Adult hemophagocytic syndrome in emergency department setting: the implications of hormone therapy on diagnosis and prognosis / 中华急诊医学杂志

Objective:To assess the implications of hormone therapy on confirmation of clinical diagnosis and prognosis of adult hemophagocytic syndrome (HPS) in the emergency department setting.Methods:The eligible 34 patients admitted with suspected HPS in the Emergency Department of Peking University People's Hospital from September 2019 to August 2021 were respectively collected. The patients were divided into the death group and survival group according to the prognosis and divided into early hormone therapy group and standard hormone therapy group according to the timing of hormone application. Patients in the early hormone therapy group were divided into the routine 4 criteria group and non-routine 4 criteria group according to the conditions of meeting the four HLH-2004 diagnostic criteria. Medical records of the following were collected and statistically analyzed: complete blood count, blood biochemical index, coagulation function, serum ferritin, NK cell activity, sCD25 level, peripheral blood smear, bone marrow biopsy, abdominal ultrasound scan, and abdominal CT on admission, and recheck the clinical indicators such as blood count, blood biochemical index and blood coagulation dunction 5-7 days later.Results:①Patients from the death group were older, with higher APACHEⅡ scores and SOFA scores, higher total bilirubin, and lower serum albumin. ② Univariate Logistic analysis showed age ( OR=1.098, CI: 1.019-1.183, P=0.014), APACHE Ⅱ score ( OR=1.144, CI: 1.017-1.285, P=0.024), SOFA score ( OR=1.441, CI: 1.079-1.925, P=0.013) were associated with the risk of death. Multivariate Logistic analysis showed that age ( OR=1.099, CI: 1.014-1.190, P=0.021) was associated with the risk of death. There was no significant correlation between early hormone therapy and clinical prognosis. Kaplan-Meier survival curves showed that there was no difference in the 60-day survival rate between the early hormone therapy group and the standard hormone therapy group. ③ The level of triglyceride still increased after early hormone therapy, and the number of indexes meeting the diagnostic criteria of HLH-2004 increased significantly. All patients met the criteria of Hscore>169, and 3 patients did not meet at least 5 diagnostic criteria of HLH-2004, accounting for 16.7% of the total cases of early hormone therapy. ④ Starting hormone therapy when the four HLH-2004 diagnostic criteria were met could reduce the length of hospital stay. Prothrombin time and activited partial thomboplastin time were closer to normal levels in patients 5-7 days after treatment. Early hormone therapy had no significant effect on treatment response and in-hospital death risk. There were no significant differences in APACHE Ⅱ score, SOFA score, confirmation of diagnosis, treatment response, clinical prognosis, and related clinical indicators after hormone therapy between the routine 4 criteria and non-routine 4 criteria groups. Conclusions:Initiation of early hormone therapy has no significant effect on the confirmation of clinical diagnosis, treatment response, in-hospital mortality, and 60-day survival rate of patients with HPS, and can quickly correct coagulation dysfunction and effectively reduce the length of hospital stay. An earlier start of hormonal therapy (meeting the four HLH-2004 diagnostic criteria) may be considered by the emergency physician when a patient is highly suspected of HPS diagnosis

Risk Assessment of Insect-resistant and Herbicide Tolerant Genetically Modified Maize 1507 for Cultivation, Import, Processing, Food and Feed Uses under Directive 2001/18/EC and Regulation (EC) No 1829/2003

