bluuebunny/crossref_metadata_2025 huggingface dataset:
Correlates of increased lean muscle mass in women with polycystic ovary syndrome
Authors: Carmina E , Guastella E , Longo R A , Rini G B , Lobo R A
Published: July 2009

Objective

Muscle mass plays an important role in determining cardiovascular and metabolic risks in polycystic ovary syndrome (PCOS). In addition, whether lean mass influences carotid intima-media thickness (IMT) in PCOS has not been assessed.

Design

Prospective investigation.

Methods

Ninety-five women with PCOS were age- and weight-matched to 90 ovulatory controls. All women had dual X-ray absorptiometry for lean, fat and bone mass, and bone mass density (BMD). Serum testosterone, sex hormone-binding globulin, insulin, and glucose and carotid IMT were determined. Free androgen index (FAI) and insulin resistance (by QUICKI) were calculated.

Results

In PCOS, waist circumference and insulin were higher and QUICKI lower than in controls (P<0.01). Trunk fat mass, % trunk fat, and lean mass were higher in PCOS compared to controls (P<0.01), while total bone mass and BMD were similar. IMT was increased in PCOS (P<0.01) but only 15% of PCOS patients had abnormal (≥0.9 mm) values. Lean mass correlated with fat parameters, insulin, QUICKI, and FAI, but not with total testosterone; and after adjustments for insulin and QUICKI, lean mass still correlated with fat mass (P<0.01) but not FAI. Lean mass correlated with IMT (P<0.01), but this was dependent on insulin. However, excluding those patients with abnormal IMT values, IMT correlated with lean mass independently of insulin. Bone mass correlated with lean and fat mass, but not with insulin or androgen. PCOS patients with ‘pathological’ IMT values had higher % trunk fat, lean mass, and insulin, lower QUICKI, and higher testosterone and FAI compared with those with normal IMT.

Conclusion

Lean mass is increased in PCOS, while bone mass is similar to that of matched controls. The major correlates of lean mass are fat mass and insulin but not androgen. Lean mass also correlated with IMT, and although influenced by insulin, small changes in IMT may partially reflect changes in muscle mass, while clearly abnormal values relate to more severe abnormalities of PCOS.
The d3/fl-GH receptor gene polymorphism does not influence quality of life and body composition in GH-deficient adults receiving GH replacement therapy
Authors: Adetunji O R , MacFarlane I A , Javadpour M , Alfirevic A , Pirmohamed M , Blair J C
Published: July 2009

Context

The growth response to recombinant human growth hormone (rhGH) in GH deficient (GHD) patients may be influenced by polymorphisms in the growth hormone receptor (GHR) gene.

Objectives

To investigate adults with GHD who have been treated with rhGH for more than 1 year to determine the relationship between genomic deletion of exon 3 in the GHR gene and quality of life (QoL), body composition (BC) and serum IGF1 levels, and to compare these variables to a healthy adult control population.

Design

Cross-sectional study.

Methods

A total of 100 healthy adult controls and 131 patients were studied. Deletion of exon 3 in the GHR gene was determined in DNA that was isolated from peripheral blood. QoL was determined using the adult GHD assessment scale and three other validated QoL instruments.

Results

In the control population, the frequency of the genotypes was 53% fl/fl, 40% d3/fl and 7% d3/d3, and in the patient population, 55, 39 and 6% respectively. There was no significant difference in QoL scores and BC in control subjects with the fl/fl genotype compared with those with the d3/d3 or fl/d3 genotype. There was no difference in the rhGH dose required to optimize serum IGF1, QoL or BC in patients with the fl/fl genotype compared with those with the d3/d3 or d3/fl genotype.

Conclusion

Deletion of exon 3 in the GHR gene does not influence adult height, QoL or BC of the normal adult population nor does it influence rhGH dose, QoL and BC in GHD adults treated with rhGH for more than 1 year.
The genetics of induced pluripotency
Authors: Ralston Amy , Rossant Janet
Published: July 2009

The flurry of recent publications regarding reprogramming of mature cell types to induced pluripotent stem cells raises the question: what exactly is pluripotency? A functional definition is provided by examination of the developmental potential of pluripotent stem cell types. Defining pluripotency at the molecular level, however, can be a greater challenge. Here, we examine the emerging list of genes associated with induced pluripotency, with particular attention to their functional requirement in the mouse embryo. Knowledge of the requirement for these genes in the embryo and in embryonic stem cells will advance our understanding of how to reverse the developmental clock for therapeutic benefit.
Ion Irradiation of Ternary Pyrochlores
Authors: Whittle Karl R. , Smith Katherine L. , Blackford Mark G. , Redfern Simon A.T. , Harvey Elizabeth J. , Zaluzec Nestor J. , Lumpkin Gregory R.
Published: July 2009

Synthetic pyrochlore samples Y2Ti2-xSnxO7 (x=0.4, 0.8, 1.2, 1.6), Nd2Zr2O7, Nd2Zr1.2Ti0.8O7, and La1.6Y0.4Hf2O7, were irradiated in-situ using the IVEM-TANDEM microscope facility at the Argonne National Laboratory. The critical temperatures for amorphisation have revealed a dramatic increase in tolerance with increasing Sn content for the Y2Ti2-xSnxO7 series. This change has also found to be linear with increasing Sn content. Nd2Zr1.2Ti0.8O7 and La1.6Y0.4Hf2O7 were both found to amorphise, while Nd2Zr2O7 was found to be stable to high doses (2.5×10^15 ions cm-2). The observed results are presented with respect to previously published results for irradiation stability predictions and structural disorder.
Carbon Nanofiber-Network Sensor Films for Strain Measurement in Composites
Authors: Nguyen Nguyen Q , Lee Sangyoon , Gupta Nikhil
Published: July 2009

