Últimos itens adicionados do Acervo: Biblioteca Digital da Produção Intelectual e Científica da Unicamp

A Biblioteca Digital da Produção Intelectual e Científica da Unicamp tem por objetivo reunir e disseminar a produção intelectual, acadêmica e cultural da universidade e preservar sua memória institucional, além de contribuir para ampliar a visibilidade da instituição e dos seus pesquisadores em âmbito nacional e internacional.

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‣ Ausência de relação entre hipertensão arterial sistêmica e desempenho cognitivo em idosos de uma comunidade

DI NUCCI, Fabiana Regina Chinaglia de Freitas; COIMBRA, Arlete Maria Valente; NERI, Anita Liberalesso; YASSUDA, Mônica Sanches
Fonte: Faculdade de Medicina da Universidade de São Paulo Publicador: Faculdade de Medicina da Universidade de São Paulo
Tipo: Artigo de Revista Científica
Português
CONTEXTO: Pesquisas documentam que a hipertensão arterial pode estar envolvida no declínio cognitivo em pacientes idosos. Estima-se que até 60% dos idosos apresentem hipertensão arterial, tornando-os mais suscetíveis ao declínio cognitivo. OBJETIVO: Investigar a relação entre hipertensão arterial e desempenho cognitivo em idosos não portadores de demências ou depressão. MÉTODO: A amostra foi constituída por idosos participantes de pesquisa populacional em andamento sobre envelhecimento no município de Amparo (SP). Seguindo critérios de inclusão e exclusão, foram selecionados 80 homens e mulheres (40 hipertensos e 40 normotensos) com idade igual ou superior a 60 anos, equivalentes quanto às variáveis sociodemográficas e de saúde. Para avaliar sintomas depressivos, foi utilizada a Geriatric Depression Scale (GDS). Os testes cognitivos utilizados foram a bateria neuropsicológica Consortium to Establish a Registry for Alzheimer's Disease (CERAD) e o Teste do Desenho do Relógio e Dígitos ordem direta e inversa. A análise estatística foi realizada por meio de análise de regressão logística com modelo univariado e multivariado e análise de conglomerados (cluster analysis). RESULTADOS: Não foram encontradas diferenças estatisticamente significativas para as variáveis cognitivas entre os dois grupos. A diferença para fluência verbal aproximou-se da significância estatística (p = 0...

‣ A gestão do desenvolvimento local no Brasil: (des)articulação de atores, instrumentos e território

MARTINS, Rafael D'Almeida; VAZ, José Carlos; CALDAS, Eduardo de Lima
Fonte: Fundação Getúlio Vargas Publicador: Fundação Getúlio Vargas
Tipo: Artigo de Revista Científica
Português
As ideias de desenvolvimento local são controversas, pouco consensuadas e, às vezes, até antagônicas entre si, tanto no Brasil quanto no debate internacional. Diante dessa polêmica, este artigo discute a gestão do desenvolvimento local a partir de instrumentos selecionados por meio de uma análise exploratória não apenas conceitual e teórica, mas sobretudo prática. Do ponto de vista metodológico, foi realizada uma análise comparada de experiências regionalmente distribuídas, levando-se em conta suas inserções em redes sociais e seus resultados econômicos na região em que está inserida (Sul, Sudeste e Nordeste). Percebe-se que refletir sobre o desenvolvimento local desdobra-se em duas frentes: uma de reprodução da lógica capitalista em escala localizada (tradicional) e outra de tentativas contra-hegemônicas (solidária). Assim, algumas questões centrais foram identificadas para orientar uma reflexão sobre a intervenção dos atores da sociedade civil e dos governos na formulação de propostas e iniciativas de desenvolvimento econômico local.; The ideas of local development are controversial, there is little consensus, and sometimes they are even antagonistic, in Brazil and abroad. Given this controversy, this article discusses local development management...

