Cribra orbitalia represents one of the most frequent bone pathologies in skeletal remains of past populations. This lesion is characterised by porous, furrowed even trabecular disruption on the outer table of the compact bone on the orbital roof. Although the origin of cribra orbitalia is linked to marrow hyperplasia as a consequence of iron deficiency anemia, even other causes are not ruled out. Both occurences cribra orbitalia alone and coincidence with other signs of diseases have been recorded. Research of this study applies to cribra orbitalia as a long- term stress indicator on the skeleton and a symptom of specific diseases or anemic syndroms. Skeletal remains from Czech medieval sites with presence of cribra orbitalia as well as whole graveyard from Oškobrh were analysed. Macroscopical investigation did not demonstrate periodic coincidence of cribra orbitalia and specific bone signs of the diseases. However, the following bone changes have been observed: hyperostosis porotica, increased vascularization, supranasal porosity, inflammatory- hemorrhagic reaction on the endocranium which can in terms of differential diagnosis help to clarify the nature and/or cause of the origin of cribra orbitalia. Comparison of the population from Oškobrh with other medieval graveyards showed that frequency of...

Submitted by Beatriz Batista Trigo (beatrizbtrigo@hotmail.com) on 2018-08-21T18:41:25Z No. of bitstreams: 1 Dissertacao Beatriz Batista Trigo.pdf: 1261932 bytes, checksum: 24b3472ef232d399d51c17b258886009 (MD5) / Approved for entry into archive by Ederson Vasconcelos Pereira null (edersonpereira@fmva.unesp.br) on 2018-08-21T19:12:51Z (GMT) No. of bitstreams: 1 trigo_bb_me_araca_int.pdf: 1261932 bytes, checksum: 24b3472ef232d399d51c17b258886009 (MD5) / Made available in DSpace on 2018-08-21T19:12:51Z (GMT). No. of bitstreams: 1 trigo_bb_me_araca_int.pdf: 1261932 bytes, checksum: 24b3472ef232d399d51c17b258886009 (MD5) Previous issue date: 2018-08-01 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / As diferentes espécies de Leishmania causam amplo espectro de manifestações clínicas sendo genericamente classificadas em leishmaniose cutanêa (LC), mucocutânea (LMC) e leishmaniose visceral (LV), acometendo tanto crianças como adultos, e várias espécies de mamíferos. Para a identificação da espécie faz-se necessário o isolamento do protozoário a partir de amostras biológicas e o diagnóstico em laboratórios de referência. Atualmente, o “padrão ouro” para identificação de cepas de Leishmania spp. em estudos epidemiológicos é o multilocus enzyme electrophoresis (MLEE), a qual é uma técnica laboriosa e de aplicação restrita à amostras em cultivo. As técnicas baseadas na Reação em Cadeia da Polimerase (PCR) têm sido bastante utilizadas para caracterizar e diferenciar as espécies de Leishmania. Tal diferenciação pode ser importante para a determinação do tratamento correto aos pacientes, diminuindo a letalidade, e para estudos epidemiológicos com o mapeamento do padrão de distribuição das leishmanioses, auxiliando assim na priorização das medidas de controle desta zoonose. A presente pesquisa teve como objetivo avaliar in silico os oligonucleotídeos iniciadores já utilizados no diagnóstico molecular e validar, por PCR em Tempo Real, sua especificidade em cepas de referência cultivadas in vitro. / Different species of Leishmania cause a wide spectrum of clinical manifestations which are generically classified as cutaneous leishmaniasis (CL), mucocutaneous (MCL) and visceral leishmaniasis (VL), affecting children and adults, as well as several species of mammals. Species identification requires isolating the protozoan from biological samples and the use of diagnostic techniques done in reference laboratories. Currently, the "gold standard" for identifying strains of Leishmania spp. in epidemiological studies is the multilocus enzyme electrophoresis (MLEE), which is a laborious technique and restricted used in cultured samples. Techniques based on the Polymerase Chain Reaction (PCR) are being more frequently used in order to characterize and differentiate Leishmania species. Such differentiation is important to indicate the adequate treatment for the patients minimizing lethality and for epidemiological purposes as mapping its distribution pattern, in order to help prioritizing the control measures for this zoonosis. The present research aimed to evaluate the currently used primers for molecular diagnosis and validate them by Real Time PCR for their specificity in reference strains cultivated in vitro.