A carbon nanofiber-based sensor film is designed and calibrated for force measurement. The sensor is designed for use in structural health monitoring of composite materials. The sensing scheme is based on creating a network of carbon nanofibers on the surface of the composite material. In the experimental scheme a patch of nanofiber reinforced epoxy resin film is developed and adhesively bonded to the laminate. The extension of the sensor film due to the applied force leads to a change in the connectivity of carbon nanofibers in the film, resulting in the change in the resistance of the network. Results show that such sensing schemes have high sensitivity and repeatability. Use of nanofibers can provide a low cost and more efficient alternative to other sensor films that rely on carbon nanotubes.
Pb(Zr,Ti)O3 Nanofibers Produced by Electrospinning Process
Authors: Mensur Alkoy Ebru , Dagdeviren Canan , Papila Melih
Published: July 2009

Lead zirconate titanate (PZT) nanofibers are obtained by electrospinning a sol-gel based solution and polyvinyl pyrrolidone (PVP) polymer, and subsequent sintering of the electrospun precursor fibers. The PVP content of the precursor solution is critical in the formation of the fully fibrous mats. Scanning electron microscope (SEM) is used to examine the morphology of the precursor fibers and annealed PZT nanofibers. The diameters of the precursor PZT/PVP green fibers have increased with the aging of the precursor solution along with an increase in the viscosity. The viscosity of 500 mPa results in successful fibrous mats, yielding green PZT/PVP fibers with a diameter of 400 nm. The fiber mats are then sintered at 700°C. X-ray diffraction (XRD) pattern of the annealed PZT fibers exhibits no preferred orientation and a pure tetragonal perovskite phase. Preparation of piezocomposites by infusion of epoxy into the nanofiber mat facilitates successful handling of the fragile mats and enables measurements of dielectric properties.
Self-Assembly of Polyhedral Hybrid Colloidal Particles
Authors: Perro Adeline , Duguet Etienne , Ravaine Serge , Manoharan Vinothan N.
Published: July 2009

We have developed a new method to produce hybrid particles with polyhedral shapes in very high yield (liter quantities at up to 70% purity) using a combination of emulsion polymerization and inorganic surface chemistry. The procedure has been generalized to create complex geometries, including hybrid line segments, triangles, tetrahedra, octahedra, and more. The optical properties of these particles are tailored for studying their dynamics and self-assembly. For example, we produce systems that consist of index-matched spheres allowing us to define the position of each elementary particle in three-dimensional space. We present some preliminary studies on the self-assembly of these complex shaped systems based on electron and optical microscopy.
Accelerating Copper Dissociated Dislocations to Transonic and Supersonic Speeds
Authors: Branicio Paulo Sergio , Tsuzuki Hélio , Rino José Pedro
Published: July 2009

The acceleration of dissociated dislocations to transonic and supersonic velocities in copper fcc crystals is investigated using molecular dynamics simulations. A thin and long system with a single stationary dislocation is constructed to study the dislocation acceleration process in anisotropic materials, which have two transverse, νT1 and νT2 , and one longitudinal acoustic velocity, νL along the dislocation glide direction. Copper is used as the representative anisotropic material and the embedded atom model is used to calculate interatomic forces. The common neighborhood parameter and local stresses are used to monitor the position and structure of the dislocations. Initial stationary dislocations on the (111) plane, aligned along the direction are accelerated in the direction in two different ways. By using the shear stress of a homogeneously sheared simulation box, and by using a strain-rate deformation obtained by shearing the top and bottom atomic layers in opposite directions by a given velocity. Results show that different levels of stress make dislocations accelerate and move in three distinguished regimes: i) in a plateau of velocities close to 1.6 km/s in the subsonic regime just below νT1; ii) in a narrow range of velocities around 2.6 km/s in the first transonic regime between νT1 and νT2; iii) in the second transonic regime, above νT2 but below νL, with increasing velocities for increasing stresses. Supersonic dislocations moving above νL are generated but their motion is transient. To be generated, they require high stresses above the shear strength which trigger spontaneous nucleation of dislocation dipoles throughout the system. The stacking fault width fluctuates around 35 Å in the subsonic regime but decline subsequently with velocity and fluctuates around 13 Å in the second transonic regime. In the first transonic regime however the stacking fault anomalously increases with velocity. Both the decreasing stacking fault width for fast dislocations and the plateau of velocities in the first transonic regime, indicating the existence of a radiation-free state, are in agreement with theoretical predictions.
Risk factors of heterotopic ossification in traumatic spinal cord injury
Authors: Coelho Cláudia Virgínia C. , Beraldo Paulo Sergio S.
Published: July 2009

OBJECTIVE: Heterotopic ossification (HO) is a complication of the spinal cord injury (SCI). It can result in anchylosis, harming the rehabilitation and quality of life. Previous publications had not elucidated the relation between possible independent variables, the aim of this study. METHOD: From 230 patients with SCI, admitted in 1998 at Hospital SARAH Brasilia, 33 with HO (14.3%; CI95% 10.1-19.6) were compared with 33 controls. The risk factors had been tested in bivariate analysis and in a model of logistic regression. RESULTS: Spasticity (odds ratio=3.8; CI95% 1.15-12.30), number of pressure ulcers (2.1; CI95% 1.08-3.89) and time lapsed since the injury (1.1; CI95% 1.02-1.24) were independently associated with HO. There was a confounder effect among these variables, without interaction. CONCLUSION: Spasticity, pressure ulcer and time of injury are associated with HO in spinal cord injury. The first two factors can be prevented and treatable.
Diffusion tensor imaging of the cervical spinal cord of patients with relapsing-remising multiple sclerosis: a study of 41 cases
Authors: Cruz Jr. L. Celso Hygino , Domingues Romeu C. , Gasparetto Emerson L.
Published: July 2009

