Com o objetivo de analisar o efeito de supressão das emissões otoacústicas transientes com a apresentação de ruído branco contralateral, foram avaliadas 51 crianças de 7 a 11 anos, sendo 15 sem queixas auditivas (grupo controle) e 36 com distúrbio de processamento auditivo (divididas em dois grupos experimentais). Foram determinados, para cada grupo, a média e o desvio padrão dos valores de supressão em cada condição de estímulo: clique linear e clique não linear. Verificou-se que a proporção de ausência do efeito de supressão foi significativamente maior nos grupos de crianças com distúrbio de processamento auditivo, comparados ao grupo controle / This study concerns the suppression of transient evoked otoacoustic emissions by contralateral white noise in children with auditory processing disorder. Fifty-one children between 7 and 11 years old were assessed, being 15 children without auditory complaints (control group) and 36 with auditory processing disorder (divided in two experimental groups). The mean suppression of otoacoustic emissions and standard deviation were determined for each group, both in linear and nonlinear acquisition mode. The results provided evidence that proportion of absence of otoacoustic emissions suppression was significantly higher in auditory processing disorder groups, when compared to control group

O presente trabalho teve como objetivo avaliar o risco de óbito por leucemia, neoplasias do sistema nervoso central e esclerose lateral amiotrófica em adultos em relação à exposição a CM, no Município de São Paulo. Foi realizado um estudo do tipo caso-controle populacional envolvendo 6224 sujeitos. Casos e controles foram extraídos da base de dados do PROAIM, e foram pareados por sexo, faixa etária e distrito administrativo de residência. Foram considerados casos todos os óbitos pelos desfechos específicos, em adultos com 40 anos ou mais, residentes no Município de São Paulo, ocorridos entre 2001 e 2005. Controles foram constituídos por óbitos por todas as outras causas ocorridos no mesmo período. A exposição foi avaliada de acordo com a distância das residências dos sujeitos para a linha de transmissão (LT) mais próxima. Foi encontrado um aumento do risco de óbito por leucemia entre os indivíduos que moravam mais próximo às LT, com OR ajustado de 1,8 (IC 95%: 0,8 - 4,3) e 2,5 (IC 95%: 1,0 - 7,2) entre os sujeitos que moravam a 50 m e entre 50 e 100 m das LT, respectivamente, em relação aos que moravam a mais de 400 m. / This work aimed at evaluating the risk of death by leukemia, brain tumor and amyotrophic lateral sclerosis in adults in relation to magnetic field exposure, in the city of São Paulo. A population-based case-control study was held, and 6224 subjects were enrolled. Cases and controls were selected from the PROAIM database, and were matched by sex, age and district of residence. Cases were all deaths ocurred between 2001 and 2005 by the specific causes, ocurring in adults 40 years and older, living in the city of São Paulo. Controls were selected from all other deaths ocurred at the same period. Exposure to magnetic fields was accessed according to the distance of the dwelling to the closest transmission line (TL). The risk of death by leukemia was elevated within the subjects living closest to the TL, with an adjusted OR of 1,8 (CI 95%: 0,8 - 4,3) and 2,5 (CI 95%: 1,0 - 7,2) for people living within 50 m and within 50 to 100 m away from the TL, respectively, in relation to people living at 400 m or further.

