Morfología microestructural dérmica en juveniles de dos especies hermanas de tiburón pala, Sphyrna tiburo y S. vespertina / Dermal microstructural morphology in juveniles of two sister species of bonnethead shark, Sphyrna tiburo and S. vespertina

RESUMEN: Los dentículos dérmicos son estructuras dermales presentes en el grupo de los condrictios, tienen un papel muy importante en su biología y se les ha utilizado como un carácter taxonómico que permiten reconocer grupos o especies. Por lo que en el presente trabajo se compara la morfología dermal de los juveniles de dos especies de tiburones pala, Sphyrna tiburo y S. vespertina, cuyo origen evolutivo está emparentado con el cierre del istmo centroaméricano. Para ello se obtuvieron muestras dermales (1 cm2) de tres regiones corporales y se procesaron para obtener imágenes de alta resolución por medio de Microscopia electrónica de barrido (MEB). Los dentículos de ambas especies tienen un patrón morfológico común, con variaciones en la longitud de las prolongaciones de las crestas, área libre y superposición de los dentículos, y grado de notoriedad de la ornamentación microestructural.

SUMMARY: The dermal denticles are dermal structures present in the group of chondrichthyans, they have a very important role in their biology and they have been used as a taxonomic character that allows to recognize groups or species. Therefore, in the present work, the dermal morphology of the juveniles of two species of shovel sharks, Sphyrna tiburo and S. vespertina, whose evolutionary origin is related to the closure of the Central American isthmus, is compared. For this, dermal samples (1 cm2) from three body regions were obtained and processed to obtain high resolution images by means of scanning electron microscopy (SEM). The denticles of both species have a common morphological pattern, with variations in the length of the ridge extensions, free area and overlapping of the denticles, and the degree of notoriety of the microstructural ornamentation.

Longitudinal study of sleep behavior and motor development in low-birth-weight preterm children from infancy to preschool years

Abstract Objective: To verify the relationship between sleep characteristics and motor development in low-birth-weight preterm infants during infancy and preschool years. Method: Forty-one healthy preterm infants (<37 weeks' gestation) with low birth weight (≤1500 g) were assessed longitudinally at three different time points: at 6 months of corrected age, at 12 months of corrected age, and at 4-5 years of chronological age. At 6 and 12 months, motor development was assessed using the Denver Developmental Screening Test II and Alberta Infant Motor Scale, while sleep-related habits and disturbances were assessed using the Brief Infant Sleep Questionnaire. At 4-5 years, motor development was reassessed using the Pediatric Evaluation of Disability Inventory and sleep was reassessed using the Sleep Disturbance Scale for Children. Correlations were performed using sleep quality as the predictor variable and motor development as the outcome variable. Results: Most infants had suspected delay/atypical development at 6 and 12 months, with no difference between the scales (p = 1.000). Suspected delay/atypical development were associated with lateral sleep position (p = 0.004), greater number of nighttime awakenings (p = 0.008), and longer awake periods (p = 0.014) only at 6 months. At 4-5 years, the suspected delay/atypical development observed at 6 and 12 months disappeared. Conclusions: Sleep quality correlated with delayed/atypical motor development in healthy preterm infants with low birth weight only at 6 months of corrected age, which did not appear to affect later development of motor skills.

¡Corte! Una nueva epidemia: autolesiones en la adolescencia / ¡Cut! A new epidemic: self-harm in adolescence

El siguiente trabajo pretende abordar una problemática que, a pesar de ser muy frecuente, no deja de ser llamativa: las autolesiones en los adolescentes. La pregunta que orientará el escrito tendrá que ver con lograr una cabal comprensión de por qué la población adolescente se muestra tan vulnerables a esta práctica. Para ello, se enumerarán y analizarán los distintos trabajos psíquicos que el adolescente deberá realizar en esta etapa, para así enlazarlo con la función que el corte en el propio cuerpo pudiera tener. En particular, se focalizará en el vínculo con los padres, en la construcción de la propia identidad, así como en la inscripción psíquica de un nuevo cuerpo, para lo cual será fundamental el sostén que solo podrá proveer el grupo de pares, aun cuando esto podría conllevar ciertos riesgos. Por último, se abre lugar a formas de intervención en esta problemática y a las particularidades que la clínica con adolescentes nos presenta