OBJECTIVE: To evaluate the fractional anisotropy (FA) values of the multiple sclerosis (MS) plaques and normal-appearing cervical spinal cord (NASC) by diffusion tensor MRI imaging (DTI). METHOD: Forty-one patients with relapsing-remising MS and 37 controls were evaluated. All MRI exams were performed using a conventional protocol, as well as diffusion tensor MR imaging. Regions of interest were placed within the spinal cord lesions and in the normal appearing spinal cord adjacent to the plaque. RESULTS: The FA values were statistically reduced in the plaques compared to the surrounding NASC and to equivalent location in controls. A reduction in FA values was also observed in the spinal cord of MS patients without visible lesions on T2WI. CONCLUSION: We observed reduced fractional anisotropy in the demyelinating plaques and in the NASC of MS patients, corroborating the hypothesis that the histological extension of the MS lesions is more severe than the abnormalities seen in the conventional MRI sequences.
Retrocollis, anterocollis or head tremor may predict the spreading of dystonic movements in primary cervical dystonia
Authors: Godeiro-Junior Clecio , Felício Andre Carvalho , Aguiar Patrícia Maria de Carvalho , Borges Vanderci , Silva Sonia Maria Azevedo , Ferraz Henrique Ballalai
Published: July 2009

BACKGROUND AND PURPOSE: Few studies have attempted to develop clinical predictors for cervical dystonia (CD) aiming at progression of the dystonic movement. METHOD: We retrospectively evaluated 73 patients with primary CD who underwent treatment with Botulinum toxin type-A (BTX-A). The patients were assembled in two groups according to the spread of dystonia during follow-up: spreading and non-spreading CD. We performed a binary logistic regression model using spreading of cervical dystonia as dependent variable aiming to find covariates which increase the risk of spreading. RESULTS: Our logistic regression model found the following covariates and their respective risk ratios: time of disease >18.5 months=2.4, retrocollis=1.9, anterocollis=1.8, head tremor=1.6. CONCLUSION: Time of disease >18.5 months, retrocollis, anterocollis and head tremor may predict spreading of dystonic movement to other regions of the body in CD patients.
Prevalence and impact of headache and migraine among Brazilian Tupiniquim natives
Authors: Domingues Renan Barros , Cezar Priscila Bacchetti , Schmidt Filho Jair , Moraes Filho Milton Nunes de , Pinheiro Mariana Novaes , Marchiori João G. , Brito Francine , Domingues Simone Aires
Published: July 2009

This is the first study to evaluate the prevalence of headache and migraine among Tupiniquim Brazilian natives. A high prevalence of headache was found and the most prevalent headache was migraine. Women were more commonly affected than men. A high impact of headache was found, especially among migraineurs. Half of the headache sufferers were under medical assistance for headache given by the government Family Health Program (PSF). Most of them declared to use common analgesics. None of them was taking prophylactic therapy for this medical problem.
Factors relating to depressive symptoms among elderly people with chronic vestibular dysfunction
Authors: Gazzola Juliana Maria , Aratani Mayra Cristina , Doná Flávia , Macedo Camila , Fukujima Márcia Maiumi , Ganança Maurício Malavasi , Ganança Fernando Freitas
Published: July 2009

OBJECTIVE: To identify factors relating to depressive symptoms among elderly people with chronic vestibular dysfunction. METHOD: This was a cross-sectional study in which 120 elderly people with chronic vestibular dysfunction answered the Geriatric Depression Scale questionnaire. Multivariate linear regression analysis was performed (p<0.05 and 95% CI). RESULTS: The patients presented a mean score of 12.86 ± 6.39 points on the Geriatric Depression Scale, and 67 of them (55.8%) scored above the cutoff of 11 points. The predictive model for worsening of depressive symptoms was composed of female gender, memory and concentration disorders, insomnia, hearing disorders, poor sight, nonuse of walking aids and greater emotional impact of dizziness. CONCLUSION: Greater numbers of depressive symptoms among elderly people with chronic vestibular disease were related to the presence of memory and concentration disorders, insomnia, hearing disorders, very poor sight, greater emotional impact of dizziness, female gender and nonuse of walking aids.
Dementia and mild cognitive impairment in patients with Parkinson's disease
Authors: Tedrus Gloria Maria Almeida Souza , Fonseca Lineu Corrêa , Letro Grace Helena , Bossoni Alexandre Souza , Samara Adriana Bastos
Published: July 2009

The objective of this research was to assess the occurrence of cognitive impairment in 32 individuals (average age: 67.2 years old) with Parkinson' disease (PD). Procedures: clinical-neurological assessment; modified Hoehn and Yahr staging scale (HYS); standard neuropsychological battery of CERAD (Consortium to Establish a Registry for Alzheimer' Disease); Pfeffer questionnaire; and Clinical Dementia Rating. A comparison was made with a control group (CG), consisting of 26 individuals with similar age and educational level but without cognitive impairment. The PD patients showed an inferior performance in the CERAD battery when compared to the CG. Three PD sub-groups were characterised according to cognition: no cognitive impairment - 15 cases; mild cognitive impairment - 10; dementia - 7 cases. There was a significant association between motor disability (HYS) and the occurrence of dementia. Dementia and mild cognitive impairment frequently occur in PD patients and should be investigated in a routine way.
EEG alpha peak frequency analysis during memorizing of figures in patients with mild cognitive impairment
Authors: Schmidt Magali Taimo , Anghinah Renato , Basile Luis Fernando , Forlenza Oreste , Gattaz Wagner Faride
Published: July 2009