The Norwegian Environment Agency (NEA) and the Norwegian Food Safety Authority (NFSA) requested the Norwegian Scientific Committee for Food Safety (Vitenskapskomiteen for mattrygghet, VKM) for an opinion of potential risks to biodiversity and agriculture in Norway associated with import of seeds for sowing, and cultivation of insect-resistant and herbicide-tolerant genetically modified maize 1507 under Directive 2001/18/EC (Notification C/ES/01/01). The notification is still pending for authorisation in the European Union. VKM is also requested to assess the applicant´s post-market environmental monitoring plan, and the management measures suggested in the draft implementing decision of the European Commission. As VKM delivered a scientific opinion on this application including cultivation in 2014 (VKM, 2014), VKM is asked to assess whether the previous risk assessment is still valid concerning cultivation, and to update the opinion after current knowledge. The assessment shall specifically consider Norwegian conditions. Furthermore, as the notification does not cover food and feed uses of maize 1507, VKM was not asked for a health risk assessment of maize 1507. However, VKM has decided to update the previous safety evaluation of the food and feed uses of maize 1507 and derived products from 2014. VKM appointed a working group consisting of members from the Panel on Genetically Modified Organisms, the Panel on Alien Organisms and trade in Endangered Species (CITES) and the VKM staff to answer the requests. The Panel on Genetically Modified Organisms has assessed and approved the final report. The genetically modified maize 1507 was developed to provide protection against certain lepidopteran target pests, such as the European corn borer (ECB, Ostrinia nubilalis), and some species belonging to the genus Sesamia. The insect resistence is achieved by the expression of a synthetic version of the truncated c ry1F gene derived from Bacillus thuringiensis subsp. aizawai, a common soil bacterium. Maize 1507 also expresses the phosphinothricin - N - acetyltransferase (pat) gene, derived from the soil bacterium Streptomyces viridochromogenes. PAT protein confers tolerance to the herbicidal active substance glufosinate-ammonium. The PAT protein expressed in maize 1507 was used as a selectable marker to facilitate the selection process of transformed plant cells and is not intended for weed management purposes. Since the scope of the notification C/ES/01/01 does not cover the use of glufosinate-ammonium-containing herbicides on maize 1507, potential effects due to the use of such herbicides on maize 1507 are not considered by VKM. In delivering its scientific opinion, VKM considered relevant peer-reviewed scientific publications and information provided by the applicant in the notifications C/ES/01/01, C/NL/00/10, the applications EFSA/GMO/NL/2004/02 and EFSA/GMO/RX/1507, and scientific opinions and comments from EFSA and other EU member states. VKM has evaluated maize 1507 with reference to its intended uses in the European Economic Area (EEA), and according to the principles described in the Norwegian Food Act, the Norwegian Gene Technology Act and regulations relating to impact assessment pursuant to the Gene Technology Act, Directive 2001/18/EC on the deliberate release into the environment of genetically modified organisms, and Regulation (EC) No 1829/2003 on genetically modified food and feed. VKM has also decided to take into account, the appropriate principles described in the EFSA guidelines for the risk assessment of GM plants and derived food and feed (EFSA, 2011a), the environmental risk assessment of GM plants (EFSA, 2010a), selection of comparators for the risk assessment of GM plants (EFSA, 2011b) and for the post-market environmental monitoring of GM plants (EFSA, 2011c). The scientific opinion of maize 1507 include molecular characterisation of the inserted DNA and expression of novel proteins, comparative assessment of agronomic and phenotypic characteristics, nutritional assessments, toxicology and allergenicity. An evaluation of unintended effects on plant fitness, potential for gene transfer, interactions between the GM plant and target and non-target organisms, effects on biogeochemical processes, the postmarket environmental monitoring plan and coexistence measures at the farm level has also been undertaken. It is emphasised that VKM’s mandate does not include assessments of contribution to sustainable development, societal utility and ethical considerations, according to the Norwegian Gene Technology Act and Regulations relating to impact assessment pursuant to the Gene Technology Act. These considerations are therefore not part of the risk assessment provided by VKM. Molecular Characterization: Appropriate analyses of the transgenic DNA insert, its integration site, number of inserts and flanking sequences in the maize genome, have been performed. The results show that one copy only of the insert is present in maize 1507. Homology searches with databases of known toxins and allergens have not indicated any potential production of harmful proteins or polypeptides caused by the genetic modification in maize 1507. Southern blot analyses and segregation studies show that the introduced genes cry1F and pat are stably inherited and expressed over several generations along with the phenotypic characteristics of maize 1507. VKM considers the molecular characterisation of maize 1507 satisfactory. Comparative Assessment: Comparative analyses of maize 1507 to its non-GM conventional counterpart have been performed during multiple field trials located at representative sites and environments in Chile (1998/99), USA (1999) and in Europe (1999, 2000 and 2002). With the exception of small intermittent variations, no biologically significant differences were found between maize 1507 and the conventional maize. Based on the assessment of available data, VKM concludes that maize 1507 is compositionally, agronomically and phenotypically equivalent to its conventional counterpart, except for the introduced characteristics, and that its composition fell within the normal ranges of variation observed among non-GM varieties. The field evaluations support a conclusion of no phenotypic changes indicative of increased plant weed/pest potential of 1507 compared to conventional maize. Food and Feed Safety Assessment: Whole food feeding studies on rats, broilers, pullets, pigs and cattle have not indicated any adverse health effects of maize 1507. These studies further indicate that maize 1507 is nutritionally equivalent to conventional maize. The PAT and Cry1F proteins do not show sequence resemblance to other known toxins or IgE allergens, nor have they been reported to cause IgE mediated allergic reactions. Some studies have however, indicated a potential role of Cry-proteins as adjuvants in allergic reactions. Based on current knowledge, VKM concludes that maize 1507 is nutritionally equivalent to conventional maize varieties. It is unlikely that the PAT and Cry1F proteins will introduce a toxic or allergenic potential in food or feed based on maize 1507 compared to conventional maize. Environmental Risk Assessment: Maize is the only representative of the genus Zea in Europe, and there are no cross-compatible wild or weedy relatives outside cultivated maize with which maize can hybridise and form backcross progeny. Vertical gene transfer in maize therefore depends on cross-pollination with other conventional or organic maize varieties. In addition, unintended admixture of genetically modified material in seeds represents a possible way for gene flow between different crop cultivations. The risk of pollen flow from maize volunteers is negligible under Norwegian growing conditions. Since maize 1507 has no altered agronomic and phenotypic characteristics, except for the specific target insect resistance and herbicide tolerance, the likelihood of unintended environmental effects as a consequence of spread of genes from maize 1507 is considered to be extremely low. There are no reports of the target lepidopteran species attaining pest status on maize in Norway. Since there are no Bt-based insecticides approved for use in Norway, and lepidopteran pests have not been registered in maize, issues related to resistance evolution in target pests are not relevant at present for Norwegian agriculture. There are a limited number of published scientific studies on environmental effects of Cry1F protein. Published scientific studies show that the likelihood of negative effects of Cry1F protein on non-target arthropods that live on or in the vicinity of maize plants is low. In Norway, the maize cultivation is marginal. The total crop area of forage maize is estimated to 2000-2800 decares, equivalent to less than 0.1 % of the areas with cereal crops. The area of individual fields is limited by the topography such that the quantity of maize pollen produced under flowering is also limited. The potential exposure of Cry1F-containing maize pollen on non-target lepidopteran species in Norway is therefore negligible. Cultivation of maize 1507 is not considered to represent a threat to the prevalence of red-listed species in Norway. Exposure of non-target organisms to Cry proteins in aquatic ecosystems is likely to be very low, and potential exposure of Cry proteins to non-target organisms in aquatic ecosystems in Norway is considered to be negligible. VKM concludes that, although the data on the fate of the Cry1F protein and its potential interactions in soil are limited, the relevant scientific publications analysing the Cry1F protein, together with the relatively broad knowledge about the environmental fate of other Cry1 proteins, do not indicate significant direct effects on the soil environment. Despite limited number of studies, most studies conclude that effects on soil microorganisms and microbial communities are transient and minor c

