bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of amiodarone versus metoprolol in treating atrial fibrillation after coronary artery bypass grafting
Authors: Kamali Alireza , Sanatkar Amir , Sharifi Mehrzad , Moshir Esmaeil
Published: March 2017

Introduction

Atrial fibrillation (AF) is the most common arrhythmia affecting patients in open heart ICU after coronary artery bypass grafting (CABG). Most cardiac surgery textbooks recommend beta blockers as the drug of choice for treating such a condition while many experienced physicians and a number of anesthesiology references offer amiodarone as the drug of choice. Therefore, because of insufficient evidence and the aforementioned controversy, we decided to conduct a study evaluating these two antiarrhythmic medicines.

Methods

This is a double-blind, randomized, clinical trial performed on patients admitted for CABG at Amir al Momenin hospital in Arak province, Iran, who developed new onset AF after surgery. Based on the type of medication used, these patients were randomly divided into two groups: amiodarone (A) group and metoprolol (M) group. Each group consisted of 73 cases. All data were analyzed via SPSS 19.

Results

Among the results achieved in this study, amiodarone was successful in treating AF in 55 patients (73%), while metoprolol achieved normal rhythm in treating AF in 69 patients (92%). With a p-value of 0.04, it seems that metoprolol is more effective in treating AF.

Conclusion

Metoprolol seems to be a most efficacious medication for post-CABG AF (p-value = 0.004).
Correlation between ECG changes and early left ventricular remodeling in preadolescent footballers
Authors: Zdravkovic M , Milovanovic B , Hinic S , Soldatovic I , Durmic T , Koracevic G , Prijic S , Markovic O , Filipovic B , Lovic D
Published: March 2017

The aim of this study was to assess the early electrocardiogram (ECG) changes induced by physical training in preadolescent elite footballers. This study included 94 preadolescent highly trained male footballers (FG) competing in Serbian Football League (minimum of 7 training hours/week) and 47 age-matched healthy male controls (less than 2 training hours/week) (CG). They were screened by ECG and echocardiography at a tertiary referral cardio center. Sokolow–Lyon index was used as a voltage electrocardiographic criterion for left ventricular hypertrophy diagnosis. Characteristic ECG intervals and voltage were compared and reference range was given for preadolescent footballers. Highly significant differences between FG and CG were registered in all ECG parameters: P-wave voltage (p < 0.001), S-wave (V1 or V2 lead) voltage (p < 0.001), R-wave (V5 and V6 lead) voltage (p < 0.001), ECG sum of S V1–2 + R V5–6 (p < 0.001), T-wave voltage (p < 0.001), QRS complex duration (p < 0.001), T-wave duration (p < 0.001), QTc interval duration (p < 0.001), and R/T ratio (p < 0.001). No differences were found in PQ interval duration between these two groups (p > 0.05). During 6-year follow-up period, there was no adverse cardiac event in these footballers. None of them expressed pathological ECG changes. Benign ECG changes are presented in the early stage of athlete’s heart remodeling, but they are not related to pathological ECG changes and they should be regarded as ECG pattern of LV remodeling.
Alveolar cleft closure with iliac bone graft: a case report.
Authors: Tammama Tichvy , Syamsudin Endang , Fathurachman Fathurachman
Published: March 2017

Objective: The present article is to report a case of a patient with alveolar cleft that was treated with the application of iliac bone graftMethods: A nine year-old girl with maxillary alveolar cleft had labioplasty and palatoplasty. The cleft was closed using iliac bone graft and the result was the canine erupts on the graft site get a better alveolar arch, and no more oronasal fistule. Alveolar cleft can be treated by the use of iliac bone graft.Results: Based on the clinical and radiographic development of the patient, the treatment for overall seemed success with the obtain of maxillary arch continuity, provide bone that is available for permanent canine to erupt, optimal alar base reconstruction, the fistulae was eliminated, provide a better nasal alar cartilage support, get a stabil the maxillary segment for orthodontic treatment, and obtain an ideal alveolar morphology.Conclusion: The timing of alveolar bone grafting usually associated with the state of the developing of dentition. Post operative management is important to get a good result, and to prevent any complications.
Revitalisasi Nilai-nilai Sosial Tauhid dalam Merespons Realitas Kekinian
Authors: Zainuddin Ahmad
Published: March 2017

This article discusses the efforts to revitalize social values on the basis of faith in monotheism that is alienated from social reality. So far, Islamic movement is too normative and tends to neglect differentiation, segmentation and social stratification in society. Consequently, the normative sentiments regarding the unity of the people became much more prominent than the actual commitment to defend the weak, displaced and oppressed groups in society. To understand Islam needs to look at the historical determinism, in order to avoid a partial understanding. Pure and social ritual can be performed equally an ideal personification of a true Muslim. The egalitarian character of Islam as a religion of liberation manifestation should be used to understand human conception and reality. Thus, someone will not be separated from his nature as human being who must worship the Lord and carry out social functions, as well as to avoid the trap of ritual extremism or social extremism. The revitalization of social values of monotheism by integrating relational networks of Islam in social change gave birth to anti ethnocentrism, universalism and liberation.
AÇAÍ PULP DEMAND IN THE RETAIL MARKET OF BELÉM, STATE OF PARÁ
Authors: SANTANA ANTÔNIO CORDEIRO DE , SANTANA ÁDINA LIMA DE , SANTANA ÁDAMO LIMA DE
Published: March 2017