Made available in DSpace on 2014-12-17T15:32:20Z (GMT). No. of bitstreams: 1 DeniseHIPO_DISSERT.pdf: 4556175 bytes, checksum: 89c325ea02bf77fa8472508c05c7634d (MD5) Previous issue date: 2012-02-16 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The correct histological diagnosis of vascular lesions in the oral mucosa is critical, especially in defining the treatment and prognosis, as some vascular lesions show spontaneous involution and others do not show such behavior. This study analyzed the expression immunohistochemistry of human glucose transporter protein (GLUT-1), in oral benign vascular tumors and to reclassify such lesions according to with his immunoexpression. In addition, we evaluated the immunohistochemical expression of hypoxia-inducible factor 1 alpha (HIF-1?), the main transcription factor involved in cellular adaptation to hypoxia. We analyzed 60 cases of benign oral vascular tumors: 30 cases with histological diagnosis of HEM and 30 cases of oral pyogenic granuloma (PG). The results of this research showed that of the 30 lesions initially classified as HEM, only 7 showed immuno-positivity for GLUT-1, remaining with the initial diagnosis. The remaining 23 were reclassified as vascular malformation (VM) (13 cases) and PG (10 cases). All cases in the sample with an initial diagnosis of PG were negative for GLUT-1, demonstrating the accuracy of histological diagnosis of these lesions. Concerning to the immunoexpression of HIF-1?, the Mann-Whitney test revealed a statistically significant difference between the cases of GP and MV (p = 0.002), where the median of GP (m=78) was higher than the MV (m=53). Based on these results, this study showed that a histological diagnosis alone is not always sufficient for the correct diagnosis of oral HEM and that HIF-1? participates in the pathogenesis of vascular lesions / O correto diagn?stico histol?gico de les?es vasculares em mucosa oral ? fundamental, sobretudo na hora de definir o tratamento e progn?stico, visto que algumas dessas les?es apresentam involu??o. Este trabalho analisou a express?o imunohistoqu?mica da prote?na humana transportadora de glicose (GLUT-1), em tumores vasculares benignos orais e reclassificou tais les?es de acordo com sua imunoexpress?o. Al?m disso, avaliou a express?o imuno-histoqu?mica do fator 1 induz?vel por hip?xia (HIF-1?), principal fator de transcri??o envolvido na adapta??o celular ? hip?xia. Foram analisados 60 casos de tumores vasculares benignos orais, sendo 30 casos com diagn?stico histol?gico de HEM e 30 casos de granulomas piog?nicos orais (GP). Os resultados desta pesquisa demonstraram que das 30 les?es inicialmente classificadas como HEM, apenas 7 apresentaram imuno-positividade para GLUT-1, permanecendo com o diagn?stico inicial. As 23 restantes foram reclassificadas em malforma??o vascular (MV) 13 casos e GP 10 casos . Todos os casos da amostra com diagn?stico inicial de GP apresentaram-se negativos para GLUT-1. Quanto ? imunoexpress?o do HIF-1?, o teste de Mann-Whitney revelou diferen?a estatisticamente significativa entre os casos de GP e MV(p=0,002), onde a mediana do GP (m=78) foi superior a da MV (m=53). Com base nesses resultados, este estudo mostrou que o diagn?stico histol?gico por si s? nem sempre ? suficiente para o diagn?stico correto do HEM oral e que o HIF- 1? participa da patog?nese das les?es vasculares

Orientador: Cáris Maroni Nunes / coorientadora: Silvana de Cássia Paulan / Banca: Valérioa Marçal Felix de Lima / Banca:Adam Taiti Harth Utsunomiya / Resumo: As diferentes espécies de Leishmania causam amplo espectro de manifestações clínicas sendo genericamente classificadas em leishmaniose cutanêa (LC), mucocutânea (LMC) e leishmaniose visceral (LV), acometendo tanto crianças como adultos, e várias espécies de mamíferos. Para a identificação da espécie faz-se necessário o isolamento do protozoário a partir de amostras biológicas e o diagnóstico em laboratórios de referência. Atualmente, o "padrão ouro" para identificação de cepas de Leishmania spp. em estudos epidemiológicos é o multilocus enzyme electrophoresis (MLEE), a qual é uma técnica laboriosa e de aplicação restrita à amostras em cultivo. As técnicas baseadas na Reação em Cadeia da Polimerase (PCR) têm sido bastante utilizadas para caracterizar e diferenciar as espécies de Leishmania. Tal diferenciação pode ser importante para a determinação do tratamento correto aos pacientes, diminuindo a letalidade, e para estudos epidemiológicos com o mapeamento do padrão de distribuição das leishmanioses, auxiliando assim na priorização das medidas de controle desta zoonose. A presente pesquisa teve como objetivo avaliar in silico os oligonucleotídeos iniciadores já utilizados no diagnóstico molecular e validar, por PCR em Tempo Real, sua especificidade em cepas de referência cultivadas in vitro. / Mestre