OBJECTIVE: To investigate spectral analysis of electroencephalograms (EEG) for the alpha frequency band during rest and cognitive stimulation in healthy adults and individuals with mild cognitive impairment. METHOD: We analyzed 56 EEGs from 28 patients, 7 men and 21 women, 12 of whom (40%) were controls, 16 patients with mild cognitive impairment (60%). Ages ranged from 61 to 83 years. All individuals were patients in the Psycho-geriatric Out-patients Clinic of LIM-27, of the Psychiatric Institute of the Clinicas Hospital of the Faculty of Medicine of the University of São Paulo, IPq-HCFMUSP, between 2004 and 2007. Each patient underwent two exams with an interval of at least six months between them. During the exam, performed after a period of wakefulness and rest, the patients memorized series of pictures. RESULTS: Analysis of spectral potential both at rest and during the memorizing task showed no statistical differences between baseline and final recordings. CONCLUSION: Spectral analysis of EEGs showed coherent results with the clinical stability of the patients evaluated but was unable to distinguish between the control group and patients with MCI. Future studies should include a larger sample and a longer follow up.
Performance of a Brazilian population in the EC 301 calculation and number processing battery: a pilot study
Authors: De Luccia Gabriela , Ortiz Karin Zazo
Published: July 2009

BACKGROUND: From a neuropsychological point of view calculation is a very complex function. A simple arithmetic operation demands many neurocognitive mechanisms that involve verbal, spatial and graphical processing, memory and attention. OBJECTIVE: To verify the calculation and number processing of healthy subjects and the effect of gender, age and schooling on their performance. METHOD: Forty-four normal subjects without complaints or neurological changes were evaluated. RESULTS: The educational level was significantly linked to performance in the majority of tests of the EC 301 battery, whereas no differences were noted regarding age and gender. CONCLUSION: Evaluation of the data of the healthy population shown in this study indicated that educational level can affect calculation and number processing, It is possible to note that battery EC 301 demonstrated sensitivity for appraisal of these abilities and therefore can be employed for clinical assessment in calculation and number disorders.
Reliability of the Brazilian version of the Cambridge Cognitive Examination Revised CAMCOG-R
Authors: Paradela Emylucy Martins Paiva , Lopes Claudia de Souza , Lourenço Roberto Alves
Published: July 2009

The study' goal was to evaluate the reliability of the Cambridge Cognitive Examination Revised-Brazilian version (Br-CAMCOG-R), a neuropsychological battery measuring the global cognitive function. It was applied on 123 elders and retested at a mean interval of 30.7 days; 60 were evaluated by two raters at the same time. The intraclass coefficient for the set of items and for the subscales varied from 0.93 to 0.98. In the retests the agreement was nearly perfect for the set of items. There was no expressive range in the stability of the instrument for sex, age, schooling, or for the presence of dementia. The Cronbach' alpha of the set of items of the test was high (0.89). The Br-CAMCOG-R has obtained a high level of stability with time, agreement among raters, and optimum internal consistency; it can be useful for epidemiological studies and in specialized clinics to evaluate cognitive functions in elders.
Performance of 119 Brazilian children on Stroop paradigm: Victoria version
Authors: Charchat-Fichman Helenice , Oliveira Rosinda Martins
Published: July 2009

BACKGROUND: The Stroop paradigm evaluates susceptibility to interference and is sensitive to dysfunction in frontal lobes. Performance in the Stroop changes along the development. Despite its usefulness in research and clinical settings, there are few studies with Brazilian samples. OBJECTIVE: This study investigates the performance and age effect on Stroop paradigm of Brazilian children. METHOD: A sample of 119 children, aged from 7 to 10 years, was submitted to the Victoria version of Stroop. RESULTS: The pattern of results observed was similar to that observed in foreign studies with adults and children. Younger children were overall slower than older ones (positive correlation between age and naming time). Also, younger children showed more susceptible to interference than older ones (negative correlation between age and number of errors for the maximal interference condition). CONCLUSION: There was an age effect explained in terms of developmental changes in information processing velocity and attention selectivity.
Benign childhood epilepsy with centrotemporal spikes: word and pseudoword discrimination
Authors: Fonseca Lineu Corrêa , Tedrus Glória Maria A.S. , Oliveira Eder Donizetti Peres de , Ximenes Valeria Lopes
Published: July 2009

In the active phase of benign childhood epilepsy with centro-temporal spikes (BCECTS) there may be a fall in scholastic performance. OBJECTIVE: To study lexical decision in children with BCECTS. METHOD: 42 children with BCECTS were compared with a control group with respect to their hits and response time in a visual discrimination of words and pseudowords task (DWPT). RESULTS: The children with BCECTS had a lower percentage of hits for words and pseudowords and showed longer response times for pseudowords. They also frequently showed inferior reading and writing performance in the school performance test. The percentage of hits for pseudowords was lower when there was bilateral, asynchronous epileptiform activity. CONCLUSIONS: The DWPT provided contributions for reading assessments in children with BCECTS. The results indicated the need for attention in detecting reading difficulties in children with BCECTS.
Neuropsychomotor development before and after open-heart surgery in infants
Authors: Rocha Taís Sica da , Guardiola Ana , Piva Jefferson Pedro , Ricachinevski Cláudia Pires , Nogueira Aldemir
Published: July 2009

There are few Brazilian studies on neuropsychomotor follow-up after open-heart surgery with circulatory bypass in infants. Twenthy infants had neurodevelopmental outcomes (neurological exam and Denver II test) assessed before open-heart surgery, after intensive care unit discharge and 3-6 months after hospital discharge. Heart lesions consisted of septal defects in 11 cases (55%). The mean circulatory bypass time was 67 ± 23.6 minutes. Fifteen infants had altered neurological examination and also neurodevelopment delay before surgery. After 6 months it was observed normalization in 6 infants. When Denver II test indexes were analysed, it was observed an improvement in all domains except personal-social. Although those infants were in risk of new neurological findings, an early improvement on neuropsychomotor indexes were seen.
Color doppler evaluation of the influence of type of delivery, sex, postnatal age and time post feeding on full term healthy newborns cerebral blood flow
Authors: Aranha Carlos Alberto , Lederman Henrique Manoel , Segre Conceição A.M.
Published: July 2009