ABSTRACT The aim of this work was to estimate the parameters associated to the demand for açaí pulp in the retail market of Belém. Multiple regression analysis was applied to identify the key variables that impact on product consumption and to estimate the price and income elasticities and cross demand. The econometric estimation method applied was the least squares to correct heteroscedastic variance problems. Results have shown that the demand for açaí pulp is price and income inelastic. Fish and cassava flour were confirmed as complementary products of strong influence on the decisions of consumers. Product quality, with regard to its association to Chagas disease, also revealed a strong influence on product choice for household consumption. Finally, the socio-economic benefit of açaí pulp was R$ 762.78 million per year.
Morphological variation among populations of Hemigrammus coeruleus (Characiformes: Characidae) in a Negro River tributary, Brazilian Amazon
Authors: Lazzarotto Henrique , Barros Thiago , Louvise José , Caramaschi Érica Pellegrini
Published: March 2017

ABSTRACT We explored patterns of phenotypic variation in Hemigrammus coeruleus from the Unini River basin, a blackwater river in the Brazilian Amazon. Geometric morphometrics was used to evaluate variation in body shape among populations from four tributaries (UN2-UN5). We found no evidence for sexual dimorphism in body size and shape. However, morphological differences among populations were detected as the analyses recovered significant groups corresponding to each sub-basin, with some overlap among them. The populations from UN2, UN3 and UN5 had more elongate bodies than fish from UN4. The most morphologically divergent population belonged to UN4, the tributary with the most divergent environmental conditions and the only one with seasonally-muddy waters. The morphological variation found among these populations is likely due to phenotypic plasticity or local adaptation, arising as a product of divergent ecological selection pressures among sub-basins. This work constitutes one of the first to employ a population-level geometric morphometric approach to assess phenotypic variation in Amazonian fishes. This method was able to distinguish subtle differences in body morphology, and its use with additional species can bring novel perspectives on the evaluation of general patterns of phenotypic differentiation in the Amazon.
Rede de descanso e ninho: comparação entre efeitos fisiológicos e comportamentais em prematuros
Authors: Costa Kassandra Silva Falcão , Beleza Ludmylla de Oliveira , Souza Lissandra Martins , Ribeiro Laiane Medeiros
Published: March 2017

RESUMO Objetivo comparar os efeitos da aplicação de redes de descanso em prematuros, após a troca de fraldas, em comparação com o ninho. Métodos pesquisa quase experimental, crossover, com 30 prematuros internados em uma unidade de cuidados intermediários de um hospital público de Brasília, DF, no período de novembro de 2011 a março de 2012. Foram avaliados os efeitos das duas intervenções (ninho e rede) após a troca de fraldas. Para análise dos dados utilizou-se o teste t de Student com nível de confiança de 95% (p < 0,05). Resultados os prematuros, quando em rede, se mostraram menos estressados (p=0,002), tiveram menos características definidoras para o diagnóstico de enfermagem “Comportamento Desorganizado do Bebê” (p=0,05) e permaneceram em postura terapêutica em relação ao ninho (p=0,04). Conclusão quando comparado ao ninho, os prematuros posicionados em redes estiveram menos estressados, mais organizados e em melhor postura terapêutica.
Habilidades de aliteração e rima em crianças com distúrbio específico de linguagem
Authors: Pedott Paula Renata , Cáceres-Assenço Ana Manhani , Befi-Lopes Debora Maria
Published: March 2017

RESUMO Objetivo investigar e comparar o desempenho de escolares com distúrbio específico de linguagem (DEL) e em desenvolvimento típico de linguagem em atividades de identificação de aliteração e rima e verificar, em ambas as tarefas, a influência dos distratores semânticos e fonológicos. Método participaram do estudo 12 escolares previamente diagnosticados com DEL (GP) e 48 escolares em desenvolvimento típico (GC) com idade entre 7 anos e 9 anos e 11 meses. Todos cursavam o 2º ou 3º ano do ensino fundamental I e apresentavam audição e inteligência não verbal preservadas. Como medidas experimentais, foram utilizados testes padronizados de identificação de aliteração e rima, com presença de distratores semânticos e/ou fonológicos. Resultados a análise intragrupo demonstrou que ambos os grupos apresentaram desempenho inferior em rima do que em aliteração (GC p<0,001; GP p=0,011). A análise intergrupos indicou que o desempenho do GP foi inferior ao do GC em ambas as tarefas (aliteração p=0,001; rima p=0,009). A análise dos erros indicou que na aliteração, em comparação ao GC, os escolares do GP utilizaram mais distratores semânticos (p=0,004) e outros (p<0,001), enquanto na rima utilizaram mais distratores fonológicos (p=0,048) e outros (p=0,031). Conclusão o GP apresentou dificuldade em tarefas de aliteração e rima, demonstrando estar aquém dos seus pares sem alteração de linguagem. Estes escolares demonstraram analisar os estímulos apresentados nas tarefas de consciência fonológica de forma mais global, o que os fez desprezar aspectos segmentais importantes. Estes dados reforçam a necessidade da inclusão precoce destas habilidades no processo terapêutico da população com DEL.
Diabetes mellitusin a cohort of patients with acromegaly
Authors: Rodrigues Ticiana Costa , Costenaro Fabiola , Fedrizzi Daniela , Oliveira Marcelle D. , Lima Paula B. de , Boschi Vitor , Czepielewski Mauro Antônio
Published: March 2017

