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INTRODUCTION: Cancer is a disease that affects a large population, being the colorectal cancer one of the most prevalent. The early diagnosis of these neoplasms represents a better life expectancy. The high cost of diagnostic tests and the low socioeconomic status are considered factors leading to delayed diagnosis. OBJECTIVES: Assess the difference between colorectal cancer staging in patients of private clinics and patients of the Brazilian National Health Service (SUS) and assess the changes in cancer staging in the past five years. METHODS: This retrospective study was conducted with 53 patients divided in two groups (SUS and private clinic) diagnosed with colorectal cancer and treated in 2009. Staging of patients diagnosed in 2009 was compared with data from patients diagnosed in 2004, already published in 2005. RESULTS: Both groups were similar in gender and age. Regarding the staging of patients, no statistical difference was observed between the two groups (p=0.147). When comparing the staging of patients diagnosed in 2009 with that of patients studied in 2004, patients diagnosed in 2009 presented early stages (II and III) in relation to patients analyzed in 2004 (III and IV), pINTRODUÇÃO: O câncer é uma doença que afeta grande parte da população, sendo o câncer colorretal um dos mais prevalentes. O diagnóstico precoce dessas neoplasias resulta em uma melhor expectativa de vida. O alto custo dos exames diagnósticos e o baixo nível socioeconômico são apontados como fatores que levam ao atraso no diagnóstico. OBJETIVOS: Avaliar a diferença no estadiamento de câncer colorretal no momento do diagnóstico de pacientes oriundos da clínica privada e pacientes do Sistema Único de Saúde (SUS), assim como, avaliar as mudanças no estadiamento nos últimos cinco anos. MÉTODOS: Estudo retrospectivo envolvendo 54 pacientes divididos em dois grupos (SUS e clínica privada) diagnosticados no ano de 2009. Os estadiamentos dos pacientes diagnosticados em 2009 foram comparados com os dados de pacientes diagnosticados em 2004, já publicados em 2005. RESULTADOS: Ambos os grupos eram similares em gênero e idade. Em relação ao estadiamento dos pacientes não houve diferença estatística entre os dois grupos (p=0,147). Na comparação entre os pacientes de 2009 e os pacientes estudados em 2004 se evidencia que os pacientes de 2009 apresentaram-se com estádios mais precoces (II e III) em relação aos pacientes de 2004 (III e IV), p

Iron accumulation in the brain has been associated to the pathogenesis of neurodegenerative disorders. We have previously demonstrated that iron overload in the neonatal period results in severe and persistent memory deficits in adult rats. Alterations in histone acetylation have been associated with memory deficits in models of neurological disorders. Here we examine histone acetylation in the brain and the effects of the histone deacetylase inhibitor (HDACi) sodium butyrate (NaB) on memory in the neonatal iron overload model in rats. Rats received vehicle or 30.0-mg/kg Fe⁺² orally at postnatal days 12-14. When animals reached adulthood, they were given training in either novel object recognition or inhibitory avoidance. Histone acetylation in the dorsal hippocampus and the effects of NaB were examined in separate sets of rats. Iron overload led to a reduction in H3 lysine 9 acetylation in the hippocampus, without affecting the acetylation of other H3 and H4 lysine residues. A single systemic injection of NaB (1.2 g/kg) immediately after training ameliorated iron-induced memory impairments. The results suggest that a reduction in H3K9 acetylation might play a role in iron-induced memory impairment and support the view that HDACis can rescue memory dysfunction in models of brain disorders.

Postconditioning is a procedure based on the induction of intracellular protective reactions immediately after the onset of reperfusion. Because of the growing need to prevent ischemia/reperfusion (I/R) injury during liver surgery and transplantation, we investigated the possibility of pharmacologically inducing hepatic postconditioning. The effects of the adenosine A2A receptor agonist 2p-(2-carboxyethyl)-phenyl-amino-5'-N-ethylcarboxyamido-adenosine (CGS21680; 5 μmol/L) and the phosphatase and tensin homologue deleted from chromosome 10 (PTEN) inhibitor dipotassium bisperoxo-(5-hydroxypyridine-2-carboxyl)-oxovanadate [bpV(HOpic); 250 nmol/L] were investigated in primary rat hepatocytes during reoxygenation after 24 hours of cold storage and in an in vivo model of rat liver warm I/R. The addition of CGS21680 at reoxygenation significantly reduced hepatocyte death through the activation of the phosphoinositide 3-kinase (PI3K)-protein kinase B (PKB)/Akt signal pathway and through the reduction of the intracellular level of PTEN. PTEN lowering was associated with the increased generation of reactive oxygen species after A2A receptor-mediated stimulation of β-nicotinamide adenine dinucleotide phosphate oxidase (NOX). The inhibition of PI3K or NOX with wortmannin or diphenyleneiodonium chloride, respectively, and the addition of the antioxidant N,N'-diphenyl-p-phenylenediamine reversed the effects of CGS21680. The PTEN inhibitor bpV(HOpic) mimicked the protection provided by CGS21680 against reoxygenation damage. An in vivo rat treatment with CGS21680 or bpV(HOpic) during reperfusion after 1 hour of partial hepatic ischemia also promoted PKB/Akt activation and ameliorated alanine aminotransferase release and histological lesions induced by 2 hours of reperfusion. We conclude that adenosine A2A receptor agonists and PTEN inhibitors are possibly useful agents for the pharmacological induction of postconditioning in the liver.

