Ecological study of gastric cancer in Brazil:Geographic and time trend analysis

AIM:To investigate the geographic distributions and time trends of gastric cancer(GC)incidence and mortality in Brazil.METHODS:An ecological study of the DATASUS registry was conducted by identifying hospitalizations for GC between January 2005 and December 2010.The data included information on the gender,age,and town of residence at the time of hospital admission and death.RESULTS:The GC rates,adjusted according to available hospital beds,decreased from 13.8 per 100000in 2005 to 12.7 per 100000 in 2010.The GC rates decreased more among the younger age groups,in which the male-to-female difference also decreased in comparison to the older age groups.Although the lethality rates tended to increase with age,young patients were proportionally more affected.The spatial GC distribution showed that the rates were higher in the south and southeast.However,while the rates decreased in the central-west and south,they increased in the northern regions.A geographic analysis showed higher rates of GC in more urbanized areas,with a coast-toinland gradient.Geographically,GC lethality overlapped greatly with the hospital admission rates.CONCLUSION:The results of this study support the hypothesis of a critical role for environmental factors in GC pathogenesis.The declining rates in young patients,particularly males,suggest a relatively recent decrease in the exposure to risk factors associated with GC.The spatial distribution of GC indicates an ongoing dynamic change within the Brazilian environment.     

miR-429 expression in bladder cancer and its correlation with tumor behavior and clinical outcome

We previously showed that microRNA-429 (miR-429) played an important role in epithelial–mesenchymal transition (EMT) of urothelial cell carcinoma of the bladder. We herein evaluated the expression of miR-429 in bladder cancer and its potential relevance to clinicopathological characteristics and patient survival. Relative expression levels of miR-429 in surgical bladder cancer tissue specimens obtained from 76 patients with bladder cancer were measured by chromogenic in situ hybridization. miR-429 expression was significantly higher in specimens from alive patients than expired patients in both of 5-year overall survival (OS) (0.59 ± 0.09 vs. 0.27 ± 0.12; p < 0.05) and 5-year recurrence-free survival (RFS) (0.63 ± 0.10 vs. 0.33 ± 0.10; p < 0.05). The univariate Cox proportional hazards analysis revealed that tumor grade, stage, and miR-429 expression were significantly associated with patient survival. In multivariate analysis, tumor stage and miR-429 expression were significantly associated with 5-year OS (hazard ratio [HR] 4.70, p < 0.001) and 5-year-RFS (HR 2.20, p < 0.05). The Kaplan–Meier analysis showed that patients with miR-429 expression had significantly better 5-year OS and 5-year RFS rates than those without miR-429 expression (84.4% vs. 61.4%, p < 0.05 and 71.9% vs. 45.5%, p < 0.05, respectively). miR-429 may be considered as an adjunctive prognostic marker in addition to tumor grade and stage in bladder cancer.     

不同药物对急性中毒性肾衰家兔作用效果的比较

目的观察10%葡萄糖、0.9%氯化钠溶液、肾上腺素对急性中毒性肾衰家兔的作用效果。方法制备家兔急性中毒性肾衰模型,观察急性中毒性肾衰状态下家兔动脉血压、心率、血尿素氮、血清肌酐的变化,以及注射10%葡萄糖、0.9%氯化钠溶液、肾上腺素对肾衰家兔动脉血压、心率、血尿素氮、血清肌酐的影响。对比肾衰前后以及肾衰后各药物注射后家兔的生命体征变化。结果肾衰家兔与正常家兔相比动脉血压下降,心率略下降,血清尿素氮、肌酐明显上升;肾衰家兔注射葡萄糖后动脉血压和心率都基本不变,血清尿素氮、肌酐略上升;注射0.9%氯化钠溶液后血压升高,心率略升高,血清尿素氮、肌酐略下降;注射肾上腺素后动脉血压上升,心率下降,血清尿素氮、肌酐明显下降。结论肾上腺素对急性中毒性肾衰家兔的治疗效果最佳。     

Red blood cell transfusion in newborn infants

Red blood cell transfusion is an important and frequent component of neonatal intensive care. The present position statement addresses the methods and indications for red blood cell transfusion of the newborn, based on a review of the current literature. The most frequent indications for blood transfusion in the newborn are the acute treatment of perinatal hemorrhagic shock and the recurrent correction of anemia of prematurity. Perinatal hemorrhagic shock requires immediate treatment with large quantities of red blood cells; the effects of massive transfusion on other blood components must be considered. Some guidelines are now available from clinical trials investigating transfusion in anemia of prematurity; however, considerable uncertainty remains. There is weak evidence that cognitive impairment may be more severe at follow-up in extremely low birth weight infants transfused at lower hemoglobin thresholds; therefore, these thresholds should be maintained by transfusion therapy. Although the risks of transfusion have declined considerably in recent years, they can be minimized further by carefully restricting neonatal blood sampling.     