The following work aims to address a problem as frecuent as it is striking: self-harming in adolescents. The question that will guide the work will have to do with achieving a full understanding of why the adolescent population are so vulnerable to this practice. For this, the different psychic works that the adolescent must carry out at this stage will be listed and analyzed, in order to link it with the function that self-harm (cutting) in the body itself could have. In particular, it will focus on the bond with the parents, on the construction of their own identity, as well as on the psychic inscription of a new body, for which the support that only the peer group will be able to provide will be essential, even when this could carry certain risks. Finally, there is an opening possibility for intervening this problem and its particularities that the adolescent clinic presents to us

Three Rare Concurrent Complications of Tertiary Hyperparathyroidism: Maxillary Brown Tumor, Uremic Leontiasis Ossea, and Hungry Bone Syndrome

A 48-year-old woman in her 40’s with end-stage renal disease and tertiary hyperparathyroidism (HPT) presented for a rapidly progressive maxillary tumor. Initial workup was notable for elevated intact parathyroid hormone (PTH) and diffuse thickening of skull and facial bones on computed tomography, and maxillary tumor biopsy with multinucleated giant cells. She underwent subtotal parathyroidectomy (with removal of a parathyroid adenoma and 2 hyperplastic glands) and partial resection of maxillary brown tumor. The patient’s post-operative course was complicated by hungry bone syndrome, with hypocalcemia refractory to aggressive calcium repletion. Teriparatide (recombinant PTH) was utilized with rapid resolution of hypocalcemia. To our knowledge, this is the first case of maxillary brown tumor in tertiary HPT to be reported in the USA. This case also supports teriparatide as a novel therapeutic for hungry bone syndrome refractory to aggressive calcium repletion.

Real-time data monitoring for ulcerative colitis: patient perception and qualitative analysis

BACKGROUND/AIMS: TrueColours ulcerative colitis (TCUC) is a comprehensive web-based program that functions through email, providing direct links to questionnaires. Several similar programs are available, however patient perspectives are unexplored. METHODS: A pilot study was conducted to determine feasibility, usability and patient perceptions of real-time data collection (daily symptoms, fortnightly quality of life, 3 monthly outcomes). TCUC was adapted from a web-based program for patients with relapsing-remitting bipolar disorder, using validated UC indices. A semi-structured interview was developed and audio-recorded face-to-face interviews were conducted after 6 months of interaction with TCUC. Transcripts were coded in NVivo11, a qualitative data analysis software package. An inductive approach and thematic analysis was conducted. RESULTS: TCUC was piloted in 66 patients for 6 months. Qualitative analysis currently defies statistical appraisal beyond “data saturation,” even if it has more influence on clinical practice than quantitative data. A total of 28 face-to-face interviews were conducted. Six core themes emerged: awareness, control, decision-making, reassurance, communication and burden of treatment. There was a transcending overarching theme of patient empowerment, which cut across all aspects of the TCUC experience. CONCLUSIONS: Patient perception of the impact of real-time data collection was extremely positive. Patients felt empowered as a product of the self-monitoring format of TCUC, which may be a way of improving self-management of UC whilst also decreasing the burden on the individual and healthcare services.

Safety Results and Analysis of Eribulin Efficacy according to Previous Microtubules-Inhibitors Sensitivity in the French Prospective Expanded Access Program for Heavily Pre-treated Metastatic Breast Cancer / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Eribulin is approved for advanced breast cancers refractory to anthracyclines and taxanes. Efficacy according to sensitivity to previous therapies has been poorly explored. MATERIALS AND METHODS: Safety data were collected prospectively and we retrospectively collected efficacy data from the five French centres that participated in the Eribulin E7389-G000-398 expanded access program. Our main objectives were exploration of safety and analysis of eribulin efficacy (progression-free survival [PFS] and overall survival [OS]) according to sensitivity to the last microtubule-inhibiting agent administered. RESULTS: Median eribulin treatment duration was 3.3 months for the 250 patients included in this prospective single-arm study. Two hundreds and thirty-nine patients (95.6%) experienced an adverse event (AE) related to treatment including 129 (51.6%) with grade ≥ 3 AEs. The most frequently observed toxicities were cytopenias (59.6% of included patients), gastro-intestinal disorders (59.2%), and asthenia (56.4%). The most frequent grade 3-4 AE was neutropenia (37.2% with 4.8% febrile neutropenia). Median PFS and OS were 4.6 and 11.8 months, respectively. Patients classified as responders to the last microtubule-inhibiting therapy had a longer OS (hazard ratio [HR], 0.69; 95% confidence interval [CI], 0.51 to 0.94; p=0.017), and tended to display a better PFS (HR, 0.78; 95% CI, 0.58 to 1.04; p=0.086). OS improvement was still significant in multivariate analysis (adjusted HR, 0.53; 95% CI, 0.35 to 0.79; p=0.002). CONCLUSION: This work based on a prospective study suggests that identification of patients likely to be more sensitive to eribulin could be based on their previous response to microtubules inhibitors.