Early detection of Alzheimer's disease (AD) and related dementias in the elderly is critical for improving treatment methods and is a necessary component for improving public health interventions. One of the earliest and most common behavioral syndromes of AD is apathy and is associated with executive dysfunction. Apathy in AD is often misdiagnosed as depression due to an overlap in symptoms. Studies that have found depression to be associated with executive dysfunction have not always controlled for the presence of apathy. The Geriatric Depression Scale (GDS) is a widely used instrument designed to assess depression in the elderly. This study utilized the GDS and a set of standard neuropsychological instruments to investigate the relationship between apathy, depression, and executive functions in individuals with AD and related dementias. The first objective of this study was to determine if apathy has a greater impact on executive functions compared to depression in AD and related dementias. The second objective was to determine the effectiveness of the GDS as a screen for apathy. The results of the analyses did not support the hypotheses. However, exploratory analyses suggested a possible non-linear relationship with apathy and various levels of dementia severity. Exploratory analysis also suggested mean levels of endorsement for apathy varied by diagnosis. Further research is warranted to investigate this relationship and the GDS endorsement patterns for caregivers regarding their impression of the demented individual.

The theoretical part of the thesis contains a brief description of the anatomy and electrophysiology of the heart, as well as both, surface and intracardiac electrocardiograms. The thesis also describes the different types of cardiac tachycardias, their differential diagnosis and what is known as The Expert System. The practical section of the thesis notes and outlines the tree diagrams, and additionally describes various software solutions of The Expert System. Further, the thesis includes the classification of the heart rhythm, using The Expert System method with three typical tachycardia cases, and including a list of questions asked by The Expert System to the user. Answers to all questions asked are being assessed in the text, as well as illustrated in submitted examples of intracardiac ECG recordings. The Expert System has been verified during a series of catheterization procedures on 26 patients (where the evaluated cardiac rhythm was 34). The classication of the type of heart rhythm (per The Expert System) when comparing the results with the doctors coincided in 100 % of tested cases.

The Auditory Continuous Performance Test (ACPT) was evaluated on one group of subjects who had been diagnosed as having attention deficit-hyperactivity disorder (ADHD) and another group for whom ADHD had been ruled out. Although the specificity of the ACPT was acceptably high for a screening test, the sensitivity was very low. The conclusions drawn from these results are limited because of small sample size (n = 23). However, until reports based on large study samples are forthcoming, the use of the ACPT as a screening test for ADHD appears questionable.

Parkinson’s disease and Essential tremor are the two most prevalent movement disorders in the world, but due to overlapping clinical symptoms, accurate differential diagnosis is difficult. As a result, approximately 60% of patients with movement disorders symptoms will have their diagnosis changed at least once before death. By their subjective nature, clinical exams are inherently imprecise, leading to the desire to create an objective, quantifiable test for movement disorders; a test that currently is elusive. Eye movements have been studied for a century, and are widely appreciated to be quantifiably affected in those with neurological disease. Through a collaborative effort between the VA hospital and VCU, over 1,000 movement disorder subjects had their eye movements recorded, utilizing an SR Research Eyelink 2. Patients with Parkinson’s disease exhibited an ocular gaze tremor during fixation, normal reflexive saccades, and reduced blink rate. Subjects with Essential tremor exhibited slowed saccadic dynamics, with increased latencies, in addition to a larger number of square wave jerk interruptions of otherwise stable fixation. After diagnostic features of each disorder were identified, prospective data collection could occur in a blinded fashion, and oculomotor features used to predict clinical diagnoses. It was determined that measures of fixation stability were capable of almost perfectly differentiating subjects with PD, and a novel, combined parameter was capable of similar results in ET. As a group, it appears as if these symptoms do not progress as the disease does, but subanalyses show that individual patients on constant pharmaceutical doses tracked over time do slightly change and progress. The near perfect separation of disease states suggest the ability of oculomotor recording to be a powerful biomarker to be used for the differential diagnosis of movement disorders. This tool could potentially impact and improve the lives of millions of people the world over.