OBJETIVOS: Comparar a eficácia e segurança do sulfato de magnésio em relação ao polietilenoglicol no preparo intestinal para colonoscopia em pacientes com idade igual ou superior a 70 anos. MÉTODOS: Foram selecionados para o estudo sessenta pacientes acima de 70 anos, de ambos os sexos e que foram aleatoriamente divididos em dois grupos: o grupo controle, utilizando o polietilenoglicol e o grupo em estudo com sulfato de magnésio. Foram avaliados a qualidade do preparo, a tolerância pelos pacientes e os efeitos adversos produzidos por cada substância. O colonoscopista possuía informação prévia sobre o tipo de preparo. RESULTADOS: Os pacientes apresentaram uma distribuição homogênea nos grupos e nos fatores idade, patologias prévias, efeitos colaterais, qualidade de preparo e tempo de chegada ao ceco na realização da colonoscopia. Diferiram na distribuição do sexo, apresentando um maior número de indivíduos do sexo feminino no grupo que utilizou o sulfato de magnésio, porém sem relevância estatística. CONCLUSÃO: O sulfato de magnésio não demonstrou diferença estatística quanto aos níveis de segurança e eficácia em pacientes maiores de 70 anos, para o preparo intestinal, quando comparado ao polietilenoglicol.OBJECTIVES: To compare efficacy and safety of magnesium sulphate in relation to polyethylene glycol in bowel preparation for colonoscopy. METHODS: Sixty patients older than 70 years old, of both genders, were selected for the study, and were randomly divided into two groups: the control group, using polyethylene glycol and the in study group with magnesium sulphate. Quality of preparation, patient tolerance, and side effects produced by each substance were evaluated. Colonoscopist was blinded in relation to the information of bowel preparation. RESULTS: Patients present a homogeneus distribution in groups, in factors as age, past pathologies, side effects, cleansing quality and time taken to reach cecum during colonoscopy. There were differences in gender distribution, being higher the number of female individuals in the group which used magnesium sulphate, however with no statistical significance. CONCLUSION: Magnesium sulphate presented no statistical difference in relation to safety and efficacy levels in patients older than 70 years old, for bowel preparation, when it is compared with polyethylene glycol.

A recuperação de dados armazenados em Bancos de Dado em geral é feita utilizando estruturas de indexação, que permitem fazer a recuperação dos dados muito mais rapidamente do que se a busca fosse feita sequencialmente. No entanto, as estruturas de indexação que podem ser utilizadas dependem das propriedades dos domínios de dados indexados e do tipo de consultas que devem ser respondidas. Tradicionalmente, os gerenciadores de bancos de dados suportam bem dados de domínios que possuem a propriedade de relação de ordem total, tais como números e textos com a relação de ordem lexicográfica permitindo consultas por igualdade e consultas envolvendo relações de ordem tais como >, < ou =, >, < ou = etc. Além disso, as estruturas de indexação comumente utilizadas em sistemas gerenciadores de bases de dados são construídas para serem armazenadas em disco, particionando o conjunto de dados em registros de tamanho fixo. O exemplo mais comum desse arranjo é o das árvores de indexação, quando os registros são então chamados \"nós\". Aplicações mais sofisticadas frequentemente apresentam dados em outros domínios, com outros tipos de consulta. Quando as aplicações lidam com dados em domínio métrico, além dos próprios elementos de dados, é definida uma função de similaridade (ou de distância) entre pares de elementos, e essa função é a única maneira de comparação entre dois elementos de dados do conjunto. Existem diversas estruturas de indexação criadas para dados em domínios métricos . Entretanto essas estruturas ou são estáticas (impedindo que novos elementos sejam acrescentados depois que a estrutura foi criada), ou são para armazenamento em disco. Neste trabalho foi desenvolvida uma nova estrutura métrica dinâmica para dados métricos totalmente armazenada em memória principal. Uma outra propriedade interessante dessa estrutura é que a execução de uma consulta por existência (point query) percorre um único caminho de busca. Essa característica é muito interessante, pois todas as outras árvores dinâmicas existentes requerem que a navegação seja feita não apenas em profundidade, mas também em largura. A estrutura proposta permite a navegação apenas em profundidade para a consulta por existência. The stored data recovery in Data bases, in general is made using indexation structures, that allow to much more quickly make the data recovery of that if the search was made sequentially. However, the indexation structures that can be used depend on the domains properties of the of indexing data and the type of queries that must be answered. Traditionally, the data bases management systems support well domains dataset that possess the property of relation of total order, such as numbers and texts with the lexicographical relation order allowing to queries for equality and queries involving order relations such as >, < or =, > and < or =. Moreover, the commonly indexing structures used in data bases management systems are constructed to be stored in record, partitioning the data set in registers of so great fixture. The example most common of this arrangement is of the indexing trees, when the registers then are called \"nodes\". Sophisticated applications more frequently present datasets in other domains, with other types of quey. When the applications deal with data in metric domain, beyond the proper data elements, a similarity function (or distance) between pairs of elements is defined, and this function is the only way of comparison enters two elements of data of the set. There are diverse metric domain data indexing structures created. However these structures are static (hindering that new elements are added later that the structure was created), or are for record storage. In this work a new dynamic metric structure for metric data total stored in principal memory e was developed. One another interesting property of this structure is that the execution of a quey for existence (point query) covers an only way of search. This characteristic is very interesting, therefore ali the other existing dynamic trees require that the navigation is made not only in depth, but also in width. The structure proposal allows the navigation only in depth for the quey for existence.