The Cardiovascular Response to Acoustic Stimuli

The purposes of this investigation were to determine whether adults display alterations of cardiac rate under acoustical stimulus conditions and whether such alterations are influenced by signal level. The stimulus consisted of a narrow band of noise centered at 1000 Hz and presented at 20, 40, 60 and 80 dB SPL. The stimulus was found to produce alterations of heart rate significantly different from variation under non-stimulus conditions, indicating that cardiovascular responses occurred. However, the responses themselves were unaffected by differences of sound pressure level.     

Type a Behavior and Cardiovascular Recovery from a Psychosocial Stressor

Abstract

The present study examined heart rate responses of Type A and Type B individuals during and after performance on the Stroop perceptual conflict task. The student version of the Jenkins Activity Survey was administered to thirty-two male Caucasians, who then performed the Stroop task for six minutes under conditions that emphasized time urgency and competition. Results showed that Type A's recovered significantly slower than Type B's after task completion. Type A's, compared to Type B's reported feeling more angry, time pressured, and impatient. The notion that Type A individuals may be at higher risk for coronary heart disease because of maladaptively prolonged cardiovascular arousal was discussed.     

Continuous Measurement of O2 Consumption and CO2 Elimination During a Wakeful Hypometabolic State

Abstract

A previous investigation has demonstrated that the practice of a meditational technique elicits a wakeful, hypometabolic state. Measurement of O₂ consumption and CO₂ elimination was made by sampling techniques; mean values of these parameters were calculated from 6–10 minute samples. The present study extends this investigation, using a recently developed method of continuous measurement of O₂ consumption and CO₂ elimination. Continuous measurement of these parameters permitted the determination of mean values for the entire experimental periods as well as for selected intervals and permitted the examination of the sequence of respiratory changes. The present study reports statistically significant decreases in O₂ consumption of 5 percent and CO₂ elimination of 6 percent for the entire 20 minutes of the meditation period. These are lower than the sample values of 16 percent and 15 percent reported in the previous study. However, when selected intervals of the meditation period are examined, decreases in O₂ consumption and CO₂ elimination are comparable to those previously reported. The results are consistent with the difference between the discontinuous sampling measurement method originally employed and the continuous measurement method of the present investigation.     

Significance of the SISI Test and Its Relation to Recruitment

Auditory brainstem responses (ABR) evoked by clicks allow a threshold evaluation for the high-frequency range (2-4 kHz) but not for middle and low frequencies (0.5-1 kHz). In 19 normally hearing subjects aged between 24 and 40 years, ABRs have been recorded using clicks and 0.5- and 1-kHz tone pips, with durations of 6 and 3 ms, respectively, and rise-decay times of 3 and 1.5 ms. The input signal was filtered by a passband filter of 20-5000 Hz. Parameters of tracings elicited by the different kinds of stimuli are compared. Tone-pip ABR morphology does not show the conventional seven peaks but a single large vertex-positive wave. On the ascending branch high-frequency potentials, probably corresponding to the I, II, III and IV-V click-evoked peaks, were visible in some cases, but they rapidly disappeared as the stimulus intensity was decreased. Their 2.3-3 ms greater mean latency values are presumably related to the rise times of the stimuli employed. In terms of bioelectric generators, this large vertex-positive peak probably corresponds to the Jewett V wave. It probably represents a generalized asynchronous dendritic activity. Thus it is possible to obtain ABRs to middle- and low-frequency stimuli. Mean amplitude values of the slow wave are considerably higher than those of the Jewett V wave, but standard deviations are also larger. The positive wave has been identified in response to 1-kHz tone pips in 100% of cases at 30 dB nHL and in 52% of cases at 20 dB, while for 0.5-kHz tone pips in 73.7% of cases at 30 dB and in 57% at 20 dB. On the whole the threshold is located between 15 and 30 dB nHL.