INTRODUÇÃO: Os astrocitomas difusamente infiltrativos são os tumores mais freqüentes de Sistema Nervoso Central (SNC) com uma taxa de 5-7 novos casos por 100.000 pessoas ano. São tumores altamente invasivos e estão associados com alterações de alguns genes como EGF (fator de crescimento epidérmico) e o EGFR (receptor do fator de crescimento epidérmico), que podem criar um aumento da atividade mitogênica, acarretando aumento de proliferação e maturação celular, apoptose, angiogênese e metástase. O nível de expressão destes genes pode ser influenciado por alterações genéticas, como a presença de polimorfismos. Uma mudança única de base (SNP) pode alterar a expressão gênica e, sendo assim, estar associada ao aumento do risco de desenvolver astrocitomas. Nesse trabalho, foram analisados 2 SNPs na região não traduzida (c.-191C>A e c.-216G>T) e um SNP no exon 16 (c.2073A>T) do gene EGFR, e um outro SNP na região não traduzida no gene EGF (c.61A>G). Os SNPs foram associados a expressão gênica do EGFR e a sobrevida dos pacientes. MÈTODOS: Foi realizado um estudo caso-controle com 193 casos de astrocitomas difusamente infiltrativos e 200 controles por amplificação por PCR seguido de digestão enzimática. Os produtos digeridos das amostras foram analisados por eletroforese em gel de agarose e poliacrilamida e corados com brometo de etídeo. A expressão gênica foi realizada após extração de RNA do tecido tumoral seguida de transcrição reversa e PCR em tempo real. Testes de qui-quadrado, odds ratio (OR), intervalo de confiança 95% (IC95%), t de Student e curvas de Kaplan-Meier foram realizados para análises estatística. RESULTADOS: A análise das freqüências dos genótipos dos polimorfismos mostrou uma diferença na distribuição entre casos e controles para o polimorfismo c.2073A>T. Pacientes com o genótipo TT apresentou um menor risco para astrocitoma quando comparados com o genótipo AA (OR=0,51, IC95%=0,29-0,99). Nenhuma correlação foi encontrada para os outros polimorfismos analisados. Também não foi encontrada correlação entre os genótipos dos polimorfismos e os níveis de expressão de EGFR e a sobrevida dos pacientes. CONCLUSÃO: Nosso trabalho mostrou haver um possível fator de proteção quando o paciente é portador do genótipo TT, o que pode levar a uma diminuição do risco de desenvolver o tumor. Pacientes com genótipo TT do polimorfismo c.2073A>T do gene EGFR apresentam um menor risco para astrocitomas difusamente infiltrativos do que os com o genótipo AA. / INTRODUCTION: Diffusely infiltrative astrocytomas are the most frequent tumors of the Central Nervous System (CNS) with a rate of 5-7 new cases in 100,000 individuals per year. They are highly invasive, and they are associated to alterations in some genes as EGF (epidermal growth factor) and EGFR (epidermal growth factor receptor), which may increase mitogenic activity, leading to increase of proliferation, cellular maturation, apoptosis, angiogenesis, and metastasis. Genetic alterations, as presence of polymorphisms of single nucleotide change (SNP) could influence their expression level, and thus could be associated to increased risk in developing astrocytomas. In the present study, two SNP of non-coding region (c.-191C>A and c.-216G>T) and one SNP in exon 16 (c.2073A>T) of EGFR, and another SNP of non-coding region of EGF (c.61A>G) were analyzed. The SNPs were associated to EGFR expression level and to survival time. METHOD: a case-control study of 193 of diffusely infiltrative astrocytomas and 200 controls was carried out, with PCR amplification and enzymatic digestion, which products were analyzed in agarose gel or polyacrylamide gel electrophoresis stained by ethidium bromide. EGFR expression level was studied by real time PCR after RNA extraction followed by reverse transcription of tumor tissues compared to epileptic non-neoplastic brain tissues. Stastistical analysis were performed by chi-square, odds ratio (OR), 95% confidence interval (95% CI), Student-t test and Kaplan Meier. RESULTS: The polymorphic genotype frequency was different between case and controls for the polymorphism c.2073A>T. Patients with TT genotype presented lower risk to develop astrocytoma when compared to genotype AA (OR=0.51, CI95%=0.29- 0.99). No other correlation was observed for the remaining studied polymorphisms. There was neither correlation between the polymorphic genotypes and the EGFR expression levels nor with survival time. CONCLUSION: The present study showed a possible protection factor in developing astrocytomas for the patients harboring the genotype TT of c.2073A>T polymorphism of EFGR, thus the patients presenting TT genotype have lower risk to develop diffusely infiltrative astrocytoma than patients presenting the genotype AA.

No description available.