O objetivo desta dissertação foi verificar como é feita a Gestão da Inovação em três empresas do Grupo Tramontina S.A. Buscou-se também realizar um comparativo da Gestão da Inovação de cada empresa estudada com os três modelos de Gestão da Inovação abordados no referencial teórico: modelo Stage-Gate de Cooper; modelo Funil do Desenvolvimento de Clark e Wheelwright e; modelo de Rotinas de Tidd, Bessant e Pavitt. Com caráter qualitativo esta pesquisa exploratória de múltiplos-casos realizou dez entrevistas semiestruturadas. A interpretação dos dados ocorreu na forma de análise de discurso com a assistência do software Atlas.ti Versão 6. Os resultados mostram que cada unidade da Tramontina possui sua estrutura administrativa bem como sua forma de fazer a Gestão da Inovação. Os fatores convergentes entre todas as unidades estudas são os dois planejamentos, PLANES e PAIM. Como resultado ao comparativo do modelo de Gestão da Inovação das unidades com os modelos de Gestão da Inovação da literatura pode-se apontar que todas as unidades possuem fatores semelhantes e diferentes com cada um dos modelos, concluindo que nenhuma empresa pratica puramente um dos modelos, mas sim um composto de características de ambos os métodos. The aim of this work was to verify how is the innovation management in three companies Tramontina Group SA sought to also carry out a comparative of each company's Innovation Management studied with the three innovation management models covered in the theoretical framework: Model Stage-Gate Cooper; Model Hopper Clark and Wheelwright and Development; Model Tidd routines, Bessant and Pavitt. With this qualitative exploratory study of multiple cases held ten semi-structured interviews. The interpretation of the data was in the form of discourse analysis with the assistance Atlas.ti software version 6. The results show that each unit of Tramontina has its administrative structure and its way to the Innovation Management. The converging factors among all studied units are the two schedules, PLANES and PAIM. As a result of the comparative Innovation Management model units with innovation management models of literature we can point out that all units have similar and different factors with each model, concluding that any company purely a practice models, but a compound of the characteristics of both methods.

Nos mercados de varejos altamente competitivos há uma constante busca pela diferenciação e lealdade dos consumidores. Contudo, a compreensão de como os atributos de imagem de loja são percebidos pelos consumidores é uma questão de suma importância. É nesse contexto dinâmico do varejo que o presente trabalho de pesquisa foi desenvolvido, tento como principal objetivo identificar a relação entre imagem de varejo de vestuário e a lealdade dos consumidores da geração Y. O estudo se inicia com uma revisão bibliográfica sobre imagem, imagem de loja, lealdade e o modelo conceitual de imagem de loja (MCIL). A pesquisa foi realizada através de levantamento de campo com aplicação de questionário estruturado e a população foi definida como sendo consumidores da geração Y – nascidos entre final dos anos 1970 até o ano 2000, cuja amostra foi constituída de 394 respondentes. Os dados foram avaliados através da análise estatística multivariada de dados, utilizando a técnica de Modelagem de Equações Estruturais. Como resultados foi obtida a confirmação de que a imagem de loja é composta pelos construtos atmosfera, instalações, mix de produtos (mercadoria), promoção, pessoal de vendas e serviços e o modelo teórico proposto foi considerado adequado, indicando que a lealdade é explicada por 23,8% pela imagem de loja, apresentando uma boa contribuição tanto acadêmica quanto gerencial. In the highly competitive retail market there is a constant search for differentiation and customer loyalty. However, understanding how store image attributes are perceived by consumers is a matter of paramount importance. It is in this dynamic retail context that this research work was carried out, try as main objective to identify the relationship between retail clothing image and the loyalty of consumers of Generation Y. The study begins with a literature review of image, image store loyalty and the conceptual model of store image (MCIL). The survey was conducted through a structured questionnaire application with field survey and the population was defined as consumers of Generation Y - born between the late 1970s until 2000, whose sample consisted of 394 respondents. The data were analyzed by multivariate statistical analysis of data, using structural equation modeling technique. The results were obtained confirmation that the store image is composed of the constructs atmosphere, facilities, merchandise, promotion, sales personnel and service and the proposed theoretical model was appropriate, indicating that loyalty is explained by 23.8% by the image store and offer great contribution both academic and managerial.

