Variation in adrenal and thyroid hormones with life-history stage in juvenile northern elephant seals (Mirounga angustirostris)

Interpretation of stress responses in wildlife is inadequate due to the range of natural variation and potential confounds of individual and life-history variables. In marine mammals, endocrine response data are sparse and variable across species. Blood adrenal and thyroid hormones were measured in 144 chemically immobilized yearling elephant seals at Año Nuevo State Reserve to characterize variation between sexes and across semiannual haul-outs. There was no relationship between hormone concentration and time needed for collecting blood or diel pattern, suggesting that concentrations represented baseline values. Serum cortisol concentrations did not vary with gender or across fasts but increased dramatically during molting. Cortisol was significantly correlated with aldosterone at all measured life-history. Thyroxine levels were lower in females and decreased with fasting in both sexes during the Fall haul-out. Cortisol concentrations were correlated with reverse T3 concentrations across all measured life-history stages suggesting an important impact of cortisol on deiodinase enzymes and thyroid function. Significant variation in stress hormone concentrations with gender and life- history stage emphasizes the importance of contextual variables when interpreting serum hormone concentrations

Meta regression analysis to indirectly compare dalteparin to enoxaparin for the prevention of venous thromboembolic events following total hip replacement

<p>Abstract</p> <p>Background</p> <p>Patients undergoing elective total hip replacement (THR) surgery are at an increased risk for venous thromboembolic events (VTEs). Dalteparin and enoxaparin are recommended as thromboprophylaxis for at least 10 days in these patients. Even though both agents have proven clinical effectiveness through placebo controlled studies, there have been no head to head trials to assess comparative effectiveness. Indirect statistical techniques were used to compare safety and efficacy between dalteparin and enoxaparin following THR surgery.</p> <p>Methods</p> <p>A literature search was conducted from January 1980 to November 2009 for randomized trials evaluating dalteparin or enoxaparin prophylaxis in THR patients. In trials where a common control was used (e.g. placebo), indirect statistical comparisons between dalteparin and enoxaparin were performed using meta regression analysis with active drug as the primary independent variable.</p> <p>Results</p> <p>A total of nine placebo controlled enoxaparin (n = 5) and dalteparin (n = 4) trials met the inclusion criteria. THR patients treated with enoxaparin or dalteparin had a 50% VTE risk reduction compared to the placebo control (RR = 0.50, p < 0.001). This benefit was achieved without a significant increase in the risk for major bleeds (RR = 1.19, p = 0.76), heparin induced thrombocytopenia (HIT) (RR = 1.13, p = 0.83) or death (RR = 0.72, p = 0.59). The indirect comparison was not able to find significant differences between enoxaparin and dalteparin in terms of VTEs (p = 0.36), major bleeds (p = 0.45), HIT (p = 0.48) and death (p = 0.86).</p> <p>Conclusions</p> <p>The findings suggested comparable safety and efficacy between dalteparin and enoxaparin in TKR patients. Therefore, treatment decisions should be based on other considerations, such as patient or physician preference, ease of administration and cost.</p

Facing the challenge? Creative tourism in Croatia

In the last decade, creativity has become a buzz word in developmental context, from creative industries, creative classes, creative economy, creative cities, creative business, creative governance to creative tourism. Creative industries have often been used in the context of creative cities’ development creating their image internationally especially through tourism. In order to attract visitors, a new type of tourism has been developed: creative tourism. The article questions its definition as it also questions the need of cities to be re-branded through creative tourism. Two Croatian case studies are featured as to re-think the position of creative tourism in local development: the city of Dubrovnik which relies on heritage as it main resource and the city of Zagreb which still needs to define its main tourism resource but has a lot of potential in cultural/creative industries. The article argues that creativity does not always mean introducing new types of trendy developments in the destination but rather knowing how to develop new development models which suit the local context