Analysis on value of Community Herbal Monograph in registration of traditional Chinese medicinal products in Europe / 中草药

The Community Herbal Monograph (CHM) is an official document which reflects the scientific opinion of European Medicines Agency (EMA) and plays an important role in technical harmonization of the herbal medicinal products. The role of CHM is very similar with the centralized procedure in the EU level as it represents the technical coordination results of the assessment about safety and efficacy of herbal medicine. The monograph and national procedure, decentralized procedure, and mutual recognition procedure together constitute the coexistence characteristic of centralization and decentralization of the EU medical legislation. The CHM and the traditional herbal medicine registration also constitute the core content of Directive 2004/24/EC in the EU and member state level respectively. And the CHM plays an important role in the registration of traditional herbal medicinal products in the EU member state. However, it has not yet been fully studied by domestic experts and scholars. This paper makes intensive studies on the value of CHM and analyzes the application of monograph in traditional herbal medicine registration. The purpose is to clarify the value and importance of CHM in the registration of traditional Chinese medicine in EU and to provide reference for the Chinese enterprises which are aspiring to open up the EU market.

Analysis of difficult problems on European Union laws and regulations of traditional herbal medicinal products / 中国中药杂志

Registration of Chinese patent medicine in European Union (EU) is of great significance to the internationalization of traditional Chinese medicine as EU market acts as an important position in the global botanical market. In retrospect, the domestic studies on EU regulations of traditional herbal medicinal products have been conducted for more than 10 years, but there is still some cognitive bias and lack of research. In this paper, a review of the relevant research progress and the main misunderstanding problems about Directive 2004/24/EC, like the centralized and decentralized supervision system of traditional herbal medicinal products in the EU, marketing authorization procedures for traditional herbal medicinal products, Community Herbal Monograph and List Entries, would be systematically analyzed, so as to provide reference for the registration of Chinese patent medicine in EU.