OBJETIVOS: Analisar a aderência de pacientes ao controle colonoscópico após ressecção endoscópica de pólipos adenomatosos. PACIENTES E MÉTODOS: Foram avaliados 74 pacientes que realizaram colonoscopia e apresentaram pólipos adenomatosos. Estes indivíduos foram orientados a realizar colonoscopia de controle após 1 ano, de acordo com o número de adenomas, diâmetro e classificação histológica. Além da orientação na consulta, os pacientes foram avisados por ligação telefônica no período indicado para colonoscopia de controle. RESULTADOS: No período de outubro de 2000 até abril de 2006 foram acompanhados 74 pacientes. Destes 51% eram do sexo masculino, sendo que a idade média foi de 52 anos. A aderência à colonoscopia de controle neste grupo foi de 82 %, sendo que no sexo feminino foi de 94% e no masculino, de 71%, demonstrando diferença estatisticamente significante (P= 0,023). Quanto à faixa etária, não houve diferença estatística entre os grupos, porém com uma tendência a menor aderência no grupo acima de 60 anos que poderá ser confirmada com aumento da amostra. CONCLUSÃO: Devido à recorrência de pólipos adenomatosos após a primeira polipectomia, está indicado o acompanhamento periódico desses pacientes. A colonoscopia, acompanhada de polipectomia das lesões adenomatosas, é a melhor ferramenta para a prevenção do câncer colorretal nestes indivíduos. Este trabalho demonstra que pacientes do sexo masculino possuem uma menor aceitação ao acompanhamento endoscópico, estando indicadas neste grupo medidas que promovam uma maior aderência a este tipo de prevenção.OBJECTIVES: To analyze the patients' adherence after endoscopic resection of polyps with adenomas. PATIENTS AND METHODS: 74 patients who have been undergone to colonoscopy and have presented polyps with adenomas were evaluated. These patients have been oriented to do colonoscopy control which has varied in time according to the number of adenomas, diameter and histological classification. Besides the appointment orientation, the patients have been informed through phone calls during the period indicated for colonoscopy control. RESULTS: From October 2000 to April 2006, 74 patients have been followed, 51% of them were male and the average age was 52. The adherence to colonoscopy control in this group has been 82%, among the female group 94% and in the male 71%, showing a significant statistical difference (P< 0,05). In relation to the age range there has not been statistical difference among the groups, however, with a tendency to a minor adherence in the group over 60 which could be confirmed with the sample increase. CONCLUSION: Due to the polyps with adenomas recurrence after the first polypectomy, it has been indicated to these patients periodical follow up. Colonoscopy followed by polypectomy of the adenomas injuries has been the best tool for the colorectal cancer prevention in these subjects. This study demonstrates that male patients have got a minor acceptance to endoscopic follow up, indicating measures that promote a major adherence of that group to this kind or prevention.

OBJETIVOS: Analisar a aderência de pacientes ao controle colonoscópico após ressecção endoscópica de pólipos adenomatosos. PACIENTES E MÉTODOS: Foram avaliados 74 pacientes que realizaram colonoscopia e apresentaram pólipos adenomatosos. Estes indivíduos foram orientados a realizar colonoscopia de controle após 1 ano, de acordo com o número de adenomas, diâmetro e classificação histológica. Além da orientação na consulta, os pacientes foram avisados por ligação telefônica no período indicado para colonoscopia de controle. RESULTADOS: No período de outubro de 2000 até abril de 2006 foram acompanhados 74 pacientes. Destes 51% eram do sexo masculino, sendo que a idade média foi de 52 anos. A aderência à colonoscopia de controle neste grupo foi de 82 %, sendo que no sexo feminino foi de 94% e no masculino, de 71%, demonstrando diferença estatisticamente significante (P= 0,023). Quanto à faixa etária, não houve diferença estatística entre os grupos, porém com uma tendência a menor aderência no grupo acima de 60 anos que poderá ser confirmada com aumento da amostra. CONCLUSÃO: Devido à recorrência de pólipos adenomatosos após a primeira polipectomia, está indicado o acompanhamento periódico desses pacientes. A colonoscopia, acompanhada de polipectomia das lesões adenomatosas, é a melhor ferramenta para a prevenção do câncer colorretal nestes indivíduos. Este trabalho demonstra que pacientes do sexo masculino possuem uma menor aceitação ao acompanhamento endoscópico, estando indicadas neste grupo medidas que promovam uma maior aderência a este tipo de prevenção.

Biomedical implants often exhibit poor clinical performance due to the formation of a periimplant avascular fibrous capsule. Surface modification of synthetic materials has been evaluated to accelerate the formation of functional microcirculation in association with implants. The current study used a flow-mediated protein deposition system to modify expanded polytetrafluoroethylene (ePTFE) with a laminin-5-rich conditioned growth medium and with medium from which laminin-5 had been selectively removed. An in vitro model of endothelial cell adherence determined that laminin-5 modification resulted in significantly increased adhesion of human microvessel endothelial cells to ePTFE. In vivo studies evaluating the periimplant vascular response to laminin-5-treated samples indicated that absorption of laminin-5-rich conditioned medium supported accelerated neovascularization of ePTFE implants. A flow system designed to treat porous implant materials facilitates laminin-5 modification of commercially available ePTFE, resulting in increased endothelial cell adhesion in vitro and increased vascularization in vivo.

Granular cell tumor rarely affects the gastrointestinal tract. The symptoms are often unspecific and the diagnosis is reached accidentally by colonoscopy. We report the case of a 42-year-old patient diagnosed with granular cell carcinoma of the colon based on an incidental finding in colonoscopy, who was treated successfully by endoscopic excision of the tumor.O tumor de células granulares raramente acomete o trato gastrointestinal. Os sintomas muitas vezes são inespecíficos e o diagnóstico é feito ao acaso através da colonoscopia. Nós reportamos o caso de um paciente de 42 anos diagnosticado com tumor de células granulares de cólon devido a um achado incidental da colonoscopia e tratado com sucesso com remoção endoscópica.