OBJECTIVES: To evaluate the presence of diabetes mellitus (DM) in a cohort of patients with acromegaly. METHODS: This was a cross sectional study. RESULTS: Fifty-eight acromegalic patients were assessed. Only 29% met the criteria for cure, and 27% had the disease controlled. Twenty-two had DM; HbA1c was equal to 7.34 ± 2.2%. Most of the diabetic patients (18 out of 22, 82%) did not meet criteria for cure. They were more often hypertensive [16/22 (73%) vs. 17/36 (46%), p = 0.04], and used statins more frequently [14/22 (64%) vs. 8/36 (21%), p = 0.004]. After regression analysis, hypertension was associated with diabetes [odds ratio (OR): 9.28 (95% CI: 1.59 - 54.00), p = 0.01], and cured/ controlled acromegaly was associated with protection against the presence of diabetes [OR: 0.17 (95% CI: 0.03 - 0.78), p = 0.02]. CONCLUSIONS: The presence of DM was associated with active acromegaly and presence of hypertension. However, absolute levels of GH and IGF-1 did not differ between patients with and without diabetes.
Síndrome metabólica em adolescentes de diferentes estados nutricionais
Authors: Stabelini Neto Antonio , Bozza Rodrigo , Ulbrich Anderson , Mascarenhas Luis Paulo Gomes , Boguszewski Margaret Cristina da Silva , Campos Wagner de
Published: March 2017

OBJETIVO: Verificar a prevalência de síndrome metabólica (SM) em adolescentes de diferentes estados nutricionais. SUJEITOS E MÉTODOS: A amostra constitui-se de 582 adolescentes de 12 a 18 anos de idade. A classificação do estado nutricional por meio do índice de massa corporal (IMC) foi realizada utilizando as tabelas de referência do NCHS. A SM foi diagnosticada se três ou mais fatores de risco estivessem presentes. RESULTADOS: A prevalência geral de SM foi 6,7% (IC: 4,9%-9%); rapazes 9,4%; moças 4,1%. Prevalência de SM de 17,2% (IC: 10%-28,2%) e 37,1% (IC: 23,2-53,7%) foi observada em adolescentes com sobrepeso e obesidade, respectivamente. Todos os adolescentes obesos tinham pelo menos um fator de risco presente e demonstraram elevada razão de prevalência de SM comparados aos adolescentes com peso normal (RP: 11,1; IC: 5,75-21,47). CONCLUSÃO: Alta prevalência de SM foi observada em adolescentes obesos, neste sentido, estratégias de prevenção devem ser concentradas no controle do peso corporal desde o início da adolescência.
Genotyping of hepatitis B virus in a cohort of patients evaluated in a hospital of Porto Alegre, south of Brazil
Authors: Becker Carlos Eduardo , Mattos Angelo Alves de , Bogo Maurício Reis , Branco Fernanda , Sitnik Roberta , Kretzmann Nelson Alexandre
Published: March 2017

CONTEXT: In recent years the hepatitis B virus (HBV) genotyping has been considered a relevant factor in the natural history of the disease. OBJECTIVE: To determine hepatitis B virus genotypes and its epidemiological and clinical implications, in a cohort of patients in a hospital in Porto Alegre, South of Brazil. Methods - Sixty seven patients with HBV chronic infection markers who were being treated at ''Complexo Hospitalar Santa Casa'', in Porto Alegre, RS, Brazil, were evaluated. Demographic and epidemiological data were collected from these group of patients by following a standard protocol and ALT and HBeAg were determined. The genotypes and subtypes were determined by in-house PCR and, finally, the samples were sequenced. The level of significance used was 5%. RESULTS: The qualitative analysis for HBV-DNA by PCR was positive in 79.1% of the samples (53/67). The genotype was determined in all positive VHB-DNA samples and the genotypes A (34%), D (60.4%) and F (5.4%) as well as the subtypes adw, ayw and adw4 were found. No significant correlation was found between the hepatitis B virus genotypes and demographic variables considered as risk factors for hepatitis B virus infection. There was also no correlation between the genotypes and the serological and laboratory variables related to liver disease. CONCLUSION: We concluded that the most prevalent genotype found was D. However, further studies are needed to allow us to evaluate the implications of genetic variability in the clinical evolution of HBV carriers.
Melatonin protects the liver and erythrocytes against oxidative stress in cirrhotic rats
Authors: Rosa Darlan Pase da , Bona Silvia , Simonetto Douglas , Zettler Claudio , Marroni Cláudio Augusto , Marroni Norma Possa
Published: March 2017

CONTEXT: Cirrhosis is a progressive chronic hepatopathy which constitutes an irreversible stage of liver dysfunction. OBJECTIVES: To evaluate the oxidative stress in the blood of cirrhotic rats treated with the antioxidant melatonin. METHODS: Cirrhosis was induced through inhalation of carbon tetrachloride. Liver integrity was evaluated by measuring serum enzymes, oxidative damage measured by lipoperoxidation, and antioxidant enzyme activity in erythrocytes. Lipoperoxidation, total nitrates, collagen, and histology by picrosirius staining were evaluated in the livers of these animals (n = 15), which were divided in three groups: control, carbon tetrachloride, and carbon tetrachloride + melatonin. Melatonin (20 mg/kg) was administered intraperitoneal from week 10 of carbon tetrachloride inhalation. In order to shorten the cirrhosis induction time, phenobarbital (0.3 g/L) was added to the animals' drinking water. RESULTS: A significant impairment in the liver integrity of melatonin-treated animals as compared to cirrhotic animals was observed. In rat erythrocytes and liver, lipoperoxidation was significantly increased in the cirrhotic rats as compared to controls, as measured through thiobarbituric acid reactive substances, and significantly decreased in melatonin-treated animals as compared to cirrhotic ones. In blood, a decrease in superoxide dismutase and glutathione peroxidase enzymes was detected in the cirrhotic group as compared to the control group, with increased superoxide dismutase activity when melatonin was administered. A reduction in the levels of total nitrates was detected in the hepatic tissue of the animals in the carbon tetrachloride group as compared to the control group and an increase of these levels in the carbon tetrachloride + melatonin group. As for hepatic collagen, we found a significant increase in the carbon tetrachloride group as compared to the controls and a regression of these values in the treated group. In histology, the rats in the carbon tetrachloride group showed fibrosis and formation of fibrotic nodules, characterizing liver cirrhosis; there was reduction of nodules and fibrosis in the melatonin treated group. CONCLUSION: The data allow us to suggest that the observed oxidative stress is related to the damages caused by carbon tetrachloride and that the use of melatonin can minimize these damages
Prediction of severe complicatons and death in superobese patients undergoing open gastric bypass with the Recife Score
Authors: Martins-Filho Euclides Dias , Katz Leila , Amorim Melania , Ferraz Álvaro Antônio Bandeira , Ferraz Edmundo Machado
Published: March 2017

