising competitiveness, characteristic of the global market, and of the need of improving the efficiency and productivity in organizations, the constant improvement in the way of acting of managers it becomes peremptory. Aware that, so far, enterprises support, essentially, on the accounting system, which, many times, gives restrict and insufficient information for the taking of decisions in a short term, it is shown to be necessary to invest in measuring systems, connected to the organizational strategy, which contains signs that allow a better planning and control and, furthermore, give birth to and measure signs on a long term. With the aim of contributing for the improvement of the managing pattern, specifically, the management of Cape Verdean enterprises, and, in particular, the one of the enterprise in study, we propose, as an aim of this dissertation, the study of the use of the traditional managing tools, in view of the emerging new tools. Thus, we present, as study case, the evaluation of the system of management control of the Enterprise Bento - Comércio, Construtores, Imobiliária e Investimentos, Sociedade Anónima, (Bento, S.A.), analyzing the system of strategic management, used by the enterprise to be able to propose eventual improvements. During the bibliographic revision, we studied many strategic management tools, among which we chose the Balanced Scorecard (BSC) as an instrument capable to respond to the gaps detected in the management strategy of the enterprise, in which, after a brief description of the theoretical aspects of the concept, supported on the empiric studies published, we present a proposal for its adoption, conception and implementation. We would like to accentuate that, during the study we noticed that there exists, on the behalf of the management of the enterprise, a major awareness of the importance of communication and diffusion of its strategy among the different hierarchical levels, what makes clear that the enterprise is really open to bet on its strategic innovation.

Validation of the potentially avoidable hospital readmission rate as a routine indicator of the quality of hospital care

BACKGROUND: The hospital readmission rate has been proposed as an important outcome indicator computable from routine statistics. However, most commonly used measures raise conceptual issues. OBJECTIVES: We sought to evaluate the usefulness of the computerized algorithm for identifying avoidable readmissions on the basis of minimum bias, criterion validity, and measurement precision. RESEARCH DESIGN AND SUBJECTS: A total of 131,809 hospitalizations of patients discharged alive from 49 hospitals were used to compare the predictive performance of risk adjustment methods. A subset of a random sample of 570 medical records of discharge/readmission pairs in 12 hospitals were reviewed to estimate the predictive value of the screening of potentially avoidable readmissions. MEASURES: Potentially avoidable readmissions, defined as readmissions related to a condition of the previous hospitalization and not expected as part of a program of care and occurring within 30 days after the previous discharge, were identified by a computerized algorithm. Unavoidable readmissions were considered as censored events. RESULTS: A total of 5.2% of hospitalizations were followed by a potentially avoidable readmission, 17% of them in a different hospital. The predictive value of the screen was 78%; 27% of screened readmissions were judged clearly avoidable. The correlation between the hospital rate of clearly avoidable readmission and all readmissions rate, potentially avoidable readmissions rate or the ratio of observed to expected readmissions were respectively 0.42, 0.56 and 0.66. Adjustment models using clinical information performed better. CONCLUSION: Adjusted rates of potentially avoidable readmissions are scientifically sound enough to warrant their inclusion in hospital quality surveillance.

Novel mutation in the tyrosine kinase domain of FGFR2 in a patient with Pfeiffer syndrome.

Mutations in the fibroblast growth factor receptor 2 (FGFR2) cause a variety of craniosynostosis syndromes. The mutational spectrum tends to be narrow with the majority of mutations occurring in either exon IIIa or IIIc or in the intronic sequence preceding exon IIIc. Mutations outside of this hotspot are uncommon and the few identified mutations have demonstrated wide clinical variability, making it difficult to establish a clear-cut genotype-phenotype correlation. To better delineate the clinical picture associated with these unusual mutations, we describe a severely affected patient with Pfeiffer syndrome and a missense mutation in the tyrosine kinase (TK) domain of FGFR2.