INTRODUÇÃO: A sepse é uma resposta inflamatória sistêmica causada por infecção suspeita ou confirmada. As avaliações clínicas são essenciais para a sua detecção e tratamento precoce. Hemoculturas podem demorar até dois dias para produzir um resultado, e nem sempre são confiáveis. No entanto, estudos recentes sugeriram que a expressão de CD64 de neutrófilos pode ser uma alternativa sensível e específica para o diagnóstico de uma infecção sistêmica. OBJETIVO: Analisar a diferença de valores entre CD64 de indivíduos com síndrome de resposta inflamatória sistêmica (SIRS), e sepse suspeita ou confirmada, que satisfazem os critérios de diagnóstico para SIRS ao chegar na unidade de emergência. MÉTODO: Este foi um estudo de coorte prospectivo observacional. A amostra foi composta de 109 pacientes com idade de 18 anos ou mais, com critérios de SIRS na chegada ao serviço de emergência. Expressão CD64 foi medida no prazo de 6 horas de internação, e novamente após 48 h. RESULTADOS: A análise da curva ROC sugeriu que um corte de 1.45 dos níveis de CD64 poderia diagnosticar sepse com uma sensibilidade de 0,85, especificidade de 0,75, uma precisão de 82,08%, um valor preditivo positivo de 0,964, um valor preditivo negativo de 0,375 e uma razão de verossimilhança de 3,3381. A área sob a curva foi de 0,832. CONCLUSÃO: CD64 parece ser útil como biomarcador, sensível e específico para discriminar entre SRIS e sépsis. INTRODUCTION: Sepsis is a systemic inflammatory response to suspected or confirmed infection. Clinical evaluations are essential for its early detection and treatment. Blood cultures may take as long as two days to yield a result, and are not always reliable. However, recent studies have suggested that neutrophil CD64 expression may be a sensitive and specific alternative for the diagnosis of systemic infection. OBJECTIVE: To analyze the difference in CD64 values between subjects with systemic inflammatory response syndrome (SIRS), suspected or confirmed sepsis, who meet diagnostic criteria for SIRS upon arriving at an emergency unit. METHOD: This was a prospective observational cohort study. The sample consisted of 109 patients aged 18 years with criteria for SIRS on arrival to Emergency department. CD64 expression was measured within 6 hours of hospital admission, and once again after 48 h. RESULTS: ROC curve analysis suggested that a cutoff of 1.45 for CD64 expression could diagnose sepsis with a sensitivity of 0.85, a specificity of 0.75, an accuracy of 82.08%, a positive predictive value of 0.964, a negative predictive value of 0.375 and a positive likelihood ratio of 3.3381. The area under the curve was 0.832. CONCLUSION: CD64 appears to be a useful, sensitive and specific biomarker in discriminating between SIRS and sepsis.

Sepsis is a systemic inflammatory response against suspected or documented infection. In an infectious process, inflammation is triggered activating leukocytes, mainly neutrophils. CD64 is a surface antigen weakly expressed on non-activated mature neutrophils. When neutrophil CD64 is strongly expressed on neutrophils, it means neutrophils were activated, thus suggesting the presence of bacterial infection or acute fungal infection. A large number of biological substances has been investigated as candidate biomarkers and/or mediators of sepsis. Recent studies have focused on the investigation of neutrophil CD64 as a possible biomarker for the diagnosis of sepsis.

On January 27, 2013, a fire at the Kiss Nightclub in Santa Maria, Brazil led to a mass-casualty incident affecting hundreds of college students. A total of 234 people died on scene, 145 were hospitalized, and another 623 people received treatment throughout the first week following the incident.1 Eight of the hospitalized people later died.1 The Military Police were the first on scene, followed by the state fire department, and then the municipal Mobile Prehospital Assistance (SAMU) ambulances. The number of victims was not communicated clearly to the various units arriving on scene, leading to insufficient rescue personnel and equipment. Incident command was established on scene, but the rescuers and police were still unable to control the chaos of multiple bystanders attempting to assist in the rescue efforts. The Municipal Sports Center (CDM) was designated as the location for dead bodies, where victim identification and communication with families occurred, as well as forensic evaluation, which determined the primary cause of death to be asphyxia. A command center was established at the Hospital de Caridade Astrogildo de Azevedo (HCAA) in Santa Maria to direct where patients should be admitted, recruit staff, and procure additional supplies, as needed. The victims suffered primarily from smoke inhalation and many required endotracheal intubation and mechanical ventilation. There was a shortage of ventilators; therefore, some had to be borrowed from local hospitals, neighboring cities, and distant areas in the state. A total of 54 patients1 were transferred to hospitals in the capital city of Porto Alegre (Brazil). The main issues with the response to the fire were scene control and communication. Areas for improvement were identified, namely the establishment of a disaster-response plan, as well as regularly scheduled training in disaster preparedness/response. These activities are the first steps to improving mass-casualty responses.Dal PonteST, DornellesCFD, ArquillaB, BloemC, RoblinP. Mass-casualty response to the Kiss Nightclub in Santa Maria, Brazil. Prehosp Disaster Med. 2015;30(1):1-4.