Analysis on current status of assessment on herbal medicinal products in EU and its enlightenment / 中草药

It is of great importance to bring proprietary Chinese medicines to EU as its herbal medicinal product is world-leading, yet the current status for registrations from China is full of challenges. The routes for registration of herbal medicinal products are introduced at first and then the current registration status on the overall assessment of the products, the characteristics of combinations, the utilization of EU monograph and main indications are analyzed. Suggestions on registering proprietary Chinese medicines are made in the end.

O processo de elaboração da Política Nacional de Assistência Social de 2004 / The development process of the 2004 Brazilian National Social Assistance Policy

Este artigo resgata o processo de elaboração da Política Nacional de Assistência Social de 2004, apresentando o contexto político em que foi elaborada e aprovada, os atores do processo e os embates teóricos travados. Para tanto, realizou-se revisão bibliográfica, pesquisa documental, entrevistas com testemunhas-chave e análise de conteúdo do tipo categorial. Foi possível compreender que a Política contou com um momento favorável, bem como com a participação de sujeitos da academia, da gestão e militantes. Embora seja um avanço, a Política Nacional de Assistência Social de 2004 faz parte de um processo ainda em construção.

This article demonstrates the development process of the 2004 Brazilian National Social Assistance, presenting the political context in which it was developed and approved, the key figures of the process and the theoretical debates established. Therefore, we made use of bibliographic review, documentary research and interviews with key witnesses of the case. For the analysis, we made use of categorical content analysis. It was possible to understand that the policy was approved in a good political time. The academia, managers and activists participated in that process. Although it is a breakthrough, the 2004 Brazilian National Social Assistance Policy is part of a process that is still under construction.

Key issues in registration of Chinese materia medica in European Union based on "Community Herbal Monograph" / 中草药

The European Legislation Directive 2004/24/EC introduced a simplified registration procedure for traditional herbal medicinal products, which has largely reduced the difficulty of registration for herbal medicinal products. The traditional Chinese medicinal products still face a lot of challenges such as 15-year minimum medicinal use requirements in the European Union (EU) and limited self-medication indication categories and administration modes. As the criteria for a Community Herbal Monograph assessment is in many aspects similar to assessment of safety and efficacy aspects in the registration of a traditional herbal medicinal product, this article has made a systematic evaluation of the latest assessment of Community Herbal Monograph and presented the key issues in traditional Chinese medicinal product registration based on a Community Herbal Monograph perspective. The results from this article will ultimately contribute to supporting and assisting the non-European traditional herbal medicinal product registration in EU.

Eficacia da descontaminacao de residuos biologicos infectantes de laboratorios de microbiologia apos tratamento termico por autoclavacao / Efficacy of the decontamination of biological infectious waste after thermal treatment by autoclaving

A pesquisa foi realizada no Laboratório Central de Saúde Pública de Minas Gerais com o objetivo de validar o processo de descontaminação de resíduos infectantes do subgrupo A1 e identificar possíveis falhas no procedimento preliminar à sua disposição final. Foram avaliados tanto a descontaminação dos resíduos totalmente descartáveis acondicionados em sacos plásticos termorresistentes quanto o processo de descontaminação dos resíduos reutilizáveis provenientes do Laboratório de Tuberculose, acondicionados em caixas metálicas. Enquanto os resultados obtidos no primeiro estudo indicaram uma deficiência considerável no tratamento dos resíduos, no segundo caso a eficácia foi comprovada. Medidas preventivas e corretivas foram propostas e adotadas como consequência deste trabalho, e são aqui descritas.

Laboratory studies were performed at the Central Laboratory of Public Health of Minas Gerais in order to validate the process of infectious waste decontamination (subgroup A1) from the public health service and identify possible flaws in the procedure preliminary to its final disposal. We evaluated both the decontamination of disposable waste packed in thermo-resistant plastic bags as well and the decontamination process of reusable waste from the Tuberculosis Laboratory packed in metallic boxes. The results of the first study indicated a significant deficiency in waste treatment, while in the second case efficacy was demonstrated. Preventive and corrective measures were proposed and adopted as a result of this work and are described herein.