CONTEXT: Superobese patients who undergo gastric bypass have a greater incidence of complications. The greater incidence of comorbidity in this group leads to a higher surgical risk, and a need for special care. By analyzing the risk factors identified in the preoperative period, scoring them, constructing a score and assessing the occurrence of serious complications and death, we will have elements to identify which patients are at greater risk. OBJECTIVE: To determine the accuracy of the Recife Score for predicting serious postoperative complications and death in superobese patients who undergo Roux-en-Y gastric bypass surgery by the conventional method. METHODS: An ambidirectional study was conducted to validate the diagnostic test on 203 severely obese patients submitted to Roux-en-Y gastric bypass at the Hospital das Clínicas of the Federal University of Pernambuco, Recife, PE, Brazil, from September 1997 to May 2007. The dependent variables were major postoperative complications and death. The independent variable was the Recife Score. The data were analyzed using the Epi-Info 3.5.1 program. The accuracy of the Recife Score was analyzed considering the following parameters: sensitivity, specificity, positive predictive value, negative predictive value, positive verisimilitude ratio and negative verisimilitude ratio. RESULTS: The accuracy of the Recife Score with cut-off points higher than 3 and higher than 5 to predict serious postoperative complications was, respectively, a frequency of complications of 12.3%, with a risk ratio of 2.83, sensitivity of 57.1% and specificity of 69.8%, and 12.5%, with a risk ratio of 1.88, sensitivity of 7.1% and specificity of 96.3%. The accuracy of the Recife Score with cut-off points higher than 3 and higher than 5 to predict death was, respectively, a frequency of death of 7.7%, with a risk ratio of 10.62, sensitivity of 83.3% and specificity of 69.5%, and 12.5%, with a risk ratio of 4.88, sensitivity of 16.7% and specificity of 96.5%. CONCLUSION: A Recife Score >3 prior to conventional gastric bypass presents a high level of accuracy in the prediction of serious postoperative complications and death.
Relationship between caga-positive Helicobacter pylori infection and risk of gastric cancer: a case control study in Porto Alegre, RS, Brazil
Authors: Meine Gilmara Coelho , Rota Cláudia , Dietz Judite , Sekine Setsuo , Prolla João Carlos
Published: March 2017

CONTEXT: Gastric cancer is the second most common cause of cancer related death worldwide. Although Helicobacter pylori has been classified as a class I carcinogen, the presence of infection is not a factor that alone is able to lead to gastric cancer, and one of the possible explanations for this is the existence of different strains of H. pylori with different degrees of virulence. OBJECTIVES: To investigate the association between cagA-positive H. pylori and gastric cancer, using polymerase chain reaction (PCR) for the detection of this bacterial strain. METHODS: Twenty-nine patients with gastric cancer were matched by sex and age (± 5 years) with 58 patients without gastric cancer, submitted to upper gastrointestinal endoscopy. All patients were evaluated for the status of infection by H. pylori (through urease test, histological analysis and PCR for the genes ureA and 16SrRNA) and by cagA-positive strain (through PCR for cagA gene). RESULTS: Evaluating the presence of infection by cagA-positive H. pylori, it was verified that the rate of infection was significantly higher in the group with gastric cancer when compared with the matched controls, occurring in 62.1% and 29.3%, respectively (OR = 3.95; CI 95% 1.543-10.096). CONCLUSIONS: There is an association between cagA-positive H. pylori strain and risk of gastric cancer.
Common bile duct stones: analysis of the videolaparoscopic surgical treatment
Authors: Santo Marco Aurelio , Domene Carlos Eduardo , Riccioppo Daniel , Barreira Lian , Takeda Flavio Roberto , Pinotti Henrique Walter
Published: March 2017

CONTEXT: About 9% of the Brazilian population has gallstones and the incidence increases significantly with aging. The choledocholithiasis is found around 15% of these patients, and a third to half of these cases presented as asymptomatic. Once the lithiasis in the common bile duct is characterized through intraoperative cholangiography, the laparoscopic surgical exploration can be done through the transcystic way or directly through choledochotomy. OBJECTIVE: To evaluate the results and outcomes of the laparoscopic treatment of common bile duct lithiasis. METHODS: Seventy consecutive patients were evaluated. They prospectively underwent the treatment of the lithiasis in the common bile duct and the exploration ways were compared according to the following parameters: criteria on their indication, success in the clearance, surgical complications. It was verified that about ½ of the choledocholithiasis carriers did not show any expression of predictive factors (clinical antecedents of jaundice and/or acute pancreatitis, compatible sonographic data and the pertaining lab tests). The laparoscopic exploration through the transcystic way is favored when there are no criteria for the practice of primary choledochotomy, which are: lithiasis in the proximal bile duct, large (over 8 mm) or numerous calculi (multiple calculosis). RESULTS: The transcystic way was employed in about 50% of the casuistic and the choledochotomy in about 30%. A high success rate (around 80%) was achieved in the clearance of the common bile duct stones through laparoscopic exploration. The transcystic way, performed without fluoroscopy or choledochoscopy, attained a low rate of success (around 45%), being 10% of those by transpapilar pushing of calculi less than 3 mm. The exploration through choledochotomy, either primary or secondary, if the latter was performed after the transcystic route failure, showed high success rate (around 95%). When the indication to choledochotomy was primary, the necessity for choledochoscopy through choledochotomy to help in the removal of the calculi was 55%. However, when choledochotomy was performed secondarily, in situations where the common bile duct diameter was larger than 6 mm, the use of choledochoscopy with the same purpose involved about 20% of the cases. There was no mortality in this series. CONCLUSION: The laparoscopic exploration of the common bile duct was related to a low rate of morbidity. Therefore, the use of laparoscopy for the treatment of the lithiasis in the common bile duct depends on the criteria for the choice of the best access, making it a safe procedure with very good results.
Hepatic hyperplasia and damages induces by zearalenone Fusarium mycotoxins in BALB/c mice
Authors: Chatopadhyay Pronobesh , Pandey Anurag , Chaurasia Asshwani K. , Upadhyay Addesh , Karmakar Sanjev , Singh Lokendra
Published: March 2017