Exposure to stressful events early in life may have permanent deleterious consequences on nervous system function and increase the susceptibility to psychiatric conditions later in life. Maternal deprivation, commonly used as a source of neonatal stress, impairs memory in adult rats and reduces hippocampal brain-derived neurotrophic factor (BDNF) levels. Inflammatory cytokines, such as interleukins (IL) and tumor necrosis factor-α (TNF-α) have been shown to be increased in the peripheral blood of patients with psychiatric disorders. The aim of the present study was to investigate the effects of maternal separation on the levels of IL-10 and TNF-α, and BDNF in the hippocampus and prefrontal cortex of adult rats. We also evaluated the potential ameliorating properties of topiramate and valproic acid on memory deficits and cytokine and BDNF changes associated with maternal deprivation. The results indicated that, in addition to inducing memory deficits, maternal deprivation increased the levels of IL-10 in the hippocampus, and TNF-α in the hippocampus and in the cortex, and decreased hippocampal levels of BDNF, in adult life. Neither valproic acid nor topiramate were able to ameliorate memory deficits or the reduction in BDNF induced by maternal separation. The highest dose of topiramate was able to reduce IL-10 in the hippocampus and TNF-α in the prefrontal cortex, while valproate only reduced IL-10 levels in the hippocampus. These findings may have implications for a better understanding of the mechanisms associated with alterations observed in adult life induced by early stressful events, and for the proposal of novel therapeutic strategies.

End product application is an important consideration when evaluating a material in an in vivo setting (Didisheim, Cardiovasc Pathol 1993;2:1S–2S). Small animal models allow high through-put evaluation of biocompatability. Previous preclinical evaluations have often used a rat subcutaneous model for the characterization of material-tissue interaction. Recent advances in genetic manipulation have provided mouse models with selective expression of a wide range of critical proteins. The rat model does not have many of the resources (i.e., knockouts, SCID, nude) that are present in mouse strains. The availability of these mice provides a resource to delineate the mechanisms regulating the healing associated with implants. However, before the mouse models can be used, they must be validated with respect to their ability to accurately assess tissue reponses to materials. In this study the tissue responses after the implantation of expanded polytetrafluoroethylene (ePTFE) were compared between rat and mouse. Discs of ePTFE (30-μm internodal distance) were implanted in subcutaneous and epididymal fat tissue of rats (Sprague-Dawley) and mice (129-SVJ). After 5 weeks the samples were removed and evaluated for vascular density, inflammation, and fibrous encapsulation. No difference in the vessel density was observed within the peri-implant subcutaneous and adipose tissue or within the porous material. However, a significant difference was found in the number of activated macrophages and giant cells between these two species. Implants in the rat exhibited greater numbers of activated inflammatory cells in the peri-implant tissue. The data indicate that the mouse and rat provide a comparable model for evaluating angiogenesis and neovascularization associated with synthetic porous implants. © 2001 Wiley Periodicals, Inc. J Biomed Mater Res 59: 682–689, 2002

Background/Aims The efficacy of ischemic preconditioning (IPC) in preventing reperfusion injury in human liver transplants is still questioned. Phosphoinositide-3-kinase (PI3K) is essential for IPC development in rodent livers. This work investigates whether PI3K-dependent signals might account for the inconsistent responses to IPC of transplanted human livers. Methods Forty livers from deceased donors were randomized to receive or not IPC before recovery. PI3K activation was evaluated in biopsies obtained immediately before IPC and 2h after reperfusion by measuring the phosphorylation of the PI3K downstream kinase PKB/Akt and the levels of the PI3K antagonist phosphatase tensin-homologue deleted from chromosome 10 (PTEN). Results IPC increased PKB/Akt phosphorylation ( p =0.01) and decreased PTEN levels ( p =0.03) in grafts, but did not significantly ameliorate post-transplant reperfusion injury. By calculating T 2h / T 0 PKB/Akt phosphorylation ratios, 10/19 (53%) of the preconditioned grafts had ratios above the control threshold (IPC-responsive), while the remaining nine grafts showed ratios comparable to controls (IPC-non-responsive). T 2h / T 0 PTEN ratios were also decreased ( p ⩽0.03) only in IPC-responsive grafts. The patients receiving IPC-responsive organs had ameliorated ( p ⩽0.05) post-transplant aminotransferase and bilirubin levels, while prothrombin activity was unchanged. Conclusions Impaired PI3K signaling might account for the variability in the responses to IPC of human grafts from deceased donors.

Human muscle hypertrophy brought about by voluntary exercise in laboratorial conditions is the most common way to study resistance exercise training, especially because of its reliability, stimulus control and easy application to resistance training exercise sessions at fitness centers. However, because of the complexity of blood factors and organs involved, invasive data is difficult to obtain in human exercise training studies due to the integration of several organs, including adipose tissue, liver, brain and skeletal muscle. In contrast, studying skeletal muscle remodeling in animal models are easier to perform as the organs can be easily obtained after euthanasia; however, not all models of resistance training in animals displays a robust capacity to hypertrophy the desired muscle. Moreover, some models of resistance training rely on voluntary effort, which complicates the results observed when animal models are employed since voluntary capacity is something theoretically impossible to measure in rodents. With this information in mind, we will review the modalities used to simulate resistance training in animals in order to present to investigators the benefits and risks of different animal models capable to provoke skeletal muscle hypertrophy. Our second objective is to help investigators analyze and select the experimental resistance training model that best promotes the research question and desired endpoints.