Crianças e Adolescentes em Tratamento Oncológico: uma Análise sobre a Visão do Adiamento do Início ou Interrupção da Educação Escola / Children and Adolescents in Cancer Treatment: an Analysis of the Vision of Postponing the Beginning or Interruption of School Education / Niños y Adolescentes en Tratamiento Oncológico: un Análisis sobre la Visión del Aplazamiento del Inicio o Interrupción de la Educación Escolar

Introdução: A longa durabilidade do processo terapêutico oncológico leva a mudanças na rotina da criança e do adolescente com perda social relevante, impossibilitando-os de frequentar a escola formal durante o período terapêutico. Objetivo: Analisar, na visão de crianças e adolescentes em tratamento oncológico em um hospital especializado da cidade de Salvador - BA, as implicações e elementos envolvidos no adiamento do início da educação escolar ou na sua interrupção. Método: Estudo descritivo com abordagem qualitativa realizada na Oncopediatria do Hospital Aristides Maltez, por meio de entrevistas realizadas individualmente com crianças e adolescentes em tratamento oncológico. Resultados: Foram entrevistadas crianças e adolescentes, sete do sexo masculino e cinco do feminino, com idades entre 8 e 17 anos. Desses, dois nunca estudaram, enquanto os demais puderam frequentar a escola formal. Conclusão: O recebimento do diagnóstico repercute de maneiras distintas entre as crianças e adolescentes. Foram verbalizadas dificuldades de ordens clínica e psicológica, tais como efeitos colaterais do tratamento clínico, mudança de rotina e impossibilidade de frequentar a escola formal. Para os adolescentes, lidar com a necessidade do abandono escolar é difícil, uma vez que estão mais próximos de avançar para o ensino superior ou mercado de trabalho.

Introduction: The long duration of the oncological therapeutic process leads to relevant changes in the routine of the child and adolescent with social loss, making it impossible to attend formal school during the therapeutic period. Objective: To analyze, in the vision of children and adolescents in cancer treatment in a specialized hospital in the city of Salvador - BA, the implications and elements involved in the postponement of the beginning of school education or its interruption. Method: A descriptive study with a qualitative approach performed at Oncopediatria of the Aristides Maltez Hospital through interviews conducted individually with children and adolescents on cancer treatment. Results: Children and adolescents were interviewed, seven males and five females, aged between eight and seventeen. Out of these, two never studied while the others were able to attend formal school. Conclusion: Receiving the diagnosis has different repercussions among children and adolescents. Difficulties of clinical and psychological orders were verbalized, such as side effects of clinical treatment, change of routine and impossibility of attending formal school, etc. For teenagers, dealing with the need for school drop-out is difficult as they are closer to moving towards higher education or the job market.

Introducción: La larga durabilidad del proceso terapéutico oncológico lleva a cambios en la rutina del niño y del adolescente con pérdida social relevantes, imposibilitándole de frecuentar la escuela formal durante el período terapéutico. Objetivo: analizar, en la visión de niños y adolescentes en tratamiento oncológico en un hospital especializado de la ciudad de Salvador - BA, las implicaciones y elementos involucrados en el aplazamiento del inicio de la educación escolar o interrupción de ésta. Método: Estudio descriptivo con abordaje cualitativo realizado en la Oncopediatría del Hospital Aristides Maltez a través de entrevistas realizadas individualmente con niños y adolescentes en tratamiento oncológico. Resultados: Se entrevistaron niños y adolescentes, siete del sexo masculino y cinco del femenino, con edades entre ocho y diecisiete años. De ellos, dos nunca estudiaron mientras que los demás pudieron asistir a la escuela formal. Conclusión: La recepción del diagnóstico repercute de maneras distintas entre los niños y adolescentes. Se han verbalizado dificultades de orden clínico y psicológico, tales como efectos colaterales del tratamiento clínico, cambio de rutina e imposibilidad de asistir a la escuela formal, etc. Para los adolescentes, tratar con la necesidad del abandono escolar es difícil, ya que están más cerca de avanzar hacia la enseñanza superior o el mercado de trabajo