CONTEXT: Zearalenone is a mycoestrogen and considered a mycotoxin. OBJECTIVE: To establish whether zearalenone produced hepatotoxicity via oral administration. METHODS: Zearalenone was orally administered at a dose of 50 mg, 100 mg and 200 mg ZEN/body weight/daily, respectively, for 14 days to three groups of BALB/c mice. Diagnostic modalities used to evaluate hepatic damage and impaired hepatic function pre- and post zearalenone administration included hepatic marker enzyme activity, pentobarbital sleeping time, cytochrome P-450 activities and histopathologic evaluation of liver. RESULTS: Significant histopathologic changes viz. sinusoidal congestion, cytoplasmic vacuolization, hepatocellular necrosis and neutrophil infiltration were observed after evaluating of liver section from each group after accumulated zearalenone exposure. Further, zearalenone exposure increased activities of alanine transaminase, aspartate transaminase and lipid peroxides whereas activities of tissue glutathione and cytochrome P450 were decreased as compared to control mice. Zearalenone also increased the sleeping time and decreased sleeping latency after pentobarbital through intraperitoneal route as compared to control mice which indicates that the impairment of hepatic metabolizing enzymes by zearalenone. CONCLUSION: Zearalenone is a potential hepatotoxin by oral route.
Ultrastructure of developing human muscle: the problem of multinucleation of striated muscle cells
Authors: Minguetti Guilberto , Mair W. G. P.
Published: March 2017

The authors studied by electron microscopy the muscle of 27 human foetuses ranging from 9 weeks to 9 months development. It was possible to observe that disintegration of the plasma membranes of adjacent myoblasts and myotubes which share a common basement membrane tube appears to occur in longitudinally disposed cells of those categories. This may help to explain how further nuclei may be incorporated into well developed myotubes and how the striated muscle cells become multinucleated during embryonic myogenesis and regeneration in vivo.
Ptose palpebral bilateral com paralisia unilateral do olhar vertical para cima: registro de caso
Authors: Brasil Neto Joaquim Pereira , Tosta Elza Dias , Henriques Fernando Guilhon
Published: March 2017

Os autores descrevem um caso de ptose palpebral bilateral com paralisia do olhar vertical para cima, predominantemente unilateral, após acidente vascular hemorrágico do tronco encefálico. Outra característica marcante do quadro clínico foi um estado de sonolência que regrediu lentamente. Após revisão da literatura sobre a fisiopatologia da ptose palpebral e dos movimentos oculares verticais, juntamente com a análise de casos publicados, são propostas explicações para os aspectos clínicos peculiares do presente caso, sempre relacionadas ao resultado da tomografia computadorizada.
Doenças cerebrovasculares em uberlândia: II. epidemiologia e clínica
Authors: Castro Samuel Caputo de , Marcelino Paulo Cesar O. , Santos Marcelo B. , Bacalá Jr. Sílvio
Published: March 2017

Estudamos prospectivamente as características clínicas e epidemiológicas de 157 pacientes com doenças cerebrovasculares em Uberlândia, MG. A incidência de novos casos foi 0,8/1000hab/ano. O prognóstico revelou-se sombrio: 40% de óbitos; apenas 30% retornam ao trabalho; quase 30% dos demais ficam inválidos. Os principais fatores de risco para as DCV em nossa região foram a hipertensão arterial, a doença de Chagas, o ataque isquêmico transitório (este para os infartes completos) e hipercolesterolemia.
Meningoencefalite linfocitária difusa aguda: relato de um caso clínico-patológico
Authors: Pittella José Eymard Homem , Brasileiro Filho Geraldo , Ottoni Carlos Milton Coutinho
Published: March 2017

É descrito um caso autopsiado de meningoencefalite linfocitária difusa aguda numa criança de 8 anos de idade. O quadro clínico teve início 7 dias antes do óbito e foi caracterizado por febre e cefaléia occipital seguidos por piora do estado geral, vômitos e crise convulsiva generalizada com parada cárdio-respiratória e coma. O estudo anatomopatológico mostrou alterações apenas no encéfalo, onde se evidenciou edema cerebral intenso e infiltrado inflamatorio predominantemente linfocitário, perivascular, particularmente na substância branca, em todas as regiões examinadas. Este caso é comparado a outros semelhantes registrados na literatura e discute-se a etiopatogênese da meningoencefalite linfocitária difusa aguda. Destaca-se a necessidade de relatar os casos de encefalite aguda não-bacteriana pelo fato de que a maioria deles permanece com a etiologia indeterminada.
Constelação familiar e esquizofrenia
Authors: Tekzis Antônios I.
Published: March 2017