Evaluation of the PetrifilmTM EB and TEMPO® EB systems with ISO 21528-2:2004 method for the count of Enterobacteriaceae in milk

The development of alternative microbiological techniques is driven by the necessity to meet the current needs to deliver rapid results in the manufacturing process of foods, but it is important that these methods be evaluated for each application. The objective of the present study was to assess the PetrifilmTM EB and the TEMPO® EB systems with ISO 21528-2:2004 for the count of Enterobacteriaceae in pasteurized and UHT milk samples. We analyzed the microflora of 141 pasteurized milk samples, 15 samples of artificially contaminated pasteurized milk and 15 samples of artificially contaminated UHT milk. Investigation of the method PetrifilmTM EB and ISO 21528:2 regression analysis showed a high correlation in the samples, r = 0.90 for the microflora of pasteurized milk, r = 0.98 for artificially contaminated pasteurized milk and r = 0.99 for the artificially contaminated UHT milk. In evaluating the system TEMPO EB ® method and ISO 21528:2 correlation was also significant in the analyzed samples, with r = 0.86 for the microflora of pasteurized milk, r = 0.96 for artificially contaminated pasteurized milk and r = 0.99 for artificially contaminated UHT milk. No statistically significant differences were observed between the three methods conducted to analyze artificially contaminated pasteurized and UHT milk at three inoculum levels. In conclusion, the PetrifilmTM EB system and the TEMPO® EB system may be an alternative to the ISO 21528-2:2004 for the Enterobacteriaceae assay for milk as because of the ease-of-operation and the time reduction achieved for conducting the microbiological assay using these systems.

Posterior reversible encephalopathy syndrome in pediatric patients undergoing treatment for hemophagocytic lymphohistiocytosis: clinical outcomes and putative risk factors

BACKGROUND: Hemophagocytic lymphohistiocytosis (HLH) is a rare multiorgan disease of toxic immune activation caused by the interaction of cytotoxic T cells and innate immune cells and frequently involves the central nervous system (CNS). Posterior reversible encephalopathy syndrome (PRES) might develop during treatment with the HLH-2004 protocol from the Histiocyte Society. The aims of this study were to evaluate clinical outcomes and putative risk factors for prediction of PRES related to HLH. METHODS: We reviewed the medical records of 28 patients with HLH who were treated between April 2005 and April 2012. We compared various clinical and laboratory parameters in patients without or with PRES to evaluate putative risk factors related to development of PRES. RESULTS: Six (21.4%) of the patients experienced PRES during treatment with the HLH-2004 protocol. Clinical and laboratory manifestations were not different compared with other conditions causing PRES. The main mechanism of PRES may be related to the HLH-2004 protocol and a high pro-inflammatory state. Most patients recovered quickly from neurologic manifestations without significant long-term sequelae. Preceding hypertension, an increase in ferritin level >50% compared with 1 week before development of PRES and hyponatremia were statistically significant factors. CONCLUSION: PRES is clinically reversible and has a favorable outcome in patients with HLH. Awareness of PRES and a differential diagnosis of other causes of neurologic complications, including CNS involvement of HLH, can help avoid unnecessary treatment or delayed management. Patients with preceding hypertension, hyponatremia, and rising ferritin levels during HLH treatment should be closely monitored for PRES.

Calidad microbiológica de carne de res comercializada en el mercado municipal de Culiacán, Sinaloa / Microbiological quality of beef sold in the municipal market of Culiacan, Sinaloa

The microbiological quality of raw meat was evaluated in 18 retail units of the municipal market in Culiacan, Sinaloa. The levels of E. coli were measured using methods from the Bacteriological Analytical Manual, and the O157 sero-group and the H7 antigen were also evaluated using chromogenic media and PCR, respectively. The results were confirmed using real time-PCR (PCR-TR) and PCR to detect virulence genes (vt1, vt2, eaeA and hlyA). Of the samples tested, 31.5% were positive for E. coli, with concentrations between 100 and 700 CFU/g of beef. Nine suspected E. coli O157:H7 strains were isolated from 16 samples, which were then discarded by the PCR-TR test. The virulence genes were not detected. The microbial contamination of beef could indicate the presence of pathogens from fecal sources. To guarantee the quality of these products, it is important to incorporate food safety programs.

Se evaluó la calidad microbiológica de carne de res en 18 comercios del mercado municipal de Culiacán, Sinaloa. Para determinar E. coli se usó la metodología del Manual Bacteriológico Analítico, y para evaluar el serogrupo O157 y antígeno H7, se usaron medios cromogénicos y PCR, respectivamente. La confirmación se hizo por PCR tiempo real (PCR-TR) y la detección de genes de virulencia (vt1, vt, eaeA y hlyA), por PCR. El 31.5% de muestras resultaron positivas para E. coli, con concentraciones entre 100 y 700 UFC/g. Se aislaron nueve cepas presuntivas de E. coliO157:H7 de 16 muestras, las cuales fueron descartadas con la técnica PCR-TR. No se detectaron genes de virulencia. La contaminación microbiana de la carne de res podría indicar la presencia de patógenos provenientes de fuentes fecales. Por ello es importante incorporar programas de inocuidad para garantizar la calidad de estos productos.