‣ Charcot foot: Skin temperature as a good clinical parameter for predicting disease outcome

Moura-Neto, Arnaldo; Fernandes, Tulio Diniz; Zantut-Wittmann, Denise Engelbrecht; Trevisan, Rafael Ortiz; Sakaki, Marcos Hideyo; Godoy Santos, Alexandre Leme; Nery, Marcia; Ribeiro Parisi, Maria Candida
Fonte: Elsevier; Clare Publicador: Elsevier; Clare
Tipo: Artigo de Revista Científica
Português
Twenty-eight diabetics presenting with acute Charcot foot were immobilized and the temperature difference between limbs measured at each month. All patients had monthly follow-up visits for a year and the relapse rate was zero. We found that skin temperature is a good parameter to ensure safe immobilization withdrawal. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

‣ A study of pent-up demand in ophthalmology: Divinolandia Hospital/Unicamp

Machado, Maria Cecilia; Kara-Jose, Newton; Arieta, Carlos Eduardo Leite; Lourenco, Jose Leonardo Garcia; Carvalho, Regina de Souza
Fonte: Soc Brasileira Oftalmologia; Rio de Janeiro Publicador: Soc Brasileira Oftalmologia; Rio de Janeiro
Tipo: Artigo de Revista Científica
Português
Objective: To assess the waiting time for eye care identifying the number of patients with each complaint; to investigate how the waiting time may worsen the patient's condition; to check the screening of urgent cases for effectiveness; and to devise means of increasing the medical-surgical care capacity. Methods: A retrospective descriptive survey was conducted using data obtained on 12 occasions during collaborative team visits to provide eyecare services. These initiatives were designed to decrease the waiting time and to treat urgent cases that occurred on each occasion; eyecare services were provided every Saturday, in the period from June to August 2006, in 16 cities of the region covered by Conderg (Consortium for the Development of the Sao Joao da Boa Vista Administrative Region). Results: Referrals used 1,743 (87.1%) of the 2,000 places available. The most frequent diagnoses were refractive errors, with 683 cases, corresponding to 39.1% of the total, followed by cataracts, with 296 cases, corresponding to 20.9%. Of the 238 surgeries indicated, 54.6% were phakectomies. Thirty-five (2.0%) cases were considered urgent. Conclusion: The most common diagnoses made during the team visits to manage the excess demand for eyecare were refractive errors and cataracts...

‣ Relationship between serum uric acid and internal carotid resistive index in hypertensive women: a cross-sectional study

Addeo Cipolli, Jose Alexandre; Ferreira-Sae, Maria Carolina; Martins, Rafael Prado; Pio-Magalhaes, Jose Alexandre; Bellinazzi, Vera Regina; Matos-Souza, Jose Roberto; Nadruz Junior, Wilson
Fonte: Biomed Central Ltd; London Publicador: Biomed Central Ltd; London
Tipo: Artigo de Revista Científica
Português
Background: The impact of serum uric acid (SUA) on arteries of hypertensive subjects remains to be fully established. This study investigated the relationship between SUA and carotid structural and hemodynamic parameters in hypertensive men and women. Methods: Three hundred and thirty eight patients (207 women and 131 men) were cross-sectionally evaluated by clinical, laboratory, hemodynamic and carotid ultrasound analysis. Common carotid diameters, circumferential wall tensions, Young's Elastic Modulus, Stiffness Index, Arterial Compliance and intima-media thickness (IMT) were determined. Internal carotid artery resistive index (ICRI), a hemodynamic measure that reflects local vascular impedance and microangiopathy, was also assessed. Results: Univariate analysis showed no significant correlation of SUA with carotid diameters, elasticity/stiffness indexes, IMT and circumferential wall tensions in both genders. Conversely, SUA correlated with ICRI (r = 0.34; p < 0.001) in women, but not in men, and hyperuricemic women presented higher ICRI than normouricemic ones (0.684 +/- 0.007 vs. 0.649 +/- 0.004; p < 0.001). Stepwise and logistic regression analyses adjusted for potential confounding factors showed that ICRI was independently associated with SUA and hyperuricemia in women. Conclusions: This study demonstrated that SUA was associated with ICRI in hypertensive women...

