Este artigo apresenta um levantamento e uma análise das políticas e infraestruturas de compartilhamento de dados de pesquisa em saúde adotadas pelos institutos e centros que compõem o NIH – NationalInstitutesofHealth (Institutos Nacionais de Saúde), organismo norte-americano de pesquisa biomédica. A partir de pesquisa bibliográfica sobre definições e conceitos abordados neste estudo, o trabalho empírico consistiu na realização de buscas, nos sites dos institutos, centros e escritório central do NIH, de iniciativas de abertura e compartilhamento de dados de pesquisa. Localizaram-se no escritório central no NIH áreas responsáveis por essas ações, e foram identificados políticas e repositórios de compartilhamento de dados cadastrados no diretório de busca da NLM – U.S. National Library of Medicine (Biblioteca Nacional de Medicina dos Estados Unidos). Como resultado, foram feitas análises sobre cada uma dessas iniciativas, considerando: as principais políticas de dados adotadas e seus principais objetivos, tipos e níveis de acesso e de publicação dos dados, formas de inserção e contribuição de dados, existência ou não de códigos de conduta, principais áreas de pesquisa envolvidas, tipos de repositórios (temáticos ou institucionais). As considerações finais fornecem subsídios para debates sobre diferentes tipos e abordagens de abertura e compartilhamento de dados de pesquisa científica, indicando questões pertinentes aos desdobramentos futuros da pesquisa.
Objetivo: Validar os critérios mínimos de diagnóstico histopatológico da doença do enxerto contra hospedeiro crônica oral, com base em critérios de classificação do NationalInstitutesofHealth, e correlacioná- los com as características clínicas. Métodos: Quarenta e um espécimes contendo mucosa oral e glândulas salivares foram analisados em lâminas coradas por hematoxilina-eosina. Os espécimes histológicos foram avaliados de forma cega, por dois patologistas calibrados, utilizando os critérios recomendados para diagnóstico histopatológico de doença do enxerto contra hospedeiro crônica propostos pelo Consenso do NationalInstitutesofHealth. A classificação clínica da doença do enxerto contra hospedeiro crônica foi correlacionada após a análise das lâminas. Resultados: Nossos resultados mostraram que o epitélio estava comprometido em 39/41 espécimes, apresentando acantose (29/70,7%), exocitose de linfócitos (29/70,7%), espessamento da lâmina basal (29/70,7%) e apoptose (15/36,6%). O tecido conjuntivo apresentou infiltrado inflamatório intersticial em 38 (92,7%) casos. Nas glândulas salivares menores, observaram-se fibrose periductal (38/92,7%), infiltrado inflamatório periductal misto (32/78%), ectasia ductal (30/73,2%), linfócitos em torno e migrando para dentro dos ácinos (30/73,2%), e fibrose intersticial (29/70,7%). As manifestações clínicas mais comuns foram mucosa de aspecto liquenoide (40/97,6%), queixa de sensibilidade bucal ao se alimentar (38/92,7%), e sensação de boca seca (36/87,8%). Conclusão: Os critérios mínimos para o diagnóstico histopatológico da doença do enxerto contra hospedeiro crônica oral, com base no Consenso do NationalInstitutesofHealth, foram validados neste estudo, e não houve correlação entre a gravidade das manifestações clínicas e a gravidade das características histopatológicas.
in Cloquet, Minnesota and received his medical degree from the University of Minnesota Medical School in 1946. Ater residency training at Boston City Hospital, a tour of duty with the U.S. Navy Army Medical Research Center in Cairo, Egypt, and research fellowships in virology, he became Assistant Professor and Instructor in Research Medicine at the University of Pitsburgh School of Medicine. He moved to Harvard School of Public Health as Associate Professor of Tropical Medicine in 1955, where he became Professor of Tropical Public Health in 1964. In 1969 he was recruited by the NationalInstitutesofHealth (NIH) to become the Chief of the Laboratory of Parasitic Diseases at NIAID, where he remained as lab chief and later senior scientist until his retirement in 2004.