Mechanical performance of encapsulated restorative glass-ionomer cements for use with Atraumatic Restorative Treatment (ART)

The Atraumatic Restorative Treatment (ART) approach was suggested to be a suitable method to treat enamel and dentine carious lesions in patients with disabilities. The use of a restorative glass-ionomer with optimal mechanical properties is, therefore, very important. Objective To test the null-hypotheses that no difference in diametral tensile, compressive and flexural strengths exists between: (1) The EQUIA system and (2) The Chemfil Rock (encapsulated glass-ionomers; test materials) and the Fuji 9 Gold Label and the Ketac Molar Easymix (hand-mixed conventional glass-ionomers; control materials); (3) The EQUIA system and Chemfil Rock. Material and Methods Specimens for testing flexural (n = 240) and diametral tensile (n=80) strengths were prepared according to standardized specifications; the compressive strength (n=80) was measured using a tooth-model of a class II ART restoration. ANOVA and Tukey B tests were used to test for significant differences between dependent and independent variables. Results The EQUIA system and Chemfil Rock had significantly higher mean scores for all the three strength variables than the Fuji 9 Gold Label and Ketac Molar Easymix (α=0.05). The EQUIA system had significant higher mean scores for diametral tensile and flexural strengths than the Chemfil Rock (α=0.05). Conclusion The two encapsulated high-viscosity glass-ionomers had significantly higher test values for diametral tensile, flexural and compressive strengths than the commonly used hand-mixed high-viscosity glass-ionomers. .

Prevalencia de depresión en pacientes adultos con enfermedad celíaca / Prevalence of depression in adult celiac disease patients

Introduction: Celiac disease (CD) is an autoimmune disorder that affects the gastrointestinal tract and other systems like the neuropsychiatric system, where depression is the most frequent disease. Objectives: To determine the prevalence of depression in adult celiac patients and relate these results with the adherence to a gluten-free diet. Materials and Methods: Descriptive cross-sectional study, with +18-year-old patients diagnosed with CD, confirmed with biopsy. 123 subjects from Fundación Convivir and from Instituto de Diagnóstico Gastroenterológico answered Beck Depression Inventory II (BDI-II) vía e-mail, which consists of 21 questions on personal aspects of their life; and also a survey on general aspects generales. A result of > 20 points was considered depression. Results: Average age was 38.9 years, 82.9 percent female. 17.1 percent (21 cases) present with depression according to BDI-II score. 62.6 percent adhere to the diet and 10.4 percent present depression; on the other hand, of 37.4 percent that are non-adherent, 28.3 percent present this disease. The association between both variables is statistically significant (p < 0.014). Discussion: High prevalence of depression was determined in CD patients compared to 9 percent, corresponding to the countries global figure. Most of them showed previous history of depressive disease. Adequate adherence to a gluten-free diet is associated to lower prevalence of depression.

Introducción: La enfermedad celíaca (EC) es una patología autoinmune que afecta al aparato gastrointestinal y a otros sistemas como el neuro-psiquátrico, área en la que la depresión es la patología más frecuente. Objetivos: Determinar la prevalencia de depresión en pacientes adultos con EC y relacionar resultados con la adherencia o no a una dieta libre de gluten. Materiales y Métodos: Estudio descriptivo de corte transversal que incluyó a pacientes de 18 años o más, con diagnóstico de EC confirmado por biopsia. Se aplicó vía correo electrónico el Inventario de Depresión de Beck II (BDI-II) que consta de 21 preguntas sobre aspectos de su vida personal; y una encuesta de antecedentes generales a 123 sujetos provenientes de la Fundación Convivir y del Instituto de Diagnóstico Gastroenterológico. Se consideró depresión si el puntaje es > 20 puntos. Resultados: La edad promedio fue de 38,9 años y el 82,9 por ciento eran mujeres. El 17,1 por ciento (21 casos) presentan depresión según la escala de BDI-II. El 62,6 por ciento son adherentes a la dieta y presentan depresión el 10,4 por ciento; en cambio del 37,4 por ciento que no son adherentes, el 28,3 por ciento presenta esta patología. La asociación entre ambas variables es estadísticamente significativa (p < 0,014). Discusión: Se determinó una alta prevalencia de depresión en pacientes con EC en comparación con 9 por ciento que corresponde a la cifra global del país. La mayoría de ellos presentaban antecedentes previos de enfermedad depresiva. Una adecuada adherencia a la dieta libre de gluten se asocia a una menor frecuencia de depresión.