Resistance training is a potent stimulus to increase skeletal muscle mass. The muscle protein accretion process depends on a robust synergistic action between protein intake and overload. The intake of protein after resistance training increases plasma amino acids, which results in the activation of signaling molecules leading to increased muscle protein synthesis (MPS) and muscle hypertrophy. Although both essential and non-essential amino acids are necessary for hypertrophy, the intake of free L-leucine or high-leucine whole proteins has been specifically shown to increase the initiation of translation that is essential for elevated MPS. The literature supports the use of protein intake following resistance-training sessions to enhance MPS; however, less understood are the effects of different protein sources and timing protocols on MPS. The sum of the adaptions from each individual training session is essential to muscle hypertrophy, and thus highlights the importance of an optimal supplementation protocol. The aim of this review is to present recent findings reported in the literature and to discuss the practical application of these results. In that light, new speculations and questions will arise that may direct future investigations. The information and recommendations generated in this review should be of benefit to clinical dietitians as well as those engaged in sports.

We have recently shown that chronic treatment with cannabidiol (CBD) was able to recover memory deficits induced by brain iron loading in a dose-dependent manner in rats. Brain iron accumulation is implicated in the pathogenesis of neurodegenerative diseases, including Parkinson’s and Alzheimer’s, and has been related to cognitive deficits in animals and human subjects. Deficits in synaptic energy supply have been linked to neurodegenerative diseases, evidencing the key role played by mitochondria in maintaining viable neural cells and functional circuits. It has also been shown that brains of patients suffering from neurodegenerative diseases have increased expression of apoptosisrelated proteins and specific DNA fragmentation. Here, we have analyzed the expression level of brain proteins involved with mitochondrial fusion and fission mechanisms (DNM1L and OPA1), the main integral transmembrane protein of synaptic vesicles (synaptophysin), and caspase 3, an apoptosis-related protein, to gain a better understanding of the potential of CBD in restoring the damage caused by iron loading in rats. We found that CBD rescued iron-induced effects, bringing hippocampal DNM1L, caspase 3, and synaptophysin levels back to values comparable to the control group. Our results suggest that iron affects mitochondrial dynamics, possibly trigging synaptic loss and apoptotic cell death and indicate that CBD should be considered as a potential molecule with memory-rescuing and neuroprotective properties to be used in the treatment of cognitive deficits observed in neurodegenerative disorders.

To describe the perception of the evolution of nursing shortage from 2000 to 2009 according to Nursing Coordinators and the strategies to face it.Nursing coordinators of 11 hospitals or districts of Friuli Venezia Giulia, Trentino Alto Adige and Veneto regions were interviewed in 2000, 2004 and 2009 to collect data and assess their perception on nurses' shortage.In the first interview the medium gap between staff planned and in service was -5.4%; in 2004 -9.4% and in 2009 -3.3%. The shortage, once with a seasonal trend is now constant and appreciated in all the wards. In years 2000 and 2004 on average 5 strategies to face the shortage were implemented, in 2009 7. No systematic strategies have been used with the exception of the unification of wards, mainly during summer for letting people go on holydays. According to Nursing Coordinators the effects of the shortage are already observable (although not quantified) on patients and nurses.The nurses' shortage has been one of the challenges of the last 10 years. Its causes have changed but not the strategies implemented.

This paper describes the study of the behavior of two-dimensional and parallel horizontal flat plates with uniform internal heat generation subjected to laminar forced convection of water. The governing equations are solved numerically using the finite volume technique with Power-Law interpolating scheme and the SIMPLE algorithm. After the simulations the temperature and velocity fields were obtained for various plates spacing and fluid inlet velocities, as well as the Nusselt number values.

There are many situations where it is needed to represent and analyze the concepts that describe a document or a collection of documents. One of such situations is the information retrieval, which is becoming more complex by the growing number and variety of document types. One way to represent the concepts is through a formal structure using ontologies. Thus, this article presents a fast and simple method for automatic extraction of ontologies from documents or from a collections of documents that is independent of the document type and uses the junction of several theories and techniques, such as latent semantic for the extraction of initial concepts, Wordnet and similarity to obtain the correlation between the concepts.