‣ Predictive Factors of Failure in a Fixed 15 mCi I-131-Iodide Therapy for Graves' Disease

Moura-Neto, Arnaldo; Mosci, Camila; Santos, Allan O.; Amorim, Barbara J.; de Lima, Mariana C. L.; Etchebehere, Elba C. S. C.; Tambascia, Marcos Antonio; Ramos, Celso Dario; Zantut-Wittmann, Denise Engelbrecht
Fonte: Lippincott Williams & Wilkins; Philadelphia Publicador: Lippincott Williams & Wilkins; Philadelphia
Tipo: Artigo de Revista Científica
Português
Purpose: To investigate the factors influencing the success rate in a fixed, 15 mCi approach for treatment of Graves' hyperthyroidism. Material and Methods: The thyroid function outcome ( hyperthyroidism or euthyroidism/hypothyroidism) was verified at least 1 year after radioiodine therapy (RIT) retrospectively and compared with presenting clinical characteristics and pre-RIT parameters in 87 patients treated with I-131-iodide for Graves' disease in a tertiary care center. Results: After RIT, 16 patients (18.4%) became euthyroid, 54 patients (62.1%) became hypothyroid, and 17 (19.5%) remained hyperthyroid. We found no statistically significant association between thyroid function outcome and gender (P = 0.50), ophthalmopathy (P = 0.69), drug used (methimazole or propylthiouracil; P = 1.00), maintenance or withdrawal of thionamides pre-RIT (P = 0.98), or Tc-99m sodium pertechnetate thyroid uptake prior to RIT (P = 0.75). The only variable associated with the success rate was thyroid mass <62 g (P < 0.001). Conclusions: Our study has shown that a fixed 15 mCi approach for treatment of Graves' disease was effective, but high failure rates were observed in patients presenting larger goiters, particularly those with estimated thyroid mass >62 g.

‣ Association of HLA-DRB5*01 with protection against cutaneous manifestations of rheumatoid vasculitis in Brazilian patients

Nishimura, Wester Eidi; Lavras Costallat, Lilian Tereza; Muchinechi Fernandes, Sandra Regina; Conde, Roseneide Aparecida; Bertolo, Manoel Barros
Fonte: Elsevier; New York Publicador: Elsevier; New York
Tipo: Artigo de Revista Científica
Português
Objective: To evaluate the frequency of HLA classes I and II and their association with the cutaneous manifestation of rheumatoid vasculitis (RV) in Brazilian patients. Patients and methods: During one year we selected 130 patients with rheumatoid arthritis (RA) classified according to the American College of Rheumatology, 1987. All patients underwent a clinical and laboratory questionnaire to exclude other causes of cutaneous vasculopathy (neoplasia, infections, illicit drug use, diabetes mellitus, and tobaccoism). Seventy-three patients with any risk factor for other causes of vasculopathy were excluded. Fifty-seven without risk factors for other causes of vasculopathy were included in the study, 17 with RV according to Scott and Bacon's criteria, 1984. Demographic data, time of RA diagnosis, disease activity (DAS28), presence of rheumatoid factor, and anti-cyclic citrullinated peptide antibodies were analyzed. The HLA alleles were typed using the DNA-amplified polymerase chain reaction with low-resolution hybridization and sequence-specific primers. Results: The comparison between the 40 patients without RV and the 17 patients with RV showed an increased frequency of HLAB*14 (Pc = 0.168) and HLA-Cw*08 (Pc = 0.084) in patients with RV and an increased frequency of HLA-DRB5*01 (Pc = 0.048) in patients without RV. Conclusion: The HLA-DRB5*01 may confer protection against that extra-articular manifestation of RA.; Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

‣ Allergenicity of Bos d 5 in Children with Cow's Milk Allergy is Reduced by Transglutaminase Polymerization