Le mésothéliome pleural est considéré comme très spécifique d’une exposition à l’amiante. Cependant, certains aspects de l’étiologie de cette maladie n’ont pas encore été bien caractérisés. Les objectifs de cette étude sont : i) d’estimer la relation dose-effet entre exposition professionnelle aux fibres d’amiante et survenue de mésothéliome pleural selon différents indicateurs temporels d’exposition ; ii) d’étudier l’effet d’une exposition professionnelle aux laines minérales et aux poussières alvéolaires de silice cristalline libre sur le risque de survenue de mésothéliome pleural et iii) d’identifier les professions et secteurs d’activité à risque de survenue de mésothéliome pleural à partir de données recueillies sur une période de 20 ans. Les cas provenaient de ceux recrutés dans une précédente étude cas-témoins réalisée entre 1987 et 1993 et des cas enregistrés dans le programme national de surveillance du mésothéliome entre 1998 et 2006 (1 199 hommes). Les témoins ont été appariés en fréquence sur l’année de naissance et le sexe (2 378 hommes). L’exposition professionnelle à l’amiante, aux laines minérales et à la silice a été évaluée à partir de matrices emplois-exposition. Les relations dose-effet ont été estimées à l’aide du modèle logistique et leur forme a été obtenue grâce à l’utilisation de fonctions splines cubiques restreintes. Si la relation dose-effet à l’amiante est bien confirmée (particulièrement aux faibles doses), cette étude apporte de nouveaux résultats sur la relation temps-effet (rôle du temps écoulé depuis la dernière exposition ou effet de l’âge à la première exposition). Elle ouvre également de nouvelles perspectives sur le rôle des co-expositions (laines minérales) et permet d’identifier de nouvelles activités à risque, comme les mécaniciens automobiles. / Asbestos exposure is recognized as the primary cause of pleural mesothelioma. However, some aspects of etiology of this disease have not been well characterized. The objective of this study was to elucidate dose-response relationships of temporal pattern of occupational asbestos exposure in males, using case-control data, to study effect of man made vitreous fibers and silica dust on the risk of pleural mesothelioma and finally, to describe occupations and industries at high risk for this cancer among men in France according a period of twenty years of observation. Cases came from a French case-control study conducted in 1987-1993 and from the French National Mesothelioma Surveillance Program in 1998-2006 (1,199 males). Population controls were frequency matched by sex and year of birth (2,378 males). Occupational asbestos exposure was evaluated with a job-exposure matrix. The dose-response relationships were estimated using logistic regression models and form of this relationship were estimated using restricted cubic spline functions. Dose-response relationship was confirmed (particularly for lowest doses). However, this study provides new results about time-effect relationships (role of time since last exposure or effect of age at first exposure). This study opens up new prospects on the role of co-exposure (mineral wool) and permit to identify new activities at risk for pleural mésothéliome as motor vehicle mechanics.

INTRODUÇÃO: O desenvolvimento das habilidades auditivas sofre influência dos estímulos sonoros aos quais as crianças são expostas. Filhos ouvintes de pais surdos (CODAs - Children of Deaf Adults) geralmente não recebem os estímulos de fala da mesma forma que crianças filhas de ouvintes. Tendo em vista que as informações sonoras são importantes para o processo maturacional do sistema auditivo, torna-se pertinente a análise das habilidades auditivas de CODAs que foram pouco expostas à linguagem oral na primeira infância. OBJETIVO: Comparar o processamento auditivo de crianças filhas de surdos, que foram pouco expostas à língua oral no início de suas vidas, com o de crianças filhas de ouvintes. MÉTODO: Participaram deste estudo 60 crianças, na faixa etária entre 5 e 10 anos de idade, com avaliação audiológica básica (audiometria, logoaudiometria e imitanciometria) dentro dos limites de normalidade, destras, sem histórico de doenças sistêmicas e/ou neurológicas que pudessem afetar o sistema nervoso central e sem aprendizado prévio de música ou de segunda língua oral. Foram formados dois grupos semelhantes quanto a idade e sexo, sendo o Grupo Estudo (GE) composto por 30 crianças filhas de surdos sinalizadores, e o Grupo Controle (GC), por 30 crianças filhas de ouvintes. Os testes selecionados foram: Pediatric Speech Intelligibility em português, Dicótico de Dígitos, Padrão de Frequência, Gaps-In-Noise e também testes de Memória para Sons Instrumentais e Verbais. RESULTADOS: Houve diferença estatisticamente significante de desempenho entre os dois grupos, em todos os testes aplicados, com pior desempenho para o GE. Na análise de desempenho dos grupos por faixa etária, foi possível observar que a média de desempenho do GE ficou abaixo da apresentada pelo GC em todos os testes e em todas as idades avaliadas, sendo a diferença de desempenho entre os grupos maior em faixas etárias menores (5 e 6 anos). CONCLUSÕES: Pode-se concluir que a pouca exposição a estímulos linguísticos orais no início da infância, associada a fatores específicos da vivência de grande parte dos CODAs estudados, contribuiu para o baixo desempenho do GE nos testes. Assim, esses resultados indicam que estímulos sonoros ambientais, sobretudo os de linguagem oral, exercem importante influência no desenvolvimento das habilidades auditivas. Este estudo chama a atenção para a importância do acompanhamento auditivo de filhos ouvintes de pais surdos, assim como para a necessidade de exposição destas crianças aos sons linguísticos orais desde o início de suas vidas / INTRODUCTION: The development of auditory skills is influenced by the sound stimuli to which children are exposed. Hearing children of deaf adults (CODAs) do not usually receive speaking stimuli in the same way as those of hearing adults. Given that sound information is important to the maturation process of the auditory system, it is pertinent to analyze the auditory skills of hearing children of deaf signer adults that were little exposed to oral language in their infancy. OBJECTIVE: To compare the auditory processing of CODAs that were little exposed to oral language in their early infancy with that of children of hearing adults. METHOD: A total of 60 children aged 5-10 years participated in the present study. All participants received normal ratings in their basic audiometric evaluation (audiometry, speech audiometry and imitanciometry). They were right-handed, without a history of systemic and/or neurological diseases that might affect the central nervous system, and without previous musical or second spoken language training. Two groups similar in age and sex were established: the Study Group (SG) comprised 30 children of deaf signer adults and the Control Group (CG) comprised 30 children of hearing adults. The tests selected were Pediatric Speech Intelligibility, Dichotic Digits, Pitch Pattern, Gaps-In-Noise, and Memory for Instrumental Sounds and Verbal Sounds. RESULTS: The SG performed significantly worse than the CG for all tests. Moreover, an analysis of the performance of the groups per age range revealed that for all age ranges assessed, the SG performance average was below that of the CG average; the performance difference between the groups was greater in younger children (5- and 6-year olds). CONCLUSIONS: It can be concluded that the low exposure to oral linguistic stimuli during infancy, associated with specific aspects of the experience of a large proportion of the CODAs studied, contributed to the low performance of the SG in the tests. These results indicate that ambient sound stimuli, especially those related to oral language, strongly influence auditory skills. This study highlights to the importance of the auditory follow-up of hearing CODAs, as well as to the need for exposing these children to oral linguistic sounds from a very early age