OBJECTIVE: The purpose of this study was to evaluate with Color Doppler the influence of type of delivery, sex, postnatal age and time post feeding on full term healthy newborns cerebral blood flow. METHOD: 50 newborns were studied. The Doppler parameters, peak-systolic velocity, end-diastolic velocity, mean velocity, pulsatility index and resistance index, were measured in the anterior cerebral artery, middle cerebral artery, posterior cerebral artery, and basilar artery. The data were compared and analyzed by statistical tests. Informed consent was obtained from all parents, and the study was approved by institutional ethical committee and review board. RESULTS: We observed not statistically significant differences on cerebral blood flow Doppler parameters in relation to type of delivery, sex, postnatal age and feeding in full term healthy newborns. CONCLUSION: We believe that the knowledge of these cerebral hemodynamic profile of newborns in the first days of life can contribute in an accurate interpretation of cranial Doppler abnormal findings when pathologic flow velocities are analyzed.
Regional cooling for reducing brain temperature and intracranial pressure
Authors: Forte Luis Vicente , Peluso Cássio Morano , Prandini Mirto Nelso , Godoy Roberto , Rojas Salomon Soriano Ordinola
Published: July 2009

OBJECTIVE: To evaluate the effectiveness of regional cooling for reducing brain temperature (BrTe) and intracranial pressure (ICP) in patients where conventional clinical treatment has failed. METHOD: Regional cooling was carried out using ice bags covering the area of the craniectomy (regional method) in 23 patients. The BrTe and ICP were determined using a fiber optic sensor. Thirteen patients (56.52%) were female. The ages ranged from 16 to 83 years (mean of 48.9). The mean APACHE II score was 25 points (11-35). The patients were submitted, on mean, to 61.7 hours (20-96) of regional cooling. RESULTS: There was a significant reduction in mean BrTe (p<0.0001-from 37.1ºC to 35.2ºC) and mean ICP (p=0.0001-from 28 mmHg to 13 mmHg). CONCLUSION: Our results suggest that mild brain hypothermia induced by regional cooling was effective in the control of ICP in patients who had previously undergone decompressive craniectomy.
Remyelination in experimentally demyelinated connexin 32 KnockOut mice
Authors: Ramos Adriano Tony , Maiorka Paulo César , Dagli Maria Lúcia Zaidan , Hosomi Fernando Yutaka Moniwa , Violin Kalan Bastos , Latorre Andréa , Viott Aline de Marco , Masuda Eduardo Kenji , Trost Maria Elisa , Martins Tessie Beck , Graça Dominguita Lühers
Published: July 2009

The aim of this study was to evaluate the role of connexin 32 (Cx 32) during remyelination of the peripheral nervous system, through a local injection of either 0,1% ethidium bromide solution or saline in the sciatic nerve of Cx 32 knockout mice. Euthanasia was performed ranging from 1, 2, 3, 7, 15, 21 to 30 days after injection. Histochemical, immunohistochemical, immunofluorescence and transmission electron microscopical techniques were used to analyze the development of the lesions. Within the sciatic nerves, Schwann cells initially showed signs of intoxication and rejected their sheaths; after seven days, some thin newly formed myelin sheaths with uneven compactness and redundant loops (tomacula) were conspicuous. We concluded that the regeneration of lost myelin sheaths within the PNS followed the pattern already reported for this model in other laboratory species. Therefore, these results suggest that absence of Cx 32 did not interfere with the normal pattern of remyelination in this model in young mice.
Solving the conundrum of Job: a probable biblical description of chronic renal failure with neurological symptoms
Authors: Resende Luiz Antonio de Lima , Kirchner Daniel Rocco , Resende Lucilene Silva Ruiz e
Published: July 2009

The disease described in the Bible' Book of Job is controversial and had been of interest of theologists, psychiatrists, and dermatologists for many years. We describe several signs and symptoms compatible with chronic renal failure with neurological alterations.
Migraine in the triptan era: progresses achieved, lessons learned and future developments
Authors: Bigal Marcelo E. , Krymchantowski Abouch V. , Ho Tony
Published: July 2009

Triptans, serotonin 5-HT1B/1D receptor agonists, more than revolutionizing the treatment of migraine, stimulated also ground breaking research that provided insights into the anatomy, physiology, and molecular pharmacology of migraine. This knowledge, in turn, is stimulating research on new mechanisms of action for the treatment of migraine. Accordingly, it is opportune to critically review the main advances in migraine science that happened in the triptan era. Herein we first review and conceptualize some of the progresses achieved in migraine science during the triptan era. We then review the class of the triptans - mechanism of action and clinical evidence. We close by briefly discussing the class of CGRP receptor antagonists, which is currently being developed for the acute treatment of migraine.
Malformations of cortical development
Authors: Guerreiro Marilisa M.
Published: July 2009

Malformations of cortical development (MCD) have been increasingly identified. The purpose of this presentation is to review the current knowledge of the MCD. Before we address this issue, we will briefly present a review of cortical development. The second part of this presentation will address the most important MCD. Finally, the last part of this presentation will address the correlation between MCD and epilepsy.
Uso de álcool por adolescentes: estudo de base populacional
Authors: Strauch Eliane Schneider , Pinheiro Ricardo Tavares , Silva Ricardo Azevedo , Horta Bernardo Lessa
Published: July 2009