Olivier, Celso Eduardo; Villas-Boas, Mariana Battaglin; Netto, Flavia Maria; Zollner, Ricardo de Lima
Fonte: Mary Ann Liebert Inc; New Rochelle Publicador: Mary Ann Liebert Inc; New Rochelle
Tipo: Artigo de Revista Científica
Português
Background: Cow's milk allergy in pediatric patients is an unresolved issue. Among the proteins in milk, bovine whey beta-lactoglobulin (Bos d 5) is the most commonly allergenic. Allergenicity to native cow's milk proteins in humans is a well-studied issue, but very little is known about the allergenicity of cross-linked proteins found in bioprocessed dairy products. Objective: The objective of this study was to evaluate the allergenicity of polymerized bovine whey beta-lactoglobulin in symptomatic children diagnosed with IgE-mediated Bos d 5 hypersensitivity. Methods: Side-by-side skin prick tests with native and polymerized bovine whey beta-lactoglobulin were performed in 22 symptomatic children allergic to cow's milk with detectable specific IgE to Bos d 5 by CAP Systems Pharmacia. A matched control group tolerant to cow's milk and undetectable specific IgE to Bos d 5 was established for comparison. Wheal mean diameter was compared between the native and polymerized groups by paired t-tests. Results: The mean difference in wheal mean diameter observed between native versus polymerized bovine whey beta-lactoglobulin in the paired skin prick test of the allergic group was 2.27 mm (p = 0.02; 95% CI 0.38-4.16). Conclusions: The skin prick test showed a significant reduction in the allergenicity of polymerized compared with native bovine whey beta-lactoglobulin in children with IgE-mediated Bos d 5 hypersensitivity.

‣ A pituitary adenoma secreting follicle-stimulating hormone with ovarian hyperstimulation: treatment using a gonadotropin-releasing hormone antagonist

Garmes, Heraldo Mendes; Grassiotto, Oswaldo Rocha; Fernandes, Yvens Barbosa; Queiroz, Luciano de Souza; Vassalo, Jose; de Oliveira, Daniel Minutti; Benetti-Pinto, Cristina Laguna
Fonte: Elsevier; New York Publicador: Elsevier; New York
Tipo: Artigo de Revista Científica
Português
Objective: To describe the management of a patient with a pituitary adenoma secreting follicle-stimulating hormone (FSH) associated with ovarian hyperstimulation who was treated with a gonadotropin-releasing hormone (GnRH) antagonist. Design: Case report. Setting: University teaching hospital. Patient(s): A woman of reproductive age with secondary amenorrhea and ovarian hyperstimulation due to a pituitary adenoma secreting FSH, which persisted after transsphenoidal surgery. Intervention(s): Clinical treatment with a GnRH antagonist. Main Outcome Measure(s): A decrease in serum estradiol levels. Result(s): During the treatment period, ovarian hyperstimulation decreased as shown by a reduction in estradiol levels and an improvement in the patient's clinical condition and in the ultrasonography parameters. Conclusion(s): The GnRH antagonist was found to be effective for the short-term treatment of ovarian hyperstimulation secondary to a pituitary adenoma secreting FSH, thus representing a therapeutic option that should be taken into consideration in such cases. (Fertil Steril (R) 2012;97:231-4. (C) 2012 by American Society for Reproductive Medicine.)

‣ Effect of age at disease onset in the clinical profile of spondyloarthritis: a study of 1424 Brazilian patients

Skare, T. L.; Leite, N.; Bortoluzzo, A. B.; Goncalves, C. R.; da Silva, J. A. B.; Ximenes, A. C.; Bertolo, M. B.; Ribeiro, S. L. E.; Keiserman, M.; Menin, R.; Carneiro, S.; Azevedo, V. F.; Vieira, W. P.; Albuquerque, E. N.; Bianchi, W. A.; Bonfiglioli, R.
Fonte: Clinical & Exper Rheumatology; Pisa Publicador: Clinical & Exper Rheumatology; Pisa
Tipo: Artigo de Revista Científica
Português
Objectives To analyse demographic and clinical variables in patients with disease onset before and after 40, 45 and 50 years in a large series of Brazilian SpA patients. Methods A common protocol of investigation was prospectively applied to 1424 SpA patients in 29 centres distributed through the main geographical regions in Brazil. The mean age at disease onset was 28.56 +/- 12.34 years, with 259 patients (18.2%) referring disease onset after 40 years, 15.1 (10.6%) after 45 years and 81 (5.8%) after 50 years. Clinical and demographic variables and disease indices (BASDAI, BASFI, BASRI, MASES, ASQoL) were investigated. Ankylosing spondylitis was the most frequent disease (66.3%), followed by psoriatic arthritis (18%), undifferentiated SpA (6.7%), reactive arthritis (5.5%), and enteropathic arthritis (3.5%). Results Comparing the groups according to age of disease onset, those patients with later onset presented statistical association with female gender, peripheral arthritis, dactylitis, nail involvement and psoriasis, as well as negative statistical association with inflammatory low hack pain, alternating buttock pain, radiographic sacroiliitis, hip involvement, positive familial history, HLA-B27 and uveitis. BASDAI, BASFI and quality of life...