As crises não epilépticas psicogênicas (CNEP) podem ser definidas como episódios de alteração de movimentos, sensações ou experiência similar à epilepsia causada por processo psicológico e sem associação com descarga elétrica cerebral anormal. Estima-se que o número de casos de pacientes com CNEP seja de 2 a 33 por 100.000 habitantes. O índice de CNEP corresponde ainda a aproximadamente 5% dos pacientes tratados como epilépticos. Os pacientes com CNEP são tratados como possuindo epilepsia refratária, chegando ao limite máximo do tratamento medicamentoso e sem a obtenção de resultados satisfatórios. Objetivos: relatar os efeitos do tratamento psicanalítico individual em pacientes com CNEP. Método: A casuística foi composta por 37 pacientes com diagnóstico prévio de CNEP realizado por meio da monitorização por vídeo-EEG. Foram realizadas sessões individuais de tratamento psicanalítico, com frequência semanal, com duração aproximada de 50 minutos e duração total de 48 sessões em 12 meses. Resultados: Este estudo constatou elevado índice de sucesso no tratamento dos pacientes com CNEP: 29,7% (n=11) de cessação/cura dos sintomas e 51,4% (n=19) redução das crises convulsivas. Foi constatada associação entre cessar ou reduzir as crises e sexo (p < 0,01), religião (p < 0,01) e término do tratamento (p < 0,01). Conclusão: Este estudo apontou a eficácia do tratamento psicanalítico individual realizado com pacientes com CNEP, podendo ser considerada uma forma de assistência essencial para que haja decréscimo ou cessação das crises. / Psychogenic non-epileptic seizures (PNES) can be defined as episodes of alteration of movement, feeling or a similar experience to epilepsy caused by a psychological process and with no association with abnormal electrical discharges in the brain. It is estimated that the number of cases of patients with CNEP is from 2 to 33 in 100.000 inhabitants. The number of patients with PNES reaches 5% of those treated as epileptics. Patients with PNES are treated as if they had intractable epilepsy, with unsatisfactory results even after medication treatment is used to its maximum limits. Objectives: to present the effects of individual psychoanalytical treatment in patients with PNES. Methods: The case base was composed of 37 patients with PNES. The diagnosis was reached with video-EEG monitoring. . Psychoanalytical treatment was carried out through 12 months of weekly sessions of around 50-minutes each, in a total of 48 individual sessions. Results: This study found a high success rate in the treatment of PNES patients. 29,7% (n=11) of patients saw cessation or cure of symptoms and 51,4% (n=19) saw a decrease in the number of episodes. There is an association between cessation or decrease in the number of episodes and sex (p < 0,01), religion (p < 0,01) and concluding treatment (p < 0,01). Conclusions: Individual psychoanalytical treatment applied to patients with PNES is considered effective and can be considered as an essential form of assistance for the reduction of cessation of episodes. Psychogenic non-epileptic seizures, Conversion disorder, Psychoanalysis, Treatment