O presente trabalho tem como propósito estudar o grau de associação entre variáveis familiares e a esquizofrenia. Para o objetivo proposto, foram observados 404 pacientes esquizofrênicos (201 do sexo masculino e 203 do sexo feminino), que estavam internados em 5 hospitais psiquiátricos da área metropolitana de São Paulo. A maioria dos pacientes provinha de uma família de baixo nível sócio-econômico-cultural. O número médio de filhos por mulher, entre as mães dos pacientes, foi bastante elevado, 6,60, enquanto esse valor médio era 4,65 na população geral. Havia desagregação familiar em 55% dos casos estudados. Quanto à idade dos pacientes quando se deu a desagregação familiar, verificou-se que a maioria tinha entre zero e três anos.
The role of the endothelial dependent relaxing factor in the regulation of cerebral circulation
Authors: Salles Antonio A. F. de
Published: March 2017

It has recently been demonstrated that vessel dilation induced by several physiological agents is dependent on an intact vascular endothelium. In order to explain this endothelium dependence, it has been hypothesized that a still unknown chemical substance, generically named Endothelium Dependent Relaxing Factor (EDRF) is necessary for physiological vasodilation. The role of this EDRF in the cerebrovascular physiology is not yet well understood. In this article the cerebrovascular physiological control is reviewed in relationship with possible EDRF actions. The importance of endothelial lesions in the cerebrovascular responses is discussed.
Estudo dos linfócitos circulantes por anticorpos monoclonais na miastenia grave
Authors: Marchiori Paulo E. , Duarte Alberto J. , Birolli M. Izabel A. M. , Figueiredo Cristina A. , Scaff Milberto , Assis J. Lamartine de
Published: March 2017

Os autores avaliam os linfócitos T (CD3, CD4, CD8, CD4/8) por anticorpos monoclonais e rosácea em 20 pacientes e linfócitos B por Fab' por imunofluorescência em 9 pacientes com miastenia grave. Observam elevação significante na população de linfócito B e redução nos linfócitos T totais CD3+ por rosáceas. Não foram observadas modificações nas subpopulações celulares com timectomia e corticosteróides.
Acidente vascular cerebral: análise de 190 casos autopsiados
Authors: Hilbig Arlete , Britto Almiro , Coutinho Ligia M. Barbosa
Published: March 2017

Foram estudados 190 casos de AVC autopsiados no Departamento de Patologia da Fundação Faculdade Federal de Ciências Médicas de Porto Alegre, tendo sido encontrados 94 (49,4%) casos de hemorragia, 67 (35,26%) de infartos e, em 29 (15,26%) casos, observou-se associação de hemorragia e infarto. Tanto os infartos quanto as hemorragias foram mais freqüentes em homens que em mulheres. As médias de idade foram 34,9 anos para as hemorragias e 48,6 anos para os infartos. Dos AVC hemorrágicos, a variedade intraparenquimatosa foi a mais freqüente. Os infartos predominaram em território da artéria cerebral média. As causas determinantes de hemorragia foram principalmente a hipertensão arterial sistêmica e processos infecciosos. No grupo dos infartos, a aterosclerose predominou.
Breve comentário sobre a patogenia da cisticercose espinhal
Authors: Sperlescu A. , Balbo R. J. , Rossitti S. L.
Published: March 2017

A hipótese de que embriões cisticercóticos possam alcançar os espaços suba-racnóideos espinhais por migração descendente a partir de espaços intracranianos previamente infestados não é compatível ao acometimento leptomeníngeo espinhal primário, que observamos em duas pacientes. É sugerido que nesses casos os embriões invadem o sistema nervoso central através do fluxo sangüíneo retrógrado pelo plexo venoso vertebral interno e veias intervertebrais, e que o compartimento intracraniano do liqüido cefalorraqueano possa ser secundariamente invadido pelos cisticercos.
Corpus callosum stimulation and stereotactic callosotomy in the management of refractory generalized epilepsy: preliminary communication
Authors: Marino Jr. Raul , Gronich Gary
Published: March 2017

Corpus callosum stimulation produced by chronically implanted electrodes, placed either by craniotomy or stereotactically, failed to control refractory generalized epilepsy in humans and also in experimentally produced penicillin epilepsy in cats. However, the patients that suffered, craniotomy, frontal lobe retraction or pneumoencephalograms, without callosal section, showed remarkable improvement of their seizure condition due to these, unspecific manipulation effects. Stereotactic anterior callosotomy emerged as a sequel of these functional neurosurgical findings, and as an alternative procedure to preclude undesirable neuropsychological and neurological side effects of split brain syndrome and of brain retraction, associated to conventional callosotomy. Ten patients with various disabling convulsive disorders have undergone this new operation, which showed to be less traumatic and better tolerated than open callosotomy.
Crescimento craniano na criança
Authors: Rosado M. Luiza Constante , Barbieri Marco A. , Bettiol Heloisa , Gomes Uilho A. , Moura-Ribeiro M. Valeriana L.
Published: March 2017

Os autores fazem ampla revisão dos estudos e pesquisas realizadas sobre crânio em recém-nascidos e lactentes, procurando analisar e correlacionar os dados antropométricos com os vários fatores biológicos e sociais maternos.
Aspectos ultra-estruturais da doença de Parkinson
Authors: Mattos James Pitágoras de , Alencar Alexandre , Silva Angela Gonçalves da , Fonseca Maria Evangelina Ferreira
Published: March 2017

A análise de cinco encéfalos humanos, quatro de pacientes parkinsonianos e um de controle, pela microscopia eletrônica de transmissão, evidenciou as seguintes mais freqüentes alterações: empobrecimento de fibras nervosas, grande aumento do espaço intersticial, desintegração do neurópilo e tumefação e degeneração das mitocôndrias. Com exceção das alterações mitocondriais, as demais ocorreram em todos os encéfalos dos parkinsonianos, fato não observado no caso controle, o que torna difícil atribuí-las à fixação. Traduzem, em última análise, a perda neuronal crônica. Houve, também, presença de depósitos amorfos no interior das mitocôndrias, dos axônios, do citoplasma e do espaço intersticial.
Parkinsonismo induzido pela flunarizina
Authors: Sá Paulo N. Discher de , Heinisch Liana Miriam Miranda
Published: March 2017

