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Background & Aims: Quantification of the number of noninhibited responses (lures) in the inhibitory control task (ICT) has been proposed for the diagnosis of minimal hepatic encephalopathy (MHE). We assessed the efficacy of ICT compared with recommended diagnostic standards., Methods: We studied patients with cirrhosis and healthy individuals (controls) who underwent the ICT at 2 centers (center A: n=51 patients and 41 controls, center B: n=24 patients and 14 controls). Subjects were evaluated for MHE by psychometric hepatic encephalopathy score (PHES). Patients from center B also were assessed for MHE by critical flicker frequency and spectral electroencephalogram analyses., Results: Patients with cirrhosis had higher ICT lures (23.2+/-12.8 vs 12.9+/-5.8, respectively, P<.01) and lower ICT target accuracy (0.88+/-0.17 vs 0.96+/-0.03, respectively, P<.01) compared with controls. However, lures were comparable (25.2+/-12.5 vs 21.4+/-13.9, respectively, P=.32) among patients with/without altered PHES (center A). There was a reverse, U-shaped relationship between ICT lure and target accuracy; a variable adjusting lures was devised based on target accuracy (weighted lures at center B). This variable differed between patients with and without MHE. The variable weighted lures was then validated from data collected at center A by receiver operator characteristic curve analysis; it discriminated between patients with and without PHES alterations (area under the curve=0.71+/-0.07). However, target accuracy alone was as effective as a stand-alone variable (area under the curve=0.81+/-0.06)., Conclusions: The ICT is not useful for the diagnosis of MHE, unless adjusted by target accuracy. Testing inhibition (lures) does not seem to be superior to testing attention (target accuracy) for the detection of MHE., (Copyright (c) 2010 AGA Institute. Published by Elsevier Inc. All rights reserved.)

Background: Morbidity and mortality following traditional surgical treatment of gastric outlet obstruction is high. The aim of this work was to identify risk factors predictive of postoperative complications and mortality following gastroenterostomy., Methods: One-hundred sixty-five consecutive patients subjected to open gastroenterostomy from January 1996 through July 2003 were included. Data on vital signs and operative variables were retrieved from medical records and recorded retrospectively. Risk factors for postoperative complications and mortality within 30 days after operation were analyzed with multiple logistic regression., Results: The 30-day complication and death rates were higher after emergency operations (80% and 60%) than after elective operations (32% and 25%). A multivariate analysis disclosed that hypoalbuminemia (< or = 32 g/l), comorbidity, high age, and hyponatremia (< 135 micromol/l) were significantly associated with postoperative death, whereas hypoalbuminemia, comorbidity, high age, and emergency operation were predictors of postoperative complications., Conclusions: Complications and mortality after gastroenterostomy due to gastric outlet obstruction are associated with modifiable and non-modifiable risk factors. Prior to surgery means should be taken to correct low albumin and sodium levels to prevent complications. In addition, the surgeon should consider alternative treatment modalities including laparoscopic gastroenterostomy, self-expanding metallic stents, or tube gastrostomy to relieve or palliate gastric outlet obstruction.

In this study we propose a reflection on nursing as an object of history. Our proposal is based on studies which have dealt with the history of nursing in Brazil and with the new perspectives of history studies. Our reflection is guided by an analysis of the history of nursing in Brazil and the social circumstances which determined the development of this profession in this context. This research adopted methodological proposals which are usually used in historical studies. The data collection was done through oral history and the analysis of documentary sources. The review of the social phenomenon, through the data collected, showed the importance of studies of historic nature and how much these can help on the understanding of the nursing professional identity as well as on the strengthening of this category. We hope that this project motivates the production of other works on this subject and calls the attention for the importance of preserving our historical memory.

The present study analyses the themes proposed by research projects in nursing. It focuses on the projects that were sent to a Brazilian governmental research fomentation agency--CNPq--in the period of time between November 1998 and November 2000. The objective of this work is to identify the recurrent themes proposed in nursing research projects, and discuss its adherence to lines of research under study by nursing professionals which have the support of CAPES. It also relates these themes to the priorities of research established by CNPq. In order to achieve the objectives mentioned, an exploratory and descriptive study was carried out. The primary sources were evaluation grids of research projects. The secondary sources were studies, written and statistics reports from CNPq. Results show that most of the scholarships awarded by CNPq are in the southeast region of Brazil, where a larger number of researchers and post-graduation programs are concentrated. It also reveals that there is a diversity of themes being explored and that there is a relation between the themes and the parameters adopted for the studies.