Aleitamento materno: uma perspectiva de ensino virtual

TCC(especialização) - Universidade Federal de Santa Catarina. Centro de Ciências da Saúde. Programa de Pós-graduação em Enfermagem. Linhas de Cuidado em Saúde Materna, Neonatal e do LactanteO aleitamento materno possui extrema importância para a saúde do recém-nascido, leva a proteção ao lactente contra doenças infecciosas, autoimunes, obesidade e diabetes, bem como o fortalecimento dos laços afetivos entre mãe e criança. O objetivo desse estudo é relatar a experiência no desenvolvimento de práticas educativas para promoção do aleitamento materno. Trata-se de uma pesquisa qualitativa, utilizando a técnica de solução de problemas com um público alvo constituído principalmente de mulheres e gestantes atendidas em uma Unidade Básica de Saúde (UBS) do município de Santa Rosa do Tocantins, Tocantins. Para escolha do tema baseou-se em conversas informais com gestores e a comunidade. A partir da necessidade encontrada, foi elaborada uma página no facebook abordando o tema: “A importância do aleitamento materno”, sobre o nome Amamentação é vida-Santa Rosa do Tocantins com o intuito de sensibilizar as mulheres acerca do tema, de forma lúdica e descontraída. Através deste meio de interação social ocorreu uma discussão construtiva e a conscientização da importância e benefícios do aleitamento materno para o bebê e sua mãe, explicando sobre a importância do aleitamento materno exclusivo até os seis meses de idade

Facing the challenge? Creative tourism in Croatia

In the last decade, creativity has become a buzz word in developmental context, from creative industries, creative classes, creative economy, creative cities, creative business, creative governance to creative tourism. Creative industries have often been used in the context of creative cities’ development creating their image internationally especially through tourism. In order to attract visitors, a new type of tourism has been developed: creative tourism. The article questions its definition as it also questions the need of cities to be re-branded through creative tourism. Two Croatian case studies are featured as to re-think the position of creative tourism in local development: the city of Dubrovnik which relies on heritage as it main resource and the city of Zagreb which still needs to define its main tourism resource but has a lot of potential in cultural/creative industries. The article argues that creativity does not always mean introducing new types of trendy developments in the destination but rather knowing how to develop new development models which suit the local context

Las mejores 13 universidades para estudiar ingeniería comercial según la opinión de sus propios alumnos

Tesis (Ingeniero Comercial)La presente investigación se centra en las percepciones de los estudiantes, dado que a una persona, que le interese postular a la carrera de ingeniería comercial, le sería beneficioso contar con la opinión de quienes viven de cerca el servicio. A través de un muestreo probabilístico estratificado, se le aplica a la población objetivo, un cuestionario que mide de manera representativa la opinión de los alumnos ante distintas variables que determinan la calidad de los programas de ingeniería comercial y la calidad del servicio educacional otorgado por 13 universidades. Finalmente, la investigación arroja un ranking que permite jerarquizar las universidades por orden de calidad, de manera tal que, se contribuye con información asequible, distinta, válida y confiable, a quienes desean estudiar en los mejores programas de ingeniería comercial del país

Sensibilidade estacional em população de altas latitudes e sua relação com variáveis de adaptação e estilo de organização temporal de trabalho