Contribuição para a formação de Psicólogos: análise de artigos de Carolina Bori publicados até 1962 / Contributions to the training of Psychologists: analyzing Carolina Bori’s articles published until 1962 / Contribuciones a la formación de dos Psicólogos: analise de artículos de Carolina Bori publicados hasta 1962

A Psicologia, no Brasil, foi reconhecida legalmente no ano 1962. Contudo, antes desse ano, diversos profissionais já atuavam na área. Carolina Martuscelli Bori tem sido considerada um desses profissionais, e, dentre as contribuições que deu, sua luta para melhorar a formação profissional é uma das mais citadas. Com este trabalho, buscou-se conhecer sua contribuição a partir de artigos que Bori publicou até o ano 1962. A partir de uma busca feita nas revistas Ciência e Cultura, Boletim de Psicologia e Jornal Brasileiro de Psicologia, e no seu currículo Lattes, pela busca na biblioteca da Universidade de São Paulo e em referências de artigos escritos sobre a própria Carolina Bori, 19 artigos foram localizados, dos quais oito foram publicados até 1962. A análise feita permite afirmar que a obra de Carolina Bori apresenta discussões que podem auxiliar na elaboração e no direcionamento de várias questões éticas e acadêmicas atuais, como: a pesquisa experimental em cursos de graduação, a metodologia científica, o desenvolvimento científico e a produção do conhecimento...

Psychology in Brazil was legally recognized in 1962. However, before this year, many professionals have worked in this area. Carolina Martuscelli Bori has been considered one of those professionals and among the contributions she made, her efforts to ameliorate the professional training is one of the most cited. This article investigates Bori’s contribution published until 1962. The search was made in the journals Ciência e Cultura, Boletim de Psicologia and Jornal Brasileiro de Psicologia and in her curriculum Lattes, in search for the library of the University of São Paulo and references of Carolina Bori’s articles. Altogether, 19 articles were located, eight of which were published until 1962. The analysis allows us to state that the work of Carolina Bori presents discussions that may assist the design and targeting of various current ethical and academical issues, as experimental research in undergraduation courses, scientific methodology, scientific development and knowledge production...

La Psicología en Brasil fue reconocida legalmente en 1962. Sin embargo, antes de este año, muchos profesionales han trabajado en la area. Carolina Martuscelli Bori ha sido considerado uno de estos profesionales y entre los aportes que hizo, su lucha por una mejor formación professional es una de las más citada. Este trabajo tuvo como objetivo conocer la contribución de Bori a partir sus artículos publicados hasta el año de 1962. Las busquedas a los artículos fueron efectuadas en las revistas Ciência e Cultura, Boletim de Psicologia y la Revista Brasileira de Psicologia, em su curriculum Lattes, em búsqueda em la biblioteca de la Universidade de São Paulo y en las referencias de los artículos escritos por la própria Carolina Bori. 19 artículos fueron localizados, de los quales ocho fueron publicados hasta 1962. El análisis permite afirmar que el trabajo de Carolina Bori presenta discusiones que pueden ayudar en el direccion y la preparacion en varios temas éticos y académicos actuales, como la investigación experimental em los cursos de pregrado, la metodologia científica, el desarrollo científico y la producción del conocimiento...

The main CT findings and its cut-off value to differentiate multilocular cystic renal cell carcinoma / 中国医师进修杂志

Objective To determine the main CT features and the key points of differential diagnosis of multilocular cystic renal cell carcinoma (MCRCC) classified according to 2004 WHO pathological diagnostic criteria. Methods According to the criteria, 40 patients were divided into two groups: MCRCC group and other subtypes of cystic renal cell carcinoma (CRCC). The CT findings were evaluated and compared between two groups for cystic content, wall, septum, nodularity, calcification and enhancement. ROC curve was used to determine the cut-off value of the possible CT feature which could distinguish MCRCC from other subtypes of CRCC. Results Seventeen cases of MCRCC group and 23 cases of CRCC group were included in this study according to the diagnostic criteria. MCRCC appeared as a well defined multilocular cystic mass with thin wall and sepia and no expansile solid nodules. Thickness of cystic wall and/or septum is was main CT findings to distinguish MCRCC from other subtypes of CRCC (P ＜ 0.01 ). The cut-off value of the thickness was 6 mm and its sensibility, specificity was 89% ,75% respectively. Conclusion Cystic wall and/or septum with a thickness of less than 6 mm are the main CT findings to dis tinguish MCRCC from other subtypes of CRCC.