Os autores estudaram 19 pacientes com parkinsonismo induzido pela flunarizina. A retirada da medicação levou ao desaparecimento dos sinais e sintomas em todos os casos em período de tempo que variou de 7 dias a 10 meses. Depressão foi observada em 68,5% da amostra.
HTLV-I associated myelopathy in Brazil: a preliminary report
Authors: Castro L. H. Martins , Chaves Cláudia J , Callegaro D. , Nóbrega J. P. S. , Scaff M.
Published: March 2017

In this preliminary report the authors present the finding of a high prevalence (37.5%) of seropositivity of antibodies to HTLV-I tested by Western blotting in a sample of 16 Brazilian patients with chronic myelopathies of undetermined origin.
Neurocisticercose I: evolução clínico-laboratorial de 151 casos
Authors: Takayanagui Osvaldo M.
Published: March 2017

A neurocisticercose é grave problema de saúde pública em nosso meio, representando 7,3% das internações e 2,7% dos atendimentos efetuados pela Disciplina de Neurologia da FMRP-USP, no período de 1979 a 1986. Foram selecionados 151 pacientes com o tempo de seguimento mínimo de 6 meses para o estudo da evolução clínico-laboratorial, tema raramente enfocado na literatura. Dos 82 pacientes que apresentaram crises epilépticas, 36,6% desenvolveram na evolução outras formas clínicas da NC. A associação de um segundo quadro neurológico foi observado em 55% dos 40 pacientes com a forma hipertensiva e em 19% dos 21 pacientes com a forma meningítica. Na forma epiléptica a presença de cistos na TC do crânio e/ou de anormalidades no LCR indica risco maior de desenvolvimento posterior de outras síndromes neurológicas. Não se verificaram diferenças significativas nos padrões de anormalidades destes exames nas demais formas clínicas. As lesões císticas na TC do crânio foram acompanhadas de anormalidades do LCR em 90,9%, principalmente a pleocitose e a positividade da reação de Weinberg. Em contraposição, esta proporção foi de apenas 26% naqueles com calcificações.
Mitochondrial myopathy and myoclonic epilepsy
Authors: Arruda Walter O. , Torres Luiz F. B. , lombes Anne , Dimauro Salvatore , Cardoso Belkiss A. , Teive Hélio A. G. , Paola Duilton de , Seixas Ricardo R.
Published: March 2017

The authors describe a family (mother, son and two daughters) with mitochondrial myopathy. The mother was asymptomatic. Two daughters had lactic acidosis and myoclonic epilepsy, mild dementia, ataxia, weakness and sensory neuropathy. The son suffered one acute hemiplegic episode due to an ischemic infarct in the right temporal region. All the patients studied had hypertension. EEG disclosed photomyoclonic response in the proband patient. Muscle biopsy disclosed ragged-red fibers and abnormal mitochondria by electron microscopy. Biochemical analysis showed a defect of cytochrome C oxidase in mitochondria isolated from skeletal muscle. Several clinical and genetic aspects of the mitochondrial encephalomyopathies are discussed.
Síndrome de turcot relato de dois casos
Authors: Vellutini Eduardo A. S. , Pahl Felix H. , Vieira Maria José F. , Aguiar Paulo H. P. de , Vellutini Darcy F. , Almeida Gilberto M. de , Habr-Gama Angelita
Published: March 2017

Os autores descrevem dois pacientes com associação de polipose intestinal e tumor do sistema nervoso central (síndrome de Turcot), discutindo aspectos clínicos, genéticos e terapêuticos.
Benzodiazepínicos padrões de uso, tolerância e dependência
Authors: Bernik Márcio Antonini , Soares Márcia B. de Macedo , Soares Cláudio de Novaes
Published: March 2017

Os autores procuram abordar, através de revisão da literatura recente, os principais aspectos a respeito dos benzodiazepínicos (BDZ), uma das drogas largamente utilizadas em todo o mundo como ansiolíticos e hipnóticos. Para isso, sáo apresentados: breve histórico sobre o surgimento das drogas hipnótico-sedativas e ansiolíticas, e como evoluiu seu consumo (e abuso) ao longo dos últimos anos; os principais conceitos aceitos a respeito dos mecanismos de ação dos BDZ; o desenvolvimento de tolerância aos efeitos dos RDZ, abordando inclusive sua tolerância diferencial; por fim, alguns aspectos sobre a sfndrome de abstinência que se segue à retirada abrupta dos BDZ, enfocando a questão da dependência.
The practice of neurosomnology
Authors: Culebras Antonio
Published: March 2017

Since the application of electrophysiologic methods borrowed from the EEG laboratory to the study of sleeping humans, sleep disorders medicine has acquired the scientific organization necessary for its acceptance in the modern clinic. Although still in evolution, the medical science of sleep is becoming increasingly linked to the functions of the brain, carving in the territory of neurology a parcel of its own that we call neurosomnology. Patients referred to the sleep disorders specialist receive an initial evaluation that includes general medical, neurologic and when appropriate other specialized examinations. In the sleep laboratory patients undergo nocturnal and daytime polysomnography recordings which incorporate electrical brain activity, eye movements, muscle tone, EKG, limb movements, respirations, oximetry and in special circumstances penile tumescence. Scoring of the record is performed by a trained technologist and final interpretation is made by the clinical polysomnographer. The final diagnosis is discussed by the multidisciplinary team and recommendations are given at a follow-up visit by the sleep disorders specialist. Therapeutic management includes sleep hygiene, psychological support, pharmacologic treatment, ventilatory assistance and surgical interventions.
Epilepsia parcial en niños
Authors: Campos O. Patricia , Herrera G. Genaro
Published: March 2017