No description available.

Contexte: L’iode est un micronutriment provenant des aliments. Il est établi que, dans les régions d'endémie goitreuse caractérisées par un apport d'iode insuffisant, l’incidence des goitres et des cancers différenciés de la thyroïde (CDT) de type folliculaire est plus élevée qu'ailleurs. En revanche, l’influence de l’apport alimentaire en iode sur le risque de CDT de type papillaire, forme représentant actuellement plus de 80% des CDTs dans la plupart des pays, ne fait pas l’objet d’un consensus. Il semble cependant que cette incidence soit plus élevée dans les îles du pacifique qu’ailleurs. Par ailleurs, les propriétés de protection redox du sélénium pourraient protéger la glande thyroïdienne et aider à maintenir la production d'hormones thyroïdiennes, mais la relation entre l’apport en sélénium et le CDT n’avait été que très peu étudiée.Objectifs: L’objectif général de ce travail de thèse était d'explorer la relation entre l'apport alimentaire en iode et le risque de CDT. Plus spécifiquement, il s’agissait 1) d’étudier la relation entre l’apport alimentaire en iode et le risque de CDT dans les cinq études cas-témoins du consortium Epi-Thyr, conduites en Nouvelle Calédonie, en Polynésie Française, en France métropolitaine (deux études) et à Cuba; 2) d’étudier l’interaction entre cet apport et quatre polymorphismes nucléotidiques (SNP) identifiés dans la plupart des études d’association pangénomiques (GWAS) comme associés au risque de CDT, ainsi qu’avec les facteurs de risque environnementaux connus ; et 3) d’évaluer l’intérêt du sélénium présent dans les ongles comme un bio-marqueur potentiel du risque de CDT.Matériel et Méthodes: La régression logistique conditionnelle a été utilisée pour analyser la relation entre l'apport alimentaire en iode et le risque de CDT d’abord dans l’étude Cuba incluant 203 cas et 212 témoins, puis dans l’ensemble des cinq études incluant au total 2162 cas et 2571 témoins. Les questionnaires alimentaires de ces cinq études étaient dérivés de ceux de l’étude de cohorte E3N. Les mesures de l’iode et du sélénium dans les aliments traditionnels polynésiens et cubains avaient été réalisées spécialement pour cette étude. Quatre SNPs avaient été génotypés, dont deux sur le gène FOXE1, un sur le gène ATM et un autre près du gène NKX2-1. Les mesures de l’iode, du sélénium et des autres oligoéléments métalliques avaient été réalisées dans les ongles des sujets de l’étude Polynésie Française.Résultats: Il n’a pas été observée, une association significative entre l’apport alimentaire en iode et le risque de CDT dans l’étude réalisée à Cuba. Dans l'ensemble des cinq études, la majorité des cas et des témoins ont été considérée comme présentant une carence légère en iode selon la classification du Réseau Mondial d'Iode (IGN). Bien que le risque de CDT ne soit pas lié à l'apport alimentaire en iode, ce risque était significativement réduit avec l’augmentation de la consommation de poisson, ceci de manière plus importante dans l'étude réalisée à Cuba que dans les autres. En outre, une augmentation de l’apport alimentaire en iode a été significativement associée à une diminution du risque de CDT uniquement dans l’étude réalisée en Polynésie Française et chez les Polynésiens. Une augmentation significative du risque de CDT associée au nombre de l'allèle mineur (A) du SNP rs965513 près de FOXE1 parmi les sujets qui ont consommé moins d'iode que la médiane dans l'étude réalisée à Cuba. Pour les femmes qui ont eu un nombre de grossesses élevé et qui étaient déficitaires en iode, l'augmentation de l'apport alimentaire en iode réduisait leur risque de CDT. Par ailleurs, il n’a pas été possible de mettre en évidence un intérêt du sélénium dans les ongles comme bio-marqueur prédictif du risque de CDT. / Context: Iodine is a trace element derived from food. In endemic goiter areas characterized by dietary iodine deficiency, it is established that the incidence of goiter and differentiated thyroid cancers (DTC) of follicular type is higher than elsewhere. On the other hand, the influence of dietary iodine intake in the risk of papillary thyroid cancer which currently