OBJETIVO: Estimar a prevalência e os fatores associados ao uso de álcool por adolescentes. MÉTODOS: Estudo transversal de base populacional realizado entre 2005 e 2006, em Pelotas (RS), com 1.056 adolescentes entre 11 a 15 anos de idade. Foi aplicado um questionário de auto-preenchimento anônimo, baseado no modelo da Organização Mundial de Saúde para uso de drogas. Para análise dos dados, foi utilizada a regressão de Poisson. RESULTADOS: A prevalência de adolescentes que referiram o consumo de bebidas alcoólicas no último mês foi de 23,0% (IC 95%: 20,4;25,4), a prevalência foi de 21,7% entre o sexo feminino e 24,2% entre o masculino. A prevalência de consumo de álcool aos 11 anos foi de 11,9%. Na análise de regressão múltipla, entre adolescentes do sexo masculino, o uso de bebidas alcoólicas foi maior naqueles que relataram o uso de tabaco no último mês, nos mais velhos e naqueles que já tinham tido relação sexual. Nas adolescentes do sexo feminino a idade foi à única variável associada ao uso de bebidas alcoólicas. CONCLUSÕES: O uso de bebidas alcoólicas foi prevalente em ambos os sexos e com início extremamente precoce. Tabagismo e já ter tido relações sexuais também estiveram associados ao uso de bebidas alcoólicas. Há necessidade de medidas preventivas com maior precocidade, visando controlar o uso de álcool na faixa etária dos 11 aos 15 anos.
Renda e inserção profissional dos médicos brasileiros após instituição do Sistema Único de Saúde
Authors: Luiz Ronir Raggio , Bahia Lígia
Published: July 2009

OBJETIVO: Analisar as tendências de inserção no trabalho e composição de renda dos médicos a partir das Pesquisas Nacionais por Amostra de Domicílio (PNAD). MÉTODOS: Os microdados das PNAD de 1988, 1993, 1998 e 2003 foram analisados segundo parâmetros demográficos, sociais e ocupacionais. Na análise exploratória foram consideradas as tendências relacionadas com o emprego e renda dos médicos. As associações estatísticas foram avaliadas pelo teste qui-quadrado. RESULTADOS: Quanto ao perfil demográfico observou-se uma tendência de ampliação da presença de mulheres e de profissionais com mais de 55 anos, além da preservação da alta proporção de brancos. Com relação à ocupação e à renda, observou-se um aumento do empresariamento médico e a manutenção de elevados rendimentos, em termos relativos, especialmente para aqueles que mesclavam ocupações de empregado e empregador. CONCLUSÕES: A possibilidade do exame de características individualizadas de ocupação e renda e dos múltiplos vínculos dos médicos, disponíveis nas PNAD, ainda que limitadas, contribui para o aprofundamento da compreensão dos padrões e mudanças da inserção dos médicos brasileiros no mercado de trabalho no período pós-implementação do Sistema Único de Saúde.
Desigualdade social, crescimento urbano e hanseníase em Manaus: abordagem espacial
Authors: Imbiriba Elsia Nascimento Belo , Silva Neto Antônio Levino da , Souza Wayner Vieira de , Pedrosa Valderiza , Cunha Maria da Graça , Garnelo Luiza
Published: July 2009

OBJETIVO: Analisar a epidemiologia de hanseníase segundo a distribuição espacial e condições de vida da população. MÉTODOS: Estudo ecológico baseado na espacialização da hanseníase em Manaus (AM), entre 1998 e 2004. Os 4.104 casos obtidos do Sistema de Informações de Agravos de Notificação foram georreferenciados de acordo com a localização dos endereços em 1.536 setores censitários urbanos, por meio de quatro técnicas: correios (73,7% dos endereços encontrados); Programa de Cadastro de Logradouros (7,3%); Programa Saúde da Família (2,1%) e folhas de coleta do Instituto Brasileiro de Geografia e Estatística (1,5%). Para cálculo do coeficiente de detecção utilizou a população de 2001. Na análise espacial foi aplicado o método bayesiano empírico local para produzir uma estimativa do risco da hanseníase, suavizando o efeito da flutuação das taxas, quando calculadas para pequenas áreas. Para análise da associação entre espacialização e fatores de risco empregou-se a regressão logística, tendo como variáveis explicativas a ocorrência de casos em menores de 15 anos (indicador de gravidade) e o Índice de Carência Social construído a partir das variáveis do Censo 2000. RESULTADOS: O coeficiente de detecção apresentou-se hiperendêmico em 34,0% dos setores e muito alto em 26,7%. A medida de associação (odds ratio) referente às variáveis explicativas foi significativa. A combinação de baixa condição de vida e ocorrência em menores de 15 anos foi adotada para identificar as áreas prioritárias para intervenção. CONCLUSÕES: A análise espacial da hanseníase mostrou que a distribuição da doença é heterogênea, atingindo mais intensamente as regiões habitadas por grupos em situação de maior vulnerabilidade.
Sorologia da hanseníase utilizando PGL-I: revisão sistemática
Authors: Moura Rodrigo Scaliante de , Calado Karla Lucena , Oliveira Maria Leide W. , Bührer-Sékula Samira
Published: July 2009