This study is intended to determine the frequency of seasonal sensitivity in a sample of a Chilean high latitude (extreme southerly) population, and its correlation with labor activities involved in several types of shift work, with variables of general adaptation. A total of 465 participants took part in answering questionnaires to measure seasonality impacts through SPAQ (Seasonal Pattern Assessment Questionnaire), subjective happiness (Oxford scale), social adaptation (Bell), and anxiety and depression (MASQE30). The principal results indicate that the frequency of seasonal sensitivity in this sample was high, in a moderate level near the upper limit, and this is considered to have a significantly negative impact on daily life. Regarding seasonal patterns, the most common effect was in the summer profile, suggesting that people perceive benefits with the increase in sunlight, which correlates negatively with happiness. The analysis according to work-shift shows differential profiles for each one. These results are discussed relative to the importance for development of public policies to further the physical and mental health of extreme-southern populations.El trabajo estudió la frecuencia de sensibilidad estacional en una muestra de población austral chilena, alta latitud sur y su relación con actividades laborales desarrolladas en diferentes turnos de trabajo y con variables de adaptación general. Un total de 465 personas participaron respondiendo instrumentos midiendo estacionalidad (SPAQ), felicidad subjetiva (Escala de Oxford), adaptación social (Bell) y ansiedad y depresión (MASQE30). Los resultados principales indican que la frecuencia de sensibilidad estacional es alta, su nivel declarado en promedio es moderado, en su límite superior, y es evaluada como de impacto negativo significativo en la vida diaria. Respecto de los patrones estacionales, el más numeroso fue el de verano, que indica que las personas perciben beneficios con el aumento de luz, lo que correlaciona negativamente con la felicidad. Los análisis según turno de trabajo mostraron perfiles diferenciales para cada uno. Se discuten estos resultados en torno a su importancia para el desarrollo de políticas públicas asociadas a la salud física y mental de poblaciones australes.Este trabalho estudou a frequência de sensibilidade sazonal em uma amostra de população austral chilena, nas altas latitudes do sul, e sua relação com atividades laborais desenvolvidas em diferentes turnos de trabalho e com variáveis de adaptação geral. Um total de 465 pessoas participaram respondendo instrumentos que mediam a sazonalidade (SPAQ), a felicidade subjetiva (Escala de Oxford), a adaptação social (Bell) e a ansiedade e a depressão (MASQE30). Os principais resultados indicam que a frequência de sensibilidade estacional é alta, seu nível declarado em média é moderado em seu limite superior e é avaliado como de impacto negativo significativo na vida diária. Com respeito aos padrões estacionais, o mais numeroso foi o do verão, que indica que as pessoas percebem benefícios com o aumento da luz, o que se relaciona negativamente com a felicidade. As análises de acordo com o turno de trabalho mostraram perfis diferenciais para cada um deles. Discutem-se esses resultados em torno a sua importância para o desenvolvimento de políticas públicas associadas a saúde física e mental das populações austrais

Primary malignant melanoma of the stomach: report of a case

We report a case of primary malignant melanoma (MM) of the stomach. The patient, a 73-year-old man, was referred to our hospital for investigation of an elevated lesion in the stomach, detected by gastroscopy. On admission, physical examinations and laboratory data were unremarkable. Gastroscopy revealed a pigmented, elevated tumor, approximately 2 cm in diameter, in the posterior wall of the stomach. A biopsy was taken, which resulted in a diagnosis of MM, based on the presence of melanin in tumor cells. F-18 fluorodeoxyglucose positron emission tomography showed no accumulation of tracer except for the tumor in the stomach, indicating that it was a primary MM of the stomach. The patient underwent distal gastrectomy, but died of recurrence 1 year later. Very few cases of primary MM of the stomach have been reported. Thus, we report this case, followed by a review of the literature

Noncutaneous malignant melanoma: a prognostic model from a retrospective multicenter study

Abstract Background We performed multicenter study to define clinical characteristics of noncutaneous melanomas and to establish prognostic factors patients who received curative resection. Methods Of the 141 patients who were diagnosed of non-cutaneous melanoma at 4 institutions in Korea between June 1992 and May 2005, 129 (91.5%) satisfied the selection criteria. Results Of the 129 noncutaneous melanoma patients, 14 patients had ocular melanoma and 115 patients had mucosal melanoma. For mucosal melanoma, anorectum was the most common anatomic site (n = 39, 30.2%) which was followed by nasal cavity (n = 30, 23.3%), genitourinary (n = 21, 16.3%), oral cavity (n = 14, 10.9%), upper gastrointestinal tract (n = 6, 4.7%) and maxillary sinus (n = 5, 3.9%) in the order of frequency. With the median 64.5 (range 4.3-213.0) months follow-up, the median overall survival were 24.4 months (95% CI 13.2-35.5) for all patients, and 34.6 (95% CI 24.5-44.7) months for curatively resected mucosal melanoma patients. Adverse prognostic factors of survival for 87 curatively resected mucosal melanoma patients were complete resection (R1 resection margin), and age > 50 years. For 14 ocular melanoma, Survival outcome was much better than mucosal melanoma with 73.3% of 2 year OS and 51.2 months of median OS (P = .04). Conclusion Prognosis differed according to primary sites of noncutaneous melanoma. Based on our study, noncutaneous melanoma patients should be treated differently to improve survival outcome.Peer Reviewe