Corticoides en la Enfermedad de Meniere / Steroids in disease Meniere

La Academia Americana de Otorinolaringología-HNS en195 define a la Enfermedad de Meniere como un síndrome idiopático de hidrops endolinfático que clínicamente se manifesta por crisis vertiginosas esporádicasespontáneas y recurentes asociadas a hipoacusia, plenitud ótica y acufenos.El vértigo se define como un trastorno del equilbriocaracterizado por una sensación de movimiento rotatorio del cuerpo o los objetos que lo rodean.El acúfeno es la percepción de sonido en ausencia deuna señal simultánea acústica o eléctrica. Sería el resultado de una actividad aberante producida en una ovarias localizaciones de la vía auditva desde la cócleahasta la corteza cerebral, que es procesada de modoanómalo y que es interpretado eróneamente por loscentros superiores como un ruido. Se hacen patentescuando alcanzan una intensidad que supera el enmascaramiento del sonido ambiental que nos rodea.Objetivo Determinar los resultados en la audición,acufeno y vértigo luego tratamiento intratimpánico concorticoides en la Enfermedad de Meniere Definitva.Determinar el impacto en la calidad de vida luego deltratamiento intratimpánico.Material y método Se realizó un estudio prospectivo,utilzando el método estadístico, que incluyo a 13 pacientes de ambos sexos mayores de 14 años que consultaron por Enfermedad de Meniere al Servicio de Otorinolaringología del Hospital Nacional de Clínicas Córdoba Argentina durante el periodo comprendido entrelos años 209-2012. Conclusión Concluimos que el vértigo en los pacientesque presentan Enfermedad de Meniere mejora en todoslos aspectos, siendo este el síntoma que motiva la consulta, proponemos este tratamiento en los pacientes quepresentan vértigo incapacitante.

The American Academy of Otolaryngology-HNS in 195defined Meniere's disease as an idiopathicendolymphatic hydrops syndrome manifests clinicalysporadic, spontaneous and recurent vertiginous crisesasociated with hearing los, tinitus and aural fulnes.Vertigo is defined as a balance disorder characterized bya sensation of rotational movement of the body orsurounding objects.Tinitus is the perception of sound in the absence of anacoustic or electric signal simultaneously. Would resultfrom aberant activity produced in one or more locationsof the auditory pathway from the cochlea to the cerebralcortex, which is procesed and anomalously beingmisinterpreted by the higher centers as noise. Becomeaparent when they reach an intensity that exceds theambient sound masking around us.Objetive Determine the results in hearing, tinitus anddizines after intratympanic corticosteroid therapy inMeniere 's Disease Final.Determine the impact on quality of life after intratympanictreatment.Materials and methods A prospective study wasperformed using the statistical method ,which included13 patients of both sexes over 14 years consulting forMeniere's disease the Department of Otolaryngology,National University Hospital -Córdoba Argentina for theperiod betwen 2009 -2012. Conclusion We conclude that he vertigo in patients withMeniere's disease improved in al aspects, which is thesymptom that motivates the query, we propose thistreatment in patients with disabling vertigo.

Nivel de dolor en pacientes amigdalectomizados / Level of pain in tonsilectomy patients

Obtener datos epidemiológicos de lasamigdalectomías realizadas durante dos años quirúrgicos en el Hospital Nacional de Clínicas. Valorar la incidencia entre la técnica quirúrgica empleada y el gradode dolor postoperatorio. Relacionar la técnica quirúrgica con el dolor postoperatorio y la incorporación de ladieta.Material y método: Se realizó un estudioprospectivo, utilzando el método estadístico, que incluyó a 10 pacientes de ambos sexos, de 14 a 56 años deedad, amigdalectomizados en el Hospital Nacional de Clínicas de Córdoba -Argentina -con técnica de Danielso decolación y utilzación de Ansa, en el periodo comprendido entre marzo del 2010 y abril del 2012.

Get epidemiological data oftonsilectomy surgery performed for two years in theNational Clinical Hospital.Ases whether there is arelationship betwen surgical technique and the degreof postoperative pain. Relate surgical technique with thereturn of the diet.Materials and methods A prospective study wasperformed using the statistical method, which included10 patients of both sexes aged 14 to 56 years old,tonsilectomy in the National Clinical Hospital of Cordoba- Argentina, with Daniels technique, or parietal peritoneumand using Ansa ,in the period betwen March 2010 and April 2012.