Submitted by Erika Demachki (erikademachki@gmail.com) on 2014-10-20T16:34:20Z No. of bitstreams: 2 Dissertação - Vania Lúcia Dias Soares - 2010.pdf: 2719926 bytes, checksum: 1c97489df4974bad588171364647d4d2 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Approved for entry into archive by Jaqueline Silva (jtas29@gmail.com) on 2014-10-20T17:09:31Z (GMT) No. of bitstreams: 2 Dissertação - Vania Lúcia Dias Soares - 2010.pdf: 2719926 bytes, checksum: 1c97489df4974bad588171364647d4d2 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) / Made available in DSpace on 2014-10-20T17:09:31Z (GMT). No. of bitstreams: 2 Dissertação - Vania Lúcia Dias Soares - 2010.pdf: 2719926 bytes, checksum: 1c97489df4974bad588171364647d4d2 (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2010-06-08 / Neuropsychological assessment and differential diagnosis between infective and degenerative dementias.. There are no studies comparing the neuropsychological profile of patients with parasitic infectious dementia (DIP) and other forms of primarily degenerative dementia. The objectives were to compare the neuropsychological deficits present in three groups of patients with dementia and a normal control group in relation to the DIP group. For this purpose, we prospectively evaluated 130 individuals with dementia from Dementia Unit, Hospital das Clinicas, Federal University of Goias and from the Tropical Diseases Hospital, Goiânia, aged above 18 years, divided in the following groups: infectious dementia (DIP), Alzheimer's disease (AD) , frontotemporal lobar degeneration(DLFT) , parkinsonism plus (PP) and normal controls. All underwent extensive neuropsychological assessment, addressing all cognitive domains (verbal and visual memory, attention, executive functions, gnosis, praxis, visuospatial skills, language). The productions were transcribed into tables and quantified by specific tests (Stroop, Trail Making A / B, Cancelation Test, Maze, Digit Span, Rey Figure, RAVLT, Logical Memory, Verbal Fluency, Hooper and Proverbs from WAIS). The DIP group generally presented with severe neuropsychological deficits present in multiple cognitive domains, and possibly even higher than those presented by primarily degenerative dementia in the elderly. These cognitive deficits can signal that the functional and / or lesional disturbances in DIP group undertake extensive brain areas or even that are impaired basic neuropsychological functions (attention, executive functions) that support the other functions with which are interdependent (memory, visuospatial functions). The DIP group had a higher run time, and committed more errors in the bell cancellation test than the control group (p <0.001), indicating deficits in selectivity and planning suggestive of involvement of fronto-subcortical areas. Overall, the DIP group had a performance in memory tasks higher than the AD group, equal to the DLFT group and lower than the PP group, suggesting the presence of heterogeneous hippocampal pathology in DIP group. The results emphasize that the neuropsychological assessments aid in the differential diagnosis of dementia and the topographic location of lesions associated with the predominant profile of cognitive dysfunction. / A avaliação neuropsicológica constitui importante suporte no diagnóstico diferencial entre as diversas formas de demência. Ainda não existem estudos comparando o perfil neuropsicológico de pacientes com demência infecto-parasitária (DIP) e outras formas de demência primariamente degenerativa. Os objetivos desta pesquisa foram comparar as alterações neuropsicológicas presentes em quatro grupos de pacientes com demência em relação ao grupo de pacientes com DIP e comparar o perfil neuropsicológico do grupo DIP com um grupo controle constituído por sujeitos saudáveis, pontuando os elementos neuropsicológicos diferenciadores entre eles. Para tanto, foram avaliados prospectivamente 130 indivíduos portadores de demência do ambulatório de Demências do Hospital das Clínicas da Universidade Federal de Goiás e do Hospital de Doenças Tropicais, Goiânia, com idade acima de 18 anos divididos no seguintes grupos:demência infecto parasitária (DIP), doença de Alzheimer (DA), degeneração lobar frontotemporal (DLFT) , parkinsonismo plus (PP) e controles normais. Todos realizaram avaliação neuropsicológica extensa, contemplando todos os domínios cognitivos (memória verbal e visual, atenção, funções executivas, gnosias, praxias, habilidades vísuo-espaciais, linguagem). As produções foram transcritas em tabelas e quantificadas por meio de testes específicos (Stroop, Trail Making A/B, Sinos, Labirinto, Dígitos, Figura Rey, RAVLT, Memória Lógica, Fluência Verbal, Hooper e Provérbios do WAIS). O grupo DIP apresentou desempenho cognitivo prejudicado em praticamente todos os domínios, quando comparado ao grupo controle normal. O grupo DIP apresentou maior tempo de execução e cometeu muito mais erros no teste de cancelamento dos sinos que o grupo controle (p < 0,001), indicando déficits na seletividade e no planejamento sugestivos de comprometimento de áreas fronto-subcorticais. No geral, o grupo DIP apresentou desempenho em tarefas de memória superior ao grupo DA, igual ao grupo DLFT e inferior ao grupo PP e controle, sugerindo a presença heterogênea de patologia hipocampal no grupo DIP. Os resultados ressaltam que as avaliações neuropsicológicas auxiliam no diagnóstico diferencial das demências e na localização topográfica das lesões associadas ao perfil predominante de disfunções cognitivas.