Colorectal cancer

This is the final version of the article. Available from the publisher via the DOI in this record.This is one of a series of occasional articles highlighting conditions that may be more common than many doctors realise or may be missed at first presentation. Easily Missed serie

Acoustic Wave Velocity as a Selection Trait in Eucalyptus nitens

Previous studies in Eucalyptus nitens have revealed favourable genetic correlations exist between acoustic wave velocity (AWV) in standing trees and modulus of elasticity (MOE), which can determine the suitability of trees for structural timber and/or engineered wood products. This study investigates the strength and stability of genetic variation in standing tree AWV across a range of environments in Tasmania, where there are a number of large plantation estates and breeding trials. Trees under study were from open-pollinated progeny trials established in 1993. Across sites, for standing tree AWV the ranking of E. nitens races did not change and within-race additive genetic correlations were strong (0.61 to 0.99). Heritabilities (0.16 to 0.74) and coefficients of additive genetic variation (2.6 to 4.8) were moderate for this trait. Correlations between standing tree AWV and both basic density and diameter at breast height (DBH) were favourable. Results indicate that there is potential to improve MOE in E. nitens through the exploitation of genetic variation in AWV among and within races, the expression of genetic variation in AWV is relatively stable across different growing environments, and past selection for basic density and growth in pulpwood breeding programs is unlikely to have adversely affected MOE

The Postoperative Morbidity Survey was validated and used to describe morbidity after major surgery.

OBJECTIVES: To describe the reliability and validity of the Postoperative Morbidity Survey (POMS). To describe the level and pattern of short-term postoperative morbidity after major elective surgery using the POMS. STUDY DESIGN AND SETTING: This was a prospective cohort study of 439 adults undergoing major elective surgery in a UK teaching hospital. The POMS, an 18-item survey that address nine domains of postoperative morbidity, was recorded on postoperative days 3, 5, 8, and 15. RESULTS: Inter-rater reliability was perfect for 11/18 items (Kappa=1.0), with Kappa=0.94 for 6/18 items. A priori hypotheses that the POMS would discriminate between patients with known measures of morbidity risk, and predict length of stay were generally supported through observation of data trends, and there was statistically significant evidence of construct validity for all but the wound and neurological domains. POMS-defined morbidity was present in 325 of 433 patients (75.1%) remaining in hospital on postoperative day 3 after surgery, 231 of 407 patients (56.8%) on day 5, 138 of 299 patients (46.2%) on day 8, and 70 of 111 patients (63.1%) on day 15. Gastrointestinal (47.4%), infectious (46.5%), pain-related (40.3%), pulmonary (39.4%), and renal problems (33.3%) were the most common forms of morbidity. CONCLUSION: The POMS is a reliable and valid survey of short-term postoperative morbidity in major elective surgery. Many patients remain in hospital without any morbidity as recorded by the POMS

Why don't serum vitamin D concentrations associate with BMD by DXA? A case of being 'bound' to the wrong assay? Implications for vitamin D screening.

BACKGROUND: The association between bone mineral density (BMD) and serum25-hydroxyvitamin D (25(OH)D) concentration is weak, particularly in certain races (eg, BlackAfrican vs Caucasian) and in athletic populations. We aimed to examine if bioavailable vitamin D rather than serum 25(OH)D was related to markers of bone health within a racially diverse athletic population. METHODS: In 604 male athletes (Arab (n=327), Asian (n=48), Black(n=108), Caucasian (n=53)and Hispanic (n=68)), we measured total 25(OH)D, vitamin D-binding protein and BMD by DXA. Bioavailable vitamin D was calculated using the free hormone hypothesis. RESULTS: From 604 athletes, 21.5% (n=130) demonstrated severe 25(OH)D deficiency, 37.1% (n=224) deficiency, 26% (n=157) insufficiency and 15.4% (n=93) sufficiency. Serum 25(OH)D concentrations were not associated with BMD at any site. After adjusting for age and race, bioavailable vitamin D was associated with BMD (spine, neck and hip). Mean serum vitamin D binding protein concentrations were not associated with 25(OH)D concentrations (p=0.392). CONCLUSION: Regardless of age or race, bioavailable vitamin D and not serum 25(OH)D was associated with BMD in a racially diverse athletic population. If vitamin D screening is warranted, clinicians should use appropriate assays to calculate vitamin D binding protein and bioavailable vitamin D levels concentrations than serum 25(OH)D. In turn, prophylactic vitamin D supplementation to 'correct' insufficient athletes should not be based on serum 25(OH)D measures

Acesso à Justiça ante ao controle de constitucionalidade contemporâneo

O presente estudo tem por objetivo central realizar uma análise crítica do controle difuso de constitucionalidade e o acesso à justiça numa perspectiva do pensamento de Jacques Derrida. Tal se justifica ante à substancialidade que tal acesso exerce em vias democráticas, que por vezes é violado, limitado ou simplesmente confundido com acesso à jurisdição. Ressalta-se o fato que o acesso à jurisdição costumeiramente se mistura com o acesso à justiça, e tal se mostra impactante quando se tem uma ordem constitucional democrática, tal qual posta no Brasil atual. Para que o objeto se construa ao longo dessa pesquisa, utiliza-se o método analítico documental. Para que se tenha uma análise concreta da questão do acesso à justiça, necessário se faz pautar o estudo avaliando de que modo o controle difuso de constitucionalidade faz com que se efetive o direito referente ao acesso à justiça. Impedir o acesso do indivíduo à justiça, tendo por base a questão do efeito erga omnes, é pauta central no pensamento de Jacques Derrida, o qual tece um viés crítico agudo ao vislumbrar que tal efeito, na realidade, se mostra como uma impossibilidade de análise pelo magistrado no caso concreto. É possível concluir, em linhas gerais, que o acesso à justiça não pode ficar engessado por óbices criados a partir da generalidade dos efeitos erga omnes, fazendo com que se torne necessária uma maior e mais específica atuação do Poder Judiciário para que o direito à jurisdicionalização seja efetivamente uma meta de direitos fundamentais.Palavras-chave: constitucionalidade; controle; difuso; crítica.Access to Justice before the control of contemporary constitutionality  ABSTRACT The present study has the main objetive of performing a critical analysis of the diffuse controle of the constitutionality and access to justice in a Jacques Derrida’s perspective of thought. It is justified in front of the substantiality that this access exercises in democratic scenarios, which is often violated, limited or simply confused with access to jurisdiction. We highlight the fact that the access to jurisdiction is usually mixed up with access to justice, which shows itself significant when there is a constitutional democratic order, as in the Brazil’s one nowadays. So that the object is constructed along this research the documental analytical method is used. So that a concrete analysis on the matter is is obtained, it is necessary to rule the study evaluating how the diffuse control of constitutionality brings about the right regarding the access to justice. Obstructing the access of the individual to justice, based on the erga omnes effect, is a central spot in Jacques Derrida’s thought, who spins a sharp critical slant when he ponders that such effect, actually, shows itself as an impossibility of analysis by the magistrate in the concrete case. It is possible to conclude, in general, that the access to justice cannot be plastered by obstacles created from the generality of the erga omnes effects, making necessary a higher and more specific performance from the Judiciary so that the right to jurisdicionalization be effectivelly a goal of fundamental rights. Keywords: constitutionality; control; diffuse; criticism. Data de submissão: 08-05-2016Data de aceitação: 30-07-201