El psiquiatra en formación. Reflexiones acerca del comienzo, el tránsito por la formación básica, los puntos sólidos y débiles del sistema formativo / [Training psychiatrists: considerations about the beginning, the transit through basic formation, the strong and the weak points of the formation system].

In the present article we will show the results of the workshop known as The First Training Psychiatrists Latin-American Meeting (2012). We will explore as well, the impact of the psychiatric practice on young physicians who look to the specialty. In this article we intend to update existing bibliography on the subject, and share the results of two research studies done by this team: a questionnaire conducted to first year medical residents working in Metropolitan Buenos Aires (2008/9) and a workshop carried out with the participants of the Latin- American meeting mentioned above.

Hyperglycemia in nondiabetic patients during the acute phase of stroke / Hiperglucemia en no diabéticos durante fase aguda del ictus

OBJECTIVE: To determine patterns of hyperglycemic (HG) control in acute stroke. METHODS: Anonymous survey through Internet questionnaire. Participants included Latin-American physicians specialized in neurocritical care. RESULTS: The response rate was 74 percent. HG definition varied widely. Fifty per cent considered it when values were >140 mg/dL (7.8 mmol/L). Intravenous (IV) regular insulin was the drug of choice for HG correction. One fifth of the respondents expressed adherence to a protocol. Intensive insulin therapy (IIT) was used by 23 percent. Glucose levels were measured in all participants at admission. Routine laboratory test was the preferred method for monitoring. Reactive strips were more frequently used when monitoring was intensive. Most practitioners (56.7 percent) monitored glucose more than two times daily throughout the Intensive Care Unit stay. CONCLUSIONS: There is considerable variability and heterogeneity in the management of elevated blood glucose during acute phase of stroke by the surveyed Latin-American physicians.

OBJETIVO: Determinar patrones de control de hiperglucemia (HG) en el ictus agudo. MÉTODOS: Encuesta anónima, mediante cuestionario vía Internet. Los participantes incluyan médicos latinoamericanos especializados en cuidados neurocríticos. RESULTADOS: Las encuestas fueron respondidas por el 74 por cento de los convocados. Las definiciones de hiperglucemia fueron variadas. El 50 por cento de los que respondieron consideran HG cuando glucemia >140 mg/dL (7.8 mmol/L). Insulina regular intravenosa fue la droga de elección para su control. Solo la quinta parte de los encuestados manifestaron adherencia a un protocolo. El 23 por cento emplea el régimen insulínico intensivo (TII). Glucemia fue obtenida a la admisión a la Unidad de Terapia Intensiva (UCI) por el total de los participantes. Test rutinario de laboratorio fue el método preferido para la monitorización. Tiras reactivas fueron utilizadas con mayor frecuencia cuando se aplicó monitoreo intensivo. El 56.7 por cento monitoriza glucemia más de dos veces al día durante la estadía en UCI. CONCLUSIONES: Existe una considerable variabilidad y heterogeneidad en el manejo de la hiperglucemia durante la fase aguda del ictus entre los médicos latinoamericanos encuestados.

Patient Simulation: A Literary Synthesis of Assessment Tools in Anesthesiology / 보건의료교육평가

High-fidelity patient simulation (HFPS) has been hypothesized as a modality for assessing competency of knowledge and skill in patient simulation, but uniform methods for HFPS performance assessment (PA) have not yet been completely achieved. Anesthesiology as a field founded the HFPS discipline and also leads in its PA. This project reviews the types, quality, and designated purpose of HFPS PA tools in anesthesiology. We used the systematic review method and systematically reviewed anesthesiology literature referenced in PubMed to assess the quality and reliability of available PA tools in HFPS. Of 412 articles identified, 50 met our inclusion criteria. Seventy seven percent of studies have been published since 2000; more recent studies demonstrated higher quality. Investigators reported a variety of test construction and validation methods. The most commonly reported test construction methods included "modified Delphi Techniques" for item selection, reliability measurement using inter-rater agreement, and intra-class correlations between test items or subtests. Modern test theory, in particular generalizability theory, was used in nine (18%) of studies. Test score validity has been addressed in multiple investigations and shown a significant improvement in reporting accuracy. However the assessment of predicative has been low across the majority of studies. Usability and practicality of testing occasions and tools was only anecdotally reported. To more completely comply with the gold standards for PA design, both shared experience of experts and recognition of test construction standards, including reliability and validity measurements, instrument piloting, rater training, and explicit identification of the purpose and proposed use of the assessment tool, are required.