Postconditioning is a procedure based on the induction of intracellular protective reactions immediately after the onset of reperfusion. Because of the growing need to prevent ischemia/reperfusion (I/R) injury during liver surgery and transplantation, we investigated the possibility of pharmacologically inducing hepatic postconditioning. The effects of the adenosine A2A receptor agonist 2p-(2-carboxyethyl)-phenyl-amino-5'-N-ethylcarboxyamido-adenosine (CGS21680; 5 μmol/L) and the phosphatase and tensin homologue deleted from chromosome 10 (PTEN) inhibitor dipotassium bisperoxo-(5-hydroxypyridine-2-carboxyl)-oxovanadate [bpV(HOpic); 250 nmol/L] were investigated in primary rat hepatocytes during reoxygenation after 24 hours of cold storage and in an in vivo model of rat liver warm I/R. The addition of CGS21680 at reoxygenation significantly reduced hepatocyte death through the activation of the phosphoinositide 3-kinase (PI3K)-protein kinase B (PKB)/Akt signal pathway and through the reduction of the intracellular level of PTEN. PTEN lowering was associated with the increased generation of reactive oxygen species after A2A receptor-mediated stimulation of β-nicotinamide adenine dinucleotide phosphate oxidase (NOX). The inhibition of PI3K or NOX with wortmannin or diphenyleneiodonium chloride, respectively, and the addition of the antioxidant N,N'-diphenyl-p-phenylenediamine reversed the effects of CGS21680. The PTEN inhibitor bpV(HOpic) mimicked the protection provided by CGS21680 against reoxygenation damage. An in vivo rat treatment with CGS21680 or bpV(HOpic) during reperfusion after 1 hour of partial hepatic ischemia also promoted PKB/Akt activation and ameliorated alanine aminotransferase release and histological lesions induced by 2 hours of reperfusion. We conclude that adenosine A2A receptor agonists and PTEN inhibitors are possibly useful agents for the pharmacological induction of postconditioning in the liver.

OBJETIVOS: Comparar a eficácia e segurança do sulfato de magnésio em relação ao polietilenoglicol no preparo intestinal para colonoscopia em pacientes com idade igual ou superior a 70 anos. MÉTODOS: Foram selecionados para o estudo sessenta pacientes acima de 70 anos, de ambos os sexos e que foram aleatoriamente divididos em dois grupos: o grupo controle, utilizando o polietilenoglicol e o grupo em estudo com sulfato de magnésio. Foram avaliados a qualidade do preparo, a tolerância pelos pacientes e os efeitos adversos produzidos por cada substância. O colonoscopista possuía informação prévia sobre o tipo de preparo. RESULTADOS: Os pacientes apresentaram uma distribuição homogênea nos grupos e nos fatores idade, patologias prévias, efeitos colaterais, qualidade de preparo e tempo de chegada ao ceco na realização da colonoscopia. Diferiram na distribuição do sexo, apresentando um maior número de indivíduos do sexo feminino no grupo que utilizou o sulfato de magnésio, porém sem relevância estatística. CONCLUSÃO: O sulfato de magnésio não demonstrou diferença estatística quanto aos níveis de segurança e eficácia em pacientes maiores de 70 anos, para o preparo intestinal, quando comparado ao polietilenoglicol. OBJECTIVES: To compare efficacy and safety of magnesium sulphate in relation to polyethylene glycol in bowel preparation for colonoscopy. METHODS: Sixty patients older than 70 years old, of both genders, were selected for the study, and were randomly divided into two groups: the control group, using polyethylene glycol and the in study group with magnesium sulphate. Quality of preparation, patient tolerance, and side effects produced by each substance were evaluated. Colonoscopist was blinded in relation to the information of bowel preparation. RESULTS: Patients present a homogeneus distribution in groups, in factors as age, past pathologies, side effects, cleansing quality and time taken to reach cecum during colonoscopy. There were differences in gender distribution, being higher the number of female individuals in the group which used magnesium sulphate, however with no statistical significance. CONCLUSION: Magnesium sulphate presented no statistical difference in relation to safety and efficacy levels in patients older than 70 years old, for bowel preparation, when it is compared with polyethylene glycol.

The cellular mechanisms by which ischemic preconditioning increases liver tolerance to ischemia/reperfusion injury are still poorly understood. This study investigated the role of the hypoxia-inducible factor-1 (HIF-1) in the protection associated with the late phase of liver preconditioning. Late preconditioning was induced in primary cultured rat hepatocytes by a transient (10 minute) hypoxic stress or by 15 minutes incubation with the adenosine A2A receptors agonist CGS21680 24 hours before exposure to 90 minutes of hypoxia in a serum-free medium. Late preconditioning induced the nuclear translocation of HIF-1 and the expression of carbonic anhydrase IX (CAIX), a HIF-1–regulated transmembrane enzyme that catalyzes bicarbonate production. Such effects were associated with prevention of hepatocyte killing by hypoxia and the amelioration of intracellular acidosis and Na+ accumulation. The inhibition of PKC-mediated and PI3-kinase–mediated signals with, respectively, chelerythrine and wortmannin abolished HIF-1 activation and blocked both CAIX expression and the protective action of late preconditioning. CAIX expression was also prevented by interfering with the transcriptional activity of HIF-1 using a dominant negative HIF-1β subunit. The inhibition of CAIX with acetazolamide or the block of bicarbonate influx with disodium-4-acetamido-4′-isothiocyanato-stilben-2,2′-disulfonate also reverted the protective effects of late preconditioning on intracellular acidosis and Na+ accumulation. Conclusion: The stimulation of adenosine A2A receptors induced late preconditioning in liver cells through the activation of HIF-1. HIF-1–induced expression of CAIX increases hepatocyte tolerance to ischemia by maintaining intracellular Na+ homeostasis. These observations along with the importance of HIF-1 in regulating cell survival indicates HIF-1 activation as a possible key event in liver protection by late preconditioning. (HEPATOLOGY 2008.)