A sorologia utilizando o antígeno espécie-específico do Mycobacterium leprae, PGL-I, pode ser um marcador de carga bacteriana em pacientes com hanseníase. Estudos identificaram potencial de uso da sorologia na classificação de pacientes para fins de tratamento, monitoramento de terapia, risco de recidiva e na seleção dos contatos com maior risco de adoecer. Foi realizada uma revisão sistemática e 26 artigos foram incluídos na análise comparativa. Avaliamos os resultados do uso da sorologia PGL-I em diferentes situações, suas limitações e possíveis aplicações. Estudos mostraram eficácia da sorologia PGL-I na classificação de pacientes, monitoramento da terapia, e nas reações hansênicas como teste preditivo. Para diagnóstico precoce e seguimento de população de alto risco, as metodologias utilizadas ainda não demonstraram custo-benefício favorável, porém estudos indicam que a utilização do teste poderá influenciar positivamente nos programas de controle da hanseníase. Com técnicas simples e robustas, o uso da sorologia PGL-I é viável.
Associação do teste sorológico ML Flow com a baciloscopia
Authors: Lyon Sandra , Silva Rozana Castorina da , Lyon Ana Cláudia , Grossi Maria Aparecida de Faria , Lyon Sílvia Helena , Azevedo Maria de Lourdes , Bührer-Sékula Samira , Rocha Manoel Otávio da Costa
Published: July 2009

Realizou-se estudo descritivo e exploratório relacionando as covariáveis aos resultados do teste sorológico ML Flow e baciloscopia. Foram estudados 60 casos novos de hanseníase diagnosticados no Centro de Referência em Dermatologia Sanitária. Para a baciloscopia, foi utilizada a coleta de esfregaço dérmico em quatro sítios, sendo o resultado expresso pelo índice bacilocópico. O ML Flow foi registrado de modo qualitativo e semi-quantitativo. Para o estudo da concordância, foi utilizado o índice de Kappa e, para sua interpretação, os critérios de Landis e Koch. Para análise estatística foram realizados a regressão logística e o teste de Kruskal-Wallis. O ML Flow mostrou forte associação com a baciloscopia, observou-se que o aumento gradativo do índice baciloscópico foi acompanhado pelo aumento semi-quantitativo dos níveis de anticorpos medidos pelo ML Flow, tendo sido positivo em 100% dos casos com baciloscopia positiva. Os resultados deste estudo evidenciaram que o ML Flow, por estar fortemente correlacionado à bacilocopia, poderá tornar-se um valioso instrumento auxiliar na classificação e alocação dos pacientes para fins de tratamento.
O uso da sorologia como ferramenta adicional no apoio ao diagnóstico de casos difíceis de hanseníase multibacilar: lições de uma unidade de referência
Authors: Oliveira Maria Leide W. , Cavaliére Flávia Amorim Meira , Maceira Juan Manoel Pineiro , Bührer-Sékula Samira
Published: July 2009

Sete casos de hanseníase multibacilar (MB) e dois casos com suspeição de hanseníase atendidos em situações distintas do atendimento clínico-dermatológico na Universidade Federal do Rio de Janeiro são descritos. Todos apresentaram dificuldades no diagnóstico visto que não tinham sinais e sintomas cardinais da hanseníase. Um teste sorológico utilizado como ferramenta auxiliar foi útil no processo de diagnóstico ou exclusão de cada caso e facilitou as discussões acadêmicas na hora do exame clínico. A sorologia e baciloscopia de linfa são consideradas como os únicos instrumentos rápidos e de baixo custo para a confirmação de casos MB atípicos, e as vantagens e desvantagens de cada exame são discutidas. Ambos os testes complementam o processo diagnóstico e classificação dos casos para fins terapêuticos. A vantagem da baciloscopia está na sua capacidade de confirmação do diagnóstico. As vantagens da sorologia são: (a) sua aplicabilidade para uso direto por profissionais de saúde no momento da consulta, visto que os resultados são imediatos, (b) a possibilidade da participação dos pacientes no processo, e (c) oferece uma oportunidade para melhor ensino da patogênese da hanseníase.
A influência do teste sorológico ML Flow na classificação da hanseníase
Authors: Grossi Maria Aparecida de Faria , Leboeuf Maria Ana Araújo , Andrade Ana Regina Coelho de , Lyon Sandra , Antunes Carlos Maurício de Figueiredo , Bührer-Sékula Samira
Published: July 2009

Estudo descritivo e exploratório correlacionando o ML Flow, a baciloscopia e a classificação em paucibacilar (PB) e multibacilar (MB), envolveu 1.041 casos novos com hanseníase em 13 municípios de Minas Gerais, de outubro de 2002 a março de 2004. A concordância entre o ML Flow e a classificação pelo número de lesões cutâneas e a baciloscopia foi moderada (Kappa:0,51 e 0,48, respectivamente) e, substancial (Kappa:0,77) com a classificação final. De janeiro de 2000 a março de 2004, a proporção de casos novos MB no Estado, passou de 78,1 para 65,8%. A queda no percentual de MB foi maior nos serviços participantes da pesquisa ML Flow (73,1 para 53,3%). A diferença de PB e MB nos serviços participantes e não participantes, de janeiro a março de 2004, foi estatisticamente significativa, indicando implicação direta e benéfica no tratamento e no controle da endemia em Minas Gerais.
Fatores de risco para a soropositividade do ML Flow em pacientes com hanseníase
Authors: Grossi Maria Aparecida de Faria , Leboeuf Maria Ana Araújo , Andrade Ana Regina Coelho de , Bührer-Sékula Samira , Antunes Carlos Maurício de Figueiredo
Published: July 2009