Diagnostic value of magnetic susceptibility weighted imaging in diffuse axonal injury / 中华放射学杂志

Objective To study the diagnostic value of susceptibility weighted imaging (SWI) in diffuse axonal injury (DAI) and investigate the relationship between SWI and clinical prognosis. MethodsTwenty patients (15 males and 5 females) with DAI were included in this study. Routine sequences (T1WI, T2WI and FLAIR) and SWI were performed on a 3.0 T MRI scanner. There were 8 cases whose Glasgow score scale (GCS) ranged from 3.0 to 5.0, 4 cases from 6.0 to 8.0 and 8 from 9.0 to 12.0. The interval time between injury and examination were from 3 hours to 20 days. The number and volume of lesions observed on SWI and routine sequence were compared using Mann-Whitney U-test and paired t-test. Pearson correlation was used to analyze the relationship between the number and volume of all lesions and GCS. Results The lesions showed punctate, beaded, patchy and cord-like hypointense signal with various size on SWI (lesion diameter <2.0 cm). Distribution of lesions was multifocal with clear boundary. Routine MRI scan found a total of 78 lesions, while SWI sequence detected 424 lesions. The number of the lesions found on SWI was more than that on conventional MRI (U=-15.447,P＜0.01). The total volume of the lesions measured on routine MRI and SWI were 19 340 mm3 and 38 042 mm3, respectively. The total volume measured on SWI was more than that on routine MR (t=5.870,P＜0.01). The number and volume of all lesions were negatively correlated with GCS (r=-0.802, -0.767, P＜0.01). Conclusion SWI sequence could find more bleeding lesions than the routine MRI sequences. The number and the volume of the lesions were closely related to GCS. SWI showed high value in the diagnosis and prediction of the prognosis of DAI.

The suggestions on the entry of Chinese medicines into European Community monographs for traditional herbal medicinal products / 国际中医中药杂志

Directive 2004/24/EC of the European Parliament and the Council entered into force on April 30th, 2004. After 7 years, there is no Chinese medicine to be registered successfully in European market as traditional herbal medicinal products. The thesis gives some ideas to tackle this problem. Procedure for the Preparation of Community Monographs for Traditional Herbal Medicinal Products (EMEA/HMPC/182320/2005) published by European Medicines Agency is an important guidance for traditional herbal products to enter European Community monographs. The thesis introduces and details the procedure as well as gives feasible suggestions about the procedure. It suggests that Chinese medicines enter European Community monographs first, and then apply the registration according to the directive 2004/24/EC. This is an easier access to European market.

Caracterização ambiental de lamas de beneficiamento de rochas ornamentais / Environmental characterization of processing sludge of ornamental stones

As lamas de beneficiamento de rochas ornamentais (LBRO) são resíduos que apresentam composição química variada em função da composição das rochas, do processo de beneficiamento, dos processos de reaproveitamento de águas e lamas, das propriedades dos insumos, entre outros fatores. A caracterização e classificação das LBRO são de grande importância, principalmente para o Estado do Espírito Santo, por possuir um expressivo número de empresas do setor. Neste trabalho, são apresentados os resultados de caracterização e classificação de lamas de desdobramento e polimento de mármores e granitos, segundo a NBR 10004/2004. Todas as amostras de lamas de tear convencional e de politriz analisadas foram classificadas como Classe IIA. Percebeu-se que a identificação dos resíduos por fonte geradora permite a proposição de tecnologias limpas, como o uso de teares a fio diamantado que utilizam o mínimo de insumos e de pastilhas diamantadas metálicas isentas de elementos tóxicos, contribuindo para a melhoria das características químicas das LBRO.

The sludges produced in the cutting and polishing of ornamental stones are residues with diverse chemical composition that depend on the composition of the stones, the cutting and polishing process, the processes involved in the recycling of water and sludges, among others. The characterization and classification of these resulting sludges have great importance, especially for the State of Espírito Santo, Brazil, which is an important producer of ornamental stones. In this work, the results of characterization and classification of developmental and polishing sludges were presented, according to the Brazilian standard NBR 10004/2004. All the sludge samples from the cutting and polishing equipment were classified as Class IIA. We observed that the identification of the residues according to the generation source allows the proposition of clean technologies usage, such as cutting equipment with diamond coated wires, that use a minimum of raw materials, and metal diamond coated pads, free of toxic material, thus contributing to improve the chemical characteristics of these sludges.