Se presença una serie retrospectiva y prospectiva de 101 pacientes con diagnóstico de epilepsia parcial evaluados en el Consultório Externo de Neuropediatría del Hospital General Base Cayetano Heredia entre Enero de 1984 y Julio de 1988 con un seguimiento entre 6 meses y 4 alios. Las edades oscilaron entre 6 meses y 13 anos. Encontráronse 19¹% de epilepsias idiopáticas con un 7.7% del total para epilepsias benignas de la infância. Del 39% de epilepsias sintomáticas el mayor porcentaie correspondió en orden de frecuencia a secuelas de problemas perinatales, granulomas tuberculosos y secuelas de infecciones en el sistema nervioso central.
Registro eletromiográfico do fenômeno de strümpell aplicado ao diagnóstico da síndrome piramidal
Authors: Alonso José L.
Published: March 2017

Depois de observar há vários anos que o registro eletromiográfico (BMG) do fenômeno de Strümpell (FS) é útil para diagnosticar síndromes piramidais, a partir de março-1987, o autor passou a pesquisar o FS sistematicamente durante a EMG dos músculos tibials anteriores. Realiza esse registro com eletrodo concêntrico de agulha e calibração de 0,05 a 0,2mV e 1s por divisão. Ao paciente, em decúbito dorsal, é solicitado realizar extensão vagarosa e completa da coxa. O FS positivo caracteriza-se por EMG de contração tônica involuntária, de amplitude crescente, do músculo tibial anterior, simultaneamente à extensão da coxa. Com a finalidade de sistematizar a EMG dessa sincinesia e de avaliar sua utilidade no diagnóstico da síndrome piramidal, o autor revisou os 579 relatórios de EMG realizados a partir de março-1987. Foram encontrados 26 (4,49%) relatórios de pacientes com FS positivo, que serviu para estabelecer ou confirmar que esses pacientes apresentavam síndromes piramidais. Em 20 pessoas de idade parecida e sem sinais de liberação piramidal, a pesquisa do FS se acompanhava de silêncio eletromiográfico (90%) ou de algumas contrações clônicas (10%) do tibial anterior. O autor recomenda a inclusão da pesquisa de FS no exame EMG convencional dos tibials anteriores, especialmente em casos de esclerose lateral amiotrófica e frente a síndromes mielorradiculares ou medulares.
Neurocisticercose incidência no estado do Rio de Janeiro
Authors: Clemente Hamilton A. Martins , Werneck Antonio L. dos Santos
Published: March 2017

Cem pacientes com neurocisticercose, nascidos e residentes no Estado do Rio de Janeiro, foram estudados no período de setembro-1981 a dezembro-1989. A incidência aproximada de um caso por mês mostra que a doença não é rara neste Estado brasileiro.
Shy-Drager syndrome a case report with polysomnography
Authors: Aloe F. S. , Marchiori P.E. , Reimão R.N. , Scaff M.
Published: March 2017

The authors report a case of Shy-Drager syndrome in a 53 year-old male patient. Autonomic failure was made evident by physical examiration as well as laboratory tests. A sleep recording showed decreased percentage of REM sleep and apneas of the central type. The possible mechanisms for this sleep disorder are discussed.
Clinical and epidemiological profile of patients with multiple sclerosis in Uberaba, Minas Gerais, Brazil
Authors: Ribeiro Sônia Beatriz Félix , Maia Danilo Fonseca , Ribeiro João Batista , Cardoso Fabrízio Antônio Gomide , Silva Cátia
Published: March 2017

Multiple sclerosis (MS) is an immune-mediated disease that affects the central nervous system. Clinical presentation and prevalence vary widely around the world. OBJECTIVE: To describe the clinical and epidemiological aspects of patients with MS in Uberaba (MG). METHOD: We conducted a transversal descriptive study, with data analysis of 35 patients with MS. RESULTS: Prevalence of MS was 12.5 cases/100,000 inhabitants, with a predominance in females (71.4%) and Caucasoid (85.7%). The current average age was (43.8 ys). The most common initial symptom was sensory (40%), followed by optical neuritis (25.7%). Expanded Disability Status Scale average score was 2.4. The relapsing-remitting form was predominant (88.6%), most (74.3%) were on immunomodulatory treatment and (40%) had college education. CONCLUSION: Prevalence of MS in Uberaba (MG) is considered average in accordance to Kurtzke and Page and clinical features are consistent with most Brazilian studies.
Neurological diagnoses in the emergency room: differences between younger and older patients
Authors: Lange Marcos C. , Braatz Vera L. , Tomiyoshi Carolina , Nóvak Felipe M. , Fernandes Artur F. , Zamproni Laura N. , Piovesan Élcio J. , Nóvak Edison M. , Teive Helio A.G. , Werneck Lineu C.
Published: March 2017

Neurological diseases are prevalent in the emergency room (ER). The aim of this study was to compare the neurological diagnoses between younger and older patients evaluated in the ER of a tertiary care hospital. METHOD: Patients admitted to the ER who required neurological evaluation in the first 24 hours were separated into two groups based on age, <;50 years old and >50 years old. RESULTS: Cerebrovascular disease (59.6% vs. 21.8%, p<0.01) was most frequent in the >50 years old group. Seizures (8.1% vs. 18.6%, p<0.01) and primary headache (3.7% vs. 11.4%, p<0.01) were most frequent in the <;50 years old group. CONCLUSION: The current study demonstrated that these three neurological diagnoses represented the majority of the neurological evaluations in the ER. National guidelines for ER teams that treat these prevalent disorders must be included in clinical practice and training.