Com o objetivo de avaliar a hipótese de redução da sensibilidade do hemicampo nasal do campo visual, o que aumentaria a assimetria temporal-nasal dos hemicampos, nos pacientes com estrabismo convergente de aparecimento precoce (antes de dois anos de idade) em comparação aos normais, foram estudados os dois olhos de 66 pacientes, 33 estrábicos e 33 normais, com idade que variou de 7 a 30 anos, com o método da perimetria estática, utilizando-se o programa SITA Standard, do perímetro Humphrey HFA-II Série 700. / With the objective of analysing the hypothesis that a reduction in sensitivity of the nasal hemifield, that in turn would lead to an increase in the nasotemporal asymmetry of the visual field, in patients with early onset convergent strabismus - before 2 years of age - if compared to normal patients, both eyes of 66 patients - 33 esotropes and 33 normal - were studied. Patient's age varied from 7 - 30 years. The method of examination was that of Static Perimetry utilizing the Sita Standard program, of the Humphrey perimeter HFA II 700 Series. The results depicted a clear accentuation of the nasotemporal asymmetry in esotropes if compared to normal patients. This asymmetry was due to the evident decrease of sensitivity in the most peripheral of the chosen points of study. The quantitative sum of values of sensitivity of these points exhibited an average reduction of -15,71% in relation to the normal patients. For both groups, normal and esotropes, there was no difference in values of sensitivity between the to eyes.

Introdução: Tem se afirmado que não há a possibilidade de haver melhora da estabilidade dinâmica postural utilizando exercícios na água, isto é, onde a gravidade apresenta-se diminuída. Neste estudo randomizado e controlado avaliamos e comparamos a estabilidade dinâmica postural em indivíduos saudáveis que realizaram exercícios sensório-motor no solo ou na água. Métodos: Através do Biodex Balance System®, foram avaliados os limites de estabilidade postural, antes e após um programa de exercícios, de 60 indivíduos saudáveis do sexo masculino divididos em 3 grupos (solo, piscina e controle). Os indivíduos dos grupos solo e piscina realizaram um treinamento sensório-motor por 2 meses no solo e na água respectivamente; o grupo controle não realizou nenhum tipo de exercício. Resultados: 1) Foram encontradas diferenças significativas na estabilidade dinâmica entre o grupo solo e controle; 2) Foram encontradas diferenças significativas na estabilidade dinâmica entreo grupo piscina e controle; 3) Não foram encontradas diferenças significativas entre o grupo solo e piscina. Conclusões: realizar exercícios sensório-motor melhora a estabilidade postural em indivíduos saudáveis do sexo masculino, sem diferenças significativas entre os ambientes de treino (solo e água) comparados / Introduction: It has been stated that there is no way to improve dynamic postural stability using exercises in water, i.e. where there is reduced gravity. In this controlled, randomized study, we evaluate and compare postural dynamic stability in healthy individuals who performed sensory-motor exercises on the ground or in water. Methods: Through the Biodex Balance System®, the limits of postural stability were evaluated before and after a program of exercises, in 60 healthy males, divided into three groups (ground, swimming pool and control). The individuals in the ground and swimming pool groups carried out sensorial-motor training for two months, on the ground and in the water, respectively; the control group did not perform any kind of exercises. Results: 1) Significant differences were found in dynamic stability between the ground and control groups; 2) Significant differences were found in dynamic stability between the swimming pool and control groups; 3) No significant differences were found between the ground and swimming pool groups. Conclusions: performing sensory-motor exercises improves postural stability in healthy males, without significant differences between the training environments (ground and water) compared in this study