Competing interests: This study was funded by a grant from the Hotchkiss Brain Institute. Adrian V. Specogna has received salary support awards from the Alberta Heritage Foundation for Medical Research, the University of Calgary, and the Tomorrow’s Research Cardiovascular Health Professional training program. Scott Patten is a Senior Health Scholar with Alberta Innovates, Health Solutions. Michael Hill is supported by the Heart & Stroke Foundation of Alberta/NWT/NU and Alberta Innovates, Health Solutions. Tanvir C. Turin has no disclosures. This does not alter their adherence to all the PLOS ONE policies on sharing data and materials.
Os principais documentos que circulam no mundo científico vêm apontando que as grandes empresas farmacêuticas pouco ou nenhum interesse têm nestas que são cha- madas “doenças negligenciadas” ou “endemias da pobreza”. Apenas os grandes institutos públicos de pesquisa do mundo conferem prioridade a estas doenças. Esses mesmos do- cumentos exortam os institutos de pesquisa dos países endêmicos que assumam seu com- promisso com a resolução desses graves problemas de seus países. Entre estes institutos, encontra-se a Fundação Oswaldo Cruz (FIOCRUZ), ao lado dos NationalInstitutesofHealth, Instituto Pasteur e Sanger Institute.
Objective: To identify the prevalence of post stroke depression (PSD) and their socio-demographic and clinical predictors among elderly stroke survivors after hospital discharge to home. Methods: In this cross-sectional study, 90 elderly stroke survivors were evaluated 14 days after hospital discharge with the following scales: NationalInstitutesofHealth Stroke Scale, Functional Independence Measure, and Geriatric Depression Scale – 15 items (GDS-15). PSD was defined as a score > 5 on GDS-15. After univariate analyses, a multivariate logistic regression model was built to identify independent predictors of PSD. Results: Fourteen days after hospital discharge, 27.7% (95%CI 18.1 to 37.2) of elderly stroke survivors had PSD. Functional dependence was the only independent predictor of PSD (OR: 1.04 95%CI: 1.01 to 1.09; p = 0.02). Conclusion: After stroke, depressive symptoms are common among elderly survivors. The degree of functional dependency is the main predictor of PSD among elderly stroke patients in Brazil.
17. Shulman HM, Kleiner D, Lee SJ, Morton T, Pavletic SZ, Farmer E, et al. Histopathologic diagnosis of chronic graft- versus-host disease: NationalInstitutesofHealth consensus development project on criteria for clinical trials in chronic graft-versus-host disease: II. Pathology Working Group Report 12. Biol Blood Marrow Transplant. 2006 Jan;12(1):31-47. 18. Martin PJ, Weisdorf D, Przepiorka D, Hirschfeld S, Farrell
Between July and November 2005, we sequentially applied the following scales: EQ-5D, modiied Barthel Index (mBI) and the NationalInstitutesofHealth Stroke Scale (NIHSS). he EQ-5D is a generic instrument which approaches ive dimensions ofhealth (mobility, self-help, habitual activities, pain, anxiety/depression), each one with three levels of abnormality. A composite QoL score was calculated based on previously published criteria, where scores varied between 0 and 1, with death re- ceiving a score of 0 and 1 being the best state ofhealth 10 .
Interviews with patients and family members were con- ducted within 48 hours of hospital admission. Data collected included demographics, mode of arrival (emergency medical services versus patients own means), presence of stroke risk factors, NationalInstitutesofHealth Stroke Scale (NIHSS) scores, thrombolysis status and knowledge of stroke warning signs and therapeutic time window using a standardized, structured questionnaire. Admission time was recorded for every patient. The time of symptoms onset or time from last seen well was obtained from the patient or available witness. Door to neuroimaging time ( for all patients) and door to needle time ( for patients treated with thrombolysis) were also registered.