Hollingshead e Redlich: a pesquisa sobre classe social e doença mental cinquenta anos depois / Hollingshead and Redlich: research on social class and mental illness fifty years after

O artigo analisa o livro Social class and mental illness: a community study, de A.B. Hollingshead e F.C. Redlich, na marca dos cinquenta anos de sua publicação. Destaca o papel desses pesquisadores que, de formações distintas (sociologia e psiquiatria), fizeram parte do grupo pioneiro que nos anos 1950 iniciou a construção da sociologia médica. O cuidadoso trabalho metodológico e o fato de abordarem tema inédito garantiram a originalidade de seu projeto. Aborda a pesquisa e sua importância para a sociologia e a psiquiatria, com ênfase nos estudos sobre classe social, utilizando como principais fontes as bibliográficas, análises críticas feitas à obra e estudos afins.

The relationship between pathology grading and clinical grading for lupus nephritis in 59 cases / 中华风湿病学杂志

Objective To investigate the relevance of the clinical score and pathology score and assess two scoring system including the British Islet Lupus Assessment Group2004 (BILAG2004) and systemic lupus erythematosus disease activity index 2000 (SLEI)AI2000) by analyzing the biopsy results and related laboratory tests on lupus nephritis (LN). Methods Retrospective analyzed 59 cases of patients with renal biopsy. All biopsied tissues were scored based on the to ISN/RPS2003 lupus nephritis pathological typing standards. Meanwhile, respective index (AI), chronic Index (CI) and tubulointerstitial lesions (TIL) score were used to evaluate the activities of lupus nephritis and SLEDAI2000 and BILAG2004 were used to evaluate the clinical disease activity. The adssociation between pathological changes and disease activities was assessed. Results ①According to ISN/RPS2003 pathological type standard, among these 59 patients, type Ⅳ was the most common type,which accounted for 44.07 percent of all biopsied tissues. ② For those patients. With LN typeⅡ,Ⅲ Ⅳ, their SLEDAI2000 score and BILAG2004 renal biopsy AI was positively correlated (0<r<1, P <0.01), for those patients with LN type Ⅴ, their score BILAG2004 and kidney biopsy AI was positively correlated (0<r<1, P<0.05).③BILAG2004 score had stronger correlation with AI than SLEDAI2000. ④SLEDAI2000 score with AI in patients with type Ⅲ LN had the strongest association, followed by type Ⅱ. BILAG2004 score with AI in patients with type Ⅲ LN had the closet association, followed by type Ⅳ. ⑤ BII,AG2004 score, SLEDAI2000 score and CI, TIL had no significant association in all patients groups (P>0.05). Conclusion BILAG2004 score and SLEDAI2000 scoring system can be used to assess the disease pathology activity of patients with lupus nephritis. The study has found that BILAG2004 scoring system is superior to SLEDAI2000 score system for the assessment of LN patients on pathological activities, especially for with severe LN patients. As a non-invasive method of assessment, BILAG2004 score system is better than SLEDAI2000 score system in guiding clinical treatment.

Classificação dos resíduos de serviços de saúde de um hospital veterinário / Classification of health services waste from a veterinary hospital

O trabalho avalia aspectos referentes à classificação e segregação dos resíduos gerados no Hospital Veterinário da Ulbra (RS), a partir de estudos realizados para a elaboração do Plano de Gerenciamento dos Resíduos de Serviço de Saúde (PGRSS), para a instituição. O plano foi baseado na resolução RDC nº 306/2004 da ANVISA (Brasil, 2004), que define as diretrizes para o manejo dos resíduos de instituições de saúde, incluindo a segregação, coleta, armazenamento, transporte interno e externo, tratamento e disposição final. A partir da caracterização, classificação e do diagnóstico das atividades de manejo dos resíduos do hospital, foi possível avaliar a importância da segregação, no local de origem, para a redução de resíduos que necessitam de tratamentos especiais, bem como para a redução de riscos de propagação de doenças.

This work evaluates some referring aspects to the residues classification and segregation generated in Ulbra's Veterinary Hospital (RS), starting from studies accomplished in the elaboration of a Residues Health Service Management Plan (PGRSS), for the institution. The plan was based on RDC nº 306/2004 ANVISA's Resolution (Brasil, 2004), that defines the guidelines for handling the health institutions residues, including the segregation, collection, storage, internal and external transportation, treatment and final disposition. From the characterization, classification and the diagnostic handling activities of hospital residues, it was possible to evaluate the segregation importance, in the origin location, for the residues reduction that need special treatments, as well as for the risks reduction of diseases propagation.