‣ Software Application That Evaluates the Diagnostic Accuracy of Nursing Students

Jensen, Rodrigo; Panse Silveira, Paulo Sergio; Siqueira Ortega, Neli Regina; Baena de Moraes, Maria Helena
Fonte: Wiley-Blackwell; Hoboken Publicador: Wiley-Blackwell; Hoboken
Tipo: Artigo de Revista Científica
Português
PURPOSE: Apply the educational software Fuzzy Kitten with undergraduate Brazilian nursing students. METHODS: This software, based on fuzzy logic, generates performance scores that evaluate the ability to identify defining characteristics/risk factors present in clinical cases, relate them with nursing diagnoses, and determine the diagnoses freely or using a decision support model. FINDINGS: There were differences in student performance compared to the year of the course. The time to perform the activity did not present a significant relation to the performance. The students' scores in the diagnoses indicated by the model was superior (p = .01). CONCLUSIONS: The software was able to evaluate the diagnostic accuracy of students. IMPLICATIONS: The software enables an objective evaluation of diagnostic accuracy.; Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

‣ Mini-Mental State Examination sentence writing among community-dwelling elderly adults in Brazil: text fluency and grammar complexity

Neri, Anita Liberalesso; Ongaratto, Lia Lopes; Yassuda, Monica Sanches
Fonte: Cambridge Univ Press; New York Publicador: Cambridge Univ Press; New York
Tipo: Artigo de Revista Científica
Português
Background: In normal aging, the decrease in the syntactic complexity of written production is usually associated with cognitive deficits. This study was aimed to analyze the quality of older adults' textual production indicated by verbal fluency (number of words) and grammatical complexity (number of ideas) in relation to gender, age, schooling, and cognitive status. Methods: From a probabilistic sample of community-dwelling people aged 65 years and above (n = 900), 577 were selected on basis of their responses to the Mini-Mental State Examination (MMSE) sentence writing, which were submitted to content analysis; 323 were excluded as they left the item blank or performed illegible or not meaningful responses. Education adjusted cut-off scores for the MMSE were used to classify the participants as cognitively impaired or unimpaired. Total and subdomain MMSE scores were computed. Results: 40.56% of participants whose answers to the MMSE sentence were excluded from the analyses had cognitive impairment compared to 13.86% among those whose answers were included. The excluded participants were older and less educated. Women and those older than 80 years had the lowest scores in the MMSE. There was no statistically significant relationship between gender...

‣ Is it just lactose intolerance?

Olivier, Celso Eduardo; Silva Lorena, Sonia Leticia; Pavan, Celia Regina; Pereira Goncalves dos Santos, Raquel Acacia; dos Santos Lima, Regiane Patussi; Pinto, Daiana Guedes; da Silva, Mariana Dias; Zollner, Ricardo de Lima
Fonte: Ocean Side Publications Inc; Providence Publicador: Ocean Side Publications Inc; Providence
Tipo: Artigo de Revista Científica
Português
Acquired delayed-onset hypolactasia is a common autosomal recessive condition. Cow's milk allergies, conversely, are less common conditions that may manifest with equivalent symptoms and are able to simulate and/or aggravate lactose intolerance. This study was designed to evaluate the contribution of IgE-mediated cow's milk sensitization to the symptomatology of adult patients with lactose-free diet refractory lactose intolerance. Forty-six adult patients with lactose intolerance and persistent symptoms despite a lactose-free diet underwent skin-prick test to investigate cow's milk, goat's milk, and soy protein-specific-IgE. SDS-PAGE immunoblotting was used to investigate the presence of cow's milk protein-specific IgE. The percentage of patients who had skin reactions to whole cow's milk, alpha-lactalbumin, beta-lactoglobulin, caseins, goat's milk, and soy was 69.5, 36.9, 56.5, 56.5%, 54.3, and 50%, respectively. The percentage of patients with immunoblot-detected IgE specific for alpha-lactalbumin, beta-lactoglobulin, caseins, and bovine serum albumin was 21.7, 63, 67.3, and 2.1%, respectively. IgE -mediated sensitization to cow's milk is a frequent comorbidity in subjects with lactose-free diet refractory lactose intolerance and is worth consideration in patients with this condition. (Allergy Asthma Proc 33:432-436...