Objective: To validate the minimal criteria of the histopathologic diagnosis of oral chronic graft-versus-host disease, based on the histopathologic classification of the NationalInstitutesofHealth and correlate them with clinical features. Methods: Forty-one specimens containing both oral mucosa and salivary glands were analyzed in slides stained with hematoxylin-eosin. The histological specimens were blindly examined by two trained pathologists using criteria recommended for the histopathologic diagnosis of chronic graft-versus-host disease proposed by the NationalInstitutesofHealth Consensus. The clinical classification of chronic graft-versus-host disease was correlated with analysis of slides. Results: Our data showed that the epithelium was involved in 39/41 specimens, presenting acanthosis (29/70.7%), exocytosis of lymphocytes (29/70.7%), thickening of basal lamina (29/70.7%), and apoptosis (15/36.6%). Connective tissue presented interstitial inflammatory infiltrate (38/92.7%). Minor salivary glands showed periductal fibrosis (38/92.7%), mixed periductal inflammatory infiltrate (32/78%), ductal ectasia (30/73.2%), lymphocytes around and into acinar units (30/73.2%), and interstitial fibrosis (29/70.7%). The most common clinical manifestations were lichenoid aspect (40/97.6%), complaints of sensitivity to oral feeding (38/92.7%), and dry mouth sensation (36/87.8%). Conclusion: This study validated the NationalInstitutesofHealth Consensus of minimal histologic criteria for diagnosis of oral chronic graft-versus-host disease and has not found an association between the severity of clinical manifestation and the histopathological stage.
Objective: Ischemic stroke (IS) prognostic scales may help clinicians in their clinical decisions. This study aimed to assess the performance of four IS prognostic scales in a Brazilian population. Method: We evaluated data of IS patients admitted at Hospital Paulistano, a Joint Commission International certiied primary stroke center. In-hospital mortality and modiied Rankin score at discharge were deined as the outcome measures. The performance ofNationalInstitutesofHealth Stroke Scale (NIHSS), Stroke Prognostication Using Age and NIHSS (SPAN-100), Acute Stroke Registry and Analysis of Lausanne (ASTRAL), and Totaled Health Risks in Vascular Events (THRIVE) were compared. Results: Two hundred six patients with a mean ± SD age of 67.58 ± 15.5 years, being 55.3% male, were included. The four scales were signiicantly and independently associated functional outcome. Only THRIVE was associated with in-hospital mortality. With area under the curve THRIVE and NIHSS were the scales with better performance for functional outcome and THRIVE had the best performance for mortality. Conclusion: THRIVE showed the best performance among the four scales, being the only associated with in-hospital mortality. Keywords: ischemic stroke, prognostic scales, NIHSS, THRIVE, Brazil.
Study developed at Department of Radiology and Imaging Sciences, NationalInstitutesofHealth (NIH) Clinical Center, Bethesda, MD, USA. 1. MD, PhD, Professor at Radiology Department – Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil, Fellow of Radiology and Imaging Sciences, NationalInstitutesofHealth (NIH) Clinical Center, Bethesda, MD, USA. 2. MD, Fellow of Radiology and Imaging Sciences, NationalInstitutesofHealth (NIH) Clinical Center, Bethesda, MD, USA. 3. MD, Staff Clinician, Department of Radiology and Imaging Sciences, NationalInstitutesofHealth (NIH) Clinical Center, Bethesda, MD, USA. 4. MD, Professor at Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. 5.MD, PhD, Director, Department of Radiology and Imaging Sci- ences, NationalInstitutesofHealth (NIH) Clinical Center, Bethesda, MD, USA. Mailing Address: Dr. Marcelo Souto Nacif. Cordell Avenue 4583, 20814 Bethesda, MD, USA. E-mail: email@example.com. Web site: www.msnacif.med.br
