A new cultural adaptation of the University of Pennsylvania Smell Identification Test

OBJECTIVES: The University of Pennsylvania Smell Identification Test, a test of olfactory function that is widely used by otolaryngologists, geriatricians, and neurologists, has been translated into more than a dozen languages. In some instances, cultural and socioeconomic factors have necessitated changes in the odorant items or the response alternatives to make the test scores congruent with North American norms. The objective of this study was to compare the performance of Brazilian subjects on a new Portuguese language version of the University of Pennsylvania Smell Identification Test with their performance on an earlier Portuguese language version of the test, as well as to assess the influences of gender, age, ethnicity, and economic status on the test scores. METHODS: Based on pilot data, several response alternatives of the earlier Portuguese language version of the test were altered in an effort to improve test performance. Forty-nine healthy Brazilian volunteers, who represented several economic classes, were tested. The test scores of the study cohort who received the newer version of the test were compared with those of a group of 25 subjects who received the earlier version of the test. RESULTS: The mean score for the new version [35 (2.1)] was significantly (p = 0.002) higher than that for the earlier version [32.5 (3.5)]. Although no apparent influence of socioeconomic status was observed, the female participants outperformed the male participants in the current subject cohort. CONCLUSION: The changes made in the new cultural adaptation of the Portuguese version of the University of Pennsylvania Smell Identification Test were effective in increasing the average test scores of the participants. Overall, the female subjects outperformed the male subjects on the test

A Picture of Present Ubicomp Research Exploring Publications from Important Events in the Field

In this work we use a dataset of papers published in top conferences focused on ubiquitous computing (ubicomp) to provide an overview and analysis of recent ubiquitous computing research performed internationally and in Brazil. The contributions of this study are twofold. First, we extracted useful information from our dataset such as representativeness of authors and institutions, and the formation of communities. Second, we analyzed all papers published between 2010 and 2011 in all top international conferences, creating a taxonomy of recent ubicomp research performed internationally. Afterthat we mapped SBCUP papers (Brazilian ubicomp conference) according to this taxonomy, which enables the comparison of international and national research. This study is useful to guide novices in the field and it also provides experienced researchers with facts enabling the discussion of ubicomp research.Key words: Ubiquitous computing, scientific network, collaboration network, Pervasive, Percom, Ubicomp, SBCUP, taxonomy, characterization

RINITE ALÃ?RGICA: ASPECTOS CLÃNICOS E FISIOPATOLÃ?GICOS

Resumo: a rinite alérgica (RA) é uma doença inflamatória crônica de elevada prevalência no país e alta morbidade. Os mecanismos imunopatológicos precisos envolvidos na fisiopatologia da RA ainda não estão bem compreendidos. Um melhor entendimento sobre a fisiopatologia da RA pode permitir o desenvolvimento e inserção de novas abordagens terapêuticas no sentido de melhorar a qualidade de vida dos pacientes. Palavras-chave: Rinite alérgica. Imunopatogênese. Fisiopatologia

N -acetylcysteine and endothelial cell injury by sulfur mustard

Understanding the underlying mechanisms of cell injury and death induced by the chemical warfare vesicant sulfur mustard (HD) will be extremely helpful in the development of effective countermeasures to this weapon of terror. We have found recently that HD induces both apoptosis and necrosis in endothelial cells ( Toxicol. Appl. Pharmacol . 1996; 141: 568–583). Pretreatment of the endothelial cells for 20 h with the redox-active agent N -acetyl-L-cysteine (NAC) selectively prevented apoptotic death induced by HD. In this study, we tested the hypotheses that pretreatment with NAC acts through two different pathways to minimize endothelial injury by HD: NAC pretreatment acts via a glutathione (GSH)-dependent pathway; and NAC pretreatment acts to suppress HD-induced activation of the nuclear transcription factor NFΚB. We used a fluorescence microscopic assay of apoptotic nuclear features to assess viability and electrophoretic mobility shift assays (EMSAs) to assess the activity of NFΚB following exposure to HD. The cells were treated with 0–10 mM GSH for 1 h prior to and during exposure to 0 or 500 ΜM HD for 5–6 h. Cells were also treated with 50 mM NAC or 200 ΜM buthionine sulfoximine (BSO), an inhibitor of GSH synthesis, alone or in combination overnight prior to exposure to 0 or 500 ΜM HD for 5–6 h. Externally applied GSH up to a concentration of 5 mM had no toxic effect on the cells. Mild toxicity was associated with 10 mM GSH alone. There was a dose-related enhancement of viability when 2.5 and 5 mM GSH were present during the HD exposure. Pretreatment with BSO alone had no discernible toxicity. However, pretreatment with this inhibitor of GSH synthesis potentiated the toxicity of HD. Pretreatment with 50 mM NAC, as previously reported, provided substantial protection. Combining pretreatment with both BSO and NAC eliminated the protective effect of NAC pretreatment alone on HD injury. These observations are highly suggestive that NAC enhances endothelial survival via GSH-dependent effects and confirms and extends the work of others with different models that externally supplied GSH alone may be a fairly effective countermeasure against HD injury of endothelium. We next examined the hypothesis that HD may activate the nuclear transcription factor NFΚB by performing EMSAs with nuclear extracts of endothelial cells following exposure to 0, 250 or 500 ΜM HD. This demonstrated an up to 2.5-fold increase (scanning densitometry) in activation of NFΚB binding to its consensus sequence induced by 500 ΜM HD after 5 h of HD exposure. Paradoxically, treatment of the endothelial cells alone with 50 mM NAC activated NFΚB, although HD-induced activation of NFkB was partially suppressed by NAC at 5 h. Factor NFΚB is an important transcription factor for a number of cytokine genes (e.g. tumor necrosis factor, TNF), which can be activated following stress in endothelial cells. Taken together, these observations suggest that the protective effects of NAC may be mediated by enhanced GSH synthesis. The increased GSH may act to scavenge HD and also prevent oxidative activation of NFΚB. Under some conditions, NAC may act as an oxidizing agent and thus increase NFΚB activity. The NFΚB-dependent gene expression may be important in inducing endothelial cell death as well as in generating a local inflammatory reaction associated with the release of endothelial-derived cytokines. Copyright © 2000 John Wiley & Sons, Ltd.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/34703/1/671_ftp.pd