‣ GQ-16, a Novel Peroxisome Proliferator-activated Receptor gamma (PPAR gamma) Ligand, Promotes Insulin Sensitization without Weight Gain

Amato, Angelica A.; Rajagopalan, Senapathy; Lin, Jean Z.; Carvalho, Bruno M.; Figueira, Ana C. M.; Lu, Jenny; Ayers, Stephen D.; Mottin, Melina; Silveira, Rodrigo L.; Souza, Paulo C. T.; Mourao, Rosa H. V.; Saad, Mario J. A.; Togashi, Marie; Simeoni, Luiz
Fonte: Amer Soc Biochemistry Molecular Biology Inc; Bethesda Publicador: Amer Soc Biochemistry Molecular Biology Inc; Bethesda
Tipo: Artigo de Revista Científica
Português
The recent discovery that peroxisome proliferator-activated receptor gamma (PPAR gamma) targeted anti-diabetic drugs function by inhibiting Cdk5-mediated phosphorylation of the receptor has provided a new viewpoint to evaluate and perhaps develop improved insulin-sensitizing agents. Herein we report the development of a novel thiazolidinedione that retains similar anti-diabetic efficacy as rosiglitazone in mice yet does not elicit weight gain or edema, common side effects associated with full PPAR gamma activation. Further characterization of this compound shows GQ-16 to be an effective inhibitor of Cdk5-mediated phosphorylation of PPAR gamma. The structure of GQ-16 bound to PPAR gamma demonstrates that the compound utilizes a binding mode distinct from other reported PPAR gamma ligands, although it does share some structural features with other partial agonists, such as MRL-24 and PA-082, that have similarly been reported to dissociate insulin sensitization from weight gain. Hydrogen/deuterium exchange studies reveal that GQ-16 strongly stabilizes the beta-sheet region of the receptor, presumably explaining the compound's efficacy in inhibiting Cdk5-mediated phosphorylation of Ser-273. Molecular dynamics simulations suggest that the partial agonist activity of GQ-16 results from the compound's weak ability to stabilize helix 12 in its active conformation. Our results suggest that the emerging model...

‣ Kinin B1 Receptor in Adipocytes Regulates Glucose Tolerance and Predisposition to Obesity

Mori, Marcelo A.; Sales, Vicencia Micheline; Motta, Fabiana Louise; Fonseca, Raphael Gomes; Alenina, Natalia; Guadagnini, Dioze; Schadock, Ines; Silva, Elton Dias; Torres, Hugo A. M.; dos Santos, Edson Lucas; Castro, Charlles Heldan; D'Almeida, Vania; And
Fonte: Public Library Science; San Francisco Publicador: Public Library Science; San Francisco
Tipo: Artigo de Revista Científica
Português
Background: Kinins participate in the pathophysiology of obesity and type 2 diabetes by mechanisms which are not fully understood. Kinin B-1 receptor knockout mice (B-1(-/-)) are leaner and exhibit improved insulin sensitivity. Methodology/Principal Findings: Here we show that kinin B-1 receptors in adipocytes play a role in controlling whole body insulin action and glucose homeostasis. Adipocytes isolated from mouse white adipose tissue (WAT) constitutively express kinin B-1 receptors. In these cells, treatment with the B-1 receptor agonist des-Arg(9)-bradykinin improved insulin signaling, GLUT4 translocation, and glucose uptake. Adipocytes from B-1(-/-) mice showed reduced GLUT4 expression and impaired glucose uptake at both basal and insulin-stimulated states. To investigate the consequences of these phenomena to whole body metabolism, we generated mice where the expression of the kinin B-1 receptor was limited to cells of the adipose tissue (aP2-B-1/B-1(-/-)). Similarly to B-1(-/-) mice, aP2-B-1/B-1(-/-) mice were leaner than wild type controls. However, exclusive expression of the kinin B1 receptor in adipose tissue completely rescued the improved systemic insulin sensitivity phenotype of B-1(-/-) mice. Adipose tissue gene expression analysis also revealed that genes involved in insulin signaling were significantly affected by the presence of the kinin B-1 receptor in adipose tissue. In agreement...