5 Department of Pediatrics, University of California San Diego, La Jolla, California, United States of America, 6 NationalInstitutesofHealth, Bethesda, Maryland, United States of America, 7 MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom, 8 Computational Biology group, Department of Integrative Biomedical Sciences, IDM, University of Cape Town, Cape Town, South Africa, 9 School of Interdisciplinary Informatics, University of Nebraska at Omaha, Omaha, Nebraska, United States of America, 10 Department of Biochemistry and Molecular Genetics, School of Medicine, University of Virginia, Charlottesville, Virginia, United States of America, 11 School of Informatics and Computing, Indiana University, Bloomington, Indiana, United States of America, 12 Tufts University School of Medicine, Boston, Massachusetts, United States of America, 13 Department of Biology, Georgetown University, Washington, D.C., United States of America, 14 School of the Biological Sciences, University of Cambridge, Cambridge Systems Biology Centre, Cambridge, United Kingdom, 15 Departments of Computer Science and Bioengineering, University of Illinois, Urbana, Illinois, United States of America
In this paper, we describe a simple taxonomic approach for clinical data mining elaborated by Marczewski and Steinhaus (M-S), whose performance equals the advanced statistical methodology known as the expectation- maximization (E-M) algorithm. We tested these two methods on a cohort of ischemic stroke patients. The comparison of both methods revealed strong agreement. Direct agreement between M-S and E-M classifications reached κ3%, while Cohen’s coefficient of agreement was = 0.ι66(P < 0.0001). The statistical analysis conducted and the outcomes obtained in this paper revealed novel clinical patterns in ischemic stroke patients. The aim of the study was to evaluate the clinical usefulness of Marczewski-Steinhaus’ taxonomic approach as a tool for the detection of novel patterns of data in ischemic stroke patients and the prediction of disease outcome. In terms of the identification of fairly frequent types of stroke patients using their age, NationalInstitutesofHealth Stroke Scale (NIHSS), and diabetes mellitus (DM) status, when dealing with rough characteristics of patients, four particular types of patients are recognized, which cannot be identified by means of routine clinical methods. Following the obtained taxonomical outcomes, the strong correlation between the health status at moment of admission to emergency department (ED) and the subsequent recovery of patients is established. Moreover, popularization and simplification of the ideas of advanced mathematicians may provide an unconventional explorative platform for clinical problems.
ferramentas metodológicas “para eliminar as fontes de possíveis distorções na análise dos resultados”, visto que “as condições dos estudos clínicos controlados com randomização não podem ser cumpridas por completo nos estudos clínicos de acupuntura”. Apresenta as conclusões e recomendações do documento Consensus Statement on Acupuncture, gerado em 1997 pela conferência organizada pelo NationalInstitutesofHealth (NIH). Abarca brevemente os programas de ensino de acupuntura nos Estados Unidos e no Brasil, evidenciando a dificuldade do tratamento, devido à não familiaridade das teorias chinesas à luz da medicina ocidental, bem como a intercorrência de efeitos adversos e alguns aspectos legais e éticos exigidos pela prática de acupuntura.
Resumen | El Accidente Cerebrovascular es el responsable de altas tasas de mortalidad y dependencia funcional en adultos. La terapia precoz con trombolítico intravenoso se ha asociado con un mejor pronóstico funcional. El objetivo de este estudio fue comparar la severidad del déficit neurológico de pacientes que recibieron o no terapia trombolítica después de ACV. Se evaluaron 56 pacientes, 18 que recibieron el trombolítico (Grupo GT) y 38 que no recibieron la terapia trombolítica (GNT). Los individuos fueron evaluados en la hospitalización y en el alta hospitalaria (AH) en cuanto a la severidad del déficit por la NationalInstitutesofHealth Stroke Scale (NIHSS). La media de edad de la muestra estudiada fue de 65,9 ± 11,4 años. Los
For the selection of articles, there was online access to the following databases: Scientific Electronic Library Online (SciELO), US National Library of Medicine/ NationalInstitutesofHealth (PUBMED) Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Literature Latin-American and Caribbean Health Sciences (LILACS). The search in various databases was to broaden the scope of research and minimize potential biases. Descriptors in Health Sciences (DeCS) used for data collection were “Nursing”, “safe sex” and “HIV” combined through the Boolean connector “AND” with the keywords “vulnerability” and “Immune Deficiency Syndrome acquired”, in Portuguese, English, and Spanish.