representing more than 80% of DTCs in most countries, has not achieved a consensus. It appears, however, that this incidence is higher in the Pacific islands than elsewhere. In addition, the redox protection properties of selenium could protect the thyroid gland and help to maintain the production of thyroid hormones, but few studies evaluated the relationship between selenium intake and DTC.Objectives: The general objective of this thesis was to explore the relationship between dietary iodine intake and DTC risk. More specifically, it was 1) to study the relationship between dietary iodine intake and the risk of DTC in five case-control studies of Epi-Thyr consortium, carried out in New Caledonia, French Polynesia, Metropolitan France (two studies) and Cuba; 2) to investigate the interaction between this intake and four single-nucleotide polymorphisms (SNP) identified in most genome-wide association studies (GWAS) as associated with DTC risk, as well as the interaction with the well-established environmental risk factors; and 3) to evaluate the benefit of selenium present in fingernails as a potential bio-marker of DTC risk.Materials and Methods: Conditional logistic regression was used to analyze the relationship between dietary iodine intake and DTC risk first in the Cuba study including 203 cases and 212 controls, and then in the pooled analysis of the five studies including a total of 2162 cases and 2571 controls. The dietary questionnaires of these five studies were derived from those in the E3N cohort study. Measurements of iodine and selenium in traditional Polynesian and Cuban foods were specifically carried out for this pooled analysis. Four SNPs were genotyped, including two of FOXE1 gene, one of ATM gene and another near NKX2-1 gene. Measurements of iodine, selenium and other metal trace elements were made in the fingernails of the participants of the French Polynesia study.Results: There was no significant association between dietary iodine intake and DTC risk in the Cuba study. In the pooled analysis of the five studies, the majority of the cases and the controls was considered as being in mild dietary iodine deficiency according to the IGN classification. Although DTC risk was not found to be linked to dietary iodine intake, this risk significantly decreased with high fish consumption, this reduction in DTC risk per quartile of fish consumption was more important in the Cuba study than in the other studies. Additionally, higher dietary iodine intake significantly associated with lower DTC risk only in the French Polynesia study and in Polynesians. A strong increase in DTC risk associated with the number of the minor allele (A) of the SNP rs965513 near FOXE1, among participants who consumed less iodine than the median value in the Cuba study. For the women who had a high number of full term pregnancies and who were iodine deficient, increasing dietary iodine intake may reduce their risk of suffering from DTC. Moreover, it was not possible to demonstrate an interest in fingernail selenium as a biomarker that predicts DTC risk.

Purpose: The purpose of this study is to assess risk factors associated with TB co-infection in HIV/AIDS patients taking antiretroviral therapy (ART). Methodology: An observational, analytic, case-control and quantitative study was conducted on a randomly selected 367 HIV and AIDS patients of whom 92 of them were TB co-infected. Data collection was done by using self-structured questionnaire. Result: In this study, educational status, waste disposal system, monthly income, contact history with a patient of active tuberculosis or presence of a family member with active tuberculosis, drug adherence, knowledge on tuberculosis prevention and history of exposure to substance were factors independently associated with the occurrence of active tuberculosis among HIV and Aids patients taking ART. Conclusion: The findings highlight the need for on-going educational, informational and other interventions to address the risk factors of tuberculosis in HIV and Aids patients in order to decrease the rate of TB co-infection / Health Studies / M.A. Public Health

No description available.