‣ Leg Blood Pressure Measured in Orthostatic Posture Is Associated With Left Ventricular Mass in Normotensive Subjects

Gemignani, Tiago; Matos-Souza, Jose R.; Franchini, Kleber G.; Nadruz, Wilson, Jr.
Fonte: Nature Publishing Group; New York Publicador: Nature Publishing Group; New York
Tipo: Artigo de Revista Científica
Português
BACKGROUND Changing from a supine to an orthostatic posture is associated with substantial increments in leg blood pressure (BP) levels, which could ultimately influence the hemodynamic burden imposed on the heart. This study investigated the relationship between brachial and leg BP measurements and the left cardiac chamber's structure and assessed the role of body posture changes in this regard. METHODS One hundred and thirty normotensive, nondiabetic, nonsmoking, normolipemic subjects were evaluated by a clinical history, anthropometry, the analysis of metabolic parameters, echocardiography, and the measurement of BP in the arm and the calf in both supine and orthostatic positions. RESULTS Significant correlation coefficients between the leg BP measurements and the cardiac structure were detected, especially between the orthostatic pulse pressure (PP) and the left ventricular (LV) wall thickness (r = 0.38; P < 0.001), the orthostatic PP and the LV mass (r = 0.37; P < 0.001), and the orthostatic systolic BP (SBP) and the left atrial size (r = 0.35; P < 0.001). Stepwise and standard regression analysis adjusted for brachial BP and anthropometric and metabolic variables confirmed that the leg orthostatic PP was independently related to the LV wall thickness and mass. Moreover...

‣ Men's health: a population-based study on social inequalities

Bastos, Tassia Fraga; Goi Proto Alves, Maria Cecilia; de Azevedo Barros, Marilisa Berti; Galvao Cesar, Chester Luiz
Fonte: Cadernos Saude Publica; Rio de Janeiro Publicador: Cadernos Saude Publica; Rio de Janeiro
Tipo: Artigo de Revista Científica
Português
This study evaluates social inequalities in health according to level of schooling in the male population. This was a cross-sectional, population-based study with a sample of 449 men ranging from 20 to 59 years of age and living in Campinas, Sao Paulo State, Brazil. The chi-square test was used to verify associations, and a Poisson regression model was used to estimate crude and adjusted prevalence ratios. Men with less schooling showed higher rates of alcohol consumption and dependence, smoking, sedentary lifestyle during leisure time, and less healthy eating habits, in addition to higher prevalence of bad or very bad self-rated health, at least one chronic disease, hypertension, and other health problems. No differences were detected between the two schooling strata in terms of use of health services, except for dental services. The findings point to social inequality in health-related behaviors and in some health status indicators. However, possible equity was observed in the use of nearly all types of health services.; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES); Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

‣ MRI-Texture Analysis of Corpus Callosum, Thalamus, Putamen, and Caudate in Machado-Joseph Disease

de Oliveira, Marcia S.; D'Abreu, Anelyssa; Franca, Marcondes C., Jr.; Lopes-Cendes, Iscia; Cendes, Fernando; Castellano, Gabriela
Fonte: Wiley-Blackwell; Malden Publicador: Wiley-Blackwell; Malden
Tipo: Artigo de Revista Científica
Português
BACKGROUND/PURPOSE Texture analysis (TA) is a branch of image processing, which attempts to convey "texture" information from digital images, such as magnetic resonance images (MRI). Machado-Joseph disease (MJD) affects mainly cerebellum and brainstem, but recent studies have shown that other cerebral structures may also be affected. OBJECTIVE To investigate subtle structural abnormalities in corpus callosum (CC), thalami, putamen, and caudate nuclei of patients with MJD using TA. METHODS Eighteen healthy volunteers and 18 patients with MJD were studied (mean age at disease onset = 34.7 years; disease duration = 9.6 years; mean expanded CAG in the MJD1 gene = 73). A TA approach based on the gray-level cooccurrence matrix was applied to T1-MRI. Regions of interest were manually segmented for each subject, and texture parameters were computed for each of the aforementioned anatomical structures. RESULTS TA parameters showed differences between the 2 groups for the caudate nuclei, thalami, and putamen. No differences were found for the CC. CONCLUSIONS TA was capable of detecting tissue alterations in MRI of patients with MJD. These alterations were in areas already shown to be affected by histopathological studies. In addition, we confirmed the thalamic involvement in patients with MJD...