Após o primeiro ano de transplante cardíaco (TC) o desenvolvimento da doença coronária do transplante se torna a principal causa de morbidade e mortalidade desses pacientes. Neste período, aproximadamente 40% dos pacientes com (TC) desenvolvem hiperlipidemias que contribuem para a gênese da doença coronária do transplante. Alterações no metabolismo lipídico, entre elas, no metabolismo dos quilomícrons e da lipoproteína de baixa densidade (LDL) já foram reportadas no pós transplante. Por outro lado, a concentração da lipoproteína de alta densidade (HDL) nesses pacientes é ainda controversa. Tem sido reportado que a avaliação somente da concentração da HDL não é o suficiente para avaliar todo o papel protetor, portanto aspectos funcionais da HDL devem ser testados. Neste estudo, a propriedade fundamental da HDL de receber lipídeos das outras lipoproteínas foi avaliada em pacientes com TC, através da lipoproteína artificial (LDE). Foi também avaliado o diâmetro da HDL e a sua enzima antioxidante, a paraxonase 1 (PON1). Foram estudados 20 pacientes com TC e 20 indivíduos normolipidêmicos pareados por sexo, idade e índice de massa corpórea. Amostras de sangue foram coletadas, após jejum de 12hs, para determinação do perfil lipídico, glicose, atividade da PON1, diâmetro da HDL e transferência de lipídeos da LDE para a HDL. A concentração de colesterol total e LDL-colesterol não foram diferentes entre os grupos, enquanto a concentração de HDL_colesterol foi menor no grupo TC (p=0.01). A concentração de triglicérides no TC foi aproximadamente 40% (p=0.001). A concentração de apo A-I e apo B foram similares entre os grupos. A glicose plasmática está aumentada nos pacientes transplantados (p=0.008). O diâmetro da HDL é menor nos pacientes do grupo TC quando comparados ao do grupo controle (p=0.047), enquanto a atividade da PON1 não diferiu entre os grupos. A transferência de colesterol e éster de colesterol da LDE para a HDL foi menor em pacientes com TC quando comparados aos controles (p= 0,045 and 0,003 respectivamente). Por outro lado, não encontramos diferenças entre os grupos na transferência de triglicérides e fosfolípides. Os resultados nos mostram que a transferência de colesterol e éster de colesterol está diminuída no TC. Como o éster de colesterol é o principal constituinte do núcleo da HDL, a menor transferência de colesterol para a HDL pode ter contribuído para o menor diâmetro da HDL observado neste grupo. Estas alterações no metabolismo da HDL podem potencialmente desestabilizar o pool de colesterol plasmático e o transporte reverso de colesterol. Este achado pode contribuir para o acelerado processo aterosclerótico que frequentemente ocorre nestes pacientes. / After the first year from the transplantation procedure transplant coronary heart disease becomes a major complication and the leading cause of late morbity and mortality of those patients. After the first year, roughly 40% of heart transplantation (HT) patients develop hyperlipidemias what is implicated in the genesis of transplant coronary heart disease. Alterations in plasma lipid metabolism such as disturbed chylomicron and low-density lipoprotein (LDL) metabolism were also reported. On the other hand, levels of high-densitylipoprotein (HDL) cholesterol are controversy in those patients. It has been perceived that the estimation of the lipoprotein concentration does not suffice to evaluate the overall HDL protective role and that the functional aspects of the lipoprotein should be tested. In this study, the fundamental property of HDL to receive lipids from other lipoproteins modeled by a artificial lipoprotein (LDE) was tested in HT patients, together with size and the HDL-associated antioxidant paraxonase 1 (PON 1). We studied 20 heart transplantation patients and 20 healthy normolipidemic subjects paired for sex, age and body mass index. Blood samples were collected after 12h fasting, for determination plasma lipids, glucose, paraxonase 1 activity, HDL size and transfer of lipids from LDE to HDL. The total cholesterol and LDL cholesterol concentration did not differ in the two groups, whereas HDL cholesterol was smaller in HT (p=0.01). Triglycerides were roughly 40% greater than those of the controls (p=0.001). Apo A-I e apo B concentration values were similar comparing HT patients with controls. Plasma glucose was greater in HT than in controls (p=0.008). HDL particle diameter was smaller in HT patients then in controls (p=0.047), whereas the activity of PON 1 is not different in both groups. The transfer of cholesterol and cholesteryl ester from LDE to HDL were smaller in HT patients than in controls (p= 0.045 and 0.003, respectively). On the other hand, there was no difference in the transfer of triglycerides and phospholipids between HT patients and controls. The results showed that the acceptance of cholesterol and cholesteryl esters by the HDL fraction is diminished in HT. Since cholesteryl ester constitute most of the HDL core and cholesterol is transformed in cholesteryl ester, decreased acceptance of both cholesterol from other lipoprotein particles may account for the smaller HDL particle diameter found in the HT patient group. These alterations in HDL metabolism can potentially destabilizing the plasma cholesterol pool and the reverse cholesterol transport. This finding can contribute for the accelerated atherosclerotic process that commonly occurs in those patients.

No description available.