Impaired angiogenesis following hind-limb ischemia in diabetes mellitus mice / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate vascular endothelial growth factor (VEGF) and its signaling pathway spontaneous response in type 2 diabetes mellitus (T2DM) mice to surgery-induced hind-limb ischemia.</p><p><b>METHODS</b>Sixty mice were randomly divided into two groups, one was fed with normal chow as control, and another was fed with high fat diet to induce T2DM. Fourteen weeks later, mice were surgically induced to hind-limb ischemia. Blood flow restoration was monitored with laser Doppler perfusion imaging. Tibialis anterior muscle was collected after 3 days of hind-limb ischemia. VEGF mRNA and protein expressions were analyzed using real-time PCR and ELISA; expressions of VEGF downstream signal molecules and receptors were analyzed using Western blotting and RT-PCR, respectively.</p><p><b>RESULTS</b>Perfusion recovery 10, 20, 30 days after ischemia was significantly attenuated in T2DM compared with control group (P < 0.05). T2DM impaired VEGF signaling pathway although VEGF levels increased in T2DM group. After ischemia, T2DM group had a comparable increase in VEGF expression compared with control group, but still had an impaired VEGF signaling pathway.</p><p><b>CONCLUSION</b>VEGF signaling pathway is abnormal in T2DM mice, although VEGF had a response to the ischemic stimulation.</p>

Current Update on the Management of Locally Advanced Non-small Cell Lung Cancer

Locally advanced NSCLC is a heterogenous group of bronchogenic malignancies that are traditionally thought to be unresectable without overt distant metastasis or malignant pleural effusion. The mainstay of treatment for this class of diseases until the early 1990s was radiation alone, which resulted in a dismal outcome. The new technologies in radiation therapy (e.g. 3D-CRT) and the shift in paradigm (e.g. omission of ENI) have enabled the dose-escalation, which translated to improved outcome compared to the conventional radiotherapy using 2-D planning. The trials combining chemotherapy with radiotherapy, first sequentially, then concurrently, have changed the standard of care for patients with good functional status to concurrent chemoradiation. Some studies have shown survival benefits to adding consolidative systemic therapy with concurrent chemoradiation. We will outline the development of the current treatment standard of locally advanced NSCLC and present selected topics undergoing active research to forecast the next generation of NSCLC therapy

Requisitos e habilidades do trabalhador: um estudo empírico de anúncios de empregos / Worker's requisites and skills: a job advertisement empiric study

Com o objetivo de identificar requisitos e habilidades exigidos do trabalhador no contexto de trabalho atual foram registrados 5738 anúncios dominicais de empregos veiculados em um jornal de Salvador. Uma das conclusões foi que a área de comércio é a que mais utiliza esse meio (27,3%). A disponibilidade adicional de tempo, a ambição e o dinamismo (atitudes e comportamentos) são solicitados pelas áreas de saúde, educação, administrativo-financeira, comércio e serviços domésticos. A comunicação, fluência verbal e habilidade de redação são requisitos cognitivos para as áreas administrativo--financeira e comercial. A liderança e coordenação de equipes habilidade interpessoais) são solicitadas pelos cargos de secretaria e atendente. Para serviços domésticos ainda é requerida disponibilidade para dormir no local de trabalho. O comércio e a área de serviços exigem que o trabalhador possua carro, moto, celular e resida próximo ao local de trabalho.

The objective of the study was to identify the working requirements - requisites and skills - in the current context of work. Sunday job advertisements (n=5738) from a local newspaper in Salvador were analyzed. One of the conclusions is that the commercial segment is the one that uses job advertisements the most (27,8%) followed by services (15,5%) and health (12,3). Additional time availability, ambition and dynamism (attitude and behavior) are required in the areas of health education, financial-administrative, commerce and domestic service. Communication, verbal fluency and writing skills are requirements from the commercial and financial administrative areas. Leadership and team coordination (interpersonal skills) are required for secretarial and assistance positions. Regarding domestic service it is also required the availability to sleep in the workplace. The areas of commerce and services expect that the worker have a car, motorcycle, a cell phone and that the person lives near the workplace.