‣ Olfactory impairment in familial ataxias

Moscovich, Mariana; Munhoz, Renato Puppi; Teive, Helio A.; Raskin, Salmo; Carvalho, Margarete de J.; Barbosa, Egberto R.; Ranvaud, Ronald; Liu, Jilin; McFarland, Karen; Ashizawa, Tetsuo; Lees, Andrew J.; Silveira-Moriyama, Laura
Fonte: Bmj Publishing Group; London Publicador: Bmj Publishing Group; London
Tipo: Artigo de Revista Científica
Português
The main clinical manifestations of the spinocerebellar ataxias (SCAs) result from the involvement of the cerebellum and its connections. Cerebellar activity has been consistently observed in functional imaging studies of olfaction, but the anatomical pathways responsible for this connection have not yet been elucidated. Previous studies have demonstrated olfactory deficit in SCA2, Friedreich's ataxia and in small groups of ataxia of diverse aetiology. The authors used a validated version of the 16-item smell identification test from Sniffin' Sticks (SS-16) was used to evaluate 37 patients with genetically determined autosomal dominant ataxia, and 31 with familial ataxia of unknown genetic basis. This data was also compared with results in 106 Parkinson's disease patients and 218 healthy controls. The SS-16 score was significantly lower in ataxia than in the control group (p<0.001, 95% CI for beta=0.55 to 1.90) and significantly higher in ataxia than in Parkinson's disease (p<0.001, 95% CI for beta=-4.58 to -3.00) when adjusted for age (p=0.001, 95% CI for beta=-0.05 to -0.01), gender (p=0.19) and history of tobacco use (p=0.41). When adjusted for general cognitive function, no significant difference was found between the ataxia and control groups. This study confirms previous findings of mild hyposmia in ataxia...

‣ Correlation among the visual gait assessment scale, Edinburgh visual gait scale and observational gait scale in children with spastic diplegic cerebral palsy

Bella, Geruza P.; Rodrigues, Nadia B. B.; Valenciano, Paola J.; Silva, Luciana M. A. E.; Souza, Regina C. T.
Fonte: Associacao Brasileira Pesquisa Pos-Graduacao Fisioterapia-Abrapg-Ft; Sao Carlos Publicador: Associacao Brasileira Pesquisa Pos-Graduacao Fisioterapia-Abrapg-Ft; Sao Carlos
Tipo: Artigo de Revista Científica
Português
Background: Gait disorders are very common in children with spastic diplegia cerebral palsy (CP). In order to improve the CP children's gait and to quantify the outcomes of this intervention it becomes essential to perform an instrumented analysis before and after the intervention. Objectives: To analyze the correlation among the Edinburgh Visual Gait Scale (EVGS), the Visual Gait Assessment Scale (VGAS) and the Observational Gait Scale (OGS). Methods: Cross sectional study aiming to analyze the gait of 8 children with spastic diplegia CP with level I or II in the Gross Motor Function Classification System (GMFCS) through the EVGS, VGAS and OGS scales performed by 3 examiners. This study was approved by the Research Ethics Committee of the Universidade Estadual de Campinas (UNICAMP). Weighted Kappa scores were used to analyze the data considering a significance level of 5%. Results: The intra-rater analyses showed a moderate to excellent agreement (k=0.41, 1.00) among the methods of the children's classification, being the comparison between VGAS and the EVGS scales presented the highest level of agreement, while the OGS scale presented a considerable disagreement in comparison with other scales. The inter-rater agreement showed to be predominantly high. Conclusions: The results provide evidence that the VGAS and the EVGS scales are more suitable for children's spastic diplegia CP gait assessment when compared to OGS.