O diagnóstico precoce da hanseníase, a correta classificação e o estudo dos fatores de risco relacionados à soropositividade, tornam-se importantes para o tratamento do doente e controle da endemia, especialmente, quando a responsabilidade pelo atendimento desses pacientes está sendo absorvida pelos serviços de atenção básica. Estudo descritivo e exploratório utilizando regressão logística avaliou a associação das variáveis: sexo, idade, modo de detecção, número de lesões cutâneas e de nervos acometidos, grau de incapacidade, baciloscopia, com o resultado do teste sorológico ML Flow, em 1.072 casos novos com hanseníase em 13 municípios de Minas Gerais. A soropositividade (50,7%) estava estatisticamente associada aos pacientes com 15 anos ou mais de idade (OR:2,6), mais de cinco lesões cutâneas (OR:7,5), mais de um nervo acometido (OR:2,4) e com baciloscopia positiva (OR:5,5 para IB<2 e OR:191,2 para IB>2), colaborando, assim, com a classificação e o tratamento adequados dos doentes.
Sorologia rápida para hanseníase (teste ML Flow) em pacientes dimorfos classificados como paucibacilares pelo número de lesões cutâneas: uma ferramenta útil
Authors: Barreto Jaison Antônio , Nogueira Maria Esther Salles , Diorio Suzana Madeira , Bührer-Sékula Samira
Published: July 2009

A hanseníase ainda é doença endêmica no Brasil, com cerca de 40.000 novos casos por ano. Devido à dificuldade na realização de exames laboratoriais em campo, classifica-se a forma clínica contando-se lesões, o que pode causar subdiagnóstico de casos multibacilares e falha terapêutica. Para avaliar uma nova ferramenta para diagnóstico de hanseníase multibacilar, o teste ML Flow, foi realizado em 21/77 (27,3%) pacientes com hanseníase dimorfa (6 DV e 15 DT) não tratados, com até cinco lesões de pele, avaliados de acordo com a classificação de Ridley & Jopling (R&J). O teste ML Flow foi positivo em 14/21 (66,6%) pacientes (4 DV e 10 DT); em 7/21 (33,3%) pacientes (5 DT e 2 DV) o resultado foi negativo. A classificação da hanseníase baseada somente na contagem de lesões pode falhar em diagnosticar casos MB. O ML Flow é ferramenta útil no diagnóstico de hanseníase dimorfa com até cinco lesões cutâneas.
Avaliação da concordância entre exames clínicos e laboratoriais no diagnóstico da hanseníase
Authors: Teixeira André Costa , Cruvinel Danilo Lemos , Roma Fábio Rodrigues de , Luppino Leandro Ferreira , Resende Luís Henrique Pereira , Sousa Theo de , Bührer- Sékula Samira , Goulart Isabela Maria Bernardes
Published: July 2009

Este estudo avaliou a concordância entre o diagnóstico clínico e o diagnóstico laboratorial da hanseníase, utilizando os resultados de biópsias dos laboratórios A e B e o teste ML-Flow. A concordância diagnóstica clínico-histopatológica foi de 67,6%. Os laboratórios apresentaram um índice de concordância de 73,7% em relação ao índice baciloscópico, e o laboratório B detectou 25,4% a mais de casos positivos. A maior concordância foi obtida para a forma V, e a menor para a forma I. A maior discrepância diagnóstica ocorreu para a forma DD. A concordância clínico-laboratorial foi de 41,3% para o laboratório A e 54% para o B. O teste ML-Flow reclassificou 10,7% dos pacientes. A classificação espectral é importante para o melhor entendimento da doença e para seu tratamento adequado, mas não é utilizada em centros de saúde, que adotam os critérios simplificados da OMS, que poderiam ser complementados pelo teste ML-Flow. Tal simplificação é inaceitável para os Centros de Referência em assistência, ensino e pesquisa em hanseníase, de modo que é recomendada a padronização pela classificação de Ridley-Jopling.
Soroprevalência do teste ML Flow em contatos de hanseníase de Minas Gerais
Authors: Andrade Ana Regina Coelho de , Grossi Maria Aparecida de Faria , Bührer-Sékula Samira , Antunes Carlos Maurício Figueiredo
Published: July 2009

A hanseníase é um problema de saúde pública no Brasil. As ações de controle estão baseadas no diagnóstico e tratamento dos indivíduos doentes e na vigilância de seus contatos. Os testes sorológicos permitem identificar, entre os contatos, aqueles com maior risco de desenvolver hanseníase. O ML Flow foi utilizado em 2.840 contatos intradomiciliares de casos novos de hanseníase, diagnosticados entre outubro de 2002 e março de 2004, em Minas Gerais. O ML Flow foi positivo em 20,5% dos contatos de hanseníase, sendo maior nos contatos do sexo masculino (22,4%), nos maiores de 15 anos (21,7%), nos contatos de doentes multibacilares (23,9%). A chance de um contato ser soropositivo foi maior se convivia com caso multibacilar (OR=1,75), idade superior a 15 anos (OR=1,38) e sexo masculino (OR=1,25). O acompanhamento desses contatos permitirá, no futuro, avaliar o risco que a soropositividade representa no desenvolvimento de hanseníase.
Fatores associados à soropositividade do teste ML Flow em pacientes e contatos de pacientes com hanseníase menores de 18 anos
Authors: Ferreira Maria Aparecida Alves , Antunes Carlos Maurício de Figueiredo
Published: July 2009

Estudo transversal em menores de 18 anos, sendo 115 casos novos de hanseníase e 1.011 contatos intradomiciliares. Determinaram-se as proporções da soropositividade do ML Flow e fatores associados ao teste positivo. Observou-se soropositividade em 21,7% dos pacientes e 19,7% dos contatos. Nos pacientes, a regressão logística indicou associação com baciloscopia positiva e número de lesões cutâneas maior que cinco. A análise por árvore de decisão mostrou associação com baciloscopia, classificação de Madri, número de nervos acometidos e idade. Nos contatos, as duas análises indicaram as mesmas associações: classificação do caso-índice, idade e tipo de serviço de saúde. As variáveis que explicaram melhor a soropositividade, em menores de 18 anos, são aquelas associadas à maior carga bacilar. Assim, o teste ML Flow poderia ser utilizado também na infância para ajudar na correta classificação dos pacientes para tratamento e na identificação dos contatos com maior risco de desenvolver hanseníase.