Yes / To determine whether or not jugular venous reflux (JVR) is associated with structural brain parenchyma changes in individuals with mild cognitive impairment (MCI) and Alzheimer's disease (AD). 16 AD patients (mean (SD): 81.9 (5.8) years), 33 MCI patients (mean (SD): 81.4 (6.1) years) and 18 healthy elderly controls (mean (SD): 81.5 (3.4) years) underwent duplex ultrasonography and magnetic resonance imaging scans to quantify structural brain parenchyma changes. Normalized whole brain (WB), gray matter (GM) and white matter (WM) volumes were collected, together with CSF volume. JVR was strongly associated with increased normalized WB (p = 0.014) and GM (p = 0.002) volumes across all three subject groups. There was a trend towards increased WB and GM volumes, which was accompanied by decreased CSF volume, in the JVR-positive subjects in both the MCI and AD groups. When the MCI and AD subjects were aggregated together significant increases were observed in both normalized WB (p = 0.009) and GM (p = 0.003) volumes for the JVR-positive group. No corresponding increases were observed for the JVR-positive subjects in the control group. Through receiver operating characteristic analysis of the brain volumetric data it was possible to discriminate between the JVR-positive and negative AD subjects with reasonable accuracy (sensitivity = 71.4%; specificity = 88.9%; p = 0.007). JVR is associated with intracranial structural changes in MCI and AD patients, which result in increased WB and GM volumes. The neuropathology of this unexpected and counterintuitive finding requires further investigation, but may suggest that JVR retrogradely transmits venous hypertension into the brain and leads to brain tissues swelling due to vasogenic edema.

No description available.

No

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado / Background: There are no internationally validated questionnaires to investigate the prevalence of infant wheezing. This study was undertaken to validate a questionnaire for the International Study on the Prevalence of Wheezing in Infants (Estudio Internacional de Sibilancias en Lactantes, EISL). Material and Methods: Construct and criterion validity were tested for the question 'Has your baby had wheezing or whistling in the chest during his/her first 12 months of life?'. Construct validity (i.e. the ability of parents and doctors to refer to the same symptoms with the same words) was tested in a sample of 50 wheezing and 50 non-wheezy infants 12-15 months of age in each of 10 centres from 6 different Spanish- or Portuguese-speaking countries. Criterion validity (i.e. the ability of parents to correctly detect the symptom in the general population) was evaluated in 2 samples (Santiago, Chile and Cartagena, Spain) of 50 wheezing and 50 non-wheezing infants (according to parents) of the same age, randomly selected from the general population, who were later blindly diagnosed by a paediatric pulmonologist. Results: Construct validity was very high (κ test: 0.98-1) in all centres. According to Youden's index, criterion validity was good both in Cartagena (75.5%) and in Santiago (67.0%). Adding questions about asthma medication did not improve diagnosis accuracy. Conclusions: The EISL questionnaire significantly distinguished wheezy infants from healthy ones. This questionnaire has a strong validity and can be employed in large international multicentre studies on wheezing during infancy. / Revisión por pares