L'étude des potentiels auditifs du tronc cérébral évoqués par des clics permet une évaluation objective du seuil auditif dans le domaine des hautes fréquences (2-4 kHz), mais pas dans celui des fréquences moyennes et basses (0, 5-1 kHz).

Nous avons étudié, chez 19 sujets normo-entendants aˇgés de 24 à 40 ans, les potentiels auditifs du tronc cérébral évoqués par des clics et des pips tonaux de 0,5 et 1 kHz, la durée des pips tonaux étant respectivement de 6 et 3 ms, avec un temps de montee de 3 et 1,5 ms.

Le signal était filtré avec une bande passante de 20-5000 Hz. Nous avons ainsi comparé les paramètres des tracés obtenus avec ces différents types de stimulus et trouvé que les pips tonaux n'évoquaient pas l'apparition des sept pics conventionnels, mais seulement une onde assez ample, positive au vertex; parfois, il est possible de reconnaiˇtre sur sa branche ascendante la présence de potentiels à haute fréquence qui correspondent selon toute probabilité aux pics I, II, III et IV-V évoqués par des clics. Leur amplitude décroiˇt et ils disparaissent lorsqu'on diminue l'intensité de la stimulation. Les latences de cette onde ample, positive au vertex, supérieures de 2,3-3 ms à celles de l'onde V de Jewett, sont probablement liées au temps de montée du stimulus employé. En termes d'origine bioélectrique, cette onde correspond vraisemblablement à celle du pic V de Jewett. Elle semble représenter une activité dendritique, asynchrone. On peut done obtenir des potentiels auditifs du tronc cérébral avec des stimuli de basse et de moyenne fréquence. Les amplitudes moyennes de cette onde sont beaucoup plus importantes que celles du pic V de Jewett, mais les déviations standard sont aussi plus grandes. Cette onde est présente dans 100% des cas pour les pips tonaux de 1 kHz à 30 dB nHL et dans 52% à 20 dB, tandis qu'elle est présente dans 73,7% des cas à 30 dB et dans 57% à 20 dB lorsque on emploie des pips tonaux de 0,5 kHz. Les seuil objectif se situe ainsi entre 15 et 30 dB nHL.     

Cardiac Autonomic Function and Global Left Ventricular Performance in Autoimmune Eauthyroid Chronic Thyroiditis: Is Treatment Necessary at the Euthyroid Stage?

Objective: Autoimmune chronic thyroiditis (ACT) is characterized by lymphocyte infiltration in the thyroid gland and the presence of antithyroid antibodies in serum. Medical treatment does not affect antibody levels and treatment decision is not definite yet for the euthyroid patients. We aimed to evaluate cardiac autonomic function and global left ventricular performance in autoimmune euthyroid chronic thyroiditis and determine the need for medical treatment. Method: We studied 30 ACT patients and 25 healthy control subjects. Cardiac autonomic function is evaluated by heart rate recovery (HRR). Global left ventricular performance is evaluated by two‐dimensional echocardiography and pulsed‐wave tissue Doppler echocardiography. Results: There was no difference between patients and controls with respect to clinical and biochemical parameters except hemoglobin (13.67 ± 1.25 g/dL, 14.51 ± 1.35 g/dL, p:0.047) and low density lipoprotein (120.71 ± 24.91 mg/dL, 100.55 ± 14.73 mg/dL, p: 0.003). Tei index was significantly higher in ACT group (0.521 ± 0.074, 0.434 ± 0.034, P < 0.0001). E′/A′ was found to be significantly lower (1.234 ± 0.42, 1.750 ± 0.291, P < 0.0001) and E/E′ was found to be higher than the controls (8.482 ± 0.449, 6.039 ± 0.209, P < 0.0001). HRR was significantly lower than the controls (20 ± 4 BPM, 30 ± 8 BPM, P < 0.0001). Conclusion: Although left ventricular performance is found to be normal by conventional echocardiographic methods, it is found to be impaired when Tei index and tissue Doppler parameters are used. Cardiac autonomic function is also impaired in ACT patients. As a result of these cardiac changes, medical treatment may be considered earlier, even at the euthyroid stage. (Echocardiography 2011;28:15‐21)