EuroQol (EQ-5D) measure of quality of life predicts mortality, emergency department utilization, and hospital discharge rates in HIV-infected adults under care

BACKGROUND: Health-related quality of life (HR-QOL) is a relevant and quantifiable outcome of care. We implemented HR-QOL assessment at all primary care visits at UCSD Owen Clinic using EQ-5D. The study aim was to estimate the prognostic value of EQ-5D for survival, hospitalization, and emergency department (ED) utilization after controlling for CD4 and HIV plasma viral load (pVL). METHODS: We conducted a retrospective analysis of HIV clinic based cohort (1996–2000). The EQ-5D includes single item measures of: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each item is coded using 3-levels (1 = no problems; 2 = some problems; 3 = severe problems). The instrument includes a global rating of current health using a visual analog scale (VAS) ranging from 0 (worst imaginable) to 100 (best imaginable). An additional single item measure of health change (better, much the same, worse) was included. A predicted VAS (pVAS) was estimated by regressing the 5 EQ-5D health states on VAS using reference cell coding of health states and random effects linear models. Survival models were fit using Cox modelling. Hospitalization and ED rate models were estimated using population-averaged Poisson models. RESULTS: 965 patients met eligibility criteria. 12% were female; 42% were non-white. Median time-at-risk was 1.2 years. Median CD4 was 233. Median log(10)(pVL) was 4.6. 47 deaths occurred. In two Cox models controlling for CD4 and pVL, the adjusted hazard ratios (aHR) for VAS and pVAS as time-varying covariates were 0.73 (95% CI: 0.63–0.83) and 0.66 (95% CI: 0.56–0.77) respectively, for every 10 point increase in (p)VAS rating. In Poisson regression models predicting ED visit rates and hospital discharge rates controlling for current CD4 and pVL, each of the EQ-5D health dimensions, VAS, and health change items were significantly (p < 0.05) associated with the outcomes. For ED visit rates, the adjusted incidence rate ratios (aIRR) were 0.86 (0.83–0.89) and 0.79 (0.75–0.82) for VAS and pVAS, respectively. For hospital discharge rates, the aIRR's were 0.85 (0.82–0.88) and 0.79 (0.75–0.82) for VAS and pVAS, respectively. CONCLUSION: EQ-5D is a brief and prognostically useful predictor of mortality, hospitalization, and ED utilization among adults under care for HIV infection, even after adjusting for CD4 and HIV plasma viral load

PRÁTICAS DO CUIDADO NO AMBIENTE HOSPITALAR: INTERFACES DO ESTÁGIO SUPERVISIONADO EM ODONTOLOGIA – RELATO DE EXPERIÊNCIA

Introdução: Assistência odontológica a pacientes em nível hospitalar potencializa a eficácia do cuidado integral à saúde. Objetivo: Relatar a experiência de acadêmicos do Curso de Odontologia da Universidade Federal do Maranhão (UFMA) durante o estágio obrigatório em ambiente hospitalar. Métodos: Trata-se de um estudo descritivo, tipo relato de experiência, de acadêmicos do Curso de Odontologia da Universidade Federal do Maranhão no estágio obrigatório multiprofissional desenvolvido no Hospital Universitário. Resultados: Os estudantes realizaram a atividade prática durante o segundo semestre de 2019, fomentando as habilidades teóricas e práticas com o convívio em ambiente hospitalar. A convivência com profissionais das demais áreas da saúde permite ao acadêmico uma melhor compreensão da dinâmica de funcionamento de uma equipe multiprofissional e da atribuição de cada um na rotina assistencial dispensada aos pacientes. Conclusão: A experiência do estagiário no hospital possibilita desenvolver uma ampla visão da atuação na área e favorece sua maior inserção na equipe multidisciplinar.Palavras-chaves: Unidade Hospitalar de Odontologia. Comunicação Interdisciplinar. Hospitais de Ensino