Os estudos epidemiológicos relativos ao denominado câncer ocupacional têm como objetivo o estudo do câncer em populações trabalhadoras e a identificação de fatores causais. O número de agentes que comprovadamente causam câncer em seres humanos é ainda pequeno, cerca de trinta. A estes fatores podem ser agregados algumas atividades ocupacionais e processos industriais onde agentes potencialmente cancerígenos existem mas não foram ainda identificados. A quase totalidade dos estudos epidemiológicos buscando relacionar ocupação e câncer foram realizados nos países desenvolvidos, com processos de industrialização mais antigos e consolidados. Nesta investigação o objetivo é estudar a relação trabalho e câncer no contexto de um país subdesenvolvido e recentemente industrializado. O estudo explora os riscos ocupacionais determinantes da neoplasia pulmonar na Região Metropolitana de São Paulo (RMSP). O trabalho está dividido em duas partes. Na primeira são discutidos aspectos relativos ao câncer com particular destaque ao carcinoma broncogênico e à aplicação da metodologia epidemiológica na área da saúde do trabalhador, em especial para o estudo do câncer relacionado à ocupação. A segunda parte contempla a descrição do estudo de caso-controle construído para atingir os objetivos definidos. Os dados do estudo foram levantados no período de 1º de julho de 1990 a 31 de janeiro de 1991 em quatorze hospitais que concentram o atendimento a pacientes com câncer de pulmão na RMSP. Um total de 316 casos e 536 controles, emparelhados com os casos por sexo e idade, foram selecionados para análise. Tabagismo, tabagismo passivo, história migratória, outros cânceres na família e estrato sócio-econômico, além de sexo e idade, foram as outras variáveis estudadas. A análise univariada permitiu identificar as variáveis que estavam interferindo na relação principal estudada. Posteriormente, utilizou-se as técnicas de análise estratificada e de regressão logística para controlar as variáveis tabagismo, referência à carcinoma de pulmão na família, sexo e idade. Os resultados revelam que os trabalhadores que estiveram ligados por tempo prolongado aos setores de produção, de ramos de atividades industriais nos quais há maior probabilidade de exposição à substâncias cancerígenas, têm cerca de duas vezes o risco de desenvolverem carcinoma broncogênico em relação aos trabalhadores com menor probabilidade de exposição a substâncias cancerígenas como os que referiram nunca terem trabalhado fora de casa. / Epidemiological studies on occupational cancer have as their objective the study of cancer in working populations and the distribution of causal factors. The number of agents proved to cause cancer in humans is still rather small, about thirty. It could be added some occupational activities and industrial processes where hazardous agents are known to exist, but have not been identified. Almost all epidemiological studies to evaluate the relationship between occupation and cancer were carried out in developed countries, where industrialization process is older and more structured. In this investigation the objective is to study the association between occupation and cancer in a developing and newly industrialized country context. In this sense, the study explores occupational risks for lung cancer in the Metropolitan Region of São Paulo (MRSP). This work is split in two parts. Firstly it was introduced a review of some aspects on cancer, particularly lung cancer, and the use of epidemiologic methodology related to worker\'s health, particularly cancer. In the second part it was described the hospital-based case-control study carried out to reach defined objectives. This research was conducted between 1st July 1990 and 31st January 1991 in fourteen hospitais which concentrate lung cancer cases in the MRSP. It has been selected a total of 316 cases and 536 controls, matched by hospital, sex and age with cases. Smoking, passive smoking, migratory history, cancer in the family and socio-economic status, besides sex and age, were other variables studied. Univariate analysis identified variables that could interfere in the main studied associatian. Through stratification and logistic regression approaches the variables gender and age, smoking and reference to lung neoplasy in family, were controlled. The results showed that workers linked to the production sectors of industries where there are higher risk of exposure to carcinogenic products have about two fold the risk of developing lung cancer rather than those workers with the lowest risk of exposure to carcinogens.

Avaliar por ressonância magnética (IRM), placa e remodelamento coronários, comparar estenose por IRM e cinecoronariografia (CINE) e correlacionar achados de US de carótidas em pacientes (pts) com DAC. Avaliamos 10 controles(ctls) e 26 pts (lesão > 50% à CINE). Realizamos cortes transversais em artérias DA e CD (2Dblack-blood). Calculamos espessamento parietal (EP), área luminal (AL), área da parede (AP) e área total do vaso (ATV). Detectamos significantes aumentos em EP, AP e ATV nos pts vs. ctls, sem diferenças quanto a AL. Ajustando AL pela ATV, houve redução desta relação nos pts vs. ctls (remodelamento positivo). Em conclusão, a IRM identifica a parede e remodelamento de coronárias em pts com DAC, não houve correlação entre IRM e CINE quanto à estenose e placa em carótidas foi mais prevalente nos pts / To test magnetic resonance imaging (MRI) in detecting atherosclerotic plaque and coronary remodeling in patients (pts) with CAD, to compare stenosis grade (MRI vs. angiography), and to correlate carotid plaque by US and CAD. Cross-sectional slices (2D black-blood) was performed in LAD and RCA in 10 controls (ctls) and 26 pts ( > 50% stenosis) by MRI. Maximum wall thickness (WT), vessel wall area (VWA), luminal area (LA) and total vessel area (TVA) were analyzed. MRI detected increases in WT, VWA and TVA in pts vs. ctls, but not for LA. Adjusting LA for TVA, reduction was found in pts (positive remodeling). In conclusion, MRI allowed vessel abnormalities and coronary remodeling in pts with CAD, there was no correlation between stenosis grade (MRI vs. angiography) and carotid plaque was more prevalent in pts